Each of the models of counselling and psychotherapy we have studied so far has its own version of reality. The simultaneous existence of multiple and often conflicting truths has led to increasing scepticism that a singular, universal theory will one day explain human behaviour and the systems we live in. Modernists believe in the ability to describe objective reality accurately and assume that it can be observed and systematically known through the scientific method. Modernists believe people seek therapy for a problem when they have deviated too far from some objective norm. Postmodernists, in contrasts, do not believe realities exist independent of observational processes and of the language systems within which they are described. Social constructionism is a psychological expression of this postmodern world view; its values the clients reality without disputing whether it is accurate or rational. To social constructions, any understanding of reality is based on the use of language and is largely a function of the situations in which people live. Once a definition of self is adopted, it is hard to recognise behavioura counter to the definition; for example, it is hard for someone who is suffering from depression to acknowledge the value of a periodic good mood in his or her life. In post modern thinking forms of language and the use of language in stories create meaning. There may be as many meanings as there are people to tell the stories, and each of these stories expresses a truth for the person telling it. Every person involved in a situation has a perspective on the reality of that situation but the range of truths is limited due to the effects of specific historical events and the language uses that dominate particular social context. Clients are viewed as expects about their own lives. De Jong and Berg 2013 put this notion about the therapists task well: we do not view ourselves as expert at scientifically assessing client problems and then intervening. Instead, we strive to be expert at exploring clients frames of reference and identifying those perceptions that clients can use to create more satisfying lives. The collaborative partnership in the therapeutic process is considered more important than assessment or technique. Social constructionist theory is grounded on the premise that knowledge is constructed through social processes. What we consider to be the truth is a product of interactions between people in daily life.
Historical Glimpse of social constructionism – a mere hundred years ago, Freud, Adler and Jung were part of a major paradigm shift that transformed psychology as well as philosophy, science, medicine, and even the arts. In the 21st century, postmodern constructions of alternative knowledge sources seem to be one of the paradigm shifts most likely to affect the field of psychotherapy. Diversity, multiple frameworks and integration – collaboration of the knower with the known – are all part of this new social movement, which provides a wider range of perspectives in counselling practice. Among the best known postmodern perspectives on therapy practice are the collaborative language systems approach, solution focused brief therapy, solution-orientated therapy, narrative therapy and feminist therapy.
The collaborative language system approach – when people seek therapy, they are often stuck in a dialogic system that has a unique language, meaning and process related to the problem. Therapy is another conversational system that becomes therapeutic through its problem-organising problem-dissolving nature. In the not-knowing position, therapists still retain all of the knowledge and personal, experiential capacities they have gained over years of living but they allow themselves to enter the conversation with curiosity and with an intense interest in discovery. Based on the referral or intake process, the therapist enters the session with some sense of what the client may wish to address. The questions the therapist asks are informed by the answers the client-expert has provided. The clients answer provide information that stimulates the interest of the therapists, still in a posture of inquiry, and another question proceeds from each given answer. Socratic method without any preconceived idea about how or in which direction the development of the stories should go. By staying with the story, the therapist-client conversation evolves into a dialogue of new meaning, constructing new narrative possibilities.
Solution-focused brief therapy (SFBT) is a future-focused, goal-orientated therapeutic approach to brief developed initially by Steve de Shazer and Insoo Kim Berg at the Brief Family Therapy Center in Milwaukee in the early 1980s.
Key Concepts – Unique Focus of SFBT – the solution-focused philosophy rests on the assumption that people can become mired in unresolving past conflicts about blocked when they focus on past or present problems rather than on future solutions. Therapists focus on what is possible and they have little or no interest in gaining an understanding of how the problem emerged. Assessing problems is not necessary for change to occur. It is within the scope of SFBT practice to allow for some discussion of presenting problems to validate clients experience and to let them describe their pain, struggles and frustrations. In solutions-focused brief therapy, clients choose the goals they wish to accomplish, little attention is given to diagnosis, history taking, or exploring the emergence of the problem.
Positive Orientation – solution focused brief therapy is grounded on the optimistic assumption that people are healthy and competent and have the ability to construct solutions that can enhance their lives. Therapists role is to help clients recognise the competencies they already possess and apply them toward solutions. The essences of therapy involves building on clients hope and optimism by creating positive expectations that change is possible. Solution-focused brief therapy has parallels with positive psychology, which concentrates on hat is right and what is working for people rather than dwelling on deficits, weakness and problems. Because clients often come to therapy in a problem-oriented state, even the few solutions they have considered are wrapped in the power of the problem orientation. Therapists can be instrumental in assisting clients in making a shift from a fixed problem state to a world with new possibilities. One of the goals of SFBT is to shift clients, sections on by reframing what White and Epston 1990 refer to as clients, problem-saturated stories, through the counsellors skillful use of language.
Looking for what is working – the emphasis of SFBT is to focus on what is working in clients lives which stands in stark contrast to the traditional models of therapy that tend to be problem-focused. They promote hope by helping clients discover exceptions, or times when the problem is less intrustive in their life. SFBT focuses on finding out what people are doing that is working and then helping them apply this knowledge to eliminate problems in the shortest amount of time possible. There are various ways to assist clients in thinking about what has worked for them. De Shazer 1991, prefers to engage clients in conversations that lead to progressive narratives whereby people create situations in which they can make steady gains towards their goals. De Shazer might say, ‘tell me about times when you felt a little better and when things were going your way’.
Basic Assumptions Guiding Practice – Walter and Peller think of solution-focused therapy as a model that explains how people change and how they can reach their goals rather than a model of the causes of problems:
- Individuals who come to therapy do have the capability of behaving effectively, even though this effectiveness may be temporarily blocked by negative conditions
- There are advantages to a positive focus on solutions and on the future
- There are execptions to every problem or imes when the problem was absent
- Clients often present only one side of themselves
- No problem is constant, and change is inevitable
- Clients are doing their best to make change happen
- Clients can be trusted in their intention to solve their problems
Characteristics of Brief Therapy – the average length of therapy is 3 to 8 sessions, with the most common length being only one session.
- Rapid working alliance between therapist and client
- Clear specification of achievable treatment goals
- Clear division of responsibilities between client and therapist with active client participation and a high level of therapist activity
- Emphasis on clients strength, competencies, and adaptive capacities
- Expectation that change is possible and realistic and that improvement can occur in the immediate future
- Here and now orientation with a primary focus on current functioning in thinking, feeling and behaving
- Specific, integrated, pragmatic, and eclectic techniques
- Periodic assessment of progress toward goals and outcomes
- Time sensitive, including making the most of each session and ending therapy as soon as possible
The core task is for SFBT practitioners to learn how to rapidly and systematically identify problems, create a collaborative relationship with clients and intervene with a range of specific methods.
Therapeutic Process – the therapeutic process rests on the foundation that clients are the experts on their own lives and often have a good sense of what has or has not worked in the past and what might work in the future. In short, collaborative and cooperative relationships tend to be more effective than hierarchical relationships in therapy. De Shazer 1991 believes clients can generally build solutions to their problems without any assessment of the nature of their problems.
- Clients are given an opportunity to describe their problems
- The therapist works with the client in developing well-formed goals as soon as possible
- The therapist asks clients about those times when their problems were not present or when the problems were less severe
- At the end of each solution-building conversation, the therapist offers clients summary feedback, provides encouragement, and suggest what clients might observe or do before the next session to further solve their problem
- The therapist and clients evaluate the progress being made in reaching satisfactory solutions by using a rating scale
Therapeutic Goals - SFBT reflects some basic notions about change, about interaction and about reaching goals. The solution-focused therapist believes people have the ability to define meaningful personal goals and that they have the resources required to solve their problems. Goals are unique to each client and are constructed by the client to create a richer future. From the first contact with clients, the therapist strives to create a climate that will facilitate change and encourage clients to think in terms of a range of possibilities. Solution-focuse therapists concentrate on small, realistic, achievable changes that can lead to additional prositive outcomes. Solution-focused therapists use questions such as these that presuppose change, posit multiple answers and remain goal-directed and future-orientated; what did you do, and what has changed since last time?. Murphy 2015 emphasises the importance of assisting clients in creating well defined goals that are 1. Stated positively in the clients language, 2. Are action-oriented, 3. Are structured in the here and now, 4. Are attainable, concrete, specific, and measurable, 5. Are controlled by the client. Therapists need to be mindful of not becoming overly technique driven at the expense of the therapeutic alliance. Solution-orientated therapy offers several forms of goals; changing the viewing of a situation or a frame of reference, changing the doing of the problematic situation and tapping the client strengths and resources. Talking about problems can produce ongoing problems, talk about change can produce change.
Therapists Function and Role – solution-focused practitioners believe that every client motivated in the sense that he or she wants something as a consequence of meeting with a therapist. Consistent with the postmodern and social constructionist perspective, solution-focused brief therapists adopt a not-knowing position to put clients in the position of being the experts about their own lives. It is important that therapists actually believe that their clients are the true experts on their own lives. Clients are experts on what they want changed. Clients will have their own ways of building their preferred futures even if this is often not clear to them when they begin therapy. The therapist task is to point clients in the direction of change without dictating what to change. A key therapeutic task consists of helping clients imagine how they would like life to be different and what it would take to make this transformation happen.
Therapeutic Relationship – the quality of the relationship between therapist and client is a determining factor in the outcomes of SFBT so relationship building or engagement is a basic step in SFBT. The therapeutic process works best when clients become actively involved when they experience a positive relationship with the therapist and when counselling addresses what clients see as being important. Clients are encourage to do something different and to be creative in thinking about ways to deal with their present and future concern. De Shazer 1988 has described three kinds of relationships that may develop between therapists and their clients:
1. Customer – the client and therapist jointly identify a problem and a solution to work toward
2. Complainant – the client describes a problem but is not able or willing to assume a role in constructing a solution, believing that a solution is dependent on someone else actions
3. Visitor – the client comes to therapy because someone else, thinkgs the client has problem.
De Jong and Berg 2013 recommend using caution so that therapists do not box clients into static identities. These three roles are only starting points for conversation. Rather than categorising clients, therapists can reflect on the kinds of relationships that are developing between their clients and themselves.
Application: Therapeutic Techniques and Procedures – some of the key techniques that solution-focused practitioners are likely to employ include looking for differences in doing, exception questions, scaling questions and the miracle question. Murphy 2015 reminds us that these solution-focused techniques should be used flexibly and tailored to the unique circumstances of each client. Therapy is best guided by the clients goals, perceptions, resources and feedback.
Pretherapy Change – simply scheduling an appointment often sets positive change in motion. During the initial session, it is common for therapists to ask – what have you done since you called for the appointment that has made a difference in your problem. Therpists can elicit, evoke, and amplify what clients have already done by way of making positive change.
Exception Questions – SFBT is based on the notion that there were times in clients lives when the problems they identify were not problematic. These times are called exceptions and represent news of difference. Solution-focused therapists ask exception questions to direct clients to times when the problem did not exist or when the problem was not intense. Exceptions are those past experiences in a clients life when ti would be reasonable to have expected the problem to occur but somehow it did not. It also provides a field of opportunity for evoking resources, engaging strengths, and positing possible solutions.
The miracle question – therapy goals are developed by using what de Shazer calls the miracle question which is a main SFBT technique. The therapist asks – if a miracle happened and the problem you have was solved overnight, how would you know it was solved and what would be different. O’Hanlon and Weiner-Davis belief that changing the doing and viewing of the perceived problem changes the problem. De Jong and Berg identify several reasons the miracle questionis a useful technique.
Scaling questions – used when change in human experiences are not easily observed, such as feelings, moods and communication, and to assist clients in noticing that they are not completely defeated by their problem.
Formula first session task – is a form of homework a therapist might give clients to complete between their first and second sessions. Therapist might say - between now and the next time we meet, I would like you to observe, so that you can describe to me next time, what happens in your life that you want to continue to have happen. According to De Shazer, this intervention tends to increase clients optimism and hope about their present and future situation
Therapist Feedback to Clients – generally take a 5 to 10 break toward the end of each session to compose asummary of message for clients. De Jong and Berg 2013 describe three basic parts to the structure of the summary feedback; compliments, a bridge, and suggesting a task. Compliments are genuine affirmations of what clients are already doing that is leading toward effective soltuoins. Second, a bridge links the initial compliments to the suggested tasks that will be given. The bridge provides the rationale for the suggestions. The third aspect of feedback consists of suggesting tasks to clients which can be considered as homework. Observational tasks ask clients to simply pay attention to some aspect of their lives.
Terminating – from the very first solutions-focused interview, the therapist is mindful of working toward termination. Once clients are able to construct a satisfactory solution, the therapeutic relationship can be terminated. Establishing clear goals from the beginning of therapy lays the groundwork for effective termination. Prior to ending therapy, therapists assist clients in identifying things they can do to continue the changes they have already made into the future. Guterman 2013 maintains that the ultimate goal of solution-focused counselling is to end treatment. Because of this model of therapy is brief, present-centered and addresses specific complaints it is very possible that clients will experience other development concerns at a later time.
Application to group counselling – believes that people are competent and that given a climate where they can experience their competent and that given a climate where they can experience their competency they are able to solve their own problems, enabling them to live a richer life. SFBT is designed to be brief, the leader has the task of keeping group members on a solution track rather than a problem track, which helps members to move in a positive direction. The group leader works with members in developing well-formed foals as soon as possible. Leaders concentrate on small, realistic, achievable changes that may lead to additional positive outcomes. The facilitator asks members about times when their problems were not present or when the problems were less severe. The membesr are assisted in exploring these expections, and special emphasis is placed on what they did not make these events happen. The advantage of group counselling is that the audience widens and more input is possible. The art of questioning is a main intervention use in solution-focused groups. Questions are asked from a positive of respect, genuine curiosity, sincere interest and openness. – what did you do and what has changed since last time. Creating group context in which the members are able to learn more about their personal abilities is key to members learning to resolve their own concerns. Offers a great deal of promise for practitioners who want a practical and time-effective approach to interventions in school settings. This model has much to offer to school counsellors who are responsible for serving large caseloads of students in a K – 12 school system.
Narrative Therapy – Michael White and David Epston 1990 are best known for their use of narrative in therapy. Individuals construct the meaning of life in interpretive stories which are then treated as truth. Adopting a postmodern, narrative, social constructionist view sheds light on how power, knowledge, and truth are negotiated in families and other social and cultural contexts.
Key Concepts:
Focus of Narrative Therapy – involves adopting a shift in focus from most traditional theories. Therapists are encouraged to establish a collaborative approach with a special interest in listening respectfully to clients stories.
The Role of Stories – one of the theoretical underpinnings of narrative therapy is the notion that problems are manufactured in social, cultural, and political context. We live out lives by the stories we tell about ourselves and that others tell about us.
Listening with an open mind – all social constructionist theories emphasise listening to clients without judgement or blame, affiring and valuing them. Narrative practice goes further in deconstructing the systems of normalising judgment that are found in medical, psychological, and educational discourse. Normalising judgement is any kind of judgement that locates a person on a normal curve and is used to assess intelligence, mental health or normal behaviour. Narrative therapists help clients modify their painful beliefs, values and interpretations as clients create meaning and new possibilities from the stories they share. Narrative therapists strive to listen to the problem-saturated story of the clients without getting stuck. Winslade and Monk 2007 – maintain that the therapist believes the clients abilities, talents, positive intentions, and life experiences can be the catalysts for new possibilities for action. During the narrative conversations, attention is given to avoiding totalising language which reduces the complexity of the individual by assigning an all – embracing single description to the essence of the person. This is called double listening. The narrative perspective focuses on the capacity of humans for creative and imaginative thought, which is often found in their resistance to dominant discourse. Do not assume that they know more about the lives of clients than their clients do.
Therapeutic Process –
- Collaborate with the client to come up with a mutually acceptable name for the problem
- Personify the problem and attribute oppressive intentions and tactics to it
- Investigate how the problem has been disrupting, dominating, or discouraging to the client
- Inviting the client to see his or her story from a different perspective by inquiring into alternative meanings for events
- Discover moments when the client wasn’t dominated or discouraged by the problem by searching for exceptions to the problem.
- Find historical evidence to bolster a new view of the client as competent enough to have stood up to, defeated or scapred from the dominance or oppression of the problem
- Ask the client to speculate about what kind of future could be expected from the strong, competent person who is emerging
- Find or create an audience for perceiving and supporting the new story
Winslade and Monk 2007 – stresses that narrative conversations do not follow the linear progression described here; it is better to think of these steps in terms of cyclical progression containing the following elements:
- Move problem stories toward externalising descriptions of problems
- Map the effects of a problem on the individual
- Invite the individual to evaluate the problem and its effects
- Listen to signs of strength and competence in an individual problem saturated stories
- Build a new story of competence and document these achievements
Therapeutic Goals – a general goal of narrative therapy is to invite people to describe their experience in new and fresh language. In doing this, they open new vistas of what is possible. The new language enables clients to develop new meanings for problematic thoughts, feelings and behaviours
Therapist Function and Role – narrative therapists are active facilitators. The concepts of care, interest, respectful curiosity, openness, empathy, contact and even fascination are seen as a relational necessity. A main taks of the therapist is to help clients construct a preferred story line. White and Epson 1990 start with an exploration of the client in relation to the presenting problem. Like the solution focused therapist, the narrative therapist assumes the client is the expert when it comes to what he or she wants in life. Monk 1997 emphasises that narrative therapy will vary with each client because each person is unique.
The therapeutic relationship – place great importance on the values and ethical commitments a therapist brings to the therapy venture. Collaboration, compassion, reflection and discovery charaterise the therapeutic relationship. Winsalde, Crocket, Monk 1997 describe this collaboration as co-authoring or sharing authority. Clients are often stuck in a pattern of living a problem-saturated story that does not work.
Techniques – in agreement with Carl Rogers on the importance of the therapist way of being rather than being technique driven. More than the application of skills; it is based on the therapist personal characteristics that create a climate that encourages clients to see their stories from different perspectives.
Questions - seem embedded in a unique conversation, part of a dialogue about earlier dialogues, a discovery of unique events, or an exploration of dominant culture processes and imperatives. Use questions as a way to generate experience rather than to gather information. Through the process of asking questions, therapists provide clients with an opportunity to explore various dimensions of their life situations. Attempt to engage people in deconstructing problem-saturated stories, identifying preferred directions, and creating alternative stories that support these preferred directions.
Externalization and Deconstruction – White believed that person is not the problem, the problem is the problem. Help clients deconstruct these problematic stories by disassembling the taken for granted assumptions that are made about an event, which then opens alternative possibilities for living. One of the processes for deconstructing the power of narrative. This process separates the person from identification with the problem. By understanding cultural invitations to blame oneself, clients can deconstruct this story line and generate a more positive, healing story. The method used to separate the person from the problem is referred to as externalising conversation, which open sup space for new stories to emerge. Externalising conversations counteract oppressive, problem-saturated stories and empower clients to feel competent to handle the problems they face. 2 stages of structuring externalising conversations are 1. To map the influence of the problem in the persons life, 2. To map the influence of the persons life back on the problem. Mapping influence of the problem on the persons generates a great deal of useful information and often results in people feeling less shamed and blamed. Mapping consists of inviting clients to explore the consequences of the problem in all areas of life. – when did this problem first appear in your life. Important to identify instances when the problem did not completely dominate a clients life.
Search for Unique outcomes – in the narrative approach, externalising questions are followed by questions searching for unique outcomes. Therapists talks to the client about moments of choice or success regarding the problem. Linking a series of such unique outcomes together starts to form a counter story. It is within the account of unique outcomes that a gateway is provided for alternative versions of a persons life. – what do you think this tells me about what you have wanted for your life and about what you have been trying for in your life. Circulation questions – now that you have reached this point in life, who else should know about it? These questions are not asked in a barrage-like manner. Questioning is an integral part of the context of the narrative conversation and each question is sensitively attuned to the response brough out by the previous questions.
Alternative Stories and Reauthoring – constructing counter stories goes hand in hand with descontruction and the narrative therapist listens for openings to counter stories. The therapists listen for clues to competence in the midst of a problematic story and builds a story of competence around it. Madigan suggest that a persons life story is probably much more interesting than the story being told. A turningpoint in the narrative interview comes when clients make the choice of whether to cntune to live by a problem-saturated story or to state a preference for an alternative story. White and Epston 1990 inquiry into unique outcomes is similar to the expection questions of solution-focused therapists. Both seek to build on the competence already present in the person.
Documenting the Evidence – believe that new stories take hold only when there is an audience to appreciate and support them. Gaining an audience for the news that change is taking place needs to occur if alternative stories are to stay alive and an appreciative to new developments is consciously sought. One technique for consolidating the gains a client makes involves a therapists writing letters to the person. Epston has developed a special facility for carrying on therapeutic dialogues between sessions through the use of letters. Usually they include as many direct quotations from what the client said as possible. Reinforce the importance of carrying what is being learned in the therapy office into everyday life. The message is conveyed is that participating fully in the worl is more important than being in therapy office.
Application to Group Counselling – many of the techniques described in this chapter can be applied to group counselling. Winsalde and Monk 2007 – claim that the narrative emphasis on creating an appreciative audience for new developments in an individuals life lends itself to group counselling.
Strengths from Diversity – one of the problems that culturally diverse clients often experience is the expectation that they should conform their lives to the trusth and reality of the dominant society of which they are a part. The social constructionist approach to therapy provides clients with a framework to think about their thinking and to determine the impact stories have on what they do. Clients are encouraged to explore how their realities are being constructed out of cultural discourse and the consequence that follow from such constructions. Narrative therapy is grounded in a sociocultural context, which makes this approach especially relevant for counselling culturally diverse clients. Furthermore, therapy becomes a place to reauthor the social constructions and identity narratives that clients are finding problematic. Narrative therapy is relational and anti-individualistic practice. The awareness can led to a new perspective on dominant themes of oppression that have been such an integral part of a clients story and with this cultural awareness new stories can be generated.
Shortcomings – pertains to the not-knowing stance the therapist assumes along with the assumption of the client as expert.
Contributions – have found that clients are able to make significant moves toward building more satisfying lives in a relatively short period of time. 5 sessions show results. Practitioners are the experts on the structure and process of therapy. Do not believe that diagnosis provide useful information to help clients change. Growing base of efficacy. The use of questioning.
Limitation – requires skilled practitioners, the attitudes of therapist.
