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Solution Focused CounSeling : Foundations and applications

Solution Focused CounSeling : Foundations and applications

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Solution Focused CounSeling : Foundations and applications

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  1. Solution Focused CounSeling: Foundations and applications Michele Aluoch, PCC River of Life Professional Counseling LLC c.2014

  2. 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

  3. 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)

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. What Works in Spite Of What Doesn’t Work • 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.”

  11. What Works in Spite Of What Doesn’t Work • 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.

  12. What Works in Spite Of What Doesn’t Work • 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 consistentand 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.”

  13. What Works in Spite Of What Doesn’t Work • 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.”

  14. What Works in Spite Of What Doesn’t Work • 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

  15. What Works in Spite Of What Doesn’t Work • 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.

  16. What Works in Spite Of What Doesn’t Work • 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.

  17. What Works in Spite Of What Doesn’t Work • 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.

  18. What Works in Spite Of What Doesn’t Work • 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.

  19. What Works in Spite Of What Doesn’t Work • 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.

  20. 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

  21. 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?”

  22. Looking For Exceptions Insert Video

  23. 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.

  24. Planning Experiments and Tests • Insert Video

  25. 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.

  26. NO Real Resistance

  27. There is some good even in what seems bad. Insert video.

  28. 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

  29. Moving Away From “Why?”

  30. Developing New Solution States

  31. Nothing stays awful forever. Insert video.

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

  33. MECSTAT • Miracle Questions • Exception Questions • Coping Questions • Scaling Questions • Time Out • Accolades • Task

  34. 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.

  35. 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

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

  37. 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

  38. 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.”

  39. 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)?

  40. 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.

  41. 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

  42. 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

  43. 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.

  44. 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?

  45. 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.

  46. Time Out • Avoiding toxic behavior • Indirectly increasing the positive

  47. Solution Focused Therapeutic Conversations Problem focusSolution Focused How long have you been What would it be like if you depressed? were not depressed? What happens when you are anxious? When your relationship problems are worse between you and your parents how do you act? Tell me about the nights when you cry yourself to sleep. Everywhere you go there seems to be pain and grief.

  48. Accolades • Compliments are important to producing change in client. • Must be verbalized. • Looking for consistent positive feedback “in spite of”

  49. 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.

  50. 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.