Moving from Supportive to Solution Focused Interventions
Objectives
~ Differentiate between supportive and solution-focused interventions
~ Identify the function of each
~ Explore interventions to facilitate transition into problem solving
What’s the Difference
~ Supportive interventions are grounded in empathy and helping the person survive the moment.
~ Plugging a hole in the hull of a ship until you can get to port
~ Solution focused interventions aim to help the person move from surviving the moment to thriving.
~ Repairing the ship and figuring out how to avoid the reef the next time
Supportive Interventions
~ Establish rapport
~ Validate the person’s feelings
~ Can help the person return to baseline/wise mind
~ Examples:
~ Active listening
~ Radical acceptance
~ Distress tolerance
Why People Get Stuck
~ Supportive interventions are like removing boiling rice from a hot stove.
~ When the rice starts to boil, it often boils over
~ The cook removes the rice from the heat and the bubbles go down.
~ The rice still needs to cook (the problem is still there) but the immediate crisis (boiling over) is past
~ The cook returns the rice to the stove to try and get it to finish cooking.
Solution Focused Interventions
~ Help people identify
~ The problem
~ Their hoped-for resolution of the problem
~ Ways they have solved similar problems
~ Exceptions
~ Other possible solutions
~ Require a clear head and the ability to concentrate (a little)
~ Require that the person feels heard and understood
~ Require motivation to make a change
Decisional Balance (Increase Motivation)
Maintain Motivation
~ Use assignments to keep people on task between sessions
~ Have daily check-ins to complete the problem log
~ Use scaffolding to develop a game plan
~ Provide reinforcement for successful completion of tasks
~ Highlight improvements
~ Try to avoid rewarding backsliding
~ Consider all factors that may enhance or impede motivation
~ Emotional
~ Mental
~ Physical (sleep, nutrition, pain, hormones)
~ Social (friends and family)
~ Occupational (school/work)
Remember
~ Everything people do serves a purpose and is generally more rewarding than the alternative.
~ Why does Sally seem to shut down or yes-but any suggestions?
~ Why does John insist on taking an excessive load even though he knows it will stress him out?
~ Why does Jane continue to use social media if it upsets her so much?
Cognitive Processing Cont…
~ Can help therapists identify and address
~ Cognitive distortions
~ Emotional reasoning
~ Faulty goal setting and problem solving skills
~ Can help clients
~ Gain a different perspective
~ Identify what parts are within their control
~ Set SMART goals and increase efficacy
Cognitive Processing
~ Tell me the problem (or write it down)
~ What are the known facts for and against your beliefs about the problem?
~ What other factors and people are involved?
~ Are you assuming things about other people or the future?
~ Are you confusing high and low probability events?
~ Which parts can you control? Which part’s can’t you control?
~ What is your hoped for resolution?
~ Is this realistic? Why or why not?
~ What are possible steps to a solution?
Problem Solving
~ Use authenticity to communicate how much you want to help the person find a way to stop hurting.
~ Look for exceptions
~ Identify ways the person or someone else has solved the problem in the past
~ Set small, achievable goals
~ Follow up regularly.
Narrative Therapy
~ Have people write down
~ What is going on (this chapter)
~ How they see the future (the next chapter)
~ Include
~ Who is there?
~ What do they do?
~ How do they feel?
Living in the AND
~ Validate people’s hurts and perspectives.
~ You are devastated and it seems like the pain will never end.
~ Help them identify things that are important to them that are going well
~ Tree
~ Collage
~ Scrapbook
~ Index cards: Who or what it is and why it is important and going well.
Summary
~ Supportive interventions are necessary to help people radically accept their feelings and situation and get into their wise mind.
~ Solution-focused interventions will help them address the situation and start moving forward to break the distress cycle.