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Solution Focused Brief Therapy

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by

Marla Lane-Parks

on 15 November 2013

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Transcript of Solution Focused Brief Therapy

Solution Focused Couple Therapy
Descriptive Analysis
Treatment
Questions...
The Sopranos
Myths Analysis
Carmela believes in the sexual myth that intimacy and sexuality are one and the same
Carmela also believes in the Beauty Myth (beauty begets intimacy) and the Myth of Abandonment
Carmela asks Tony – "What does she have that I don’t have!?
Divorce Sequence
Clinical Picture
Tony & Carmela Soprano
Tony Soprano
Early 40s
Born and raised in New Jersey
Current caporegime (capo) of the DiMeo (then Soprano) crime family
Traditional and sexist views of marriage
Suffers from panic attacks and has taken Prozac

Carmelo Soprano
Early 40s
Raised Roman Catholic
Born and raised in New Jersey
SAHM heavily involved in lives of her children
Theoretical Analysis
Solution-Focused Therapy
It is important to recognize that the essence of solution-focused therapy is an overarching worldview, a way of thinking and being, not a set of clinical operations.

Only seeks to alleviate suffering from the client’s perceived problem

Looks for a solution

Tony and Carmela have been married for 20+ years

They don’t wish to address bigger picture issues

If it ain’t broke, don’t fix it
Theory
Therapeutic Interventions
Hallmark of SFBT is to...
Therapist functions like a special kind of mirror
Eliciting Pre-Session Change
Skeleton Key Question (a generic "key" that can fit any lock) helps shift perspective.
Scaling questions
Miracle Question...
Goal Setting "How do we know when to stop meeting like this?" - It's the clients' therapy (and life).
Positive Assets Search
Client Resources
Exceptions to the problem
Therapist acts as a facilitator/ consultant, interviewing purposefully.
Directive to encourage clients to look at things differently, but does not supply answers.
Visitor, complainant, and customer-type relationships
Recognize where the client-couple may be
Treatment Moments
Session One
If it ain’t broke, don’t fix it
If it doesn’t work, do something different
Check exceptions
If you change one element, the whole system is affected
Teaching people to be less reactive
Emphasize positive and strengths
Reframing responses
Miracle question homework
Gauging severity with scaling question
Session Two
Check progress
Encouragement and praise
Emphasize your positive observations
Mutual interests
Ethical Issues
Insight is not important

Band-Aid approach

Narrow focus

Cannot be used in severe pathology

Mandated reporting

Conflict with values
Divorce Sequence

We meet Tony and Carmela at Escalation 6 in the Divorce Sequence

They have cycled through all the previous steps:
Distancing
Created strong bonds outside the marriage
Sharing external relationships of closeness with spouse
Wondered about not being together
Known affairs
Separation

Now at Escalation 6 Tony and Carmela are:
Physically separated (Tony has moved out of family home)
The emotional pain has broken Carmela
They’ve had post-separation sex
Divorce lawyers have been contacted
Alex Harte-Newby, Meghana Kotwal, Arpita Shahi and Marla Lane-Parks
Meet clients where they are
Avoid traditional diagnostic categories and preconceived notions of what may be healthy/unhealthy or functional/dysfunctional for a particular couple, individual, or family
Therapist assumes a posture of "not knowing"
Client-centered
Sessions are present to future oriented
Solution may not even seem to have a direct connection to problems.
Three types of therapist-client relationships
Typically time unlimited. Course of therapy generally lasts 1-10 sessions.
Prochaska & DiClemente
Solution Building Vocabulary
IN/OUT:
Respect/Judge
Empower/Fix
Nurture/Control
Facilitate/Treat
Invite/Insist
Hope/Fear
Strength/Weakness
Health/Pathology
Not Yet/Never
Expand/Shrink
Clinical Picture
Their Life Together
High school sweethearts who married early
Two children - Meadow (college) and AJ (high school
Live together in affluent suburb of New Jersey
History of extra marital affairs (Tony)
Seek Therapy
Large fight re: Tony's extra marital affairs
Carmela has reached her breaking point
Escalation 6 (separation: Carmela throws Tony out of the house)
Each spouse has a different view of the problem
Carmela cannot tolerate Tony's infidelities being thrown in her face
Tony doesn't understand why Carmela is so upset seemingly out of the blue
Clash of Myths in Relationship
Tony believes in the myth of engulfment - "I'll loose my freedom if I am in a relationship."

Tony also believes in the enchanting fairytale myth - Carmela’s great love for him should allow her to accept him unconditionally (regardless of his affairs)

Tony also suffers from the YNTPWWIFIL syndrome
Relationship Cycle
Relationship Cycles

Tony and Carmela have made their way through all of the relationship cycles (Wow, Symbiosis, Honeymoon, YNTPWWIFIL, Maintenance)
We meet them during the Divorce Sequence
Full transcript