Message from the Incorporated Solutions Team

MESSAGE FROM THE INCORPORATED SOLUTIONS TEAM

Traditionally therapists have been taught to seek the underlying causes of a client’s problem in order to affect a “cure,” and to understand what psychodynamic “function” problems serve before beginning to modify or ameliorate symptomatic behavior. The solution-focused approach shifts the traditional psychotherapy framework 180 degrees, inviting both the therapist and the client to concentrate instead on the solution.

With the solution-focused approach the therapist helps clients prioritize issues according to their individual perceptions, and establish a clear picture of what life will be once the presenting problem is resolved. In addition to asking problem-focused questions (which often perpetuate feelings of disempowerment or hopelessness), the therapist emphasizes competency-oriented questions which elicit the client’s strengths and successes. By demonstrating interest in the existence of the client’s competence, the therapist provides a nucleus for hope, growth and problem resolution. Clients, when encouraged to notice even the smallest of changes, begin to make distinctions that previously went unobserved, and begin to identify patterns in thoughts, feelings and behavior that facilitate solutions.

Elegant in its simplicity, solution-focused therapy rewards the therapist’s creative curiosity, gentle persistence and infinite respect. It is a constructive treatment strategy that works well with a broad range of presenting problems, and empowers clients through promoting their pre-existing competence. We are pleased to share this perspective with you.

Cynthia K. Hansen, Ph.D.

JoAnna Henry, LC.S.W.

Stuart Levy, LC.S.W.

Phillip R. Trautmann, M.D.

Do not copy without written permission from Incorporated Solutions

SECOND SESSION

Clients report: “Better”

Therapeutic Objective: Relate clients’ efforts to the goal.

Capture the recipe--(”what made the difference?”)

Co-construct the definition of change as real and potentially lasting.

Useful Questions: “Were the positive changes on purpose or did they just happen?”

“How is this change going to help you accomplish what you came

here for?”

“Could the positive changes be the start of the solution?” “What did you learn from this that will help?”

“Is this the beginning of real change?”

“What will it take for this to happen again/more often?”

SECOND SESSION

(Continued)

Clients Report: “Worse”

Therapeutic Objective: Rejoin, fully respecting the problem. Go with--or even beyond--the clients’ negative position.

Review and slow the pacing of therapy. Did the therapist get ahead

of the clients?

Deconstruct complaint pattern. Reconstruct problem definition to

something more likely to lead to change.

Review and reconstruct goal.

Look for small, overlooked exceptions.

Useful Questions: “Is this as serious as it sounds to me? May we look at that first?”

“If this continues on its present course, where might it end at worst?

And then what?”

“Let’s review what’s happened day by day since our last meeting.

When did the shift occur that things got worse?”

SECOND SESSION

(continued)

Useful Questions (when things are worse):

“In your wish for things to work out, might you be describing the

situation less bad than it really is?”

“Did I miss something?”

“Looking back, what could you have done to keep things from getting worse?”

“Have you ever been in this circumstance and done a better job?”

SECOND SESSION

(Continued)

Clients Report: “Mixed”

Therapeutic Objective: Acknowledge the worse, then expand on the better.

Deconstruct the negative part of the pattern; reconstruct problem

definition to something more likely to lead to change.

Apply something from what’s better to what’s worse.

Useful Questions: “What did you learn about what’s better that might apply to what’s worse(or to what’s the same)?”

“Considering that some things have improved while some things have not, what do you make of the fact that this has improved while that hasn’t?”

“How were you able to make improvements in this area while things

were worse? In other areas?”

SECOND SESSION

(Continued)

Client Reports: “Same”

Therapeutic Objective: Enlarge the frame to open up new possibilities. Validate absence of change/open the way for eventual change.

Deconstruct complaint pattern/reconstruct to something more likely to lead to change.

Useful Questions: Inquire fully and persistently into the absence of change. Commonly clients then discover change that’s gone unnoticed. “Is our work together on track?” (If not on track, therapist focuses on his/her shortcomings)

“Is this a standstill or a useful plateau?” “What are the pros and cons of change?” “What did you try that didn’t work?” “What were you looking to have happen?”

DECONSTRUCTION

Purpose: To destabilize the problem frame

Value: Builds a bridge between problem formulation and solution construction.

Creates space for new ideas and alternative meaning.

Transforms problem into one that is resolvable.

Identifies pieces of the frame on which a solution can be built.

Examples: Relabeling the problem

“Pushy” - “Persistent”

“Workaholic” -. “Industrious”

“Symptoms” - “Old habits”

Curiosity/confusion about the problem construction

“How do you know that?”

“What tells you that’s right/possible?”

Externalizing the problem

“When are you more in control of your anger? When is anger more in control of you? What does It take for you to be in control of the anger?”

Investigating incongruities

“How have you been able to keep your grades up while being so

depressed?”

Developing multiple perspectives

“How would your mother/spouse/teacher etc. explain this?”

INTERVENTION DESIGN

Purpose: Summarize session and individualize homework task to fit the relationship between client and therapist.

Value: Maximizes client’s cooperation in treatment.

Incorporates team perspective.

Allows therapist to offer organized feedback to the client.

Guidelines: Highlight anything useful the client is doing about what the client wants to change.

Use the client’s language.

Phrase the goal in positive terms.

(Presence of something rather than absence of something).

Acknowledge hard work required for reaching goal.

Suggest a task that is consistent with the goal and the client-therapist

relationship.

Give a rationale for any homework task that will fit with the client’s perspective.

SAMPLE SOLUTION-FOCUSED QUESTIONS

FOR ABUSED CHILD/TEEN

Exceptions:

“Is this the hardest thing that’s ever happened to you?”

“How did you handle that other thing?” (Whether it’s harder or not as hard)

“What have you noticed that’s different since this (abuse) happened? Which difference do you like and which do you dislike?”

“When you think back on the last few hours (days/weeks), are there some times when things are going better than others? What is different about those times?”

Coping Questions:

“What have you done that has helped you survive what has happened to you?”

“How have you handled all of the questions being asked you?”

“How were you able to go on each day while keeping this a secret?”

“What did you do right after it happened? How did that help?”

“What has been the hardest part for you about what has happened? How have you gotten through that?”

“Considering how horrible/awful (use client’s words here) this has been, it’s amazing you’ve been able to cope with this as well as you have. How have you been able to do that? What will it take for you to keep doing that?”

SAMPLE QUESTIONS FOR ABUSED CHILD/TEEN

(continued)

Pre-Session Change Questions:

“How did your dad/mom find out about what happened to you?”

“Whom did you tell? How did you decide to tell him/her? How did this help?”

“What else have you done that’s helped?”

“Who else has helped you?”

“How did you decide to come see me?”

“What else have you decided to do?”

“What have you noticed that tells you things are getting a little better?”

Goals:

“What would you like to have happen as a result of coming here?”

Miracle Question

“What will you start noticing about yourself that will tell you you’re healing from this? What will others notice?”

“What needs to happen for you to move on in your life the way you want to?”

“How can I help?”

SAMPLE QUESTIONS FOR ABUSED CHILD/TEEN

(continued)

Scaling Questions:

“If 1 is the worst you’ve felt and 10 is back to normal, where would you rate yourself now?”

“On a scale of 1 to 10, with 10 being it’s easy to talk about this and 1 it’s really, really hard, where would you rate this?”

“What have you done to get this far/keep things from getting worse?”

“If 1 is the feeling that all of this is your fault and 10 is the feeling that you are not at all responsible for what happened, what number would describe how you are feeling right now? What number would your parent/best friend/significant other say?”

“If 10 means talking about this has helped a lot, and 1 means it hasn’t helped much at all, where would you rate this? What is it about talking that’s helpful to you?”

SAMPLE SOLUTION-FOCUSED QUESTIONS

TO PARENTS OF ABUSED CHILD/TEEN

Exceptions:

“Is this the most difficult thing you’ve had to deal with in your life? How did you deal with (that other thing)?”

“Is this the most angry (or guilty) you’ve ever felt? How have you handled those feelings in other situations?”

“When your child has been hurt or needed you in the past, what have you done that has helped him/her? What else?”

“Have there been other times when you’ve had to talk about something difficult? How did you do it then?”

“When you think back on the last few days (weeks/months), are there some times when things are going better than others? What is different about those times?”

Coping Questions:

“Considering how horrible/awful/devastating (use client’s words here) it’s amazing you’ve been able to cope as well as you have. How have you been able to do that? What will it take for you to keep doing that?”

“What have you been doing that has helped you cope with this situation?”

“How have you managed to continue providing the day-to-day things your child needs? What have you done?”

“What have you done that has helped you cope with the changes in your family this situation has brought about?”

“What have you seen your child do to cope with this?”

“What did you do right after it happened? How did that help?”

SAMPLE QUESTIONS FOR PARENTS (continued)

Pre-Session Change Questions:

“Who did you talk to first about what happened to your child? How did that help?”

“What have you done that has helped your child? What else?”

“Who has been most helpful to you in dealing with this situation? What has he/she done that helped?

What other plans have you made, besides coming here, to help your child?”

Goals:

Miracle Question

“What would you like to have happen as a result of you and your child coming here?”

“What will be the first sign that your child/teen is beginning to heal/recover?”

“What do you think needs to happen in our session today? What difference will that make?”

“What is your greatest concern? What needs to happen that will tell you this concern has been taken care of?”

SAMPLE QUESTIONS FOR PARENTS (continued)

Scaling Questions:

“If 1 is the worst that things have been and 10 is things being back to normal, where would you rate things now? What have you done to keep things from getting worse? What have you done that’s helped?”

“If 1 is the most stressed you’ve ever been and 10 is the most calm, where would you rate yourself now? What have you done to keep yourself from getting more stressed?”

“If 10 is having complete confidence that you and your child will get through this and be OK, and 1 is the opposite, where would you rate your confidence level? What do you know about yourself/your child that gives you that amount of confidence?”