When I first came across SFBT in 1987 I remember my strangely mixed response. I was fascinated, intrigued and enthused and yet at the same time I was sceptical. Why would such an approach that ignored, indeed seemed to go against every idea that I had about therapy, how it worked and what was important, that broke almost all the rules that I had been trained to assume were necessary in the change process, work? How could it work? And if it did work was I going to have to re-write all my assumptions about therapy and how to do it? And what about all that time and energy and effort and money that I had invested in learning to be a ‘problem-focused’ therapist? Was all of that wasted? And can lasting change really happen in such a small number of sessions? What about all the damage that people have experienced in their development, in their growing up? What about 'serious' problems, trauma, abuse, long-standing mental health difficulties – surely these need to be addressed directly? And what about the bereaved, will they really want to engage in 'solution talk'. Surely they will want to spend time talking about their loss and their pain before they move on. The reasons for scepticism are endless and it is all too easy for us, the proponents of SF, to turn that scepticism into hostility. So what can we do that might be useful, that might work in environments that are at best indifferent, at worst hostile and dismissive.
1. Remember that scepticism is a perfectly normal and expectable response to coming across SF for the first time. Many of us will have experienced the same. Only clear evidence of efficacy finally put my last lingering concerns and doubts to rest – why should our colleagues be any different?
2. Remember that SFBT is only one of the approaches that works. Other approaches work too! That may be a surprise to us but has to be recognised, accepted and acknowledged. Since one of the factors in good outcome is 'worker affiliation to model' it is terribly unlikely that SFBT would be the best model for every worker to use. So from that point of view it is 'right' that colleagues use other models.
3. Remember that SFBT does not work with 100% of clients – it is not the new 'miracle cure'. It would therefore reduce the effectiveness of the service that we offer if we only had one way of working with people.
4. Restrain your own enthusiasm for the approach; avoid the temptation to evangelise. When we are perceived as trying to convert others to our way of working we are by implication stating 'my approach is better than your approach'. Inevitably, and accurately, our colleagues will experience that as critical of them and very possibly patronising, suggesting that we think that we know better than them. This stance can only alienate potential allies and supporters.
5. Always do what your role requires. Fill in the forms correctly, do the risk assessments that are required. When Chris Iveson, Harvey Ratner and I started using SFBT in a Health Service Mental Health Clinic in London in 1987 we were required to fill out a diagnostic assessment at the end of the first session. We found that mostly we could do this on the basis of a SF first meeting but if we could not we might need to ask a few additional questions at the end of the session. Other colleagues have been required to complete a mental state examination before asking the 'best hopes' question, whilst another was required to carry out a risk assessment at the beginning of every meeting, prior to either asking about 'best hopes' or 'what's been better'. If, at a time when we are using an untrusted approach, we also fail to carry out our employer's requirements, we risk increasing the hostility to the model and indeed putting our own jobs at risk.
6. Treat colleagues as well as we treat our clients. Look for the best in them. Look for what they are doing that is working. Be curious about new departures and developments in their work even if this is not the way that we would choose to work. Assume good will on their parts – people choose to work in the way that they do for their own good reasons, just as we do. We can use SF in supervision of colleagues using other models perfectly effectively. We can also use it, in a similar way, in informal interactions with our colleagues. When we do this our colleagues might begin to experience a little of the quality of interest and validation that our clients, hopefully, experience.
7. Consider whether you would be prepared to 'fit in' with the language of the clinic. Would you be prepared to fill in the 'goals' section of the assessment form, rather than crossing-out 'goals' and writing 'best hopes'. What about the 'presenting problem' section? We could tempt fate by striking this out and writing 'in SFBT we are not interested in problems' or we could just fill this in finding the answers in the unstated side of the 'best hopes'. Action plans – well of course we don't think in these terms but what about filling in here a simple observation suggestion ' between this session and the next the client is going to research what is likely to be useful in improving the relationship with her daughter'.
8. Stay confident in your talking about SFBT. Get familiar with the research. SFBT is one of the approaches that clearly works. Develop your way of describing your approach and of answering colleagues' questions. Acknowledge that the approach is surprising and in many ways different and that the most interesting thing is that it works. Assuming that colleagues accept the research findings, research similar to the research that they rely on to justify their own approaches, how might colleagues explain that it works.
9. Reading, training, on-line lists. If you are isolated in your clinic it will be hard for you to have the conversations about your work that feed the development of your practice and sustain it and keep it alive. You will probably have to replace this by actively seeking our activities that will replace this 'life-support' process for your therapeutic approach.
10. Get some support. If you are isolated, working in a problem-focused and problem-dominated clinic it is very hard to keep you own SF practice going and developing. You need to find a SF friends- either a colleague in your own clinic who might be open to discussing and exploring these ideas, or a support group locally or someone online. Finding the support is often the difference between keeping our practice alive or finding it withering away in the face of problem-focused dominance.
I am always optimistic that colleagues can come to see the value in SF, even if they, like us at times, find it puzzling and the first part of this response is based on that belief that we can behave in a way that will either enhance the likelihood of others becoming open to and interested in what we are doing, or we can behave in a way that will reduce the chances of our colleagues coming to support our practice. In the end what convinces people is seeing clients change and seeing clients maintain those changes.
Evan George
London
April 2018
Bill O'Hanlon is a long-standing friend of the BRIEF team. His many books and his wonderful presentations have inspired a generation of therapists and counsellors. Find out more about Bill and his work at http://billohanlon.com/
