SOLUTION-FOCUSED AND PARADOXICAL COUNSELING

STRATEGIES

Chapter 10

Brief Counseling:

A GENERAL OVERVIEW

FOCUS = SOLUTION

Solution-Focused Therapy

SOLUTION-FOCUSED BRIEF COUNSELING (SFBC)

Nature of People

People are free to make choices and are not victims of their genetics or environment.

People are basically good.

People are basically rational.

People respond better to a present and future counseling orientation.

People have the ability to work through their own problems.

Focuses on “what” people are doing and not “why” they are doing it.

Focus on success instead of failure

Bruce’s Components of SFBC

Develop a working alliance to attack the problem.

Identify clients’ strengths as a foundation for confidence in their abilities to make positive changes.

Implement active, eclectic counseling strategies and interventions.

Establish clear, concrete, measurable goals in order to evaluate progress.

Bruce’s SFBC Intervention Tasks

“Do something different.”

“Pay attention to what you do when you overcome the urge to …..” for the client who has trouble controlling impulsive behaviors.

“Tell me about a time when you had a good day at ____ ” for clients who have taken on the victim mentality of believing that nothing good ever happens to them.

“Observe and take notes” for clients who have trouble avoiding problem situations and interactions.

Counseling Method

Orientation: Clarify the SFBC counseling process.

Setting Goals: heart of counseling including statement of the problem:The problem.The feelings associated with the problem.The intensity of those feelings on a 1 to 10 scale.The client’s expectations of what the client would like to have happen in counseling and the goals the client would like to accomplish.

Use Active Listening when identifying the problem: (given the brief nature, then identifying the wrong problem is extremely problematic

Scaling: “Where are you on a scale of 1 to 10?”

Working with positive and negative goals.

Setting Counseling Goals

Goals owned or set by the client work best.

If clients need assistance, be sure goals are co-created.

Set goals that are behaviorally oriented. Goals work best when they are positive, concrete, and reduced to small steps.

State a goal in terms of what behavior will occur, how often it will occur, and under what conditions it will occur.

Counseling Method

Miracle question: “Should a miracle occur this evening while you were sleeping and when you woke up, you suddenly realized that your problems were solved, what would you be doing that would indicate to you that the miracle had actually taken place?”

Relationship questions: “What will your _____ say that will be different after the miracle?”

Asking and reinforcing exceptions to the problem solution.

Using positive blame.

Counseling Method

Scaling progress toward the goal.

Asking for 10% improvement

Flagging the minefield: “What things might prevent you from moving up 10% on the scale or what might sabotage your plan?”

Closing the session.

Writing the note: Write the client a message with at least 3 compliments and a bridging statement from each compliment to one of the tasks the client needs to accomplish to raise the scale score 10% or one level from a 4 to a 5.

Five Question Method

1. Ask “How do you experience the problem?”2. Ask “When do (or did) you not experience

the problem? What were you doing then?3. Have clients rate their current progress on

solving the problem on the ) to 10 scale.4. Ask the miracle question.5. Set goals based on increasing what works

for the client.

A BRIEF OVERVIEW

FOCUS = PROBLEM

PARADOXICAL BRIEF COUNSELING

PARADOXICAL BRIEF COUNSELING (PBC)

People are independent and resist compliance (actively or passively).

PBC focuses on problem formation/elimination.

PBC methods are specific and eclectic.

Problems reframed as opportunities.

PARADOXICAL BRIEF COUNSELING (PBC)

Two approaches in PBC:

1) one-down position: elevates the client to the expert role and the counselor to the less-than-expert role.

2) one-up frame of reference: the counselor, as expert, prescribes the behavior the client is to follow. “Do more of your symptomatic behavior.” Puts the resistant client in a double bind.

Benefits of SFBC and PBC

Wide appeal among cultures and clients who emphasize individual responsibility over family and community.

The approach has much to offer counselors who are working under the constraints of managed health care and who are working with large client loads.

*Methods of SFBC and PBC are not easy to master.

FAMILY COUNSELING

Chapter 15

What makes it different?

Focus on family and its members’ interactions and relations

Involves interventions to alter the entire family system

Problem diagnosis is circular causality, roles each person plays in maintaining problem

What defines a family?

Webster’s Dictionary definitions:Group of people who are (1) bound by

philosophical, religious, or other convictions, (2) common ancestry, and (3) living under the same roof.

AndBasic biosocial unit in society having as its

nucleus two or more adults living together and cooperating in the care and rearing of their own or adopted children

Systems Theory and Families

System = organized unit made up of interdependent parts

Whole unit is greater than the sum of its parts

Change in any part affects all other partsFamily is system in which each member

has a significant influence on all other members

Systems Theory and Families

Families may struggle to find a healthy balance between two extremes:

Enmeshment = over involvement in each others’ lives

Disengagement = too much detachment from one another

Systems Approach to Family Therapy: Murray Bowen

Focuses on how family members could maintain a healthy balance between being enmeshed and being disengaged.

Believes each member should have an individual identity, while maintaining closeness with family.

Murray Bowen

Spousal Relationship Are they able to differentiate themselves as

individuals apart from the couple?

Differentiation of Self ability to separate thoughts from feelings struggle to develop identity and remain part of the

family

Murray Bowen

Differentiation of Self Highly differentiated = better at handling

stress/anxiety Increased differentiation by one family member

is likely to lead other members to become more differentiated

Self-differentiation is principal goal of family therapy

Murray Bowen

De-triangulation of Self from Family Emotional System Triangulation refers to the practice of two family

members bringing a third into their conflict Can be someone inside the family or outside of

the family that is being used to “side” with one of the parents.

Examples include One parent siding with one child to manipulate the other

parent. One parent starting an affair with an outside party to

meet needs not addressed in the marriage.

Murray Bowen

Emotional Systems of the Family Understanding the emotional system and how they

work central to the theory Again achieving differentiation primary Uses “genograms” (fig. 12-2 in textbook) to

demonstrate multi-generational trends. Used these genograms to plot family events, visually

represent enmeshed families, show patterns of behavior, and demonstrate triangulation

Modeling Differentiation Using “I” statements and taking ownership of his own

thoughts, feelings, and behaviors

Structural Family Therapy

Founder viewed as MinuchinGoal: to alter family structure and empower

dysfunctional family to move towards functional family communications

Functional families characterized by each member’s success in finding the healthy balance between belonging to a family and maintaining a separate identity

Structural family therapy = a zoom lens that can focus on the entire family or a close-up of any family member

Structural Family Therapy

One way to find balance between family and individual identity is to define and clarify the boundaries between the subsystems

Boundaries range from rigid to diffuseSecret is in finding the right boundary balance

that is well definedStructural family therapy directed toward

changing the family organizational structureTake the focus off of the referred patient and

back onto the system (often by focusing it on a non-referred member of the therapist).

Strategic Family Therapy

Family members’ behavior can only be understood within the family context

Haley (1973) - therapist initiates what happens in therapy and plan for solving each problem

Focuses on paradoxes (similar in many ways to individual PBC).

Strategic Family Therapy

Haley (1976) describes four stages of a typical first interview:1. Social Stage: build rapport and assess2. Problem Stage: get clear statement of concern3. Interaction Stage; family interacts (therapist observes)4. Goal Setting: define therapy goal in concise, observable, behavioral terms

Communications Approach to Family Therapy

Gottman’s Behavioral Interviewtherapist = educatoraccurate communication is key to problem

solvingcommunicate openly and honestlymatch intent and impact in communication

Focuses on solutions (similar in many ways to individual SFBC).

Virginia Satir’s Conjoint Family Therapy

Satir had a positive view of human naturePeople are rational and have ability to make

choicesSelf-esteem and effective communication

are importantBehavior is directly related to one’s family

positionPeople need a high degree of self-esteem to

be a good marriage partner

Theory of Counseling

Four components in family situation are subject to change and correction: The members’ feelings of self-worth The family’s communication abilities The system The rules of the family

Theory of Counseling

Family unit becomes dysfunctional when members do not understand the rules

Analyzing interactions and communications is important for change

Emphasis is on development of trust in relationship

Communication = most important factor, the main determinant of the kinds of relationships people have with one another and of how people adjust to their environment, as well as being the tie that binds the family together

Theory of Counseling

Fear of rejection common source of anxietyBecause people fear rejection, they resort to

one response pattern or a combination of patterns

These universal roles are described as placater, blamer, computer, distractor and leveler

Theory of Counseling:Communication Styles

placater - peace at any price, try to please others or apologize

blamer – faultfinders, compensate for lonely feelings by bossing others around

computer - calm and correct, with no feelings, pretend no conflict exists

distractor - make irrelevant statements, evade issues, withdraw from situations

leveler - communicate in a straightforward way, honest thoughts, verbal and nonverbal communication is congruent

Keys to Satir’s System

1. Increase self-esteem of all family members (children should be included in all stages)

2. Help family members better understand each other (and their roles) in order to make changes.

3. Use experiential learning techniques (such as family scupting, simulating each other, and role play)