Solution Focused Brief Therapy — MNCLHD Alcohol and Other Drugs Service
Last updated 5 PM, 20 August 2024
This page contains additional resources following the Solution Focused Brief Therapy training. The page will be updated throughout the duration of the Solution Focused project, so you may want to come back here every now and then.
The first time you come here after Solution Focused training, please click the link to the online feedback form.
Training feedback
We would be grateful if you would complete the brief online feedback form about the training. This will provide feedback to Michael and to David and the LHD.
Introductory training. The feedback form is available HERE . When you click "Submit", you will be returned to this page.
Consolidation training. The feedback form is available HERE . When you click "Submit", you will be returned to this page.
"Heroes" training. The feedback form is available HERE . When you click "Submit", you will be returned to this page.
Additional Solution Focused resources
Click on each button to download the PDF file (you may need to right-click and choose "save file"). By clicking on any of the download links, you are agreeing that you will not distribute or share the documents.
Additional notes from Michael's presentation DOWNLOAD PDF
Beginnings — a chapter from Michael's forthcoming book DOWNLOAD PDF
Post-traumatic success — a chapter from Michael's forthcoming book DOWNLOAD PDF
At your best — a paper from our colleagues at BRIEF in London about the use of description DOWNLOAD PDF
Focused description development — the "theoretical" paper by my colleagues in London about the use of extensive description of the preferred future DOWNLOAD PDF
A blog post by Michael on the experience of being a Solution Focused client LINK
The paper by Frances Huber and Michael Durrant about clients' experiences of "the break" and the "end-of-session summary" DOWNLOAD PDF
Paper by Frank Thomas on compliments in SFBT DOWNLOAD PDF
Webinar (on YouTube) by Haesun Moon discussing Solution Focused use of language LINK
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Different thoughts about using Solution-Focused ideas
Link to an online post by Evan George about the question "How does that make you feel?" LINK
Link to a blog post from Michael that reflects on the use of the question "How did you do that?" (Note: This blog post is about working with the effects of trauma. However, the main point is about the power of the question "How did you do that?".) LINK
Link to an interview with David Hains, mental health nurse, about using Solution Focused ideas in the Emergency Department LINK
Articles related to alcohol and other drugs
de Shazer & Isebeart — The Bruges model: A Solution Focused approach to problem drinking DOWNLOAD PDF
Lewis — Solution Focused therapy and Motivational interviewing DOWNLOAD PDF
McCollum — Solution Focused group therapy for substance abuse DOWNLOAD PDF
Nelle — Solution and resource-oriented addiction treatment with the choices of abstinence or controlled drinking DOWNLOAD PDF
Pichot — Co-creating solutions for substance abuse DOWNLOAD PDF
Smock — Solution Focused group therapy for level 1 substance abusers DOWNLOAD PDF
Solution Focused groups
Paper by Banks on Solution Focused groups with adolescent "bullies" — DOWNLOAD PDF
Froerer — Solution Focused groups with people diagnosed with HIV/AIDS DOWNLOAD PDF
McCollum — Solution Focused Group Therapy for Substance Abuse DOWNLOAD PDF
Hardenberg — Solution Focused group work in mental health DOWNLOAD PDF
Research on SFBT
There is now a comprehensive, searchable database of SFBT research HERE .
Books
Ratner, H., George, E. & Iveson, C. (2012). Solution Focused Brief Therapy: 100 key points & techniques. London: Routledge. AVAILABLE HERE
Shennan, G. (2014). Solution-Focused practice: Effective communication to facilitate change. London: PalgraveMacmillan. AVAILABLE HERE
Recommended book about working with suicide. Fiske, Heather (2008) Hope in action: Solution-Focused conversations about suicide. New York: Routledge. Available as an E-book on Amazon for Kindle HERE
Michael's new book
Michael's book, Solution Focused practice: How do you do that? will be published soon. Sign up on our home page to receive an email when it is available and to receive special prepublication discount.
Australasian Solution Focused Association
Link to web site HERE
The new page for the Journal of Solution Focused Practices is HERE
Feedback Informed Treatment
A few people have asked how Feedback Informed Treatment fits with Solutuon-Focused Brief Therapy.
I have written some thoughts about this (and canvassed comments from other Soilution-Focused practitioners). It is available as a PDF file HERE .
PRACTICE ISSUES (from our online supervision sessions)
Things clients say — and how we might respond
“I need to understand why I’m drinking”.
Okay. My experience is that there are LOTS of reasons why people keep drinking too much, and it is not always easy to figure out exactly why a particular person keeps drinking too much. It MIGHT be related to something that happened earlier in your life … or it might not. It MIGHT be related to particular stresses in your life … or it might not. So, you’re thinking that you need to understand why you keep drinking in order to be able to stop. As I said, I’m not sure how easy it is to figure out exactly why you keep drinking; but I’m interested that you seem really clear that you want to stop. How come?
How are you hoping that stopping drinking will make a difference?
“The doctor told me that you’d be able to give me some tips and strategies to stop drinking”
Okay, and I’m very happy to tell you some of the things that some others of my clients have said worked for them. But I’m interested that you’re wanting some strategies to stop drinking. How come?
So, you’ve already decided you should stop. How did you make that decision?
Before we discuss particular strategies, how are you hoping that stopping drinking will make a difference? (Get AS MUCH DETAIL as possible. Lots of, “How else will that make a difference?” and, “What will your wife notice?” questions.)
Then, you might go on and discuss/suggest strategies, but do it tentatively and ask lots of, “How do you think that would make a difference for you?”
“I need you to tell me how to cope with the cravings”
Okay, and I’m happy to tell you some of the things that other people have told me helped them cope with the cravings. But, before we do that, what are some of the things that you have done to cope with the cravings — even just a little bit?
Writing notes in a Solution Focused way
When I worked in a large public hospital, I would write notes in patients’ medical record. I would use subheadings:
- Problem that lead to the patient attending
- How they would know that our service has been helpful
- Strengths, exceptions, resources
- The preferred future (how the patient would like her life to be)
- Scaling
I’m sure lots of other people thought these notes were stupid; however, that was not of great concern to me (there were lots of ways in which they thought I was stupid!).
Remember, they are called “Progress notes”, so you should expect to write about progress and not just about the problem.
How do we do an assessment in a Solution-Focused way?
Remember, from a “purist” Solution-Focused perspective, the fundamental assessment is “how does this person want things to be?”
However, you are required to assess various aspects of the problem (details of the drug or alcohol use, etc.)
First, Brett has flagged that you need to have a discussion, as a service, at some point in the future, about whether or not you need to think about your drug & alcohol assessments differently.
Second, remember my example from the Introductory training about the inpatient detox program whose assessment was “how will the judge know when you don’t need to be here anymore?”
Third, remember the SF scale that I included in the notes from the SECOND training. The scale is available HERE.
Second, third, fourth (etc) sessions
I read recently that Steve de Shazer once said that the single most important question in Solution-Focused Brief Therapy is, "What's better?"
In subsequent sessions, we want to explore ANY difference or improvement and ask how they did that, how it made a difference, how it might make a difference in the future, etc. Be persistent with, "How did you do that?". "Was it hard or was it easy?" (If they say it was easy), "How did you make it easy? You've told me that you've struggled with drinking for years; so, this week. how did you manage to make it easy to stop?" (If they say it was hard), "So, how did you manage to stick at it?" "What were the challenges you faced in not using? How did you deal with those challenges?"
When people miss sessions
If they subsequently re-engage and come to a session, begin with, "What's better?". If anything is better, just proceed as above and you might never explore what contributed to their missing the last session.
OR, you might explore how they managed to come back. "I know you missed our last scheduled session, and it's up to you whether or not we talk about what led to you missing the session, but firstly I'm interested in how you decided to come back. How did you do that?"
If clients do not re-engage, you might reach out to them but, ultimately, it is up to them whether or not they come (unless they are court-ordered). I have a colleague who would write to clients who missed a session.
I noticed that you didn't come to the session we had scheduled last week.
I hope that's because you decided that you didn't need to come back. If
that's so, I'd be interested to hear what's been better and how things
have been better. If that's not the reason you didn't come, give me a
call and we can schedule another appointment.
If clients have missed a number of sessions, you need to decide (as a service) how long you can keep the case open. In which case you might add a sentence that says,
If I haven't heard from you in the next two weeks, we will have to assume that you
have decided you do not require our service any more.
The preferred future description — and PERSISTENCE
We have talked a great deal about the centrality of the "preferred future" conversation (miracle question or similar). In the Consolidating training, I talked about the way my colleagues in London are exploring the preferred future with the client for 45 minutes or more, and often doing nothing else. I gave you an example of me doing that with a Mental Health client (the example is in my new book).
In the Heroes training we looked at a video of Elliott Connie exploring the preferred future with a client in extraordinary detail. In that video, the client's "best hopes" from this session were to stop her substance use. Elliott asked he how that would make a difference, and she said, "I would feel free and, "I would feel like I was regaining my own power and control." Elliott asked her when in her life she had last felt she had most of her own power and control, and she said it was, "When I was five or six years old." "If I had known you when you were five or six years old, what would I have seen that would have told me, "This is a person who has a real sense of her own power and control?" "I was much looser than I am now ... much more centred." Eliott asked, "So, if a miracle happened that somehow reawoken that five-or-six-year-old version of yourself, inside of yourself ... you got to keep all the memories and experiences you've had along the way, but that centred five-or-six-year-old version of you is reawakened, that sense of power and control comes bacl ... when you woke up the next morning, what's the first thing you would notice that would let you know you were back to being this version of yourself?" and the client says, "Happy!" So, Eliott asks, "What time would it be, when you woke feeling happy?" and the client answers, "Five or six." Elliott asks, "Closer to 5 or closer to 6, when you wake up feeling happy?", and they go on to describe her different morning in extraordinary detail. They describe her morning in detail for 45 minutes. Later, Jan comments that she found the questioning incredibly annoying at first. Elliott's response is that, once the client had identified that the last time she had experienced that power and control was when she was five or six years old, his job was to turn her back into the kind of person represented by that five-or-six year old, whether or not she found it annoying.
In suervision, Scott recounted spending 45 minutes with a client describing the first two hours of his day, including questions like, "What would be different about the way you put the spoonful of coffee in your cup?" The client's response was along the lines of "What the fuck is that about?", but Scott persisted and the client began to really see the possibility of being different.
Ask Scott about that case.
SFBT and AOD issues
We talked about how AOD isssues are what gets the client through the door; however, they do not determine the direction or the content of the session. Once you lnow how the client would like things to be, you are no longer an AOD counsellor; you are now a "preferred future" counsellor and AOD may or may not be relevant to0 what is talked about. The Solutio Focused process is driven by the client and how the client wants things to be different; NOT by what the therapist thinks should be the focus.
Motivational interviewing
I have added a paper on Solution Focused therapy and Motivational interviewing DOWNLOAD PDF
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