Solution Focused Therapy - Lei Lei

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Solution Focused Brief Therapy
Ball State University
Khoolod, Angela, Melanie, Elise, Hyoseok, Lei,
Manisha, Tamding, Allison
Role Play: How change occurs...
Role Play: How change occurs...
• Stage 1: Relationship - Initiate the Session
Role Play: How change occurs...
• Stage 2: Story and Strengths - Gather Data
Role Play: How change occurs...
• Stage 3: Goals
Role Play: How change occurs...
• Stage 4 & 5: Re-story and Action - Explore,
Create, and Conclude
Role Play: How change occurs...
• Thank you Melanie and Khoolod!
• Questions or Comments?
Saul Bellow
• “Socrates said that the
unexamined life is not worth
living. But the (over)
examined life makes you
wish you were dead. Given
the alternative, I’d rather be
living.”
QuickTime™ and a
decompressor
are needed to see this picture.
(O’Hanlon, 2000)
Origin
• Evolved from Systematic Paradigm.
• Originally conceived as Brief Family Therapy in
Milwaukee, Wisconsin, in the late 1970’s (de
Shazer, 1982).
• Shift from Problem Focused Brief Family Therapy
to SFT occurred in 1982.
• Founded by Steve de Shazer, Insoo Berg, Jim
Derks, Elan Nunnally, Marilyn LaCourt, Eve Lipchik.
• Nourished by students who later became
colleagues- John Walter, Jane Peller, Alex Molnar,
Kate Kowalski, Michele Weiner-Davis and
academicians- Gale Miller and Wally Gingerich.
(Lipchik, 2002 and O’Hanlon, 2003)
Interactional Concepts
• “Human beings are unique in their genetic
heritage and social development. Their
capacity to change is determined by these
factors and their interaction with others.
Problems are present life situations
expressed as emotional discomfort with
self, and in relation to others. Change
occurs through language when recognition
of exceptions and existing and potential
strengths create new actions.”
(Lipchik, 2002)
Assumptions
• Change is constant
• Emphasizing on solutions, strengths and
prospects facilitates change
• Exceptions to problems exist
• Clients are experts
• Solutions emerge from
conversation
• No right way to view
things
(Dermer, 1998)
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decompressor
are needed to see this picture.
Assumptions
• Solutions are possible without an in-depth assessment of
client’s problems.
• Emphasis is on future instead of the past, solutions rather
than problems, and client strengths, not deficiencies.
• Clients have the strengths and resources to change.
• Problems are roadblocks resulting from the inability to
recognize alternatives and not symptoms of underlying
pathology.
• Change is possible and the client is the one who generates
what is possible and contributes the movement to this
process.
• A small change in any aspect of problem leads to solution.
• Focusing on future possibilities and solutions enhances
change, as does co-operation.
(Cepeda, 2006)
Goals
• Goal negotiation - at the onset of counseling client
describes what he/she wants.
• GOAL NEGOTIATION
• Goal setting sets a path toward change.
• Effective goals should be specific, small, positive and
meaningful.
• Goals need to be described as presence of something
positive rather than the absence of something negative.
• Clients can describe “how they will know when the problem
is solved.”
• Therapist can ask- who will be doing what-to-whom-whenand-where after the problem is solved.
• Pulling from strengths and talents of client’s significant
others gives the client a view of solutions’ impact. (Cepeda, 2006)
Interviewing Steps
• MED-STAT
•
•
•
•
•
•
•
M- Miracle Question
E- Exceptions
D- Difference
S- Scaling
Quic kT ime™ and a
dec ompres sor
T- Time-Out
are needed to see this pic ture.
A- Accolades
T- Task
(Giorlando, 1997)
Framework
• Focusing on strengths and solution talk will
increase the likelihood that therapy will be brief.
• Solution-building conversation identify,
elaborate, and reinforce change behavior.
• Individuals who come to therapy do have the
capacity to act effectively, temporarily blocked by
negative cognitions.
• Clients are experts on their lives. Therapist role is
to support and amplify this expertise.
Framework
• There are exceptions to every problem that are often
undervalued.
• Presupposition language emphasizes the resumption that
change will occur, creating an atmosphere of “when,” not
“if.”
• Therapists invite clients to view their problems from a
different side. Client tend to present one side of the
problem.
• Patients have strengths, resources, and coping skills that
drive change while generating optimism and hope.
Framework
• Small change fosters bigger change.
• Extensive information about a problem is rarely necessary to
bring about change.
• Client has to want to change.
• As each individual is unique, so too
is every solution.
• Solutions evolve through
conversation.
QuickTime™ and a
decompressor
are needed to see this picture.
Framework
• Emphasizing solutions, positives, and possibilities to
facilitate change.
• There is no one right way to view things, different views
may be equally valid and fit the facts equally well.
• Change in one domain influences connected domains.
Modest changes may lead to substantial differences.
QuickTime™ and a
decompressor
are needed to see this picture.
Therapeutic Practices
& Techniques
• Focusing on client’s solutions is integral to
solution-focused therapy. Counselors identify
possible solutions by asking clients what they
value and want to maintain.
• During the initial therapy session, it is
common for solution focused therapists to
ask, “What have you done since you called for
the appointment that has made a difference in
your problem?”
Therapeutic Practices
& Techniques
• Another integral part of solution focusedtherapy is a focus on goals.
• Counselors might ask at a beginning of a
session: ‘What is your goal for today’? Or
‘What would you like to get out of our time
together today?’
Therapeutic Practices
& Techniques
• Counselors look for exceptions to the
problem by asking the client to recount
when the problem did not occur.
• Counselors use the “miracle question,”
which consist of asking the client how they
would know that the problem was gone.
Therapeutic Practices
& Techniques
• Counselors also use a technique called
normalizing the narrative. This means the
counselor focuses on the idea that we all have
concerns and that it is possible to do
something about them.
• Solution-focused counselors search for
client’s strengths during their sessions. These
strengths can be personal assets, community
assets, cultural and/or spiritual strengths.
Therapeutic Practices
& Techniques
• Counselors use scaling questions to help
clients pay closer attention to what they
are doing and how they can take steps that
will lead to changes they desire.
• The Formula First Session Task (FFST) is a
form of homework a therapist might give
clients to complete between their first and
second session.
Therapeutic Practices
& Techniques
• Counselors usually take a break of 5 to 10
minutes toward the end of each session to
compose a summary message for clients.
• The structure of the summary message
includes compliments, a bridge, and
suggesting tasks to clients.
Therapeutic Practices
& Techniques
• Elements of SFBT interviewing:
• Language: reflects “problems and solutions are subject to
perceptions and open to change”
• Problem free-talk: focuses on competence and strength
• Exceptions: exception questions
• Goals: detailed, specific, realistic, observable
• Hypothetical future: the miracle question
• Rating scales: scaling questions
• Tasks and compliments: observing exceptions, doing more
what works or something different when the problem arises
Lloyd & Dallos (2008)
Therapeutic Practices
& Techniques
• Application to group counseling:
• Share group members’ problem briefly, which helps the members
see themselves less problematic.
• Facilitates members to view other members as being resourceful.
• Promote members to keep on a solution track (not problem).
• Develop well-formed goals (small, realistic, & achievable) soon
using therapeutic questions.
• Ask when their problems were not present, and then, other
members become an observer of each member’s competency.
• Make members identify exceptions of their problems and
recognize personal resiliency and competency.
Therapeutic Practices
& Techniques
• Application of SFT to various areas:
• School setting (Kim & Franklin, 2009)
• Organization setting (Bloor & Pearson, 2004)
• Psychiatric in-patient setting (Hagen & Mitchell, 2001)
• Integration of SFT with other therapies with:
• Person-centered therapy (Cepeda & Davenport, 2006)
• Art therapy (Matto, Corcoran, & Fassler, 2003)
• Play therapy (Taylor, 2009)
Effect sizes of SFT social work studies (Corcoran & Pillai, 2009, p. 239)
Role of Therapist
• According to Guterman (2006) “therapists
have expertise in the process of change,
but clients are the experts on what they
want changed.”
• Therapists:
• Adopt a not-knowing position.
• Help point clients in the right direction.
• Strive for collaborative relationships.
Questions a Therapist might ask:
• What do you want from coming here?
• How would that make a difference for
you?
• What might be some signs to you that
the changes you want are happening?
QuickTime™ and a
decompressor
are needed to see this picture.
QuickTime™ and a
decompressor
are needed to see this picture.
Strengths
• In general, studies provided preliminary
support for the efficacy of solution-focused
brief therapy.
• Client provide their own interpretation of
life events.
• Time limited.
• Goals are set by clients.
QuickTime™ and a
decompressor
are needed to see this picture.
Limitations
• No set of formulas or recipes to follow.
• Diverse clients may expect therapist as a
expert instead of “client-as-expert.”
• For disabled/child client.
• For mandatory counseling client do not
want to change.
• What about discovering the potential
problem?
Questions or Comments?
References:
Bloor, R., & Pearson, D. (2004). Brief solution-focused organizational re-design : A model for international mental health consultancy.
International Journal of Mental Health, 33, 44-53.
Cepeda, L.M., & Davenport, D.S. (2006) Person-centered therapy and solution-focused brief therapy: An integration of present and future
awareness. Psychotherapy: Theory, Research, Practice, Training, 43(1), 1-12
Corcoran, J., & Pillai, V. (2009). A review of the research on solution-focused therapy. British Journal of Social Work, 39, 234–242.
Guterman, J. T. (2006). Mastering the art of solution-focused counseling. Alexandria, VA: American Counseling Association
Corey, G. (2009). Theory and practice of counseling and psychotherapy (8th ed.). California: Wadsworth.
Dermer, B., S., Hemesath, C., W., & Russell, C., S., (1998) A feminist critique of solution focused therapy. The American Journal of Play
Therapy, 26, 239-373
Giorlando, M., E., & Schilling, R., J., (1997). On Becoming a Solution-focused Physician: The MED-STAT Acronym. Families Systems and
Health 15(4), 361-373
Greeberg, G., Ganshorn, K., & Danilkewich, A., (2001). Solution-Focused Therapy: Counseling Model for Busy Family Physicians. Canadian
Family Physician. 47, 2289-2295
Gregoire, J., & Jungers, C. (2007). Solution-Focused brief family therapy. The Counselor's Companion: What Every Beginning Counselor Needs
to Know (1 ed., pp. 394-395). Mahwah, NJ: Lawrence Erlbaum.
Guterman, J. T. (2006). Mastering the art of solution-focused counseling. Alexandria, VA: American Counseling Association
Hagen, B. F., & Mitchell, D. L. (2001). Might within the madness: Solution-focused therapy and thought-disordered clients. Archives of
Psychiatric Nursing, 15, 86-93.
Ivey, A., Ivey, M., & Zalaquett, C. (2009). Microskills and counseling theory: Sequencing skills and interview stages. Intentional Interviewing &
Counseling (pp. 396-438). California: Wadsworth.
Kim, J. S., & Franklin, C.(2009) Solution-focused brief therapy in schools: A review of the outcome literature. Children and Youth Services
Review, 31,464-470.
Lethem, J. (2002). Brief solution focused therapy. Child and adolescent mental health, 7, 4, 189-192.
Lipchik, E. (2002). Beyond technique in solution-focused therapy: Working with emotions and the therapeutic relationship. New York: The
Guilford Press.
Lloyd, H., & Dallos, R. (2008). First session solution-focused brief therapy with families who have a child with severe intellectual disabilities:
mothers' experiences and views. Journal of Family Therapy, 30, 5-28.
Matto, H., Corcoran, J. Fassler, A. (2003).Integrating solution-focused and art therapies for substance abuse treatment: guidelines for practice. The
Arts in Psychotherapy, 30(5), 265-272.
O'Hanlon, B. (2000). Do one thing different: Ten simple ways to change your life. New York: Harper Collins publishers.
O'Hanlon, B., & Weiner-Davis, M. (2003). In search of solutions: A new direction in psychotherapy. New York: W. W. Norton & Company.
Taylor, E. R. (2009). Sandtray and solution-focused therapy. International Journal of Play Therapy, 18, 56-68.
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