Short-term counseling models, particularly solution-focused approaches, have gained prominence largely due to pressures from insurance companies and legal systems that demand rapid symptom reduction and measurable outcomes. While I understand the pragmatic reasons behind this shift, I must speak from a place of deep honesty shaped by both personal and professional experience.
I have witnessed firsthand how insurance systems negatively affect clinical decision-making. As the spouse of a medical doctor, I have observed the frustration that arises when treatment plans are dictated not by what is best for the patient, but by what an insurance company is willing to authorize. Similarly, during my work as a drug and alcohol counselor in rehabilitation centers, I saw how insurance providers routinely approved treatment in rigid 30-day increments—as if individuals struggling with decades of addiction, trauma, and destructive patterns could be meaningfully “healed” in a matter of weeks. This reality is discouraging and, in many cases, ethically troubling.
From a theoretical standpoint, solution-focused brief therapy (SFBT) can be useful in short-term contexts because it emphasizes strengths, client agency, and small, achievable goals (de Shazer et al., 2007). When time is limited, counselors can support clients by maintaining a clear focus on the presenting concern, collaborating on realistic goals, and reinforcing any movement toward change. Skills such as precision in questioning, intentional goal setting, and outcome tracking become especially important when sessions are few (Murdock, 2025).
However, acknowledging the utility of short-term approaches does not require ignoring their limitations. Research on behavior change consistently shows that lasting transformation takes time. Habit formation alone often requires months, not weeks, and the Transtheoretical Model of Change clearly indicates that individuals are not considered to be in the Action stage until sustained change has occurred over a significant period—often six months or more (Prochaska & DiClemente, 1983). This raises an honest question: who are we truly helping in 30 days?
While counselors do the best they can within systemic constraints—and many of us entered this profession because we genuinely care—there is no technique or skill that can reliably produce deep, lasting change for issues rooted in decades of trauma, addiction, or maladaptive thinking within such a narrow timeframe. From my perspective, the current insurance-driven model often functions more as a financial machine than as a system genuinely centered on client welfare. This concern also invites ethical reflection. The ACA Code of Ethics emphasizes beneficence, nonmaleficence, and client welfare as central professional obligations (American Counseling Association, 2014). When financial systems consistently restrict adequate care, it is worth asking whether those systems themselves stand in tension with the very ethics counselors are called to uphold.
For this reason, I do not aspire to be embedded in that system. My calling is to Christian counseling ministry and private-practice life coaching, where I can walk with individuals over time and honor the reality that true healing is often slow, relational, and deeply personal. I offer these reflections not out of disrespect, but out of conviction—and a desire for a counseling profession that places people above policies.
Biblical Foundation
Scripture affirms what both research and lived experience reveal: transformation is a process, not an event.
- Galatians 6:9 (CSB)
“Let us not get tired of doing good, for we will reap at the proper time if we don’t give up.”
Healing and growth occur “at the proper time,” not on an insurance schedule. - Proverbs 20:5 (CSB)
“Counsel in a person’s heart is deep water; but a person of understanding draws it out.”
Deep issues require time, patience, and discernment to surface. - Philippians 1:6 (CSB)
“I am sure of this, that he who started a good work in you will carry it on to completion until the day of Christ Jesus.”
God Himself frames growth as an ongoing work, not a short-term intervention.
From a Christian worldview, reducing care to brief, transaction-based encounters risks minimizing the sacred complexity of the human soul. Counseling that seeks lasting change must respect both the depth of the wound and the time required for restoration.
References
American Counseling Association. (2014). ACA code of ethics. https://www.counseling.org/resources/aca-code-of-ethics.pdf
de Shazer, S., Dolan, Y., Korman, H., Trepper, T., McCollum, E., & Berg, I. K. (2007). More than miracles: The state of the art of solution-focused brief therapy. Haworth Press.
Murdock, N. L. (2025). Theories of counseling and psychotherapy: A case approach (5th ed.). Pearson Education.
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395. https://doi.org/10.1037/0022-006X.51.3.390
#ChristianCounseling, #SolutionFocusedTherapy, #MentalHealthEthics, #AddictionRecovery, #TruthInCounseling, #FaithAndPsychology, #wonderfullymed
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