When determining the intervention that would be used, many questions needed to be answer. Is the approach appropriate for addressing the problem? Is the approach relevant and appropriate to Selena? Many interventions were reviewed and studied. The invention that I felt would work best with Selena would be solution-focused therapy. Solution-focused therapy emerged in the last 20 years as a strategy for working with adults, families, and minors and has been successful.
Hepworth et al. (2013) stated “this approach emphasizes the identification of solution, rather than resolving problems” (p. 421). Hepworth et al. (2013) also stated that “the goal of this approach is to release their unconscious resources; thereby shifting from a problem-oriented perspective to one that is more solutionbased” (p. 421). According to Trepper et al. 2006), Although there has not been a plethora of well-controlled, clinical trial studies of the effectiveness of solution-focused therapy, those that have been done, along with smaller clinically-based and quasiexperimental studies, suggest that SFT: (a) is more effective than no treatment; (b) is at least as effective as current psycho-social treatment; (C) in some cases and/or for some problems may be more effective than problem-focused treatment and (d) in most cases, shows significantly fewer sessions to achieve similar outcomes (p. 136).
After discussing SET with Selena and her grandmother, it was decided that the SFT intervention would be used in the case. Solution-Focus Therapy (SFT) is an appropriate therapy to use when working with children and family. SFT is a family systems approach in which the family is looked at as whole rather than individual units. Solution-focused techniques are organized around two fundamental strategies which are to develop a well-focused goal and generate a solution (Nichols, 2014). Therapists who use solution-focused therapy choose interventions from behavioral and cognitive treatments.
Many of the techniques used are goal setting, scaling, identifying, miracle question, and solution talk. Hepworth et al. (2013) states “The solution-focused therapy approach involves practical procedures and techniques that can be readily learned and applied in many practice situations” (p. 437). Nichols (2014) states “Solution-focused therapists assume that people are resilient and resourceful” (p. 227). Solution focused therapy is one approach one could use when working with Selena and her family.
This intervention was most beneficial as this approach allows Selena to emphasize on the identification of solution. rather than resolving problems. It also allows Selena to emphasize on her own strengths and attributes which also promotes a positive image of herself and her capacities (Hepworth & Rooney, 2013). The solution focused approach brings about empowerment and positive change within oneself. The intervention also asserts that Selena has the right to determine her desired outcome which encourages long lasting change. It gives Selena a since of control over her own life.
With solution focused therapy, the principle of the intervention is that the client is the expert of their life and the therapist takes the stance of curiosity and uses questions and responses (Nichols, 2014). There is, however, substantial evidence of the effectiveness of the approach in practice settings and with different populations (Hepworth & Rooney, 2013). There is evidence in the effectiveness of SFT with minors. Solutionfocused therapy starts with completing a thorough assessment. During the assessment phase, it was important for Selena to explain what would be different in her life if her problems were solved.
Selena in her own words explained that her life would be problem free if she did not get in trouble all the time. Selena continued to explain that she gets in trouble because of her grades in school or her behaviors at home. Selena feels that her grandparents and teachers are always mad at her. Before we could continue with developing goals, it was important to assess Selena’s motivation for change (Nichols, 2014). Selena’s motivation for change had to be “distinguished among visitor, complainants, and customers” (Nichols, 2014, p. 29) which are distinctions that de Shazer uses to assess motivation. It was determined that Selena was a customer because she had clear complaints and was ready to take action. That was determined because Selena requested help and she is open to discussing her problems. Once Selena’s motivation was determined, it was then time to proceed to the next step of goal setting (Nichols, 2014).
Selena stated that she did not want to get in trouble all the time. The question was asked, “What specifically will you do to not be in trouble all the time? Selena stated that she would complete her homework assignments in order to improve her grades at school. She continued to explain that she would try not to her push her sister, yell, or slam doors when she is angry. Selena gave examples of times when she has been in trouble at home and times when she solved her own problems. During the interview, the technique of identifying exceptions was used which allows clients to think of times when their problems was absent or less bad than the current situation. Another technique used was solution talk.
This technique is used to convey to the client a sense of hope, sense of control, and openness to possibilities by using tools such as open ended questions, use wording to suggest problems are temporary, focus on coping behaviors, and offering a different perspective (Trepper, 2006). At this point, the miracle question was asked. Miracle questions that therapist ask to clients help clients visualize and hypothesize what their problem would be like if it were all of sudden solved (Trepper, 2006).
Selena was asked, “What if tomorrow, you woke up and you were not in trouble at home, what would be different? Selena stated that she would be happy because no one in the home would be mad at her. She continued to explain that all the things that she would not have done in which others would not be mad. At this point, Selena developed her own goal. The session ended with a developed goal. Selena was encouraged to return the following week to discuss the progress on her goal. The next week, Selena returned to discuss the progress of her goal. Selena reported that she had several good days. Selena stated that she had gotten in trouble for slamming her door.
Selena was encouraged to continue to do the things that she had done on her good days. Selena did feel that she was making progress and reported that she felt good on the days that she had not been trouble. The social worker complimented Selena on her behaviors and encouraged her to continue. It was also explained to Selena that this would be our last session as the program was coming to an end. Selena’s grandmother was provided with a resource list that included contact information for counseling services in case additional services were needed after Camp Brave was over.
One critique that I would have to mention is that the scaling question was not used. Using scaling questions would have let Selena identify the changes in her depression. A strength that I would have to mention is the use of the miracle question which allowed for Selena to formulate a goal. Allowing Selena to create her own goal gave her a sense of empowerment and control over her own life. Selena outcomes could have improved if she had the opportunity to attend at least one more session.
