10. Solution Focused Therapy

Question 1

what does solution focused therapy branch off?

Answer 1

constructivist therapies

Question 2

what is constructivist therapies influenced by?

Answer 2

Post Modern Thinking

Question 3

what does the constructivist theory say about reality

Answer 3

that reality is constructed: Not objective immutable facts

Question 4

what does constructivist therapies say about theories?

Answer 4

theories are only interpretations arising from individual observation process

Question 5

what does constructivist therapies focus on?

Answer 5

therapeutic conversations

Question 6

What is the constructivist view of reality in human nature?

Answer 6

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

Question 7

what is the constructivist view of people in human nature

Answer 7

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

Question 8

what does constructivist therapy help clients with?

Answer 8

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

Question 9

what are the key assumptions of constructivist therapy?

Answer 9

• 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

Question 10

what are the alternative titles of constructivist therapy?

Answer 10

• brief therapy
• solution oriented therapy
• possibility therapy
• constructivist therapy
• narrative therapy

Question 11

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

Answer 11

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

Question 12

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

Answer 12

o ‘managed health care’ movement

o demand for outcome based therapies

Question 13

what are the fundamental principles of solution focused therapy?

Answer 13

• 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

Question 14

what are the basic assumptions of solution focused therapy?

Answer 14

• 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

Question 15

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

Answer 15

a fit between the client and therapist

Question 16

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

Answer 16

mutual respect for each others role; collaborative and cooperative

Question 17

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

Answer 17

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

Question 18

what is the therapist’s role in SFT?

Answer 18

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

Question 19

what is the client’s role in SFT?

Answer 19

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

Question 20

what are the 3 kinds of relationships?

Answer 20

complainant, visitor and customer

Question 21

what is the complainant relationship?

Answer 21

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

Question 22

what is a visitor relationship?

Answer 22

• 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’

Question 23

what is the customer relationship?

Answer 23

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

* prepred to invest in finding a solution

Question 24

what sort of langauge should be involved in SFT goaling?

Answer 24

positive langauge - the presence of…

Question 25

what should the focus be in SFT goaling?

Answer 25

focus on beginnings not the end; focus on minimal change

Question 26

what should be the action form of goaling in SFT?

Answer 26

concrete, specific, observable and measurable

Question 27

who has control of goaling in SFT?

Answer 27

the client

Question 28

whose language should SFT goaling be in?

Answer 28

the clients

Question 29

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

Answer 29

hard work

Question 30

what context should goaling in SFT be in?

Answer 30

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

Question 31

what questions are involved in pre-therapy change?

Answer 31

• 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

Question 32

what is the SFT process?

Answer 32

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

Question 33

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

Answer 33

o Enhance client’s understanding and control | o identify client resources, strengths and competencies

Question 34

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

Answer 34

o facilitate cooperation with change | o identify client concerns

Question 35

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

Answer 35

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

Question 36

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

Answer 36

o reframe in possibility language | o explore exceptions

Question 37

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

Answer 37

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?)

Question 38

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

Answer 38

``` 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( ```

Question 39

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

Answer 39

o construct solution frames o allocate tasks o relapse prevention

Question 40

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

Answer 40

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

Question 41

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

Answer 41

* 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

Question 42

compared to SFT what are the factors of other models?

Answer 42

* 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

Question 43

what are the contradictions of SFT?

Answer 43

* 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).

Question 44

what is the evidence of the effectiveness of SFT?

Answer 44

* 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