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PYB208 > 10. Solution Focused Therapy > Flashcards

10. Solution Focused Therapy Flashcards

1
Q

what does solution focused therapy branch off?

A

constructivist therapies

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2
Q

what is constructivist therapies influenced by?

A

Post Modern Thinking

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3
Q

what does the constructivist theory say about reality

A

that reality is constructed: Not objective immutable facts

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4
Q

what does constructivist therapies say about theories?

A

theories are only interpretations arising from individual observation process

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5
Q

what does constructivist therapies focus on?

A

therapeutic conversations

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6
Q

What is the constructivist view of reality in human nature?

A

It assumes that realities are socially constructed and there is no absolute reality

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7
Q

what is the constructivist view of people in human nature

A

as healthy, competent, resourceful beings who have the ability to construct solutions and alternative stories to enhance their lives

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8
Q

what does constructivist therapy help clients with?

A

helps clients to recognise their competencies and build on their potential strengths and resources

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9
Q

what are the key assumptions of constructivist therapy?

A
  • Invites a critical stance towards taken-for-granted knowledge
  • language and concepts are historically and culturally constructed
  • knowledge is constructed through social processes
  • these social constructions impact on social life and influence social action
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10
Q

what are the alternative titles of constructivist therapy?

A
  • brief therapy
  • solution oriented therapy
  • possibility therapy
  • constructivist therapy
  • narrative therapy
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11
Q

In the development of Solution focused therapy, who and what were the fundamental theoretical impetuses?

A

o Milton Erikson Brie Hypnotherapy
o Mental Research Institute (MRI) in Palo Alto – communication processes in families
o Established brief Family Therapy Centre in Wisconsin – Steve de Shazer, Insoo Berg, Bill O’Hanlon, Michele Weiner-Davis, Gregory Bateson, Jay Hayley

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12
Q

In the development of Solution focused therapy, what were the fundamental practical impetuses?

A

o ‘managed health care’ movement

o demand for outcome based therapies

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13
Q

what are the fundamental principles of solution focused therapy?

A
  • Competency based
  • non-pathologising (“difficulties” arise from ineffective solutions or unhelpful narratives)
  • does not look for causes
  • change oriented
  • collaborative
  • present/future oriented
  • optimistic ‘solution focused’ conversations
  • therapeutically economical
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14
Q

what are the basic assumptions of solution focused therapy?

A
  • Change is occurring constantly
  • small change can lead to larger change
  • clients have resources & strengths to think and act in different ways
  • exceptions for coping are always present
  • there are no ‘right’ solutions
  • A therapist’s not knowing affords the client an opportunity to construct a solution
  • If it isn’t broken don’t fix it: once you know what works do more of it; if it doesn’t work don’t to it again
  • There are different ways of viewing things
  • there are always possibilities for change
  • each session should be approached as if it was the last
  • client resistance is indicative that client’s goals are not being followed
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15
Q

in solution focused therapy, what does the relationship between a client and therapist aim to develop?

A

a fit between the client and therapist

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16
Q

what should the client and therapist demonstrate in the therapeutic relationship in SFT?

A

mutual respect for each others role; collaborative and cooperative

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17
Q

what should the therapist do in the therapeutic relationship in SFT?

A

should show acceptance of client’s world view; provide opportunity and latitude for client to make choices

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18
Q

what is the therapist’s role in SFT?

A

an expert on change processes, is energetic and remains in charge of the session

19
Q

what is the client’s role in SFT?

A

the client is the expert on the nature of the complain and the preferred solution

20
Q

what are the 3 kinds of relationships?

A

complainant, visitor and customer

21
Q

what is the complainant relationship?

A
  • the client acknowledges that there is a problem but believes the solution is dependent on someone else’s action
  • others must change
22
Q

what is a visitor relationship?

A
  • mandate or non-voluntary clients who are sent by others
  • these clients are unlikely to acknowledge that they have a problem and our ambivalent about counselling and may want to ‘check it out’
23
Q

what is the customer relationship?

A
  • client who acknowledge that they have a problem, and are

* prepred to invest in finding a solution

24
Q

what sort of langauge should be involved in SFT goaling?

A

positive langauge - the presence of…

25
Q

what should the focus be in SFT goaling?

A

focus on beginnings not the end; focus on minimal change

26
Q

what should be the action form of goaling in SFT?

A

concrete, specific, observable and measurable

27
Q

who has control of goaling in SFT?

A

the client

28
Q

whose language should SFT goaling be in?

A

the clients

29
Q

what is required from the client in order to succeed in goaling in SFT?

A

hard work

30
Q

what context should goaling in SFT be in?

A

within the client’s life context and attanable by the client

31
Q

what questions are involved in pre-therapy change?

A

• Pre-therapy change
o what have you done since yo made the appointment that has made a difference in your problem?
• exception question (directing client to a time in their life when the problem/issue did not exist)
• presupposition questions (what is better/different since last we met)
• future oriented questions – “what do you see down the road for yourselves after this is resolved”
• scaling questions (to do with motivation, severity of issue)
• on a scale of 1-10
• hypothetical questions (if this was fixed in 6 months, what would that be like?)
• Pessimistic questions (despite everything. You still continue – how do you do it?)
• miracle question
• how will you know that the miracle has occurred? the miracle being the issue was completely resolved

32
Q

what is the SFT process?

A
  1. Pre-problem talk
  2. Assume customership
  3. Acknowledgement
  4. Change to viewing
  5. Co-construct map of ‘solution land’
  6. Access resources
  7. Change the doing
  8. Follow-up
33
Q

what is involved in the pre-problem talk step in the SFT process?

A

o Enhance client’s understanding and control

o identify client resources, strengths and competencies

34
Q

what is involved in the assume customership step in the SFT process?

A

o facilitate cooperation with change

o identify client concerns

35
Q

what is involved in the acknowledgement step in the SFT process?

A

o Client’s construction of the problem
o mapping influence of the problem on client’s life
o validating concerns while keeping possibilities open

36
Q

what is involved in the change to viewing step in the SFT process?

A

o reframe in possibility language

o explore exceptions

37
Q

what is involved in the co-construct map of ‘solution land’ step in the SFT process?

A

o goaling
o use of ‘video-talk’ (if the description is unclear you may ask ‘If you made a vide of… happening what would I see on the tape?’ or ‘If I was a fly on the wall what would I see happening?)

38
Q

what is involved in the access to resources step in the SFT process?

A 
o	transfer competence (“We can help clients draw upon the confidence and ease they feel in situations where they are competent and effective and apply it in a new area. They can also draw useful metaphors and practical help from these areas and apply them to current areas of difficulty”)
o	compliments (cheer-leading-not flatter-very specific(
39
Q

what is involved in the change the doing step in the SFT process?

A

o construct solution frames
o allocate tasks
o relapse prevention

40
Q

what is involved in the follow up step in the SFT process?

A

o elicit: positive changes
o amplify ask for details
o reinforce: highlight / flag / cheer-lead
o start: ‘what else…, what more’

41
Q

compared to other models, what are the factors of SFT?

A
  • focus on change
  • search for exceptions
  • generate new possibilities
  • assume competence and resources
  • give responsibility
  • focus on action
  • collaborative
  • client as expert
  • demonstrate curiosity
  • use client’s words
42
Q

compared to SFT what are the factors of other models?

A
  • look for cause/etiology
  • provide treatment
  • discover a cure
  • assume pathology or disability
  • allocate blame
  • focus on thinking, feelings
  • directing, controlling
  • counsellor as expert
  • predetermined outcomes
  • uses jargon, labels
43
Q

what are the contradictions of SFT?

A
  • Where a TR cannot be established (severe mental illness)
  • Where “good” SFBT has been tried and hasn’t worked
  • Where “a solution” is not an option/good idea
  • Where an organisation “needs” a waiting list (SFBT is brief, so waiting lists can be reduced relatively quickly).
44
Q

what is the evidence of the effectiveness of SFT?

A
  • SFBT officially supported as evidenced-based by numerous agencies and institutions, such as SAM HSA (Substance Abuse and Mental Health Services Administration)’s National Registry of Evidence-Based Programs & Practices (NREPP). To briefly summarize:
  • There have been 77 empirical studies on t he effectiveness of SFBT,
  • There are been 2 met a-analyses (Kim, 2008; Stams, et al, 2006) , 2 systematic review s. ◦ There is a combined effectiveness data from over 2800 cases.
  • Research w as all done in “real world” settings (“effectiveness” vs. “efficacy” studies), so t he result s are more generalizable.
  • SFBT is equally effective for all social classes.
  • Effect-sizes are in the low to moderate range, t he same t hat are found in met a-analyses for other evidence-based practices, such as CBT and I PT. Overall success rat e average 60% in 3-5 session

PYB208 (7 decks)

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