Solution Focused Therapy:Solution Focused Therapy:

Presented by:Presented by:

Teri Pichot, LCSW, MAC, LACTeri Pichot, LCSW, MAC, LACtpichot@jeffco.ustpichot@jeffco.us

Its application to Substance Abuse Treatment

Problem SolvingProblem Solving

Evaluate the problemEvaluate the problem

Diagnose the problemDiagnose the problem

Utilize known information about the Utilize known information about the diagnosed problemdiagnosed problem

Evaluate client resources/strengthsEvaluate client resources/strengths

Determine the best course of treatmentDetermine the best course of treatment

Implement the treatmentImplement the treatment

Problem

Problem Solving

Solution BuildingSolution BuildingDetermine the desired goalDetermine the desired goal

Assist the client in creating a detailed Assist the client in creating a detailed description of the goaldescription of the goal

Assist the client in evaluating where he/she Assist the client in evaluating where he/she is in relation to the desired goalis in relation to the desired goal

Assist the client in evaluating times in Assist the client in evaluating times in which he/she was successful in moving which he/she was successful in moving toward the desired goaltoward the desired goal

Work backward to discover keys to successWork backward to discover keys to success

Problem

Solution Building

Solution-Focused PrinciplesSolution-Focused Principles

If it’s not broken don’t fix itIf it’s not broken don’t fix it

If something is working, do more of itIf something is working, do more of it

If it is not working, do something differentIf it is not working, do something different

Small steps can lead to large changesSmall steps can lead to large changes

The solution is not necessarily directly The solution is not necessarily directly related to the problemrelated to the problem

Solution-Focused PrinciplesSolution-Focused PrinciplesContinuedContinued

The language requirements for solution The language requirements for solution development are different than those development are different than those needed to describe a problemneeded to describe a problem

No problem happens all the time. There No problem happens all the time. There are always exceptions that can be utilizedare always exceptions that can be utilized

The future is both created and negotiableThe future is both created and negotiable

Common InterventionsCommon Interventions

Miracle QuestionMiracle Question

ScalingScaling

Difference QuestionsDifference Questions

Relational QuestionsRelational Questions

Exception QuestionsException Questions

ComplimentsCompliments

Miracle QuestionMiracle Question

““Imagine that when you go to bed tonight, Imagine that when you go to bed tonight, a miracle happens. The miracle is that a miracle happens. The miracle is that the problem that brought you here is the problem that brought you here is gone! However, since you were asleep, gone! However, since you were asleep, you are unaware that a miracle you are unaware that a miracle happened. What would be the first happened. What would be the first things that you notice that let you know things that you notice that let you know that this miracle happened?”that this miracle happened?”

Five Elements of the Miracle Five Elements of the Miracle QuestionQuestion

The change must be of some significance to The change must be of some significance to the client (unlikely to happen naturally)the client (unlikely to happen naturally)

The “Miracle” must be definedThe “Miracle” must be defined

It must have the element of immediacy It must have the element of immediacy (“tonight while you are sleeping”)(“tonight while you are sleeping”)

The client must be unaware that the miracle The client must be unaware that the miracle occurredoccurred

The client is to discover the clues that the The client is to discover the clues that the “Miracle has occurred”“Miracle has occurred”

Scaling QuestionsScaling Questions

Makes concepts measurableMakes concepts measurable

Provides assessment informationProvides assessment information

Provides the tool to measure changeProvides the tool to measure change

Neutral tool to explore exceptions and Neutral tool to explore exceptions and highlight changehighlight change

Use 0-10 or 1-10 scalesUse 0-10 or 1-10 scales

The 10 equals the desired goalThe 10 equals the desired goal

The 1 must be definedThe 1 must be defined

ComplimentsCompliments

Key Component: Should be client drivenKey Component: Should be client driven

(highlight areas of success that the client (highlight areas of success that the client has already identified as useful)has already identified as useful)

Focuses on aspects within the client’s life Focuses on aspects within the client’s life rather than on behavior during the sessionrather than on behavior during the session

Behavioral reinforcement vs. complimentBehavioral reinforcement vs. compliment Must be genuineMust be genuine

Difference QuestionsDifference Questions

Explores meaning (has a deepening effect)Explores meaning (has a deepening effect) Increases hope that change will make a Increases hope that change will make a

meaningful differencemeaningful difference Encourages clients to explore if potential Encourages clients to explore if potential

changes are realistic, feasible, and changes are realistic, feasible, and worthwhileworthwhile

Enhances motivation by making the Enhances motivation by making the benefits more “real”benefits more “real”

Exception QuestionsException Questions

Times in which the problem does not exist Times in which the problem does not exist or is less severeor is less severe

Assists the therapists in exploring if Assists the therapists in exploring if something that a client tried was usefulsomething that a client tried was useful

Highlights various verbal pathsHighlights various verbal paths Client drivenClient driven Only useful if the client sees them as Only useful if the client sees them as

useful in helping to get to the “Miracle”useful in helping to get to the “Miracle”

Relationship QuestionsRelationship Questions

Assists the client in exploring how the Assists the client in exploring how the changes impact all elements of his/her changes impact all elements of his/her systemsystem

Assists the client in keeping the plan Assists the client in keeping the plan realistic and inclusive of all factorsrealistic and inclusive of all factors

Increases the client’s ability to “step into Increases the client’s ability to “step into someone else’s shoes”someone else’s shoes”

Increases empathyIncreases empathy

Solution Focused HomeworkSolution Focused Homework

Comes from what the client has identified Comes from what the client has identified as importantas important

Often generated from clues the client Often generated from clues the client discovered during the sessiondiscovered during the session

Can be observational or action orientedCan be observational or action oriented

Can be assigned by the therapist or self-Can be assigned by the therapist or self-assignedassigned

ReferenceReference

Pichot, T., & Dolan, Y. (2003). Pichot, T., & Dolan, Y. (2003). Solution-Solution-

focused brief therapy: Its effective use focused brief therapy: Its effective use

in agency settings.in agency settings. Binghamton, NY: Binghamton, NY:

Haworth.Haworth.

Benefits of Using AnimalsBenefits of Using Animals

An animal’s very presence has been shown An animal’s very presence has been shown to:to:

Decrease blood pressureDecrease blood pressure

Lower heart rateLower heart rate

Decrease amount of medication neededDecrease amount of medication needed

Speed recovery timesSpeed recovery times

General Goals of AAAGeneral Goals of AAA

Change the power differential between Change the power differential between clients and staff membersclients and staff membersIncrease the general comfort level of Increase the general comfort level of clientsclientsEncourage clients to focus on a positive Encourage clients to focus on a positive activityactivityAssist clients in focusing attention on an Assist clients in focusing attention on an external source (assists with low-level external source (assists with low-level worry, anxiety, and depression)worry, anxiety, and depression)