¶ Applying Solution-Focused Therapy With Adolescents
Welcome to our Theory to Therapy series here at LicensureExamscom . My name is Stacy and this is my co-host , Dr Linton Hutchinson .
Hi there everybody . This series is all about helping you to take all that textbook theory knowledge that you got from grad for a school , hopefully and put it to some practical use on your exam .
It's one thing to know who the wizard was behind psycholanalysis or rational motor behavior therapy , but do you know how to apply the principles of those theories in a clinical setting ?
That's right . As therapists , it's important for you to have an understanding of foundational counseling theories , but it's even more essential to be able to implement those approaches effectively . The exam is designed to test your ability to do just that . So , Linton , I thought we'd take a look at a case study today involving an adolescent . What do you think ?
Yeah , sure .
Yeah , sure thing . What's this case study about ?
All right . Well , it's about a 14-year-old girl named Gracie . Got that , gracie , not Stacy .
I yeah sure .
Uh-huh , it was having some trouble at school and the scenario starts out by telling me that I'm a therapist working in a school setting and my client has fallen behind in her classes . She's really struggling in school and she's actually been begging her mom to homeschool her , but her mom's not in a place to take on that responsibility .
Her parents are divorced and she and her mom moved to an apartment that's in a different school district , so now she's , you know , going to a new school , her dad's not paying child support and her mom is having a hard time financially .
Well , okay , Let me check in with you and summarize what I've heard so far 14-year-old female refusing to go to school . Parents are divorced , recently moved and mom is struggling with finances . Does that track ?
Yep , we are on the same page . So the scenario goes on to tell me that she has not been able to make any friends , and when she tried to post a picture of herself in her new school on Facebook , she started getting comments from mean girls at school who made fun of her clothes , the style of her glasses and her crooked teeth .
Okay , so that's all the information we have to go on so far in the case study .
Okay , I got it . So when we're looking at this case study , you need to consider her age and her situation . She's 14 years old and she's being bullied . That's the main issues that we have , stacey .
Okay , so , given that information , what do you think about solution focus therapy ? It's all about focusing on strengths , successes , solutions . It's brief , so basically you work with Gracie to identify her goals and then you collaborate on problem solving strategies that she can use to reach those goals .
Yeah , that sounds like a perfect place to start . You know , you hear the term collaborate a lot in therapy and this is especially important when you're dealing with , you know who ? Teenagers , oh yes , they don't have a lot of control in their life , so it's important to give them at least some semblance of power and control in the therapy process .
There's so many restrictions when you're 14 . You can't drive , you can't boat , you can't get a job , and you're totally under the thumb of your parents and definitely under the thumb of school .
Well , hang on there , lisha , Speak for yourself . I loved school when I was growing up and I had this great little gig going when I was in second grade I don't know if I told you this before , so I've always okay . Well , I've always loved puzzles you know this about me and I drew up these wild mazes .
I got really creative with them , and then word search puzzles were the other thing I really liked . So then I went and made copies at the Xerox machine at my mom's work , because I go in after school with her sometimes to work and then I bring them back to school and I sold them .
I put them together in these little booklets and I sold them to the other kids in my class for like 25 cents a pop , which was big money back then in second grade .
Oh yeah , you did that when you were in second grade . Yeah yeah , it's quite the venture Stacy . That explains a lot of things , and I thought it was all due only to your German heritage .
Yeah Well , it worked well until I got busted , because apparently it was against school policy . And I'm not thinking about that stuff . It's against school policy to sell stuff to other kids in school . So how was I a little you know second graders supposed to know that ? But um , okay , well , back to our case study .
We picked solution focus therapy as our theoretical approach . Now , what would this look like in practice ?
Well , let's see . There's some general steps to follow when using solution focus therapies with especially with a teenager . The first step is to establish rapport . What do you think stays ? I like it Okay . Now , this step is not exclusive to solution-focused therapy . It's really your first task with any client , no matter what theoretical construct you're using .
The steps will become more specific to solution-focused therapy as we continue . But to start the therapeutic process , we're going to listen to Gracie's concerns and validate her feelings . Understanding her unique worldwide view and building a connection is critical in a theoretical therapy . It's critical in the therapy process , especially with a 14-year-old .
Without that , gracie won't feel comfortable to share her experiences and you're not going to be able to do anything with it .
Got you Well . It also sounds like she might be a tough cookie to crack , because I know teenagers can be notoriously guarded . They can be defensive . We need to be aware of that as we move forward and remember to nurture this therapeutic alliance we're talking about . Okay , what's next ? Lyndon ?
Okay , all right . The next step is to identify the problem . Now you , as a therapist , might have your own ideas about what a client's problem is , but your job as a solution-focused therapist is to understand the problem from the client's perspective , not yours .
Remember solution-focused therapy is not aimed at understanding the problem in depth , but to create a context where the client's issues are addressed . Pretty simple we don't need to deep dive into the client's past , just enough to create an understanding of the situation . We're snorkeling here . We're not deep diving .
But who wants to stay on the surface of things ?
I know , I know I'm tempted to try things , examine and explore Gracie's problem from every angle , but when you're wearing a solution-focused hat , your role is to focus on finding solutions rather than analyzing how the problem got to be a problem . Remember , solution-focused therapy is a reef , so minimal time is spent talking about the actual problem .
The majority of therapy time should be spent on talking about de-gu eyelids .
Okay , all right , you're right . So let's say , in the case study , gracie tells me that she doesn't feel like she fits in and she doesn't wanna go to school . That's what she identifies as the problem . So what do I do next ?
Okay , now it's time to create some treatment goals . Work with her to determine what she would like to achieve through therapy , not what you would want her to achieve . The goal should be positive , specific and realistic .
All right , right . Well , I have a question before we continue . Gracie is a 14 year old . I'm guessing that if I ask her what her goals are that she wants to work on at therapy , I'd probably just get like a blank stare . Maybe she'd sigh and roll her eyes , something like that .
No kidding , that's to give it . Here's the technique that comes to mind . It's called the miracle question . Heard of it . Well , people also call it the magic wand question .
Especially when you're working with younger kids , this technique involves you asking the client to imagine what would life look like if your problem was miraculously solved overnight , and then have her think about how she would know that it worked .
Oh , okay , all right . So in this case study , let's say she tells me I'd wake up and the bullying would be gone and I'd actually want to go to school . So that gives us some clarity . I could work with her to create some overall treatment goals , like achieving a sense of belonging , acceptance with peers at school . How does that sound ?
Yeah , you got it . Now I know what you're gonna ask me next , Stacey .
What's that ?
You're gonna ask yeah , exactly what next Ha ?
ha , ha ha . Okay , you got me , Linton . What's next ? Yeah , you're right . Well , once we've solidified our treatment goals , how do we now use solution-focused therapy to actually work toward achieving those goals ?
Okay , well , at this point , the focus is on finding things that Gracie has done well and building up from there , and we can do this in a few ways . One method is asking coping questions . We'll ask her about a time when her problem wasn't present or it was less severe than it is now .
This helps us to identify strategies that she has already successfully used in the past and can be used now in the present .
This sounds a little bit like when we say it's in there . Linton , when we're talking to students is that they've already got these strategies . They've already done stuff successfully . It's already in there , they just need to get it back out again , find it again .
Okay , so let's say this time Gracie tells me that at her last school she won a few awards in math competitions . She's an artistic gal who loves to make paper collages and she's great at solving puzzles .
Yep , right Now that I'm thinking about it , it sounds a little like this case might be a cloaked self-disclosure . Stacey .
All right , Linton , don't get ahead of yourself there , buddy , just so we're on the same track . This case study , all names , characters and incidents portrayed are fictitious . No identification with actual persons , living or deceased places , buildings and products are intended or should be inferred .
It sounds more and more like this may have triggered some unresolved childhood issues for you , stacey , maybe being loved for what you can do and accomplish rather than just for who you are .
All right . Well , that is a whole other episode in Can of Worms there , perhaps , when we talk about psychodynamic therapy . But let's get back to our puzzle-loving teenager , gracie no way shape-reformed , stacey . Are there any other techniques that would be helpful to identify strengths and resources that Gracie already possesses ?
Sure , you can use the exception question where you ask her about times in the past when the problem didn't ever exist . For example , Gracie , can you tell me about a time when you felt happy and accepted at school ? Something like that ? This can open up a discussion about her positive experiences rather than focusing what on her current bullying .
What was she doing then and what can she draw on for support ?
Okay , that sounds good . So we've identified her existing strengths , skills and resources , and then how do we use this information to help move her forward ?
Aha , now it's time to put the puzzle together there , stacey .
Oh , I like this metaphor , Linton .
At this point , you and your client will develop a plan centered around their strengths and their resources . Remember those treatment goals you established earlier . Now you can begin to brainstorm how to actively achieve them . This often involves setting small , achievable skills , experimenting with different behaviors and reinforcing what has already worked .
Okay , I gotcha . So can you give an example of what you would consider as something small and achievable ?
Yeah , okay , Let me think let's say that Gracie wants to feel more accepted than like she belongs somewhere at school . Okay , One baby step could be to find an extracurricular activity that interests her , something with a group of people who share similar interests , you know , like math , puzzles and art .
So maybe she could join a math club , chess club or sign up for an art class after school , something like that . Maybe having her look forward to something will make Gracie feel part of a group and this will go a long , long way towards achieving that goal .
I love it . That makes a lot of sense . So I know a big part of therapy involves reviewing progress . You hear about this all the time with treatment plans , review progress , review progress . So how do you use solution focus therapy to evaluate the effectiveness of treatment ?
Okay , that's where the scaling questions come into play . We ask her to rate her current situation on a scale from 1 to 10 , with 10 being she feels completely connected and accepted at school and one being she doesn't feel like she belongs there at all .
We could use this rating system over time , when you're doing therapy with her , to evaluate if the interventions that you've done , that you've collaboratively put together with her , are working or if other approaches need to be tried .
All right , that makes perfect sense . So , just like in real life , if something is not working , you can change it . All right . So now I have one more question before we wrap up . Linton , Can you use solution focus therapy in ?
other cases , of course . Solution focus therapy can be useful in so many different contexts . I think it's best used without clients that want a practical and concrete solutions to their current issue and want to look and develop ways to make positive changes without spending years and years diving into their past .
It's really helpful when working with young people , so it emphasizes building on strengths and resources they already possess to help them move quickly forward . It's also valuable in cases where the client has difficulty verbalizing their experiences or accepting or being able to access deep levels of insight .
Okay , well , thank you . So let's sum up the steps that you'd most likely use with solution focus therapy , if you will .
Okay , establish report , identify the problem , establish the goals , look for previous solutions that have worked , explore exceptions to the problem , develop those solutions and , lastly , review progress with the client .
Okay , thank you very much , Linton .
¶ Empowering Clients and Solution Focus Therapy
As we wrap up today's episode , we want to leave you with this message Remember to focus on what the client can do , not what they can't do , but what they can do , because when you empower a client and you recognize their unique strengths , they can start to believe in themselves and make changes in their lives . And that is the crux of solution focus therapy .
Hey , hey , hey , hey . I think we just solved a problem how to approach case studies like this when you take the exam .
Ah , and just think of what we could do if someone gave us a miracle Linton , or had a magic wand .
Well , until next time .
It's in there .