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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 firstname.lastname@example.org 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 ProblemConnect all nine dots using four straight lines without lifting your pen off the paper. Take a minute to try to solve it. . . . . . . . . .
“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 A genius once said…
“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) • Actionsof anyone involved with the problem… including US! (reactions, dance sequences) Among other things, these methods… GET THE STUDENT’S ATTENTION!!!
Increase in Diagnostic Categories from DSM-I (1952) to 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)
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 and important. The success of counseling rests largely on the extent to which the client’s resources and opinions are recruited and respected throughout the helping process. [Additional Materials, Page A-1] Model/ Technique 15% Client 40% Hope 15% Relationship 30%
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 • 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, change-focused 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. 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 Where you want to be (Now) (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.
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) • Select the “good behavior” to be increased. • Videotape the student displaying good behaviors (prompted or unprompted). • Edit the tape(s) to create a “Greatest Hits” movie (1-2 minutes long). • 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 Doingof 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) andChild 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@example.com