04.Topic 4_ The Solution Focused Brief Therapy and Strengths

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Topic 4: The Solution Focused Brief Therapy and Strengths Perspective Skills Laboratory Topic overview Solution-focused brief therapy and the strengths perspective are o±en used interchangeably in counselling settings as both emerged in response to conventional therapeutic models that predominately focused on pathology and a problem deficit-focus of people, especially psychoanalysis (Healy, 2014). Despite these similarities, it is worth exploring and appreciating the distinct origins and techniques that characterise each approach. Media cannot be printed. Background to Solution Focused Brief Therapy No problem exists 100% of the time The problem is the problem, not the person It is more useful to explore what is happening when the problem is absent, rather than the causes of the problem Problems can be changed Before exploring the techniques and theoretical background of solution-focused brief therapy (SFBT), it is important to know the context as to which such a modality emerged. A team of researchers and family therapy practitioners, including prominent practitioners Insoo Kim Berg and Steve de Shazer, spent many days, and late nights at their clinic, asking how their practice could be more effective, and more efficient (hence the word 'brief'). They watched thousands of hours of recorded counselling sessions and took notes as to when clients experienced hope and increased engagement. They constructed models and specific questions over time that led to what is now referred to as SFBT. Of course, the model has evolved over time, which we will discuss further. SFBT shi±s attention from the past and the problem to a focus on the future and how change can be achieved in behavioural terms. At times you can even have an SFBT conversation with someone without ever mentioning the problem, as the focus is on a preferred future and how it can be achieved. SFBT is not simply about 'finding solutions' (as many practitioners say in everyday practice). All therapies are focused on finding solutions and so it is overly simplistic to reduce this therapy to such a catchphrase. In fact, the focus on finding or prescribing solutions to a client would be considered solution-forced . SFBT is based on the premise that client goals and solutions are more important than the problems they face. It also inherently believes that significant change is possible even in the context of brief (short-term) interventions. Some underlying assumptions of SFBT are (Healy, 2014):

Complex problems don't necessarily require complex and lengthy solutions Take things at face value Assume competence and good reasons for clients' feelings, thinking, actions, and interactions Keep the focus on clients’ behaviour, coping in the present, and/or hopes for the future. Expect that the change that the client wants will happen slowly. Never be more enthusiastic for change than the client. You cannot work harder than your client does for change. It's their journey, not yours. Don’t give advice; instead, ask the client about their ideas and then ask about others’ advice (e.g. what would your mother/best friend notice?) Relay your respect for, interest in, and, as much as you can, understanding of the client’s position. Use only what the client is already doing or is already able to describe in detail in identifying tasks or making suggestions at the end of your conversation. Start again if the conversation digresses: What does the client want? What is important to him or her? What else do you need to know in order to work together with the client in a way that is useful? 1. asking about your best hopes for your session (how will they know your time together has been useful); 2. what will they notice a±erward that will indicate something has changed?; and 3. what will other people notice? Over the years, SFBT has emerged to where workers focus less about what the client will do in their preferred future to what they will notice . McKergow (2016) described that the evolution of SFBT led to more simplicity in the questions, which makes it appear to be deceptively simple, yet requiring a rigid stance in how the practitioner views the client. For example, the solution-focused worker does not view any person as unmotivated or resistant . If a client does not want to work with you, it is probably because you (the worker) or your approach is not aligned with the client's preferred future. General principles of practice are: If your client has been referred for problematic behaviour, such as self-harm, you may ask if there were times where they resisted certain urges. These are exceptions to the problem and they indicate that your client has been able to overcome difficulties previously. There are many arguments we have heard about the shortcomings of an SFBT approach. Some say it does not take into account people's emotions enough, or only remains on the surface. Others have said it is useful to ask a client's best hopes but then do "the real psychotherapeutic work" and dive deeper into the client's problems and traumatic history. All of these statements are value judgements made by the practitioner. Your client may want to discuss their history, and we must validate their concerns, but we do not go where the client does not take us. Another concern is how relevant SFBT can be in corrections, residential settings, or settings where clients may experience a lack of choice. For instance, if a client is incarcerated, their best hopes may include not being incarcerated, which you cannot facilitate as the social worker. You can still work with this by asking questions like, "A±er this stay here, what would people notice to indicate things are heading in the right direction?" As you gain more detail about your client's preferred future post-incarceration, inquire as to what you the worker might notice your client doing that would indicate they heading in the right direction. Much of this approach is informed by Vitor Frankl's pivotal text Man's Search for Meaning . As you can see, while SFBT is deceptively simple on the surface, the framework requires more and more discipline as we implement such a stance in our practice. ↑ Back to top Types of questions for SFBT Best Hopes & Goal Formulation

1. What are your best hopes for today's session? 2. How will you know today has been useful? 3. What difference will that change make? 4. What will [THIRD PARTY PERSOON] notice? 5. What will take place rather than the problem? [Positive rather than Negative] 6. What would an ideal day look like for you? 7. How will you know that you will not need to come back to see me ? 8. When will you consider our work together a success? 9. How will I know when our work together has been a success? 10. Suppose your best friend had the same problem, what advice would you give them? Scaling Questions 1. On a scale of 0 to 10, 10 being that the problem that brought you here has been sufficiently solved, and 0 being the worst moment you've experienced, where are you now? 2. What does that number stand for? 3. How is that you are already at that number? 4. What would one step higher look like? What would others notice? 5. How do you already manage to be at this number and not lower? 6. What do you see as a next step? 7. Suppose I'm a fly on the wall. What do I see you doing differently when you are up 1 point? 8. What is the highest number at which you've ever been? 9. Did you ever imagine you get this far? 10. On a scale of 0 to 10, how much confidence do you have that you can keep doing...? Exceptions Questions 1. What has changed since you booked this first appointment? 2. What is already working in the right direction? 3. What else has helped so far? 4. At what times do you already see parts of your preferred future already happening? 5. How did you manage that? 6. What do you think you did to make that happen? 7. What do you think [THIRD PARTY PERSON] would say the likelihood of that occurring again? 8. When was the last time you had a good day? 9. When is the problem not a problem for other people in your life? 10. What were you doing differently that made things better? Of course, there are many SFBT questions. Research these by doing critical reading via a library search. ↑ Back to top Required Reading Corcoran, J. (2022). Solution-focused therapy. In K Bolton, J.C. Hall and P. Lehmann (Eds.), Theoretical perspectives for direct social work practice: A generalist-eclectic approach (4th ed., pp.349 - 360). Springer. McKergow, M. (2016). SFBT 2.0: The next generation of solution-focused brief therapy has already i d J l f S l ti F d B i f Th 2 (2) 1 17 R t i d f htt //di it l h l

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Additional reading arrived. Journal of Solution-Focused Brief Therapy, 2 (2), 1–17. Retrieved from: https://digitalschol arship.unlv.edu/cgi/viewcontent.cgi?article=1039&context=journalsfp (https://digitalscholarship.unlv.ed u/cgi/viewcontent.cgi?article=1039&context=journalsfp) Sung, J., Mayo, N., and Witting, A. (2018). A theoretical investigation of postmodern approaches used in medical settings: Solution-focused brief therapy. The Family Journal, 26 (2). Doi: 10.1177/1066480718778527 ↑ Back to top Background to the Strengths Perspective Required Reading Additional reading Activity Consider Jenny or another scenario from your practice, and reflect upon the questions below. How might the strengths-based and SFBT ideas be used? What ideas/evidence do you have about some strengths Jenny might have? It is likely you have come across the strengths perspective in previous subjects (e.g. SWTP1) and if you already work in the human services sector. The strengths perspective is perhaps one of the most popular perspectives that is increasingly utilised in a range of fields of practice and unlike SFBT it is applied across individual, group and community levels of practice (Healy, 2014). Similar to SFBT, the strengths perspective emerged as a counter-response to traditional pathology based therapies, which many social workers have come to embrace in order to move away from a deficit-focused perspective. However, there are key differences between SFBT and the strengths perspective. SFBT tends to focus on clients changing the way they respond to problems in their environment, whereas a strengths perspective will aim to draw on resources that already exist in the environment to solve problems (Healy, 2014). There are debates about how to classify the strengths perspective (Healy, 2014) - is it an approach, a practice model, a theory or a paradigm? Each of these words have slightly different meanings and we adopt the most commonly used term in the literature - perspective , which Chenoweth and McAuliffe (2017, p.269) define in their glossary as a "a particular way of looking at the world or a 'conceptual lens' through which to view human behaviour and social structures". This neatly reflects the underlying tenets of the strengths perspective, which centres on viewing human behaviour through an optimistic and resilience-oriented conceptual lens. Any application in practice comes from this overarching perspective. Simmons, C., Shapiro, V. Accomazzo, S. and Manthey, T. (2022). Strengths-based practice: A metatheory to guide the social work profession. In K Bolton, J.C. Hall and P. Lehmann (Eds.), Theoretical perspectives for direct social work practice: A generalist-eclectic approach (4th ed., pp.99-115). Springer. Healy, K. (2014). Strengths and solution-focused theories: Future-oriented approaches. In Social work theories in context: Creating frameworks for practice (2nd ed.), (pp. 161-182). Palgrave Macmillan.

What ideas/evidence do you have about some strengths Jenny might have? How might you apply a strengths perspective to her situation? What evidence is there of strengths in Jenny's relationships and community? How might you elicit this information? Advanced activity Justify your answers to each question, with reference to key theoretical underpinnings and additional reading in the area. ↑ Back to top Watch: Therapies In-Action 5, Counselling Therapies, Session 5: Solutions Focused Therapy https://search-alexanderstreet- com.ezproxy.csu.edu.au/view/work/bibliographic_entity%7Cvideo_work%7C1779358 Solution-Focused Therapy with Insoo Kim Berg https://csu.kanopy.com/video/solution-focused-therapy Irreconcilable Differences: A Solution-Focused Approach to Marital Therapy with Insoo Kim Berg https://csu.kanopy.com/video/irreconcilable-differences-solution-focused-approach-marital-therapy Brief Solution-Focused Therapy Media cannot be printed. Solution-focused therapy / Insoo Kim Berg, LCSW. San Francisco, California, USA : Kanopy Streaming 2014 Media cannot be printed. Irreconcilable differences: A solution-focused approach to marital therapy / Insoo Kim Berg, LCSW. San Francisco, California, USA : Kanopy Streaming 2014 Media cannot be printed. ↑ Back to top

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