Listening For Solutions2010

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Presenting at the Australian College of Mental Health College Greater Western Sydney on Friday the 26th March 2010

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Listening For Solutions2010

  1. 1. Listening for Solutions Skillfully and patiently weaving a therapeutic conversation Therapeutic Options Embracing Diversity © 2010 Albert Morrison MNurs (AdvPrac)
  2. 2. MANDALA Therapeutic Options Embracing Diversity
  3. 3. Gosford Mental Health Centre Therapeutic Options Embracing Diversity
  4. 4. Talk Therapies Does therapy work? Study after study and studies of studies clearly demonstrate that it does and the average client is better off than 80% of the untreated sample. The Heart and Soul of Change: What works in Therapy, p4. 2009 Therapeutic Options Embracing Diversity
  5. 5. What really works? Cognitive Behavior Therapy Dialectical Behavior Therapy Mindfulness Therapy Solution Focused Brief Therapy Rational Emotive Behavior Therapy Humanistic Existential Therapy Transpersonal Therapy Gestalt Therapy Brief Therapy Motivational Interviewing Acceptance and commitment therapy Existential therapy Systemic therapy Narrative therapy Eclectic therapy Integrative Problem-Solving therapy Therapeutic Options Embracing Diversity
  6. 6. All approached work equally as well with some of the people some of the time. No difference in outcomes between different types of treatment or different amounts of competing therapeutic approaches. Godley, S. H. Jones, N., Funk, R., Ives, M Passetti, L. (2004). Comparing Outcomes of Best Practice and Researched-Based Outpatient Treatment Protocols for Adolescents , Journal of Psychoactive Drugs. 36(1), 35-38 Therapeutic Options Embracing Diversity
  7. 7. Meta-analysis of all studies between 1980-2006 comparing bona fide treatments for children with ADHD, conduct disorder, anxiety, or depression: No difference in outcome between approaches intended to be therapeutic; Miller, S. D., Wampold, B. E, & Varhely, K. (2008). Direct comparisons of treatment Modalities for youth disorders: A Meta-analysis. Psychotherapy Research, 18(1). 5-14 Therapeutic Options Embracing Diversity
  8. 8. Which approach “fits with, engages, and helps” that particular client at this moment in time? Miller, S. (2004) Therapeutic Options Embracing Diversity
  9. 9. “If its not working its not the technique it’s the relationship” “engagement is the number one predictor of outcomes” Miller, S.(2004) Therapeutic Options Embracing Diversity
  10. 10. Therapeutic Options Embracing Diversity
  11. 11. THE ALLIANCE Biggest Predictor of Outcome Therapeutic Options Embracing Diversity
  12. 12. Solution Focused in a Nutshell Therapeutic Options Embracing Diversity
  13. 13. Solution Focused in a Nutshell The client constructs his or her own solution based on his or her own resources and successes De Shazer, 1988, P. 50 Therapeutic Options Embracing Diversity
  14. 14. Solution Focused in a Nutshell First developed at the brief family therapy practice Milwaukee in the United States. Not for profit organisation started in 1978 and in 1982 therapists noticed exceptions to problems in the therapeutic engagement. Centre closed in 2007 rights transferred to the Solution Focused Therapy Association http//www.sfbta.org (2009) Therapeutic Options Embracing Diversity
  15. 15. Solution Focused in a Nutshell Therapeutic Options Embracing Diversity
  16. 16. Outcome Research SFBT may be helpful to clients May be useful in a broad range of applications Research moving in the right direction Efficacy phase More careful study needed Gingerich, J. W., & Eisengart, S. (2000) Therapeutic Options Embracing Diversity
  17. 17. Solution Focused in a Nutshell How will you know that talking to me today will be helpful? When discharged how will you know that being here in hospital has been helpful? How will you know that you're ready for discharge? How will the magistrate know that you are ready to go home? Therapeutic Options Embracing Diversity
  18. 18. Solution Focused in a Nutshell What’s better? What tells you that things are better? What’s different? What are you doing instead? Therapeutic Options Embracing Diversity
  19. 19. Solution Focused in a Nutshell Exception When the problem is less or absent what happens? Getting the detail Therapeutic Options Embracing Diversity
  20. 20. Therapeutic Options Embracing Diversity
  21. 21. Solution Focused in a Nutshell What is the first thing, the smallest thing you will you notice that will tell you that the miracle has happened? What else will be happening? What else will you notice? Therapeutic Options Embracing Diversity
  22. 22. Solution Focused in a Nutshell SCALING 0--------------------------------------------------10 Therapeutic Options Embracing Diversity
  23. 23. THE PROJECT Therapeutic Options Embracing Diversity
  24. 24. TINI SURVEY 1 Prior to the commencement of this practice development activity a pre-project survey was distributed to all 32 nursing staff on the 19th January 2009. A total of 50% returned their survey by the due date 4th February 2009. Therapeutic Options Embracing Diversity
  25. 25. TINI SURVEY 1 Nurses were asked to list 3 things that they knew about SFBT 81% were able to list at least something 56% felt moderately confident in using SFBT in their practice Therapeutic Options Embracing Diversity
  26. 26. TINI SURVEY 1 62% indicated that SFBT should be part of their practice 56% had greater than 5yrs experience Therapeutic Options Embracing Diversity
  27. 27. TINI In-service & Workshop In- Therapeutic Options Embracing Diversity
  28. 28. Therapeutic Options Embracing Diversity
  29. 29. TINI 2 23 surveys were distributed to staff at the conclusion of project with 12 surveys returned 52% 75% of respondents had more knowledge of SFBT than at the start of the project Therapeutic Options Embracing Diversity
  30. 30. TINI 2 66% of respondents had used SFBT in their nursing practice in the last 12 months 90% of respondents indicated that SFBT was helpful in establishing and maintaining a therapeutic relationship with their clients Therapeutic Options Embracing Diversity
  31. 31. TINI 2 91% of respondents would like to see SFBT as an ongoing part of nursing practice 66% of responded that they would like more training in SFBT Therapeutic Options Embracing Diversity
  32. 32. De Shazer, S. (1988) Clues: Investigating solutions in brief therapy. New York; Norton Gingerich, J., W. & Eisengart, (2000). Solution-Focused Brief Therapy: A Review of the Outcome Research. Family Practice 39. (4) 477-498 Godley, S. H. Jones, N., Funk, R., Ives, M Passetti, L. (2004). Comparing Outcomes of Best Practice and Researched-Based Outpatient Treatment Protocols for Adolescents , Journal of Psychoactive Drugs. 36(1), 35-38 Jong, P. & Berg, I (2008) Interviewing for Solutions (3rd ed.). Belmont, CA Thomson. http//www.sfbta.org (2009) Miller, S. D., Wampold, B. E, & Varhely, K. (2008). Direct comparisons of treatment Modalities for youth disorders: A Meta-analysis. Psychotherapy Research, 18(1). 5-14 Duncan, B. I., Miller, S. D., & Sparks, J. A. (2004). The Heroic Client. Wiley San Francisco Therapeutic Options Embracing Diversity
  33. 33. Listening for Solutions Skillfully and patiently weaving a therapeutic conversation Therapeutic Options Embracing Diversity

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