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Solution-Focused Brief Therapy and Motivational Interviewing

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Laura Irick

on 10 December 2015

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Transcript of Solution-Focused Brief Therapy and Motivational Interviewing

At a Glance: Solution-Focused Brief Therapy & Motivational Interviewing
SFBT is a future-focused, goal-oriented therapeutic approach to brief therapy.
Emphasizes strengths & resiliencies by focusing on exceptions to problems & listening to ideas about solutions
Therapists encourage clients to increase behaviors that worked for them in the past
View clients as experts on their own lives
"How can your life be different?" or "How can you bring about the desired changes?"
MI is integrated with SFBT to facilitate change through collaboration
Addresses impasses clients experience during change process
Honors client's stories, recognizes client strengths & preferences, & enhances motivation
Key Concepts of Solution-Focused Brief Therapy
Positive Orientation
Focus on solutions, not problems
Looking for what is working
Basic assumptions that guide practice
Positive Orientation
Concentrates on what is right & what is working rather than dwelling on deficits
View people as resourceful and competent
People have the ability to construct solutions that can change the direction of their lives
Respectful & hopeful counseling builds on existing positive dimensions that are already working for person in other events
Clients quickly become involved in resolving their problems, which makes for an empowering approach
Shift clients' perceptions by reframing problem-saturated stories through skillful use of language

Focus on Solutions, Not Problems
VIP: the client is not the problem, the problem is the problem!
Work on externalizing the problem
What is possible NOW & in the future- little interest put on the presenting problem or exploring past issues
No necessary relationship between problems & their solutions
Looking for What IS Working
Key concept: "Once you know what works, do more of it."
Counselors assist clients in paying attention to the exceptions to their problem patterns, or their instances of success
Find out what is working then help apply this knowledge to eliminate problems in the shortest amount of time possible
"Tell me about times when you felt a little better & when things were going your way."
"What have you done in the past that worked?"
Contributors
Insoo Kim Berg & Steve de Shazer
Developed at the Brief Family Therapy Center in Milwaukee in early 1980s because they were dissatified with constraints of existing therapy models
William Miller & Stephen Rollnick
Co-founded originally as a a brief intervention for problem drinking & has been established as an evidence based practice in the treatment of individuals with substance use disorders
Solution-focused brief therapy & motivational interviewing
Basic Assumptions Guiding Practice
Role and Function of a Group Leader
Collaborative, cooperative, & consultative stance
Empathy & the collaborative partnership are more important than assessment or technique
Avoid talk that embodies diagnosis, assessment, & intervention
Language
creates
reality
"A Not Knowing Position"
Makes the client the expert on their own life
Leader continuously deflects questions
Follows the lead of the members
Create climate of mutual respect, dialogue, inquiry, & affirmation
Counselor's role to create opportunities for members to experience themselves being resourceful
Main task: help clients imagine how they would like life to be different & what it would take to bring about changes
Respectful curiosity allows client & counselor to work together to explore both the impact of the problem and what they are doing to reduce the effects of the problem
Motivational Interviewing
MI is about an attitude towards people & their problems, not a set of generalizable techniques.

Method for addressing reluctance or ambivalence within a person
Rooted in the philosophy of client-centered therapy with a twist
MI is deliberately directive & has specific goals of reducing ambivalence about change & increasing intrinsic motivation
The MI Spirit: arranging conversations so that people talk themselves into change, based on their own values & interests
Collaborative conversational style for strengthening a person's own motivation & commitment to change
Counselor provides the conditions for growth & change communicating attitudes of accurate empathy & unconditional positive regard
Attitudes & skills are based one person-centered philosophy
Focuses on present & future conditions & empowers clients to find ways to achieve their goals
The Process of a SFBT Group
Accept people where they are & assist them in creating solutions.

(1) Find out what group members want rather than searching for what they do not want
(2) Do not look for pathology, instead, look for what they are doing that is already working & encourage them to continue in that direction
(3) If what members are doing is not working, encourage them to experiment with something different
(4) Keep therapy brief by approaching each session as if it were the last & only session
Applications: Therapeutic Techniques & Procedures
Techniques should never be given prominence over the work of members in a group.
Looking for differences in doing
Pretherapy change: simply scheduling an appointment can set positive change in motion
"What changes have you noticed since you called to make the appointment for this session?"
Exception questions
: Directs clients to times in their lives when the problem did not exist
Scaling questions:
"On a scale of zero to 10, where zero is the worst you have been & 10 represents the problem being solved, where are you with respect to _______?"
The Miracle Question
: "If a miracle happened & the problem you have was solved while you were asleep, what would be different in your life?"
Hypothetical solutions reflect the belief that changing the
doing
and
viewing
of the perceived problem changes the problem
Common Concepts Between SFBT and MI
Nonpathological, health-promoting emphasis
Multiple perspectives
Reframing "resistance"
Cooperation is key
Use of client strengths & resources
Temporal sensitivity
Strategies for bringing about change
Strengths & Limitations
MI
Vast research confirms effectiveness for wide range of clinical problems
Efficient & cost effective
Complimentary to other treatment methods
Not as effective on its own
SFBT Group Work in Schools
Offers counselors a collaborative framework aimed at achieving small, concrete changes that enable students to discover a more productive direction
Counselors are able to provide effective counseling to more students in less time
The model underscores the importance of small changes and co-constructed goals.
The approach helps students develop positive goals rather than negative "stop doing it" goals.
Goals: small, realistic & achievable
SFBC is perceived as effective & practical because it emphasizes "what works" rather than "why" something is a problem.
SFBT with Multicultural Populations
"Putting clients first & keeping them in the driver's seat throughout the helping process provides built-in safeguards for culturally sound counseling services."
Practice multi-cultural curiosity: listen respectfully to clients and approach client without a preconceived notion about their experience
"Tell me more about the influence that {some aspect of your culture} has played in your life."
The not-knowing stance the group leader assumes can limit the effectiveness of SFBT for some clients
Think of solution-focused therapy as a model that explains how people change and how they can reach their goals.
Some basic assumptions for an SFBT group:
If members can reorient themselves in the direction of their strengths using solution-talk, there is a good change counseling will be brief
Individuals have the capability of behaving effectively, even if they are temporarily blocked by negative thoughts and language
There are exceptions to every problem- finding exceptions create solutions.
No problem is constant, and change is inevitable
Small changes pave the way for larger changes
Any problem is solved one step at a time
People want to change, have the capacity to change, and are doing their best to make change happen
Each individual is unique and so, too, is each solution
Group members can be trusted to create these solutions
SFBT
Optimistic orientation
Nonpathologizing stance
Effective for wide range of problems
Practical, time-limited, strengths based
The use of questioning
Difficult for some to generate genuine respectful interest with members
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