Brief therapy in the Israeli kibbutz

Abstract

Analysis of results of therapy in an unselected sample of 211 kibbutz patients seen over a three year period by the author in his capacity as kibbutz member and psychiatrist indicated that over 70% of the identified patients responded very satisfactorily to brief therapy. About one-third of the clients did not need more than a single comprehensive therapy session to achieve continuous improvement. In a minority of the cases more than 10 sessions were required. The results were significantly better in cases treated by brief therapy than in the sample treated by long-term therapy, where the pre-treatment severity was determined to be greater. The paper describes the unique aspects of brief therapy in the kibbutz setting, giving an outline of the author's model of intervention, using all components of the individual, family, and community ecosystem.KEY WORDS: short-term family therapy; brief therapy; the kibbutz experience.Today the myth that good psychotherapy requires a large number of therapy sessions is gradually being eroded. The classic psychoanalytic elitist and costly model of in-depth psychotherapy, based on an average of four-to-five weekly sessions over an unlimited period of time, has become less and less common. Initially this was replaced by less prolonged "psychodynamic," "strategic," or "psychoanalyticallyoriented" forms of once-weekly therapy sessions over a period of several years, until the appearance in the past three decades of a multiMordecai Kaffman, MD, a member of the International Advisory Board of Contemporary Family Therapy and an honorary member of the Israeli Family Association by special nomination, is the medical director and chief psychiatrist at the Kibbutz Child and Family Therapy Clinic (TELEM), PO Box 48154,

Walk-In Single-Session Therapy: Client Satisfaction and Clinical Outcomes

“…Of those asked, almost half reported that one session is enough. This response is consistent with reports in other studies, in which 12% to 58% of their subjects said "yes" to this question (Boyhan, 1996;Kaffman, 1995;Littrel, Malia, & Vanderwood, 1995;Miller & Slive, 2004;Perkins & Scarlett, 2008;Price, 1994;Silverman & Beech, 1979;Talmon, 1990) and supports the sufficiency of SST. Furthermore, we obtained a moderate to high effect size on most analyses.…”

“…In Israel, Kaffman (1995) conducted a follow-up study of 211 of his own cases seen at the Kibbutz Child and Family Therapy Clinic to determine the efficacy of brief therapy. Research assistants contacted the former clients and they were asked about improvement in their presenting problem, relief of complaints, and whether new symptoms had developed.…”

“…Talmon (1990) contacted 60 outpatients 3 to 12 months after a single session of therapy and learned that 58% reported needing only one session. Kaffman (1995) revealed that onethird of the families he had seen a few years previously were successfully treated with a single session (N = 64). Similarly, at the Dalmar Child and Family Care Clinic (N = 32), 12% decided that the SST was sufficient.…”

“…Nonetheless, the authors proposed that SST may be best suited for milder problems such as behavioral problems in children. Similarly, Kaffman (1995) reported that most clients with a successful outcome had presented with an adjustment disorder. Campbell (1999) studied the effect of family types and family pride on problem severity and coping at 6-week follow-up.…”

Counseling Psychology in Israel

“…There are approximately 200 kibbutzim (plural of kibbutz) in Israel that are affiliated with three main political streams that differ from one another in terms of their conservatism as to the original kibbutz ideas as well as to religiosity. In addition to general psychological counseling training, practitioners in these centers ought to be acquainted with the unique kibbutz culture and special problems (e.g., Kaffman, 1995). First, equal opportunities make women's roles, development, and positions much more nontraditional than in the rest of Israeli society.…”