Solutions in Support
We are not funded to provide therapy and few staff are qualified either as therapeutic counsellors or social workers. In turn clients come to us looking for a support service and are not necessarily looking for therapy. We take the view that the use of the SF approach can provide a useful framework for the construction of a support plan, and augment and add significant value to support workers conversations, providing a set of techniques to enhance the function of support in the lives of our clients.
However SF very much grew out of therapeutic work, and has its origins in more clinical settings.
Inside Caer Las we talk about solution focused [SF] ‘practice’, or SF ‘work’ as opposed to ‘therapy’; this is because we incorporate SF thinking, questions, and methodology into the way we provide our support service to vulnerable adults.
What is Solution Focused Practice?
Solution Focused Brief Therapy [SFBT] was pioneered in Milwaukee, USA, in the 1980’s by social workers Steve De Shazer and Insoo Kim Berg. SFBT is a goal-orientated, collaborative approach to psychotherapeutic change that is conducted through direct observation of clients' responses to a series of precisely constructed questions. SFBT focuses on addressing what clients want to achieve, exploring the construction of a solution, rather than the history and archeology of problem(s). In pioneering the approach De Shazer identified one key tenet as: “Whatever the problem behaviour there will always be exceptions”. One of our jobs as practitioners is to amplify those exceptions.
SF is now practiced across the globe in areas such as Education, Criminal Justice, Social Work, housing Support, Mental Health and Substance misuse. As of June 2008 there were 77 relevant studies: 2 meta-analysis; 8 randomised controlled trials, showing a benefit from SFBT with 5 showing benefit over existing methods. Independent research has consistently shown that Solution Focus can deliver results on a par with many other related therapeutic approaches, but can often do so with fewer sessions.
In the context of support work where funding may be limited or face time with clients restricted by virtue of workload, this is definitely a consideration.
What does SF involve?
Put simply, in SF the practitioner wants to understand the client's overarching hoped for outcome [from the work], is curious about the concrete behavioural detail of this new future happening, and seeks to amplify instances of this already happening. In so doing the practitioner is interested in the strengths and resources the client is bringing to bear that help them to move towards their goal.
SF conversations typically focus on the practitioner asking the client questions that help them to  describe an overarching hoped for outcome, from the work (their ‘Best Hopes’),  describe a rich, detailed picture of what the future would look like if those best hopes were to be fully realised (their ‘Preferred Future’), and  describe instances, current activities and behaviours that recognise elements of that future already happening, or represent progress towards it (‘Instances’ of the change already happening).
SF Practice is highly adaptable; these three basic components can be adapted to be useful in therapy, support work, coaching and clinical supervision.
Caer Las and SF Support Work?
If one considers the three component parts of the SF interview and compares them to the rudimentary structure of a support plan, it is possible to see the overlap.
Assumptions of the approach
The approach makes a few key and significant assumptions, upon which the practice rests:
- To assume that change is not only possible, but happening all the time
- To see a person as being more than a problem
- To look for resources rather than deficits
- To explore possible and preferred futures
- To explore what is already contributing to their lives
- To treat clients as the experts in all aspects of their lives
How does Solution Focused Practice Work?
By following one of De Shazer’s maxims of acknowledging “problem talk”, [but not encouraging it] and focussing on questions about the solution, the practitioner can work with the client to encourage thinking that will ultimately be useful to them in the service of fulfilling their goals.
So for example the client may report that things have got worse for them since the last meeting. In this case it would not be helpful to ignore this information; so, one might express empathy, and then follow up by enquiring how the client managed to stop things getting even worse. e.g:
“It sounds like you've had a very tough week, what was it that you did that stopped things becoming even worse for you?”
The role of the practitioner is to ask useful, solution focused questions; this in a therapeutic context would be called the intervention. The ‘work’ is done by the client, the therapy taking place when the client is thinking and formulating a response to the question posed.
The ‘contracting’ process is carried out, at the beginning of the first session. This careful and entirely client-focused conversation that begins by enquiring what is wanted from the service, is fundamental. If an airline passenger does not state the destination when purchasing a ticket, how can the airline help them reach their desired location. This is not to say this is easy, it can take the skilled practitioner some time, to find the right questions, and hit upon a ‘contract’ whereby both client and practitioner have an agreed ‘best hope’ to work towards. In SF we are looking for progress not perfection. We are not looking to burden or overwhelm the client with lofty goals; instead we wish to understand what the client is looking to achieve, on their own terms, and to ask questions that can usefully facilitate thinking and ultimately behaviour in support of this direction of travel.
Practitioners are encouraged not to contract on hopes that are expressed in the negative; e.g. “I’d like to cope better with my problems”. The practitioner might instead be interested in what would be happening if the client was consistently able to cope, and what kind of life the client would have if they did not regard the same issues as problems in the future. This might lead to a broader, more overarching hoped for result such as “I’d like more control of my life”.
The parallels between the “goal of the support” work and the “best hopes” are clear, however the difference is that the discipline of using the SF techniques ensures that the worker is always responding to the client's agenda, within the legitimate brief of the agency. It gives shape and focus to the support in a way which ensures that the goal is aspirational without it falling into the trap of being the agencies goal, or purely the funding bodies requirement. The intention is to create a purely collaborative contract for support that delivers what the funder is paying for, supports the client on route to their hoped for goals, and works within the legitimate remit of the agency. Where support is intended to promote and sustain personal independance, the SF approach provides a disciplined framework that ensures that the work, the thinking, and the change is all within the client’s control.
By encouraging the client to describe what life would be like should their Best Hopes be realised, the practitioner is facilitating a future focused, positive conversation, that elicits concrete behavioural detail. Studies have shown that this kind of talk makes the ‘hoped for outcome’ more tangible, attainable and realistic for the client. It does not ‘send’ them externally dictated goals, or someone else's solution.
This process is about the client taking the driving seat and being given the space to become the architect of their own future. The practitioner's role is to be endlessly curious about who will notice the changes? what will they notice? how will the client know that the change is helpful? what difference will this make?
Inevitably problem talk can arise; it is not the role of the practitioner to dismiss this, but moreover to acknowledge how tough it must have been. It also provides the opportunity to highlight the client's strengths and resources; how did they cope? what kept them going?
In the support planning context this is a useful way of putting some detail into the plan. It tells the practitioner what the change will be like in reality for the client, and makes it clear what the agency can do, to help the client toward their goals. What it avoids, is making a list of deficits, barriers and problems the client encounters, which has the danger of the worker lapsing into ‘helping’ mode rather than ‘supporting’ mode.
The extremely powerful tool of beginning any second or subsequent support session with the question - “what has been better since we last talked?” encourages the client to examine the progress made, since arriving in the service. It is a conversation that far from giving meaningless, and baseless platitudes, encourages the client to describe their progress; what has been helpful? how did they manage to do that? what helped them to do a thing? Again the practitioner is like a dogged detective seeking out the clues to what is helping positive change take place.
SF inside the organisation
As well as using the skills and techniques of Sf with clients, we would encourage SF management meetings, team meetings, supervision and appraisal.
However in the context of a charitable business SF cannot be a blueprint for all conversations. There are time when a support workers will need to give practical help, offer professional advice, or refer to another agency. A broken door requires a carpenter, not a SF conversation.
Equally it would not be helpful to try and couch an eviction or a disciplinary sanction in SF terms. Management Accounts and board reports need to trade in absolute facts, not the workers best hopes.
However, it is potentially very useful to treat staff and managers as experts in their field, encourage solution talk in meetings, acknowledge problems without amplifying them, and using scaling questions to understand what is already working in a team, and what progress might look like.
Developments in SF
Since the death of its two founders in the mid 2000’s developments to the approach have been pioneered by BRIEF, London. [Evan George, Harvey Ratner and Chris Iveson]. The “Brief” element to the thinking has been a consistently emerging factor, captured succinctly in BRIEF’s reference to Occam’s Razor.
The principle named after William of Occam, a 14th century philosopher, states that, if there are a number of explanations for observed phenomena, the simplest explanation is preferred.
i.e. “keep it simple”. The practical benefits of this being, shorter interventions with clients, avoiding the creation of co-dependent relationships, and delivering the hoped for outcome via the shortest possible route.
In Caer Las, workers who provide front line services are provided with an introductory course in SF, annual follow ups courses, and other support and training aids such as literature, membership of UKASFP [United Kingdom Association of Solution Focused Practitioners], video footage, support from managers, and mentoring from experienced practitioners.
They are obviously employed as support workers first and foremost, however where it is in the best interests of the client, they are encouraged and advised to draw on the principles, techniques and practices of SF. The analogy being that SF training, provides support workers with malleable, but robust tools, skills, much as a carpenter benefits from having well manufactured purpose built tools that he can draw on whatever the circumstance his work may cause him to encounter.