Postmodern Approaches
Solution-focused Brief Therapy
Narrative Therapy
Present and future oriented
Focus on what is possible, not understanding the problem
Looks for what is working
Basic Assumptions Guiding Practice
Use positive "solution talk"
Clients can behave effectively once the recognize effective behaviors
Exceptions to every problem can help with solutions
Clients need help to see other sides of story they are presenting
Small changes pave the way for larger ones
Therapists should take cooperative stance rather than a controlling one
Each solution is unique, no "right" solutions
Therapeutic Process
Clients describe problems, therapist asks, "How can I be useful to you"?
Develop well formed goals, "What will be different in your life if when your problems are solved"?
Inquires about times when problems were not present
Therapist offers summary feedback after each session and provides encouragement
Evaluate progress with client using a rating scale and form plan together.
Therapeutic Relationship
Customer - client and therapist work together to identify and solve problem
Complainant - client states problem but not willing to take a role in constructning solution
Visitor - client in therapy due to someone else thinking client has problem
Techniques
Pre-therapy change - Ask what has been done since calling for appointment
Exception Questions - Identify times when the problems didn't exist, "news of difference"
The Miracle Question - IF a miracle happened and the problem was solved overnight, how would you know it was solved and what would be different?
Scaling Questions - Asking people to rate feelings, moods, progress on a numerical scale
Formula First Session Task - Homework after first session that asks the client to observe what in their life they would like to continue to have happen in their lives. Discussed in second session.
Therapist Feedback - take break during session and formulate feedback and discuss it. Compliments, bridge, suggested tasks (observational, behavioral)
Terminating - Identify changes that mean success and encourage the maintenance of these changes
Narrative Therapy
Focus is on the "stories" of clients to look for times when clients were more resourceful
Our stories shape our reality and construct what we feel, see, and do.
Listen with an open mind
Therapeutic Process
Collaborate on naming the problem
Personify the problem and attribute oppressive intentions and tactics to it
Investigate how problem as affected the client
Invite the client to view story from a different perspective
Search for exceptions to discouragement
Find historical evidence to bolster new view of client as competent to defeat problem
Ask client to speculate about the future for the new strong competent person that is developing
Find or create an audience for perceiving and supporting the new story, a new social context
Therapeutic techniques
Questions
- Questions are structured to empower client, to seach for "differences that make a difference"
Externalization and Deconstruction - view the problem as the problem, not the person. Externalization one way of deconstructing the power of a narrative and separating the person from identifying with it.
1. map influence on person's life
2. map influence of person's life on problem
Alternative stories and re-authoring - listen for opening for new stories, i.e. discover competence in problem saturated story and help client construct new story that is success oriented
Documenting the evidence - having a social context for news that change is taking place is important - letter writing is one method