by Tony Vasquez, MSW, edited by Laura Morrison, May 2014
Through my experiences in therapy and working with a wide variety of clients I have found many successes by utilizing a very short term method but long lasting intervention called Solution Focused Therapy (SFT). This brief and goal oriented therapy modality has been a very useful tool in working with clients for short periods of time. Solution focused therapy is used to help the client find solutions for immediate challenges and helps them build coping tools to utilize to manage future challenges.
I have found that the best part of this talk therapy intervention can in some cases bring immediate relief to some clients after just one session. When implementing SFT or Brief Solution Focused Therapy you complete work with a client in about 7-10 sessions. The driving force for SFT, in my opinion, is that the client is already willing to accept help and wanting to change but is usually “stuck” and does not know where to begin. The job of the mental health counselor is to help them identify solutions.
After determining the reason the client is seeking therapy you will begin your work in SFT by asking the "Miracle Question". As an example, the Miracle Question may go something like this:
“So tonight you will go to bed as you normally do and around 4 am a miracle happens. You don’t know that a miracle has happened but when you awaken everything in your life is exactly how you want it to be, what does that look like to you?”
This question is an excellent way to know what the client wants and how they envision their life when everything is going well. The client is asked to really think about what would make their situation better or improved. They will think about how things will be when their life is free of the issues or concerns. The clients responses to the miracle question will help to develop a goal and treatment plan, individualized to meet the patients specific needs.
I ask the client to be realistic and to strive toward a tangible goal. I have had many clients tell me that this question has not been posed before. Oftentimes, clients are unable to answer the miracle question right away. This provides a good opportunity to leave the client reflect on the question and formulate and answer for homework. To be honest I have had a client who said that she wanted to win the lottery for her problems to be solved! I still wonder if she ever won. Remember that in order to be successful we need realistic and tangible goals. As mental health professionals and we must help clients to identify realist goals and the appropriate steps needed to take in order to reach their goals.
Throughout the SFT process it is important to get a weekly update in order to gauge the client’s progress toward their goal or goals. I will always open the dialogue in the beginning of a session and inquire if anything has changed, has anything gotten worse, has your situation improved, or is it still the same since our last session? I always ask the client to expound in order to explore their thoughts and feelings revolving around an issue. This is a great opportunity to help the client identify triggers to their stressors as well as helping them to identify appropriate coping strategies. When the response is positive and heading toward their goal I like to use praise to reinforce their work and also point out any exceptions that may have occurred.
Another helpful way to measure any improvements or assess setbacks is to utilize scaling questions. Scaling questions are used to help the client assess their own progress. I like to use a Likert scale that ranges from 0-10 with 0 being the worst and 10 being the best. I ask the client why they chose their number and the reason why. It is important to have the client discuss how they have dealt with difficult issues and about the outcome. Let the client describe or give credit to an improvement. We can also use this opportunity to help them identify an exception, those times when something did not happen as they wanted or expected. It is important to help the client recognize if something has improved, and to ask them what had changed that led to the improvement. What was happening at that time? What were their thoughts at the time? And then encourage the client to do more of it!
The job of a mental health counselor is to work collaboratively with the client to help them become their own change agent. Counselors encourage the client to start with small positive changes, and to help them realize that it can lead to larger more significant changes. This process of thinking can help build momentum so the client can actually start to see and feel positive changes in their life. We can often help increase a client’s knowledge of their own power to make positive changes. We can also help our client’s build up their natural resources so they can have these helpers after our work is over.
By helping the client identify their strengths it can empower them to address their issues in the “now” and move on. We help the client focus on today and to find solutions for their problems now and subsequent issues in the future.
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