Solution-Focused Brief Therapy Part 1

Solution-Focused Brief Therapy Part 1
Arlene Brett Gordon, PhD, LMFT Based on work of Steve de Shazer and Insoo Kim Berg This product is supported by Florida Department of Children and Families Substance Abuse and Mental Health Program Office funding. Arlene Brett Gordon, Ph.D., LMFT

Arlene Brett Gordon, Ph.D., LMFT
Who am I? Arlene Brett Gordon, Ph.D. Licensed Marriage and Family Therapist AAMFT and State Supervisor Training Solution Focused Brief Therapy since 1993 nationally and internationally Trained by and worked with Insoo Kim Berg from 1992 until her passing in 2007 Currently the director of the Brief Therapy Institute, Department of Family Therapy at Nova Southeastern University in Ft. Lauderdale Adjunct professor training master’s and doctoral students in clinical practice Arlene Brett Gordon, Ph.D., LMFT

Who Are You? It is most helpful to me if I know about you. Let’s take a POLL: Please type in your degree and/or your area of study. Do you work with mandated clients? Do you provide home-visits? Do you work in a residential setting? Are you a supervisor? Arlene Brett Gordon, Ph.D., LMFT

Big & Little Story of Life Solutions No brother Birthday Problems Johnny is not doing his homework. No TV Arlene Brett Gordon, Ph.D., LMFT

Solution-Focused Brief Therapy developed by Steve deShazer & Insoo Kim Berg 1. Focus on the client’s strengths and abilities. 2. Find out what is working and do more of it. 3. Clients have the resources for change. 4. Clients generate workable solutions. 5. Change starts small and has a ripple effect. 6. Focus on the future when the problem has been solved. 7. Focus on when the problem is not a problem. Arlene Brett Gordon, Ph.D., LMFT

Family Systems: Genograms
Key: Male Female Deceased Pregnancy Pets Married Unmarried Separated/Divorced Arlene Brett Gordon, Ph.D., LMFT Arlene Brett Gordon, PhD Families Facing Solutions

Genograms: Getting a better understanding of the family system.
Lyle 5 Arlene Brett Gordon, PhD, LMFT, CFLE Solution-Focused Center of Florida

Solution Focused Keys Level of client engagement: Visitor, complainant, customer Use of compliments: Direct, relational, self Joining from each person’s perspective Child, parent, teacher, service provider Recognizing client’s resources Family and community support Arlene Brett Gordon, Ph.D., LMFT

Who is the Client? Who is most vested in change?
Visitor: May appear resistant, wants to avoid participation Little hope for change Complainant: “Fix my Kid”, does not see self a part of the problem Offers details about what is wrong Customer: * most invested in change * collaborates on goals and is hopeful for change * proactive in working toward the solution * eager to work with helping system Arlene Brett Gordon, Ph.D., LMFT

Hope & Expectancy Hope & Goals Developing a goal leads to an expectation of change Expectation of change leads to increased motivation (Reiter, 2011) Expectancy is “the activating energy of hope” (Friedman & Fanger, 1991, p. 34) Expectancy factors: Client’s impact of believing in therapy Instillation of hope Arlene Brett Gordon, Ph.D., LMFT

Key Factors Relevant to Client Change Processes
Common Factors Key Factors Relevant to Client Change Processes Lambert (1992).

Consider: Recall one compliment that you received as a child: What was it? Who gave you the compliment? What influence has it had on your life? your career? How did you use the information to affect your choices? Take a POLL. Write it down. Arlene Brett Gordon, Ph.D., LMFT

Tools: Compliments Direct Compliments: Come from you. I like the way you are ready to work with me. I think you make good decisions. Indirect Compliments: Come from another (Relationship Questions) What would your mother say if she knew how hard you were were working? What would your children notice if you were able to control your temper? Self Compliments: Response comes from client. You did what? How were able to do that? What other good decisions do you make? Arlene Brett Gordon, Ph.D., LMFT

Family/Resource Systems: Ecograms
Client Who/what are resources for this system? Arlene Brett Gordon, Ph.D., LMFT Arlene Brett Gordon, PhD Families Facing Solutions

Group Activity: Engagement
Think of a time when you failed. How did you feel? List of three words which describe how you felt. Think of a time when you were successful. How did you feel? List of three words which describe how you felt. Arlene Brett Gordon, Ph.D., LMFT

Joining: Building a Collaborative Relationship
Picture yourself in each client’s context. Ask yourself: What is it like to be this mother and have these challenges? Compliment cooperation. You seem very busy. Thank you for finding time to meet with me. Respect the client’s understanding of the problem. It is often different than the referring source’s problem definition. School: Johnny does not behave in school. The parents must do something. Home: If the school does not stop calling I might loose my job. Compliment what each person is doing well. Arlene Brett Gordon, Ph.D., LMFT

What is going on in this picture? What is the family doing? Where are you in this picture? A solution-focused worker works with the family to help them discover the pieces they need to create their own solutions. Arlene Brett Gordon, Ph.D., LMFT

What has to happen for you to know that this meeting was worth your time? Ask Yourself… 1. What is important to the client? 2. How do they understand the problem? 3. What are the client’s solution-building strategies? 4. What has worked? What has not worked? 5. What are they willing to do? Not do? 6. What resources are available? Arlene Brett Gordon, Ph.D., LMFT

Empowering Clients Each client is the EXPERT of their life situation. Recognize each client’s ability to be proactive in creating change and building solutions. Collaborate to negotiate goals. What needs to happen first? Compliment individual strengths. Highlight what each person does well. Discover past successes and stress exceptions to the problem. Respect each client’s personal, familial and cultural boundaries. Each family has their own culture. Be curious and ask how this person solves problems. Arlene Brett Gordon, Ph.D., LMFT

Activity: Solution-Focused Listening (Josee Lamarre in Nelson, 2005)
How well can you listen to some one complain, complain, complain? I am going to complain about something that happened to me. Your job is to listen. Listeners, Listen carefully. You will be asked in a little while to type in a response to a question I ask you. Here I go! Arlene Brett Gordon, Ph.D., LMFT

Solution-Focused Brief Therapy Part 2
Arlene Brett Gordon, PhD, LMFT Based on work of Steve de Shazer and Insoo Kim Berg This product is supported by Florida Department of Children and Families Substance Abuse and Mental Health Program Office funding. Arlene Brett Gordon, Ph.D., LMFT

Who am I? Arlene Brett Gordon, Ph.D. Licensed Marriage and Family Therapist AAMFT and State Supervisor Training Solution Focused Brief Therapy since 1993 nationally and internationally Trained by and worked with Insoo Kim Berg from 1992 until her passing in 2007 Currently the director of the Brief Therapy Institute, Department of Family Therapy at Nova Southeastern University in Ft. Lauderdale Adjunct professor training master’s and doctoral students in clinical practice Arlene Brett Gordon, Ph.D., LMFT

Part 1 Review Arlene Brett Gordon, Ph.D., LMFT

Solution-Focused Questions as Tools
Exceptions Miracle Questions Scaling Questions Coping Questions Relational Questions Arlene Brett Gordon, Ph.D., LMFT

1. Exception Questions Focus on times when the client solved problems. Was there ever a time when you were able to…? Exceptions are those times when the problem does not happen, when the problem is not a problem. Bring past successes to the present, and apply them to the future. How were you able to get you baby to the doctor in the past? Who was helpful to you? Do you think they might be able to help you again? Note small, but important differences. You were able to get to school on time one day this week? How were you able to do that? Talk of success empowers. It convinces them to have power in their own lives. You were able to do all that? What else can you do? When discussing the parent’s story, focus on successes. Arlene Brett Gordon, Ph.D., LMFT

2. The Miracle Question Suppose when you go to sleep tonight, a miracle occurs and the problems that brought me here today are solved. Since you are sleeping, you don’t know that a miracle has happened and that your problem is solved. What do you suppose you will notice different the next morning that will tell you there has been a miracle? Arlene Brett Gordon, Ph.D., LMFT

Family/Resource Systems: Ecograms
Psychiatrist Your agency Your Client GAL Court M.Q. “What is your goal for YOU?” AA Parenting Who/what are resources for this system? Arlene Brett Gordon, Ph.D., LMFT Arlene Brett Gordon, PhD Families Facing Solutions

The Miracle Question: Goals
1. Ask the client to describe these imagined changes in concrete, specific and achievable terms. What will be different once the miracle has occurred? 2. Elicit information in a way that your client actually envisions the miracle happening. What will you be doing? What will your son be doing? Who else in the family would notice? 3. Have your client describe the first steps taken to initiate the behaviors that will lead to the miracle/goal. What do you think is your first step towards your miracle? 4. Use your client’s own ideas in formulating the solution. Arlene Brett Gordon, Ph.D., LMFT

Nice Clothes Money Job Interview Newspaper Morning Alarm Clock Arlene Brett Gordon, Ph.D., LMFT

Goal Setting: A Plan of Action
Collaborate with the client to develop: 1. Well-formed, realistic goals. 2. Described in specific, concrete, behavioral terms. 3. Described in familial terms and expressed as the “start of something” instead of the “end of something”. 4. Ways that change will improve each stakeholder’s life. Arlene Brett Gordon, Ph.D., LMFT

3. Scaling Questions On a scale of 1 to 10’ 10 meaning the most hopeful and 1 meaning the opposite, how hopeful are you that you will ______? What is the level of commitment to the intervention? How confident are they? How hopeful are they that they will reach their miracle? Where is this client in the process of change? Arlene Brett Gordon, Ph.D., LMFT

3. Scaling Questions: A Self-Assessment Tool
Use to assess things usually considered too abstract to make concrete: Self-esteem, self-confidence, willingness to work to create change, prioritize problems, hopefulness, control.... Discuss what would have to happen for your client to go up a point or half a point. What would have to be different for you to be at a 6½? Discuss who will notice the change What will they notice that you are doing differently? If response is 7 or higher, ask the client to explain why they are so confident. Assess progress. You said that you were at a one when we started our work together. Where would you say you are right now? Arlene Brett Gordon, Ph.D., LMFT

Sfbta.org The Solution Focused Brief Therapy Association website: Download documents Training information Presentations Arlene Brett Gordon, Ph.D., LMFT

4. Coping Questions Use the Coping Question if the client: Can not recall any successes. Little hope of change. Unable to work towards solutions. Ask: How do you manage to do as well as you do with all these challenges? How come things are not worse? Arlene Brett Gordon, Ph.D., LMFT

4. Coping Questions 1. Helpful when there are no exceptions or results to the miracle question. You have been through a lot lately. How have you coped and still done what you needed to do? 2. Can be uplifting to your client as you discover their resources for change. I can see you are discouraged. So tell me, how do you keep going? What motivates you to keep going? 3. Clients do many things right. Once they are recognized, you can help the client build on those strengths. 4. Help your client make decisions based on her knowing that she does make some good decisions. Arlene Brett Gordon, Ph.D., LMFT

5. Relationship Questions
Questions that ask the client about the perception of important others such as family members, teachers, coworkers. What do you think the children would notice when they see how hard you are working? Who at this home is most helpful? Does she know you feel this way? What will the teacher say when all your children are ready for their evaluation? Do you think the other family members might notice? How does all this effort help your children? Arlene Brett Gordon, Ph.D., LMFT

Talking Solutions with Mandated Clients Review
Begin to Negotiate Goals Referral Source Client’s Perspective Goal Negotiation Working with the Client’s Context Miracle Question Scaling Question Relationship Question Coping Question Arlene Brett Gordon, Ph.D., LMFT

How to Respond to: I Don’t Know
Pretend you know. What would your mother (best friend, teacher) say? What would be different in your life if you did know? Guess. Is it important to know? Suppose you knew. What would be different? Perhaps you don’t know yet. What will be different when you do know? Maybe this is something you need to think about. Ask the question in another way. Stay silent. Be patient. Arlene Brett Gordon, Ph.D., LMFT

On-Going Evaluation Engage clients to view your work together as an on-going process. Scaling sessions provide on-going information about the family’s perception of change. Evaluation is an on-going process. a. Each meeting is evaluative. “What’s better?” b. Use only the useful information that is important in reaching the goal. c. Demonstrate flexibility to change based on new information. d. Admit any mistakes. Arlene Brett Gordon, Ph.D., LMFT

Ongoing Sessions: What’s Better
Initiate solution talk: “What’s better?” Client #1: Things were a bit easier this week. I was able to finally make any appointment with my daughter’s teacher. Worker: Wonderful. Good for you. What do you plan on talking with her about? or What questions do you need answered? At the end of your meeting, what do you hope will be different for your daughter? What do you think your next step will be? * Arlene Brett Gordon, Ph.D., LMFT

Ongoing Sessions: What’s Better
Initiate solution talk: “What’s better?” Client #2: Nothing….nothing was better this week. John continued to throw tantrums and leave without permission. I am just so frustrated. Worker: Sounds like it has been a challenging week. Did anything happen that would at least tell you things are not getting worse? or Oh, that sounds so challenging. Let me ask you…how did you get through the week? Can you recall one time when John surprised you and did not throw a tantrum or leave? Arlene Brett Gordon, Ph.D., LMFT

Worker’s Focus 1. When do the exceptions occur? 2. Who is most interested in finding solutions? 3. What are everyone’s strengths and resources? 4. Explore who tried what, where, how? 5. Discard what did not work. 6. Together establish small and realistic behavioral goals. 7. Together list past successes and accomplishments. 8. Present the next task as the next step. 9. Scale for hopefulness. Arlene Brett Gordon, Ph.D., LMFT

Interventions Compliments Direct Relational Self Illusion of Choice Provide clients with options and ask them to pick one. Instead of asking a visitor if she wants another appointment, ask: Would you like to make another appointment on either Tuesday or Wednesday? Arlene Brett Gordon, Ph.D., LMFT

Interventions Normalizing Reassuring client that what she is doing is in the normal range of behaviors Age-appropriate behaviors Reframing Helps to conceptualize the problem in a new way. Provides an alternative interpretation. Suggests a new way of behaving. Arlene Brett Gordon, Ph.D., LMFT

Sliding Doors The Present The Future Jail No Girlfriend No School No Job Which road do you want to travel? Married Nurse Home Arlene Brett Gordon, Ph.D., LMFT

Magic Square (Korman in Nelson, 2005)
Problem Box Solution Box Resources Scale Arlene Brett Gordon, Ph.D., LMFT

Clinical Review Who are the members of the client’s system? ___________________________________________________________________________________________________________________ What are their concerns and challenges? What are each member’s strengths (compliments)? Level of engagement: Who is a customer, complainant, visitor? ___________________________________________________________________________________________________________________ What has to happen for you to know that the your last session was helpful? What are the exceptions to the problem? What is each member’s miracle? __________________________________________________________________________________________________________________________________________ How hopeful and/or committed are the family members?(scaling) What are the between-session tasks? Arlene Brett Gordon, Ph.D., LMFT

References Berg, I. K. (1994). Family-based services: A solution-focused approach. New York: W. W. Norton. Berg, I. K., & Kelly, S. (2000). Building solutions in child protective services. New York: W. W. Norton. Berg, I. K., & Steiner, T. (2003). Children’s solution work. New York: W. W. Norton. Cade, B. & O’Hanlon, W.H. (1993). A brief guide to brief therapy. NY: Norton. Friedman, S., & Fanger, M. T. (1991). Expanding therapeutic possibilities: Getting results in brief psychotherapy. Lanham, MA: Lexington Books. Nelson, T.S. (Ed.). (2005) Education and training in Solution Focused Brief Therapy. Binghamton, NY: Hawthorn Press. Reiter, M. D., (2010). Hope and Expectancy in Solution-Focused Brief Therapy. Journal of Family Psychotherapy, 21, Pichot, T. & Dolan, Y. (2003). Solution-Focused Brief Therapy: Its effective use in agency settings. New York: Hawthorn Press. Walter, J., & Peller, J. (1992). Becoming solution-focused in brief therapy. New York: Brunner-Mazel. And personal communication gathered from hundreds of conversations with Insoo Kim Berg between 1991 and 1/6/2007. Arlene Brett Gordon, Ph.D., LMFT FFS: 2007

Thank You Arlene Brett Gordon, Ph.D., LMFT

Solution-Focused Brief Therapy Part 1

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