O’Connell, B. (2012). Solution-focused therapy (3rd ed.) (Part I: pp. 39-40; Part II: pp. 77-93). SAGE Publications.
Aims of the First Session
In the first session the solution-focused practitioner seeks to:
- make a contract around the best hopes of the client;
- form a collaborative relationship with the client;
- create a climate for change;
- clarify as far as possible the client's goals;
- highlight the client's resources;
- negotiate tasks.
Written accounts of therapy fail to capture the intangibles of the therapeutic relationship. Transcripts of solution-focused sessions can look slick, formulaic, and devoid of mystery. It needs to be reiterated that the quality of our relationships with clients as human beings is more significant than any of the techniques we use or the theories we espouse. Techniques are no substitute for a relationship built on respectful and attentive listening, reflective silences, empathy, genuineness, immediacy, and acceptance. Practitioners need to be transparent when using the approach and must ensure that clients receive accessible information about the work in order that they may gain informed, realistic expectations of the session.
In order for the client to be an active, informed and consenting participant the therapist will need to explain briefly the model to be followed and what the client can expect to happen in sessions. You would not normally walk into a restaurant to find there was no menu and the waiter would merely ask what you felt like eating. You would expect some guidelines as to what was on offer. In the therapy context the ‘menu’ could be a leaflet or statement from the therapist. An example of this might be as follows.
Example
Therapist: | Before we start I would like to explain how we are going to use this time together and how I hope it could be helpful to you. I think it is important for me to understand your concerns and for us both to know what you would like to see happening in your life. My strong belief is that you have lots of strengths and skills that will help you overcome your difficulties. Part of my job will be to listen out for those and ask you questions about them. I also believe that we can learn a lot from what is going right in our lives and I hope that we can talk about that too. I will not be telling you what to do, instead I would rather help you find solutions that work for you. |
Obviously, these precise phrases will vary according to the circumstances, but they need to be delivered in a calm, confident, positive and friendly way. Therapists will need to explain the confidentiality policy or any other organisational protocols. Clients will then be invited to ask any questions about the process. It is vital that the therapists listens carefully to a client's initial comments. If the therapist gets off to a difficult start, the client may already decide that it was a mistake to come and so will withdraw her co-operation or sabotage attempts at solution-talk.
In describing the second and subsequent sessions, I feel compelled to issue the same therapeutic health warning given at the start of the last chapter. Textbook clients do not exist and practitioners are not automatons. Each client will have a unique combination of needs and abilities, so for some, change can be sudden and dramatic, while for others it will prove slow and difficult. The outline for a second session is therefore only a guide and not a definitive script. The model serves the client, the client does not serve the model, and that model is a crafted conversation, not a determined logical sequence of interventions. There is no mechanical formula. O'Hanlon and Weiner-Davis (1989: 77) graphically describe the therapeutic process as:
A bit like rock climbing. You have an idea of the goal, but the actual scaling of the mountain involves using general methods of rock climbing adapted to a particular mountain. Sometimes you may even have to break the rule of the accepted method to reach the goal. The mountain will ‘teach’ you how to scale it. Likewise, clients have taught us how to help them reach their goals and sometimes they have taught us that it will take something other than our usual procedures to get there.
Aims of the Second Session
In co-operation with the client, the aims of the second and subsequent sessions will be to:
- review task performance;
- deconstruct the problem;
- co-construct solutions;
- consolidate constructive change;
- develop new strategies for change;
- evaluate and plan the ending.
Other than the final heading these aims do not follow a prescribed sequence. Some solution-focused practitioners will start the second session by asking, ‘What's changed, what's better, or what's different?’ Others will adopt a less direct approach and accept that the client is likely to want to report on the past week, with all its successes and failures. If the client needs to engage in a further discussion of the problem, it is important to listen with respect and attentiveness. The client may need to retell stories or provide new ones until he feels sure that the counsellor understands and is trustworthy. As she listens, she will be able to hear how the client constructs his world. At the same time, this conversation will enable the client to ‘reality test’ his current and potential courses of action. In addition to listening to the client, the counsellor can ask coping and scaling questions throughout, while also ensuring that the client is not experiencing this as her trivialising the problem or being oppressively optimistic.
Review Task Performance
Solution-focused counsellors will vary in the significance they choose to attach to offering clients tasks. In the early years of SFT task-giving occupied a more central role. The emphasis has now moved away from counsellors prescribing tasks, to supporting clients in undertaking tasks that they themselves have designed. Common sense suggests that clients are more likely to make changes that they themselves have initiated rather than take on board those proposed by someone else, although some clients do respond positively to direction from an authority figure. In practice, some clients will be less compliant than others and will modify any counsellor suggestion. For example, James was given the paradoxical task of worrying about his problem for 15 minutes every day in an attempt to reduce the amount of time he wasted worrying about his problems. He carried out the task for three days, then got bored and decided that it would be more productive to spend the time thinking about what he could do to solve his problems. When he reported this to the counsellor, he was congratulated and encouraged to continue to pursue his ideas about what was most helpful for him.
De Shazer (1996) advises against giving a client another task if he fails to accomplish the one already given to him. The counsellor may congratulate the client for knowing that the time was not right to do what had been agreed. The counsellor may then ask, ‘What did you do instead?’ When clients engage in constructive solutions that are different from those agreed in the session, counsellors will congratulate them on taking an independent decision. Non-compliance is often a healthy sign! Most counsellors will be delighted when clients design and commit to their own action plan. There is no point in a counsellor advocating a course of action that is unacceptable to a client. The task has to fit each client in a specific context at a specific time in that client's life. Some counsellors will work hard to devise clever strategies for clients, only to find that these will shrivel up in the cold light of day.
Not all clients will feel motivated to engage in between session work. Experience will have led them to believe that nothing will make a difference. They can feel that they have tried everything and that nothing works. Their life position is thus one of passive victimhood or learned helplessness. Yet resigning oneself to one's fate still requires an ability to cope with the limitations of the situation. In such a case counsellors will help clients recognise that they are using coping strategies to stop a situation from deteriorating. It could be that using more of these could even improve it.
Some clients will have received the formula first-session task to do – ‘Please notice and come back and tell me things that you would like to see continue in your life’ – and so the second session will often begin with a client reporting back the answers to this purposefully vague task. The answers can often help to redress the problem-centred view of life the client has held up until then.
Deconstruct the Problem
White (1993: 34) defines deconstruction as:
procedures that subvert taken-for-granted realities and practices: those so-called ‘truths’ that are split off from the conditions and the context of their production; those disembodied ways of speaking that hide their biases and prejudices; and those familiar practices of self and of relationship that are subjugating people's lives.
There will often be a fine line between joining clients in their perceptions and unique experiences of problems and the necessity at times to explore other interpretations of the situation, other ‘truths’. It is not in the spirit of SFT to do this in a confrontational, ‘counsellor as educator’ way, as one might find in the cognitive therapies. It will more often be the case that a worker will help a client to compare times when the problem does not happen with times when it does and, in so doing, they will clarify the problem itself. The reframing that can emerge from this is more likely to be consistent with the client's own values and viewpoints than would be the case using less collaborative methods.
The self-labelling used by clients will be the end-product of many years of socially constructed linguistics. The vocabulary adopted will be crucially important. While having a diagnosis of an illness can be a source of relief and reassurance in some circumstances, it can also be an albatross around a person's neck. In solution-focused work, counsellors know the power language has to construct social reality and will be conscious that the language used to describe the ‘problem’ may be part of the problem. As a result, counsellors need to be aware of the constructions they place on the language clients use. They have to question themselves here as much as their clients and be aware of their motivation in encouraging scepticism about the labels clients have collected.
As humans we will seek to understand our life experiences, although there will be times when, as individuals and as a community, their meaning eludes us and we will be left with mysteries. The pace of life in contemporary society and the erosion of traditional political, social and religious beliefs can leave people feeling that they ‘had the experience and missed the meaning’. The absence of this compelling meaning often lies at the heart of our personal troubles and anxieties. Our desire for meaning and purpose can sometimes lead us into a rigid and closed attitude to our experiences, with the result that we will adopt a single filter by which to view the world. This narrowness may prove inadequate in the face of a rapidly changing and challenging environment. Our problems can often result from the self-limiting restrictions we impose on our view of life.
As counsellors, we need to be aware of how our assumptions, biases and prejudices can colour our understanding of clients. Our aim is to help people find meaning within the specific context of their lives. In an archaeological dig, the meaning and purpose of a particular artefact can only be fully discovered by a careful examination of its location and reference to all the other finds there. If the pattern of relationships has been lost or is unavailable for some reason, the meaning and purpose of the piece becomes obscure.
Similarly, in the psychological field, there will be choices to be made about meaning that will be intrinsically linked to the context of clients’ lives.
There are various techniques that a solution-focused counsellor will use to deconstruct problems with clients.
Reframing
Reframing provides an alternative perspective on the problem. As Watzlawick puts it:
To reframe means to change the conceptual and/or emotional setting or viewpoint in relation to which a situation is experienced and to place it in another frame which fits the ‘facts’ of the same concrete situation equally well or even better, and thereby changes its entire meaning.
(Watzlawick, Weakland and Fisch 1974: 95)
An example of this would be indecision reframed as wise caution. While acknowledging the value of caution, particularly if it compensates for another person’s impulsiveness (spontaneity), the counsellor can explore whether there are times when the client could allow herself to go off duty and be just a little less cautious for a while.
In the following exchange the two participants are negotiating the meaning of crying.
Example
Female client: | Since she died one thing I’ve done very little of is actually cry about it. I still don’t think I can cry about it and I don’t know whether that’s odd or I just don’t need to, I don’t know. People keep telling me I would feel a lot better if I let it all out and there were one or two times I felt I would have liked to have sat down and had a good cry. |
Counsellor: | Do you usually cry about other things? |
Client: | No, I don’t often cry when I’m upset. |
Counsellor: | I guess people do what they need to do for themselves. Everyone’s different and it might be interesting to think of how you would feel and what you would do differently after you did cry. But I don’t feel that you have to think of yourself as needing to do that – ‘there must be something wrong with me if I don’t cry.’ Everyone’s different. |
From a constructivist perspective, tears have many possible meanings, all of which are negotiable between the two parties. The client holds the dominant cultural belief that she ought to be able to cry about her loss and that she will not get better until she does. She feels anxious and odd because she is unable to cry like other people do. The counsellor explores the meaning which crying currently occupies in the client’s life and offers the view that crying is an option but not a necessity for the client. He suggests that there is no one right way to express feelings. If the client accepts this she may feel released from the obligation to cry and this in turn will break the causal connection between having to cry and her recovery. Learning to cry in a culturally acceptable way (with strong gender expectations about the place crying occupies in the life of a woman) might be a very difficult thing for her to do and could require a lot of time to accomplish. In the meantime, counselling could be prolonged.
Externalisation
Externalisation of the problem is a form of reframing. It is a way of constructing a therapeutic conversation which locates the problem as being ‘out there’, not something within the person. It offers a different perspective from which the client can view his problem. Externalising the problem allows the possibility of the person shifting his attitude towards it. The client can, for example, have a greater sense of agency and power whereas previously there was a passive-victim stance. Talking about the problem as something which is ‘in a relationship with’ the client, rather than something the client ‘is or has’, changes the counsellor’s approach to it. Instead of being the expert who has esoteric knowledge about the inner workings of the client’s thoughts and feelings, there is a sense of ‘joining with the client’ in more of an outward than an inward journey.
Example
Frank was subject to recurring bouts of depression. He was convinced that he had been ‘hard wired’ genetically to be a depressed person, just like his father. His depression was ‘something’ deep within him. This attitude contributed to a sense of fatalism and hopelessness in the face of this powerful condition. His depression prevented him from valuing anything good about himself or noticing any times when he was less depressed. He was at a loss to explain how he had managed to come out of past depressions. His problem felt like a life sentence. With support, he was eventually able to externalise his depression as a force that attacked him from time to time and overcame him, wrapping its gray blanket of gloom around him. This new way of looking at his feelings opened up new possibilities for:
- learning to recognise the signs of an attack looming;
- knowing what he did, and could do, to defend himself;
- knowing what worked in fighting it off or reducing the length or intensity of an attack.
It also helped him to appreciate that there was much more to him than his problem. He had strengths, experiences, qualities, values and knowledge that he could utilise in the fight against the depression. Depression is, of course, an illness which is not simply shaken off by an act of will power, but how sufferers view it is an important element in their ability to recover from its worst effects.
Externalisation can also help to decrease the conflict and blame about ownership of, and the responsibility for, a problem. Without discounting accountability, it is possible to talk about a problem in a way that does not personalise it and thus invites blame, defensiveness and self-justification. For example, it can help a couple to face a problem undermining their relationship together: instead of following a sterile routine of each person blaming the other, it can open the door to finding alternative solutions (White and Epston, 1990).
Testing Constructs
The solution-focused counsellor may employ deconstructing strategies that are used in personal construct counselling. Kelly (1955) advocated a model of the person as a scientist who develops a hypothesis, predicts what might happen, then tests it out and evaluates the results. A counsellor may:
- invite a client to test constructs for their predictive validity or internal consistency;
- make more explicit the assumptions on which the constructs are being made;
- invite a client to employ a different construct and experiment with it.
A counsellor questions the client's viewing of the problem by commenting on that client's thinking as this:
- exaggerates the problem and makes it very difficult to solve;
- takes extreme, all-or-nothing positions and leaves little room for compromise or negotiation;
- projects responsibility on to others – at some point clients need to become customers for change who take ownership of some aspect of the problem;
- sets unrealistic standards by aiming for perfection and dismisses ‘good enough’ as ever being a viable option;
- makes tenuous or illogical connections between events – clients may see two associated events as causally connected.
In SFT, the meaning of each client's experiences is negotiable, depending on the outcome of the linguistic transactions in which the client and therapist engage. Therapists adopt a ‘not knowing’ position in which they disown the role of expert in clients’ lives. The purpose of the therapeutic dialogue is to negotiate jointly a meaning for each client's situation that will create the possibility of change for that person. If talking about the problem appears to disempower a client, a therapist can avert this by attempting to use other discourses that are potentially more open to change.
Co-Construct Solutions
In SFT, counsellors help clients to focus in a concrete and detailed way on the various elements within a solution – namely, those changes that they have stated they wish to bring about. In ongoing work, they will collaborate in designing solutions that will fit with their clients’ preferred strategies.
Revisit the Miracle Question
Answers to the miracle question will change as the work progresses. Clients may decide that one part of the ‘miracle’ scenario is happening already or that, on reflection, they do not want all, or some aspect, of the miracle.
Predictions
Predictions (Kral and Kowalski, 1989) are quite often utilised in SFT, particularly with those clients who will report that change happens randomly and cannot, therefore, be repeated. Predictions can help to discover which changes clients would like and how these came about on a particular occasion. A counsellor will invite a client to predict each evening whether or not tomorrow is going to be a good or a bad day. At the end of the day, the client will check this prediction for its accuracy. If it was accurate, the client tries to identify what it was that shaped the day. If the prediction was inaccurate, the client might discover the positive experiences that made it a better day than expected, or if the day was worse than predicted, might try to identify any trouble spots that could be avoidable in the future, at least to some extent. According to Berg (1991) clients will tend, at least initially, to predict more bad days than they actually have. The self-monitoring of predictions can prove to be a valuable learning experience for clients.
Exploring Past Suggestions
In addition to exploring past solutions, there may be some mileage in recalling unused ‘solutions’. The reasons for not following these solutions may still be relevant, of course. It might perhaps emerge that the suggested course of action was (and still remains) a sensible one, but the client was unable to accept it from the person who suggested it. In new circumstances, the client might be willing to revise an earlier decision.
Scaling
set goals. These immensely simple, practical, powerful questions can enable clients and counsellors to be clear about the direction in which the work is going. They can also ensure that a counsellor stays close to a client's agenda. As in the first session, the use of numbers is a self-regulating activity that clients can use to symbolise their relationship to a problem. It is rare for clients to be unable or unwilling to engage with scaling questions as most will experience these as empowering. They convey ownership as it is clients who will judge where they are on the scale. The therapist will keep out of this and will not challenge a client's judgement. Many clients will find that scaling their situation makes them feel more hopeful, especially when the emphasis is on making small movements along the scale. This breaks the client situation down into small, manageable parts. Instead of the problem feeling like a mountain, it can be scaled down to a series of climbable hills, with each step being plotted along the way. Scaling is a DIY tool that clients can, and frequently do, use between sessions.
At the second session, counsellors will normally ask clients where they are on a scale of zero to ten, with zero representing either the starting point in counselling or a time when the problem was at its worst, and ten a time when the problem has been solved. Clients’ initial responses may well be, ‘Nothing has changed, everything's the same’. It can take time for some clients to remember what has happened since their last session. Their response can be heavily biased towards what has happened in the past day or two, or even the past hour or two. When their counsellor enquires more closely ‘Our first session was last Wednesday. How were things on Thursday/Friday/Saturday?’ the answers can become more revealing. With clients who take a pessimistic view of their situation and who tend to report only negative changes, their counsellor will ask coping questions, such as, ‘It sounds as if you've had a difficult week. How did you get through it? Which was your worst day/which was your second worst day/which was your least worst day?’ Scaling discloses the variations in each client's situation. It is precisely in this evidence of movement that the possibility can arise for a client's ‘hidden solutions’ to surface.
Many skilled and creative practitioners will find ways of illustrating scales in ways which will appeal to their clients. Some examples I have come across included:
- stepping stones across a river;
- different levels, as in computer games;
- a series of mountain peaks;
- smiley face at one end, miserable face at the other.
Example
Client: | Friday wasn’t too bad. |
Counsellor: | What was happening on Friday? |
Client: | I managed to sleep better than I’ve been doing. |
Counsellor: | What difference did that make to you during the day? |
Client: | I was able to work better and I wasn’t feeling so down all the time. |
Counsellor: | What else was different on Friday? |
Client: | Because I wasn’t so tired all day, I was in a better mood and I wasn’t snapping at my partner all the time. |
Counsellor: | So, on a scale of zero to ten, ten being everything was perfect, what were you on Friday? |
Client: | Six. |
Counsellor: | Would it be all right if you were six every day? |
Client: | It would be all right to be six most of the time, but as long as I had some days when I was higher than that – say eight or nine. |
Counsellor: | What would it take for you to have two days next week which were six? |
Client: | Get to bed early and get a good night’s sleep would be a start. |
Counsellor: | Anything else? |
Client: | Make myself some proper meals and cut down on my drinking. |
Counsellor: | How could you do that? |
Consolidating progress is at least as important as making it in the first place.
Example
Client: | I’ve had a really bad week. I feel like I’m back at square one again. |
Counsellor: | So where would you say you were on the scale today? |
Client: | Minus five. |
Counsellor: | How long do you think you will stay at minus five before you move up or down? |
Client: | I don’t know. It all depends. If I could only learn to say no when my boss asks me to take on more work, everything would be fine. |
Counsellor: | If you managed just once to say no, you think it would make a big difference? |
Client: | Yes. |
Counsellor: | When will you know you’re ready to move from minus five and start moving up the scale again? |
Client: | I’m ready now. I don’t want to feel as bad as this again. Things have got to get better. |
Counsellor: | What will be the first signs for you that you’re beginning to fight back? |
Client: | When I stop taking work home with me. |
Counsellor: | How could you do that? |
The counsellor may also explore through scaling what the client is doing to stop the situation deteriorating.
Example
Counsellor: | I know it’s been a bad week, but how did you stop it from being even worse? |
Client: | I went out with my friend on Friday and we had a good talk. It helped me to face Monday. I don’t know how I would cope if I couldn’t lean on her. |
Counsellor: | So she’s important to you. What else do you do or stop doing when you manage to stop the slide? |
Client: | I tell myself I’m a lot better than I was a year ago. I know I’m not as much of a doormat as I used to be. I think of all I’ve been through and survived. |
Counsellor: | So when you get negative self-critical thoughts, you answer back by remembering how strong you must have been to come through what you did. |
Client: | Yes. |
Counsellor: | How do you remind yourself of that? |
Clients might report that they are generally better, but not in relation to the problem area itself. They may see no connection between these improvements and the original problem. They might also report that the original problem is now solved, but ‘things’ are still not better. Counsellors will simply stay with clients as they work towards a better understanding of what a client wants.
Consolidate Constructive Change
The purpose of each successive session is to assess change and to help to maintain it so that a solution can be achieved. (Lipchik and de Shazer, 1986: 88)
This focus on change must be achieved in a climate that allows every client to feel safe and respected. As the counsellor asks questions, the focus moves from the general to the particular in relation to that client's perspective. At times it will seem as if the focus is getting narrower as they each come at the issue from different angles. On occasions clients will recognise that at some time in the past they have had this conversation with themselves, but now they can hear it differently in the presence of another person.
The constructivist view that people create meaning for their own lives fosters a climate of experimentation and risk taking in which counsellors encourage clients to explore different ways of viewing and acting in relation to their problems. This is similar to the personal construct view of the client as a scientist who conducts experiments in living. Counsellors will invite clients to share their curiosity as to what might happen next.
It is vital that clients feel able to report their failures as well as successes. Some clients will seek the approval of their counsellor and may think that they can only achieve this by reporting good news. This is not helpful because as human beings we learn from our mistakes and failures as well as our successes. Counsellors must ensure that clients feel all their experiences are valid and helpful to the work.
Clients will often make progress following an initial interview. This may be due in part to the relief that comes from unburdening one's concerns to another human being. The act of seeking help may in itself restore a sense of power and control in a client's life. Talmon's (1990) research into single sessions demonstrated the power of a first session, showing how it could promote new thinking and behaviour in clients and how, despite the scepticism of many counsellors, it can meet clients’ treatment goals. A solution-focused counsellor sets out to help clients be more aware of how they made changes, however small, and how they might maintain or extend them. If a client reports positive change, the counsellor will offer encouragement and compliments: ‘That couldn't have been easy’, ‘It sounds as if you handled that really well’, ‘Not many people could have done what you've done’, ‘How did you manage to do it?’, and so on. How this feedback is delivered is just as important as its actual content. The manner of delivery will vary according to the personality and circumstances of each client, with a celebratory tone being appropriate in some instances but not in others. It is important for the therapeutic momentum that clients are facilitated in accepting credit for the changes they have made and do not attribute their progress to the counsellor. The meaning which clients attribute to changes they have made will be affected by how pessimistic/optimistic they are; how passive or active; how self-critical or self-affirming; how dependent or independent. The pacing and timing of a counsellor's interventions will be measured by these responses.
Clients can often feel ambivalent about the changes they are contemplating or have already made. We must remember here that change brings losses as well as gains. Some clients will choose to live with the status quo because the price of change would be too high. Others, in their desperation to escape a painful situation, may make changes that they are then unable to sustain or these will produce short-term benefits but prove destructive in the long term. Some people will want cast-iron guarantees that the changes they make will bring the desired results, while others will procrastinate because they are seeking a perfect solution, which of course does not exist.
A counsellor helps clients to consolidate change by asking questions about what is working and how they could maintain or amplify change. These strategies are described in Figure 5.1 under the headings of maintenance, learning and evaluation.
- Maintenance strategies What needs to happen for the changes to keep happening? What might stop you from doing that? How would you overcome those obstacles? What would be worth doing again (perhaps in a slightly different way)? (Watzlawick, Weakland and Fisch 1974). What do you think you need to keep going? What will be the first thing you do once you see the signs of the problem returning? Who could be on your side to help you with some or all of this?
- Learning strategies How did you decide to do that? What do you think it says about you? (White 1988) What have you learned from what you have tried so far? What have you learned to stop doing? How will you manage to stop yourself doing it again? What will be the gains for you when you abandon your ‘failed solutions’? What have you thought about doing instead? How will you be able to remind yourself of what you’ve learned if the problem arises again? Are there any strategies which you are thinking of experimenting with? Are there some aspects of the problem which you feel you have to live with and others which you think you need to change?
- Evaluation strategies Are you finding this therapy helpful, is it making a difference? Are the changes along the lines that you want? Is your goal the same or has it altered? What should we be doing more or less of? Is there something that’s missing that you think I should know about? What else do I need to know in order to help you move?
In particular, the counsellor will use scaling questions.
Figure 5.1 Counsellor Strategies
Some clients will state that their goal is to have a better understanding of both themselves and their problems, even when they know from experience that this better understanding does not guarantee that they will be motivated to change or will know what to change or how to achieve this. Understanding can just as easily lead us into justifying the status quo and can become a defence against making changes. Anyone who has battled against an addiction to food, drugs, cigarettes, alcohol or anything else, will understand the gulf between having an intellectual conviction and acting upon this.
The tenor of the approach is that a new awareness can result when clients act differently and that experiential learning is more valuable and powerful than intellectual knowledge: ‘learning to be the person you want to be is quite different – and often less time-consuming – than learning why you are the way you are’ (Fanger, 1993). We often understand the past more easily by reflecting on the present and the future than by undertaking a direct historical investigation. However, when clients make it clear that understanding, for them, is the pre-requisite for constructing solutions, this needs to be respected and co-operated with, otherwise they are likely to lack sufficient motivation to continue.
Maintenance Strategies
What needs to happen for you to keep the changes going? What might stop you from doing that? How will you overcome those obstacles? What would be worth doing again (perhaps in a slightly different way) (Watzlawick et al., 1974)? What do you think you need in order to keep going? What would be the first thing you would do if you saw signs of the problem returning? Who could be on your side to help you with some or all of this?
Learning Strategies
How did you decide to do that (exception)? What do you think that says about you (White, 1988)? What have you learned from what you have tried so far? What have you learned to stop doing? How will you manage to stop yourself doing it again? What will be the gains for you when you abandon your ‘failed solutions’? What have you thought about doing instead? How will you be able to remind yourself of what you've learned if the problem arises again? Are there any strategies with which you are thinking of experimenting? Are there some aspects of the problem that you feel you have to live with and others you think you need to change?
Evaluation Strategies
Are you finding these sessions helpful, are they making a difference? Are the changes along the lines you want? Is your goal the same or has it altered? What should we be doing more or less of? Is there anything else you think it would be helpful to tell me? What else do I need to know in order to help you more?
Research indicates that the maximum impact of counselling takes place in the first six to eight sessions (Koss and Butcher, 1986). In brief counselling, where time is rationed, there are fewer opportunities to recover from an unproductive start – hence the importance of an early and ongoing evaluation by both parties and a willingness on the counsellor's part to change something if it is not working. The solution-focused approach is a pragmatic one in which counsellors will experiment with different interventions, depending on whether or not these are helping clients to move towards their goals. If clients are not making progress, they may need to:
- revisit the problem;
- reappraise a client's goals;
- re-evaluate the relationship.
Developing or Reinforcing Strategies for Change
If we do not change our direction we are likely to end up where we are headed.
(Chinese Proverb)
Counsellors build on what clients are doing already to help them take the next small step towards their goal. That step may be towards making further progress, maintaining progress already made, or halting further deterioration. So what can counsellors do when their clients report no progress or a deterioration?
It is vital not to focus too much on setbacks. A counsellor may even have warned a client of possible relapses. Failing can provide opportunities for learning. At the very least a client can eliminate one course of action from the list of possible solutions. A relapse or setback can help to throw into clearer relief what a possible solution might look like. And what made a situation worse might give some clue as to what could make it better. A counsellor will also try to build on a client's determination not to give up, saying, ‘So while there have been difficulties you have decided to …?’
The counsellor may then ask:
- ‘Do you think that we need to do something different?’
- ‘Do you feel our goals need adjusting?’
- ‘Do we need to review our timetable?’
- ‘How did you manage to stop things getting worse?’
- ‘How did you cope despite the problem not improving?’
In some cases, the problem will recede (temporarily or permanently) into the background and something else, either another problem or something positive, will come to the fore. As counsellors, we can hold clients back by not having enough faith and trust in their ability to make changes in their lives. While incremental change may most often prove to be the wisest course of action, there will still be some occasions when clients are ready for major changes and excessive caution or pessimism on our part can result in them missing the optimum moment for making that change. It is worthwhile noting that a successful outcome often leads to further successful outcomes.
Example
A female client presented at the first session with depression. She was currently off work on sick leave. She felt guilty that she was neglecting her children. When she returned the following week, she had managed to cook a meal for her two children every day after school, had helped them with their homework three times, and had visited her place of work to renegotiate her job. The counsellor expressed surprise that she had done so much in one week and asked how she had managed it. Her reply was that she had not intended to do all of these things, but had decided to take control and make a start and one thing had led to another.
Evaluating the Session and Planning the Ending
It is helpful to distinguish between treatment goals and life goals (Ticho, 1972), otherwise counselling can become unduly prolonged. It is not a treatment goal to help a client find a partner or a job, for example, although the treatment goal might be to develop specific social skills in order to achieve that goal. Counselling is the beginning of a process that does not demand the counsellor to be there at the end. Figure 5.2 lists a number of questions that focus on how clients could carry forward what they have gained or learned from counselling.
- How confident do you feel about following the plan?What will you need to keep you to it?
- What do you think the possible obstacles might be and how will you overcome them?
- What do you need to remember if things get difficult for you again?
- What are the benefits for you that will make the effort worth it?
- Who is going to be able to help and who do you feel will be more part of the problem?
- How long do you think it will take before you feel this is not a big problem any longer?
- How will you remind yourself about the things you know help?
Figure 5.2 Questions for ending and after-care
Endings should be on the agenda from the very beginning. It should be our aim to remove ourselves from clients’ lives as soon as is helpfully possible – that is, as soon as clients are confident that they can carry on the changes which they have begun to make. Otherwise there is the danger of dependency and a loss of focus in the work. An agency that offers ongoing support to clients has to define this in such a way that it does not become confused with goal-directed counselling.
In SFT, clients will define the goals of counselling and will also largely determine when a contract should end. To some practitioners this will sound like a recipe for long-term work, but for most clients a brief intervention will be their treatment of choice. Clients are more often satisfied with achieving limited, but realistic, goals than are their counsellors.
Scaling is a useful tool for clarifying endings. A counsellor will ask clients what will be ‘good enough’ for them on a scale of zero to ten, with zero being the status quo and ten being the morning after a miracle. That counsellor will then invite clients to describe what will be happening or not happening when they have reached the desired point on the scale. Rarely will clients aspire to being a ten; the most common answers will be seven or eight.
It is crucial that there is a firm agreement as to what will constitute the signs for counselling to end. Without this definition, it will be difficult to monitor progress. Experience teaches us that endings are not always as clear-cut as we would like and there can be differences in perception between counsellor and client as to whether or not ending is appropriate. A solution-focused counsellor will always give a client the benefit of the doubt.
In all forms of counselling, endings need preparation and sensitive handling. In brief therapy, when time will have been an issue, badly handled endings can leave clients feeling that their problems have been trivialised or they have been written off as being beyond help. This can then feed into previous negative experiences and leave clients with a devastating sense of failure and rejection.