Brief History of SFBT

Solution Focused Brief Therapy began in the 1970s largely with the work of Steve de Shazer and Insoo Kim Berg. It developed from the focus of identifying what works in therapy rather than from theory about what should work. Steve de Shazer was highly influenced by the work of Milton Erickson through reading Jay Haley’s Strategies of Psychotherapy. This along with his work at the Mental Research Institute in Paolo Alto would form the foundations of SFBT.

Erickson posed radical ideas regarding the role of the therapist, the competency of the clients and the meaning of psychotherapy in general. His approach involved using the client’s own language and worldview as the focus of his work. Cade and O’Hanlon expand on this:

“Since we have no general or explanatory models to guide us, clients goals and visions of the future become our compass settings, and help us map our way to their hoped for destinations.”

Throughout the 70s and 80s Steve de Shazer and Insoo Kim Berg were developing what was to become known as Solution Focused Brief Therapy (SFBT). In particular in 1977 the introduction of a break within a session, the development of the Miracle question in 1983.

Interest in SFBT on a wider scale began in the late eighties and early nineties, following the publication of Steve de Shazer’s book “Keys to Solutions in Brief Therapy”.

In the late 1980’s a team of London based social workers and family therapists set up the Brief Therapy Practice, which later became known simply as BRIEF. Insoo Kim Berg and Steve de Shazer presented their ideas for the first time in Britain at their inaugural conference in 1990.

SFBT continued to spread across the world culminating in the creation of the European Brief Therapy Association (EBTA) in 1993 very shortly after Insoo Kim Berg and Steve de Shasser called a meeting to create the International Brief Therapy association (IBTA).

The Association for Solution Focused Hypnotherapy (AfSFH) was launched in 2010.

The Importance of the IC

Solution Focused Hypnotherapists are aware of the importance of the early moments of therapy and the importance of being impressive in every sense of the word. The Initial Consultation (IC) forms the foundations of therapy and as a result it can be argued is the most important session of them all. There should be a seamless flow of dialogue and the IC should be memorable. It is more important to get to know the person rather than the problem. It is also useful to give recognition to the changes the client has already achieved (seeking help and turning up for the appointment are all different actions which lead to a better future) and what has already got better (Pre-Treatment Change).
Whilst the exact detail of the problem is less important there is also the need for information gathering and it is understood that clients will often only listen once they themselves have been heard.
Explanations of the how the brain works can assist the worker in delivering an impressive and memorable IC which is so important in accelerating the process of change within the client. Explanations would include how negative thoughts can shift the locus of our thinking in to different areas of the brain which are less able to come up with the solutions required to live happily in a modern environment. It should also include the importance of positive thoughts, actions and interactions and how these will help release chemicals in the brain which make us feel happier, more confident and more in control, as well as making it easier to continue those positive thoughts actions and interactions.
It is also important to include an explanation of the conscious thought processes which can normally give a sensible and proper direction to our thoughts and decisions and how these can be hijacked by an oversensitive primitive and emotional brain which generally operates within the primitive parameters of Anxiety, Depression and/or Anger.
It is also important to explain and discuss how the brain has a built in mechanism to help us deal with problems and stresses in our lives helping us to make sense of the world and our place within it. It is therefore important to explain how sleep, and in particular REM sleep, works and how we can use and maximise this tool to help overcome symptoms or problems.

What a New Hypnotherapy Supervisor May Include in a Learning Needs Assessment

According to Hawkins and Shohet (2006) a new hypnotherapy supervisor might want to carry out a self-assessment of their learning needs based on the following categories:

1. Supervision Intervention

Understanding the purpose, the boundaries and the type of supervision.  A new supervisor may want to take the assessment further in this regard by following Heron’s (1975) six category intervention analysis which are split in to two groups (“Authoritative Interventions” and “Facilitative Interventions”).

2. Supervision Management Skills

These may include the need to explain the purpose of Supervision and negotiate contracts and maintaining any agreed boundaries.

3. Traits or Qualities

The new Supervisor may want to assess whether they have the necessary commitment, and is able to: use authority appropriately; be sensitive and adaptable; use humour and have an ethical maturity.

In Addition

They should also have a commitment to ongoing development that includes meeting their own supervision and CPD requirements, able to recognise their own limitations and can accept feedback.

The new supervisor should also assess their own exploration of empathy and how this can be expressed during supervision.

There are other approaches that can be taken to the self-assessment.  Including those identified by Ronnestad & Skovholt (2003) and Clarkson & Gilbert (1991).  It is also useful for the new supervisor to have an understanding of their own learning style. Kolb provides a useful four stage learning styles model.

A Brief Overview of the History of Counselling Supervision

Very briefly, the development of Counselling Supervision can be broken down in to three main stages. The first stage began with Freud who liked to gather small groups to discuss and review the work of those attending. It is understood that this was a largely informal process before Max Eitington began to formalise the process and make it a requirement in the 1920’s.

Supervision was not just used for therapists but also had groundings in other helping professions.

As the number of counselling/psychotherapy models grew so supervision grew into a second phase of development beginning in the 1950s. Counselling bound or psychotherapy bound supervision in which the supervision models were closely aligned to the model of counselling or psychotherapy being used by the attendees. The line between supervision, counselling and psychotherapy during this stage was often blurred.

The third stage began in the 1970s and brought a greater emphasis on education rather than counselling.  With it came a shift away from the person delivering the therapy and more towards the work carried out. It was from America that much of the research and development of Supervision models came. With them came a shift towards the ‘reflective practitioner’ as Supervision became more and more a reflection on practice. Much of the Supervision practice we see now in the UK for counselling, psychotherapy and hypnotherapy came from models and frameworks that developed in America.

The Four Burners Theory!

I have long been a fan of James Clear’s blog. His regular emails have survived many an unsubscribe cull over the years as he has written so much good material. One of my favourites is his explanation of the Four Burners Theory. His full article can be found here and I would highly recommend you read it: jamesclear.com/four-burners-theory.

In brief he describes the theory that we can look at our lives as a four burner stove. One burner is our family; one our work; one our friends and one our health. Essentially there is only a limited supply of gas. If we are to become true experts in any one of these four quadrants we have to  turn off one or even two of them to allow a greater flow of gas to the remaining burners and have them consistently burn at full strength.

We are all constantly looking for the right balance and are of course having to make trade offs or compromises between quadrants in order to remain sane and meet our responsibilities. If we are lucky we have a lot of control over which ones we have burning most brightly at any one time. Even the most casual observer might recognise that the first burner to be turned down when others (often work) need more heat is our health.

However, I think there is an extra element to this which is important we take in to account. I often talk to my customers about a stress bucket and how things that need to be processed by the brain (very often negatives such as set backs, losses, painful experiences etc) end up in the bucket. We know the subconscious will process these things during downtime, when accessing a positive trance state and, most importantly, during REM sleep. All these things will lighten the load in the bucket.

However, when the bucket gets too full the brain will work less effectively, we will be more likely to suffer mood swings, anger, anxiety, low mood and a whole host of other negative side affects. We will be less focused and our performance may suffer at work, we may feel less connected to our friends and family and looking after our health becomes an even greater chore. In short the weight of the bucket restricts the supply of gas to all the burners meaning none of them will burn as brightly as we would like. Frustratingly this can create a negative thought loop (“I am not doing enough/performing as well as I know I can” etc) which continues to pile more things in to the bucket cutting the gas supply further.

 

171116 Four Burner Stress Bucket Picture

There are of course ways to reduce the amount that goes in to the bucket. Skills we can practice, things we can do or perceive differently. Ultimately though it is often crucial that we find a way to redirect some additional gas to the health burner, because this will have a direct impact on the weight of the bucket too. The temptation to cut the gas supply to this burner is a very short term way of thinking.

Need help getting your stress bucket under control or working towards having a better supply of gas to the burner of your choice? Alex Brounger is a Clinical Hypnotherapist with clinics in Stroud and Cirencester in Gloucestershire. If you do not live near Stroud or Cirencester visit the AfSFH’s (Association for Solution Focused Hypnotherapy) web page: afsfh.com or contact Alex for further help. Alex is the Chief Executive for the AfSFH.

 

10 Reasons You Should See A (Qualified) Hypnotherapist Now

There still remains a lot of mystery and myth around Hypnosis and Hypnotherapy. The fact remains that good quality scientific evidence is building and continuing to support this talking therapy as an effective way to help people cope with a wide range of symptoms and conditions.  So look past the nonsense and learn how hypnotherapy can help you. Here are 10 reasons why you should visit a Hypnotherapist sooner rather than later:

Hypnotherapy can help you sleep better:

Good sleep is a cornerstone for good health. By entering in to a meditative or hypnotic trance state we are effectively practising the pre-cursor stages of sleep, which means that when it comes to bed time we are better able to drift off. Hypnosis also accurately replicates the same processes that take place during REM sleep which means we can have less REM sleep during the night. Having too much REM sleep at night can wake us up, resulting in a disturbed sleep pattern. Sleep well and you will find it easier to maintain a healthy weight, cope with stress better and wake feeling refreshed and ready to take on the day.

Hypnotherapy can make you more confident:

Hypnosis can help release us from fear (even if we don’t recognise it as such) and gain access to the solution finding brilliance of the intellectual brain. This results in feelings of confidence and empowerment as we become better adept at coping with life’s challenges. Self doubt slips away as it becomes easier to do those positive things that result in the release of natural feel good chemicals in the brain. Don’t just survive… thrive!

Hypnotherapy can make you less irritable:

Irritability, or flashes of anger, result from an over activation of the amygdala in the brain. Hypnosis encourages the amygdala to calm down which become less trigger happy. This means we are less likely to have these moments.

Hypnotherapy can help you get some energy back:

Hypnosis activates the parasympathetic nervous system (rest and digest response) which in very basic terms is the opposite to the sympathetic nervous system (fight or flight response). The rest and digest response is, broadly speaking, regenerative or energy giving. The fight flight response is generally energy sapping. By accessing a state of hypnosis we restore our natural balance between these two parts of the nervous system which results in better energy levels.

Hypnotherapy can help you gain control over the things you want to gain control over

People often suggest they do not like the idea of hypnosis and hypnotherapy because it involves giving up control of their mind to someone else. This is of course complete nonsense. In fact Dr. David Spiegel, Associate Chair of Psychiatry at Stanford University School of Medicine suggests: “…hypnosis is not mind control. It’s a naturally occurring state of concentration; it’s actually a means of enhancing your control over both your mind and your body.”

Hypnotherapy can help you think more clearly

A relaxed mind is a clear mind. By entering in to a state of focused attention (hypnosis) our mind can relax and put our worries and fears to one side for a little while. Our primitive mind, or limbic system, becomes less active enabling resources to be sent to those areas of the brain which are better able to come up with solutions. This allows us to consider our worries and troubles from a different, more confident perspective allowing the brain space and time to find its own solutions.

Hypnotherapy can make you more positive

Anything can be improved through practice. Positivity is no different. A good hypnotherapist will want you to practice being positive. (For more tips on positivity see this article) allowing us to more readily identify the good things that are going on in our lives.

It can help improve your relationships

Relationships driven by irritability, lack of sleep and negativity are rarely good ones! Primitive brain responses to our loved ones comments and actions (or lack of) do not lead to a positive relationship either and sometimes we can be so lost in our own previous patterns of behaviour we do not notice when it is us that are being the bad guys. Accessing our intellectual capacity more frequently through hypnotherapy and we are better able to manage disagreements, keep things in perspective and work towards conversations that work for everyone.

You’ll enjoy it!

Modern therapy should be enjoyable. We learn better when we are in a positive and relaxed frame of mind and modern therapy is often about learning new ways of doing, thinking and interacting. Hypnosis itself certainly should be a positive and enjoyable experience if we are to get the most out of it.

It can make you look younger

OK so I have to be a bit careful what I say here, especially as I am not aware of any studies which have actually proved this. However, I can say with complete confidence that people who come to see me for their last session typically look younger than they did when they came to see me for their first session! It can probably put down to getting benefit from reasons 1-9 above.

How will hypnotherapy help you?

It can be surprising how hypnotherapy can help people. Often people come for a specific reason and many of the above manifestations appear as a lovely side affect. In many cases people come precisely for one or more of the reasons given above. Ultimately any appointment with a good hypnotherapist should be an enjoyable and positive experience which benefits you in hoped for and surprising ways.

If you are in or near Stroud or Cirencester in Gloucestershire and would like to book an appointment with Alex, take a look at his website here: abHypnotherapy.co.uk. If you live further afield visit the AfSFH’s (Association for Solution Focused Hypnotherapy) web page: afsfh.com or contact Alex for further help. Alex is the Chief Executive for the AfSFH.

Why are you the way you are… and why do you need to know?

Estonian-American Neuroscientist and psychobiologist, Jaak Panksepp from Bowling Green State University argues that the brain is in many ways a seeking system. He suggests we all have an innate drive to discover and learn, to satisfy our curiosity and to understand why something is the way it is. More so if that something is related to ourselves. We may ask: “Why do I do that?” or “why am I the way I am?”. Not unnecessarily bad questions to ask ourselves but frustrating if we can not find an answer.

The psychologist Jerome Kagan also argues that uncertainty resolution is one of the biggest determinants of our behaviour. He suggests we want to relieve the distress of the unknown. This can of course lead us to difficulties if we are struggling with a condition or set of symptoms which our GP or other medical practitioner can not explain. The answer can often be found in neuroscience and for this reason I will often have brain based conversations with my clients, utilising the very latest in neuroscience research. By explaining, in simple terms, how the brain works, how we can struggle with some of the more, and less, well known symptoms, my clients and customers often have a moment of relief, a moment of understanding which allows them to realise that they are normal. This usually results in an immediate reduction in anxiety levels and an increase in hope. We are all looking for, to use Arie Kruglanski’s term, “cognitive closure”.

When we are faced with situations in which we are unable to achieve “cognitive closure” it can affect our mood, our actions and our choices. It can feed in to the obsessional nature of the primitive brain preventing us from seeing the bigger picture and beyond the problem, thereby making the problem worse.

In addition, by explaining to clients in general terms what they should be doing more (and less!) of, without advising them to do something specific, my clients come to understand how they can better engage their own intellectual and mental resources to see a way forward which may not have been obvious to them previously.

Generally speaking I make sure that clients have a very thorough understanding of how our minds works and how, if we are not careful, it can trip us up. This knowledge stays with them long after a series of sessions is completed which can lead to long term well-being rather than just a short term fix.

Alex Brounger is a full time Solution Focused Hypnotherapist with practices in Cirencester and Stroud, Gloucestershire. His website is: abHypnotherapy.co.uk

Alex is also a Hypnotherapy Supervisor and is a Senior Lecturer for CPHTBelfast.co.uk

Does Hypnotherapy Work? – CORP research programme

I am often asked “Does hypnotherapy work for …?” or “Can hypnotherapy help with …?” or just simply “Does hypnotherapy work?”.  I normally answer with something along the lines that I don’t have a magic wand but if people come to see me open to making changes and with a willingness to take on board the evidence, as revealed by the latest neuroscience, on how the brain works then you can be confident that hypnotherapy will make a very real difference to your well-being. And that’s regardless of the reason you have expressed an interest in the first place.

My Clients tell me hypnotherapy has worked for them – but is that enough?:

Of course, I have many client examples of how successful my work with them has been.  I don’t blame those people who are cynical (I was a cynic about hypnosis and hypnotherapy once!) and I know anecdotes do not make the best evidence, especially if those come from the mouth of an enthusiastic practitioner like myself.  There is already a huge amount of evidence that demonstrates the effectiveness of hypnotherapy, but it is important we continue to uncover more.  It was for this reason I chose to become part of an excellent research programme which was created to demonstrate the effectiveness of Solution Focused Hypnotherapy for a variety of conditions.

The Research Programme:

The programme is called CORP (Clifton Practice Rating Outcome Programme).  I ask my customers to rate themselves against the following scales (either on a piece of paper or, more usually, on a piece of software of the same name) during the Initial Consultation and at the end of each session after that.  The seven scales are:

1/ Thoughts – How positive have your thoughts been?

2/ Interaction – How interactive have you been with others?

3/ Activity – How would you rate your level of activity?

4/ Confidence – How would you rate your confidence?

5/ Strengths & Resources – How well are you utilising your strengths and resources?

6/ Achievement – How much have you achieved?

7/ Happiness – How would you rate your level of happiness?

The information gathering fits seamlessly in to our sessions.  Once customers have indicated, on a bar, where they feel they fall, between two points (for example, my thoughts have been very negative at one end to very positive at the other), the software allocates a score out of 10. The scores from all the questions are added together to give a result out of 70.  In this way changes over time are measured and illustrated in the form of a graph.  Customers can then see by how much they have improved on these scales in the time they have been to see me.  I can also monitor how well I am doing across my whole client population and my results contribute to the broader results of the research which, at the time of writing, includes more than 80 Solution Focused Hypnotherapists nationally. As a result, of a volume of results are being collected giving a statistically significant indicator of the success of Solution Focused Hypnotherapy.

Solution focused therapy, by its very nature, is not problem focused.  This can make it difficult to measure its effectiveness without focusing on problems or symptoms.  By choosing these outcome rating scales rather than more problem specific ones negates this difficulty, and encourages clients to focus on those areas which will, with appropriate effort, inevitably lead to an improvement in their condition.

Who Benefits?

The short answer is everybody!  But most importantly, my clients benefit.  The programme allows them to monitor their own progress in a way which may not be obvious when relying on pure feelings and emotion at that moment, whilst trying to compare that with their feelings and emotions of a few weeks ago. It also enables me in many situations to indicate (by showing the graph of past results) how quickly and to what extent they might expect to see an improvement across those measures.  Moreover, customers complete this shortly before leaving the clinical environment which serves as a nice reminder of where their focus should be to continue to move forwards.

I benefit, and so do my clients, by being able to compare my performance against the global average of other Solution Focused Hypnotherapists across the country.  This helps keep me sharp and encourages me to stay on top of my game!

And of course, hypnotherapy generally benefits.  The greater the base of evidence, the more we can prove that hypnosis and its associated ideas are an effective, helpful and powerful set of tools for improved wellbeing, overcoming symptoms and a driver for good health the more it will become mainstream and the more people can benefit from it.