Solution-Focused Brief Therapy

A Multicultural Approach

Johnny S. Kim, Ph.D., Johnny Kim

• Publisher: SAGE Publications, Inc
• Year: 2013
• Print ISBN: 9781452256672
• eBook ISBN: 9781483323442
• Edition: 1
• Topic: Education
• Subtopic: Education Counseling

This first-of-its-kind book provides a practical overview of the essentials of solution-focused brief therapy (SFBT) from a multicultural perspective, including intervention skills, research, applications, and implications for practice. Case examples illustrate SFBT in action with a wide range of client populations. In addition, the book incorporates recommendations from the recently developed and approved SFBT treatment manual, published by the Solution-Focused Brief Therapy Association.

1

Solution-Focused Brief Therapy and Cultural Competency

Johnny S. Kim

Introduction

NASA’s Space Pen Dilemma¹

When the United States’ National Aeronautics and Space Administration (NASA) first started sending astronauts into outer space, it quickly realized that a ballpoint pen didn’t work. To solve this problem, NASA scientists spent years and about a million dollars to develop a pen that could write in zero gravity, upside down, on almost any surface, and at temperatures ranging from below freezing to 300 degrees Celsius.

During this same time, the Russians were also sending their cosmonauts into outer space and therefore faced a similar dilemma. Their solution to the problem . . . was to use a pencil.

The appeal of solution-focused brief therapy reminds me of the NASA space pen joke described above. Although this story is notfactually accurate (the United States did use a pencil in the beginning, and the space pen was developed independently by Paul Fisher who received no NASA funding²), the punch line still resonates. There is something to be said about a simple, practical solution to a problem versus a time-consuming and complicated one. Over the past three decades, solution-focused brief therapy (SFBT) has become a popular therapeutic model for clinicians and professional counseling schools in part because of the model’s strengths-based focus and simplicity. For example, building on Saleebey’s (1992) summary of strengths-based assumptions and principles, De Jong and Miller (1995) make a case for how SFBT can advance social work’s tradition of using strengths-based principles by incorporating various SFBT techniques and assumptions.

This chapter begins by providing an overview of SFBT and its history. It describes how SFBT was developed inductively from a multidisciplinary team of clinicians working at the Mental Research Institute in the 1970s. Later, the Brief Family Therapy Center was created in the 1980s by de Shazer and Kim Berg, and this led to the rise in popularity of SFBT among many clinicians. Recently, SFBT training, research, and networking continues through the founding of the Solution-Focused Brief Therapy Association (SFBTA) in the 2000s. In addition, the theoretical framework for how SFBT works will be discussed. The chapter will conclude with a discussion on the importance of incorporating a multicultural approach to using SFBT with minority clients.

What Is SFBT?

Before we can discuss the origins of SFBT, it would be useful to provide a quick overview of the core components of the therapy model and its appeal. More specific details of the intervention techniques will be discussed in Chapter 2 and expanded upon with specific clients in Chapters 4–13. Many of the early writings on the SFBT model and techniques were introduced in books and peer-reviewed articles written by several of the developers, but over the past several years, efforts have been made to manualize the therapy model to distinguish it from other similar therapy interventions.

In 1997, de Shazer and Kim Berg took one of the first steps to manualize SFBT by publishing an article identifying four characteristics that must be featured during the first interview. Although there is no set order to these features, they are necessary if the clinician is to be doing solution-focused therapy. The four characteristics necessary are as follows:

1. The therapist must ask the “miracle question.”

2. Scaling questions must be asked at least once.

3. Toward the end of the interview, the therapist must take a break.

4. After the break, the therapist gives the client a set of compliments and sometimes suggestions or homework tasks.

Gingerich and Eisengart (2000) further operationalized SFBT in their systematic review of all the outcome studies by including only studies that contained the four characteristics listed above, along with searching for presession change, setting goals for the client, and searching for exceptions to the problem. Prior to the development of the treatment manual discussed in Chapter 2, these were considered the core techniques necessary in SFBT.

Most solution-focused interviews occur during the traditional 50–75-minute session. The structure of the interview is divided into three parts. The first part, which usually lasts 5–10 minutes, is spent making small talk with the client to find out a little bit about the client’s life. The second part of the session, which takes up the bulk of the time—around 40 minutes—is spent discussing the problem, looking for exceptions, and formulating goals. The final part of the therapy session, which lasts around 5–10 minutes, involves giving the client a set of compliments, homework, and determining whether to meet again.

Historical Background

Originating in the early 1980s at the Brief Family Therapy Center (BFTC) in Milwaukee, Wisconsin, SFBT was developed inductively by Steve de Shazer (1988), Insoo Kim Berg (1994), and colleagues (Berg & De Jong, 1996; Berg & Miller, 1992; Cade & O’Hanlon, 1993; Lipchik, 2002; Murphy, 1996) who wanted to study effective therapeutic techniques and to determine what worked in therapy sessions. They used one-way mirrors to observe each other’s techniques and would consult with the team behind the mirror during the therapy session. The mental health team at BFTC was interested in looking for instances when the problem was not occurring in the client’s life and collaborating with the client on developing goals (de Shazer, 1985). Over the past 20 years, many people such as Bill O’Hanlon, Ron Kral, Eve Lipchik, Yvonne Dolan, and Scott Miller have studied and trained with Steve de Shazer and Insoo Kim Berg at BFTC and have contributed to the development of the model (Hawkes, Marsh, & Wilgosh, 1998). The SFBT model has been applied to a wide range of problems, such as psychiatric disorders, alcohol abuse, crisis-oriented youth services, and school-related behavior problems (Franklin, Biever, Moore, Clemons, & Scamardo, 2001).

The origins of the development of SFBT can be traced back to de Shazer and colleagues (Fisch, Weakland, & Segal, 1983; Watzlawick, Weakland, & Fisch, 1974) at the Brief Therapy Center of the Mental Research Institute (MRI) during the late 1970s. The brief therapy approach at MRI tried to resolve a client’s problem in a shorter amount of time (within a 10-session limit), as opposed to the traditionally longer psychodynamic therapeutic approaches. The rationale for this session-limited approach gained traction because earlier studies (Garfield, 1978; Gurman, 1981; Koss, 1979) showed clients stayed in therapy an average of 6–10 sessions regardless of the clinician’s plans or modality (de Shazer, 1985). However, brief therapy, as viewed by de Shazer and his colleagues at MRI, went beyond just fewer therapy sessions. They believed clients wanted to be freed from their problems as quickly as possible; therefore, it was the clinician’s ethical duty to make the most use of that limited contact. Because the practitioners at MRI believed in shorter number of sessions for the clients’ sakes, the focus of the counseling sessions was not on trying to understand the root cause of the problem. Instead, the emphasis was to find effective ways of thinking about the problem and practical ways of dealing with it (Furman & Ahola, 1994).

In 1975, de Shazer began working on a more comprehensive model of brief therapy by including the client and family members in developing problem constructions (de Shazer, 1985). By 1978, de Shazer left MRI and with a core group of colleagues (Insoo Kim Berg, Elam Nunnally, Eve Lipchik, and Alex Molnar) started BFTC (de Shazer, 1985). SFBT, the model, began to develop in 1980 and was given that name by 1982 (de Shazer & Berg, 1997). This group of clinical practitioners (along with future team members Wallace Gingerich, Scott Miller, and Michele Weiner-Davis) continued to explore what worked in counseling sessions through consultations and experimentations with different techniques. What evolved through these sessions was an understanding and belief that doing something different in a problematic situation can be enough to inspire positive change to help satisfy the client (de Shazer, 1985). The BFTC team eventually began shifting its focus from figuring out how to solve problems to identifying solutions and how to get there with the client. Diverging from their work at MRI, de Shazer and colleagues at BFTC made a conscious effort to focus on solutions instead of problems when working with clients. In further developing the solution-focused model, specific techniques such as miracle and exception questions were developed to aid in identifying solutions.

It has been more than 30 years since the SFBT model was introduced, and it has continued to evolve and grow. Prior to the deaths of Steve de Shazer (1940–2005) and Insoo Kim Berg (1934–2007), the North American solution-focused community created SFBTA in 2002, which continues to hold its annual conferences throughout the United States and Canada. Along with the conferences that offer workshops and presentations for clinicians and researchers, SFBTA continues to promote SFBT by providing training resources, promoting and advancing research in the therapy model, and continuing the work that Insoo and Steve started.

Antecedents and Influences

Although SFBT has distinguished itself from other forms of brief therapy with its solution talk, the solution-focused model has had many influences during its development. One of the earliest influences on Steve de Shazer and the SFBT model was Milton Erickson and his pioneering work in brief therapy in the mid-1950s. While at MRI, de Shazer would study Erickson’s approach and techniques of brief hypnotherapy to help figure out what clinicians do that is effective. For example, two key components of brief therapy de Shazer learned from Erickson, which were later incorporated into SFBT, were (1) using what the client brings to the counseling session and (2) not trying to find or correct any causative underlying psychological disorders (de Shazer, 1985). These two components became key assumptions in the SFBT model of recognizing the strength and resources of each client and focusing on the present and future since the past cannot be changed.

Milton Erickson’s crystal-ball technique and hypnosis methods also influenced Steve de Shazer in his development of the SFBT model. Erickson developed the crystal-ball technique in 1954 to enable clients, who are in a hypnotic trance, to see into the future where the complaint is gone. De Shazer expands on Erickson’s work by using this technique in a way that allows clients to construct their own solution (de Shazer, 1985). The first two steps of de Shazer’s crystal-ball method teach the client to notice his or her own behavior as well as the behaviors of others and to recall times of success in the client’s life, again focusing on his or her own behavior as well as the behaviors of others. The third step transports the client into the future all the while remembering the successful resolution of the problem. The fourth step asks the client to remember how the problem was solved, the client’s reaction, and the reaction of others.

The use of hypnotic trance was varied and has evolved throughout the years in SFBT. de Shazer describes hypnosis as more of a “focused attention” that is part of the interaction between the hypnotist and client. Rather than the traditional trance induction, the solution-focused clinician and client are paying close attention to what the other is saying (de Shazer, 1985). These crystal-ball techniques would evolve into some of the major building blocks of SFBT, mainly looking for exceptions (successes) and focusing on solutions rather than problems.

Earlier works by Minuchin’s structural family therapy, strategic family therapy, and Milan’s systemic family therapy also contributed to the development of solution-focused therapy (Hawkes et al., 1998). All three family therapies were developed in the 1970s and also were influenced by Milton Erickson’s brief therapy model. The idea of assigning tasks to help create change in a client was an important advancement for family therapy, which later influenced the development of SFBT.

The use of tasks in structural family therapy helps clients learn new ways of relating to one another by moving them beyond their ordinary experiences with each other. Minuchin believed there was a family hierarchy where each subsystem (i.e., grandparent, parent, children) of the family had authority according to its place on the hierarchy. He theorized that problems in families occurred when these subsystems experienced distortion or became too rigid. A healthy family and its members, Minuchin believed, had clear boundaries in their family hierarchy, and tasks were used to help family members learn these boundaries (Hawkes et al., 1998).

Strategic family therapy was developed by a group of clinicians from MRI where de Shazer worked. Strategic family clinicians focused on solving a client’s problem by examining the interactions clients had with other involved party members such as family or friends. Once the clinician had an understanding of the problem and of all those involved, tasks were used to change the usual way problems were handled. For example, a parent might be given a task to compliment their child for good behavior as opposed to their usual methods (grounding, hitting, yelling, etc.) of punishing their child for bad behavior (Hawkes et al., 1998; Watzlawick et al., 1974). Furthermore, paradoxical tasks were sometimes used by the clinician or when families were considered “stuck” and change was not occurring. The rationale for these paradoxical tasks, such as encouraging a wife who constantly needs reassurances from her husband to become more dependent on him, was to push the client into one extreme direction so that they would want to go toward the desired direction (Hawkes et al., 1998).

Evolving from the structural and strategic models, systemic family therapy expanded on Minuchin’s family focus by including individuals, couples, and families. Systemic family clinicians incorporated how other members within the client’s social network viewed the problem as well as incorporated social institutions (e.g., school, church, work), ethnicity, and gender influences on the problem. For systemic family clinicians, tasks are not as important for the therapy session as they are for structural or strategic models. There is more of an emphasis in messages, which examined the families’ different understanding of the problem and discussed each member’s interpretation. Messages were used to question the meaning of the client’s problem (Hawkes et al., 1998).

Similar to structural family therapy and strategic family therapy, SFBT encourages clients to do something different that may help them move beyond their traditional approach to solving the problem to help create small changes. The use of tasks allows clinicians to break up patterns of unsuccessful attempts by a client to solve her problem by shifting her approach to resolving the problem. Besides tasks, the systemic family therapy model’s openness in letting clients define problems and the respectful attitude of the clinician influenced the SFBT clinician’s approach to working with clients.

Starting with Erickson’s brief therapy model, SFBT has been influenced by many aspects of structural, strategic, and systemic therapy models. However, according to Lethem (2002), the SFBT currently aligns itself more under the metatheory of social constructionism, which asserts that individual constructs are shaped entirely through conversations with others. Granvold (1996) defines metatheory as “a related group of theories sharing assumptions and assertions” (p. 345). Falling under the metatheory umbrella of social constructionism along with SFBT are Saleebey’s strengths perspective model, Brower and Nurius’s cognitive ecological model, and White and Epston’s narrative therapy model. Although each of these therapy models has different techniques to use with clients, they all share the same underlying assumption of the client’s construction of reality (Franklin, 1998).

Theory of Change in SFBT

Social Constructionism

The metatheory social constructionism has been a major influence on the theoretical philosophies of SFBT (Berg & De Jong, 1996; Franklin, 1998). Unlike scientific positivism, which believes in an objective truth or reality, social constructionism contends reality is socially or ps...

Table of contents

• Cover Page
• Halftitle
• Dedication
• Title
• Copyright
• Contents
• Preface
• Acknowledgments
• About the Editor
• Chapter 1 Solution-Focused Brief Therapy and Cultural Competency
• Chapter 2 Solution-Focused Therapy Treatment Manual for Working With Individuals
• Chapter 3 Does Solution-Focused Brief Therapy Work?
• Chapter 4 Solution-Focused Approach With Asian American Clients
• Chapter 5 Solution-Focused Approach With African American Clients
• Chapter 6 Solution-Focused Approach With Hispanic and Latino Clients
• Chapter 7 Solution-Focused Approach With American Indian Clients
• Chapter 8 Solution-Focused Approach With Asian Immigrant Clients
• Chapter 9 Solution-Focused Approach With Multicultural Families
• Chapter 10 Solution-Focused Approach With LGBTQ Clients
• Chapter 11 Solution-Focused Approach With Clients With Disabilities
• Chapter 12 Solution-Focused Approach With Economically Poor Clients
• Chapter 13 Solution-Focused Approach With Spiritual or Religious Clients
• Index
• Advertisement