How To Do Deep Therapy - Briefly
How To Do Brief Therapy - Deeply
With the advent of Managed Care and more limited funds for long-term therapy, there has been a growing movement toward more short-term, constructive, solution-based approaches to creating change in psychotherapy, especially in the field of Brief Therapy.
The question most often asked by Experiential clinicians is: Can the Brief models, with their emphasis on brevity and focus on finding solutions, take enough time to explore the affective states, and experiences of the client? Or, said another way: Can lasting change happen – briefly?
The answers (or solution, so to speak) come in the form of a both/and approach, rather than an either/or position. There is choice. There is room in the structure of a therapy session for adapting and integrating Experiential components into Brief Therapy models, and conversely, weaving Brief Solution Focused components into Experiential work. The process of integration is natural, fluid, and in fact, very effectively supports the ever-increasing trend toward a more holistic mind/body approach in psychotherapy.
To illustrate the integration, I've chosen a representative model from each side, Focusing Oriented Therapy from the Experiential approach, and Solution Oriented Therapy from the Brief Therapy approach.
The beauty of the Focusing Oriented model is in its gentleness, respectfulness, and explicit teaching of an attitude toward the Self that is caring, empathic, willing to listen, and most of all values all parts of the Self. Focusing honors the wisdom of the felt-sense and provides a safe and nurturing environment that promotes healing and growth.
The beauty of the Solution Oriented model is in its respectful, positive attitude and non-problem-oriented approach. The model provides a safe structure in which to explore and create new, more constructive possibilities, with consequent alternative behaviors. The skillful use of language allows clients to access, in a time-efficient manner, what they do want, rather than what they don't want.
The integration of the two models allows the client to experience the gentle process of Focusing with a Solution orientation. The purpose of this book, therefore, is to demonstrate how Experiential Therapy and Brief Therapy can work together, harmoniously, and seamlessly, providing clients with an increased sense of awareness of Self, and an enhanced sense-of-hopefulness through finding manageable solutions to seemingly impossible situations.
As is beautifully stated in Ecclesiastes, "To every thing there is a season, and a time...." The clinician will ultimately choose what feels right, and when.
The SOFT (Solution Oriented Focusing Therapy) approach
Some examples of INTEGRATION SPOTS:
If Brief Therapy is the orientation of choice, consider taking a moment to help clients better prepare for the therapy hour. Often they are hurrying in at the last moment, feeling stressed, and not quite in sync with what they are about to do. It is very effective to ask them to:
Take a minute to close their eyes, if they are comfortable doing that. If they are not (or find closing their eyes strange in some way, or too cut off or isolated), simply let them know that just for this moment, it is not necessary to relate to you (the therapist). They are welcome to close their eyes, stare out the window, or gaze into space. The clinician then continues:
Take a few deep breaths....and allow yourself to wind down...and just be here....
Then ask the client to reflect upon any or all of the following:
How am I doing, right now....?
What is important for me today....?
Is there anything in my life that feels like it needs attention, right now....?
How do I want to use the next hour....?
The client has just reflected upon one of the above questions, for instance, How am I doing, right now? and responds with irritation, and in a somewhat explosive manner:
Client: How am I doing? You want to know how I'm doing? I feel like crap...is how I feel!
Therapist (slowly): So is that where we want to start?...All about....feeling like crap?
Client: Yeah, but...there's also a whole issue about my daughter.
Therapist: OK....So there's a lot going on today...Can you just take a moment to see...when you say to yourself, All about...I feel like crap...and All about...the issue with my daughter...where you sense is the right place for us to start today....
Client: OK....I want to talk about my daughter...that's part of why I feel like crap anyway!
This may seem like a small point, but the client is now fully focused and present to the issue. He came in unfocused and vaguely connected to "I feel like crap." He is now tuned-in to "all about my daughter" and ready to go to work on it.
INTEGRATION:Start a Brief Therapy session with an experiential moment to slow down; it will help the client become more present and attentive to the work at hand - and - the session will go better!
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
INTEGRATION spot: Asking Solution Oriented questions using the Focusing Oriented approach to listening.
Experiential listening is at the core of the Focusing Oriented model. The skillful use of asking questions is at the core of the Solution Oriented model. Both models use listening as a way of helping clients feel valued and understood.
The Focusing model has developed the skill of listening into a highly refined art form. The Solution model would be deeply enriched by adding fragments of experiential listening to its approach. The two models can be easily combined.
Therapist: (asks in Solution style): If your wife was here with us, right now... what do you imagine she'd say you could do, that would be helpful to her?
Client: She'd say she wants me to phone her more often.
Therapist: (listens and reflects in Focusing style): So, she says, that your calling her more often would make a real difference to her...
Client (takes a moment to experience what the therapist has said): Yes, it would help her feel more appreciated...
Therapist (listens and reflects in Focusing style): She will feel more appreciated by you...
Client (experiences): Yes...she really would.
Therapist (asks in Solution style): How do you imagine it will be for you...when she's feeling more appreciated?
Client: She'll be so much more understanding about what's going on for me...
Therapist (listens and reflects in Focusing style): You'll feel so much more understood by her...you feel she'll understand so much more about...what a stressful period this is for you....
Client (experiences): Yes... I know she would...and that would be such a relief...to feel that we were really on the same side...
Solution: Concentrates on, What will be different?
Focusing: Concentrates on, What will feel different?
The SOFT approach combines both models.
Bala Jaison, Ph.D. is a psychotherapist for individuals and couples, Director of Focusing for Creative Living in Toronto, and a Certifying Coordinator for the International Focusing Institute. She has developed a unique style of integrating Solution Oriented and Focusing Oriented Therapy, which she currently teaches to therapists both here and abroad. In addition to her private practice, Dr. Jaison works in the business community and the school system, translating this work into programs on Conflict Resolution, Problem Solving, and The Peacemaker's program for children. She is the co-creator of the International Focusing Weeklong and also the co-editor of the Folio, the academic journal for the International Focusing Institute.
More praise for Integrating Experiential and Brief Therapy.......
"I love this book! It is brilliant in its simplicity, clear and accurate, showing exactly where the two approaches meet, differ, and cross."
Dr. Erna de Bruijn, M.D.
"The book is like a breath of fresh air! - readable, concrete, and immediately applicable. It's a terrifically accessible tool – direct, simple, and humorous. It really works. I particularly appreciate how it embodies these two seeming disparate practices, into a workable and powerful whole that makes sense."
Karen Whalen, Ph.D.
York University, Toronto, Ontario.
"Family medicine practice and training have come to rely on brief psychotherapy strategies as a means of accommodating a large volume of patients who are in immediate need. I have come to rely on this timely, clearly written, and very valuable resource in my own practice and in the training of other physicians and residents."
Pauline Pariser M.Asc. M.D. C.C.F.P.
"Your book is fabulous! I've already referred to certain sections for use with particular clients. I especially like the four Interventions to the "Miracle Question". Wanted to mention the Fifth Intervention - Your book is the "Miracle Answer"! How did I ever live without it?"
Carole G. Pentony, Ph.D.,
"Dr. Jaison's book is an invaluable resource when I teach physicians strategies in psychotherapy. It gives a clear and practical approach to the integration of solution-focused strategies with experiential psychotherapy. I recommend that all psychotherapists read this book."
Mel Borins, M.D.
Faculty of Medicine
University of Toronto
This page was last modified on 07 November 2003