solution-focused and paradoxical counseling strategies chapter 10 brief counseling:
TRANSCRIPT
SOLUTION-FOCUSED AND PARADOXICAL COUNSELING
STRATEGIES
Chapter 10
Brief Counseling:
A GENERAL OVERVIEW
FOCUS = SOLUTION
Solution-Focused Therapy
SOLUTION-FOCUSED BRIEF COUNSELING (SFBC)
Nature of People
People are free to make choices and are not victims of their genetics or environment.
People are basically good.
People are basically rational.
People respond better to a present and future counseling orientation.
People have the ability to work through their own problems.
Focuses on “what” people are doing and not “why” they are doing it.
Focus on success instead of failure
Bruce’s Components of SFBC
Develop a working alliance to attack the problem.
Identify clients’ strengths as a foundation for confidence in their abilities to make positive changes.
Implement active, eclectic counseling strategies and interventions.
Establish clear, concrete, measurable goals in order to evaluate progress.
Bruce’s SFBC Intervention Tasks
“Do something different.”
“Pay attention to what you do when you overcome the urge to …..” for the client who has trouble controlling impulsive behaviors.
“Tell me about a time when you had a good day at ____ ” for clients who have taken on the victim mentality of believing that nothing good ever happens to them.
“Observe and take notes” for clients who have trouble avoiding problem situations and interactions.
Counseling Method
Orientation: Clarify the SFBC counseling process.
Setting Goals: heart of counseling including statement of the problem:The problem.The feelings associated with the problem.The intensity of those feelings on a 1 to 10 scale.The client’s expectations of what the client would like to have happen in counseling and the goals the client would like to accomplish.
Use Active Listening when identifying the problem: (given the brief nature, then identifying the wrong problem is extremely problematic
Scaling: “Where are you on a scale of 1 to 10?”
Working with positive and negative goals.
Setting Counseling Goals
Goals owned or set by the client work best.
If clients need assistance, be sure goals are co-created.
Set goals that are behaviorally oriented. Goals work best when they are positive, concrete, and reduced to small steps.
State a goal in terms of what behavior will occur, how often it will occur, and under what conditions it will occur.
Counseling Method
Miracle question: “Should a miracle occur this evening while you were sleeping and when you woke up, you suddenly realized that your problems were solved, what would you be doing that would indicate to you that the miracle had actually taken place?”
Relationship questions: “What will your _____ say that will be different after the miracle?”
Asking and reinforcing exceptions to the problem solution.
Using positive blame.
Counseling Method
Scaling progress toward the goal.
Asking for 10% improvement
Flagging the minefield: “What things might prevent you from moving up 10% on the scale or what might sabotage your plan?”
Closing the session.
Writing the note: Write the client a message with at least 3 compliments and a bridging statement from each compliment to one of the tasks the client needs to accomplish to raise the scale score 10% or one level from a 4 to a 5.
Five Question Method
1. Ask “How do you experience the problem?”2. Ask “When do (or did) you not experience
the problem? What were you doing then?3. Have clients rate their current progress on
solving the problem on the ) to 10 scale.4. Ask the miracle question.5. Set goals based on increasing what works
for the client.
A BRIEF OVERVIEW
FOCUS = PROBLEM
PARADOXICAL BRIEF COUNSELING
PARADOXICAL BRIEF COUNSELING (PBC)
People are independent and resist compliance (actively or passively).
PBC focuses on problem formation/elimination.
PBC methods are specific and eclectic.
Problems reframed as opportunities.
PARADOXICAL BRIEF COUNSELING (PBC)
Two approaches in PBC:
1) one-down position: elevates the client to the expert role and the counselor to the less-than-expert role.
2) one-up frame of reference: the counselor, as expert, prescribes the behavior the client is to follow. “Do more of your symptomatic behavior.” Puts the resistant client in a double bind.
Benefits of SFBC and PBC
Wide appeal among cultures and clients who emphasize individual responsibility over family and community.
The approach has much to offer counselors who are working under the constraints of managed health care and who are working with large client loads.
*Methods of SFBC and PBC are not easy to master.
FAMILY COUNSELING
Chapter 15
What makes it different?
Focus on family and its members’ interactions and relations
Involves interventions to alter the entire family system
Problem diagnosis is circular causality, roles each person plays in maintaining problem
What defines a family?
Webster’s Dictionary definitions:Group of people who are (1) bound by
philosophical, religious, or other convictions, (2) common ancestry, and (3) living under the same roof.
AndBasic biosocial unit in society having as its
nucleus two or more adults living together and cooperating in the care and rearing of their own or adopted children
Systems Theory and Families
System = organized unit made up of interdependent parts
Whole unit is greater than the sum of its parts
Change in any part affects all other partsFamily is system in which each member
has a significant influence on all other members
Systems Theory and Families
Families may struggle to find a healthy balance between two extremes:
Enmeshment = over involvement in each others’ lives
Disengagement = too much detachment from one another
Systems Approach to Family Therapy: Murray Bowen
Focuses on how family members could maintain a healthy balance between being enmeshed and being disengaged.
Believes each member should have an individual identity, while maintaining closeness with family.
Murray Bowen
Spousal Relationship Are they able to differentiate themselves as
individuals apart from the couple?
Differentiation of Self ability to separate thoughts from feelings struggle to develop identity and remain part of the
family
Murray Bowen
Differentiation of Self Highly differentiated = better at handling
stress/anxiety Increased differentiation by one family member
is likely to lead other members to become more differentiated
Self-differentiation is principal goal of family therapy
Murray Bowen
De-triangulation of Self from Family Emotional System Triangulation refers to the practice of two family
members bringing a third into their conflict Can be someone inside the family or outside of
the family that is being used to “side” with one of the parents.
Examples include One parent siding with one child to manipulate the other
parent. One parent starting an affair with an outside party to
meet needs not addressed in the marriage.
Murray Bowen
Emotional Systems of the Family Understanding the emotional system and how they
work central to the theory Again achieving differentiation primary Uses “genograms” (fig. 12-2 in textbook) to
demonstrate multi-generational trends. Used these genograms to plot family events, visually
represent enmeshed families, show patterns of behavior, and demonstrate triangulation
Modeling Differentiation Using “I” statements and taking ownership of his own
thoughts, feelings, and behaviors
Structural Family Therapy
Founder viewed as MinuchinGoal: to alter family structure and empower
dysfunctional family to move towards functional family communications
Functional families characterized by each member’s success in finding the healthy balance between belonging to a family and maintaining a separate identity
Structural family therapy = a zoom lens that can focus on the entire family or a close-up of any family member
Structural Family Therapy
One way to find balance between family and individual identity is to define and clarify the boundaries between the subsystems
Boundaries range from rigid to diffuseSecret is in finding the right boundary balance
that is well definedStructural family therapy directed toward
changing the family organizational structureTake the focus off of the referred patient and
back onto the system (often by focusing it on a non-referred member of the therapist).
Strategic Family Therapy
Family members’ behavior can only be understood within the family context
Haley (1973) - therapist initiates what happens in therapy and plan for solving each problem
Focuses on paradoxes (similar in many ways to individual PBC).
Strategic Family Therapy
Haley (1976) describes four stages of a typical first interview:1. Social Stage: build rapport and assess2. Problem Stage: get clear statement of concern3. Interaction Stage; family interacts (therapist observes)4. Goal Setting: define therapy goal in concise, observable, behavioral terms
Communications Approach to Family Therapy
Gottman’s Behavioral Interviewtherapist = educatoraccurate communication is key to problem
solvingcommunicate openly and honestlymatch intent and impact in communication
Focuses on solutions (similar in many ways to individual SFBC).
Virginia Satir’s Conjoint Family Therapy
Satir had a positive view of human naturePeople are rational and have ability to make
choicesSelf-esteem and effective communication
are importantBehavior is directly related to one’s family
positionPeople need a high degree of self-esteem to
be a good marriage partner
Theory of Counseling
Four components in family situation are subject to change and correction: The members’ feelings of self-worth The family’s communication abilities The system The rules of the family
Theory of Counseling
Family unit becomes dysfunctional when members do not understand the rules
Analyzing interactions and communications is important for change
Emphasis is on development of trust in relationship
Communication = most important factor, the main determinant of the kinds of relationships people have with one another and of how people adjust to their environment, as well as being the tie that binds the family together
Theory of Counseling
Fear of rejection common source of anxietyBecause people fear rejection, they resort to
one response pattern or a combination of patterns
These universal roles are described as placater, blamer, computer, distractor and leveler
Theory of Counseling:Communication Styles
placater - peace at any price, try to please others or apologize
blamer – faultfinders, compensate for lonely feelings by bossing others around
computer - calm and correct, with no feelings, pretend no conflict exists
distractor - make irrelevant statements, evade issues, withdraw from situations
leveler - communicate in a straightforward way, honest thoughts, verbal and nonverbal communication is congruent
Keys to Satir’s System
1. Increase self-esteem of all family members (children should be included in all stages)
2. Help family members better understand each other (and their roles) in order to make changes.
3. Use experiential learning techniques (such as family scupting, simulating each other, and role play)