Are You Hurting Your Clients By Doing This in Therapy?

https://youtu.be/C06E8dBCI2I

Practicing Solution Focused Brief Therapy requires that you focus on the individual and not the group or culture that the individual comes from. This is a massively important lesson, and it’s been one of the highlights of the training that we’re doing here.

So Adam and I are here in Anaheim, where we’re teaching a two day intensive. The group is at lunch right now, which is why the room is empty. But we have been focused on helping this group really understand Solution Focused Brief Therapy and be able to practice it with competence and confidence and come away with really important lessons.

And yesterday, we were addressing, why do we think this approach is effective with all people, regardless of their background, circumstances, or referring problems?

And Adam, kicked it off saying some really, really important things.

It’s so key that in our field, we tend to treat people like the groups they are in. Like, I read a book about people that have bipolar disorder or trauma. So based on that knowledge, I’m gonna treat this person [a certain way]. And a lot of therapy is about trying to figure out what group to put them in. So we know how to treat them. But in Solution Focused Brief Therapy, we have to treat them as individuals. Even if you know what group they’re in, you don’t know what their individual journey has been within that group. And that’s what makes this approach so remarkable.

I want to have Adam make some other points, because some of the stuff he was saying during this training were remarkable, and I want him to highlight something.

What I want to share is, I want you to remember how important it is to treat the person as an individual, even if you know the group that they belong to. Because even with that knowledge, you don’t know what their individual journey has been within the group.

So now I want Adam to take it…

A couple of things are really important about what Elliott just said. And I think, one, we live in an era where evidence based practice is really being pushed and promoted. And you have to know, I’m a researcher. I really value evidence. But I think there’s a few things that we overlook.

And one, evidence based practice doesn’t just mean that there’s research that says that it works. There are actually three components to this. One is empirical support, which is the research. Two is clinical expertise, which just means I have to be really good at my job. I have to know how to do it and do it really well. But the third thing is client values. What I’m doing has to match and meet what my client needs.

And you just heard Elliott say, we can’t treat people like they come from a group. If I treat somebody as though they come from a group of like, oh, you’re a woman. I know how to treat women. Or you’re, oh, you’re African American. I know how to treat African Americans. That’s not only insensitive, but it also doesn’t look at them as an individual to say, this is what you need, or Elliot used the words of, this is how you have walked that particular journey.

When I do Solution Focused Brief Therapy, I have to say, “What is your desired outcome?” Regardless of what groups you might fit into, “What is it that you want? What is it that you need? What desired outcome are you seeking?” And then in my work, I need to customize that by using their individual language.

Only by understanding their desired outcome, and only by using their language can I say for sure I am meeting what the client needs. I am matching my expertise with their value system. That’s the only way we can make this an evidence based approach.

So I think that’s one thing. The other thing I think I would say about this topic is that in the DSM, we really are bound to these different categories. We say, oh, you have these symptoms, and so therefore you are this, or you have this disorder. And I think that in and of itself is a white, generally white privileged perspective that says, if you don’t fit the norm, then you have X disorder or there’s something wrong with you. And I think one of the things that we need to do is we need to decolonize the way that we do psychotherapy.

And that means instead of trying to put people in boxes and saying, this is what’s wrong with you, we need to look forward and we need to say, “What is it that you’re seeking? If you were able to be the best version of yourself, how would that show up?” And only by individualizing like that, instead of trying to force people into categories of denigration, can we actually get to a place where we can be useful and helpful to people.

And so I think for a couple of reasons, psychotherapy really should reevaluate how we teach, how we train, but also how we treat individuals, because that’s actually how we’re going to do useful, meaningful work.