5/19/15 - naadac.org · 21/5/2015 · 5/19/15 3 audience polling question #2 solution-focused...
TRANSCRIPT
5/19/15
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Evidenced-Based Solution-Focused Brief Therapy: Its Effective Use with the Most
Challenging Clients Presented by Teri Pichot, LCSW, MAC, LAC
May 21, 2015
Misti Storie, MS, NCC, APC
Director of Training & Professional Development
NAADAC, the Association for Addiction Professionals
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Produced By NAADAC, the Association for Addiction Professionals
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www.naadac.org/solutionfocusedbrieftherapy Cost to Watch: Free CE Hours Available: 1.5 CEs CE Certificate for NAADAC Members: Free CE Certificate for Non-members: $20
To obtain a CE Certificate for the time you spent watching this webinar:
1. Watch this entire webinar.
2. Pass the online CE quiz, which is posted at
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3. If applicable, submit payment for CE certificate or join NAADAC.
4. A CE certificate will be emailed to you within 21 days of submitting the quiz.
CE Certificate
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Using GoToWebinar – (Live Participants Only)
§ Control Panel
§ Asking Questions
§ Audio (phone preferred)
§ Polling Questions
Webinar Learning Objectives
Understand the difference between problem-solving and solution-building
Understand what the research tells us about what causes change for clients
Identify three skills that they can immediately begin using with clients
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Teri Pichot, LCSW, MAC, LAC www.denversolutions.com [email protected]
Webinar Presenter
Audience Polling Question #1
The word “Brief” in Solution-Focused Brief Therapy is defined as:
Extratherapeutic Factors – 40%
Therapy Relationship Factors – 30%
Therapeutic Technique – 15%
Expectancy, Hope, Placebo – 15%
What Causes Change??
Miller, S. D., Duncan, B. L., & Hubble, M. A. (1997). Escape from babel. New York, NY: Norton.
87% Client/extra-therapeutic factors 13% Effect of the service delivered
From 13% effect of the service (appearing as partially overlapping factors):
ü 1% (8% from 13%) is for the specific model/technique used. ü 4% (30%- +) for the Model/Technique delivered (meaning with the
power of allegiance and placebo added to the specific model). ü 5-7% (38-54%) for the Therapeutic Alliance ü 5-9% (46-69%) for Therapist Effect
Latest on What Causes Change
Duncan, B. L., Miller, S. D., Wampold, B. E., & Hubble, M. A. (2010). The heart & soul of change: Delivering what works in therapy, 2nd edition. Washington, DC: APA.
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Audience Polling Question #2
Solution-Focused Brief Therapy was created by:
Audience Polling Question #3 The primary motivation for creating Solution-Focused Brief Therapy was:
§ Evaluate the problem
§ Diagnose the problem
§ Utilize known information about the diagnosed problem
§ Evaluate client resources/strengths
§ Determine the best course of treatment
§ Implement the treatment
Problem Solving Problem Solving
www.denversolutions.com
Problem
§ Determine the desired goal
§ Assist the client in creating a detailed description of the goal
§ Assist the client in evaluating where he/she is in relation to the desired goal
§ Assist the client in evaluating times in which he/she was successful in moving toward the desired goal
§ Work backward to discover keys to success
Solution Building Solution Building
www.denversolutions.com
Problem
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www.denversolutions.com
FAMILY
IDENTIFIED
CLIENT
LEGAL SYSTEM/
SOCIAL SERVICES
REGULATION
COMMUNITY
Definition of a “Client” in SFBT
Audience Polling Question #4 Solution-Focused Brief Therapy is basically the same as Motivational Interviewing.
Keep Delete
Change
What We Do with Client Words X x x
x x X
Problems Outcome
Process
What People Bring to the Conversation
x x x
X x x
Curiosity § Time for both
§ Can’t be curious and know at the same time
§ SF approach holds back suggestions
§ More likely to do things client identified as helpful
§ Less pressure on professional to “fix it”
§ Resolves “yes but”s
Give vs. Discover
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§ How will you know I gave you the “right” resource?
§ What will you have done to better the odds of this resource working for you?
§ What will be different afterward that will let you know this was a good choice for you?
§ What will you have done to keep this resource working for you?
Helpful Questions
§ Any time you are tempted to give concrete resources that aren’t urgent
§ Any time a client wants you to “fix it” and it isn’t urgent
§ Any time you are frustrated by the client not following through with previous referrals/suggestions
When to Use
§ Identifying a quality, skill, or trait the client will have
§ Working in past-tense
§ Asking how life is different, how they did it, etc.
§ Empowers
§ Helps to determine what’s needed (support, meds, therapy)
Working from the Solution-Side
§ Any time you are stuck
§ Any time you need direction
§ Any time you need to increase client hope
When to Use
§ Do we explore the problem? (i.e., the cause, the outcome of bad decisions, the “whys” of bad choices)
§ Do we explore what is important to the client or what is helping the client get closer to what he/she wants? (i.e., successes, good decisions, the “whys” of good choices)
Verbal Paths
§ It’s a way of working with clients
§ Specifically helpful when you are becoming overwhelmed and feeling hopeless about the client’s problems
§ Any time other professionals are becoming negative about the client
§ Any time the client is becoming discouraged during a conversation
When to Use
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§ Designed around a specific event
§ Working in past-tense
§ Imagine that it is just past the event
§ Keep the outcome vague
§ Imagine that you feel proud of how you handled it despite the outcome
§ What did you do, what did you say, how did you do it, etc.
Fast Forwarding
§ Any time a specific event is resulting in stress or a mental health symptom (or exacerbating it)
§ Any time client is having a difficult time seeing past the event
§ Any time you need to increase client hope that they can get through an event
When to Use
§ Make concepts measurable
§ Provide assessment information
§ Provide the tool to measure change
§ Neutral tool to explore exceptions and highlight change
§ Use 0-10 or 1-10 scales
§ The 10 equals the desired goal
§ The 1 must be defined
Scales
§ Any time clients are thinking black/white
§ Any time clients aren’t giving themselves credit
§ Any time hope is needed
§ Any time perspective is needed
§ Any time you need to understand a concept better
When to Use
§ Assist the client in exploring how the changes impact all elements of his/her system
§ Assist the client in keeping the plan realistic and inclusive of all factors
§ Increase the client’s ability to “step into someone else’s shoes”
§ (Increases empathy)
Relationship Questions
§ Any time you need to increase meaning
§ Any time you need the client to become more empathic about how her decision might impact others
§ Any time you want to increase critical thinking
§ Any time you want to increase motivation for change
When to Use
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§ Pichot, T. (2012). Animal-assisted brief Therapy: A solution-focused approach (2nd ed). New York, NY: Routledge.
§ Pichot, T., with Smock, S. A. (2009). Solution-focused substance abuse treatment. New York, NY: Routledge.
§ Pichot, T., & Dolan, Y. (2003). Solution-focused brief therapy: Its effective use in agency settings. Binghamton, NY: Haworth.
References
Teri PIchot, LCSW, MAC, LAC www.denversolutions.com [email protected]
THANK YOU
www.naadac.org/solutionfocusedbrieftherapy Cost to Watch: Free CE Hours Available: 1.5 CEs CE Certificate for NAADAC Members: Free CE Certificate for Non-members: $20
To obtain a CE Certificate for the time you spent watching this webinar:
1. Watch this entire webinar.
2. Pass the online CE quiz, which is posted at
www.naadac.org/solutionfocusedbrieftherapy
3. If applicable, submit payment for CE certificate or join NAADAC.
4. A CE certificate will be emailed to you within 21 days of submitting the quiz.
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