Review of Chapter 13

1. Review of Chapter 13 Postmodern Therapy EPSY 6363 Dr. Sparrow

2. Postmodern Theory • Derived from Social Constructionism • Theory of human nature: There is no single reality • One’s reality and identity is constructed from one’s: • beliefs and values • experiences • relationships

3. Postmodern Therapy • If there is no single reality, then there can be no “expert” • If there is no expert, therapy involves working collaboratively within the client’s frame of reference • Two schools • Solution focused • Narrative

4. Solution-Focused Brief Therapy • Came about, in part, due to declining resources for outpatient therapy. • Case managers allowed only a few sessions. • A therapist had to work within a short-term model of change

5. Solution-Focused Brief Therapy • The theory of human nature that characterizes SFBT is very similar to person-centered therapy, reality therapy, and other existential-humanistic therapies: Each person can solve his or her own problems • By focusing on competencies, rather than pathology or problems, therapy can be brief. • What was different about SFBT is the belief that the client already knows what to do, but is not aware of it.

6. Solution-Focused Brief Therapy • A person comes to you for help and complains about a problem. • As a SFT therapist, you don’t focus on the complaint, but inquire into the immediate past to look for exceptions: When was the problem not evident? • You discover what the person was doing then that could be seen as a solution for the present concern. • You simply support the client in doing that again--provide encouragement, feedback, etc.

7. Solution-Focused Brief Therapy • Specific techniques • focus on small, achievable changes; goal oriented and future oriented • assumption of pretherapy change: “What have you done since you have called...? • Exception questions • Miracle question • Formula First Session Task: “What happens that you’d like to continue happening...?

8. Solution-Focused Brief Therapy • Specific techniques continued: • Therapist feedback compliments • Bridge links compliments to tasks that will be given • Suggesting tasks • Termination with provision for returning to work on another issue. Initial question: What needs to be different? No need to fix everything.

9. Case Scenario: Mary’s Problems • On the basis of interpreting some ambiguous messages from a professor, and from two friends, Mary begins to think that most people don’t like her, and so she withdraws from relationships. She avoids the professor’s gaze, starts to do poorly in the class, and avoids her friends. She waits for her friends to contact her, and when they don’t, she feels even more strongly that they don’t like her, and that she isn’t likable. She becomes depressed and unable to work and socialize.

10. Solution-Focused Brief Therapy • Specific techniques • focus on small, achievable changes; goal oriented and future oriented. What can you do to make a modest start, Mary? • assumption of pre-therapy change: “Mary, what have you done since you have called that represents progress...? • Exception questions: When did you not experience this sense of isolation and judgment? What were you doing then?

11. Solution-Focused Brief Therapy • Miracle question: If you woke up tomorrow and the problem did not exist, what would your day be like? Mary might say that she would happily call her friends without fear of rejection, and might make an appointment with her professor to discuss her progress, etc. • Formula First Session Task: “I want you to be aware of the things that happen this week that you would like to continue to happen.” Mary might realize that she enjoys knitting and reading, and that some solitary activities are quite pleasurable.

12. Solution-Focused Brief Therapy • Specific techniques continued: • Therapist provides positive feedback & compliments • Links compliments to tasks that will be given • Suggests tasks • Termination with provision for returning to work on another issue. Initial question: What needs to be different? No need to fix everything.

13. Narrative Therapy • Reality or truth is made up of “interpretive stories.” • Culture and society and family may promote certain stories that may work against the freedom and opportunity of the individual. • Stories grow out of conversations with others.

14. Narrative Therapy Methods • Therapists listen with an open mind. They are active facilitators and inquirers. • Help clarify meanings and revise beliefs based on client’s lead. • Maintain faith in the client’s ability to recognize competencies. • Come up with a name for the problem • Personify, attribute oppressive intentions.

15. Narrative Therapy Methods • Externalize and deconstruct the problem: the person is not the problem. • Discover moments when the person was not dominated by the problem. Search for unique outcomes. • Speculate on what kind of future the client will have when they are free of the problem and “problem saturated” language. • Find a social context for expressing the new story. • Finally, describe their experience in fresh language, in which they are no longer fused with the problem.

16. Case Scenario: Mary’s Problems • On the basis of interpreting some ambiguous messages from a professor, and from two friends, Mary begins to think that most people don’t like her, and so she withdraws from relationships. She avoids the professor’s gaze, starts to do poorly in the class, and avoids her friends. She waits for her friends to contact her, and when they don’t, she feels even more strongly that they don’t like her, and that she isn’t likable. She becomes depressed and unable to work and socialize.

17. Narrative Therapy Methods • Therapists listen with an open mind. They are active facilitators and inquirers, so therapist would listen carefully to Mary’s story, asking questions throughout. • Therapist would clarify meanings and assist in revising beliefs based on Mary’s lead. • Therapists maintain faith in the client’s ability to recognize competencies, so there would be no pressure on Mary to come up with solutions. • Therapist would help Mary to come up with a name for the problem, and then help her personify and attribute oppressive intentions to the problem.

18. Narrative Therapy Methods • The therapist would: • Encourage Mary to externalize and deconstruct the problem: the person is not the problem. • Would search for moments when the person was not dominated by the problem. Search for unique outcomes. • Speculate on what kind of future Mary will have when she is free of the problem and “problem saturated” language. • Help Mary find a social context for expressing the new story. • Help her find a way to describe her experience in fresh language, in which she are no longer fused with the problem.