Solution Focussed Approach

Introduction
to
Solution Focused Practice

www.johnwheeler.co.uk
Where it came from*
The Solution-focused approach was developed
in the 1980s by Steve de Shazer and Insoo Kim
Berg of the Brief Family Centre in Milwaukee,
USA.
They modified existing Brief Therapy,
keeping only those elements which were
linked to a good outcome for the clients.

Slides 2-5 adapted from Alasdair MacDonalds website
www.solutionsdoc.co.uk
Central assumptions
The goals for the work are chosen by the service
user
Service users have resources which they will bring
to the work.
A detailed history is not essential for a Solution-
focused conversation to arrive at solutions.
Problem talk and speculation about motives or
purposes of symptoms are avoided.
The practitioner adopts the service users
vocabulary and tracks their use of language.

Overview of SF tools
Goals are defined in practical and recognisable
ways.
Talk about pre-session changes, exceptions,
scaling tasks and the miracle question keeps the
focus on effective solutions.
Homework tasks are offered to continue the
process of change between sessions.
Individuals, couples or families may be seen; joint
sessions are common even if one individual is the
main focus.

Research
An important research finding is that Solution
Focused Practice is equally effective for all
social classes whereas many other
psychological approaches favour the well-
educated and affluent. In practice those with
few resources are the ones most in need of
effective help.
Another advantage is that results are usually
achieved within 3 6 sessions.
Small group discussion
What, so far, has
caught your
interest as a Social
Worker?
What, so far, has
you thinking that
a Solution
Focused approach
might help you
help the people
you work with??
Future focus
Presence of whats wanted rather than the absence
of something that isnt. You can only measure whats
happening.
Dont assume you know what the service user means
What would that look like?
How could other people tell it was happening?
Why is this important to you?
Goals/Best Hopes/Preferred Future

Here is a sampling of the
kinds of conversations that I
have observed around goals,
best hopes, and preferred
futures with the current
group I'm working with -
homeless military veterans,
many of whom have gotten
into a mess with drugs or
alcohol, losing jobs, getting
physically ill, even sleeping
outside or in very rough
conditions.
Dvorah Simon. U.S. 2014
"What are your goals?" (a question that I am required to ask by the agency I work for)

- I want to get sober
- I want to get a decent place to live
- I want to help for my PTSD
- I don't want to go to jail

"What are your best hopes for our work together?"

- I'll understand why I drink.
- I'll get into that housing program.
- I'll get vocational counseling.

Preferred future questions such as, "Suppose you complete this program and it's two
years from now and you are living the life you want to be living. What will it look
like?"

- I'll have a nice apartment and my kids will be able to visit me.
- I'll be going to college and getting an anthropology degree.
- I'll have a plot of land and I want to build a tiny house. I'm researching all the
neat ways of doing that now!
- I will be selling tamales out of a food truck. My sister makes them and they are
delicious!

I think each of these kinds of conversations can be
useful but for what I've been doing, the preferred
future questions often seem to provoke far richer,
imaginative, and individualized responses. Also for
people who have been through a lot of "programs",
the goals answers can often be things they think or
have been told they should want.

I learned this years ago with a woman who came to me with such severe anorexia that
between the time she called me and our first appointment, she had to spend 2 weeks in a
hospital so she wouldn't die of starvation. When I asked her what her goals were for our
work together, she said a very reasonable thing: "I need to learn how to eat normally." She
then went on to tell me all the therapies she had tried hadn't worked! So she knew that
"eating normally" was what she SHOULD want but had a kind of despair about whether
that would ever be achievable.

When I asked the miracle question, the most wonderfully different answer came out. "I
see myself going to the theatre with friends." We then had a long and detailed
conversation about what sort of theatre she enjoys, and how she would like to enjoy going
to it. Finally I asked what connection there might be with going to theatre and her eating,
and she said, "because after the show we all go out to eat, and right now I'm afraid of
being too weird, so I just don't go." Her love of theatre gave us something she WANTED to
work with, around which the (very real) eating issues could be attended to. It also gave ME
a beautiful sense of "there's a living, breathing, imagining, yearning person in there" which
helped me overcome my initial fear of working with someone who looked pretty scarily
vulnerable.
Discussion in pairs
Suppose everything
works out well, and in
a few months you are a
professionally qualified
Social Worker.
How would you be able to tell that you were
doing a good job?
How would your service users be able to tell
that you are doing a good job?
How would your colleagues be able to tell that
you are doing a good job? www.johnwheeler.co.uk
Scaling questions
10
0
The Social Worker you
imagine yourself being.
No evidence at all
? NOW
How can you tell its this
number and not lower?
Scaling continued
Add 1 to the number
How would this be different from how it is at
the moment?
General wellbeing.
Progress towards goals.
Pre-meeting change.
Identify coping strategies.
Relapse prevention.
Safety.
Scaling questions
10
0
n
Where you want to
get to
As bad as it could be
Current
evaluation
One step
closer to 10
Using scales on placement
Who might it be
useful to use
scaling questions
with on your
placement, and
how in particular?
Solution talk vs. problem talk
Gassmann, D. &

Grawe, K. (2006) General change mechanisms: the relation
between problem activation and resource activation in successful and unsuccessful
therapeutic interactions. Clinical Psychology & Psychotherapy. 13. 1: 1-11.
Best outcomes correlated to interviews where
interviewer mainly focused on resource
activation
Poorest outcomes correlated to interviews
where interviewer mainly focused on problem
activation

What we think about our service users
Flckiger, C. and Grosse Holtforth, M. (2008), Focusing the therapist's
attention on the patient's strengths: a preliminary study to foster a
mechanism of change in outpatient psychotherapy. Journal of Clinical
Psychology, 64: 876890.
When practitioners thought about their
clients strengths for ten minutes before they
saw them there were better outcomes when
compared to a control group of practitioners
who didnt
Binocular vision
++++++
+++
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++++++
+++
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Support

Assessment
++++++
+++
- - - - - -
- - - -
Intervention
++++++
+++
- - - - - -
- - - -
PROBLEM
PROBLEM
EXCEP-
TIONS
EXCEP-
TIONS
EXCEP-
TIONS
EXCEP-
TIONS
EXCEP-
TIONS
Potential ways of finding exceptions
Tell me about times when this problem isnt
quite so bad, or doesnt happen at all? What are
you or others doing differently at those times
which might help to explain this?
Can you think of a time in the past when youve
had some success dealing with this issue?
Can you think of another issue which youve
managed to deal with in the past which is a bit
like this one?
LISTEN

Exceptions on placement
What are the issues that are going on in the
lives of the service users you are working with
where there are likely to be exceptions?
Miracle question
Suppose, when you go to bed tonight, a
miracle happens, and the problems you
have at the moment are resolved, but
because you are asleep you dont know.
When you wake tomorrow, what will be the
first sign the miracle has happened?

Exercise in pairs
Suppose between now and the next time you are on
placement a Miracle happens and the miracle makes the
placement experience exactly right for you.
What would be a first sign to you that such a miracle had
happened on your placement?
What would other people notice was different about you
because of this?
What would you do more of or differently because the
miracle had happened?
What would please you most about the placement because
the miracle had happened?

4 reasons for asking the Miracle
Question
Harry Korman (2007) More than Miracles. Pp 40-41. Haworth Press

One way to create goals
The Miracle question as a virtual miracle, an
emotional experience
Prepares for exceptions
-> ask about exceptions
Part of creating a progressive story
-> scaling
www.solutionfocusedtrainers.co.uk
What are you most likely to
take away from today?

What difference do you
hope that will make to your
work with service users?

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