焦点解决疗法技术：运用未来完美提问设定远大目标

英文原文

When using solution-focused techniques, counsellors are encouraged to be flexible in their approach. The primary consideration is to always work within the client’s frame of reference in a solution-focused manner. The use of appropriate language is an important factor in the success of solution-focused therapy. In particular, counsellors should remain enthusiastic about their clients’ exceptions and accomplishments.

It is beyond the scope of this article to provide you with in-depth knowledge of the full range of solution-focused techniques available. However, we should offer you sufficient introduction to begin applying them in your counselling practice. We include the following techniques: Pre-session change, Problem-free talk, The miracle question, Exception questions, Do one thing different, Scaling questions, Coping questions, Breaks, Compliments, Tasks, Solution talk, Presupposing change, End of session feedback.

The miracle question is a technique that counsellors can use to assist clients to think “outside the square” in regard to new possibilities and outcomes for the future. The miracle question has been asked thousands of times throughout the world. It has been refined as practitioners have experimented with different ways of asking it. The question is best asked deliberately and dramatically: “Now, I want to ask you a strange question. Suppose that while you are sleeping tonight and the entire house is quiet, a miracle happens. The miracle is that the problem which brought you here is solved. However, because you are sleeping, you don’t know that the miracle has happened. So, when you wake up tomorrow morning, what will be different that will tell you that a miracle has happened and the problem which brought you here is solved?”

Asked this way, the miracle question requests clients to make a leap of faith and imagine how their life will be changed when the problem is solved. This is not easy for clients. It requires them to make a dramatic shift from problem-saturated thinking to a focus on solutions. Most clients need time and assistance to make that shift.

Having created a detailed miracle picture, the counsellor starts to gain some understanding of what the client hopes to achieve and counsellor and client can begin to work toward these solutions. This is achieved through highlighting exceptions in a client’s life that are counter to the problem. Finding times when the problem wasn’t so much of a problem helps empower clients to seek solutions.

Exception questions provide clients with the opportunity to identify times when things have been different for them. Examples of exception questions include: Tell me about times when you don’t get angry. Tell me about times you felt the happiest. When was the last time that you believe you had a better day? Was there ever a time when you felt happy in your relationship? What was it about that day that made it a better day? Can you think of a time when the problem was not present in your life?

When looking for exceptions, be aware that such questions can be phrased to ask for not only the client’s perception of exceptions (individual questions) but also the client’s perception of what significant others may notice (relationship questions).

Scaling questions invite clients to perceive their problem on a continuum. Scaling questions ask clients to consider their position on a scale (usually from 1 to 10, with 1 being the least desirable situation and 10 being the most desirable). Scaling questions can be a helpful way to track clients’ progress toward goals and monitor incremental change.

To use these types of questions, the therapist begins by describing a scale from one to ten where each number represents a rating of the client’s complaint(s). The therapist might say, “On a scale of one to ten, with one being the worst this problem has ever been, and ten being the best things could be, where would you rate things today?”

Once a therapist is given a number, he or she explores how that rating translates into action-talk. For example, if the client rates his or her situation at a three, the therapist asks, “What specifically is happening to indicate to you that it is a three?” The next step is to determine the goals and preferred outcomes. To do this, the therapist asks the client where things would need to be for him or her to feel that the goals of treatment have been met or that therapy has been successful.

“We aim for small changes that will represent progress in the direction of goals and preferred outcomes.”

Examples of scaling questions include: You said that things are between a 5 and a 6. What would need to happen so that you could say things were between a 6 and a 7? How confident are you that you could have a good day like you did last week, on a scale of one to ten, where one equals no confidence and ten means you have every confidence?

The client’s concerns are real and troublesome, BUT the individual has managed to survive up to this point, at least enough to get to your rooms and ask for help. Thus, coping questions are the quintessential solution-focused intervention. They can be asked when the client seems overwhelmed and unable to generate any possible solution.

The basic structure is simple. It goes something like: “Since [the problem] began, how do you [solution/cope]?” For example, “Since your schedule became so busy and challenging, how have you managed to complete your work and your other duties every day?” Coping questions reframe the client’s reactions to problems as resources for future solutions. To make this type of intervention work, the counsellor needs to carefully attend to the client’s concerns and to acknowledge the pain that they have caused. The coping questions then focus on what has kept the client going so far: a key resource for future solutions.

Solution-focused therapists choose their language carefully, with the ever-present aim of increasing clients’ hope and optimism, sense of control, and openness to possibilities and change. The focus, of course, is on solutions, not problems. Here is a list of language habits that can facilitate solution talk: Prioritise open questions, Use language that presupposes positive change, Externalise the problem, Normalise people’s problems, Use coping questions, Reinforce and notice strengths and successes, Create hypothetical solutions, Concentrate on describing and changing behaviours, Use rituals, metaphors, stories, and symbols to convey indirect messages that can promote change, Frequently use words such as change, different, possibility, what, and how, which suggest change, Use inclusive language which allows supposedly incompatible outcomes to coexist, Use reframing and relabelling to offer different perspectives, Match clients’ vocabulary or style of talking to promote a collaborative relationship; then change the language to encourage a change in clients’ perspectives, Make suggestions, Offer solution prescriptions, Interrupt the complaint pattern.

When clients are focused on changing the negative aspects (or problems) in their lives, positive changes can often be overlooked, minimised, or discounted due to the ongoing presence of the problem. The solution-focused approach challenges counsellors to be attentive to positive changes (however small) that occur in their clients’ lives. Questions that presuppose change can be useful in assisting clients to recognise such changes. They can be questions such as, “What’s different or better since I saw you last time?” This question invites clients to consider the possibility that change (perhaps positive change) has recently occurred in their lives.

If evidence of positive change is unavailable, counsellors can pursue a line of questioning that relates to the client’s ability to cope, using questions such as: How come things aren’t worse for you? What stopped total disaster from occurring? How did you avoid falling apart? These questions can be followed up by the counsellor positively affirming the client with regard to any action they took to cope.

When you give someone a gift, you typically might wrap it up nicely with a bow. Similarly, a solution-focused therapist wants to wrap up the gift of understanding and insight which occurred in the session, putting onto it the “bow” of compliments, and often some suggestions as well. De Jong and Kim Berg note that this is not just about the optics of the session: “At the end of each solution-building conversation, we construct messages for our clients that include compliments and usually some suggestions. The compliments emphasise what clients are already doing that is useful in solving their problems. The feedback is based on the information that clients have revealed to us in the conversation about well-formed goals and exceptions. It always focuses on what the clients, given their frame of reference, need to do more of and do differently in order to enhance their chances of success in meeting their goals.”

中文翻译

在使用焦点解决技术时，咨询师被鼓励采用灵活的方法。首要考虑是始终以焦点解决的方式在来访者的参考框架内工作。恰当的语言使用是焦点解决疗法成功的重要因素。特别是，咨询师应该对来访者的例外情况和成就保持热情。

本文无法提供所有可用焦点解决技术的深入知识。然而，我们应该提供足够的介绍，让你开始在咨询实践中应用它们。我们包括以下技术：会谈前改变、无问题谈话、奇迹问题、例外问题、做一件不同的事、量表问题、应对问题、休息、赞美、任务、解决方案谈话、预设改变、会谈结束反馈。

奇迹问题是咨询师可以用来帮助来访者“跳出框框”思考未来新可能性和结果的技术。奇迹问题已在全世界被问过数千次。随着实践者尝试不同的提问方式，它已被完善。这个问题最好以深思熟虑和戏剧性的方式提出：“现在，我想问你一个奇怪的问题。假设今晚你睡觉时，整个房子都很安静，一个奇迹发生了。这个奇迹是把你带到这里的问题解决了。然而，因为你在睡觉，你不知道奇迹已经发生。那么，当你明天早上醒来时，会有什么不同告诉你奇迹已经发生，把你带到这里的问题已经解决了？”

以这种方式提问，奇迹问题要求来访者做出信念的飞跃，想象问题解决后他们的生活将如何改变。这对来访者来说并不容易。它要求他们从充满问题的思维戏剧性地转向关注解决方案。大多数来访者需要时间和帮助来完成这种转变。

创建了详细的奇迹图景后，咨询师开始了解来访者希望实现什么，咨询师和来访者可以开始朝着这些解决方案努力。这是通过强调来访者生活中与问题相反的例外情况来实现的。找到问题不那么严重的时候有助于赋予来访者寻求解决方案的能力。

例外问题为来访者提供了识别事情对他们来说不同的时刻的机会。例外问题的例子包括：告诉我你不生气的时候。告诉我你感到最快乐的时候。你相信你上次有更好的一天是什么时候？有没有什么时候你在关系中感到快乐？那天是什么让它成为更好的一天？你能想到问题不在你生活中的时候吗？

在寻找例外时，要注意这些问题不仅可以用来询问来访者对例外的感知（个人问题），还可以用来询问来访者对重要他人可能注意到什么的感知（关系问题）。

量表问题邀请来访者在连续体上感知他们的问题。量表问题要求来访者考虑他们在量表上的位置（通常从1到10，1表示最不理想的情况，10表示最理想的情况）。量表问题可以是跟踪来访者朝着目标进展和监测渐进变化的有用方式。

要使用这些类型的问题，治疗师首先描述一个从一到十的量表，其中每个数字代表来访者抱怨的评级。治疗师可能会说：“在一个从一到十的量表上，一表示这个问题最糟糕的时候，十表示事情可能最好的时候，你今天会把事情评在哪里？”

一旦治疗师得到一个数字，他或她就会探索这个评级如何转化为行动谈话。例如，如果来访者将他或她的情况评为三，治疗师会问：“具体发生了什么让你觉得它是三？”下一步是确定目标和期望的结果。为此，治疗师询问来访者事情需要达到什么程度，他或她才会觉得治疗目标已经实现或治疗已经成功。

“我们的目标是小的变化，这些变化将代表朝着目标和期望结果方向的进展。”

量表问题的例子包括：你说事情在5和6之间。需要发生什么你才能说事情在6和7之间？你有多自信你能像上周那样有一个好日子，在一个从一到十的量表上，一等于没有信心，十意味着你完全有信心？

来访者的担忧是真实且麻烦的，但是这个人已经设法生存到现在，至少足以来到你的房间并寻求帮助。因此，应对问题是典型的焦点解决干预。它们可以在来访者似乎不知所措且无法产生任何可能解决方案时提出。

基本结构很简单。它类似于：“自从[问题]开始以来，你如何[解决方案/应对]？”例如，“自从你的日程变得如此繁忙和具有挑战性以来，你是如何设法每天完成工作和其他职责的？”应对问题将来访者对问题的反应重新定义为未来解决方案的资源。为了使这种干预有效，咨询师需要仔细关注来访者的担忧，并承认它们造成的痛苦。然后应对问题关注到目前为止是什么让来访者继续前进：未来解决方案的关键资源。

焦点解决治疗师谨慎选择语言，始终以增加来访者的希望和乐观、控制感以及对可能性和变化的开放性为目标。当然，重点是解决方案，而不是问题。以下是可以促进解决方案谈话的语言习惯列表：优先使用开放式问题，使用预设积极变化的语言，外化问题，正常化人们的问题，使用应对问题，强化和注意优势和成功，创造假设性解决方案，专注于描述和改变行为，使用仪式、隐喻、故事和符号来传达可以促进变化的间接信息，经常使用诸如变化、不同、可能性、什么和如何等暗示变化的词语，使用包容性语言，允许看似不相容的结果共存，使用重构和重新标记来提供不同的视角，匹配来访者的词汇或说话风格以促进协作关系；然后改变语言以鼓励来访者视角的变化，提出建议，提供解决方案处方，打断抱怨模式。

当来访者专注于改变生活中的负面方面（或问题）时，由于问题的持续存在，积极变化常常被忽视、最小化或打折。焦点解决方法挑战咨询师注意来访者生活中发生的积极变化（无论多小）。预设变化的问题可以帮助来访者识别这些变化。它们可以是诸如“自从我上次见到你以来，有什么不同或更好？”这样的问题。这个问题邀请来访者考虑变化（也许是积极变化）最近在他们生活中发生的可能性。

如果没有积极变化的证据，咨询师可以提出一系列与来访者应对能力相关的问题，使用诸如以下问题：为什么事情没有变得更糟？是什么阻止了完全灾难的发生？你是如何避免崩溃的？这些问题可以由咨询师跟进，积极肯定来访者为应对所采取的任何行动。

当你给某人礼物时，你通常可能会用蝴蝶结把它包好。同样，焦点解决治疗师希望包装在会谈中发生的理解和洞察的礼物，给它加上赞美的“蝴蝶结”，通常还有一些建议。De Jong和Kim Berg指出，这不仅仅是关于会谈的表面：“在每个解决方案构建对话结束时，我们为来访者构建包含赞美和通常一些建议的信息。赞美强调来访者已经在做的对解决问题有用的东西。反馈基于来访者在关于形成良好目标和例外的对话中向我们揭示的信息。它总是关注来访者，根据他们的参考框架，需要多做和不同做什么，以增加他们实现目标成功的机会。”

文章概要

本文系统介绍了焦点解决疗法（SFBT）的核心技术，特别强调了如何运用未来导向的提问方式设定远大目标。文章详细阐述了奇迹问题、例外问题、量表问题、应对问题等关键技术，这些技术都旨在帮助来访者从问题思维转向解决方案思维。奇迹问题通过假设奇迹发生引导来访者想象问题解决后的理想未来，例外问题帮助识别问题不存在的时刻，量表问题量化进展并设定具体目标，应对问题挖掘来访者已有的应对资源。文章还强调了语言使用的重要性，包括预设积极变化、外化问题、使用包容性语言等，这些语言策略能增强来访者的希望感和控制感。结合关键词“使用未来完美提问设定SFBT中的远大目标”，本文展示了如何通过未来导向的提问（如奇迹问题）激发来访者的愿景，并通过例外问题、量表问题等将远大目标分解为可实现的步骤，最终促进积极变化。

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