Solution-Focused Family Therapy…

Starting with a review of Old Notes…

First a Definition…

“Solution-Focused Brief Therapy (SFBT) is a future oriented, goal-directed approach to brief therapy that uses questions designed to identify exceptions (times when the problem does not occur or could occur less in the client’s life), solutions (a description of what life will be like when the problem is gone or resolved), and scales which are used to measure the client’s current level of progress toward a solution and reveal the behaviors needed to achieve or maintain future progress.” (Metcalf, 2011, p.) 287)

  1. Focused on the Present not the Past
  2. Postmodern  & Social Constructionist 
  3. Pragmatic – Structure rigidly imposed
  4. Client is the expert…not pathological.   

Assumptions of SFT

  1. “Clients have resources and strengths to resolve problems
  2. Change is constant.  The therapists job is to identify/amplify change
  3. It is unnecessary to know about the complaint in order to solve it
  4. small changes in one part of the system can affect changes in another part of the system
  5. Clients define the goals.
  6. Rapid change or resolution of a problem is possible
  7. There is no one ‘right’ way to view things, different views may be just as valid and may fit the facts just as well.
  8. Focus on what is possible and changeable, not what isn’t.” (Metcalf, 2011, p. 293).

How Change Happens…

Change happens by learning to see the problem different and constructing new stories about what is happening.  Therapists help clients find exceptions to their complaints and believe change is possible. This allows the client to think different and think of solutions.

Therapist Role & Interventions…

The therapist works collaboratively with the client to construct solutions.  The client is the expert.  SFT has two main strategies:

Questions

“Are designed to help the client focus on exceptions and make presuppositions about future actions while building a positive outlook and encouraging achievement.”  (Metcalf, 2011, p. 296).  there are three types of questions…

  1. MIRACLE QUESTION – “Ask client to think about what things would be life if the problem no longer existed and instead you could have your preferred future.” (Metcalf, 2011, p. 298).
  2. EXCEPTION-FINDING QUESTIONS  – “Asks clients to think about times when their troubles were less severe, frequent or altogether absent.” (Metcalf, 2011, p. 298).
  3. SCALING QUESTIONS – “Client’s rate how they feel on scale of 1-10.” (Metcalf, 2011, p. 298)..

Interviewing Techniques….

“Serve to validate concerns and assist clients in experiencing significant shifts in their thinking about their situation” (Metcalf, 2011, p. 296-298).

  1. The client is the expert, the therapist promotes change.
  2. Discussion is problem free and instead focuses on solutions.
  3. Utilize compliments to help normalize client’s experiences….

A Working Template…

  1. PHASE ONE – “JOIN AND BUILD RAPPORT”: Introduce yourself and greet everyone, explain role as SFT family therapist. “My name is ____. As we begin talking, it would help me to get to know if you would tell me more about yourself and what you appreciate about each other.” (Metcalf, 2011, p. 299).  
  2. PHASE TWO – “UNDERSTANDING THE PRESENTING ISSUE”: Ask why they entered therapy and listen as they clarify the issue and what they hope to accomplish. Normalize and create exemptions…. “How do you explain your ability to ______ during this time?” (Metcalf, 2011, p. 299).  
  3. PHASE 3 – “ASSESSMENT OF FAMILY DYNAMICS”: Doesn’t assess presenting issue, but provide possibilities and solutions. “Could you describe the times when the problem occurred less?” (Metcalf, 2011, p. 299).  
  4. PHASE 4 – “GOALS”: specify the client’s goals that will be relevant and meaningful to client. The Miracle Question: “Suppose tonight while you sleep, a miracle occurs. When you wake up tomorrow, what will be different?” (Metcalf, 2011, p. 299).  
  5. PHASE 5 – “AMPLIFYING CHANGE”: Whenever you hear exceptions, verbalize your discoveries with curiosity and sincerity to the client, even if the exceptions are slight. “What difference did that make for you?” (Metcalf, 2011, p. 299).  
  6. PHASE 6 – “TERMINATION”: Each week, ask the clients whether they wish to come back, and if so, when. This puts them in charge of therapy. “What did we do during our time together that you found helpful, if anything?” (Metcalf, 2011, p. 299).  

References

Metcalf, L, (2011). Marriage and family therapy: A practice oriented approach. New York: Springer Publishing Company

Discussion Board Post 2.1

Definition of Solution Focused Therapy

Solution Focused Therapy is form of brief therapy that is very goal-oriented in its approach. Instead of examining the problem, it directs the client’s attention toward solutions (Metcalf, 2011). Instead of focusing on reliving the past, it focuses on changes to create in the client’s desires for the future (Metcalf, 2011).   Since reality is conceived as a constructed, rather than absolute concept, the client is the expert not the therapist (Metcalf, 2011). It is for this reason that the therapist’s role is collaborative in nature, and involves redirecting the client toward possibility.   The primary goal of Solution Focused Therapy is empowerment for client in whom emotions are validated in a brief and highly structured context (Metcalf, 2011).

Two Concepts: Social Constructionism & Postmodernism

            Metcalf, (2011) briefly mentions postmodernism and social constructionism as two theoretical underpinnings to this approach. Since I was interested in understanding what these terms met, I thought I’d search the library’s database.   Social Constructionism essentially points at the self-fulfilling nature of society’s influences upon us (Social Constructionism, 2008). In other words, our everyday experiences are comprised of an array of socially defined concepts ranging from personal identity, social interaction, beliefs, values, thoughts, and feelings (Social Constructionism, 2008).   According to Metcalf, (2011) postmodernism appears to assert that truth is essentially a matter of subjective interpretation and not objective fact. When taken together, these two perspectives create a view of the individual as the creator of his/her experience.

Strengths & Weaknesses

One strength of Solution Focused Therapy, is its pragmatic and brief nature. These two qualities are especially attractive in light of the influence of managed care and popularity of brief therapy.   Additionally, as a logical and easy-to-understand approach, it is easy to explain and provides quick solutions for clients.

The weaknesses associated with Solution Focused Therapy can be understood in terms its one-sided perspective. As Metcalf (2011) explains Solution Focused Therapy sees individuals as creators of their reality, and in this respect the experts. Clients are never viewed as “never pathological or resistant” (Metcalf, 2011, p291) in Solution Focused Therapy. In mental health, pathology refers to the causes and effects of psychological disorder.   As mental health professionals, it seems impossible to do our job if we are unable to attend to the presence of a psychological disorder.

Additionally, Solutions Focused Therapy has its limits from a cultural perspective. For example, this method may not be a good fit for individuals with a cultural background that includes a collectivist orientation. This is because Solution Focused Therapy excludes generational patterns, family history and past experience as relevant factors to its overall approach (Metcalf, 2011).

References

Fischer, R. K. (2014). Postmodernism. Reference & User Services Quarterly, 54(1), pp 29-33.

Metcalf, L, (2011). Marriage and family therapy: A practice oriented approach. New York: Springer Publishing Company

Social Constructionism. (2008). In W. A. Darity, Jr. (Ed.), International Encyclopedia of the Social Sciences (2nd ed., Vol. 7, p. 578). Detroit: Macmillan Reference USA.

Finally, Discussion Board Post 2.2

Initial Reaction

The video assigned this week provides a vivid example of how Solutions Focused Brief Therapy can work with families and couples. At the introduction of this video, Isoo Kim Berg mentions several notable key points. Firstly, with this therapy model, building solutions involves focusing on exemption finding (I’d Hear Laughter, 1997). Secondly, the miracle question is reflective of the therapist’s role in assisting clients to build their own solutions (I’d Hear Laughter, 1997). Finally, scaling questions, allow clients to assess their progress in a manner that doesn’t impose the therapist’s ideas of normalcy (I’d Hear Laughter, 1997).

I appreciate this therapy method due to its pragmatic and brief nature. It defines reality as a personal and social creation and not objective fact (Metcalf, 2011). As a result, the therapist is able to utilize an approach that validates and respects a client’s own perceptions. The limits of this method are related to the fact that it can at times move too quickly to a solution, without first examining the problem carefully. Metcalf’s (2011) utilization of the Cinderella story in chapter one provides an excellent illustration of this.  Individual and family therapists would address the Cinderella story differently due to divergent views of the problem, (Metcalf, 2011). When applying this insight to the video, I wonder if any issues were left unaddressed. For example, what about the tension between Lou and Jan? I would like to know more.   How was Lou’s difficulty finding a job influenced by his overall well-being? Finally, is there more to Sarah’s story that didn’t come out in the sessions? In life, I believe problems are not simply a matter of what we are experiencing, but how we choose to define them. Sometimes the best solutions in life come from a shift in perspective in the absence of any action.

The Miracle Question

The miracle question plays a pivotal role in Solution Focused Therapy and involves asking the client to imagine a life in which one’s problems were suddenly eliminated (Metcalf, 2011).   In this video, Insoo asks the clients to consider if they woke tomorrow and discovered their problems were just 10% improved, how life would look (I’d Hear Laughter, 1997). Jan states she would expect everybody up in the morning ready to start the day, and willing to engage in meaningful interaction. Lou would wake up to a kiss from his wife, and Sarah stated the home environment would be much lighter.

In this specific video, I do feel the Miracle Question is useful in achieving its goal of encouraging the clients to formulate a solution. Through a series of questions, the therapist assists the clients as they clarify what actions could yield meaningful change. They are enabled to see life in new ways and let go of the problem by focusing on a solution.

How Was Therapist Effective?

I do feel this therapist’s techniques were effective, because the family’s problems weren’t very complex in nature. Issues more complex such as alcoholism, mental illness, or abuse, wouldn’t be suitable for brief therapy.   The therapist’s greatest successes were in her ability work with the clients to formulate a problem. This began as they discussed the changes they sought.   Assigning homework and discussing progress in a follow-up session, allowed for the experience of a quick remedies to their problems.

Is This Model A Good Fit For Me?

I feel it is way too soon in my development as a future therapist to decide on a specific theoretical perspective. Nonetheless, I do feel Solution Focused Therapy is useful as brief and pragmatic perspective that empowers clients to create change that aligns with their life goals. When applicable in this respect, I can certainly see using it in the future at some point.

References

I’d Hear Laughter [Video file]. (1994). Psychotherapy.net. Retrieved September 8, 2015, from The Psychotherapy.net Collection.

Metcalf, L, (2011). Marriage and family therapy: A practice oriented approach. New York: Springer Publishing Company

 

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