Postmodern Approaches

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Postmodern Approaches
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Overview

• Postmodernists believe in the subjective
  realities that do not exist independent of
  observational processes.
• Social constructionism is a therapeutic
  perspective within a postmodern worldview it
  stresses the client's reality without disputing
  whether it is accurate or rational.

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continued

• In postmodern thinking, language and the use of
  language in stories create meaning.
• In social constructionism the therapist disavows
  the role of expert, preferring a more
  collaborative or consultative stance.
• Clients of the therapists are viewed as experts
  in their own lives.

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Solution-Focused Brief Therapy

• Solution-focused brief therapy differs from
  traditional therapies by eschewing the past in
  favor of both the present and the future.
• It is so focused on what is possible that it has
  little or no interest in gaining an understanding
  of the problem.
• De Shazer suggests that it is not necessary to
  know the cause of the problem to solve it.
  Gathering information about a problem is not
  necessary for change to occur.

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continued

• In solution-focused brief therapy clients choose
  the goals they wish to accomplish in their time
  in therapy, and little attention is given to
  diagnosis, history taking, or exploration of the
  problem.

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The Therapeutic Process

• Bertolino and OHanlon stress the importance of
  creating collaborative therapeutic relationships
  and see doing so as necessary for successful
  therapy.
• If the clients are involved in the therapeutic
  process from beginning to end, the chances are
  increased that therapy will be successful.
• Walter and Peller describe four steps that
  characterize the process of Solution-focused
  relief therapy.

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4 Steps

• 1. Find ou what clients want rather than
  searching for what they do not want.
• 2. Do not look for pathology, and do not attempt
  to reduce clients by giving them a diagnostic
  label. Instead, look for what clients are doing
  that is already working and encourage them to
  continue in that direction.

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continued

• 3. If what clients are doing is not working, then
  encourage them to experiment with doing something
  different,
• 4. Keep therapy brief by approaching each session
  as if it were the last and only session.

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3 kinds of therapist/client relationships

• De Shazer developed 3 different kinds of
  relationships that can develop between the client
  and the therapist.
• These 3 are customer, complainant, and visitor.
• 1. customer the client and therapist jointly
  identify a problem and a solution to work toward.
  The client realizes that to attain his/her goals,
  personal effort is required.

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• 2. complainant the client describes a problem
  but is not able or willing to assume a role in
  constructing a solution, believing that a
  solution is dependant on someone elses actions.
  The client expects the therapist to change the
  person who is attributed with the problem.
• 3. visitor the client who comes to therapy
  because someone else thinks the client has a
  problem. Client may not agree they have a problem
  therefore may not identify anything to explore
  during therapy.

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Therapeutic Techniques

• PRETHERAPY CHANGE-during the initial therapy
  session it is common for a solution-focused
  therapist to ask, What have you done since
  calling for your appointment that has made a
  difference in your problem?
• EXCEPTION QUESTIONS- these are used to direct
  clients to times when the problem did not exist.

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..cont.

• THE MIRACLE QUESTION-therapist ask. if a miracle
  happened and the problem you have was solved
  overnight, how would you know it was solved and
  what would be different?
• SCALING QUESTIONS-when the therapists ask such
  questions, On a scale of one to 10, when zero
  being when you first came to therapy and 10 being
  after the miracle occurs, rate your problem now.

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• FORMULA FIRST SESSION TASK-something that
  resembles homework given from the therapist to
  the client, between now and the next time we
  meet I want you to observe so that you can
  describe to me next time, what happens in your
  home life that you want to continue to happen.

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Therapists Feedback to clients

• During the last 5 to 10 minutes of the session
  the therapist usually compose a summary message
  for the clients. During this time therapists
  formulate feedback that will be given to the
  clients. There are three parts to this
  compliments, a bridge and suggesting a task.

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Narrative Therapy

• According to Michael White, individuals construct
  the meaning of life in interpretive stories,
  which are then treated as truth.
• Therapists are encouraged to establish a
  collaborative approach with a special interest in
  listening to clients stories. Therapists use
  these stories to engage us in therapy, avoid
  diagnosing and labeling, and help clients with
  mapping out the problem.

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The Therapeutic Process

• Steps in the therapeutic process include
• Collaborate with the client to come up with a
  mutually acceptable name for the problem.
• Personify the problem and attribute oppressive
  intentions and tactics to it.
• Investigate how the problem has been disrupting,
  dominating, or discouraging to the client.
• Invite the client to see his or her story from a
  different perspective by offering alternative
  meanings for the events.

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• Discover moments when the client wasnt dominated
  of discourage by the problem by searching for
  exceptions to the problem.
• Find historical evidence to bolster a new view of
  the client as competent enough to have stood up
  to, defeated, or escaped the dominance of
  oppression of the problem.
• Ask the client to speculate about what kind of
  future could expected from the strong, competent
  person that is emerging.
• Find or create an audience for perceiving and
  supporting the new story. Clients need to live
  the new story outside of therapy.

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Therapists goals and function

• A general goal of narrative therapy is to invite
  people to describe their experience in a new and
  fresh language. In doing this they open up new
  vistas of what is possible.
• A main task of the therapist is to help the
  clients construct a preferred story line.
• Like the social-focused therapy, narrative
  therapy believes that the client is the expert
  when it comes to what they want in life.

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Therapeutic Techniques

• QUESTIONS-therapists use questions to generate
  experience rather than to gather information.
• EXTERNALIZATION AND DECONSTRUCTION- therapists
  believe its not the person that is the problem
  but that its the problem that is the problem.
  This is one way to separate the person from
  identifying with the problem.

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Summary

• In both social-focused and narrative therapies
  the therapist-as-expert is replaced with the
  client-as-expert mindset.
• Both are also based on the optimistic assumption
  that people are healthy, competent, resourceful,
  and posses the ability to construct solutions and
  alternative stories that can enhance their lives.