Transcript Postmodern Approaches

Postmodern Approaches
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.
…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.
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.
…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.
The Therapeutic Process
• Bertolino and O’Hanlon 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.
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.
…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.
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.
• 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 else’s 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.
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.
..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.
• FORMULA FIRST SESSION TASKsomething 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’.
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.
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.
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.
– Discover moments when the client wasn’t
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.
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.
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 it’s the problem that is the problem.
This is one way to separate the person
from identifying with the problem.
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.