Solution Focused Brief Therapy Ball State University Khoolod, Angela, Melanie, Elise, Hyoseok, Lei, Manisha, Tamding, Allison

Solution Focused Brief Therapy

Solution Focused Brief Therapy

Ball State UniversityBall State UniversityKhoolod, Angela, Melanie, Elise, Hyoseok, Lei, Manisha, Tamding,

Allison

Role Play: How change occurs...




• Stage 1: Relationship - Initiate the Session

• Stage 1: Relationship - Initiate the Session



• Stage 2: Story and Strengths - Gather Data

• Stage 2: Story and Strengths - Gather Data



• Stage 3: Goals• Stage 3: Goals



• Stage 4 & 5: Re-story and Action - Explore, Create, and Conclude

• Stage 4 & 5: Re-story and Action - Explore, Create, and Conclude



• Thank you Melanie and Khoolod!• Questions or Comments?

• Thank you Melanie and Khoolod!• Questions or Comments?

Saul BellowSaul Bellow

• “Socrates said that the unexamined life is not worth living. But the (over) examined life makes you wish you were dead. Given the alternative, I’d rather be living.”

• “Socrates said that the unexamined life is not worth living. But the (over) examined life makes you wish you were dead. Given the alternative, I’d rather be living.”

QuickTime™ and a decompressor

are needed to see this picture.

(O’Hanlon, 2000)

OriginOrigin• Evolved from Systematic Paradigm.• Originally conceived as Brief Family Therapy in Milwaukee, Wisconsin, in the late 1970’s (de Shazer, 1982).

• Shift from Problem Focused Brief Family Therapy to SFT occurred in 1982.

• Founded by Steve de Shazer, Insoo Berg, Jim Derks, Elan Nunnally, Marilyn LaCourt, Eve Lipchik.

• Nourished by students who later became colleagues- John Walter, Jane Peller, Alex Molnar, Kate Kowalski, Michele Weiner-Davis and academicians- Gale Miller and Wally Gingerich.

• Evolved from Systematic Paradigm.• Originally conceived as Brief Family Therapy in Milwaukee, Wisconsin, in the late 1970’s (de Shazer, 1982).

• Shift from Problem Focused Brief Family Therapy to SFT occurred in 1982.

• Founded by Steve de Shazer, Insoo Berg, Jim Derks, Elan Nunnally, Marilyn LaCourt, Eve Lipchik.

• Nourished by students who later became colleagues- John Walter, Jane Peller, Alex Molnar, Kate Kowalski, Michele Weiner-Davis and academicians- Gale Miller and Wally Gingerich.

(Lipchik, 2002 and O’Hanlon, 2003)

Interactional ConceptsInteractional Concepts• “Human beings are unique in their genetic heritage and social development. Their capacity to change is determined by these factors and their interaction with others. Problems are present life situations expressed as emotional discomfort with self, and in relation to others. Change occurs through language when recognition of exceptions and existing and potential strengths create new actions.”

• “Human beings are unique in their genetic heritage and social development. Their capacity to change is determined by these factors and their interaction with others. Problems are present life situations expressed as emotional discomfort with self, and in relation to others. Change occurs through language when recognition of exceptions and existing and potential strengths create new actions.”

(Lipchik, 2002)

AssumptionsAssumptions• Change is constant• Emphasizing on solutions, strengths and prospects facilitates change

• Exceptions to problems exist• Clients are experts• Solutions emerge from conversation• No right way to view things

• Change is constant• Emphasizing on solutions, strengths and prospects facilitates change

• Exceptions to problems exist• Clients are experts• Solutions emerge from conversation• No right way to view things



(Dermer, 1998)

AssumptionsAssumptions• Solutions are possible without an in-depth assessment of client’s problems.

• Emphasis is on future instead of the past, solutions rather than problems, and client strengths, not deficiencies.

• Clients have the strengths and resources to change.

• Problems are roadblocks resulting from the inability to recognize alternatives and not symptoms of underlying pathology.

• Change is possible and the client is the one who generates what is possible and contributes the movement to this process.

• A small change in any aspect of problem leads to solution.

• Focusing on future possibilities and solutions enhances change, as does co-operation.

• Solutions are possible without an in-depth assessment of client’s problems.

• Emphasis is on future instead of the past, solutions rather than problems, and client strengths, not deficiencies.

• Clients have the strengths and resources to change.

• Problems are roadblocks resulting from the inability to recognize alternatives and not symptoms of underlying pathology.

• Change is possible and the client is the one who generates what is possible and contributes the movement to this process.

• A small change in any aspect of problem leads to solution.

• Focusing on future possibilities and solutions enhances change, as does co-operation. (Cepeda, 2006)

GoalsGoals• Goal negotiation - at the onset of counseling client describes what he/she wants.

• GOAL NEGOTIATION• Goal setting sets a path toward change.• Effective goals should be specific, small, positive and meaningful.

• Goals need to be described as presence of something positive rather than the absence of something negative.

• Clients can describe “how they will know when the problem is solved.”

• Therapist can ask- who will be doing what-to-whom-when-and-where after the problem is solved.

• Pulling from strengths and talents of client’s significant others gives the client a view of solutions’ impact.

• Goal negotiation - at the onset of counseling client describes what he/she wants.

• GOAL NEGOTIATION• Goal setting sets a path toward change.• Effective goals should be specific, small, positive and meaningful.

• Goals need to be described as presence of something positive rather than the absence of something negative.

• Clients can describe “how they will know when the problem is solved.”

• Therapist can ask- who will be doing what-to-whom-when-and-where after the problem is solved.

• Pulling from strengths and talents of client’s significant others gives the client a view of solutions’ impact.

(Cepeda, 2006)

Interviewing StepsInterviewing Steps

•MED-STAT•M- Miracle Question•E- Exceptions•D- Difference•S- Scaling•T- Time-Out•A- Accolades•T- Task

•MED-STAT•M- Miracle Question•E- Exceptions•D- Difference•S- Scaling•T- Time-Out•A- Accolades•T- Task



(Giorlando, 1997)

FrameworkFramework• Focusing on strengths and solution talk will increase the likelihood that therapy will be brief.

• Solution-building conversation identify, elaborate, and reinforce change behavior.

• Individuals who come to therapy do have the capacity to act effectively, temporarily blocked by negative cognitions.

• Clients are experts on their lives. Therapist role is to support and amplify this expertise.

• Focusing on strengths and solution talk will increase the likelihood that therapy will be brief.

• Solution-building conversation identify, elaborate, and reinforce change behavior.

• Individuals who come to therapy do have the capacity to act effectively, temporarily blocked by negative cognitions.

• Clients are experts on their lives. Therapist role is to support and amplify this expertise.

FrameworkFramework• There are exceptions to every problem that are often undervalued.

• Presupposition language emphasizes the resumption that change will occur, creating an atmosphere of “when,” not “if.”

• Therapists invite clients to view their problems from a different side. Client tend to present one side of the problem.

• Patients have strengths, resources, and coping skills that drive change while generating optimism and hope.

• There are exceptions to every problem that are often undervalued.

• Presupposition language emphasizes the resumption that change will occur, creating an atmosphere of “when,” not “if.”

• Therapists invite clients to view their problems from a different side. Client tend to present one side of the problem.

• Patients have strengths, resources, and coping skills that drive change while generating optimism and hope.

FrameworkFramework• Small change fosters bigger change.• Extensive information about a problem is rarely necessary to bring about change.

• Client has to want to change.• As each individual is unique, so toois every solution.

• Solutions evolve through conversation.

• Small change fosters bigger change.• Extensive information about a problem is rarely necessary to bring about change.

• Client has to want to change.• As each individual is unique, so toois every solution.

• Solutions evolve through conversation.



FrameworkFramework• Emphasizing solutions, positives, and possibilities to facilitate change.

• There is no one right way to view things, different views may be equally valid and fit the facts equally well.

• Change in one domain influences connected domains. Modest changes may lead to substantial differences.

• Emphasizing solutions, positives, and possibilities to facilitate change.

• There is no one right way to view things, different views may be equally valid and fit the facts equally well.

• Change in one domain influences connected domains. Modest changes may lead to substantial differences.



Therapeutic Practices & Techniques

Therapeutic Practices & Techniques

• Focusing on client’s solutions is integral to solution-focused therapy. Counselors identify possible solutions by asking clients what they value and want to maintain.

• During the initial therapy session, it is common for solution focused therapists to ask, “What have you done since you called for the appointment that has made a difference in your problem?”

• Focusing on client’s solutions is integral to solution-focused therapy. Counselors identify possible solutions by asking clients what they value and want to maintain.

• During the initial therapy session, it is common for solution focused therapists to ask, “What have you done since you called for the appointment that has made a difference in your problem?”

Therapeutic Practices& Techniques


• Another integral part of solution focused-therapy is a focus on goals.

• Counselors might ask at a beginning of a session: ‘What is your goal for today’? Or ‘What would you like to get out of our time together today?’

• Another integral part of solution focused-therapy is a focus on goals.

• Counselors might ask at a beginning of a session: ‘What is your goal for today’? Or ‘What would you like to get out of our time together today?’



• Counselors look for exceptions to the problem by asking the client to recount when the problem did not occur.

• Counselors use the “miracle question,” which consist of asking the client how they would know that the problem was gone.

• Counselors look for exceptions to the problem by asking the client to recount when the problem did not occur.

• Counselors use the “miracle question,” which consist of asking the client how they would know that the problem was gone.



• Counselors also use a technique called normalizing the narrative. This means the counselor focuses on the idea that we all have concerns and that it is possible to do something about them.

• Solution-focused counselors search for client’s strengths during their sessions. These strengths can be personal assets, community assets, cultural and/or spiritual strengths.

• Counselors also use a technique called normalizing the narrative. This means the counselor focuses on the idea that we all have concerns and that it is possible to do something about them.

• Solution-focused counselors search for client’s strengths during their sessions. These strengths can be personal assets, community assets, cultural and/or spiritual strengths.



• Counselors use scaling questions to help clients pay closer attention to what they are doing and how they can take steps that will lead to changes they desire.

• The Formula First Session Task (FFST) is a form of homework a therapist might give clients to complete between their first and second session.

• Counselors use scaling questions to help clients pay closer attention to what they are doing and how they can take steps that will lead to changes they desire.

• The Formula First Session Task (FFST) is a form of homework a therapist might give clients to complete between their first and second session.



• Counselors usually take a break of 5 to 10 minutes toward the end of each session to compose a summary message for clients.

• The structure of the summary message includes compliments, a bridge, and suggesting tasks to clients.

• Counselors usually take a break of 5 to 10 minutes toward the end of each session to compose a summary message for clients.

• The structure of the summary message includes compliments, a bridge, and suggesting tasks to clients.



• Elements of SFBT interviewing:• Language: reflects “problems and solutions are subject to perceptions and open to change”

• Problem free-talk: focuses on competence and strength

• Exceptions: exception questions • Goals: detailed, specific, realistic, observable

• Hypothetical future: the miracle question• Rating scales: scaling questions• Tasks and compliments: observing exceptions, doing more what works or something different when the problem arises

• Elements of SFBT interviewing:• Language: reflects “problems and solutions are subject to perceptions and open to change”

• Problem free-talk: focuses on competence and strength

• Exceptions: exception questions • Goals: detailed, specific, realistic, observable

• Hypothetical future: the miracle question• Rating scales: scaling questions• Tasks and compliments: observing exceptions, doing more what works or something different when the problem arises

Lloyd & Dallos (2008)



• Application to group counseling:• Share group members’ problem briefly, which helps the members see themselves less problematic.

• Facilitates members to view other members as being resourceful.

• Promote members to keep on a solution track (not problem).

• Develop well-formed goals (small, realistic, & achievable) soon using therapeutic questions.

• Ask when their problems were not present, and then, other members become an observer of each member’s competency.

• Make members identify exceptions of their problems and recognize personal resiliency and competency.

• Application to group counseling:• Share group members’ problem briefly, which helps the members see themselves less problematic.

• Facilitates members to view other members as being resourceful.

• Promote members to keep on a solution track (not problem).

• Develop well-formed goals (small, realistic, & achievable) soon using therapeutic questions.

• Ask when their problems were not present, and then, other members become an observer of each member’s competency.

• Make members identify exceptions of their problems and recognize personal resiliency and competency.



• Application of SFT to various areas:• School setting (Kim & Franklin, 2009) • Organization setting (Bloor & Pearson, 2004)

• Psychiatric in-patient setting (Hagen & Mitchell, 2001)

• Integration of SFT with other therapies with:• Person-centered therapy (Cepeda & Davenport, 2006)

• Art therapy (Matto, Corcoran, & Fassler, 2003)

• Play therapy (Taylor, 2009)

• Application of SFT to various areas:• School setting (Kim & Franklin, 2009) • Organization setting (Bloor & Pearson, 2004)

• Psychiatric in-patient setting (Hagen & Mitchell, 2001)

• Integration of SFT with other therapies with:• Person-centered therapy (Cepeda & Davenport, 2006)

• Art therapy (Matto, Corcoran, & Fassler, 2003)

• Play therapy (Taylor, 2009)

Effect sizes of SFT social work studies (Corcoran & Pillai, 2009, p. 239)

Role of TherapistRole of Therapist

• According to Guterman (2006) “therapists have expertise in the process of change, but clients are the experts on what they want changed.”

• Therapists:• Adopt a not-knowing position.• Help point clients in the right direction.

• Strive for collaborative relationships.

• According to Guterman (2006) “therapists have expertise in the process of change, but clients are the experts on what they want changed.”

• Therapists:• Adopt a not-knowing position.• Help point clients in the right direction.

• Strive for collaborative relationships.

Questions a Therapist might ask:

Questions a Therapist might ask:• What do you want from coming here?

• How would that make a difference for you?

• What might be some signs to you that the changes you want are happening?

• What do you want from coming here?

• How would that make a difference for you?

• What might be some signs to you that the changes you want are happening?





StrengthsStrengths

• In general, studies provided preliminary support for the efficacy of solution-focused brief therapy.

• Client provide their own interpretation of life events.

• Time limited.• Goals are set by clients.

• In general, studies provided preliminary support for the efficacy of solution-focused brief therapy.

• Client provide their own interpretation of life events.

• Time limited.• Goals are set by clients.



LimitationsLimitations

• No set of formulas or recipes to follow.

• Diverse clients may expect therapist as a expert instead of “client-as-expert.”

• For disabled/child client.• For mandatory counseling client do not want to change.

• What about discovering the potential problem?

• No set of formulas or recipes to follow.

• Diverse clients may expect therapist as a expert instead of “client-as-expert.”

• For disabled/child client.• For mandatory counseling client do not want to change.

• What about discovering the potential problem?

Questions or Comments?Questions or Comments?

References:References:Bloor, R., & Pearson, D. (2004). Brief solution-focused organizational re-design : A model for international mental health consultancy. International Journal of Mental Health,

33, 44-53.Cepeda, L.M., & Davenport, D.S. (2006) Person-centered therapy and solution-focused brief therapy: An integration of present and future awareness. Psychotherapy: Theory,

Research, Practice, Training, 43(1), 1-12Corcoran, J., & Pillai, V. (2009). A review of the research on solution-focused therapy. British Journal of Social Work, 39, 234–242.Guterman, J. T. (2006). Mastering the art of solution-focused counseling. Alexandria, VA: American Counseling AssociationCorey, G. (2009). Theory and practice of counseling and psychotherapy (8th ed.). California: Wadsworth. Dermer, B., S., Hemesath, C., W., & Russell, C., S., (1998) A feminist critique of solution focused therapy. The American Journal of Play Therapy, 26, 239-373Giorlando, M., E., & Schilling, R., J., (1997). On Becoming a Solution-focused Physician: The MED-STAT Acronym. Families Systems and Health 15(4), 361-373Greeberg, G., Ganshorn, K., & Danilkewich, A., (2001). Solution-Focused Therapy: Counseling Model for Busy Family Physicians. Canadian Family Physician. 47, 2289-

2295Gregoire, J., & Jungers, C. (2007). Solution-Focused brief family therapy. The Counselor's Companion: What Every Beginning Counselor Needs to Know (1 ed., pp. 394-

395). Mahwah, NJ: Lawrence Erlbaum.Guterman, J. T. (2006). Mastering the art of solution-focused counseling. Alexandria, VA: American Counseling AssociationHagen, B. F., & Mitchell, D. L. (2001). Might within the madness: Solution-focused therapy and thought-disordered clients. Archives of Psychiatric Nursing, 15, 86-93.Ivey, A., Ivey, M., & Zalaquett, C. (2009). Microskills and counseling theory: Sequencing skills and interview stages. Intentional Interviewing & Counseling (pp. 396-438).

California: Wadsworth.Kim, J. S., & Franklin, C.(2009) Solution-focused brief therapy in schools: A review of the outcome literature. Children and Youth Services Review, 31,464-470.Lethem, J. (2002). Brief solution focused therapy. Child and adolescent mental health, 7, 4, 189-192.Lipchik, E. (2002). Beyond technique in solution-focused therapy: Working with emotions and the therapeutic relationship. New York: The Guilford Press. Lloyd, H., & Dallos, R. (2008). First session solution-focused brief therapy with families who have a child with severe intellectual disabilities: mothers' experiences and views.

Journal of Family Therapy, 30, 5-28.Matto, H., Corcoran, J. Fassler, A. (2003).Integrating solution-focused and art therapies for substance abuse treatment: guidelines for practice. The Arts in Psychotherapy,

30(5), 265-272.O'Hanlon, B. (2000). Do one thing different: Ten simple ways to change your life. New York: Harper Collins publishers. O'Hanlon, B., & Weiner-Davis, M. (2003). In search of solutions: A new direction in psychotherapy. New York: W. W. Norton & Company. Taylor, E. R. (2009). Sandtray and solution-focused therapy. International Journal of Play Therapy, 18, 56-68.

Bloor, R., & Pearson, D. (2004). Brief solution-focused organizational re-design : A model for international mental health consultancy. International Journal of Mental Health, 33, 44-53.

Cepeda, L.M., & Davenport, D.S. (2006) Person-centered therapy and solution-focused brief therapy: An integration of present and future awareness. Psychotherapy: Theory, Research, Practice, Training, 43(1), 1-12

Corcoran, J., & Pillai, V. (2009). A review of the research on solution-focused therapy. British Journal of Social Work, 39, 234–242.Guterman, J. T. (2006). Mastering the art of solution-focused counseling. Alexandria, VA: American Counseling AssociationCorey, G. (2009). Theory and practice of counseling and psychotherapy (8th ed.). California: Wadsworth. Dermer, B., S., Hemesath, C., W., & Russell, C., S., (1998) A feminist critique of solution focused therapy. The American Journal of Play Therapy, 26, 239-373Giorlando, M., E., & Schilling, R., J., (1997). On Becoming a Solution-focused Physician: The MED-STAT Acronym. Families Systems and Health 15(4), 361-373Greeberg, G., Ganshorn, K., & Danilkewich, A., (2001). Solution-Focused Therapy: Counseling Model for Busy Family Physicians. Canadian Family Physician. 47, 2289-

2295Gregoire, J., & Jungers, C. (2007). Solution-Focused brief family therapy. The Counselor's Companion: What Every Beginning Counselor Needs to Know (1 ed., pp. 394-

395). Mahwah, NJ: Lawrence Erlbaum.Guterman, J. T. (2006). Mastering the art of solution-focused counseling. Alexandria, VA: American Counseling AssociationHagen, B. F., & Mitchell, D. L. (2001). Might within the madness: Solution-focused therapy and thought-disordered clients. Archives of Psychiatric Nursing, 15, 86-93.Ivey, A., Ivey, M., & Zalaquett, C. (2009). Microskills and counseling theory: Sequencing skills and interview stages. Intentional Interviewing & Counseling (pp. 396-438).

California: Wadsworth.Kim, J. S., & Franklin, C.(2009) Solution-focused brief therapy in schools: A review of the outcome literature. Children and Youth Services Review, 31,464-470.Lethem, J. (2002). Brief solution focused therapy. Child and adolescent mental health, 7, 4, 189-192.Lipchik, E. (2002). Beyond technique in solution-focused therapy: Working with emotions and the therapeutic relationship. New York: The Guilford Press. Lloyd, H., & Dallos, R. (2008). First session solution-focused brief therapy with families who have a child with severe intellectual disabilities: mothers' experiences and views.

Journal of Family Therapy, 30, 5-28.Matto, H., Corcoran, J. Fassler, A. (2003).Integrating solution-focused and art therapies for substance abuse treatment: guidelines for practice. The Arts in Psychotherapy,

30(5), 265-272.O'Hanlon, B. (2000). Do one thing different: Ten simple ways to change your life. New York: Harper Collins publishers. O'Hanlon, B., & Weiner-Davis, M. (2003). In search of solutions: A new direction in psychotherapy. New York: W. W. Norton & Company. Taylor, E. R. (2009). Sandtray and solution-focused therapy. International Journal of Play Therapy, 18, 56-68.

Documents

Solution Focused Brief Therapy Ball State University Khoolod, Angela, Melanie, Elise, Hyoseok, Lei, Manisha, Tamding, Allison