Cue the Video

• http://www.youtube.com/watch?v=kGijXKclgRw

Solution-Focused Brief Therapy

Michael Matthews, Kim Michaud, Ricshawn Adkins Roane & Luis Sosa

The Development of SFBTIn this section we will discuss:

The Development of SFBTBrief History

Important Theoretical ConceptsUnderlying AssumptionsStages in TreatmentTimingFinding Solutions

History

• originated 1970’s• Mental Research Institute (Palo Alto,CA)

• Cognitive/Behavioral• Change of actions/thoughts

• Psychodynamic• Efficient / results-oriented

• Systems• Reciprocal relationships: client/others• Social systems

Theoretical Concepts

• Einstein: A problem can’t be solved at level of its creation

• Little attention to human development & past pathologies

• Focus on positive change in small increments

Assumptions

• Troubling behavior client’s static frame of reference• Clients are capable of change given increased hope &

expectancy• Client’s imagined positive frame clinician’s

ideas/suggestions client’s hope for change goals• Concrete goals & changed perceptions/behavior

progress• Small changes snowball positively

Early Contributors• Steve de Shazer

– Miracle question Clues “If you woke up andmiraculously your complaint wasgone, how would you know?” Task Suggestions• Insoo Kim Berg

• O’Hanlon & Weiner-Davis

– Stepping stones to goals • behavior changes > understanding

• Talmon – Starts on the phone: Notice good that’s happening before we have first

session

Timing

• Therapy relationships relatively brief – 6 to 20 sessions

• Scheduling is flexible– Breaks for clinicians to develop clues– Breaks for clients to implement

• Treatment lasts until goal is reached / complaints resolved

Treatment Stages

• Seven Treatment Stages which include:– ID solvable complaint unsuccessful interactions/ mishandling

things– Establishing specific, observable, measurable, concrete goals

which will change client’s VIEWING, DOING, OR ACCESSING RESOURCES client’s positive imaginings or exceptions

– Strategic tasks evaluation of tasks Progress

– Termination by client : goal accomplished

Finding Solutions

• View clients as experts with strengths/resources they need to change

• Focus on change in progress/expand on positive exceptions

• Provide rationale for tasks• Encourage new behaviors, not just cessation

of old• Make solutions practical and specific

Treatment Using SFBT

In this section we will discuss:•SFBT Therapeutic Goals•The Therapeutic Alliance•Therapeutic Techniques

Jamie, Ricshawn, Ellington & HathawayMinka-en, Tokyo, Japan

2010

Therapeutic Goals

• Establish climate conducive to change

• Shift from problem-talk to solution-talk

• Identify “exceptions”

• Tap inner resources

The Therapeutic Alliance

• Positive orientation

• Collaborative and consultative relationship

• Therapist-as-expert replaced by client-as-expert

• Therapist as facilitator of change

SFBT Therapeutic Techniques

• Clues• Complaint Pattern Intervention• Focus on strengths• Formula First Session Task• Homework• Miracle Question

• Pretherapy Change• Problem Externalization• Scaling Questions• Summary Feedback/Compliments• Termination• Videotalk

Solution Talk

Make Suggestions

Termination

Section Review

In this Section we discussed:•SFBT Therapeutic Goals•The Therapeutic Alliance•Therapeutic Techniques

Application & Current Use of Solution Focused Theory

Section Overview:• Application to Diagnostic Groups• Application to Multicultural Groups• Application to Other Groups• Current Use of Solution Focused Brief

Therapy

What Type of Client is Best for SFBT?

• Is motivated to face their difficulties and change

• Has a history of good relationships • Can be flexible and creative • Has succeeded in finding solutions to

past problems • Has a strong support group

The Scope of SFBT• Has expanded and is meant to help anyone who is in the midst of a crisis

Focus is on helping clients realize that they are more than their symptoms and/or experiences

• The use of trances, stories, and solution talk are used to validate what

others invalidate within themselves. (This invites the client to consider new opportunities.)

• Promote a client’s boundaries/the ability to maintain those boundaries • Rituals provide consistency & facilitate transitions & can also promote

connection with other people, memories and one’s history and culture.

Application to Diagnostic Groups

Well suited to treatment of mood and anxiety disorders

Concepts and Strategies associated with SFBT • Attention to motivation• Emphasis on small successes• Efforts to find exceptions

It is likely that a counselor will need to apply more than just SFBT

Application to Multicultural GroupsSFBT respects and honors the unique cultural backgrounds – each client is

seen as the expert on his or her own life SFBT Focuses on: Health Client Dignity CollaborationResources EmpowermentStrengths Self- Determination • Flexible -- What’s most important to each client can be emphasized on a

case by case basis • Does not place great weight on the importance of cultural factors • The key is client motivation

Application to Other Groups

Useful for clients of all ages but may need modification for children

Child Modification: The use of Integrated expressive play techniques

Current Use of Solution Focused Brief Therapy

Growing in popularity because of its efficiency and effectiveness

Well received because it advocates:Goal settingMeasurement of progressEmpowerment of clientsCollaborative therapeutic alliance

• Use of intervention and homework tasks makes this easy to integrate with other theories—particularly those that focus on behavior change. (Cognitive behavioral, REBT, Adlerian and reality therapy)

Cue the Video

Evaluation of SFBT

In this section we will discuss SFBT:•Limitations •Strengths•Contributions

Limitations

• Too much focus on the presenting problem • Client history is neglected• Not usually appropriate as the primary or only

treatment plan• Lack of focus on insight• Can be costly for the client

Strengths

• Effective and efficient • Well received by clients• Deals with immediate problems• Challenges clients to think • Encouraging and empowering • Can be combined with other counseling

approaches

Contributions

• Optimistic orientation • Provides clinicians with powerful new

interventions (The miracle question, emphasis on exceptions and possibilities, and its emphasis on small behavioral changes)

Section Review

In this Section we discussed:•Limitations •Strengths •Contributions

ReferencesCorey, M. S., and Corey, G. (2011, 2007). Becoming a helper (6th ed., pp.

174-176). Belmont, California: Brooks/Cole.Corey, G. (2005). Postmodern Approaches. In L. Gebo, J. Martinez, M.

Flemming, & S. Gesicki (Eds.), Theory and Practice of Counseling and Psychotherapy (7th ed., pp. 382-419). Belmont, California: Brooks/Cole.

Gladding, S. T. (2009). Counseling: A Comprehensive Profession (6th ed., pp. 242-244). Upper Saddle River, New Jersey: Pearson.

Ivey, A. E., D’Andrea, M., Ivey, M. B., & Simek-Morgan, L. (2007). Theories of Counseling and psychotherapy: A Multicultural perspective (6th ed., pp. 65-71 & 101-108). Boston: Allyn & Bacon.

Seligman, L. (2010). Theories of counseling and psychotherapy: Systems, strategies and skills (3rd ed., pp. 366-369). Upper Saddle River, New Jersey: Merrill, Prentice-Hall, Inc.