btss.org.uk Brief Therapy Support Services Ltd - Solution Focused Brief Therap

Many times Communities and families or support networks put pressure on individuals to conform to their standards of behaviour. There are many people who do not feel comfortable within their family, support network or within their own community and for these people daily life can be exhausting.

Often the excellent support offered by statutory services, such as the NHS, are not geared for people who 'fall between the cracks' of learning disability and mental health services. The MLSS aims to provide the link between these individuals and services they need within the NHS or other agencies. Very often, these people have Autistic Spectrum Condition [put link to ASC tab on site] so much of what is on this site talks about ASC. However, the Brief Therapy Support Service does not only work with people who have Autism. We also welcome work with people who feel they would like to change something about their life whatever the reason!

The MLSS is underpinned by the principles of Solution Focused Brief Therapy which is explained in the article below:

Introduction to Solution Focused Brief Therapy (SFBT)
Using SFBT in supporting individuals who ‘do not fit’ into traditional service models

It can be difficult for therapists to know the best way to support someone who has tried traditional therapy options without success. This lack of fit with typical psychological therapies can be due to differences in processing information, poor memory or attention, differences in communication skills or just a mismatch with what the person wants and what is on offer. In order to participate in traditional ‘talking therapies’ a certain level of verbal communication, memory and attention are required. Additionally, a client and therapist need to be able to establish a good therapeutic relationship in order to affect a positive outcome. This relationship often requires the individual to agree with the therapist’s diagnosis or treatment plan, and sometimes this is not acceptable to the client.

Since 2002, BTSS has been working with adults, many of whom have High Functioning Autism (HFA) or Asperger Syndrome and their carers. We have been using the principles of Solution Focused Brief Therapy (SFBT) to guide our work and have noticed with some individuals an increase in eye contact, verbal interaction, reported self esteem, and problem solving behaviours. Many carers and clients have noticed an increase in participation in activities, fewer highly emotional events and a sense of progress in a positive direction. Individuals who have been labelled ‘difficult to engage’ have requested return appointments and rarely miss their appointments.

Solution Focused Brief Therapy (deShazer, 1985) works on the following principles:

If it ain’t broke, don’t fix it
If it isn’t working stop doing it
If it IS working, do more of it
No problem happens all the time
Change is inevitable
People have histories of problem-solving, coping and moving on

If it ain’t broke, don’t fix it Traditional therapists are trained to look for problems and to identify the root of the problems. Different types of therapy have different types of beliefs about why problems develop and what types of treatment will be needed to fix the problems. For example, Cognitive Behaviour Therapists work from the belief that problems arise when people have distorted beliefs about what is going on around them, which lead them to have powerful feelings that are not appropriate to a situation which in turn leads the person to show behaviours that are inappropriate in some way. When a person comes to see a CBT therapist, the therapist will be listening out for problems with the client’s thinking, feeling or behaviours and seek a treatment plan that will influence one or more of these areas. If the person does not come with a problem in one of these areas, the therapist will seek to find problems in these areas, believing that all difficulties can be traced back to thoughts, feelings or behaviours.

SF therapists would not start from the premise that we know why problems develop or what kind of treatment is required to fix problems. If the person does not believe altering their thoughts, feelings or behaviour will lead them to the goal the wish to achieve, the SF therapist would not seek to find problems in these, or any other, areas of the client’s life.

To use an analogy, when I take my car to the mechanic because my oil light keeps coming on, I do not like it when he also wishes to replace my tyres. In solution focused terms, if a client comes wishing to make more friends, we would not look for problems with their mood. We would stick to the job in hand and work on how to make more friends. Improving mood may or may not become an aim along the way, it is up to the client to decide that.

If it isn’t working, stop doing it When I lose my keys, I must look in my handbag about ten times before accepting the fact that the keys are not in there. Why? Why do we so often keep doing something that isn’t working?! I often hear parents saying “How many times do I have to tell you…?” If the first 2 or 3 times do not get the desired result, solution focused therapists would say stop doing it! It seems so simple yet so hard to do. Solution focused therapist are very good at giving permission – if that is needed – for people to stop doing things that are not working for them, even if the book says they are doing the right things. This simple little change can have cumulative effects on ones life.

If it IS working, do more of it Solution focused therapists believe that there is no one right way to do something. If something works for you, keep doing it unless there are good reasons for doing it. Some parents given their children money for doing household chores whilst other people (often grandparents!) think that children should contribute to the running of the house without being ‘bribed’. An SFBT question would be ‘does it work to pay your kids and if so, keep doing it unless you have other reasons for wanting to change’. If something is working, keep doing it!

No problem happens all the time Some problems can seem so big that people FEEL they happen all the time. The reality is, however, that there are always exceptions to problems. That is, there are always times when the problem isn’t happening, or if it is happening the effect isn’t quite so severe. An SF therapist is much more interested in these times than they are in the times when the problem is occurring. The idea being that by increasing the times when the problem isn’t happening, we will automatically decrease the time with the problem IS happening. Solution focused therapists will ask lots and lots of questions about exceptions to the problem and about times when the person copes well with the problem. It is in learning the detail of these occurrences that possible ways forward can be found. Additionally, solution focused therapists are very often pleasantly surprised at all the resources people have to cope with their problems on a daily basis. We need to notice and name these resources so the person can keep doing them because – they work!

Change is inevitable The world goes round. Nothing stays the same, so we can rest assured that change will occur. Even if a person does nothing more than breathe for 24 hours, something will change, which is kind of a reassuring thought. Because change is going to happen, we may as well take some control over what changes happen, how they happen and when they happen in order to get maximum benefit from the changes that occur. This helps a solution focused therapist to give a client hope that the future can and will be different from the present – because we know one way or another, something will change!

People have histories of success What a traditional therapist might want to know about is the history of a client’s problem. How long have you had this problem? When did it start? Who has been affected by it and so on are all of interest to problem-focused therapists. Solution focused therapists flip this around and are more interested to hear about a client’s history of coping with problems. SFBT questions would be “Gosh, that sounds hard. How did you cope with moving school so many times?” or “How did you cope knowing that no one believed what you were saying? What kept you going?” People are reservoirs of strength, skills and knowledge from which amazing coping strategies are born. How does an adult, for example, who has lived in an ‘institution for the mentally handicapped’ since age 10 come to be so funny, caring and generous as an adult? How did that happen? Those are the things SFBT wishes to know more about, rather than talking about problems. The more one talks about problems the bigger those problems become! Conversely, the more one talks about strengths and resources, the more confident they become!