Post Modern Counseling

8/13/2019 Post Modern Counseling

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Theory and Practice of

Counseling and Psychotherapy

MacDonald

Postmodern Approach

(solution-focused brief therapy and narrative

therapy)


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Questions If persons see therapists, in general,

what is/are the expectation(s) from their

therapist?

If persons sees therapists for their

problem, what is/are the final goals

after completing the therapy sessions?


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View of Human Nature

Assume that realities are socially constructed.There is no absolute reality.

View people are healthy, competent, resourceful,and have the ability to construct solutions andalternative stories to enhance their lives.

Help clients recognize their competencies andbuild on their potential, strengths, and resources.


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Key Concepts of

Solution-Focused Brief Therapy Therapy grounded on a positiveorientation --- people are

healthy and competent

Downplay past, while highlight present and future View people are healthy, competent, and resourceful, and

have the abilityto construct solutionsto enhance their lives

Therapy is concerned with looking for what is working

Therapists assist clients in finding exceptions to theirproblems

The therapy process is to focus on creating solutionsratherthan talking about the problems


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Basic Assumptions ofSolution-Focused Therapy

People can create their own solutions

Small changes lead to large changes The client is the expert on his or her own life

The best therapy involves a collaborative

partnership

A therapists not knowing afford the client an

opportunity to construct a solution


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Therapeutic Goals Believe clients have the ability to define their goals and

the resources required to solve their problems

Focus on small, realistic, and achievable changes

Small change leads to big change

Remain goal-directed and future-oriented

E.g., what has changed since last session?

Talk about solutions instead of talking about problems


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Therapists function and Role No knowing position: clients as experts about their own

lives.

Create a collaborative relationships

Create a climate of mutual respect in which clients are

free to create and explore solutions

Help clients to explore what they would like things to

be different, how to make a difference, and what signs

to indicate the changes are happening.


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Relationship Between Therapist and Client

The therapeutic relationship is an important factor for

change to occur.

Solution-focused brief therapy is designed to be brief, sotherapist must shift the focus as soon as possible from

talking about problems to exploring solutions

Help clients to use their strengths and resources to

construct solutions


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Techniques Used inSolution-Focused Brief Therapy

Pre-therapy change: What have you done

since you made the appointment that hasmade a difference in your problem?

Exception questions: Direct clients to times

in their lives when the problem did not exist.


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Techniques Used in

Solution-Focused Brief Therapy

Miracle question: If a miracle happened and

the problem you have was solved overnight,what would be different in your life?

Scaling questions: On a scale of zero to 10,

where zero is the worst you have been and10 represents the problem being solved, how

would you rate your anxiety right now?


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Techniques Used in

Solution-Focused Brief Therapy

Formula first session task: ask clients toobserve about what happens in your life

(relationship, family) that you want tocontinue to happen

Therapist feedback to clients: therapists

provide summary feedback for clients---compliment what clients have done towardeffective solutions, provide rationale for thesuggestions, and suggest a homework

assignment


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Case discussion Mary feels that she must win everyones

approval. She has become a super nice

guy who goes out of her way to please

everyone. Rarely does she assert herself,

for fear that she might displease someone

who then would not like her. How do you apply solution-focused brief

therapy to help Mary to solve her problem?


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Case discussion Tom, a college sophomore, want to

overcomes his shyness around women. He

doe not date and even des his best to keep

away from women because he is afraid

they will reject him. But he want to solve

his problem. How do you use solution-focused brief

therapy to help Tome to solve his problem?


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Questions? Reactions? What are your reactions?

What did a therapist (Dr. OHanlon)

do?

What can you as a therapist continue

to do by using solution-focused brief

therapy?


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The Therapeutic Process in

Narrative Therapy Collaborate with the client in identifying

(naming) the problem

Separate the person from his or her problem

Investigate how the problem has been disruptingor dominating the person

Search for exceptions to the problem

Ask clients to speculate about what kind of futurethey could expect from the competent person thatis emerging

Create an audience to support the new story


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Therapeutic Goals

Therapists invite clients to describe

their experience in new language andfacilitate the discovery or creation of

new options that are unique to them


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Narrative Therapists function and role

To become active facilitators

To demonstrate care, interest, respectful curiosity,openness, empathy, contact, and fascination

To adopt a not-knowing position that allows being guidedby the clients story

To help clients construct a preferred alternative story

To separate the problem from the people (instead ofperson own the problem)

To create a collaborative relationship --- with the clientbeing the senior partner


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Therapeutic Relationship Emphasize the quality of therapeutic

relationship, in particular therapists attitudes

Client-as-expert, clients are the primaryinterpreters of their own experiences

Therapists seek to understand client's lived

experience and avoid effort to predict, interpret,and pathologies.


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Therapeutic Techniques No recipe, no set agenda, and no formula

This approach is grounded in a philosophical

framework Questionsand more questions:

Questions are used as a way to generate experiencerather than to gather information

Asking questions can lead to separating personfrom problem, identifying preferred directions,and creating alternative stories to support thesedirections.


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Therapeutic Techniques Externalization & Deconstruction

Externalization is a process of separating the

person from identifying with the problem Externalizing conversations can lead clients

in recognizing times when they have dealt

successfully with the problem

Problem-saturated stories are deconstructed

(taken apart) before new stories are co-

created


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Therapeutic Techniques Search for unique outcomes

Successful stories regarding the problem

Creating Alternative Stories The assumption is that people can continually

and actively re-author their lives

Invite clients to author alternative storiesthrough unique outcomes

An appreciative audience helps new stories totake root


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Therapeutic Techniques Documenting the evidence

Therapists write and send a letter to clients

between sessions regarding their strengths

and accomplishments, alternative story, and

unique outcomes or exceptions to the

problems.


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From a multicultural perspective Contributions

Fit with diverse worldview

Clients provide their own interpretations of

life events

Limitations

Diverse clients may expect therapist as a

expert instead of client-as-expert


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Summary and Evaluation Contributions

Client-as-expert (not knowing position)

View people are competent and able to createsolutions and alternative stories

Do not support the DSM-IV-TR labelingsystem

A brief approach, is good for managed care.

In general, studies provided preliminarysupport for the efficacy of solution-focused

brief therapy


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Summary and Evaluation Limitations

No set of formulas or recipes to follow

Inexperienced therapist may view SFBT astechniques. However, the attitude of the therapist is

critical to the success of outcomes.

Therapists need to be able to make quick

assessments, assist clients in setting up the goals, andeffectively use appropriate interventions

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