Solution Focused Therapy Model and Mft

¶ … 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 me to steer the miracle question approach in the way I intended, that is towards a behavioral solution to her problem of depression. 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 could approach her job and feeding/providing her children and dealing with difficult co-workers by setting positive goals and measuring here progress at reaching them over a period of time. With patient B, I was also able to use general systems model and postmodernism to allow her time to give her experiences and for us to identify patterns that were causing problems and arrange new values for her to help in difficult times.

The solution focused therapy model is based on the work of Steve de Shazer and Insoo Kim Berg et al. who used a goal-oriented approach to helping clients beginning in the 1970s in Milwaukee. The basis of the approach was in a mental health services setting in the inner-city and therapy was modified and refined over time through the course of observations and the measuring of results.

The key takeaway that developed was that overtime, conversations with clients and questioning can help lead the way to a better understanding of what it is the client wants and needs to accomplish to improve his/her quality of life (Berg, Dolan, 2001; De Jong, Berg, 2007). The general systems model originated with Ludwig von Bertalanffy in the late 1920s and grew to apply to various disciplines over the years, as its applicability -- the interaction of components in a non-linear conduct (Kuhn, 1974; Bertalanffy, 1968).

By showing how patterns occur in systems of thought and behavior, the theory could be applied to therapy/psychology and used to order a new system of values for patients suffering from an obstacle in their path towards a more positive lifestyle. The postmodernism model is related to the solution focused therapy model and is based on arriving at a solution for the patient through the course of allowing the patient to talk and the nature of the patient's problem to unfold through conversation.

It gives priority to the subjective experience and is rooted in the postmodern phenomenon or philosophy of thinkers such as Hume, Kant and Nietzsche and developed further in the French school by philosophers such as Foucault. My preferred pathway is the solution focused therapy model because it gives me an opportunity to converse with the client and guide the course of the conversation towards the topic of developing a goal-oriented solution.

Because I embrace the behavioral therapy approach, I see value in identifying a cognitive goal that can be implemented in a behavioral manner, and engaging the patient in a conversation through questioning is a manner that I find often helpful. However, as sometimes is the case, as client A showed, the individual is.