Solution-focused brief counseling: guidelines, considerations, and implications for school psychologists.
Although counseling is regarded as one of the most desirable job tasks among school psychologists, counseling in the school context brings about unique challenges that are not typically experienced in traditional clinical settings. For instance, school-based mental health services tend to be conducted under time constraints and within limited sessions. Thus, there is a need for school psychologists to employ counseling approaches that are amenable to the school context. Solution-Focused Brief Counseling (SFBC) is a recently developed approach that may be conducive to such challenges and is applicable to various populations of students with a variety of school problems (Murphy, 2008).
Given the potential goodness-of-fit within the school setting, SFBC was used to provide mental health counseling services to several students participating in a local behavioral collaboration project between the University of California, Santa Barbara (UCSB) and two elementary schools in a southern California school district. Advanced school psychology students implemented SFBC with several first through-sixth graders identified with a variety of mental health challenges, such as feelings of depression and anxiety, disruptive behavior, along with social skills deficits. The following sections describe the core components of SFBC, developmental considerations for using this approach with various student populations, applications of SFBC, and future directions and implications for school psychologists providing SFBC.
SFBC is a strength-based, student-driven approach that attempts to facilitate change by identifying and implementing solutions, rather than exploring the origin and nature of problems. It has been suggested that SFBC ".. .offers great promise as a time-effective, cooperative approach for school [psychologists] that shifts the focus from 'what's wrong' to 'what's working' with students" (Murphy, 1997, p. 5). SFBC generally occurs in 4-6 sessions and is guided by seven core principles that are imperative to elicit positive behavioral changes (Sklare, 2005). Table 1 provides a complete listing of these principles. Most importantly, SFBC requires creating clear, student-driven goals that identify ideal behaviors. Such goals should be concrete, specific, and focused on positive, rather than negative, behaviors. To accomplish these goals, students are encouraged to do more of what has been successful in the past or to do something entirely different - if their current solutions are not providing favorable outcomes (de Shazer, Dolan, Korman, McCollum, Trepper, & Berg, 2007; DeJong & Berg, 2008). In addition to these guiding principles, several key elements are used to elicit change and are integral for the SFBC process. Table 2 provides a description of these key elements, along with examples of their practical application in the school context. It is noteworthy that these key elements do not have to be provided in sequential order and some may be used repeatedly throughout a single counseling session (de Shazer et al., 2007; DeJong & Berg, 2008).
SFBC is appropriate when working with children whose cognitive abilities are adequate to comprehend and appreciate the concepts central to the solution-focused process (Nims, 2007). This approach requires students to use their cognitive abilities to describe problems and emphasizes the use of language as an important solution-building tool. Language is used throughout therapy to delineate treatment goals and to find out what steps students have taken to achieve their goals. Therefore, SFBC is not appropriate with children who do not have the necessary language skills or the ability to use abstract concepts to translate complex ideas into words so that their needs and desires are understood (Berg & Steiner, 2003). For example, SFBC would typically be inappropriate for children that are pre-kindergarten age, given the reliance on cognitive abilities and language acquisition (Nims, 2007). However, there is some evidence that developmentally appropriate language adjustments can be made to interventions, allowing SFBC to be used with children as young as five years old (DeJong and Berg, 2002). In addition, play- or art-based strategies such as using puppets, drawings, or stories may be effectively incorporated into work with younger students (Berg & Steiner, 2003). In the present project, doctoral students experienced difficulty using this approach with younger students in K through third grades, who seemed to lack the cognitive skills and sustained attention to actively engage in SFBC.
Thus, it is important for school psychologists to determine whether SFBC is an approach that can yield potential benefits given the idiosyncratic abilities and characteristics of the individual student. As another example, using SFBC in secondary education settings may be particularly effective because it is responsive to the adolescent quest for identity and autonomy (Murphy, 1997). In addition, the focus on student-driven goals and utilizing the student's strengths, key student words, belief systems, and theories of change supports the therapeutic relationship and the success of SFBC (Selekman, 2005). School psychologists working in secondary education settings and considering using SFBC should also be familiar with developmental features of adolescence such as the need for independence and self-direction to enhance working with this population (Murphy, 1997). Research has reported that preadolescents and adolescents made significant progress toward achieving their goals using SFBC (DeJong & Berg, 2008).
IMPLICATONS FOR PRACTICE
Student Needs and Referral Routes
School psychologists provide support services, including counseling, to diverse students with diverse needs. Students frequently enter counseling via recommendations from parents, teachers, and/or administrators. The SFBC approach recognizes that students have different motivations for counseling and therefore it may be valuable to consider the referral route and potential implications for counseling services. Students will typically fall into one of three distinct categories: (a) visitors, (b) complainants, and (c) customers (de Shazer et al., 2007).
Visitors. Visitors typically enter counseling because they are forced by another person. They may be uncommitted to changing, not want to acknowledge that a problem exists, and may be resistant to implementing counselor suggestions or interventions. Since students receiving counseling are often referred by others, they are frequently entering as visitors. The emphasis of student-driven goals in SFBC can be especially powerful with visitors in developing the therapeutic relationship and starting the change process.
Complainants. Complainants are students that understand the existence of a problem and yet are unwilling to take action to resolve it. They perceive themselves as innocent bystanders who do not have the power to facilitate change, as change is thought to be someone else's responsibility.
Customers. Customers acknowledge the presence of a problem and want to actively change it. They are most inconvenienced by the problem and express a sense of urgency to find a solution. In the education system, parents, teachers and administrators may also be considered customers.
Using the previously described categories for students, school psychologists should tailor interventions based on students' referral route and responsiveness to counseling, to help them resolve problems and generate optimal solutions (Murphy, 1997). Considering the importance of the relationship between the professional and the client as related to outcomes of counseling (Lambert, 1992), it is important for school psychologists to be aware of students' disposition regarding the counseling support services provided.
Factors that Enhance the Therapeutic Process
Practitioners providing school-based mental health services should have a general understanding of the importance of various dimensions of counseling. Lambert (1992) summarized three decades of research regarding "what works" in helping people change during the therapeutic process. Four inter related factors have been found to lead to successful outcomes: (a) client factors - personal strengths, beliefs, resources (40%); (b) relationship factors - empathy, acceptance, and warmth (30%); (c) expectancy factors - hope and expectancy for change (15%); and (d) model/technique factors - theoretical orientation and intervention techniques (15%). This indicates that the aspects most predictive of change are client and relationship factors. Consequently, while practitioners using the SFBC approach should place an emphasis on the core components and specific techniques, it is most critical to build the therapeutic alliance and focus on "what the client brings" to counseling. In addition, recognizing and building upon students' strengths and resources directly aligns with the principles of SFBC.
SFBC is a therapeutic approach that is widely used in the United States and increasingly in other countries (Gingerich & Eisengart, 2000). It has been used in social service agencies, educational settings, family therapy, couples therapy, and for the treatment of sexual and substance abuse (de Shazer, 2007). Practitioners typically report successful outcomes associated with the implementation of SFBC. However, little research has been conducted on its effectiveness in helping children (Corcoran & Pillai, 2009).
Gingerich and Eisengart (2000) conducted a review of the outcome research related to SFBC, including all controlled studies of SFBC student outcomes in the English literature up to the year 1999. Recently, Corcoran and Pillai (2009) conducted an updated review of the research on SFBC. Few studies were identified that examined the effectiveness of SFBC with children and adolescents. Practitioners typically report successful outcomes associated with the implementation of SFBC. For a comprehensive description of the outcome research related to SFBC, please refer to Gingerich and Eisengart (2000) and Corcoran and Pillai (2009).
The following provides a brief review of the extant literature on SFBC with children and adolescents. Table 3 includes a summary of research that has used components of SFBC with youth in clinics or school-based settings. Several studies may have been excluded from the aforementioned reviews of the outcome literature based on methodology and implementation issues (Corcoran & Pillai, 2009; Gingerich & Eisengart, 2000). Collectively, this research offers insights regarding outcomes associated with the use of SFBC with youth.
SFBC has been associated with a number of positive outcomes in children and adolescents. For instance, Franklin, Biever, Moore, Clemons, and Scarmado (2001) examined the effectiveness of solution-focused counseling with fifth- and sixth-grade students who received special education services and were identified as needing help solving school-related behavior problems. Results indicated that children receiving SFBC made positive changes with a range of behavioral problems. In addition, a comparison study examined the effectiveness of SFBC versus Cognitive Behavioral Therapy (CBT) in a sample of children with behavior problems (Corcoran, 2006). Both SFBC and CBT interventions were equally effective and made significant improvements over time, as measured by behavioral data gathered from parent rating scales (e.g., Conners' Rating Scales; Conners, 1990). Accordingly, SFBC appears to be a promising counseling approach that may yield results comparable to the well-established CBT approach (Corcoran, 2006). In addition, a meta-analysis of Solution-Focused Brief Therapy outcome studies (Kim, 2008) found that the effect sizes of Solution-Focused Brief Therapy were comparable to those in other psychotherapy and social-work meta-analysis conducted in real-world settings (Kelly, Kim & Franklin, 2008). Importantly, SFBC has demonstrated similar success to other counseling approaches, generally with fewer sessions (Kelly, Kim & Franklin, 2008). Overall, the literature on SFBC with children has (a) primarily targeted specific behavior problems, (b) often involved very small sample sizes, (c) rarely examined implementation fidelity, and (d) seldom used rigorous experimental methodology. In order to determine the effectiveness of the approach it is important to evaluate treatment outcomes.
When providing counseling services, it is vital for school psychologists to monitor progress to assess for desired behavioral changes. Previous research has used behavior rating scales, such as the Conner's Rating Scales (Conners, 1990); the Feelings, Attitudes, and Behaviors Checklist (FAB-C; Beitchman, 1996); and the Behavioral Assessment System for Children (BASC; Reynolds & Kamphaus, 1992) to measure progress toward specific social, emotional, and behavioral goals. Instruments that briefly measure mental health concerns are ideal when evaluating treatment outcomes in school-based brief counseling. However, change may not be apparent after only a few sessions as measured by such omnibus standardized measures (Corcoran & Pillai, 2009). More sensitive behavioral and emotional progress monitoring tools appropriate to examine SFBC outcomes are needed in the field.
Murphy (2008) notes that SFBC is an outcome-informed approach, in which two progress-monitoring tools can be used for each session: (a) the Child Outcome Rating Scale (CORS; Duncan, Miller, & Sparks, 2003) and (b) the Child Session Rating Scale (CSRS; Duncan, Miller, Sparks, & Johnson, 2003). Each measure assesses elements of treatment outcomes (e.g., personal distress, well-being) and the therapeutic alliance (e.g., respect and understanding). These scales are practical and time-efficient ways for school psychologists to systematically evaluate counseling progress. Moreover, they provide quick feedback that allows practitioners to immediately correct relationship problems when they occur (Murphy, 2008).
When counseling young children (e.g., K-4th grade) the UCSB team experienced some difficulty obtaining accurate information from these scales. Children appeared to be inclined to respond in an overly positive nature (e.g., everything in life was going well, and the psychologist-student relationship was perfect). Although studies have found these measures to have adequate reliability and validity evidence for adults, further research is necessary to examine the psychometric properties of these instruments with young children (Murphy, 2008). Preliminary experiences of the UCSB collaboration team suggest that these outcome and alliance measures may include concepts that are difficult for young children to comprehend.
FUTURE DIRECTIONS FOR RESEARCH
While SFBC has much to offer the arena of school-based mental health, further research is warranted to validate its use in the educational context and/or with children and adolescents. Research has revealed mixed results related to certain outcomes (e.g., GPA, self-esteem, attendance; Froeschle et al., 2007; Franklin, 2007), thus additional research is necessary to better understand "for whom and with what" SFBC is most effective. Furthermore, school psychologists are increasingly being asked to establish their role as evidence-based practitioners (Huber, 2007). While school psychologists may be critical consumers, their role in conducting research and evaluation unfortunately tends to be limited (Fagan & Wise, 2007). In order to have research applicable to the field, school psychologists must become more involved in the production of relevant research. In addition, as school psychologists are on the "frontlines," offering support to students in short-term, long-term, and crisis situations, they are the most informed regarding what is needed and capable of demonstrating and evaluating what works.
Further challenges to the study of SFBC include the lack of measurement tools sensitive to behavioral and emotional change. The importance of developing a Response to Intervention (Rtl) framework with academic, social, emotional, and behavioral challenges is imperative in the field. In order to do so, omnibus measures (e.g., Conners', BASC), not developed for the purpose of progress monitoring, cannot be the only standardized option for evaluating change. There is an exigent need in the field for the development of standardized measures of social, emotional, and/or behavioral change.
Finally, the application of SFBC principles and techniques to other aspects of a school psychologist's job duties holds promise. Solution-Focused interventions have shown promise in a variety of school psychologists' roles such as classroom management (Berg & Shilts, 2005), counseling and social skills groups (Metcalf, 2008), discipline (Metcalf, 2005), special education referrals (Metcalf, 2008), alternative schools such as Gonzolo Garz Independence High School in Austin, Texas (Kelly, Kim &
Franklin, 2008) and consultation. Solution-focused consultation models have received most attention as promising methods of consultation (e.g., Dougherty, 2005). As direct interactions with students may have limits, it will be vital to take advantage of alternative methods, influencing those surrounding children (e.g., teachers, parents) in order to effect change in students' lives. As a consultant, an individual may engage in a variety of roles such as advocate, expert, trainer/educator, collaborator, fact finder, and process specialist.
Solution-Focused Brief Counseling (SFBC) is a strengths-based, student-driven approach that focuses on developing solutions to problems rather than on their origins. Students are considered to be competent and capable of constructing solutions that will eliminate problems and promote optimal wellbeing. This approach may prove useful for practitioners providing school-based mental health services because of its emphasis being time-effective and goal-oriented. Given the many challenges students face, it is important for the therapeutic environment to be a place that students can feel empowered and their strengths highlighted. Presently, there is a paucity of empirical evidence supporting the use of SFBC with children and adolescents; however, the extant literature reveals that it may be associated with favorable outcomes. Further research is warranted to determine whether SFBC may be a valuable counseling technique to implement in the schools with students who are experiencing social, emotional, and behavioral challenges.
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Correspondence may be sent to Shane Jimerson, UCSB, GGSE, CCSP, Santa Barbara, CA 93106-9490 or e-mail: Jimerson@education.ucsb.edu
Camille N. Jones, Shelley R. Hart, Shane R. Jimerson, Erin Dowdy,
James Earhart, Jr., Tyler L. Renshaw, Katie Eklund,
University of California, Santa Barbara
Solutions and Strengths, LLC and Stillwater Area Public Schools, MN
table 1. General guiding principles of Solution Focused Brief Counseling 1. People are capable of remarkable change and are resouceful, bringing strengths and successes to the counseling situation. 2. Cooperation and a strong student-practitioner alliance enhances change. 3. Focus on future solutions, rather than past problems. 4. No problem is constant; there are always exceptions to problems. 5. Small changes can "ripple" into bigger changes. 6. Ongoing and systematic student feedback improves outcomes. 7. If it works, do more of it; if it does not, do something different. Note. Adapted from "Best practices in conducting brief counseling with students" (p. 1440) by J. Murphy, 2008. TABLE 2. Key Elements of Implementing Solution Focused Brief Counseling Intervention Description Example(s) Socializing/Joining Explore --How san I help you student's today? interests, Tell me abOut strengths and something you are resources. good at. Problem Description Have student --How is this describe what situation a problem the current for you? problem is. for visitors --What is it about the problem may this that makes it a need tu be problem? reframed in --How have you dealt terms uO what with it? Was that the teasher ur helpful? parent thinks the problem is. --Why dues your teacher think this is a problem? --If we were to ask the principal, what do you think he would say? Goal Development Have student --What do you want dessribe what tu be different for they want to be you in (pick one: different. school, home, life)? Student is encouraged to --When you are nut frame their getting (discipline goals as a slips in class, sent solotion rather to the principal, than the etc.), what will you absense of a be doing instead? problem. Details are --When that happens, clarified about what things will be what will be better or different better fpr them for you? when these shanges occur. Pretreatment Change If the student --Since this is aware uf the appointment was first scheduled, have you counseling notised any positive session in changes? Please tell advance, they me about these frequently changes. start tu nutise pusitive changes priur tu their first sessiun. In the first session, the practitioner asks abuut positive changes that are already starting to happen in order to build hope and identify effestive solution attempts. Exception Questions Ask student --Tell me about the about times in last time that her life when (solution) happened. the problem was not happening --Tell me about a or was less time resently when severe. the problem was Exception better, even if it questions are was only a little frequently very bit better. helpful in identifying effective solutions and student strengths and resources. Relationship Students --What will your Questions construct parents/teachers descriptions of notice that would interactional tell them that the events and problem is gone? significance. Miracle Questions The student is --I'm going to ask asked to you a strange describe the question. Suppose things he would while you were notice if a sleeping tonight a miracle miracle happens. The occurred and miracle is that the the problem was problem is solved. gone. The But because you were miracle sleeping, you don't question know the miracle has magnifies even happened. When you minute glimpses wake up tomorrow, of exceptions what will be and is pursued different that will and explored in tell you that the depth. miracle has happened and the problem has been solved? --What else?... What else? Scaling Questions Have student --On a scale of 1- describe on a 10 how confident are scale of 1-10 you that you can how confident find a solution? she is in finding a --What would it take solution to the to get from a '5' to problem. a '6'? Scaling helps the student to start to take small steps toward resolving their problem. Constructing Interview --I notice you said Solutions student to in the past you have clarify found a solution by previous doing your homework solutions, at homework club. exceptions and What will need to to co-create happen for that new solutions. solution to work for Emphasis is you now? placed on utilizing and refining current, effective skills and resources versus teaching new skills. Coping Questions Coping --I imagine that questions are [this problem] has particularly been difficult for helpful if the you. How have you problem is not been dealing with getting better that so far? to clarify strengths and resources, build hope and identify potential solutions. Checking In Practitioner --Is there anything asks the else you I should student for know about the clarification situation? in regards to whether or not --Is there anything any other I forgot to ask? information needs to be given. Taking a Break and Practitioner --Thank you so much Reconvening takes a break for talking with me; to collect I really admire your thoughts and strength, talking comes up with about these things compliments and can be really tough. suggestions for the student. "Formula First Practitioner --Between now and Session Task" (de asks the the next time we Shazer, 1985) student to meet, I would like notice what is you to observe so occurring in you can describe to their life that me next time, what they want to happens in your continue. This (pick one: question classroom, school, assists the home, life) that you student in goal want to continue. development, builds hope, and develops solution ideas for future sessions. Experiments/Homework Practitioner --I have noticed you Assignments suggests the said that your goal student is to finish a full implement an week of your reading experiment response journal. between One of the great sessions at her things you have done discretion. was to finish one These part of the experiments are assignment during based on the week. I'm something the wondering what you student is will need to do to already doing complete two parts that is moving of that assignment them toward her in the next week? goal. Collaboration to Practitioner --E-mail teacher or Support Behavior communicates parent to say, "I Change with teachers, have permission to parents, etc. share that my about the student has some student's goals ideas about changing and to prompt her behavior. Please them to notice notice and any positive acknowledge any changes in the positive changes student's that she makes in behavior the next week." Follow-Up Practitioner --What has been asks about the better since the progress since last time we met? the last session and about what has been better since the last session. TABLE 3. Emperical Findings of Solution Focused Brief Counselling with Childr en Authors Year Use N M/F Froeschle, 2007 Effectiveness of 40 = F = 80 Smith, & drug prevention SFBC Richards program that group incorporated SFBC 40 = interventions control group Corcoran 2006 Comparison 139 SFT- Not Study of SlT v. 58 Reported Treatment as completed Usual Treatment; (Cognitive Behavioral 100 CBT- Therapy-CBT) 27 for Behavior completed Problems in Treatment Children Perkins 2006 Single Session 216 145 boys; SFT 71 girls Conoley et 2003 SFBC with 3 M =3 al. (2003) families who had aggressive and oppositional children Yarbrough & 2002 Counseling 3 M =3 Thompson Approaches on Off-Task Behavior Franklin, 2001 Effectiveness of 7 Children M = 3 Biever, SFT with identified F = 4 Moore, Children in a as learning Clemons, & School Setting disabled Scamardo or needing help solving school- related behavior problems Corcoran & 2000 Effectiveness of 136; M = 86 Stephenson SFT with Child 58,8% F = 50 Behavior attrition Problems rate Springer, 2000 Effectiveness of 10 M =4 Lynch, & SFBC with F = 6 Rubin Children of Incarcerated Parents Authors Ethnicity Grade Age Froeschle, SFBC group: 8th Not Smith, & Mexican- Reported Richards American = 22 Caucasian = 16 African- American = 2 Corcoran Not Reported Elementary, 5-17 Middle, and years; High Mean = School 10 Perkins Not Reported 5-12 years(n = 159); 13-15 (n = 57) Conoley et European Elementary 8-9 al. (2003) American years Yarbrough & African- 3rd & 4th 8 & 9 Thompson American = 1 Caucasian = 1 Franklin, Mixed Race 5th & 6th 10-12 Biever, (Latino- years Moore, Caucasian) = 2; Clemons, & Caucasian = 3; Scamardo Latino = 2; Corcoran & White (non- Elementary, Not Stephenson Hispanic) = 106; Middle, and Reported African- High American = 12; School Mexican- American = 3; Asian = 3; Other = 4 Springer, Hispanic 4th & 5th Not Lynch, & grade Reported Rubin Authors Intervention Measures Froeschle, Solution- --American Drug and Smith, & Action- Alcohol Survey (ADAS) Richards Mentorship --Substance Abuse (SAM) Screening Inventory program Adolescent Version 2 integrated with (SASSI-A2) SFBC --Piers-Harris Children's Self Concept Scale-2 --Home and Community Social Behavior Scales --School Social Behavior Scales-2 Corcoran SFT provided --Feelings, Attitudes, and by Master- Behaviors Scales for level social Children (FAB-C) work students; --Conners' Parent Rating 4-6 sessions Scale Treatment as Usual = CBT Perkins Single Session Devereux Scales of Therapy (2hrs) Mental Disorders (DSMD); Frequency of MPP; Severity of MPP; Health of the Nation Outcome Scales for Children and Adolescents Conoley et Solution- Parent Daily Report al. (2003) Focused (PDR); BASC Family Therapy Yarbrough & SFT and Homework Assignments Thompson Reality Therapy Franklin, SFT provided AB Single Case Design Biever, by Advanced Moore, Doctoral Clemons, & Students Scamardo trained by developers at Brief Family Therapy Center in Milwaukee; 5-7 sessions Corcoran & SFT provided --Feelings, Attitudes, and Stephenson by Master- Behaviors Scales for level social Children (FAB-C) work students; --Conners' Parent Rating 4-6 sessions Scale Springer, Group SFBC Hare Self-Esteem Scale Lynch, & provided by Rubin Marriage and Family Therapy graduate students; 6 sessions Authors Findings Froeschle, SFBC was Smith, & associated Richards with decreased drug use, increased knowledge of drug-use consequences and socially competent behaviors. Corcoran Both groups made significant improvements over time; SFT appears to show results comparable to CBT Perkins Treatment group showed significant improvement. Students were satisfied with therapy Conoley et Reduction in al. (2003) externalizing behaviors (e.g., ODD; conduct problems) Yarbrough & Child Thompson receiving SFT improved in completion of homework assignments. He went from no homework assignments to completing all assignments in 3 of 4 subjects Franklin, Children made Biever, positive Moore, changes on a Clemons, & range of Scamardo behavioral problems Corcoran & Significant Stephenson positive difference in Conner's ratings, except for Anxiety scale; FAB-C conduct problems and self-image revealed significant differences Springer, Increase in Lynch, & self-esteem Rubin among members of the SFBC group.
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|Author:||Jones, Camille N.; Hart, Shelley R.; Jimerson, Shane R.; Dowdy, Erin; Earhart, James, Jr.; Renshaw,|
|Publication:||The California School Psychologist|
|Date:||Jan 1, 2009|
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