Northwest Brief Therapy Training Center
Solution-focused therapy builds on the strengths and resources clients have to help them develop solutions that uniquely fit them and their circumstances. This can be a particularly difficult challenge when dealing with the exceptional circumstance of clients who present as completely hopeless and helpless. They may see themselves as powerless over their situation and complain extensively about how impossible that situation is. Oftentimes these people have severe chronic medical problems and/or a personal history of severe abuse or mental illness. As a therapist it is easy to become discouraged and hopeless about this kind of client too.
Reassurance does not work with these clients. In fact, it is likely to have the opposite effect of the one intended. The client is not reassured but typically makes even more hopeless and desperate statements. She/he is picking up on the therapist´s sense of helplessness and as a result may feel more out of control her/himself. All of a sudden it is the therapist’s job to make the client feel better, not the client’s job. In any case, a sense of empowerment and self confidence cannot be imposed from without, it must come from within.
Coping questions can solve this dilemma while cooperating with clients as well as accepting their view of the problem. The therapist can begin to help clients see their strengths and resources in trying circumstances and stay “behind” them rather than reassure them or take over and try to impose a solution (which is unlikely to fit well or be long-lasting).
Coping questions ask about how clients somehow manage to keep going in spite of the adversity they face. For example, someone who is suicidal obviously has not killed himself yet. Someone living with chronic pain is enduring it somehow. In spite of a terrible childhood, a client manages to get through the day and take care of her baby.
A solution-focused therapist is curious about this and coping questions are designed to discover how clients manage to keep going in spite of all that is against them. Taking this approach helps clients discover resources and strengths they most likely did not know they had. When used properly and with persistence the result is empowering and uplifting. It helps shift their view of themselves in a positive, client-enhancing direction:
“How did you manage to get up this morning (make it to this appointment, get through yesterday, etc.)?”
“How do you keep going day after day when there seems to be no hope?”
“How is it (“What do you do so) that things are not worse?”
“How come you have not killed yourself yet? What has held you back?” (if thinking of suicide)
“How did you learn to cope with such an awful situation, when you were still so young? Did you have to do it all by yourself?” (talking about childhood abuse/trauma)
This type of question helps the therapist let clients lead in telling what they are capable of, what is good about them and allows them to recognize strengths, resources and abilities they oftentimes had not thought of themselves.
Once you get an answer to a coping question, the next task is to build on that answer, to expand it. So pursue their response and ask questions like:
“What did you do to get up this morning (keep going yesterday, stay alive today, get through that period in your childhood, etc.)?”
“What would it take for you to keep doing what you’ve been doing?”
“Where did you learn to do that? Or did you figure it out by yourself?” (follow up question: “How did you figure out this was a good way to do it?)”
Caution: When working with clients who present as powerless and hopeless, make sure you’re not “the customer” for your own services, that you’re not the one who is most bothered by the problem or want a solution more than the client. Instead, stay with the client’s identified problem/goal. You might ask how the concern you have relates to issue(s) the client has identified. Your work together has to be on the client’s goal to succeed.