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Solution Focused Therapy Case Study on Marion

Essay by   •  August 13, 2012  •  Research Paper  •  2,314 Words (10 Pages)  •  2,805 Views

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The essay will be looking at a case study in light of the existential humanistic approach of Solution Focused Therapy (SFT). The case involves a client named Marion who comes to therapy seeking help because she is "feeling down". An overview of the principles and goals of SFT will be covered as well as exploring how the theory of SFT is applied in a practical manner with Marion. Details of how a therapist might use SFT dialogue to help Marion will also be covered. The advantages and disadvantages of SFT will be explored and the essay will try and capture a general sense of how SFT is applied.

Solution focused therapy (SFT) was primarily derived by Insoo Kim Berg and Steve de Shazer at the brief therapy centre in Milwaukee. Berg and De Shazer where influenced by Milton Erikson's work as well as the work by the team at Mental Research Institute in California (Johnson, 2009). Matthew Selekman a leading contributor to the development of SFT along with De Shazer came up with a number of key SFT principles. These principles included ideas such as one does not need to know much about the problem in order to solve it and that the client defines the goal of the treatment. They believed that most clients already possess the resources they need in order to change and that the client is the expert of their own lives. It is the client who defines the goal of treatment and that there are many ways of looking at a situation, all equally correct. Other principles included that resistance is not a useful concept, cooperation is essential and change is inevitable (Bannink, 2006).

Central to SFT is the belief that, in a person's life there are always exceptions to the ideas, feelings, interactions and behaviours that are or can be associated with the problem. The most well-known and influential aspects of SFT include the miracle question, scaling questions and exception times. The miracle question was derived by Insoo Kim Berg after one of Insoo's clients stated "It could only take a miracle to solve her problems". To which Insoo replied "OK", suppose a miracle did happened and the problem that brought you here is solved?" (Berg & Szabó, 2005). The use of scaling questions in SFT is a very prominent skill. The client will be asked to rate something on a scale of 0-10 or 1-10. Scaling questions are a useful means that SFT therapists use to measure a client's progress (Berg & Szabó, 2005). Scaling questions can also measure the degree that a problem has been solved, as well as how far off a satisfactory outcome is from the present situation (Berg & Szabó, 2005). For example Marion may be asked, " What rating do you give yourself on a scale of 0 to 10, where 10 equals lots of hope and zero equals no hope?. This question might be followed by' "How do you manage to be at that number", or what would one point higher look like? (Johnson, 2009). The next key component to SFT is that of exception times. An exception is when the problem is not around all the time. Even when a client does not have previous solutions that can be replicated, most have recent examples of exceptions to their problem (Berg & Szabó, 2005). These are times when the problem might have occurred but did not (Johnson, 2009). An example might be tapping into a time when Marion did have an interest or a desire to do something for herself and explore what that might look like in the here now.

In addition to the Miracle question, scaling and exception times, compliments and tasks are important skills used in the SFT framework. Compliments are used at the end of the session as a way to encourage clients and give a message of hope. Tasks, also known as homework, are exercises which are given to the client to complete outside of therapy (Johnson, 2009).

SFT therapists concentrate on small, realistic, achievable alterations that can lead to additional positive outcomes Corey (2013). Because success is likely to build upon itself, modest goals are viewed as the beginning of change. Corey (2013) describes the importance of helping clients in developing clear goals that are stated positively in the client's language. These goals should be process or action oriented and structured in the here and now. It is also important that they are attainable, concrete, specific and measurable and are controlled by the client. Setting Goals in SFT is highly driven by the client as based on the picture of what their desired future might resemble. By finding out what is important to Marion, she will be more likely to be invested in making the needed changes to achieve her goals (Corey, 2103). SFT goal negation is one of the most important aspects, making an agreement at the start of therapy about what the finish line is with the client is crucial. If the finish line keeps moving around, therapy can be ongoing and without a clear finish line the desired outcome cannot be known (Berg & Szabó, 2005).

SFT would take the view that small modifications in Marion's cognitive and behavioural expressions can lead to significant life changes. SFT also would see Marion as a client that has definite strengths, coping skills and unique problem solving abilities to create positive change (Washington, 2011). SFT emphasises Marion's strengths and resilience's by focusing on exceptions to her problems and conceptualized problems (Corey, 2013). SFT is grounded on the optimistic assumption that people are healthy and competent and have the ability to construct solutions to enhance their lives. An underlying assumption in SFT would be that Marion already has the ability to resolve the challenges that life brings her (Corey, 2013). Marion describes that she is questioning "whether she really made the right choices in life". Although everything, that Marion says is important, SFT pays little attention to diagnosis, history talking or exploring the source of the problem (Berg & Szabó, 2005). SFT has the view that even if Marion does not have a previous solution that can be repeated, she might have recent examples of exceptions to her problem (Berg & Szabó, 2005). These are times when a problem could occur, but does not. SFT would look for strengths that Marion has such as Marion has probably has been a good mother and homemaker, so these competencies in these fields might be explored with Marion(Johnson, 2009).

A SFT therapist may work with Marion by initially giving Marion an opportunity to describe her problems. The therapist might then explore with Marion about the times in which her problems did not exist or when her problems were less severe. Marion would be assisted in exploring exception times when Marion's problem is gone or at least not as bad, with special prominence on what she did to make these circumstances happen (Corey, 2013).

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