1. Questions as Therapy Using systemic ideas in a learning disability context Selma Rikberg Smyly Consultant Clinical Psychologist Formerly: Ridgeway Partnership Oxfordshire Learning Disability NHS Trust selma.smyly@hotmail.co.uk

2. Pre-session hypothesising To develop and maintain curiosity in therapist Help develop systemic questions. Cecchin: Not “falling in love” with ones hypothesis as a way of maintaining curiosity Systemic concept Life as storied; the problem saturated narratives of our clients (Lynggaard) “study of disability is the study of the disabeling society” (Hayden- Laureat)

3. Nature of change/aim of therapy; Loosening the connection between the individual and the problem “The person is not the problem the problem is the problem” Questions as therapy; how to prioritise context and relationship questions over problem focused questions (using circular questions, reframes, punctuating alternative stories, seeing multiple stories as a resource : both and) Change happens at the level of meanings and beliefs by “creating new stories or new meanings to old stories” (Hoffman) Finding the “difference which makes the difference” (Bateson)

4. When to use systemic approaches: 1.Complex referrals/ front door assessments/ initial consultations 2.Transitions e.g. form children’s to adult services 3.When working with families and behavioural /cognitive approaches have not been helpful 4.When other approaches have already been tried 5.When feeling stuck and not knowing how to proceed 6.When multiple views become a hindrance

5. Asking about the relevant network  Who are they  What is their relationship to problem/client  What is their expectation of /relationship to/ help Who invited the therapist, who is the referrer Prata, Selvini et.al.(1980) The problem of the referring person. Reder and Fredman (1996) The relationship to help: interacting beliefs about the treatment process.

9. Position of therapist /transparency /self reflexivity; who are we doing this work, what do we pay attention to/what do we miss out? (genogrammes, lifecycle stages, cultural context) Interest in referring person; why now, who’s idea was it? ( relationship to help; customer/visitor/ complainant) Pre session hypothesising; turning assessment on its head Multiple perspectives: multiple solutions, seeing difference as a resource/ opportunity for change (curiosity, inviting of difference, non blaiming stance, both /and) “ The person is not the problem the problem is the problem”

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