Mastering the Art of Solution-Focused Counseling, Second Edition

Model Description. Solution Focused Brief Therapy
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Perhaps a client is struggling with their child because the child gets aggressive and calls the parent names.

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If the parent continually retaliates and also gets angry, perhaps they can recall another area of their life where they remain calm even under pressure; or maybe, they have trained a dog successfully who now behaves and can identify how kindness, patience and consistency were keys to eliciting the dog's good behavior. This could lead to discussion of using kindness, patience and consistency to create healthy boundaries the child might cooperate with.

It also relaxes them and helps build rapport, and it can give you ideas to use for treatment Everybody has natural resources that can be utilised. These might be events The idea behind accessing resources is that it gives you something to work with that you can use to help the client to achieve their goal Even negative beliefs and opinions can be utilised as resources'. A key task in SFBT is supporting clients to identify and attend to their own internal competencies, skills and resources; as well as their immediate support systems and supportive social networks. This focus helps the client construct narratives as internally competent and externally supported.

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Expanding language here often identifies new ways to bring existing resources to bear upon present problems. Therapists empower clients to identify their own resources by way of scaling questions, problem-free talk, and during exception-seeking. Resources can be Internal : the client's skills, strengths, qualities, beliefs that are useful to them and their capacities, or External : supportive relationships such as, partners, family, friends, faith or religious groups and also support groups.

Solution-focused brief therapy is one of a family of approaches, known as systems therapies, that have been developed over the past 50 years or so, first in the US, and eventually evolving around the world, including Europe.

Many of the concepts of brief therapy were independently discovered by several therapists, in their own practices, over several decades in the s notably Milton Erickson , as described by authors such as Haley, and became popularized in the s and s. Solution-focused brief therapy has branched out in numerous spectrums — indeed, the approach is now known in other fields as simply solution focus or solutions-oriented therapy. Most notably, the field of addiction counseling has taken up SFBT as one of the most cost-effective means to treat problem drinking.

Johns Hopkins University , the Center for Solutions in Cando, ND, and notable others, have implemented SFBT as part of their program, where they use it as part of a partial hospitalization and in residential treatment facility for both adolescents and adults. The field of Christian pastoral counseling has also seen solution-focused brief therapy make inroads into its practices where it is referred to as solution-focused pastoral counseling [19] or brief pastoral counseling.

Solution-focused counseling is a solution-focused brief therapy model. Various similar, yet distinct, models have been referred to as solution-focused counseling. For example, Jeffrey Guterman developed a solution-focused approach to counseling in the s. This model is an integration of solution-focused principles and techniques, postmodern theories, and a strategic approach to eclecticism. Guterman describes the theory and practice of solution-focused counseling in a book he authored, Mastering the Art of Solution-Focused Counseling. The Journal of Marital and Family Therapy reviewed Guterman's counseling model, stating that he "clearly demonstrates and stresses the adaptability of this model as well as its usefulness for the client and therapist.

Solution-focused consulting is an approach to organizational change management that is built upon the principles and practices of solution-focused therapy. While therapy is for individuals and families, solution-focused consulting is being used as a change process for organizational groups of every size, from small teams to large business units.

A contemporary therapy linking the solution-focused brief therapy model back to the hypnotherapy of Milton H Erickson, the hypnotherapist who inspired Steve de Shazer and Insoo Kim Berg. Solution-focused brief therapy Solution-focused brief therapy SFBT [1] [2] is a goal-directed collaborative approach to psychotherapeutic change that is conducted through direct observation of clients' responses to a series of precisely constructed questions. This article needs additional citations for verification.

January Pichot, T. Solution-focused Brief Therapy. New York: Haworth. Arlington, Virginian: American Psychiatric Publishing. New York: Routledge. CS1 maint: multiple names: authors list link Trepper, Terry S. Tale of Solution. New York: WW Norton.

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Lipchik, Eve New York: Guilford. The second part "you manage to get up each morning etc. Undeniably, they cope and coping questions start to gently and supportively challenge the problem-focused narrative. Problem-free talk In solution-focused therapy, problem-free talk can be a useful technique for identifying resources to help the person relax, or be more assertive, for example. Solution focused therapists will talk about seemingly irrelevant life experiences such as leisure activities, meeting with friends, relaxing and managing conflict.

The therapist can also gather information on the client's values and beliefs and their strengths. From this discussion the therapist can use these strengths and resources to move the therapy forward. For example; if a client wants to be more assertive it may be that under certain life situations they are assertive. This strength from one part of their life can then be transferred to the area with the current problem. Or if a client is struggling with their child because the child gets aggressive and calls the parent names and the parent continually retaliates and also gets angry, then perhaps they have an area of their life where they remain calm even under pressure; or maybe they have trained a dog successfully that now behaves and can identify that it was the way they spoke to the dog that made the difference and if they put boundaries in place using the same firm tonality the child might listen.

Dan Jones , in his Becoming a Brief Therapist book writes:. It also relaxes them and helps build rapport, and it can give you ideas to use for treatment Everybody has natural resources that can be utilised. These might be events The idea behind accessing resources is that it gives you something to work with that you can use to help the client to achieve their goal Even negative beliefs and opinions can be utilised as resources ' [1].

A key task in SFBT is to help clients identify and attend to their skills, abilities, and external resources e. This process not only helps to construct a narrative of the client as a competent individual, but also aims to help the client identify new ways of bringing these resources to bear upon the problem. Resources can be identified by the client and the worker will achieve this by empowering the client to identify their own resources through use of scaling questions, problem-free talk, or during exception-seeking.

Resources can be Internal : the client's skills, strengths, qualities, beliefs that are useful to them and their capacities. Or, External : Supportive relationships such as, partners, family, friends, faith or religious groups and also support groups.

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Solution Focused Brief Therapy is one of a family of approaches, known as systems therapies, that have been developed over the past 50 years or so, first in the USA, and eventually evolving around the world, including Europe. The concept of brief therapy was independently discovered by several therapists in their own practices over several decades notably Milton Erickson , was described by authors such as Haley in the s, and became popularized in the s and s.

By leading the patient to advocate for his or her own change, intrinsic motivation is enhanced, leading to amelioration of barriers to beginning or sustaining change. The spirit of MI includes collaboration, evocation, and autonomy. Collaboration is the focus of the shared decision-making, empowering the patient's involvement and voice in the therapeutic process.

Evocation focuses on clinicians implementing attending skills, such as open-ended questions, affirmations, reflections, and summarizations, to draw on the patient's values, goals, and attitudes.

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Supporting patient autonomy effectively encourages self-efficacy throughout the therapeutic process for the patient, and in this case, his or her families, through supporting patient decision-making and avoiding challenging or encouraging resistance in the patient. MI approaches resistance uniquely, generally seen as an indicator that the provider should use a different approach, with the goal of leading the patient to argue for change and develop confidence to change.

Current research also indicates the effectiveness of multidisciplinary training and implementation of MI across settings for various mental health and medical occurrences. Moderators for the analysis included comparison group, patient distress, MI type i.

The similarities in interventions and objectives between SFT and MI strategies have been proven to fit well within the medical setting. Focus and attention on medical family therapy has increased as a result of managed care and the desire and need for integration of care and services in medical settings.

Jeffrey Guterman

Additionally, the recognition of the importance of the patient's family system as essential to best medical outcomes has promoted medical family therapy as a profession. This growth reflects the necessity of a systemic approach to healthcare. Research supports the effective treatment of these conditions such as chronic pain, eating disorders, and depression by family-based interventions. Medical family therapists are the answer to this need.

Patients experience multiple interworking systems, which include biological, psychological, social, and spiritual components BPSS , all of which have the potential to influence the family system, and provide essential sources of coping and support. These needs corroborate with the fit of SFT[ 7 , 27 ] and MI[ 10 ] for treating patients in medical family therapy settings.

SFT allows for autonomy of the patient and his or her family, as well as providing a family-centered approach that focuses on reaching solutions rather than engaging in problem-saturated talk. Medical family therapist can work collaboratively and in conjunction with the medical providers and with patients in medical settings promoting adherence to treatment recommendations.

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SFT and MI are excellent interventions to elevate the patients in their role of the healthcare team. MI specifically achieves this by focusing on autonomy, increasing intrinsic motivation, and enhancing patient self-efficacy. This leads to empowerment of the patients and their family, enhanced rapport and validation of their status as valued individuals in the process. Rather than speaking at them, the clinician is speaking with them and expressing empathy for the patients. MI in healthcare settings is present-focused, leading to a directive style that empowers and validates the patients and their families, capitalizing on strengths and change talk i.

Some examples of current implementation of SFT and MI include the field of nursing's implementation of SFT as a modality of care into diabetes, cancer, and other common and chronic presenting problems in medical settings. SFT contains a degree of overlap in principles and desired outcomes for treatment as demonstrated by current implementation with other medical providers i.

Nurses, for example, aim to improve trust, promote positive patient orientations and perceived control in managing their illness, emphasize and bolster patient strengths, and develop health-directed goals.

As previously noted, research supports SFT principles previously used in in-patient settings as resulting in less behavioral conflicts, decreased length of stay, increased levels of collaboration between nursing and other medical staff, and decreased readmission rates.

MI is useful in healthcare settings in establishing brief, effective rapport and trust with patients, and can be a critical aspect of the stages needed for nurses to establish a present, solution-focused approach to patient care. Implementing MI techniques and interventions with previously developed SFT nursing models will only amplify the patient- and solution-focused approach.

Solution Focused Therapy

Due to the past success, buy-in, and familiarity with the SFT by nurses, this type of therapy may lend itself well to medical family therapists making the collaborative transition easier to accomplish between medical family therapists and traditional members of the medical team. These underlying premises of care and goals lend themselves well to a collaborative team, and their utilization can bolster professional integration of services based upon delivery models and general aims of service. Currently, a shortage in the evidence for an SFT and MI blended approach to treating families in a medical family therapy setting exists in the literature reviewed, indicating it to be a recommended area for future research and programmatic development based upon the proven utility and success of both of these interventions for better medical outcomes using medical family therapy.

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Solution-Focused consulting is an approach to organizational change management that is built upon the principles and practices of Solution-Focused therapy. I am grateful to Alasdair Macdonald for adding an updated foreword to this edition. Integrative brief solution-focused therapy: A provisional roadmap. Adelaide : Dulwich Centre Publications. London : Continuum. Adler , A.

The potential for increased acceptance and amplified reimbursement abilities may be possible through the implementation of MI and SFT by medical family therapists. In this review, the authors have highlighted the literature utilizing the components of MI and SFT that have been proven to be effective in marriage and family therapy, medical settings, and by medical professionals.