Title: Minnesota Child Welfare Training System Solution-Focused Brief Therapy Treatment Strategies
1Minnesota Child WelfareTraining System
Solution-Focused Brief TherapyTreatment
Strategies Interventions Bob Bertolino,
Ph.D.Assistant Professor, Rehabilitation
CounselingMaryville University St. Louis,
MissouriSr. Clinical Advisor, Youth In Need,
Inc. St. Charles, Missouri
2There is More to See
3Creating A Culture of Care and Respect
Philosophy, Research, Practice
4Creating A Culture of Care and Respect
- Philosophy
- Ideas/principles that inform change. Philosophy
reflects ones core beliefs about the world and
the human condition. It precedes and informs
theory. - Research
- Comes from different agendas. Although it is
influenced by economics, politics, society, etc.,
we owe it to our clients and to ourselves to
search for what each has to offer and how that
can influence ethical, effective, and respectful
practice. - Practice
- Evolves from philosophy and research and should
fit with and be respectful of clients worldviews
including their cultural backgrounds,
preferences, and expectations. Modes of practice
should also assist with helping clients to meet
their needs, achieve goals, and experience
improved outcomes.
5No More Boxes Recalibrating Compasses and
Expanding Personal Worldviews
6You must be the change you wish to see in the
world Mahatma Gandhi
7Recalibrating Compasses
- What are the core beliefs you have about the
people with whom you work? - How have you come to believe what you believe and
know what you know? What have been the most
significant influences on your beliefs? - How have your beliefs and assumptions affected
your work with clients? With colleagues? With
the community? - Do you believe that change is possible even with
the most difficult and challenging clients? - How do you believe that change occurs? What does
change involve? What do you do to promote change? - Would you be in this field if you didnt believe
that the clients with whom you work could change?
8H. O. P. E.
9HHumanismOOptimismPPossibilitiesEExpectancy
- Optimism is the faith that leads to achievement.
- Nothing can be done without hope or confidence.
- - Helen Keller
10Experience as a CatalystThe Presence of H.O.P.E.
- What inspires or moves you?
- How does that increase your sense of hope?
- What does an increased sense of hope allow you to
do? - How can you promote hope with others?
- How do you maintain your sense of hope when you
are struggling with clients?
11What Does The Data (Research) Say?
12What Does The Data Say?
- The most significant portion of change occurs
earlier rather than later in services - Dose-Response Effect
- The clients rating of the therapeutic
relationship is the best and most consistent
predictor of outcome - One of the best predictors of negative outcome is
lack of structure - Most clients are making some form of progress
13What Does the Data Say? (cont.)
- Real-Time feedback increases factor of fit
- Long-term services without an improved outcome
combined with more of the same on the part of
the therapist equals an impossible case - Long-term services with high alliance scores and
no improvement in outcomes can indicate
dependence - Practitioners whose clients do not seem to be
making progress tend to do similar things - More of the same, Clients must get worse before
they get better, More severe diagnosis, Return
to their models
14What Does the Data Say? (cont.)
- Non-model-specific factors account for 8-12x more
than methods and models and up to 92 of the
variance - Although models (approaches) account for very
little of the variance in outcome, the person of
the practitioner can significantly affect change - Among effective approaches it is the similarities
not the differences that account for the
significant portion of change (e.g., MST, FFT,
BSFT, MI, CBT, etc.) - Through different mechanisms of change, effective
approaches are vehicles for activating and
transporting common factors
15(No Transcript)
16Hubble, M. A., Duncan, B. L., Miller, S. D.
(Eds.) (1999). The heart and soul of change
What works in therapy. Washington, D.C.
American Psychological Association. Lambert, M.
J. (1992). Psychotherapy outcome research
Implications for integrative and eclectic
therapists. In J. C. Norcross M. R.
Goldfried (Eds.), Handbook of psychotherapy
integration (pp. 94-129). New York Basic Books.
17Ingredients of Change
- Wampold, B. E. (2008). The great psychotherapy
debate Models, methods, and findings (2nd ed.).
New Jersey Lawrence Erlbaum.
18Points of Convergence
- Culturally sensitive
- Relationship-oriented
- Client-informed
- Collaborative
- Change-oriented
- Outcome-oriented
- Strengths and solution-based
19Martin Seligman
- What we have learned is that pathologizing does
not move us closer to the prevention of serious
disorders. The major strides in prevention have
largely come from building a science focused on
systematically promoting the competence of
individuals. Fifty years of working in a medical
model on personal weakness and the damaged brain
has left mental health professionals ill-equipped
to do effective prevention. We need massive
research on human strength and virtue. We need
practitioners to recognize that much of the best
work they do is amplifying the strengths rather
than repairing their patients weakness.
20Principles of SSB Philosophy
- Client Contributions
- The Therapeutic Relationship and Alliance
- Cultural Competence
- Change as a Process
- Expectancy and Hope
- Model and Factor of Fit
21Active Client Engagement (A.C.E.)Principles in
Motion
22Create a Context of Collaboration
- Point
- Start services by offering options that are
respectful of clients and their cultures and
incorporate their preferences and perceptions - Preparatory
- How
- Be prepared
- Keys to Collaboration
23Strengthen Through Presence
24The Therapeutic Relationship in Context
- Even for those who are convinced that the
therapeutic relationship is healing by and of
itself, there are strategies that can foster its
impact. In other words, since not all kinds of
relationships are likely to bring about change,
one needs to be aware of interventions (including
modes of relating) that should be encouraged or
avoided for the relationship to become a
corrective experience. (Castonguay Beutler,
2006, p. 353) - Castonguay, L. G., Beutler, L. E. (2006).
Common and unique principles of therapeutic
change What do we know and what do we need to
know? In L. G. Castonguay L. E. Beutler (Eds.),
Principles of therapeutic change that work (pp.
353-369). New York Oxford University Press.
25Strengthen Through Presence
- Point
- Listen and Attend to Clients Stories and
Strengths - Engagement
- How
- Acknowledge and validate
- Consider the influence of words
- Use possibility-laced language
- Separate experience from action
- Summarize, validate, and soften
- Avoid platitudes or trying make things more
positive - Be aware of stories of impossibility
- Be a life witness
- Strengths-Based
- Engagement
- and Practice
- Creating Effective
- Helping Relationships
- Allyn Bacon
- February, 2009
26The Influence of Words
27The Influence of Words
- Sad. Helpless. Inconvenience. Defeat. Tired.
Oppressed. Doubtful. Uninterested. - Life is so hard. Nothing seems to go my way.
There is no one to turn to. It feels like Ive
been forgotten. Times are hard. Nothing seems
to help. Things will not get better. In fact,
they will probably get worse. There is no hope.
28The Influence of Words
- Exciting. Fun. Laughter. Joy. Anticipation.
Possibility. Aliveness. Love. Peace. - When I think about the future I become energized.
There is so much I can accomplish. Life is
wonderful. There are so many possibilities in
the world.
29Being a Valuing orLife Witness
30Learn Clients Orientations
- Point
- Gain an improved understanding of clients
perceptions, perspectives, and theories - Words and Pictures
- How
- Ask questions as to what clients attribute
problems to and possible solutions - Assess clients readiness for change (Stage of
Change)
31Address Case Management Matrix
- Point
- Explore services and program parameters
- Monitor relationship and outcome
- Interim Family Safety Guidelines
- How
- Provide information
- Collaborate and negotiate
- Concurrent planning
- Introduce outcome measures
- Use feedback processes to client perceptions of
the alliance
32Eliciting Client Feedback
- In Initial Sessions and Interactions
- Are there certain things that you want to be sure
we talk about? - What is most important for me to know about you
and/or your situation/what youve been
experiencing? - What ideas do you have about how therapy/coming
here/coming to see me might be helpful to you? - Checking In As Sessions and Interactions
Progress - Have we been talking about what you want to talk
about? - Are we moving in a direction that seems right for
you? - Are there other things that we should be
discussing instead? - What, if anything, should I do differently?
- At the End of Sessions and Interactions
- How did the session go for you?
- How was the pace of our conversation/interaction/s
ession? - Did we work on what you wanted? Was there
anything missing?
33Accommodate Services to Clients and Others Goals
- Point
- Create focus and direction
- Gain clarity regarding goals and indicators of
change and progress - How
- Determine what needs to change
- Determine how it will be known that sufficient
change has been made and goals have been met - Determine what will indicate that progress is
being made
34Be Change-Oriented and Solution-Focused
- Points
- Consider strategies that offer the best possible
fit for clients - Methods should fit with and be sensitive of
clients cultures, beliefs - Focus on processes that enhance change
- Similar-But-Different Role Play
- How
- Reassess clients readiness for change
- Collaborate on tasks/way to achieve goals and
improve outcomes
35Evaluate Plan
- Points
- Ensure expectations are clear
- Ensure plans are clear
- Final Family Safety Plan
- How
- Discuss benefits of positive change
- Discuss possible consequences of lack of
follow-through - Encourage feedback
36Monitor Progress
- Points
- Determine progress and gains
- Identify barriers to change
- Determine next steps
- Follow-Up
- How
- Identify, amplify, and extend change
- Reassess goals
- Determine outcomes
- Explore transitions
- Check in with self and remain aware of pathways
of impossibility
The Therapists Notebook for Strengths and Solution-Based Therapies Homework, Handouts, and Activities Bob Bertolino Michael Kiener Ryan Patterson Routledge Summer, 2009
37Its not enough to be compassionate.You must
act. Tenzin Gyatso 14th Dalai Lama, 1992
38ThankYou
39Bob Bertolino, Ph.D.TCCT, LLC P.O. Box 1175
St. Charles, Missouri 6330201.314.852.7274
bertolinob_at_cs.com www.bobbertolino.com
- Maryville University
- 650 Maryville University Drive
- Saint Louis, Missouri
- 63141 USA
- 01.314.529.9659 (Phone)
- 01.314.529.9139
- rbertolino_at_maryville.edu
- www.maryville.edu
- Youth In Need, Inc.
- 516 Jefferson
- Saint Charles, Missouri
- 63301 USA
- 01.636.946.0101 (Phone)
- 01.636.925.0125 (Fax)
- rbertolino_at_youthinneed.org
- www.youthinneed.org