Transcript A Story about Research

Doing What Works: Brief Solution-Focused
Counseling in Schools
John J. Murphy, Ph.D.
University of Central Arkansas
Translating research into practice
www.drjohnmurphy.com
[email protected]
Kansas Association of School Psychologists (KASP) 2009 Fall Conference
Pair and Share (5 minutes): Assessing
the Outcome and Fit of Services
Pair up and share your answers to the
following questions:
•
What do you want from the workshop?
•
How will you know the workshop was
effective when it is over? Two weeks
from now?
•
How will you know the workshop is a
good fit for you while it’s happening?
What Do You See?
Kenny’s Story
“Connect the Dots” Task:
Anatomy of a Chronic Problem
Connect all nine dots using four straight lines
without lifting your pen off the paper. Take a minute
to try to solve it.
.
.
.
.
.
.
.
.
.
A genius
once said…
“You can’t solve a
problem with the same
type of thinking that
created it.”
—Albert Einstein
Solutions require
SOMETHING DIFFERENT
rather than
more of the same
“Something Different” =
• Focusing on “what’s working” and “what’s right”
– Exceptions to the problem (non-problem times)
– Natural Resources in the student’s life (family,
friends, hobbies, values) (vs. Killer D’s)
• Changing ANYTHING in the problem pattern
– Perceptions about the student or the problem
(explanations, interpretations, attributions)
– Actions of anyone involved with the problem…
including US! (reactions, dance sequences)
Among other things, these methods…
GET THE STUDENT’S ATTENTION!!!
Articles Published Since 1887
Source: Psychological Abstracts
80000
JOY
70000
60000
HAPPINESS
50000
40000
30000
LIFESATISFACTION
20000
ANXIETY
10000
DEPRESSION
0
TOPICS
Increase in Diagnostic Categories from
DSM-I (1952) to DSM-IV-TR (2000)
400
350
300
250
200
150
100
50
0
DSM-I 1952
DSM-II 1968
DSM-III 1980
DSM-IV 1994
DSM-IV-TR 2000
Therapeutic (and Other) Influences
• Milton Erickson
– Utilization, crystal ball, no “general” theory
• Mental Research Institute (Watzlawick, Weakland, Fisch)
– Brief strategic Therapy [If it Doesn’t Work, Do Something
Different]
• Brief Family Therapy Center (De Shazer, Berg)
– Solution-Focused Brief Therapy [If It Works, Do More of It]
• Narrative Therapy (White, Epston)
– The person is not the problem; the problem is the problem
• Client-Directed/Outcome-Informed Therapy (Duncan, Miller)
– Heroic clients; client feedback
• Personal/Professional Experiences; Psychotherapy Research…
Skeleton Keys
(Solutions)
that
Fit Most Locks
(School Behavior Problems)
I FEEL GOOD…and you will too
when you see this research!!!
The Change Pie (1000+ studies): Common Factors
of Successful Counseling (Lambert, Wampold, ...)
Of all the ingredients in
counseling, the client is by
far the most powerful
Model/
and important. The
Technique
Client
success of
15%
Hope
counseling rests
40%
15%
largely on the
extent to which the
client’s resources and
Relationship
opinions are recruited
30%
and respected throughout
the helping process.
[Additional Materials, Page A-1]
Assumptions of Brief Solution-Focused
Counseling (BSFC)
1. People are unique, capable, and resourceful.
2. Cooperation (alliance) promotes solutions.
3. It is generally more useful to focus on future solutions
rather than past problems.
4. No problem is constant. There are always fluctuations
and exceptions.
5. If it works, do more; if it doesn’t, try something
different.
Tasks and Techniques of Brief
Solution-Focused Counseling
1. Build cooperative, change-focused relationships
(alliances)
2. “Meet clients where they are” by clarifying the problem
3. “Find out where clients want to go” by developing
goals
4. Encourage “something different” by (a) building on
exceptions and other resources, or (b) changing the
viewing and doing of the problem
5. Evaluate and empower progress
[Additional Materials, Page A-2]
Task 1. Build cooperative, changefocused relationships (alliances)
• Tell clients you want to be useful and need their help
(feedback) to do so
• Reflect and validate clients’ concerns, perceptions, and feelings
(“No wonder you feel that way…”)
• Compliment clients and recruit their strengths, resources, and
heroic stories
• Create a culture of feedback by using short rating scales (ORS,
SRS) to obtain client feedback on the progress (outcome) and
fit (alliance) of services…and adjust services accordingly
• Incorporate the client’s own words into goals and conversations
• Be curious vs. all-knowing; Ask vs. tell (“I wonder if this would
work…; How did you do that?”)
Role Play (Teacher Consultation): How
to (and How Not to) Reflect and
Validate Clients’ Concerns,
Perceptions, and Feelings
Task 1. Build cooperative, change-focused
relationships (alliances)
Technique: Reflect and validate clients’
concerns, perceptions, and feelings
You Can’t Re-Arrange the Furniture…
Unless You’re Invited Into the House
Ripped from the Headlines...
Alliance Rules!!!
Analyzing over 1000 research studies,
Orlinsky et al. (2004) concluded that (1) the client’s
perception of the alliance is the best predictor of
outcomes, and (2) client participation is the
centerpiece of a strong alliance.
ClientPractitioner
Bond
Agreement
on Goals
Agreement
on tasks
Strong Alliance
Better Outcomes
Task 2. “Meet clients where they are”
by clarifying the problem.
• Clarify the key concern/problem and related
details (Where? When? With whom? How is it a
problem for you?)
• Ask about previous solution attempts (What
have you tried? How did it work?)
• Ask “How can I help?”
Solution-Focused, NOT Solution-Forced
Where you are
(Now)
Where you want to be
(Future)
Problem
Goal
Task 3. “Find out where clients want
to go” by developing goals
5-S Guideline of Effective Goals
Significant (consistent with their values, beliefs, own words)*
Specific (clear, concrete, descriptive; “videotalk”)
Small (reasonable, attainable; next small step)
Start-based (stated as “start” or “more” of what
clients want vs. less of what they don’t want)
Self-manageable (within clients’ control vs.
other people’s control)
[See sample questions under “Goals” and “Questions for Young People Viewed
as Reluctant or Resistant,” Additional Materials, Pages A-3 and Page A-4]
Source: Murphy, J. J. (2008). Solution-focused counseling in schools (2nd ed.).
Alexandria, VA: American Counseling Association.
Terrence (Grade 5), the School Bully
Task 4. Encourage “something
different” by (a) building on exceptions
and other resources, or (b) changing the
viewing and doing of the problem
Building on “exceptions” to the
problem
Explore non-problem times (exceptions)
(Where? When? With whom?), how clients
made them happen, and how they could
replicate or increase them
[See sample questions under “Exceptions,” Additional
Materials, Page A-3]
Practice Exercise: Interviewing for Exceptions [Additional
Materials, Page A-5]
Using “Video Exceptions” to Increase
Behavior (Self-Modeling)
1. Select the “good behavior” to be increased.
2. Videotape the student displaying good
behaviors (prompted or unprompted).
3. Edit the tape(s) to create a “Greatest
Hits” movie (1-2 minutes long).
4. Have the student view the tape several
times (every other day at school for two
weeks for a total of 5 or 6 viewings).
Video (student, age 9): Increasing social interaction
through self-modeling
Summary of Building on Exceptions
It’s easier to move a train or river in the direction it’s
already going than to push it in the opposite direction
Building on Other Resources
Identify “natural resources” in the
student’s life, and build them into school
interventions. Resources may include:
• Special interests, talents, hobbies
• Resilience, coping skills
• Family and friends
• Values, beliefs, life experiences
• Heroes and influential people
• Solution ideas [See questions under
“Other Resources,” Additional Materials, Page A-3]
Changing the Viewing or Doing
of the Problem
Change the Viewing: Offer different
explanations of the problem in order to
encourage different responses (“Could it
be that …; I wonder…”)
Change the Doing: Encourage actions
that “shake up” the typical problem pattern
by inviting clients to change anything in
their performance of
(or response to) the problem
[See questions under “Changing the Viewing
or Doing,” Additional Materials, Page A-3]
Changing the Viewing:
Young Woman OR Old Woman?
You’re Right!
Reframing the Problem (same behavior,
different explanation)
Description/Steps: 1) Assign a different explanation or motive
to problem behavior that promotes different responses from
the student, teacher, or others [Examples: View fooling around
in class as a generous act of giving up one’s own freedom to
provide entertainment to other students; View arguments with
peers as a sign of social interest and concern]
Examples/Applications
Questions?
REMINDER: The way we view or explain a problem is an
interpretation, not a fact.
Changing the Doing: Do the Problem
“Differently”/Be Unpredictable
Encourage the student or teacher to alter some
aspect of his or her performance of the
problem (duration, intensity, location,
sequence, time of day, etc.), or to respond very
differently the next time the problem occurs
(change the typical response in unpredictable
and surprising ways)
So, You Wanna Change Me, Huh?
When Things Are Stuck and Not Working,
We Have Two Options
Option 1: Pull the Rope Harder (“More of the Same”)
Option 2: Drop the Rope (“Something Different”)
Dwayne (12th grade) [Video Clip #1]
—National Merit Scholar
—Referred by teachers for not working on the Extended
Essay requirement needed to pass English class and
graduate
—Mom, teachers, and principal have tried reasoning
with Dwayne to no avail (“Think of your future. Just
write something and turn it in. It just has to be there, it
doesn’t have to be good.”
—Although no one views Dwayne as mean or rude, they
view him as “very stubborn” on this issue
—Everyone is at wit’s end—Mom has contacted a
psychiatrist to “find out what’s wrong” and assess the
need for medication
Brainstorming Exercise (Dwayne)
In groups of 3 to 5 people, discuss the following:
1. What resources does Dwayne bring to counseling?
How might one or more of these resources be applied
toward a solution?
2. What existing views and actions might be serving to
increase (rather than resolve) the problem?
3. Think of at least one different explanation or view of
Dwayne’s behavior. How might this new view be
presented to promote a solution? How would you
proceed with Dwayne and others in this situation?
Results of Activity: Intervention Ideas
[Dwayne: Video Clips 2 and 3] The Rest of the Story
Task 5. Evaluate and empower progress
Evaluate progress (outcome) and “fit”
(alliance) on an ongoing basis
1) Evaluate progress using the Outcome
Rating Scale (ORS) and other relevant
measures—grades, discipline reports,
observations, etc.
2) Evaluate alliance (client-practitioner
relationship and “fit” of services) using the
Session Rating Scale (SRS)
Client feedback = Better Outcomes
*Anker, Duncan, & Sparks (2009): Significantly better
outcomes (vs. equivalent comparison group)
in couples therapy when using the ORS and SRS (Norway)
*Reese, Nosworthy, & Rowlands (in press): Significant
improvement in college counseling center outcomes using
continuous feedback via ORS and SRS
*Miller, Duncan, Brown, Sorrell, & Chalk (2006): Use of ORS and
SRS significantly reduced drop out and improved outcomes
(effect sizes increased from .39 to .79)
*Lambert et al. (2003): 65% increase in practitioner effectiveness
after receiving client feedback
Two Quick Feedback Measures: (1) Outcome Rating Scale (ORS)
and Child-ORS (CORS): Assesses client’s experience of change
(outcome); (2) Session Rating Scale (SRS) and Child SRS
(CSRS): Assesses client’s experience of “fit” (alliance)
[Additional Materials, Pages A-7 through A-11]
Outcome Rating Scale (ORS) and
Child ORS (CORS—age 6 to 12)
[Additional Materials, Pages A-7, A-8]
• Administered at the beginning of (or just before) every
session
• ORS (8th grade reading level); CORS (3rd grade
reading level; includes smiley and frowny faces)
• People rate themselves (and/or others) on each
dimension by marking a 10-centimeter line
• Scoring: Unless using a computerized program, each
line is scored (between 0.0 and 10.0 cm) using a
centimeter ruler or template; all four lines are added
to produce a Total score (40 = highest possible score)
Session Rating Scale (SRS) and Child
SRS (CSRS; age 6 to 12)
[Additional Materials, Pages A-9, A-10]
• Completed at the end of every session
• SRS is written at 7th grade reading level; CSRS adds
smiley and frowny faces to assist younger students
(age 6 to 12)
• Interpretation: 0-34 (poor alliance); 35-38 (fair
alliance); 39-40 (strong alliance)
• Explore any area below 9, and end by asking what
else would improve future meetings
• Purpose: Detect and correct alliance problems
Client Feedback: Quotes From
the Experts
“Shouldn't I be telling you what I think about this?”
—Molly, age 10
“It's a lot better when you ask a person
what they want to do…” —Molly, age 10
“I’d just like to say something right now. I think these forms
are a good idea.” — Carlos, age 13
Empower progress whenever it occurs
•
Give students (and others) credit and explore
how they made improvements
•
Ask their advice for others
•
Use letters and other documents to reinforce
success [see “Letters/Documents for
Empowering Progress,” Additional Materials,
Page A-6]
•
Invite them to join the Consultant Club*
•
Help them prepare for relapse
Consultant Club
Membership Certificate
This is to accept
Chelsea Martin
as an official member of the Consultant Club.
The Consultant Club is a group of people who have
made important changes in their lives, and who would
be willing to serve as a consultant to Dr. John Murphy
for advice on helping others.
, Consultant
(Consultant’s Signature)
, Club President
(Dr. John Murphy)
That’s All, Folks!
THANK YOU and best wishes
in your work
Translating research into practice
www.drjohnmurphy.com [email protected]