Joshua Gonsher
Bill O’Hanlon, MS, and Solution-Oriented Family Therapy
Key Points
Watching the interaction between Bill O’Hanlon, MS, and the video facilitators and the
family, I no longer wish to raise him on the high pedestal I had previously. He was one of the
therapists I found in my research who discovered how to conduct therapy in the brief tradition;
who was a devout follower of Milton H. Erickson, MD; and to whom I looked up as a pioneer
and expert in the approach that focused mainly on the present and future. Before “getting to
know him” through these interviews, I had thought he could do no wrong; after intimately
understanding the why and how of his “no-theory therapy,” however, I am no longer enamored
of him. I still appreciate the product but do not enjoy the delivery method.
The key items of Solution-Oriented Family Therapy really piqued my interest. Therapists
and practitioners of this approach do not focus on the why of what is going on for the clients or
try to find an explanation for their behaviors. They simply want to find solutions and help people
feel better. This orientation was formed when O’Hanlon was depressed and suicidal in the past
and wanted to feel better himself. He discovered psychotherapy, what he called the “art of how
to help people change,” but realized that it focused on “how people got messed up.” Since that
was not decreasing his pain, he decided to pursue what made people happy. As such, this therapy
is focused on the present and future instead of on the past.
Another item that excited me was that there was no need for an orientation or theory. I do
use these terms interchangeably, but I should specify that O’Hanlon has called it the “no-theory
therapy,” as I referenced above. Therefore, this has no specific techniques or strategies. He said
it was stylistic and depended on the personality of the therapist. However, he did label two parts:
acknowledgment and possibility or change or solution. Therapists of this kind are not concerned
very much with feelings and emotions, but for the acknowledgement part, if therapists do not
convey that they understand their clients’ feelings, suffering, points of view, and/or concerns,
people may not come along for the next part.
The first part of the change section involves changing the viewing. O’Hanlon will help
the clients look at what is not working and will attempt to teach them how to look at life
differently. O’Hanlon said Erickson would have his clients who were in pain look at something
in their bodies that was not in pain, which would often cause the individuals to lose that original
pain. This he calls attentional change. The second part of this section involves changing the
doing, which is helping them change how they behave and interact in and out of session. This
would include homework and in-session interventions. Finally, the third part of the change
section is changing the context, wherein therapists attend to the culture, sexuality, gender
identity, class, and/or ethnicity, among other items of client background, and see the possibility.
They seek to know what has worked, what is working, and what could work? These exceptions
to the rules (e.g., He changes “She never helps around the home” into “She sometimes helps.”)
become possibilities. Language is used to create possibility.
This therapy does not view resistant clients as “stuck;” instead, it considers them “wellintentioned people who are stuck in some particular way but want to change if they can find a
way.” As mentioned earlier, this is in line with the belief in the power and potential of language
in that these clients have not “yet” found a way to change consistently. Another component of
this therapy that is integral is that it does not believe that insight (“knowing why you do the
things that you do and being confronted with that”) is necessary. O’Hanlon stated that he has
“changed a lot of things without having a clue why [he] did them, ultimately where they came
from.”
What Was Helpful
I have emphasized the importance of figuring out client backgrounds and pasts since
entering my doctorate program, and now, being put on the remediation plan, it has become an
even more salient part, given that one of my action items is to gather client history more
accurately and completely. Additionally, with my past as an English major and English teacher, I
have found that understanding what has transpired in individuals’ lives (or the lives of literary
characters) is a key to why they act the way they do. However, I have been trying to reconcile
this with my philosophical beliefs, which state that there is no cause and effect, only influence.
Though I no longer believe in fatalism or that one’s past determines one’s present and future, if I
want to know “why” my clients are acting the way they are, looking at their pasts just may help
with that. Additionally, knowing where a client comes from creates more empathy in me.
However, this focus seems to work regardless of orientation/theory/approach since it does not
concern itself with the why, as stated earlier in the Key Points section.
I employ humor a lot and find it can soften people, coax them out of their shells, and
provide relief from an otherwise heavy situation. Seeing that O’Hanlon uses humor and says
“butt out” to the dad, I feel justified in my use. However, I would be wary of using that kind of
language even though it is not technically bad. One must know one’s audience.
A component of being a therapist that I truly appreciate even in this age of collaboration
between clinician and client is that someone in psychic distress will seek out therapists since they
have a level of expertise that the client does not. It could be that merely knowing one is on one’s
way to an expert’s office is enough to lower distress. I do not know if it is indicative of this
approach, but when the mother said that her knowing they were going to have an appointment
with the therapist may have improved family relations a little, the therapist said that they had an
imaginary appointment with him every week and that they should be on their best behavior.
O’Hanlon compared this to flossing before going to the dentist, but it did reinforce my belief in
valuing experience.
One thing I find helpful in therapy is not labeling a client as “having a disease.” If we
name it, we make the mistake of believing that the thing so named exists. In this interaction,
O’Hanlon called dysfunctional behavior “habits” since “language is a virus.” Solution-Oriented
Therapy understands how language can affect everyone in the session or conversation and is
careful not to abuse this power. I like how he used the language of his clients even though he
said he did not really want to do that; it was the virus of language that infected him. A further
example of how powerful language is in when the facilitator asked why O’Hanlon did not switch
the seating arrangement around since the daughter was “clammed” in the middle (referencing the
“clam up” phrase some family members said), he said he would rather focus on the oyster and
that the daughter was now a pearl, creating a wonderful reframe and empowering instead of
disenfranchising.
What Does Not Make Sense
While several elements of this therapy were wonderful, there were quite a few that did
not ring true or authentic with me. What if the clients want to speak more about their emotions?
How does an approach that does not concentrate on emotions and feelings allow for that?
Additionally, since the why is not important, how does a therapist manage if clients want a
“reason” for their behaviors? Furthermore, though O’Hanlon claims he is not very directive, he
seems rather invested in the family’s accepting his suggestions as to what would be the best
thing to change. It is almost as though they do not come up with anything, and he is doing all the
work. What about letting the clients discover things to change or improve on their own? And
finally, he says language is used to create possibility, but he also says language is a virus and
infects the session or conversation. I would like to understand this apparent paradox more
clearly.
How I Would Do It Differently
As a trainee, it is not necessarily my place to tell a seasoned clinician how to improve or
what to change, but there are significant elements that I would include or remove since they are
blatant violations of what are considered best practices. O’Hanlon clearly states that he wants to
help his clients find what is “effective and respectful” and stand “against the approaches which
are disrespectful or ineffective.” When the facilitators discuss what else could be helpful, he
discounts them. I think this is a rather large judgment call. Additionally, I would not have been
on the defensive as much as O’Hanlon is. He is acting like a rebellious teenager instead of like
an adult, and he constantly needs to prove himself by saying that the research on this approach is
not really that great or that this kind of brief therapy does attend to feelings and is not shallow.
Another component I would change is in the treatment of feelings. O’Hanlon does not
think, “Let’s get into those things [emotions]” but acknowledges that if the clinician does not, the
clients will not feel understood and will not progress into the change component. Before my
current status, I also would not have focused too much on feelings; however, I would get into
those things as I understand how important building trust and establishing rapport is, and
attending to someone’s emotions is a wonderful way to do that.
I understand the importance of disclosure. It can normalize feelings and lessen anxiety. It
can establish rapport and bring illustrations. However, there is a time and a place. O’Hanlon
certainly disclosed a lot, but he could have used more neutral examples instead of revealing too
much intimate detail.
I have recently become acutely aware of my multiple identities and their
intersectionalities. O’Hanlon speaks of how his identities might also influence or bias clients, but
it appears he leads his clients to where he wants them to go, which is not something I would do.
Though he speaks about not letting his biases get in the way, it seems that he is unaware of who
he actually is.
According to Carl Rogers, a good therapist should do more listening than talking, but
O’Hanlon talks a lot. I do not think I heard any times when the family was just sitting in silence.
While that technique is not my favorite, I have begun to see the benefit in “Don’t just do
something! Sit there.”
O’Hanlon kept telling them that he had to wrap up, but he was not very firm in his
boundary setting. He must have “finished” the session four times. I have learned how therapeutic
saying “no” can be. Replicating a ruptured relationship and then repairing it has far-reaching,
positive effects; letting clients have their way can be detrimental to the alliance, relationship, and
growth.
Finally, clinicians should be solid with their “issues.” Ideally, a therapist should be free
of emotional or historical “baggage” and completely available for the client. O’Hanlon seemed to
need approval and appeared confused about his own self-worth. He also seemed to be fishing for
compliments or at least approval since he asked how it was for the clients and did not seem
satisfied when they only answered “okay.”
Other Questions/Reactions
Finally, if I were touting the effectiveness or power of a new theory, I would have been
entirely prepared. I might have a script or at least have memorized key tenets of my approach.
Not so with O’Hanlon, who looked to be grasping at straws when describing his approach. He
first said there were 2 parts but while explaining them came up with a 3rd. He did go back and
clarify, but it was confusing at the outset. Additionally, when asked about research on this
philosophy, he said there was only a little and what was there was not very great. He clarified
that and explained that certain elements (i.e., “attending to people and being empathic and
warm”) have been researched. He said that he thinks, “time will tell whether the research
supports it.” If it there is research, objectively review it. If there is no research, own that and
conduct it; do not explain that it is unnecessary. The rest of my questions or reactions have been
laid out in the above paragraphs.