When I’m working with the women at Sanford House, positive outcome is largely associated with the woman-counselor connection. Our client’s hopes for a better future, must be heard and supported throughout the process, by all members of the clinical staff. Using the techniques offered through evidence based* Solution Focused Therapy (SFT), we are able to establish a strong woman-counselor bond. Solution Focused Therapy is future-focused, goal-directed, and centers on solutions, rather than on the problems that brought a woman to seek therapy in the first place.
Solution Focused Therapy
Step 1: Establish Collaborative Relationships:
As a woman enters treatment at Sanford House, her perception of a strong relationship with her counselor, is a great indicator of how well she will respond to treatment. The more a client is involved in the recovery process, the better the outcome. A solution focused approach assumes that most people have previously solved many problems before, and have some ideas as to how to solve their current problems.
We ask the questions, “What will need to happen to improve your life?” “What has worked for you in the past?” “Are there times when this has been less of a problem?” As we work through goals and establish aftercare plans, it is vital to fit the counseling to the woman, not the woman to the counseling. It is important to customize counseling to each woman, rather than requiring them to conform to the counselor’s favorite ideas or methods of counseling.
Step 2: Identifying Specific, Practical Goals:
The hallmark of SFT is its emphasis on clear and realistic goal negotiations. The approach assumes that all clients have some knowledge of what would make their life better. Even though they may need help in describing the details of these goals in treatment.
Client-Counselor Goals should be:
- Significant: It is of utmost importance that the counseling goals be personal and relevant to each woman.
- Specific: It is important for goals to be concrete and measurable. We ask the question, “What should we accomplish today, to allow us to know that we are on the right track?”
- Small: When we think of practical goals they are also goals that are attainable. At the same time, the goals should be challenging enough to inspire the women to work hard.
- Start-Based: Often in treatment facilities, the women are able to tell you what they don’t want. It is our desire as counselors, to help the women express the start or presence of something desirable. Not always, the end or absence of something undesirable. Using start-based goals causes the women to move toward what they want (the solution), rather than away from what they don’t want, (the problem).
Step 3: Building on What is Working
Solution Focused Therapy encourages women to take note and build on what is working in their lives – their strengths and abilities. Not focus on what is wrong, missing and not working in their lives. We ask the questions, “When is the problem absent or less noticeable?” “How did you make that happen?” What will it take to have that happen more in your future?”
No one can attain a goal, without knowing what the goal is. Often our clients come to Sanford House not knowing what to expect or what their goals should be. They don’t know how to define “recovery” and what it means to them. These women have been numbing themselves for so long, they can’t remember what life was like before they were actively using. They have gotten off track; they have lost their way.
As a Counselor…
As a counselor, I always want to meet the clients where they are on the path. When we sit down in a comfortable environment and talk about their strengths and past successes, the client gains confidence. They realize there are still things they do very well. All is not lost.
Solution Focused Therapy has proven to be another effective modality. I have worked with several women who have had years in recovery, only to relapse. For those women, SFT is extremely helpful. Relapse feels like a complete failure to them and there is value in uncovering their favorable characteristics. When they remember the hard work they have already done, they can begin to transfer coping skills they have developed previously, to the present time. The outcome has been positive and they are still in recovery today.
*Evidence Based Practice (EBP) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett D, 1996)