Anne Bodmer Lutz, B.S.N., M.D.
Human beings are unique in two ways – we are tool-bearing and talkative. This ability to talk provides us with opportunities to communicate with others. Some conversations enhance possibility, while others diminish it. When possibility is enhanced, we have self-agency – a sense that we can take the necessary actions to address what concerns or troubles us – to accomplish our hopes, ambitions, and dreams. How can we help people transform their stories and create a conversational space that enhances hope and possibilities? Solution-Focused brief therapy (SFBT) can be thought of like a new language requiring fluency and skills different from the native problem-solving language we are all fluent in.
SFBT is a future-focused, goal-directed approach to brief therapy. The developers meticulously observed hundreds of therapy sessions, carefully noting which questions proved to be most consistently linked to clients’ subsequent reports of progress. These questions were then incorporated into the solution-focused approach. (More Than Miracles, de Shazer et al.).
Let’s get started on the Top Ten Solution-Focused Translations!
#10: The Indirect Compliment: How did you do it?
Let’s look at this lovely question. How conveys “in what manner? By what means?” Notice the question is not “Did you do it?” but instead “HOW” did you do it. Did (observe it is past tense), conveys they have done it already. Noticing with clients what they have already done enhances a sense of self-efficacy because they have already accomplished it. The second verb “to do” (to accomplish, perform and execute) conveys past success. How are problems (or as I like to translate “challenges”) solved? It requires action or the verb “to do.” Most of us are less fluent in the use of the indirect compliment, which is in the form of a question, and have greater ease when providing “direct compliments” such as “Wow” or “Congratulations.” Listening for opportunities to compliment clients based on their complaints (and who doesn’t love to complain) with indirect compliments is a powerful question to enhance self-efficacy and hope. What the heck – try asking the indirect compliment with your patients, colleagues, children, loved ones. I assure you no harm will be done!
#9: What are your best hopes?
This is the solution-focused translation of the chief complaint (What brought you here). The question is not “do you have hopes?, But rather “What” are your best hopes. It is hopeful, future-directed and creates a narrative which communicates to clients their competence and hopes to live a more satisfying life on their behalf.
#8: What else? How else? Who else?(Three for the price of one)
Effective solution-building requires getting as many details as possible about prior successes. These questions leave no potential strength uncovered and are the metaphorical “language shovels” that dig for the details of success. What else are you good at? How else did you do it? How else was it helpful? Who else is most important to you?
#7: Who are the most important people in your life and what do you most appreciate about them?
All people live in relationships. Relationships are not only crucial for survival but also essential resources that help people solve their problems. Problems are solved in one of two ways. Either the problem is solved, or the client and those most important to them no longer view the behaviors as problematic. For “challenges” to be considered solved, the client’s system must be in agreement that there are no significant problems. What better way to learn who is important to your client than to ask.
#6: What do you know?
What do you know conveys that clients have knowledge, understanding and a recognition of what is important in their life. Asking clients what they know about marijuana, medications, their diagnosis attests to their competence. One of my favorites is to ask parents “What do you know about your child that tells you they will succeed in life?” It has continually amazed me that parents are always able to answer this question no matter how dire the situation appears.
#5: Have you ever had to cope with trauma, domestic violence, hurricanes, homelessness, mudslides, poverty, loss, death, etc. ?
Incorporating the one-word “cope” within the question demonstrates that your client has coped. If they say yes, my next question is “How have you coped?” When clients are sitting in front of you talking, they have indeed coped. Remember that cope is one letter away from hope.
#4: You must have a good reason?
Asking clients their good reasons for behaviors that appear harmful (i.e.) self-harm, drug use, staying in a domestically violent relationship, to name a few, reveals how clients engage in these behaviors because in some ways they are useful and beneficial for them. The question does not condone the behavior but instead helps to understand the client’s motivation to do what they are doing. This can help lead the conversation towards alternatives.
#3: Was it different for you?
Noticing positive differences, also known as exceptions, are times when an expected problem could have occurred but didn’t. Positive differences often go unnoticed by clients. Meticulously paying attention to these differences often discovers past successes.
#2: On a scale from 1-10, where ten is you are satisfied, and things are good enough, and one is the opposite, where would you say you are?
Scaling questions can minimize language confusion that often occurs within conversations. They are quick, easily adaptable and client-centered. Solution-Focused scaling questions are constructed in such a way that the 10 highlights a positive direction of where the clients want to move forward (i.e.) confidence in ability, satisfaction with relationships, ability to keep safe, or helpfulness of medications. Asking what keeps the number from being lower (and what else) often uncovers further undiscovered strengths and past successes. It is one of many potential amplifying questions used to “work the scale” and often leads to more possibilities to compliment and bring to light more past successes.
#1: What are you good at and enjoy?
This question affords your client an opportunity to talk about parts of their life going well and communicates they are more than their presenting problem. These strengths are essential resources that would otherwise often be undiscovered within the conversation and are critical resources that can often assist them in solving their problem. Investigating details by asking how they learned the skills; what else they are good at and how else they learned these skills recognizes a client’s expertise and mastery expanding the narrative of their accomplishments and abilities.
De Shazer, Steve, et al. More than Miracles: the State of the Art of Solution-Focused Brief Therapy. London, Routledge, 2012.
Franklin, Cynthia, et al. Solution-Focused Brief Therapy: a Handbook of Evidence-Based Practice. New York, Oxford University Press, 2012.
Lutz, Anne Bodmer. Learning Solution-Focused Therapy: an Illustrated Guide. Arlington, VA, American Psychiatric Publishing, a Division of American Psychiatric Association, 2014.