Family Based Services: A Solution-Focused Approach

A professor pointed out to me how different family based services are depending on where you live (and who does the training). For instance, in Pennsylvania it’s very structural (focuses on hierarchy, enmeshment, etc) and in Wisconsin it’s more solution-focused. While I think both have their strong points, I tend to lean more toward the use of solution-focused in any sort of therapeutic session. I read Family Based Services by Insoo Kim Berg over my break from class and found it very informative–not only for working with families, but in working with anyone. It reinforced for me why I subscribe to a solution-focused framework. Insoo writes in such an easy to understand way and the book flows so nicely. It was a very quick read and I just adore her writing style. I wish I could have met her, but she passed before I finished high school. Still, she has such insightful and influential work in the mental health field. I strongly recommend checking out her work and I’ll share some of my notes from the current work.

I find the strong points of this approach, as outlined in this book, include:

  • Focusing on solutions, doing more of “what works” instead of just trying to eliminate a problem
  • Acknowledging that the change process is inevitable, and that everything is constantly changing
  • Looking for exceptions to the problem and showing that nothing happens all of the time
  • There is no clear connection between cause and effect
  • The therapist is a guide rather than an expert
  • Acknowledging that a good therapeutic relationship ISN’T enough, the client must behave/think differently for a change to occur.
  • Confrontation is indirect. Take a curious stance. (Ex: You said that you don’t care about X, but you look sad to me. I’m confused about that, can you help me understand?)

Additionally, here are some interventions that I love

  • Reframing (Ex: Client complains that they always withdraw from people. You could respond with “So you’ve become really skilled at protecting yourself.”
  • Externalizing the problem so it doesn’t define the person. (Ex: “How have you managed to combat anxiety?” Rather than “your anxiety” or “you’re anxious”)
  • Change a small element in a familiar pattern (Ex: Tell a couple that they are only going to fight in public or in the kitchen from now on).

And important, but not always so obvious, notes on violence:

  • As hard as it may be, don’t side with the victim against the perpetrator
    • Doing so may impede the healing/change process and the perp may withdraw
  • Don’t force the victim to leave the relationship
    • This could be especially dangerous, depending on the situation. Always consult.

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