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Regardless of the therapeutic approach, working with children and youth can be very different from working in a helping role with adults. And this certainly holds true when using a solution focused approach. In this episode of Leading From Behind, we take a brief and very basic look at some of the general considerations for the solution focused therapist when working with children. In particular, we highlight the importance of seeing young people (including very young kids) as still having expertise about their own lives. We also note the importance of building a strong therapeutic alliance with this population, as without it, successful outcomes are often doomed. Finally, we highlight how creativity can be very important when using some of the common solution focused questions with younger clients.
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In this episode of Leading From Behind, we take a general look at using the solution focused approach in working with couples. While the basic structure or process of working with couples is essentially the same as when we work with individuals, this episode highlights some of the unique differences and challenges when there is more than just one client in the room.
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In this episode of Leading From Behind, we examine solution focused conversations with mandated or involuntary clients. For the purposes of this discussion, we describe mandated clients as people who attend sessions reluctantly and who may have little or no agreement with the referral source's description of the problem. In addressing this subject, we highlight the importance of seeing mandated clients as having expertise about their own lives, and their own good reasons for the adopting the positions they hold. Our role, as solution focused therapists, is to find a place of collaboration that reflects what's important to the client and what might also be important to the referral source. Along the way, we note how focusing on exceptions to the problem can be a useful way of building such collaboration.
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Client feedback on the therapeutic alliance and the presence of early change have been identified as the best predictors of outcome in psychotherapy. The Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) are tools that help the solution focused practitioner generate this important feedback. In this episode of Leading From Behind, we conclude our look at Feedback Informed Treatment practices by examining how the ORS & SRS is administered, scored and then used as way of collaborating with clients in seeking a positive outcome. During the resource segment of the episode, we provide more specific information on how to obtain a free personal license for the ORS & SRS. We also identify a useful online community for clinicians (regardless of therapeutic approach) who use feedback informed treatment practices in their work.
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This is the first of two episodes devoted to feedback informed treatment practices. In many countries, there's a growing demand for accountability and transparency in psychotherapy. Programs, services and individual clinicians face increasing responsibility to provide evidence of their effectiveness. In this episode of Leading From Behind, we look at the rationale for including feedback informed treatment practices into your work as a solution focused therapist. Feedback informed treatment practices involve the solicitation of structured feedback from our clients at each session, regarding progress and their perception of the therapeutic alliance. In collaboration with the client, the feedback can be used to make any adjustments necessary to invite a positive outcome. There is increasing evidence that feedback informed treatment practices can improve outcomes and reduce dropouts, waiting lists and the average length of time some people spend in therapy. Most of all, these practices honour the client's expertise and opinions (a foundation of the solution focused approach) and bring much needed accountability and transparency to our work as clinicians.
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Building one's skills in solution focused practice requires intentionality. In this episode of Leading From Behind, we look at three methods of maintaining an ongoing focus in this area. For most of this episode, we look at how participating in consulting teams can create rich opportunities for learning in a supportive environment. In the absence of having a group of colleagues available for a team approach, we also note how even sitting in each other's sessions can be a useful learning experience. Finally, we note the benefits that can come from reviewing audio or video recordings of your work with clients.
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In this episode of Leading From Behind, we conclude our beginning examination of the process of conversation in follow-up sessions in solution focused therapy. This time, we highlight how scaling questions, questioning about the next small sign of change and, of course, the end of session message are utilized. In the resource segment of the program, we provide some detail about a recently-announced solution focused therapy conference planned for Orlando, Florida. The inaugural Solution Focused Therapy Expo founded by Elliot Connie and Linda Metcalf will be held from February 14-15, 2014. We also note the release of the first edition of a new online journal devoted to solution focused therapy. The International Journal of Solution Focused Practices published its first work this month and new editions will appear every six months. Details about the conference and the new journal can be found at the links below: Solution Focused Therapy Expo International Journal of Solution Focused Practices
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In this episode of Leading From Behind, we continue our look at follow-up sessions. Although the solution focused therapist is concerned with "what's better" in follow-up sessions, clients invariably will report setbacks and/or circumstances that appear to remain unchanged since the previous session. The focus in this episode, therefore, is on how the solution focused practitioner responds to the many variations of 'better, worse and the same,' while at the same time maintaining a solution building stance.
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A significant part of follow-up sessions in solution focused practice involves the exploration of improvements in the client's life since the previous contact. In this episode of Leading From Behind, we examine the process and skills used by the solution focused practitioner, we begin the follow-up session with the simple question, "What's better?" To facilitate this discussion, we return to our case example, as we explore how the solution focused practitioner elicits, amplifies and reinforces the client's responses to the question.
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While follow-up sessions in solution focused practice require many of the same skills, questions and elements of first sessions, there's no question that the structure is often more fluid. This is because of the many variations and possibilities that a client can bring back for a follow-up session. In the first of a series of episodes devoted to this subject, this episode of Leading From Behind offers a general introduction to the conversations we have with clients when they return for a follow-up session. In particular, we introduce the the classic beginning to such sessions, where the solution focused practitioner asks the questions, "What's better?" As well, we talk about the key follow-up process to this question, where we seek to amplify and reinforce what the client has achieved since the previous section.
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Between session tasks, assignments or homework are a common element in psychotherapy. In this episode of Leading From Behind, we take a look at how, when, and even if, this practice fits with our understanding of solution focused therapy. We also note the importance of characterizing between session tasks as suggestions or experiments, rather than an obligatory assignment that's crucial to the process of change. Finally, we provide a few examples of the two types of tasks that we might offer to our clients; ones that involve noticing what's wanted and ones that involve doing even small parts of the client's preferred future. Finally, in the resource segment of this episode, we provide a reminder about some upcoming conferences relating to solution focused practice in three different parts of the world:
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We continue our examination of end of session feedback by looking at the construction and delivery of the message in our ongoing case example. In particular, we review what stands out from the conversation with our client that's worth considering in developing some compliments, validation, a restatement of what's important to the client and, finally, a suggestion or between-session task. The use of the solution focused approach with groups is the focus of the resource segment of the podcast. Two books of note are mentioned that would be useful for anyone with an interest in applying solution focused ideas in this type of helping environment.
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One of the unique elements of solution focused therapy is the "break" and the delivery of end-of-session feedback to the client. In episode 11 of Leading From Behind, we begin the first of two shows devoted to this topic. In particular, we examine the rationale for providing very deliberate feedback to the client and the importance of taking an actual break to develop it. We also identify four key components of the feedback. In the resource segment of this episode we identify three books that serve as examples of the diverse settings where solution focused practice can be utilized.
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Eliciting and amplifying small signs of change are a central aspect of solution focused practice. This is in keeping with the belief that small change leads to larger change. In episode 10 of Leading From Behind, we take a look at how we explore the idea of a small sign of change as we near the end of a first session. In particular, we underline the importance of being curious about a small sign of change or what the client might notice that would represent a small change, rather than negotiating some kind of next step or action that the client must or need to take. In hearing the client's response to this question about small change, we also examine how we often need to use the same skills we use when asking follow-up questions about the client's preferred future. This can involve the deconstruction of language, adopting a "not-knowing" position and, sometimes, using relationship questions as a way of locating a response that's clear, achievable, specific and behavioural.
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Scaling questions are a unique and essential element of solution focused practice. In this episode of Leading From Behind, we examine some of the ways that these questions are useful in first sessions. In particular, we look at the most common scaling question asked in solution focused therapy: An invitation to clients to describe where they see themselves in relationship to their preferred futures. We also underscore how this particular scaling question sets the stage for two key follow-up questions. The first invites the client to describe how she has come to choose this particular number and why it's not lower. The second invites the client to describe the next small sign of change or, in other words, how she'll know that she's moving up on this scale in some small, yet meaningful way. As part of the discussion about scaling questions, we also examine how they're used to understand the client's energy for change, as a means of gauging confidence and, how they can be useful in recognizing risk of harm to self or others. We also highlight how a scaling question can be combined with a relationship question, in further highlighting the client's expertise about her own life. In the resource segment of this episode, we highlight the following: The recent creation of the Australasian Solution Focused Brief Therapy Association (AASFBT), its upcoming first conference and plans for the creation of the Journal of Solution Focused Brief Therapy An early reminder about the next Solution Focused Brief Therapy Association's upcoming annual conference to be held in Toronto, Canada from November 6-11, 2013
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In this episode of Leading From Behind, we take a closer look at one of the key elements of the solution focused approach. In the first session, and after a full exploration of the client's preferred future, the solution focused practitioner asks about exceptions - moments or times when even small parts of the preferred future already occur.
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In Episode 7 of Leading From Behind, we continue our exploration of the questions and skills used in exploring the details of the client's response to the Miracle Question. We also examine the use of relationship questions to expand the client's description of the preferred future During the resource section of the podcast, we provide two sources of information pertaining to outcome research on the effectiveness of solution focused therapy. Links mentioned in the podcast: Dr. Alasdair Macdonald Wally Gingerich
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The exploration of the client's preferred future is a central part of a first session in solution focused therapy. In Episode 6 of Leading From Behind, we begin our examination of the questions, skills and techniques used by the therapist during this key portion of the session. In particular, we outline how the Miracle Question sets the stage for this conversation. More important, we look closely at the key follow-up questions that invite the client to describe a preferred future that's specific, achievable, behavioural and reflects the presence of something, rather the absence. We describe how the deconstruction of language during the conversation enables such descriptions. We also note the importance of amplifying the client's descriptive responses as part of the solution building process. Finally, we identify some useful ways of responding to the understandable "I don't know" replies often encountered during this part of the session. Finally, in our resource segment, we highlight Yvonne Dolan's significant contributions to the practice and development of solution focused therapy.
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In Episode 5 of Leading From Behind, we examine the conversation that takes place in the first session of solution focused therapy, up to the point before we shift into questions about the client's preferred future. A "role-play" case example is used to demonstrate some of the questions and skills used during this portion of a first session. In particular, we look at how to find out about the client's best hopes from the conversation, the use of coping questions and indirect compliments. Finally, we underline the importance in asking about pre-session change. The resource segment of the podcast provides the following web links: European Brief Therapy Association Network Site Elliot Connie: Solution Building in Couples Therapy by Elliot Connie The Art of Solution Focused Therapy edited by Elliot Connie & Linda Metcalf The Connie Institute International Journal of Solution-Focused Practices
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