Solution Focused Therapy simplified

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Quick summary: Solution focused is based on the idea that if you get people to start solving and to stop over analyzing the problem they will be more likely to reach a resolution in the present and they will be more likely to seek out solutions or to put the majority of there perceptual energy towards solutions in the future. In short if you focus on problems – you live within problems… if you focus on solutions – you live within solutions. I have outlined techniques to help people to use this method.

 

The basic components of the Solution focused method – theories and such…

 

If people start using solutions they will be rewarded naturally and the person will therefore engage in more solution-oriented behaviors. The idea is to get some momentum behind the process of solving. 

 

Postmodernism = we create our own reality.

  • This means that if you focus on problems then problems become your reality. If you choose to focus your attention (consciously and subconsciously) on isolating problems then you reality (which is your subjective perception) will be made up of problems. 
  • Solutions – with the help of the therapist, clients learn to focus on solutions. They will then look for solutions in their world as opposed to constantly looking for problems.

 

Therapist directs the clients toward solutions – though postmodernism-based interventions are not inherently theories which suggest that a therapist is an expert, solution focused interventions require the therapist to be very active in directing all communication away problem saturated narrative and towards solution-saturated narratives.

Systemic – this theory suggest that if you offer positive change or a solution into a family system then there will be a ripple effect in which other parts of the system will begin to focus on solutions.

Strength based – This theory is far more concerned with investigating and accenting strengths and hopes then with diagnosing a problem.

Successful treatment – resolution is created by adding solutions as opposed to removing problems.

The goal is to help the client to focus on the positives that will arrive in their future as they focus their attention on solutions.

  

 

Techniques – what a therapist can do to help people to live with a solution oriented mindset.

 

Miracle question – the therapist asks, “When you wake up and everything is resolved what will you notice… what changes will be present… what solutions will be used?”

  • It is important for the therapist to model the use of definitive language by saying ‘will’ instead of ‘could’… this increases hope.
  • I also like the questions, “when you are all done with therapy and we say goodbye what will you notice that has entered into your life?”

 

Scaling questions – the client is asked to rate their current circumstance on a scale of 1 – 10. Example, “how is your communication with your wife right now with one being perfectly bad and 10 being perfectly good?”

  • After a number is reported by the client the therapist will ask a solution oriented question such as, “what will be happening when we raise your number by just one point?”

Deconstruction – break down the solution into more manageable parts. If the solution was “to have a clean house” then the therapist would help the clients to break down the necessary steps to do so (put away clothes, buy dish soap, assign chores etc).

Coping Questions – these questions offer a space for the therapist to empathize with the client’s emotional reaction to the problem while gently redirecting the focus to a client’s strength or resilience.

  • Example “with all the pain you are holding from the passing of your mom how have you been so strong as to successfully care for the needs of your children?” or this could be phrased as a statement … “I am impressed with your motherly abilities in the face of the hardship that you are going through.” 

 

Strength based questions – the therapist will have the clients list their own strength and the strengths of their family members. The therapist will ask what strengths can be used in assisting the defined solutions.

Hope – hope is talked about openly. Ex. “what are you hopeful about?”

Gently redirect clients back to solutions – when a client derails into a problem saturated narrative the therapist will say something like, “I can tell that this is difficult for you and you really want me to understand to effects of this problem, I can help you best if we can allow ourselves to focus on solutions… when things are just a little better what will you notice?” Some therapists are less concerned with being gentle and might say something like,” we are talking about problems again… what is a small step you will make towards a solution?”

 

Encourage a focus away from the belief that problems have an external origin. “What can you do to help with the solution?”

Internal focus – Encourage people to identify the changes that they can make as opposed to focusing on the changes that their partner or other family members could make. 

 

Unique Outcomes – address hopelessness, which often arises from over-generalizations, with contrary examples. Ex. He never shows affection… the therapist would help the couple to find a time when affection was displayed. 

Find what you are doing right and do it more.

A deeper understanding of the problem is not necessary – change the focus to the solution. History, emotional impact of the problem etc are not particularly necessary in this approach.

Validate solutions that exist.

Acknowledge positive change.

Encourage and utilize definitive language – ex “I will start to be more involved.” as opposed, “I could be or if I am to be more involved”

 

“problem based thinking is the problem… solution based thinking is the solution”

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.

Genograms – reducing blame and finding solutions in your family tree

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Quick summary – When visiting certain therapists (trained in family therapy) you might have the opportunity to do a genogram to shed some light on some of the themes or patterns in your multi-generational family – your family tree. A genogram typically lists 3 to 4 generations of your family (ex. your children, their siblings and their cousins; you, your siblings and your cousins; your parents and their sibling) and uses a combination of shapes and lines to visually symbolize how all the people are connected.  A Genogram can be used for many different purposes – I enjoy helping clients to look for commonality to reduce self-blame and to look for instances in which another family member resolved an issue similar to the client’s presenting concern.

   Example of a genogram (higher = older generation),(square = male and circle = female)(I would have names and ages next to each person’s symbol)       

             

Families have rituals, customs, behaviors and beliefs that are passed on from generation to generation – Often people are unaware that they are making choices based on fairly set family values – “what influenced you to parent as you do?” – client answers “I don’t know… that is the way that my parents did it I guess,” (or – “I didn’t want to parent like my parents did.”) Looking at a family tree (genogram) can give you insight into why you make some of the choices that you make.

Reducing Blame – Often clients (especially parents) will come to a family therapy session feeling really awful as they blame themselves for the difficulties that someone in their family is facing. As a therapist I will often ask clients to point out where this problem exists in other areas of the family to help the client to see that the problem is related to the family as a whole and not a solely to a set individual. (As strength-based therapist I tend to believe that finding fault is less beneficial than finding strengths and solutions).

  • The problem could have a biological explanation, which is easier to identify if you can see that many people in a family have similar symptoms. (ex. “perhaps he is irritable do in part to his digestive issues that I see many men in you family deal with.”)

 

  • The problem could be based on a family ritual that started 80+ years ago (ex. the family tends to drink alcohol when there are financial problems – this ritual started with the clients grandfather during the depression.)

 

  • Genograms can offer a reasonable explanation for a behavior that a client is not proud of. Ex. If a client is blaming himself or herself for emotionally shutting off to their partner it can be helpful for them to identify where in the family that behavior also exists, and why that behavior is adaptable, which will help in the process of finding a replacement for the behavior.

 

  • This is not about transferring blame – chances are you could probably trace many issues for multiple generations. I will talk about trauma in a future blog, but in short it is possible that a problem facing a client today is in some way related to a trauma in the family that happened 100+ years ago. (Ex. If your great grandfather was held in a prisoner camp before he came home to father your grandfather, this experience might affect the way males emotionally engages their children in your family for multiple generations. Ultimately in this example the only thing to blame is an abstraction, being –  a human’s natural reaction to violence and oppression)

 

Solutions – My absolute favorite set of questions concerning a genogram are-

– “Who else in your family went through what you are going through in their own way?”  I will then use a colored pen to mark all the people in the client’s family who have experienced a similar concern.

I then get a different color pen and ask

– “Out of the people that have experienced a concern like yours, tell me the people that you believe were able to attain a solution that you find agreeable?” (I will name the concern specifically –ex. problems with the legal system).

After all the people are marked I will ask the client or clients to talk specifically about a family member that overcame their difficulty.

– “Tell me about this person; how were they able to resolve or overcome this difficulty?”

 

– “What is it about this person that you admire or what are their strengths?”

– “In what ways are you similar to this person?”

 

-“Lets talk about how this family member’s solution might work for you and what changes you would have to make to the solution to meet your specific needs.”

 

This process has three purposes – it reduces blame, it isolates strengths and solutions that already exist, and it creates a sense of hope (as someone else already succeeded).

 

“We are what we eat and we are our family” – me

 

Again I focused this blog on reducing blame and finding solutions, future blogs will cover all the other benefits of the genogram experience. (Often a client will simply look at their genogram and the image will bring about revelations that the therapist could not have anticipated – and sometimes simply naming everyone in the family raises subjects that need to be worked through in therapy – ex. the uncle you admired that passed away too soon.)

 

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.