Week Eight Flashcards
constructive therapies
• Influenced by Post Modern thinking/Philosophy
• MPTP is an intellectual movement that allowed us to think critically about what we can know.
○ Questioned how we can be sure of how reality or experience of the world is constructed (internally)
• Reality is constructed: not objective immutable facts (so is meaning negotiable)
• Theories are only interpretations arising from individual observation processes – critical position
• Focus on therapeutic conversations
view on human nature
- Assume that realities are socially constructed. There is no absolute reality.
- Radical departure from traditional therapies.
- Did not look at what was wrong with people but rather focused on overcoming this and exploring resources.
- View people as healthy, competent, resourceful, who have the ability to construct solutions and alternative stories to enhance their lives.
- Help clients recognise their competencies and build on their potential, strengths, and resources.
key assumptions of CT
- invites a critical stance towards taken-for-granted knowledge
- language and concepts are historically and culturally constructed
- knowledge is constructed through social processes
- The way we make sense of the world influences how we behave.
- these social constructions impact on social life and influence social action
- See language as a primary feature of change
constructivist therapies
- Solution Focused Brief Therapy
- Not focused on the problem.
- Solution oriented therapy
- Possibilinty therapy
- Narrative therapy
- Collaborative Language Systems
development of SFT- theoretical impetus
• Milton Erikson’s Brief Hypnotherapy
• Mental Research Institute (MRI) in Palo Alto – communication processes in families
• Erikson believed that we didn’t need to interpret the client’s experience and that insight was not necessary for change.
○ Would use how the client engages with the world when designing their intervention.
• Erikson believed that people had existing resources, which were generally contained within the unconsciousness.
• Established brief Family Therapy Centre in Wisconsin- Steve de Shazer, Insoo Berg, Bill O’Hanlon, Michele Weiner-Davis, Gregory Bateson, Jay Hayley
• Explained that often the solution can make the problem worse.
○ i.e teenager rebels, parent gives punishment, as rebellion increases so does punishment - not effective.
Roots go back to Milton Erikson’s work; his use of language, metaphor and hypnosis (1970’s); accepted the worldview and life patterns of the clients and worked with them
De Shazer & Berg met in Palo Alto at the Mental Research Institute and was influenced by the researchers who were referred to as strategic therapists
BFTC established in 1978 – worked with individuals, couples & families
Treatment that offered outcomes in a limited space of time
It is the outcomes of the service not the service per se that should be the focus of attention
Make therapy available to a wider cross section; too elitist
practical impetus
- ‘managed health care’ movement
* demand for outcome based therapies
fundamental principles
• competency based
• We do not need to understand the problem to facilitate change.
• Clients have resources & strengths; already coping; they are the experts on problems/solutions; strengths based and optimistic view of human nature
• non-pathologising (“difficulties” arise from ineffective solutions or unhelpful narratives)
No diagnostic labels; rejects disease model; does not focus on dysfunction, deficits (biologically/psychologically compromised clients)
• does not look for causes
• change oriented
• Change is continuous in and out of therapy; minimum change; incremental change; therapeutic task is not to create but to engage with that task, move it on.
• Collaborative
• Complementary roles; therapy is about empowerment of clients in their role; standing side by side with them; it is a collaborative inquiry which is respectful of the client
• Counsellor in a position of curiosity
• Counsellor keep charge of the process but the client is the expert.
○ Puts client in a position of power.
• present/future oriented
• optimistic ‘solution focused’ conversations
Strong belief in possibilities for change; no link between cause and solution; use of presupposition language • therapeutically economical
basic assumptions
• change is occurring constantly
• Counsellor asks questions to invite the client to see this.
• small change can lead to larger change
• Small changes are often more achievable.
• 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
• Knowledge of the client can get in the way, thus the counsellor acts curious.
• 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 do it again
How clients have and are coping; what is different; acknowledging and validating small change; showing benevolent curiosity
Facilitating the transfer of skills that already exist not skills training
Assumes there will be exceptions; “clients are not under the influence………”
• there are different ways of viewing things
• Think outside the box; a different perspective can get clients unstuck; more of the same syndrome
• there are always possibilities for change
• Therapist amplifies change
• Rapid change is possible; clients discover that they already have the solution to their complaint; no formal contract.
• each session should be approached as if it was the last
• It is brief therapy, between 1-12 sessions.
• client resistance is indicative that client’s goals are not being followed
• The notion of resistance is irrelevant as it assumes the client is not doing what the counsellor wants, that is not the power dynamic in CT.
therapeutic relationship
- Work to develop ‘fit’ between client and therapist
- Demonstrate mutual respect for each others role; collaborative and cooperative
- Show acceptance of client’s world view
- Provide opportunity and latitude for client to make choices
- The therapist is the expert on change processes, is energetic and remains in charge of the session
- The client is the expert on the nature of the complaint and the preferred solution
- Therapist ought to be careful about how their beliefs impact on their work
3 kinds of relationships
Complainant: the client acknowledges that there is a problem but believes the solution is dependent on someone else’s action: others must change
- Visitors: mandated 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’
- Customer: clients who acknowledge that they have a problem, and are prepared to invest in finding a solution
general SFBT interview format
- HOSTING Social stage [problem free talk]
- PRE SESSION CHANGE
- GOALING (for preferences and possibilities) Finding out what the client wants to be different [using miracle questions, coping questions]
- EXCEPTIONS to the problem [instances of the miracle] and ‘video-talking’ these
- SCALING QUESTIONS [scaling progress, motivation, willingness]
- BREAK
- Therapist leaves the room and talks to the consultation team. And develops the message for the client.
- MESSAGE [compliments, bridge and task or experiment]
hosting and problem free talk
• Fundamental to the solution focused Approach is the importance of building rapport quickly and supporting clients to speak about areas of their lives that they feel are working.
• Problem free talk is talking about things outside of the problem. Discussing their interests, what they enjoy or what they are interested in.
• This supports the quick generation of rapport and may elicit some contexts of competence/resources and skills that may be relevant to solution building.
• Often some of the things we enjoy can help us with the problem.
‘ Before we start could you tell me a little bit about something you enjoy doing in your life that you’d like to do more of if you could?
‘ What do you guys do as a family that you enjoy? What did you used to do?
‘ What are something that you appreciate about your mother Jamie’
pre-session change
Search for Change that has occurred prior to the First session:
‘What’s different for you since you first made the appointment’?
‘How has the concern that you’ve brought today changed since you first decided to come in’?
‘How did you manage to do this’?(Action Talk)
Preferred future is when the problem is not around
- How will that feel? - How will you know when the problem is no longer around? - Will people recognise this?
goaling
- Developing a vision of what will be different for the client when the problem has been resolved, generates hope, provides possible solution behaviours and clarifies the change that is hoped for.
- Goaling …..
- is a continuous process of inviting clients to explore and define what they want to be different in their live
- Needs to be monitored and checked during counselling
- Are we still on track to achieving what you came for?
- Is that still what you want or would you like to change this goal?
- Notice the difference between defining sub-steps to achieving a fixed goal and an ongoing process of goaling
miracle question
- Miracle and Crystal ball Questions
- How will you know that you don’t need us here any longer?
- How will you know that your work with us has been useful?
- What will be the first thing you notice that will tell you that the problem is resolved?
- Imagine a future where the problem has been resolved what is happening differently? How would that be different, how would you feel, how would your day be different?
- Who would be the first to notice? (interactional difference)
- When your son is more relaxed what would you be doing diffrently? (Interactional Difference)
