Solution Focused Therapy
SOLUTION-FOCUSED THERAPY
A short-term approach to intervention in which the social worker
and client attend to solutions or exceptions to problems more so
than to problems themselves.
It helps clients identify and amplify their strengths and resources
toward the goal of finding solutions to presenting problems.
Principles
If it ain’t broke, don’t fix it
If it works, keep doing it
If it’s not working, stop
Small change leads to larger change
Keep intervention as simple (concrete) as possible
UNIQUE ASSUMPTIONS OF
SOLUTION FOCUSED THERPY
There is no necessary connection between problems and solutions
Events in a person’s past and present are not necessarily causally
connected
One need not understand a problem in order to resolve it
Depth is not synonymous with truth
BASIC APPROACH OF
SOLUTION-FOCUSED THERAPY
Two Primary Activities
Development of well-formed goals within the client’s
frame of reference
Development of solutions based on exceptions
The Process
Describe the problem
Develop goals
Explore for exceptions
End of session feedback
Evaluate client progress (each session)
SOLUTION-FOCUSED INTERVENTION
THROUGH THE HELPING PROCESS
The Social Worker’s General Approach
Give Compliments (Direct and indirect)
Ask Future- Oriented Open-Ended Questions
The worker’s language should always imply the likelihood of change
Emphasis is on the future when the problem no longer exists
“What will you be doing when _____ “
The Pessimistic Stance (gets clients to argue for their own change)
“It sounds like the problem is serious. How come things are not worse?”
“What are you (or your family) doing to keep things from getting worse?
“How has that been helpful? Would _____ agree?”
The Social Worker’s General Approach (Cont.)
Reframe
Introduce clients to new ways of looking at themselves or the
problem issue
Externalize
Discuss the problem as something apart from the client, rather than
something that is central to the client’s nature
“You struggle with substance abuse” vs. “You are a substance
abuser”
THE SOCIAL WORKER’S ACTIVITIES
Facilitate:
Change talk (seeking differences)
Solution talk (constructing preferred futures)
Strategy talk (for managing the problem) via:
Coping questions
Present multiple options
Scaling (levels of confidence, motivation, and progress)
If the client is comfortable, he or she will disclose all of what is
important
GOALS OF THE FIRST SESSION
Build positive feelings and a sense of hope: “Tell me what will be
different for you when our time here has been successful.”
Assessment Topics
Client’s perceptions of the problem
Client’s beliefs about the sources of the problem
How the problem affects the client
How the client has coped with the problem thus far
What the client has tried already
What the client’s experiences have been with other helpers
CREATE A CLIMATE FOR CHANGE
Inquire about Pre-Session Change
“Has anything changed relative to the presenting problem since
you set up this appointment?”
“Are these the kinds of changes you would like to continue see
happen?”
Do not minimize the significance of any efforts the client has
made, or any changes that may have occurred prior to the first
meeting
CLARIFY THE CLIENT’S
GOALS FOR INTERVENTION
Encourage clear problem definition
Prioritize (work on only one problem at a time)
The Miracle Question - “Imagine when you go to sleep one
night a miracle happens……. but you don’t know it…… what
would be the first signs for you that ……”
Perspective of the client
Perspective of a significant other
Partialize problems into discreet, measurable units
Scaling questions (for goal setting and assessing motivation)
CHARACTERISTICS OF
WELL-FORMULATED GOALS
Realistic
Challenging
Include the possibility of interpersonal interaction
Situational (vs. broad) focus
Concrete, measurable
Focus on the presence of desirable behavior rather than the
absence of a behavior
Enable a focus on “steps” rather than a final result
Client recognizes a role for him or herself
EXPLORING FOR EXCEPTIONS
Exceptions - past experiences in a client’s life when the problem
might reasonably have been expected to occur, but somehow did
not
Recent exceptions are more useful to intervention
Random versus deliberate exceptions
Also …..
Identify the client’s areas of competence, strengths
Identify protective factors that can be mobilized
EXAMPLES OF EXCEPTIONS QUESTIONS
“What was going on in the past when the problem wasn’t a problem?”
“Tell me about a time recently when the problem did not exist (or was
less troublesome)“
“How did you make that (the exception) happen?”
“What were you thinking?”
“Who was there?” “How did they have a part in creating the exception?”
“When did it happen?” “Where did it happen?”
“What did you think and feel as a result of doing that?”
EXPLORE TASK IDEAS
The End-of-Session “Message”
Compliments
Summary statement of positive strategies
Tasks
Personal functioning
Interactions with others
Interactions with resource systems
The Formula First Session Task
“Between now and the next time we talk, notice the things in your life
that you would like to continue”
SUBSEQUENT SESSIONS
Ask: “What’s better?”
Client should be encouraged to report positive and negative
developments
Clients may be ambivalent about “positive” changes that involve
loss
Ask questions about:
Maintenance strategies “What needs to happen for these changes to
keep happening? What obstacles may get in your way, and how
might you overcome those?”
Learning strategies “What have you learned so far from what you’ve
been doing? What have you learned not to do?”
REVIEW TASK PERFORMANCE
All session-to-session tasks should be jointly designed by the social
worker and client; the client should take the lead in devising them
Practitioners vary in the importance they place on the specificity of tasks,
their accomplishment, and “reporting in”
The client’s lack of or inability to follow through with a task signals the
need to renegotiate tasks or goals or to review motivation
Scaling questions regarding progress and confidence. Use of a 0 - 10 scale
promotes specificity of focus and concrete indicators of movement
DEVELOP OR REINFORCE
NEW STRATEGIES FOR CHANGE
Build on what the client is already doing
Don’t focus too much on setbacks, but ask:
Should you be doing something different?
Are your goals realistic? Your timetable?
What did you do to stop it from getting worse?
How did you cope with the problem not improving?
Possibly revisit the miracle question (clients may change their answers)
The Surprise Task - “Between now and the next time we meet, do
something that will pleasantly surprise _____ (a significant other person)”
EVALUATE EACH SESSION
Evaluation Questions
“Is our work together helpful to you? Are the changes along the lines that
you hoped? Have your goals changed? What should we be doing
differently?”
During each session ask the client (on a 0 to 10 scale) what number will
signify good-enough problem resolution
After a goal is achieved, set additional goals or end the intervention
Remind the client at the end of each session how progress toward goal
achievement is being demonstrated
SOLUTION-FOCUSED INTERVENTION
WITH “VISITORS”
Maintain the position of “not knowing”
Agree with the client’s perceptions of the presenting situation
Assume that there are good reasons for the client’s negativity
Ask the client to elaborate on feelings of anger and negativity
Turn client complaints into beginning goals for the intervention
Listen for other people who are important to the client
Ask what previous professional helpers” (if any) could have done
differently to be more helpful
Ask for the client’s perceptions of “best interest” and what he or she
wants
Make sure non-negotiable requirements are clear
Give the client as much control of the intervention process as possible
INTERVENTION WITH CLIENTS IN CRISIS
“How can I help?”
“What have you tried already?”
“What do you want to be different?”
Ask Coping Questions
“How do you get out of bed in the morning?”
“How did you survive long enough to get here today?”
“How have you managed to cope this far?”
“How come things are not worse?”
QUESTIONS TO ASK
WHEN ENDING INTERVENTION
“What do you need to remember if things get difficult for you again?”
“What will be the benefits for you that will make the effort worth it?”
“Who is going to be able to help you?
“Who do you think will be more a part of the problem?”
“How long do you think it will take before this is not a big problem
anymore?”
“How will you remind yourself about the things you know are helpful?”
“What do you expect the hardest challenge will be?”
“What do you think the possible obstacles might be, and how will you
overcome them?”
SFT IDEAS THAT ARE “TRANSFERABLE”
TO OTHER APPROACHES
Considering the balance of time spent discussing the client’s past,
present, and future
Scaling and the miracle-question can be useful when the social
worker feels “stuck” with a client
Attention to the client’s coping strategies can correct against a
deficits bias
It is not always necessary to look for detailed explanations of client
problems
The danger of fostering client dependency on formal intervention
CRITICISMS OF SOLUTION-FOCUSED
INTERVENTION
The practice denies clients the opportunity to explore presenting
problems in greater depth
Its encouragement of clients to "think positively" may induce denial or
minimization of problems
Clients may feel discouraged from sharing important details or negative
feelings about the presenting issue
SFT may create a false impression on young practitioners that
intervention is relatively “easy” or straightforward