Modeling the client's world through brief solution-focused therapy

The shift to a managed care philosophy means that clients with psychiatric needs are likely to have both fewer and briefer inpatient hospitalizations. Identification of focused goals and measurable outcomes may not translate easily into inpatient programs that have been more process oriented or have based definitions of improvement on complete or near-complete remission of the admission diagnosis. In the context of these shifts, nursing's focus on maintaining a safe environment, developing a therapeutic relationship, providing information, and valuing holistic and individualized care may be lost in programs that treat all clients in the same "packaged" programs. This article describes the philosophical assumptions that underlie the brief inpatient program. The next article in this issue describes how solution-focused therapeutic modalities are used in the continuum of care.