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Back to Basics
Bill O’Hanlon
Finland
March 2007
Back to BasicsFor a copy of these PowerPoint slides, you may email me at
[email protected]• Be sure to specify the name of the workshop, the date
and the place• The presentation is not on my website, you must email
and request that it be sent to you• Even if you do not have PowerPoint, you can download
a free viewer• The deal: I will trade you these slides for putting you on
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SFT: A revolution in psychotherapy
• It has changed the practice of therapy all over the world
• Many books and articles have been written about it• Psychology (positive psychology), social work
(strength-based social work), and organizational consulting (Appreciative Inquiry) have variations of it in widespread use today
• Steve and Insoo traveled all over the world planting the seeds of this approach and introducing these ideas to thousands
Exercise
• In small groups, tell the other group members when you first became aware of SFT, what attracted you to the approach and your favorite story or memory about Insoo, Steve or SFT
Precursors and Background of SFT
• Milton Erickson’s African Violet Queen• Case treated by Erickson in the 1950s• I heard it from Erickson in 1977
Precursors and Background of SFT
• Don Norum - The Family Has The Solution• A presentation given in Milwaukee in 1978,
attended by Steve deShazer, Insoo Kim Berg and Eve Lipchik
• The premise was that families and family members often have solutions, but they rarely mention them because therapists don’t ask about them
Precursors and Background of SFT• Milton Erickson
• Resource-oriented therapist• Believed that people have the answers to their problems
within themselves and in their social situations• Everything, even symptoms, are potentially resources• Find what the person does well, where their strengths are and use
them in service of change
• The use of language is important; be careful to assume and evoke change
• Evoke rather than instruct or tell• Pseudo-orientation in time (the crystal ball technique)• People’s experience is changeable, sometimes very rapidly• Utilize what people are already doing• Small changes in patterns can effect change• Each person is unique, so each therapy must be unique
Precursors and Background of SFT
Steve’s influences
• The Social Construction of Reality (Berger and Luckman)
• Fritz Heider’s Balance Theory
Precursors and Background of SFT
• MRI Brief Interactional Therapy• Designed to be deliberately brief• Held that repetitive interactions created problems
or held problems in place• The problem is the attempted solution• Attempted to de-frame, reframe and change interactional
patterns around the problem• Small changes can result in bigger changes• Be careful of pushing for change as it may cause a
backlash
• MRI theorists initially resisted SFT
Precursors and Background of SFT
• Systemic Therapies and the Milan Family Therapists• Began to study the therapist-client system• The therapist became part of the problem or part
of the solution depending on what he/she evoked• The use of “invariant prescription” began to show
that the solution/intervention was not necessarily related to the problem
Precursors and Background of SFT
• Thomas Szasz, Foucault, radical psychiatry and critiques of psychotherapy, pathological labeling/diagnosis• Questioning both the legitimacy and helpfulness of
diagnosis and pathology• Challenging the idea of “mental health” and
“mental illness”
Philosophy and Assumptions of SFT• People have resources, skills, strengths, abilities,
competencies and solutions• What gets focused on and talked about during therapy
increases in emphasis and prominence• What caused the problem is not as relevant as what
helps make the situation better• Focus more on actions, viewpoints and contexts than
on personality traits, feelings or intentions• Clients are experts on their own lives and experiences• Resistance is typically brought about by unhelpful
interactions between therapists and clients• It is not always necessary to understand all about the
problem in order to begin to change it
Principles of SFT• If it is working for the client(s) and doesn’t harm anyone,
there is no need to intervene or change it, even if it doesn’t fit some theoretical model of “mental health”
• If you find something that works, even a little, encourage the client to do more of that
• Do not take up unhelpful or problematic conversations. Listen politely and then refocus on what is working, could work or what the client wants
• Ask about and listen for exceptions, solutions and preferences
• Compliment people when possible and when congruent and not patronizing; recognize their progress, positive coping skills and their competence
• Therapy should be as brief as possible
Attitudes of SFT
• Curiosity• Non-expert stance (clients are experts on their lives,
responses to our interventions, and experiences)• Not interested in causes, labels, diagnoses or
exploring the past• No normative model for “healthy” thinking or living• Pragmatic• Not much use of jargon; very plain speaking
First Wave
Past-oriented Past causes for problems; usually trauma Pathology/deficit-oriented Therapist as expert Theory-driven
Examples: Psychoanalysis; psychodynamic; hypnoanalysis; family-of-origin/multi-generational therapy; most trauma therapies; genetic/neurological set
Second Wave
Present-oriented Current causes for problems Problem-oriented Therapist as expert Theory-driven
Examples: Behavior therapy; cognitive therapy; family systems; EMDR; TA; addictions therapies; DBT
Third Wave
Present towards the future-oriented Not oriented to causes Solution-oriented; strengths-based Client as expert Collaborative Agnostic as to causes and theories
Examples: Solution-focused; narrative; collaborative language systems; solution-oriented; possibility therapy; new neurological theories with plasticity
Common Factors research
• Therapy is successful about 68% of the time• When it is successful, research has indicated that there are four common factors
to its success• These are:
• Client factors: The person’s strengths, resources, social supports, environments and the type (frequency, intensity, and duration) of the complaints they have (40%)
• The therapeutic relationship: How engaged and connected is the client in the therapy? A therapist who is perceived by the client as warm, empathic, genuine, trustworthy, non-judgmental and respectful contributes to developing a positive alliance. (30%)
• Expectancy, hope and placebo: The therapist’s optimism, confidence and sense of hope make a difference. (15%)
• Theory/technique: What procedures and model the therapist is guided by or uses. How much the therapist has allegiance to his/her model and methods. (15%)
Lambert, M. J. (1992). Implications of outcome research for psychotherapy integration. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 94-129). New York: Basic Books.
The Use of Time in SFT
• The past is used to find exceptions to the problem, strengths, competencies, and positive coping skills, not to discover the cause of the problem or earlier traumas or troubles
The Use of Time in SFT
• The present is used to find complaints and desires for change, exceptions to the problem, strengths, competencies, and positive coping skills, not to discover what maintains the problem or “resistance”
The Use of Time in SFT
• The future is used to investigate or imagine what a time without the problem or complaint would look like, what the person prefers and the criteria for stopping therapy successfully
Methods of SFT
• Skeleton key interventions• Between now and the next session, notice what is
going right in your situation; we don’t want to get rid of anything that is working
• Write about what you is bothering you for 15 minutes each night, always at the same time; then, when you have fully expressed everything you think needs to be expressed, read it over each night until you really feel that it is complete and you have gotten it all out, then burn the paper you have written on
Methods of SFT• The Miracle Question• The key to its successful use is to get the person experientially
involved in the question• Set the scene; wait until they are there in their experience and
imagination• Give them the premise (a miracle occurs when you are asleep that
resolves the concern you brought to therapy/counseling)• Then break it down into the near future and ask about personal feelings,
actions and perceptions as well as interpersonal feelings, actions and perceptions
• It may be enough just to discuss the problem-free future; or you might encourage the person to bring little bitd of that future into the present or near future
• Variations: Magic wand; time machine; crystal ball; rainbow bridge; letter from the future self
Exceptions and Solutions
• Investigate other times of successfully navigating or resolving a similar problem
• Find times when the problem would have been expected but didn’t occur
• Find someone in the person’s life who has solved a similar problem well
• Discover times when the problem is not quite as severe
• Find out what the person is doing when the problem is not happening
Evoke competence
• Find out in what settings the person is competent and skilled
• Find out who believes or believed in the person and their goodness and abilities; perhaps ask on behalf of that person what they would advise if they were present
• What advice would the person give others who were facing this or a similar problem?
• Suggest that the person transfer skills, knowledge and abilities from a context of competence to the problem area
Positive coping
• Find out how the person has been coping positively with the problem
• Ask why the problem isn’t worse or does not always occur
• Ask the person to give you advice or comfort for others who might be going through the same kind of problem or suffering
Noticing pre-interview change
• Find out about any positive change or progress in the problem situation in recent times
• Ask the person to give you their sense or idea about why this change has happened and what it might take to continue positive change in the future
Give compliments, honor clients, notice and highlight cooperation and motivation
• Notice and acknowledge any positive development or positive risk-taking or efforts clients show
• Compliment clients for coming to therapy and cooperating with the process
Ascertaining customership, motivation and engagement in the change process• Is the person there for change? Were they sent
by someone else?• Who is motivated to make change and what
change?• Window shoppers - compliment and send them on
their way• Complainants - Listen respectfully and acknowledge;
perhaps they will become motivated customers• Visitors - Find out what they want and give them
perceptual tasks only; sometimes they become clients or customers
• Clients/Customers - They can be given action tasks or perceptual tasks
Scaling
• Ask the client to rate on a scale of 1-10 (or 1-100) where they are now with their concern, where they would like to be and what enough progress would be to stop wanting or needing therapy
• Ask them what it would take to increase their rating by a small, achievable amount
Positive prediction
• Ask the client to predict how many days they will be at the higher number they say they are capable of achieving in the time between sessions
Other SFT methods
• Investigating or attributing personal agency to change• Wow, how did you do that?
• Perceptual tasks
• Action tasks
Exercise
• In small groups, discuss your best success using SFT in your work, which methods you would like to use more and what difference working this way has meant in your life and your work
The Language of SFT• Scaling questions• Difference questions and observations• Accomplishment questions and observations• Goal or preferred outcome questions and checking• Preferred future questions• Compliments/praise/appreciation• Exception questions and observations• Description questions• Smaller steps questions and statements• Highlighting change questions and observations• Motivation/customership questions• Positive prediction questions• Positive expectancy questions or statements
Exercise
• In small groups, discuss which questions and statements you have found work best for you and the people with whom you work
Research Support for SFT
• Brief therapy research
• SFT research
• Psychotherapy outcome research
• Positive psychology findings
Brief Therapy Research
In well-designed psychotherapy studies, distinguished by experienced therapists, clinically representative clients and appropriate controls and follow-up, brief therapy has been shown to be as effective as longer courses of treatment.
[Koss and Butcher (1986) “Research on brief psychotherapy,” (pp. 627-670) in Garfield and Bergin (Eds.) Handbook of Psychotherapy and Behavior Change. NY: Wiley.]
Brief Therapy ResearchThe average duration of therapy is 5-8 sessions in both private practice and community mental health centers, regardless of the theoretical orientation or techniques used by the clinician.
Clients generally expect to stay in therapy about 6-10 sessions and no longer than 3 months.
[Garfield (1978) “Research on client variables in psychotherapy,” in Garfield and Bergin (Eds.) Handbook of Psychotherapy and Behavior Change. NY: Wiley; Taube, Burnes & Keesler (1984) “Patients of psychiatrists & psychologists in office-based practice: 1980,” American Psychologist, 39: 1435-1447; National Institute of Mental Health (1981) “Provisional data on federally funded community mental health centers, 1978-79,” U.S. Gov. Printing Office; Howard, Kopta, Krause, & Orlinsky (1986) “The dose-effect relationship in psychotherapy.” American Psychologist, 41: 159-164.]
Brief Therapy Research75% of those clients who benefit from therapy get that benefit within the first 6 months in therapy. The major positive impact in therapy happens in the first 6-8 sessions, followed by continuing but decreasing positive impact for the next 10 sessions. No one form of psychotherapy is demonstrable better than others for the wide range of clients and problems. [Lambert, Shapiro and Bergin, 1986, “The effectiveness of psychotherapy,” in Garfield and Bergin (Eds.) Handbook of Psychotherapy and Behavior Change. NY: Wiley. and Smith, Glass, and Miller (1980) The Benefits of Psychotherapy. Baltimore: Johns Hopkins University Press]
Brief Therapy ResearchMany studieshave shown that even very brief course (1 session or 6 sessions) can dramatically reduce the use of both inpatient and outpatient (best estimates are between 9 and 24% reduced general medical savings) even up to five years after the brief therapy. Biodyne Institute did a study involving people who visited a doctor more than 20 times a year and gave them an average of 7 therapy sessions. The therapy reduced patients’ use of medical services by between 22% and 34%.
Brief Therapy Research[Cummings, N.A. & Follette, W.T. (1968) “Psychiatric services and medical utilization in a prepaid health plan setting, Part II,” Medical Care, 6:31-41; Cummings, N.A. & Follette, W.T. (1976) “Psychotherapy and medical utilization: An eight-year follow-up,” In H. Dorken (Ed.), Professional Psychology Today (pp. 176-197). San Francisco: Jossey-Bass; Cummings, N.A. (1991) “Arguments for the financial efficacy of psychological services in health care settings. In Sweet, J.J., Rozensky, R. G., & Tovian, S.M. (Eds.) Handbook of clinical psychology in medical settings (pp. 113-126) NY: Plenum Press; Cummings, N.A. (1994) “The successful application of medical offset in program planning and clinical delivery,” Managed Care Quarterly, 2, 1-6; Goldberg, I.D., Krantz, G., & Locke, B.Z. (1970) “Effect of a short-term outpatient psychiatric therapy benefit on the utilization of medical services in a prepaid group practice medical program,” Medical Care, 8, 419-428; Jones, K.R. & Visci, T.R. (1979) “Impact of alcohol, drug abuse and mental health treatment on medical care utilization: A review of the literature,” Medical Care, 17(suppl.), 1-82; Munford, E., Schlesinger, H.J. & Glass, G.V. (1978) “A critical review and indexed bibliographical of the literature up to 1978 on the effects of psychotherapy on medical utilization,” NIMH: Report to NIMH under Contract No. 278-77-0049-M.H.; Pallak, M.S., Cummings, N.A., Dorken, H. & Henke, C.J. (1993) “Managed mental health, medicaid, and medical cost offset,” New Directions for Mental Health Services, 59, (Fall), 27-40; Cummings, N.A. & VandenBos, G.R. (1981) “The twenty-year Kaiser-Permanente experience with psychotherapy and medical utilization: Implications for national health policy and National Health Insurance,” Health Policy Quarterly, 1(2), 159-175.]
Brief Therapy ResearchEmotionally disturbed children and their families who received a brief assessment and a follow-up interview showed more improvement (closer to the goals set by the therapist at the initial session) in a 4-year follow-up than those families who had time-unlimited psychodynamic therapy or time-limited (12-session) psychodynamic therapy.[Smyrnios and Kirkby (1993) “Long-term comparisons of brief vs. unlimited psychodynamic treatments with children and their parents,” Journal of Consulting and Clinical Psychology, 61, pp. 1020-1027.]
Brief Therapy ResearchSeveral studies have indicated that one session is the most common length of treatment (30% in one study, 39% in another, and 56% in another) across the range of clinicians, whether biologically-oriented psychiatrists, psychoanalysts, or eclectically-oriented therapists. Surprisingly, follow-up research indicates that a large percentage (78% in one study) felt that they got what they wanted and that their problem was better or much better from that one session.
[Talmon (1990) Single Session Therapy. SF: Jossey-Bass and Pekarik & Wierzbicki (1986) “The relationship between expected and actual psychotherapy duration,” Psychotherapy, 23: 532-534.]
SFT ResearchResearch done through the Milwaukee Brief Family Therapy Center on solution-focused therapy showed that 77% felt they had met their treatment goal and 14% thought they had made progress toward their treatment goal. In an18-month follow-up of 164 cases 51% reported their problem was still resolved and 34% reported that the problem was not as bad as when they started therapy (85% then thought they experienced long-term improvements). All these clients, which presented with diverse problems and from diverse ethnic populations and genders) received less than 10 sessions of therapy (average of 3.0 sessions).
[Research done by Dave Kaiser and reported in Wylie, M.S. (1990) “Brief Therapy on the Couch,” Family Therapy Networker, 14: 26-34, 66.]
SFT ResearchResearch done in Sweden found that 80% of the clients completing solution-focused therapy accomplished their stated treatment goals. Average length of treatment was 5 sessions.
[Andreas, B. “A follow-up of patients in solution-focused brief therapy,” Paper presented at the Institution for Applies Psychology, University of Lund, Sweden.]
SFT ResearchThe more “solution-talk” (discussion of solutions and goals by clients) in the initial session, the more likely the client was to complete therapy (vs. dropping out).
Shields, C.G., Sprenkle, D. H., & Constantine, J.A. (1991) “Anatomy of an initial interview: The importance of joining and structuring skills,” American Journal of Family Therapy, 19, pp. 3-18.
Positive Psychology Research
Optimism and Positive Psychology
• Psychotically optimistic dogs
Pessimistic vs. OptimisticExplanatory Styles
Pessimistic Optimistic
Bad stuff is permanent and will persist, pervasive and out of my control; Bad stuff reflects my resourcelessness and bad qualities (“I’m such a loser”)
Bad stuff is time and context limited (“I am just going through a rough patch”; or “This job sucks”) and under my influence; I possess good and resourceful qualities
Positive Psychology Research
One study found that even naturally pessimistic people who spent one week doing exercises in which they identified and wrote down times in the past in which they were at their best, their personal strengths, expressing gratitude to someone you have never properly thanked, and writing down three good things that happened made them happier when their happiness levels were measured 6 months later
Seligman, M., Stern, T., Park, N & Peterson, C. (2005) “Positive Psychology progress: Empirical validation of interventions,” American Psychologist, 60: 410-421.
Positive Psychology ResearchTwo studies show that focusing on or creating pleasant experiences enhances
our learning or performance abilities. • Kids who were asked to spend 30 seconds remembering happy things did
better on learning tasks they were given just after remembering the happy stuff.
• Internists who were given some candy (vs. reading humanistic statements about medicine and a control group) did better at diagnosing a hard-to-diagnose case of liver disease.
References: Masters, J., Barden, R. and Ford, M. (1979) "Affective states, expressive behavior, and learning in children," Journal of Personality
and Social Psychology, 37:380-390.
Isen, A, Rosensweig, A. and Young, M. (1991) "The influence of positive affect on clinical problem solving," Medical Decision Making, 11:221-227.
Positive Psychology Research
People who are in a more positive mood are better liked by others and more open to new ideas and experiences
Frederickson, Barbara (1998) “What good are positive emotions?” Review of General Psychology, 2:300-319.
Positive Psychology Research
Several studies have shown that whatever the most recent or last part of an experience is tends to color and strongly influence our overall memory or sense of that experience. A particularly graphic example involves people who were undergoing proctological exams. Patients were divided into two groups: the first was given the standard proctological exam; the second was given the exam but the scope was left in but not moved for an extra minute at the end (sorry for the pun) of the exam. Those patients who experienced the longer exam were more willing to undergo the procedure again in the future. Ending on a good note makes a difference in how the whole (sorry again) experience is remembered.
Reference: Redelmeier, D., and Kahneman, D. (1996) "Patients' memories of painful medical treatments: Real-time and retrospective evaluations of two minimally invasive procedures," Pain, 116:3-8.
Positive Psychology Research
Happily married couples say 5 positive remarks for every negative remark, even when having conflicts
Couples who are headed for divorce use less than 1 (0.8) positive remarks for every negative one
Source: Gottman, J., Gottman, J. And DeClaire, J.(2006). 10 Lessons to Transform Your Marriage. NY: Crown.
Positive Psychology Research The Gratitude Exercise
At the end of each day, after dinner and before going to sleep, write down three things that went well during the day. Do this every night for a week. The three things you list can be relatively small or large in importance. After each positive event on your list, answer in your own words the question: “Why did this good thing happen?” and “What did I have to do with this good thing happening?”
This exercise was found to increase happiness and decrease depression up to 6 months after the week [note: 60% of participants carried on the habit]
Seligman, M.; Steen, T.A.; Park, N.; and Peterson, C. and (2005). “Positive psychology progress: Empirical validation of interventions,” American Psychologist, 60:410-421.
Development and Refinements of SFT
• Possibility therapy
• Inclusive therapy
• Solution-Oriented Hypnosis
• Narrative therapy
• Spirituality as a resource and source of solutions
Acknowledgment and Possibility
Carl Rogers with a twist• 3 methods
• Reflecting in the past tense• Reflecting from total to partial• Reflecting from truth/reality claims to
validating perceptions
Future Pull:Orient to a Future with Possibilities
Elspeth McAdam. . . A young girl I was working with had experienced abuse.
She walked into my office as a very large girl with shaved hair, tattoos on her head, and I don't think she had showered in a week. I had been asked to see her because she was so angry. She clearly didn't want to come and see an expletive expletive shrink. She was very angry at being there. I just said to her, 'You've talked to everybody about your past. Let's talk about your dreams for the future.' And her whole face just lit up when she said her dream was to become a princess. In my mind I could not think of two more opposite visions–but I took her very seriously. I asked her about what the concept of princess meant for her.
Elspeth McAdamShe started talking about being a people's princess who would do things for
other people, who would be caring and generous and a beautiful ambassador.
She described a princess who was slender and well dressed. Over the next
few months, we started talking about what this princess would be doing. I
discovered that, while this girl was 14 and hadn't been attending school for a
long time, the princess was a social worker. I said, 'Okay it is now ten year's
time and you have trained as a social worker. What university did you go to?'
She mentioned one in the north of England. I asked, 'What did you read
[study] there?' She said, 'I don't know, psychology and sociology and a few
other things like that.' Then I said, 'Do you remember when you were 14?
You'd been out of school for two or three years. Do you remember how you
got back in school?'
Elspeth McAdamShe said, 'I had this psychiatrist who helped me.' I said, 'How did she
help you?' And she started talking about how we made a phone call to
the school. I said, "Who spoke? Did you or her?' She replied, 'The
psychiatrist spoke but she arranged a meeting for us to go to the
school.' I said, 'Do you remember how you shook hands with the head
teacher when you went in? Do you remember what you wore?' We
went into these minute details about what that particular meeting was
like–looking from the future back. And she was able to describe the
conversations we had had, how confident she had been, how well she
had spoken, and the subjects she had talked about. I didn't say any
more about it.
Elspeth McAdamAbout a month after this conversation she
said to me, 'I think it's about time we went to the school, don't you? Can you ring and make an appointment?' I asked if she needed to talk about it any more and she said no, she knew how to behave. When we went into the school she was just brilliant. I first met that girl ten years ago. Now she is a qualified social worker. She fulfilled her dream–although she didn't go to the university she mentioned.
Letter From The Future
• Write a letter from your future self to your current self from a place
you are happier and have resolved the issues that are concerning
you now
• From [five years/two months/ten years/one year] from now
• Describe where you are, what you are doing, what you have gone
through to get there, and so on
• Tell yourself the crucial things you realized or did to get there or
write about some crucial turning points that led to this future
• Give yourself some sage and compassionate advice from the future
Working backwards from the future• When we are done with therapy and things are better, what will be happening in your
life?
• What could you do, think or focus on during the next while that would help you move
a little bit in that direction or would at least be compatible with it?
• If your problem disappeared, what would be different?
• In your relationships?
• In your daily life?
• In your thinking or focus of attention?
• In your actions?
• In any other areas?
• Is there any part of that you could start to implement in the near future?
Future Pull
“The best thing about the future is that comes only one day at a time.” –Abraham Lincoln
Future Pull"You have to go fetch the
future. It's not coming towards you, it's running away." –Zulu proverb
Future Pull Interventions
Problems into goals• Rephrase from what is unwanted to what is desired• Redirect from the past to the future• Mention the presence of something rather than the absence of something• Suggest small increments rather than big leaps
Future Pull Interventions
Expectancy talk• Yet, so far• Before• After• How quickly?
Overview of SFT model• Change the doing
• Actions• Interactions• Language• Nonverbal behavior
• Change the viewing• Meanings/interpretations• Focus of attention
• Change the context• Anything that surrounds the complaint
Inclusive Therapy
Undoing Injunctions• Restraining: Can’t• Compelling: Have to
Inclusion Level 1Permission #1
• To
• You can
• It’s okay
• You’re okay if
Inclusion Level 1• Permission #2
• Not to have to
• You don’t have to
• It’s okay if you don’t
• You’re okay if you don’t
Inclusion Level 2Inclusion of seeming opposites
• You can and not
• Opposite polarities
• Previously incompatible experiences/traits
Inclusion“Do I contradict myself? Very
well, then I contradict myself. I am large, I contain multitudes.”
–Walt Whitman
Inclusion“Consistency is the last
refuge of the unimaginative.”
–Oscar Wilde
Inclusion“The only completely
consistent people are the dead.”
–Aldous Huxley
Inclusion
Ambivalent? Well, yes and no
Inclusion Level 3Exceptions
• That’s the way it is, except when it’s not
• Moments of exception
• Including the opposite possibility
• Recognizing complexity
Inclusion/Exceptions
“Nothing is as dangerous as an idea when it is the only one you have.” – Emile Chartier
The Inclusive Self
Devalued aspects(Disidentified Self)
(Non-identified self)
Future selves
Resources
Exceptions
Previoussolutions
Polarities
AlternativeStories
Spirituality
Alien voices(society’s/others)
Community
Identified Self(Identity Story)
Nature
Solution-Oriented Hypnosis
• Evocation rather than revealing traumatic roots of problems or re-programming beliefs
• Better with automatic (non-deliberate) problems (somatic/emotional issues)
• Permissive vs. authoritarian
Narrative Therapy
• Added the “being”/identity to the doing and viewing• Externalizing• The search for valued/hero qualities• Spreading a new story about the client
ExternalizingExternalizing• Name/personify
• Investigate negative effect of problem on people concerned
• Investigate exceptions to problem’s dominance or intrusion
• Elicit/investigate valued/hero qualities that allowed/created exceptions
Strengthening the Strengthening the Valued Identity StoryValued Identity Story
• Finding supportive historical evidence
• Speculating on the future with preferred/valued/hero story dominant
• Spreading the story to others
Strengthening the Strengthening the Valued Identity StoryValued Identity Story
Share the valued story with the larger social context• In person
• In imagination
Spirituality as a Resource
Definition of spirituality: Connecting to something beyond the ego and small self
Spirituality
Three Cs of spirituality:
• Connection
• Compassion
• Contribution
Seven Pathways to Connection
• Soul/heart/deep or core self• Body• Another• Others• Nature• Art• Bigger meaning or purpose (could involve
God, higher power, cosmic consciousness)
Connection to Nature
Children diagnosed with ADHD were more calm, more
focused and more able to follow directions after spending
time in a “green” setting like a park or backyard.
Frances E. Kuo and Andrea Faber Taylor, A Potential Natural Treatment for Attention-
Deficit/Hyperactivity Disorder: Evidence From a National Study, American Journal of Public
Health, Sep. 2004; 94: 1580 - 1586
Connection to Nature Patients with rooms overlooking deciduous trees healed more quickly
and had less need for pain medication than patients who viewed a brick
wall.
Dental patients who stared at a large mural of a natural scene had
lower blood pressure and less anxiety than those who didn’t.
Inmates whose cell windows face the prison yard made 24% more
sick-call visits than those whose cells looked outward on rolling
farmland and trees.
Frumkin, Howard, American Journal of Preventative Medicine, 20(3), 2001
Personal, Interpersonal and Transpersonal Connections
Personal
Interpersonal
Transpersonal
God
Higher power
Universe
AnotherCommunity
Family
Body
Soul
CosmicConsciousness
Brahman
Allah
Great Spirit
Nature
Tao
Goddess
Connective rituals• A review of 50 years of research on family rituals showed that regular
routines had a positive effect on health and family relationships• Of the 32 studies reviewed, one of the more common routines identified
was dinnertime, along with bedtime, chores, and everyday activities such as talking on the phone or visiting with relatives. The most frequently identified family rituals were birthdays, Christmas, family reunions, Thanksgiving, Easter, Passover, funerals and Sunday activities including the "Sunday dinner."
Fiese, Barbara H.; Tomcho, Thomas J.; Douglas, Michael; Josephs, Kimberly ; Poltrock, Scott; and Baker, Tim. (2002)."A Review of 50 Years of Research on Naturally Occurring Family Routines and Rituals: Cause for Celebration?," ; Journal of Family Psychology, Vol. 16, No. 4.
Connective rituals• Rituals involve repetitive activities that connect one to
oneself, others and/or to something beyond self and others (God, higher power, bigger meaning and so on)
• Can be daily, weekly, monthly, yearly or seasonally repeated
• Religion has been shown to be correlated with positive mental health (less depression, anxiety and major mental illness) and more stable relationships (more marital stability and lower divorce rates); Perhaps rituals built in to religious traditions might explain some of this positive correlation
See: Koenig, Harold George; McCullough, Michael E.; Larson, David B. (2001) Handbook of Religion and Health.
Oxford: Oxford University Press.
Compassion/Contribution/Service
Mitzvah therapy• The African Violet Queen• Sol Gordon’s Abuse Victim
Ghandi
The best way to find yourself is to lose yourself in the service of others.
The Talmud
The highest form of wisdom is kindness.
Contribution• Is there anywhere your client could be of service or make a contribution that would
help them make amends or heal wounds?
• Become aware of some social injustice or victim situation that moves or touches you.
• Every time you experience some recurrent problem, do one thing to contribute to the
relief of the victim’s suffering or to righting some social injustice. It may be writing a
letter, making a donation of money or time to some charitable group, praying, or
some other action you are moved to.
Directions and predictions for the future of SFT
• More integration with the mainstream of therapy
• More research support for SFT
• More refinement of the methods, with same basic theory/assumptions
Exercise
• In small groups, discuss what has been the most helpful part of this workshop and how you think you might use it in your work or your life
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Bill O’Hanlon, M.S., LMFTPossibilities
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