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Solution-Focused
Counseling:
Advanced Techniques
and Applications
Education Session
American Counseling Association
Jeffrey T. Guterman, Ph.D.
Clayton V. Martin, M.S.
Saturday, March 14, 2015
10:30 a.m. – 12:00 p.m.
American Counseling Association
2015 Annual Conference
Orlando, Florida
Hyatt Regency, Ballroom M
Copyright © 2015 by Jeffrey T. Guterman and Clayton V. Martin
The PowerPoint for this Education Session is available at http://JeffreyGuterman.com
Solution-Focused Counseling 2
Contents
About the Presenters ............................................................................................................... 3
Selected Publications by the Presenters .................................................................................. 4
Education Session Description ............................................................................................... 5
Education Session Objectives ................................................................................................. 5
Formula First Session Task ..................................................................................................... 5
Principles of Solution-Focused Counseling ............................................................................ 5
Implications of a Postmodern Position ................................................................................... 6
Problem and Exception ........................................................................................................... 6
Theory of Change ................................................................................................................... 6
Common Change Factors ........................................................................................................ 7
Stages of Solution-Focused Counseling ................................................................................. 7
Coconstructing Problems and Goals ....................................................................................... 8
S.M.A.R.T. GOALS ............................................................................................................... 8
Identifying Exceptions ............................................................................................................ 8
Questions for Amplifying Exceptions .................................................................................... 9
Solution-Focused Tasks .......................................................................................................... 9
Solution Identification Form ................................................................................................. 10
Scaling Form ......................................................................................................................... 11
Solution-Focused Checklist .................................................................................................. 12
Outcome Rating Scale (ORS) ............................................................................................... 13
Session Rating Scale (SRS) .................................................................................................. 14
Child Outcome Rating Scale (CORS) ................................................................................... 15
Child Session Rating Scale (CSRS) ...................................................................................... 16
Young Child Outcome Rating Scale (YCORS) .................................................................... 17
Young Child Session Rating Scale (YCSRS) ....................................................................... 18
Suggestions and Considerations for Using Rating Scales and Client Feedback .................. 19
References and Suggested Readings ..................................................................................... 20
Suggested Internet Resources ............................................................................................... 22
Solution-Focused Counseling 3
About the Presenters
Jeffrey T. Guterman, Ph.D. is a mental health counselor in Fort Lauderdale, Florida. He is
author of over 125 publications. The first edition of his book Mastering the Art of Solution-
Focused Counseling was published by the American Counseling Association (ACA) in 2006,
it was translated in Korean in 2007, and an updated and expanded second edition was
published by ACA in 2013. He has presented numerous workshops on solution-focused
counseling.
Contact Information
Email: jguterman@gmail.com
Phone: 305-725-4583
Web: http://JeffreyGuterman.com
Twitter: http://twitter.com/JeffreyGuterman
Clayton V. Martin, M.S. is a counselor in Atlanta, Georgia. He has presented workshops on
the topics of strength-based approaches to counseling and LGBTQ advocacy issues in
counseling. He has written articles for counseling journals on solution-focused approaches to
counseling and philosophical issues in counseling. He has extensive clinical experience in
solution-focused counseling with children, adolescents, and young adults in various clinical
settings.
Contact Information
Email: cmartin51277@gmail.com
Phone: 404-449-3028
–
Jeffrey T. Guterman, Ph.D. and Clayton V. Martin, M.S. are available to provide training and
workshops for your organization on various topics. Program topics and formats will be
tailored to meet the needs of your organization.
Solution-Focused Counseling 4
Selected Publications by the Presenters
de Castro, S., & Guterman, J.T. (2008). Solution-focused therapy for families coping with
suicide. Journal of Marital and Family Therapy, 34, 93-106.
Guterman, J. T. (1994). A social constructionist position for mental health counseling.
Journal of Mental Health Counseling, 16, 226-244.
Guterman, J.T. (1996a). Doing mental health counseling: A social constructionist re-vision.
Journal of Mental Health Counseling, 18, 228-252.
Guterman, J.T. (1996b). Farewell to families: Language systems in the postmodern era. The
Family Journal: Counseling and Therapy for Couples and Families, 4, 139-142.
Guterman, J.T. (1996c). Reconstructing social constructionism: A reply to Albert Ellis.
Journal of Mental Health Counseling, 18, 29-40.
Guterman, J.T. (1996d). Tales of mental health counseling. Journal of Mental Health
Counseling, 18, 300-306.
Guterman, J.T. (1998). Identifying pretreatment change before the first session. Journal of
Mental Health Counseling, 20, 370-374.
Guterman, J.T. (2013). Mastering the art of solution-focused counseling (2nd
ed.).
Alexandria, VA: American Counseling Association.
Guterman, J.T., & Leite, N. (2006). Solution-focused counseling for clients with religious
and spiritual concerns. Counseling and Values, 51, 39-52.
Guterman, J. T., Martin, C.V., & Kopp, D.M. (2012). Science and humanities: A necessary
unity for the counseling profession. Journal of Humanistic Counseling, 51, 145-154.
Guterman, J.T., & Martin, C.V. (in press). Using puppets with aggressive children to
externalize the problem in narrative therapy. In (A.A. Drewes & C. Schaefer, Eds.),
School age play therapy. Washington, DC: American Psychological Association.
Guterman, J.T., Mecias, A., Ainbinder, D.L. (2005). Solution-focused treatment of migraine
headache. The Family Journal: Counseling and Therapy for Couples and Families,
13, 195-198.
Guterman, J.T., & Schildbach, J. (2014, June). The stigma of mental illness and the noble
savage. Counseling Today, pp. 60-63.
Martin, C.V., Guterman, J.T., & Kopp, D.M. (2012). Extending the dialogue about science
and humanities: A reply to Hansen. Journal of Humanistic Counseling, 51, 161-163.
Martin, C.V., Guterman, J. T., & & Shatz, K. (2012). Solution-focused counseling for eating
disorders. VISTAS, 1-11.
Solution-Focused Counseling 5
Education Session Description
Solution-focused counseling is a comprehensive model that emphasizes clients' strengths,
resources. This session provides an opportunity to learn advanced solution-focused
counseling techniques and clinical applications. Solution-focused counseling is a
comprehensive model that emphasizes clients' resources, strengths, and effective coping
skills to bring about positive change. If these resources—called exceptions—are identified
and amplified, then problem resolution can be brought about in an effective and efficient
manner. Case examples illustrate using solution-focused counseling for a variety of clinical
problems and populations.
Education Session Objectives
1. Identify and review the main principles of solution-focused counseling.
2. Identify and review the theory of problems and change in solution-focused counseling.
3. Identify and review the clinical stages in solution-focused counseling.
4. Identify and review advanced techniques used in solution-focused counseling.
5. Identify and review clinical applications of solution-focused counseling.
Formula First Session Task
Between now and next time we meet, I want you to observe so that you can tell me next time,
what happens in your life that you want to continue to have happen (cf. Molnar & de Shazer,
1987).
Principles of Solution-Focused Counseling
 Solution-focus
 Collaborative approach
 Small changes can lead to big results
 Emphasis on process
 Strategic eclecticism
 Brief by design, but not always
 Responsiveness to diversity
 Committed to outcome
Solution-Focused Counseling 6
Implications of a Postmodern Position
for Solution-Focused Counseling
 Clinical reality as a social construction rather than an objective reflection of reality.
 Counselors as participant-observers rather than independent of clients and problems.
 A perspective that understands language as the distinction of treatment concern rather
than human systems as the locus of problems.
 A collaborative approach and an emphasis on cooperating rather than a perspective
that views clients’ oppositions to change as resistance.
Problem and Exception
 Problem:
o Problem: A subjective and/or intersubjective complaint
o Problem/Exception : The subjective or intersubjective complaint is subsumed
by the problem/exception formal theory which is used across cases to
conceptualize problems and change
 Exception: “Times when the complaint/problem does not happen even though the
client has reason to expect it happen” (de Shazer, 1991, p. 83).
Theory of Change
Theory of Change: When the problem is the rule, then exceptions tend to remain hidden or
decrease. When exceptions are identified and amplified, the problem tends to decrease.
Exceptions can be amplified by encouraging clients to do more of the behaviors that have led
them to solve the problem in the past, or to observe times when they are dealing better with
the problem, or ascribe significant meaning to the exceptions.
Solution-Focused Counseling 7
Common Change Factors
Research in the area of common change factors (Lambert, 1992) clearly supports the theory of change
in solution-focused counseling (Guterman, 2013). Lambert identified four common change factors
that contribute most to improvement in counseling and psychotherapy. According to Lambert, each of
these common change factors accounts for the following percentages of improvement that occur in
counseling and psychotherapy:
1. Client factors (or self-help): 40%
2. Client-counselor relationship factors: 30%
3. Expectancy factors: 15%
4. Model factors: 15%
These findings support the theory of solution-focused counseling for two reasons. First, the finding
that client factors accounts for the most improvement in counseling (40%) affirms solution-focused
counseling’s theory of change. The primary function of a solution-focused counselor is to help clients
tap into their problem-solving resources and potentials. Although a wide variety of techniques are
used in the model (which accounts for 15% improvement based on the research), solution-focused
counseling is to be considered a process model because it attributes change mainly to what the client
does to solve problem rather than to the model. In effect, its focus on client factors is the model. The
second reason that research on common change factors supports solution-focused counseling is
because the model emphasizes the important role of the client-counselor relationship. The finding that
client-counselor factors account for 30% of improvement supports the unique emphasis that solution-
focused counseling places on developing a collaborative relationship between the client and
counselor.
Stages of Solution-Focused Counseling
 Coconstructing problems and goals
 Identifying and amplifying exceptions
 Coconstructing tasks
 Evaluating the effectiveness of tasks
 Reevaluating problems and goals
Solution-Focused Counseling 8
Coconstructing Problems and Goals
1. Coconstruct solvable problems (e.g., ineffective coping skills, rather than merely
‘depression’).
2. Develop goals in positive language (an increase in something), rather than
negative language (a decrease in something).
3. Encourage clients to provide video description of the problem.
4. Coconstruct a problem and a goal that fits with the client's worldview.
S.M.A.R.T. Goals
 Specific Goals
 Measurable Goals
 Achievable Goals
 Relevant Goals
 Time-based Goals
Identifying Exceptions
 Presuppositional questions: Ask, “When has there been a time when _____ (the
problem) has not happened?” or “When has _____ (the goal) happened?” rather than,
“Has there been a time?
 Identifying small exceptions
 Identifying potential exceptions
o The miracle questions:
Suppose that one night there is a miracle and while you are sleeping the
problem . . . is solved: How would you know? What would be different?
(de Shazer, 1988, p. 5)
Solution-Focused Counseling 9
Questions for Amplifying Exceptions
 How did you make it happen?
 How is that different from how you have dealt with the problem in the past?
 How did it make your day go differently?
 Who else noticed?
 What did you tell yourself to make it happen?
 What does this say about you and your ability to deal with the depression?
 What are the possibilities?
Solution-Focused Tasks
Task # 1
The client is told and asked, “Between now and the next time, I would like you to observe, so
that you can tell me next time, about those times when you are able to make it (the goal)
happen.”
Rationale: This task is given if the client is able to construct a problem and goal, and
identify and amplify exceptions.
Task # 2
The client is told and asked, “Between now and the next time, I would like you to pay
attention to and make note of what you do when you are able to effectively cope with or deal
with the problem.”
Rationale: This task is given if the client is able to construct a problem and goal and
identify exceptions, but is unable to amplify exceptions.
Task #3
The client is told and asked, “Between now and the next time, I would like you to observe, so
that you can tell me next time, what happens in your life (relationship, family, work
situation) that you want to continue to have happen.”
Rationale: This task is given if the client is able to construct a problem and goal, and
potential exceptions, but is unable to identify exceptions.
Task #4
The client is told and asked, “Try to avoid making any drastic changes. If anything, think
about what you will be doing differently when things are improved.”
Rationale: This task is given if the client is able to construct a problem, but is unable to
construct a goal.
Task #5
The client is told and asked, “The situation is very volatile. Between now and the next time,
attempt to think about why the situation is not worse.”
Rationale: This task is given if the client is in severe crisis.
Solution-Focused Counseling 10
Solution Identification Form
Name ________________________Age (Years):____ Sex: M / F
Session # ____ Date: ________________________
Who is filling out this form? Please check one: Self_______ Other_______
If other, what is your relationship to this person? ____________________________
Date and
Time
Describe the solution (What
happened)
Describe how you came up with the
solution (What you did to make the
solution happen)
Solution-Focused Counseling 11
Scaling Form
Name ________________________Age (Years):____ Sex: M / F
Session # ____ Date: ________________________
Who is filling out this form? Please check one: Self_______ Other_______
If other, what is your relationship to this person? ____________________________
Please rate your progress on the problem and goal for each day on a scale from 0 to 10
with “10” being the least and “0” or “1” being the best. Also, describe what you did to
make the progress in relation to the problem and goal.
Date Rating Describe what you did
Solution-Focused Counseling 12
Solution-Focused Checklist
 Did you carefully and patiently try to help the client identify exceptions?
o Small exceptions?
o Potential exceptions?
 Did you try asking questions differently?
 Did you persist in your efforts?
 Did you negotiate small, simple, and relevant goals that the client knows how to
accomplish?
 Did you try helping the client to amplify the exceptions?
 Maybe the client identified a small or potential exception during the session but he or
she—and you!—considered it to be irrelevant or unremarkable.
 Did you try a strategic approach to eclecticism?
 Did you try doing something different?
Solution-Focused Counseling 13
Outcome Rating Scale (ORS)
This scale is for illustration purposes only. The actual scale, which includes 10-centimeter
lines for each item, may be downloaded from http://www.scottdmiller.com. Adapted from
Guterman (2013) and used with permission of Scott D. Miller (http://www.scottdmiller.com).
Name ________________________Age (Years):____ Sex: M / F
Session # ____ Date: ________________________
Who is filling out this form? Please check one: Self_______ Other_______
If other, what is your relationship to this person? ____________________________
Looking back over the last week, including today, help us understand how you have been
feeling by rating how well you have been doing in the following areas of your life, where
marks to the left represent low levels and marks to the right indicate high levels. If you are
filling out this form for another person, please fill out according to how you think he or she
is doing.
ATTENTION CLINICIAN: TO INSURE SCORING ACCURACY PRINT OUT THE
MEASURE TO INSURE THE ITEM LINES ARE 10 CM IN LENGTH. ALTER THE
FORM UNTIL THE LINES PRINT THE CORRECT LENGTH. THEN ERASE THIS
MESSAGE.
Individually
(Personal well-being)
I----------------------------------------------------------------------I
Interpersonally
(Family, close relationships)
I----------------------------------------------------------------------I
Socially
(Work, school, friendships)
I----------------------------------------------------------------------I
Overall
(General sense of well-being)
I----------------------------------------------------------------------I
Solution-Focused Counseling 14
Session Rating Scale (SRS)
This scale is for illustration purposes only. The actual scale, which includes 10-centimeter
lines for each item, may be downloaded from http://www.scottdmiller.com. Adapted from
Guterman (2013) and used with permission of Scott D. Miller (http://www.scottdmiller.com).
Name ________________________Age (Years):____ Sex: M / F
Session # ____ Date: ________________________
Who is filling out this form? Please check one: Self_______ Other_______
If other, what is your relationship to this person? ____________________________
Please rate today’s session by placing a mark on the line nearest to the description that best
fits your experience.
Relationship
I-------------------------------------------------------------------------I
Goals and Topics
I------------------------------------------------------------------------I
Approach or Method
I-------------------------------------------------------------------------I
Overall
I------------------------------------------------------------------------I
I felt heard,
understood, and
respected.
I did not feel
heard,
understood, and
respected.
We worked on
and talked
about what I
wanted to
work on and
talk about.
We did not
work on or
talk about
what I wanted
to work on and
talk about.
Overall,
today’s session
was right for
me.
There was
something
missing in the
session today.
The therapist’s
approach is a
good fit for
me.
The therapist’s
approach is
not a good fit
for me.
Solution-Focused Counseling 15
Child Outcome Rating Scale (CORS)
This scale is for illustration purposes only. The actual scale may be downloaded from
http://www.scottdmiller.com. Adapted from Guterman (2013) and used with permission of
Scott D. Miller (http://www.scottdmiller.com).
Name ________________________Age (Years):____
Sex: M / F_________
Session # ____ Date: ________________________
Who is filling out this form? Please check one: Child_______ Caretaker_______
If caretaker, what is your relationship to this child? ____________________________
How are you doing? How are things going in your life? Please make a mark on the scale to
let us know. The closer to the smiley face, the better things are. The closer to the frowny
face, things are not so good. If you are a caretaker filling out this form, please fill out
according to how you think the child is doing.
Me
(How am I doing?)
I------------------------------------------------------------------------------------I
Family
(How are things in my family?)
I------------------------------------------------------------------------------------I
School
(How am I doing at school?)
I------------------------------------------------------------------------------------I
Everything
(How is everything going?)
I------------------------------------------------------------------------------------I
Solution-Focused Counseling 16
Child Session Rating Scale (CSRS)
This scale is for illustration purposes only. The actual scale may be downloaded from
http://www.scottdmiller.com. Adapted from Guterman (2013) and used with permission of
Scott D. Miller (http://www.scottdmiller.com).
Name ________________________Age (Years):____
Sex: M / F_________
Session # ____ Date: ________________________
Who is filling out this form? Please check one: Child_______ Caretaker_______
If caretaker, what is your relationship to this child? ____________________________
How was our time together today? Please put a mark on the lines below to let us know how
you feel.
Listening
I-----------------------------------------------------------------------------------I
How Important
I-----------------------------------------------------------------------------------I
What We Did
I-----------------------------------------------------------------------------------I
Overall
I-----------------------------------------------------------------------------------I
The therapist
listened to me.
The
therapist did
not always
listen to me.
What we did
and talked
about were
important to
me.
What we did
and talked
about was not
really that
important to
me.
I hope we do
the same kind
of things next
time.
I wish we
could do
something
different.
I liked what
we did today.
I did not
like what
we did
today.
Solution-Focused Counseling 17
Young Child Outcome Rating Scale (YCORS)
This scale is for illustration purposes only. The actual scale may be downloaded from
http://www.scottdmiller.com. Adapted from Guterman (2013) and used with permission of
Scott D. Miller (http://www.scottdmiller.com).
Name ________________________Age (Years):____
Sex: M / F_________
Session # ____ Date: ________________________
Who is filling out this form? Please check one: Child_______ Caretaker_______
If caretaker, what is your relationship to this child? ____________________________
Choose one of the faces that shows how things are going for you. Or, you can draw one
below that is just right for you.
Solution-Focused Counseling 18
Young Child Session Rating Scale (YCSRS)
This scale is for illustration purposes only. The actual scale may be downloaded from
http://www.scottdmiller.com. Adapted from Guterman (2013) and used with permission of
Scott D. Miller (http://www.scottdmiller.com).
Name ________________________Age (Years):____
Sex: M / F_________
Session # ____ Date: ________________________
Who is filling out this form? Please check one: Child_______ Caretaker_______
If caretaker, what is your relationship to this child? ____________________________
Choose one of the faces that shows how things are going for you. Or, you can draw one
below that is just right for you.
Solution-Focused Counseling 19
Suggestions and Considerations for
Using Rating Scales and Client Feedback
1. Introduce the rating scales to clients by describing their purposes in clear and simple
language.
2. Openly discuss the ratings with clients, and be prepared to take the ratings seriously,
but not personally.
3. Adapt and revise counseling sessions based on the ratings and feedback received from
clients.
4. Adjustments based on rating scales and client feedback may reduce the likelihood of
drop outs and thereby improve treatment outcomes.
5. When clients have difficulty reading or are otherwise unable to understand the rating
scales, especially children, counselors should consider explaining the rating scales
clients.
Solution-Focused Counseling 20
References and Suggested Readings
Berg, I.K., & Miller, S.D. (1992). Working with the problem drinker: A solution-focused
approach. New York: Norton.
de Castro, S., & Guterman, J.T. (2008). Solution-focused therapy for families coping with
suicide. Journal of Marital and Family Therapy, 34, 93-106.
de Shazer, S. (1982). Patterns of brief family therapy. New York: Norton.
de Shazer, S. (1984). The death of resistance. Family Process, 23, 11-17.
de Shazer, S. (1985). Keys to solution in brief therapy. New York: Norton.
de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: Norton.
de Shazer, S. (1991). Putting difference to work. New York: Norton.
de Shazer, S. (1994). Words were originally magic. New York: Norton.
de Shazer, S. (1997). Commentary: Radical acceptance. Families, Systems, & Health, 15,
375-378.
de Shazer, S., Berg, I. K., Lipchik, E., Nunnally, E., Molnar E., Gingerich, K., & Weiner-
Davis, M. (1986). Brief therapy: Focused solution development. Family Process, 25,
207-222.
Duncan, B. (2014). On becoming a better therapist: Evidence based practice one client at a
time. (2nd
edition). Washington DC: American Psychological Association
Duncan, B.L., Miller, S., Huggins, A., & Sparks, J. (2003a). Young child outcome rating
scale. Chicago: Author.
Duncan, B.L., Miller, S., Huggins, A., & Sparks, J. (2003b). Young child session rating
scale. Chicago: Author.
Duncan. B.L., Miller, S.D., & Sparks, J. (2003). Child outcome rating scale. Chicago:
Author.
Duncan. B.L., Miller, S.D., & Sparks, J.A. (2004). The heroic client: A revolutionary way to
improve effectiveness through client-directed, outcome-informed therapy. San
Francisco: Jossey-Bass.
Duncan, B.L., Miller, S.D., Sparks, J.A., & Johnson, L.D. (2003). Child session rating scale.
Fort Lauderdale, FL: Author.
Franklin, C., Trepper, T.S., McCollum, E.E., & Gingerich, W.J. (2011). Solution-focused
brief therapy: A handbook of evidence-based practice. New York: Oxford University
Press.
Gergen, K.J. (2009). An invitation to social construction (2nd ed.). Thousand Oaks, CA:
Sage.
Guterman, J. T. (1994). A social constructionist position for mental health counseling.
Journal of Mental Health Counseling, 16, 226-244.
Guterman, J.T. (1996). Doing mental health counseling: A social constructionist re-vision.
Journal of Mental Health Counseling, 18, 228-252.
Guterman, J.T. (1998). Identifying pretreatment change before the first session. Journal of
Mental Health Counseling, 20, 370-374.
Guterman, J.T. (2013). Mastering the art of solution-focused counseling (2nd
edition)
Alexandria, VA: American Counseling Association.
Guterman, J.T., & Leite, N. (2006). Solution-focused counseling for clients with religious
and spiritual concerns. Counseling and Values, 51, 39-52.
Solution-Focused Counseling 21
Guterman, J.T., Mecias, A., Ainbinder, D.L. (2005). Solution-focused treatment of migraine
headache. The Family Journal: Counseling and Therapy for Couples and Families,
13, 195-198.
Held, B.S., (1992). The problem of strategy within the systemic therapies. Journal of Marital
and Family Therapy, 18, 25-35.
Johnson, L.D., Miller, S.D., & Duncan, B.L. (2000). Session rating scale 3.0. Chicago:
Author.
Lambert, M.J. (1992). Implications of outcome research for psychotherapy. In J.C. Norcross
M.R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 94-129). New
York: Basic Books.
Lambert, M.J., Whipple, J., Smart, D., Vermeersch, D., Nielsen, S., & Hawkins, E. (2001).
The effects of providing therapists with feedback on patient progress during
psychotherapy: Are outcomes enhanced? Psychotherapy Research, 11, 49-46.
Lipchik, E. (2002). Beyond technique in solution-focused therapy: Working with emotions
and the therapeutic relationship. New York: Guilford.
Martin, C.V., Guterman, J. T., & & Shatz, K. (2012). Solution-focused counseling for eating
disorders. VISTAS, 1-11.
Miller, S., & Duncan. B.L. (2000). Outcome rating scale. Chicago: Author.
Molnar A., & de Shazer, S. (1987). Solution-focused therapy: Toward the identification of
therapeutic tasks. Journal of Marital and Family Therapy, 13, 349-358.
Murphy, J.J. (2008). Solution-focused counseling in middle and high schools (2nd
ed.)
Alexandria, VA: American Counseling Association.
O'Hanlon, B., & Rowan, T. (2003). Solution oriented therapy for chronic and severe mental
illness. New York: Norton.
O'Hanlon, W. H., & Weiner-Davis, M. (1989). In search of solutions: A new direction in
psychotherapy. New York: Norton.
White. M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.
Solution-Focused Counseling 22
Suggested Internet Resources
Jeffrey T. Guterman, Ph.D.
PowerPoint for this Institute is available at http://JeffreyGuterman.com
Twitter: http://twitter.com/JeffreyGuterman
Facebook: http://facebook.com/jeffreygutermanpage
International Center for Clinical Excellence (ICCE)
http://www.centerforclinicalexcellence.com
Scott D. Miller, Ph.D.
http://www.scottdmiller.com
Institute for Solution-Focused Therapy
http://www.solutionfocused.net
Solution-Focused Brief Therapy Association (SFBTA)
http://www.sfbta.org

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Solution-Focused Counseling: Advanced Techniques and Applications (Handout)

  • 1. Solution-Focused Counseling: Advanced Techniques and Applications Education Session American Counseling Association Jeffrey T. Guterman, Ph.D. Clayton V. Martin, M.S. Saturday, March 14, 2015 10:30 a.m. – 12:00 p.m. American Counseling Association 2015 Annual Conference Orlando, Florida Hyatt Regency, Ballroom M Copyright © 2015 by Jeffrey T. Guterman and Clayton V. Martin The PowerPoint for this Education Session is available at http://JeffreyGuterman.com
  • 2. Solution-Focused Counseling 2 Contents About the Presenters ............................................................................................................... 3 Selected Publications by the Presenters .................................................................................. 4 Education Session Description ............................................................................................... 5 Education Session Objectives ................................................................................................. 5 Formula First Session Task ..................................................................................................... 5 Principles of Solution-Focused Counseling ............................................................................ 5 Implications of a Postmodern Position ................................................................................... 6 Problem and Exception ........................................................................................................... 6 Theory of Change ................................................................................................................... 6 Common Change Factors ........................................................................................................ 7 Stages of Solution-Focused Counseling ................................................................................. 7 Coconstructing Problems and Goals ....................................................................................... 8 S.M.A.R.T. GOALS ............................................................................................................... 8 Identifying Exceptions ............................................................................................................ 8 Questions for Amplifying Exceptions .................................................................................... 9 Solution-Focused Tasks .......................................................................................................... 9 Solution Identification Form ................................................................................................. 10 Scaling Form ......................................................................................................................... 11 Solution-Focused Checklist .................................................................................................. 12 Outcome Rating Scale (ORS) ............................................................................................... 13 Session Rating Scale (SRS) .................................................................................................. 14 Child Outcome Rating Scale (CORS) ................................................................................... 15 Child Session Rating Scale (CSRS) ...................................................................................... 16 Young Child Outcome Rating Scale (YCORS) .................................................................... 17 Young Child Session Rating Scale (YCSRS) ....................................................................... 18 Suggestions and Considerations for Using Rating Scales and Client Feedback .................. 19 References and Suggested Readings ..................................................................................... 20 Suggested Internet Resources ............................................................................................... 22
  • 3. Solution-Focused Counseling 3 About the Presenters Jeffrey T. Guterman, Ph.D. is a mental health counselor in Fort Lauderdale, Florida. He is author of over 125 publications. The first edition of his book Mastering the Art of Solution- Focused Counseling was published by the American Counseling Association (ACA) in 2006, it was translated in Korean in 2007, and an updated and expanded second edition was published by ACA in 2013. He has presented numerous workshops on solution-focused counseling. Contact Information Email: jguterman@gmail.com Phone: 305-725-4583 Web: http://JeffreyGuterman.com Twitter: http://twitter.com/JeffreyGuterman Clayton V. Martin, M.S. is a counselor in Atlanta, Georgia. He has presented workshops on the topics of strength-based approaches to counseling and LGBTQ advocacy issues in counseling. He has written articles for counseling journals on solution-focused approaches to counseling and philosophical issues in counseling. He has extensive clinical experience in solution-focused counseling with children, adolescents, and young adults in various clinical settings. Contact Information Email: cmartin51277@gmail.com Phone: 404-449-3028 – Jeffrey T. Guterman, Ph.D. and Clayton V. Martin, M.S. are available to provide training and workshops for your organization on various topics. Program topics and formats will be tailored to meet the needs of your organization.
  • 4. Solution-Focused Counseling 4 Selected Publications by the Presenters de Castro, S., & Guterman, J.T. (2008). Solution-focused therapy for families coping with suicide. Journal of Marital and Family Therapy, 34, 93-106. Guterman, J. T. (1994). A social constructionist position for mental health counseling. Journal of Mental Health Counseling, 16, 226-244. Guterman, J.T. (1996a). Doing mental health counseling: A social constructionist re-vision. Journal of Mental Health Counseling, 18, 228-252. Guterman, J.T. (1996b). Farewell to families: Language systems in the postmodern era. The Family Journal: Counseling and Therapy for Couples and Families, 4, 139-142. Guterman, J.T. (1996c). Reconstructing social constructionism: A reply to Albert Ellis. Journal of Mental Health Counseling, 18, 29-40. Guterman, J.T. (1996d). Tales of mental health counseling. Journal of Mental Health Counseling, 18, 300-306. Guterman, J.T. (1998). Identifying pretreatment change before the first session. Journal of Mental Health Counseling, 20, 370-374. Guterman, J.T. (2013). Mastering the art of solution-focused counseling (2nd ed.). Alexandria, VA: American Counseling Association. Guterman, J.T., & Leite, N. (2006). Solution-focused counseling for clients with religious and spiritual concerns. Counseling and Values, 51, 39-52. Guterman, J. T., Martin, C.V., & Kopp, D.M. (2012). Science and humanities: A necessary unity for the counseling profession. Journal of Humanistic Counseling, 51, 145-154. Guterman, J.T., & Martin, C.V. (in press). Using puppets with aggressive children to externalize the problem in narrative therapy. In (A.A. Drewes & C. Schaefer, Eds.), School age play therapy. Washington, DC: American Psychological Association. Guterman, J.T., Mecias, A., Ainbinder, D.L. (2005). Solution-focused treatment of migraine headache. The Family Journal: Counseling and Therapy for Couples and Families, 13, 195-198. Guterman, J.T., & Schildbach, J. (2014, June). The stigma of mental illness and the noble savage. Counseling Today, pp. 60-63. Martin, C.V., Guterman, J.T., & Kopp, D.M. (2012). Extending the dialogue about science and humanities: A reply to Hansen. Journal of Humanistic Counseling, 51, 161-163. Martin, C.V., Guterman, J. T., & & Shatz, K. (2012). Solution-focused counseling for eating disorders. VISTAS, 1-11.
  • 5. Solution-Focused Counseling 5 Education Session Description Solution-focused counseling is a comprehensive model that emphasizes clients' strengths, resources. This session provides an opportunity to learn advanced solution-focused counseling techniques and clinical applications. Solution-focused counseling is a comprehensive model that emphasizes clients' resources, strengths, and effective coping skills to bring about positive change. If these resources—called exceptions—are identified and amplified, then problem resolution can be brought about in an effective and efficient manner. Case examples illustrate using solution-focused counseling for a variety of clinical problems and populations. Education Session Objectives 1. Identify and review the main principles of solution-focused counseling. 2. Identify and review the theory of problems and change in solution-focused counseling. 3. Identify and review the clinical stages in solution-focused counseling. 4. Identify and review advanced techniques used in solution-focused counseling. 5. Identify and review clinical applications of solution-focused counseling. Formula First Session Task Between now and next time we meet, I want you to observe so that you can tell me next time, what happens in your life that you want to continue to have happen (cf. Molnar & de Shazer, 1987). Principles of Solution-Focused Counseling  Solution-focus  Collaborative approach  Small changes can lead to big results  Emphasis on process  Strategic eclecticism  Brief by design, but not always  Responsiveness to diversity  Committed to outcome
  • 6. Solution-Focused Counseling 6 Implications of a Postmodern Position for Solution-Focused Counseling  Clinical reality as a social construction rather than an objective reflection of reality.  Counselors as participant-observers rather than independent of clients and problems.  A perspective that understands language as the distinction of treatment concern rather than human systems as the locus of problems.  A collaborative approach and an emphasis on cooperating rather than a perspective that views clients’ oppositions to change as resistance. Problem and Exception  Problem: o Problem: A subjective and/or intersubjective complaint o Problem/Exception : The subjective or intersubjective complaint is subsumed by the problem/exception formal theory which is used across cases to conceptualize problems and change  Exception: “Times when the complaint/problem does not happen even though the client has reason to expect it happen” (de Shazer, 1991, p. 83). Theory of Change Theory of Change: When the problem is the rule, then exceptions tend to remain hidden or decrease. When exceptions are identified and amplified, the problem tends to decrease. Exceptions can be amplified by encouraging clients to do more of the behaviors that have led them to solve the problem in the past, or to observe times when they are dealing better with the problem, or ascribe significant meaning to the exceptions.
  • 7. Solution-Focused Counseling 7 Common Change Factors Research in the area of common change factors (Lambert, 1992) clearly supports the theory of change in solution-focused counseling (Guterman, 2013). Lambert identified four common change factors that contribute most to improvement in counseling and psychotherapy. According to Lambert, each of these common change factors accounts for the following percentages of improvement that occur in counseling and psychotherapy: 1. Client factors (or self-help): 40% 2. Client-counselor relationship factors: 30% 3. Expectancy factors: 15% 4. Model factors: 15% These findings support the theory of solution-focused counseling for two reasons. First, the finding that client factors accounts for the most improvement in counseling (40%) affirms solution-focused counseling’s theory of change. The primary function of a solution-focused counselor is to help clients tap into their problem-solving resources and potentials. Although a wide variety of techniques are used in the model (which accounts for 15% improvement based on the research), solution-focused counseling is to be considered a process model because it attributes change mainly to what the client does to solve problem rather than to the model. In effect, its focus on client factors is the model. The second reason that research on common change factors supports solution-focused counseling is because the model emphasizes the important role of the client-counselor relationship. The finding that client-counselor factors account for 30% of improvement supports the unique emphasis that solution- focused counseling places on developing a collaborative relationship between the client and counselor. Stages of Solution-Focused Counseling  Coconstructing problems and goals  Identifying and amplifying exceptions  Coconstructing tasks  Evaluating the effectiveness of tasks  Reevaluating problems and goals
  • 8. Solution-Focused Counseling 8 Coconstructing Problems and Goals 1. Coconstruct solvable problems (e.g., ineffective coping skills, rather than merely ‘depression’). 2. Develop goals in positive language (an increase in something), rather than negative language (a decrease in something). 3. Encourage clients to provide video description of the problem. 4. Coconstruct a problem and a goal that fits with the client's worldview. S.M.A.R.T. Goals  Specific Goals  Measurable Goals  Achievable Goals  Relevant Goals  Time-based Goals Identifying Exceptions  Presuppositional questions: Ask, “When has there been a time when _____ (the problem) has not happened?” or “When has _____ (the goal) happened?” rather than, “Has there been a time?  Identifying small exceptions  Identifying potential exceptions o The miracle questions: Suppose that one night there is a miracle and while you are sleeping the problem . . . is solved: How would you know? What would be different? (de Shazer, 1988, p. 5)
  • 9. Solution-Focused Counseling 9 Questions for Amplifying Exceptions  How did you make it happen?  How is that different from how you have dealt with the problem in the past?  How did it make your day go differently?  Who else noticed?  What did you tell yourself to make it happen?  What does this say about you and your ability to deal with the depression?  What are the possibilities? Solution-Focused Tasks Task # 1 The client is told and asked, “Between now and the next time, I would like you to observe, so that you can tell me next time, about those times when you are able to make it (the goal) happen.” Rationale: This task is given if the client is able to construct a problem and goal, and identify and amplify exceptions. Task # 2 The client is told and asked, “Between now and the next time, I would like you to pay attention to and make note of what you do when you are able to effectively cope with or deal with the problem.” Rationale: This task is given if the client is able to construct a problem and goal and identify exceptions, but is unable to amplify exceptions. Task #3 The client is told and asked, “Between now and the next time, I would like you to observe, so that you can tell me next time, what happens in your life (relationship, family, work situation) that you want to continue to have happen.” Rationale: This task is given if the client is able to construct a problem and goal, and potential exceptions, but is unable to identify exceptions. Task #4 The client is told and asked, “Try to avoid making any drastic changes. If anything, think about what you will be doing differently when things are improved.” Rationale: This task is given if the client is able to construct a problem, but is unable to construct a goal. Task #5 The client is told and asked, “The situation is very volatile. Between now and the next time, attempt to think about why the situation is not worse.” Rationale: This task is given if the client is in severe crisis.
  • 10. Solution-Focused Counseling 10 Solution Identification Form Name ________________________Age (Years):____ Sex: M / F Session # ____ Date: ________________________ Who is filling out this form? Please check one: Self_______ Other_______ If other, what is your relationship to this person? ____________________________ Date and Time Describe the solution (What happened) Describe how you came up with the solution (What you did to make the solution happen)
  • 11. Solution-Focused Counseling 11 Scaling Form Name ________________________Age (Years):____ Sex: M / F Session # ____ Date: ________________________ Who is filling out this form? Please check one: Self_______ Other_______ If other, what is your relationship to this person? ____________________________ Please rate your progress on the problem and goal for each day on a scale from 0 to 10 with “10” being the least and “0” or “1” being the best. Also, describe what you did to make the progress in relation to the problem and goal. Date Rating Describe what you did
  • 12. Solution-Focused Counseling 12 Solution-Focused Checklist  Did you carefully and patiently try to help the client identify exceptions? o Small exceptions? o Potential exceptions?  Did you try asking questions differently?  Did you persist in your efforts?  Did you negotiate small, simple, and relevant goals that the client knows how to accomplish?  Did you try helping the client to amplify the exceptions?  Maybe the client identified a small or potential exception during the session but he or she—and you!—considered it to be irrelevant or unremarkable.  Did you try a strategic approach to eclecticism?  Did you try doing something different?
  • 13. Solution-Focused Counseling 13 Outcome Rating Scale (ORS) This scale is for illustration purposes only. The actual scale, which includes 10-centimeter lines for each item, may be downloaded from http://www.scottdmiller.com. Adapted from Guterman (2013) and used with permission of Scott D. Miller (http://www.scottdmiller.com). Name ________________________Age (Years):____ Sex: M / F Session # ____ Date: ________________________ Who is filling out this form? Please check one: Self_______ Other_______ If other, what is your relationship to this person? ____________________________ Looking back over the last week, including today, help us understand how you have been feeling by rating how well you have been doing in the following areas of your life, where marks to the left represent low levels and marks to the right indicate high levels. If you are filling out this form for another person, please fill out according to how you think he or she is doing. ATTENTION CLINICIAN: TO INSURE SCORING ACCURACY PRINT OUT THE MEASURE TO INSURE THE ITEM LINES ARE 10 CM IN LENGTH. ALTER THE FORM UNTIL THE LINES PRINT THE CORRECT LENGTH. THEN ERASE THIS MESSAGE. Individually (Personal well-being) I----------------------------------------------------------------------I Interpersonally (Family, close relationships) I----------------------------------------------------------------------I Socially (Work, school, friendships) I----------------------------------------------------------------------I Overall (General sense of well-being) I----------------------------------------------------------------------I
  • 14. Solution-Focused Counseling 14 Session Rating Scale (SRS) This scale is for illustration purposes only. The actual scale, which includes 10-centimeter lines for each item, may be downloaded from http://www.scottdmiller.com. Adapted from Guterman (2013) and used with permission of Scott D. Miller (http://www.scottdmiller.com). Name ________________________Age (Years):____ Sex: M / F Session # ____ Date: ________________________ Who is filling out this form? Please check one: Self_______ Other_______ If other, what is your relationship to this person? ____________________________ Please rate today’s session by placing a mark on the line nearest to the description that best fits your experience. Relationship I-------------------------------------------------------------------------I Goals and Topics I------------------------------------------------------------------------I Approach or Method I-------------------------------------------------------------------------I Overall I------------------------------------------------------------------------I I felt heard, understood, and respected. I did not feel heard, understood, and respected. We worked on and talked about what I wanted to work on and talk about. We did not work on or talk about what I wanted to work on and talk about. Overall, today’s session was right for me. There was something missing in the session today. The therapist’s approach is a good fit for me. The therapist’s approach is not a good fit for me.
  • 15. Solution-Focused Counseling 15 Child Outcome Rating Scale (CORS) This scale is for illustration purposes only. The actual scale may be downloaded from http://www.scottdmiller.com. Adapted from Guterman (2013) and used with permission of Scott D. Miller (http://www.scottdmiller.com). Name ________________________Age (Years):____ Sex: M / F_________ Session # ____ Date: ________________________ Who is filling out this form? Please check one: Child_______ Caretaker_______ If caretaker, what is your relationship to this child? ____________________________ How are you doing? How are things going in your life? Please make a mark on the scale to let us know. The closer to the smiley face, the better things are. The closer to the frowny face, things are not so good. If you are a caretaker filling out this form, please fill out according to how you think the child is doing. Me (How am I doing?) I------------------------------------------------------------------------------------I Family (How are things in my family?) I------------------------------------------------------------------------------------I School (How am I doing at school?) I------------------------------------------------------------------------------------I Everything (How is everything going?) I------------------------------------------------------------------------------------I
  • 16. Solution-Focused Counseling 16 Child Session Rating Scale (CSRS) This scale is for illustration purposes only. The actual scale may be downloaded from http://www.scottdmiller.com. Adapted from Guterman (2013) and used with permission of Scott D. Miller (http://www.scottdmiller.com). Name ________________________Age (Years):____ Sex: M / F_________ Session # ____ Date: ________________________ Who is filling out this form? Please check one: Child_______ Caretaker_______ If caretaker, what is your relationship to this child? ____________________________ How was our time together today? Please put a mark on the lines below to let us know how you feel. Listening I-----------------------------------------------------------------------------------I How Important I-----------------------------------------------------------------------------------I What We Did I-----------------------------------------------------------------------------------I Overall I-----------------------------------------------------------------------------------I The therapist listened to me. The therapist did not always listen to me. What we did and talked about were important to me. What we did and talked about was not really that important to me. I hope we do the same kind of things next time. I wish we could do something different. I liked what we did today. I did not like what we did today.
  • 17. Solution-Focused Counseling 17 Young Child Outcome Rating Scale (YCORS) This scale is for illustration purposes only. The actual scale may be downloaded from http://www.scottdmiller.com. Adapted from Guterman (2013) and used with permission of Scott D. Miller (http://www.scottdmiller.com). Name ________________________Age (Years):____ Sex: M / F_________ Session # ____ Date: ________________________ Who is filling out this form? Please check one: Child_______ Caretaker_______ If caretaker, what is your relationship to this child? ____________________________ Choose one of the faces that shows how things are going for you. Or, you can draw one below that is just right for you.
  • 18. Solution-Focused Counseling 18 Young Child Session Rating Scale (YCSRS) This scale is for illustration purposes only. The actual scale may be downloaded from http://www.scottdmiller.com. Adapted from Guterman (2013) and used with permission of Scott D. Miller (http://www.scottdmiller.com). Name ________________________Age (Years):____ Sex: M / F_________ Session # ____ Date: ________________________ Who is filling out this form? Please check one: Child_______ Caretaker_______ If caretaker, what is your relationship to this child? ____________________________ Choose one of the faces that shows how things are going for you. Or, you can draw one below that is just right for you.
  • 19. Solution-Focused Counseling 19 Suggestions and Considerations for Using Rating Scales and Client Feedback 1. Introduce the rating scales to clients by describing their purposes in clear and simple language. 2. Openly discuss the ratings with clients, and be prepared to take the ratings seriously, but not personally. 3. Adapt and revise counseling sessions based on the ratings and feedback received from clients. 4. Adjustments based on rating scales and client feedback may reduce the likelihood of drop outs and thereby improve treatment outcomes. 5. When clients have difficulty reading or are otherwise unable to understand the rating scales, especially children, counselors should consider explaining the rating scales clients.
  • 20. Solution-Focused Counseling 20 References and Suggested Readings Berg, I.K., & Miller, S.D. (1992). Working with the problem drinker: A solution-focused approach. New York: Norton. de Castro, S., & Guterman, J.T. (2008). Solution-focused therapy for families coping with suicide. Journal of Marital and Family Therapy, 34, 93-106. de Shazer, S. (1982). Patterns of brief family therapy. New York: Norton. de Shazer, S. (1984). The death of resistance. Family Process, 23, 11-17. de Shazer, S. (1985). Keys to solution in brief therapy. New York: Norton. de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: Norton. de Shazer, S. (1991). Putting difference to work. New York: Norton. de Shazer, S. (1994). Words were originally magic. New York: Norton. de Shazer, S. (1997). Commentary: Radical acceptance. Families, Systems, & Health, 15, 375-378. de Shazer, S., Berg, I. K., Lipchik, E., Nunnally, E., Molnar E., Gingerich, K., & Weiner- Davis, M. (1986). Brief therapy: Focused solution development. Family Process, 25, 207-222. Duncan, B. (2014). On becoming a better therapist: Evidence based practice one client at a time. (2nd edition). Washington DC: American Psychological Association Duncan, B.L., Miller, S., Huggins, A., & Sparks, J. (2003a). Young child outcome rating scale. Chicago: Author. Duncan, B.L., Miller, S., Huggins, A., & Sparks, J. (2003b). Young child session rating scale. Chicago: Author. Duncan. B.L., Miller, S.D., & Sparks, J. (2003). Child outcome rating scale. Chicago: Author. Duncan. B.L., Miller, S.D., & Sparks, J.A. (2004). The heroic client: A revolutionary way to improve effectiveness through client-directed, outcome-informed therapy. San Francisco: Jossey-Bass. Duncan, B.L., Miller, S.D., Sparks, J.A., & Johnson, L.D. (2003). Child session rating scale. Fort Lauderdale, FL: Author. Franklin, C., Trepper, T.S., McCollum, E.E., & Gingerich, W.J. (2011). Solution-focused brief therapy: A handbook of evidence-based practice. New York: Oxford University Press. Gergen, K.J. (2009). An invitation to social construction (2nd ed.). Thousand Oaks, CA: Sage. Guterman, J. T. (1994). A social constructionist position for mental health counseling. Journal of Mental Health Counseling, 16, 226-244. Guterman, J.T. (1996). Doing mental health counseling: A social constructionist re-vision. Journal of Mental Health Counseling, 18, 228-252. Guterman, J.T. (1998). Identifying pretreatment change before the first session. Journal of Mental Health Counseling, 20, 370-374. Guterman, J.T. (2013). Mastering the art of solution-focused counseling (2nd edition) Alexandria, VA: American Counseling Association. Guterman, J.T., & Leite, N. (2006). Solution-focused counseling for clients with religious and spiritual concerns. Counseling and Values, 51, 39-52.
  • 21. Solution-Focused Counseling 21 Guterman, J.T., Mecias, A., Ainbinder, D.L. (2005). Solution-focused treatment of migraine headache. The Family Journal: Counseling and Therapy for Couples and Families, 13, 195-198. Held, B.S., (1992). The problem of strategy within the systemic therapies. Journal of Marital and Family Therapy, 18, 25-35. Johnson, L.D., Miller, S.D., & Duncan, B.L. (2000). Session rating scale 3.0. Chicago: Author. Lambert, M.J. (1992). Implications of outcome research for psychotherapy. In J.C. Norcross M.R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 94-129). New York: Basic Books. Lambert, M.J., Whipple, J., Smart, D., Vermeersch, D., Nielsen, S., & Hawkins, E. (2001). The effects of providing therapists with feedback on patient progress during psychotherapy: Are outcomes enhanced? Psychotherapy Research, 11, 49-46. Lipchik, E. (2002). Beyond technique in solution-focused therapy: Working with emotions and the therapeutic relationship. New York: Guilford. Martin, C.V., Guterman, J. T., & & Shatz, K. (2012). Solution-focused counseling for eating disorders. VISTAS, 1-11. Miller, S., & Duncan. B.L. (2000). Outcome rating scale. Chicago: Author. Molnar A., & de Shazer, S. (1987). Solution-focused therapy: Toward the identification of therapeutic tasks. Journal of Marital and Family Therapy, 13, 349-358. Murphy, J.J. (2008). Solution-focused counseling in middle and high schools (2nd ed.) Alexandria, VA: American Counseling Association. O'Hanlon, B., & Rowan, T. (2003). Solution oriented therapy for chronic and severe mental illness. New York: Norton. O'Hanlon, W. H., & Weiner-Davis, M. (1989). In search of solutions: A new direction in psychotherapy. New York: Norton. White. M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.
  • 22. Solution-Focused Counseling 22 Suggested Internet Resources Jeffrey T. Guterman, Ph.D. PowerPoint for this Institute is available at http://JeffreyGuterman.com Twitter: http://twitter.com/JeffreyGuterman Facebook: http://facebook.com/jeffreygutermanpage International Center for Clinical Excellence (ICCE) http://www.centerforclinicalexcellence.com Scott D. Miller, Ph.D. http://www.scottdmiller.com Institute for Solution-Focused Therapy http://www.solutionfocused.net Solution-Focused Brief Therapy Association (SFBTA) http://www.sfbta.org