焦点解决疗法中量表探索目标助力创伤康复

英文原文

Solution-focused therapy is a type of treatment that highlights a client’s ability to solve problems, rather than why or how the problem was created. It was developed over some time after observations of therapists in a mental health facility in Wisconsin by Steve de Shazer and Insoo Kim Berg and their colleagues. Like positive psychology, Solution Focused Therapy (SFT) practitioners focus on goal-oriented questioning to assist a client in moving into a future-oriented direction. Solution-focused therapy has been successfully applied to a wide variety of client concerns due to its broad application. It has been utilized in a wide variety of client groups as well. The approach presupposes that clients have some knowledge of what will improve their lives. The following areas have utilized SFT with varying success: depression, relationship difficulties, drug and alcohol abuse, eating disorders, anger management, communication difficulties, crisis intervention, incarceration recidivism reduction. Goal clarification is an important technique in SFT. A therapist will need to guide a client to envision a future without the problem with which they presented. With coaching and positive questioning, this vision becomes much more clarified. With any presenting client concern, the main technique in SFT is illuminating the exception. The therapist will guide the client to an area of their life where there is an exception to the problem. The exception is where things worked well, despite the problem. Within the exception, an approach for a solution may be forged. The ‘miracle question’ is another technique frequently used in SFT. It is a powerful tool that helps clients to move into a solution orientation. This question allows clients to begin small steps toward finding solutions to presenting problems (Santa Rita Jr., 1998). It is asked in a specific way and is outlined later in this article. Experiment invitation is another way that therapists guide clients into solution orientation. By inviting clients to build on what is already working, clients automatically focus on the positive. In positive psychology, we know that this allows the client’s mind to broaden and build from that orientation. Utilizing what has been working experimentally allows the client to find what does and doesn’t work in solving the issue at hand. During the second half of a consultation with a client, many SFT therapists take a break to reflect on what they’ve learned during the beginning of the session. Consultation breaks and invitations for more information from clients allow for both the therapist and client to brainstorm on what might have been missed during the initial conversations. After this break, clients are complemented and given a therapeutic message about the presenting issue. The message is typically stated in the positive so that clients leave with a positive orientation toward their goals. Scaling questions are questions that allow a client to rate their experience. They also allow for a client to evaluate their motivation to change their experience. Scaling questions allow for a practitioner to add a follow-up question that is in the positive as well. An example of a scaling question: “On a scale of 1-10, with 10 representing the best it can be and one the worst, where would you say you are today?” A follow-up question: “ Why a four and not a five?” Questions like these allow the client to explore the positive, as well as their commitment to the changes that need to occur. Solution-Focused Therapy is an approach that empowers clients to own their abilities in solving life’s problems. Rather than traditional psychotherapy that focuses on how a problem was derived, SFT allows for a goal-oriented focus to problem-solving. This approach allows for future-oriented, rather than past-oriented discussions to move a client forward toward the resolutions of their present problem. This approach is used in many different areas, including education, family therapy, and even in office settings. Creating cooperative and collaborative opportunities to problem solve allows mind-broadening capabilities. Illuminating a path of choice is a compelling way to enable people to explore how exactly they want to show up in this world.

中文翻译

焦点解决疗法是一种强调来访者解决问题能力的治疗方法，而不是关注问题为何或如何产生。它是由史蒂夫·德·沙泽尔、茵素·金·伯格及其同事在威斯康星州一家心理健康机构观察治疗师一段时间后发展起来的。与积极心理学一样，焦点解决疗法（SFT）从业者专注于以目标为导向的提问，帮助来访者朝着面向未来的方向前进。由于其广泛的应用性，焦点解决疗法已成功应用于各种来访者关注的问题，也被用于多种来访者群体。该方法假设来访者对自己生活的改善有一定了解。以下领域已不同程度地成功应用了SFT：抑郁、关系困难、药物和酒精滥用、饮食障碍、愤怒管理、沟通困难、危机干预、减少再犯。目标澄清是SFT中的一项重要技术。治疗师需要引导来访者设想一个没有他们呈现的问题的未来。通过指导和积极提问，这一愿景变得更加清晰。对于任何来访者关注的问题，SFT的主要技术是照亮例外。治疗师将引导来访者关注生活中问题例外的领域。例外是指尽管存在问题，但事情进展顺利的地方。在例外中，可以找到解决方案的途径。“奇迹问题”是SFT中常用的另一种技术。它是一个强大的工具，帮助来访者转向解决方案导向。这个问题让来访者开始采取小步骤寻找呈现问题的解决方案（Santa Rita Jr., 1998）。它以特定方式提出，并在本文后面概述。实验邀请是治疗师引导来访者进入解决方案导向的另一种方式。通过邀请来访者在已经有效的基础上继续发展，来访者会自动关注积极方面。在积极心理学中，我们知道这能让来访者的思维从该导向中拓宽和构建。利用实验证明有效的方法，让来访者找到解决当前问题有效和无效的方法。在与来访者咨询的后半段，许多SFT治疗师会休息一下，反思在会话开始时学到的东西。咨询休息和邀请来访者提供更多信息，让治疗师和来访者共同头脑风暴，思考在初始对话中可能遗漏的内容。休息后，来访者会得到赞美，并获得关于呈现问题的治疗性信息。该信息通常以积极的方式陈述，以便来访者带着积极的目标导向离开。量表问题是让来访者评估自己体验的问题。它们也让来访者评估改变体验的动机。量表问题允许从业者添加一个同样积极的后续问题。量表问题的例子：“在1-10的量表上，10代表最好，1代表最差，您认为今天您处于哪个位置？”后续问题：“为什么是四而不是五？”这样的问题让来访者探索积极方面，以及他们对需要发生的变化的承诺。焦点解决疗法是一种让来访者拥有解决生活问题能力的方法。与关注问题如何产生的传统心理治疗不同，SFT允许以目标为导向解决问题。这种方法允许面向未来而非过去的讨论，推动来访者朝着解决当前问题的方向前进。这种方法用于许多不同领域，包括教育、家庭治疗，甚至办公室环境。创造合作和协作解决问题的机会，可以拓宽思维的能力。照亮选择之路是一种引人注目的方式，让人们探索他们究竟想如何在这个世界上展现自己。

文章概要

本文介绍了焦点解决疗法（SFT）的核心技术和应用，特别强调了量表问题在目标探索中的作用。SFT由德·沙泽尔和伯格等人发展，注重来访者的优势和解决问题的能力，而非问题本身。关键技术包括目标澄清、照亮例外、奇迹问题、实验邀请和量表问题。量表问题允许来访者量化自己的体验和动机，例如在1-10的量表上评分，并通过后续问题探索积极变化。SFT已成功应用于抑郁、关系困难、创伤等多种领域，通过未来导向的讨论帮助来访者设定目标并采取小步骤实现解决方案。文章还提到SFT在创伤康复中的应用，通过量表探索目标，帮助来访者从积极角度评估进展，增强希望和信心。

高德明老师的评价