Tag Archives: solution-focused counseling

The use of evidence-based practices with oppressed populations

By Geri Miller, Glenda S. Johnson, Mx. Tuesday Feral, William Luckett, Kelsey Fish and Madison Ericksen December 3, 2018

Therapy must always be tailored to the individual; there is no one-size-fits-all model. However, certain approaches have been empirically verified for use with a variety of clientele. It is critical that all counselors, especially those working with client populations that are oppressed, have both an overview of evidence-based practices and specific techniques related to these approaches in their clinical toolboxes to help them provide the best counseling services possible.

Counselors are frequently required to use evidence-based practices and need to know how to use them effectively in counseling clients who are oppressed. Specifically, the unique development of the therapeutic relationship between oppressed clients and privileged clinicians must be understood and addressed. Multicultural counseling experts Derald Wing Sue and David Sue maintain that the dynamics of oppression shift the influence of the therapeutic relationship. Thus, counselors must alter their application of evidence-based practice techniques.

Solution-focused brief therapy and low socioeconomic status

Take a moment to think about what the basic needs of your own life are. What is impossible for you to live without? For many of us, our basic needs are continually met. Therefore, they often go unnoticed — they are woven into our everyday lives and ways of being in the world.

For others, questions such as “Will I eat today?” or “Will I have a safe and warm place to sleep tonight?” are asked daily. Often, the answer is “no.” Concerns such as clean drinking water, access to hygiene products and finding adequate shelter affect an inordinate number of individuals in the United States. School counselors and licensed professional counselors have a moral and ethical obligation to address these matters, with the intention of removing barriers and cultivating a safe space for clients in both the therapeutic relationship and the environment beyond our office walls.

Glenda Johnson (one of the co-authors of this article) worked as a school counselor and an advocate in a school system in which the majority of students came from low socioeconomic status (SES) backgrounds. Many of the students were on free or reduced lunch plans because their families’ financial resources were severely limited. At the core of Johnson’s work was the intent to ensure that every child’s basic needs were met while they were at school. She emphasized the importance of working collaboratively with other school staff members to build a team and a foundation for connecting these students and their families to resources.

It is also vital to assess an individual’s behaviors, emotions and reactions through a holistic, biopsychosocial approach rather than focusing only on the school context. Learned behavior concerns, inattention, difficulty with emotion regulation (anger), sadness and loss of hope are often the result of a lack of resources. Johnson recalls that if a student acted out, one of her first questions would be, “Did you have breakfast this morning?”

Johnson shares an anecdote that highlights the powerful act of providing a safe, therapeutic space for students to identify and voice their emotions openly with peers. As a school counselor, she infused the identification of various emotions into a game of musical chairs, and what transpired was completely unexpected. A student identified a “sad” emotion and explained that their father recently had lost his job. The student was experiencing fear about not having enough food to eat during this time. Then, other students began to share similar stories without prompting. The game of musical chairs transformed into a collaborative and touching experience as the students identified common ground and connected on deeper levels of understanding and empathy.

When providing services to individuals from a low SES, counselors may find it helpful to use a strengths-based therapeutic approach. The evidence-based practice of solution-focused brief therapy (SFBT) zeros in on the therapeutic relationship and the clinician’s way of being. In this relationship, there is an acknowledgment of reality but also an emphasis on solution-focused thought and reframing. Focusing on strengths, the counselor and client work together to identify and move toward making small changes in any area because a small change in one area often leads to change in another area.

SFBT often introduces the “miracle” question: “Suppose that when you go to sleep tonight, a miracle occurs that solves your problem, but because you were sleeping, you did not realize what happened. When you wake up in the morning, how will you realize a miracle happened? What will you notice that you are doing differently?” These questions enhance and expose glimpses of solutions that an individual may struggle to identify in everyday life situations.

Additionally, SFBT places great value on successes. The counselor and client celebrate achievement and may use scaling to note the client’s progress. When working in a school system, the counselor could develop a creative and motivating way for children to rate themselves and their progress toward goals. For example, Johnson created a rating scale, complemented by the colors green, yellow and red, for kindergartners and first-graders. Green identified a completed goal, yellow identified progress toward a goal and red identified room for improvement. Similarly, she used a rating scale of 1-5 for students in second through fourth grades. Under this scenario, a student could check in with a rating, such as, “I am at a 3 and working toward a 5.” The counselor might respond, “What would it take to get to a 3.5?” The scale provided a visual for children to identify, track and celebrate their successes.

In SFBT, the counselor acknowledges client strengths and walks alongside these clients as they create and work toward their goals and future successes. “Flagging the minefield” is another technique counselors can introduce to help clients generalize and apply what they learn in counseling to future situations. Flagging the minefield is a particularly important facet of SFBT because it assists individuals in recognizing potential obstacles or barriers that will appear in their lives. The counselor and client work together to identify tools and resources the client can apply in other settings and relationships.

When working with students living in poverty, counselors should introduce a strengths-based approach and identify and gather resources to assist students and their families in removing barriers and meeting basic needs. Cultivating a safe, therapeutic relationship with students that focuses on solution building can assist them in building a stronger sense of self.

Motivational interviewing, SFBT and rural adolescent substance abusers

Adolescence is a vulnerable time and a critical period for developmental outcomes. During this stage of life, adolescents are exploring and forming their peer relationships and personal identities while beginning to distance themselves from family. Experimentation with substances often begins during this time. In 2012, Tara Carney and Bronwyn Myers found a correlation between the early onset of substance use and an elevated risk for later development of substance use disorders. Additionally, because early substance use may impact the growth of the adolescent brain, it has the potential to heighten one’s risk for delayed social and academic development.

Adolescents living in rural areas are marginalized in multiple ways. Children are an underserved minority population, as are rural populations. Sheryl Kataoka, Lilly Zhang and Kenneth Wells (2002) found that among youth with a recognized mental health need (estimated at 10 million to 15 million people), only 20-30 percent receive specialized mental health care. Rural communities are more likely to have fewer clinicians or require a long drive to see those clinicians, making it more difficult to obtain care. These disadvantages are exacerbated by the tumultuous nature of adolescence.

Motivational interviewing and brief interventions are two evidence-based practices particularly suited to this population because these approaches are generally influential in their therapeutic role while also being cost-effective. Motivational interviewing facilitates behavior change through exploration and resolution of ambivalence, and it focuses on being optimistic, hopeful and strengths-based. It uses principles of empathy, discrepancy, self-efficacy and resistance, and offers specific techniques such as OARS (Open questions, Affirmations, Reflective listening, Summarizing). SFBT emphasizes solutions, changes clients’ perceptions and behaviors, helps clients access their strengths and uses techniques such as exception to the problem, specification of goals and the miracle question.

Individual interventions with the use of the same interventions for multiple sessions are ideal, and research suggests that the earlier the intervention, the better the outcome. Early intervention shows better results than both preventive measures and later interventions because it reduces the need for more specialized interventions and provides applicable and useful tools and tactics for adolescents as they enter into various student, peer, familial and professional roles.

Challenges certainly exist when working with children and adolescents, particularly because many biological, environmental and social shifts occur organically during this time. As children and adolescents rapidly transition on a continuum of development, they become “moving targets.” Interventions that prove effective for those ages 11-12 often cease to be effective by ages 13 or 14. It is vital that counselors remain aware of this across the life span. Although adolescents are beginning to distance themselves from their caregivers, familial relationships and parental involvement remain crucial during this period.

To appropriately and competently involve the families of rural adolescents, some understanding of cultural values is necessary. In 2005, Susan Keefe and Susie Greene identified core Appalachian values, including egalitarianism, personalism, familism, a religious worldview, a strong sense of place and the avoidance of conflict. In the Appalachian region, assuming authority without demonstrating an authoritarian attitude is important. Language tends to be simple, direct, honest and straightforward. Family is extremely important, exemplified by the adage “blood is thicker than water.” Individuals’ relationship to the land is complex, and it can be beneficial to explore how clients view economic deprivation. In 2016, Sue and Sue also pinpointed some tendencies of rural clients, including having a “street-smart” attitude and way of being, depending on systems due to living in poverty and valuing survival at all costs.

As a result, subtle techniques such as stages of change, motivational interviewing and SFBT may be useful for this population. In stages of change, the intervention is matched to the stage of the client’s readiness to change (precontemplation, contemplation, preparation, action, maintenance, termination). Motivational interviewing facilitates an invitation to engage, and its strengths-based, hopeful tone can be helpful for clients living in an environment populated by deficits such as poverty and lack of education. The practical nature of brief therapy fits well with the no-nonsense worldview of clients coming from rural backgrounds.

Unfortunately, published rural studies often focus on specific regions or populations. Few interventions have been tested in rural settings, and the evidence from systematic reviews is often too general and not specific to the rural context. Ideally, rural communities could review interventions tested with various target populations in a range of settings. Such information is not usually available, however, and the strength of evidence is unlikely to be the only factor considered in choosing an intervention. The research on rural adolescent populations is limited, and little consistency exists across studies related to measurement tools. Furthermore, disseminating evidence-based practices to schools, families and community settings in rural areas is difficult due to the lack of resources.

However, it is important to note that there have been great improvements in substance abuse treatment and prevention with children and adolescents who live in rural areas. A 2016 Monitoring the Future survey of eighth-, 10th- and 12th-graders by the National Institute on Drug Abuse found the lowest ever reported rates of use for all illicit drugs, including alcohol, marijuana and nicotine. As further research is conducted, it will be important to delve into this information to identify what is already working with these individuals and what can be improved to better serve them moving forward.

Evidence-based practices with transgender clients

Transgender individuals face discrimination on multiple fronts. Many experience familial rejection, unequal treatment, harassment and physical violence during daily living. The rate of substance abuse within the transgender community is three times higher than that of the general population. There is a profound lack of competent health care for transgender individuals, and the care that is available may be inaccessible to a majority of the transgender population. The rate of unemployment within the transgender community is also three times greater than that of the general population, due in part to factors such as workplace discrimination, poverty and homelessness. Transgender people also face discrimination and mistreatment in shelters.

With high rates of homelessness, substance abuse and mistreatment, transgender people also have frequent interactions with law enforcement, where they can be subject to police brutality and discrimination. Within the criminal justice system, a high rate of physical and sexual assault is perpetrated against transgender individuals, and they are often denied medical treatment while incarcerated or detained.

Poor health outcomes for transgender people correlate with risk factors such as economic and housing instability, lower educational attainment, lack of family support and other intersectional factors such as race, ethnicity, immigration status and ability.

According to the 2015 U.S. Transgender Survey, 18 percent of transgender people who sought mental health services experienced a mental health professional attempt to stop them from being transgender. This correlated with higher rates of serious psychological distress and suicide attempts and an increased likelihood of running away from home, homelessness and engaging in sex work.

Research conducted in 2015 by Samantha Pflum et al. emphasized the lack of access to transgender-affirming resources and communities for individuals living in rural locations. The history of mistreatment and abuse of lesbian, gay, bisexual, transgender and gender-nonconforming clients by medical and mental health professionals must be acknowledged. Gender and sexual minority clients still face discrimination within the helping professions, and for individuals holding multiple marginalized identities, these experiences are compounded.

Even well-meaning providers are likely to make mistakes when working with marginalized clients. According to Lauren Mizock and Christine Lundquist, one of these mistakes is education burdening, or relying on the client to educate the provider about transgender culture or the general transgender experience. Resources exist to facilitate competence in these areas, and clinicians have a responsibility to refrain from placing the burden of their education on the client.

Some counselors participate in gender inflation, or focusing on the client’s gender to the exclusion of other important factors. Other counselors engage in gender narrowing, applying restrictive, preconceived ideas about gender to the client, or gender avoidance, which involves ignoring issues of gender altogether. Gender generalizing occurs when a clinician assumes that all transgender clients are similar. Gender repairing operates from a belief that a transgender identity is a problem to be “fixed.” Gender pathologizing involves viewing transgender identity as a mental illness or as the cause of the client’s issues. Finally, gatekeeping occurs when a provider controls client access to gender-affirming resources.

Acceptance of a client’s gender identity is ultimately not enough to provide competent, affirmative services. Understanding the nuances of these common mistakes will help clinicians provide a safe therapeutic environment that is affirming of these clients’ identity and humanity.

The Association for Lesbian, Gay, Bisexual and Transgender Issues in Counseling (ALGBTIC), a division of the American Counseling Association, has developed competencies for counseling transgender clients (see counseling.org/knowledge-center/competencies) that focus on the following eight domains:

  • Human growth and development
  • Social and cultural foundations
  • Helping relationships
  • Group work
  • Professional orientation
  • Career and lifestyle development competencies
  • Appraisal
  • Research

Counselors can work within this framework to:

  • Promote resilience by using theoretical approaches grounded in resilience and wellness
  • Conceptualize the development of a transgender individual across the life span
  • Understand internal and external factors influencing identity development
  • Consider how identity interacts with systems of power and oppression (especially for minority transgender individuals)
  • Examine counselors’ own internalized beliefs and how those beliefs affect attitudes toward transgender clients
  • Reevaluate approaches to working with transgender clients as new research emerges

One intervention that has been identified for use with this population by Ashley Austin and Shelley Craig is transgender-affirmative cognitive behavior therapy (CBT). Transgender-affirmative CBT modifies CBT interventions to address specific minority stressors, such as victimization, harassment, violence, discrimination and microaggressions, that transgender people commonly face. This approach uses psychoeducation to help clients understand the connections between transphobic experiences and mental health issues such as stress, anxiety, depression, hopelessness and suicidality. Experiences are processed through a minority stress lens to help clients move from a pathologizing-of-self mindset to an affirming view of themselves as people coping with complex circumstances.

Clinicians are advised to affirm the existence of discrimination and to help these clients identify influences on their mental health by using the transgender discrimination inverted pyramid (see below). 

Transgender individuals internalize messages at each level, and it can be beneficial to have a visual for how these messages trickle down and influence mental health. Clinicians can empower transgender clients by assisting them in challenging internal and societal transphobic barriers. A few examples are challenging negative self-beliefs, connecting with a supportive community and advocating for self and community.

Another approach recommended for use with transgender clients by Joseph Avera et al. in 2015 is the Indivisible Self model, an Adlerian wellness model refined by Jane Myers and Thomas Sweeney that emphasizes strengths. There are five wellness factors of self in this model:

  • Creative Self: Cognitions, emotions, humor and work
  • Coping Self: Stress management, self-worth, realistic beliefs and leisure
  • Social Self: Friends, family and love)
  • Essential Self: Spirituality, self-care, gender identity and cultural identity
  • Physical Self: Physical and nutritional wellness

This model easily can be adapted to a transgender-specific lens, especially regarding the Essential Self, by exploring gender and cultural identity and how they influence client experiences and beliefs. Used in conjunction with the ALGBTIC transgender competencies, the Indivisible Self model offers helping professionals both a conceptual and practical framework for working effectively with transgender clients.

For all clients, and transgender clients in particular, intersectional factors magnify the experience of oppression. Sand Chang and Anneliese Singh recommend addressing the intersectionality of race/ethnicity and gender identity for both clients and clinicians. This involves:

  • Challenging assumptions about the experiences of transgender and gender-nonconforming people of color
  • Building rapport and acknowledging differences within the therapeutic dyad
  • Assessing client strengths and resilience in navigating multiple oppressions
  • Providing a variety of resources that are affirming to transgender and gender-nonconforming people of color

In addition, assisting clients in locating social support is advised. Social support increases healthy coping mechanisms and helps with self-acceptance, thereby reducing psychological stress related to discrimination. Social support can also help to normalize and validate emotions related to discrimination.

Conclusion

Evidence-based practices have consistently been shown to be helpful to clients, but counselors must remember that they operate within the context of a relationship. To use evidence-based practices effectively, we must hold on to our humanness. The implementation of a single technique will look very different depending on who is in the room and what they are bringing with them.

Often, the expectations for using evidence-based practices might create pressure for counselors to follow a strict formula for treatment. Process variables such as honoring the personal relationship between the counselor and the client, maintaining a “therapist’s heart” and respecting the unique aspects of the client may seem to be at odds with the procedure for using a specific intervention. A working knowledge of multicultural issues can provide some context for how to shift evidence-based practices to fit the client rather than pressuring the client to conform to a prescribed, generalized format.

Using interventions with a solid evidence base is good practice. Adjusting their implementation on the basis of the unique identity of the person sitting across from us is great practice.

 

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Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

Geri Miller is a professor in the Department of Human Development and Psychological Counseling (clinical mental health counseling track) at Appalachian State University (ASU) in North Carolina. She is a licensed professional counselor, licensed psychologist, licensed clinical addictions specialist and substance abuse professional practice board certified clinical supervisor. She has been a volunteer counselor at a local health department since the early 1990s. Her clientele has primarily consisted of women with little opportunity for jobs or education and who experience barriers of poverty. Contact her at millerga@appstate.edu.

Glenda S. Johnson is an assistant professor in the Department of Human Development and Psychological Counseling (school counseling program) at ASU. She is a licensed professional counselor and a licensed school counselor in North Carolina. Her scholarly focus includes school counselors delivering comprehensive school counseling programs, students who are at risk of dropping out of high school and the mentoring of new counseling professionals.

Mx. Tuesday Feral received their master’s degree in clinical mental health counseling and a certificate in systematic multicultural counseling from ASU. They are the support programs director for Tranzmission, a nonprofit organization serving the Western North Carolina nonbinary and transgender community through education, advocacy and support services. Tuesday offers training and workshops in trans cultural competence and cultural humility on local, state and national levels.

William Luckett received his master’s degree in clinical mental health counseling from ASU with a certificate in addictions counseling. He has interests in somatic therapy approaches, mindfulness, religious and spiritual topics in counseling, and substance abuse counseling. He currently provides in-home counseling to rural families in Virginia.

Kelsey Fish is a student in ASU’s clinical mental health counseling program and a clinical intern with Daymark Recovery Services in rural Appalachia. Her clinical interests include expressive arts therapy, adolescents, and gender and sexual minority issues.

Madison Ericksen is a graduate of the clinical mental health counseling program at ASU. She has specialized training and interest in trauma-informed practices that use mindfulness, eco-based and expressive art therapies as complementary treatments alongside traditional therapy. She provides strengths-based and resiliency-focused outpatient counseling for children and families.

 

Letters to the editor:  ct@counseling.org

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

Parenting in the 21st century

By Laurie Meyers February 22, 2018

Remember when receipt of a coffee mug emblazoned with “Best Mom Ever” or a T-shirt proclaiming “Best Dad Ever” was enough to validate someone’s skills and aptitude as a parent? In the 21st century, it seems that the ante has been raised. In the eyes of society, parents barely qualify as competent — much less “perfect” — unless they can check off all of the following qualifications:

  • Not only attend to, but anticipate, their child’s every need
  • Orchestrate their child’s academic success
  • Provide their child with all the best experiences and most useful activities
  • Make home an oasis of peace and harmony for the family (while simultaneously prospering in their own careers)

Attendance to one’s children at all times is mandatory. No exceptions will be made for parents working two jobs just to get by, single parents or parents of children with special needs. No foolproof instruction manual will be provided.

These extreme expectations, paired with the rapidly accelerating pace of modern life, present significant obstacles and pressures for parents who genuinely want to make their children feel cared for without driving themselves crazy. Many counselors are routinely helping clients respond to these and other challenges of modern-day parenting.

Parenting, problems and pride

“Always on” parenting requires a lot of problem-solving, which leaves parents focused on all the things that are going wrong, says American Counseling Association member Laura Meyer, a licensed clinical mental health counselor in Bedford, New Hampshire, who specializes in parenting issues and women’s concerns. In particular, working parents often have a difficult time attending every school function that is offered because they typically take place during the workday. This can feel like a failure, particularly for mothers, says Meyer, who is currently researching women’s parenting experiences.

As a kind of antidote, Meyer encourages clients to look for instances when they did something that made them proud of their parenting: “Maybe I wasn’t able to be there for this one particular event, but I made the costume that my kid wore in the play.”

It’s easy for parents to become trapped in the problems that they face, so Meyer encourages a solution-focused approach. For example, she has a client who is struggling with parenting a son who has intermittent explosive disorder. “She was at her wit’s end,” Meyer says. “He was kicking her [and] she was dragging him out of public venues.”

Meyer asked the woman to tell her what went well that week. At first, the client couldn’t think of anything. Then she remembered putting up a Christmas tree with her son. They had enjoyed decorating it together, and the mother took a photo. Meyer asked the client what might happen if every time that she and her son had a good moment together, she took a photo and included it in a chatbook — a social media app that allows users to generate photo books from uploaded pictures. Then they could sit down and look at the photos together each week.

The client burst into tears, saying it would make a huge difference to look at and remember some of the little victories rather than always thinking exclusively about the failures. Meyer suggested that the client could also use the photos to talk with her son about why that particular experience or day had been so good and then ask him how he had been able to remain calm.

Meyer encourages clients to use their counseling sessions as a time to stop and reflect on the quality of their relationship with their child rather than continually reacting to crises. Parents are often susceptible to getting caught up in the everyday duties of being a parent and missing out on the joy, love and upside of parenting, she says.

Helping prevent sexual abuse

Over the course of seven days in January, 156 young women and teenagers gathered in a courtroom in Michigan to recount how Lawrence Nassar, former physician for the USA Gymnastics team and Michigan State University, sexually violated them. Their stories detailed the widespread damage an unchecked predator with access to children and teenagers can wreak. Some of those who came to speak were accompanied by their parents, who were left to ask — in the words of one mother who testified — “How could I have missed the red flags?”

Most parents don’t have much accurate information about sexual predators, says ACA member Jennifer Foster, an assistant professor of counselor education and counseling psychology at Western Michigan University. Her research focuses on child sexual abuse.

In the past, most sexual abuse prevention efforts were aimed at children in the school system, she says. “This helped to create awareness, but the efforts had a major flaw in that they put the burden of stopping abuse on kids,” Foster observes.

As a former licensed mental health counselor and school counselor in Florida, Foster worked with many children who had been abused. “They would say to me, ‘I did say stop. I did say no,’” she recalls. Unfortunately, it is easy for children to be outmaneuvered and overpowered by adults and older children, so prevention efforts should focus on parents and other adults, Foster asserts.

Foster now helps educate parents about sexual predators. “I want parents to know all the scary info,” she says. This includes working to break down conventional myths. When asked to think about the profile of a “typical” predator, most people picture an adult male with a criminal record who is a stranger, or at least not someone the family knows well. Foster tells parents to picture instead the people they might invite to Thanksgiving dinner, because 90 to 96 percent of sexual predators are either family members or someone who is close to the family (the Rape, Abuse & Incest National Network puts this number at 93 percent). According to the Crimes Against Children Research Center, 36 percent are other children.

Parents don’t typically picture a female offender either, and although the reported incidence of sexual abuse by women is low, experts think that the actual rate is higher, Foster says. Unfortunately, parents are much more likely to hand over the care of their children to a woman — in a day care setting, for instance — without really knowing the person’s background, she continues.

Research also indicates a high rate of sibling-on-sibling sexual abuse, often with the use of force, Foster says. Many parents like to assume that this is something that happens only in families with lower socioeconomic status, but the truth is that it can take place in any family. Foster adds that research indicates that if child or juvenile offenders get treatment, they are likely to recover and not go on to commit the same offense again.

Foster teaches parents about some of the behavioral red flags of possible sexual predators, including spending more time with children than with peers, lacking adult friends, having numerous child-friendly hobbies and making inappropriate sexual comments about children. Foster reported a local teacher who regularly made sexually suggestive comments to his female students, such as, “If you were my daughter, I wouldn’t let you out the door in those pants because I know what I would be thinking.”

“That is such a great example of covert abuse, which was allegedly ignored by school staff when girls repeatedly complained about the teacher. That was one of multiple comments he made. They were told, ‘You’re taking it the wrong way. You misheard. You don’t know how to take a compliment.’ Then, when he had an opportunity and a student in isolation, the abuse moved to overt, with him putting his hand up her shirt.”

That student happened to be a member of a youth group Foster helps lead at her church. She believes the girl felt encouraged to disclose to her because of a pen that Foster often uses that says, “Rape. Talk about it.” Another girl in the group asked why Foster had that pen, and that gave Foster an opening to talk about the work she has done with sexual trauma survivors. After the group, the girl who had been violated told Foster about her experience. Foster contacted the school, which she says took no official action, instead simply allowing the teacher to resign.

Parents should also be wary of adults who are always putting their hands on kids or giving kids hugs, Foster says. These behaviors will often take place in front of other people because predators are testing to see if anyone notices and is alarmed by their actions. Predators also try to spend time alone with children and may give them gifts. Foster says that giving gifts can be an entirely benevolent act, but she also warns that it can be a part of the grooming process. Foster’s family has established a rule that her children won’t take gifts from anyone without first asking Foster or their father.

Foster also teaches her children that no secrets should be kept in their family (although she does distinguish between secrets and surprises). Part of the reasoning for this practice is that sexual predators often try to get children to keep small secrets. For example, “Don’t tell your mom I gave you ice cream before dinner. She’ll be mad at me!” Small secrets are a test of sorts, Foster explains. The predator is trying to gauge what a child will and will not tell his or her parents.

Predators are opportunistic — always looking for ways to be “helpful,” Foster says. They often try to come to the rescue, particularly with families in vulnerable situations, such as a family with a chronically ill child, a family that is new to town or a family headed by a single parent, she says. Becoming the family savior is part of the end goal so that they can get time alone with the children, Foster explains.

Although Foster believes that the burden of spotting and stopping child sexual abuse must be placed on adults, she says that it is still important for children to know that it is not OK for someone to touch them inappropriately. Foster likes to teach parents the language that Feather Berkower, a child sexual abuse prevention expert, uses about “body safety.” The concept is simple enough that even little children can learn it.

Body safety means that no one can look at, touch or take pictures of the child’s private parts, and children should not look at or touch another person’s body parts, Foster explains. She believes that children who aren’t taught about body safety are more vulnerable because they don’t have the language to talk about something that has made them feel uncomfortable, including actual abuse. Children should also learn the anatomically correct names for body parts, Foster says.

Foster’s son knows that everyone has to follow body safety rules. If he goes to a friend’s house, Foster also makes sure that the friend’s parents are aware that Foster’s family follows body safety rules. In addition, because of the prevalence of child-on-child sexual abuse, Foster does not allow closed doors when friends come over to play at her family’s house. She also intermittently checks in with her son about his interactions with the adults in his life by asking if he had fun with the person, what they did together and whether the person followed the body safety rules.

Most parents are also in the dark about how to keep their children safe online, Foster says, but they need to be aware that sexual predators often use online means to target children. Perpetrators often develop social media accounts and profiles, posing as someone who is the same age as the child or adolescent they are targeting and then revealing their true age later. After earning the young person’s trust, the predator may attempt to entice the child or adolescent to meet in person and move their encounters offline.

Foster recommends that families confine technology use to open spaces such as the TV room or kitchen. Parents can make use of tracking tools, but they should also have an open dialogue with their children about their online activity, Foster says. She also advises that parents find out what kind of technology rules other parents have before allowing children to go to their friends’ houses.

As a whole, Foster says, a higher level of vigilance against sexual abuse is required. She notes that most parents are good about discussing safety with their children when it comes to looking both ways before crossing the street, using a helmet when riding a bike or always wearing a seatbelt in the car. But more children are sexually abused each year than are hit by cars, and relatively few families take active steps to prevent that from happening.

“When it comes to child sexual abuse, adults need to take on the responsibility to create safe homes and communities,” Foster says. “Counselors [can] give them the tools they need.”

No longer partners but still parents

“Divorce changes kids’ lives [and] usually not in good ways,” says Kristin Little, a licensed mental health counselor whose Seattle-area practice includes a focus on counseling families that are navigating divorce or separation. “However, kids can manage even difficult divorce changes if well-supported and protected from the most harmful effects of conflict [such as] loss of confidence in their parents’ ability to lead, loss of stability in home/school life and loss of relationship with either or both parents.”

Little says the most essential thing that mental health professionals can do when counseling parents who are separated, divorced or in the process of divorcing is to introduce the idea of the separation of “adult mind” and “parent mind.”

“Parents can be experiencing a high level of anger or sadness while their marriage is ending. This is normal and expected and may be important for them to explore individually,” she says. “However, they continue to be parents and need to separate their own adult experience and reactions from their parenting roles. Giving parents the permission to feel, yet reminding them that they have the responsibility to attend to parenting needs, make important decisions, [and] see and respond to their children’s needs and feelings as separate from their own, is vitally important.”

ACA member Kimberly Mason, a licensed professional counselor (LPC) in Madisonville, Louisiana, who specializes in family and relationship issues, says that many parents have difficulty managing their anger, guilt and shame, and setting aside their conflict while parenting. To better shield their children from strife, she gives the following recommendations to parents:

1) Have ground rules for communication. Parents should not berate each other or argue in front of their children. If necessary, they should go to a private area to work out their conflict.

2) Each parent should seek individual counseling to work through his or her own issues. This can help limit the level of animosity and frequency of arguments that may occur in the home.

3) Model mutual respect for each other in front of the children. Each partner should also talk to family members and friends and ask them to refrain from saying negative things about the other partner in front of the children.

Parents who are facing divorce or separation are often terrified, which can override their ability to collaborate and make decisions, Little says. They may seek safety by sticking to past patterns of interacting and relying on assumptions about roles or capabilities that they held during the marriage or relationship, she explains. They often have difficulty envisioning change.

“This can result in one parent insisting that they are more experienced than the other and thus deserving of more time, which inevitably triggers fear and anger in the other parent and results in what we often see as a tug of war that rarely serves the kids’ or parents’ needs,” Little says.

Counselors can be a neutral “referee” of sorts for parents, steering the conversation away from who is wrong or right and instead toward developing a working co-parenting relationship that focuses on the future, she says.

ACA member Monika Logan, an LPC in Frisco, Texas, has a practice that focuses on divorce and parenting issues. She says that parents need to learn to form a more businesslike relationship by setting aside their emotions toward each other. Parents can begin to do this by “working on their own feelings related to the separation or divorce and developing a support network,” she says.

Little agrees with encouraging that approach. “[It] allows them to get the important job of parenting done,” she says. “It is essentially undoing the patterns, dynamics and practices of the marriage to allow for a renegotiation of how they will interact [and] the tasks they will agree to in the new co-parenting relationship.”

Each partner must agree to the new “business” guidelines or they won’t work, says Mason, who is also a core faculty member at Walden University. They must commit to putting their children’s needs above their own and making joint decisions. Compromise and consistency are also essential. The parents must be willing to back each other up when making decisions so that the children will still view them as a team, she emphasizes.

“Contrary to what some people describe, healthy co-parenting can be anywhere along the spectrum from parallel parenting — having little contact and overlap between homes and parents — to how co-parenting is usually thought of — frequent collaboration and interaction,” Little says.

There is no one-size-fits-all approach to co-parenting, she says. A counselor’s job is to help parents craft a plan that works for each partner, minimizes conflict and, most important, meets the needs of their children.

Coming to terms with coming out

As the LGBTQ (lesbian, gay, bisexual, transgender and questioning or queer) community has gained greater acceptance during the past 10 to 20 years, it has become more common for young people to come out to their parents, says ACA member Misty Ginicola, an LPC in West Haven, Connecticut, whose practice specialties include LGBTQ issues. She adds that those who come out are also often taking that step at younger ages than in the past — for instance, as middle schoolers rather than as teenagers.

How parents react to that decision is incredibly important to the mental health of the child. Ginicola, the lead editor of the ACA-published book Affirmative Counseling With LGBTQI+ People, has witnessed parent reactions in her practice that ran the gamut from accepting yet concerned to completely opposed and voicing a desire to “fix” their child. She tells parents looking to “cure” a child that counselors cannot, either from an ethical or a practical standpoint, change someone’s sexual/affectional orientation. However, Ginicola does try to address the concerns of all parents who come to her for help, whether they are “affirming” parents (who are supportive of their child’s orientation) or “disaffirming” (those who reject LGBTQ status).

Even parents who are supportive of the LGBTQ community may have problems adjusting to their own child coming out, she says. They may ask if the child is “sure” or, if a child comes out as gay or lesbian and then subsequently shows interest in someone who is other gendered, they may say, “Oh, so you’re really not [gay or lesbian],” Ginicola reports. These kinds of reactions often spring from parents’ fears that their child will be bullied or belittled or face other hurtful consequences, she says.

However, Ginicola explains to parents that when they ask those kinds of questions or make those kinds of statements, what their children actually hear is that something is wrong with them. Children are very vulnerable when coming out. In fact, the risk of suicide is highest during the coming-out process, but research shows that having supportive parents reduces this risk by half. So, it is crucial for parents to strive to always communicate support and to be willing to admit and apologize when they have said the wrong thing, Ginicola emphasizes.

Ginicola also teaches parents that although they cannot keep their children from being bullied, they can help them cope by building and reinforcing their self-esteem, teaching them good social and emotional skills, and ensuring that they have allies such as friends, teachers and school counselors in place.

One of the ways parents can help build their children’s self-esteem is by helping them find places where they will be accepted through whatever interests and activities they enjoy, Ginicola says. She cautions, however, that parents must take it upon themselves to ensure that these places are safe and not an environment in which their child will be rejected or targeted.

Parents should also talk to their child’s school to confirm that it has sound anti-bullying policies in place, Ginicola says. Most important, parents must make sure their children understand that there is nothing wrong with them and that they are not the problem, she emphasizes.

Unfortunately, the reality is that although acceptance for those who identify as LGBTQ has grown tremendously, they are still at increased risk for experiencing violence, meaning that parents need to talk to children who have come out about safety, Ginicola says. Specifically, children should be careful about who their friends are and make sure that they attend parties and other social events with people who are affirming, she says. Parents should also caution children who are not fully out to be very careful about whom they tell, not because there is anything wrong about telling but because sometimes it can be unsafe, Ginicola says.

Open communication is also essential. Children need to know and trust that they can tell their parents anything, Ginicola says. It is particularly critical that children understand the necessity of informing their parents about any instances of bullying, violence or other actions that threaten a child’s safety, she says.

Counselors must also prepare parents for the rejection that they will experience, Ginicola points out. For example, it is possible that family members might say hurtful things about a child who has come out and question how the parents are raising the child, she says. Community members may also weigh in with their own judgments, which Ginicola has experienced personally, including when a neighbor called child protective services because Ginicola lets her nongender-conforming son wear pink shoes to school. Nothing came of the neighbor’s call, but “it’s scary to realize that while I am getting the rejection for him now, someday he will receive that,” she says.

In some cases, parents may lose a whole community in which they previously felt secure and safe, Ginicola says. For example, in the African-American community, the church often serves as the main safe space for its congregants, but many churches are not affirming of LGBTQ individuals. By choosing to support their children who identify as LGBTQ, the parents may lose an essential source of support.

In cases such as these, Ginicola helps her clients process their grief and encourages them to seek alternative sources of support, such as other parents who have gone through similar experiences. She is also able to recommend online and local groups to which parents can turn. Ginicola also provides validation for the parents, emphasizing that it is the culture that is the problem, not the parents themselves. Another part of the service that counselors can provide these clients is to make sure they are practicing good self-care, she adds.

Ginicola also sees parents who are totally unsupportive of their child’s LGBTQ status. She acknowledges walking a fine line with these clients. Although she doesn’t want to support their beliefs, she tries to identify a way to reach them so that they don’t instead go find a therapist who is willing to attempt to “change” their child.

“[It requires] the same principles that underlie work with any parent that is potentially destructive to a child,” Ginicola says. “[It’s] a delicate balance of keeping them feeling validated without promoting harming their child.”

She starts by probing for what is at the root of the parents’ nonaffirming stance. “Let’s say it’s religious beliefs. You [as the counselor] can’t start quoting Bible verses,” Ginicola says. “That’s not our place, and they’re not going to listen to us anyway because we’re not within their religious group.”

Ginicola validates parents by saying she can see that it might be difficult to feel caught between two conflicting forces — the instinct to love and support their child versus their belief in a religious tradition that rejects their child. Rather than attempting to challenge their religious beliefs, she looks for inconsistencies and discrepancies that she can point out.

“I might say, ‘I’m hearing you say that in your faith you are supposed to love and support your child but also hearing that this [coming out] is something you can’t support. How do you feel about that conflict?’”

Ginicola tries to get these clients to a point at which they are willing to join local or online support groups and talk to other parents who have gone through the same experience. She reasons that these parents will be the best source of support and advice on coping with the conflict of belonging to a faith tradition that does not affirm LGBTQ identity and culture, yet wanting to support a child who is LGBTQ.

Sometimes parents are unwilling to let go of whatever beliefs are informing their anti-LGBTQ stance. In these situations, Ginicola lets them know that they are choosing a dangerous path. When families utterly reject children who come out as LGBTQ, the risk of suicide is exponentially increased.

“At some point,” Ginicola observes, “they have to ask themselves, do they want a gay son or a dead son?”

 

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Additional resources

To learn more about the topics discussed in this article, take advantage of the following select resources offered by the American Counseling Association:

Counseling Today (ct.counseling.org)

Books (counseling.org/publications/bookstore)

  • Stepping In, Stepping Out: Creating Stepfamily Rhythm by Joshua M. Gold
  • Casebook for Counseling Lesbian, Gay, Bisexual, and Transgender Persons and Their Families edited by Sari H. Dworkin and Mark Pope
  • Youth at Risk, sixth edition, edited by David Capuzzi and Douglas R. Gross

Practice briefs (counseling.org/knowledge-center/practice-briefs)

  • “Divorce and Children” by Elizabeth A. Mellin and Lindsey M. Nichols
  • “Parenting Education” by Carl J. Sheperis and Belinda Lopez

ACA divisions

  • Association for Child and Adolescent Counseling (acachild.org)
  • International Association of Marriage and Family Counselors (iamfconline.org)

 

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Laurie Meyers is the senior writer for Counseling Today. Contact her at lmeyers@counseling.org.

Letters to the editorct@counseling.org

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Helping students change with dignity

By John J. Murphy August 26, 2016

“We may need to solve problems not by removing the cause but by designing the way forward.”

— Edward de Bono

 

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In the book All I Really Need to Know I Learned in Kindergarten, author Robert Fulghum said he had learned life’s most important lessons as a young child in kindergarten. In that same spirit, this article could be titled, “Most of What I Know About Counseling Students, I Learned From Students.”

As much as I appreciate my formal training, the best lessons of all — the ones that really got my attention and took hold — have come from the young people I’ve been privileged to serve. MurphyThese lessons can be condensed into two practical principles of school-based counseling: 1) Involve students and 2) build solutions from strengths and resources.

As further testimony to the expertise of my youthful teachers, these two strategies are strongly supported by mountains of empirical research in counseling and psychotherapy. More specifically, research indicates that counseling outcomes depend largely on the quality of the client-counselor alliance, the client’s hope for a better future and the extent to which the client’s opinions, values, strengths, social supports, life experiences and other “client factors” are incorporated into counseling.

This article translates these findings and principles into the following steps and techniques of solution-focused counseling, a practical and culturally sensitive approach to helping young people change with dignity.

Step 1: Establish collaborative relationships

The client’s perception of a strong client-counselor alliance is the most reliable predictor of successful outcomes, and client involvement is the key to a strong alliance. The more involved students are in their own counseling, the better the outcomes. The following techniques help to strengthen alliances and improve outcomes in solution-focused counseling.

Adopt the ambassador perspective. Approach every session as a cross-cultural exchange and every student as a unique “culture of one,” with the humility, respect and curiosity that a foreign ambassador would show when entering an unfamiliar country or culture. Good ambassadors look, listen and learn from people before making any assumptions
or suggestions.

Compliment students. Anything we can do to boost students’ hope will improve outcomes, which is why compliments are an important part of solution-focused counseling. Compliments help to reframe students’ views of themselves and their circumstances, and they are often folded into questions in solution-focused counseling. For example, asking a student who complains of being stressed out and depressed, “How have you managed to juggle so many things for so long?” invites a more hopeful and empowering self-perception. Students can be complimented for attending counseling sessions (“It takes courage to meet like this”), cooperating in the conversation (“I appreciate your help and patience in answering my questions”) and trying to improve their lives (“With all you’ve been through, where do you find the strength to keep on trying instead of giving up?”).

Fit counseling to students versus students to counseling. Just as a tailor adjusts a suit to fit the owner, we need to customize counseling to each student rather than requiring students to conform to our favorite ideas and methods. This means incorporating students’ key words and phrases into the conversation, exploring their theories and opinions, and determining what they want from us and our services.

Incorporating students’ language into counseling conversations validates their perceptions and reinforces the client-driven emphasis of solution-focused counseling. For example, if Maria says, “My teacher gets on my back all the time about my behavior,” we could ask, “What have you found helpful in getting your teacher off your back?”

Another way to fit counseling to students is to explore their opinions about the problem and potential solutions. This can be done through asking questions such as, “What needs to happen to improve things at school?” and “If you were counseling people in a similar situation, what would you advise them to do?” A student’s ideas about the problem and its possible solution can be cobbled into interventions that are more likely to be accepted and implemented by the student than interventions that come from other sources.

Obtaining feedback from students is another way to ensure the provision of student-driven rather than counselor-driven services. The Outcome Rating Scale and Session Rating Scale — two four-item client feedback scales that take one minute to administer and score — provide ongoing snapshots of students’ perceptions of counseling progress and alliance. Collecting feedback from clients during every meeting, and adjusting services based on this feedback, has been shown to dramatically improve counseling outcomes regardless of one’s theoretical orientation.

Step 2: Develop practical goals

In addition to providing students with a sense of hope, purpose and direction for the future, goals help them persist in the face of setbacks and obstacles. Effective goals share several characteristics that can be summarized in the 5-S guideline: significant, specific, small, start based and self-manageable.

Significant: The most important feature of a counseling goal is its personal relevance to the client. Good goals are goals that matter to students, and we can develop these goals by asking questions such as “What are your best hopes for counseling?” and “What is the most important thing you want to change about school right now?”

Specific: Goals also need to be specific and concrete so that students, counselors and anyone else involved can tell when they are reached. The following sample questions help counselors partner with students to develop specific goals: “If we videotaped you being less anxious at school, what would we see you doing?”; “What will be happening next week to let us know that we’re on the right track?”

Small: Practical goals are small enough to be attained, yet challenging enough to inspire action. Questions that help in this regard include the following: “What will be the first small sign that things are moving in the right direction?”; “You rated school as a 2 on a 10-point scale. What would a 2.5 or 3 look like at school?”

Start based: When asked what they want from counseling, most students tell you what they don’t want: “I want to get in less trouble at school” or “I want to be less depressed.” When students state goals in negative terms, we can ask the following “instead of” questions to encourage goals that express the start or presence of something desirable rather than the end or absence of something undesirable: “What will you be doing in class instead of getting in trouble?”; “What would you rather be doing instead of being depressed?” In addition to being more noticeable and measurable than negatively worded goals, start-based goals are more motivating because they focus students’ attention on moving toward what they want (solutions)
rather than away from what they don’t want (problems).

Self-manageable: Students may initially focus on how other people should change instead of considering what they could do differently (“My teachers need to back off and chill a little”). This perspective, accurate as it may be, usually impedes solutions by holding others responsible for changing while placing oneself in a passive and powerless role. When this occurs, counselors can acknowledge students’ perceptions while inviting them to consider what they might do to improve

the school situation: “What have you found helpful in getting your teachers to back off and chill?”

Step 3: Build on what is ‘right’

Instead of emphasizing what is wrong, missing and not working (problems, deficits, limitations), solution-focused counseling invites students and others to notice and build on what is “right” with students and their lives (successes, strengths, resources).

Build on exceptions. Struggling students typically are aware of their failures and problems at school, which is one reason why building on exceptions is so effective in grabbing and keeping their attention. Exceptions refer to the “good times” at school — times when the problem could have happened but did not. These nonproblem occasions are minisolutions that are already happening, just not as often as people would like.

Building on exceptions is a core technique of solution-focused counseling that involves three steps: 1) eliciting exceptions (“When is the problem absent or less noticeable?”), 2) exploring the conditions under which exceptions occur (“How did you make that happen? What was different about your approach?”) and 3) expanding their presence and frequency at school (“What will it take to make that happen more often at school? Are you willing to try that approach in another class?”). This strategy is based on the practical idea that it is more efficient to increase what students are already doing than it is to teach them brand-new behaviors from scratch.

Many students are surprised to learn that they are doing “something” right, and they become more hopeful when they realize that they already have what it takes to turn things around at school. On a more personal level, building on exceptions encourages struggling students to change the question from “How can I be more like other students?” to “How can I be more like myself during my better moments?”

Build on other student resources. In solution-focused counseling, all students are viewed as resourceful and capable of changing. It is our job as counselors to help them identify and apply the “natural resources” in their lives toward school solutions. Natural resources include heroes and influential people (family, friends, actors, athletes); resilience and coping (students’ abilities to cope with life’s adversities); values (students’ deeply held beliefs); special interests (cooking, sports, movies); and community support systems (places of worship, neighborhood groups, clubs). These resources, individually or in combination, can be woven into respectful Branding-Images_Studentsinterventions that improve school behavior while respecting students’ cultural heritage and life experiences.

Let’s look at a quick example involving Ben, a 10-year-old student who loved baseball. After a few minutes of general baseball talk, we explored similarities between the challenges of school and the challenges of baseball. For instance, we talked about how long the baseball season is and how important it is to not let a few bad games ruin the entire season. Ben agreed to try a baseball experiment at school that involved “stepping up to the plate every day” and doing his best, knowing that he would sometimes “strike out” and have bad days. Ben improved his classroom behavior over the next two weeks, and his teacher commented on his impressive turnaround.

This example captures the general nature of building on student resources — identify an available, naturally occurring resource in the student’s life and link the resource to a school solution. Because every student offers a unique set of resources, resource-based interventions are constructed one student at a time with no preconceived notions about what they should look like. You are not likely to find them in treatment manuals or lists because a) they cannot be selected or developed before meeting the student, b) they evolve from the student-counselor relationship and are often formulated on the spot in collaboration with the student and c) they are based completely on material supplied by the student — which is precisely why they work so well. I describe these techniques and many others in greater detail while offering more than 50 real-world illustrations in the new third edition of my book Solution-Focused Counseling in Schools (2015), published by the American Counseling Association.

Solution-focused counseling rests on two main values. First, students should be given every opportunity to be actively involved in their own care because they are the very people for whom school-based counseling services are designed. In addition to honoring core principles of multiculturalism and social justice, giving clients a voice in shaping and evaluating counseling services results in better outcomes. Second, all students are doing “something” to help themselves — if only to keep the problem from getting worse — and these assets and resources can be applied toward school solutions. Without denying the reality and pain of school problems, we can improve outcomes by identifying students’ strengths and resources and incorporating them into the counseling process.

I hope this article was successful in showing that solution-focused counseling in schools is far more than a set of techniques. It is instead a new and different way to approach young people, problems and solutions.

 

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Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

John J. Murphy, a professor in the Department of Psychology and Counseling at the University of Central Arkansas, is the author of several well-regarded books, including the third edition of Solution-Focused Counseling in Schools, published by the American Counseling Association. Contact him at jmurphy@uca.edu and learn more about his work at drjohnmurphy.com.

Letters to the editor: ct@counseling.org

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Behind the Book: Solution-Focused Counseling in Schools

By Bethany Bray November 2, 2015

One of the many reasons solution-focused counseling is a good fit for school settings is because it’s a client-directed approach, says John Murphy, a longtime school psychologist and author of Solution-Focused Counseling in Schools.

School counselors often find the bulk of their time consumed with noncounseling tasks. When they Branding-Box-Solutionare able to meet with a student, using a solution-focused approach provides a customizable way to forge a therapeutic bond with the young person in a short amount of time.

“The simple and practical premise of solution-focused counseling – find what works and do more of it – is one of its most appealing features for school practitioners,” Murphy writes in the book’s conclusion. “This does not mean, however, that it is easy to do. Solution-focused work requires careful attention to language, client feedback, relationship building and other therapeutic nuances and skills. Mastery of these skills requires patience and practice. If your experience is anything like mine, however, it is well worth the effort.”

Solution-Focused Counseling in Schools was originally released in 1997; the American Counseling Association published a third edition of Murphy’s book earlier this year.

 

Q+A: John Murphy on Solution-Focused Counseling in Schools

In the book’s introduction, you write “schools are not set up to accommodate counseling.” Can you elaborate on what you mean by that?

This is not a criticism, merely an observation that the main purpose of schools is to teach reading, writing, math and other important academic skills. Unlike mental health centers and private practice settings where counseling is the main focus and the physical setting reflects that focus, school settings present some unique challenges for counselors.

These challenges include working around students’ and teachers’ busy class schedules, safeguarding client confidentiality and conducting “counseling sessions” whenever and wherever you can — in the lunchroom, on the playground, talking with a parent by phone or walking alongside a student or teacher in the hallway. This requires a lot of flexibility on the part of school practitioners.

But let’s not forget that there are advantages to school-based counseling as well. In addition to offering instant access to students and teachers, schools provide a natural and familiar setting for students and parents who might otherwise have to leave their community and travel long distances to receive services. For these reasons, and the fact that we know more than we ever have about helping people change, I ended the new edition of Solution-Focused Counseling in Schools by stating that there has never been a better time to be a school-based counselor.

 

From your perspective, what makes a solution-focused approach effective in helping elementary through high school students? How is it a “good fit”?

For starters, solution-focused counseling (SFC) is a clear and practical approach that makes sense to students, caregivers and counselors. Research tells us that people are more likely to benefit from counseling approaches that make sense to them, that respect their input and goals, and that customize counseling to them rather than requiring them to conform to the counselor’s preferred methods. SFC meets all of these criteria, which explains why it is effective with students of all ages.

Although solution-focused counselors validate problem-related experiences and struggles, they gently invite students to take action instead of spending a lot of time analyzing the problem. The “less talk, more action” nature of SFC seems to appeal to students as well as school counselors, who have very little time to do counseling in the first place.

Another reason SFC works with students is because it grabs their attention as “something different” rather than more of the same. Most students with school problems are well accustomed to problem-focused conversations with adults. These well-intentioned conversations emphasize what is wrong with students, with little or no attention to what they are doing well, which may include coping with a problem or preventing it from getting worse. In contrast, solution-focused conversations seek out students’ strengths and resources and explore how these assets could be applied toward solutions. In my experience, conversations that recognize and build on what is right and working with students engage their participation more effectively than “more of the same,” problem-saturated discussions.

The solution-focused approach fits with school counselors as well. In teaching classes and workshops throughout the U.S. and overseas, counselors often tell me that the solution-focused emphasis on “doing what works” as quickly as possible is more practical than cumbersome, time-consuming approaches that don’t fit well for schools and school problems. Building on students’ strengths also appeals to counselors’ desire to empower, energize and encourage people. The fact that solution-focused counseling accommodates a variety of cultural backgrounds and life experiences is another important feature in today’s increasingly diverse world. Most people, including myself, signed up for this business to lift people up, and SFC fits nicely with this goal.

 

What prompted you to do a third edition of this book? What’s new and different in this edition?

Though many of the basic ideas and techniques of SFC have been carried over from previous editions, several aspects of my approach to SFC have changed since the previously published second edition in 2008. Research continues to clarify specific elements of effective counseling, all of which are incorporated into the new edition of Solution-Focused Counseling in Schools. These elements include the importance of building a strong counselor-client alliance and of collecting ongoing client feedback.

The third edition has new chapters on topics such as the restrictive influence of problems and practical strategies for developing “goals that matter,” as well as additional practice exercises at the end of each chapter and a widely expanded chapter on innovative ways to use solution-focused strategies in group counseling, classroom teaching, peer helping programs, parent education, consultation with parents and teachers, systems-level change and referral forms. I also included new appendices with examples of solution-focused checklists and referral forms, therapeutic letters to students of all ages, scripts for introducing client feedback tools and handy crib sheets for conducting SFC sessions.

 

What is a main takeaway you want counselors of all types, including nonschool counselors, to know about the importance of solution-focused counseling in school settings?

The main takeaway is that the ideas and techniques in this book are “value added.” A value-added technique adds value and impact to whatever it is combined with, making everything else you do with clients more effective. Examples of value-added techniques include obtaining client feedback, giving compliments, validating students’ experiences and exploring exceptions to the problem.

The beauty of these techniques is that there are no risks or downsides to using them. The worst thing that can happen is that the person does not respond and nothing changes, at which point you simply move on to something else. Even then, value-added techniques can enhance the alliance by conveying respect for people’s input, wisdom and capability. The bottom line is this: You can use the techniques in this book regardless of your theoretical orientation and regardless of whether or not you consider yourself a solution-focused practitioner.

 

You were a public school teacher and school psychologist for many years. How have you seen the role of school counselor/psychologist change since then?

I haven’t seen much of a change in the roles of most school counselors or school psychologists, especially when it comes to the small amount of time they spend in intervention-related activities such as individual and group counseling, parent/teacher consultation and schoolwide prevention/intervention programs. I am not criticizing the professionals who fill these roles, many of whom would like to spend more time on such activities. School counselors and psychologists often tell me that they are pulled in so many different directions and saddled with certain responsibilities that leave little time for counseling and other intervention-related services. Unfortunately, the situation will not change in a big way if schools continue to rely exclusively on outside professionals and agencies to provide the bulk of school-based counseling and intervention services.

 

What advice would you give to a new professional who is starting a career as a school counselor?

Find ways to stay active, involved and hopeful about your profession and the people you serve. Effective practitioners are continually engaged in professional learning and development. They also find ways to sustain their hope in the midst of the ongoing problems and challenges they face on a daily basis. I would also advise them to make sure that their job description and role includes sufficient time for counseling and intervention activities.

 

Besides your book, what resources would you recommend for school counselors who would like to learn more about solution-focused counseling?

There are many more resources on solution-focused counseling with young people and schools than there were when I wrote the book’s first edition almost 25 years ago. An Internet search of “solution-focused counseling in schools” will yield various articles and chapters. The Solution-Focused Brief Therapy Association’s website (sfbta.org) contains general information about SFBT. I also maintain a website on solution-focused and strengths-based practices in schools that has a variety of links and additional information about solution-focused practice in schools, workshop offerings on the topic and other related topics (drjohnmurphy.com).

 

 

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Solution-Focused Counseling in Schools is available from the American Counseling Association bookstore at counseling.org/publications/bookstore or by calling 800-422-2648 x 222

 

For more insights from Murphy, see these downloadable VISTAS articles from ACA:

Solution-Focused Counseling in Schools

Building School Solutions From Students Natural Resources

Student-Driven Interviewing Practical Strategies for Involving Students in School Solutions

 

Also, see ACA’s podcast with Murphy on solution-focused school counseling: bit.ly/1OSO26v

 

 

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About the author

John J. Murphy is a licensed psychologist and professor of psychology and counseling at the University of Central Arkansas. Previously, he was a public school teacher and school psychologist.

 

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Bethany Bray is a staff writer for Counseling Today. Contact her at bbray@counseling.org

 

Follow Counseling Today on Twitter @ACA_CTonline and on Facebook: facebook.com/CounselingToday

 

 

The solution-focused taxi

By Fredrike Bannink and John McCarthy May 16, 2014

taxi

“Taxi! Taxi!”

Nearly everyone has experienced taking a cab ride. The idea of hailing a taxi, asking the driver to go to a particular destination and paying the fare is something to which many people can easily relate. The metaphor of such a journey translates to solution-focused counseling, and this article offers five ideas that can be used to conceptualize counseling from this perspective.

 

1) Deciding to take a taxi: A person’s decision to seek counseling (that is, to become a client) precedes the hailing of the taxi.  According to MentalHealth.gov, fewer than four in 10 adults with a diagnosable mental health challenge obtain professional services. For children and teens, that figure is less than 20 percent.

Numerous obstacles can deter the decision. William Miller and Stephen Rollnick’s motivational interviewing approach highlights the notion of ambivalence in taking steps toward change. Meanwhile, a qualitative study published in 2012 by Amelia Gulliver, Kathleen Griffiths and Helen Christensen found stigma to be the most significant barrier to seeking mental health assistance among youth who were elite athletes. Seeking solutions, relief or something positive is the hope in standing curbside with hand raised and asking for help.

 

2) Finding the right taxi: The next step is finding an available cab, which can be a difficult endeavor in a busy city. Assuming that a cab stops, what is the first thing that prospective customers do upon entering a taxi? Fundamentally, customers seek safety and assess whether the cab can take them to their destination successfully. Secondarily, customers might evaluate the cab’s cleanliness, scent or the space provided for them. Some observers may even notice the design of the cab. As someone once commented in one of my (Fredrike Bannink’s) workshops, the front windshield is larger than the rear one, signifying that it is preferable to focus forward (that is, on the future) rather than backward (in the past). I (John McCarthy) once waited 15 minutes in a downpour for a cab, only to reject it because of its odor. (The driver proceeded to growl at me.) If the cab is not acceptable, people may exit it as quickly as they entered.

Consider the array of taxis to choose from: rickshaws, compact cars, sedans, luxury vehicles. In a similar way, prospective clients search for counselors (representing the modality of movement in the therapeutic journey) with whom they can collaborate. Whether implicitly or explicitly, they wonder about the safety that accompanies trust: “Can I have faith in this counselor related to confidentiality and competence?” In other words, does this counselor have a valid “driver’s license”? If the fit is not correct, the client may terminate counseling as quickly as that prospective customer exited the taxi.

In essence, the solution-focused counselor (cabdriver) has five goals to meet via asking the right questions — helping the client (customer) get to his or her desired destination in a) the safest, b) most pleasant, c) most direct and d) least expensive manner in e) the shortest possible time.

 

3) Determining the destination: “Where would you like to go?” the cabdriver asks. This query represents the goal-formulation element, set at the beginning of the therapeutic journey, that is critical in solution-focused counseling. Describing the destination — the positive end result — dictates the direction of the solution-focused taxi. The passengers (clients) set the destination because they have the resources to determine the site, while the driver (counselor) brings competency to the process through his or her knowledge of the city and how to take passengers to their destinations in the best possible way.

We live in worlds that our questions create. The questions we ask determine what we find, and what we find determines our behavior as counselors. Asking questions is an important technique in solution-focused counseling. Solution-focused counselors are not knowing — they ask questions to elicit the clients’ expertise instead of giving advice — and they lead from one step behind.

If the passenger said, “I don’t know where I want to go,” the cabdriver might be baffled, sitting in the driver’s seat and wondering how to proceed. The driver could simply drive, hoping to get the passenger to the desired destination in some haphazard way, but the odds of that are quite slim. The likely result would be a dissatisfied customer. If the passenger said: “I don’t want to go to the airport,” the cabdriver would ask, “So where DO you want to go?” Nondestinations are of limited benefit to cabdrivers and their customers because they merely indicate the places where the ending point isn’t.

In reality, however, clients may not yet know their goal upon coming to counseling. In their mind, something needs to be changed, but what that something is may be unknown. They know only one thing: what they want to get away from. An overly eager counselor may respond, “I understand that you don’t know where you want to go yet. Let’s get started anyway.” But where and how to proceed? If the client relates, “I just don’t want to be depressed anymore,” the starting point is a negative goal. As Steve de Shazer indicated in 1991, the idea of stating negative goals is one way to ensure therapeutic failure.

Rather, the cabdriver could ask, “What do you know about your destination?” Elements of what the destination is like can be helpful in finding the direction. I (Fredrike Bannink) once heard the story of a passenger in Asia who got in the taxi at the airport but didn’t know the name of the hotel where he had a reservation. Yet because he knew the vicinity — a conference center somewhere near the city — the driver was able to look up the hotels in that area and began naming them aloud. Eventually, the customer exclaimed, “Yes, that’s the one!” The idea of linking the preferred future — the destination of the client — to the current location is instrumental in solution-focused counseling.

The idea of having or inviting other people in the taxi with the main passenger is an intriguing notion. Perhaps they are in the front seat, the back seat or even metaphorically squeezed into the glove compartment. These fellow passengers may represent the main passenger’s (client’s) support system, which could include family members, partners, friends and key advocates at school or work. While they do not tell the main passenger where to proceed, they are along for the counseling ride in a helpful, encouraging manner.

Perhaps passengers truly have no inkling of where they want to go, but it is conceivable that someone else does. The cabdriver may ask, “Who or what do you think can help you?” If this is not helpful, the cabdriver may come up with suggestions that have helped other passengers in the past: “Hey, I have an idea,” the cabdriver may say. “Why don’t you look at the contacts in your cell phone, perhaps under ‘favorites’? Maybe one of them would know the direction.”

Sometimes another person wants to determine or even does determine what the destination should be. Solution-focused counseling conceptualizes the alliance as a customer relationship, a complainant relationship or a visitor relationship. In a customer relationship, clients see themselves as part of the problem and/or the solutions and are motivated to change. In a complainant relationship, clients acknowledge a problem and suffer from it but do not see themselves as part of that problem and/or the solutions. They may think someone or something else should change. In a visitor relationship, clients are mandated and may view themselves as problem-free. From their perspective, it is others who have the problem regarding them or who falsely perceive them as the problem.

Clients in a visitor or complainant relationship could well get some guidance from another significant figure in their life regarding what change in behavior is desired or necessary. The eighth-grade student referred to the school counselor may give a curt, “I have no clue why I’m here,” but the English teacher might. In a similar way, the adult in a drug rehabilitation program may express astonishment at being sent to counseling, but the probation officer may have a clear notion of why that happened. Meanwhile, clients in couples therapy may want the other person to change.

 

4) Making progress: How will the cabdriver and passenger know whether they are driving in the right direction? Charles Snyder’s hope theory states that hope is like a journey: a destination (goal), a road map (pathway thinking) and a means of transport (agency thinking) are needed. Research on the subject of hope has shown that it is important to have a goal and ways to reach that goal. Solution-focused counseling encourages clients to develop a detailed vision of what their lives might be like when their problems are over and to make a “mental road map” of how to get there. The emphasis is on inviting clients to create the vision by drawing on their own frames of reference by listening for openings in sometimes problem-focused conversations. This fosters hope and motivation in clients and promotes self-determination.

Another way of knowing that the cabdriver and passenger are making progress is to evaluate the process and invite the passenger to give feedback from time to time. Is the client progressing toward his or her preferred future? If not, what should be done differently? Solution-focused counseling is based on two assumptions: If something works (better), do more of it; and if something is not working, do something else.

Still, bumps in the road may be encountered. “Uh oh,” the cabdriver says to the passenger after the destination is determined and they are under way. “There’s some construction that I didn’t anticipate.” With that, another possibly less desired route must be taken. In Gerald Sklare’s 2004 book Brief Counseling That Works, he discusses the idea of “flagging the minefield,” a process that examines possible obstacles to the goal of success in solution-focused counseling. In the taxi metaphor, bumps in the road and construction may necessitate taking another road. That doesn’t mean, however, that the destination won’t be reached. It will simply be found in another way. As the saying goes, “All roads lead to Rome.”

 

5) Ending the ride: It is the passenger who determines the end of the cab ride. De Shazer stated in 1991 that if counselors accept the clients’ problem statements at the beginning of treatment, by the same logic they should also accept clients’ declarations of successful improvement as a reason to end the treatment. Clients’ destinations — and thus the end of the ride — come into view if, during the sessions, the client and counselor have been attentive to:

  • The occurrence of exceptions and the presence of parts of the client’s preferred future that indicate the desired changes are taking place
  • The client’s vision and description of a new life
  • The confirmation that change is taking place and that the client’s new life has, in fact, begun

 

Conclusion

The metaphor of the solution-focused taxi offers a constructive vision of what solution-focused counseling can look like. Deciding to take a taxi, finding the right one, determining the destination, making progress and ending the ride are all parts of the metaphor that make it easy to utilize. This metaphor may serve to change the focus of counseling and how counselors work in helping people to change.

 

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Fredrike Bannink, a clinical psychologist and master of dispute resolution, is an international author, speaker and trainer in Amsterdam who specializes in solution-focused counseling, positive psychology and cognitive behavior therapy. Visit her website at fredrikebannink.com.

 

John McCarthy is a professor in the Department of Counseling at Indiana University of Pennsylvania. Contact him at john.mccarthy@iup.edu.