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Solution Focused Psychotherapy in a Mother-Baby Residential Unit. . Presented by Dr Ian Harrison Karitane Continuing Education Program April 14th 2010. What is Solution-Focused Therapy?. PART 1. The Solution-Focused Approach. short-term (brief), not long-term therapy a focus on :
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Solution Focused Psychotherapy in a Mother-Baby Residential Unit. Presented by Dr Ian Harrison Karitane Continuing Education Program April 14th 2010
The Solution-Focused Approach • short-term (brief), not long-term therapy • a focus on: • solutions (not problems), • strengths (not weaknesses), on • what’s going well (not what’s gone wrong) & • what to do next (not who is to blame).
The Problem-Focused Approach So what is the problem... with your baby? Why does... your baby become so unsettled? What other problems…does her unsettledness cause? Who is to blame… for her difficulties in sleeping? What other things…make the problem hard to solve?
Some solution-focus “rules” and principles. S.I.M.P.L.E….
Don’t ask “Why”. Instead ask “What”. Avoid problem talk. Solutions (not problems)
Asking …What? What might the solution look like? How would we know when we have the solution? What would we see? What would others notice?
The action is in the interaction. In-between
Avoid “underlying” problems People act in contexts created by their interactions and those of others. What appears is what we work with Everything that is important is tangible, visible, audible.
Find out when the solution is already happening. All problems have exceptions. Make use of what’s there.
The “detective” approach No “problem” happens all the time The solution may already be occurring albeit to a minor, “invisible” degree. At what times is your baby settled or more settled How did you do that? (not why) Since change is always occurring we identify and amplify useful change
What you focus on grows.Focus on possibilities not problems, resources not deficits. Possibilities – past, present and future
Past, Present and Future Future: We are used to thinking of future possibilities Present: we uncover and highlight current resources.” Possibility Machines”. (We don’t make them up) Past: We try to highlight positive experiences from the past
Make use of solution-focussed language, $5 words, not $200 words. Language – simply said.
“Words are not reality” People like the sound of their own words Don’t argue over words (which are only symbolic in any case) Instead agree on what we want to happen. Scaling can help with subtle descriptions “Oh he’s shocking! It’s terrible!” What is the difference between 4 and 5?
Mind your Language The words we use direct our attention and our thinking How do we direct attention to the solution? Don’t ask “WHY” We look for the positive in the client’s statements and we respond to that. Assume a desire to move forward and look for that desire.
Solution Focused Language and Reframing • Reframing is not… “SPIN” • Reframing doesn't get rid of the problem. It puts the problem in a new light. • Reframing gives you a boost along the way towards the solution. It helps to remove barriers. • There is no “right” way of looking at things. Different views may fit the facts just as well.
The Solution Focus does Not Mean • “SPIN!” • “Count your blessings!” • “I don’t want to listen to your whinging!” • “You don’t really have a problem.”
Solution Focused Language and Reframing • Client: “It sounds good in theory but I don’t think I’m going to be able to do it.” • “OK. You like the sound of what I’m saying. But you think it will take a lot of work and some skill”. • “It sounds good in theory but I don’t think the baby is going to agree to it.” • “OK. You like the idea a lot. Can you be completely sure that the baby won’t agree to it as well? Perhaps with a bit of time they will like the idea as well. Let’s give it a try and see how we go.”
Solution Focused language and Reframing • Client: “The last time we tried that it didn’t work.” • “It’s disappointing that it didn’t work last time. Every time is different though. I wonder if the next few times that we try, here at Karitane, that you might have more success.” • “The baby has just woken up again (tears) and all the work I put in is completely wasted.” • “I know it’s disappointing that she has woken when you’ve been so hopeful but has it really been completely wasted? I wonder: what did you learn that we could use again next time?”
Only do what works.If it is not working, stop doing it! Every case is different.
Some more solution-focus “rules” and principles. • There is always a better way. • There is no failure, only feedback. • People are resourceful. Look for strengths. • Flexibility works. Be ready to change the game. • Give praise whenever you can. • Keep it simple. Change the minimum possible to achieve the goal. • The client is the “expert” in his or her life
IT’S “SIMPLE” Solutions not problems Inbetween - the action is in the interaction Make use of what’s there Possibilities – past, present, future Language – simply said Every case is different
Let’s take a ….PEEP at the Solution The PEEP Method.
…PEEP 1. Preferred outcome 2. Exceptions to the problems 3. Existing resources 4. Progress made so far
Some Notes on Goal Setting LETS GO BOWLING!
Goal Setting and SMART Goals Specific Measureable Attractive/Authentic Realistic Time Frame
Avoid “unsolvable” problems! Only engage in solvable problems.
Realistic Goals • Areas of: Concern Influence Control
Approach Goals Moving away from this Moving towards this Approach Goal Avoidance Goal
Goal Setting • Vague goals produce vague efforts. • “I want things to be better between my baby and me.” • “I want my baby to be more settled.” • OK, but what would you like to have achieved by the end of today? • “Frankly I’d like to have tried something new. I would have liked to have stopped doing what’s not working.”
Goal Setting Strategies • Outcome goals vs. Learning goals • Distal goals vs. Proximal goals T1 T2 T3 T4 T5 T6 T7 Short Term Proximal Long Term (Distal)
Moving on. Name the new game. • Are you getting into struggle with the client? Are they just not getting it? • “This doesn’t seem to be working. Is there something else we could be working on?” • Don’t ask why is this happening? • We don’t imply that there is something more relevant or useful we just ask “Should we move on?”
Scaling • Used to measure how close we are to our goals • But Also • To motivate clients • To help plan the next steps • To stimulate solution thinking • We use a scale of 1…….10
Scaling • Where are you now • “About a 4” • Using small steps we ask how would you know if you had got to a “5”? What would be different? What would you notice with just a small improvement from 4 to 5? • What would you need to do to get there. • By the way how did you get from 3 to 4? What has helped so far?
Probing for…Solutions Reframe the Problem: Express it in terms of a Preferred Outcome When is the problem already less intense?
Probing for…Solutions Look for exceptions: When does the solution already exist? When is the problem already less intense? What resources does the client already have? What options exist?
Probing for…Solutions Keep action steps simple and small Are they really do-able? Can they be written down? “What can’t be written, can’t be done!” “If it ain’t written, it ain’t coachin’ .”
HAPPY SOLUTION-FOCUSEDCOACHING! THE END
