寻解法Solution_focussed_therapy

寻解面谈的背景及发展

- Steve de Shazer 及 其妻子 Insoo Kim Berg 等人于七十年代后期创立 ―短期定庭中心‖

- 八十年代末期引入香港

- 1992年理工大学把这模式引进社会工作深造文凭和硕士课程中

- 广泛应用于家庭服务、外展、学校社会工作、小区发展、青少年综合服务及精神病患者康复服务等。

寻解面谈的主要特

Koss and Butcher (1986)，Bloom (1992，1997)

1. 有限的时间

2. 有限的、明确的、合理可行的辅导目标

3. 谨密的合作关系

4. 迅速的介入

5. 鼓励案主表达感受

6. 维持清晰的面谈焦点

寻解面谈的基本假设及辅导模式

1. 相信案主有足够能力和资源去解决自己的困难，而不把案主看成一个有问题和有缺憾的人 → 不断发掘案主的潜能。

2. 不执着于问题的定性和成因，问题的诊断和评估。

3. 以现在及将来为焦点，与案主谋求一个可行的目标或方向。

4. 从案主的强处及成功经验出发，增加案主应变及解决问题的能力。

5. 通过工作员与案主的 ―谈话过程‖，对问题重新建构解决问题的方案。

6. 提供足够空间，让案主表达对 (负面) 行为及事件的理解和感受，并关心及引导他们期望的转变。

三个基本立场

1. 非理论性 (atheoretical)

2. 非规范性 (non-normative)

3. 以案主为中心及主导 (client-determined)

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三条黄金定律

1. 如无破损，且由得他 (If it ain‘t broken，don‘t fix it.)

- 工作员不应以自己的标准和意愿，将问题强加于案主，要视乎案主的观感，以有没有案主的邀请为准，决定应否介入。

2. 如见成效，继续尝试 (If it works，do more of it.)

- 留意案主成功的经验，鼓励他/她继续尝试，推动其积极及有效的行为，加强案主改变的决心。

3. 努力无效，另寻他法 (If it doesn‘t work，do something different.)

- 当以往的方法无效时，要作出反省及检讨，改以其它方法解决问题。

五组问句

1. 询问面谈前的转变 (Pre-session Change Question)

- 研究指出，约三分二的案主回答说事情有某些改善时，工作员可跟进及鼓励案主作更详细的描述，从中可出不少解决问题的线索。

2. 询问例外情境 (Exception-finding Question)

- 例：「什么时候你的儿子会主动做好功课？」

3. 奇迹问句 (Miracle Question)

- 以假设性问句，引领案主至将来问题已解决的时刻，描述当下的情境或自己的行为表现会是怎样的 (VAK)。

- 例：「假如有一个奇迹，帮你解决了跟 老师 / 女儿 / 丈夫 关系上的问题，你想象你和 xx 的相处会怎样的呢？」

4. 刻度问句 (Scaling Question)

- 例：「你现时课堂的表现 / 夫妻关系 / 亲子关系，可用甚么数字来描述？」(1- 10分，以十分为最高)」

5. 应付问句 (Coping Question)

- 当案主诉说前途一片灰黯，自己一事无成，感到极大挫折时，工作员相信案主仍能努力坚持至今，总有办法应付问题，或防止问题继续恶化，这组问句其实也可激发案主跳出「专向负面向」的习惯，尝试用正面的句子去带动积极想法。

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寻解面谈之应用

例：我丈夫永远不会帮忙做家务!

这段婚姻真失败，都是我不懂得博取丈夫的欢心!

儿子太顽劣了，全是因为我教导无方!

过去我所做的一切都是白费的，我真是一无是处!

回应：

基本辅导技巧

- 听你的描述，感觉到你丈夫及儿子的表现令到你很不舒服，甚至可能有些沮丧，不知应怎样面对….. (初层次同理心反应)

- 我看到你已付出最大的努力，但是事情的发展并不能完全由你控制，到目前为止，你还未看到你过往所作出种种努力的成果…(初层次同理心反应)

- 我相信你在婚姻及管教上，一定有些不愉快的经验，可否说多一点？(鼓励表达)

- 很多妻子或母亲，遇到婚姻困难，儿子顽劣，都会怀疑自己是否一个好妻子、好妈妈。(外化、普遍化)

- 你好希望丈夫能分担你一点家务，儿子「听听话话」…. (高层次同理心反应)

寻解面谈辅导技巧

- 目前来说….你最想得到改善的是什么？(目标导向)

- 如果你对目前的困难给一个分数，由一至十，一分最低，十分最高，你会给多少分？(刻度问句)

- 如果困难改善了，情况会是怎么样的？(奇迹问句)

- 有没有一些情况 (在什么情况下？)，丈夫及儿子的表现令你表现满意？是什么表现？ (例外情境问句？)

- 你做了什么他们会有这样好的表现？(应付问句)

回应练习

1. 案主：我的儿子不能停下来，太活跃，无法控制自己，没有方法令他安静下来，我很担心，怀疑他心理不正常！

工作员：____________________________________________________________

(请试用基本辅导技巧响应)

2. 案主：我和妻子经常为小事吵架，并且一发不可收拾！

工作员：____________________________________________________________

(请试用基本辅导技巧响应)

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3. 案主：我希望改善和儿子的沟通。

工作员 (请试用基本辅导技巧响应)：

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

4. 案主：我希望丈夫待我好一点。

工作员 (请试用基本辅导技巧响应)：

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

5. 一位家长怒气冲冲向你说：「我个仔小学初小时成绩都不错，升上了四年级后，成绩日渐退步，每天都要做大量功课，做来做去都做不完，他说很多都不懂，我又不懂教他; 近来更无心做作业、温习。你们学校究竟为什么要给学生这么多功课，上堂怎样教书的，为什么他无心向学?」

请试以综合技巧与这位家长进行一次简短面谈：

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

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寻解面谈法应用 ─ 个案例子

内容

背境

不笨是四年级的学生，他的爸爸眼见儿子的学业成绩差了，功课较以前艰深，每天做功课至深夜，自己又不懂怎样教他，故此向老师投诉学校功课多，并使他孩子无心向学。

分析

这是爸爸他本人的问题，他有责任去处理之，不能把责任假手于人。

在处理其情绪上，老师可作一个积极的聆听者。在解决问题上，老师可探索有没有一些案主个人的内在资源及小区上的外在资源可运用，以协助其解决问题。

家长持有很多「非理性」的想法 (自己未必尽过力帮助孩子，却抱怨学校「教不好学生」。

面谈过程

家长：(怒气冲冲) 我个仔不笨读初小时成绩不错，升上四年级后，成绩日渐退步，每天都要做大量功课，做来做去做不完，他说很多都不识做，我又唔识教他；近来佢更无心做作业，温习。 你们学校究竟为什么要给学生这么多功课，你们上堂是怎样教书的？弄得佢无心向学？

教师：见到个仔成绩差了，功课跟不上，[高层次同理心] (教师的响应是处理案你好忧心，不知所措，想出问题主的问题而非他的「非理性」想法。

在来帮助他，是吗?

家长：梗系啦，如果唔系都唔驶来你

啦!

佢以前做功课都系9:00前做哂，而家无 12:00 都做唔哂，功课深咗，我又唔识教佢，晚晚搞到佢见到功课就喊，你教我点做！

教师：听你咁讲，不笨以前都好乖，而家做功课情况没以前咁理想，要12点后才做完。但系自升上四年级后佢系咪每次都要做成12点钟，有没有试过边日唔驶做到咁夜?

家长：唔…有一次咁多。

教师：你做了什么令佢有好的表现?

[简述语意]技巧

[询问例外情境]技巧

[应付问句]技巧

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家长：嗰次我用海马公园 ‗大佢‘，话如果

佢唔系10:00前做哂功课，第二日就无得去海马公园，佢咪做得哂啰！

教师：照你咁讲，不笨其实都有能力，也对学生的能力及家长的方法作出肯定

试过早做完功课，只要你给他有足够的外在刺激，吸引佢。

家长：但系我唔可以餐餐带佢去海马公园呢！ 我又要搵食，自己又无读过书。晚晚陪佢做功课做到深夜，没街去，又无得睇波… 但仲系搞唔掂佢晚晚喊，我又忍唔住闹佢，迫佢收声，做功课，搞到我两父子的关系越来越差，我都唔知点算，我真系唔识做老豆！

自贬句子，减低自己的不安。

负面地描述问题

表现无能句子

较正面的家长可能会以正面的想法和语言代替之，积极去寻一些与他处境、能力相约，但能有效地处理孩子学习问题的家长之想法和做法。

[外化—普遍化] 技巧

[欣赏、鼓励] 技巧

教师：其实不少家长在孩子读升上四年级时见到孩子做功课的时间长了、表现差了都会很担心。

我见到你都好锡个仔，好关心佢，你已付出很大的努力，只系事情的发展并不能完全由你控制，也暂时看不到自已努力的成果。

家长：唉…….

老师：其实，情况未必如你所想的咁差，【刻度问句】技巧

如果你就不笨的学业困难给予一个

分数，一至十，一情况最差，十情况好，你会给他什么分数？

家长：唔…四分左右。

老师：假如不笨的学业情况得到改善，情【奇迹问句】

况会是怎样的?

家长：佢能够自己应付功课，不用每晚做

到深夜; 佢上堂会留心，不用回家后茫无头绪，每事问。

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老师：其实，老师都好想见到不笨的学业情况有这样的改善。我也相信不笨有能力读书，只是未能好好发挥。才先生，你有没有想过为不笨定立一个奖励计划，刺激一下佢的上进心，好似你上次令佢在 10:00前做完功课?

家长：即系点呀?

【从案主成功经验出发，以现在及将来为焦点，与案主谋求一个可行的方案】

老师；或者，你可以与不笨共同定立一个【如家长同意，计划也见成效，则继作适的时间表，要他每日在指定的续尝试；如努力无效，另寻他法。】

时间 (如 10:30) 前完成功课。若佢

可以做到，你便给他一个积点，集齐一定数量的积点，便可给他选择进行一项他喜爱的活动。而老师在学校亦多留意他的表现，见到他积极学习，留心上课，便在他的手册上记录，你看到亦可给他一个积点，以示奖励。我们可试行奖励计划两星期，看看不笨的情况，再修订。希望在家长与老师合作下，可以帮到不笨改善学习情况。才先生，你对这个奖励计划有什么意见吗？

参考书目

1. 《解困之道 寻解面谈应用手册及个案汇编》，杨家正、游达裕等编 (2001)。

香港：香港大学出版社。

2. 《寻解导向：于社会工作的应用》，何会成、朱志强 (1999)。

香港：八方文化企业公司。

3. The Solution-focused School Counselor Shaping Professional Practice，Thomas E.

Davis & Cynthia J. Osborn (2000). USA；Accelerated Development.

─ 完 ─

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Soution-focussed Therapy by Insoo Kim Berg

20 MINUTE INTERVIEW

1. Referred client

Whose idea was it that you come to see me?

What will convince ____ that you don‘t need to see me?

On a scale of 1 to 10 (1 being the worse, 10 the best) where would you rate

yourself at this time? Where ____ would rate you on the same scale?

Where ____ would like you to be at?

How important is it for you to make these changes (scale of 1 to 10)?

How willing are you to work at it?

2. Self-Referred Client

What has to be different as a result of your coming and talking to me today?

(Turning complaint into a goal). ―All my friends are turning against me‖ into

―So you would like to have more friends who are on your side?‖

When was he last time you did this, even a little bit (or a short time)?

How did you do this? (What would your best friend say you did this?)

What would it take you to do this again?

What needs to happen to move up a single point on the scale?

What would other say you need to do to move up on the scale?

3. Miracle Question

Suppose a miracle happened while you were sleeping and the problem that brought

you here is solved. What would you be doing differently?

Who would be the first to notice you are doing things differently? What would

he/she notice different about you then?

When w as the last time it happened, even a little bit?

How did you do that?

What would it take you to do it again?

If you were to pretend, even a little while, that a small portion of the miracle had

occurred, what one or two things would you be doing differently?

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4. Questions for the Referring Person

Support and agree with the teacher, acknowledge his/her hard work with the child,

frustrations and the effort that already has gone into making progress (if true).

What special qualities do you see in this child that tells you that he can do it?

How would you rate the potential for this child for change for the better?

What is the minimum change this child has to make?

Tell me a bout the last time when the child was even a little more like he should be.

How do you suppose that happened?

On a scale of 1 to 10:

Where would you rate the present behavior of the child?

Where is the highest rating the child has achieved?

Where would you rate this child‘s potential for change?

What is the first small thing I can do to be of help to you?

5. Steps to Homework and Closure of the Session

Agree with and use client‘s words and world view

Compliment whenever possible

Suggestions toward solutions that can begins with

since you believe (think, feel) that . . .

Because (it is not your fault . . . )

I agree (I can see it seem like others are picking on you . . . )

to the referring person:

―I appreciate your (concern, frustration, worries . . .) regarding Jimmy, therefore,

it would be helpful in my work with Jimmy if you can (think about, watch for

signs of, keep track of ) and tell me what difference it makes for Jimmy. I will

(talk with Jimmy, his parents, assess his motivation, check into resources,

depending on their idea/view of what I can do to be of assistance to them.)

(Copyright: Insoo Kim Berg, 2000)

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Solution-Building Procedures

Insoo Kim Berg

1. What needs to be different with ________ (complaints)?

(Goal negotiation – miracle question)

2. What do you know about your ________ that tells you that this

can happen? (Exception find questions)

3. When was the most recent time when this happened?

(Exceptions)

4. How close to your goals have your moved so far?

(Scaling questions)

5. What is the next small step you need to take toward your goal?

(Scaling questions)

6. How confident are you that you can maintain the level of

success achieved so far? What significant others would scale

your level? (Scaling questions)

7. Termination.

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Useful Questions for Working with Involuntary Clients

1. Whose idea was it that you need to come here?

What is your understanding why you are here?

2. What makes ____ (pressuring person) think that you need to come here?

What does ____ think you need to do differently?

What does ____ think is the reason you have this problem he thinks you

have?

3. What would ____ say that, at a minimum, you have to do differently?

What do you have to do to convince___that you don‘t need to come

here?

4. When was the last time that you did this (what the client said ____said

needs to be different)?

What was different in your life then?

How did you manage to do this?

What would ____ say s/he noticed different about you then?

5. Suppose you were to decide to do that again, what would be the first

small step you would take make it happen again?

How confident are you that you could do that again? (Scales)

What would ____ say the chances are that you will do this again?

6. Suppose you were to decide to do this, what would be different between

you and your _____(important person)?

What would your ____ (important person) say how that will be helpful

to him/her?

7. Suppose you were to decide to do this, what other differences would it

make in your life?

What would be going on in your life then that is not going on now?

8. How will know when you have done enough?

(Copyright: Insoo Kim Berg, 1999)

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List of Questions Lead-In

The most difficult part of mastering new concepts and skills used in SFBT is like learning

a new language and learning to think differently. The following are some suggestions to

make you feel comfortable using Solution-building conversations.

Wh Questions (What, Who, Where, When, Which, and How)

What does ____expect to come out of your coming to this meeting?

What needs to come out of this meeting so that you can say this is helpful?

Which part do you agree with and which part do you disagree with?

What tells you that you are at 5?

Tell me about the times when you are more productive? What is different then?

What do you know about him/her that tells you that he/she can do this?

What difference is it going to make in your _____?

How would that be helpful to you?

What has been changed, even a little bit, since you made this appointment?

Tentative Language (Perhaps, it seems, suppose, it appears, it sounds like . . .

I am not sure about this, what do you suppose . . .

Do you suppose . . . ?

It sounds like what you really want is . . . to be more hopeful about yourself.

I’m not it will happen, but suppose, just suppose your son changed . . . How would

that be helpful to you? What difference would it make to your relationship?

What will change in your ____ (depression, fighting, drug use, etc)?

Relationship Questions

What would your best friend (boss, mother) say you are like when you are calmer?

What would ____notice different about you that will tell her that things are better?

What would your daughter say she likes best about your being sober? (Not What your

daughter would say she hates about your being drunk?)

Personal Meaning and Language

You are clear about not doing drugs. What about it that is so important not to do drugs?

You must have a good reason to . . . ?

So, how would that be helpful for you to (not go to work, stay in bed, drink more . . .)?

What Else?

What else would it take for you to stop drinking and stay sober?

What ____ would say it would take for you to stay sober?

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Building Solutions with Mandated Clients

Insoo Kim Berg

Self Check – Set aside your personal biases against the client, if any.

Set aside whatever you may heard or read about the client from others. Be

open to hearing the client‘s point of view.

Find a way to maintain ―a not-knowing‖ postures.

I. Assess the Person, Not the Problem

A. Connect with the person by:

- find out what is important to the client

- find out the person‘s aspirations and dreams

- find out who is important to this person

B. Find out how to face the problem together with the client by:

- putting your self ―one-step behind‖ the client (or side by side).

- Find out what the client is able to do toward what he wants

(exception finding questions)

II. Collaboratively Negotiate for Sustainable Solutions.

A. Find out the details of what the client wants (not what he does not want)

B. Past and recent successes in different social contexts (exceptions)

C. What does the client need to do to repeat the exceptions? (Scaling)

- Ask ―How did you know to do that?‖ ―How did you do it?‖

Useful questions: open-ended, miracle questions, exception-finding, scales

II. Helping the Client to Assess His/Her Own Progress Toward

Own Goals

A.

B.

C.

D.

E.

Ask many variations of scaling questions

Ask what is the next small step to achieve the desirable small level

Find out how significant others would rate the client‘s progress

Ask what it will take to get there (toward 10)

Ask relationship questions (What would _____ say where you are at?)

Useful questions: Scaling, relationship questions, look out for exceptions.

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Working Assumptions about Parents

Until Prove Otherwise we Believe all Parents Want to:

 be proud of their child





have a positive influence on their child

hear good news about their child and what their

child is good at

 give their child a good education and a good chance

of success in life (however they define it)



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see their child’s future is better than theirs

have a good relationship with their child

be hopeful about their child

feel that are good parents

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Working Assumption about Children

Until Proven otherwise we believe that all children want to:

 have their parents be proud of them

 please their parents and other adults

 be accepted as a part of a social group

 be active and involved in activities with others

 learn new things

 be surprise and surprise others

 voice their opinions and choices

 make choices when given an opportunity

(Insoo Kim Berg, 2002)

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Case Presentation/Consultation Outline

I.

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II.

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(Copyright: Insoo Kim Berg, 2002)

General Posture that Participants Bring:

Curiosity and discovery of client and practitioner competence

Solution-Focused language use during case discussions

Bring in the client‘s perspective into discussion

Referral information is another perspective – not written in stone

Case consultation/staffing outline:

Brief description of what the client/referring agent wants from this contact?

What would the client say you have done that‘s been helpful so far?

What would the client say are the signs of successes?

What are signs of success for the agency/program/therapist?

What tells the client/program that s/he can accomplish these goals?

What has been accomplished toward the goal so far?

What is the next small step to move toward 10?

How will client/practitioner know it is good enough to close the case?

What did we learn from this case discussion?

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