Brief Therapy Solution Focus at single session for couple problems

With today’s article we will discover how to apply Single Session Therapy in the intervention with the couple . In this case we will focus on the integration of the SST method with another therapy model equally oriented towards maximizing the results of the intervention, Solution-Focused Brief Therapy (TBCS) (de Shazer et al ., 1986; Nunnally et al. , 1985).

 As in the case of family intervention, are there doubts about the adequacy of this method for couple intervention?

Couple work raises the same doubts as family work , which as we have already shared in the previous article, in which we spoke about the Guidelines for creating a SST with families , is often conceived as a complex activity that requires the acquisition of specific technical skills on the part of the therapist and a long period of elaboration by the clients to obtain results.

  

Are there, however, methods that allow even in the case of the couple’s intervention to obtain results in the shortest possible time, if not even in a single therapy meeting?

The answer is yes!

There are some ways of managing therapeutic conversations that are able to maximize their effectiveness and for this reason able to make the intervention brief , among these the model of Brief Therapy Centered on the Solution stands out .

  

Let’s see which assumptions the TBCS model is inspired by

As de Shazer (1989) argued , TBCS has no theoretical basis , but is based on rules (“If it ain’t broke, don’t fix it” – “Once you know what works, do it more” – “If it doesn’t work , don’t do it again. Do something different” ) which form the philosophical basis from which the model was developed and which have led practicing therapists to share some hypotheses about clients and therapy:  

1. All clients are motivated towards achieving something : it is the therapist’s job to find out towards what.
2. It is the therapist’s job to discover the best way to collaborate with the client , considered the latter in its uniqueness. The idea of ​​’resistance’ is not helpful as it prevents the development of cooperation between therapist and client.
3. Trying to figure out the cause of a problem isn’t a necessary or particularly helpful step in solving it.
4. Successful work depends on knowing what the client wants from therapy . Once this is established, the therapist’s job is to find the fastest way to get there.
5. As rigid as the problem pattern may seem, there are always times when the customer is implementing solutions . The most cost-effective approach to therapy involves helping the client step up to doing “what already works” .
6. The problems do not represent the underlying pathology, they are just the things the client wants to do without . In most cases the customer will be the best judge of when the problem is resolved.
7. Sometimes only the smallest of changes are needed to reach the solution to the problem. It is not always necessary to involve all the people involved in the problem (Ratner George & Iveson, 2012).

 

 Now let’s look at the method for conducting One-Session Solution-Centered Therapy for relationship problems

The simplest way is to manage the couple interview as if it were two separate managements of the partners , but intertwined if the other partner is present (although the presence of the partner is not always necessary for an effective result ) (Ratner George & Iveson, 2012). Starting from this, let’s see the 8 steps to follow for a Single Session TBCS :

1. The dialogue between therapist and client should not focus on problems and should be oriented towards building relationships
2. Identify the problem
3. Use the “miracle question” or prompt the client to visualize “life without problems”
4. Look for exceptions to the problem pattern
5. Proceed up the ladder of progress towards solving the problem
6. Identify the next step
7. To congratulate
8. Finish with an assignment or directive, the form of which is based on the level of motivation of the client (customer, complainer or visitor) (George, Iveson & Ratner, 2014).

 

During the session, the therapist will have the task of alternating the image of the change between the partners , in order to make the concept of “cause-effect” fade in the relationship between the partners during the process. This work will involve a shift of focus from the problem , represented by the question “who will initiate the change in the relationship first?”, to the solution , represented by the question “what will you do differently?” addressed to both members of the couple.

 

Conclusions

The couple intervention based on the Single Session Solution-Centered Therapy described in this article has shown us how it is not always necessary to prepare a complex and articulated work to obtain a result , even when working with family systems or with the couple . What makes the intervention effective and quick , in fact, is precisely the presence of a simple and clear structure, whose basic principles envisage the reduction of the complexity of the intervention by the therapist and the enhancement and use of the resources of the patient .    

 

Angelica Giannetti
Psychologist,
Team Psychotherapist of the Italian Center
for Single Session Therapy

 

 Bibliography

de Shazer, S., Berg, IK, Lipchik, L., Nunnally, E., Molnar, A., Gingerich, W. et al. (1986). Brief therapy: focused solution development, Family Process , 25:207–222.

de Shazer, S. (1989) Resistance revisited. Contemporary Family Therapy , 11:227–233.

Nunnally, E., de Shazer, S., Lipchik, E. and Berg, IK (1985). A study of change: therapeutic theory in process. In E. Efron (Ed.), Journeys: Expansion of the Strategic-Systemic Therapies . New York: Brunner/Mazel.

Ratner, H., George, E., Iveson, C. (2012). Solution Focused brief therapy: 100 key points and tecchniques , London: Routledge.

Ratner, H., George, E., Iveson, C. (2012). Love is All Around: A Single Session Solution – Focused Therapy. In Hoyt, M.F., Talmon, M. (2014). Capturing the moment . Single Session Therapy and Walk-In Services , UK: Crown House Publishing Ltd.