28 Mar Discuss the three types of questions used in Sol
Question #1 Chapter 15
Discuss the three types of questions used in Solution-focused therapy. Give an example of each. According to Solution-focused therapy, discuss how each facilitates client change/improvement.
Question #2 Chapter 16
What types of clients and client problems are best suited for Narrative models of treatment? Is this approach effective only with high functioning clients, or can it be used effectively to treat more serious problems (e.g., substance abuse, sexual abuse, or severe mental illness)?
Question #3 -Case Study Question Chapter 16, titled “Briefcases: Moving Past Delinquency”
Brief Cases: Moving Past Delinquency
The opioid epidemic did not bypass the suburbs where the McCoy family lived. Joe, the youngest of three, started experimenting with his father’s back pain medication at age 16 years. By age 17 years, he had become addicted and got into serious trouble with the law, which resulted in a recovery program, and, when he relapsed and got in trouble with the law again, incarceration. When Joe was released, he went with his family for therapy. Instead of dwelling on his past, the therapist asked Joe what he would like to become and asked the family how they could help Joe reauthor his life. Joe decided to go back to school and get his GED. He then set his sights on finding a job where he could work outdoors. The family was supportive as Joe took small daily steps to accomplish his plan….
In relation to this case study, which Narrative Therapy treatment technique would you use during the family counseling therapy session?
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Solution-Focused Brief Therapy
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Solution Focused Brief Therapy
Grew out of strategic therapy
Represents a departure from a focus on pathology-drive approaches to therapy by concentrating on skills, strengths, and resources that clients possess
It is change-oriented in that it emphasizes finding solutions for dealing with problems
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Major Theorists
Steve deShazer
Insoo Kim Berg
Michele Weiner-Davis
Eve Lipchik
Bill O’Hanlon
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Steve deShazer
Helped to establish the Brief Family Therapy Center
Emphasized solutions over problems, and identified his theory as brief family therapy
Often referred to later in life as the “Grand Old Man of Family Therapy”
Died unexpected in 2005 in Vienna, Austria
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Insoo Kim Berg
Helped to establish the Brief Family Therapy Center, where she served as Executive Director
Helped found the Solution-Focused Brief Therapy Association
Developed the miracle question
Authored or co-authored 10 books on solution-focused therapy and numerous articles
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Bill O’Hanlon
Trained under Milton Erickson
Has become a major proponent of solution-focused therapy, which he prefers to call possibility therapy
Characterizes his approach as one that is pragmatic and full of Midwestern values
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Michele Weiner-Davis
Has written popular books on solution-focused family, such as Divorce Busting.
Creator of the relationship program, Keeping Love Alive.
Recipient of the American Association of Marriage and Family Therapy’s Outstanding Contribution to the Field of Marriage and Family Therapy Award and Smart Marriages’ Impact Award
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Premises of the Theory
Built on the philosophy of social constructionism
Shares some of the same premises about families as the M R I strategic approaches
Emphasizes the belief that dysfunctional families get stuck in dealing with problems
Aim of therapy is to break repetitive, nonproductive behavioral patterns by setting up situation in which families take a more positive view of troublesome situations and participate actively in doing something different
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Premises of the Theory
Three basic rules for helping families make positive changes:
If it is not broken, do not fix it.
Once you know what works, do more of it.
If something does not work, do not do it again. Do something different.
Identifying what a problem is versus a nonproblem (or exception) is a key component in solution-focused brief therapy
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Premises of the Theory
Does not focus on a detailed family history of problems
Causal understanding is unnecessary.
Families really want to change.
Only a small amount of change is necessary.
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Treatment Techniques
Co-creation of a problem
Miracle question
Exceptions
Scaling
Second-order (qualitative) change
Compliment
Clue
Skeleton keys
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Treatment Techniques
Between now and next time we meet
Do something different
Pay attention to what you do when
A lot of people in your situation would have
Write, read, and burn your thoughts
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Role of the Therapist
Therapists determine how active a family will be in the change process. Clients usually fall into one of three categories
Visitors
Complainants
Customers
Therapists are facilitators of change
Presuppositional questioning
Positive blame
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Role of the Therapist
Solution-focused family therapists believe that it is important to fit therapeutic interventions into the context of family behavior
Often a team approach
Solution-focused family therapists encourage families to make small changes and to do so rapidly
Therapist does not distinguish between short- and long-term problems
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Process and Outcome
Solution-Focused Family Therapy is focused on encouraging client-families to seek solutions and utilize internal resources.
Pathology does not play a role in the process.
Assumes that change is inevitable – it’s only a matter of when.
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Unique Aspects of Solution-Focused Family Therapy
Solution-focused theories Concentrate on and are directed by a family’s theory
Therapists assist families in defining their situations clearly, precisely, and with possibilities
Solution-focused therapy does not focus on clinical understanding of the family situation by the family or the therapist
It is empowering and meant to assist families in assessing and utilizing their resources
Emphasizes achievable goals, such as small behavioral changes.
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Narrative Family Therapy
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Narrative Family Therapy
Originated in Australia and New Zealand
Focuses on helping families solve difficulties by depersonalizing them and rewriting family stories
Focuses on externalizing problems so families can work together on them.
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Major Theorists
Michael White
David Epston
Michael Durrant
Gerald Monk
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Michael White
Influenced by Bruner, Foucault, and Vygotsky, as well as by Feminist theory
He also learned that narratives may be overshadowed by dominant problem-saturated stories
Influenced by Foucault
Believed that problems could be addressed when a culture’s values and ideas could be questioned or challenged.
Established the Adelaide Narrative Therapy Centre
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Premises of the Theory
Nonsystemic approach to working with individuals and families based on liberation philosophy
Distinguishes between logico-scientific reasoning and narrative reasoning
People live their lives through their stories, and families are formed and transformed through stories
Emphasizes empowering client-families to develop their unique and alternative stories (reauthoring their lives)
Client-families urged to externalize problems to solve them
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Treatment Techniques
Externalization of the Problem
process by which therapists seek to separate problems from people
Results in the following:
Decrease in unproductive conflict between persons
Lessening of the sense of failure and unresolved problem places on a person
Increase of cooperation among family members to problem solve and engage in dialogue with each other
Opening up of new possibilities for action
Freeing of persons to be more effective and less stressed in approaching problems (White & Epston, 1990)
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Treatment Techniques
Influence (Effect) of the Problem on the Person: the process of asking each family member to give a no-holds-barred account of how the problem has affected him or her
Influence (Effect) of the Person on the Problem: asking family members how they have influenced a problem
Raising Dilemmas: helping families examine possible aspects of a problem before the need arises
Predicting Setbacks: planning for and anticipating potential setbacks in family therapy
Using Questions
Exceptions Questions
Significance Questions
Letters
Celebrations and Certificates
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Treatment Techniques
Using Question: to challenge families to examine the nature of the difficulties they bring to therapy and what resources they have and can use to handle their problems
Exceptions Questions: directed toward finding instances when a situation reported to be a problem was not true
Significance Questions: questions utilized to search for and reveal the meanings of important exceptions (Kurtz & Tandy, 1995)
Letters: done after therapy sessions, serving as a medium for continuation of the dialogue between the therapist and family members as a reminder of therapy sessions
Celebrations and Certificates
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Treatment Techniques
Letters:
Complete after therapy sessions have concluded
Serve as a medium for continuation of the dialogue between the therapist and family members as a reminder of what transpired in the therapy sessions
Celebrations and Certificates
a unique and important part of narrative therapy
Used to bring closure to therapy.
Serve as a tangible affirmation of the defeat of a problem
Also, they mark the beginning of a new description of a family (White & Epston, 1990)
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Role of the Therapist
Collaborator, who assumes the role of nonexpert
Centrifugal, or decentered
Use relationship skills such as attending, paraphrasing, clarifying, summarizing, and checking
Assist families in separating themselves from old, problem-saturated stories by constructing new stories (reauthoring)
Help new stories emerge by looking for unique outcomes, or storied experiences that do not fit the problem saturated story (Molina et al., 2004, p. 144)
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Process and Outcome
Process consists of three phases:
Deconstructing the dominant cultural narrative
Externalizing the problem
Reauthoring the story (Molina et al., 2004, p. 144)
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Unique Aspects of Narrative Family Therapy
Emphasizes reauthoring by families of their stories
Individuals and families asked to look for exceptions to the difficult situations they are experiencing
Expectations of setbacks and the raising of dilemmas are built into narrative family therapy
Letters are sent to families about their progress, and celebrations are held when goals are achieved.
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