Solution-Focused brief Therapy

What is going well? And what else? And what else?

By Frances Cook, MSc, MRCSLT (Hons) Cert. CT (Oxford)

De Shazer 's model of Solution Focused Brief Therapy is based on several core assumptions about the nature of change. Clients are viewed as being 'stuck ' in problem patterns in which attempts to resolve or cope with their difficulties have become part of the problem.

alt text However it is assumed that there will be times when problems do not occur or occur less and that clients therefore have within themselves the strengths and resources necessary to resolve difficulties.

In Brief Therapy it is assumed that small changes will initiate other changes in a 'ripple ' effect, thus helping clients to move towards their goals. Brief Therapy should therefore be as time-efficient as possible and as short-term as is required to establish a momentum of change.

Brief Therapy is orientated towards the future. This is achieved by devoting minimal time to exploring complaints or problems, by directing clients to 'responses that are self-enhancing and strength-producing ' and using language that implies an expectation of positive change. The focus of therapy is on what is changeable and possible rather than on what is impossible and intractable.

The therapist 's role is to see a person as more than their problem, to look for resources rather than deficits, to help clients identify goals or 'preferred futures, ' to identify and amplify existing strengths and resources, and to identify and make use of 'exceptions to the rule. ' Problems may be elaborated in order to help clients identify patterns and repetitive cycles, but the greater focus is on identification of solutions, exceptions and the 'difference that will make a difference. ' The process of therapy involves building rapport, identifying problem patterns, establishing goals, exploring strengths and solutions, emphasizing positive coping and predicting, and preparing for relapse.

From the outset, interventions are specifically about the future and solution focused. Clients are treated as experts in their lives, questions are used to establish goals or signs of change, which are small, relevant, achievable, and described in positive, behavioral terms. Some initial, global goals such as 'feel more confident' or 'be happier ' are further refined by asking 'What else will happen because you 're feeling more confident? ' or 'How will people know that you 're feeling happier? '

Rating scales are used throughout therapy and provide objective measures of change, while the emphasis on establishing concrete goals means that specific behavioural, if anecdotal, evidence from clients is gained.

Find out what is already working ' and do more of it. Move from what 's going wrong to what 's going well - and what else, and what else, and what else?

References:
Bateson, G. (1972) Steps to an Ecology of Mind. N.Y: Ballantine Books.
Budman, S., Friedman, S., & Hoyt, M. (1992) Last words on first sessions. In Budman, S., Hoyt, M & Friedman, S. (Eds.) The First Session in Brief Therapy. New York:Guilford.
de Shazer, S. (1985) Keys to Solution in Brief Therapy. New York: Norton.
de Shazer, S. (1988) Clues: Investigating Solutions in Brief Therapy. New York: W.W.Norton.
de Shazer, S. (1991) Putting differences to work. NY: W.W. Norton & Co.
Hoyt, M (1994) Single session solutions. In M. Hoyt (ed) Constructive Therapies. New York:Guilford.
Iveson, G.E. & Ratner,C. (1990) Problem to Solution: London. BT Press.
O 'Hanlon, P, & Weiner-Davis, M. (1989) In search of solutions. NY: Norton.

CELEBRITY FOCUS

Marilyn Monroe

From Edward S. Herrington's letter to Southcoasttoday.com

I am writing in response to "The importance of voice" (May 29), which mentioned that famous actor James Earl Jones struggled with stuttering. Another famous voice that you cited was the trademark breathy voice of Marilyn Monroe; however, you did not make mention of the fact that Marilyn Monroe also struggled with stuttering at various points in her life, sometimes very painfully.

Bob Love

Bob Love has dreamt about being a great public speaker since his early days in Bastrop Louisiana, even though, as a young man, he could barely put two words together, let alone speak a full sentence.

In spite of his severe stuttering disability, Bob Love, the son of a sharecropper, rose to become a Chicago Bulls NBA superstar, whose records were eventually surpassed by Michael Jordan. Throughout his entire athletic career, Bob Love kept his stuttering a secret from the fans who adored him, thinking he could do his “talking” on the basketball court.

Jack Paar

While Jack Paar is among the most prominent of the entertainers on the Stuttering Foundation’s list of Famous People Who Stutter, he deserves special recognition as he was among the first to openly address his stuttering in public. As host of The Tonight Show from 1957-1962, he spoke of his difficulties as a stuttering child and teenager, giving hope to young people.

King George

In November 2010, worldwide movie audiences were presented with a most interesting and unusual movie release with The King’s Speech, starring Colin Firth as King George VI and Helena Bonham Carter as his wife Elizabeth.

Unfortunately, history may have forgotten the courageous and inspiring story of Prince Albert who stuttered badly and never dreamed that he would ever be king when his older brother, King Edward VIII, abruptly abdicated the throne in 1936 to marry Wallis Simpson, an American divorcee.

Bruce Willis

While the world knows Bruce Willis as an A-list actor, few know that he struggled with stuttering throughout his first 20 years.

Walter Bruce Willis was born in 1955 in West Germany to his German mother, Marlene, and his American GI father, David Willis. The family settled in David’s hometown of Penns Grove, New Jersey in 1957, and the couple has three other children.