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Brief Therapy with Intimidating Cases: Changing the Unchangeable

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A Proven Technique Applying Brief Therapy to Difficult andChallenging Disorders

Changing the Unchangeable is a myth shattering book that revealshow short-term therapy can be used as a powerful tool for treatingclients who present a range of complex psychological disordersincluding severe depression, delusions and paranoia, anorexia,alcoholism, obsessive-compulsive behavior, and borderlinepersonality disorder.

"Fisch and Schlanger have done an admirable job of addressing thedifficult. They have done this with detailed description of casesand of step-by-step explanations for dealing with the'unchangeable' briefly.""Filled with rich examples, this is anincisive, carefully analyzed exploration of the pioneeringpractices created at MRI's Brief Therapy Center."-Carlos E. Sluzki,clinical professor of psychiatry, University of California LosAngeles

192 pages, Hardcover

First published December 30, 1998

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Richard Fisch

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Profile Image for Felipe Gaviria Villegas.
9 reviews
January 21, 2026
Fisch y Watzlawick, dos de las figuras más importantes en el desarrollo de la terapia breve y la Escuela de Palo Alto, presentan de una manera muy concreta cómo se puede aplicar esta técnica en casos que muchos psicólogos catalogarían de "graves". Su punto va más allá de los tratados en el libro, pero se centran en la depresión profunda, los delirios y la paranoia, la anorexia, el alcoholismo, el TOC, la automutilación, y los problemas múltiples. Pareciera que el propósito es que los psicólogos perdamos el miedo de los problemas que parecen intimidantes, que nuestro primer instinto no sea remisión a psiquiatría y la medicalización. Presentan ejemplos puntuales de su propia experiencia en los que se han abordado estos casos con éxito, y comentando que en los que no han tenido éxito ha sido por una pobre aplicación de las técnicas de la terapia breve, más que por una imposibilidad de tratar las problemáticas mencionadas. La terapia breve es contradictoria con los modelos clásicos de psicoterapia, con un modelo centrado en los problemas, y los autores comentando que en Palo Alto se maneja un máximo de 10 sesiones por paciente (en otros modelos, 10 sesiones bastan para realizar la evaluación inicial y poco más). Este libro es sumamente interesante para darse una idea de los principios de la terapia breve, y permite ver más a profundidas su alcance práctico.
Profile Image for Reix.
449 reviews10 followers
October 28, 2017
I really love this kind of brief therapy and I find it very useful. The book shows several real cases, as well as the principles of the functioning of this non-directive therapy, centered in the problem (the disfunctional behaviour), instead of treating the patient as if he/she was an ill person. The behaviour is the one who is ill, but not the person, something really important to get the client feel confident and non judged. Besides, trying to normalize the "wrong" behaviour, breaks a lot of barriers to get the final objective.
The most interesting cases, in my opinion, are the ones about paranoid people that only with a couple of sessions get to normalize their disfunctional behaviours and weird thoughts.
There's still a long way to do in problem centered therapy, but for me, the greatest barriers for its more outspread use are the economic interests: most therapists prefer to keep a troubled patient for a long time instead of helping him/her faster, so they can get more money in the process...
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