Brief Therapy Interview Strategies

Icebreaker Compliment or Positive Statement (Examples)

I’d like to thank you for getting here so promptly today.
I do appreciate that very much.
I’d like to thank you for taking the time to come in today.
I’d like to thank you for filling out all those forms.
I’d like to thank you for answering all those questions on the forms you filled out.
I’d like to thank you for coming in and giving me the time to go over some things with you.

Basic approach to changing the mindset of clients from involuntary to voluntary status:

Our work with them follows this schema:

Whose idea is it that you come here?  What makes ___ think you should come here?  What does ____want you to be doing differently? Is this something you want? (Goal frame)
If yes, proceed as with a voluntary client.
If no, ask: Is there something you would like out of coming here? (Goal frame)

If yes, proceed as with a voluntary client.
If no, explore the consequences of not coming to sessions.

Source: Walter, J. L., and Peller, J. E. (1992). Becoming solution-focused in brief therapy, 247. New York: Routledge.

Utilization strategy

It involves the therapist learning from the outset as many of the specific strengths and resources the client possesses.
Asking questions that will evoke positive data.

e.g. Work history in a particularly interesting or difficult job • Interesting profession • Challenging work experiences • Hobbies • Talents • Interests • Sense of humor • Desire for change • Positive attitudes • Use of language • Beliefs • Intentions • Narrative abilities • General experiences

Conversational Questions

Conversational questions maintain effectiveness not only because of the engaging attitude of the therapist, but also because of the quality and substance of well-chosen questions. Clients might be asked about what kinds of questions they felt the therapist should have or could have previously asked in the session (but didn’t); or about what kinds of things prior therapists did that could have been done differently or better; or what they did that was totally useless and ineffectual. In all, this strategy constitutes an elemental therapeutic process of entering and expanding the areas of the unsaid or the not-yet-said (Anderson & Goolishian, 1988, p. 381).

“You have seen many therapists. What do you suppose they overlooked or missed with you?”
If I were to work with another family just like you, what advice would you give me to help that family out?
Who had the idea in the family to go for therapy?
If there were one question you were hoping I would ask, what would that be?
If there were one issue in this family that has not been talked about yet, what would that be?
Who in the family will have the most difficult time taking about this issue? (Selekman,
Who probably had the most difficult time coming here today?
What is one major thing holding everyone back?
What is one major reason for not talking together as a family?
What are some things I should be asking about you?
If you’ve been to other therapists, what are some of the things you didn’t like about the questions they asked or how they asked the questions?
What do you think are some needs that we should discuss first, before moving forward?
What did you like or dislike about your prior therapists?
What people in the family could change things if they had the power?
What people do you trust the most? Why is that so?
What is one small thing that could be changed to help get us started today?

 Dyadic questioning and triadic questioning#

The client’s voicing of what others might believe and what others might be saying or thinking paradoxically allows the therapist access into the client’s world.

Scaling questions and percentage questions

“On a scale from one to ten, how painful was it for you to come here at the beginning of this session? Ten being no pain, and one being very painful.”

“If the number one stands for a low level of confidence to lose five pounds and ten stands for a high level of confidence to lose five pounds, what was your level of confidence at the beginning of this session?”
“What would it take to bring your level of confidence up to a four? What needs to happen?”
Percentage questions are slightly different…

Normalization

Therapist use of statements to imply client problems not necessarily viewed “as pathological manifestations but as ordinary difficulties of life”
(O’Hanlon & Weiner-Davis, 1989, p. 93).

The goal of this strategy is to pre-emptively depathologize client problems and the client’s view of the problems.

The normalization statement also contains the counselor’s implicit acceptance of the client.

Deframing

Deframing is defined as a strategy that introduces uncertainty into the client’s present and past view of things which have not been shown to be useful (O’Hanlon & Beadle, 1997 p. 35).
Deframing is achieved by calling into doubt the client’s beliefs or belief system.

Examples of Deframing Questions:

How do you know that to be so? What makes you say that? How is that so? Where did you get that idea? On what basis have you reached that conclusion? What do you think is the origin of that belief? What is the foundation on which you rest your case? Did you ever have any doubts about those thoughts? Are you sure that’s accurate? What makes you so sure? What are the benefits in believing that? What influenced you to think along those lines? Why would you want to stick with that belief?

Positive connotation

whereby the therapist—after examining the family interactional patterns—ascribes worthy motives and noble intentions to what otherwise might be considered only symptomatic behavior

Coping questions

With families that . . . do not respond well . . . I shift gears and mirror their pessimistic stance by asking them:

“How come things aren’t worse?”;

“What are you and others doing to keep this situation from getting worse?”

Once the parents respond with some specific exceptions, I shift gears again and amplify these problem-solving strategies and ask:

“How did you come up with that idea!?”;

“How did you do that!?”; “What will you have to continue to do to get that to happen more often?” (Selekman, 1993, pp. 65–66)

“I’m just very curious as to how come things haven’t gotten any worse?”

“So what else is there that has prevented things from getting any worse?”
“So, it seems like something positive has already begun. How did you get that to happen?”

“So what other changes do you think you might have started and not have realized until our conversation today?”

 Pessimistic questions

In effect, the therapist’s act of joining clients in their worsening situation helps to create a reverse psychology scenario where the therapist—now being one of them, so to speak—is suggesting pre-emptively a kind of hopelessness that, ironically, the client might best handle with some kind of positive activity.
Often this line of questioning will enable family members to generate some useful problemsolving and coping strategies to better manage their difficult situation. Typical examples of pessimistic questions are as follows:

“What do you think will happen if things don’t get better?”;

“And then what?”; “Who will suffer the most?”;

“Who will feel the worst?”; “What do you suppose is the smallest thing you could do that might make a slight difference?”; “And what could other family members do?”; “How could you get that to happen a little bit now?” (Selekman, 1993, p. 72)

Problem tracking

involves tracing past behavioral transactions for the express purpose of noting problem-interaction sequences;
use this when strategies don’t seem to be working effectively…

“If you were to show me a videotape of how things look when your brother comes home drunk, who confronts him first [asking a sibling of the identified client], your mother or your father?”;
“After your mother confronts him, what does your brother do?”; “How does your brother respond?”; “Then what happens?”; “What happens after that?” Ideally the brief therapist will secure a detailed picture from the family members regarding the specific family patterns that have maintained the presenting problem. (Selekman, 1993, pp. 76–77)

Therapists may also employ other prominent strategies such as those listed below.
• Exception-oriented questions
• Miracle question sequence
• Problem dissolution.

Problem dissolution

Integrative therapists O’Hanlon and WeinerDavis begin

“with the assumption that it is possible to negotiate a therapeutic reality that dissolves the idea that there is a ‘problem’ ”

(1989, p. 57).
This involves introducing uncertainties that challenge the client’s dysfunctional beliefs and past dysfunctional behaviors, and debunks and demystifies them.
problem tracking (leading to)
—> exception orientated questions
—> miracle questions
—> problem dissolution

Exception-oriented questions
————————

There are always times when the identified problem is less severe or absent for clients. The counselor seeks to encourage the client to identify these occurrences and maximize their frequency. What happened that was different? What did you do that was different?
wikipedia

The miracle question

The miracle question or “problem is gone” question is a method of questioning that a coach, therapist, can utilize to invite the client to envision and describe in detail how the future will be different when the problem is no longer present.
“If you woke up tomorrow, and a miracle happened so that you no longer easily lost your temper, what would you see differently?” “What would the first signs be that the miracle occurred?”

Use of silence

The pause serves to give the client time and psychological space to think especially if the therapist’s question involves something painful
“So far we’ve spent about 15 minutes together, and you’ve said very little. We’ve already discussed the consequences of your not coming to future sessions. Your parents may decide to take action that may not please you. I’ll remain silent for a while, and whenever you feel like saying something to get things moving along, I’ll welcome your remarks.”

Source

Interviewing and Brief Therapy Strategies: An Integrative Approach

George Carpetto ISBN-13: 9780205490783

Chapter 7: Excerpt http://www.pearsonhighered.com/samplechapter/0205490786.pdf

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