The Centre for Solution Focused Practice

How can we think about the client’s ‘best hopes’?

 

So let’s start from the beginning. When Chris, Harvey and I came across SFBT in 1987 first sessions started with the question ‘what brings you here?’, clearly a problem-focused question. The client’s answer to this question then provided the platform for the therapist to ask an exception question. Some 10 years or so later SFBT had already changed in many ways with the Miracle Question becoming much more prominent, not just a tool to assess the salience of exceptions, which was how de Shazer originally saw it and thought about it. This key change formed the context, the foundation for a major shift in our practice at BRIEF. We began to be increasingly doubtful about the need for the client to loop back through the problem that brought them to therapy before moving forward in the direction of the preferred future. Why not, we asked ourselves, ask an opening question which would move the talking more directly in the direction of the hoped-for outcome? And so, over a period of time, the ‘best hopes’ question was born. Using de Shazer’s language we felt that we had ‘straightened the line’ a little (de Shazer 1988), taken out an unnecessary detour, on the journey from ‘problem to solution’.

This shift was associated with a heap of other questions that we were asking ourselves at the same time. We had begun to worry about the concept of exceptions to the extent that focusing on the absence of something, the times that the problem does not happen, requires the respondent to bring to mind the presence of that thing. It is not possible to think about the times that one is not depressed without thinking about being depressed. This was relatively easily resolved by coining the term ‘instances’ (Ratner et al., 2012) which we chose to define as small elements of the preferred future which were in place, thereby straightening that line a little more – best hopes, preferred future, instances, with the conversation now going nowhere near the problem. However we also became concerned about the name of our approach ‘Solution Focused Brief Therapy’. We were concerned that this name did not accurately convey what we were doing, after all the word ‘solution’ has no life or meaning without the word ‘problem’, solution’s shadowy and yet ever-present sibling, and by this time we were leaving the concept of ‘problem’ out of our therapy and our thinking. We thought about a name that we would have preferred, ‘outcome focused brief therapy’ perhaps, but out of respect and gratitude to Steve de Shazer and Insoo Kim Berg, and a recognition of the extent to which the name SFBT had become embedded and established, we decided to stick with SFBT. However what is now worrying me is whether that term ‘outcome’, a term that I never used out loud, but which was my own private name for what we did, still fits with my thinking.

So where do we start from? The difficulty that I have with the ‘best hopes’ question goes back to de Shazer’s use of the words ‘any’ and ‘anything’ in Clues (de Shazer, 1988). All of you who read this blog regularly will know that de Shazer indicates to us that the therapist is interested in ‘anything’ that might be evidence in follow-up sessions of ‘better’, whether or not the ‘any’ or ‘anything’ have any connection with the original ‘best hopes’ or not. This suggests that it is not the role of the therapist to somehow ‘get’ the client to their ‘best hopes’, since after all the ‘any’ that the client reports may not be connected to the ‘best hopes’. Indeed the point at which the client decides that they do not need to return to therapy is not pre-determined or even substantially constrained by the client’s answer to the ‘best hopes’ question. The client may decide that something else is indicative to them that life is OK enough. Why then would we refer to the ‘best hopes’ process as ‘establishing a contract’, as we have at BRIEF for many years, (although sometimes substituting the word ‘commission’ for the word ‘contract’)? A contract (or commission) implies a requirement, in fact a legal requirement, to deliver and if delivery is not achieved the worker can be thought of as ‘in-breach of contract’. This idea imposes a rigidification onto the change process, potentially limiting the range of events or experiences which are to be counted as evidential of good outcome. If we thought that it was our job to deliver on the ‘best hopes’ then clearly the worker in follow-up sessions would be regularly reminding the client of their ‘best hopes’. We would start sessions not with the open and de-limited question ‘what has been better since we last spoke?’, but the question ‘what evidence of your best hopes happening have you noticed since we last spoke’, with a temptation to remind the client what those ‘best hopes’ were in case they have forgotten. Similarly when using scale questions in follow-ups we would feel obliged to redefine 10 as your ‘best hopes all happening’ and to remind the client of the description of the life containing those best hopes that they have given us. However I now think that this would introduce unnecessary restriction into the client’s thinking. So it now seems to me that we need to find another term for ‘contract’ that fits our current practice.

So if we are not going to define the ‘best hopes’ in terms of the necessary end-point of the therapy how are we going to define it? It might help us in seeking for a term to consider how the ‘best hopes’ question works. As is well known the Solution Focused approach is non-normative. When clients come to us we can have no idea as regards what they ‘should’ be talking about with us. Indeed given that there is no pre-assessment, no process with which to determine what the problem is, no theory of problem at all within our approach, we can have no idea at what clients should be addressing in their sessions. This raises the question how can we determine what to focus on in the first session. And the answer of course is by asking about the client’s best hopes. As our friend Harry Korman so elegantly stated ‘you can’t have any questions to ask until you know what the client wants’. So the answer to the ‘best hopes’ question is the point when we can start ‘asking questions’; but what does that mean about the questions that we ask in order to establish the client’s best hopes. Well of course these are also questions but they are questions from a different ‘language game’ (Wittgenstein, 1965) and as is the case with different language games there are different rules. When we are asking the ‘best hopes’ question we are evaluating the client’s answer according to a set of criteria, criteria that Harry Korman (Korman, 2017) defined as:
something that the client wants,
that fits with the worker’s legitimate remit’
that the client and worker working well together could hope to achieve.

At BRIEF we might simplify those criteria and generally just consider whether the first answer to the best hopes question is something that could happen tomorrow and if not we would keep asking questions until we arrive at something that could happen the next day. For example if the client were to say ‘I’d have a job’ we might ask the client ‘Imagine that you wake up and you were to notice that you were on your way to a job, what is the first thing that would be different?’ In this (short) sequence it is my view that the best hopes are being reframed from ‘I’d have a job’ to ‘being on your way to a job’, even if we don’t make that re-definition overt. If the client were to answer ‘the only thing that would make a difference would be if I were to have my own apartment’, we would probably ask ’and what difference would that make?’ We are subtly shifting the client’s ‘best hopes’ to the experience that the client might have if they were to be living in their own apartment, without challenging the client’s best hopes directly. We are not saying ‘how can we work on you having your own apartment since that is outside your control- what about something that is potentially within your control’, we are just inviting the client to re-describe what they want in alternative terms. These small shifts become clear when we compare them with the way that we respond when the client says ‘I’d be more confident’. If the client responds in this way we will immediately ask ‘imagine that you woke up tomorrow and you find yourself more confident in the way that is just right for you and just right for your life, what is the first thing that you will notice?’ so during the ‘best hopes’ sequence the worker is evaluating the client’s response in order to arrive at an answer that is ‘workable’. As soon as we shift into a description of the ‘best hopes’ happening we stop, I believe, evaluating the client’s answers in the same way. So the ‘best hopes’ sequence operates to establish a viable starting point for a Solution Focused conversation rather than the outcome that until recently I had thought that we were describing. We could perhaps think of it as a direction as long as we remember to hold that definition of direction tentatively and lightly rather than assuming that it is somehow ‘contractual’. Perhaps the word ‘focus’ would work – we are jointly establishing an agreed ‘focus’ for the talking.

If you have read to this point thank-you for indulging me while I have been trying to work out what I think. What I have realised is that as I have been writing I have noticed a number of other questions, doubts and worries arising. It is a little like changing one part of a jigsaw puzzle and finding that other parts that fitted fine before no longer fit, changing one part demands that we re-configure the whole thing. I am not sure that I had bargained on that and I certainly do not yet have any more answers. The good thing about writing a blog is that it really is a first draft. It does not have to be right (as if THAT were possible) – just interesting perhaps!

de Shazer, Steve (1988) Clues: Investigating Solutions in Brief Therapy. New York: Norton.
Korman, Harry. (2017) The Common Project http://www.sikt.nu/…/The-common-project-small-revisions-201…
Ratner, Harvey, George, Evan and Iveson, Chris (2012) Solution Focused Brief Therapy: 100 Key Points and Techniques. London: Routledge
Wittgenstein, Ludwig. Philosophical Investigations. New York: The Macmillan Company, 1965.

Evan George
London
12th August 2018

Archives

Featured Video

What is SF - a 2020 version of the approach

Image

July 9, 2020