Constructivism - Solution Focused Brief Therapy (SFBT) Flashcards
Who developed Solution-Focused Brief Therapy?
-Steve de Shazer - was at MRI (influence). Milton Erickson also an influence.
-Insoo Kim Berg
At the Brief Family Therapy Center in Milwaukee, in the late 1970’s.
-Yvonne Dolan
-Eve Lipchik
What is the main thrust of SFBT?
Brief treatment with minimal intervention, focusing on solutions guided by prior successes.
Deemphasizes the problem, underlying pathology, and family history.
What is “Normal” vs “Dysfunctional” in SFBT?
- No “normative’ model
- No single “right way” to live and act
- Thus, no need to analyze conceptual ideas of patterns, structures
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Difficulties exist when people engage in problem-focused thinking rather than their own
competencies to solve problems
What is the stance of the therapist in SFBT?
- Work collaboratively with clients to negotiate achievable goals
- Highlight exceptions to the problems
- Design interventions to amplify non-problematic patterns
- Believe that clients have the ability to solve their own problems with only slight shifts in how they
behave or view problems - Convey hope and understanding through use of solution-focused language
- May first validate previous difficulties and empathize with Ct’s experience of the problem
- Experts on therapy process/convo, not the client’s life/experience
What are assumptions of SFBT?
- Client wants to change
- Client has strengths, resources they need
- No such thing as resistance
- Focus on present & future, and on past (for exceptions)
- The problem is not always happening
- Language creates reality: Changing problem-talk to solution-talk is effective
- Small changes snowball into big changes, as families change their view of themselves and their ability to solve problems
- There’s no need to attend to hypothetical underlying causes: non-pathologizing
- Don’t need to dig into causes. Solutions are not necessarily related to problems.
- Therapeutic relationship (hope, encouragement) is key
What are treatment goals of SFBT?
- Shift problem-talk to solution-talk
- Help clients make changes (thought, action)
- “Good enough” is fine - client decides
- Modest, clear, specific goals
- Identify resources
- Build on successful past solutions and problems
- When clients can begin to focus on exceptions and engage in non-problematic behavior, over time,
exceptions become the norm
What are the Levels of Commitment to Change in SFBT?
VISITOR
- No specific problem
- No commitment to participating productively in treatment
COMPLAINANT
- Brings specific problem
- Currently unwilling to focus on solution
CUSTOMER
- Brings problem and a willingness to work toward
resolution
- Therapist leans on relationship to move therapy forward
- Therapist gives compliments AND an assignment, asking client to
observe for exceptions
- Can progress beyond solutions focused language,
compliments, and assignments to amplify behaviors in moving client toward goals
What is the idea of Resistance in SFBT?
- “Resistance” is a non-helpful idea and points to countertransference. Use POTT!
- Resistance does not exist: Either clients are using their natural protective mechanisms or a realistic desire to be cautious
and go slowly, OR the therapist has not yet found an intervention that fits the client’s solution
What are interventions in SFBT?
- First session: what is happening in their life they want to continue
- Hear & validate struggles first!
- Ask about client strengths
- Scaling questions
- Mid-session feedback break: summarize session so far, give compliments, assign task (“experiment”)–then roll feedback into next half of session
- Compliments
- Setting clear, achievable, specific goals
- Helping client think about what they want to be different in the future
- Amplify times they did things that worked - problem gone or less severe
- Predict the next day, then see what happens
When do SFBT therapists use the Miracle question?
- When clients are vague about complaints
- When client needs to get unstuck
- When clients feel hopeless or need encouragement
What happens in assessment in SFBT?
- Assess exceptions (no problem happening)
- Assess what worked in the past
- Assess client strengths
- Assess what might be different when problem is gone (miracle question)
When does SFBT therapy terminate?
The client decides the problem is gone/solved
How long does SFBT last?
Sessions last about an hour, include a short break
Sessions are loosely scheduled, meaning couples may have 1 or more sessions, with the average being 3-4 sessions.
What is the Skeleton Key question?
“Between now and when we meet, I would like you to pick one thing you definitely want to keep happening/doing”
What are the phases of the first SFBT therapy session?
Within each session:
1 - Socializing & Joining
2 - Describing the problem
– Miracle Q
– Exception, Agency, Coping Qs
– Scaling
3 - Goal setting (future oriented Qs)
4 - Break
5 - Ending (give feedback, suggest experiment/task)
