1、Theory and Practice of Counseling and PsychotherapyPsych422Chapter13:Postmodern Approach(solution-focused brief therapy and narrative therapy)QuestionsnIf persons see therapists,in general,what is/are the expectation(s)from their therapist?nIf persons sees therapists for their problem,what is/are th
2、e final goals after completing the therapy sessions?View of Human Nature nAssume that realities are socially constructed.There is no absolute reality.nView people are healthy,competent,resourceful,and have the ability to construct solutions and alternative stories to enhance their lives.nHelp client
3、s recognize their competencies and build on their potential,strengths,and resources.Key Concepts of Solution-Focused Brief TherapynTherapy grounded on a positive orientation-people are healthy and competentnDownplay“past”,while highlight“present and future”nView people are healthy,competent,and reso
4、urceful,and have the ability to construct solutions to enhance their lives nTherapy is concerned with looking for what is workingnTherapists assist clients in finding exceptions to their problemsnThe therapy process is to focus on creating solutions rather than talking about the problemsBasic Assump
5、tions of Solution-Focused TherapynPeople can create their own solutionsnSmall changes lead to large changesnThe client is the expert on his or her own lifenThe best therapy involves a collaborative partnershipnA therapists not knowing afford the client an opportunity to construct a solutionTherapeut
6、ic Goals nBelieve clients have the ability to define their goals and the resources required to solve their problemsnFocus on small,realistic,and achievable changesnSmall change leads to big changenRemain goal-directed and future-orientednE.g.,what has changed since last session?nTalk about solutions
7、 instead of talking about problemsTherapists function and Role nNo knowing position:clients as experts about their own lives.nCreate a collaborative relationshipsnCreate a climate of mutual respect in which clients are free to create and explore solutionsnHelp clients to explore what they would like
8、 things to be different,how to make a difference,and what signs to indicate the changes are happening.Relationship Between Therapist and ClientnThe therapeutic relationship is an important factor for change to occur.nSolution-focused brief therapy is designed to be brief,so therapist must shift the
9、focus as soon as possible from talking about problems to exploring solutionsnHelp clients to use their strengths and resources to construct solutions Three Kinds of Relationships in Solution-Focused TherapynCustomer-type relationship:client and therapist jointly identify a problem and a solution to
10、work toward.Realize personal efforts is required.nComplainant relationship:a client who describes a problem,but is not able or willing to take an active role in constructing a solution.Expect other person to change.nVisitors:clients who come to therapy because someone else thinks they have a problem
11、.Disagree they have a problem.Techniques Used in Solution-Focused Brief TherapynPre-therapy change:What have you done since you made the appointment that has made a difference in your problem?nException questions:Direct clients to times in their lives when the problem did not exist.Techniques Used i
12、n Solution-Focused Brief TherapynMiracle question:If a miracle happened and the problem you have was solved overnight,what would be different in your life?nScaling questions:On a scale of zero to 10,where zero is the worst you have been and 10 represents the problem being solved,how would you rate y
13、our anxiety right now?Techniques Used in Solution-Focused Brief TherapynFormula first session task:ask clients to observe about what happens in your life(relationship,family)that you want to continue to happen nTherapist feedback to clients:therapists provide summary feedback for clients-compliment
14、what clients have done toward effective solutions,provide rationale for the suggestions,and suggest a homework assignmentCase discussionnMary feels that she must win everyones approval.She has become a“super nice guy”who goes out of her way to please everyone.Rarely does she assert herself,for fear
15、that she might displease someone who then would not like her.nHow do you apply solution-focused brief therapy to help Mary to solve her problem?Case discussion nTom,a college sophomore,want to overcomes his shyness around women.He doe not date and even des his best to keep away from women because he
16、 is afraid they will reject him.But he want to solve his problem.nHow do you use solution-focused brief therapy to help Tome to solve his problem?Questions?Reactions?nWhat are your reactions?nWhat did a therapist(Dr.OHanlon)do?nWhat can you as a therapist continue to do by using solution-focused bri
17、ef therapy?Key Concepts of Narrative TherapynListen to clients with an open mindnEncourage clients to share their storiesnListen to a problem-saturated story of a client without getting stucknTherapists demonstrate respectful curiosity and persistencenThe person is not the problem,but the problem is
18、 the problemThe Therapeutic Process in Narrative TherapynCollaborate with the client in identifying(naming)the problemnSeparate the person from his or her problemnInvestigate how the problem has been disrupting or dominating the personnSearch for exceptions to the problem nAsk clients to speculate a
19、bout what kind of future they could expect from the competent person that is emergingnCreate an audience to support the new storyTherapeutic Goals n Therapists invite clients to describe their experience in new language and facilitate the discovery or creation of new options that are unique to themN
20、arrative Therapists function and rolenTo become active facilitatorsnTo demonstrate care,interest,respectful curiosity,openness,empathy,contact,and fascinationnTo adopt a not-knowing position that allows being guided by the clients storynTo help clients construct a preferred alternative storynTo sepa
21、rate the problem from the people(instead of person own the problem)nTo create a collaborative relationship-with the client being the senior partnerTherapeutic RelationshipnEmphasize the quality of therapeutic relationship,in particular therapists attitudes nClient-as-expert,clients are the primary i
22、nterpreters of their own experiences nTherapists seek to understand clients lived experience and avoid effort to predict,interpret,and pathologies.Therapeutic TechniquesnNo recipe,no set agenda,and no formulanThis approach is grounded in a philosophical frameworknQuestionsand more questions:nQuestio
23、ns are used as a way to generate experience rather than to gather informationnAsking questions can lead to separating“person”from“problem”,identifying preferred directions,and creating alternative stories to support these directions.Therapeutic TechniquesnExternalization&Deconstruction nExternalizat
24、ion is a process of separating the person from identifying with the problemnExternalizing conversations can lead clients in recognizing times when they have dealt successfully with the problemnProblem-saturated stories are deconstructed(taken apart)before new stories are co-createdTherapeutic Techni
25、quesnSearch for unique outcomesnSuccessful stories regarding the problemnCreating Alternative Stories nThe assumption is that people can continually and actively re-author their livesnInvite clients to author alternative stories through“unique outcomes”nAn appreciative audience helps new stories to
26、take rootTherapeutic TechniquesnDocumenting the evidencenTherapists write and send a letter to clients between sessions regarding their strengths and accomplishments,alternative story,and unique outcomes or exceptions to the problems.From a multicultural perspectivenContributionsnFit with diverse wo
27、rldviewnClients provide their own interpretations of life events nLimitationsnDiverse clients may expect therapist as a expert instead of“client-as-expert”Summary and EvaluationnContributionsnClient-as-expert(not knowing position)nView people are competent and able to create solutions and alternativ
28、e storiesnDo not support the DSM-IV-TR labeling systemnA brief approach,is good for managed care.nIn general,studies provided preliminary support for the efficacy of solution-focused brief therapy Summary and EvaluationnLimitationsnNo set of formulas or recipes to follownInexperienced therapist may view SFBT as techniques.However,the attitude of the therapist is critical to the success of outcomes.nTherapists need to be able to make quick assessments,assist clients in setting up the goals,and effectively use appropriate interventions
