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Solution Focused Therapy

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Calandra Williams

on 26 March 2014

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Transcript of Solution Focused Therapy

Solution Focused Therapy
Role of the Therapist
The role of the therapist is to ask clients a number of specific questions intended to get him or her to realize how to change & obtain certain goals.
If it isn't broken, don't fix it
Techniques/Interventions
Starts the process of “solution-talk,” emphasizing the client’s strengths & resiliencies from the beginning.
Offers the beginning of making concrete & positive goals.

Amy Newberry, Brooke Cargill & Calandra Williams
Therapists also...
Listen to a client with an open mind
Encourage the sharing of stories
Listen to the client's problem
Help the client understand that they are a person not a problem, their problems are problems.
Pull out client's strengths & help them turn to resources that they have available
Create collaborative relationships to help find workable solutions together
Help client assess & recognize when desired changes are happening
Therapists also...
Solution focus therapy can be as brief or open-ended as needed.

Therapy is usually terminated when clients feel that the goals have been reached or when they feel that the needed behavioral changes have been made.

The client may terminate therapy when they feel sufficiently "on track" & are no longer in need of assistance from the therapist.

In solution-focused brief therapy, the client is encouraged to determine the length of time needed between sessions. This approach helps the client take ownership of the process and recognize his power to control change. (realizing that one has the power to choose often is the solution itself)
Major Time Frame for Focus of Therapy
There is an unconscious process of underlying change that takes place within solution focused therapy.
re-balances the power in a relational connection
promotes further & more effective problem solving capabilities
unconsciously supports behavioral choices
promotes effective interactions with others
Roles of the Unconscious Processes
REFERENCES
Brief Therapy. (n.d.). www.brieftherapynetwork.com

Gehart, D.R., & Tuttle, A.R. (2003). Theory-based treatment for planning for marriage and family
therapists. Australia: Brooks/Cole.

Gingerich, W. J., & Eisengart, S. (2000). Solution-focused brief therapy: A review of the outcome
research.
Family Process
, 39(4), 477-498.

Iveson, C. (2002). Solution-focused brief therapy
. Advances in Psychiatric Treatment
, 8, 149-156.
http://dx.doi.org/10.1192/apt.8.2.149

Solution-Focused Brief Therapy Association. (n.d.). www.sfbta.org

Solution-Focused Brief Therapy Association. (2013). Solution focused therapy treatment manual for working with individuals: Revised 2013. www.sfbta.org

Treatment Improvement Protocol (TIP) Series, No. 34. Center for Substance Abuse Treatment.
Rockville (MD) :Substance Abuse and Mental Health Services Administration (US); 1999

Visser, C. F. (2013). The origin of the solution-focused approach.
International Journal of Solution-
Focused Practices
, 1(1), 10-17. http://dx.doi.org/http://dx.doi.org/10.14335/ijsfp.v1i1.10

Solution Focused Therapy (SFT) was developed in the late 1970’s at the Brief Family Therapy Center in Milwaukee, WI.


Steve de Shazer (1940-2005) Insoo Kim Berg (1934-2005)

Contributors: Patricia Hudson, Eve Lipchik, Scott Miller, William O’Hanlon, Jane Peller, Michelle Weiner-Davis, John Walter

Solution focused brief therapy (SFBT), often referred to as simply 'solution focused therapy' or 'brief therapy'

Type of talking therapy based upon social constructionist philosophy

Solution-focused therapy is an approach to psychotherapy based on solution-building rather than problem-solving. It explores current resources and future hopes rather than present problems and past causes

Evolved from the Palo Alto Ca. based Mental Research Institute (MRI) which is a brief treatment approach for children and families

Gregory Bateson- anthropologist/cyberneticist did extensive research with communication. He believed that a social system in which people function is a great importance to the development and solution of problems.

Milton Erickson – unconventional approach to psychotherapy and coined the term ‘brief therapy’ for his method of addressing therapeutic change in relatively few sessions. He believed individuals could solve their own problems, therapy did not need to be long process and even a small change would set a larger change in motion.

Erickson was noted for his ability to "utilize" anything about a patient to help them change, including their beliefs, favorite words, cultural background, personal history, or even their neurotic habits.

SFT like MRI focuses on observable behaviors, avoids looking for causes, utilizes what clients brings to the table, believes that problems are situational difficulties between people, and that a small systemic change can make a difference.

DIFFERENCE-MRI focuses on the PROBLEM

In the 1980’s- SFT shifted the focus from problems to SOLUTIONS

As the model evolved, the client’s voice became more and more important. Each time a client reported that some intervention had led to a positive change, the team considered that intervention useful. They equated “what worked” with what the client found useful.
Deshazer, Berg and associates observed hundreds of hours of therapy sessions paying close attention to what seemed to happen to families and couples right before they reported having had a break-through moment

It is important for clients to determine their therapy goals. This enables the therapist and clients to know when therapy with end.

The clearer a client is about his or her goals the more likely it is they will be achieved.

Finding ways to elicit and describe future goals has since become a pillar of solution-focused therapy.

(1) Maintain a future focus-what clients want to achieve through therapy, rather than on the problem(s) that made them seek help.

(2) The therapist does not make interpretations.

(3) Avoid looking for causes.

(4) Focus on strengths and emphasize the positive.

(5) One does not need to understand the problem to resolve it and the solution may not be directly related to the problem. This approach is based on positive actions rather than a great deal of theoretical discussion.

(6) The counselor asks the client to envision their preferred future and then, working with the counselor, the client starts to work toward achieving this goal(s).

Solution Focused Therapy –
Basic Tenets
The emphasis is on finding what works in a given area and crafting small, workable steps that the client is willing to do.
If it works, do more of it
If it's not working, do something different
Solution-Focused Therapy
Has taken almost 30 years to develop into what it is today.
Proven to be an effective intervention

Individual, Couple, Family & Groups
All age groups
Problems including eating disorders, behavioral problems, child abuse, family breakdown, drug use relationship problems etc.
It is increasingly taken out of the therapy or counseling room & applied in a wide variety of settings where people want to get along or work together
It is simple to learn, but difficult to practice because our old learning gets in the way.
The model continues to evolve and change.
"What changes have you noticed that have happened or started to happen since you called to make the appointment for the session?"
Pre-session change
The miracle question is a way to ask for a client’s goal in a way that communicates respect for the immensity of the problem and leads to the client coming up with smaller, more manageable parts of the goal.

“Suppose that one night, while you were asleep, there was a miracle and this problem was solved. How would you know? How will your husband know without you saying a word?”

What clients are able to co-construct w/ the therapist in answer to the miracle question can usually be taken as the goals of therapy.


Scaling Questions are used for the client to evaluate his/her own current status and to set goals from week to week to measure progress.

Asking from 0 – 10, how willing the client is to actually do something to move towards their preferred future is helpful in assessing motivation for change.

Scaling Questions
There are 3 major components of this intervention:

1. It is an assessment device

2. It makes it clear the client’s evaluation is more important than the therapists

3. It is a powerful intervention in and of itself b/c it focuses the dialogue on previous solutions and exceptions, and punctuates new changes as they occur.
Miracle Question
COMPLIMENTS:
Assist in the process of establishing a therapeutic relationship
Highlight the clients’ progress, strengths, and resources.
Taking a Break and Reconvening
The therapist often will take a break to collect his or her thoughts and then come up w/ compliments and ideas for possible experiments. When the therapist returns to the session, he or she can offer the family compliments.
The technique of using compliments allows the therapist to reflect back to the clients what they have already done to begin to solve the problem.
These questions allow the client to search for times in the past and present when the problem was/is not apparent.

They provide the client w/ the opportunity to identify the solutions that have worked and are working, thus creating possibilities and solutions for change.


Exception Questions
The SFBT therapist spends most of the session listening attentively for talk about previous solutions, exceptions and goals.
In SFBT, therapists frequently end the session by suggesting a possible experiment for the client to try between sessions, these are based on something the client is already doing.

Homework is sometimes designed by the client

Experiments/Homework Assignments

Both follow the basic philosophy that what emanates from the client is better than if it were to come from the therapist.
The focus of therapy is on solutions and future possibilities; Goals are central in this approach.

The client and therapist attempt to identify how the problem will be solved and how they will know when the problem has been alleviated.

The therapist tries to elicit smaller goals rather than larger ones.

The client is encouraged to frame their goals as the presence of a solution rather than the absence of a problem.
Goals connect emotions, cognition, behavior and interaction. Connecting descriptions of undesired emotions, behavior and interactions with each other in contexts where they make sense is an important part of SFBT.
Goals of Treatment
These goals should be specific & attainable, and identify specific preferred behaviors and interactions.



1. Personally meaningful
2. State positively what the clients will be doing, instead of what they won’t be doing
3. Are stated in behavioral terms & as the first small step
4. Goals as within client’s control
5. Goals as something new and different
6. Goals as a behavior that the client can practice regularly

Useful goals in SFBT are:
Goals of Treatment
The goal is framed as something that the client can regularly practice on his or her own and does not depend on the initiation of someone else.
Major Contributions
Major Contributions
History
History
Basic Tenets
Full transcript