With today’s article, we share the use of some techniques that can influence one of the key factors underlying the use of Single Session Therapy (SST), which is the expectation of change (Battino, 2018).
Why is expectation so important in Single Session Therapy?
In all forms of therapy, the expectation of change, understood as overcoming difficulties or achieving a goal, represents an essential therapeutic factor. However, in the context of SST, it plays an even more significant role.
What differentiates SST from other approaches?
SST is an intervention method that leverages a person’s ability to access personal resources to overcome a problematic situation. To achieve this result, trust in change, both from the client and the therapist, is essential to move towards the identified goal.
But what exactly do we mean when we talk about expectation?
In psychology, there are many studies on the effect of expectation in therapy. All these studies confirm the influence that the expectation of change can have on how individuals respond to situations, both at the level of mental processes and behavioral reactions (Kirsch, 1985, 1990, 2010). If initial expectations are crucial for determining change, it is equally important to implement strategies to monitor these expectations during the therapeutic process. Below, we will explore how to do so.
Which techniques allow us to use expectation as an essential factor for change?
Now let’s look at some techniques that allow us to work on expectation from the very first moment.
“As If” Technique
This technique involves encouraging individuals to act “as if” the issue that led them to seek help has already been resolved. The pioneers of this therapeutic maneuver were the researchers at the Mental Research Institute in Palo Alto (Fisch et al., 1982). The premise behind the technique is that of a self-fulfilling prophecy — the idea that if a person behaves as if they have already achieved the desired result, they will indeed achieve it. For example, if someone presents the problem of feeling judged by others, the therapist will suggest that the person behave and live as if they were no longer afraid of others’ judgment, within a specific time frame. This will, in short, lead to modifications in the person’s behavior and external reactions, creating new convictions.
Miracle Question Technique
The Miracle Question, initially developed by Insoo Kim Berg at the Brief Family Therapy Center (Miller & Berg, 1995; Berg & Dolan, 2001), is a further development of the “as if” approach and is formulated as follows:
“Suppose that tonight, after our session, you go home, fall asleep, and while you are sleeping, a miracle happens. The miracle is that the worries you brought here are solved, and you are satisfied. But you don’t know how the miracle happened because you were sleeping. When you wake up in the morning, what is the first thing you will notice, and how will you know that this miracle has occurred?”
Once this question is asked, for the next twenty or thirty minutes, the conversation with the client will focus on visualizing their day, resulting in a detailed description of what has changed after the miracle. The more detailed the person is in describing the scenario beyond the problem, the more the miracle becomes a reality.
Restructuring Technique
Restructuring is a process that involves changing the way a situation is perceived and, consequently, its meaning (Watzlawick, Weakland, & Fisch, 1974). Changing the perception of reality by observing it in different contexts or from different perspectives means changing the meaning attributed to events and, as a result, modifying behavioral and thinking patterns to deal with them. An example of restructuring is when, at the beginning of a session, we tell the client how courageous they are for being there to face their difficulties. Speaking about concerns and not “problems” (since problems are harder to solve than concerns) is a form of restructuring. This change in language is more useful in guiding the client towards change (Battino, 2011).
Conclusions
To conclude, let’s use a quote from Albert Einstein that encapsulates the concept presented so far and the power of expectation: “Take a centenarian who breaks a mirror: he will be happy to know that he still has seven years of bad luck!”
Angelica Giannetti
Psychologist, Psychotherapist
Team of the Italian Center for Single Session Therapy
Bibliography
Battino, R. (2011). Healing language: A guide for physicians, dentists, nurses, psychologists, social workers, and counselors, www.Lulu.com.
Berg, I.K., & Dolan, Y.D. (2001). Tales of solutions: A collection of hope-inspiring stories, New York, Norton.
de Shazer, S. (1982). Patterns of brief family therapy, New York, Guilford Press.
CannistrĂ , F., & Piccirilli, F. (2018). Single Session Therapy: Principles and Practices. Giunti Editore.
Fisch, R., Weakland, J.H., & Segal, L. (1982). The tactics of change: Doing therapy briefly, San Francisco, Jossey-Bass.
Kirsch, I. (1985). “Response expectancy as a determinant of experience and behavior,” American Psychologist, 40, p. 1189-1202.
Kirsch, I. (1990). How expectancies shape experience, Washington, DC, APA Books.
Kirsch, I. (1994). “Clinical hypnosis as a nondeceptive placebo,” American Journal of Clinical Hypnosis, 37, p. 95-106.
Kirsch, I. (2010). The emperor’s new drugs: Exploding the antidepressant myth, New York, Basic Books.
Kuehn, J.L. (1965). “Encounter at Leyden: Gustav Mahler consults Sigmund Freud,” Psychoanalytic Review, 52, p. 345-364.
Miller, S.D., & Berg, I.K. (1995). The miracle method, New York, Norton.
Talmon, M. (1990). Single session therapy: Maximizing the effect of the first (and often only) therapeutic encounter, San Francisco, Jossey-Bass.
Watzlawick, P., Weakland, J.H., & Fisch, R. (1974). Change: La formazione e la soluzione dei problemi, Rome: Astrolabio.