On Solution Focused Therapy, Narrative Therapy, and Distinctions that Make a Difference [entry-title permalink="0"]

Anne-Marie asked me to put together some thoughts on the cross-connections, similarities, and differences between the solution-focused (SF) and narrative approaches to therapy. First, some history: In the late 80s and early 90s, when I worked at an adolescent treatment centre in Calgary, Alberta, Canada, my colleagues and I were interested in both the SF and narrative approaches. We presented on what we then saw as the similarities and differences, and later published these ideas (Chang & Phillips, 1993). We thought the approaches were similar, but not everyone agreed (de Shazer, 1993).

Please pause for a moment. If you have received training in both approaches, or seen them both demonstrated, reflect on what you saw that you thought was similar. Turn your eyes away from the monitor for a moment, and start reading again when you are ready. You might have thought that practitioners of both approaches regard clients with genuine curiosity about their lives, adopt a non-impositional stance, and ask about when the problem is not as influential. But you may also have noticed some differences. If you have been trained in SF, you might have noticed narrative therapists externalize the problem, discuss larger cultural discourses that support problems, or ask about what therapeutic changes imply about a client’s identity. These procedural differences reflect some important differences in thinking.

Although Steve de Shazer was very oriented toward social justice in his personal life, he did not exercise this commitment in the therapy room. Narrative therapists, on the other hand, believe that the personal, professional, and political ought to converge in all arenas of life, including the therapy room.  Both SF and narrative exemplify a postmodern view of language, in which language is seen as constructing social reality, not representing something “inside” that is already there. However, narrative interviewing often focuses on larger cultural stories (discourses), while SF elicits conversations about the here and now. Disrupting cultural discourses by, as narrative therapists following Foucault would say, fomenting “an insurrection of knowledges” is philosophically much different than engaging in “language games” a SF therapists, following Wittgenstein, think of their work. Over the last twenty years, these distinctions have become more pronounced (Chang, Combs, Dolan, Freedman, Mitchell, & Trepper, 2012, 2013; Chang & Nylund, 2013).

As one who has been practicing since the 80s, a professor, and a “theory geek,” I think these differences are important. I think it is important for my students to be clear about the origin of the ideas that guide their practice. I enjoy digging into the philosophy that stands behind the therapy models we use, and how the ideas of various psychotherapy models evolved (Chang et al., 2012, 2013). After all, our theories and models of therapy are the tools of our trade, and we should know them well. However, not everyone places the same importance on the provenance of ideas. So, although there are many distinctions between narrative and SF, are these distinctions that make a difference? It depends on your purpose.

In North America in the past 20 years, narrative and solution-focused therapies have become a regular part of curriculum to train counsellors and therapists. North American counselling textbooks tend to aggregate them together as “postmodern” approaches. These approaches seem to be part of a trend in the field – focusing more on client resources, and away from pathology.  Narrative and SF are sometimes lumped in with a variety of approaches that are gaining exposure and popularity. The mental health Recovery Model is an outgrowth of the recovery movement, a grassroots emphasis on placing control of care in the hands of mental health consumers (Jacobson & Greenley, 2001). The strengths perspective is now popular in North American social work education (Saleebey, 2003). It is founded on: fostering hope based on historical successes; harnessing clients’ resources; reducing stigmatizing language; and flattening the hierarchy between the client and therapist. Resilience literature describes factors that protect, or at least mitigate, the effects of adverse influences on individuals and families (Walsh, 1996). Positive Psychology is “is the scientific study of well-being, of what allows individuals and communities live fully” (Tarragona, 2010). These approaches emerge from different intellectual traditions, but can accommodate therapeutic practices from solution-focused and narrative therapies. I had the privilege of attending a conference in Norway last month, Beyond the Therapeutic State, sponsored by the Taos Institute.  The conference focused on alternate, nonpathologizing forms of care and intervention that respect clients’ knowledge and strengths. This trend of focusing on adaptive behaviors and strengths is heartening. On the other hand, both White and de Shazer disavowed the idea that they are looking for strengths that reside within an individual, because logically, this would also require us to locate deficits within individuals (Bannink, 2010; Chang et al., 2013; also see Elliott Connie’s blog at http://elliottspeaks.com/blog/).

For some of you, it is important to dive deep into the intellectual traditions that support your theoretical models of practice. Others might be attracted by the emphasis on strengths and solutions, and apply techniques from a variety of resource-driven approaches, without a great deal of concern about where the ideas come from. While I think there are many differences between SF and narrative therapy, many of you will combine these, and other resource-based approaches, into a pragmatic blend that is collaborative. Most importantly, your approach must  fit for you (Chang, 2011). Hopefully, you will adopt a solution-focused presence (Chang, 2013) without having to use all the techniques. A “pure” approach, SF or narrative, is neither desirable nor practical for most practitioners.

For some, being theoretically pure is useful. If you are a novice counsellor, this may be the best way for you to learn the theory and procedure of a particular model of therapy, as long as you see your chosen model as pragmatically useful, rather than exclusively true (Amundson, 1996). Furthermore, the field needs some innovators and practitioners to position themselves as purists to pilot new therapeutic practices and test the limits of their models. Our friend Harry Korman, who has previously written in this blog, state that this is his purpose. People like Harry may be a bit like computer programmers who know all the complexities of the program they wrote, while the rest of us simply use the software.

So do the distinctions between SF and narrative constitute differences that make a difference? That is up to you.

References

Amundson, J. (1996). Why pragmatics is probably enough for now. Family Process, 35(4), 473-786.

Bannink, F. (2010, November).  How are solution focus and positive psychology linked?Presentation at the meeting of the Solution-Focused Brief Therapy Association, Banff, AB.

Chang, J. (2011). An interpretative account of counsellor development. Canadian Journal of Counselling and Psychotherapy, 45(4), 406–428.

Chang, J. (2013). On being solution-focused in adversarial places: Supervising parenting evaluations for family court. In F. N. Thomas, Solution-focused supervision: A resource-oriented approach to developing clinical expertise (pp. 187-196). New York: Springer Science and Business.

Chang, J., Combs, G., Dolan, Y., Freedman, J., Mitchell, T., & Trepper, T. (2013). From  Ericksonian roots to postmodern futures. Part II: Shaping the future. Journal of Systemic Therapies, 32(2), 35–45.

Chang, J., Combs, G., Dolan, Y., Freedman, J., Mitchell, T., & Trepper, T. (2012). From  Ericksonian roots to postmodern futures. Part I: Finding postmodernism. Journal of Systemic Therapies, 31(4), 63–76. doi: 10.1521/jsyt.2012.31.4.63.

Chang. J., & Nylund, D. K. (2013). Narrative and solution-focused therapies: A twenty-year retrospective. Journal of Systemic Therapies, 32(2), 72–88.

Chang, J., & Phillips, M. (1993). Michael White and Steve de Shazer: New directions in family therapy. In S. G. Gilligan & R. Price (Eds.), Therapeutic conversations. New York: Norton.

de Shazer, S. (1993). White and de Shazer: Vive la difference. In S. G. Gilligan & R. Price (Eds.), Therapeutic conversations. New York: Norton.

Jacobson, N., & Greenley, D. (2001). What is recovery? A conceptual model and explication. Psychiatric Services, 52, 482–485.

Tarragona, M. (2010, April). Positive psychology and social constructionist practices: Strange bedfellows or dynamic duo? Presentation at Collaborative and Dialogic Practices in Therapy and Social Change Conference, Cancun, Mexico.

Saleebey, D. (2003). Strengths-based practice. In R. A. English (Ed.), Encyclopedia of social work (19th ed.) (pp. 150-162). Washington, DC: NASW Press.

Walsh, F. (1996). The concept of family resilience: Crisis and challenge. Family Process, 35(3), 261–281. doi: 10.1111/j.1545-5300.1996.00261.x


 

Jeff Chang, Ph.D. (http://familypsychologycentre.webs.com/jeff), lives and works in Calgary, Alberta, Canada. He is the Director of The Family Psychology Centre, and Associate Professor of Counselling at Athabasca University. He publishes and presents on SF and narrative approaches, children’s mental health, school-based services, high conflict divorce interventions, and clinical supervision. He is the editor of Creative Interventions with Children: A Transtheoretical Approach and coauthor (with Philip Barker) of Basic Family Therapy (6th ed.).

This post is adapted from:

Chang, J. (2012). Integrating approaches: Purposes, principles, and possibilities. RATKES: Journal of the Finnish Association for Solution- and Resource-Oriented Methods, 4(4), 29-33.

Chang. J., & Nylund, D. K. (2013). Narrative and solution-focused therapies: A twenty-year retrospective. Journal of Systemic Therapies, 32(2), 72–88.