Every therapeutic conversation is constructed from a multitude of small choices, decisions that we make some of them so small that we hardly notice ourselves making them. Which of the client’s words do we keep alive in our next question and which do we let go by? Do our questions invite certainty from the client ‘how will you know?’ or are they more tentative ‘how could you know, maybe, perhaps?’. Do we ask about the client’s best hopes ‘for our talking’ or ‘from our talking’? Indeed do we ask about the client’s best hopes from our talking today’ or do we leave the best hopes less defined ‘your best hopes from our talking together?’, not specifying how many meetings our talking may entail. All of us make our decisions on these matters and a myriad more each time we talk with a client, and each of these decisions detain us no more than a milli-second in the flow of the talking. And yet of course each decision makes a difference, each one is significant, each one very slightly shifts the conversation that we co-construct with our client.
A few of weeks ago Ibrahim Duvarci, our eagle-eyed friend from Izmir in Turkey pointed us towards another of these small points having read the following in Peter de Jong and Insoo Kim Berg’s book Interviewing for Solutions (4th Edition 2013):
“During first sessions, clients are taking measure of us and the context in which services are offered. That is, they are beginning to build a sense of whether they can trust us and whether they want to work seriously on anything with us. In addition, most clients who come for services expect that it will take more than one session to solve their problems. In that case, if clients are asked at the end of the first session whether they think it makes sense to come back, that perception may be that we do not want to work with them, we lack confidence in our abilities to be useful, all we lack confidence in their capacities to build solutions. Consequently, at the end of the first meeting, we suggest you tell clients you want to see them again and that, when they come back, you would like to hear about what is going better. This approach best fosters client trust and confidence in the practitioner and at the same time, has the added benefit of fostering an expectation of positive change in the client. At the end of the feedback in the first session, ask the client, ‘So, when do you think it would be most useful for you to return?’ This question begins to send a message to clients that they are competent to decide for themselves what is best, while at the same time letting the clients know you think it would be useful for them to see you again. In later sessions, after clients have become more confident in both your capacities and their own, begin asking whether they think they need to meet with you again.” (pp 144- 145)
Ibrahim asked for my view on this knowing that this does not fit with what has been my standard practice for many years.
Clearly Peter and Insoo’s formulation indicates to clients that we believe that they require to come back for another session, indeed that we do not think that one session is going to be sufficient, that one session is not going to make enough of a difference and yet how can we possibly know this. We have long talked in our field about ‘treating each session as if it is the last’ and many of us would subscribe to the idea, one that strongly resonates with me, that we do not have the right to waste the client’s time. Why should the client come twice if once suffices? And yet do not Peter and Insoo perhaps have a point here. My struggles with the issue that they raise have led to an evolution over time of my practice. In my early days of Solution Focused practice I would have negotiated the next appointment in a very similar manner to the one that is suggested in Interviewing for Solutions. However over time I became uncomfortable with implying that I knew that clients should come back and I moved to an alternate formulation, a rather clunky formulation I must say, as I tried to incorporate a shift of thinking ‘I would love to see you again, and sometimes people already know that they would find another session useful; other people already know that either they do not need another session or that they do not want one, that this is not right for them, and other people have not yet decided and want to go away to have a think – what are you thinking?’ Now after a first session most clients answered that they would like another session please. This formulation was part of my wider pre-occupation with centralising the client in the process and coincided with moving away from giving clients feedback at the end of sessions. The shift fitted with the idea ‘trust the client’ which was very central to my work at the time. The last sentence in Peter and Insoo’s paragraph imply a somewhat doubtful evaluation of the client’s capacities, suggesting that the client might not feel confident in their capacities or indeed in our capacities, and our developing thinking would not have sat comfortably with this doubtful evaluation. More recently my practice has moved on again, and it is the ‘trust in the client’ idea that has driven the change. So now I say to people something on the lines of ‘it has been a pleasure meeting you. Only you are going to be able to decide whether this session today is enough, or whether it would be useful to meet again, and it might be hard to know right now. What about this, that you let me know if you think that another meeting would be of use to you – email, text me and it will be easy to set up a time.’ Who knows whether this will turn out to be the final iteration of my ending/next session/another session formulation journey. We will see. What I like about it is the clear implication that this one session today might be enough and the fact that the client’s judgement is unilaterally ‘trusted’.
Finally can I just say that I very much agree with Peter and insoo’s second point ‘‘So, when do you think it would be most useful for you to return?’ This question begins to send a message to clients that they are competent to decide for themselves what is best . . . ‘ ( p144). However I did always frame this a little differently as well. I used to say, if my clients elected to return, ‘so when do you think that it might be useful to meet again, two weeks, three weeks, less than that or more than that?’. I would put in the ‘two weeks, three weeks’ since so many of my clients had seen therapists on a weekly schedule that they seemed to assume that this is what therapy was, meeting weekly with a therapist and I wanted to introduce the fact of a choice. As it happens of course, using this formulation most people tended to opt either for two or three weeks. However many many years ago I said this to a client at the end of a first session and he responded ‘well about six months would work’. I had never, I think, heard more than four weeks and so I was a little taken aback ‘six months . . . . right . . . six months . . . . Ok . . . . well let’s make a time then’. And then my trust in the client collapsed and I added, shamefully, ‘and if for any reason it might seem useful to review earlier than that just give me a ring and we can fix a time’. The client came back 6 months later to tell me about the changes that he had made.
So in conclusion I now assume that there are ‘advantages and disadvantages’, ‘possibilities and restrictions’ to any and every formulation and we just need to make a choice - on balance. Less right or wrong than more or less fitting perhaps.
Could I thank our friend Ibrahim Duvarci and of course Peter and Insoo for writing a book that has been immensely useful in our field.
DeJong, Peter and Berg, Insoo Kim (4th edition, 2013) Interviewing for Solutions. Pacific Grove, California: Brooks/Cole.
09 October 2022