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8/13/2019 soltherapy

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Presented byJoe Enright

Solution-Focused Therapy


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Origins

Originally termed Solution-Focused BriefTherapy

Developed in the 1980s by social workers Steve de Shazer and

Berg (husband and wife)

Developed from aspects of several brief therapies Aim

To provide brief therapy without any unnecessary components

Distill therapy down to only the elements necessary for positive

MacDon

History


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Psychodynamic Emphasis on and respect for clients words and views, and no pressure for the clie

be different

Behavior Therapy Goals and baseline measurement

CBT Highlights clients thoughts and perceptions

Systems Theory Acting as if change has already occurred

Brief/Strategic Therapy Non-expert stance, importance of clients language, minimal number of sessions,

change, problem and solution not connected

Novel aspects of Solution-Focused Therapy Faith in peoples abilities, resources, and motivation for change Absence of formal theory of change - deemed unnecessary

Development


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All that is necessary is that the person involved in a t

situation does something different. Steve de Shazer (1985)

Solution-Focused Therapy Model


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Disciplined and pragmatic approach, not theoretical. Basic Assumption = People are capable of change on their own

Major Tenets:

If it isnt broken, dont fix it If it works, do more of it If its not working, do something different Small steps can lead to big changes The solution is not necessarily directly related to the problem The language for solution development and that for problem descr

different The future is both created and negotiable

de Shazer, 1985; Shazer & Dolan, 200

Description


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Democratic approach to therapist-client hierarchy

Never pass judgment and avoid interpretations

Dont try to convince, influence, scold, or push

Expand options and offer alternative directions Lead from one step behind

Berg & Dolan, 2001; Shazer & Dolan, 2007; Cantw

Therapists Role


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Positive, collaborative, solution-focused stance No such thing as client resistance

Explore past solutions

Explore exceptions to the problem

Questions only, no directives or interpretations Focus on the present and future

Compliments

Encouragement and Experimentsde S

General Approach/Techniques


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Intro and "Problem-talk" Pre-session change

Solution-focused goal setting

Miracle Question

Scaling Constructing solutions and exceptions

Break time

After break, compliments and homework

MacDonald, 2007; de S

Components of the 1st(Only?) Therapy Sessi


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Only one problem (brief therapy)

Not interested in collecting a thorough history

Intro and Problem-Talk


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Miracle Question

Scaling

Constructing solutions and exceptions

Break time





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Three possible answers:

1) Nothing has happened Begin session generally (How can I h

2) Things have gotten better Jump to solution-focused goal set

(Would you like these change

3) Things are about the same Jump to exploring previous solutexceptions (How have you kept things from getting worse?)

de Shazer &

Pre-session Changes


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Miracle Question

Scaling


Break time





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Small goals

Worded as a solution, not absence of a proble

MacDonald, 2007; de Sha

Solution-Focused Goal Setting


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Miracle Question

Scaling


Break time





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Now I want to ask you a strange question. Suppose that while

sleeping tonight and the entire house is quiet, a miracle happe

miracle that the problem which brought you here is solved. Ho

because you are sleeping, you dont know that the miracle has

So, when you wake up tomorrow morning, what will be differetell you a miracle has happened and the problem which broug

is solved?

de Shaze

Miracle Question


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Scale problems/goals from 1-10 at pre-therapy, current time

time

Allows ongoing measurement of progress in subsequent sess

Evidence of positive change

de

Scaling


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Intro and "Problem-talk"

Pre-session change


Miracle Question

Scaling


Break time





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Overarching aim of the rest of the session.

Find examples of solutions and exceptions to th


Constructing Solutions and Exceptions


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Intro and "Problem-talk"

Pre-session change


Miracle Question

Scaling


Break time





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Consult with team if available

Think of compliments, and consider experime

homework

Present compliments

Suggest homework experiments


Break-time

After the break


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Reportedly, one of the most popular in the world; applicableproblems

Often used in family and couples therapy - viewed as highly cwith a systems theory approach

Has been used with clients with problems such as sexual abu

substance abuse, and schizophrenia* Also utilized in social services, social work, educational, and

settings

Walk-in settings

Corcoran & Pillai, 2009; de Shazer & Dolan 2007; Macdonald, 2007; Mc

Application


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Very little research conducted on effectiveness Not currently recognized as evidence-based

Most studies demonstrate small to moderate positive effects

treating non-psychiatric problems.

One study demonstrated an equivalent reduction in depress

compared to a interpersonal therapy control Relatively Recent meta-analysis looked at 22 studies:

-Small effect sizes for internalizing behavior (e.g. depression, anxiety, low se

-Small effect sizes for externalizing behaviors (e.g. conduct, youth offender r

-Small effect sizes for Family and Relationship problems

Kim et al., 2010; de Shazer & Dolan, 2007; Sundstrom, 1993; Gingerich & Eisengart, 2000; Corco

Research Support


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Berg, I. K., & Dolan, Y. (2001). Tales of solutions: A collection of hope-inspiring stories. WW Norton & Co.

Cantwell, P., & Holmes, S. (1994). Social construction: A paradigm shift for systemic therapy and training. Australian Family Therapy.

Corcoran, J., & Pillai, V. (2009). A review of the research on solution-focused therapy. British Journal of Social Work,

De Shazer, S. (1985). Keys to solution in brief therapy(pp. 3-17). New York: Ww Norton.

De Shazer, S., Dolan, Y. M., & Korman, H. (2007). More than miracles. Haworth Press.

De Shazer, S., & Berg, I. K. (1997). What works?Remarks on Research Aspects of SolutionFocused Brief Therapy.Jo121-124.

Gingerich, W. J., & Eisengart, S. (2000). SolutionFocused Brief Therapy: A Review of the Outcome Research*. Family

Kim, J. S. (2008). Examining the effectiveness of solution-focused brief therapy: A meta-analysis. Research on Social

Kim, J. S., Smock, S., Trepper, T. S., McCollum, E. E., & Franklin, C. (2010). Is Solution-Focused Brief Therapy EvidenceThe Journal of Contemporary Social Services, 91(3), 300-306.

Macdonald, A. (2011). Solution-focused therapy: Theory, research & practice. Sage.

Sundstrom, S. M. (1993). Single-session psychotherapy for depression: Is it better to be problem-focused or solutionDissertation, Iowa State University.

References

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