Solution-Focused brief Therapy

What is going well? And what else? And what else?

By Frances Cook, MSc, MRCSLT (Hons) Cert. CT (Oxford)

De Shazer 's model of Solution Focused Brief Therapy is based on several core assumptions about the nature of change. Clients are viewed as being 'stuck ' in problem patterns in which attempts to resolve or cope with their difficulties have become part of the problem.

alt text However it is assumed that there will be times when problems do not occur or occur less and that clients therefore have within themselves the strengths and resources necessary to resolve difficulties.

In Brief Therapy it is assumed that small changes will initiate other changes in a 'ripple ' effect, thus helping clients to move towards their goals. Brief Therapy should therefore be as time-efficient as possible and as short-term as is required to establish a momentum of change.

Brief Therapy is orientated towards the future. This is achieved by devoting minimal time to exploring complaints or problems, by directing clients to 'responses that are self-enhancing and strength-producing ' and using language that implies an expectation of positive change. The focus of therapy is on what is changeable and possible rather than on what is impossible and intractable.

The therapist 's role is to see a person as more than their problem, to look for resources rather than deficits, to help clients identify goals or 'preferred futures, ' to identify and amplify existing strengths and resources, and to identify and make use of 'exceptions to the rule. ' Problems may be elaborated in order to help clients identify patterns and repetitive cycles, but the greater focus is on identification of solutions, exceptions and the 'difference that will make a difference. ' The process of therapy involves building rapport, identifying problem patterns, establishing goals, exploring strengths and solutions, emphasizing positive coping and predicting, and preparing for relapse.

From the outset, interventions are specifically about the future and solution focused. Clients are treated as experts in their lives, questions are used to establish goals or signs of change, which are small, relevant, achievable, and described in positive, behavioral terms. Some initial, global goals such as 'feel more confident' or 'be happier ' are further refined by asking 'What else will happen because you 're feeling more confident? ' or 'How will people know that you 're feeling happier? '

Rating scales are used throughout therapy and provide objective measures of change, while the emphasis on establishing concrete goals means that specific behavioural, if anecdotal, evidence from clients is gained.

Find out what is already working ' and do more of it. Move from what 's going wrong to what 's going well - and what else, and what else, and what else?

References:
Bateson, G. (1972) Steps to an Ecology of Mind. N.Y: Ballantine Books.
Budman, S., Friedman, S., & Hoyt, M. (1992) Last words on first sessions. In Budman, S., Hoyt, M & Friedman, S. (Eds.) The First Session in Brief Therapy. New York:Guilford.
de Shazer, S. (1985) Keys to Solution in Brief Therapy. New York: Norton.
de Shazer, S. (1988) Clues: Investigating Solutions in Brief Therapy. New York: W.W.Norton.
de Shazer, S. (1991) Putting differences to work. NY: W.W. Norton & Co.
Hoyt, M (1994) Single session solutions. In M. Hoyt (ed) Constructive Therapies. New York:Guilford.
Iveson, G.E. & Ratner,C. (1990) Problem to Solution: London. BT Press.
O 'Hanlon, P, & Weiner-Davis, M. (1989) In search of solutions. NY: Norton.

CELEBRITY FOCUS

Mel Tillis

Mel Tillis, born Lonnie Melvin Tillis, was an influential figure in country music, both as a songwriter and a performer. His journey to fame was marked by overcoming personal challenges, including a stutter that he turned into a defining part of his public persona.

Kenyon Martin

Kenyon Martin, the basketball sensation who was named to the NBA’s All Star Team in 2004, joins other famous people who stutter in a new brochure. The brochure - which unfolds into a small poster - is available free of charge from The Stuttering Foundation.

The poster is intended to give children and adults who stutter inspiration as they grapple with their speech disorder.

Ken Venturi

As much of the nation watches the U.S. Open Golf Championship, it is impossible not to think about our late friend Ken Venturi. Ken overcame many challenges to win the Open at Congressional in 1964 and go on to become the voice of golf for more than three decades.

However, Ken faced no bigger obstacle than stuttering. Ken Venturi was a champion to those who stutter, going out of his way to share his personal experience when consulted by a colleague, friend, or child who stutters.

Bob Love

Bob Love has dreamt about being a great public speaker since his early days in Bastrop Louisiana, even though, as a young man, he could barely put two words together, let alone speak a full sentence.

In spite of his severe stuttering disability, Bob Love, the son of a sharecropper, rose to become a Chicago Bulls NBA superstar, whose records were eventually surpassed by Michael Jordan. Throughout his entire athletic career, Bob Love kept his stuttering a secret from the fans who adored him, thinking he could do his “talking” on the basketball court.

Byron Pitts

Byron Pitts has brought much attention to stuttering with his memoir, Step Out on Nothing: How Faith and Family Helped Me Conquer Life’s Challenges, released in September, 2009. The book not only details his speech difficulties, but also his illiteracy until age 12 and his unstable family life. Pitts overcame the odds to become the chief national correspondent with ABC News.