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Couples Therapy: Solution Focused

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Carmen Rodriguez

on 4 November 2013

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Transcript of Couples Therapy: Solution Focused

Dwaimy Rosas-Atkins, Mariya Pavlovsky, Gabi Reyes, & Carmen Rodriguez
Solution Focused Couples Therapy
Alex Whitman and Isabel Fuentes
SFBT Treatment
*Presenting problem: Where to live once the baby is born. Alex has permanent residence in New York and Isabel lives in Nevada. Disagreement about how and where they will raise their child.
Before the Session:

Alex/Isabel calls requesting an appointment-

Therapist: requests that couple observe what happens in their relationship that they want to continue to have happen.
Initial Session
1st part:
*Session begins with brief period of socializing and joining in which therapist would learn how the couple met and about the different cultures they come from.

*The therapist would bring up the homework task or “experiment” that was given over the phone prior to the session.

*Questions will be asked about the early stages of their relationship that will elicit positive talk about what they admire in each other and remind Isabel and Alex of why they got together in the first place
-There have been times in the past that the relationship has been better functioning and so the therapist needs to understand what is different now.
Initial Session Continued...
Session Questions:
The Miracle question
“Suppose tonight while you sleep, a miracle happens. When you awake tomorrow morning, what will you see yourself doing, thinking, or believing about yourself that will tell you a miracle has happened in your life?”

In my miracle Alex and I would not be arguing so much about where we will live. We would be spending more time laughing and enjoying one another instead of yelling and hurting one another’s feelings.

In my miracle Isabel would understand how important my job is for our family and have some compassion for the dilemma that I am placed in. My job is in New York and I am currently the only person contributing financially to our family.

Therapist: How will the two of you know you have solved the problems that bring you here or that you have reached your goals? How will this change the way you feel about your partner and your relationship? When have you noticed that the two of you do better with this problem?
Scaling Questions
At some point in the session the therapist would ask the couple a scaling question: on a scale from 1 to 10, with 1 being absolutely no hope and 10 being complete confidence, what number would you give your current level of hope? Motivation? Progress?

I would say I am at a 3 in hope.
I would say I am at a 5 in hope.

What will it take to move you from a 3 to a 4? The therapist may even ask each partner to guess the other’s rating, which can highlight differences in perception as well as imply that such differences are both normal and acceptable.
Session Break
Before beginning the break, the therapist might ask Alex and Isabel to think of a homework activity that might be useful for them.
Resuming and Concluding Session
The therapist might resume the session by first asking for the views and thoughts of the clients in evaluating the session and constructing a plan of action.

Feedback and “homework” tasks, which flow from the preceding conversation, can be designed collaboratively to promote goal attainment by reflecting and reinforcing client competencies and any emerging “solution talk”.

So what I would like to suggest to you between now and the next time we get together, is for each of you to keep track of what the other person is doing that makes things a little bit better for the marriage. And when we come back together we will discuss this more.
Subsequent Sessions
(elicit): what’s better? What happened that you liked?
(amplify): Tell me more? Walk me through how the two of
you did that.
(reinforce): Wow! Impressive! That sounds great!
(start again): And what else is better? Use scaling question.
Discuss the homework. The scaling question is re-explored.
SFBT stops when the clients are satisfied that their goal or goals have been met or achieved, a situation that can be identified by their response to these questions:
How can we know when to stop meeting like this?
Ethical Considerations
Clients are encouraged to participate in the evaluation of the session and the decision about further work. There is no “automatic” assumption that more sessions will be needed or desired, and it is the client’s rather than the therapist who have primacy in making decisions about the length of treatment.
Latino Cultural Values and Beliefs
Cultural Values
Cultural Myths
Cultural Beliefs
Si Dios Quiere
Myth: One & Only
Myths: F-O-O
The enchanting fairy tale myth
Myth of sameness
Stages of Relationship
What happened?
Divorce Sequence
Power struggle
Communication breaks
Personal growth
Las Vegas / New York
Mexican / American cultures
Cultural differences in raising child
"Let's get married"

Embrace pregnancy.

Move in together.
Isabel: "Destiny brought us together"

Alex: "You are everything I never knew I wanted"
Isabel and Alex meet. Isabel goes home with Alex.
(3 months later)
Signs everywhere.
Still expecting baby.
Divorce Sequence
Report of strengthening of outside relationship
Familismo / American Dream
Escalation 1
Escalation 2
Escalation 3
Familismo / American Dream
Strengthening outside relationships
Not physically sexual
Escalation 4
Secret: New York
Rationale not to be together. Divorce as option.
Cultural conflicts
American Dream
Individualism vs Collectivism
Isabel Fuentes
Mexican-America photographer residing in Las Vegas, NV
Avid believer of fate and signs as indicators of destiny
Youngest sibling of five brothers
Independent, free-spirited
Keeps frequent contact with family of origin
Protected by father, brothers, uncles, cousins as baby of family
Strongly believes in respeto, familismo
Has long term plans to live in the desert region
Alex Whitman
Caucasian male residing in Manhattan
Career-minded corporate supervisor
Sent to Las Vegas, NV to oversee nightclub opening
Protestant background
Only child
Removed from family of origin, contact on national holidays
"Love is a gift, Alex, not an obligation."
"I had no idea that families talked at dinner."
Isabel Fuentes-Whitman and Alex Whitman
Isabel and Alex met as they waited in line to use a restroom at a Mexican bar in Las Vegas. They spend the night together. No contact until 3 months later
Isabel becomes pregnant and they marry at a Vegas wedding chapel
Isabel shares the news with her family almost immediately, Alex occults it
Isabel plans to raise baby in Las Vegas, Alex intends to move back to Manhattan
Alex finds out he'll be on long term assignment in New York for baby's due date, keeps this from Isabel
Isabel discovers the secret from another source. Hurt and angry, Isabel lies to Alex about having a miscarriage
Isabel goes to Mexico for the remainder of her pregnancy without telling Alex. Alex discovers Isabel is still pregnant and the two reunite when Isabel comes back to Las Vegas to give birth
Reasons for Therapy
Differing views on:
Location of present and future residence
Power of Destiny
Home Decorating
Pet Policy
Roles of immediate family members
Cultural Values
Isabel Fuentes: It was a sign, Alex.
Alex Whitman: Of what?
Isabel Fuentes: That the baby would be Catholic.
Alex Whitman: Oh, well, then it's a good thing you weren't stopped in front of an IHOP.
Intro to Solution Focused Therapy
The Therapist's Role
Solution Focused Therapy Structure
Goals of Therapy
Solution Focused Therapy
Solution focused brief therapy (SFBT) is a competency based approach which focuses on a client's strengths rather than their failings.
It differs from more traditional therapeutic models as it focuses on solutions rather than problems.
It is a competency based model that minimizes the emphasis of the past and instead highlights the client's strengths and prior successes.
Some basic assumptions of SFBT:
Therapy is briefer when focused on strengths and solutions
Focus should be of the desired future not on past problems
Clients have a wealth of resources and solution behaviors that are already present
Therapists show clients how to view their problems in a different way
Clients want to change and have the skills to make changes
Is a process that involves asking specific, solution focused questions to formulate future-oriented goals, identify exceptions and amplify the client’s strengths.
Therapists must not focus on client pathology or analysis of the problem- often a very different approach to other therapeutic models.
The therapist takes the stance that the client is the expert and refrains from providing advice or interpretations.
On initial phone contact, the therapist may invite whomever is involved to the first session.
Working with only one of the partners present is allowed and can still have powerful effects upon all concerned.
Typically there is one therapist, who sits across from the clients
SFT is usually time-unlimited (no preset session maximum)
Session appointments are made one at a time because one session may be enough.
A course of therapy generally lasts 1-10 sessions, sometimes longer, and clients can return on an intermittent or as-needed basis.
SFT is a directive that it deliberately encourages clients to look at things differently, but it does not supply answers. Rather, it provides a context for clients to focus on "what's right" and other possible ways of being "right."
Solution focused therapists conceptualize three types of therapist-client relationships, which can (and do) alternate within sessions: customer, complaint, and visitor.
Visitor: therapist can't define a clear complaint or goal, cooperation involves nothing more than sympathy,politeness, and compliments for whatever the clients are successfully doing.
Complaint: relationship where clients present a complaint but appear unwilling to take action or want someone else to change, the therapist cooperates by accepting their views, giving compliments, and sometimes prescribing observational tasks (e.g., notice exceptions to the complaint pattern).
Customer: they want to do something about a complaint, the principle of fit allows the therapist to be more direct in guiding them toward solutions.
Visitors and complainants can become customers and vice versa.
One of the main reasons to cooperate with clients in this way is to increase possibilities for customership.
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