Short summary of Solution-focused Brief Therapy, best I’ve seen
My notes, slightly revised for clarity from Therapeutic Conversations (1993), the papers and presenter cross-talk comments on each other’s presentations, at a 1992 Oklahoma Conference.
This below is one clinical therapist responding to other clinical therapists about theory, technique and method. Please forgive them their stilted language.
Solution-focused therapy generally begins with a period of joining and rapport-building. A brief description of the presenting complaint is elicited. If the client cannot construct a complaint, clients should be given compliments only and no therapeutic task. The therapist should relate to such a client as a visitor (de Shazer 1988).
If the client can construct a complaint, then the therapist searches for exceptions.
In the case where the client has experienced exceptions to the problem, it is important to elicit a description of how the complaint situation differs from the exception.
If these differences can be elaborated clearly by the client, a direct prescription can be given to enact the described solution [If it works, do more of it]. (Molnar and de Shazer, 1987).
If exceptions have been experienced; yet, the client cannot elaborate the difference between the problem situation and the exception, two courses of action can be taken.
Tasks of observation
“Pay attention to what you do the next time you overcome the urge to [enact the problem].”
This can be used when clients perceive themselves as in control of the situation.
Tasks of prediction
“Predict whether the next [time period] will have more instances of [exception to the problem].”
This can be used when clients perceive themselves not in control of events.
When the client cannot identify an exception, then the therapist’s efforts are focused upon developing hypothetical solutions (“How will you know when the problem is solved?”).
If the solution description offered by the client is vague, then the Formula First-Session Task is delivered (“Between now and the next time we meet, we would like you to observe, so you can describe to us next time, what happens in your family, you wish to continue to happen.”)
If the hypothetical solution is clear, then a direct prescription to enact it may be offered..
In the event the complaint pattern is part of a global frame, an elaborate world view, providing the context for the problem but also for the client’s entire life — then this frame needs de-constructing. How? Doubt is introduced when discrepancies in the logic of the frame are discerned by the therapist; and, brought to the client’s awareness (de Shazer, 1988).
The conduct of further sessions depends upon the client’s report on the effect of the intervention message in the previous session. When clients report behaviors and experiences they want to continue, the therapist questions the family to clarify how the changes will affect the family ecology.
After this is clear to family members, the therapist focuses on expanding and maintaining these descriptions into the future (Lipchik and de Shazer, 1986).
If the family follows a prescribed tasks in a straightforward way; yet, no positive change is experienced, the problem may need to be re-defined. If the family has followed a prescribed task, tasks of prediction and observation may fit better with the client system (de Shazer, 1988).
pgs 106–107
= = =
Hypothesizing [by the therapist more likely to be a Protector than useful]
… They would probably agree with O’Hanlons (1986) views of hypothesizing:
… I think hypotheses are mere distractions at best; and at worst, become self-fulfilling prophecies for the therapist or for the client. . . . All Brief therapists ought to have couches in their offices . . . for the therapist to use whenever he or she gets a hypothesis — lie down on the couch until it goes away! (p 33).
“Rarely is a book generated by a conference as good or better than the genuine thing. Therapeutic Conversations is this and more. A star-studded cast of theorists and practitioners talk about ‘generating possibilities through therapeutic conversations.’ Each presentation is accompanied by a reflective commentary, and often the presenter’s commentary on this commentary―blending to sharpen the ideas and capture the essence and spirit of the conference’s conversational style. Unquestionably, Therapeutic Conversations has to be the best source available for bringing into focus the similarities and the differences among these contributors. Where else can you eavesdrop on what White thinks of de Shazer or what de Shazer thinks of what White thinks of de Shazer!” ―Harlene Anderson, Ph.D., Houston Galveston Institute
