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Mastering the Art
of Solution-Focused Counseling
Jeffrey T. Guterman, Ph.D.
Copyright © 2016 Jeffrey T. Guterman
Session Objectives
1. Participants will learn the main principles of solution-focused
counseling.
2. Participants will learn the theory of problems and change in
solution-focused counseling.
3. Participants will learn the clinical stages in solution-focused
counseling.
4. Participants will learn solution-focused counseling techniques.
5. Participants will learn clinical applications of solution-focused
counseling.
Principles of
Solution-Focused Counseling
• Solution-focus
• Collaborative approach
• Small changes can lead to big results
• Emphasis on process
• Strategic eclecticism
• Brief by design, but not always
• Responsive to diversity
• Committed to outcome
Theory of Problems in
Solution-Focused Counseling
• Problem/Exception
• Exception refers to times when the problem is
not happening.
• Depressed/Not Depressed
Theory of Change for
Solution-Focused Counseling
Problem / Exception
Common Change Factors
• Client factors (self-help): 40%
• Client-counselor relationship factors: 30%
• Expectancy factors: 15%
• Model factors: 15%
Using client feedback to
improve treatment outcome
in solution-focused
counseling
Stages of Solution-Focused Counseling
• Coconstructing problems and goals
• Identifying and amplifying exceptions
• Coconstructing tasks
• Evaluating the effectiveness of tasks
• Reevaluating problems and goals
Coconstructing Problems and Goals
• Coconstruct solvable problems (e.g., ineffective coping skills
for depression, rather than merely ‘depression’)
• Develop goals in positive language (an increase in something),
rather than negative language (a decrease in something)
• Encourage clients to provide video description of the problem
• Coconstruct a problem and a goal that fits with the client's
worldview
S.M.A.R.T. Goals
• Specific
– Small
– Incremental
• Measurable
• Attainable
• Relevant
• Time-based
Mapping the Influences of the Problem
• Identifying potential exceptions
• Externalizing the problem
Identifying and Amplifying Exceptions
• Presuppositional questions
• Identifying small exceptions
• Identifying potential exceptions
– The miracle question
• Questions for amplifying exceptions
Excerpt from Session
Counselor: You mom says you hit everyone that
bothers you. Would you say that’s true?
Eric: Yes. (Pause) Ain’t scared of nobody.
Counselor: Your mom also says you don’t know any
other way to solve problems. Is she right about
that?
Eric: I don’t need any other ways.
Excerpt from Session
Counselor: Eric, help me understand something. You
seem like this session is bothering you a lot. I mean, like
I’m bothering you.
Eric: Damn right.
Counselor: So why haven’t you hit me yet?
Eric: What?
Counselor: Yeah, I’m serious.
Excerpt from Session
Eric: Shit, I don’t know. After a day like today, I
don’t need any more trouble.
Counselor: So, maybe you are able to solve
problems a different way? It sounds like your
mom might be wrong about you, Eric. What else
do you think people get wrong about you?
Miracle Questions
Suppose that one night there is a miracle
and while you are sleeping the problem
was solved.
How would you know?
What would be different?
Excerpt from Session
Counselor: Where would you rate your depression?
Vanessa: Nine. Easy. What a waste, we’ve been
doing this for four months, and I’m still no better.
Counselor: Are you sure about that? You had to go
to the hospital twice in the first two months of
counseling. Now, however, you’re facing a bunch of
challenges in math and science, so there’s extra
pressure.
Excerpt from Session
Vanessa: Right. So things have gotten even worse!
Counselor: Yes, they have gotten harder. But in spite
of all of this, you’ve managed to avoid Hospital
Time. How have you stopped the ball from rolling
up to Hospital Time? You certainly might not have
done that in the beginning.
Vanessa: I don’t know.
Excerpt from Session
Counselor: Think about it. Take your time.
Vanessa: I guess I’m not as afraid of life as I used
to be.
Counselor: Tell me more about that.
References and Suggested Readings
Berg, I.K., & Miller, S.D. (1992). Working with the problem drinker: A solution-focused approach. New York: Norton.
de Castro, S., & Guterman, J.T. (2008). Solution-focused therapy for families coping with suicide. Journal of Marital and Family
Therapy, 34, 93-106.
de Shazer, S. (1982). Patterns of brief family therapy. New York: Norton.
de Shazer, S. (1984). The death of resistance. Family Process, 23, 11-17.
de Shazer, S. (1985). Keys to solution in brief therapy. New York: Norton.
de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: Norton.
de Shazer, S. (1991). Putting difference to work. New York: Norton.
de Shazer, S. (1994). Words were originally magic. New York: Norton.
de Shazer, S. (1997). Commentary: Radical acceptance. Families, Systems, & Health, 15, 375-378.
de Shazer, S., Berg, I. K., Lipchik, E., Nunnally, E., Molnar E., Gingerich, K., & Weiner-Davis, M. (1986). Brief therapy: Focused
solution development. Family Process, 25, 207-222.
Duncan, B. (2014). On becoming a better therapist: Evidence based practice one client at a time. (2nd edition). Washington DC:
American Psychological Association
Duncan, B.L., Miller, S., Huggins, A., & Sparks, J. (2003a). Young child outcome rating scale. Chicago: Author.
Duncan, B.L., Miller, S., Huggins, A., & Sparks, J. (2003b). Young child session rating scale. Chicago: Author.
Duncan. B.L., Miller, S.D., & Sparks, J. (2003). Child outcome rating scale. Chicago: Author.
Duncan. B.L., Miller, S.D., & Sparks, J.A. (2004). The heroic client: A revolutionary way to improve effectiveness through client-
directed, outcome-informed therapy. San Francisco: Jossey-Bass.
Duncan, B.L., Miller, S.D., Sparks, J.A., & Johnson, L.D. (2003). Child session rating scale. Fort Lauderdale, FL: Author.
Franklin, C., Trepper, T.S., McCollum, E.E., & Gingerich, W.J. (2011). Solution-focused brief therapy: A handbook of evidence-based
practice. New York: Oxford University Press.
Gergen, K.J. (2009). An invitation to social construction (2nd ed.). Thousand Oaks, CA: Sage.
Guterman, J. T. (1994). A social constructionist position for mental health counseling. Journal of Mental Health Counseling, 16,
226-244.
References and Suggested Readings
(continued)
Guterman, J.T. (1996). Doing mental health counseling: A social constructionist re-vision. Journal of Mental Health Counseling, 18,
228-252.
Guterman, J.T. (1998). Identifying pretreatment change before the first session. Journal of Mental Health Counseling, 20, 370-374.
Guterman, J.T. (2013). Mastering the art of solution-focused counseling (2nd edition) Alexandria, VA: American Counseling
Association.
Guterman, J.T., & Leite, N. (2006). Solution-focused counseling for clients with religious and spiritual concerns. Counseling and
Values, 51, 39-52.
Guterman, J.T., Mecias, A., Ainbinder, D.L. (2005). Solution-focused treatment of migraine headache. The Family Journal:
Counseling and Therapy for Couples and Families, 13, 195-198.
Held, B.S., (1992). The problem of strategy within the systemic therapies. Journal of Marital and Family Therapy, 18, 25-35.
Johnson, L.D., Miller, S.D., & Duncan, B.L. (2000). Session rating scale 3.0. Chicago: Author.
Lambert, M.J. (1992). Implications of outcome research for psychotherapy. In J.C. Norcross M.R. Goldfried (Eds.), Handbook of
psychotherapy integration (pp. 94-129). New York: Basic Books.
Lambert, M.J., Whipple, J., Smart, D., Vermeersch, D., Nielsen, S., & Hawkins, E. (2001). The effects of providing therapists with
feedback on patient progress during psychotherapy: Are outcomes enhanced? Psychotherapy Research, 11, 49-46.
Lipchik, E. (2002). Beyond technique in solution-focused therapy: Working with emotions and the therapeutic relationship. New
York: Guilford.
Martin, C.V., Guterman, J. T., & & Shatz, K. (2012). Solution-focused counseling for eating disorders. VISTAS, 1-11.
Miller, S., & Duncan. B.L. (2000). Outcome rating scale. Chicago: Author.
Molnar A., & de Shazer, S. (1987). Solution-focused therapy: Toward the identification of therapeutic tasks. Journal of Marital and
Family Therapy, 13, 349-358.
Murphy, J.J. (2008). Solution-focused counseling in middle and high schools (2nd ed.) Alexandria, VA: American Counseling
Association.
O'Hanlon, B., & Rowan, T. (2003). Solution oriented therapy for chronic and severe mental illness. New York: Norton.
O'Hanlon, W. H., & Weiner-Davis, M. (1989). In search of solutions: A new direction in psychotherapy. New York: Norton.
White. M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.
Suggested Internet Resources
Jeffrey T. Guterman, Ph.D.
Homepage: http://JeffreyGuterman.com
Twitter: http://twitter.com/JeffreyGuterman
Facebook: http://facebook.com/jeffreygutermanpage
International Center for Clinical Excellence (ICCE)
http://www.centerforclinicalexcellence.com
Scott D. Miller, Ph.D.
http://www.scottdmiller.com
Institute for Solution-Focused Therapy
http://www.solutionfocused.net
Solution-Focused Brief Therapy Association (SFBTA)
http://www.sfbta.org

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Mastering the Art of Solution-Focused Counseling: PowerPoint

  • 1. Mastering the Art of Solution-Focused Counseling Jeffrey T. Guterman, Ph.D. Copyright © 2016 Jeffrey T. Guterman
  • 2. Session Objectives 1. Participants will learn the main principles of solution-focused counseling. 2. Participants will learn the theory of problems and change in solution-focused counseling. 3. Participants will learn the clinical stages in solution-focused counseling. 4. Participants will learn solution-focused counseling techniques. 5. Participants will learn clinical applications of solution-focused counseling.
  • 3. Principles of Solution-Focused Counseling • Solution-focus • Collaborative approach • Small changes can lead to big results • Emphasis on process • Strategic eclecticism • Brief by design, but not always • Responsive to diversity • Committed to outcome
  • 4. Theory of Problems in Solution-Focused Counseling • Problem/Exception • Exception refers to times when the problem is not happening. • Depressed/Not Depressed
  • 5. Theory of Change for Solution-Focused Counseling Problem / Exception
  • 6. Common Change Factors • Client factors (self-help): 40% • Client-counselor relationship factors: 30% • Expectancy factors: 15% • Model factors: 15%
  • 7. Using client feedback to improve treatment outcome in solution-focused counseling
  • 8.
  • 9. Stages of Solution-Focused Counseling • Coconstructing problems and goals • Identifying and amplifying exceptions • Coconstructing tasks • Evaluating the effectiveness of tasks • Reevaluating problems and goals
  • 10. Coconstructing Problems and Goals • Coconstruct solvable problems (e.g., ineffective coping skills for depression, rather than merely ‘depression’) • Develop goals in positive language (an increase in something), rather than negative language (a decrease in something) • Encourage clients to provide video description of the problem • Coconstruct a problem and a goal that fits with the client's worldview
  • 11. S.M.A.R.T. Goals • Specific – Small – Incremental • Measurable • Attainable • Relevant • Time-based
  • 12. Mapping the Influences of the Problem • Identifying potential exceptions • Externalizing the problem
  • 13. Identifying and Amplifying Exceptions • Presuppositional questions • Identifying small exceptions • Identifying potential exceptions – The miracle question • Questions for amplifying exceptions
  • 14. Excerpt from Session Counselor: You mom says you hit everyone that bothers you. Would you say that’s true? Eric: Yes. (Pause) Ain’t scared of nobody. Counselor: Your mom also says you don’t know any other way to solve problems. Is she right about that? Eric: I don’t need any other ways.
  • 15. Excerpt from Session Counselor: Eric, help me understand something. You seem like this session is bothering you a lot. I mean, like I’m bothering you. Eric: Damn right. Counselor: So why haven’t you hit me yet? Eric: What? Counselor: Yeah, I’m serious.
  • 16. Excerpt from Session Eric: Shit, I don’t know. After a day like today, I don’t need any more trouble. Counselor: So, maybe you are able to solve problems a different way? It sounds like your mom might be wrong about you, Eric. What else do you think people get wrong about you?
  • 17. Miracle Questions Suppose that one night there is a miracle and while you are sleeping the problem was solved. How would you know? What would be different?
  • 18.
  • 19. Excerpt from Session Counselor: Where would you rate your depression? Vanessa: Nine. Easy. What a waste, we’ve been doing this for four months, and I’m still no better. Counselor: Are you sure about that? You had to go to the hospital twice in the first two months of counseling. Now, however, you’re facing a bunch of challenges in math and science, so there’s extra pressure.
  • 20. Excerpt from Session Vanessa: Right. So things have gotten even worse! Counselor: Yes, they have gotten harder. But in spite of all of this, you’ve managed to avoid Hospital Time. How have you stopped the ball from rolling up to Hospital Time? You certainly might not have done that in the beginning. Vanessa: I don’t know.
  • 21. Excerpt from Session Counselor: Think about it. Take your time. Vanessa: I guess I’m not as afraid of life as I used to be. Counselor: Tell me more about that.
  • 22. References and Suggested Readings Berg, I.K., & Miller, S.D. (1992). Working with the problem drinker: A solution-focused approach. New York: Norton. de Castro, S., & Guterman, J.T. (2008). Solution-focused therapy for families coping with suicide. Journal of Marital and Family Therapy, 34, 93-106. de Shazer, S. (1982). Patterns of brief family therapy. New York: Norton. de Shazer, S. (1984). The death of resistance. Family Process, 23, 11-17. de Shazer, S. (1985). Keys to solution in brief therapy. New York: Norton. de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: Norton. de Shazer, S. (1991). Putting difference to work. New York: Norton. de Shazer, S. (1994). Words were originally magic. New York: Norton. de Shazer, S. (1997). Commentary: Radical acceptance. Families, Systems, & Health, 15, 375-378. de Shazer, S., Berg, I. K., Lipchik, E., Nunnally, E., Molnar E., Gingerich, K., & Weiner-Davis, M. (1986). Brief therapy: Focused solution development. Family Process, 25, 207-222. Duncan, B. (2014). On becoming a better therapist: Evidence based practice one client at a time. (2nd edition). Washington DC: American Psychological Association Duncan, B.L., Miller, S., Huggins, A., & Sparks, J. (2003a). Young child outcome rating scale. Chicago: Author. Duncan, B.L., Miller, S., Huggins, A., & Sparks, J. (2003b). Young child session rating scale. Chicago: Author. Duncan. B.L., Miller, S.D., & Sparks, J. (2003). Child outcome rating scale. Chicago: Author. Duncan. B.L., Miller, S.D., & Sparks, J.A. (2004). The heroic client: A revolutionary way to improve effectiveness through client- directed, outcome-informed therapy. San Francisco: Jossey-Bass. Duncan, B.L., Miller, S.D., Sparks, J.A., & Johnson, L.D. (2003). Child session rating scale. Fort Lauderdale, FL: Author. Franklin, C., Trepper, T.S., McCollum, E.E., & Gingerich, W.J. (2011). Solution-focused brief therapy: A handbook of evidence-based practice. New York: Oxford University Press. Gergen, K.J. (2009). An invitation to social construction (2nd ed.). Thousand Oaks, CA: Sage. Guterman, J. T. (1994). A social constructionist position for mental health counseling. Journal of Mental Health Counseling, 16, 226-244.
  • 23. References and Suggested Readings (continued) Guterman, J.T. (1996). Doing mental health counseling: A social constructionist re-vision. Journal of Mental Health Counseling, 18, 228-252. Guterman, J.T. (1998). Identifying pretreatment change before the first session. Journal of Mental Health Counseling, 20, 370-374. Guterman, J.T. (2013). Mastering the art of solution-focused counseling (2nd edition) Alexandria, VA: American Counseling Association. Guterman, J.T., & Leite, N. (2006). Solution-focused counseling for clients with religious and spiritual concerns. Counseling and Values, 51, 39-52. Guterman, J.T., Mecias, A., Ainbinder, D.L. (2005). Solution-focused treatment of migraine headache. The Family Journal: Counseling and Therapy for Couples and Families, 13, 195-198. Held, B.S., (1992). The problem of strategy within the systemic therapies. Journal of Marital and Family Therapy, 18, 25-35. Johnson, L.D., Miller, S.D., & Duncan, B.L. (2000). Session rating scale 3.0. Chicago: Author. Lambert, M.J. (1992). Implications of outcome research for psychotherapy. In J.C. Norcross M.R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 94-129). New York: Basic Books. Lambert, M.J., Whipple, J., Smart, D., Vermeersch, D., Nielsen, S., & Hawkins, E. (2001). The effects of providing therapists with feedback on patient progress during psychotherapy: Are outcomes enhanced? Psychotherapy Research, 11, 49-46. Lipchik, E. (2002). Beyond technique in solution-focused therapy: Working with emotions and the therapeutic relationship. New York: Guilford. Martin, C.V., Guterman, J. T., & & Shatz, K. (2012). Solution-focused counseling for eating disorders. VISTAS, 1-11. Miller, S., & Duncan. B.L. (2000). Outcome rating scale. Chicago: Author. Molnar A., & de Shazer, S. (1987). Solution-focused therapy: Toward the identification of therapeutic tasks. Journal of Marital and Family Therapy, 13, 349-358. Murphy, J.J. (2008). Solution-focused counseling in middle and high schools (2nd ed.) Alexandria, VA: American Counseling Association. O'Hanlon, B., & Rowan, T. (2003). Solution oriented therapy for chronic and severe mental illness. New York: Norton. O'Hanlon, W. H., & Weiner-Davis, M. (1989). In search of solutions: A new direction in psychotherapy. New York: Norton. White. M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.
  • 24. Suggested Internet Resources Jeffrey T. Guterman, Ph.D. Homepage: http://JeffreyGuterman.com Twitter: http://twitter.com/JeffreyGuterman Facebook: http://facebook.com/jeffreygutermanpage International Center for Clinical Excellence (ICCE) http://www.centerforclinicalexcellence.com Scott D. Miller, Ph.D. http://www.scottdmiller.com Institute for Solution-Focused Therapy http://www.solutionfocused.net Solution-Focused Brief Therapy Association (SFBTA) http://www.sfbta.org