Solution-Focused Therapy and Counselling

 

Just as its name implies, solution-focused therapy concentrates on solutions and is directed by goals and future-focused instead of focusing on the issues that caused a client to look for therapy. This approach was developed in a mental health centre situated in the inner city. Clients did not undergo any screening before being accepted. Over several years, Shazer and Berg devoted countless hours watching therapy sessions. They paid careful attention to the therapists’ emotions, questions, and behaviours throughout the session, as well as how different activities of the therapist affected the client and the session’s therapeutic outcome. Activities and questions related to the clients’ reported progress were recorded and integrated into the Solution-Focused Approach.

Since its early stages of development, Solution-Focused has grown into one of the top schools of brief therapy and a significant influence in a variety of fields, including criminal justice, education, business, domestic violence offender’s treatment ,child welfare, and social policy. Considered to be a practical and goal-driven model, Solution-Focused therapy places an emphasis on concise, clear, and realistic goal negotiations. It assumes that all clients have some idea of what could be done to improve their life and already possesses the minimum skills needed to create solutions, even though they may require assistance describing the aspects of their better life.

 

Key Tools and Concepts

Conversation during solution-focused therapy sessions focuses on cultivating and accomplishing the client’s vision of solutions. A variety of techniques/ questions may be used to clarify these solutions, as well as how to achieve them. They include:

Evaluating previous solutions: Many therapists learn that people have resolved problems in the past, giving them some idea of how they may be able to solve their present problem. To assist clients in seeing these possible solutions, therapists may ask, “What did you do that was helpful in the past?” or “Have there been times in your life when this was not as much of a problem?”

Looking for exceptions: Even in cases when a client doesn’t have a prior solution that can be duplicated, most will possess recent examples of exceptions to their problems. Although there is only a small difference between a past solution and an exception, it is considered to be significant. A past solution is something the client has tried without outside help that proved to be helpful, but later stopped doing. An exception is something that occurs in place of the problem, usually without warning or conscious intent. Exceptions may be identified by asking questions such as “What’s different about the occasions during which this problem wasn’t so big?”

Questions that are present and future-focused vs. focused on the past: Solution-focused therapists tend to focus on the present and the future, reflecting the basic belief that problems are best solved by focusing on something that previously worked and how a client wants their life to be as opposed to focusing on the problem’s origin and their past. They may ask “What will you be doing next week that you see as an indication you are continuing to make progress?”

Compliments: Validating what a client is doing well and acknowledging how hard their problems are, while also conveying that they therapist has been listening and cares, is a crucial component of solution-focused brief therapy. In therapy, compliments tend to be worded in the form of appreciatively toned questions such as “How did you do that?” This allows the client to also compliment themselves while giving an answer.

Encouraging the client to do more of what works: After creating a positive frame by giving compliments and discovering previous solutions and exceptions to the problem, therapists can gently invite clients to do more of what has worked in the past or to the encourage them to try changes they have mentioned they would like to try. This is often referred to as “an experiment.”

Miracle Question (MC): This is a powerful tool for generating the first small steps of “solution states.” It involves helping clients to describe realistic, small, and doable steps they can begin to take as soon as the next day. The “miracle question” is the result of a suicidal woman with an alcoholic partner and 4 wild children who created chaos. Desperate for a solution, she needed a “miracle” to get her life back on track. Since this technique was developed, it has been tested multiple times in various cultures. Here’s an example:

Therapist: “Let me ask you a strange question. It’ll require imagination on your part. Are you imaginative?”

Client: “Um, yeah. I’ll try my best.”

Therapist: “Great. Here it is after. After we talk today and you go back home, you’ll still have plenty of everyday tasks to fill the rest of the day, such as cooking, cleaning, etc. Now, when it’s time to go to bed and everyone else is asleep and your house is quiet…in the middle of the night, a miracle occurs and all the sudden your problem is solved. Of course, since this happened while you were asleep, you aren’t aware a miracle has occurred. Now, you are coming out of your sound sleep. What would be the first sign that would make you wonder if a miracle had occurred and your problem was really gone? What would it be?”

Client: “I guess it would be getting up and feeling like I can face the day instead of simply wanting to bury myself in the covers and hide.”

Therapist: “Let’s say you do get up and face the day. What would be one small thing you would do that you didn’t do this morning?”

Client: “Um, saying a cheerful good morning to my kids. Usually, I just scream at them.”

Therapist: “How do you think your children would respond to a cheerful greeting?”

Client: “Surprise at hearing me talk cheerful. They’d be calmer and relaxed, which would make the morning a bit easier…something we haven’t had in a long time.”

Therapist: “So, what would you do then that you didn’t do this morning?”

Client: “Crack a joke and put them in a good mood.”

These small steps serve as building blocks for a completely different kind of day when the client begins implementing some of the behavioural changes they envisioned. This is the longest question asked in Solution-Focused therapy and it tends to have a hypnotic affect. You tend to see a visible change in a client’s demeanour. Some even smile when discussing their solution. The next step involves identifying recent times when the client has had a small miracle (an exception) and getting them to repeat these forgotten experiences.

Scaling questions(SQ) are ideal for sessions when there isn’t enough time to utilise the MQ. It is also a great way to help clients assess their current situation, track their progress, or evaluate how others would rate them on a 0-10 scale. It is perfect for use with anyone, including children, with poor verbal skills. SQ can be used to ask about clients’ confidence level, depression, confidence/ optimism, motivation, progress they’ve made, or any other area in which their performance needs to tracked. Here’s an example of SQ using a couple that have been married for 30 years, but have fought for the last 15 and aren’t sure if their marriage can survive.

 

Therapist: The two of you know your marriage better than anyone, so let me ask you a question this way. On a scale of 1-10 with 10 meaning you are completely confident your marriage will make it and 1 meaning that it’s not going to last and you might as well walk away right now, what number would you give your marriage?

Wife: (after a short pause): I would say a 6.5.

Therapist: (to husband) What about you?

Husband: (visibly flinched when he heard his wife’s response) I would have to go with 1.3.

Therapist: Why is it 1.3?

Husband: Well, that’s the reason we are here tonight.

Coping Questions (CQ) act as a strong reminder that even during periods of overwhelming stress and depression, all clients must continue to participate in useful things. Even at their worst, most clients still get out of bed, get dressed, eat, and do the activities that right major effort. CQ, such as “How have you been able to carry on?” or “How have you kept things from getting worse?” offer a different method of examining a client’s determination and adaptability.

A Brief Break

Typically, during the 2nd half of each session, solution focused therapists take a short consultation break, allowing the therapist (and possibly any other team members)a period for reflection on what has occurred so far. Before the break, the client will be asked, “Can you think of anything I have not asked you that you believe is important for me to know?”

After the break, the client is commended and often offered a therapeutic message that is based on his stated goal. This is usually done in the form of an invitation for the client to observe and practice with behaviours that move them in a positive direction toward their goal.

 

Research Findings

Despite its inductively developed model, solution focused therapy has generated consistent interest linked to assessing its effectiveness. Initially, research was based almost entirely on client self-reports. However, more forms of studies have been introduced. Some involve randomized comparison groups, such as the study completed by Lindforss and Magnusson who examined the effects of solution focused therapy on the recidivism rate at Hageby Prison in Stockholm, Sweden. Following their prison discharge, clients were followed at 12 and 16 months. The solution focused group regularly did better than the control group.