take for them to get to a 3 on both goals and expressed confidence that they could achieve this based on the fact that they had survived another stressful situation in the past with Mr. Davis’s accident. The family agreed that they would continue the family sessions, communicate with each other more, and have ground rules to not yell at each other. This was incremental improvement, but the family was on their way to achieving their goals . Intervention skills Four sets of skills are part of the solution-focused practitioner’s approach to working with families: problem description, goal setting (including the “miracle question” described below), exploring exceptions, and scaling questions. Problem description refers to the initial assessment in which the practitioner asks the family to describe how they see the problem. While the family may be accustomed to a problem- oriented focus, the practitioner learns of their past efforts in addressing the problem; this reminds the family that they have the capacity to resolve their problems. The practitioner then asks what has and has not worked in the past to solve the problem, thus introducing the idea that the family has the capacity to resolve their problems (Nichols, 2014). Drawing on the earlier example of the family whose son was fighting in self-defense over being bullied for being gay, the therapist asks for a brief history from the different family members’ perspectives and then explores how they have previously tried to solve challenges the family faced. Goal setting is an extremely important technique in solution- focused family therapy because it enables both the client and the therapist to know when the problem is solved and to measure progress from session to session (de Shazer, 1988). Good questions for the therapist to ask include: “Specifically, how will you be doing this?” and “What specifically will tell you that you’ve solved your problem (or reached your goal)?” (Nichols, 2014, p. 231). Such goal setting is optimistic in nature because it presumes the family’s ability to solve their problem. A very common goal-setting strategy is asking the miracle question , which is a question to elicit a family’s vision of when the problem is solved. The therapist can ask: “Suppose that one night, while you were asleep, there was a miracle and this problem was solved. How would you know? What would Narrative therapy is the newest of the three models presented. The concepts of narrative therapy were originated by Michael White and David Epston; together they co-authored Narrative Means to Therapeutic Ends (White & Epston, 1990). Over the last 30 years narrative therapy has come to be a mainstream model for working with families with various presenting issues. The concepts and intervention skills of narrative family therapy appear in Table 6. The goal of narrative family therapy is to help families “transform … identities from flawed to preferred, not by getting family members to confront their conflicts but by separating persons from problems and then uniting the family to fight a common enemy” (Nichols, 2014, p. 247). While there are many elements associated with narrative family therapy, the three central concepts are deconstruction, unique outcomes, and reconstruction. These concepts can be used to assist family members with reconceptualizing the problems that are present in their families. The first concept, deconstruction , refers to helping families understand how they live their lives based on the stories they have told themselves. Instead of focusing on family pathology, deconstruction looks at the roots of the problem as being outside of the family and the family as simply narrating their story based on a social construction. Specifically, deconstruction exposes the problem-saturated stories that can infiltrate a family and make life difficult for them, often without their knowledge Narrative family therapy Theory
be different?” (de Shazer, 1988, p. 5). Such a question forces families to focus on the absence of the problem and how achievement of their goals could help them attain a future without the problem. The goals do need to be realistic. T he therapist asks the miracle question of the family, and the parents report that they would spend more time with their son and daughter to ensure that their children felt loved, and would advocate with the principal for their children’s safety at school. It is important to note that the goals need to be very realistic; therefore, wanting someone to change a sexual orientation (or wanting someone to be alive when he or she is not, etc.) are not examples of realistic goals. Exploring exceptions is a technique in which the focus is on the family identifying a time when something went well versus what has gone wrong. This promotes family resourcefulness and reinforces the idea of the family as the expert on their particular circumstance. Examples of questions that explore exceptions include: “When in the recent past might the problem have happened but didn’t (or was less intense or more manageable)?” and “What was different about those times when the problem didn’t happen?” (Nichols, 2014, p. 355). The therapist asks the family to describe an earlier time when they overcame a challenge. The family shares that several years ago the daughter had been hospitalized for a month due to an illness and the family had been able to Scaling is a technique in which the family members are asked to use a scale to identify their progress toward a goal (e.g., a scale of 1 to 10, with 1 representing the “least progress” and 10 representing the “most progress”). This technique provides a practical way for families to measure their own progress on goals both within and between sessions, and can provide a strong sense of optimism and encouragement for families. It is noteworthy that small change on a scale (e.g., a one-point difference) is recognized, and a realistic question, such as “What will it take for you to move from a 4 to a 5?” helps clients focus on realistically continuing their short-term goals. When asked by the th erapist about their progress on this scale, the family states that they are a 2 on the scale of accomplishing their goal of spending more time together, and they brainstorm and select ideas to increase that score to a 4 over the next week. of the stories’ origin. Deconstructing these problem-saturated stories provides an opportunity for families to fully understand how their lives have been narrated by a particular message that they have unwittingly internalized and acted upon. The process of deconstructing sets the stage for families to gain a new perspective. Table 6: Concepts and Intervention Skills of Narrative Family Therapy Concepts ● Deconstruction. ● Unique outcomes. ● Reconstruction. Intervention Skills ● Mapping the influence of the problem on the family. ● Externalizing conversations. ● Deconstructing destructive cultural assumptions. ● Relative influence questions. ● Reading between the lines of the problem story. ● Reauthoring. ● Reinforcing the new story. Note . From Nichols, M.P. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson; and White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York, NY: W.W. Norton.
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