Solution–focused therapy (SFT), unlike other forms of therapy argues that a person doesn’t have to understand any problem in order to resolve the problem and that the solution isn’t necessarily related to the problem. The purpose of this paper is to give a brief overview, description and rationale of Solution-focused therapy as well as an explanation of the therapeutic processes involved in SFT. This paper will also demonstrate through case example; systemic case conceptualization/hypotheses, goals of treatment, as well as interventions used through the entire treatment plan process.
Solution-focused therapy “focuses on people’s competence rather than their deficits, their strengths rather than their weaknesses, their possibilities rather than their limitations” (O’Hanlon, H., Weiner-Davis, M. (1989, p. 1.). Solution-focused therapy (SFT), also known as Solution-Focused Brief Therapy (SFBT) was developed in the 1980’s by Steve de Shazer, Insoo Kim Berg, along with their team, Patricia Hudson, Williams – Hanlon, Eve Lipchilk, Jane Peller, Scott Miller, John Walter, and Michelle Wiener-Davis from the Brief Family Therapy Family Center in Milwaukee, USA.
This theory was based on over twenty years of empirical research, theoretical development, as well as clinical practice. Solution focused therapy (SFT) targets the desired therapeutic outcomes of therapy as a solution without focusing on the issues or behaviors that brought the client to therapy. This form of therapy is a competency based model which is different in many ways from the traditional theories or approaches (Berg, I.K., (1994).
The therapist encourages the client to envision their ideal future; collaborating with the client to establish a group of steps needed to achieve the desired goal. By examining and analyzing the client’s vision, the therapist can determine what abilities, skills and resources the client can develop and use in order to achieve the envisioned outcome. de Shazer, S., (1985), suggests that the client is the expert; the development of a solution is not necessarily related to the problem; if something works, continue with it; if something doesn’t work, do something different; if it isn’t broken, don’t try to fix it.
The therapeutic process for SFT is always the same regardless of the client’s concerns. SFT behavioral analyses are made of the exceptions instead of the problem. SFT uses the process of operant conditioning: the discussion and implementation of the client’s desired behavior is recognized and complimented by the therapist (positive reinforcement), the conversation and actions of undesired behavior is stifled (frustrative non-reward) due to the therapist’s lack of recognition.
SFT also uses the process-of classical conditioning: the therapist suggests a homework assignment the client such as, doing something different or to ‘pretend the miracle has happened’ (counter conditioning) (Bannink, F. P., (2007). Joining with the client means having a discussion about the client’s issue or presenting problems prior to the first scheduled session. It is important for the therapist to pay attention to any changes made previous to the first therapeutic session.
Once that has taken place; the focus shifts to the here and now and focuses on how clients change instead of diagnosing and treating problems. Signature questions are used in SFT interview sessions and are meant to establish a therapeutic process where the therapist effectively listens to the client’s words; while the client expresses what is important to them, their wants, needs and related successes. The therapist then formulates and asks other questions by being cognoscente of the client’s use of key words and phrases. It is also important to continue the effective listening process as the clients continue to answer questions based on their frame of reference.
Through this continual process of listening, connecting and absorbing, along with the client responding; the therapist and client together can construct new and adjusted meanings that work toward building positive solutions. Structured feedback from the therapist should look at the client’s strengths and establish the next steps towards the future, concluding the session. How change is brought about
Solution Focused therapy focuses on promoting change in the direction of the client’s goals. When a client enters into a therapist’s care, the Solution Focused model follows a set of questions that will dictate where a client is starting from. Where a client is staring from is simply defined as where a client is willing to begin in the therapy process, which includes the amount of disclosure the client may be willing to exhibit. The therapist using this model may first ask the clients a question of what is the problem.
This should then lead into what is the main cause of this problem. Next, the client may be asked what maintains the problem. After these questions are answered or at least attempted by the client, the therapist should have an idea about the client’s patterns of behavior and thinking around the problem. Having this knowledge will give the therapist a starting point from which to work from (Walter & Peller, 1992). By understanding where the client is at right now, the therapist is able to construct solutions using the Solution Focused model. To construct solutions, there remain some assumptions, these may include; that there is a solution to the problem or that multiple solutions exist.
That the solutions are constructible, the therapist and the client are able to construct the solutions and that the therapist and the client construct and or invent solutions rather than discover them. Finally, after solutions have been constructed, the therapist would want this process to be modeled in order for it to be implemented by the client. In short, step one; find out what the client wants. Step two, look for what is working and do more of that. Step three, do something different.
Solution Focused therapy is the answer to the question of how do we construct solutions? It is a total model; it encompasses a way of thinking, a way of conversing with clients and a way of constructing solutions interactively. Solution Focused therapy is not a collaboration of techniques; rather it reflects fundamental notions about change, about interaction and about attaining goals. The focus in therapy is shifted from the past to present day, where we look for causes and map patterns of problem maintenance (Walter & Peller, 1992).
Elise, an African American/Caucasian woman, and Lionel, an African American male and have been in a married for two years and both are 27 years of age. They reported having no children, but both desire to have children before they reach 30 years of age. They both wanted to seek counseling because they argue constantly and can’t seem to resolve the conflict in their relationship.
Elise reports she withdraws whenever Lionel loses his temper. She states “he just explodes over the slightest thing and this behavior must change before we bring children into this world!” Elise also expressed that Lionel becomes verbally abusive and loud. Lionel has expressed having irrational behavior and acting out since he was a child. His parents never
seemed to pay attention or worry about this behavior. Hypothesis
Establishing effective communication skills will dissolve unresolved conflict. Early-Phase Goals
1. Develop and maintain a supportive relationship with Lionel and Elise. a.Allow Elise and Lionel to share in their own versions of the problem story, while effectively listening for the highlighting strengths, exceptions and resources.
b.Maintain a beginner’s mind to assist in understanding each client’s perspective on Lionel’s outbursts and other couple issues, while exploring and remaining sensitive to the couple’s perspective. 2. Begin the process of identifying exceptions, possibilities, and possible solutions to Lionel’s outbursts/Elise’s withdrawal and the couple’s ability to resolve conflict.
a.Discuss the communication issue as something that is solvable and in terms of solution. b.Identify Elise’s and Lionel’s strengths and resources and individuals and as a couple. Middle-Phase Goals
1. Increase number of respectful communication exchanges between Lionel and Elise that allow each to feel heard. a.Using scaling questions to identify small steps to be taken by Lionel and Elise between sessions that will move them closer to maintaining open, healthy by directing them to scale improvements in communication (one being no positive changes in communication and ten being the desired communication interaction). b.Monitor exceptions to Lionel’s outbursts/Elise’s withdrawal and times when the outbursts were not a problem.
2. Assist couple in learning to resolve conflict without angry, explosive episodes or withdrawal. a.Monitor exceptions when Lionel and Elise have been able to resolve conflict successfully and identify factors that led to the successful outcome. b.Scale changes in conflict-resolution skills.
c.Compliment progress and solutions.
1. Increase couple’s readiness for children and parenting. a.Allow Lionel and Elise to discuss readiness for children and parenting while effectively listening for strengths and resources. b.Scale the couple’s readiness to parent and take steps to get on track. c.Compliment existing strengths and identify additional strengths and resources.
2. Highlight progress and attainment of goals and develop a plan for anticipated challenges, identifying Lionel and Elise’s strengths, resources, and solutions. a.Identify what changes have worked and the best strategies for staying on track. b.Focus on future-oriented talk and highlight use of solutions in the future. c.Compliment on progress, change, and achievement in communication and conflict-resolution skills and Lionel’s diminished verbal outbursts. Therapist’s Thoughts
Although this therapist therapy of choice is Multigenerational Family Therapy; Solution-focused has its attributes, such as the Miracle Question. The genius behind this question is that it forces you to stop thinking about why you can’t achieve something and allows you to imagine how your life could be if something miraculous occurred. Solution-Focused therapy empowers the client with the ability to find resolution to their own issues and problems. This therapist feels that Solution-focused therapy is an appropriate addition to the Family Systems concepts.
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