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presents
Solution-Focused Counseling:
An Integrative Approach
Friday, November 12, 2010
8:45 a.m. – 4:15 p.m.
Celebration Church, Metairie, Louisiana
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Learning Objectives
1. Understand key concepts and principles that inform solution-focused counseling.
5. Develop knowledge and skills for practicing various solution-focused techniques, including (a)
solution-focused questions, (b) mapping influences of the problem, and (c) scaling
techniques.
6. Develop knowledge and skills for the application of solution-focused counseling to a variety of
clinical issues and populations, including clients with co-occurring disorders.
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Introduction to Solution-Focused Counseling
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Introduction to Solution-Focused counseling
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Introduction to Solution-Focused Counseling
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Introduction to Solution-Focused Counseling
• Collaborative approach
• Solution-focus
• Small changes can lead to big results
• Emphasis on process, not content
• Strategic approach
• Brief by design, but not always
• Responsiveness to diversity
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Solution-Focused Counseling Theory
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Solution-Focused Counseling Theory
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Solution-Focused Counseling Theory
Theory of problem formation
Problems are seen to maintain themselves simply because they maintain
themselves and because clients depict the problem as always happening.
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Solution-Focused Counseling Theory
Problem/Exception
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Solution-Focused Counseling Theory
• Process/Content distinction
– Process refers to what counselors and clients do (i.e., interventions,
methods, and techniques) to facilitate change.
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Solution-Focused Counseling Theory
Theory of change
Problem / Exception
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Solution-Focused Theory
Theory of change
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Solution-Focused Theory
Theory of change
• Amplifying exceptions
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Solution-Focused Theory
Theory of change
Problem/Exception
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Solution-Focused Theory
Theory of change
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Solution-Focused Theory
– You determine that the client’s worldview is in keeping with the formal
content of some other clinical theory and it is subsumed within the formal
content (as informal content) of solution-focused counseling.
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Solution-Focused Theory
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Clinical Stages in Solution-Focused Counseling
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Clinical Stages in Solution-Focused Counseling
• Conducting an intake
• Joining with the client
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Clinical Stages in Solution-Focused Counseling
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Clinical Stages in Solution-Focused Counseling
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Clinical Stages in Solution-Focused Counseling
Co-constructing a goal
– Positive
• Develop goals in positive language (i.e., as an increase of something)
rather than negative language (i.e., as a decrease of something).
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Clinical Stages in Solution-Focused Counseling
• Identifying exceptions
– Identifying small exceptions
– Identifying potential exceptions
• Amplifying exceptions
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Clinical Stages in Solution-Focused Counseling
• Identify exceptions
– Questions aimed at identifying exceptions
• “When has there been a time?” (presuppositional questions)
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Clinical Stages in Solution-Focused Counseling
• Miracle question
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Clinical Stages in Solution-Focused Counseling
A client was self-referred for work problems. For the past five years, he
had owned and operated a convenience store. The client reported that he
has frequently felt anxiety and stress at work when he is understaffed and
therefore is not able to get home in the afternoons. The client reported
that the staffing problem is something that he cannot change at this time
because he cannot afford to hire more staff.
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Clinical Stages in Solution-Focused Counseling
Goal
Increase effective coping skills at work
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Clinical Stages in Solution-Focused Counseling
Identifying and amplifying exceptions
– Client: I would say when I am fully staffed and I am able to work a normal amount of
hours, and I get to go home in the afternoon sometimes. Then I can better deal with
that.
– Counselor: But you've been telling me, though, that being fully staffed is not, is a rare
event.
– Counselor: Counselor: But, again, this is, and correct me if I'm wrong, this is not the
situation. In other words, this is really not going to happen now. What you were telling
me before, if I'm correct, is what you're looking to do is finding ways to cope with the
bad situation, and that is, when you're not staffed.
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Clinical Stages in Solution-Focused Counseling
Identifying and amplifying exceptions
– Counselor: But, again, this is, and correct me if I'm wrong, this is not the situation. In
other words, this is really not going to happen now. What you were telling me before, if
I'm correct, is what you're looking to do is finding ways to cope with the bad situation,
and that is, when you're not staffed.
– Counselor: The realities. The reality of the situation, I mean, what you can't change.
– Client: Exactly.
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Clinical Stages in Solution-Focused Counseling
Identifying and amplifying exceptions
– Counselor: When have you found a time when you've been able to deal with that
effectively?
– Client: Probably when I see that, that, that I can control and change the situation. But
obviously that doesn't happen very often. But when I feel like I am in command of the
situation, then I can cope with it much better.
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Clinical Stages in Solution-Focused Counseling
Identifying and amplifying exceptions
– Client: Probably when I see that, that, that I can control and change the situation. But obviously that
doesn't happen very often. But when I feel like I am in command of the situation, then I can cope
with it much better.
– Counselor: How are you able to do that? In those situations when you are coping better?
– Client: I think I am just looking at the situation differently. I’m saying, “It will pass.”
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Clinical Stages in Solution-Focused Counseling
Identifying and amplifying exceptions
• Workshop Exercise #1:
Practice identifying and amplifying exceptions
Break into pairs and take turns role playing. First, one of you will be the counselor and the
other will be the client. Then, you will reverse roles.
Practice identifying and amplifying exceptions in keeping with the solution-focused counseling
model.
For purposes of this exercise, consider that the problem and goal has already been co-
constructed as follows. The problem is ineffective coping with stress at the workplace. The
problem is conceptualized within solution-focused counseling’s problem/exception theory as
Ineffective coping at the workplace / Effective coping at the workplace
The goal is: Increase effective coping skills with stress at the workplace
In your role as counselor, spend no more than 5 minutes in a conversation with your client in
attempt to identify and amplify exceptions to the problem. Then, switch roles. This means that
the entire exercise should last no more than 10 minutes. Document all exceptions and
amplifications that are identified.
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Clinical Stages in Solution-Focused Counseling
Co-constructing tasks
• Task #1
– The client is told and asked, "Between now and
the next time, I would like you to observe, so that
you can tell me next time, about those times
when you are able to make it (the goal) happen."
• Rationale: This task is given if the client is able to
construct a problem and goal, and identify and amplify
exceptions.
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Clinical Stages in Solution-Focused Counseling
Co-constructing tasks
• Task #2
– The client is told and asked, “Between now and
the next time, I would like you to pay attention to
and make note of what you do when you are able
to effectively cope with or deal with the problem.”
• Rationale: This task is given if the client is able to
construct a problem and goal and identify exceptions,
but is unable to amplify exceptions
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Clinical Stages in Solution-Focused Counseling
Co-constructing tasks
• Task #3
– The client is told and asked, "Between now and the
next time, I would like you to observe, so that you can
tell me next time, what happens in your life
(relationship, family, work situation) that you want to
continue to have happen."
• Rationale: This task is given if the client is able to construct a
problem and goal, and potential exceptions, but is unable to
identify exceptions.
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Clinical Stages in Solution-Focused Counseling
Co-constructing tasks
• Task #4
– The client is told and asked, "Try to avoid making
any drastic changes. If anything, think about what
you will be doing differently when things are
improved."
• Rationale: This task is given if the client is able to
construct a problem, but is unable to construct a goal.
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Clinical Stages in Solution-Focused Counseling
Co-constructing tasks
• Task #5
– The client is told and asked, "The situation is very
volatile. Between now and the next time, attempt
to think about why the situation is not worse."
• Rationale: This task is given if the client is in severe
crisis.
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Clinical Stages in Solution-Focused Counseling
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Clinical Stages in Counseling
• Maintain a solution-focus
• Identify and amplify exceptions
• If the client maintains that there are no exceptions,
then re-construct the problem and goal
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Clinical Stages in Solution-Focused Counseling
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Clinical Stages in Solution-Focused Counseling
Exercise #2
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Solution-Focused Counseling Techniques
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Solution-Focused Counseling Techniques
• More of the same
– Did you carefully and patiently help the client identify exceptions?
• Small exceptions?
• Potential exceptions?
– Did you negotiate a small, simple, and relevant goal that the client knows how to accomplish?
– Maybe the client identified a small or potential exception during the session but he or she—and
you!—considered it to be irrelevant or unremarkable.
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Solution-Focused Counseling Techniques
– Help the client identify how the problem has influenced his or her
life across various domains (e.g., work, relationships, health,
recreation).
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Solution-Focused Counseling Techniques
• Scaling techniques
– Many clients understand the problem as an on/off experience.
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Solution-Focused Counseling Techniques
• Scaling techniques
Case Example
The intensity of the headache precipitated by Steven’s eating spicy food was
rated as 9, whereas the other headaches were rated significantly lower: 6, 5,
5, and 2. The duration of the spicy food headache, three days, was also
significantly longer than all of the other episodes. The counselor then
redirected the couples’ attention to the headache that Steven rated as 2.
Steven noted in the diary that he had coped effectively with that headache by
concentrating on a distracting stimulus, namely, watching a movie on
television. He also noted that when the headache started, he told himself, “It
will pass.” According to Steven, these coping methods contributed to the mild
intensity of the headache and its duration of only one hour. The counselor
asked the couple to identify any other entries in the diary that were reflective
of a healthy lifestyle or effective coping. Lori noted that they had taken brisk
walks in the morning on six occasions during the past three weeks, and that
Steven had a migraine on only one of these days. (Guterman, Mecias, &
Ainbinder, 2005, p. 197)
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Solution-Focused Counseling Techniques
• Journaling
– Ask the client to keep track of times when the problem does not
happen or when the goal happens.
– Ask the client to describe in detail what they did, how they coped,
and what was different when the problem did not happen.
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Solution-Focused Counseling Techniques
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Solution-Focused Counseling Techniques
– This is a good question to ask if you are unclear where you and the
client left off after the prior session.
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Solution-Focused Counseling Techniques
– Go slow
– Summarize
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Solution-Focused Applications
Co-occurring disorders
• Collaborative
• Normalizing
• Small changes
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Solution-Focused Applications
Co-occurring disorders
– Customer
• Hidden customer
– Complainant
– Visitor
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Exercise #2
When has there been a time when you have been
particularly effective at helping clients identify
and build upon their own resources, strengths,
and problem-solving capabilities and thereby
develop solutions to their problems.
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References
• Berg, I. K., & Miller, S.D. (1992). Working with the problem drinker: A solution-focused approach. New York: Norton.
• de Shazer, S. (1985). Keys to solution in brief therapy. New York: Norton.
• de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: Norton.
• de Shazer, S. (1991). Putting difference to work. New York: Norton.
• Guterman, J.T. (2006). Mastering the art of solution-focused counseling. Alexandria, VA: American Counseling Association.
• Guterman, J.T., Mecias, A., Ainbinder, D.L. (2005). Solution-focused treatment of migraine headache. The Family Journal: Counseling
and Therapy for Couples and Families, 13, 195-198.
• Held, B.S., (1992). The problem of strategy within the systemic therapies. Journal of Marital and Family Therapy, 18, 25-35.
• Lyotard, J. (1979). The Postmodern condition: A report on knowledge. Minneapolis, MN: University of Minnesota Press.
• Molnar A., & de Shazer, S. (1987). Solution-focused therapy: Toward the identification of therapeutic tasks. Journal of Marital and
Family Therapy, 13, 349-358.
• Watzlawick, P., Weakland, J. H., & Fisch, R. (1974). Change: Principles of problem formation and problem resolution. New York Norton.
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Internet resources
• Jeffrey T. Guterman, Ph.D.
– http://www.jeffreyguterman.com
• Brief Family Therapy Center (BFTC)
– http://www.brief-therapy.org
• The Brief Therapy Practice
– http://www.brieftherapy.org.uk
• Solution Focused Brief Therapy Association
– http://www.sfbta.org
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