¶ … Marriage Family Therapy My main clients are single-parent African-American women from low socio-economic backgrounds. They present themselves for therapy as a result of overwhelming feelings of stress, depression, and/or medical conditions such as high blood pressure, diabetes, etc. Some clients use non-prescription drugs such as marijuana. My primary therapy model is solution focused therapy and my secondary MFT models are general systems theory and post-modernism. My goal in using solution focused therapy is to collaborate with clients in identifying goals that they could set for themselves to achieve a higher quality of life for themselves. My secondary goals, using my secondary models, is to draw out the subjective experience of my clients so that it can analyzed from an objective standpoint by identifying patterns in the behavior and thinking that they demonstrate in response to questions that I ask.

For example, in order to understand what goals might be appropriate for a client A, I like to guide the client towards a goal by taking the "miracle question" approach: I ask, "Suppose that while you slept, your problem that brought you here was solved, and you woke up not knowing how it was solved but that it was -- what would you do?" She answered that she would jump up for joy and be happy. I asked her to take it step-by-step -- what would she think when she woke up. She said she would think that she had died and gone to heaven and then she would remember that she was still alive as soon as her kids started fighting two seconds later. My client would not easily allow...

She kept replying in snarky or half-serious answers that were self-defeating. I tried to indicate that what could actually solve the problem was if she woke up each day and reminded herself that she can make the miracle happen if she wants, she just has to act that way. The client did not seem to want to face this and instead was happier to be able to list her grievances to me; so I decided to try my secondary approaches, which were postmodernism and general systems. Thus, in conjunction with the core concept of the model (using questioning to lead to a collaborative process of identifying behavioral and cognitive goals to improve the quality of life) failed to find an applicable "in" with the patient.
Thus, with client A, as she began listing her grievances -- her fighting kids, her lack of financial support from any direction, her work, her sisters, her mother, her boyfriend, etc., -- it occurred to me that I could help by allowing her subjective experience to manifest itself. By allowing her to talk I could deconstruct her beliefs about how she viewed her surroundings in order to re-examine her values and help her to define new principles that could her steer her towards a better relationship with her children and a more confident outlook on life.

With patient B, I found that the miracle questioning approach worked better as she took a more thoughtful approach to the question. She was more in tune with her emotions and wanted not so much to vent as patient A did (which indicated the postmodern and general systems models would work better), but rather to listen to my questions and respond with absolute trust and authenticity. She immediately picked up on the direction in which I was heading and saw the idea -- that by changing her perception of reality, her behavior and response to her world, and approaching life from a positive place rather than from a feeling of victimhood, she could overcome the feelings of suffocation that she was experiencing. Thus, with patient B, we devised a solution to her problem by focusing on how she…