Solution-focused therapy (SFT)

As a previous employer, the NSPCC, says on-line:

Solution-focused practice concentrates on helping people move towards the future that they want and to learn what can be done differently by using their existing skills, strategies and ideas – rather than focusing on the problem” [My emphasis].

You will find a useful summary to this approach at:

https://solutionfocused.net/what-is-solution-focused-therapy/

Solution-focused therapy (SFT) was originally developed in the USA after the 1970’s by Milwaukee psychotherapists Steve De Shazer and Insoo Kim Berg. Their interest was in paying attention to what worked best for the individual. This compared with the more traditional psychotherapies that presumed to know what works for different types of people and different ‘problems’. Traditional approaches to therapy, particularly in the early twentieth century, ‘pathologised’ the behaviour of the client. Treatment tended to define what was going wrong, and to show how it can be put ‘right’.

By contrast, de Shazer and Berg set out to treat the ‘client’ as the expert on their own life.  The role of the therapist is to walk along side the individual and to ask questions or give encouragement.  Their aim is to build the self-confidence, in the individual, to give opportunities to make positive changes in their lives. In this respect, the model is often misunderstood – as an approach offering solutions. Understandable, given the name, but the key issue about ‘solutions’ here is – who finds then and how do they find them?  There are models that give the impression of steering clear of ‘solutions’; look closely enough,  however, and you will find subtle strategies to control and manage clients in the consulting room.   Two common ‘coercions’ was in the use of silence and interpretation.

My own approach is to solutions is to know I am an influence. I make this explicit by saying there are ‘solutions’ available; they may not be visible.  That way can a ‘client’ see the need to draw a line – set a boundary –  to ensure I do not have sole responsibility for designing a small, safe experiment. My website offers any number of ‘solutions’ so please advise if my explanations fail to convey the importance of tweaking what is on offer to your own circumstances.

The Solution-focused (SF) approach asserts that the client can find their own – bespoke – solution.  The therapist’s role is to walk with them as they find it. We will facilitate that ‘walk’ using any intervention that works – from wherever – but designed by a ‘client’. That includes living with interventions that do not work; small defeats can be helpful. Elsewhere on this website, I go one step further and argue that the ones that do not work, can be the most impactful in the longer run. This attitude does not recommend anarchy, regardless of risk. It does not support the old adage of “all shall have prizes”.

The SF approach asks that we demonstrate enough self-discipline – as therapists – not to see ourselves, or our training, as the central feature in the effective management of change. That way, a client can fill the space that is now available for exploration.

Particularly important is de Shazer and Berg’s idea that the solutions are typically found in the “exceptions” to the problem; that is, when a ‘problem’ is not actively affecting the individual. Heather Murray, at:

Solution Focused Therapy | Simply Psychology

summarises some ‘take-home’ Messages about SF as:

  • a future-oriented, goal-directed approach to solving human problems of living.
  • with a focus on the client’s health rather than the problem, on strengths rather than weaknesses or deficits, and on skills, resources and coping abilities that would help in reaching future goals.
  • taking a positive view of change in order to increase the frequency of current useful behaviour. This does not mean ignoring complications and obstacles, but – rather – learning from them.

Some safe experiments coming out of the Solution-focused approach

I’d like to think this website is full of possibilities, but here are a few emerging specifically from SFT:

  • look for ways to ask questions of yourself; gain an understanding of your strengths and weaknesses; and the opportunities and threats surrounding you. The SWOT analysis is relevant here: see an illustration of this experiment on: https://your-nudge.com/2018/05/17/power-threat-and-meaning/
  • use the Johari Window to explore inner resources that you might not have noticed before, say, for example,  things that you use in a work setting and could transfer to other problems, say, in relationships closer to home.
  • Use kind and compassionate language towards yourself. This is addressed in an organised way by Compassion-focused therapies.
  • just notice when you ruminate over a problem, unaware of the strengths and abilities that they do have. This approach, and several others, is described on: https://your-nudge.com/anxiety-and-the-older-not-so-smart-sibling/
  • The Miracle Question: use visualisation, touched on at the bottom of this page, to imagine that you have gone to sleep. Imagine that when you wake up in the morning, feeling refreshed, your problem has vanished.  Ask yourself how do you know that your problem has gone? What is different about this morning? What is it that has disappeared or changed in your life?’ In this changed circumstance, how you know that the issue is now being managed differently. Indeed how did you get the issue out of your life, if it has vanished. Just notice what is particularly different in your life – in your home, in your community or, indeed, in yourself.
  • Exception-searching to identify times when you did cope with life’s complications. It is rare for us to fail – again and again – sometimes we simply do not notice the occasional time when we get something right. Go out and look for those exceptions.  Solution-focused therapy has the belief that there are exceptions or moments in our lives when an issue is not present, or it does not cause any negative effects. When is that; describe these exceptions
  • Using scales to monitor your own progress and the ‘smaller’ changes that you do make during safe experimenting. There is some discussion of scales at: https://your-nudge.com/using-a-record-of-feelings-facts-and-thoughts/
  • Coping Questions: Stop to think:  how have I managed to cope in some areas of my life. This could lead you to clues to your own solution. It also will help you know that there are times a problem fades; this could lessen the power of that issue over your emotional and mental state.

complements

This involves the practitioner actively listening to the client to identify and acknowledge their strengths and what they have done well, then reflecting them back to the client, whilst also acknowledging how difficult it has been for them.

This offers encouragement and values the strengths that the client does have. The practitioner will use direct compliments (in reaction to what the client has said), for example, ‘that’s amazing to here!’, ‘wow, that’s great’.

Indirect compliments are also used to encourage the client to notice and compliment themselves, such as coping questions or using an appreciatively toned voice to dive deeper into something highlighting the positive strengths of the client.

For example, ‘How did you manage that?!’ with a tone of amazement and happy facial expressions.

 

Scales

 

The practitioner will ask the client to rate the severity of their problem or issue on a scale from 1-10. This helps both the practitioner and client to visualize where abouts they are with the problem or issue.

Examples of scaling questions include:

‘On a scale of 1 to 10 where would you rate your current ability to achieve this goal?’; ‘From 1-10 how would you rate your progress towards finding a job?’; ‘Can you rate your current level of happiness from 1-10?’; ‘From 1-10 how much do you attribute your level of alcohol consumption to be one of the main obstacles, or sources of conflict in your marriage?’.

They can be used throughout sessions to compare where the client is at now, in comparison to the first or second session, also to rate how far from or near to their ideal way of being, or to completing their goal, they are.

This can help both practitioner and client to notice if something is still left to be done to reach a 9 or 10, and can then start the exploration into what that is.

Scaling helps to give clarity on the client’s feelings, it also helps to give sessions direction, and highlights if something is holding back the client’s ability to solve the problem still or not.


 

 

Some references from Heathe Murray

De Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: Norton & Co.

De Shazer, S., Berg, I. K., Lipchik, E., Nunnally, E., Molnar, A., Gingerich, W., & Weiner-Davis, M. (1986). Brief therapy: focused solution development. Family Process, 25(2): 207–221.

De Shazer, S., & Dolan, Y. (2012). More than miracles: The state of the art of solution-focused brief therapy. New York: Haworth Press

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Designing a small, safe experiment

Models relating ot therapy