Thinking about follow-up sessions takes me back to one of my favourite Steve de Shazer quotes. In Keys (1985) de Shazer writes: ‘Anything that prompts the client to say that ‘things are better’ needs to be identified as verification of change, and anything that is new or different or more effective that the client reports needs to be encouraged or amplified.’ (Italics added)
Of course the key word here is ‘anything’. We are not only interested in only those things that might fit with the client’s description of their best hopes or preferred future in the first session. We are interested in ‘anything’. Where I think this points us is that in SFBT our primary goal in follow-up sessions is to co-construct with the client an experience of change and certainly my working assumption remains that when clients are experiencing change that the experience of change is associated with a greater likelihood of more change. The mechanism for this in de Shazer’s writing is not necessarily spelled out however from the time of his early works de Shazer repeatedly emphasised the importance to him of the idea ‘expectation’. For instance in Keys (1985) he writes ‘what you expect to happen influences what you do; therefore, if you expect something different to happen, then doing something different (to perhaps make it happen) makes sense. Of course, what you specifically want to happen might not, but since you did something different, at least something different will happen, and, therefore you might feel more satisfied’ (p45). It might therefore not be too great a stretch to think that he may have had the idea that when people are noticing changes, however small, that this is one factor which facilitates the development of ‘expectation’.
This idea that our primary process task is to invite our client into an experience of change, which certainly is the basis of my work and thinking, does raise other tricky questions and the main one is what this way of thinking implies in relation to the status of the ‘best hopes’. In SFBT we pay considerable attention to the eliciting of ‘best hopes’ and we take the trouble to spell out in our model a set of criteria for the effective construction of those hopes and we will not begin to move forward in the work until we know ‘what the client wants’ as we often find ourselves saying. Of course this makes complete sense; since SFBT is a non-normative approach how could we know what to ask the client to describe, their preferred future, unless we know what the client wants from us. But the question what are the ‘best hopes’ what is their status in the work, is raised by de Shazer’s use of the word ‘anything’. Are the ‘best hopes’ the outcome that must be delivered, a ‘contract’ with the client, and if they are how does that fit with ‘anything’? As it happens I do not think of the ‘best hopes’ as a ‘contract’ or a ‘commission’, with me as the therapeutic equivalent of a Deliveroo rider. I see the ‘best hopes’ as a starting point for a conversation, you can’t start until they have been specified, but subsequently they can be held lightly, they are not fixed and contractual; indeed the client’s ‘best hopes’ can be fluid and can change, even without me being aware of the change.
Within this way of thinking how can therapy be brief, how can we know when to end? We might remember de Shazer in Clues (1988) writing ‘Without goals, therapists and clients cannot know when the therapy has succeeded or failed’ (p93). So how can we end if we view the ‘best hopes’ as merely a necessary starting point – on your marks, get set, go – the moment when the therapeutic gun is fired – rather than a pre-defined end-point? What maintains the focus without which brevity can only be achieved by chance rather than by design? And I think that the answer here is the scale question. If each time we meet the client, towards the end of the session we ask the scale question and 10 is framed as ‘no need to come back – you are sufficiently on track’, then the work is likely to remain brief! So in this way of working the ‘best hopes’ slip out of sight after the first meeting and what we are working towards is the client’s definition of enough progress to be able to say ‘no more sessions’. As with most things I find myself saying about SFBT we can find an earlier version, a pre-shadowing, in de Shazer’s writings. Again in Clues (1988) he writes ‘The goal is best thought of as some member of the class of ways that the therapist and the client will know that the problem is solved rather than any particular member of that class’ (p93), just one member of the class not the only way of knowing.
de Shazer, Steve (1985) Keys to Solution in Brief Therapy. New York: Norton.
de Shazer, Steve (1988) Clues: Investigating Solutions in Brief Therapy. New York: Norton.
Evan George
London
March 2018
