Postmodern Approaches

Overview Postmodernists believe in the subjective realities that do not exist independent of observational processes. Social constructionism is a therapeutic perspective within a postmodern worldview: it stresses the client's reality without disputing whether it is accurate or rational.

…continued In postmodern thinking, language and the use of language in stories create meaning. In social constructionism the therapist disavows the role of expert, preferring a more collaborative or consultative stance. Clients of the therapists are viewed as experts in their own lives.

Solution-Focused Brief Therapy Solution-focused brief therapy differs from traditional therapies by eschewing the past in favor of both the present and the future. It is so focused on what is possible that it has little or no interest in gaining an understanding of the problem. De Shazer suggests that it is not necessary to know the cause of the problem to solve it. Gathering information about a problem is not necessary for change to occur.

…continued In solution-focused brief therapy clients choose the goals they wish to accomplish in their time in therapy, and little attention is given to diagnosis, history taking, or exploration of the problem.

The Therapeutic Process Bertolino and O’Hanlon stress the importance of creating collaborative therapeutic relationships and see doing so as necessary for successful therapy. If the clients are involved in the therapeutic process from beginning to end, the chances are increased that therapy will be successful. Walter and Peller describe four steps that characterize the process of Solution-focused relief therapy.

4 Steps 1. Find ou what clients want rather than searching for what they do not want. 2. Do not look for pathology, and do not attempt to reduce clients by giving them a diagnostic label. Instead, look for what clients are doing that is already working and encourage them to continue in that direction.

…continued 3. If what clients are doing is not working, then encourage them to experiment with doing something different, 4. Keep therapy brief by approaching each session as if it were the last and only session.

3 kinds of therapist/client relationships De Shazer developed 3 different kinds of relationships that can develop between the client and the therapist. These 3 are customer, complainant, and visitor. 1. customer: the client and therapist jointly identify a problem and a solution to work toward. The client realizes that to attain his/her goals, personal effort is required.

2. complainant: the client describes a problem but is not able or willing to assume a role in constructing a solution, believing that a solution is dependant on someone else’s actions. The client expects the therapist to change the person who is attributed with the problem. 3. visitor: the client who comes to therapy because someone else thinks the client has a problem. Client may not agree they have a problem therefore may not identify anything to explore during therapy.

Therapeutic Techniques PRETHERAPY CHANGE-during the initial therapy session it is common for a solution-focused therapist to ask, ‘What have you done since calling for your appointment that has made a difference in your problem?’ EXCEPTION QUESTIONS- these are used to direct clients to times when the problem did not exist.

..cont. THE MIRACLE QUESTION-therapist ask. ‘if a miracle happened and the problem you have was solved overnight, how would you know it was solved and what would be different?’ SCALING QUESTIONS-when the therapists ask such questions, ‘On a scale of one to 10, when zero being when you first came to therapy and 10 being after the miracle occurs, rate your problem now.

FORMULA FIRST SESSION TASK-something that resembles homework given from the therapist to the client, ‘between now and the next time we meet I want you to observe so that you can describe to me next time, what happens in your home life that you want to continue to happen’.

Therapists Feedback to clients During the last 5 to 10 minutes of the session the therapist usually compose a summary message for the clients. During this time therapists formulate feedback that will be given to the clients. There are three parts to this; compliments, a bridge and suggesting a task.

Narrative Therapy According to Michael White, individuals construct the meaning of life in interpretive stories, which are then treated as “truth.” Therapists are encouraged to establish a collaborative approach with a special interest in listening to clients’ stories. Therapists use these stories to engage us in therapy, avoid diagnosing and labeling, and help clients with mapping out the problem.

The Therapeutic Process Steps in the therapeutic process include: Collaborate with the client to come up with a mutually acceptable name for the problem. Personify the problem and attribute oppressive intentions and tactics to it. Investigate how the problem has been disrupting, dominating, or discouraging to the client. Invite the client to see his or her story from a different perspective by offering alternative meanings for the events.

Discover moments when the client wasn’t dominated of discourage by the problem by searching for exceptions to the problem. Find historical evidence to bolster a new view of the client as competent enough to have stood up to, defeated, or escaped the dominance of oppression of the problem. Ask the client to speculate about what kind of future could expected from the strong, competent person that is emerging. Find or create an audience for perceiving and supporting the new story. Clients need to live the new story outside of therapy.

Therapists goals and function A general goal of narrative therapy is to invite people to describe their experience in a new and fresh language. In doing this they open up new vistas of what is possible. A main task of the therapist is to help the clients construct a preferred story line. Like the social-focused therapy, narrative therapy believes that the client is the expert when it comes to what they want in life.

Therapeutic Techniques QUESTIONS-therapists use questions to generate experience rather than to gather information. EXTERNALIZATION AND DECONSTRUCTION- therapists believe its not the person that is the problem but that it’s the problem that is the problem. This is one way to separate the person from identifying with the problem.

Summary In both social-focused and narrative therapies the therapist-as-expert is replaced with the client-as-expert mindset. Both are also based on the optimistic assumption that people are healthy, competent, resourceful, and posses the ability to construct solutions and alternative stories that can enhance their lives.