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Solution-Focused Therapy Overview

1.

Strength-building model

  • Clients are assumed to have the necessary capacities to solve their own problems.
  • Focus of treatment is bolstering motivation and resources.
  • When deficits are identified as a substantial barrier to change, then skill building is introduced.
2.

Helping process

Engagement, problem exploration, solution exploration, goal setting, taking action, and termination.

3.

Solution focused therapy

  • Influenced by the philosophies of constructivism and social constructionism.
  • Language is used to influence the way clients view their problems.
    • Help them see the potential for solutions.
    • Create an expectancy for change.
  • Development of solutions derived from non-problem times rather than a problem focus.
4.

Constructivism

Reality does not exist as an objective phenomenon; instead, it is a mental construction comprised from the assumptions that people hold about themselves and the world.

5.

Social constructionism

Mental constructions are formed through social interaction.

6.

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.
7.

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.
8.

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.

9.

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
10.

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.
11.

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.
12.

Definitive Phrasing

  • Employment of words such as when and will implies that change will occur.
  • “When you are better, what will you be doing?”
13.

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?”
14.

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.
15.

The Customer

  • The client who is motivated and willing to participate in the change process.
16.

The Complainant

  • Motivated chiefly for change in another person rather than for change in the self.
17.

The Visitor

  • Typically unmotivated and is attending only because he or she has been mandated to do so.
18.

Language on Opening Contact

19.

Strategies to engage clients: Customer

20.

Strategies to engage clients: Complainant

21.

Strategies to engage clients: Visitor

22.

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)
23.

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.
24.

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.
25.

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.
26.

Indirect Complimenting

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