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Theory and Practice of
Counseling and Psychotherapy
MacDonald
Postmodern Approach
(solution-focused brief therapy and narrative
therapy)
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Questions If persons see therapists, in general,
what is/are the expectation(s) from their
therapist?
If persons sees therapists for their
problem, what is/are the final goals
after completing the therapy sessions?
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View of Human Nature
Assume that realities are socially constructed.There is no absolute reality.
View people are healthy, competent, resourceful,and have the ability to construct solutions andalternative stories to enhance their lives.
Help clients recognize their competencies andbuild on their potential, strengths, and resources.
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Key Concepts of
Solution-Focused Brief Therapy Therapy grounded on a positiveorientation --- people are
healthy and competent
Downplay past, while highlight present and future View people are healthy, competent, and resourceful, and
have the abilityto construct solutionsto enhance their lives
Therapy is concerned with looking for what is working
Therapists assist clients in finding exceptions to theirproblems
The therapy process is to focus on creating solutionsratherthan talking about the problems
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Basic Assumptions ofSolution-Focused Therapy
People can create their own solutions
Small changes lead to large changes The client is the expert on his or her own life
The best therapy involves a collaborative
partnership
A therapists not knowing afford the client an
opportunity to construct a solution
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Therapeutic Goals Believe clients have the ability to define their goals and
the resources required to solve their problems
Focus on small, realistic, and achievable changes
Small change leads to big change
Remain goal-directed and future-oriented
E.g., what has changed since last session?
Talk about solutions instead of talking about problems
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Therapists function and Role No knowing position: clients as experts about their own
lives.
Create a collaborative relationships
Create a climate of mutual respect in which clients are
free to create and explore solutions
Help clients to explore what they would like things to
be different, how to make a difference, and what signs
to indicate the changes are happening.
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Relationship Between Therapist and Client
The therapeutic relationship is an important factor for
change to occur.
Solution-focused brief therapy is designed to be brief, sotherapist must shift the focus as soon as possible from
talking about problems to exploring solutions
Help clients to use their strengths and resources to
construct solutions
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Techniques Used inSolution-Focused Brief Therapy
Pre-therapy change: What have you done
since you made the appointment that hasmade a difference in your problem?
Exception questions: Direct clients to times
in their lives when the problem did not exist.
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Techniques Used in
Solution-Focused Brief Therapy
Miracle question: If a miracle happened and
the problem you have was solved overnight,what would be different in your life?
Scaling questions: On a scale of zero to 10,
where zero is the worst you have been and10 represents the problem being solved, how
would you rate your anxiety right now?
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Techniques Used in
Solution-Focused Brief Therapy
Formula first session task: ask clients toobserve about what happens in your life
(relationship, family) that you want tocontinue to happen
Therapist feedback to clients: therapists
provide summary feedback for clients---compliment what clients have done towardeffective solutions, provide rationale for thesuggestions, and suggest a homework
assignment
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Case discussion Mary feels that she must win everyones
approval. She has become a super nice
guy who goes out of her way to please
everyone. Rarely does she assert herself,
for fear that she might displease someone
who then would not like her. How do you apply solution-focused brief
therapy to help Mary to solve her problem?
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Case discussion Tom, a college sophomore, want to
overcomes his shyness around women. He
doe not date and even des his best to keep
away from women because he is afraid
they will reject him. But he want to solve
his problem. How do you use solution-focused brief
therapy to help Tome to solve his problem?
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Questions? Reactions? What are your reactions?
What did a therapist (Dr. OHanlon)
do?
What can you as a therapist continue
to do by using solution-focused brief
therapy?
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The Therapeutic Process in
Narrative Therapy Collaborate with the client in identifying
(naming) the problem
Separate the person from his or her problem
Investigate how the problem has been disruptingor dominating the person
Search for exceptions to the problem
Ask clients to speculate about what kind of futurethey could expect from the competent person thatis emerging
Create an audience to support the new story
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Therapeutic Goals
Therapists invite clients to describe
their experience in new language andfacilitate the discovery or creation of
new options that are unique to them
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Narrative Therapists function and role
To become active facilitators
To demonstrate care, interest, respectful curiosity,openness, empathy, contact, and fascination
To adopt a not-knowing position that allows being guidedby the clients story
To help clients construct a preferred alternative story
To separate the problem from the people (instead ofperson own the problem)
To create a collaborative relationship --- with the clientbeing the senior partner
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Therapeutic Relationship Emphasize the quality of therapeutic
relationship, in particular therapists attitudes
Client-as-expert, clients are the primaryinterpreters of their own experiences
Therapists seek to understand client's lived
experience and avoid effort to predict, interpret,and pathologies.
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Therapeutic Techniques No recipe, no set agenda, and no formula
This approach is grounded in a philosophical
framework Questionsand more questions:
Questions are used as a way to generate experiencerather than to gather information
Asking questions can lead to separating personfrom problem, identifying preferred directions,and creating alternative stories to support thesedirections.
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Therapeutic Techniques Externalization & Deconstruction
Externalization is a process of separating the
person from identifying with the problem Externalizing conversations can lead clients
in recognizing times when they have dealt
successfully with the problem
Problem-saturated stories are deconstructed
(taken apart) before new stories are co-
created
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Therapeutic Techniques Search for unique outcomes
Successful stories regarding the problem
Creating Alternative Stories The assumption is that people can continually
and actively re-author their lives
Invite clients to author alternative storiesthrough unique outcomes
An appreciative audience helps new stories totake root
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Therapeutic Techniques Documenting the evidence
Therapists write and send a letter to clients
between sessions regarding their strengths
and accomplishments, alternative story, and
unique outcomes or exceptions to the
problems.
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From a multicultural perspective Contributions
Fit with diverse worldview
Clients provide their own interpretations of
life events
Limitations
Diverse clients may expect therapist as a
expert instead of client-as-expert
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Summary and Evaluation Contributions
Client-as-expert (not knowing position)
View people are competent and able to createsolutions and alternative stories
Do not support the DSM-IV-TR labelingsystem
A brief approach, is good for managed care.
In general, studies provided preliminarysupport for the efficacy of solution-focused
brief therapy
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Summary and Evaluation Limitations
No set of formulas or recipes to follow
Inexperienced therapist may view SFBT astechniques. However, the attitude of the therapist is
critical to the success of outcomes.
Therapists need to be able to make quick
assessments, assist clients in setting up the goals, andeffectively use appropriate interventions