Handbook of Solution-Focused Brief Therapy

Clinical Applications

Thorana S Nelson, Frank N Thomas, Thorana S Nelson, Frank N Thomas

• Publisher: Routledge
• Year: 2012
• ISBN:
  9781136864643
• Edition: 1
• Topic: Psicología
• Subtopic: Historia y teoría en psicología

An invaluable guide to the history, descriptions of practice strategies, and applications of SFBT! The Handbook of Solution-Focused Brief Therapy is a unique, comprehensive guide that assists clinicians, regardless of experience level, in learning and applying the concepts of Solution-Focused Brief Therapy (SFBT) to particular situations with clients. Noted experts discuss the therapy practices and various uses for the approach in detail, which focuses on encouraging clients to look at exceptions, times when the problem could have occurred and did not, and goals and future possibilities. A history of the practice model and its interventions is discussed, along with limitations, descriptions of practice strategies, applications to specific client populations, and clinical problems and concerns. This useful resource also includes an illustrative case study that uses the SFBT model. The Handbook of Solution-Focused Brief Therapy first lays a foundation of knowledge, providing chapters on the crucial assumptions and practices, history, and epistemology behind the approach. Further chapters use that basis to explain the application of the approach with several clinical issues and various populations, including couples, depression, domestic violence, schools, children, pastoral work, therapist burnout, and a few "outside therapy room" applications. Other chapters focus on the important issues in therapist training and supervision. Extensive references are provided at the end of each chapter. Topics discussed in the Handbook of Solution-Focused Brief Therapy include:

• assumptions within the SFBT tradition
• history of the SFBT approach
• epistemology
• SFBT with couples
• depression
• domestic violence offenders
• public schools
• children and young people
• SFBT in faith-based communities
• assessing and relieving burnout in mental health practice
• SFBT beyond the therapy room
• supervision of training
• possible limitations, misunderstandings, and misuses of SFBT
• a tribute to the late Steven de Shazer, co-founder of the SFBT approach

The Handbook of Solution-Focused Brief Therapy is an invaluable reference for all types of therapists, including psychologists, counselors, social workers, and family therapists at any level of experience, including students, trainees, and experienced therapists.

SECTION II:

APPLICATIONS

In which we present situations for which Solution-Focused Brief Therapy may be useful.

Chapter 4

Solution-Focused Therapy with Couples

Phillip Ziegler

Tobey Hiller

History and Ideas of our Approach

Couples therapy is challenging, and not for the faint hearted. It is a constant work-in-progress to find effective, elastic, and creative ways to meet the complex and sometimes confusing charge of helping two people who are at odds—or sometimes, at war—to sort out and improve their relationship along the lines that make sense to them. Primary among the therapeutic imperatives is finding a way to establish an inclusive rapport; that is, to connect with both partners, respecting and integrating what are often sharply differing points of view. To show why we think solution-focused therapy (SFT) offers an effective way of dealing with this and many other problems and questions that can confound both novice and experienced couples therapists, we want to give a brief account of the evolution of our own thinking about couples therapy.

We first began to work with couples in the early 1970s. Until the early 1990s, we were generally guided by ideas about what makes long-term intimate relationships flourish or deteriorate, by various models of normative relationships, and by scattered research findings about what distinguishes functional from dysfunctional relationships. We felt our helping role included identifying and helping to change people’s troubled thinking and destabilizing interactions, and we focused on both intrapsychic and systemic sources of marital discord and dissatisfaction. Guided also by a rather vaguely outlined normative model of healthy relationships, we tried to teach couples how to relate better as intimates and partners. This meant, among other things, modeling respectful relationship, introducing new ways of handling conflict, and teaching good communication skills.

Whatever techniques we used, we intended to foster emotional and cognitive breakthroughs that could lead to greater mutual understanding, respect, and affection in the couple. We were often quite successful in helping couples turn around their troubled relationships. But over the years, we continued to look for more effective and efficient ways of working, and although we assessed ways we were becoming more effective, we often talked about our failures, and where we, our models, and our techniques had not worked very well or produced much positive change.

In our practices and our conversations, we began to notice certain landmarks and recurring features in the couples counseling therapy landscape, landmarks that might make navigation more precise. We became increasingly interested in the important roles that perception and meaning-making play in relationship life, and, significantly, we noticed a strong correlation among positive changes in people’s perceptions, the meanings they ascribed to each other’s gestures, and their eventual success at the end of our work together. It seemed that the sooner this took place, the better the outcome. We also noticed the therapeutic power of highlighting of a couple’s positive bond and their various strengths and assets throughout the therapeutic process. In other words, we were trying to distinguish exactly what we were doing in our work with couples that seemed to contribute to the success of the therapy. Gradually, we found ourselves moving away from a theory of couples therapy based on the eradication of dysfunction in behalf of a template model of intimate relationship toward a quite different view of how to conduct couples therapy. We were being guided by a different question: instead of focusing on what makes relationships fail, we focused on what makes marital therapy work.

Reflecting back, over 20 years of experience in working with couples, we were able to pick out a few patterns that seemed to correlate with our successes. When we were able to create a safe place for the couple to “talk things out” and come to some greater mutual understanding, things usually got better. In an atmosphere of safety, partners were frequently able to shift from an adversarial stance primed for blame and defense to some form of teamwork, finding renewed pleasure in working as allies for mutually desired changes. In this shift, partners also became better able to take in each other’s differing perceptions and explore misunderstood and blocked meanings, which tended to lower the incidence of conflict. A better alliance between the partners produced more emotional leeway and fewer triggerhappy reactions. This zone of safety, collaboration, and receptivity or respect was just as important for couples who decided to part, making it more manageable to work through the painful process of separation in a spirit of cooperation.

In hindsight, we realized that our natural tendency to highlight peoples’ assets, bond, and special qualities as a couple (an emphasis on their competency and efficacy) had a positive effect on a couple’s ability to maintain their alliance and generate hope and motivation to work collaboratively, and that this orientation helped the couple draw on their strengths and resources in behalf of the daunting work of change. We also saw that immediacy counted: When we were able to generate hope and a collaborative atmosphere with our couples right away, preferably in the first session, these early changes made them enthusiastic and energetic in their commitment to change and supported therapeutic success.

Looking at our work through this evolving new lens, we noticed that a few specific techniques, tools, or perspectives seemed to be particularly effective in creating the kind of collaborative and safe environment we were finding ideal for effective therapy; we’ll mention three important ones here. When used appropriately, all these techniques can contribute to the therapist’s ability to be responsive to the partners’ differing needs and points of view and establish an inclusive rapport. Although couples therapy is never simple, we have found these tools to be reliable and flexible, and almost always appropriate in the early and ongoing sessions of couples work. These tools include the reframing techniques of normalizing and mutualizing as well as what we call the “good story” orientation, which highlights a couple’s successes and builds evidence of the partners’ effectiveness in dealing with the challenges of relationship life.

Normalizing is a reframing technique in which the couple’s problems are redefined as common rather than unique. This has two effects: first, it implies that the couple and the individual partners are not strange, abnormal, or deviant and that their problems are experiences familiar to many couples. Second, it defines conflict and differing points of view as part and parcel of relationship life. This kind of problem-definition reframe can go a long way to reducing divisive feelings of shame, isolation, and desperation, and support a sense that the couple’s issues/problems/concerns are manageable. Problems that are viewed as unique and complex seem by nature potentially defeating or insoluble, while common problems, defined simply, are perceived as much easier to solve.

Mutualizing is another reframing technique in which the problem is defined as something that exists between the partners in a fluid relational context rather than as a defect, situation, or trouble caused by one or both of them. Mutualizing reframes the problem definition in a way that promotes a shift away from adversarial positions and puts both partners on the same side so that they can work together against a common problem or external force that is now seen as making trouble for them both, sometimes in different but related ways. It opens a space for partnership revitalization. Michael White and David Epston (1990) have refined this kind of reframing technique in Narrative Therapy, calling it “externalizing the problem.” Mutualizing also leads to another important contextual shift: It supports an inclusive rapport in therapy. Instead of adjudicating or taking sides, this shift makes it possible for the therapist to position herself or himself as a collaborator in exploring ways to solve a shared problem with the couple while also understanding the impact(s) that problem may have for each partner as an individual.

The third important element, a hallmark of our own couples work (Ziegler & Hiller, 2001), is not so much a technique as an orientation. The “good story” orientation involves approaching the couple’s relational life together as a set of holistic narratives or stories on a continuum of “good” (relationship-supportive) to “bad” (relationship-destructive). All couples have mutual and individual conceptions of their lives together that range from the very positive to the very negative. Over time, events—especially emotionally charged experiences—and repeating patterns of interaction give gravitational weight to these polar narratives that have both perceptual and interpretive power. When a relationship begins to deteriorate (for whatever reason), there is a tendency for the influential shaping power of the bad story narrative to begin overshadowing the perceptual and interpretive powers of the couple’s good story narrative. This can set in motion a downward spiral in the couple’s relational life and the bad story thickens, growing in influence. When couples therapy is undertaken without regard to these experience-defining narrative contexts, changes made at the level of behavior, cognition, and emotion are often ignored or eroded because, when the bad story is still exercising its influence over what the partners notice about each other’s actions and the meanings they ascribe to them, even positive or reparative acts are not received as constructive.

Further, the bad story context is inherently a conflictual, divisive, or distanced one in which the partners are at odds or remote from each other. As the therapist works with a couple to reinvigorate the good story and helps them to find ready exits from it (without reducing the importance of the bad story), the pressure on the therapist to take sides or desert the multiperspective point of view diminishes. Differences are likely to be viewed as tolerable or creative when couples are living more within their good stories. Helping a couple caught in their bad story to create bridges back to their good story involves (a) listening for, asking about, and identifying positive themes in the various problem stories related by the partners; (b) looking for signs of the good story context; and (c) searching for pathways back into the positive set of assumptions and ideas about the partner and relationship. Even as we listen and try to understand each person’s experience of the difficulties, we are alert to narrative bits and pieces that might be woven into stories that reveal partner and relationship strengths and resources.

The use of these three tools, which all involve conversation using generative and curious questions by the therapist, will go a long way to reducing confusion and alliance difficulties therapists face when working with couples. Asking questions that come out of these framework orientations helps make it possible for a therapist to hold and respect varying and even opposed perspectives from the partners and to proceed toward exploring individual meanings and ways to find common ground with everyone onboard. In addition, focusing on goals helps to bring out shared perspectives and decrease the time that a couple spends in argument about who is to blame and in trying to triangulate the therapist into getting the partner to change.

As our work became increasingly couple-contextual, collaborative, and strength-based, we came to see that we could help couples design and carry out their own uniquely applicable therapy—a custom-built program of change, respecting both what changes needed to happen and how to bring them about. Our job as therapists became helping couples clarify their goals, finding the shared space in those pictures, helping them figure out for themselves what could help them realize those desired changes, and reminding them of their successes as we went along.

It was at this time we began hearing about other theoreticians and clinicians who were thinking along similar lines and were developing ways of working that sounded like they would fit nicely into our own evolving approach. We were most intrigued and excited by Steve de Shazer and Insoo Kim Berg’s Solution-Focused Brief Therapy (de Shazer & Berg, 1985) and Bill O’Hanlon’s Possibility Therapy (Hudson & O’Hanlon, 1991). We also drew from Narrative Therapy developed by Michael White and David Epston (White & Epston, 1990) as well as Harry Goolishian and Harlene Anderson’s Collaborative Language Therapy (Anderson, 1997; Anderson & Goolishian, 1992), but solution-focused therapy (SFT) was, for us, the best fit. Recreating partnership couples therapy (RPCT) is our integration and adaptation of these three constructionist therapies into our own work, with a special emphasis on SFT (Ziegler & Hiller, 2002). The following is our formulation of the assumptions of a solution-focused approach to couples therapy:

• Change is occurring all the time. Experience is always varied. By...

Table of contents

• Cover Page
• Half Title page
• Series Page
• Title Page
• Copyright Page
• Dedication
• Notes for Professional Librarians and Library Users
• Contents
• About the Editors
• Contributors
• Foreword
• Introduction
• Acknowledgments
• Section I: Foundations
• Section II: Applications
• Section III: Training
• Section IV: Last Words
• Index
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