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Solution Focused Therapy

Solution Focused Therapy (SFT), as its name suggests, focuses on solutions and is goal-oriented, rather than problem focused as many other therapies are.  It is also known as Brief Solution Focused Therapy or Solution Focused Brief Therapy, and was developed by Steve de Shazer and Insoo Kim Berg, who were influenced by the work of Milton Erickson.  Bill O'Hanlon (who worked closely with Erickson) adopts less structured approaches, which he calls Solution-Oriented Therapy and Possibility Therapy.

Basic philosophy & assumptions

  • Change is constant and inevitable

  • Clients are the experts and define goals

  • Clients have resources and strengths to solve problems

  • Future orientation - history is not essential

  • Emphasis is on what is possible and changeable

  • Short term

  • Clients want change

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Milton Erickson's work, on which SFT was initially developed (along with NLP, Human Givens, Strategic Therapy, Solution Oriented & Possibility Therapy, and of course Ericksonian Hypnotherapy) is primarily permissive (giving clients permission to be who they are), validating (any response or behaviour is valid), observing, and utilising (making use of what clients bring).  Erickson also placed emphasis on metaphors, use of language and indirect techniques.

 

 

Solution Focused Therapy acknowledges distress, but focuses on success.  Therapy consists of discussions in which the client is encouraged to find their own solutions.  Different forms of questions enable this process:

The Miracle question

  • De Shazer's (1988) miracle question:  "Suppose that one night, while you are asleep, there is a miracle and the problem that brought you here is solved. However, because you are asleep you don't know that the miracle has already happened. When you wake up in the morning, what will be different that will tell you that the miracle has taken place? What else?"

  • Erickson's original version of the question involved asking his client to look into the future and see themselves as they wanted to be, problems solved, and then to explain what had happened to cause this change to come about.  He might also ask clients to think of a date in the future, then worked backwards, asking them what had happened at various points on the way.

  • O'Hanlon suggests other variations of the question: a time machine, crystal ball, rainbow bridge and a letter from a future self

Building on the miracle question:

  • What difference would you (& others) notice? 

  • What are the first things you notice?

  • Has any of this ever happened before?

  • Would it help to recreate any of these miracles?

  • What would need to happen to do this?

  • What else?

Exception Questions

  • Has anything been better since the last appointment?  What's changed?  What's better? 

  • Can you think of a time in the past (month/year/ever) that you did not have this problem? 

  • What would have to happen for that to occur more often? 

  • When doesn't the problem happen? 

  • What's different about those times? 

  • What are you doing or thinking differently during those better times?

  • When have you been able to stop doing....?

  • Are there times when you expect to...but you remember something that helps you calm down?

  • What else?

 

 

 

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Coping Questions

  • How do you cope with these difficulties?

  • What keeps you going?

  • Who is your greatest support?

  • What do they do that is helpful?

  • What do you do that stops the problem getting worse?

  • When you've had this problem before, what helped you get through then?

  • How did you manage to solve the problem?

  • What advice would you give to someone else who has this problem?

  • What else?

Scaling questions

  • On a scale of 1 to 10 where 1 is the worst it's ever been and 10 is after the miracle has happened, where are you now?

  • Where do you need to be?

  • What will help you move up one point?

  • How can you keep yourself at that point?

  • What would be the first sign that you had moved on one point further?

  • Who would be the first person to notice you've moved one point up?  What would they notice?

  • What else?

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De Shazer's Skeleton Keys

  • Between now and next time....observe what works - notice what is going well in your situation that you would like to continue (keep doing what works)

  • Do something different

  • Pay attention to when.....(an exception happens)

  • Write, read, and burn thoughts

  • Write about what is bothering  you for 15 minutes each night, at the same time.  When you've fully expressed everything you think needs to be expressed, read it over each night until you really think it's complete, and you've got it all out, then burn the paper you've written on

 

 

 

 

 

 

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