10. Solution Focused Therapy Flashcards
what does solution focused therapy branch off?
constructivist therapies
what is constructivist therapies influenced by?
Post Modern Thinking
what does the constructivist theory say about reality
that reality is constructed: Not objective immutable facts
what does constructivist therapies say about theories?
theories are only interpretations arising from individual observation process
what does constructivist therapies focus on?
therapeutic conversations
What is the constructivist view of reality in human nature?
It assumes that realities are socially constructed and there is no absolute reality
what is the constructivist view of people in human nature
as healthy, competent, resourceful beings who have the ability to construct solutions and alternative stories to enhance their lives
what does constructivist therapy help clients with?
helps clients to recognise their competencies and build on their potential strengths and resources
what are the key assumptions of constructivist therapy?
- 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
what are the alternative titles of constructivist therapy?
- brief therapy
- solution oriented therapy
- possibility therapy
- constructivist therapy
- narrative therapy
In the development of Solution focused therapy, who and what were the fundamental theoretical impetuses?
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
In the development of Solution focused therapy, what were the fundamental practical impetuses?
o ‘managed health care’ movement
o demand for outcome based therapies
what are the fundamental principles of solution focused therapy?
- 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
what are the basic assumptions of solution focused therapy?
- 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
in solution focused therapy, what does the relationship between a client and therapist aim to develop?
a fit between the client and therapist
what should the client and therapist demonstrate in the therapeutic relationship in SFT?
mutual respect for each others role; collaborative and cooperative
what should the therapist do in the therapeutic relationship in SFT?
should show acceptance of client’s world view; provide opportunity and latitude for client to make choices
what is the therapist’s role in SFT?
an expert on change processes, is energetic and remains in charge of the session
what is the client’s role in SFT?
the client is the expert on the nature of the complain and the preferred solution
what are the 3 kinds of relationships?
complainant, visitor and customer
what is the complainant relationship?
- the client acknowledges that there is a problem but believes the solution is dependent on someone else’s action
- others must change
what is a visitor relationship?
- 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’
what is the customer relationship?
- client who acknowledge that they have a problem, and are
* prepred to invest in finding a solution
what sort of langauge should be involved in SFT goaling?
positive langauge - the presence of…
what should the focus be in SFT goaling?
focus on beginnings not the end; focus on minimal change
what should be the action form of goaling in SFT?
concrete, specific, observable and measurable
who has control of goaling in SFT?
the client
whose language should SFT goaling be in?
the clients
what is required from the client in order to succeed in goaling in SFT?
hard work
what context should goaling in SFT be in?
within the client’s life context and attanable by the client
what questions are involved in pre-therapy change?
• 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
what is the SFT process?
- Pre-problem talk
- Assume customership
- Acknowledgement
- Change to viewing
- Co-construct map of ‘solution land’
- Access resources
- Change the doing
- Follow-up
what is involved in the pre-problem talk step in the SFT process?
o Enhance client’s understanding and control
o identify client resources, strengths and competencies
what is involved in the assume customership step in the SFT process?
o facilitate cooperation with change
o identify client concerns
what is involved in the acknowledgement step in the SFT process?
o Client’s construction of the problem
o mapping influence of the problem on client’s life
o validating concerns while keeping possibilities open
what is involved in the change to viewing step in the SFT process?
o reframe in possibility language
o explore exceptions
what is involved in the co-construct map of ‘solution land’ step in the SFT process?
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?)
what is involved in the access to resources step in the SFT process?
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(
what is involved in the change the doing step in the SFT process?
o construct solution frames
o allocate tasks
o relapse prevention
what is involved in the follow up step in the SFT process?
o elicit: positive changes
o amplify ask for details
o reinforce: highlight / flag / cheer-lead
o start: ‘what else…, what more’
compared to other models, what are the factors of SFT?
- 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
compared to SFT what are the factors of other models?
- 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
what are the contradictions of SFT?
- 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).
what is the evidence of the effectiveness of SFT?
- 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
