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    Interviewing for solutions 2010.doc Interviewing for solutions 2010.doc Document Transcript

    • Kienhuis, J. (2010) Interviewing for Solutions, Chapter 6, 156-182, in Dollevoet T., Kienhuis, J.,Lieshout, van N., Minenkova, I, Radygina, V., Schrurs, J. (2010) ‘I am an Adult Person - Development and Implementation of Occupational Therapy for Multi Handicapped Youth in Belarus, Matra Program, Publisher NGO Belapdimi, Minsk, Belarus Interviewing for solutions Jos Kienhuis Fontys University of Applied Sciences (Tilburg, the Netherlands) A solution-focused approach validates clients being the ‘experts of their own lives’ and having exclusive ideas about where they want to go and how they want to get there (de Shazer, 1994)IntroductionThe strengths and the joy one will meet when working with the clients who visit the social centers in Minskhas been clearly observed in the passion and motivation of the trainees during the execution of the 2 year OTTrain the Trainer program in Minsk. The passion for their clients and their work is identified in theircommunication, homework, questions, video tapes and collaboration during the workshops using theircognitive and pragmatic intelligence, discussing and exchanging the best fitting solutions for their adults in thesocial centers in a changing society. This chapter will start with the short history, the principles and mainassumptions definition of the solution focused approach (6.1). In paragraph 6.2 we will go into interviewing forsolutions and creating hope. The 8-step dance will be described in paragraph 6.3 and in 6.4 we address the artof questioning. The final paragraphs 6.5 and 6.6 will be about enabling clients to have a voice and aboutswarm intelligence & resilience.6.1 Solution-focused approach: history and definitionThe solution-focused approach derives from solution-focused brief therapy (SFBT) which was developed at theBrief Family Therapy Center in Milwaukee by its co-founders Steve de Shazer, Insoo Kim Berg and colleaguesas a response to the question, “What works in counseling and therapy?” The co-developers of the modelworked in a therapy clinic with a team and other therapists observing clients behind a one-way mirror andusing qualitative, process research methods attempting to discover the most effective and efficient therapytechniques for getting clients to change quickly (De Shazer et al., 1986). Through the years the solution-focused brief therapy approach has become one of the leading schools of brief therapy throughout the worldas well as a major influence in such divergent fields as business, social policy and education. Figure 1: problem talk – solution talk Solution-Focused Brief Therapy can be defined as a short-term goal-focused therapeutic Problem Talk Solution Talk approach which helps clients change by constructing solutions rather than dwelling on • Problem formulating • Goal Formulation problems (Figure 1). Elements of the desired • Analyzing causes • Focus at progress solution are often already present in the • Blaming explanations • Asking for exceptions clients life, and become the basis for ongoing • Defensive attitude • Empowerment change. The ability to articulate what the changes will be like is often more important • Good attitude, temper than understanding what led to the problem. • Bad attitude, temper • No collaboration • Collaboration SFBT is based on the idea that, if our aim is to • No ideas • Many ideas help clients change, we ought to use things related to how change happens rather than concentrating on how problems develop. No progression Progression Understanding the details and cause of the problem is often not necessary to finding a solution. In the western world, we like to look for causes to our problems. We think that it ishelpful to jump into anyones problem box. It is more or less ingrained in our mindset; it is almost like ourInterviewing for Solutions – © 2010 Jos Kienhuis 1
    • lifeblood. It is the way we see things. We feel that if we go into all the possible details of what may havecaused a problem, we will be able to solve it. Often we seem to believe that we cannot begin to build asolution until we fully understand what has gone wrong before. Often by dwelling on the cause of problemswe can perpetuate and exaggerate them. Over-engaging in self-reflection and focusing on problems actuallymakes us feel worse.George, Iveson & Ratner (1999) suggest that we should start a conversation or session with a period ofproblem-free talk. It is often a good beginning, especially if clients are unsure of what they want from thesession at the start. Just a few minutes talk (socializing – an important first step) about something that theyenjoy or a skill that they possess allows them to feel at ease and ready to focus on what they want, or whatdirection is helpful for them. There will be sufficient time to set a baseline account of the problem too, whichwill make it easier to assess progress. By looking for solutions we shift their focus from the past to the future.The important issue here is how clients want things to be different and what it will take to make it happen.Envisioning a clear and detailed picture, of how things will be when things are better, creates hope andexpectation and makes a solution possible. SFBT is future oriented and majors on the establishing andelaboration of clear goals. Goals direct the therapy process and help it remain focused and brief (if we do notknow where we are going, we do not know when we have got there). SFBT also focuses on solution languageand the client strengths and resources to help clients recognize how to use their resources to bring aboutchanges (Kienhuis & Switek, 2007). An inquiring attitude is requested being a professional, listening attentiveand with professional curiosity to the clients ideas, perspectives, and goals.Butter (2008) thinks that professionals ought to possess an open, communicative and reflexive attitude, anattitude of continuous self research and reflection being aware of your conceptual models and to explicit andstructure them in your work also willing to let go of so-called ‘mindsets’. An open attitude toward another andyourself is a characteristic that he embraces. Harinck & Meijer (2007), state that an open unprejudicedattitude is of vital importance. An inquiring attitude goes beyond the individual person himself and includes avariety in professional behavior on instrumental, communicative and normative level (Claasen. a.o., 2009).Harinck and Meijer mention four aspects of an inquiring attitude; curiosity – the discovery that you do notknow something and that you are eager to know it; sensitivity for signals – being alert when things do and donot work out fine and go for insights through reflection asking yourself and clients solution-focused questions;putting question marks at your daily job. A professional reflects on the quality of his behavior, skills andattitude in order to become a better one; good administration and observation are important characteristicsof an inquiring attitude too. Harinck en Meijer (2007) continue to say that an inquiring attitude is an approachthat cannot always be observed instantly. An inquiring attitude focuses on expanding insights in a certain areaof the professional activities. Harinck, Kienhuis and de Wit (2009) did research on the inquiring attitude ofstudents and teacher trainers in Higher Education and mention in this perspective that one has an inquiringattitude when he is open for new things and ready for the unexpected.The solution-focused model thus is a mental health model that offers specific skills and change strategies forenabling and facilitating positive future behaviors. It is future-oriented, goal-directed, and offers a set of well-defined and easy to learn intervention methods that focus on making changes in clients’ perceptions,behaviours and social environment. Underlying these intervention-related aspects there are a number oftenets that characterize and can be related to the effectiveness of the solution-focused approach. Thesetenets serve as guidelines for therapists when co-constructing and communicating with clients. Some mainassumptions are mentioned here.1. If it isn’t broken do not fix it.All kind of theories, therapy, models, philosophies of interventions are irrelevant if an identified problem hasbeen solved already by the client. If there is no problem, there should be no therapy.2. If it works do more of itIf a client is in the process of solving a problem, the primary role of the therapist should be to encourage theclient to do more of what is already working. SFBT therapists do not judge the quality of a client’s solutions,only whether it is effective. As a result of identifying what works well, the client is able to repeat this successand the solution further evolves.3. Clients are seen as competent: there are always exceptions to the problem behaviourThis orientation on strength rather than weakness focuses the therapist on identifying the client’s resources,enabling the person to solve their own problems. Solution-focused therapists elicit from the client personalstrategies and social situations that have helped them avoid the problem in the past. Clients always displayexceptions to their problems, even small ones, and these exceptions can be utilized to make small changes (deShazer, Dolan a.o. (2007)4. The focus is on solutionsInterviewing for Solutions – © 2010 Jos Kienhuis 2
    • Focusing on the solution to the problem and not the problem itself is especially emphasised. By steppingoutside the problem (seeing problems as influences to be overcome) and ‘exception finding’ (identifying timeswhen problems are absent), those involved with the client are able to work together to defeat the problem.5. Clients are experts on their own livesIn addition, solution-focused therapists see the client as the expert on their own problems and lives. Simplyput, solution-focused therapists define the problem as what the client says it is. For this reason, the therapisttakes a ‘not knowing position’. This does not mean that the therapist has no expertise, but rather that he orshe does not know as much about the client and his or her resources as the client does (De Jong & Berg, 2002).6. The language for solution development is different from that needed to describe a problem.The language of problems tends to be very different from that of solutions. (de Shazer, Dolan, a.o. 2007).Problem talk is usually negative and past-history focused in order to describe the origins of a problem, andoften suggests the permanence of the problem. The language of solutions however is usually more positive,hopeful, and future-focused, and suggests the transience of problems. In this perspective we listen to thevoice of Wittgenstein (1962) who stated that the world of the happy is quite another than that of theunhappy. Röhrig (2005) asks us to scale ourselves on a scale from 1 to 10 in terms of ‘How good are you atcriticizing someone in such a way that he or she has accepted your criticism without being hurt or insulted’?When giving constructive criticism a first step to take is to talk about what already is going well. That issolution talk. A solution-focused question during an interview could be: ‘You have probably thought about thissituation and how to change it for the better. Tell me, what do you suggest? What could be a first small step toachieve your goal?7. Clients have the desire to succeedConsistent with an optimistic view of the client, solution-focused therapists do not believe in the concept ofresistance and lack of desire to succeed. In contrary, it is assumed that all clients have the desire to change.When clients say ‘no’ we see this as a healthy response of the client to tell us that we should not push furtherthan the client can bear. From this perspective it is not right to criticize clients on their courage to present aclear opinion (Le Fevere de Ten Hove, 1996). Instead we should draw the conclusion that we did not receivemandate from the client yet and n order to join with a client we have to adapt our therapeutic intervention.The Korzybski Institute in Belgium has developed a flowchart for this matter which gives direction for thetherapist in a scheme of interventions (not a diagnosis), based on four possible levels of client-therapistrelationships: a visitor, a searcher, a buyer and a co-therapist relationship.8. Future orientationA solution-focused approach is future-oriented. There is not much investigation into the past except to inquireabout those times when the client has been able to develop solutions to the undesired behavior. Instead, thesolution-focused therapist helps the client develop and visualise behaviour that is more desirable or adaptive.These assumptions can help to support or reframe our ‘present beliefs’ about co-construction andcommunication with our clients when needed or useful. Constructing a different way of thinking can certainlyhave an impact on our mental model leading us from a more problem-oriented stance towards a moresolution-focused one, making room for increasing empowerment of clients and encouraging them by focusingon possibilities and strengths to create hope. Isebaert (2007), states, that it is the humanity of the therapist(with his characteristics and background) who is able to create hope. From this perspective we draw thequestion: ‘How do we know and how can we observe that our clients are hopeful, or becoming more hopeful?What is it that we see, hear or experience when we are interviewing for solutions, using our (total)communication skills with clients?’6.2. Interviewing for Solutions – creating hopeAn interesting quote about ‘Hope” can be found in the title of the music album ‘Anthem’ of Leonard Cohen:‘There are cracks, cracks in everything. That’s how the light gets in.’It is reframing a situation. In the perspective of interviewing for solutions Taylor and Fiske (2005) quoteCooper, Darmody, and Dolan (2003) who say that working with clients are “hope-friendly” acts. Just enteringinto therapeutic conversation, at any level, seems to us to be a statement of hopefulness—hopefulness that,as Lance Taylor (2005) points out, is already there, available for “tapping into”. The ‘taps’ are questions thathelp clients say:• what they would prefer to be doing more of• what are some examples of this happening already• what do they do to help these things happen• what benefits result from these efforts• what are some next stepsTaylor (2005) continues to say that one thing we look for is simply the client’s response to being heard: thehead nodding as the therapist reflects an understanding of what has been said, the body shifting, perhapsleaning slightly forward—what some would call early signs of rapport or positive relationship. Often theseInterviewing for Solutions – © 2010 Jos Kienhuis 3
    • signs are accompanied or followed by a language shift, from problem description to a statement aboutwanting change, a first “invitation” to solution talk. When clients talk about what gives them hope, they oftenrefer to those moments: you listened, you understood, that gave me hope. The basic skills of reflectivelistening are the heart of helping. Listening mindfully and open to the client’s views, free from mental“chatter”, is an attitude and a daily challenge in working with clients. As stated by Isebaert, (2007) creatinghope, concerns different aspects that reflect the humanity of the therapist. These aspects are appreciation,authenticity, empathy, care and interest that are described more detailed now.1. Appreciation: the therapist appreciates by respecting the client and the members of the client system, hisbeliefs, existential decisions, and the choices made in an active manner.2. Authenticity: the therapist will in collaboration with the client construct a new therapeutic reality and thetherapist will show those emotions that are authentic and helpful for building future perspectives for theclient.3. Empathy: a therapist is also able to use his sensibility and intuition to crawl under the skin of anotherperson and to verbally and non-verbally express with empathy what the client has experienced.4. Care: Care for a patient does not only mean being concerned, it also means loving attention. Care is apedagogical aspect of the therapeutic relationship and the therapist stimulates the self-motivation of theclient.5. Interest: a therapist takes interest in the aspects that are of importance of the client. He will be an activelistener and be asking respectful and curious questions for concrete details. In the next paragraph you willread about the communication of strengths and hope by using the 8-step dance.These five aspects represent an important way of expressing ethical commitment. The occupational therapist’personal moral qualities are of the utmost importance to clients. Many of the personal qualities consideredimportant in the provision of services have an ethical or moral component and are therefore considered asvirtues or good personal qualities. It would be inappropriate to prescribe that all occupational therapistsshould possess these qualities, since it is fundamental that these personal qualities are deeply rooted in theperson concerned and developed out of personal commitment rather than the requirement of an externalauthority. In the BACP (British Association for Counseling and Psychotherapy) we read that personal qualities,to which occupational psychotherapists are strongly encouraged to aspire, include:Empathy: the ability to communicate understanding of another person’s experience from that person’s perspectiveSincerity: a personal commitment to consistency between what is professed and what is done.Integrity: commitment to being moral in dealings with others, personal straightforwardness, honesty and coherence.Resilience: the capacity to work with the client’s concerns without being personally diminished.Respect: showing appropriate esteem to others and their understanding of themselves.Humility: the ability to assess accurately and acknowledge one’s own strengths and weaknesses.Competence: the effective deployment of the skills and knowledge needed to do what is required.Fairness: the consistent application of appropriate criteria to inform decisions and actions.Wisdom: possession of sound judgment that informs practice.Courage: the capacity to act in spite of known fears, risks and uncertainty.Fundamental values of counseling for occupational therapist include a commitment to respecting humanrights and dignity of the client, and ensuring the integrity of the therapist-client relationships which was sowell to be seen on the video tapes made by the trainees in the OT Train the Trainer Program. It is a value toenhance the quality of professional knowledge of personnel for the future and its application and to alleviatepersonal distress and suffering of the client. Values inform principles. They represent an important way ofexpressing a general ethical commitment that becomes more precisely defined and action-orientated whenexpressed as a principle for instance like the principle autonomy. Autonomy means to have respect for theclient’s right to be self-governing. This principle emphasizes the importance of the client’s commitment toparticipate in and relate to activities on a voluntary basis. The principle of autonomy opposes themanipulation of clients against their will, even for beneficial social ends.6.3 The 8-step danceClients and occupational therapists find themselves in a varied panorama of everyday activities and learningsituations, which demands a lot of flexibility. They are constantly challenged to come up with differentsolutions. Adopting the metaphor of Cauffman (2001), we see solution-focused communication as a dancebetween therapist(s) and client(s). Many dancing steps are possible and can be combined. The solution-focused 8-step dance, therefore, is not a rigid dance. This dance allows therapists to do a ‘tango’ or even a‘waltz’ or ‘quick-step’, which is quite different from doing a ‘quick-trick’. Sometimes a therapist uses only oneInterviewing for Solutions – © 2010 Jos Kienhuis 4
    • of the steps in a conversation with a client, other times an occupational therapist might use more steps or usethem all. The most elegant dance is the dance that is most effective for a client. When you want to dance youhave to start one way or another. Carrying out step number one ‘making contact’ is, therefore, the best stepfor an occupational therapist is to start the dance.When we compare the assumptions and contents of solution-focused communication, carried out through the8-step dance with the starting points for enabling clients to have a voice (§ 6.5), we see that there is a greatdeal of consensus. They both are focused on building relationships and assuming an inquiring attitude on thepart of the occupational therapist in order to co-construct solutions for ‘educational issues’ with clients. Theyplace the highest emphasis on respect for clients and their competencies, strengths, and resources to reachjoint goals.This brings us to the question how we enable our clients to have a voice, since doing so involves joining withthe client, which in fact naturally leads us to use a shared language – a solution language (see also figure 1).In chapter 4 about occupational therapy and chapter 5 about video interaction guidance we already have readabout the value of total communication with clients, having an observing eye for clients’ language andgestures, using verbal and non-verbal language to voice them, embracing the tenets and assumptions of thesolution focused approach.Littrell and Peterson (2005) examined how language shapes the way we understand the world. They statedthat language is a way of structuring the world, giving meaning to it. Perhaps for most people language is“invisible”, simply woven into the fabric of our lives and not seen as a separate strand in itself. Because we areso immersed in language, we are not aware of how we use it and how language affects us. A technique thatinvolves consciousness about our use of language is called ‘reframing’. When we are reframing the problemsituation we look at a ‘problem’ from another perspective. Reframing is about changing the meaning we giveto events, not necessarily changing the events themselves. When a client is quite self-centered you couldreframe this in: “Iwan, I see that you are taking good care of yourself, could you be so kind to pass the breadfor me?’. Or, ‘They call you stubborn? Then you must have a strong will?’ We like to add that solution focusedlanguage shapes the world for clients in a ‘strengths based perspective’. The 8-step dance, as described andillustrated in figure 2, appears to be a useful tool for doing so (Kienhuis, 2007).Figure 2: 8-step dance (Cauffman, 2001) 1. Making contact: the engine of change runs by building a strong relationship with clients, parents and scaling professionals 1. making contact Contextualize: every situation finds itself in a specific context Goals: useful goals (the client’s goals) are signs thatfuture contextualize show us the shortest way to solutionsorientation compliments Resources: every client, parent, professional has resources Exceptions: there are exceptions to any problem Compliments: to compliment is a verb – a do word exceptions goalsetting Future orientation: solutions are realistic by using imagination resources Scaling: using the scaling-technique can help to determine differentiationWe will go into the different steps now adding per step solution-focused questions (SF Questions).1. Making contactThe engine of change runs by building a strong relationship with clients, parents and professionals. One couldask for the recipe of creating a powerful relationship with the clients in the social centers. It is our first step!The following hints will get you started (Cauffman, 2006). • It is your job to develop a positive and respectful relationship with your clients and to collaboratively create the right cooperative mindset. • Stay focused on their way of thinking and speaking; adjust to the language of your client. Speak the same language, verbally and nonverbally. • Go slow and go with the flow. Organize room and quality time to build up cooperation in the working relationships at your center • Kiss – principle: keep it smart and simple – do not make things complex neither for your clients nor for your colleagues. Develop the goals with each client in RUMBA – formulated terms.Interviewing for Solutions – © 2010 Jos Kienhuis 5
    • • Stay away of the fantasy of being the savior of your client. “If we can abandon our missionary zeal we have less chance of being eaten by cannibals” as Carl Whitaker (1983) puts it. • Cooperate like a flock of birds. Don’t bump into each other. Stay connected as a group and fly at the same speed. Work together as a TEAM – Together Everybody Achieves More! SF Questions: assume competence and create the futureHi Sasha, what needs to come out of this meeting that will tell you this has been a worthwhile visit for you?What made you decide to come to see me? I hear you say that you do not agree with the situation? So youmust know what you prefer instead? How will you know Elena that at the end of the day this workshop hasbeen useful for you? What will be different for you in your work? What will your clients notice?Contextualize: every situation finds itself in a specific contextEverything that we encounter in life or at work, we encounter in a specific context. Questions about thecontext show the client that you are more interested in him as a person than in his issues or problems. Yourclient is assured by your approach that his voice will be heard with the highest respect and appreciation.Asking context questions will result to discover collaboratively the pieces of information that will lead theclient in the direction of a solution. Like: ‘I hear you had a wonderful evening at home. Could you tell mesomething more about it?’ SF Questions: contextualizeWhen you are happier, what are you doing then? At what times you are happier? When you are happier, whatwill Valentina or Lena notice? In which situations are you less happy? With whom are you happy, in whatplace? How did you manage to finish your work on Wednesday?Goals: useful goals (the client’s goals) are signs that show us the shortest way to solutionsWithout a goal of your client you cannot score. Useful goals are fun to carry out. They are realistic, concreteand achievable and preferably from small goals – small steps - to big ones. Take one step at the time. Usefulgoals are the goals where the client is motivated for. Unclear goals will make you feel dissatisfied. You willsoon become insecure, since you will not notice any progress. In table 1 you see an adapted interview modelthat can be used as a guideline for a solution-focused motivation interview. The model derives from Furman.He used it during a Conference presentation at Fontys University in 2007. Goals can help you in your workperhaps alongside the use of scales, to help you and your client to identify progress, and to notice when youhave reached!Table 1: Solution-focused motivation interview about having a job What do you think are benefits for yourself of having a job? What else could be a benefit? What may be the benefits for others? What else could be a benefit? Where would you say you are now on realizing a 1 2 3 4 5 6 7 8 9 10 job on the scale from 1 to 10? |-----------------------------------------------------------------------| ______________☺ What have you already done to get that far? What else have you done? Who has helped you? In what way? Who else have helped you to get this far already? How will you know that you have moved up one 1 2 3 4 5 6 7 8 9 10 little step on the scale? |-----------------------------------------------------------------------| ______________☺ How will you know that you have moved up two 1 2 3 4 5 6 7 8 9 10 steps on the scale? |-----------------------------------------------------------------------| ______________☺ To whom will you report about your progress? How will you do this? Who do you acknowledge when you have reached your goal, finding a job? For what part? Who else? How will you celebrate Inna, when finding a job?Interviewing for Solutions – © 2010 Jos Kienhuis 6
    • Goals in solution-focused therapy, based partly on De Shazer (1991) will usually have different qualities. Goalsat the first place should be important to the client, and seen by them as involving their hard work. Goalsshould be small rather than large and be described in specific, concrete, behavioral terms who will be doingwhat, where, when, how. They should be described as the start of something and not as the end of something:what the first steps will be, not the end point. The description of a goal should be framed in positive terms andinclude the presence of new behaviors rather than the absence or cessation of existing behaviors. Goalsshould be clear about what the client will do. Since it is not helpful to describe what a client will not do!Therefore we have to construct goals in achievable steps within the practical constraints of clients lives. Goalsare therefore interactional - who is going to notice your changes and how? What will the changes mean toyour friends or colleagues at the job, your family? Establishing realistic and concrete goals is not an easy task,yet experience shows that the more we can help a client clarify his or her problem-free future the more likelyit is to happen.Solutions can often be different to goals. They often show up as original and unexpected ideas and actionsfrom your client or from others around them. Clarity about goals and purpose can help you and clients a greatdeal and you need to have your ears wide open for the unique, new things they will bring to your meetings.Resources: every client, parent, professional has resourcesThe solution-focused approach assumes that every human system, individually or as a team, has resources atits disposal at all times, even in times of trouble. Most of the times clients or teams have momentarily lostconfidence in their own solution-focused possibilities. Cauffman (2006) says in this perspective, that clientshave (temporarily) lost their personal manual on how to use their resources. Therefore it is our job as anoccupational therapist to help (re) discover these ‘forgotten’ resources and/or to give clients new tools forbuilding fitting solutions. The essence of resource orientation with your clients is that you turn your attentionand the attention of the staff to everything that goes well in spite of the problems you are facing. The focus ison what still works and on the resources that are available. It is in fact stepping out of the viscious circle of acounterproductive problem stance. Instead you boost your possibilities for finding fitting solutions. Sharry,Madden & Darmody (2001) advise us to become solution detectives, making us aware of the possibilities. Thismeans that we intent to discover the solution and credit the client with his achievement. SF Questions: goalsWhat is your dream Tatiyana? What is it that you are motivated for? What would you like to achieve thismorning? Suppose you can do three wishes, what is it that you wish for? What would be a good result for you?When are you feeling at your best? How does that look like? What do you want instead of your problem? Howwill you mother know that things are going better? How do you know that this problem can be solved? Whatwill be the first sign that things are going better? Tell me Yuliya, what is going to be your next step? What canwe do today to make our meeting useful? What needs to happen today that tells us that we did a good job?Exceptions: there are exceptions to any problemNo single problem is present all the time and with the same intensity. Each exception contains the beginningof a solution. There are always exceptions to the problem. Exceptions can be identified in moments and undercircumstances when the problem occurs to a lesser degree or even not at all. No client is bad tempered,depressed, hyper at the same degree during a day. In these exceptions we are able to find and to address thepartial solutions. Exceptions can be identified by asking ‘who, how, what, when and where’ questions. Stevede Shazer has said on many occasions that why-questions should be avoided since it leads to speculative andgeneral answers that do not usually clarify goals or behavior. How come is a good alternative, since it is morelikely to lead to a behavioral description (Macdonald, 2007). It may be helpful for all of us to daily wipe ourlooking glasses to have clear sight and notice resources in order to voice our clients. In developing a healthyresource appetite, you will create a productive atmosphere which is a motivator for success. SF Questions: exceptionsWhen does your problem happen less? How do you manage to cope with fear when you have to go to thedentist? Can you make this happen again at home too? In what other situations do you feel proud? At whattimes the problem is less present? Do I hear you well Veronika, you feel good when you go shopping? Can youtell me more about that? What days at the center do work out fine for you? How do you manage to be in timeon Tuesdays?Compliments: to compliment is a verb – a do word – and should be used dailyCompliments must be appropriate to the situation and based on reality. They must be genuine, authentic andsincere. You should not exaggerate your compliments. Complimenting is much more that just trying to befriendly. It is an attitude in order to join with your clients and to develop a working relationship and istherefore strongly connected with the first step ‘making contact’ or socializing. Complimenting tells your clientInterviewing for Solutions – © 2010 Jos Kienhuis 7
    • that you observed that they are on the right track and that they show useful behavior. Sharing your authenticappreciation helps your client to do more of what works. The efficiency of complimenting is not dependent onculture it is dependent on how your compliment is. SF Questions: complimentsWow Danuta! How did you manage to do that? How did you know doing that was important? Where did youget that idea from? Unbelievable Yuri, how did you know how to get there?Future orientation: solutions are realistic by using imaginationThe past is a limitation. Nor our clients neither we can change it. It would be a waste of time and energy to tryto do so. The problems of us and our clients also belong to the past. Solutions though belong to the future. Forinstance when you have a problem at this moment, we can conclude that your solution for it by definitionbelongs to the future. If you had a solution for this problem it would not be a problem anymore.By looking to the future, we ask our clients to bring the desired future into the realm of today. Envisioning is astrategy to move people into a desired future state. It allows individuals to shift their thinking into the future,releasing them from their current state. To make this possible we ask our clients future oriented questions. SF Questions: future orientationSuppose you could change your life by one snap of your finger? How would your life look like Nataliya?Suppose your Belarusian was fluently Maria, how would that make a difference to you?The miracle question is a special future-oriented question and goes something like this. Suppose you woke uptomorrow morning and a miracle has occurred while you were sleeping and the problems had disappearedand the solution was present. How would you know that the solution was present Elena? What would bedifferent? How would you feel? What would you notice first? How would other people know? If I asked youOlga to make a video about your life, what would be your main strengths and what other topics need to bepresented?Scaling: using the scaling-technique can help to determine differentiationThe solution focused approach is about constructing possibilities. At one end of the scale we are looking formiracles, at the other end we are looking for mere possibilities.There are different types of scales to identifydifferentiation and progress and we can use scales in different creative ways like using smiley’s, ladders,drawings, etc. In fact you can scale everything. You can scale for feelings, progress, motivation, success,collaboration, presentation, usefulness, etc. Scaling helps us to stay away from the tendency to think and talkin black and white terms. How often do we hear ourselves and hear our clients use phrases like ‘it is alwayslike that!’ or ‘he never is on time!’ In this context the next question may be useful. Where are you now? When or 1 is ‘no motivation at all’ and ☺ or 10 stands for, ‘very motivated to go to work’. We suggest to talk andto think in differentiation about the situations and the problems we meet in life. Although we all have ourshare of problems, we know that in a way we share and we collect happy and sunny times too. Thisdifferentiated modus - this mindset - allows us to have more freedom in thinking and acting which will alsoinfluence the way we speak and use words. We can choose to speak in differentiated shades of gray (or moreaccurately in colour) or in black and white tones. The latter often leads to frustration, since things simplyaren’t black and white. SF Questions: scalingWhen 1 is ‘I cannot live independently’ and 10 is ‘I live in my apartment’ where are you now on the scale ofindependence? Tell me Svetlana, what makes you smile already on this scale? How are you managing to stayon track on the scale? How come you did not slide backwards? What will be your next step on the scale?6.4 The art of questioningThe solution focused approach very well permits the discussion of problems. In fact, in solution focusedinterviewing, therapists will create space for ‘honoring’ the problem or the issue, which is vital for the therapyif clients are to feel that the therapist understands their predicament and is interesting in helping. Talkingabout what clients want to be different will almost always be talking about the problems since clients will bedescribing or pointing out the difference between the problem and what they want. Solution focusedtherapists will devote their energy to eliciting a rich description of the clients’ solution, rather than to producea very detailed description of the problem (de Shazer, a.o. 2006). They give two reasons for this.At first when clients develop a detailed description of a solution, it is very likely that they will find avenues tomake their goal come true. When clients are voiced and encouraged to develop their own path, themotivation to walk it is built.Secondly problem descriptions often become routinized. They live their own lives, not being helpful and notfocusing on the exceptions and use of the resources of the client during a certain period of time. For instancethe label ‘depression’ can become an all-encompassing description leading one to attend primarily to evidencethat one is depressed. De Shazer and others (2006) state:Interviewing for Solutions – © 2010 Jos Kienhuis 8
    • ‘Periods of tiredness, moments of discouragements, relationships faux pas, nettling irritation at small slights, etc., are granted foreground status while hopeful thoughts about the future, small accomplishments, satisfying interactions, and moments of contentment are either ignored completely or dismissed as naïve or untrustworthy because they do not corroborate the description of depression’ (p. 154).Helping the client to develop a solution description (see table 2) will provide a positive and different linguisticstructure. Former experiences are seen as trustworthy, are embraced as evidence and are seen as thedevelopment of a solution by a client coming to pass.Table 2: Asking questionsProblem-focused thinking results in asking Solution-focused thinking results in askingproblem-focused questions solution-focused questions• When did your problem arise? • When does your problem happen less?• What went wrong? • How did you succeed to make it smaller?• How come you do not cope? • How come you are already on a 4 on the scale?• Other people must be very embarrassed? • What would be a good result for you?• What more problems do you have? • What will your friend say when she is satisfied?• Why did you not say anything? • What will be your first step to do so?• How did your problem get bigger for you? • How do you manage to stay on track? "The easiest success measurement tool is a simple question. What did you do today to move forward? The easiest project plan on earth is also a simple question. What will you do tomorrow to move forward? At the end of each day, document your success and design your next move." Rich DiGirolamoA solution focused therapist takes a not-knowing stance, using his sincere curiosity and respectful languagewithout labeling or defining a client. This not knowing stance, which we regard as inevitable, and even think ofas a basic attitude and a skill, includes all kinds of supposed knowledge or foreknowledge, e.g. gender (male,female), age, diagnosed problem, cultural minority. Rademakers (2004) states, that every client is a minority ofone. He explains that every client has his own unique history, his own unique experience, and his own uniquefuture. The mentioned not-knowing stance affects the way we ask questions. In this process we are experts insolution-focused interviewing to help the client find his own solutions by means of his unique history andresources. We believe that it is the expertise of the client to find fitting solutions. Therefore we communicatethe message to clients that they know best how to solve a problem situation. We think that he is the expert ofhis own life. Each client needs room to be able to present his problem. So it is our job to take time to listenand to voice our client and ask questions that lead to solutions. We do so in order to not only constructunderstanding but also to have a conversation that allows the client to decide what he wants to change in hislife. In the next paragraph we will go into the meaning of ‘voicing the client’.6.5 Voicing the ClientsHadfield and Haw (2001) state that the links between the rights of young people, their treatment by societyand ‘voice’ has been of interest to those who work with and represent young people for some time. The ideaof ‘voice’ relates with terms such as ‘working from the bottom-up’, ‘partnership’, and ‘participation’, in orderto describe different forms of collaboration between young people and professionals. ‘Voice’ is now used in awide variety of projects and policies. Hadfield and Haw continue that the ‘voice’ of young people is beingincreasingly sought as part of the general move towards social inclusion. It has become an established elementof central and local government rhetoric, but as it gains in popular usage it becomes increasingly open toquestion and criticism. This is particularly so, over the issue of whether the focus of this work should be onsupporting young people articulate their voice or directed at getting professionals to listen and respond.Inevitably, at the heart of this debate are the ones relating to issues of power and how power intersects with,and emerges through, positions of, for example, age, social class, ethnicity and gender.Occupational therapists and clients are a team. They work together in finding mutual understanding about‘the job that has to been done’. Occupational therapists and clients communicate where they want to go -what goals they want to achieve and how they can live up to their dreams. It is about enabling clients to havea voice so we can learn from them. Video interaction guidance can be a very useful instrument to do so andInterviewing for Solutions – © 2010 Jos Kienhuis 9
    • has been used during the project. Teachers, nurses, and occupational therapists too would need to know howto frame, guide, and revise tasks, and to pose and reformulate questions, so as to learn more about clients’ideas and understandings. Ball and Cohen did research on the voice of pupils (1999) and came to theconclusion that learning is not only produced in response to what arises, but also includes a kind of predictive,imaginative anticipation. We could say that occupational therapists need to learn in and from practice ratherthan in preparing to practice, knowing what to do and how to do it.There is another point of view that is grounded in the idea of emancipation through empowerment. It is aboutthe equality between the positions of clients and therapists when they respectfully dialogue during thecooperative activities where one person does not act on another, but rather people work with each other. In‘Pedagogy of Hope, reliving pedagogy of the oppressed’, (Freire, 2005) we read his statement that he couldnot ‘give’ participants a voice but rather that his work ‘provides’ participants with right to a voice. ‘No one lives democracy fully, nor do they help it to grow, if, first of all they are interrupted in their right to speak, to have a voice, to say their critical discourse, or, second, if they are not engaged, in one form or another, in the fight to defend this right, which, after all, is also the right to act.’ (p. 116).The Ladder of Participation from Hart (1992) is a model for thinking about youth participation. The bottomthree rungs (1–3) describe youth involvement that is not true participation whereas the top five rungs (4–8)describe true participation. True participation runs from rung 8 - youth-initiated, shared decisions with adults -towards rung 4 - assigned and informed by adults about the specific role of youngsters and how they are beinginvolved. Not true participation runs from rung 3 tokenism, to decoration rung 2, and to manipulation rung 1.Tokenism is where young people appear to be given a voice, but in fact have little or no choice aboutparticipation. Decoration is where young people are used to help or "bolster" a cause in a relatively indirectway, although adults do not pretend that the cause is inspired by youth. Manipulation is where adults useyouth to support causes and pretend that the causes are inspired by youth.Essentially, the debate is which of these levels of participation is actually the most meaningful? Many believethat shared decision making is most beneficial to both young people and adults. Others believe that youngpeople are most empowered when they are making decisions without the influence of adults. Most often, thisdoesnt exclude adults but reduces their role to that of support. Both arguments have merit; ultimately, it is upto each group to determine which form of decision-making best fits with the groups needs in the socialcenters for our target group.People with mental ill health or disability meet fear and prejudice from others, often based on misconceptionsabout mental ill health. Stigma increases personal suffering and social exclusion and can impede access tohousing and employment. It may even prevent people from seeking help for fear of being labeled. Largemental hospitals can easily contribute to stigma. Within reforms of psychiatric services, many countries aremoving away from the provision of mental health services through large psychiatric institutions towardscommunity based services. This goes hand in hand with instructing patients (clients) and their families as wellas the staff in active participation and empowerment strategies. The development of policy for mentallyhandicapped people throughout the years has been scheduled in a matched scheme – table 3.Table 3: development of policy towards counseling and structure of mentally handicapped people Person Counseling Structure Policy patient care, treatment Institutes Segregation human being with development, training special services normalization resources civilian giving support normal services Integration full citizen voicing the client supported living InclusionBecause of these changing concepts, care and services to people with a handicap has moved into the directionof providing support in an inclusive society. Support is addressed to the person with a handicap, as well as tohis direct environment. We are aware of the fact that there are still different forms of social exclusion likesubtle stigmatization, discrimination, self-stigmatization and territorial exclusion. These different forms ofexclusion do exist in varieties. The central issue here is that a handicapped person should be able to grow up,fulfill his life within his community and within his natural environment. In this way he is connected andincluded, and part of society. Steman and van Gennep (1997) state that a handicapped person should beenabled to have the same possibilities and support making use of services and facilities like other civilians do.Interviewing for Solutions – © 2010 Jos Kienhuis 10
    • 6.6. Swarm intelligence and resilienceSwarm intelligence (Kennedy, 2001) learns that ‘no bird ever flew on one wing’. Flocks of birds move togetheracross the sky, turning and swooping in unison, forming complex patterns. It looks like the movements areorchestrated, as if they are following one leader flying up front. Three simple rules keep birds flying togetheras a flock; • Fly in the same direction as the bird in front • Fly at the same speed as your neighbors do • Try not to bump into each otherThis phenomenon has been called distributed control. Shared values and shared goals engender these kinds ofsimple rules within an organization. A group of people who have a set of values and goals that are understoodand shared strongly simply don’t need much orchestration. Such a group easily will be able to create flow. Tocreate flow working with our clients, you have to assess collective visions and goals. Therefore we askourselves at the job: ‘Can you please talk to me about the goals and visions that we all share here at thisservice?’ This question is also true for the many professionals within the Matra project ‘I am an adult person’.The human flock capacity focuses on resourceful and client centered relationships built between occupationaltherapist and clients within the social centers. They collaboratively want to find out how to fly in the samedirection, changing from lead position. Occupational therapists do so in order to meet the unique strengthsand resources of clients and put this to work on the challenges they face, flying at the same speed.Occupational therapists use solution-focused interviewing being a highly respectful approach that acts toempower clients to rediscover their unique strengths. They try not to bump into each other or into clients,parents and care takers. A solution-focused approach embraces professional mentality, a mentality that isstrongly connected with our mindset, the daily polishing of our core principles and values that we live; beingequipped for our task to guide and stimulate young adults in society and in their development. It means thatone needs to have a heart in it; being engaged in collective intelligence and ambition.The swift and chivalrous House Martins are true examples of sensitive and goal-oriented communicators andthey do so without having collisions - taking care of each other during the flight when they cross thedangerous Sahara. They fly in high atmospheres to avoid dessert sand storms using focused eyes and ironholding crystals, (magnetite) that like a compass needle detects the correct fields of force to register the rightdestiny. They loose tons of weight; from 23 to 15 grams and during this trip they have internationalengagements. After their resort period they will start the retour flight collaboratively and face the challengesof this trip. They finally are engaged again in their habitat – a glorious heaven of hope that is filled with at least150.000 insects per brood.The resilience of birds, that seem to be very vulnerable at first sight, proves that we can be very successfulwhen we are collaborative group members, trained to do so, well equipped, sticking together, having the driveand attitude to reach our destiny. The power of faith in the strengths ‘of all birds that cross deserts, swampsor travel seas’, can be a helpful metaphor for all professionals in the field of education and health care.Believing in a strength-based approach means that ‘all birds carry solutions on their wings’. We experienceoccupational therapists being resilient professionals that work at the state social centers in Belarus. Everydaythey manage to plan flights and construct nests with their clients, parents, caretakers and colleagues. Duringthe project we became very much aware of the expression: If you are not part of the solution then you arepart of the problem. The increasing focus on solutions and on the future inspired us all and lifted us up. Duringthe project - and in many different ways - we managed to support each other during our flights. We wentthrough different stages of being wonderful-feathered birds and became better professionals on the job.ReferencesBall, D. L., & Cohen, D. K. (1999) Developing Practice, Developing Practitioners: Towards a Practice-Based Theory of Professional Development In; L. Darling-Hammond & G. Sykes (Eds.), Teaching as the Learning Profession. San Francisco: Jossey-Bass.Butter, R. (2008) Dancing with structure, Research in Ecological Pedagogic; Magazine for Special Pedagogics, 12, 531-532Cauffman, L. (2006): The Solution Tango: Seven steps to solutions in management. London: Cyan & Marshal Cavendish LtdCooper, S., Darmody, M., & Dolan, Y. (2003) Impressions of hope and its influence: An international e-mail trialogue, Journal of Systemic Therapies, 22(3), 67-78Claasen, W., Bruïne, E. de, Schuman, H., Siemons, H., Velthooven, B. (2009) Inclusive competent – generic profile of competences of inclusive education. LEOZ project 4: a Nationwide Project Expertise Center Education & Care, Antwerpen/Apeldoorn, Garant PublishersFreire, P. (1995). Pedagogy of Hope: Reliving Pedagogy of the Oppressed. New York: Continuum ndGeorge, E., Iveson, C., Ratner, H. (1999) Problem to Solution (2 edition) London: Brief Therapy PressHadfield, M., & Haw, K. (2001) ‘Voice’, Young People and Action Research Educational Action Research, 9(3)Interviewing for Solutions – © 2010 Jos Kienhuis 11
    • Haley J. (1985) Conversations with Milton H. Erickson, Rockville, MD Triangle PressHarinck, F., & Meijer, M.J. (2007) Practitioner Research in Higher Education F. Harinck (red), Developments of a postgraduate program special education/master SEN (pp. 9-32). Antwerpen/Apeldoorn, GarantHarinck, F., Kienhuis, J., de Wit, T. (2009) The inquiring attitude in bachelor- en master education in Higher Education LEOZ project 6, a Nationwide Project Expertise Center Education & Care, Antwerpen/Apeldoorn, Garant Publishers.Hart, R. (1992). Ladder of young people’s participation In R.Hart (Ed.), Children’s Participation from Tokenism to Citizenship (Vol. Innocenti Essays, no. 4). Florence: UNICEF.Isebaert, L. (2007). Book for Practice; Solution-focused Cognitive Therapy Utrecht: De TijdstroomJong, P. de, & Berg, I. (2008) Interviewing for solutions (3rd Ed.) Pacific Grove, CA: Thomson Brooks/ColeKennedy, J. & Eberhart, R.C. (2001) Swarm intelligence. San Diego: Academic Press.Kienhuis, J. (2007) Solution-focused approach: fundament for dialogue and participation. Enabling pupils to have a voice – chapter 4; in J. v. Swet, H. v. Huijgevoort, F. Cornelissen, J. Kienhuis, K. Smeets en K. Vloet (Eds.). Building towards postgraduate programs as a platform: Interactive professionalism and interactive knowledge development (pp. 11-23). Practice & Research - Fontys OSO nr 1, Antwerpen/Apeldoorn, GarantKienhuis, J. en Świtek, T. (2007) The client as an expert, Solution-Focused Approach and Practice in Poland. Kraków, Institute of Sociology, Jagiellonian University & Fontys University of Applied Sciences, TilburgLe Fevere de Ten Hove M. (1996) Le pays ou la résistance n’existe (presque) plus Therapie Familiales Genève Vol 17 nr. 2 (p. 351-357)Littrell, J. & Peterson, J. (2005) Portrait and Model of a School Counselor Boston/New York: Lahaska Press.McDonagh, C., & Sullivan, B. (2003) Enabling the Voices of the Marginalized to be Heard; paper presented at the CARN Conference, Manchester.Macdonald, A.J. (2007) Solution-focused therapy: theory, research, & practice. London: Sage.Neill, John R. and Kniskern, David P. (Eds.) From psyche to system, the evolving therapy of Carl Whitaker.Rademakers, P. (2004) How to ask solution-focused questions? SFA project Kraków, PolandRöhrig, P. (2005) Solution-focused feedback in management development. McKergow, M. and Clarke, J. (Eds.) Positive Approaches to Change: Applications of Solutions Focus and Appreciative Enquiry at Work. SolutionsBooks: Cheltenham, UK. Page 131-140.Shazer, S. de, Berg, I.K., Lipchik, E., Nunnaly, E. , Molnar, A., Gingerich, W. & Weiner-Davis, M. (1986) Brief therapy: Focused solution development, Family Process, 25, pp. 207-221Shazer, S. de (1991) Putting Difference to Work, New York/London Norton & CoShazer, S. de (1994) Words were Originally Magic, New York/London Norton & CoShazer, S. de & Dolan, Y., Korman, H., McCollum, E., Trepper, T., & Berg, I.K. (2006) More than miracles: The state of the art in solution-focused brief therapy, New York: HaworthSteman, C., Gennep, van A., Supported Living. A guide for counselors NIZW, Foundation of Care for The Handicapped The NetherlandsTaylor, L. (2004) A thumb nail map for solution-focused brief therapy. Brief Therapy Network Newsmagazine, 3(2), 1-9Taylor, L. and Fiske, H. (2005) Tapping into Hope Brief Therapy Network Annual Conference 2005: Catching the Winds of Change ndWittgenstein, Ludwig (1962/1997) Philosophical Investigations, 2 edition, trans. G.E.M. Anscombe, New York: Blackwell, 1997Interviewing for Solutions – © 2010 Jos Kienhuis 12