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M.A.Psychology CONCEPTS & APPLICATIONS OF SFBT (BRIEF PROBLEM-FOCUSED THERAPY) Course Code MAP613 CONCEPTS & Semester: III APPLICATIONS OF e-Lesson: 9 SFBT (BRIEF 4 PROBLEM-FOCUSED SLM Unit: THERAPY) P 6013) INSTITUTE OF DISTANCE AND ONLINE LEARNING
CONCEPTS & APPLICATIONS OF SFBT (BRIEF PROBLEM-FOCUSED THERAPY) INTRODUCTION 3 OBJECTIVES Ways of Knowing the Possibilities Concepts of SFBT (Brief Problem-Focused for Solution and Focused Practices Therapy). Scope of SFBT: A Review Based The Solution-Focused Brief Therapy; Theory theoretical Overview and Development. Ways of Knowing: Extending the Possibilities for Solution P 6013) INSTITUTE OF DISTANCE AND ONLINE LEARNING
TOPICS TO BE COVERED HOW SFBT CAME ABOUT SCOPE OF SFBT: A REVIEW BASED THEORETICAL OVERVIEW GOALS & APPLICATIONS OF SFBT CONCEPTS & APPLICATIONS OF SFBT (BRIEF PROBLEM-FOCUSED THERAPY)
BACK GROUND TO SOLUTION FOCUSED THERAPY (SFBT) • Founders : Steve de Shazer, Insoo Kim Berg, and the Brief Therapy Center in Milwaukee • greatly influenced by Milton Erickson who believed that everyone possessed the skills and abilities to solve their own problems and that small changes could lead to bigger changes. • Gregory Bateson played an influential role in the development of the solution-focused model. • Others include: Don Jackson, Jay Haley, John Weakland, and Bill Fry, the Mental Research Institute (MRI) Paul Watzlawick, Richard Fisch, and Janet Beavin
CORE FOUNDERS • Steve de Shazer (died • Insoo Kim Berg (Died 2005) 2007) SFBT :a future-focused, goal-directed approach to brief therapy that uses questions designed to identify exceptions, solutions, and scales, which are used both to measure the client’s progress toward a solution and reveal the behaviours needed to achieve or maintain further progress
1. THE CORE CONCEPTS OF SOLUTION FOCUSED THERAPY (SFBT)
CORE CONCEPTS OF SFBT • Takes a distinctly postmodern approach, whereby therapists dismissed the notion that examining the past was necessary and began to focus on the future. • According to the postmodern view, there are no fixed truths or realities: the truth or reality is whatever the client presents. • In other words, the postmodern view places the client as the expert, not the therapist
CORE CONCEPTS OF SFBT ❑ Social constructionism has heavily influenced the solution-focused approach: the therapist should take a “not- knowing stance” (de shazer, 1988). ❑ This means the therapist enters the therapy session not knowing what the client should do to solve his or her problem. ❑ Language can be a tool for creating change in therapy by conjuring up new descriptions or meanings for the client
THE MAIN ASSUMPTIONS SFBT 1. Clients have strengths and resources. 2. The relationship between therapist and client has therapeutic value. 3. Change happens all the time. 4. A small change will generate larger change. 5. Rapid change is possible.
The main assumptions SFBT 6. The focus is on the present and the future. 7. Clear goals are essential. 8. The attempted solution may be part of the problem. 9. The focus is on people not problems. 10. ‘Resistance’ is a function of the relationship. 11. Knowing the cause of the problem is not necessary to do effective therapy.
2. CONCEPTUALISATION OF PROBLEMS IN SFBT
CONCEPTUALISATION OF PROBLEMS 1. SFBT is focused on finding solutions not problems and therefore does not look at a person in the sense of being maladjusted. 2. It is behavior that causes maladjustment and not the innate qualities of the person. 3. The client’s narrative determines much about the repeated patterns of dysfunctional behavior.
THREE TYPES OF NARRATIVES 1. Progressive: Indicates that clients are moving forward and acting on goals. 2. Stability: Indicates client’s are keeping the status quo. 3. Regressive:Indicates client’s are retreating from goals
3. THERAPEUTIC GOALS IN SFBT
HOW BRIEF A THERAPY? ❑ Aim for 5 sessions ❑ 45 mins each session ❑ Rarely beyond 8 sessions ❑ Sometimes 1 session enough ❑ Any improvements after 3 sessions? ❑ Increase gap between sessions as time goes on 16
BASIC RULES AND ASSUMPTIONS ABOUT GOALS If it ain’t broke, don’t fix it‖: the client determines the goals of counseling, not the therapist. ―Once you know what works, do more of it‖: this helps the client see positive behaviors and reinforces proactive behaviors. ―If it’s broke, do something to fix it. If it doesn’t work, don’t do it again‖: if it is not working there is no need to try it again.
4. THERAPIST ROLE IN SFBT
THERAPIST ROLE IN SFBT The Counseling Process Three types of clients: 1. Customers: These clients are active and want to do something about their situation. 2. Complainant: These clients don’t want to do anything themselves but want someone or something else to change. 3. Visitor: A client who does not know or cannot verbalize his or her complaint or problem. Counselor/client relationship: 1. Customer—Seller; 2. Complainant—Listener; 3. Visitor—Host.
THERAPIST ROLE IN SFBT – Focus on what is right and what is working. – Every problem has exceptions that can be turned into solutions. – Little changes lead to bigger changes. – Goals are always set in positive terms. – People do want to change for the better.
THERAPIST ROLE IN SFBT – People are highly susceptible and dependent. – Don’t ask a client to do something that he or she has not succeeded at before. – Avoid analyzing the problem. – Be efficient! Don’t look for problems or solutions that won’t work. – Be a survivor not a victim. – Focus on the present and the future, not the past.
5. SFBT INTERVENTIONS
Skills overview
CORE TENETS OF SFBT • If it’s not broken, don’t fix it • Look for exceptions • Asking questions rather than telling clients what to do • Future is negotiated and created • Complements • Gentle nudging to do more of what is working • Change is constant and inevitable • The solution is not always directly related to the problem
Ask questions about.
TYPICAL FIRST SESSION ▪ Opening: Social introductions, structure session ▪ Collect Complaints - Problem ▪ Rank Complaints ▪ (What’s 1st, 2nd, 3rd) ▪ Discuss Exceptions
TYPICAL FIRST SESSION Find out what client wants from sessions \"Best hopes of our work together?\" Find out small details of life if problems solved Miracle question What do they already do that is successful \"Tell me about when the problem is not there\" What might change by taking a small step towards hope \"What would others notice about you?
Session structure • Miracle question process • Exceptions / pre-session changes • Identify Goals • Scales: situation now, willingness, confidence • Anything else/ Break • Message
De Shazer’s Miracle Question Suppose that one night, while you are asleep, there is a miracle and the problem that brought you here is solved. However, because you are asleep you don't know that the miracle has already happened. When you wake up in the morning, what will be different that will tell you that the miracle has taken place? What else? (1988)
SFBT Interventions Miracle question • Amplifying what the client wants • Concrete, behavioral, measurable terms • Realistic terms
SFBT INTERVENTIONS 1. Not knowing 2. Complementing strengths 3. Scaling questions 4. Exception questions 5. Coping questions
SFBT Interventions 1. Not Knowing • Clients experts • General attitude communicating an abundant, genuine curiosity • Micro practice skills
SFBT Interventions 2. Complementing Strengths • Strengths perspective • Building rapport and giving hope • Direct complements: positive evaluation or reaction • Indirect complements: a question implying something positive
SFBT Interventions ❑ Scaling Questions ❑ Scale of 1 – 10 ❑ 1 is the worst it’s ever been ❑ 10 is after the miracle has happened ❑ Where are you now? ❑ Where do you need to be? ❑ What will help you move up one point? ❑ How can you keep yourself at that point?
SFBT Interventions Exception Questions ■ Tell me about the times when (the complaint) does not occur, or occurs less than at other times. ■ When does your partner listen to you? ■ Tell me about the days when you wake up more full of life. ■ When are the times you manage to get everything done at work?
SFBT Interventions Exploring Exceptions • Problem description vs. exceptions • Increase awareness of current/past successes • Turning past solutions into present solutions • Finding out specifics • Creating a plan
SFBT Interventions Miracle question • Amplifying what the client wants • Formatting the question • Concrete, behavioral, measurable terms • Realistic terms
SFBT Interventions Coping Questions • Tailored to help client from feeling overwhelmed • A method for exploring exceptions • Finding the clients strengths
TYPES OF COPING QUESTIONS • Identify client resources they do not even acknowledge • Can be used even in most pessimistic situations • Genuine curiosity helps • Genuine admiration for client helps • Helps identify referred future • Ensure client doesn't feel you're contradicting them • \"Despite all the problems you still work. How you do it?\" 39
Other Useful Questions ❑ Has anything been better since the last appointment? What’s changed? What’s better? ❑ Can you think of a time in the past (month / year / ever) that you did not have this problem? ❑ What would have to happen for that to occur more often? ❑ Scaling Questions 1 – 10 ❑ With all of that going on, how do you manage to cope?
M.E.C.S.T.A. A basic undersTta.nding of the SFBT treatment approach is embodied in the acronym: M.E.C.S.T.A.T. M – Miracle Questions E – Exception Questions C – Coping Questions S – Scaling Questions T – Time-Out A – Accolades T – Task
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6. EVALUATION OF SFBT
Advantages of SFBT ❖ Fits in nicely with managed care and the pressure to provide effective counseling in a briefer time frame. ❖ Emphasizes the positive attributes in clients. ❖ It can be used effectively with a variety of clients and issues.
Disadvantages of SFBT ❖ Critics say it is too simplistic and does not have enough empirical research to support it. ❖ It may be contraindicated with dependent clients. ❖ It may not adequately address clients with serious mental issues. ❖ It may not develop the counselor/client relationship in enough depth to be therapeutic.
SFBT with Diverse Populations ❑ It does not attend to many multicultural tenets (e.g. understanding the client within his or her culture and worldview.) ❑ It does not attend to the fact that problems may indeed be out of the client’s ability to change them because the problems are system bound. ❑ It works well for clients and cultures who like a fast, no-nonsense, down-to-earth approach and who are not interested in the cognitive, behavioral or affective components of a problem. ❑ But because the client is seen as the expert, it can work well for some clients of other cultures.
CONCLUSION Solution-focused brief therapy (SFBT) gives emphasis on both present and future circumstances of a person and his/her goals instead of previous experiences. Thus, in this goal-oriented therapy compels a person to come to therapy for the symptoms or issues faced by him/her.
MULTIPLE CHOICE QUESTIONS 1. The Solution focused approach originated in _________therapy. a. Family b. Cognitive c. Behaviour d. All of these Answer- A 2. Solution-Focused Brief Therapy (SFBT) is based on over ____ years of theoretical development, clinical practice, and empirical research. a. Twenty b. Thirty c. Forty d. Fifty Answer-B
REFERENCES ❑ Jaseem, K., Mukherjee, T., & Asharaf, A. A. Z. (2014). Solution Focused ❑ Brief Therapy for Depression in an Indian Tribal Community A Pilot Study. International Journal of Solution focused Practices. ❑ Finger, R., & Galassi, J. P. (1977). Effects of modifying cognitive versus emotionality responses in the treatment of test anxiety. Journal of Consulting and Clinical ❑ Psychology, 45, 280-287. Altmaier, E. M., Leary, M. R., Halpern, S., & Sellers, J. E. (1985). Effects of stress inoculation and participant modelling on confidence and anxiety: Testing predictions of self-efficacy theory. Journal of Social and Clinical Psychology, 3, 500-505.
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