Paul Johnson asks: ‘In counselling and psychotherapy, to what extent do you think the Solution Focused approach can be integrated with other ways of talking to clients? Or does doing that risk confusing clients and diluting the effectiveness of the approach?’
This question is one of the most frequently asked on Solution Focused trainings.
If we accept a commonly held definition for the word ‘integration’ ‘the act of combining or adding parts to make a unified whole’ then I think that it is clear that the Solution Focused approach cannot be integrated with other ways of talking to clients, or at least cannot be ‘integrated’ with a problem focused approach. This becomes evident when we think about another of the most commonly asked questions about the approach, the ‘can Solution Focus be used with . . . ?’ question, and the gap after ‘with’ is typically filled with words like eating disorders, psychosis, trauma, severe depression. Naturally this is a question that makes absolute sense in the context of problem-focused models, they work with problems, (or don’t as the case might be), but Solution Focus doesn’t even start from this position. We don’t work with problems, we work with people who want something and the important question is what do they want, what are their best hopes. So the starting points for the two approaches are different, we are not even engaging in the same piece of work. In some ways you could say that we are not even working with the same client. The problem-focused practitioner is working with a depressed client whilst the Solution Focused practitioner is working with a client who perhaps wants to have a life again. These two clients may look the same, to a slightly unobservant onlooker, but as soon as we start listening in on the conversation we will realise that these two clients are different, they will be talking about different things, the way that they will be talking will be different, the way that the workers will be responding and thinking about the client will be different. These are different pieces of work. The idea of integration thus becomes hard to imagine. The problem-focused and the Solution Focused worker are not even doing the same piece of work. The client does not arrive in our consulting rooms, or on our Zoom screens ready-made, clients are co-constructed in the therapeutic process and the conversations that typify problem focused work and solution focused work ‘co-construct’ different clients.
So when people say that they are integrating the approaches what might they mean? Most commonly it seems to me that they are referring to a process of appearing to use apparently ‘Solution Focused’ techniques in the context of problem-focused pieces of work. The work has been constructed in a problem-focused manner, most typically, and then a scale question, or a miracle question, or an exception question is used. However the client, as outlined above, is not a Solution Focused client, the thinking is typically problem-focused, the context is typically problem-focused and thus the question is a different question. A question is not Solution Focused because it originated in the work of Steve de Shazer and is often used by Solution Focused practitioners; the question is Solution Focused because it fits into and naturally occurs within a Solution Focused conversation, it is part of a Solution Focused language game (Wittgenstein, 1953). So theoretically an apparently problem-focused question could be Solution Focused in the context of a Solution Focused process and conversation. For example a parent might say ‘he had another of his tantrums this morning’. Should I respond by enquiring ‘so how long did it last?’, a question I might be tempted to ask in the context of having heard about improvement, and the parent says ‘well about 5 minutes’ and I ask ‘how long do they normally last?’ and the parent says ‘oh about 20 minutes’, then the question ‘how long did it last?’ could be considered a Solution Focused question if the worker’s intent is to invite the possibility of improvement being noticed. The question fits naturally into a Solution Focused conversation.
Now ultimately I have no interest in whether people work in a Solution Focused or a problem focused manner. I may happen to love the Solution Focused approach but that is a personal preference and in the end the most important thing is whether the client gets a wonderful outcome. If the client gets a great outcome, (and not too much of their time has been wasted!), then who could argue and if the worker finds it useful to use techniques that they have drawn from the Solution Focused approach in the context of their sessions, then surely that is also to be welcomed. However it is important to be clear that this is not an integration of approaches. If the worker is conceptualising in a problem-focused way then the techniques have now been changed into problem-focused techqniques. It really is important to be clear in our thinking.
And finally thanks to Paul Johnson for the question since I have never thought about this in this way before; indeed I have found myself writing things that are truly new and different (for me). And if you would like to pursue BRIEF’s thinking in relation to this issue further here is a previous version penned by Harvey Ratner some years ago https://www.brief.org.uk/resources/faq/can-i-integrate-solution-focus-with-other-approaches.
Wittgenstein, L. (1953). Philosophical Investigations. Oxford: Blackwell.
27 November 2022