Brief Solution Models in Family Therapy

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Brief Solution Models in Family Therapy  Major
Concepts in Solution-Oriented Therapy   1.     
Clients have within them or their social systems
the resources to make the changes they need to
make. The therapists job is to access these
resources and help clients put them to use in
appropriate areas of their lives.   2.      The
role of positive expectations Having positive
expectations of clients success is more
conducive to tasks of exploration, discovery, and
healing than a psychopathological
perspective.   3.      Indirect communication
Stresses the importance of the therapists
communication in his/her role as a passive
inquirer who asks questions solely to receive an
answer regardless of its content.
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 Basic Principles
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• Clients have resources and strengths to resolve
  complaints It is therapists task to access
  these abilities and help clients put them to use.
• Change is constant Therapists can do a great
  deal to influence clients perceptions regarding
  the inevitability of change and what is supposed
  to happen during the therapy session.
•  
• The therapists job is to identify and amplify
  change He/She accomplishes this through choice
  of questions, topics focused on or ignored.
  Focus on what seems to be working however small,
  to label it as worthwhile, and to work toward
  amplifying it. If the change is in a crucial
  area, it can change the whole system.

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• It is usually unnecessary to know a great deal
  about the complaint in order to resolve it What
  is significant is what the clients are doing that
  is working. Learn from clients identifying when
  the problem is not troublesome. Clients can learn
  to function that way again to solve the problem.
•  
• It is not necessary to know the cause or function
  of a complaint to resolve it Even the most
  creative hypotheses about the possible function
  of a symptom will not offer therapists a clue
  about how people can change. It simply suggests
  how peoples lives have become static. Ask those
  who want to know why they have a symptom Would
  it be enough if the problem were to disappear and
  you never understood why had it?
• A small change is all that is necessary A change
  in one part of the system can affect change in
  another part of the system We have the sense
  that positive changes will at least continue and
  may expand and have beneficial effects in other
  areas of the persons life.

5

• Clients define the goal Do not assume that
  therapists are better equipped to decide how
  their clients should live their lives ask people
  to establish their own goals for treatment.
• Rapid change or resolution of problems is
  possible We believe that, as a result of our
  interaction during the first session, our clients
  will gain a more productive and optimistic view
  of their situations. Therapists expect them to
  go home and do what is necessary to make their
  lives more satisfying (p. 45). Average length of
  treatment is less than 10 sessions, usually 4 to
  5, occasionally only 1.

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• There is no one right way to view things
  Different views may be just as valid and may fit
  the facts just as well Views that keep people
  stuck are simply not useful. Sometimes all that
  is necessary to initiate significant change is a
  shift in the persons perception of the
  situation.
•  
• Focus on what is possible and changeable rather
  than what is impossible and intractable Focus
  on aspects of a persons situation that seem most
  changeable. This imparts a sense of hope and
  power.

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• Specific Techniques Employed in Solution Oriented
  Therapy

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• INTRODUCING UNCERTAINTY
• The therapist can introduce some uncertainty into
  the problem definition by asking What gives you
  the impression that things seem difficult to
  handle?  Or he/she can imply that there are days
  when the problem is nonexistent by asking What
  is different about the days when things seem
  manageable?

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FRAMING QUESTIONSQuestions asked can elicit
information about strengths, abilities, and
resources.  Perceptions of problems then change
significantly in this context.
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1.  The Miracle Question  Suppose that one
night, while you were asleep, there was a miracle
and this problem was solved.  How would you
know?  What would be different?This type of
question seems to make a problem-free future more
real and therefore more likely to occur.The
therapist is given guidelines and information to
help the client go directly to a more
satisfactory future.
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• 2.  The Exception Question  Asks the client to
  focus on times when problem does not occur or has
  not occurred when they expected it would.  They
  may discover solutions they had forgotten or not
  noticed.  The therapist might find clues on which
  to build future solutions.
•  
• Example  What is different about those times
  when things are working?

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• REFRAMING PROBLEM DEFINITIONS
• Therapists offer new, more workable problem
  definitions that are within the power of the
  client and therapist to solve.  They usually help
  the client reframe the problem definition to a
  more positive one or listen for a hint of
  something in the clients complaint that can be
  solved.  This co-creates the experience that the
  problem is solvable and the client has some
  ability to solve it.

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• PROBLEM SOLVING TECHNIQUES
• 1.  Dissolve the idea that there is a problem
• Help people see their situations in new ways.
• 2.  Negotiate a solvable problem
• Reduce the size of the problem in the clients
  eyes.  (Get specific about the problem focus on
  when it is not so serious a problem).
• 3.  Frame towards the idea that clients have all
  the abilities and resources to solve the problem
• Create an atmosphere that facilitates the
  realization of strengths and abilities.

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• MATCHING THE CLIENTS LANGUAGE
• Example  Use the exact words the client uses to
  describe the problem in asking questions about
  what they have done before, when it is not so
  serious a problem, etc.
• Also, attend to clients metaphors and utilize
  them also to extend observations, learn about
  their interests or hobbies to use metaphors that
  involve them.

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• MATCHING SENSORY MODALITIESUse words pertaining
  to seeing or hearing how things are and use
  words in the same vein.

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• CHANNELING THE CLIENTS LANGUAGE
• Channel away from jargon into action descriptions
  used in every day language.  This has the effect
  of depathologizing or normalizing clients
  situations.  Gradually change your terminology to
  less serious, more positive words.  (Example 
  Use the words transitional period as this give
  the client the opportunity to take solace in
  hearing that a problem is temporary, helps shape
  their expectations for the future).

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• Use of verb forms  Create a reality where the
  problem is in the past and possibilities exist
  for the present and in the future.  When you had
  this problem before, you used to . . . you were
  having difficulty . . . how did the old you . . .

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• Help clients make distinctions that are helpful
  (feeling like or thinking about . . . rather than
  doing it).

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• NORMALIZING AND DEPATHOLOGIZING
• Tell clients that their problems are
  understandable and put the situation in an
  everyday frame of reference.  Say such things as
  naturally, of course, welcome to the club,
  so what else is new, that sounds familiar, or
  yeah, me too.
•  

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• GOAL SETTING
• Start small What will be the first sign that
  things are moving in the right direction?  Goals
  must be concrete.

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• FAST-FORWARDING QUESTIONS
• For use when clients cant identify exceptions or
  past solutions.  Clients are asked to envision a
  future without the problem and describe what that
  looks like.  (The miracle question or a magic
  wand question).  What will not would be
  different?

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• FIRST SESSION PROTOCOL
• The Consultation Break  After 30-40 minutes,
  therapist excuses himself to consult with a team,
  or when working alone to think about things. 
  Talk focuses on  things the clients are doing
  that are good for them any exception to the
  complaint pattern and what the team imagines the
  clients will be like once the complaint is part
  of the past.
•  
• Compliments are then given based on what the
  client is already doing that is useful or good or
  right in some way, regardless of the specific
  content and context.  Compliments are designed to
  help the client see through their frame of the
  situation in such a way that a more flexible view
  of the situation is possible.  The purpose is to
  support the orientation toward solution while
  continuing the development of a yes set begun
  during the interview but now will be pursued in a
  more intense and focused manner.  It is designed
  to let clients know that the therapist sees
  things their way and agrees with them . . . Then
  the clients are in a proper frame of mind to
  accept clues about solutions.
•  
• Clues are focused therapeutic suggestions, tasks,
  or directives about other sorts of things that
  the clients might do that will likely be good for
  them and will lead in the direction of solution.
• Message Delivery  After intermission of 10
  minutes or less, therapist returns and gives the
  formal intervention.  This takes 5 minutes or
  less, a new appointment is set, and the session
  ends.

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• Solution-Based Psychotherapy Techniques
•  
• Strong belief that client possesses solution to
  the problem. Never ending search for exceptions
  to the problem. Use of positive lines of
  questioning, stories, and expansion of clients
  possessed solutions.

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• 1.   Clients present 3 options
•       a.      Want to stop doing something
•       b.      Want to start doing something
•       c.      Want to do something differently

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• 2.   Close examination of pretherapy change

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• 3.   Emphasis is on strengths and solutions NOT
  problem or pathology.

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• 4.   Hunt for exceptions

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• 5.   Look for difference that makes a difference

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• 6.   Do not give up with vagueness

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• 7.   Close attention to language used by client
  AND therapist

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• 8.   Future orientation

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• Assessment as Intervention
• Pay attention to the clients
•       1.      language
•       2.      interests/motivations
•       3.      frames of reference
•       4.      behavior
•       5.      symptoms
•       6.      beliefs

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• 1.   Pay close attention to their
  theories/beliefs/explanations
•       Where do they come from?
•  
• 2.   Create fit of realities regarding therapy
•       what do clients believe therapy is about?
•       ethnographic interview

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• 3.   Introduce
•       confusion
•       disbelief
•       doubt
•       normalization

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• 4.   Give close examination to their language and
  yours.
•       A.     Vague statements
•       B.      Unspecified verbs
•                He ruined the relationship (how,
  what way?). I am scared (of what)
•       C.     Specify comparison
•                He is lazy (compared to whom)
•       D.     Empty nouns
•                respect, love, anger, depression
•       E.      Generalization (all, non)
•       F.      Cannot/will not vs. does/did not
•       G.     Characterizations (lazy, aggressive)
•       H.     Challenge claims
•                How do you know you feel
  depressed 

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• 5.   What are your presuppositions
•    try to examine from another theory

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• 6.   Reformulate the problem
•       do at end of session

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• Pretherapy Assessment
•     1.  What makes you think your family needs
  our services?
•     2.  What do you expect to happen here that
  will be helpful to your family?
•     3.  What will convince you that your family
  does not need to come here?
•     4.  How many days per week does the problem
  occur? (please circle)
•                1       2          3         
  4          5          6          7
•     5.  How many hours per day in the problem
  present?
•     6.  Please place an X indicating the severity
  of the problem.
•                1lt---------------------------------
  -5----------------------------------gt10
•           very mild                               
                                                    
     very severe
•     7.  Who will be the first person to notice an
  improvement in the problem?
•     8.  What is one of the first things your
  family will be doing differently when they notice
  improvement?
•     9.  When does your family NOT have the
  problem?
•   10.  How do you explain when the problem does
  not happen?
•   11.  How will you know when the problem is
  really solved?
•   12.  What are you doing to keep things from
  getting worse?
•   13.  What would tell you that things are
  getting a little better?
• Todd, T. Pretherapy assessment. Unpublished
  measure. The Brief Therapy Institute of Denver,
  8120 Sheridan Blvd., Ste. C-112, Westminster, CO,
  80030.

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• Conducting the First Session of Solution-Focused
  Therapy

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• 1)  FINDING OUT ABOUT THE CLIENTS LIFE with a
  special attention to interests, motivations,
  competencies, and beliefs. This is accomplished
  in a social, conversational manner by chatting
  with the client about their work, hobbies,
  vocations, interests, and commitments. Special
  attention is given to metaphors and the use of
  language for the purpose of using such processes
  of communication to access the clients beliefs
  and to assist the client in changing existing
  beliefs and behaviors. This sequence is on-going
  in that the therapist is always learning about
  the client, but a short time, usually 5-10
  minutes, in given in the first session to get the
  sequence started. At the end of this sequence the
  therapist should be able to answer questions such
  as
• a)  What does the client like to do? Such as what
  subjects in school do they do like.
• b)  What are some major hobbies or interests of
  the client?
• c)  How do they use language to describe
  themselves and others?
• d)  Are there any important key words or
  metaphors that can be used to communicate to the
  client?
• e)  What is known so far about their worldview or
  beliefs?

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• 2)  GATHERING A BRIEF DESCRIPTION OF THE PROBLEM
  BEHAVIORS. After the solution-focused therapist
  is acquainted with the client he or she proceeds
  to gather a problem description from the client
  by asking questions such as What would have to
  happen for you to know that it was worth your
  time to come and see me today may be asked? Or,
  If we were successful in making progress in
  solving the problem that brought you here today,
  what would need to be different? The client will
  usually begin to volunteer information about the
  presenting problem. The therapist asks follow-up
  questions to gain a sense of the problem and
  context of the problem. However, the questions
  may be phrased in different ways to accommodate
  to individual clients.

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• The therapist should come out of this sequence
  having asked and been provided answers to the
  following questions.
• a)  What is the problem?
• b)  How long is the problem been going on?
• c)  How often does the problem occur?
• d)  Where or in what situations does the problem
  occur?
• e)  Who is there when the problem happens or who
  is involved in the problem?
• f)  What does each person do in a sequence (What
  does your teacher do?, Your classmates?  When the
  principle comes what does he do? etc.)?
• g)  Whose idea was it for you to come for help
  with the problem?
• h)  Why did you come or get sent for help now and
  not before?
• i)  What is your explanation for why this problem
  is happening?
• j)  What have you tried so far to solve the
  problem?

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•    3)  ASKING RELATIONSHIP QUESTIONS TO HELP THE
  CLIENT DEFINE THE SOCIALLY CONSTRUCTED NATURE OF
  THE PROBLEM. The therapist asks relationship
  questions such as What would your teacher say
  about your grades? What would your mother say? If
  you were to do something that made your teacher
  very happy what would that be? Who would be most
  surprised that you did really well on the test?
  What would that person say about the fact that
  you are doing so well ? Relationship questions
  are used throughout the sessions at different
  points to help the client gain a meta-perspective
  about the problem, and to assess the individual
  cognitive constructions and social constructions
  concerning the problem definition and resolution.
  Relationship questions can be used to help
  clients discuss their problems from a third
  persons perspective, making the problems less
  threatening to discuss.

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• After asking relationship sequence questions a
  therapist should know the following
• a)  How the client perceives the problem as well
  as their perceptions about others perspectives
  about the problem or problem resolution.
• b)  How the problem is being socially constructed
  and who and how they are involved with those
  social constructions.
• c)  Who from the clients perspective makes the
  problem worse and who makes it better?
• d)  What social supports and resources are
  available to the client and how these resources
  may be used to solve the problem.

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• 4)  TRACKING SOLUTION BEHAVIORS OR EXCEPTIONS TO
  THE PROBLEM. The therapist proceeds to identify
  times when the problem does not occur, effective
  coping responses, and the contexts for the
  absence of the problem. The therapist says
  something such as, Even though this is a very
  bad problem, in my experience peoples lives do
  not always stay the same. I bet that there are
  times when the problem of being sent to the
  principals office is not happening or at least
  it is better. Describe those times. What is
  different? How did you get that to happen? The
  therapist gathers as many exceptions to the
  problem pattern as possible by repeatedly asking
  the client what else... what other times...? The
  therapist must be patient and give the client
  time to construct the exceptions from episodic
  memory. Since the client is often focused on the
  problem situations the exceptions may not be on
  the tip of their tongue. Once an exception has
  been identified by the client, the therapist uses
  prompts, such as tell me more about that, to
  help the client describe in detail the
  exceptions. The therapist also uses his or her
  own affects, tone and intense attention to the
  clients story to communicate to the client that
  they are very interested in those exceptions.
  Such non-verbal gestures as nodding, smiling,
  leaning forward, looking surprised are used. They
  also may say something such as how about that,
  I am amazed, Wow! as social reinforcement to
  the client. This encourages the client to talk on
  and to develop in more detail the exceptions
  story.

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• The therapist should come out of this sequence
  knowing the following
• a)  What exceptions to the problem exist?
• b)  How often have exceptions occurred?
• b)  When was the last time an exception happened?
• c)  What was different in the situation where the
  exception occurred than in situations where the
  problem happens?
• d)  Who was involved in making the exception
  happen?

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• 5)  SCALING THE PROBLEM. Using Scaling questions
  to anchor the problem and to track progress
  toward problem resolutions. The therapist says,
  using the prior descriptions of the client
  concerning the problem descriptions and
  exceptions, On a scale of 1-10 with 1 being that
  you are getting in trouble everyday in the class,
  picking on Johnny and Susi, getting out of your
  seat and being scolded by your teacher, and 10
  being that instead of fighting with Johnny and
  Susi you are doing your work, and that you ask
  permission to get out of your seat, and your
  teacher says something nice to you, where would
  you be on that scale now? With children, often
  smiley and sad faces are also used to anchor the
  two ends of the scale.

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• Several other uses of the scaling technique in
  the therapy process include the following 1)
  asking questions about where the client is on the
  scale in relationship to solving the problem 2)
  using the scaling experience to find exceptions
  to the problems, such as saying How did you get
  to the 3? What are you doing so you are not a
  1? 3) employing scales to construct miracles
  or to identify solution behaviors. For example,
  the therapist inquires as to where on the scale
  (with 1 representing low and 10 representing
  high) the client is, and proceeds to ask the
  client how that they will get from 1 to a 3. Or,
  the therapist inquires as to how clients managed
  to move from 4 rating to 5 a rating. How did they
  get that to happen? What new behaviors did they
  implement or what was different in their lives
  that made the changes? Solution-focused
  therapists may also express surprise that the
  problem is not worse on the scale as a way of
  complimenting the clients coping behavior or as
  a way to use language to change the clients
  perception of the intractable nature of their
  problem. Or, the therapist may use the scale,
  along with the miracle question(described
  below), by asking the client, If there was an
  overnight miracle and you could get to a 9 or 10
  on the scale, what would be the first thing that
  you would notice that is different? Solution
  behaviors described by the client, through the
  use of the scaling technique, are often used in
  constructing specific tasks or homework
  assignments that are prescribed and discussed in
  future sessions.

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• The therapist should finish the scaling sequence
  having accomplished the following
• a)  Developing a scale from 1-10 with the client
  which can be referred back to in future sessions.
• b)  Having developed two concrete behavioral
  descriptions or self- anchors that describe the
  problem and its solutions. One (1) should be
  anchored as the problem behaviors and ten (10)
  the presence of solution behaviors. Therapist
  uses the clients own words, descriptions, and
  images to develop the anchors.
• c)  Having obtained a rating from the client on
  where they perceive they are on the scale today.

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• 6)  USING COPING AND MOTIVATION QUESTIONS TO
  ASSESS HOW THE CLIENT PERCEIVES THEY ARE COPING
  AND TO DETERMINE THEIR MOTIVATION FOR CHANGE.
• This is a variation on the scaling question that
  helps the therapist assess the clients
  motivation for solving the problem as well as how
  well the client perceives that they are coping
  with the problem. The therapist says something
  like  On a scale of 1-10 with 10 being you
  would do anything to solve this problem and 1
  being that you do not care so much for solving
  it, where would you say you are right now? Or
  the therapist may say On a scale of 1-10 with 1
  being that you are ready to throw in the towel,
  and give up ever doing well in school and 10
  being that you are ready to keep on trying, where
  would you rate yourself right now?

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• After asking coping and motivation questions the
  therapist should be able to determine the
  following
• a)  If the problem that has been defined is too
  overwhelming to the client. If the problem is too
  overwhelming then the problem needs to be broken
  down into smaller steps and re-defined for the
  client.
• b)  How much self-efficacy and hope the client
  possesses toward the problem resolution. If the
  client does not believe the problem can be
  solved, steps must be taken to change this
  belief. The exception questions are empowering in
  this regard.
• c)  What is the degree of commitment to work on
  the problem? If clients not interested in
  committing themselves to working on the problem,
  then the problem must be re-defined to muster
  some degree of commitment.
• d)  If the problem that has been defined is the
  one that really interests and is the priority for
  the client.

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• 7)  ASKING THE MIRACLE QUESTION TO DEVELOP
  SOLUTIONS. The therapist says, Lets suppose
  that a overnight miracle happened and the problem
  you are having with your teacher disappeared. But
  you were sleeping and did not know it. When you
  came to school the next day what would be the
  first thing that you would notice? The therapist
  proceeds to help the client envision a new way of
  behaving and how things could be different. An
  extreme amount of detail is elicited to help
  develop a set of solution behaviors that are
  concrete and behaviorally specific.

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• The therapist should come out of this sequence
  knowing the following
• a)  A detailed description of what life would be
  like without the problem.
• b)  Having helped the client develop a specific
  set of behaviors, thoughts, and feelings that can
  be substituted for problem patterns.
• c)  Obtaining from the client an idea of what is
  most important to the client and others
  concerning which changes that they will perceive
  as being a solution to the problem. Asking
  relationship questions along with the miracle
  question helps confirm this information.

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• 8)  NEGOTIATING THE GOAL FOR CHANGE. From the
  problem descriptions and the miracle question the
  therapist negotiates with the client small,
  concrete and behavioral goals that the client
  would like to work towards. The goals should
  comprise the miracle picture of the client.

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• The therapist should come out of this sequence
  having helped the client to set goals in the
  following manner.
• a)  A goal should be important to the client.
  Something that they are motivated to accomplish.
  The client should say they are committed to
  working toward the goal. Clients should have
  clearly stated that this is something that they
  want for their lives.
• b)  Goals should be small and obtainable.
  Movement should possible towards the goal
  immediately and before the next session.
• c)  Goals should be concrete, specific, and
  behaviorally defined. The therapist and client
  should be able to describe specifically what the
  client is to do. The frequency and duration, and
  context of goal directed behaviors should be
  easily described. What, when, how and with whom
  is the behavior to happen?

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• d)  Goals should include the presence rather than
  absence of a behavior. A goal should describe
  what a client is to do instead of the problem
  behavior.
• e)  Goals should be represented to the client as
  a beginning to behavior change rather than an end
  to the process. The therapist may use phrases
  like, this is a step or this is a beginning.
• f)  Goals should be realistic and achievable
  within the context of clients life. The goal
  must be a set of behaviors that a client can
  practice in everyday life. It cannot depend on
  other people to accomplish unless those people
  have agreed to work on the goal too. The goal
  should involve something the client is capable of
  doing on their own.
• g)  Goals should be understood by the client, as
  communicated by the therapist, as being hard
  work, something you have to constantly work at to
  achieve. Action must be taken and tasks must be
  completed if the goal is to be reached. The
  therapist may say things like, I know that this
  may not be easy but you have done it before.
  Are you willing to work to get this going?
  This will take a lot of effort but is something
  you can do.

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• 9)  TAKING A SESSION BREAK FOR REFLECTION,
  DEVELOPMENT OF COMPLIMENTS, AND FORMULATION OF A
  SET OF BEHAVIORAL TASKS. Near the end of the
  session the therapist takes a 5-10 minute break
  for reflection and to have time to construct the
  information gained into a behavioral task or
  homework assignment. It is not absolutely
  necessary for the therapist to give a homework
  assignment. He or she may simply offer a set of
  reflections for the client to think about, but in
  most instances such an assignment is given. Part
  of the work of the therapist is to formulate as
  many genuine compliments as possible to deliver
  to the client when they return to the session.

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The therapist should come out of the break with
this information a)  A list of compliments to
give to the client. Compliments should be based
on the exceptions generated from the client, the
miracle picture and the clients strengths and
capacities that are assessed in the session. b) 
A behavioral task or a set of reflections to be
given to the client that requires the client to
engage in behavioral exercises, recording
behaviors, or reflections aimed at changing
behavior, thoughts or feelings. c)  A bridging
statement that ties together the content of the
session with a rationale for the homework
assignment. A bridging statement is a statement
that serves as a transitional sentence or two
that moves the therapist from the compliments
sequence back to the session content to the
homework assignment. For example, Since you do
so well finishing your homework on the days that
you ride the bus, but problem is essentially
solved during those times when your mom picks you
up, I am wondering if you can play a pretend game
with me that asks you to do something different
on the days you have to ride the bus. You do
really well when you get home earlier and you
start your homework right away before you watch
TV. I am wondering if on the days you ride the
bus that you could pretend that it is an hour
earlier when you get home. In fact, I want you
set your watch and clock in your room an hour
backwards. Prepare the VCR to tape the show you
usually watch and spend that hour on your
homework.
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10) DELIVERING COMPLIMENTS AND TASKS.  The
therapist delivers the compliments and behavioral
tasks. The session is ended by setting another
appointment. To complete this sequence in a
successful manner the therapist should have a) 
Given 4-5 genuine compliments to the client. b) 
Developed a set of meaningful reflections or a
concrete behavioral task for the client to work
on in-between sessions. c)  Obtain a commitment
from the client to do the task. d)  Communicate
that they will follow-up on their successes in
the next session. e)  Set another appointment.
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Qualities of Well-formed Goals  1.  Saliency to
the client       important to the client  2. 
Small  3.  Concrete, specific, behavioral  4. 
Presence rather than absence of something  5.  A
beginning rather than an end       concentrate
on starting  6.  Realistic and achievable within
the context of clients life  7.  Perceived as
Hard Work    Berg, I., Miller, S. (1992).
Working with the problem drinker. New York W. W.
Norton.
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INTERVIEWING FOR CHANGE WITH CHILDREN Imagination
Questions If you were Barney, how would you
make Lisa happy? How will that help? What would
you tell Mom and Dad to do to make Lisa happier?
Lets say you were a great magician, how would
you change your parents? If you were a rap
singer, what would you tell other boys just like
you in your songs?
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Imaginary Wand Questions Lets say I gave you an
imaginary wand and you could wave it and make any
of your wishes come true, what would those wishes
be? If you pointed the wand at your parents, how
will they have changed? How about if you pointed
the wand at you, how will you have changed? When
these chages happen, how will that make things
better in your family?
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Reversal Questions Do you have any advice for
your parents about how they can get you to clean
up your bedroom/empty the garbage/yell less?
What ideas do you have for your parents to help
you do better in school? What advice do you have
for me when I work alone with your parents? What
should I work on changing with them?
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Externalizing Questions When ADD is trying to
get you into trouble with your parents, what does
it make you do? Does ADD make your (parents)
relationship cave in or are you able to stand
your ground as a team and not let it divide you?
When the fears are trying to scare you, what do
they whisper into your ears? Has there been
anything lately that you have done to stand up to
the fears to not let them push your son around?
Billy, what do you do sometimes to chase away the
fears?
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FAMILY PLAY AND ART THERAPY TASKS Family Squiggle
Wiggle Game Have the child pick a family member
to draw a squiggly line on a sheet of
construction paper. The child is then instructed
to draw a picture out of the squiggly line and
then tell a story about his or her picture.
Family members, the child, and the therapist will
then process the drawing. Once the discussion is
completed, the child will then be instructed to
draw a squiggly line on another sheet of paper
and pick a family member or the therapist to
create a picture out of his or her squiggly line
and tell a story about it. The Imaginary Time
Machine The child is given the following
directive Lets say I have sitting over here an
imaginary time machine and once you enter it, you
can take it anywhere in time, in the past or into
the future, where would you go? What would you
see there? Whom would you meet and talk with?
What would you talk about? If you and the famous
person from the past hopped into the time
machine and came back to 1997, how would famous
person help you out today? What advice would he
or she give you at school? How would he or she
help out with your parents? (With future time
trips) What would you bring back from Mars/the
year 3000/the childs name of the place to help
you out today?
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SOLUTION-ORIENTED TASKS The Secret Surprise Meet
alone with the child and have him or her pick two
nice surprises that he or she could perform in
one weeks time to shock the parents in a
positive way. The child is not to tell the
parents what the surprises were until the next
scheduled appointment. The parents will be asked
to play detectives and try and guess what the
surprises were. Do Something Different Task
Explain to the parents that their child has got
their number because they are too predictable.
Instruct the parents as an experiment to do
something off-the-wall wacky, or different than
their usual course of action when the child
pushes their buttons and engages in the
problematic behavior they wished to see changed
with their son or daughter.
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Positive Reframes   Negative Positive  Angry In
touch Bossy Natural leader Clingy Affectionate C
onceited Confident Dependent Connected Distant I
ndependent Goofy Creative Lies Good
storyteller Loud Expressive Plain Natural Quiet
Thoughtful Shy Self directed Sneaky Inventive S
tubborn Persistent Talks back Courageous Teases
Can have fun 
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SEQUENCES OF SOLUTION-FOCUSED QUESTIONS 1.       
GOAL DEFINITION (Clients usually start out by
describing their problems and goals in broad
terms and it takes some listening and clarifying
before a clear goal can be determined. If client
specifies several goals ask the client which one
to start with.)           What brings you here
today?         How will you know coming here is
worthwhile?         What will you be doing
differently?         What will other people
notice?         How will you know you dont have
to come here anymore?
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2.        PROBLEM DEFINITION (Solution-constructio
n is easiest when the goal is focused down to a
problem that can be described in specific
behavioral terms. (Example The goal may be to be
less depressed. The focused problem description
could be to have more energy to study, or to call
up friends and go out more.)           How is
(example depression) a problem for you?        
Is that a problem for anyone else? How is it a
problem for others?         What effect does
that have on you?         How will things be
different when the problem is solved? . . . for
you? . . . for others?
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3.        EXCEPTION QUESTIONS (Dont ask for
exceptions until you and the client are clear
about what the problem and the goal
is.)           When dont you, or didnt you
have this problem? . . . even a little
bit?         What is different at those
times?         What will make it possible for
more of that to happen?         What small
changes will you notice?         How will the
small changes make a difference for you? For
others?         What will you notice about
yourself? . . . others? What will they notice
about you?
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4.        EXISTING RESOURCE QUESTIONS          
What have you tried to do to solve the problem?
What helped even a little bit?         How have
you dealt with similar problems in the
past?         What have you learned from
previous experiences like this that might be
useful in this situation?
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  5.        MIRACLE QUESTION (This question or
any question asking about a hypothetical solution
is usually asked when the client cannot think of
any exceptions or when he/she is having
difficulties defining a goal).           If a
miracle happened tonight and you woke up tomorrow
morning and your problem was solved, how would
things be different? Describe the differences
from your point of view and what others would be
doing and experiencing.   In response to clients
answers ask           Does some of that happen
already at times? . . . even a little
bit?         What will allow more of that to
happen?         What will you have to do? . . .
others?
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6.        SCALING QUESTIONS (Usually asked to
help client get a better perspective about how
severe a problem is. This question is also asked
to track progress from session to
session.)           On a scale from 0 to 10,
with 0 being totally unacceptable and 10 as good
as you can imagine, where would you put your
relationship at this point?
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Or           On a scale from 0 to 100, with 0
being never and 100 being always, what percentage
of the time would you say you feel those anxious
feelings that make you afraid to leave the
house?   In response to answers ask          
How many degrees would it have to change for you
to feel better?         What would a small step
(from 3 to 3.5) look like? What will you be doing
differently? What will others be doing
differently?
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7.        ADVANTAGE QUESTION (Asked when clients
keep giving negative answers.)           This
may seem like a strange question, and I dont
want you to think I am not hearing how serious
this problem is for you, but is there an
advantage to your having this problem? . . . Is
there anything positive about this negative
situation?   In response to answers
ask           How can you have the advantage
without having to maintain this problem? What can
you do instead?
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8.        COPING QUESTION           How come
things arent worse? What have you done to keep
them from being worse?   If the client still does
not answer with exceptions or positives
ask           Do you think things can get
worse? What will that be like for you? For
others?         What is the smallest thing you
can imagine will make a difference?
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SUMMATION MESSAGE     1.        WHAT I HEARD YOU
SAY TODAY   This statement should
include   1.        the complaint 2.      the
goals 3.      any progress that has already been
made 4.      what the client said about how the
situation is affecting him or her (including
emotionally).   2.        MY RESPONSE IS   This
statement should include   1.        the
therapists reaction to the situation 2.     
reinforcement of positives and changes 3.     
normalizations, reframes, or new
information 4.      acknowledgement of clients
feelings.   3.        TASK   This should always
be stated as a suggestion which clients can
choose to do, rather than as an assignment.