(This document can be downloaded in its original form by clicking Brief Therapy.)
Brief Therapy and the Cultivation of the “Hidden Strengths” of the Client
I. Our attitudes about the patient are relevant to treatment.
A. Generally, society tends to focus on the dysfunction or “problem behaviors” of the client.
1. Depression, Borderline, Low self esteem, and Dysfunctional are common terms used to describe the alcoholic.
2. When we look for such pathology, we usually find it, and then treat the patient accordingly.
B. As Counselors, we have a choice as to how we are going to view the client.
1. We can see the client in terms of pathology and dysfunction
2. In terms of “Competencies, Resources, and Strengths.
C. People will sometimes fulfill our expectation of them to be sick, and dysfunctional.
1. People will become stigmatized by us, if we have a narrow view of them
2. People are often defined by “totalizing description” of themselves
3. “Self fulfilling” prophecies of the patient are difficult to overcome.
D. “Possibility”, or “Brief Therapy” seeks out the clients strengths, and then encourages their development in daily life.
1. It is “Solution Based”, that is, helping the client to find solutions to daily problems.
2. It is “Strength Based” in that it encourages the client to use and develop their strengths and assets.
3. Oftentimes, the clients “Strengths” must be pointed out to them, as they have forgotten them.
4. These strengths are “amplified” back to the client, giving them a sense of empowerment to make further changes in their lives.
5. The Brief Therapist looks for “sparkling moments” or “exceptions”, which are times when people have been successful in overcoming their problems.
II. The “Possibility Frame”
A. Three Elements……..Hope, collaboration, and novelty
1. HOPE……..people are often demoralized…….hope is critical to therapy
A. Ask questions that will instill a sense of hope
B. The goal is for the patient to reclaim their life.
C. Point out that change is already happening…….they are talking to you!!
D. Ask the client to describe what life would be like without the problem.
E. Ask questions that put the problem in a context that it can be solved.
F. Ask questions about past success in dealing with the problem.
G. Stress solutions, not the problem…..be goal oriented.
H. “ONE DAY AT A TIME, KEEP IT SIMPLE, EASY DOES IT……
J. The important thing is to stress past successes, and solutions
2. Build Collaboration and Cooperation in the Relationship
A. Respect the clients ability……..be empathetic, not sympathetic
B. Respect the clients right to be wrong…….and to learn slowly.
C. Let the client act as consultant………he is the customer.
D. We participate in the therapy as much as the patients does.
3. Novelty….helping the patient get unstuck from old behaviors……attitudes.
A. Sometimes, they just need new ideas or a fresh perspective.
B. Often, they can generate these ideas themselves, in a counseling session.
C. Offer a fresh perspective, new idea, or alternative behavior
D. Help the client to view the situation from various perspectives.
Summary: Encouraging action puts the responsibility for change onto the client for making the small but necessary changes needed as pathways to more significant changes. It under lines the importance of behavior changes, rather than just talking about the problem.
IT: RESPECTS THE CLIENT AS AN INDIVIDUAL
IT: GENERATES OPTIMISM
IT: NOTICES THE SMALL YET IMPORTANT BEHAVIOR CHANGES
IT: INTRODUCES NEW PERSPECTIVES
IT: MAKES EACH SESSION COUNT
IT: APPLAUDS AND ENCOURAGES THE CHANGES MADE.
IT: IS STRENGTH BASED
IT: HELPS COUNSELORS NOTICE “SPARKLING MOMENTS”
IT: HELPS COUNSELORS FIND NEW PATHWAYS
IT: IS SOLUTION RATHER THAN PROBLEM FOCUSED.
Guiding Principals and Strategies in Brief Therapy
Principal: Think Small
Strategy: Set limited, achievable goals within a time frame.
Principal: Complicate situations do not require complicated solutions.
Strategy: Focus on solutions, and what works rather than on what’s wrong
Principal: Complicate situations do not require complicated assumptions
Strategy: Keep it simple, don’t’ worry about figuring everyone out.
Principal: It is the relationship of collaboration between the counselor and client that is helpful in creating an environment for change.
Strategy: Get the client involved as a partner in the counseling exchange.
Principal: Get the client to agree to achievable, specific goals
Strategy: Diagram “frame” complaints in forms that are solvable….use a flexible approach……..but be focused on the small behavioral changes. Use “Possibility Language” as a way to encourage risk taking and change.
Principal: Possibility, or Brief Therapy is works best when the client can keep it simple, doing one small change at a time.
Strategy: Encourage small changes, daily routine changes, small attitude changes, risk taking, in exploring spirituality, ect.
Principal: The family and community can help with the needed change.
Strategy: Focus on available resources in the family, and community, such as priests, friends, extended family members, psychologs.
Principal: Everything changes, including families, jobs, relationships, ect.
Strategy: Reframe difficulties as “bumps in the road”, normalize transitions as being a part of life.
Principal: Social networks are very important in creating and sustaining change.
Strategy: Involve family members in counseling as “consultants” when it is good to do so.
Principal: Maintain a sense of optimism, simplicity, and playfulness in the counseling relationship.
Strategy: Have a sense of humor and fun with the client………remember that life is not much fun if we take ourselves too seriously.
Adapted from Friedman,S., & Fanger,M.T. (1991) Expanding therapeutic possibilities: Getting results in Brief Psychotherapy.
BRIEF THERAPY AND CLIENT MOTIVATION
The “Wheel of Change”…….
- Contemplation…….am I an alcoholic? What do I do?
- Determination….I will stop, by doing these things.
- Action….specific behavioral changes.
- Maintenance…….the lifestyle change are kept in order.
- Relapse…………either in attitude, or in behavior.
- pre-contemplation does occur, outside this “cycle of change”.
- This implies that the clients “decision making process” must be considered, and where he is at in the cycle of change. Intervention is helpful, but there are cases of spontaneous remission, which do occur.
- The objective, is to avoid looking in the wrong places for the solution………if the client has found part of the answer, it is better for him, and for the counseling process, if we recognize it.
SIX RELEVANT CONCEPTS IN BRIEF COUNSELING
- DIRECT FEEDBACK is given to the client about their substance abuse. We must accurately “mirror” their behavior, and it’s effects.
- THE CLIENT IS GIVEN RESPONSIBILITY FOR CHANGE.
- WE MAY GIVE ADVICE, BASED ON THE COUNSELORS EVALUATION OF THE CIRCUMSTANCES.
- WE PROVIDE A “MENU” OF OPTIONS, AND HELP THE CLIENT EXPLORE THEM, WITHOUT MAKING HIS DECISIONS FOR HIM.
- EMPATHY IS NECESSARY FOR AND ESSENTIAL… ALL FEEDBACK MUST BE DONE EMPATHETICALLY.
- SELF-EFFICACY, OR “EMPOWERMENT” IS ALSO CRITICAL IF THE CLIENT IS TO HAVE THE HOPE AND POSITIVE ATTITUDE NEEDED FOR REAL CHANGE AND GROWTH.
- WE MUST CONSIDER THE CLIENTS CHANGE FROM ONE STAGE TO ANOTHER
- ALSO, WE MUST CONSIDER THE CLIENTS AMBIVALENCE AND VACILLATION IN THE COUNSELING PROCESS.
- TOLERANCE AND FORGIVENESS DOES NOT MEAN ACCEPTING UNACCEPTABLE BEHAVIOR, OR EXCUSING IT.
- IT DOES MEAN RESPECTING THE PERSON RIGHT TO BE WHO THEY ARE.