Solution Focused Therapy, Essay Example

Abstract

Solution focused therapy is a practical approach used in group and one on one therapy sessions. The focus of this type of therapy is to have the client to increase positive behaviors and decrease negative ones.  Solution focused therapy is a newly developed treatment strategy that is grounded in theory and best practices through clinical use. The technique is effective in treating interpersonal disorders. Clients set goals and make changes in their lives and behaviors to meet the goals they have set.

Introduction

Solution focused therapy is a somewhat new model of counselling that has gained recognition in recent years. Solution focused therapy (SFT) was developed predominantly by the work of Steve de Shazer and Inso Kim Berg at the Brief Family Therapy Center in Milwaukee, Wisconsin. This husband and wife team both has social work backgrounds, consequently they felt the only way to change a person was by changing the person’s mindset (Higgins, Hurst, Wistow, 1999). This approach helps clients by assisting them in construction solutions rather than dwelling on the problems they may be having. This type of therapy has been successfully used by clients who were dealing with numerous problems including: depression, eating disorders, drug and alcohol addictions, sexual abuse, and mental health. It is believed this approach is more effective because traditional therapy focus on the causes of the problems (Higgins, Hurst, Wistow, 1999). Clients discuss what has gone wrong over and over again, and therefore relive the wrong daily. With Solution focused therapy, the client develops ways to overcome that passive role.  Solution focused therapy has gained popularity because of its flexibility and the focus it places on the client’s strength instead of weaknesses. The therapy model focuses on three points: meet the client where they are, change the client’s outlook on the situation so the client is in control, and flexibility to meet the client’s needs. Supporters of solution based therapy believe that solutions lie changing the interactions of the client. This allows the client to solve his/her own problems by overcoming habit patterns. (Bowles, Mackintosh, Torn, 2001)The client must set concrete goals and aspire to meet them. Clients will be encouraged to see themselves as normal. Finally, the clients are taught that small changes lead to life changes. Historically, solution focused therapy took place over a longer period of time. Counselors or nurses who are working with clients using this method are only allowed limited information about their clients so they will not construct pre-conceived ideas about the clients. When properly implemented, solution focused therapy produces positive behavioral changes which will reinforce coping strategies ensuring success for client living with mental illness.

Mental Illness

Millions of people are affected by mental illness. Often, victims of mental illness have underlying causes that have led to the disease-drug or alcohol addiction, rape victims, death of family members, break-up of families. Victims of mental illness find it difficult to complete daily tasks. Some suffer from severe depression, while other may only have mild symptoms. Regardless to the severity, any form of mental illness can reduce the quality of life the sufferer has. Fortunately, many forms of mental illness respond well to treatment and therapy. Medication can be taken by people suffering from various mental illnesses to help restore a balance in the brain. Once the balance has been restored one’s mood will be regulated. However, psychotherapy is the most effective to way obtain lasting benefits. Most people who suffer from mental illness convey that it stems from some past event. The past event is often so debilitating that it cause the victim to feel hopeless about life. Feeling hopeless about the future will cause the victim to enter into a vicious cycle of highs and lows. The person suffering from mental illness will have days when they feel they are well, and days when they feel hopeless again. Solution focused therapy is one type of therapy that is used to assist people suffering from mental illness. This approach offers the victim hope by teaching them to look ahead. Often people who suffer from certain mental illnesses are unable to let go of a past event which keeps them depressed. This type of therapy is different from traditional therapy because it does not spend a great deal of time focused on past events. In traditional therapy, victims are taught that in order to understand their future they must spend considerable time delving into past events.  Solution focused therapy is an effective method to use with clients who are suffering different types of mental illnesses. (Department of Health 2002)

SFT Basic Concepts

The SFT approach is based upon eight assumptions about the clients that will be served. First, it is assumed that the clients have the needed resources and strength to resolve problems. The practitioner will gradually get the client to focus more attention on the strengths than the weakness. Second, change is constant. Practitioners teach clients to behave as if change is inevitable. Third, the practitioner’s job is to amplify change. They teach the clients to focus on what is working rather than what strategies are not working. Fourth, practitioners do not need to know a lot about the problem to help the clients resolve them. Practitioners have access to the bare minimum historical information about the clients. Fifth, small changes equate to large changes. Small changes in various aspects of the clients’ life will produce the changes clients want to achieve. Sixth, the clients define the goal. Practitioners teach that there is more than one solution to all problems. What may work for one client may not work for another, so the clients define what their goal is. Seventh, rapid change is possible. Eighth, focus on changes that are tangible. Focusing on things that can’t be changed will hinder progress on things that can be changed.

SFT for Depression

Depression is an unbearable feeling of misery.  People who are depressed experience persistent sadness. Being depressed interferes with all aspects of the person’s life-work, social, and family.  People who are depressed may have any of the following symptoms: difficulty sleeping, thoughts of suicide, anxiety and constant worry, restlessness, reduced sex drive, irritability, loss of interest in previous pleasurable activities, and lack of motivation. Although depression is a mental disorder, it can produce physical symptoms. People suffering from depression may have unexplained aches and pains, loss of appetite, gain or lose weigh in a short period of time, lack energy, slow movement, and slurred speech. Depression victims often develop social anxieties as well; they may avoid social situations, leave home, quit their job, or reduce social interaction with friends or colleagues. (Department of Health 2002)  When working with clients of depression, practitioners attempt to help clients focus on happier aspects of their lives rather than aspects of their lives that they are unhappy with.  Often they use what is called the Miracle Question, which gets the client to visualize life without the problem they are trying to fix. (Bowles, Mackintosh, Torn, 2001).

SFT for Anxiety

Anxiety is the way a person reacts to stressful situations. This is not harmful until it becomes excessive and cause victims to be unable to function in their daily lives.  There are many forms of anxiety disorder. Generalized anxiety disorder is the most common anxiety disorder. Victims of this disorder have excessive anxiety more days than not. They may feel fearful of situations or tense about encounters People suffering from this experience fast heart rate, palpitations, shaking, chest pains, and even headaches. These physical symptoms are due to the person’s brain sending signals throughout the body that the person may be in danger. It is difficult for people’s body suffering from this disorder to distinguish between the levels of danger they may be in.  This disorder can be triggered by a major stressful situation like a family crisis, death, or illness. SFT is one of the most effective treatments for this disorder. (Bowles, Mackintosh, Torn, 2001). It helps to reduce the symptoms of anxiety restoring the victims’ quality of life.   In this therapy the practitioner will help the client understand his/her though patterns. They will identify any harmful thought that is making the client anxious. The client may be asked to keep a diary of thoughts that occur when the client is having an anxiety attack. This helps the client to understand what types of situations trigger the attack and what types of techniques can be used to minimize the attacks.

SFT for Substance Abuse

Substance abuse victims use mood altering drugs for recreational purposes. Usually, these drugs are illegal. Currently, it is believed that more than 21 million Americans are suffering from substance abuse. Only about 2.5 million receive treatment for their addictions. Most times, people who are dependent on drugs are in denial about how bad the situation is. They may believe the addiction is under control and that they are not dependent. Because substance abuse can impact the person’s brain, it can also alter the person’s brain. With SFT practitioner’s can teach the client how to separate how they behave on drugs and how they behave when they are not under the influence. To successfully help the person with the addiction, all aspects of the person life must be taken into account, not just he drug addiction. Often drug addiction is closely related to mental illness. (Higgins, Hurst, Wistow, 1999).

SFT for Eating Disorders

Eating disorders are conditions that people suffer from that have them preoccupied with food and/or weight. There are many types of eating disorders such as bulimia, and anorexia. Most often victims of eating disorders are females, but males can suffer from this disorder as well. (Carbaugh, Sias, 2010). Treatments for disorders usually involve psychotherapy. Consequently, SFT is very effective for the treatment of eating disorders. Some eating disorders are caused by negative effects of eating. For example, a sick reaction to food intake can cause the victim to not want to eat of fear of feeling that same sickness again. Eating disorders are very complex and can have many underlying reasons. (Carolan, Hoppe-Rooney, Burns-Jager, 2010). Often eating disorders develop during adolescence or early childhood. For example, “Eating disorders are not due to a failure of will or behavior; rather, they are real, treatable medical illnesses in which certain maladaptive patterns of eating take on a life of their own” (Carbaugh, Sias, 2010).. Through the teachings of SFT, a problem implies the existence of exceptions. Consequently, when positive coping skills are applied the problem can be solved.. Solution focused therapy involves five stages: definition of the problem and goals, identifying exceptions to the problem, assigning tasks, evaluating effectiveness of the task, and reevaluating the problems and goals.

SFT in Nursing

SFT is usually used in the psychology with patients who are suffering from mental illness related disorders. However, Solution focused therapy can be used by acute nurses. Many nurses who work in ward-based positions consider themselves counselors, therapists, and nurses all in one. (Bowles, Mackintosh, Torn, 2001) Because Solution focused therapy is focused primarily on communication skills, it can be implemented in many areas.  With this approach, the nurse attempts to elicit and reinforce the patients’ strengths. The nurse will motivate and encourage the patient to help improve his/her own future by making changes. This technique can be used for nurses who work with patients who are suffering from chronic illnesses, drug or alcohol abuse, and mental illnesses.  According to studies, “solution focused approaches are positively evaluated by staff who experience reduced emotional labor and work strain when using solution focused techniques” (Bowles, Macintosh, Torn, 2001) these techniques are easy and cost efficient, and when properly implemented they provide structure for effective interventions for patients suffering from various illnesses. Studies have proven that facilities that make use of solution focused therapy have high levels of engagement with patients and their environment is calmer and safer.

Benefits of SFT

One of the major benefits of SFT is that it sheds light on the problem that the client is facing. With this therapy, clients are able to address the issue they are facing without feeling threatened or stereotyped. They are the experts in dealing with their issue. Issues such as depression, anxiety, and stress can be reduced and interpersonal relationships can be restored. Another benefit of this type of therapy is setting clear goals. The client and practitioner both know what the clients’ goal or goals are. Consequently, at the end of the treatment, both the client and practitioner can evaluate if the goal has been met. They both can determine if further therapy is needed. Yet, another benefit of this type of therapy is that it is brief and can be done in conjunction with other solution steps. This type of therapy often takes place in six sessions or less. Most of the time is focused on setting goals and coming up with strategies to meet those goals. The focus of the therapy is the clients’ goals and not his/her past. (Bowles, Macintosh, Torn, 2001)

Conclusions

Although Solution focused therapy is a fairly new technique used in the mental health field, many practitioners and clients are pleased with it. This type of therapy is effective with disorders that alter the client’s behavior because it teaches clients ways to cope with the disorder by altering behaviors and thought processes. Clients prefer this type of therapy because it attempts to avoid negative stereotype formation. Practitioners know very little about the clients. The clients are in control of the therapy. Anxiety, depression, and eating disorders are some disorders that have responded well to SFT because they all stem from the client’s thought process.

References

Bowles, N., Mackintosh, C. and Torn, A. (2001) Nurses communication skills: an evaluation of the impact of solution focused communication training. Journal of Advanced Nursing 36 (3) 347-354

Carbaugh, R. J., Sias, S. M. (2010). Comorbidity of bulimia nervosa and substance abuse: Etiologies, treatment issues, and treatment approaches. Journal of Mental Health Counseling, 32, 125-138.

Carolan, M., Bak, J., Hoppe-Rooney, T., & Burns-Jager, K. (2010). An integrated feminist approach to disordered eating intervention in a university campus outpatient setting. Journal of Feminist Family Therapy: An International Forum, 22(1), 43-56.

Department of Health (2002) Mental Health Policy Implementation Guide: Adult Acute Inpatient Care Provision. DoH, London.

Higgins, R., Hurst, K., Wistow, G., et al (1999) Nursing acute psychiatric patients: a quantitative and qualitative study. Journal of Advanced Nursing 29 52-63