read the chapters and write a one page critique describing what was most helpful anything with which you disagreed and overall effectiveness of the chapters
write two questions that the chapter raises for you put answer with that questions
deavor, requiring both skill and creativity. I hope this book will assist you in developing both. Chapter 1 Introduction In this chapter my goal is to give you a concise list of what I believe to be the important points of Brief Therapy and to give you what other Brief Therapists believe the important points are. To make it easier to peruse the lists, I have put the points in bold print. In the following chapters, I discuss my points in more detail and offer illustrations. It is possible to heal quickly, even of longstanding problems. If you believe that therapy is a tedious process, then it will be. However, if you believe that people can heal themselves quickly, then this too can become reality. It is not important to spend much time focusing on the origin of the problem or focusing on the problem itself. Once you have allowed the client to express the problem and have responded in ways to build rapport and trust, focus on helping the client find alternatives to resolve the problem. Focusing on the present to future is far more effective than focusing on the past. Find the client’s strengths and ways to use these strengths in resolving the problem. Many times a client already possesses all that is needed to resolve the issue. The client simply needs help in recognizing strengths and in learning how to apply them to the problem. Indirect suggestions are more effective than direct commands. When you tell the client what to do, you are setting up the possibility for two negative consequences. First, issuing a command creates the opportunity for resistance from the client. Secondly, if the command is unsuccessful, the client could lose confidence in you. With indirect suggestions, there is no possibility for resistance because there has been no command; therefore, the client has the power to choose whether or not to take the suggestion. Be sure to give the client options. As you explore resolutions, find as many as you can. By creating options and allowing the client to choose which one will be most successful, you have empowered the client to take ownership of resolving the problem. Encouragement can give the client the courage to change. Encouragement can be powerful in helping the client take the action necessary to resolve the problem. Take every opportunity to encourage clients by pointing out their successes and strengths. Sometimes encouragement is all that is needed and all that can be given. Utilize what the client gives you. Rather than focusing on the deficiencies of the client, focus on the strengths. Rather than focusing on the negatives of how the client is functioning, focus on the positives or on how the negatives can be used as positives. Utilizing what the client gives you is far more productive than trying to change the client. Visualizing realistic success can be a powerful motivator and confidence builder. Notice the word “realistic” in the previous sentence. You do harm when you suggest unrealistic goals or make unrealistic promises. It is important that you help clients set attainable goals. Once a realistic goal is set, visualizing the achievement of the goal, in a very precise step-by-step video that is created in the client’s mind, can be one tool, among others, that assists the client in being successful. Patiently build trust by moving at the client’s pace. If you attempt to move too quickly or too slowly, you may lose the client. If you move too quickly, the client might fail and become discouraged. If you move too slowly, the client may become impatient and drop out of therapy. Be genuine in kind and hopeful ways. Never be dishonest even if being honest means revealing something negative to the client. It is never helpful to say kind things to the client that are untrue. Clients will know that you are being dishonest and no longer trust you. However, honesty should never be mean or demeaning. It should always be couched in kind and hopeful words. Many times all the client needs is help in getting started. Sometimes thinking small is better than thinking large. Rather than trying to fix the problem, you might be more effective in focusing the client on taking the first small step. Once the client takes the first step, perhaps you should get out of the way so the client can get on with life. Allow the client to dictate the direction of a session. The client is the expert about what is needed and the direction to be taken. This doesn’t mean that the client may not need assistance in recognizing what is needed and the direction to be taken but always remember that the client is the expert. When you begin to think that you know more than the client about what the client needs, you stop listening—treating the client as an object to be manipulated rather than a person to be respected. Always listen carefully to the client’s communication. Set positive goals rather than negative goals. It is easier to begin doing a positive behavior than it is to stop doing a negative behavior and easier to gain something than to give up something. Many times the client will want to state a goal in terms of what is not wanted. Help the client state what is wanted instead. Make certain that the client will successfully complete homework. Be sure that the homework is not too difficult or complicated. It is imperative that you set up the client for success by making the homework doable and being certain that the client has the skills and desire to complete the assignment successfully. The client’s failure may produce discouragement and self-doubt whereas success will produce confidence. Help the client recognize progress, however small. Assist the client in recognizing the progress that is being made from session to session. Seeing real progress is motivating and gives the client hope that the problem can truly be resolved. Help clients speak in specifics rather than in generalities. Nothing can be done with generalities. There is no way to get a handle on them. However, when one is specific, actions can be taken. When I allow clients to speak in general terms, I flounder. Yet when I lead them to talk very specifically about the issue, possible resolutions begin to appear. The more specific a client is, the more likely it is that the problem will be resolved. Symptoms must not necessarily be eliminated. At times it is easier to alter symptoms rather than try to eliminate them, as they cannot always be eliminated. However, the symptoms must not continue creating problems. Changing some aspect of the symptom, or how the symptom is experienced by the client, may be as effective as eliminating it. When possible, help the client to experience the problem in the here and now rather than talk about the past experience. Experiential therapy generally works faster than talk therapy. Talking about a problem does not change it, but experiencing the problem and making changes in the experience produces fast results. Lead the client to experience the problem rather than merely talk about it. View failure as feedback. Rather than feeling discouraged or disappointed when something does not work, be excited that you are one step closer to helping the client resolve the problem. Ask what can be learned from the failure in terms of what will not be successful and in terms of what might be successful with alterations. Recognize that most problems are not solvable, but resolvable. If the problem were solvable, the client would likely have solved it already. Most problems are too complex to fix. However, a part of the problem can be changed — or how it is viewed by the client can be changed—so it no longer creates the same negative consequences in the client’s life. Long term therapy many times is long term because you are trying to fix something that is unfixable. However, the client does not need to spend a lifetime stuck in the problem; enough parts of the problem can be resolved so that life is improved for the client, who can live happily and fulfilled. Presbury, Echterling & McKee (2008, pp. 17-21) discuss the following as essential guidelines for Brief Therapy: Honor every client as unique. No two clients are alike and therefore, no two clients should be treated alike. If you use the same theory or same techniques with every client, you are not honoring the uniqueness of the client. You should create a different treatment modality with each client. Always look for the survivor, not the victim. Rather than focusing on the weaknesses or disorders of the client, focus on the strengths, skills and resources of the client. Pay attention to how resilient the client is and how she has survived to this point. While the client may have experienced some difficult times, she is not a helpless victim. She has strengths that she can use to overcome her adversities. Accept that your client may be hesitant, but never resistant. When you use resistance of the client as an excuse for failure, you are being deceptive. What you call resistance is the client telling you that you have not proven that you can be trusted. It is signifying that sufficient rapport and trust have not been built. No one will resist help that assists them to be healthier. Only clients can change themselves-you can’t just tell ‘em. All healing comes from within the client. You do not heal people. When clients feel safe, they are open to change. You must create the climate for change, but it is the client who does the changing. Seek to have an effect-don’t search for the cause. Trying to figure out why a problem exists is futile. Problems are too complex to figure out. Even if you could find the cause, it would make no difference in finding a solution. Solutions don’t come from the problem. Help your client find resolutions, not define problems. Presbury, Echterling & McKee state that problems cannot be solved but they can be resolved. They cannot be fixed but some part of the problem can be changed so that it no longer inhibits the client. Value emotions-they can move your client toward resolution. Emotions help give meaning to a situation. If there is no emotion, there is no motivation to do anything about the situation. If there is too much emotion, the individual cannot make effective decisions. It is your job to be certain that the client is in the range of emotions that produce productive changes. Recognize that change is the one constant in life. No situation is forever. The circumstances of our lives are constantly changing. It is important for you to assist the client to recognize that no matter how difficult a situation might be, it will change. This is an important reality because it gives hope. You can’t change the past, so work to change the future. The past is over. No matter how hard you strive to do so, the past cannot be changed. It is a waste of time to spend much time having the client to dwell on the past. As quickly as possible, the conversation should focus on the present to future because this is what the client can control. Chevalier (1995, pp. 15-19) discusses the following as basic premises of Solution-Focused Therapy: It is easier to build on strengths and past successes than to try to correct past failures or mistakes. It is amazing to watch the energy level of the client change when the conversation moves from the negative to the positive. As the client realizes her strengths and the skills she used to be successful in the past, possibilities open up for how to resolve her present dilemma. If you listen closely, clients will tell you how to cooperate with them. Rather than trying to get the client to cooperate with you, you should discover how you can cooperate with them. The client is the expert on herself. You should listen to her and let her instruct you on what she needs. Preconceptions about clients hamper you and prevent a flexible use of technique. If you think you already know what to do with everyone who suffers from a particular disorder, you will be ineffective. You should have theories and techniques that you can use, but you should be flexible and alter the theory or technique to fit this particular client. Insight or awareness is not always necessary for change to occur; insight may occur before or after a change in behavior. If you assume that insight must always occur first, you will miss opportunities for behavior change. The focus should be on making changes in thinking and doing and the insight will take care of itself. Symptoms are not necessarily the expression of underlying past traumas, problems, or character weaknesses. It is more effective and efficient to focus on eliminating the symptom than to figure out why it exists. The cause really doesn’t matter. Knowing the cause won’t help eliminate the symptom. All parts of a system are interrelated and interconnected. When a client makes a change in one part of her life, it will affect other parts of her life. When she makes a change in her life, it will affect how she responds to others and how they respond to her. A small positive change can make powerful differences in the person making that small change. It is difficult to know if there are clear causes and effects in human relationships. Most problems are too complex to have a single cause. Usually there are several factors interacting with each other that create the problem. Thus, digging around in the problem, trying to find the cause, is futile. Change is constant and inevitable. It is not a question of will a client change, this is inevitable. It is your job to lead the client to make positive changes rather than negative changes. Small changes lead to bigger changes. Sometimes all a client needs is a little nudge in the right direction and then they will make bigger changes on their own. You make counseling more complicated than it needs to be when you think that you must continue seeing the client until they have resolved all their issues. Help them begin to move in the right direction and then get out of their way! Make no attempt to fix what is already working in the client’s life. Encourage the client to do more of what is working rather than eliminating it. The phenomena of therapeutic hypnosis teach us that behaviors deemed negative by traditional psychology can be very useful in certain situations. Examples are dissociation, positive and negative hallucination and amnesia. Complicated problems do not necessarily call for complicated answers. Many times the resolution of a complicated problem is very simple. I give many examples of this in the following chapters. Every problem has a pattern, and every pattern includes an exception to its own rule. Helping the client discover times when the problem does not exist and to notice what she is doing different in these times, gives clues to how to resolve the problem. Thinking, feeling, and behaving differently are part of the process of change; relationships change as individuals change. When a client changes one of these three components, it is likely that change will occur in the other two. It is difficult to change how one thinks without behavior and feeling changes following. Patterns of problems and solutions occur in time and space; making a change in these dimensions frequently prompts a solution to a problem. When the client changes when a problem occurs or where it occurs, this often results in a resolution rising up from the situation. By making a change in one or both of these dimensions, a new perspective is created. Nardone & Watzlawick (2005, pp. 37-54) discuss what they call the heresies of the strategic approach: Passing from closed to open theoretical systems. You should be more interested in assisting the client to effectively resolve her issue than in following a prescribed theory that research has proven to be effective. It is more important for you to work with an individual than to treat a disorder. Research is important but you should not allow it to keep you from relating to a human and working with the client in the way that the client dictates. Focus on how rather than why. Process is more important than content. Too many therapists are concerned about all the details of the story instead of the relationship with the client. Many times behavior that is labeled a disorder worked for the client in another situation so now she uses the behavior in situations where it doesn’t work. You, rather than being concerned about making the correct diagnosis and applying the correct label, should be focused on helping the client look at process and learn how to be flexible in situations and adapt her behavior to fit the situation. You are responsible. Therapy should be time limited. Just because a problem has existed for a long time does not mean that it must take a long time to resolve it. You must create wellplanned and well-applied therapeutic strategies. Clients do not come to therapy because of painful pasts but because they are dissatisfied with their present and desire a better future. It is your job to help them move toward this better future. To accomplish this, you must adapt the treatment to the client, not the client to the treatment. When therapy fails, it is not due to resistant clients but to incompetent therapists. None of us are effective 100% of the time. We are all incompetent to some degree. Change comes before insight. Nardone & Watzlawick believe that behavior must be changed first, then the thinking changes and finally the insight comes. Change must originate in a concrete experience before it becomes cognitive knowledge. Preston, Varzos & Liebert (2000, pp. 12-13) give four goals and characteristics of Brief Therapy that set it apart from other therapies: Brief therapy focuses on a specific problem not on reshaping the personality. My experience is that as one resolves problems, she does reshape her personality but it is not the focus of the therapy. Finding new ways to think and behave changes the brain, therefore, creating a new personality. Both client and therapist are actively involved. Neither you nor the client is a passive member of the counseling team. You cooperate to create change. You are not just a good listener who responds with empathy and the client is not clueless about what she needs to do. You are co-creators of change. The emphasis is on solutions, not the causes of the problems. Causes are irrelevant because they do not lead to solutions. Hours can be wasted looking for causes or discussing causes. Moving toward solutions is a much better use of time. Brief therapy is a time limited course of treatment. Many problems can be solved or at least reduced in one session. Most issues can be solved (or resolved) in four or less sessions. Littrell (1998, pp. 3-9) states the following as the defining characteristics of Brief Counseling: It is time limited. Longer is not better. Setting time limits is not detrimental to therapy. The opposite is true. By setting time limits more is accomplished in each session. Less time is wasted. It is solution focused. More progress is made when the focus is on what works in the client’s life than when the focus is on the problem. Helping the client focus on her internal and external resources and what her goals are lead to successfully resolving the issue. It is action based. To be a Brief Therapist you should give directives and assigns tasks. You should also direct clients to change their physiology. Changing physiology produces changes in attitudes and feelings. Holding one’s head up and standing erect feels different than slouching and looking down. It is socially interactive. Littrell points out four ways that this is accomplished. (1) Encourage clients to recognize people in their lives who are potentially social supports. (2) Help clients learn how to ask for and receive help from others. (3) Help clients critique how their behaviors will affect others, who in turn, will affect them. (4) Assign tasks that involve other people in supportive ways. It is detail-oriented. To be a Brief Therapist you should help your clients think in specific terms rather than in vague abstractions. The more detailed and specific the client thinks, the more possible a resolution becomes. It is humor eliciting. To be a Brief Therapist you must understand that because a problem creates pain is no reason that the movement toward resolution must also be painful. The more one can laugh, particularly at self, the less pain there is and the more likely one will find resolution. It is developmentally attentive. To be a Brief Therapist you must be aware of developmental stages and that no one stays the same throughout life. Changes are inevitable. This means that the client is not stuck in the problem for a life-time. It is relationship-based. Clients must know that you care about them, are genuine, can be trusted and truly understand their experiences. All the theories and techniques in the world will be ineffective if a relationship of trust and respect is not established. This doesn’t take many sessions to accomplish. It can be accomplished within the first few minutes of the first session, if you are competent. As you can see from these lists, there is no description of Brief Therapy that all therapists agree upon. There are some common characteristics but also each list differs in ways from the other lists. My list is more comprehensive than the others. Some of the points I make are debatable but I would prefer to err on the side of over-describing Brief Therapy than to risk omitting an important point.