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. They look at the research and have a general idea what type of treatments work best for a variety of diagnostic categories. Brief therapists don't typically like to work that way. They tend to see all clients as individuals with unique problems and unique strengths. Doing therapy briefly is difficult enough without the this kind of restraint.
Many therapists take the position that what works is best.
If one approach does not seem to be working, then another might and a change in strategy should be taken without delay. Brief therapists do not have the luxury of sticking to one model for the long run to see if it pans out as do long term therapists. Managed care and insurance programs usually require specific DSM-IV diagnoses of one individual in the family. The Brief Therapist will be reluctant to do this, or may do it while holding his or her nose. They will often find this process counterproductive especially in their search for strengths in the client and in the process of normalizing how the client sees himself or herself.