Sometimes the presenting complaints are too vague, negative or unachievable. The therapist negotiates specific, positive and achievable goals with the client. The therapist needs to be active and directive. Change happens quickly when the therapist takes charge and makes it happen. Therapists often give homework assignments to initiate changes and to promote and expedite changes between sessions.
Homework facilitates the transfer of learning from the office session to the client's daily life.
The emphasis is generally on present stresses and presenting symptoms. Time limitations demand rapid assessment and limited history taking. There is no time to spend more than one or, at most, two sessions exploring the past, but connections between the past, the present and the future, when necessary, can be made rapidly. Most importantly, though, change happens in the present and therapy time should be spent making change happen. While the marriage of Brief Therapy and Managed care seems to have been made in heaven, it is by no means a marriage without tensions.