Formulating My Sui Generis Approach For Effective Brief Therapy

By: Evan Murao

Two levels to nourish a client in a healthy and positive transition throughout therapy and the rest of the client’s life are:

  1. Primary Support Group(s)= a framework for resilience, also to retract back to homeostasis with people whom care and provide nuturing support for the client.
  2. Resource(s)= Community support groups can be helpful for a family to obtain necessary tools and methods in providing effective solutions from others who share similar experiences in their unique challenges.

The integrating theories, methods, and techniques that align to my therapy approach are:

Therapy Structure

Working along side with the client in developing a strength-based framework for success that is tailored to the client’s unique lifestyle can be profound. This framework encompasses the sui generis challenges that restrict the client from reaching their personal potential of satisfaction within their level of self-change.

The Use of Genograms

Utilizing a genogram in therapy can provide the basis for client self-assessment, as well as the self-awareness to understand how the upbringing throughout the client’s humanistic development by his/her primary support group has influenced their current existential functioning as a human being. Genograms display family information graphically in a way that provides a quick gestalt of complex family patterns; as such they are a rich source of hypotheses about how a clinical problem may be connected to the evolution of both the problem and the family’s context over time. Throughout the initial interview, the assumption is that the client is the expert in their life, as only the client knows their family best. The therapist takes on a “not knowing” position as a facilitator and recorder, who accepts what the client says in a serious manner.

As the client describes their family background with the use of a genogram, the client can begin to become aware of how their thoughts, emotions, and behaviors can stem from and be attributed to their multi-generational family patterns. It is then that the client can see that he/she is both engaged and receptive to their own perception of the external forces in their environment. The use of the genogram enables the therapist to apply knowledge of a family’s behavior patterns, key family events and of individual family members to the care of a family over time. And in doing so, there are six interpretive categories for the genogram: family structure, family life cycle, pattern repetition, life experiences, family relational patterns, and family balance and imbalance. Adopting some form of standard interpretation allows comparison of data as well as efficient focused use of questioning and hypothesizing without the client being overwhelmed by information.

Working In Conjunction With The Patient’s Framework In Restructuring Successful Cornerstone Practices

These beliefs, values, morals, and ethics are blueprints that have been crystallized in the client by their primary support group, which govern the client’s personal constructs of reality. The client’s personal constructs are then applied when the client is faced with a challenge. It is in this area of personal experience, where the client can determine their actions to be a result of negative feedback loops that leave those difficulties unresolved which could accrete into larger challenges. The concept of negative feedback loops belong to the Mental Research Institute (MRI) approach, as it focuses on family communication patterns and feedback loop mechanisms. This feedback loop is shared and reinforced by the client’s primary support group when formulating solutions to their challenges in returning to a previous state of homeostasis.

Setting Up The Goal(s) For Therapy

In knowing what the client wants from therapy, unique questions are used to stimulate the client to think about what it is that they want from therapy, and to create a path to obtaining their goal by examining what has worked for them in the past. Eliciting the client to procure self-change can be facilitated by the therapist in using the miracle question from the Solution Focused Brief Therapy perspective for the client to identify their goal of therapy. Miracle questions ask the client what slight changes would they notice, if they woke up the next morning and discovered that overnight their problem was gone. These types of questions focus on helping the client tell the therapist, as well as to them self, what it is he or she wants from therapy.

Once the client has identified what they want out of therapy, the therapist then guides the client in making their goal concrete and attainable. If the client has difficulty in establishing a clear goal that can be concrete to the client, the therapist can apply motivational interviewing techniques to assess and rejuvenate the clients motivation to change. If the client does have a clear goal that is attainable and appropriately aligns to the client’s lifestyle, the therapist can then elicit the client to make their goal concrete by conjuring up past experiences of personal success in satisfaction, which are exceptions to the client’s notable difficulties. Exceptional questions are structured in a way that asks, “Tell me more about what goes on when the problem is not occurring?” These questions ask if there was a time in the client’s past where the problem could have occurred but did not, and what was done differently that may even be a slight change to what the client is seeking from therapy.

Utilizing Language That Reflects and Aligns With The Patient In Establishing Rapport and Boundaries To Ultimately Develop A Therapeutic Working Relationship Geared Towards The Best Interest Of The Patient

The use of the client’s language to describe their reality should be mirrored by the therapist, in formulating questions that the client knows and is able to understand. Using client centered language to strengthen rapport, and elating the client’s self- esteem with appropriate positive connotations when the client speaks of personal strengths, achievements, and overcoming of trials and tribulations throughout the initial interview is important so that the client can stay solution focused instead of problem orientated.

Clinical Psychologist Bill Miller, developer of Motivational Interviewing, researched in studying that success rates of addicts in therapy correlate to dependent variables such as the duration of client making appointment and therapist meeting with client, as well as the level of empathy a therapist had in approaching the client’s challenges. What was found was that there is a significant difference in the success rate of treatment where those who were seen immediately when the motivation to change was at its highest by a therapist who is empathetic recovered three times as quickly, compared to a client who has been on a waiting list and has a therapist who is authoritative and austere.

Utilizing this approach when conducting an initial interview is essential, as it can also be seen as the intervention process that paves the way for success in therapy. The results indicate that intervening clients immediately when their motivation to change is at its highest when seeking therapy, combined with a therapist who exemplifies empathetic attributes into their therapy approach, are important aspects to consider as it is an evidence-based practice approach in ensuring success of effective treatment tactics for clients.

Facilitating The Process Of Discovering Successful Solutions

Throughout the interviewing process, the therapist is engaged with having the client find their own solutions to their difficulties. This provokes the client to become aware in knowing what it is in their distinct power, to create the change that they see for themselves. So the goal of the first session is that the therapist wants to know what the client wants. It is the client who will consider what is a successful outcome, determined from the initial interview. The therapist can then use the technique of scaling questions, which are derived from Solution Focused Brief Therapy. Scaling questions are client generated and are based off what the client wants from therapy. It is a way of measuring change according to the client’s way of measuring the change.

Assessment Phase Towards The Overview On The Direction Of Therapy

After the therapist feels that they have enough information from the client, the therapist takes a break to evaluate what client had said. Then the therapist uses that information to present a “summary” or message to the client, who includes complimenting the client on their strengths, acknowledging or validating client’s point of view about their life, and to suggest tasks that align with the client’s goal to resolving their problem. The use of a scaling question to assess where they are at in progressing to their goal helps to solidify the worth of coming in for therapy.

Structure Of Subsequent Therapy Sessions Until Goal(s) Are Met

In the subsequent sessions, the therapists’ main focus is to know what has been better since the last session. Whatever that has happened which made the client’s life better is accepted by the therapist, even if tasks suggested by therapist in the last session was not done. In this therapeutic approach, the client’s solution is always preferred over the therapist’s suggestions. As the therapist, it is important to reinforce the client’s progression and solution finding by asking the client, “How did you do that?” It gets the client thinking of the process they took to making positive change to their problem. By having the client acknowledge those thoughts and actions they took to improving their life even slightly, empowers the client to maintain progression to their goal. Scaling questions can also be beneficial to the client in tracking their progression in attaining their goal of therapy at the start and at the end of each session.

The Overview On My Sui Generis Approach to Therapy

Through examining the process of interviewing and the second session of therapy, the therapist’s role is to help the client generate their own solutions. The therapist’s job is to support and enhance the client’s strengths by giving credit back to the client so that they realize it is their solutions and not the therapist’s solutions. As a result, the client’s self-esteem is respected and they feel better about having solved their own problems.

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