Social constructionism

Mental constructions are formed through social interaction.

Milton Erickson

• Believed individuals possess the strengths and resources to resolve their problems and that the practitioner’s job is to help clients discover these resources and activate them.
• Involves amplification of symptomatic behavior through the use of paradoxical directives.

Strengths-based perspective

• Strengths, abilities, and resources are emphasized.
• Resources found by eliciting and exploring times when the problem does not exert its negative influence and/or when the client has coped successfully.
• Attention is oriented to a future without the problem to build vision, hope, and motivation for the client.
• Extensive history not necessary because understanding the past will not change the future with- out action.

Exception-finding

Past is explored only for exception finding; conversation aimed to discover how these exceptions—when problems do not occur—can be applied in the future.

Solution-focused therapy assumptions

• Small change is all that is necessary as a “spiral effect” takes place.
• Behaving differently and thinking differently are part of the processes of change.
• No one holds the objective truth, individuals are valued for their unique perspectives, with the right to determine their own goals

Evidence basis

• Assumptions underlying constructivism, such as the importance of subjec- tive meaning and the use of language to form meaning, are antithetical to the positivist, quantitative roots of treatment outcome research.
• Five well-controlled studies identified showed positive outcomes for solution focused therapy.

Use of language to influence perception

• Place problems in the past as if they are no longer exerting their negative influence.
• For example, “So you were losing your temper?” replaces “So you lose your temper?”
• The implication is that change is already in process.
• Social constructivist roots: language is the medium by which reality is shaped.

Definitive Phrasing

• Employment of words such as when and will implies that change will occur.
• “When you are better, what will you be doing?”

Possibility Phrasing

• Use of words such as if and could is used only for the purposes of preparing clients to prevent further problems.
• “If you feel the urge to use drugs, what could you do to prevent it from going any further?”

Joining Process

• Assessing the relationship the client has with the helping process.
• Solution- focused therapy acknowledges the different reasons clients may present for treatment and services.
• Uses idiosyncratic language, relationship questions, and complimenting.
• Three different client relationships are posed within the model: the customer, the complainant, and the visitor.

The Customer

• The client who is motivated and willing to participate in the change process.

The Complainant

• Motivated chiefly for change in another person rather than for change in the self.

The Visitor

• Typically unmotivated and is attending only because he or she has been mandated to do so.

Language on Opening Contact

Strategies to engage clients: Customer

Strategies to engage clients: Complainant

Strategies to engage clients: Visitor

Strategies to engage clients: All

Encouraging Collaboration

• “What will indicate to you that coming here has been successful?”
• “How will you know when you no longer need to come here?”
• “What will be happening that will indicate to you that you can manage things on your own?” (Bertolino & O’Hanlon, 2002, pp. 83, 91)
• “What ideas do you have about how I can help you?”
• “In what ways do you see me helping you reach your goals?”
• “Are there certain things that you want to be sure that we talk about?”
• “How has this conversation been helpful?”
• “In your opinion, do we need to meet again?” (to further empower the client regarding the continuation of therapy based on his/her choice)
• “How will you know when we can stop?” (a collaborative question to define client criteria for termination)
• “What did we do today that you felt make a difference?” (to learn what is instigating change and what is helpful in the process)

Idiosyncratic Language

• Practitioners should attune themselves to the idiosyncratic phrasing of the client and adopt this language.
• Clients feel understood when the worker uses their language.
• Professional jargon should be avoided as it emphasizes the practitioner’s “expert” role instead of allowing clients to be the experts on their own lives.

Relationship Questions

• Relationship questions ask clients to view themselves from the perspective of another.
• Derived from the family systems therapy intervention of circular questioning.
• Nonthreatening to clients because the questions are posed in such a way that one comments on a situation from the view of an outside observer.
• Added advantage of allowing people to increase their ability to take on other people’s perspectives and see the impact of their behavior on other people.

Compliments

• Clients may feel defensive when they first see a practitioner, expecting to be judged and criticized.
• Enhances their cooperation rather than defensiveness and resistance.
• Clients are usually more willing to search for, identify, and amplify solution patterns.
• Should be generous with compliments throughout the change process to reinforce the strengths and resources that individuals display.

Indirect Complimenting

• Positive traits and behaviors are implied.
• Examples: “How were you able to do that?” or “How did you figure that out?”