Solution-Focused Therapy Model

Steve De Shazer, Berg Lipchik, Nunnally, Molnar, Gingerich, and Weiner-Davis

• De Shazer comes from MRI

  • Instead of being problem focused-He is solution-focused

Major Concepts of Solution-Focused Therapy

Problem solving brief therapy that focuses on how to go about making things better and has elements of engineering in it.

On the other hand, it is also a social-constructivist model-makes use of client’s own description of what works and what doesn’t work.

Clinical Focus on Solutions

• Emphasizes finding solutions rather than delving into problems or their origins.

• Encourages clients to identify and replicate behaviors that have previously led to positive outcomes.

• Focuses on the present and future rather than the past, promoting a proactive approach to therapy.

• Create a sense of hope and possibility

  • Realm within hope is generated through the use of language

  • Language is reality

Co-construction and De-emphasis on History

• Therapy is a collaborative process where therapist and client co-create solutions.

• Historical context and pathology are less emphasized, allowing clients to define their own realities.

• The therapist's role is to facilitate the client's exploration of their strengths and resources.

Key Techniques and Concepts

• Exception Finding: Identifying times when the problem did not exist to highlight client strengths.

• Scaling Questions: Used to assess progress and client feelings about their situation.

• Miracle Question: A technique to help clients envision their desired future and set goals.

Influential Theorists

• Key figures include Steve de Shazer, Insoo Kim Berg, and Bill O'Hanlon, who developed the foundational principles of this model.

• Their work emphasizes the importance of client agency and the potential for change.

Theory of Dysfunction and Change

De Shazer’s theory of dysfunction is that the meaning’s people attribute to behavior limits the range of alternatives they will use to deal with the situation. The focus remains on the problem and it restricts a certain set of behaviors

• Wants to create an environment on what works and on solutions. Rather than constantly remind and reemphasize the client about the existence of the problem-wants to get away from the client being the “problem person”

• Believes within the client system there are solutions that they have and have used in the past

  • These are called exceptions

    • Looking for times when the problem didn’t exist, we’re gonna look for the exceptions to the rule that says their is a problem

    • When did the problem not exist.

• One of the easy ways the group suggests to shift from problem-focused to solution-focused is to find some time when the problem didn’t exist and discuss that and talk about why it didn’t exist at that point.

This model is trying to create a sense of hope, possibility. The realm within which that hope is going to be generated is through the use of language.

De Shazer emphasizes that language is reality, that is the reality that client system has to work with.

• Hence the focus on solutions and constructing of new possibilities and beliefs of these solutions and what they can help occur.

  • Will end up changing the way in which the client both understands what is happening and what is possible.

Understanding Dysfunction

• There is no single 'normal'; therapists should avoid imposing their views on clients.

• Dysfunction is viewed as a construction of reality, shaped by individual perceptions and experiences.

Theory of Change

• Change is facilitated through the generation of solutions rather than focusing on problems.

• Clients are encouraged to describe what works and what does not, expanding their range of behavioral options.

• The meanings attributed to behaviors can limit the client's ability to find solutions.

Stages of Therapy

• Therapy can be done with one person or the entire family

• Initial session explores what has been used for solutions in the past

  • Identifying exceptions

• Establishing a goal for the use of his miracle question

  • “If you were to go to sleep tonight and woke up in the morning and something had changed in your life miraculously, what would that look like?”

    • Uses this as a barometer for establishing what the goal of therapy is and also the prognosis in terms of how people will be able to change.

      • If they can’t come up with anything-then the prognosis is viable. If they can’t say what the miracle is.

  • Asks scaling questions to determine how far or close you are to the goal based on the miracle question

    • One a scale of 1 to 10 how close are you to the “miracle”

• Highlights how the client system is actually successful already. Through the use of formula first session task

  • Asks clients to make note of all that you don’t want change and really need to change. Emphasizing on what is already working well.

Initial Session

• The therapist helps clients identify behaviors that occurred when the problem was absent.

• Focus on hope and possibilities through language and past solutions.

• Establishing goals using the 'miracle question' and assigning initial tasks.

Subsequent Sessions

• Discuss feedback on formula first session tasks and discussing how clients perceive changes in their problems.

• Continue identifying exceptions and complementing and encouraging positive changes.

• Assign new tasks to maintain momentum in therapy.

Termination of Therapy

• Therapy concludes when the client reaches their goals, emphasizing the brief nature of the process.

  • Resolving what is brought into therapy specifically

• Clients are encouraged to maintain the solutions they have developed.

Stance of the Therapist

Therapist's Role

• The therapist takes a directive stance, guiding the session while remaining engaged in solution-focused dialogue.

• They are responsible for maintaining control of the session and encouraging a shift in the client's perception towards solutions.

• Therapist is not responsible for change

• Therapist is encouraging a shift in perception from focusing on problems to seeing solutions that are right there and available

• Relationship between therapist and client: this is the key to change

  • Empathetic, supportive, nurturing, encouraging environment

• Therapist believes the solution is within the client system.

• Therapist is respectful of when client reports they have reached their goal. Not the therapist goal

• Asks, “what went well since I last saw you”

Methods and Techniques

Key Techniques

• Complimenting: Reinforcing positive behaviors and progress made by the client.

• Empathic Nurturing: Building a supportive therapeutic relationship to foster trust and openness.

• Minimal Intervention: Focusing on solutions without delving into underlying pathology.

Specific Interventions

• Formula First-Session Task: A specific assignment given to clients to encourage solution-focused thinking.

  • Asks clients to make note of all that they don’t want to change and really need to change, and what is already working well.

• More-of-the-Same Assignments: Encouraging clients to continue behaviors that have been effective in the past.

Diagnosis and Assessment

Identifying Solutions

• Assessment focuses on identifying solutions and setting goals rather than diagnosing problems.

• Therapists evaluate whether families can identify exceptions and follow through on interventions.

Application in Specific Contexts

• Berg's application of solution-focused therapy to alcoholism illustrates its versatility and effectiveness in various contexts.

• The approach can be adapted to different family dynamics and issues.

Key Terms/Concepts

• Solution-Focused Therapy: A therapeutic approach that emphasizes solutions rather than problems, focusing on what works for the client.

• Co-construction: The collaborative process between therapist and client in creating solutions.

• Scaling: A technique used to measure progress or feelings on a scale, often from 1 to 10.

• Miracle Question: A technique used to help clients envision their desired future and identify steps to achieve it.

Key Theorists

• Steve de Shazer: One of the founders of Solution-Focused Therapy, known for his work on brief therapy and the importance of solutions.

• Insoo Kim Berg: Co-founder of Solution-Focused Therapy, emphasized the role of client strengths and resources.

  • Applies solution model to alcohol abuse

• Eve Lipchik: Contributed to the development of the approach, focusing on the therapeutic relationship.

Facts to Memorize

• Major theorists: de Shazer, Berg, Weiner-Davis, O'Hanlon.

• Key concepts: Solution-focused, co-construction, exception, scaling, miracle question.

• Therapy is brief and can involve individuals or families.

Reference Information

• Solution-focused therapy emphasizes on solutions rather than problems.

• The therapist's stance is directive and engaging, focusing on the client's strengths and past successes.

Concept Comparisons