Monday, August 5, 2019

Concepts in solution focused brief therapy

Concepts in solution focused brief therapy SFBT, believe that solutions ensue when there is a change in negative interactive patterns and behaviour and as such, giving new meaning to clients problems and tools necessary to solve their them (Stalker et al., 1999). SFBT does not pathologize but rather focuses on clients strengths (Gehart and Tuttle, 2003). It orients clients to a solution talk rather than problem talk. The SF, therapist therefore works with the clients to find solutions as they occur. This pragmatic approach to therapy utilizes concepts that enabled clients to find solutions (Cunanan, McCollum, 2006). This modality strongly supports the view that there are solutions to almost every problem and that everyone has the capability to solve their own problems. The SF, therapist believes that people are dynamic and not static and that change is constantly occurring. The SF, therapist explores with the clients problem areas that they want to change in their lives while encouraging the continuance of areas that are currently working for them. The therapists and clients then co- construct concrete goals of a preferred future and subsequently create a change within themselves (Lewis and Osborn, 2004). There are many concepts which play a vital role in this modality, these include: re-session change (Lawson, 1994; Lethem 2006, 2002), moving from a problem saturated talk to solution-focused talk (Langdridge, 2006; Lethem 2002; Talyor, 2005), looking at the exception to the problem (Ruddick, 2008), viewing change as a constant, recognizing that language has meaning and experiencing hope (Gehart and Tuttle, 2003). Pre-session change The pre-session change is the concept that assesses to see if there have been any changes for the client prior to beginning their initial session (Weiner-Davis, 1987 as cited in Lawson, 1994). This pre-session change is an integral part of therapy as it helps the therapist to begin a dialogue in focusing on the solution and helps the client to see the possibility of change (Lethem, 2002). Problem saturated talk to solution talk According to Taylor (2005), moving from the problem-saturated story to a solution talk is one of the main goals of therapy. The problem-saturated story usually occurs during the initial stage of therapy. The therapist will take a non-judgmental stance to the client story while formulating the problem that the client is sharing, while gently helping the client to shift focus and explore possible solutions. The therapist also helps in directing the clients to make goals that they would like to accomplish during and after the course of therapy (Jordan, Quinn, 1994). During this process the therapist takes a curious/neutral stance in understanding the client and their presenting issue. While the therapist focuses on the here and now of the problem and how its currently affecting the client, they help to re-focus the client in the direction towards the future (Adam et.al., 1991 as cited in Jordan Quinn, 1994). The SFBT therapist re-directs clients from a problem saturated story to a state of solution oriented story. This shift allows the therapist to begin the process of building upon the clients strength in order to help them to identify solutions to their problem (OHanlon and Wiener-Davis, 1989 as cited in Reiter, 2007). Looking at the exceptions to the problems Eliciting feedback from the client about the differences when the problem did not occur, or occurred with less severity, helps the therapist identify strengths, embedded in exceptions that the client can utilize in the future, (De Jong Berg, 2002). The use of expectancy, derived from the work of Milton Erickson, was utilized by de Shazer utilized to help clients capitalize on the resource they possess within themselves to solve their problem. The art of solution focused therapy involves not only bringing awareness to the exceptions of problems but rather the solutions that lies in their repertories. According to O Hanlon, (1999) there should be positive expectancy talk. Change is constantly happening and hope This therapy assumes that nothing is always the same, it is the belief that change is occurring all the time and small change is generative, as one small changes leads to larger changes. Additionally, this assumption also means that problems are only as big as ones definition to them. Our definition defines both the experience and size of the problem. Change occurs when clients can look at the exceptions to their problems and make that shift from the problem-saturated story to solution-focused talk (Simon, Joel K. Nelson, Thorana S. 2007). Change can be measured with scaling questions, so as to get an overview of where the client is at and if any small changes have occurred (B.OConnell, 1998). According to Miller, Duncan and Hubble (1996, p 218), hope is the exercising of ones belief that something positive will happen in each session. This takes a team approach, both therapist and client work together actively to get an outcome which finds solutions to the clients problem. Assumptions of Solution Focused Brief Therapy This theory utilizes 12 assumptions, John Walter Jane Peller (1992) from their text Becoming Solution-Focused in Brief Therapy (pp 10-34) described the following assumptions: 1. Focusing on the positive: 2. Having clients identify the exceptions to the problem. 3. Change is occurring all the time. 4. Small change generative, small changing leads to larger changing. 5. Clients are always cooperating. 6. People have the natural resource within themselves to solve their problems. 7. Meaning and experience are interactionally constructed 8. Actions and descriptions are circular. 9. The response you received is the meaning of the message. 10. The client is the expert 11. Change is constantly occurring. 12. A treatment group comprises of members who share stated goals and have desires to accomplish these goals. Nature of Reality in Solution Focused Brief Therapy Reality is the construction of ones language and as such, problems are maintained when ones construction disregard their natural capability and resources. Steve de Shazer, 1991 stated that clients and their belief system constructs reality; reality is therefore invented rather than constructed. In the event that the reality that the client is living in at present is not working for them, then the therapist can gently invite the client to enter into a momentary hypothetical. This allows the client to enter into a reality where anything is virtually possible. This gives the client the opportunity to dream as to what they would be doing in the event that this miracle was to occur. Miller, (1996) stated that therapists can use the intervention of the miracle question to enter into this reality. The use of the miracle question allows the therapist not only to join with the client but to also enter the world of the client. This intervention allows for the client to imagine a better future reality in which they want to create the future (De Shazer, 1991). According to Nelson and Thomas (2007), reality is based on how the client chooses to live their life and their perception of what life is about. Each individual owns the architecture of their reality, and they choose how to shape their world. A therapist can however identify with the reality of their clients through the use of language. According to Harland as cited in de Shazer (1991), language constitutes the human world and the human world constitutes the whole world. In order to understand the clients language, the therapist has to enter into the world of the client and understand what is happening for the client at that moment. This allows the therapist to get a clearer understanding of the clients viewpoint and what motivates them to think as they do (Odell, Butler and Dielma, 2005). In SFBT, therapists respect the clients for who they are and the reality in which they live. The therapist takes a non-judgmental stance and doesnt make comparison with the clients past issues, but rather focuses on the here and now present of the client. Miller posits that therapists respect their clients point of view by understanding the language in which they speak. Language is the clients thoughts that help to shape and express who they are. The therapist and the client enter into a therapeutic relationship through the client language as the main vehicle to their perception of reality. Understanding the clients reality is a process. Initially, the therapist is unable to be a part of the clients reality because they are on the outside; however, as the sessions progress, the therapist becomes more familiar and better able to comprehend the clients language, and subsequently becomes a part of the clients reality (Miller, (1997b) De Shazer et al., argues that people use language to shape their reality and to assist in establishing the meaning of situations, relationships, others and self. They further note that the meanings people assign to a situation may limit the range of solutions to a problem, which is of particular interest to solution-focused therapy. They explained that every individual constructs his or her meaning based on previous experiences, beliefs, family of origin or societal view (De Shazer et al. 1988). Furthermore, they posit that clients stories are usually more problem-saturated than goal-oriented. Hence, it is easier for clients to focus on their problems than the solution. As such, when the therapist and client interact, there is a `co-creation of realties; therefore, differences in perspectives and meanings should be defined Bobele et.al, states expertise lies in the manner in which the conversation is conducted, not in the ability to convey a venerated body of information (Bobele, Gardner, Biever, 1995, p. 16). Philosophy proposes that reality exist objectively in the world irrespective of ones subjectivity, language or thoughts. I believe that a persons perception is his or her reality, and so what I believe becomes my reality; subsequently, what I believe in does not necessarily hold true for someone else. For example, I believe in a supreme being and that is a part of my reality; however, that might not be the reality for another person who sees himself as a God. A persons reality is shaped by his or her beliefs and value-systems, or anything that seems real to him or her whether its conceptualized by the mind or an extension of self or environment. Reality does exist for me, but there are several forms of reality. What I can see and touch and what I believe exists not in a physical state but by fai th. I define truth as being an accurate account of reality -a claim that has been proven factual. However, I would suggest that there might be several versions of truth. Truth can be based on my perception of what is true. But this may not necessarily be factual. For example, others may not share my belief that chocolate tea is pleasant to the taste; hence, truth can also be relative. Furthermore, if everyone were behaving in a certain way and someone came along behaving in the opposite manner, and then the perception would be that something is wrong with him or her, a plausible conception of insanity. If relatively, speaking nothing is innate to a newborn baby if the mind is a blank slate, then everything we know is learned from some source. If your only source told you, the moon was a space ship in the sky, then that would be your truth. After dissecting all these terms, I believe that objective and subjective truths co-exist in my reality. I know that certain things are just facts, yet at the same time I am aware that some things that were previously taught me as truths are not based on factual grounds. For example, my value system is not based on facts, but rather on my beliefs, my truths and my reality. It defines who I am as a person. Having the knowledge that my reality may differ from my clients reality, it is imperative that I am aware of my own bias and not project my reality unto my client, as this would be counterproductive, as the client would be seeing through the lens of my reality and not theirs. It is vital for clients to know what is real for them and how it affects their lives. However, through the therapeutic relationship, my reality may be shared not imposed or forced upon clients when I integrate therapeutic interventions and feedback to clients. SFBT has reinforced for me that language helps to shape ones reality and is a driving force in how we construct or de-construct our reality. Human Nature in Solution Focused Brief Therapy SFBT has a positive approach to therapy and toward clients in general. SFBT views clients as natural problem-solvers who have only lost sight of their ability to solve problems. Another common believe is people are not the problem but the problem is the problem. Furthermore, it utilizes and enhances the clients capability. Every person has the natural resource needed to cope even before the use of interventions. Hence the therapy process should constitute of promoting and finding the solutions that naturally lies within the clients (Peller, J.L., Walker J., 1992a). This theory also reinforced the concept that the client is the expert, and the solutions lie within them. In SFBT, the client is the expert, and the facilitator takes the position of not knowing and of leading from one step behind through solution-focused questioning and responding. SFBT is focused on finding solutions not problems and therefore does not look at a person in the sense of being maladjusted. It is the behaviour that causes maladjustment and not the innate qualities of the person. The clients narrative determines much about the repeated patterns of dysfunctional behavior (Peller, J.L., Walker J., 1992b). In SFBT therapy, the client knows the solution, and the role of the therapist is help clients to identify these solutions while maintaining a respectful and supportive role and not to be confrontational but, only make suggestions are necessary alternatives (De Jong Berg, 1998, p. 21). In SFBT, the therapist is seen as a collaborator and consultant, there to help clients achieve their goals. With SFBT, clients do most of the talking, and what they talk about is considered the cornerstone of the resolution of their complaints. Usually, SFBT therapists will use more indirect methods such as the use of extensive questioning about previous solutions and exceptions (De Jong Berg, 1998, p. 21). Self is the consciousness of ones own identity; it is what defines me as an individual. It is the component that makes up my personality. Self is who I am as an individual, which comprises my strengths, limitations, dreams, fears, likes and dislikes. My sense of self follows a consistent pattern personality and behavior does not change, and is made up of past, present experiences, values and cultural background. In contrast to this, the essential self is more of the ideal self; it is the self I hope to be, the self I desire to accomplish. Murray Bowen speaks about the solid self, which is highly differentiated free of emotional process. However, for me, the solid self is like my essential self where I am more highly differentiated, less reactive, and accepting of my faults. It is a wiser me, a mature, less indecisive me, an empowered me. The main difference between the two selves is one, the self is who I am in reality and the essential self is who I hope and want to be. I believe what makes individuals different is their individuals background and cultural/family values. Furthermore, ones environment and genetics both influence what makes each of us who we are. What makes me who I am today are my culture and family values, the environment that I grew up in, the parenting style that I experienced and my experiences. This academic programmed has greatly influence my way of thinking, and has forced me to do a lot of introspection, which has been an avenue that Ive used to better understand myself. One major thing that my life experiences have taught me is that the difficulties I have encountered in my life can be likened to my life test. I feel at times Ive been given the same exam over with a few changes in the questions and by now I have to come to know the end results. As this process unfolds I have become less anxious as I believe the end result will be successful and if not its ok as I can rest assured that this test will come again. I have always been given the opportunity to take my life test over and with each success; I have become stronger and empowered. With each failure Ive also experience growth as I make adjustments so as to do better. I believe that in order for an individual to experience a fulfilling life, they should live with (1) with no regrets and know that what they do is done to the fullest. (2) Accept the things they cannot change and (3) learn from their mistakes, which will by extension make them stronger. Nature of change in Solution Focused Brief Therapy In the solution-focused approach, change is viewed as a process that is inevitable and constant (de Shazer, 1985), clients situations may often fluctuate and often the small changes may seemingly go. Therefore, it is imperative for therapist to help clients to identify when these changes occur and attempt to identify circumstances and behaviors that encourage the desired change (de Shazer, 1985b). In assessing the problem, the therapist looks for past, present or even future exceptions, in addition to identifying clients strengths, this may enable them to reach some solutions. Solution-focused brief therapy focuses exclusively or predominantly on two things (1) helping clients to achieve their desired outcome through the setting of personal goals and (2) looking at the exceptions to the problems through the implementation of previous solutions. (de Shazer, 1985c). Change is in my viewpoint a permanent modification of behavior. While change is dynamic there is some amount of finality to it, something that is adjusted can be re-adjusted, but true change has a degree of permanence. Change removes us from our comfort zone. Change has a ripping effect on those who wont let go. Change happens for me when I confront and accept that I need a behavioral modification. Acceptance for me is the turning point for change. Change begins in my heart having that desire to want better; it might be awkward and uncomfortable at first, but then it becomes more accepting and more understanding. What I have gathered from doing this research and attending classes is that therapy as a process aids understanding and recovery from psychological difficulties. Therapy deals with underlying issues spanning across inter/intrapersonal conflicts, for example depression and marital conflict. Therapy provides an avenue to express ones feelings, understand patterns of thinking, gain perspective or knowledge surrounding past events and to obtain guidance to the right path. I believe therapy happens when one consciously seeks help for change; when there is a willingness to work on ones self, therapy ensues. Therapy happens when change occurs. For me, this program has been one big therapy session and my change has occurred in small increments, based on my willingness to visualize the change in my mind and take the steps necessary to execute that change. That change for me is feeling exposed, honest with myself but freshly aware of who I am as an individual. The relationship between client and therapist is integral, as it determines whether that client leaves the therapy room being a more mentally healthy person or worse off than when they first entered. According to Carl Rogers, the therapeutic relationship forms the foundation for treatment. If a helping relationship is not the number one priority in the treatment process, then clinicians are doing a great disservice to their clients as well as to the field of therapy as a whole. I strongly believe that for me to have a successful outcome in therapy, I must first join with my client, showing a genuineness to help, validate and empathize, give positive regard and help set goals with my client. Most of what I have learnt from my professors, advisor, supervisor, classmates, research and life experiences has formed the building blocks of my therapeutic stance. It is my hope that with this foundation, I will be an effective therapist, one that will join with clients in terms of where they are at and help them work through their problems. Furthermore, openness to change and a willingness to adjust so that I can better meet the need of my clients for both therapy and personal growth is intrinsic.

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