solution focused counseling : foundations and applications

SOLUTION FOCUSED COUNSELING: FOUNDATIONS

AND APPLICATIONS

Michele Aluoch, PCCRiver of Life Professional Counseling LLC

c.2014

Facts About Solution Focused Therapy

Average length of sessions= 5-8 sessions for SFT Average length of sessions for SFBT is 1-3

sessions Max benefits of treatment are usually achieved

win 6-8 sessions for 75% or more of patients. Graduate students in research studies endorsed

and had the most successes with solution-focused approaches compared to other treatment approaches: saw real transformation and maintained changes in clients, ease of use

Facts About Solution Focused Therapy

With 80% of patients in a 2005 study having 4 sessions or fewer still 77% maintained symptom reduction at 9 month follow up (Rothwell, N., 2005)

Why Do People Have Problems?

They do things that don’t work. They don’t have an expectation of

change Lack of insight/awareness Not doing the right thing enough Unwillingness to do something different

What Keeps People Stuck Don’t listen to anybody. Listen to everybody. Endlessly analyze and never change

anything. Blame others. Blame yourself. Keep doing what does not work.

What Keeps People Stuck Keep focusing on the same things when

that does not help. Keep thinking the same thoughts that

doesn’t help. Keep putting yourself in unhelpful

environments. Keep relating to unhelpful people.

Basic Tenants of the Solution-Focused Approach

What works in spite of what doesn’t work Looking for exceptions Planning experiments and tests There is some good even in bad or unpleasant

circumstances. Nothing stays awful forever. If you have done something that works one time

before you can do it again- twice, ten times, etc. If you have done something for a small length of

time you can do it a little longer until it becomes a new habit.

Basic Tenants of the Solution-Focused Approach

Clients want things to be different to where they are not so problem bound.

Clients would not come to us if they did not believe things could be better.

Clients are capable of self evaluating. Clients are the experts on their own

lives. Treatment does not need to be scripted

to be successful and effective.

What Works in Spite Of What Doesn’t Work

Focus on client strengths A success driven model Solution building Focus on the desired outcome Uses success language: How have your

managed?... All clients have resource already.


1) A 22 year married couple states that their marriage is on the rocks again. When asked about their relationship history they state that they connected right away when

they met and moved in a few days later. Since then they both describe the relationships as “always intense-

sometimes in a good way, sometimes not.” Currently husband had been having another affair (1 of many

throughout the years) and is living with this other woman because of frustrations in the marriage. The wife

expresses anger but also admits throughout the last 22 years to having other men on the side. They both admit that “no matter what we’ve done through the years we

always come back to each other.”


2) A mother comes in stating that her daughter is nothing but strong willed, defiant, and opinionated. She wants her to be more happy and cooperative. She wants her daughter to have treatment for behavior issues.

3) A husband says his wife’s Bipolar “just plain gets to him.” He comments, “can’t she just be more self controlled and stop the mood swings?” He admits that on the other hand he would not want to lose her passion and enthusiasm as this is one of the things that drew him to her.


4) A family comes in stating that “no one ever agrees on anything.” The presenting problem is that the house has become increasingly chaotic all the time. The whole family agrees that things are out of hand with how they relate to each other. You ask if there was a time when things were different. They state “before we moved here. Life was consistent and predictable. We had the schools, friends, and jobs we had for over 10 years. This place is a world of difference and the only people we know are each other.”


5) A young adult is in trouble and is being referred by his company for counseling. The referral states that they are concerned that he is defensive, always gives input even when not asked, likes to do things his own way.” The client states that he “sees himself as made for so much more than just this current job.”


6) A young married coupe comes in after he had an affair with the neighbor lady. They are young and only married 5 years. Both state that “they have generally been happy” until recently. They met in a small town up north and their families knew each other from childhood. Both consider themselves to have strong values until this recent affair so they are shocked. They were actively involved in community events and church groups in the small town but haven’t really connected with people in the city since moving here. They have not found a church home in the last year so they are staying away from services. They used to


be involved in small town pot lucks and get togethers. They state that they were never partiers but they only way to get to know people in the current neighborhood is to “drink and watch sports at the block parties.” Both believe they let each other down by drinking and being around people with different values than they normally would. Both are desperate for friends and felt their compromising led them to drinking, the parties, and the husband’s affair. Both desire marriage reconciliation, maintanence of values, and communication with the old town 2 hours away in which they used to live.


7) A teenager has a disability. She always dreamed of being the athlete she was passionate about until her recent injury which put here in a wheelchair, She swam, ran, and played many seasonal sports until the day she was injured. Docs told her that she probably will not regain full use of her limbs except with exceptional therapy and practice. She feels out of place, battles depression and feels as if no peers really understand her. In one week she is to start mentoring jr. high girls in an after school program promoting self esteem called “You Can Do It.” She started writing a book about hopes and dreams but is unsure if she will finish it because she feels depressed, unattractive, and like her life is over since the mobility problems.


8) A man has tried to interview for job after job at his company only to find out each time he is turned down, he thinks deep down, “it’s all about who you know and who you are willing to play up to.” A colleague recently told him of a job he thinks this man is perfect for at a well know agency around town. The first reaction of the client is, “I should not even think about it because they probably have their cliques too” but the friend continues sharing how smart, creative, and relevant he believes the guy is for the job. With apprehension and doubt the gentleman schedules an interview not sure this job will come through either.


9) Grief seems to be unending for a young man in his early thirties. Matt buried 2 young children. Then one month ago his wife had a miscarriage. Matt’s best friend was shot and later died in the military. His mother recently let him know that she has terminal cancer. People say that Matt “is a strong person” but he admits to feeling weak. He is uncertain he can handle more bad news. He attends a grief support group in the community. Fellow members say that he has encouraged them. He agrees that in many situations he has been the “go to” person in life but is unsure he can do this anymore or take on one more thing. He believes he is at the end of his strength.


10) Allison was molested throughout childhood by her foster parents. Kids bullied her in school, Now here house was recently broken into, Her car also broke down and she has no money to pay for repairs. She feels like “bad things keep happening to her.” She is having flashbacks , sleep problems, and anxiety, and wondering if the problems will ever end. She says she has always been the victim in life and can’t handle it any more. She does consult with an older woman friend for emotional support and also periodically goes to “Victims of Crime” meetings in the community. She mentors other young women who have blamed themselves for being raped.

Things Will Change Planning for change vs. avoiding change Inevitable and constant Planting as seed in the client’s mind that

things always eventually turn around Therapist amplify change

Looking For Exceptions Even in the stressor or presenting

problem when does it not occur? Are there parts of the situation or

reactions which are useful? No problem happens all the time. Solutions are there already but just aren’t

implemented enough. 1) When you do not have the problem? 2) When the situation is “less bad?”

Looking For ExceptionsInsert Video

Planning Experiments and Tests

We can plan for alternatives to the presenting problem.

Therapist makes a suggestion of something to try.

Assignments outside the sessions used as adjuncts to the session.

Planning Experiments and Tests

Insert Video

There is some good even in what seems bad.

There are no problems... Only opportunities.

There are no failures.. Only learnings. There are thousands of solutions. There are no uncooperative people but

only people with unique ways of cooperating.

NO Real Resistance

PersistenceResistance

There is some good even in what seems bad.

Insert video.

Nothing stays awful forever. Give me the courage to change the things

I can change, the serenity to accept the things I cannot change and the wisdom to know the difference.

Situation What I Can’t Change What I Can Change

Moving Away From “Why?”

• Do I do from here?• Resources do I

need?• Will be different?

What• Do I manage from

here?• I get to the desired

behavior?How

Developing New Solution States

Visual Kinsethetic

Auditory Behavioral

Nothing stays awful forever.Insert video.

You can do the right thing more/longer until it is a habit.

Insert video.

MECSTAT Miracle Questions Exception Questions Coping Questions Scaling Questions Time Out Accolades Task

Miracle Questions A virtual reversal of the problem Rehearsing the preferred future If a miracle happened tonight what would be different? What if your problems were solved just like that?

What was the most recent thing that was just like this miracle?

0-10 miracle- don’t need to solve everything Small miracles Assumption: something happened and the problem is

gone. Co-constructing a new narrative with the therapist.

Miracle Questions Negotiated between the client and

therapist Deliberate wordsmithing What speakers talk into being A bringing forth of possibilities Framing as a fresh start

Exercise: Miracle Questions Anger management Unfaithfulness Behavior Problems Slacking/low motivation Work run ins with the supervisor

Exception Questions When was the problem less severe? What was happening? When doesn’t the problem happen? What would it take to recreate this? What would you have to do to create

more of this? Idea of camera check or video showing

something

Exercise: Exception Questions

How would you handle these? Drinking: “I’ve been drinking as long as I can

remember.” Anxiety: “I feel nervous and my heart races all the

time.” Relationships: “I am afraid my friend will leave me.” Marriage: “We never have any trust.” Job: “My boss is out to notice everything I do wrong.

He is waiting to fire me.” Negative Expectation: “Life never goes my way.

Nothing works out for me.”

Michele Aluoch

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Coping Questions How did you manage? What resources do you have? How could you do that again? What gets you through day to day? What is your greatest support? How did you get through that (in the

past)?

Accomplishment Questions How did you do that? How did you manage? Helping to get the client to realize that

someone thing positive happened as a result of their actions.

Scaling Questions Determining where a goal is at on the

scale now. Moving increments of one point. Scaling: preparedness for change,

readiness for new things, importance of a particular goal or desired outcome

Things get better, stay the same or get worse- how to frame for the client

Examples: Scaling Questions

Different dimensions of a young ladies life (Spiritual, intellectual, personal, etc.- what would these look like and in relationship to each other.

Example: Framing if things got better Example: Framing if things stayed the

same

Goal Questions How will we know when therapy was

successful? How will we know when therapy should

end? Looking at what elements are necessary

for problem resolution.

Typical SFT Questions What are your hopes from our work

together? How will you/other know that having

been here was useful for you? What would be the signs that you are

better? Supposing a miracle happened: what

would be different? What would one step in the right

direction look like?

Compliments or Praise How did you do that? Most people ____ yet you managed ____.

How did you decide _______ instead? To help give clients credit for their

accomplishments, good intentions or functioning.

Time Out Avoiding toxic behavior Indirectly increasing the positive

Solution Focused Therapeutic Conversations

Problem focus Solution FocusedHow long have you been What would it be like if you depressed? were not depressed?What happens when you areanxious?When your relationship problemsare worse between you and yourparents how do you act?Tell me about the nights when youcry yourself to sleep.Everywhere you go there seemsto be pain and grief.

Accolades Compliments are important to producing

change in client. Must be verbalized. Looking for consistent positive feedback

“in spite of”

Examples: Accolades Insecure/no boundaries: Never could

speak out assertively and finely stated feelings

Not a risk taker and finely tried out for team, new job, etc.

Task Concrete way of keeping what is

productive or on the path to the goal going

Homework is not best when created by the therapist.

Emphasis on the client doing his/her work

First Session: between now and next time, we would like you to observe so you can describe to us what you would like to continue happening in your life.

Task Specific observations: Observe times

between now and next time when you and ____ could have done (neg. behavior) and didn’t. Observe times where (pos. behavior) occurred.

I am betting you won’t notice how things are.

Do one thing differently. Change on part of a problem: the timing,

your body patterns, what you say, where you act, the order you do things in, the speed at which you do things, etc. (e.g. Bill’s anger)

Think of something someone else does that works.

Focus on what you could concretely do instead of what you feel.

Change what you are focusing on.

Do one thing differently. Imagine not having the problem. Create a solution focused narrative.

What were you doing, focusing on? Focus outside yourself on God, faith. Act rather than analyzing the problem

more. Use solution focused words to affirm behaviors you want (e.g. “I like it when….)

Exercise: Do something Differently

What way can the person change his or her actions?

Bob is frustrated with his classmates. When he gets answers wrong some classmates laugh at him and talk about how stupid he is. He gives them dirty looks back, screams, “Stop it! Stop it!” and cries. He does not even want to go to school anymore at this point .


Mary hates going out in public because she feels on the spot. She scopes out and notices all the people she sees looking at her. Her heart races then and she has often run out of social situations because of it. She leaves groceries behind, misses numerous appointments, and sees her family and friends less often. She is becoming more home bound and states, “this is the only place I am safe from people’s opinions.”


Andrew tries to ask a girl he likes for a date. It takes him a lot of courage but when he asks her she turns him down. He determines not to talk to people again or take risks. He sits in the corner of the lunchroom, refuses to talk to people and ignores others’ attempts at conversation with him stating that “he knows they will turn out bad too so why even try.”

Exercise: Do something Differently Think of something else someone else does.

Todd gets angry when things don’t go his way. He threatens people to make them do what he wants but now he is finding out that many people are fed up and just avoid him anymore.

Ann always sits in the corner of the room in college. He prefers to not be noticed. When the professor asks her something directly she wispers and talks very quietly often hiding her face or looking down or away from others.


Dave determines that the only way out of his trouble is suicide. More and more stresses pile up at every turn. He thinks that just when he wants to deal with one thing another comes. Since his life is full of surprises and is much harder than anyone else’s life he should just end it all. That is the only way he believes he can have less stress in life.


Focus on what you will concretely do instead of what you feel.

“All eyes are on me,” says anxious Patty. “I know I should not try new things because people will tell how bad I am. I feel sure that they an all tell how inexperienced I am and awful that I should not be even trying out for the play.”


Diane states , “I feel very self conscious. I do not like the way I am. Wish I looked differently, had better clothes, and didn’t seem so awkward to others. I always feel on the spot.”

Jim feels doubtful about interviewing for another job because when he interviews things usually do not come through. It is not just jobs though but many businesses he’s tried and relationships he sought out have had their rough spots. Why try again? He reasons. It feels like I’m up against a brick wall.


Change what you are focusing on.

Lucy looks out at the crowds of people and scans their faces before her speech. She studies the faces closely and notices how many people appear to not be exited about being there. She is sure they will not be receptive to what she has to say.


Daniel suffers from chronic pain. He states that his back , spine and knees constantly give him trouble. He is always aware of how his body is “falling apart” and that he is not as young and vibrant as he used to be.

Amber looks out her window daily to see reminders of living in a poverty stricken, unsafe neighborhood because this is all she can afford now. She frequently thinks about how she will never have anything better.


Imagine not having the problem.

Amy has become increasingly depressed to where she does not want to get out of bed, bathe or attend to tasks of daily living. She no longer visits neighbors. She eats less because even making food takes too much energy. She stays in bed at least 12-16 hours per day to forget about life.

Exercise: Do something Differently Ramon is fearful about is job because the company

is unstable. Every day he waits to hear whether he is the next one gone as the company is downsizing. He believes it is just a matter of time before he is gone too.

Caroline is doubtful whether or not she will make any real, long lasting friends since she has not connected with anyone since moving from another town 3 months ago. She feels out of place and is not sure that she will ever have anything in common with the people from the big city.

Changing Narratives What happens when others do not view

the person as mentally ill, crazy, incompetent, depressed etc.

Are there other people who managed through similar situations?

Restorative narratives Normalizing things people face

Changing Narratives Using the narrative to provide insight

into self, beliefs, values, goals Identify choices. Considering various endings to the story.

Changing Narratives Change these problem focused narratives to

solution focused narratives.

Bad things keep happening to me. Everywhere I turn there is another issue to deal with. I slipped on the ice one month ago and twisted my ankle. Now I got in a car accident. I lost my job one week ago too. All there is to do is sit at home and wait for the next bad thing around the bend. Life doesn’t seem to work well for me.

Changing Narratives Once I was a young vibrant leader of the team.

I was so fit and able to do it all. But after my work accident I can never hope to be the athlete I once was. The physical therapy is challenging and reminds me of how disabled I am. Going around my buddies and seeing them throw the football in Jim’s yard while I sit at the sidelines is degrading. I’ll only ever be the great athlete of the past. I’m just a typical slowed down 50 year old like others who never were great athletes. What was all my physical hard work even for!

Changing Narratives The flashbacks and nightmares will never

stop. I lived through a horror movie. My childhood was one abuse by mom’s different boyfriends after another. I see people so happy and trusting in relationships but I know that can never be me. People only hurt, betray, and cut down others. There is nowhere to really feel safe. If you weren’t safe in your own home how can you be safe anywhere?

Focus on God or faith.

You realize that stopping the alcohol abuse and addiction is beyond you. Many generations of your family have had alcohol problems. You can never take just one drink because it always ends up in binging, fights, and blackouts.

Focus on God or faith. Your moodswings make it hard to handle

interpersonal situations. It is challenging to be flexible. Things get to you easily. You are helpless to change unless you look outside yourself.

So many times you have said, “I feel awful. All can see is anxiety and depression. Life is paralyzing and immobilizing. When I look at myself I am miserable.”

Focus on God or faith. Too many stressors seem to be

happening at once. It seems like it has been a long time since something went well for you the way you think it does for others. Two years ago there was someone thing you worked hard at and waited on and had faith for. Then one of your dreams came true.

Highlight what works well in words.

Use language to highlight what you like: “I like it when.”

In talks with my spouse I often do not feel like he listens well. It seems like we talk two different languages. But every now and then it seems like he will understand what I am saying. He will pause, stop what he is doing and look at me and really hear me out.

Highlight what works well in words.

Many times my teenage children seem to have minds of their own. They don’t seem to care about my rules at all. They tell me they just want to do their own things But the other day I had the surprise of my life because they cleaned their rooms and talked very respectfully to me and said, “Happy birthday, mom. We love you.”

The team at work I lead seems to be very inconsistent with their productivity Some days it seems like they are slow and take all the time in the world to even get started. But when the nice weather started they worked harder and faster and got nearly double the productivity so they could go home earlier. It helped the company. Too bad they don’t have this work ethic on a regular basis.

The Language of Change Method/Technique: Therapeutic Dialogue Questioning Staging conversations: 1. Client concerns 2. Important topics 3. Exceptions and strengths 4. Resources available 5. Scaling to increase motivation for change 6. Scaling to reach the preferred future

The Language of Change Refer to the problem in past language:

“was”, “were”, “have been” versus “is” or “are”

Create expectancy- “when” versus “if” Avoid yes and no questions. Invoke

narrative. Assume problem free times. Use fast forward questions: who will

notice improvements? What will they say? How will they respond? What will you be doing?

The Language of Change Small changes are emphasized One ball or one layer at a time Shift from impossible and what’s out of

or hands to what we can do

The ACCEPT FrameworkAcknowledge, validate, and value.- attending

to client’s perceptions, normalizing experienceClarifying concerns- discovering what would

be a successful outcome for the clientChanging or challenging what is being

attended to and how it is doneEvaluating progress- are the beliefs and

actions helpful?

The ACCEPT FrameworkPlanning next steps- Set up experiments. What

is progress? Try more of what works, less of what doesn’t work. Modify as needed in small steps.

Terminating treatment- Once client is implementing viable solutions and has understanding of the possibility, solution focused applications allow them to take responsibility for applying the framework in other areas of their life

Link Past, Present, Future Past- strengths, abilities Present- clients goals, desired outcomes Future- Possibilities

Client Centered Therapist as facilitator Clients set the goals Clients shape how goals are defined Clients shape what defines when goals are

reached (scaling) Clients shape the success of counseling by

their narrative About clients working through

THE CLIENT IS THE EXPERT !!!

Client Centered Clients should always be consulted regarding

goals, directions, and interventions of therapy. Diagnosis, treatment, and notes are made

available readily to the client as a partner in determining the course of therapy.

Simple, non clinical language is used. The client’s language is used. Clients are not passive people coming to an

expert but rather are active contributors in their own planning and treatment.

Key IngredientsCooperative Therapeutic Alliance Warmth Positive Regard seeing the good in

people Flexible to new ideas Listen for solutions in problem language

PROCESS VARIABLES Still critical foundations for success Empathy Non possessive warmth Genuineness Whose are these? (Counselor Versus Client?) Hypothesis #1: Good counselors enhance treatment

when they have high levels of these variables. Hypothesis #2: Clients determine the levels of

variables. Good clients elicit high variables but poor clients elicit low variables.

NON-POSESSIVE WARMTH- mutual function EMPATHY/GENUINENESS- under control of the therapist

The Person-Centered Approach

(Original Outlook): Rogers- 1957 1. Two people in psychological contact 2. The client feels vulnerable or anxious about

something 3. The therapist is congruent and integrated 4. The therapist has unconditional positive regard

for the client. 5. The therapist shows an empathic understanding

of the client’s frame of reference. 6. The values listed above are communicated

directly to the client.

Defining Empathy(Peterson, 2007; Miville, M.L., Carlozzi, A.F., Gushue, G.V., Schara, S.L., Ueda, M., 2006;

Vanearschot, G., 2007)

1) A mode of experiencing the client

2) An ability to communicate this understanding back to the client

3) Both affective and cognitive components

Three Types of Empathy (Clark, A.J., 2010)

1. Subjective- momentary experiencing in session what it may be like to be the client

2. Interpersonal empathy-Interpretation of the client’s internal frame of reference

3. Objective empathy- the factual components of behavior

Solution Focused Assessment

Relabel what clients put in the past so as not to hinder forward movement on goals:

“I’m so depressed all the time.” “You have been depressed.”

Decrease the generalizability of the problem. “I don’t recall when I’m not miserable.

Everywhere life is awful.” “You have felt depressed much of the time

lately.”

Solution Focused Assessment

Introduce a possibility mindset. “I will never meet friends. They will

abandon and betray me too. How can I ever trust anyone?”

“You would like to consider getting into a safe healthy new relationship.”

The Questions of Solution Focused Assessment

How will we know when it’s time to leave therapy? When can we say that therapy is successful?

What kind of changes would you make?” When were you pleased about how

things were going? What was happening?

What approach worked best for you?” “What was your favorite _____ ?”


How will we know therapy has been successful?

Who decided that this treatment was good for you?

What shows that this is the best way for you to solve things?

What will others see when you are better?

How would you deal with ____ if things were better?”


What meds, therapies, decisions, actions, etc. worked best for you?

What has been most valuable to you? What would a future free of this problem

look like? What is going well? How could we use

that to our advantage?

Listening To The Client Honor the clients story. Be willing to do nothing. Sit with the client. Resist the urge to fix. Give credit for small efforts.

Key IngredientsSolution Focus There is something you do well. You just

don’t know it. Recollecting what works. Creating insight and understanding of

what is useful and advantageous for this client, this situation, this setting, etc.

Key Ingredients Answers are within the clients. Clients generally know what to do . They

just don’t do it enough. Clients have strengths in the midst of

perceived weaknesses. Breaking down the problem past is not

useful to recovery and goal attainment. Diagnosis should not be the emphasis.

Key Ingredients

Measurable Behavioral Goals How can I be useful to you? What would others notice if therapy worked fro you? How would we know therapy did what it was

supposed to do? What needs to be different for your life to be as

you’d like it? Multiple simultaneous goals Describe production action rather than absence of

action Realistic and achievable

Key Ingredients All behaviors have contexts.

Context

Individual

Interpersonal

Socio-cultural

Other

Key IngredientsMeasurable Behavioral Goals Actions are changeable. Actions do not need to be changed all at

once. Small steps can caused positive chain

reactions in other areas. Emphasize why the problem is not

worse. Talk a lot about what happens when

things work.

Key IngredientsClient Evaluation (Through Scaling) Putting a 1-10 number on motivation,

preparedness, importance of goal, progress

Areas That Can Be Changed Location Timing Frequency Interactions Antecedents Duration Nonverbals Sequences of actions Attention Reactions

Facilitating Solutions Previous solutions Exceptions Competencies Goals, hopes Possibilities

Action PlansSMART

SmallMeasurableAchievableRealisticTimeline

Exercise: Concrete, Behavioral Solution-Focused Goals

Stated Goal New Concrete, Behavioral Goal

To feel less depressed

To be more confident and assertiveTo not be so fearful in new situationsTo have a better relationship with my childTo improve the quality of my marriageTo be more motivated in school

To take care of myself better

The Language of Solution 1. exceptions to the rule (e.g when you weren’t

hopeless or acted in spite of panic) 2. the end game- thinking about what life will be like

when the problem has ended 3.highlighting choice- there are always a variety of

reactions 4. find contexts of competence (if you face this..

how to handle) 5. worst case comparison- why not worse? 6. tapping into altruistic experience- how you

learned and applied something to help others with similar issues

Types of Scaling Willing to change scaling Confidence in change scaling Relationship scaling Behavioral outcomes scaling

Key IngredientsAn active approach by setting up situations outside therapy What do you like about yourself? What are 2 things to try? What are some things that happened

right? What would hope look like?

Examples of Thoughts Provoking Considerations For Clients

Who I can trust Who I can share my story with Who helps me be less depressed, anxious,

etc. Who can get me the resources or support I

am looking for Who will leave me alone unless I need them Who/what promotes hope What helps me regain control in my life

Key IngredientsCompliments Validating is a key element. Building therapeutic alliance Building client competency In midst of genuine supportive relationship Affirmation needs to be verbal in the

therapeutic process. Affirmation needs to be specific and

behavioral.

Key Ingredients Do something different. Don’t continue what does not work. This may include switching therapist and

techniques Change goals. Change anything!!! Disrupting the

system often creates positive

Termination in Solution Focused Counseling

How will we know we have reached goals?

How do we know when to stop meeting like this?

Solution Focused Groups Change is constant. Change is inevitable. The group dynamics embody the

changes of the individuals in time

Comparison of Traditional and Solution-Focused Therapies

Traditional Counseling Solution Focused CounselingImpairments, deficits Competence, abilities,

possibilitiesPathology HealthResistance, defenses, hidden agendas

Good intentions, cooperation

Cure Consultation, small changesTherapist as expert Therapy is collaborative, shared

experience, client is expert

Comparison of Traditional and Solution-Focused Therapies

Traditional Counseling Solution Focused CounselingWorking through, insight Goals, behaviors, resultsPast Present, futureExpression of emotion Validation of experienceDiagnosis Change orientationProblem identity, character, personality

Productive action, process

Couples SFT Talk about what works. Avoid blame. Use I messages to summarize and

empathize with each other. Use action requests. Affirm helpful behaviors. Change only your part. If things aren’t working change it. Don’t

repeat the same things which don’t work.

Drug and Alcohol Treatment De- emphasize labels of alcoholic and

addict Focus on personal choices. Look at interpersonal dynamics which

contribute to denial and resistance. Acknowledge client concerns. Encourage alternative behaviors. Disease concept is not helpful- maintains

problem focus, not truth.

Chronically Mentally Ill Patients

Don’t get hung up on diagnosis. Relate to the client. Help them deal with misperceptions by others and

self critical attitudes. Be flexible to learn from the client. Just because something seems chronic does not

mean it cannot change (e. 50-60% of schizophrenics significantly improve as they get older and learn to manage symptoms better)

Support client goals Reward small incremental goals rather than cures.

Career Counseling With SBTBurwell, R., & Chen, C.P. , 2006

Strong collaborative working alliance Therapist is curious and unknowing,

being taught by client Looking at accessible resources rather

than analyzing problems Developing viable vision and alternatives

which promote hope Finding alternative solutions with the last

option being changing work environment

Career Counseling With SBTBurwell, R., & Chen, C.P. , 2006

Don’t fix what is going well. Change what is not working. When is the problem not co-occuring? Goal oriented: multiple solutions, collaborative

constructing of problems and solutions Scaling- what would be the next step Normalizing problems Restructuring problems in context Affirming efforts in spite of problems

Career Counseling With SBT

When the problem was not there or was less of an issue what behavior choices were going on?

Imagining self five years for now without the problem. What needs to happen?

Educational Settings and SFTSimm,J.,& Ingram, R., 2008

Do problem solving with students using students own ideas

Educational staff using solution focused approaches in meetings

Using solution focused approaches for behavior plans and IEPs

Using solution focused approaches in peer supports

Educational Settings and SFTSimm,J.,& Ingram, R., 2008

Concentrating on solutions Felt like a relief More do-able More successful because based on students or staff’s

own ideas Empowering Not trying to impose something from without Not an assumption of teachers or administration being

the experts Within 20 minutes or less saw results from difficult

students Efficient problem solving

Reducing Truancy Through SFTEnea, V., & Dafinoiu, I, 2009

61% compared to 0% on control group Behavioral programs imposed from without

generally did not work Motivational interviewing and SFT did well

with truant kids Stimulated intrinsic motivation Focus on pros and cons of truancy,

development of trust, building strengths and resources, brainstorming and reframing, negotiating change

Reducing Truancy Through SFTEnea, V., & Dafinoiu, I, 2009

Imaging truancy not being a big issue Reflecting on times when this happened Affirming efforts and successes at getting

up, getting to school on time, etc. Scaling Supports need to lessen truancy Options to typical truancy behaviors-

eating out, walks, meeting up with friends, smoking/drugs, etc.

Domestic Violence Therapy Using SFTMilner, J., & Singleton, T., 2008

No single factor predicts re-offense Hearing client’s unique stories Client responsibility for development of

new behaviors Consideration of exceptions to the

problems that got them in trouble Framing in terms of choices and options Learning to monitor risk and use scaling

Sexual Abuse Survivors and SFTKress, V.E., & Hoffman, R.M., 2008

Shift from self as blame to alternative possibilities

Therapeutic stories Letter writing to those who have gone

through similar things- providing wisdom and support

New symbols and representations of overcoming

Management of strong feelings Increased self confidence

Sexual Abuse Survivors and SFTKress, V.E., & Hoffman, R.M., 2008

Improved self esteem Decreased isolation Better interpersonal connectedness Awareness of strengths they did perceive

before Increased future orientation

Examples: The Girl Who Didn’t Treat Herself Well, The Caterpillar

The Girl Who Didn’t Treat Herself Well

Once upon a time there was a very kind and caring girl who was kind to everyone she met. She was kind to her friends, her teacher, and her neighbors. Because she was so kind, friendly, and agreeable, pretty much everyone liked her. However the girl who was so nice to others was not so nice to herself. She did many things to herself that were not so nice. She would smoke, she did not sleep well, have fun doing things she enjoyed, didn’t keep safe, didn’t have a sense of humor and have fun, didn’t think about the future, ate unhealthy foods and never exercised. Because neglect can make a heart sad, her heart became very sad. “You are nice to everyone but me, cried the girl’s heart. But she continued to ignore it because she thought that everyone else was more important than she was, and she believed it was selfish to take care of her own heart.


So her heart continued to cry. The tears got so hard that they clogged up her heart. When this happened, the girl felt pains in her chest and all over her body. “You have been ignoring me as I’ve cried for you to be nice to me, so I am going to give you a pain that you won’t be able to ignore---- you need to pay proper attention to me---help me!” Her heart was right about that! The pain felt so bad that she decided to go to the hospital. The doctors took pictures of her heart and found that the tears had become so hard that they clogged up her arteries leading to her heart.


“We’ve got to fix your heart,” the doctors told her. “We are going to take you to surgery to repair the damage.” So that is just what they did.

As she recovered for her surgery the doctors came to talk to the girl. “We have heard that you are nice to everyone but we have discovered that you are not nice to yourself. From now on, you must be nice to yourself. You have to eat healthy foods and get enough sleep, think positively, plan your future, exercise, talk to your friends, be with safe people, and not smoke or do drugs. If you can learn to love your body and be nice to yourself in these ways, the pain in your heart will go away. Then your heart can be filled with love for yourself as well as for others- and you will be way happier!”


Because the girl was smart and because her heart had taught her a valuable lesson, she found ways to be nice to herself. She learned to think positive plan her future, sleep well, eat right and exercise, and do lots of really caring and safe things. She learned that the more safe and healthy things she did for herself the better she felt. She was soon able to be as good to herself as she was to others. And from that time on, her heart began to smile. The girl learned that having a heart filled with love means not only loving others but also loving yourself.

The CaterpillarOnce upon a time there was a caterpillar named Anna. Anna thought, “I am not colorful like birds. I do not flutter, fly, or pollinate flowers like butterflies. I don’t make beautiful noises like crickets. I’m really different.”

As the caterpillar grew, she noticed that children were even afraid of her. Some children would occasionally say ”ewwwww” or “yuck” when they saw her. Even when they didn’t say anything mean, she thought that they were thinking they did not like her. She wondered why she couldn’t be like the others- the birds, or the crickets, or even the soft and fuzzy squirrels. She thought those other creatures must be so much happier than she. All she knew was that she felt ugly.

The CaterpillarMostly though, she just didn’t think anyone noticed her or cared about her. With all these sad thoughts, it’s no wonder Anna felt bad and sad. “Why did this happen to me?” she would cry… why can’t I be a beautiful bird? No one else knows how it feels to be me…why? Why? Why? My destiny is to be ugly and to repulse others.”

She was afraid to tell others how hurt and sad she felt. One she tried to tell someone how she felt, and they ignored her; and this hurt even worse. She thought, that’s it. I can’t trust people and I can’t trust what I think and feel either. I am just an ugly caterpillar.” So Anna went on… fighting with herself and fighting against the world and how she thought everyone saw her.

The CaterpillarShe met several other caterpillars- they all quickly became friends. Anna somehow mustered up the courage to tell the other caterpillars how she felt. They chuckled to themselves and told her that she was beautiful inside and someday she would realize this beauty. “Deep inside,” they said, “you are a beautiful butterfly! She thought…”yeah right… I’m beautiful? Come on. They’re just saying that. I’m not beautiful on the inside or on the outside!”

The caterpillars told her that in order to become a butterfly she’d need to look inside for the beauty and the strength….that they could talk with her and support her but she had to believe in herself and have faith., and only then she could do what was necessary to change into a beautiful butterfly.

The CaterpillarAnna thought this was a hopeless and very silly thing to do. She thought this was fine for her friends but that she was different. She was more ugly and way worse off than them. “Even though my friends are caterpillars, “she said, “I’m different and more hopeless than them.”

So she sat…and sat,,,and sat…and watched her friends turn into butterflies and fly away. One day she became sick and tired of sitting. That’s it, she said. I’m going to really try to believe I’m beautiful. I’m going to think positive thoughts and I’m going to feel better…even if a little part of me is afraid to do that. I’m going to really look inside myself for my beauty. I’m not going to fight myself any more.

The CaterpillarAnd then… she put her energy into trying to find the beauty, and thinking positively and trying to be happy. It was so hard though; she had to be very patient and that was really frustrating!

But she tried and tried and tried and tried to see her beauty.

As she tried she noticed and began to develop a warm, safe cocoon around her little caterpillar body. It just sprang up! It felt a little scary and weird but a little nice also! She wanted to fight it but she didn’t fight it…she embraced it. But eventually the cocoon started to feel very comfortable and safe.

And then one day she emerged from her cocoon a beautiful butterfly!

The Caterpillar“You were always beautiful,” said one of the caterpillars. “You had to put your energy into believing and look what you’ve become.” As the butterfly thought about what had happened she realized that her beauty was buried inside her just waiting to be unleashed and that others could see it in there but she couldn’t.

Couples Therapy and SFT Couples can build on successes in spite of

perceived problems New healthy observable, measurable,

achievable goals can be worked on in small steps

We can find exceptions to the problem. Couples can actively seek and look for

change. Learning to discover a window on your

spouse’s world.

Couples Therapy and SFT Teach couples how to use solution

focused language with each another: “What was useful about this?” “What tells you we are at a ____ (#)? What would people notice first if we

changed that way? How does that help you? What would be useful right now?

Solution Focused Groups 4-6 sessions Time limited Very focused and goal directed action Transition away from problem language to

strengths based language Building on the multitude of examples in group Help overcome stuckness Empower group members Help people learn new skills and redefine

problems

Solution Focused Groups Improved overall well being New options and opportunities Address universal goal of a happier life

Spiritualty Based Clients Revisit spiritual moments and times. Recreate helpful spiritual experiences. Increase the frequency of what worked.

Bring those past experiences into the present.

Solution Focused SupervisionMcCurdy, K., 2006

Collaboration between supervisor and supervisees

Process variables highlighted Allows for imperfections in counselors Concentrating on what the supervisee is

doing rather than what he or she is not doing

Emphasizing on present performance rather than past failures

Solution Focused SupervisionMcCurdy, K., 2006

Rewarding effort rather than outcome Mistakes seen as learning experiences Allowing supervisees to role model and teach

others Referring clients to supervisees Inquiring about the supervisees perspective- “What

do you think is the most important part of this counseling or supervision relationship?”

Acting as if improvements happened Use of scaling (1-10) Noting exceptions to stuckness with clients

Bibliography Burwell, R., & Chen, C.P. (June 2006). Applying the principles and

techniques of solution-focused therapy to career counselling. Counselling Psychology Quarterly, 19(2), 189-203.

Enea, V., & Dafinoiu, I. (September 2009). Motivational solution focused intervention for reducing school truancy among adolescents. Journal of Cognitive and Behavioral Psychotherapies, 9(2), 185-198.

Kress, V.E., & Hoffman, R.M. (2008). Empowering adolesent survivors or sexual abuse: application of a solution-focused Erickson counseling group. Journal of Humanistic counseling, Education, and deelpoment,47, 172-186.

McCurdy, K.G. (Summer 2006). Adlerian supervision: A new perspective with a solution focus. The Journal of Individual Psychology, 62(2), 141-153.

Miller, J.H. (September 2010). Does teaching a solution-focused model of counselling work? A follow up of graduates. Counseling and Psychotherapy Research, 10(3), 173-182.

Milner, J., & Singleton, T. (2008). Domestic violence: Solution-focused practice with men and women who are violent. Journal of Family Therapy, 30, 29-53.

Bibliography Peacock, F. (2000). Water the flowers, not the weeds.

Montreal: Open Heart Publishing. Simm, J., & Kendal, R. (March 2008). Collaborative

action research to develop the use of solution-focused approaches. Educational Psychology in Practice, 24(1), 43-53.

Strong, T., & Pyle, N.R. (2009). Constructing a conversational “miracle”: Examining the “miracle question” as it is used in therapeutic dialogue. Journal of Constructivist Psychology, 22, 328-353.

Wilson, M. & Turneil, A. (1993. Introduction to Solution Focused Brief Therapy. Centrecare Brief Therapy Service.

solution focused counseling : foundations and applications

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