We begin by giving you the background that leads up to this new approach—a brief history of the development of the ideas and the assumptions forming the basis for therapy models.
We like to think that therapists develop therapy models out of some initial struggle or question. The question may arise from the therapist’s particular experiences with a certain population of clients or with certain types of problems—for example, Freud’s questions about the repressed sexuality of his Victorian clients. The questions may arise from some beliefs about people. For example, Michael White has articulated the belief that people are separate from their problems and are oppressed by their problems (White & Epston, 1990). This belief is different from traditional beliefs that identify the person as the problem. We believe that their questions form the beginning of the therapy models that are developed. These therapy models begin to take shape as the developers speculate and then articulate answers to their initial questions about their clients or their clients’ problems. Thus, Freud’s early model development of the repression barrier and the unconscious can be seen as answers to his questions about sexual repression.
The questions that developers of therapy models ask contain presuppositions within them. Therefore, by their very asking the questions, developers pre-select directions toward particular answers or classes of answers. The evolution of the ideas and trends of therapy models can thus be traced through the assumptions within the original questions of the therapy modelers. For example:
In the early part of this century, science was shaped by the objectivism of the traditional scientific method. The chief question modelers usually asked was: What is the cause of the problem?
This question is still frequently being raised. Asking, “What is the cause of the problem?” has presuppositions which are consistent within that time frame of the traditional scientific method. The question presupposes that there is a definite problem and that there is a specific cause to that problem. The question further presupposes that one can, in fact, find the cause of the problem and describe that cause. Finally, asking, “What is the cause of the problem?” intimates that there is a relationship between finding the cause and solving the problem. This process is consistent with western science’s idea—along with traditional descriptions inherent in the scientific method—that the way to solve a problem is to find out what the cause is so that one can then effect change by eliminating the cause. Asking, “What is the cause of the problem?” is also consistent with our own everyday common sense that the way to solve any problem is to find out what is wrong and then fix it. Thus, we seem to relate all problems to the laws of mechanics—when the power lawn mower breaks down, we look for the cause of the breakdown.
Over the past decades, several approaches have been developed to identify direct alternatives in response to the question, “What is the cause of the problem?”
Within the psychoanalytic tradition, for example, the cause of the problem has been described in a number of ways that may include: developmental arrest, failure to pass a stage of life, personality disorder, poor object relations, poor self image, unresolved conflicts, sexual repression, and so on. Usually, the problems are described as symptoms of a particular underlying pathology or sometimes as defenses within a personality disorder.
Within the psychiatric tradition, furthermore, the cause may be described as a chemical imbalance, an organic predisposition, or a disease which has various psychological or behavioral manifestations.
Within either the psychoanalytic or psychiatric traditions, each causal explanation dictates a type of intervention. If the cause is diagnosed as developmental arrest, then a corrective emotional experience may be prescribed. If unresolved conflicts are diagnosed as the cause, then supportive therapy may be prescribed to bring out the conflicts and interpret them in such a way that they can be resolved. If a chemical imbalance is diagnosed, then a course of medication may be prescribed.
Within the psychoanalytic and psychiatric traditions, distinctions between primary and secondary causes may also be used. For example, someone may be diagnosed with schizophrenia as the primary diagnosis, along with a secondary diagnosis of reactive depression to the recent loss of family member. For the primary cause, schizophrenia, the patient may be given medication. For the secondary cause, the loss of a family member, the patient may be given supportive therapy.
Within the behavioral tradition, the problem may be described as being caused by a reinforcement, usually within the family, that progressively created a learned behavior. This learned behavior is subject to being continually reinforced until it assumes a life of its own and becomes self-perpetuating.
Alternative answers have thus been developed for “What is the cause of the problem?” dependent on the assumptions about the nature of “man” within the school of philosophy to which the modeler subscribed. If humans were seen as basically torn by their sexual urges, one looked for explanations within sexual development. If humans were seen as having problems because of having to repress or sublimate their individual desires and ambitions to the restrictions created by society for the greater good, then one looked for explanations within the social and political environment and for signs of stilted creativity caused by that environment.
All of these traditions and schools of thought are consistent with the presuppositions of the original question—that problems are caused and that we can find the cause. All of these traditions looked for the cause of the problem, but each came up with different answers.
During the 1950s, after the birth of cybernetics, therapy modelers began to ask a different question, leading to different answers. An entirely new direction began to be defined as modelers changed the primary question, “What is the cause of the problem?” to …
This question presupposes that a problem is being maintained and stresses its maintenance rather than its cause. As with “What causes the problem?” the therapy modeler accepts that there is a problem, but presupposes that the problem is being maintained and that there is a relationship that can be found and described between the maintenance and the problem. Most of the answers to “What maintains the problem?” explain the maintenance as taking place within interactional patterns that can be mapped in different ways.
One therapy model describes problems as maintained within certain organizational contexts and sees problems as continuing because they serve a system-conserving function for the family (Haley, 1980; Madanes, 1981). In this Strategic Therapy Model, problems have a system-maintaining purpose, and family members’ actions are organized around the problem.
Another therapy model describes problems as being maintained by certain family structures and coalitions (Minuchin, 1978). In this Structural Model, the problems are seen as being embedded in and maintained by dysfunctional family structures. A third therapy model, the Milan Model, says that problems are governed by “the fundamental rule of the family” (Selvini-Palazzoli, Boscolo, Cecchin, & Prata, 1978). Still another—the Brief Therapy Model—describes problems as maintained by the attempted solution (Weakland, Fisch, Watzlawick, & Bodin, 1974).
Each of these therapy models prescribes a course of action consistent with its answer to “What maintains the problem?” The Strategic Model of Haley and Madanes attempts to change the organizational context by changing the present incongruence of power. If a child has more power because of the problem than the parents, then interventions are designed to empower the parents and establish a congruent hierarchy.
The Structural Model of Minuchin would attempt to change the organization of the family, the overt or covert coalitions across generations. The Milan Model would attempt to break up through a counterparadox the endless paradoxical pattern embedded in the family rule. Finally, the Brief Therapy Model attempts to break up the escalating cycle of the attempted solution.
These models are coherent and are consistent with their answer to the question, “What maintains the problem?” Each model describes both the patterns of behavior and the thinking around the problem, with meaning consistent with the metaphor about problem-maintenance. Then it intervenes in a way consistent with the assessment.
Within recent years, there is another, different, and new question being asked: How do we construct solutions? The presuppositions within this question are:
We think that the answer to “How do we construct solutions?” constitutes a solution-focused brief therapy model that can be summarized in the following story.
A few years back, during that rare year when the Chicago Cubs succeeded in winning their division championship, there was a time when one of the leading hitters was in a slump. Jim Frey, the manager of the team, spotted this hitter in the clubhouse one day. The hitter, with hopes of improving his performance, was watching films of himself up at bat. Now, you can probably guess what films he chose to watch. Right! He chose films of the times when he was in the slump, when he was striking out and generally doing everything but what he wanted. He, of course, was trying to find out what he was doing wrong so he could correct his mistake. He probably subscribed to the “What is the cause of the problem?” question. However, you can imagine what he was learning by watching films of slump batting; he was learning in greater and greater detail how to be a slump batter.
So we like to think that Jim Frey must have been a “closet” solution-focused brief therapist. He joined his hitter, complimented him on his dedication to the game and on attempting to improve himself. Jim then made one suggestion to the hitter—that he go back to the film room, find films from when he was really hitting the ball, and then watch those films instead.
We think this story aptly summarizes the thrust of a solution-focused approach: “How do we construct solutions?” Very simply: One, define what the client wants rather than what he or she does not; two, look for what is working and do more of it; three, if what the client is doing is not working, then have him or her do something different.
Step one, find out what the client wants, may seem obvious and possibly even too simplistic. However, think about it for a moment. The vast majority of our clients come in telling us what they do not want. It is as if they have become so focused on their frustration and pain that they have not really thought of what they do want. At times, we have to use all our skills and support to help clients define what they do want.
Step two, look for what is working and do more of that, may also seem obvious. However, we know that in traditional training (even in those procedures that stress looking for client strengths), the important emphasis of diagnosis has been to look intensely at what is wrong and not working for the client.
Step three, do something different, may seem painstakingly obvious. However, how often have you heard the old proverb, “If at first you don’t succeed, try, try again”? Our culture has reinforced the notion of persistence in spite of procedures not working.
Solution-focused brief therapy is one answer to this question, “How do we construct solutions?” It is a total model: it encompasses a way of thinking, a way of conversing with clients, and a way of constructing solutions interactively. Solution-focused brief therapy is not a collection of techniques or an elaboration of a technique; rather, it reflects fundamental notions about change, about interaction, and about reaching goals.
You will notice in the progression of our questions—”What causes the problem?” “What maintains the problem?” “How do we construct solutions?”—that we moved successively from cause to problem-maintenance to solutions. We have also changed focus from the past, where we usually look for causes, to the present, where we map patterns of problem maintenance. Finally, with the last question, we look at the present and the future. As we shift our presuppositions away from the traditional linear notions of causality, we move toward a relativistic and “constructivist” view, as well as toward a future orientation.
With the insertion of the pronoun “we” into the question, “How do we construct solutions?” we also shift from the notion of an objective reality, or even observed reality, to an interactional construction. On a practical basis, this means that all views are equally valid; therapy becomes an interactional or joint experience, with problems and goals constructed or negotiated between client and therapist.
The most radical implication of this question, “How do we construct solutions?” is that problem information is no longer necessary and, in fact, can be limiting in many cases.
When initially we were involved first as trainees and later as trainers and research associates of the Brief Family Therapy Center of Milwaukee from 1981 to 1984, our task as therapists was to identify the problem patterns in terms of attempted solutions and then attempt to interrupt the patterns. This was consistent with the focused problem-resolution model of the Mental Research Institute of Weakland, Fisch, Watzlawick, and Bodin (1974).
During this time, an attempt was initiated by Steve de Shazer, Marilyn La Court, and Elam Nunnally to help families become more specific in their descriptions of their complaints and goals, and to become more present and future oriented. In order to help the clients who presented rather vague complaints to be able to present their goal more specifically, the therapy team gave the clients this task:
Between now and next time we meet, we (I) would like you to observe, so that you can describe to us (me) next time, what happens in your (pick one: family, life, marriage, relationship) that you want to continue to have happen.“ (de Shazer & Molnar, 1984, p. 298)
The focus of this task was to allow clients who had as yet only vague descriptions of their complaints or goals to notice when the goal actually happened and to report back. The idea was that with a fresher memory they might be able to report in a more specific fashion. Also, the task would shift their attention to the present and future, thus implicitly promoting expectations of change.
The results of the clients’ pursuing the task—searching for and selecting those signs of their goal that they wanted to continue—went far beyond the original intent. While many clients with vague descriptions came back with more specific descriptions, they also came back describing changes that had occurred, that they wanted, and that they had not previously noted. Very often, the changes were in the goal/ solution area.
This task then became routinely used as the “formula first session task,” and was used regardless of the complaint (de Shazer, 1985). The complaint may have been about a child-related problem, about a marital difficulty, about a substance abuse problem, or about anything else. In some cases, we hardly knew much at all about the complaint. Yet, regardless of the complaint or of how little we knew about it, clients came back reporting change.
The far-reaching implication of clients’ reporting change regardless of whether or not we identified anything about the problem was that problem information was not necessary (de Shazer, 1988). Previously, we had thought we needed to know about the sequences or patterns in which the problem was embedded and felt that the solution had to match the problem patterns. The results of the first session task divorced the connection in our thinking between problem and solution. We realized that only solution or goal talk was necessary, that solution construction was independent of problem processes.
The interviewing process changed radically. The research team pushed this solution-focused thinking further (de Shazer, Gingerich, & Weiner-Davis, 1985). Instead of having to wait for the second session to ask about changes or positives, they began the first session by asking about recent changes or “exceptions” to the problem (Weiner-Davis, de Shazer, & Gingerich, 1987).
Since that time, we in Chicago have continued to push the limits of the assumption that all we need is solution talk. As you will see in the succeeding chapters, the goal now is to have every aspect of therapy focused on solution construction.
In addition to this assumption that all we need is solution-oriented conversation, a solution focus is informed by a number of additional assumptions which will be described in the next chapter.
QUESTION:
By focusing on the presuppositions within the questions used in the past hundred years by researchers and modellers, you seem to be suggesting certain trends in thinking about therapy and change. Is that so?
Very definitely, we are suggesting there are several trends. There is the trend mentioned in this chapter away from notions of causality and a focus on the past to notions of meaning-making in the present and about a future. There also is a trend away from pathology and the objectifying of people to a more positive approach where people are viewed within community and as capable of creating what they want (O’Hanlon & Weiner-Davis, 1989).
1. In order to identify your own working assumptions, write down the three questions that you think are most important to your therapy or the three that you use most commonly. After writing out the questions, examine them for the presuppositions within them. These presuppositions will probably reflect your personal working beliefs about people and therapy. For example, if one of the questions you commonly use is, “How does that make you feel?” then your presuppositions are: (1) the client feels, (2) that the situation is a cause, (3) that there is a linear, causal relationship between the situation and the resulting feeling, (4) that the client can articulate his or her feeling, and (5) that the articulation or identification of the feeling would somehow be useful.
2. After identifying some of your working presuppositions, ask yourself if these are indeed what you believe. If your presuppositions do not in fact reflect your beliefs, what are your beliefs about people and change and how can you change your questions to reflect these beliefs.