Solution Focused Practice with Families – 5 practice guidelines
How is SFBT different when we are working with a family? 5 guidelines from Evan George
A: Appreciating
In BRIEF’s early days of Solution Focused Practice, almost 40 years ago, we used to start our first sessions with new clients with a few minutes of what we came to call ‘problem-free talk’ (George et al., 1990). In our first book, Problem to Solution, we described the purpose of this ‘stage of therapy’ to be ‘building rapport and locating strengths’ (1990, p 6). Over the years our thinking about this ‘stage’, as we had at first described it, changed. Influenced by Steve de Shazer’s ethos of minimalism we began to question its necessity. What evidence was there that starting first sessions in this way made a difference to outcome, and of course if it was not necessary how could we justify using the client’s time in this way. And so we dropped the ‘stage’ and most often began to open first sessions with the ‘best hopes’ question and yet the idea of working with clients from a position of appreciation has remained in my thinking and in my teaching and continues to influence my practice. The way that appreciation shows itself in my work may not always be obvious, unlike perhaps in the work of Insoo Kim Berg whose ‘wows’ punctuated her therapeutic conversations at regular intervals and influenced the practice of many of our colleagues, even though it might be argued that no-one could wow quite like Insoo could wow even though many tried. So how else can this appreciative position manifest itself if not overtly?
Solution Focused Practice sets out with a set of assumptions about people. Insoo Kim Berg wrote “It is assumed that the client is competent to know what is good for her and her family. It is further assumed that the client has the ability to solve problems and has solved problems in the past” (Berg, 1994, p 61). One might expand Insoo’s thought and argue that SF practitioners choose to assume that there is nothing ‘wrong’ with the client and that problems are ‘just’ things that people want to change, no hidden meanings, no underlying pathology, merely an invitation to ask ‘so how will you know that our talking has been of use to you?’. Steve de Shazer lays out his thinking as follows “For brief therapists their “patient” is the problem. This is the essential difference between brief therapy and other therapies for whom the “patient” is a person or persons” (de Shazer, 1985, p 17). So in Solution Focused Practice there is no thought of trying to change the client, to cure them or to treat them, merely a partnering with the client to facilitate their progress in whatever direction is right for them.
The appreciative position further influences our responses during our conversations with clients. As Insoo says “It is assumed that the client is competent to know what is good for her and her family” but further than this we would choose to assume that the client can tell us “what is good for her”. Practitioners new to the approach sometimes worry ‘but what if the client does not know what their best hopes are?’ or ‘what if the client is not able to tell us?’. To assume either that the client does not know or cannot tell us what their best hopes are would be to assume ‘incompetence’ (at the very least) in the client; indeed the thought could be seen to be insulting. So if the client is not answering we might just wait, or we might ask the question in a different way, or we might change the tone of the question making it more tentative, but fundamentally our assumption will be “If (the client) cannot answer (the question), the therapist has either asked the wrong question or asked it in the wrong way” (de Shazer et al., 2007, p 82). The client, in other words, is always giving of their best; the only person who can ‘get it wrong’ in Solution Focused Practice is the worker.
The appreciative position constantly, throughout our conversations with clients, helps us to find our focus, determining the multiple conversational choices that we make. Imagine that we start a follow-up session with the question ‘so what’s been better?’ (as most of us do) and the client responds ‘not much really?’. What do we hear in that response? Do we hear the apparent disappointment in the answer and pick up that disappointment by responding ‘I’m sorry, so it’s been tough?’ or do we hear the disappointment, certainly, but also the fact that there has been some ‘better’ even if not very much and so persist, kindly and gently with that? Of course the appreciative stance of the SF worker will lead to the latter choice ‘OK so not much . . . and what has been even a little bit better?’. The ‘OK’ and the ‘not much’ and the pause and the soft voice tone and the ‘little bit’ all indicate to the client that they have been heard and yet the appreciative stance means that our focus stays with the better. And of course there will have been some evidence of ‘better’. It is the same with the client who responds to our opening follow-up question by saying ‘well the first few days were quite good really, and then things sort of went back to usual and the last couple of days have been difficult?’. One way or another we have to acknowledge the last few days and yet our appreciative stance will take our focus back to the ‘first few days’ and then later, perhaps, to asking the client ‘so what has pleased you about the last few days even though they have been difficult?’. An appreciative stance assumes that the client is always able to discover things that they have been doing that are useful to them, moving in the direction of their preferred future.
So even though the problem-free-talk stage has gone, most of the time, and even though there are few ‘wows’ and no ‘cheer-leading’ in my practice, yet the appreciative stance ‘infiltrates’ if we want to put it that way, pretty much all of the talking that I do with my clients. And of course the worker’s appreciative stance, and this is perhaps the most important bit, invites clients to become appreciative of themselves, even clients who come to us much criticised for their choices by the world around them and often pretty critical of themselves!
Berg, Insoo Kim (1994) Family Based Services: a solution-focused approach. New York: Norton.
de Shazer, Steve (1985) Keys to Solution in Brief Therapy. New York: Norton.
de Shazer, Steve, Dolan, Yvonne, Korman, Harry, Trepper, Terry, MacCollum, Eric and Berg, Insoo Kim (2007) More Then Miracles: the state of the art of solution focused therapy. New York: Haworth.
George, E., Iveson, C. and Ratner, H. (1990; Revised and expanded Edition 1999) Problem to Solution: Brief Therapy with Individuals and Families. London: BT Press
Evan George
22 September 2024
London
How is SFBT different when we are working with a family? 5 guidelines from Evan George