Solution Focused Therapy

[David Baxter PhD]

Solution Focused Techniques
Counselling Connection
Monday, March 30th, 2009

Solution focused therapies are founded on the rationale that there are exceptions to every problem and through examining these exceptions and having a clear vision of a preferred future, client and counsellor, together, can generate ides for solutions.

Solution focused therapists are competency and future focused. They highlight and utilise client strengths to enable a more effective future. In this article, we will look at commonly utilised solution focused techniques.

Basic Assumptions
The following assumptions provide the framework on which solution focused therapy is founded:

1. There are significant advantages in focusing on the positive and on solutions for the future. Focusing on strengths and solution-talk will increase the likelihood that therapy will be brief.
2. Individuals who come to therapy do have the capacity to act effectively. This capacity, however, is temporarily blocked by negative cognitions.
3. There are exceptions to every problem.
4. Clients tend to present one side of the problem. Solution focused therapists invite clients to view their problems from a different side.
5. Small change fosters bigger change.
6. Clients want to change, they have the capacity to change and they are doing their best to make change happen.
7. As each individual is unique, so too is every solution.

Source: Corey, G. (2005). Theory and practice of counseling and psychotherapy. (7th ed.). Belmont, CA: Wadsworth.

The Miracle Question
The miracle question is a technique that counsellors can use to assist clients to think ?outside the square? in regard to new possibilities and outcomes for the future.

?The miracle question has been asked thousands of times throughout the world. It has been refined as practitioners have experimented with different ways of asking it. The question is best asked deliberately and dramatically.

Now, I want to ask you a strange question. Suppose that while you are sleeping tonight and the entire house is quiet, a miracle happens. The miracle is that the problem which brought you here is solved. However because you are sleeping, you don?t know that the miracle has happened. So, when you wake up tomorrow morning, what will be different that will tell you that a miracle has happened and the problem which brought you here is solved?? (de Shazer, 1988, p. 5.)​

Asked this way, the miracle question requests clients to make a leap of faith and imagine how their life will be changed when the problem is solved. This is not easy for clients. It requires them to make a dramatic shift from problem saturated thinking to a focus on solutions. Most clients need time and assistance to make that shift. (De Jong & Kim Berg, 2002)

Exception Questions
Having created a detailed miracle picture, the counsellor has started to gain some understanding of what the client hopes to achieve and the counsellor and client can begin to work towards these solutions. This is achieved through highlighting exceptions in a client?s life that are counter to the problem. This helps empower clients to seek solutions.

Exception questions provide clients with the opportunity to identify times when things have been different for them.

Examples of exception questions include:

1. Tell me about times when you don?t get angry.
2. Tell me about times you felt the happiest.
3. When was the last time that you feel you had a better day?
4. Was there ever a time when you felt happy in your relationship?
5. What was it about that day that made it a better day?
6. Can you think of a time when the problem was not present in your life?

When exploring for exceptions, be aware that such questions can be phrased to ask for the client?s perception of exceptions (individual questions) and the client?s perception of what significant others may notice (relationship questions).

Examples of each follow.

Elicit - So when the miracle happens, you and your husband will be talking more about what your day was like and hugging more. Are there times already which are like the miracle - even a little bit? If your husband was here and I were to ask him the same question, what do you think he would say?

Amplify - When was the last time you and your husband talked more and hugged more? Tell me more about that time. What was it like? What did you talk about? What did you say? When he said that, what did you do? What did he do then? How was that for you? Was else was different about that time? If he were here, what else might he say about that time?

Reinforce - Nonverbally: Lean forward raise eyebrows, take notes. Do what you naturally do when someone tells you something important. Verbally: Show interest. (Was this new for you and him? Did it surprise you that this happened?) And compliment. (Seems like that might have been difficult for you to do, given everything that?s happened in the relationship. Was it difficult?)

Explore how the exception happened - What do you suppose you did to make that happen? If your husband was here and I asked him, what do you suppose he would say you did that helped him to tell you more about his day?

Use compliments - Where did you get the idea to do it that way? That seems to make a lot of sense. Have you always been able to come up with ideas about what to do in difficult situations like this?

Project exceptions into the future - On a scale of 1 to 10, where 1 means every chance, what are the chances that a time like that (the exception) will happen again in the next week (month, sometime in the future)? What will take for that to happen?)

What will it take for that to happen more often in the future? Who has to do what to make it happen again? What is the most important thing for you to remember to do to make sure that _________________ (the exception) has the best chance of happening again? What?s the next most important thing to remember?

What do you think your husband would say the chances are that this (the exception) will happen again? What would he say you could do to increase the chances of that happening again? Suppose you decide to do that, what do you think he would do? Suppose he did that, how would things be different for you?around your house? in your relationship with him??

(De Jong & Kim Berg, 2002, pp. 302-303)

Scaling Questions
Scaling questions invite clients to perceive their problem on a continuum. Scaling questions ask clients to consider their position on a scale (usually from 1 to 10, with one being the least desirable situation and 10 being the most desirable). Scaling questions can be a helpful way to track coachees? progress toward goals and monitor incremental change.

?To use these types of questions, the therapist begins by describing a scale from one to ten where each number represents a rating of the client?s complaint(s). The therapist might say, ?On a scale of one to ten, with one being the worst this problem has ever been, and ten being the best things could be, where would you rate things today??

Once a therapist is given a number, he or she explores how that rating translates into action-talk. For example, if the client rates his or her situation at a three, the therapist asks, ?What specifically is happening to indicate to you that it is a three?? The next step is to determine the goals and preferred outcomes. To do this the therapist asks the client where things would need to be for him or her to feel that the goals of treatment have been met or that therapy has been successful.

We aim for small changes that will represent progress in the direction of goals and preferred outcomes.? (Bertolino & O?Hanlon, 2002, pg. 4)

Examples of scaling questions include:

• You said that things are between a 5 and a 6. What would need to happen so that you could say things were between a 6 and a 7?
  
• How confident are you that you could have a good day like you did last week, on a scale of zero to ten, where zero equals no confidence and ten means you have every confidence?

Presupposing Change
When clients are focused on changing the negative aspects (or problems) in their lives, positive changes can often be overlooked, minimized or discounted due to the ongoing presence of the problem.

The solution focused approach challenges counsellors to be attentive to positive changes (however small) that occur in their clients? lives. Questions that presuppose change can be useful in assisting clients to recognise such changes. Questions such as, ?What?s different, or better since I saw you last time?? This question invites clients to consider the possibility that change (perhaps positive change) has recently occurred in their lives.

If evidence of positive change is unavailable, counsellors can pursue a line of questioning that relates to the client?s ability to cope.

Questions such as:

• How come things aren?t worse for you?
• What stopped total disaster from occurring?
• How did you avoid falling apart?

These questions can be followed up by the counsellor positively affirming the client with regard to any action they took to cope.? (Geldard & Geldard, 2005)

References

• Bertolino, B., & O?Hanlon, B. (2002). Collaborative, competency-based counseling and therapy. Needham Heights, MA: Allyn & Bacon.
• Corey, G. (2005). Theory and practice of counselling and psychotherapy. (7th ed.). Belmont, CA: Brooks/Cole.
• De Jong, P., & Kim Berg, I. (2002). Interviewing for solutions. (2nd ed). Pacific Grove, CA: Wadsworth.
• de Shazer, S. (1988). Clues: investigating solutions in brief therapy. New York: Norton.

 

[Daniel E.]

Solution-Focused Brief Therapy with Long-Term Problems
by Joel K. Simon, MSW & Insoo Kim Berg, MSSW

Basic Assumptions:

The set of assumptions that inform solution focused practice:

1. Change is constant and inevitable;

2. Small changes result in bigger changes;

3. Since you can't change the past, concentrate on the future;

4. People have the resources necessary to help themselves: they are the experts;

5. Every human being, relationship and situation is unique;

6. Everything is interconnected;

7. Every problem has at least one exception;

8. Therapy is not the only way people change, there are many things that are therapeutic.


Many clients experience their problems as the status quo. Our experience tells us that status quo is illusionary and that exceptions are already happening. A study done by Weiner-Davis, de Shazer and Gingerich surveyed 30 clients and found that 66% reported positive, pretreatment change. In describing this study, Miller and colleagues state:

. . . The studies conducted to date clearly indicate that beneficial change can and frequently does occur prior to the initiation of formal treatment. For example, change due to the operation of chance events or client strengths may be partly responsible for approximately 40% of clients who improve enough not to need treatment on a waiting list for services.​

It becomes the therapist’s job to redirect the client’s attention to useful exceptions...

In the course of asking solution-building questions, quite often the client will raise exceptions, times that the problem either is experienced as less significant or absent entirely. When the therapist hears this, it is usually helpful to expand on exceptions. In the course of discussing the Miracle Question, solution-focused therapists might ask the client about exceptions directly. For example, “What part of the miracle is already happening?”

 

[Daniel E.]

Varieties of the miracle question

 

[Daniel E.]

7 Best Solution-Focused Therapy Techniques and Worksheets (+PDF)

A method has developed from the Miracle Question entitled, The Miracle Method. The steps follow below (Miller & Berg, 1996). It was designed for combatting problematic drinking but is useful in all areas of change.

1. State your desire for something in your life to be different.
2. Envision a miracle happening, and your life IS different.
3. Make sure the miracle is important to you.
4. Keep the miracle small.
5. Define the change with language that is positive, specific, and behavioral.
6. State how you will start your journey, rather than how you will end it.
7. Be clear about who, where, and when, but not the why.

 

[Daniel E.]

Varieties of the miracle question

The link is dead, so here is the PDF (from BenFurman.com):

 

[Daniel E.]

“The pathologized images have moved the soul in several ways: we are afraid; we feel vulnerable and in danger; our very physical sustance and sanity appear to be menaced; we want to prevent or rectify...

Pathologizing reinforces the ego's style and guilt serves a secondary gain, increasing the ego's sense of importance: ego becomes superego, drivenly busy with repairing wrongs. A guilty ego is no less egocentric than a proud one."

― James Hillman, Re-Visioning Psychology

 

[Daniel E.]

"We are born in one day. We die in one day. We can change in one day. And we can fall in love in one day. Anything can happen in just one day."

~ Gayle Forman

 

[Daniel E.]

"The therapist doesn’t have the magic . . . the client has the magic and we’d better do something small and let the magic operate.”

~ Steve de Shazer

 

[Daniel E.]

~ Russ Harris, The Happiness Trap