Term Paper on "Solution Focused Brief Therapy How it Works With Couples"

Term Paper 7 pages (1994 words) Sources: 1+

[EXCERPT] . . . .

Solution focused brief therapy (SFBT): its nature and effectiveness in couple and family therapy

The prevalence of psychotherapy as one of the leading treatments in the field of psychology illustrated how people's problems can be analyzed and possibly resolved through psychoanalytical techniques. These techniques depend on psychoanalytical theories, which delve into the individual's personal history, arguing that this would enable both the counselor (therapist) and patient/s to identify and formulate solutions that will resolve the patient's problems.

Through the years, however, long-term therapy gave way to a new alternative on psychoanalysis-based problem resolution techniques. Brief therapy or short-term therapy was introduced, a new means in which therapy can be accomplished in a shorter period of time. This eliminates the sometimes ineffectiveness and demanding nature of long-term therapy, both from the therapist and patient. Brief therapy, in effect, is more efficient in terms of time, scope, and cost when compared to long-term therapy, which is considered more exhausting, lengthy, and costly for the patient.

Bury (2000) identifies the nature and objectives achieved under brief therapy. He stated that "[p]atients' and clients' typical symptoms and troubles receive explanation within a Solution Focused model where the oft-repeated concept of forward-looking is familiar ground...SFBT inflects the treatment milieu, as well as individual therapy" (340). Thus, from this description, SFBT is "future-oriented" and "goal-centered," aims that allows the therapist freedom to center his/her focus on the primary objective at hand, which is to help the patient to formulate an effective solution to his/her problem or undertaking in the shortest period of time.

Analysis of brief therapy undertaken by Shaw et. al. (2001) showed that indeed, as Bury had asserted earlier, SFBT "requires the therapist to explore in the 'here and now' interactions, various aspects...of difficulties, symptoms, and conflicts" (93). In addition to this, what makes SFBT as effective as or more effective than long-term therapy is that it makes use of "technical innovations," a characteristic that involve the use of tests measured statistically and subsistence to therapeutic processes that are understandable by the patient, yet concretely identifies the psychological state of the individual with regard to the problem s/he is experiencing (Warren, 2002:198).

Other literature about brief therapy, meanwhile, focused on the therapeutic interventions that SFBT uses: it focuses on (1) who the person is and (2) what the person wants (Bitter and Nicoll, 2004:43). These foci are parallel with the goal- and future-oriented aims of brief therapy, for it is only by identifying the patient's personality, characteristics, and needs that the therapist will be equipped to use the appropriate tests and measures that are geared towards identifying and forming the solution to the problem.

Bitter & Nicoll, in another analysis of SFBT, summarized the salient points concerning the nature of this kind of therapy. In their article, the authors mentioned that an "integrative framework" of SFBT is composed of time limitation, focus, counselor directiveness, symptoms as solutions, and the assignment of behavioral tasks (32). While the first two characteristics have been discussed earlier in this paper, the succeeding characteristics are explicated more thoroughly in the texts that follow, which delve into the processes and techniques involved in conducting brief therapy.

The given literature above demonstrates the wide variety of advantages that SFBT has over long-term therapy. These advantages, evidently, benefit not only the individual, but most importantly couples and families. The greater number of individuals involved in couple and family therapies mean that therapy -- that is, solution to their problems -- must be used in the soonest time possible, which is only possible through SFBT.

The process of brief therapy involves different techniques. According to Sue Young and Holdorf (2003), SFBT techniques include (1) compliments, (2) miracle questions, (3) scaling, (4) exceptions, and most frequently, (5) non-problem talk.

Compliment-making is an effective therapy technique that aims to recognize the patient's "past efforts" so that s/he will be able to acknowledge the fact that the patient is able to gain "control" over his/her life in specific instances (275-6). This technique, in effect, empowers the patients in giving them hope that they are capable of handling their own problems, specifically create solutions for these. Compliment-making is appropriate for interpersonal (couple) or group (family) therapies, primarily because they are able to identify specific actions that they did previously in their lives that have been instrumental in keeping them united and harmoniously living together.

Miracle questions are created to provide the therapist a 'preview' of how the patient views his/her future life. These questions engage patients by allowing them to contemplate about specific possibilities that may happen in their lives. Questions may be hypothetical situations that focus on the individual's action when confronted with mundane events followed after by thought-provoking inquiries by the therapist (275). This technique probes into the patient's capability to think about alternative solutions to specific life situations or problems, enabling the therapist to come up with a suggested resolution that is within the understanding of the patient. This also makes the patient feel that s/he had an active role in the solution-making process that took place during the therapy.

Scaling is a more quantitative means by which problems are assessed by the therapist. In identifying the psychological disposition of the patient, the therapist makes use of scales, asking the patient to rate in either numeric or worded ratings his/her present emotional state. Disque and Bitter (2004) attests to the usefulness of scaling in objectively identifying the patient's emotional state, simply because it is able to "assess short-term relief of symptoms and disturbing emotions" (130). Thus, when coupled with the previously stated techniques, scaling is efficient in verifying whether the patient is indeed in the emotional state assessed by the therapist prior to scaling.

Exceptions are frequently used in SFBT, which is often called "The Question" in brief therapy. An exception question would be phrased as, "What would you be doing if you didn't have these symptoms or problems?" Exception questions veer the patient away from tackling the problem directly, but enabling him/her to become hopeful when s/he is given a glimpse of what the future would be like if the patient is able to overcome the problem s/he is experiencing (Bitter and Nicoll, 2004:44). This is seconded by Sue Young and Holdorf, stating that exceptions "call a posture of 'not knowing,' to allow the pupil (patient) to explain how these times happen in great detail, and what part the pupil played in bringing them about" (275). Couples and families seeking SFBT may consider exception questions efficient and effective in therapy, because it keeps patients optimistic about their lives despite the prevailing problems they experience. They become more goal-oriented as a result of this technique.

Lastly, non-problem talk is the most popular technique used in brief therapy because it prevents couples and families from engaging in destructive conflicts which may prevent the solution-making process between the patients and therapist. Non-problem talk is characterized as a process of "self-exploration," which puts "emphasis on experiential aspects of the patient-therapist interaction and "therapeutic metacommunication," defined as "the therapist's use of systematic inquiry, self-analysis, interpretation, and self-disclosure..." (Warren, 2002:202). Identifying that the (internal) self is the core of the problem experienced by the patient, non-problem talk is actually a path towards re-discovering one's self, a recognition of one's capabilities and true, honest characteristics. As argued by Guiffrida (2001), SFBT "focuses on understanding the primary functions that the symptoms fulfill in the client's life...clients learn to reframe their disorder, engage in behavioral and cognitive therapeutic interventions, and seek to focus on other areas of their lives outside of their (problem)" (63).

Non-problem talk and other SFBT techniques are actually patient-centered interventions, wherein the therapy is mainly dependent on the patient's will to overcome the problem at hand. Solutions are formulated in accordance to the patients' own reflections and insights, and the therapist merely acts as an 'organizer' and 'bridge' between the patients and solutions to their problems. Because patients are given the chance to actively participating in the process of solution-making, SFBT enables couples and families to interact among themselves, giving them the opportunity to talk about their feelings and thoughts about each other and the problem in the presence of a mediator (therapist).

Shaw et. al. underscored the essential effects of SFBT, stating that its ability to create a "therapeutic alliance" within a short period of time benefits patients who need to look at their problems with objectivity -- that is, a 'third person' or outsider's point-of-view. There were also studies that considered brief therapy as having "positive gains" because of its feasibility in making the patient "view himself or herself as in control and responsible for a cure" (Guiffrida, 2001:64). As explicated earlier, SFBT's patient-centered approach is considered a form of patient-empowered that builds up patient confidence, self-control, and even optimism.

Another positive effect of SFBT is that it provides patients an opportunity to 'reconstruct their lives,' bringing into fore the salient and insignificant experiences in the their lives (Disque and Bitter, 2004:129). Reconstruction is a way… READ MORE

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