By Dr Roger Lowe Psychologist and Clinical Family Therapist
I wonder what place Solution-Focused Brief Therapy (SFBT) has in your systemic framework?
SFBT has always had a rather ambivalent and ‘strange bedfellows’ relationship with systemic therapy. Put it this way: as a form of brief therapy, solution focus tries to leave out as much as possible, whereas systemic therapy often tries to put in as much as possible. For example, systemic case consultations often involve elaborate hypothesising from a range of theoretical perspectives, typically based on an extensive genogram. There is no such thing as a solution-focused case consultation. It is a contradiction in terms because you work the same way with everyone. There is nothing else to consult about.
So what can solution-focus offer to systemic practice? As someone with a long-standing interest in both traditions, I want to share some contemporary ideas from the solution-focus world and outline a particular skill that I think is useful for couple and family work.
To start, it is important to be clear about what SFBT can and can’t do. If important parts of your practice involve providing clients with insights or explanations about their issues, or involves hypothesising about systemic formulations, teaching skills, providing psycho-education or coaching, then SFBT can offer….absolutely nothing. It has no language for any of these activities. Its core business - its only business - is asking questions that invite change. This is what it does have a language for.
SFBT enters the picture at the point where you are ready to say to clients something that amounts to …
Given that your situation is the way it is (for whatever reasons, and with whatever degree of complexity and severity) what are your best hopes from our talking together?
This is the starting point for any SFBT conversation. For purists this will occur near the beginning of the first session, for more integrative systemic therapists, perhaps later (or never).
In my experience, systemic practitioners like to draw upon selective skills or concepts from SFBT rather than wanting to specialise in the model. This being the case, I’d like to outline one particular skill that is especially useful for systemic practice: the skill of moving from ‘best hopes’ to ‘desired outcomes’. One of the FAQs you get when teaching solution-focus is along the lines of ‘What if you are working with a couple or family who have widely divergent or conflicting goals - how can you try to find some common ground that gives hope for the relationship?’
One way is to distinguish between goals and outcomes. A typical misunderstanding of SFBT is that it is a ‘goal-focused model’. It is not. Contemporary practitioners regard it as an ‘outcome-focused’ model. What is the difference? We can think of a goal as an action - a means to an end. An outcome is the end - it is an internal experience, not an action. It is what clients want to be experiencing when their goals are reached. A key aim of SFBT is to invite clients to gradually shift from initial best hopes to desired outcomes. This often happens through a series of questions such as ‘How would that make a difference? or ‘What would be happening instead?’’
To clarify this, here is an example I have reconstructed from a session I saw with Elliott Connie, who is a major ‘influencer’ in contemporary SFBT. Elliott was working with a husband and wife (H and W) whose original positions were poles apart. H desperately wanted not to get divorced, whereas W saw little hope for the relationship.
The therapist (T) began by asking H about his best hopes from the conversation. H replied ‘not getting divorced…and wanting her to put her wedding ring back on.’ T then pursued a theme of how would that make a difference. H replied that he ‘wouldn’t be pissed any more’. So what would be happening instead? …’I’d be happy’…and how would that make a difference? After a moment, H replied ‘I’d look forward to coming home’. This is the ‘desired outcome’ that T is searching for. It is not an action goal like ‘not getting divorced’ or ‘wanting her to put her wedding ring back on’. It is an experience that H wants to have as a result of these things happening. T asked H: ‘So, if our conversation resulted in you looking forward to coming home, would that be a good outcome? and H said ‘Yes!’.
T then asked W about her best hopes and she replied by saying that she saw little hope for the relationship…”but if someone could wave a magic wand… I’d just like us to be friends again’. The words in italics are an outcome, not an action (like someone waving a magic wand) . So T asked her “so if our conversation could result in you being friends again would that be a good outcome?, and she said, Yes!
This is a useful example of working from best hopes to desired outcomes. While the couple’s starting positions seemed poles apart, the outcomes they wanted: looking forward to coming home and wanting to be friends again seem much closer and offer the possibility of some common ground and shared hope (e.g. wanting to enjoy each other’s company again). At the very least if offers a different pathway for the conversation and I suggest it is a useful skill for anyone working with couples or families.
Contemporary SFBT practitioners take the view that it is important to establish the client’s desired outcome before asking any of the usual questions (scaling questions, future-focused questions, etc.). The desired outcome becomes a theme which anchors the other questions. In other words, you might have memorised 1000 solution focused questions, but you have no way of using any of them until you establish the desired outcome.
Lastly, I wonder if this terminology of ‘best hopes’ and ‘desired outcomes’ is new for you? And what do I mean when I keep referring to ‘contemporary SFBT practice’. It will depend on when you first learned about SFBT. The model has evolved considerably in recent times to the point where the term SFBT 2.0 has been coined. It is beyond the scope of this blog to go into detail but I’d like to leave a few references and websites for you to follow up if your interest has been piqued…which I hope it has.
McKergow, M. (2016.) SFBT 2.0: The next generation of Solution Focused Brief
Therapy has already arrived, Journal of Solution Focused Brief Therapy vol 2 no 2 pp 1-17
ASFA
https://www.solutionfocused.org.au
BRIEF, London
https://www.brief.org.uk
Elliott Connie
http://www.elliottconnie.com
Image by Gerd Altmann Pixabay
Please note that this article is educational in nature and does not constitute professional advice.