Brief Therapy in Schools

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SOLUTION-​FOCUSED BRIEF THERAPY IN SCHOOLS


ii

OXFORD WORKSHOP SERIES:


SCHOOL SOCIAL WORK ASSOCIATION OF AMERICA

Series Advisory Board
Rebecca K. Oliver, LMSW, School Social Work Association of America
Timothy Schwaller, MSSW, LCSW, University of Wisconsin–​Milwaukee
Tina Johnson, MSSW, MPA, MA, University of Louisville
Cassandra McKay-​Jackson, PhD, LCSW, University of Illinois at Chicago
Laurel E. Thompson, PhD, MSW, Broward County Public Schools
Christine Anlauf Sabatino, PhD, LICSW, C-​SSWS, The Catholic University
of America
Michelle Alvarez, MSW, EdD, Southern New Hampshire University
Kevin Tan, PhD, MSW, University of Illinois at Urbana–​Champaign
Kate M. Wegmann, PhD, MSW, University of Illinois at Urbana–​Champaign
Evidence-​Based Practice in School Mental Health
James C. Raines
The Domains and Demands of School Social Work Practice:
A Guide to Working Effectively with Students, Families, and Schools
Michael S. Kelly
Solution-​Focused Brief Therapy in Schools:
A 360-​Degree View of Research and Practice
Michael S. Kelly, Johnny S. Kim, and Cynthia Franklin
A New Model of School Discipline:
Engaging Students and Preventing Behavior Problems
David R. Dupper
Truancy Prevention and Intervention:
A Practical Guide
Lynn Bye, Michelle E. Alvarez, Janet Haynes, and Cindy E. Sweigart
Ethical Decision Making in School Mental Health
James C. Raines and Nic T. Dibble
Functional Behavioral Assessment:
A Three-​Tiered Prevention Model
Kevin J. Filter and Michelle E. Alvarez
School Bullying:
New Perspectives on a Growing Problem
David R. Dupper
Consultation Theory and Practice:
A Handbook for School Social Workers
Christine Anlauf Sabatino
School-​Based Practice with Children and Youth Experiencing Homelessness
James P. Canfield
Solution-​Focused Brief Therapy in Schools:
A 360-​Degree View of the Research and Practice Principles, Second Edition
Johnny S. Kim, Michael S. Kelly, Cynthia Franklin
 iii

SOLUTION-​FOCUSED BRIEF THERAPY


IN SCHOOLS
A 360-​Degree View of the Research
and Practice Principles
SECOND EDITION

Johnny S. Kim, Michael S. Kelly, & Cynthia Franklin

OXFORD WORKSHOP SERIES

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1
Oxford University Press is a department of the University of Oxford. It furthers
the University’s objective of excellence in research, scholarship, and education
by publishing worldwide. Oxford is a registered trade mark of Oxford University
Press in the UK and certain other countries.

Published in the United States of America by Oxford University Press


198 Madison Avenue, New York, NY 10016, United States of America.

© Oxford University Press 2017

First Edition published in 2008


Second Edition published in 2017

All rights reserved. No part of this publication may be reproduced, stored in


a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
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address above.

You must not circulate this work in any other form


and you must impose this same condition on any acquirer.

CIP data is on file at the Library of Congress


ISBN 978–0–19–060725–8

1 3 5 7 9 8 6 4 2
Printed by WebCom, Inc., Canada
 v

We dedicate this book to the pioneers of school social work, who started
this profession in the early 20th century as a solution to the challenge of
building school/​home/​community linkages; to the 30-​plus national and
state associations that carry on this work today; and to our school social
work students, who are eager to become the next generation of strengths-​
based school social work practitioners.
vi
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Contents

Contributing Authors   ix

Chapter 1 Introduction: A 360-​Degree View


of Solution-​Focused Brief Therapy
in Schools   1
(Johnny S. Kim, Michael S. Kelly, & Cynthia Franklin)

Chapter 2 SFBT Techniques and Solution


Building  12
(Johnny S. Kim, Michael S. Kelly, & Cynthia Franklin)

Chapter 3 SFBT and Evidence-​Based Practice: The


State of the Science   31
(Johnny S. Kim, Michael S. Kelly, & Cynthia Franklin)

Chapter 4 SFBT Within the Tier 1 Framework:


Alternative Schools Adopting the SFBT
Model  52
(Cynthia Franklin & Samantha Guz)

Chapter 5 SFBT Within the Tier 2 Framework:


Coaching Teachers to See the Solutions
in Their Classrooms   74
(Michael S. Kelly, Johnny S. Kim, & Cynthia Franklin)

Chapter 6 SFBT Within the Tier 3 Framework:


Case Examples of School Social Workers
Using SFBT   87
(Michael S. Kelly, Johnny S. Kim, & Cynthia Franklin)

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viii

Chapter 7 SFBT in Action: Child Abuse and Neglect   107


(Robert Blundo & Kristin W. Bolton)

Chapter 8 SFBT in Action: Mental Health and Suicidal


Ideation  126
(Carol Buchholz Holland)

Chapter 9 SFBT in Action: Substance Use   153


(Adam S. Froerer & Elliott E. Connie)

Chapter 10 SFBT in Action: Eating Disorders   179


(Karrie Slavin & Johnny S. Kim)

Index  197

viiiContents
 ix

Contributing Authors

Chapter  4:  SFBT Within the Tier 1 Framework:  Alternative Schools


Adopting the SFBT Model
Samantha Guz, BS
School of Social Work
The University of Texas at Austin

Chapter 7: SFBT in Action: Child Abuse and Neglect


Robert Blundo, PhD
Kristin W. Bolton, PhD
Strengths/​Solution-​Focused Collaborative
School of Social Work
College of Health and Human Services
University of North Carolina–​Wilmington

Chapter 8: SFBT in Action: Mental Health and Suicidal Ideation


Carol Buchholz Holland, PhD
Counselor Education Program
North Dakota State University

Chapter 9: SFBT in Action: Substance Use
Adam Froerer, PhD
The Connie Institute &
Mercer University School of Medicine

Elliott Connie, MA, LPC


The Connie Institute

Chapter 10: SFBT in Action: Eating Disorders


Karrie Slavins, MSW, MPH, LMSW
School of Social Work
Western Michigan &
Private Practice
Grand Rapids, Michigan

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SOLUTION-​FOCUSED BRIEF THERAPY IN SCHOOLS


xii
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■ ■ ■

Introduction
A 360-​Degree View of Solution-​Focused Brief Therapy
in Schools
Johnny S. Kim, Michael S. Kelly, & Cynthia Franklin

Since its creation in the 1980s, solution-​focused brief therapy (SFBT) has
gradually become a common treatment option accepted by many men-
tal health professionals (MacDonald, 2007). With its emphasis on client
strengths and short-​term treatment, SFBT appears to be well suited for
school mental health contexts given the wide array of problems present-
ing in school settings and the large caseloads of most school social workers
(Franklin, Biever, Moore, Clemons, & Scamardo, 2001; Newsome, 2005).
This second edition is part of the Oxford Workshop Series and presents a
“360-​degree” view of SFBT in school settings from meta-​analytic, interven-
tion research, and practice perspectives.
All the chapters from the previous edition have been updated, and
we have added new chapters to further expand the clinical examples
demonstrating SFBT techniques. Since publication of the first edition
in 2006, research on SFBT in schools has produced several advances
that we cover here, including updates on recent systematic reviews and
discussion about SFBT listed on national evidence-​based registries. This
second edition also expands some of the original chapters by adding a
Response to Intervention (RtI) framework for schools that may want to
use the SFBT approach. And we have added several new clinical chap-
ters called “SFBT in Action.” Selected based on results from the Second
National School Social Work Survey, which identified the most common

1
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school-​related problems that school social workers encounter in their


work, these new clinical chapters further demonstrate ways to use SFBT
with students.
The chapters in this book take you through a 360-​ degree view
of SFBT in school social work practice. You will first learn about
SFBT itself, from its earliest beginnings in the 1980s to the present
day. In Chapter  2, SFBT techniques and why this approach can be
applied directly to school social work practice realities are discussed.
Additionally, the SFBT theory of change is presented to help explain
how these techniques positively affect students. In Chapter 3, the ques-
tion “Does SFBT really work?” is given a thorough review, including the
most recent results from several systematic reviews and meta-​a nalyses
on SFBT practice and giving a full picture of the current state of the sci-
ence in regards to SFBT practice. Chapter  4 provides a brief overview
of Tier 1 goals and how SFBT can work within this RtI framework that
is popular in schools. Chapter 4 focuses on one such school—​G onzalo
Garza Independence High School in Austin, Texas—​that the authors
have consulted with extensively and that illustrates a solution-​focused
Tier 1 approach adopting SFBT ideas and principles throughout the
entire school curriculum and discipline process. Chapter  5 discusses
Tier 2 goals and how SFBT can be applied to targeted groups of stu-
dents who are identified as more at-​r isk. It also features a particularly
exciting new approach to using SFBT in schools—​t he WOWW program
(“Working on What Works”)—​to illustrate how SFBT can be adapted
to classroom and small group contexts. WOWW is a teacher coaching
intervention designed to increase teacher-​s tudent collaboration for bet-
ter learning environments, and along with a detailed description of the
WOWW intervention program in the Chicago area (2007–​2012), the
promising outcome data from the initial WOWW program are analyzed
and discussed. Chapter  6 draws on some of the positive outcomes of
the Garza experience to show how school social workers in a diverse
array of K-​12 school environments have translated SFBT ideas using a
Tier 3 approach (intensive individual counseling). And with Chapters 7
through 10 (the “SFBT in Action” chapters), this second edition expands
on the practice by identifying four of the most common student prob-
lems encountered by school social workers and describing how to apply
SFBT techniques to your school practice.

2 Solution-Focused Brief Therapy in Schools


 3

In Schools, Solutions Are Everywhere


Problems abound in school settings. Students are not always ready to learn,
teachers are not always sure how to deal with the underachieving and/​or
defiant student and instead claim that he or she just “doesn’t care,” and
parents are at times eager to find someone from the school to blame. The
overall school climate provides additional possible stresses, with school vio-
lence, bullying, gang activity, and other illicit behavior happening on school
grounds while school administrators try to maintain “zero tolerance” for
these behaviors on the one hand yet foster a positive, child-​centered learn-
ing environment to increase academic achievement for all students on the
other. And as if all these problems were not enough, the field of education is
under pressure from federal, state, and local governments to provide accu-
rate and measurable progress toward yearly goals, a process that has become
even more pronounced since implementation of the No Child Left Behind
legislation in 2002.
Solutions, however, also abound in school settings. Second graders wake
up early and tell their parents that they cannot wait to get to school so they
can see their teachers and their friends. Teachers stop in the hallway to tell
colleagues about a new project they are excited about starting with their
students. In cafes, beauty shops, and church basements, parents encourage
other parents to send their own kids to a child’s school because of all the
great things that school has going for it. School leaders, in collaboration with
local law enforcement, parents, and the students themselves, create zones
of safety even for children living in economically distressed and danger-
ous neighborhoods. All the school stakeholders (teachers, parents, kids, and
administrators) welcome higher accountability standards and frame them as
an opportunity to foster a more collaborative and high-​achieving academic
culture.
Schools can be places of solutions, strengths, and successes. School-​
based mental health professionals (school social workers, school counsel-
ors, and school psychologists) have numerous ways to harness the solutions
that are already happening in their schools. A  database search revealed
more than 50 books in print on SFBT, SFBT associations in over 10 coun-
tries, and several annual national and international conferences devoted to
SFBT. In Chapter 3, we share findings from a meta-​analysis of SFBT stud-
ies that show solid (though modest) impacts in the current SFBT prac-
tice literature. Compared to a more heavily researched approach such as

Introduction: A 360-Degree View of SFBT in Schools3


4

cognitive-​behavioral therapy (CBT), SFBT is still developing rigorous out-


come studies that demonstrate its effectiveness, but as Chapter 3 shows, this
approach is on its way to joining CBT as a practice that has shown some
empirical efficacy (Franklin, Trepper, Gingerich, & McCollum, 2012).
We are sharing a 360-​degree view of an approach that is still a work in
progress and to which additional empirical research, theory, and practical
applications are being added each year. In the spirit of evidence-​based prac-
tice transparency, we do not overstate or play down the available research
on SFBT’s effectiveness: we share these findings with you and let you join
us in assessing how well these findings apply to your own practice style and
school context.

Why SFBT Is Well Suited to School Social Work Practice


Problems and solutions, to the thinking of an SFBT school social worker, are
always “abounding” in any school context. Indeed, one of the more liberat-
ing notions of SFBT is that change is continually happening, which requires
our attention to be focused on the small changes that are making poten-
tially large differences in the lives of our clients. What we do with those
small, sometimes hard-​to-​see changes is what make us SFBT school social
workers, and it could even make our school contexts become more solution
focused in their approaches to the key educational issues of today.
The following short case example demonstrates how the possibilities for
change are indeed “everywhere” and how skilled SFBT school social work-
ers can harness change to help clients make big changes in their everyday
school behavior. Read the example not only to know about the specific SFBT
techniques in action (more on those later), but also to understand how the
different members of the client system perceive the intervention being con-
ducted by the solution-​focused school social worker and then collaborate
with the social worker to help students succeed.

Bonita was one of the first students I met at my first-​ever school


social work position. She was lost, literally. She had just come
to the school as a sixth grader and wasn’t sure where her self-​
contained special education class was. She asked me for direc-
tions, and I introduced her to her teacher. The next week, she
was in my office, crying about how much she missed her old
school and didn’t like the older kids at our junior high. She had
announced to her teacher, “I hate this school, and I’m staying

4 Solution-Focused Brief Therapy in Schools


 5

at home tomorrow!” While I  validated her feelings of sadness


and anxiety, I asked if she had noticed anything getting better
for her at our school. She said that she still had a good friend
from her old school with her, and that they were in the same
class together. I asked how she would rank her experience at our
school so far on a scale of 1 to 10, with 10 being the highest on
the scale. She asked through her tears, “Can you go lower than
1?!” I said, “Sure,” and she said, “It’s a 0.”
I asked what would it take for her to say that being at our
school deserved a score of 2 or 3, and she said, “A total miracle.”
I then asked her to imagine that just such a miracle had hap-
pened that night and to picture the next day, when she was at
our school and everything was better for her here. In such a
case, what would be the first thing she’d notice that was differ-
ent? Bonita thought for a while and replied, “I would be able to
open my locker by myself.”
It turned out that Bonita had never used a combination lock
before, and this had made her feel very anxious as well as inad-
equate because all the other kids in her class were already doing
it without problems. We set a goal of working on her locker com-
bination skills with her teacher, and within weeks, Bonita was
smiling and laughing each morning as I watched her walk into
school.

Like Bonita, schools themselves are going through their own transition
in relation to the utilization of mental health services. Some policy makers
and educational leaders call for schools to become “full-​service operations,”
giving students and parents the mental health, vocational, and English-​
language training that external community agencies are not adequately
providing. Still others claim that school-​based mental health is an “extra”
service and supportable only to the degree that it produces demonstrable
differences in student academic achievement and thus allows students to
compete successfully in the global economy. One of our colleagues remem-
bers being told by a local superintendent that he would support our col-
league’s SFBT research project only if it made a measurable positive impact
on “bottom-​line” education issues for his K-​8 district (in his case, this meant
higher GPAs and increased attendance).
School leaders and parents are right in wanting more from school-​based
mental health services, and the profession itself has only begun to recognize
the need for more transparency with community stakeholders about the

Introduction: A 360-Degree View of SFBT in Schools5


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relative effectiveness of the interventions we typically employ in our school


practices. This book will equip you with a solid working knowledge of the
ideas and techniques behind SFBT, acquaint you with the most current evi-
dence on the overall effectiveness of SFBT, and finally, demonstrate several
examples of school social workers making SFBT happen in their particular
school contexts. It is our hope that by looking at SFBT from a 360-​degree
perspective, you will be ready to bring more specific SFBT ideas and tech-
niques into your school in the coming years.

Advantages of SFBT in a School Setting


Why does this approach help in a school setting? Students, teachers, and
parents are going to be visible to the school social worker even when they
are not being “treated.” In addition to using actual SFBT techniques to access
strengths in students, school social workers have a unique opportunity to
observe their students handling a variety of other challenges in their day-​to-​
day contact with the school population (Box 1.1).

SFBT Is Strengths Based
The SFBT approach posits that people have strengths; moreover, SFBT says
that those strengths are active, right now, in helping clients manage their
situation. The issue is not that clients cannot solve their problem without
additional training or somehow submitting to the school social workers’
view of the problem. Rather, their own inherent strengths will ultimately be
what they use to resolve their problem.

Box 1.1  Advantages of SFBT


● SFBT is strengths based
● SFBT is client centered
● SFBT makes small changes matter

● SFBT is portable

● SFBT is adaptable

● SFBT can be as brief (or as long) as you want it to be

● SFBT enables practitioners to gain cultural competence

● SFBT can be adapted to special education IEP goals

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 7

By not presuming that all clients are inherently in need of some treat-
ment for a particular pathology or dysfunction, strengths-​b ased school
social workers are free to see their clients do a variety of things well and
to ask questions that help their clients mobilize those inherent strengths
to do something about the particular problems they face. In addition,
school social workers usually have to document their work with cli-
ents by writing reports and case summaries:  SFBT gives them ample
opportunities not only to focus on their client’s strengths but also to
incorporate those strengths into their written assessments and other
paperwork.

SFBT Is Client Centered


SFBT starts from where the client is at—​a nd sometimes in dramatic and
powerful ways, creating contexts in which clients can determine their
own goals and decide how and where they wish to make changes in their
lives. In school settings, a solution-​oriented school social worker may
be more likely to notice and respond to what clients, whether students
or teachers, are actually asking for and wishing to change. In addition
to increasing the likelihood that the clients will implement a particu-
lar intervention and maintain progress toward their goals, focusing on
what the clients want to change also helps to make the whole referral and
placement process in school settings more client focused and thus (hope-
fully) more effective than standard behavior modification plans, which
might not always include the specific goals and wishes of every part of
the client system.

SFBT Makes Small Changes Matter


One of the biggest challenges in school social work practice is the common
complaint by parents, administrators, and teachers that change brought
about for a particular student’s emotional/​behavioral problems is too slow
or too “small.” SFBT stands this thinking on its head and asks school social
workers to focus on helping clients make small changes and then maintain
these changes, the theory being that with those small successes in hand, cli-
ents will begin to see themselves as more capable of making larger changes
in their lives. Again and again, we have seen this principle play out with
students in our school social work practice: by making one part of a prob-
lem go away, or by helping teachers see one strength of a student who they
had “given up on,” larger changes became possible, and the clients went

Introduction: A 360-Degree View of SFBT in Schools7


8

ahead and made those changes with minimal coaching or encouragement


on our part.

SFBT Is Portable
Though SFBT started as and remains a set of techniques rooted in clini-
cal psychotherapy, it can make a difference in numerous other nonclinical
school settings. Almost anywhere in a school is a potential site for applying
SFBT techniques or ideas: the class meeting where students scale their own
behavior and then talk about what they would have to do differently for
them to rate themselves higher the next week; the special education staffing
conference where parents and teachers describe exceptions when a student
does not display a problem behavior in an effort to discover what the learn-
ing environment (and student) might do differently to avoid repeating the
problem behavior; the playground mediation where students think about
how doing one thing differently might change a conflict they are having.
All these examples (and many more that you will read about in this book)
underline the various ways that school social workers can bring SFBT into
their diverse settings and adapt SFBT ideas to their multiple roles within
their schools.

SFBT Is Adaptable
SFBT can be folded or nested into other techniques being used by clinicians.
Most experienced school social workers we have worked with have charac-
terized their practice approach as “eclectic.” One of the best features of SFBT
as a maturing practice approach is its ability to be integrated into other such
approaches. Clearly, elements of SFBT fit nicely within a cognitive or behav-
ioral treatment framework. Even practitioners who tend to favor approaches
that are based more on discovering how the past impacts a student’s cur-
rent functioning will appreciate the aspects of SFBT where clients set goals
for their own progress and gauge how well they are doing based on scaling
questions.

SFBT Can Be as Brief (Or as Long) as You Want It to Be


One of the frequent complaints we hear about SFBT is that it is too surface
oriented and too brief to get into the “real work.” This may have been a
fair criticism of SFBT in its early stages (when the approach was deliber-
ately defined as being opposed to long-​term treatment), but now, SFBT is
clearly and easily adapted to single-​session, brief, and long-​term treatment

8 Solution-Focused Brief Therapy in Schools


 9

processes. The nature of SFBT (the thinking that change is possible and
constant) does not mean that clients who have more long-​term treatment
plans, such as those students in schools who have individualized education
plans (IEPs) requiring a year of social work services, cannot benefit from
the strengths-​based approach inherent to SFBT. In our practice experience,
some students we saw on a long-​term basis wound up having several distinct
SFBTs over the course of the year. The process of helping them was similar,
but the issues changed as students learned how to manage one problem and
then faced a new one.

SFBT Enables Practitioners to Gain Cultural Competence


All school personnel (school social workers included) are realizing the
increasing importance of cultural competence skills in helping them to
engage with and teach students from diverse backgrounds. Several recent
scholars have noted that one of the main persisting aspects of the racial
“achievement gap” is the cultural competence gap that separates white edu-
cators from the students of color whom they are trying to empower and teach
(Delpit & Kohl, 2006; Ferguson, 2002; Tripod Project, 2007). By emphasiz-
ing how clients perceive their problems and how they might devise solu-
tions that fit their own preferences, SFBT appears well suited to help school
social workers practice from an approach of cultural humility. In addition,
through the example of SFBT pioneers like Insoo Kim Berg, SFBT has always
advocated that clinicians frequently adopt “one-​down” positions that allow
clients to be in charge of their treatment in ways that avoid clients perceiving
the school social worker as pushy or domineering. Clinicians who are per-
ceived as authoritarian or interested only in their own particular approach
to treatment are often labeled as culturally insensitive by minorities who are
receiving mental health treatment (Fong, 2004; McGoldrick, Giordano, &
Pearse, 1996; Wing Sue & McGoldrick, 2005), and SFBT clearly offers an
alternate way for school social workers to engage clients in clinical work
without making them feel forced to adopt the social workers’ worldview.
Furthering this idea of cultural humility in the SFBT approach, Kim (2014)
describes ways to use SFBT techniques and questions from a multicultural
perspective with clients.

SFBT Can Be Adapted to Special Education IEP Goals


For many school social workers, a lot of their services are delivered to stu-
dents who have yearly goals for treatment, usually expressed through an

Introduction: A 360-Degree View of SFBT in Schools9


10

IEP. SFBT, along with CBT, is well suited to helping school social workers
write those goals and collaborate with their clients to meet those goals suc-
cessfully. By identifying discrete changes and applying scaling questions,
school social workers can easily integrate SFBT thinking into their IEP
goals. So far, this area has not been studied empirically, but our conten-
tion, from our own school experience, is that the very process of creating
IEP goals with students, teachers, and parents in a solution-​focused manner
enhanced the eventual achievement of those goals by motivating the client
system to move toward solutions rather than remain stuck at only talking
about the problem.

Summary
SFBT is well suited to school social work practice and school contexts.
A  solution-​focused school social worker can help students, particularly
those who are harder to reach, focus on what’s working and how they can
change their lives in positive ways. Although not originally created for appli-
cation in a school context, SFBT is clearly an adaptable, portable practice
philosophy that, as we will see, can be used in many diverse school contexts
at multiple levels of intervention.

References
Delpit, L., & Kohl, H. (2006). Other people’s children: Cultural conflict in the classroom (2nd
ed.). New York: New Press.
Ferguson, R. (October 21, 2002). What doesn’t meet the eye: Understanding and address-
ing racial disparities in high-​achieving suburban schools from The Tripod Project
Background. Retrieved August 1, 2007, from http://​w ww.tripodproject.org/​uploads/​
file/ ​What_​doesnt_​meet_​the_​eye.pdf
Fong, R. (2004). Immigrant and refugee children and families. In R. Fong (Ed.),
Culturally competent social work practice with immigrant children and families.
New York: Guilford Press.
Franklin, C., Biever, J., Moore, K., Clemons, D., & Scamardo, M. (2001). The effective-
ness of solution-​focused therapy with children in a school setting. Research on Social
Work Practice, 11(4), 411–​434.
Franklin, C., Trepper, T., Gingerich, W., & McCollum, E. (2012). Solution-​focused brief
therapy: A handbook of evidence-​based practice. New York: Oxford University Press.
Kim, J. S. (2014). Solution-​ focused brief therapy:  A  multicultural approach. Thousand
Oaks: CA: Sage Publications.
MacDonald, A. J. (2007). Solution-​focused therapy: Theory, research and practice. London:
Sage Books.

10 Solution-Focused Brief Therapy in Schools


 11

McGoldrick, M., Giordano, J., & Pearse, J. K. (1996). Ethnicity and family therapy
(2nd ed.). New York: Guilford Press.
Newsome, S. (2005). The impact of solution-​focused brief therapy with at-​risk junior
high school students. Children & Schools, 27(2), 83–​90.
Tripod Project. (2007). Background of Tripod research project. Retrieved August 1, 2007,
from http://​w ww.tripodproject.org/​index.php/​about/​about_​background/​
Wing Sue, D., & McGoldrick, M. (2005). Multicultural social work practice. New York:
Wiley.

Introduction: A 360-Degree View of SFBT in Schools11


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2
■ ■ ■

SFBT Techniques and Solution Building


Johnny S. Kim, Michael S. Kelly, & Cynthia Franklin

The History
In the late 1970s, psychotherapy in the United States was at its zenith. The
evidence for this high point was everywhere:  mental health services had
gone mainstream, self-​help books topped the best-​seller lists, and perhaps
most important, economic conditions had created a high degree of health
insurance support for mental health services (Cushman, 1995; Moskowitz,
2001; Wylie, 1994). The insurance money for psychotherapy usually was
not time limited and was also generous, allowing therapists from psychia-
try, psychology, and social work to earn six-​figure incomes. A review of the
popular and academic literature of that time reveals that three main schools
of psychotherapy were popular then:  psychodynamic therapy, cognitive-​
behavioral therapy (CBT), and humanistic psychology (Norcross &
Goldried, 2003). Therapy was available, usually open ended or long term, to
almost anyone who knew where to find it.
By the early 1990s, things had changed dramatically. Self-​help books
continued to crowd American bookstore shelves, but psychotherapy
had become a profession that was largely dominated by managed care.
Although still readily available to many people who needed it, psycho-
therapy was now time limited, often restricted to no more than 20 sessions
a year. Fees for therapists had been capped as well, and the golden days of
lucrative therapy practices had begun to fade (Duncan, Hubble, & Miller,
1999; Lipchik, 1994; Wylie, 1994). To a psychoanalytically informed prac-
titioner used to seeing patients for a decade or more, this new era was
dreary indeed.

12
 13

Something else important happened in psychotherapy during this era,


however, and in the heart of America, in a city known more for bratwurst
and beer than for therapeutic innovation. In Milwaukee, Wisconsin, a group
of therapists led by Insoo Kim Berg and Steve de Shazer started working with
clients in radically different ways. They only saw clients for a few sessions,
often no more than five or six times. They asked questions that focused less
on client problems and more on how clients had previously solved the prob-
lems they faced. The focus was on using solutions from the past to handle
issues of the present and future. Although consciousness of a client’s experi-
ence of loss, trauma, and other difficult feelings was incorporated into their
work, these therapists were more focused on the client’s actual strengths
and capacities to move beyond those difficult issues quickly (Berg, 1994;
de Shazer, 1988). The SFBT model for working with clients required a different
mind-​set and a unique line of questioning compared to the more popular
CBT approach.
In SFBT, clients themselves are viewed as experts on their own problems
and solutions. Rather than position therapists as authority figures or experts
in the counseling sessions, this new approach put therapists in the role of
curious questioners who also offer suggestions that both bring out client
strengths and set them on the path to finding their own solution, not the
answer or solution that the school social worker had chosen for the client.
Overall, the presumption of the therapists in Milwaukee was that clients
could change, would change, and were actually changing already. These
therapists were creating a new approach to therapy, a collection of tech-
niques and activities that would eventually become known as SFBT (Berg,
1994; De Jong & Berg, 2002; de Shazer, 1988; MacDonald, 2007). Box 2.1
shows some differences between SFBT and CBT treatment.

SFBT Theory of Change


While learning about the different SFBT techniques are important for school
social workers, understanding how those techniques work to create changes
in students can be very useful in grasping the SFBT mentality and approach.
Positive emotions were noted early in the development of SFBT. For exam-
ple, de Shazer (1985) discussed the importance of increasing positive expec-
tancy (i.e., hope) and suggested the perception that change is possible is a
critical part of the SFBT processes that help clients change. Insoo Kim Berg
also frequently discussed the importance of fostering hope in clients and

SFBT Techniques and Solution Building13


14

Box 2.1  Difference Between SFBT and CBT

SFBT SOCIAL WORKER CBT SOCIAL WORKER


MODEL MODEL
● What could be a small step ● How does it make you feel
toward achieving your goal? when the problem occurs?
● What has been going well in ● When does the problem
your life? occur in your life?
● What will you be doing differ- ● What thoughts do you have
ently when the problem is no when the problem occurs?
longer present?
● How did you know that was ● How do others react when
the right thing to do? you are behaving that way?

described how solution-​focused conversations create a sense of competence,


which is also important for helping clients change (e.g., Berg & Dolan, 2001;
De Jong & Berg, 2008). Despite such efforts to understand the therapeutic
process of SFBT, our knowledge about the possible theoretical and thera-
peutic mechanisms for change within SFBT are still in their infancy when
it comes to actual empirical studies that examine these mechanisms, espe-
cially concerning the role that positive emotions may play in the change
process of SFBT.
With the recent popularity of positive psychology and research on posi-
tive emotions such as hope, an opportunity exists to re-​examine how SFBT
techniques work in the counseling sessions. Positive emotions theory argues
that positive emotions are not simply the absence of negative emotions (e.g.,
anger, sad, frustrated, and hopelessness) or just a “good feeling” the stu-
dent has but, rather, can serve as a therapeutic value in clinical practice
(Fitzpatrick & Stalikas, 2008a). Most of the research and discussion in clini-
cal practice has viewed positive emotions as a desired outcome (i.e., “I want
to be happy again”) and neglected the possibility of positive emotions serv-
ing as a vehicle for change (Fitzpatrick & Stalikas, 2008b). We believe that
the broaden-​and-​build theory of positive emotions by Fredrickson (1998)
may provide some the most compelling evidence for explaining how SFBT

14 Solution-Focused Brief Therapy in Schools


 15

works and may be used in future research studies to examine change pro-
cesses within SFBT.
Under the broaden-​and-​build theory, positive emotions further elicit
thought-​action repertoires that are broad, flexible, and receptive to new
thoughts and actions, whereas negative emotions elicit thought-​action rep-
ertoires that are limited, rigid, and less receptive. The broadening aspect
of this theory posits that after someone experiences a positive feeling, that
person is more open and more receptive. This may be the key step in helping
students observe exceptions, make new meanings, and do something different
that is touted in SFBT practice literature (de Shazer, 1991). In addition to
broadening, this theory also posits that positive emotions help build durable
resources that can be drawn upon for future use. Students experiencing psy-
chological problems like depression or anxiety commonly to dwell on nega-
tive thoughts and beliefs about themselves or a particular situation, which
then leads to dysfunctional behaviors and further perpetuates a downward
spiral of psychopathology (Garland, Fredrickson, Kring, Johnson, Meyer, &
Penn, 2010). With positive emotions, the opposite can occur: upward spirals
of positive emotions help students build enduring resources of new thoughts,
perspectives, and options (Fitzpatrick & Stalikas, 2008b). But to counter-
act the negative emotions students experience, a greater number of positive
emotions must be experienced. Research suggests that, at minimum, a 3-​to-​
1 ratio of positive emotions experienced to negative emotions is necessary
to help generate sustained positive changes and undo the impact of nega-
tive distress (Garland et  al., 2010). Therapeutic techniques for increasing
positive emotion are fairly new to positive psychology and are still being
developed. However, techniques for increasing client strengths and posi-
tive emotions are not new to SFBT; they have existed for many years and
have been successfully applied in diverse practice settings (Kim & Franklin,
2015). Formulating answers to solution-​focused questions requires students
to think about their relationships and talk about their experiences in dif-
ferent ways, turning their problem perceptions and negative emotions into
positive formulations for change.

The Skills
As the Solution-​Focused Brief Therapy Association (SFBTA) makes clear,
“[SFBT] should be characterized as a way of clinical thinking and interacting
with clients more than a list of techniques” (SFBTA, 2006, p. 2). By viewing
a client as being engaged in a constant process of change, solution-​focused

SFBT Techniques and Solution Building15


16

clinicians are poised to tap into that client’s natural ways of healing and exist-
ing ways of viewing change (Tallman & Bohart, 1999). In July 2013, the sec-
ond edition of the Solution Focused Therapy Treatment Manual for Working with
Individuals was published on the SFBTA website for clinicians to learn more
about the clinical practices and research relevant to SFBT. It is free to down-
load at www.sfbta.org and a great resource for learning more SFBT techniques.

How SFBT Distinguishes Itself


Rather than a set of sequential techniques that must be followed rigidly,
SFBT is more of an approach (SFBTA, 2006). Every client is different, and
every professional using SFBT is going to adapt his or her approach to the
specific client’s needs and developmental level. This is perhaps most evident
in a school setting, where the client’s age can range from 5 years (a kinder-
gartner) to 65 years (a veteran principal). We focus here on how, in the first
session, SFBT distinguishes itself from other treatment models by providing
some examples of not only how to “start” doing SFBT but also how to con-
textualize the different directions SFBT can take depending on the client’s
goals and frame of reference.
An emphasis of SFBT is on the process of developing a future solution
rather than analyzing and dissecting the past manifestation of the problem.
SFBT practitioners focus on identifying past successes and exceptions to
the problem, as well as on identifying new and novel ways of responding
in future efforts to solve problems (Franklin, Biever, Moore, Clemons, &
Scamardo, 2001). Orchestrating a positive and solution-​focused conversa-
tion, often referred to as solution building, is unique to SFBT and aims to
create a context for change in which hope, competence, and positive expec-
tancies increase and a client can co-​construct with the therapist workable
solutions to problems. The task of the school social worker is to listen for
words and phrases that are aspects of a solution for the student and build on
those (Berg & De Jong, 2008). There is a constant focus by the school social
worker on not delving into problem talk but, rather, helping the student
identify what life looks like when the problem is gone and what the stu-
dent will be doing differently (Kim, 2014). This is one of the key differences
between SFBT and other strengths-​based interventions like motivational
interviewing (MI). A recent microanalysis conducted by Korman, Bavelas,
and De Jong (2013) found that SFBT counselors preserved the client’s exact
words at a significantly higher rate, while adding their own interpretations

16 Solution-Focused Brief Therapy in Schools


 17

at a significantly lower rate, than MI and CBT counselors. This study also
showed how a SFBT approach differs from other, similar approaches like MI
by highlighting the sustained focus on listening for what the clients want,
what’s important to the clients, and how clients can achieve their desired
version of themselves (Bavelas et al., 2013).
When school social workers meet with students, much of the counsel-
ing session is centered around questions or problem-​solving discussions.
Typically, the types of questions asked are:

• Questions about the student’s problem


• Questions about mistakes made
• Questions about causes of the student’s problem
• Questions about how the problems making the student feel

As these types of questions show, most approaches to counseling focus on


the problem, with little talk about the solutions or what the student wants
that is different from the current situation. This solution-​building mindset
differs from more problem-​focused approaches like CBT that focus on help-
ing clients identify problem thinking and beliefs, challenging those nega-
tive thinking patterns, and substituting more rational thoughts and beliefs.
The solution-​focused techniques described below help school social workers
accomplish this task and stay focused on the SFBT approach.

Pre-​session Change, Exception Questions, and Other Key


SFBT Techniques
One distinctive facet of the SFBT approach is the attention that the solution-​
focused school social worker pays to changes that are already in motion
from the moment the first session is scheduled. This is called pre-​session
change, and it allows the solution-​focused school social worker to model the
SFBT concept not only that change is a natural and constant occurrence, but
also that this notion can become a source of hope and empowerment for cli-
ents as they struggle to change what initially seem to be overwhelming prob-
lems they fear will take years of treatment to address (Berg, 1994; De Jong
& Berg, 2001; Murphy, 1996; Selekman, 2005). To do this, solution-​focused
school social workers at the first meeting ask questions such as “Since we
last talked on the phone and scheduled this first meeting, what’s been better
in the way that you and your son are getting along at home?” or “Since Mrs.
Smith asked me to come and see you, have there been any positive changes

SFBT Techniques and Solution Building17


18

in the way you’re behaving in her class?” On the basis of any changes that
the client identifies, the solution-​focused school professional moves on to
amplify those positive changes and sees what ideas the student might have
about maintaining such changes into the future. Box 2.2 describes questions
typically used in SFBT.

Box 2.2  Typical Questions in SFBT


Coping Questions
● How do you keep from giving up since you have tried
everything?
● How have you managed to cope so far?

● What keeps you hanging in there?

● What has been going well in your life?

Looking for Solutions
● What small change will you notice when things are
different?
● How would you know if our talk make a big difference?

● What has been better for you this week?

● When didn’t you have this problem? Even a little bit?

Relationship Questions
● What will your teacher notice about your behavior when
things have changed?
● How would your parents know you were at your best?

What would you be doing that lets them know?


● What would your teacher notice about you when things are

better?

Moving Forward
● What will you do instead of cutting class to smoke?
● What will be a small sign that you are no longer depressed?

● What will you notice about yourself that is different? What

will others notice about you that is different?


● How could you do more of that this week?

18 Solution-Focused Brief Therapy in Schools


 19

A hopeful, almost expectant tone pervades SFBT sessions, where stu-


dents and parents are welcomed and given the chance to describe how they
are already changing before they have even begun treatment. In our prac-
tice experience, we have seen this approach resonate with students used
to mental health professionals who start their first sessions trying to probe
for underlying causes to the problem behavior by asking detailed questions
about the student’s history. By setting the context squarely in the present and
asking clients to imagine a new, preferred future, many students embrace
this perspective and tailor it to their own goals. We have also found students
are more willing to talk about things they do well or things they like com-
pared to talking about their problems. This can be especially useful when
students are hesitant about seeing a school social worker as well as helpful
in quickly developing a therapeutic relationship. And it can be particularly
important when working with students who are ethnic minorities as this
allows the school social worker to practice cultural humility.
This approach is immediately apparent through the ways that solution-​
focused clinicians talk with their students from the first session. Solution-​
focused school social workers tend to focus on different areas in their initial
contact with students compared to typical treatment approaches, which are
more rooted in using the medical model to assess for student pathology. The
questions tend to focus on what the students see as their presenting prob-
lem, and little time is spent talking about root causes or past family history
that might have contributed to the problem. Rather, from the first meeting,
students are encouraged to talk about their situation in present and future
terms, with the expectation communicated that they are more in charge
of their problem now than they might have previously felt. In contrast to a
typical first session, in which great energy and effort is expended by both
the school social worker and the student to describe the problem and all
its attendant impacts for the student, solution-​focused school social work-
ers tend to ask students to tell them what they might have already tried to
address the problem and, if that the student cannot name anything that has
worked, identify those times or situations where the problem is not present
(or at least not as problematic).
Students are also encouraged to think of their preferred future self, even
in the first session. This can be done through questions that orient the ses-
sion toward future hopes and what will be different when the problem is no
longer there. More specifically, by asking students the “miracle question”
or “scaling questions,” they are invited to imagine a future reality that they

SFBT Techniques and Solution Building19


20

might be able to start bringing into being. For the miracle question, students
are asked to imagine that when they go to bed that night, a miracle takes
place, and when they wake up, their problem is solved and they feel better
and more hopeful about their day. The solution-​focused school social worker
then asks, “What would be the first thing you would notice about your new
situation that told you the miracle had taken place?” This opens up the pos-
sibilities that students can see changes happening in their lives and identify
first steps at achieving more of the changes they want (Berg, 1994). Scaling
questions can be used for a variety of subjects, asking clients to rate their
ability to manage their problem on a scale of 1 to 5, with 1 being “not able
to handle my problem at all” and 5 being “fully able to handle my problem.”
Assuming a student rates the problem as being at a 2, a solution-​focused
school social worker can ask what the student would be doing differently
if he or she is able to give a rating of 3 or 4 when they meet the next week.
With the scales, students can be asked to imagine what they would need to
do to raise (or lower, depending on the way the scale is framed) their score,
and exceptions where they may have already been doing things more in line
with their goals can be identified.
Likewise, the focus on exception questions helps the student use the past
pragmatically. By identifying times when the problem was not affecting the
student, or when the student was more able to handle a similar situation
successfully, the solution-​focused school social worker invites the student
to view his or her current reality as being less stuck and hopeless. It also
encourages the student to imagine that the “exceptions” could more easily
become the future reality because, as one student told us, “Hey, now that
I realize that it’s already been a problem I was able to beat before, why can’t
I do it again?”

Future Sessions and Goal Setting


Like many treatment approaches, SFBT favors the implementation of a goal-​
setting process between student and school social worker. Where SFBT dif-
fers is in the power sharing that goes on when setting these goals. Instead
of a process where, over time, students are expected to face their denial and
accept a reality that the school social worker is advocating, the reality of the
student is always paramount in the sessions. (This produces some interest-
ing contrasts—​and even conflicts—​when working in school settings with
children referred by teachers, which we discuss more fully in Chapter 5.)

20 Solution-Focused Brief Therapy in Schools


 21

Students can change as much or as little as they want, and they are given the
freedom by the SFBT process to set goals they can achieve. In some ways, this
goal-​setting process mirrors some of what CBT school social workers do as
they set treatment goals with clients based on specific problematic thinking
or behavior. The difference between CBT and SFBT here is that students are
not required to adopt a particular approach to their behavior or adopt new
ways of thinking about how their emotions are affected by their cognitions.
In CBT, the school social worker typically assigns tasks and makes recom-
mendations for behavioral or thought changes, whereas an SFBT approach
encourages students to do more of their own previous exception behaviors
in an effort to achieve their preferred future self (Bavelas et al., 2013).

Compliments Count
Anyone watching a videotape of a clinician doing SFBT will be immediately
struck by how often the clinician compliments the client over the course
of a regular session (Berg, 1994). Because in SFBT so much effort is spent
identifying student resiliency and setting goals based on strengths that stu-
dents have demonstrated in the past, it’s understandable that students begin
to self-​report the times between sessions that they have made at least small
gains in solving their problems. Rather than take credit for helping the stu-
dent make this change (or expressing frustration the student is not pro-
gressing more quickly), solution-​focused school social workers are quick to
highlight client gains and give compliments about their progress.
These compliments are not meant to be patronizing. Good solution-​
focused school social workers know how to convey genuine pride and
excitement at a student’s progress, often saying things like “That’s great;
tell me how you did that?” or “I am so impressed! What did you figure
out that helped you deal with your problem so successfully?” Students take
that feedback and are motivated to make more changes, either for the same
problem or for a different problem that the solution-​focused school social
worker may not even be aware of yet (De Jong & Berg, 2002; Metcalf, 1995;
Selekman, 2005).

Coping Questions
One persistent critique of SFBT has been that it is too optimistic and
does not allow clients to have deep emotional experiences in therapy
(Lipchik, 1994; Nylund & Corsiglia, 1994). This has been acknowledged

SFBT Techniques and Solution Building21


22

as a critique by SFBT’s founders (Miller & de Shazer, 2000), but in some


ways, it strikes us as a straw-​m an argument. If clients have strong, upset-
ting emotional experiences in treatment, they are certainly encouraged by
a solution-​focused school social worker to experience those feelings—​to
cry, to yell, to express what they need to express. What SFBT does not do,
and which confuses some people who are new to the approach, is place
any inherent value on intense emotional experiences in therapy (Berg &
Dolan, 2001; De Jong & Berg, 2001). Because SFBT presumes that stu-
dents can (and regularly do) solve their own problems, no particular
weight is given to any emotionally cathartic experience that might be
triggered by the school social worker during sessions. Instead, great
emphasis is placed on asking questions that allow students to help the
school social worker learn what the students want to talk about, as well
as how fast or slow the students would like to go in exploring how to
change their situation. In our two decades of doing solution-​focused
work in schools, we have witnessed many students share their hopes and
goals in SFBT with intense emotion; we have also seen many students
embrace the approach in a calm, somewhat playful way, with plenty of
laughter and spontaneity punctuating the sessions. The focus has never
been on the degree of emotional intensity or on asking them how they
feel about something; rather, it has always been on helping students gen-
erate their own solutions (Berg, 1994; Miller & de Shazer, 2000). In fact,
recently focus on SFBT has been on how the approach creates positive
emotions in students, which helps them change (discussed more in SFBT
Theory of Change below).
The most concrete way to show how this approach works for chronic
and seemingly debilitating problems that students deal with is the SFBT
coping questions. Solution-​focused school social workers often use these
questions when a student is reporting significant difficulty and even some
frustration that a situation has not gotten better. Questions like “This situ-
ation sounds really hard—​how have you managed to cope with it as well
as you have thus far?” are designed to elicit student strengths and possible
strategies that they may have used in the past to cope with their difficul-
ties (Berg, 1994; Selekman, 2005). Another coping question that we have
often used when students are complaining about the seeming impossibil-
ity of their situations is “How have you been able to keep this from getting
worse for you?” By framing the “impossible” situation as one that the student
has some control over, the solution-​focused school social worker can explore

22 Solution-Focused Brief Therapy in Schools


 23

what hidden capacities the student has for managing and potentially over-
coming problems.

Doing Something Different


One of the most exciting and fun aspects of doing SFBT in a school setting
is the ability to try out new ideas and interventions with students based on
their willingness to “do something different” about their problem. Rather
than seek to teach students a specific technique for handling their problems,
such as those associated with anger or difficulty in making friends, solution-​
focused school social workers explore what students have done about their
problems in the past and what new ideas they could try now. For example,
an 11-​year-​old student we worked with was struggling to manage his tem-
per in the classroom and had not found the traditional cognitive-​behavioral
anger management techniques offered by his special education teacher to be
helpful. He told us that he had run out of ideas because everything he had
tried before had not worked. When we told him that we thought it might be
time to “do something different,” he immediately warmed up to the idea and
started brainstorming new ideas to tackle his anger problem. Being a young
person, some of the ideas were admittedly wacky: no teacher was likely to
let him play games on his iPad all day to fend off his tirades, for example.
After sifting through his ideas, however, the student settled on a creative
solution that he was excited to implement and that we thought his teacher
would support as well: he would work out with his teacher a list of “helper
tasks” in the class that he would be able to do any time he thought he was
going to lose his temper. The teacher would get some help with things in the
classroom, and the student would get to take his mind off his frustration
and recharge.

Client Resistance? We Do Not See It that Way …


The advantage of having concepts like coping questions, “doing something
different,” brainstorming, or exception questions when working with stu-
dents is that they allow a solution-​focused school social worker to quickly
short-​circuit student resistance to working on their problems. In fact, the
very concept of resistance is eagerly debated in the SFBT literature (Berg,
1994; de Shazer, 1988; O’Hanlon & Bertolino, 1998); most SFBT writers
consider resistance to be more a product of the solution-​focused profession-
al’s inability to find common ground with the student than an actual refusal
by students to face their problems directly. By approaching the student in a

SFBT Techniques and Solution Building23


24

respectful, patient way, we have found that the ideas in SFBT allow us not
only to find some workable goal for most students in a school setting but
also to avoid labeling our students as being “in denial” about their problems.

What SFBT Does (and Does Not) Teach


Part of what has held back SFBT in some quarters is the notion that it does
not “teach” anything new to a student. Perhaps predictably, SFBT practi-
tioners often define this relative lack of specific skill training as another
strength of the approach—​namely, it does not limit interventions to specific
techniques that are generated by the school social worker. For one thing,
it’s usually easier to get people to do things that they already know how to
do (Berg, 1994; De Jong & Berg, 2002; Selekman, 2005). SFBT works hard
to help students identify the strengths and skills they already possess to
address their problems, and then tries to free them up to “do more of what’s
working” (Berg, 1994; Newsome, 2004).
Another challenge to applying SFBT in a school involves the belief of
some educators that they are there to instruct students on how to “act.” Some
educators who feel this moral imperative may be uncomfortable with SFBT’s
view of starting from where students truly are, and then working with what’s
there, as opposed to modeling a better way to behave or think. As stated ear-
lier, the benefit of SFBT is that it does not deny the presenting problems that
require intervention (e.g., student defiance or work refusal). It just frames
them differently than the traditional school practice that typically empha-
sizes the authority of the adult over the self-​determination of the student.
Undoubtedly, some educators can (and do) view SFBT as excessively
optimistic and too “easy” on kids. SFBT does impart to clients an optimistic
and future-​oriented perspective; however, we believe there is value in this
approach. Again and again, we have seen in our school practices how SFBT
can elicit new ideas from students who have traditionally viewed their prob-
lems from more fatalistic and pessimistic angles. This can involve teaching
new ideas to students, so SFBT in no way limits the skill and authority of the
teacher or school social worker using it to engage with and help a student. If
anything, we have often noticed that the process of asking SFBT questions
itself makes an impression on students who are unsure how to respond to
treatment and are anxious about seeing a mental health professional. By
starting with a curious and hopeful stance, SFBT tries to de-​escalate many
potentially difficult situations and move the focus to solving problems that
the student is having.

24 Solution-Focused Brief Therapy in Schools


 25

Finally, as a wholly student-​centered treatment approach, SFBT is


open to almost any intervention that is already underway in a student’s
life and, in the student’s view, is a helpful intervention. For example, one
student of ours was already taking anti-​a nxiety medication when we first
met her, and part of the solution-​focused treatment we conducted was
helping her identify ways to build on the benefits she was seeing from
taking her medication. In this way, students and school social workers
can collaborate on using SFBT with other treatment models (e.g., psy-
choeducation or psychopharmacology) that emphasize students setting
goals and working toward them. As discussed in Chapter 1, the porta-
bility and adaptability of SFBT in a school setting is one of the major
strengths we have seen when applying this approach for the past two
decades.

The Application
The later “SFBT in Action” chapters provide more concrete case examples of
how to use SFBT with five of the most common issues or problems school
social workers encounter. In the present chapter, we also include an example
of a solution-​focused handout developed by Franklin and Streeter (2004)
to help students set goals using SFBT techniques (see Box 2.3) and a form
developed by Garner (2004) to help practitioners evaluate their school’s
readiness to adopt SFBT ideas (see Box 2.4).

The Research
In Chapter 3, we share more information about the effectiveness of SFBT
in schools and other mental health settings obtained since the first edi-
tion of this book. In our work employing meta-​a nalytic techniques to
analyze the extant intervention studies on SFBT, we have found that this
therapy has a small to medium treatment effects on behaviors and prob-
lems typically found in a school setting. This outcome is only slightly
smaller than the typical effect of other psychotherapeutic treatments
for some of the same behaviors and problems experienced by students
(Kim, 2008).
As we note in the next chapter, in keeping with our efforts to be trans-
parent and rigorous in this book, we can highlight the claims of SFBT’s
effectiveness but also caution against overstating that, as a technique, SFBT
outperforms all other approaches to therapy. In some ways, SFBT may be best
viewed as an important technique to use with students because it facilitates

SFBT Techniques and Solution Building25


26

Box 2.3  Measuring Your Success


NAME _​_​_​_​_​_​_​_​_​_​_​_​_​_​ DATE _​_​_​_​_​_​_​_​_​_​_​_​_​_​

What were your goals for the previous semester? Check the goals that
were fully met.

When it comes to meeting your goals, what are the obstacles that get
in your way?

Choose 1 of the obstacles you listed and design a plan to overcome it.

OBSTACLE WHAT I CAN DO RESOURCES THAT CAN HELP

Having reviewed your goals, measure your progress on a scale of 1 to


10, with 1 being no progress and 10 being goal met.

Scaling allows you to see your progress on a continuum. Consider


the following criteria before marking the number that represents
your progress:

● Attendance
● Number of assignments completed
● Quality of work done

Circle the number that represents your progress.


1 2 3 4 5 6 7 8 9 10

What are 3 goals that you will set for the next semester?
1.
2.
3.

Describe what it will look like, sound like, and feel like when you are
meeting all of the goals you have set for yourself.

Source: Franklin and Streeter (2004).


 27

Box 2.4  Planning Exercise for Developing Solution-​Building Schools


Characteristics of a Solution-​Building School
Rate your school on a scale of 1 to 10, with 1 being the characteristic
is absent and 10 being the school truly represents the trait.

Faculty emphasis on building relationships with students


1 2 3 4 5 6 7 8 9 10

Attention given to individual strengths of students


1 2 3 4 5 6 7 8 9 10

Emphasis upon student choices and personal responsibility


1 2 3 4 5 6 7 8 9 10

Overall commitment to achievement and hard work


1 2 3 4 5 6 7 8 9 10

Trust in student self-​evaluation


1 2 3 4 5 6 7 8 9 10

Focus on the student’s future successes instead of past difficulties


1 2 3 4 5 6 7 8 9 10

Celebrating small steps toward success


1 2 3 4 5 6 7 8 9 10

Reliance on goal setting activities


1 2 3 4 5 6 7 8 9 10

Source: Garner (2004).

conversations about student strengths. whereas many other approaches in


schools (with competing claims of effectiveness) are more rooted in medi-
cal/​deficit models. What remains for further research to explore is whether
strengths-​based approaches like SFBT produce better outcomes for students

SFBT Techniques and Solution Building27


28

than approaches rooted in special education deficit models or social skills/​


psychoeducation models.

The Future
School settings and SFBT are in some ways a natural fit. School social work-
ers are constantly struggling with large caseloads and limited time to serve
all the students who need help, and SFBT’s emphasis on rapid engagement
and change for students can help school-​based professionals meet more stu-
dents and make a difference for them quickly. The goal-​setting process of
SFBT (involving scaling questions and asking teachers to observe behav-
iors that students are working on improving) can be easily adapted to the
outcome-​based education paperwork of Medicaid and special education to
help school social workers document their effectiveness (Lever, Anthony,
Stephan, Moore, Harrison, & Weist, 2006).
The challenge of finding ways to bring a solution-​focused perspective
using student, family, and teacher strengths into a variety of school con-
texts (e.g., special education staffing, disciplinary meetings, or teacher con-
sultations) is significant, however, and sometimes even daunting. This is
particularly true as educators increasingly favor “problem-​talk” using diag-
nostic categories derived from special education classification and psycho-
pathology language found in the Diagnostic and Statistical Manual of Mental
Disorders (Altshuler & Kopels, 2003; House, 2002). More research on SFBT
in schools (as well as collaboration between SFBT researchers and practitio-
ners in schools) remains essential to help continue the work that Insoo Kim
Berg and Steve de Shazer envisioned three decades ago.

Summary
SFBT is an approach that started in the American Midwest and has now
spread throughout the world, heavily influencing the last two generations of
practitioners. Its main ideas—​that client strengths matter, that client change
is constant, and that clients can be trusted to devise solutions to their own
problems—​are a welcome alternative to many of the deficit-​based diagnos-
tic and treatment approaches prevalent in schools today. Solution-​focused
school social workers can use techniques like the miracle question, coping
questions, and scaling questions to identify student goals and strengths to
help them make changes in their lives.

28 Solution-Focused Brief Therapy in Schools


 29

References
Altshuler, S. J., & Kopels, S. (2003). Advocating in schools for children with disabili-
ties: What’s new with IDEA? Social Work, 48(3), 320–​329.
Bavelas, J., De Jong, P., Franklin, C., Froerer, A., Gingerich, W., Kim, J., Korman, H.,
Langer, S., Lee, M. Y., McCollum, E. E., Smock Jordan, S., & Trepper, T. S. (2013, July 1).
Solution-​focused therapy treatment manual for working with individuals, 2nd ver-
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Berg, I. K. (1994). Family-​based services. New York: W. W. Norton.
Berg, I., & Dolan, Y. (2001). Tales of solutions:  A  collection of hope-​ inspiring stories.
New York: W. W. Norton.
Cushman, P. (1995). Constructing the self, constructing America: A cultural history of psycho-
therapy. Reading, MA: Addison-​Wesley.
De Jong, P., & Berg, I. (2001). Instructor’s resource manual of interviewing for solutions.
New York: Brooks/​Cole.
De Jong, P., & Berg, I. (2002). Interviewing for solutions (2nd ed.). New York: Brooks/​Cole.
De Jong, P., & Berg, I. (2008). Interviewing for solutions (3rd ed.) Belmont, CA: Brooks/​
Cole-​Thomson Learning.
de Shazer, S. (1985). Keys to solution in brief therapy. New York: Norton.
de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: W. W. Norton.
de Shazer, S. (1991). Putting difference to work. New York: Norton.
Duncan, B., Hubble, M., & Miller, S. (Eds.). (1999). Heart and soul of change: What works in
therapy. Washington, DC: American Psychological Association Press.
Fitzpatrick, M. R., & Stalikas, A. (2008a). Integrating positive emotions into theory,
research, and practice: A new challenge for psychotherapy. Journal of Psychotherapy
Integration, 18, 248–258.
Fitzpatrick, M. R., & Stalikas, A. (2008b). Positive emotions as generators of therapeutic
change. Journal of Psychotherapy Integration, 18, 137–154.
Franklin, C., & Streeter, C. L. (2004). Solution-​focused accountability schools for the 21st cen-
tury. Austin, TX: Hogg Foundation for Mental Health, University of Texas at Austin.
Franklin, C., Biever, J., Moore, K., Clemons, D., & Scamardo, M. (2001). The effective-
ness of solution-​focused therapy with children in a school setting. Research on Social
Work Practice, 11(4), 411–​434.
Fredrickson, B. L. (1998). What good are positive emotions? Review of General Psychology, 2,
300–319.
Garland, E. L., Fredrickson, B., Kring, A. M., Johnson, D. P., Meyer P. S., & Penn, D. L.
(2010). Upward spirals of positive emotions counter downward spirals of negativity:
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ment of emotion dysfunctions and deficits in psychopathology. Clinical Psychology
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Garner, J. (2004). Creating solution-​building schools training program. In C. Franklin &
C. L. Streeter (Eds.), Solution-​focused accountability schools for the 21st century. Austin,
TX: Hogg Foundation for Mental Health, University of Texas at Austin.
House, A. (2002). DSM-​I V diagnosis in the schools. New York: Guilford.

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Kim, J. S. (2008). Examining the effectiveness of solution-​focused brief therapy: A meta-​


analysis. Research on Social Work Practice.
Kim, J. S. (2014). Solution-focused brief therapy: A multicultural approach. Thousand Oaks,
CA: Sage Publications.
Kim, J. S., & Franklin, C. (2015). The importance of positive emotions in solution-
focused brief therapy. Best Practices in Mental Health, 11, 25–41.
Korman, H., Bavelas, J. B., & De Jong, P. (2013). Microanalysis of formulations in
solution-​focused brief therapy, cognitive behavioral therapy, and motivational inter-
viewing. Journal of Systemic Therapies, 32, 31–​45.
Lever, N., Anthony, L., Stephan, S., Moore, E., Harrison, B., & Weist, M. (2006).
Best practice in expanded school mental health services. In C. Franklin, M.
Harris, & P. Allen-​ Meares (Eds.), School services source-​book (pp. 1011–​ 1020).
New York: Oxford Press.
Lipchik, E. (1994). The rush to be brief. Family Therapy Networker, 18(2), 35–​39.
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Moskowitz, E. (2001). In therapy we trust: America’s obsession with self-​fulfillment. Baltimore:
Johns Hopkins Press.
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& B. Duncan (Eds.), Handbook of solution-​ focused brief therapy (pp. 184–​ 204).
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Newsome, S. (2004). Solution-​focused brief therapy (SFBT) group work with at-​risk
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Norcross, J., & Goldried, M. (2003). Handbook of psychotherapy integration. New  York:
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Nylund, D., & Corsiglia, V. (1994). Becoming solution-​focused forced in brief ther-
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oriented therapy for sexual abuse and trauma. New York: Wiley.
Selekman, M. (2005). Pathways to change (2nd ed.). New York: Guilford.
Solution-​Focused Brief Therapy Association (2006). SFBT Training Manual. Retrieved
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Tallman, K., & Bohart, A. (1999). The client as a common factor: Clients as self-​healers.
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works in therapy (pp. 91–​ 132). Washington, DC:  American Psychological
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Wylie, M. (1994, March/​April). Endangered species. Family Therapy Networker.

30 Solution-Focused Brief Therapy in Schools


 31

3
■ ■ ■

SFBT and Evidence-​Based Practice


The State of the Science
Johnny S. Kim, Michael S. Kelly, & Cynthia Franklin

Introduction
SFBT has become a popular therapy model for social work practice, espe-
cially within school settings. Part of the model’s appeal to social workers
lies in its strengths-​based focus. De Jong and Miller (1995) note that social
work history is rooted in the principles of the strengths perspective but has
lacked specific tools and techniques to put strengths-​based practice into
action. Building on Saleebey’s (1992) summary of strengths-​based assump-
tions and principles, De Jong and Miller (1995) argue that SFBT can advance
social work’s tradition of using strengths-​based principles by providing spe-
cific intervention skills and change techniques with similar philosophical
assumptions.
Practitioners from many disciplines, but especially social work, have
embraced SFBT because of the ease in implementing the model and its flexi-
bility for different practice settings. In an era of accountability and evidence-​
based practice, however, the effectiveness of SFBT is important for social
workers to consider. The chapter summarizes the research support for, and
addresses the state of research on, the SFBT model compared to other inter-
vention models. Particular emphasis is given to a meta-​analysis of SFBT and
to a review of SFBT studies conducted in school settings.
Although SFBT undoubtedly is popular among social workers in the
United States and around the world, the research on its effectiveness is
still limited in relation to its growing popularity (Gingerich & Eisengart,
2000; Triantafillou, 1997; Zimmerman, Prest, & Wetzel, 1997). This poses

31
32

problems both for social workers who have embraced the SFBT model and
for the schools of social work teaching SFBT as part of their curriculum.
Fortunately, research studies are showing that SFBT is an effective interven-
tion, and research on this model continues to grow by the year.

Early Research Studies


Two of the earliest studies on the effectiveness of SFBT were conducted by
the team at the Brief Family Therapy Center (BFTC). De Jong and Hopwood
(1996) provide an overview of the first study, which was conducted by Kiser
(1988) and consisted of follow-​up surveys (at 6, 12, and 18  months after
termination of therapy) to determine whether clients had met their goals
or felt they had made significant progress. Results showed an 80% success
rate, with 65.6% meeting their goals and 14.7% feeling they were making
significant improvements. At the 18-​month follow-​up, 86% of the contacted
clients reported success. These initial studies showed SFBT to be a promis-
ing approach.
The second study, conducted by De Jong and Hopwood (1996), involved
275 clients seen at the BFTC from November 1992 to August 1993. Similar
to Kiser’s (1988) study, participants were contacted 7 to 9 months after ter-
mination of therapy and asked whether they had met their goals. Results
from this study indicated that of the 136 participants who responded, 45%
reported meeting their goals, 32% reported some progress toward their
goals, and 23% reported no progress. On the intermediate score measure,
141 responses were calculated on the basis of the therapists’ session notes.
Results from this measure showed that 25% reported significant progress,
49% reported moderate progress, and 26% reported no progress. Limitations
of this study were similar to those of Kiser’s (1988) study because it lacked
multiple, standardized measures. Despite the lack of rigorous designs in
these two early studies, however, the initial success and positive results were
impressive enough to warrant further research on this promising model.

Systematic Reviews
Gingerich and Eisengart (2000) conducted the first systematic, qualitative
review of the 15 controlled outcome studies on SFBT up to 1999. All of these
studies used either a comparison group or single-​case, repeated-​measures
design to evaluate various client behaviors or functioning. The studies were
divided into three groups according to the degree of experimental control

32 Solution-Focused Brief Therapy in Schools


 33

employed. Five studies met the well-​controlled standard, four studies met
the moderately controlled standard, and six studies met the poorly con-
trolled standard.
Recently Gingerich and Peterson (2013) updated this previous systematic
review (Gingerich & Eisengart, 2000) and looked at 43 controlled outcome
studies on SFBT conducted internationally. Studies were grouped into six
different categories:  child academic and behavior problems, adult mental
health, marriage and family, occupational rehabilitation, health and aging,
and crime and delinquency. Overall, results showed that 74% of the studies
reported significant positive benefits for those clients receiving SFBT inter-
vention. Of particular interest to school social workers are the 14 studies
that looked at child academic and behavior problems. Table 3.1 provides a
detailed looked at these studies.
Of the 14 studies that looked at this subgroup, 11 were conducted in
school settings, mostly in the United States. Overall, 12 of the studies found
improvement in the SFBT group after intervention on all or most outcomes.
Only two studies (Cook, 1998; Leggett, 2004)  reported no difference in
the SFBT group after intervention for most or all outcomes. When exam-
ining how the SFBT group compared with the control group, three of the
studies (Cepukiene & Pakrosnis, 2011; Franklin, Moore, & Hopson, 2008;
Froeschle, Smith, & Ricard, 2007)  showed statistically significant differ-
ences on all or most outcomes over those students in the control group. An
additional three studies (Daki & Savage, 2010; Newsome, 2004; Springer,
Lynch, & Rubin, 2000) showed changes in the desired direction for the SFBT
group on all or most outcomes. Six studies (Cook, 1998; Corcoran, 2006;
Kvarme et  al., 2010; Leggett, 2004; Littrell, Malia, & Vanderwood, 1995;
Wilmshurst, 2002) did not report any difference between the SFBT and con-
trol groups on all or most outcomes. Two studies (Fearrington, McCallum, &
Skinner, 2011; Yarbrough, 2004)  did not report between-​ group results
because they used a single-​group design and did not have a comparison
group. Taken together, these studies continue to show the diversity in SFBT
application as well as the promising results when using SFBT with children
and youth.

Meta-​Analysis
The good news is that since Gingerich and Eisengart’s (2000) review, more
research studies have examined the effectiveness of SFBT. To advance the

SFBT and Evidence-Based Practice: The State of the Science33


34
Table 3.1  Child Academic and Behavior Problems (Gingerich & Peterson, 2013)

Study Setting Sample Duration And Outcome SFBT Comparison


Size Modality Measure Pre-​Post Group Contrast

Cepukiene & Foster homes 46 1–​5 sessions, Behavior problems +* +*


Pakrosnis (Lithuania) individual Somatic/​cognitive + +
(2011) counseling problems
Cook (1998) School 68 6 sessions, 30-​min Self-​concept 0 0
classroom
Corcoran University clinic 85 4–​6 sessions, family Behavior problems + 0
(2006) counseling (Conners Parent
Rating Scale)
Behavior problems 0 0
(Feelings, Attitudes,
and Behaviors Scale
for children)
Daki & Savage Learning centers 14 5 sessions, Academic achievement + 0
(2010) (Canada) 40-​min individual Reading fluency + +
counseling Reading motivation + +
Reading activity + 0
inventory
Self-​esteem + +
Behavioral disorders + +
 35
Fearrington, Inner-​city school 6 5 sessions, Assignment completion + n/​a
McCallum, 30-​min individual Assignment accuracy +
& Skinner counseling
(2011)
Franklin, School 53 5–​7 sessions, Child behavior teacher + +*
Moore, & 45-​min individual report, externalizing
Hopson counseling Child behavior teacher + +*
(2008) report, internalizing
Child behavior student + +*
report, externalizing
Child behavior student + 0
report, internalizing
Froeschle, School 65 16 sessions, 1-​h Drug use + +*
Smith, & group Attitudes + +*
Ricard Self-​concept + 0
(2007) Social competence + +*
Social behaviors + +*
Drug knowledge + +*
Kvarme et al. School (Norway) 144 5 sessions, 1-​h group General self-​efficacy +* 0
(2010) Specific self-​efficacy + +
Assertive self-​efficacy +* 0
Leggett (2004) School 67 11 sessions, 1-​h Self-​esteem + +
classroom Hope 0 0
Classroom environment 0 0

(Continued)
36
Table 3.1 (Continued)

Study Setting Sample Duration And Outcome SFBT Comparison


Size Modality Measure Pre-​Post Group Contrast
Littrell, Malia, School 54 1 session, 20-​to Alleviating concerns +* 0
& 50-​min individual Goal attainment +* 0
Vanderwood counseling Intensity of feelings +* 0
(1995)
Newsome School 52 8 sessions, 30-​min GPA +* +
(2004) group Attendance + +
Springer, Lynch, School 10 6 sessions, group Self-​esteem +* +
& Rubin
(2000)
Wilmshurst Residential pro- 65 12 weeks, 5-​day resi- Emotional/​behavioral +* ≈
(2002) gram (Canada) dential program disorders, externalizing
Emotional/​behavioral 0 +*
disorders, internalizing
Social competence +* ≈
Behavior problems +* ≈
Yarbrough School 6 5 sessions, 30-​ Assignment completion + n/​a
(2004) min individual Assignment accuracy +
counseling

Note. 0 = no difference; + = positive trend in desired direction; +* = statistical significant positive change; ≈ = approximately equal; n/​a -​not applicable.
 37

research on SFBT and provide an updated review for practitioners, a meta-​


analysis was conducted by Kim (2008). A  meta-​analysis is a quantitative
review method that allows researchers to combine and synthesize existing
studies and reanalyze them to determine overall outcomes. The effect size
statistic is used to report the outcomes of the review. By calculating effect
sizes, the meta-​analyst converts measures in primary studies to a common
metric of treatment effect or relation between variables. It is possible to
achieve small (.30), medium (.50), or large (.80) effect sizes when calculating
the outcomes. Most practice research in the social work field typically finds
small effect sizes when evaluating an intervention (Kim, 2008). See Box 3.1
for a formal definition and description of meta-​analysis.
Kim (2008) synthesized SFBT outcome studies to determine the overall
effectiveness of this approach and thus provided more empirical informa-
tion on its effectiveness. Because these studies vary in regard to research
designs, populations, and findings, a research synthesis using meta-​analytic

Box 3.1  Description of a Meta-​Analysis


A meta-​analysis integrates findings from a collection of individual
studies with similar outcome constructs to determine the magnitude
of the treatment effect (Glass, 1976). Instead of relying on anecdotal
evidence, meta-​analytic procedures can be used to synthesize quan-
titative results from studies to calculate effect sizes, which measure
the strength and direction of a relationship. The larger the magnitude
of the effect size, the stronger the treatment effect. Confidence inter-
vals can also be calculated to measure the precision of the effect size
estimate. Furthermore, heterogeneity in effect sizes is found across
studies, then predictor variables can be examined to help explain this
variability (Hall, Tickle-​Degnen, Rosenthal, & Mosteller, 1994). The
statistical method of meta-​analysis has been used to identify effective
practice methods developed and evaluated by social workers since
the 1980s (Reid, 2002). An SFBT meta-​analysis can add to this prog-
ress by systematically evaluating the effectiveness of this approach
through the aggregation of multiple outcome studies (Corcoran,
Miller, & Bultman, 1997).

SFBT and Evidence-Based Practice: The State of the Science37


38

procedures appears to be a good approach to examine the state of the empiri-


cal evidence for SFBT. By calculating effect sizes, Kim’s (2008) meta-​analysis
goes beyond the two systematic reviews discussed earlier (Gingerich &
Eisengart, 2000; Gingerich & Peterson, 2013)  by using means and stan-
dard deviations from the primary studies to come up with overall treatment
effects for SFBT.
The main research question for Kim’s (2008) meta-​analysis was the
effectiveness of SFBT for externalizing behavior problems (e.g., aggression
and conduct problems), internalizing behavior problems (e.g., depression
and self-​esteem), and family or relationship problems. These were the most
frequent outcomes measured in the studies on SFBT, and they are of con-
siderable interest to social workers. The results from the literature search
produced 22 studies that met the criteria for inclusion in the meta-​analysis.
These 22 studies were then divided and grouped into three categories based
on the outcome problem each study targeted (i.e., externalizing behavior
problems, internalizing behavior problems, and family and relationship
problems). Each of the three categories had between 8 and 12 studies, with
5 studies (Franklin, Moore, & Hopson, 2008; Huang, 2001; Marinaccio,
2001; Seagram, 1997; Triantafillou, 2002) being included in more than one
category because they examined more than one outcome problem.
Kim (2008) found that SFBT demonstrated small, but positive, treat-
ment effects favoring the SFBT group on the outcome measures. The over-
all weighted mean effect size estimates were .13 for externalizing behavior
problems, .26 for internalizing problem behaviors, and .26 for family and
relationship problems. Only the magnitude of the effect for internalizing
behavior problems was statistically significant at the p < .05 level, indicating
that the treatment outcome for the SFBT group was different from the treat-
ment outcome for the control group.
The small effect sizes calculated in Kim’s (2008) meta-​analysis are only
slightly smaller than other effect sizes calculated in similar social science
research. As Table 3.2 highlights, SFBT effect sizes are comparable to those
in other psychotherapy and social work meta-​analyses when conducted
under real-​world conditions.
Kim’s (2008) meta-​analysis did not achieve the medium and large effect
sizes for SFBT that researchers like to see in outcomes. As noted, however,
it is unusual to achieve anything above a small effect size when evaluating
applied research studies in community settings, and this would be the case

38 Solution-Focused Brief Therapy in Schools


 39

Table 3.2  Comparison of Meta-​A nalyses

Study Treatment Population Outcome Effect


Intervention Measure Size

Kim (2008) SFBT Various Externalizing .13


problems
Internalizing .26
problems
Family and .26
relationship
problems
Weisz, Psychotherapy Adolescents Depression .34
McCarty, (overall)
& Valeri Psychotherapy in Adolescents Depression .24
(2006) real-​world clinical
setting
Babcock, Domestic violence Domestically Police reports .18
Green, treatment violent males Partner reports .18
& Robie
(2004)
Gorey General social work Various Various .36
(1996) practice

with SFBT research as well. To illustrate, the small effect sizes calculated in
the SFBT meta-​analysis are only slightly smaller than the effect sizes calcu-
lated for psychotherapy. For example, psychotherapy’s mean overall effect
size on adolescent depression, when including dissertations and using more
rigorous effect size calculations than previous meta-​analyses on this subject,
was a moderate .34, with a range of −.66 to 2.02 (Weisz, McCarty, & Valeri,
2006). In addition, studies on the effectiveness of psychotherapy on adoles-
cent depression that were conducted in real-​world settings had a small over-
all weighted mean effect size of .24. Similarly, Babcock, Green, and Robie
(2004) cite other meta-​analyses on psychotherapy with small effect size
results due to difficulties in treating externalizing problem behaviors like
aggression (Loesel & Koeferl, 1987; Weisz, Weiss, Han, Granger, & Morton,
1995). Therefore, while Kim’s (2008) study found small treatment effects for
SFBT, other meta-​analyses on psychotherapy have found only slightly better
or equal results, depending on the research study setting.

SFBT and Evidence-Based Practice: The State of the Science39


40

Current Research in School Settings


While the preceding section focused primarily on SFBT research overall,
several recent studies have focused on SFBT in school settings. The applica-
tion of SFBT with students and in school settings has grown over the past
15 years and continues to be an area of interest for researchers, school social
workers, and other school-​based professionals. SFBT has been applied in
school settings to a number of problems, including student behavioral and
emotional issues, academic problems, and social skills. Recently, Kim and
Franklin (2009) reviewed the outcome literature on SFBT in schools. Table 3.3
summarizes the most rigorous experimental and quasi-​experimental design
studies on SFBT in schools that have been published in peer-​reviewed jour-
nals, some of which overlap with those noted in the Gingerich and Peterson
(2013) study.
As Table 3.3 highlights, six experimental design studies and one single-​
case design study on SFBT in schools have been published since 2000. The
results from most of the studies were mixed, thereby limiting the ability to
draw definitive conclusions. Initial impressions of these results may be mis-
leading, however, as the authors of the studies note several factors that may
have influenced the mixed results.
These types of mixed results are not unusual for studies conducted in real-​
world practice settings (viz., effectiveness study), which are more common
in social work research, as opposed to research studies conducted in clini-
cal settings (viz., efficacy studies), which are more common in psychology.
Efficacy studies conducted in clinical settings are able to control for many
factors, such as intervention training, treatment fidelity, and client selection,
that effectiveness studies conducted in practical settings are not (Connor-​
Smith & Weisz, 2003). A major problem with efficacy studies, however, is
the diminished results found when models are transferred from the clini-
cal setting to real-​world settings such as schools (Southam-​Gerow, Weisz,
& Kendall, 2003; Weisz, 2004). In contrast, all of the studies in Table 3.3
were conducted in real-​world settings and therefore show promise under
typical clinical practice situations, unlike the optimal clinical efficacy stud-
ies that have been shown to be ineffective when the model is transferred into
clinical practice settings (Kim, 2008).
An important feature in these recent studies is the positive results found
in almost all of them for those students receiving SFBT. These positive out-
comes suggest that solution-​focused therapy can be beneficial in helping

40 Solution-Focused Brief Therapy in Schools


 41
Table 3.3  SFBT Studies in Schools (Kim & Franklin, 2009)

Study Design Outcome Measure Sample Sample Results


Size Population

Corcoran (2006) Quasi-​ Conners Parent Rating 86 Students aged No significant differences between
experimental Scale; Feelings, 5–​17 years groups, with both improving at
Attitudes, and posttest. This lack of difference
Behaviors Scale for may be because the comparison
Children group received treatment as usual,
which had many CBT compo-
nents that have been empirically
validated.
Franklin Biever, Single case Conners Teacher Rating 7 Middle school Five of seven (71%) improved per
Moore, Clemons, Scale students aged teacher reports.
& Scamardo 10–​12 years
(2001)

(Continued)
42
Table 3.3 (Continued)

Study Design Outcome Measure Sample Sample Results


Size Population
Franklin, Streeter, Quasi-​ Grades and attendance 85 At-​r isk high SFBT sample had statistically signifi-
Kim, & Tripodi experimental school students cant higher average proportion of
(2007) credits earned to credits attempted
than the comparison sample. Both
groups decreased in mean atten-
dance per semester; however, the
comparison group showed a higher
proportion of school days attended
to school days for the semester.
Authors suggested that attendance
between groups may not be a fair
comparison because the SFBT
group worked on a self-​paced cur-
riculum and could decrease their
attendance when completed.
 43
Franklin, Moore, & Quasi-​ Child Behavior Checklist 59 Middle school Internalizing and externalizing score
Hopson (2008) experimental (CBCL) Youth students for the Teacher’s Report Form
Self-​Report Form showed the SFBT group declined
Internalizing; CBCL below clinical level by posttest
Externalizing; Teacher’s and remained there at follow-​up,
Report Form internal- whereas the comparison group
izing and externalizing changed little. Internalizing score
score for the Youth Self-​Report Form
showed no difference between
groups. Externalizing score
showed the SFBT group dropped
below the clinical level and contin-
ued to drop at follow-​up.
Froeschle, Smith, & Experimental American Drug & Alcohol 65 Eighth-​g rade Statistically significant differences
Ricard (2007) design Survey; Substance female students were found favoring the SFBT
Abuse Subtle Screening group on drug use, attitudes
Inventory; toward drugs, knowledge of
knowledge on physical physical symptoms of drug use,
symptoms of drug use; and competent behavior scores
Piers-​Harris Children’s as observed by both parents
Self-​Concept Scale; and teachers. No group differ-
Home & Community ences were found on self-​esteem,
Social Behavior Scales; negative behaviors as measured by
School Social Behavior office referrals, and GPAs.
Scales; referrals; and
GPA

(Continued)
44
Table 3.3 (Continued)

Study Design Outcome Measure Sample Sample Results


Size Population
Newsome (2004) Quasi-​ Grades and attendance 52 Middle school Statistically significant results, with
experimental students the SFBT group increasing mean
grade scores, whereas the compari-
son group’s grades decreased.
No difference on attendance measure.
Springer, Lynch, & Quasi-​ Hare Self-​Esteem Scale 10 Hispanic elemen- The SFBT group made significant
Rubin (2000) experimental tary school improvements on the Hare Self-​
students Esteem Scale, whereas the com-
parison group’s scores remained
the same. However, no significant
differences were found between
the SFBT and comparison groups
at the end of the study on the self-​
esteem scale.
 45

students reduce the intensity of their negative feelings, manage their con-
duct problems, improve academic outcomes like credits earned, and posi-
tively impact externalizing behavior problems and substance use (Kim &
Franklin, 2009). Although at present there may not be enough studies to
draw definitive conclusions about the effectiveness of SFBT, the use of rigor-
ous research designs in real-​world settings with increased sample sizes and
statistical power does provide support for looking upon it as a promising
therapy model. In fact, all the studies described in Table 3.3 use either an
experimental or quasi-​experimental design, which helps reduce threats to
internal validity (Rubin & Babbie, 2005). The more recent outcome studies
on SFBT have moved beyond follow-​up survey studies of the past and begun
to employ more rigorous, well-​controlled study designs, lending even more
credibility to interpretations of the results obtained. In fact, viewed practi-
cally, SFBT is offered with only a few clinical sessions and has been shown
to perform in a manner similar to other therapeutic approaches conducted
in community settings with longer therapy sessions.

Research Implications for Practice in Schools


When the first edition of this book was published, the state of the research
on SFBT and the limited numbers of studies available provided only tentative
answers about the effectiveness of SFBT in school settings. Those early, posi-
tive findings for internalizing and behavioral outcomes, however, may have
considerable clinical significance for school-​based practitioners because of
the effect sizes achieved and the fact that most of the studies involved salient
issues for school practitioners (e.g., conduct problems, hyperactivity, or sub-
stance use). Since then, much has changed, not only in terms of the num-
ber of research studies conducted on SFBT but also in the perception of
SFBT as an evidence-​based intervention. There is less talk or debate about
whether SFBT is evidence based due to the increase in outcome studies from
around the world showing its effectiveness (Franklin, Trepper, Gingerich, &
McCollum, 2012). In addition, SFBT has been listed on the Substance Abuse
and Mental Health Services Administration National Registry of Evidence-​
Based Programs and Practices site as an evidence-​based intervention.
SFBT may be beneficial for those difficult clients who have been unsuc-
cessful in resolving problems using other, more typical approaches. For
example, Franklin et al. (2008) conducted a study in a school setting with
children who were having classroom and behavior problems that could not

SFBT and Evidence-Based Practice: The State of the Science45


46

be resolved by teachers and principals. The students underwent individual


sessions of SFBT combined with teacher consultations. After receiving the
SFBT intervention, teachers reported on a standardized measure (Conners
Teacher Rating Scale) that the children’s behavior problems significantly
improved. Children also rated themselves and reported that their behav-
ior had improved. The effect sizes were medium to large for the changes
achieved.
Another advantage of SFBT for social work practice is that this model can
help to create change in the target problem quickly and can identify spe-
cific goals collaborated on by both the client and the social worker. Across
the three different outcome categories reported in the Franklin et al. meta-​
analysis, several individual studies found large effect sizes with six or fewer
therapy sessions (Cockburn, Thomas, & Cockburn, 1997; Franklin et al.,
2008; Sundstrom, 1993). Furthermore, many of the studies examining the
effectiveness of SFBT were conducted in real-​world settings and therefore
show promise under typical practice situations—​again, unlike the optimal
clinical efficacy studies, which have shown to be ineffective when the model
is transferred into clinical practice settings.
Although this chapter has focused on examining the state of the research
on SFBT and its effectiveness, keep in mind that many common factors play
an important role in treatment effectiveness. These common factors are less
about specific techniques and more about the therapeutic relationship and
individual characteristics that help bring about change in clients. These fac-
tors focus more on the personality and behavior of social workers, expec-
tations of change, and engagement in therapy-​relevant activities (Kazdin,
2005). Therefore, trying to determine whether SFBT is more effective than
other therapy models may prove futile: some studies have shown that many
therapies are basically equal in effectiveness, and other non-​treatment fac-
tors common across therapy models may bring about therapeutic change
independent of the social worker’s specific techniques (Lambert, 2005;
Reisner, 2005; Wampold, 2001). What is more essential in research is for
SFBT to demonstrate superiority to some control condition or group of cli-
ents who received treatment-​as-​usual or received no treatment (Chambless,
2002; Duncan, Miller, & Sparks, 2004).
Concerns also arise about the evaluation of treatment fidelity by the ther-
apists conducting the SFBT sessions and their training level in the model. Do
these practitioners know how to do SFBT, and how well did they do it in the

46 Solution-Focused Brief Therapy in Schools


 47

sessions? Results on the effectiveness of SFBT could be misleading if practi-


tioners aren’t adequately trained or do not adhere to the core components of
the therapy model. One possible approach to improving treatment fidelity in
outcome research studies is utilizing a treatment manual to further improve
adherence to the SFBT model. However, using a treatment manual has not
been demonstrated to improve practice to a great extent in the real world
(Duncan et al., 2004). Most therapy models that are deemed to be evidence
based, however, are manualized practices that provide some consistency
among researchers conducting the studies. Currently, the Solution-​Focused
Brief Therapy Association in North America and the European Brief Therapy
Association have created treatment manuals that will aid in improving
intervention fidelity. The introduction of these manuals demonstrates that
SFBT adherents are getting serious about training and fidelity on the model.
An excerpt from the treatment manual developed by the Solution-​Focused
Brief Therapy Association is shown in Box 3.2. Improving treatment fidelity
in future studies, and making sure that clinicians conducting SFBT sessions

Box 3.2  SFBT Manual Excerpt


Therapist Characteristics and Requirements
SFBT therapists should posses the requisite training and certification
in mental health discipline, and specialized training in SFBT. The
ideal SFBT therapist would posses (a) a minimum of a master’s degree
in a counseling discipline such as counseling, social work, marriage
and family therapy, psychology, or psychiatry; (b)  formal training
and supervision in solution-​focused therapy, either via a university
class or a series of workshops and training experiences as well as
supervision in their settings. Therapists who seem to embrace and
excel as solution focused therapists have these characteristics: (a) are
warm and friendly; (b) Are naturally positive and supportive (often
are told they “see the good in people”); (c) are open minded and flex-
ible to new ideas; (d) are excellent listeners, especially the ability to
listen for clients’ previous solutions embedded in “problem-​talk”; and
(e) are tenacious and patient.
(Bavelas et al., 2013, p. 23)

SFBT and Evidence-Based Practice: The State of the Science47


48

have extensive training in the SFBT model, will help ensure confidence in
the results obtained from the primary study.
To confidently determine the effectiveness of SFBT through a
meta-​a nalytic review, more primary studies with larger sample sizes
and rigorous research designs are required. In addition, studies using
experimental designs need to utilize standardized measures that are
sensitive enough to measure brief intervention changes and that pos-
sess satisfactory clinical sensitivity, especially for internalizing behav-
ior problems. To help reduce the number of studies excluded from
meta-​a nalysis, reported studies should include enough statistical infor-
mation to calculate effect sizes, such as means and standard deviations,
for both pretest and posttest groups as well as experimental and control
groups.

Summary
This chapter summarized the research support for SFBT and addressed
the state of the research on SFBT as compared to other intervention mod-
els. Particular emphasis was given to reviewing a meta-​analysis on SFBT
conducted by Kim (2008) as well as other, more recent systematic reviews
of SFBT studies conducted in school settings. The research on SFBT has
steadily grown over the years, and this therapy model is now viewed as
evidence based. The studies that exist consistently demonstrate that SFBT is
a promising, effective approach that is useful for students in school settings
and for community service providers.

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52

4
■ ■ ■

SFBT Within the Tier 1 Framework


Alternative Schools Adopting the SFBT Model
Cynthia Franklin & Samantha Guz

This chapter discusses the Response-​ to-​


Intervention (RtI) framework
and how to use SFBT within a Tier 1 (schoolwide) intervention approach
with at-​r isk students. Specifically, this chapter describes how the solution-​
focused approach is used as a schoolwide intervention within Gonzalo
Garza Independence High School in Austin, Texas. A  public, alternative
school of choice, Garza High School is operated by the Austin Independent
School District (AISD). This school is a part of the school district’s dropout
prevention programs but is also incorporated as a non-​profit organization.
Garza High School has utilized a solution-​focused model since 2002 and
has achieved academic success at educating students who are frequently
served by school social workers. Most of the students have many risk fac-
tors, such as serious social problems (e.g., homelessness, pregnant and par-
enting, and traumatic experiences) as well as behavioral health challenges
(e.g., substance use and mental health diagnoses). In particular, behavioral
health challenges are serious concerns to most school districts, and Garza
High School has focused most on educating students with these types of
problems. Garza has also achieved status as an effective, model school pro-
gram whose academic achievements and practices have been recognized
by the Texas Education Agency and the US Department of Education. This
makes Garza High School an excellent choice to discuss because the pro-
gram shows how solution-​focused techniques can become part of a Tier 1
approach within educational programs designed to graduate students who
have high-​r isk factors associated with their behavioral health, family, and

52
 53

community functioning. At Garza High School, all school administrators,


teachers, and staff members are trained in SFBT principles of change and
techniques to aid in their engagement and work with students.

Tier 1 Approach
Over the past 15 years, campuses have utilized a three-​tier system to meet
the needs of their diverse student populations:  universal (Tier 1), selec-
tive (Tier 2), and intensive (Tier 3) interventions. The majority of students
(95% or more) have their needs meet by the first two tiers (Sabatino, Kelly,
Moriarity, & Lean, 2013). For a school considering the three-​tier RtI system,
it is important to understand all the tiers while keeping in mind that the
most students will respond to the first two levels of intervention. Tier 1 is
particularly important because, after receiving the first tier of the RtI, 85% of
students will not require any higher level of intervention. The success of Tier 1
is due to the high-​quality instruction students received in the classroom,
which is designed to prevent future problematic behaviors. The behaviors
taught inside the classroom are reinforced throughout the entire school by
a variety of staff members. While thought of mainly as an approach to be
implemented in primary prevention within all schools, the practices embed-
ded within Tier 1 can also be implemented to create effective school pro-
grams that may target one or more groups of students such as those at high
risk of dropout.
Graduating students with high-​risk profiles requires a team that oper-
ates across the entire school to create a safe environment with a climate and
culture that will make interventions effective. Teachers, counselors, social
workers, or other school-​based professionals normally implement Tier 1 in
classrooms. This classroom-​based implementation helps Tier 1 be campus-
wide and reach each student. Although qualified school-​based professionals
lead the instruction in the classroom, the entire school staff is invested in
implementing the interventions. A solution-​focused approach can be incor-
porated into a Tier 1 intervention because SFBT engages all of the adults
surrounding the student and uses SFBT change processes to support the
student’s goals. This campuswide dedication is linked to the fidelity of a Tier 1
intervention’s implementation. Research suggests campuses that imple-
ment Tier 1 interventions with high fidelity have fewer behavioral referrals
and, overall, more positive campus climates (Allen-​Meares, Montgomery, &
Kim, 2013). To maintain the high quality of instruction, assessment, and

SFBT Within the Tier 1 Framework53


54

screening that is required of Tier 1 interventions, the school staff must be


trained and involved in the intervention in a way that is meaningful to them.
To accomplish meaningful involvement of staff in an intervention, staff
members must be equipped and supported to implement the interventions.
Staff also must believe in the credibility and effectiveness of the interven-
tions they are delivering. This requires a professional development approach
that allows collaboration between staff, administrators, researchers, and
trainers that will ultimately lead to ownership of the interventions. This was
the type of training model implemented at Garza High School when they
adopted the SFBT approach. All staff within the school received training in
ongoing process for two years that included direct instruction from experts
on SFBT, video and live demonstrations, and practice with feedback.

Designing a Solution-​Focused School Using a Tier 1 Approach


Within Garza High School, SFBT became a campuswide effort to support
at-​r isk students in their efforts toward their graduation. An essential com-
ponent of this Tier 1 approach was that all teachers and staff become trained
in SFBT principles of change and techniques. School-​based mental health
professionals such as social workers are essential to the success of a Tier 1
approach; however; it is teachers who spend the majority of time with stu-
dents. With professional development training, teachers can become profi-
cient in mental health techniques and feel confident using them (Franklin,
Kim, Ryan, Kelly, & Montgomery, 2012). This was the training philosophy
implemented at Garza High School:  train the teachers and all the staff to
be partners in the change process because schools will never get enough
social workers and counselors to meet all the needs. In fact, training all staff
actually freed social workers and counselors to do more in-​depth counsel-
ing and to create needed groups and community linkages while at the same
time supporting staff in consultations, training, and work with the students
who required additional assistance in the classroom. One of the Garza High
School teachers said this about the training philosophy:

It was the principal’s philosophy to train the entire school. Data


clerk people were in there, registrars, custodians, because she
said anyone can be an advocate. Our custodian is so involved
with a lot of our kids and has been a huge advocate and role
model for a lot of our kids. He does citywide basketball and
recruits some of our kids for that. He talks with them about

54 Solution-Focused Brief Therapy in Schools


 55

manners and accountability; it’s just amazing. Anyone can be


an [advocate]. A kid may bond with the cafeteria person, so that
person needs to be trained like everyone else.

An interprofessional approach was used to train and adapt the SFBT


approach to Garza High School. School social workers, counselors, teachers,
and administrators melded their areas of expertise into a unique application
of solution building. In such an approach, different team members share
their knowledge and expertise with one another and create new methods
for intervention by adapting that knowledge. Streeter and Franklin (2002)
called this learning across disciplinary boundaries a transdisciplinary
team approach to solving problems. First, all school staff were trained in
the solution-​focused, mental health approach to provide the staff better
skills for working with at-​r isk students. In turn, and over time, the school
staff adapted the SFBT principles of change and techniques to their edu-
cational setting. Staff were encouraged, for example, to adapt the change
principles and practices of SFBT to fit the daily challenges in teaching in
the classroom and the specific problems they encountered with students
(e.g., attendance, tardiness, lack of progress, suicidal ideation, and sub-
stance use at school). The specific adaptation was not done by consultants
or researchers but, rather, through the creative work of all the staff involved
in the school. The way SFBT was being used at Garza was then discussed in
subsequent meetings and trainings so that everyone involved continued to
learn. Importantly, students were also part of the team effort in developing
approaches. As a solution-​building school, listening to students and taking
their suggestions became a part of the culture. Students were invited to the
SFBT trainings, for example, and the principal also convened a principal’s
advisory group where students were asked to provide ideas about practices
within the school.
All staff were trained in SFBT techniques, such as solution-​talk, focusing
on strengths and exceptions, scaling, and goal setting. Specific principles
of change were emphasized, such as the importance of using positive lan-
guage as means to help someone think about the self and others differently
and of setting client-​centered goals as essential for the beginning of any
change process. Goals, for example, were to be developed collaboratively
with students and to be small, measurable, and observable to school staff
and parents (Newsome, 2005). School staff also learned the SFBT principle
for change that goals are personal and therefore intrinsically motivating for

SFBT Within the Tier 1 Framework55


56

both staff and students (Jones et al., 2009). Administrators and counselors
were further encouraged to institutionalize these practices into the school’s
academic instruction and programs (e.g., daily scaling and goals sheets) and
even a special graduation ceremony, called a Star Walk, which is described
in more detail later in this chapter.
As noted, the process of learning the philosophy of change and practic-
ing SFBT techniques at Garza High School went on for two years, but in
actuality, the professional development and learning about SFBT has never
stopped. Once the initial two-​year training was accomplishment, ongoing
consultations, usually once or twice a semester, continued the transdisci-
plinary team approach toward adaptation of the solution-​focused model
to the entire school. At the beginning of training, the original experts on
SFBT served as trainers, consultants, evaluators, and scribes of this pro-
cess, documenting this work in research and in a training manual about the
practices. While this may seem like a time-​consuming approach to training
staff how to use SFBT in a school, it also resulted in the school staff being
more competent in SFBT and able to own and, later, take over the training
and maintenance of the approach with only minimal consultations from
the researchers and trainers, making sure that everyone, including the new
teachers, were trained.
The SFBT at Garza High School has been sustained for the past 15 years,
including across one change in principal leadership of the school. When
the change in leadership occurred in 2008 and founding principal Victoria
Baldwin retired, some predicted the SFBT model would not be continued.
Ms. Baldwin, however, was involved in selecting Dr.  Linda Webb as the
new principal, and she not only maintained the SFBT approach but further
improved the curriculum and the academic achievement of the school. When
Dr.  Webb first assumed her position, one of the original trainers became
more involved again in the training functions. At this point, Dr. Webb has
been thoroughly trained in SFBT and, along with her staff, personally leads
the ongoing in-​service trainings on the SFBT approach while the original
researchers and trainers maintain a consultation and support role. The
advantages of training all the teachers and staff in the principles of change
and techniques of SFBT, and of encouraging them to adapt the approach
to the educational setting, made it easier for the Tier 1 intervention to be
implemented at high fidelity (Franklin, Kim, Ryan, Kelly, & Montgomery,
2012). By providing in-​depth training in SFBT strategies to everyone at the
school, the Tier 1 intervention also became more effective and had more

56 Solution-Focused Brief Therapy in Schools


 57

Table 4.1  Interprofessional Training of School Staff on SFBT


• Obtain support from administration.
• Identify one person to be primarily responsible for training and adherence.
• Create strong partnerships with selected school staff.
• Assess what the school is already doing to build solutions.
• Introduce the model through an interdisciplinary team structure.
• Seek input from all constituents, especially students.
• Maintain a school focus in solution-​building conversations.
• Provide opportunities for training by an expert in solution-​focused therapy.
• Supporting educators in shaping the model with their own unique philoso-
phy and approach.
Source: Franklin and Streeter (2004).

long-​term stability. Table 4.1 summarizes the interprofessional, Tier 1 train-


ing approach used at Garza High School.

Solution-​Building Approach for At-​Risk Students


Garza High School’s administrators and staff used the solution-​focused
techniques to facilitate positive relationships with students and solve prob-
lems. Teachers were trained to view students as experts in identifying their
own solutions to their problems and difficulties. This view is opposed to
the usual approach of expert-​driven strategies, and it was discovered that
teachers use the solution-​building approach more when they can implement
SFBT during everyday conversations with students in their own classrooms.
Here are some ways that Garza’s teachers used the solution-​building inter-
vention skills to help students:

• Assisting students to come up with a realistic solution.


• Looking for ways in which the solution is already occurring in the life of
the student.
• Assisting the student with creating small, measurable goals toward the
solution.
• Taking immediate steps impact educational and life outcomes (Franklin,
Montgomery, Baldwin & Webb, 2012).

As discussed in Chapter 3, the use of SFBT in schools has been shown to


be a promising intervention (Kim & Franklin, 2009). Garza students display
behaviors that may be challenging for teachers, and we now discuss how

SFBT Within the Tier 1 Framework57


58

the solution-​focused approach is used to address some common challenges


within Garza High School: suicide, self-​harm, violence, and aggression.

Suicide and Self-​Harm


A solution-​focused approach helps teachers and staff builds strong relation-
ships with students (Lagana-​R iordan et  al., 2011), which are very useful
when working with students in stressful situations. In an alternative high
school, this relationship is especially essential as multiple students on cam-
pus may be at imminent risk of self-​harm or suicide. Garza teachers will
notice immediately when a student stops attending class or begins behaving
atypically. Social workers are available to assist if a student is having a seri-
ous mental health crisis that the teacher cannot handle, and the two profes-
sionals work as a team to maintain the student in the classroom.
Box 4.1 describes a student who is struggling with mental health and
self-​harm challenges. In this case, Garza teachers and staff use a team
approach and SFBT to support the student, and part of Garza’s Tier 1 SFBT
approach is a referral system where any staff member can submit a form
about any student to a school counselor. These referrals are addressed at a
weekly student services meeting. The administration at Garza will create a
diverse Student Services Team consisting of teachers, counselors, outside
community agencies, and the Communities In Schools social workers. The
team works to better understand the students so that they can help students
create reasonable goals for themselves. In Maya’s case, a safety plan was cre-
ated and shared with Garza’s staff. This type of safety plan would involve a
staff member meeting Maya in the morning and after school. In a different
school setting, a safety plan could be embarrassing; however, Garza works to
destigmatize behavioral health challenges. This is also part of the strengths-​
based SFBT model, focusing on future possibilities rather than on the past.
As a social worker at Garza who saw students for the 2015–​2016 school
year said:

I am amazed at how easily the students tell me about their


struggles and trust that I will support and help them. The big-
gest thing about Garza is how it squashes stigma surrounding
so many issues that society battles with today—​gender and
sexuality, mental health, abuse, learning disabilities, delinquent
behavior, citizenship and immigration, and poverty. No matter
what is happening in a student’s life, they truly know that some-
one at school will sit down, listen and work hard to help.

58 Solution-Focused Brief Therapy in Schools


 59

Box 4.1  Maya: Suicide Risk


Maya enrolled in Garza High School a few months ago. Since then,
she built a strong relationship with her art teacher and become a part
of Garza’s community. However, Maya is struggling with her mental
health again; she had been previously hospitalized for self-​harm and
suicidal ideation. In the hospital, Maya was diagnosed as Bipolar 1
with a medium level of severity.
Suddenly, Maya’s art teacher noticed a change in her. Maya’s
behavior and mental attitude seemed different; Maya began skip-
ping school and reported engaging in highly risky behaviors. The
art teacher filled out a referral and turned it into the school coun-
selor. The referral form was brought to the Student Services Team,
an interprofessional team of Garza staff members. At this meeting,
they brainstormed Maya’s progress at Garza and ways to better sup-
port her. During the meeting, the team also recognized the things
Maya was doing well:  she had been doing well in school, making
new friends, and socializing appropriately at home. By listing these
strengths, the staff remembered that Maya had the potential to meet
future self-​assigned goals. Ultimately, due to the past hospitalization
and diagnosis, the Garza staff put Maya on a safety plan.
The safety plan was given to all staff on campus along with a pic-
ture of Maya so that they could identify her, even if they had never
met her. Maya was not seeing an outside therapist; therefore, she was
referred to Garza’s on campus Communities In Schools (CIS) staff.
Maya began seeing the CIS social workers weekly. It was a place
where adults were honest and respectful. Even at times when she was
worried about her own mental health state, Maya never felt stigma-
tized on campus.

This quote encapsulates the common challenges facing Garza’s student body
and how the relational and strengths-​based approach of the SFBT permeates
the school. All challenges are always framed in an SFBT approach, with a
focus on relationships, strengths, and the future solutions that can be taken
to make a difference and solve problems.

SFBT Within the Tier 1 Framework59


60

The school uses the Student Services Team to help create this inclusive
culture at Garza. All staff can refer any student to the team. In these weekly
meetings, the student’s photo is projected, and the team reviews the stu-
dent’s pattern of attendance and behavior in conjunction with what is hap-
pening with the student outside of school. The team used a solution-​focused
approach to remain on task and create small, measurable goals. In the case
of Maya, got example, the Student Services Team used compliments to vali-
date what she was doing well.
It is common for the same student to be referred to the team every
week. In these situations, the team may decide to keep an eye on this
student or consider a more in-​depth intervention. The point of these meet-
ings is to understand rather than “fix” the student. To best understand
the student’s experience, the team is made up of individuals, all staff at
Garza, who are diverse in terms of race, age, employment, educational
background, LGBT status, and gender. Rather than being held down by
frustration, the Student Services Team looks at the referred student to see
what has been working and invites the student to do more of that. This
technique is strengths based and allows the team to function for the ben-
efit of the students’ goals.

Violence and Aggression


Even when disciplining students, the administration takes a solution-​
building approach, and perhaps this contributes to why Garza High School
has so few disciplinary referrals. Violence is almost absent from the school’s
history, for example, with only a handful of fights occurring between stu-
dents since Garza’s opening in 1998. As stated previously, this may be
because Garza teachers and staff create an environment where a lot of con-
cerns and insecurities are addressed and destigmatized. Students often
report feeling accepted within the school by both their teachers and their
peers. Garza has found ways to decease interpersonal conflicts by normal-
izing and destigmatizing difficult topics and using SFBT to communicate
and mediate issues between peers and between students and teachers. The
school also emphasizes restitution and learning instead of punishment, and
this responsibility is also put in the hands of the students. When students
are given detention, for example, they are required not only to think about
what they did that got them into trouble but also to explore what they could
have done differently. They are asked to envision what a solution would look

60 Solution-Focused Brief Therapy in Schools


 61

like and how they can make those changes. The following quote from Sam
Watson, former assistant principal, shows the positive results:

During detention, students are given a thought sheet that is used


to help [them] write out what happened. We would ask specific
questions like what happened the first time, what happened the
second time, what could you have done to keep that from hap-
pening, what will you do the next time this happens? And so
that was a way for us not to have to sit there with them but still
engaged them in some mental reflection about what happened.
So it became, what can we do to do a better job? What could you
have done for this not to happen? What were some of the other
choices you could have made? What can you do to correct that?
So the kids would rattle off solutions to those questions for you
because they know the right answers.

Implementing SFBT in the Alternative School


Solution-​focused strategies were not forced upon the campus staff over-
night; rather, the process was gradual and self-​motivated. Undoubtedly, the
administration’s engagement is critical to the success of Garza as an alter-
ative high school. Garza opened its doors in 1998, and the training toward
SFBT started in 2001. The school was well prepared to accept the SFBT
training, however, and already had multiple factors that contributed to its
success as an alternative school, having purposefully adopted the best prac-
tices it could find in alternative school education. These factors, referred
to as “school readiness factors,” that assisted Garza include a constructive
organization culture, a horizontal power structure in which all staff and
teachers are perceived as capable of making a valuable contribution to the
school, staff flexibility to take risks and receive constructive feedback, as
well as monetary support and staff to continue the ongoing training and
supervision in SFBT (Franklin & Hopson, 2007).
Different schools will of course have different levels of school readiness.
The following are suggested steps for determining the readiness of a school
and helping the school move toward use of SFBT:

1. Determine the overall willingness and motivation of a school to


learn the solution-​focused model. Obtain commitment from the
administration, and guide administrators to sell the approach to

SFBT Within the Tier 1 Framework61


62

interested staff who will participate in the learning on a team instead of


mandating the training.
2. Motivate a team of individuals that includes members of important
constituents (e.g., principal, teachers, counselors, and social workers)
to learn a new way of working with students. This is more than a quick
training and going through the motions. Time commitments must be
blocked out on the school schedule, and the training must be included
in professional development. It is recommended that a training timeline
and set of goals be developed with the principal and team who will be
participating.
3. Create specific learning steps in the training process. This should be
planned out with the team across an entire academic year. For example,
first teach the philosophy of SFBT and the specific techniques in a series
of small groups and meetings. Second, build in the steps to facilitate the
learning of others and the application of techniques in the classroom.
Third, provide specific methods to coach and provide feedback on the
learning. Fourth, facilitate an ongoing follow-​up process to discuss the
applications.
4. Continue training the original team in smaller group meetings, and
provide them with opportunities to be partners in teaching others the
approach.

As stated previously, every staff member on campus should become


extremely fluent in SFBT. Professional development and staff leadership
are essential to the success of Tier 1 interventions and integral to the
building of a solution-​focused school. There is also a process to becom-
ing a solution-​focused school. The focus is not on immediate change but,
rather, on small steps and measurable goals that a campus can make to
become solution focused. The leadership team and teachers set these
goals and define the small steps they will take. The steps below relate
to the staff-​training component of becoming solution focused. These
ideas for how to improve their own competencies in the approach were
designed and implemented by the faculty and staff at Garza during its
transition from a beginning alternative school program to a solution-​
focused program.

1. A library of solution-​focused resources were made available to the


teachers and other staff.

62 Solution-Focused Brief Therapy in Schools


 63

2. Teachers organized themselves into groups and formed a book club for
readings.
3. Brown-​bag lunch meetings were scheduled for teachers, staff, and
administrators to watch and discuss videos of solution-​focused
interventions.
4. In-​service trainings for the entire staff were organized with an SFBT
trainer. This trainer also met with smaller groups (e.g., the principal,
administrators, and counselors) for additional training and consultation.
Throughout the school’s training process, other solution-​focused
trainers were brought in to inspire and boost the learning sessions.
5. A solution-​focused coach worked within the school and was available
for classroom consultations and modeling of the solution-​focused
approach. This involved periodic visits to the classroom. The solution-​
focused trainers observed teachers leading classroom groups and
using techniques like the miracle question and also provided written,
complimentary feedback about a teacher’s use of the SFBT.
6. Teachers were provided with quick reference sheets for solution-​focused
techniques they could use with students. Follow-​up meetings invited
discussions about how the techniques were used so that teachers were
teaching other teachers how to use the SFBT techniques.
7. The administration added competencies in solution-​focused intervention
to the annual performance evaluation with faculty and staff.

Schoolwide Examples of the SFBT Principles


A Tier 1 approach indicates that the solution-​focused philosophy needs
to guide interpersonal interactions and direct campuswide events so that
these events are built on principles such as focusing on strengths, relation-
ships, and community building. Garza High School instituted Mix-​It-​Up
Days, for example, which are community events held every semester that
include:  inspirational speakers; student talent shows; student, faculty and
community lunches; and a host of community visitors known as “friends
of Garza” who offer unique and caring contributions to the school. In addi-
tion to the regular graduation ceremony, Garza also has a Star Walk. Since
Garza’s curriculum is self-​paced, students often graduate in the middle of
the semester. When a student completes all of the necessary credits, the
entire school participates in each student’s individual Star Walk. Box 4.2
describes a Star Walk in the 2015–​2016 school year.

SFBT Within the Tier 1 Framework63


64

Box 4.2  Star Walk


Three years ago, Martín thought he would never graduate high
school. He had been struggling academically at his previous
high school and had poor attendance. After enrolling in Garza High
School, Martín started taking classes such as robotics and filmmak-
ing. Martín never thought of himself as a good student, but these
classes captured his attention more than those at his previous school.
Martín became invested in his work at Garza when his mom lost her
job. Since Martín’s mom was out of work, he had to take a day job.
This meant that Martín had to leave school at lunch to work. Luckily,
Martín’s teachers were supportive of his unusual schedule and helped
him finish his coursework over the next two years.
Now, Martin has completed his high school and begun his Star
Walk. First, Martin presented some of his work to his teachers as
well as his mother. Martín’s presentation focused on the work he had
done in this filmmaking class. At this presentation, Martín received
positive feedback as a teacher read a letter of reference aloud. Next,
Martín was presented with an inscribed star emblem. A photograph
was taken of Martín and his counselor while the administration listed
some of Martín’s future goals, such as enrolling in college to learn
more about filmmaking. Finally, Martín took a last walk through
the halls of Garza. Martín asked his mom and his counselor to walk
with him. As the trio strolled through the school, celebratory music
played over the intercom speakers. Students and teachers flooded out
of classrooms to celebrate Martín’s success. Some of his peers blew
bubbles, some clapped, and others brought out instruments to play.
Although Martín had celebrated the Star Walk of previous students,
he had not imagined his own. To Martín, this ritual felt like a rite of
passage. Now that he had been successful at Garza, Martín felt that
he could be successful in other places. He had set goals for himself
in high school and, with the support of staff and teachers at Garza,
had met them.
 65

The Star Walk is one of the more prevalent campuswide solution-​


focused initiatives at Garza. It aligns with the process of SFBT as it rein-
forces the student’s ability to meet self-​s et goals, and it highlights strengths
and competence and allows the student to receive compliments about suc-
cess. This ritual celebrates the student’s individuality and self-​motivation.
In the case example of Box 4.2, we can see the entire Garza community
celebrate the success of the student by pointing out his competencies and
goals. The administration also takes time to celebrate the student by pre-
senting them with their star paperweight, telling a personal, positive tes-
timonial about the student and taking a picture with the student. Note the
unique classes Martín took; these courses allowed him to receive credits
for high school but were more engaging than a traditional curriculum.
In these classes, Martín explored possible postsecondary interests and
learned real-​world skills. The unique curriculum at Garza fits into the
solution-​focused model as it allows teachers to take risks within their
teaching plans and capitalizes on students’ intrinsic motivation to learn.
For schools wanting to incorporate solution-​ focused techniques into
campuswide initiatives, it is essential that the entire school community
celebrates the use of solution-​focus strategies as well as the student’s indi-
vidual accomplishments (Franklin, Moore, & Hopson, 2008).

Academic Achievement and Success


In 2015, only 4 of the 12 high schools in the AISD met federal standards.
One of these high schools was Gonzalo Garza Independence High School.
What is surprising about this achievement is that Garza is a high school
where most of the students are considered to be at risk by the school dis-
trict. As an alternative school, Garza has many components that contribute
to its overall success, but a unique characteristic discussed in this chapter
is that the school adopted SFBT as an integral part of its philosophy and
techniques. The developers of the solution-​focused school hoped to create
a setting that would enable at-​r isk youth to overcome barriers to academic
success and ultimately earn credits and a high school diploma leading to
enrollment in postsecondary education. Last year, Garza achieved this suc-
cess with over 80% of its graduates enrolled into postsecondary education
programs by graduation.
To date, five evaluation studies have focused on Garza High School.
These include a quasi-​ experimental design (Franklin, Streeter, Kim, &

SFBT Within the Tier 1 Framework65


66

Tripodi, 2007), a qualitative design (Lagana-​R iordan et  al., 2011)  and a
concept mapping methodology (Streeter, Franklin, Kim, & Tripodi, 2011).
A fifth longitudinal study that examine on-​time graduation rates of students
who participated in the school over a four-​year time frame is in progress, but
the results of that study are yet not available for dissemination. The other
four evaluations are described below.
The first study (Franklin et al., 2007) utilized a quasi-​experimental pre-
test/​posttest comparison groups design. Participants (n = 46) in the experi-
mental group all attended Garza High School (solution-​focused alternative
school [SFAS]). Because no additional alternative school was available, the
comparison group participants (n  =  39) were recruited from a traditional
local public high school. Comparison group participants were matched with
the experimental group using the following characteristics:  attendance,
number of credits earned, participation in the free lunch program, race,
gender, and whether the student was defined as at risk according the Texas
Education Code.
Three dependent variables were observed in this study: credits earned,
attendance, and graduation rates. Data for these three variables were obtained
through the AISD records. The results of this quasi-​experimental study offer
researchers and practitioners insight toward understanding the potential
impact of the solution-​focused school on students’ school credits earned,
attendance, and graduation rates. Repeated-​measures analysis of variance
revealed no significant difference between the comparison group (matched
students attending a regular local public high school dropout prevention
program) and the SFAS participants during the 2002–​2003 academic school
year; however, a significant difference was found between groups during the
2003–​2004 academic school year, indicating that students enrolled in the
SFAS earned a greater proportion of credits than the students in the com-
parison group. One important aspect to consider is the pace at which stu-
dents progress through the SFAS program as compared to that of students
in the traditional high school setting. Garza is a self-​paced, individualized
program that allows students the flexibility to attend school for half days, to
work part-​time, and for some, to be a parent as well. The results suggested
that some students in the SFAS required about one year longer to finish
high school than those in a traditional high school. One possible conclu-
sion from this study is that while Garza students may take slightly longer,
they also display a greater likelihood of completing credits when they were

66 Solution-Focused Brief Therapy in Schools


 67

much further behind compared to the students who participated in another


dropout prevention program.
The second study (Lagana-​R iordan et al., 2011) employed a qualitative
case study methodology and recruited participants from the experimental
group in the first study (Franklin et  al., 2007). Of the 46 students who
were asked to participate, 33 elected to do so. The students were primarily
Caucasian (54.6%) or Hispanic (39.9%), and more than half (57.6%) were
female. Each participant answered 36 questions in a 45-​to 60-​minute, semi-
structured interview. The interview questions were a combination of scal-
ing questions, list items, and open-​ended questions. The interviewers used
probes to gather additional information.
The questions and probes coalesced around topics related to satisfac-
tion with current and previous schools, family history, and relationships
with peers and family. Responses were transcribed, coded, and theoretically
grouped using a thematic analysis. Methods to provide rigor and trustwor-
thiness included triangulations with quantitative data, persistent obser-
vation, and prolonged engagement. The thematic analysis results of this
qualitative study (Lagana-​R iordan et al., 2011) revealed several differences
in students’ SFAS (Garza High School) and traditional school experiences.
The majority of the perceptions students described about the SFAS were
positive. Specifically, the major positive themes that emerged were positive
teacher relationships, improving maturity level and responsibility, alterna-
tive structure, understanding about social issues, and positive peer relation-
ships. Participants in the study explained that the SFAS atmosphere was one
where teachers and peers offered understanding, support, and a greater level
of individualized attention. Additionally, students described the school’s
flexibility and expectations of empowering responsibility to be central to
their success.
Several themes regarding the students’ perceptions of the major weak-
nesses of traditional schools also emerged: problems with teachers, lack of
safety, overly rigid authority, inadequate school structure, and problems
with peer relationships. Students expressed feelings of being judged by
peers and teachers. Additionally, they felt that traditional schools were not
able to offer the individualized attention or safety necessary to foster effec-
tive learning. The findings from this study reveal important characteristics
for school social workers and other practitioners to consider when interven-
ing in the life of students at risk of school dropout.

SFBT Within the Tier 1 Framework67


68

The third study (Streeter et  al., 2011)  utilized a concept mapping
design. Concept mapping is a mixed-​methods approach to help examine
a program’s fidelity towards its guiding theory and philosophy and to
evaluate the most important program features contributing to the pro-
gram’s mission to graduate at-​risk students. Fourteen students and 37
adults (teachers, administrators, and staff) participated in the concept
mapping sessions and generated a combined total of 182 unique state-
ments as a response to the following statement: Describe the specific char-
acteristics of the alternative school that help students achieve their educational
goals. The results of the concept mapping evaluation offered 15 clusters
reflecting participants’ descriptions and understandings of the alternative
school: relationships, professional environment, respect evident through-
out the school, strengths based, sense of community, student-​student
interaction, empowering culture, cutting edge, organizational foundation,
school size and structure of the school day, admission and exit, resources
directed to student success, preparation for life, student success, and con-
tinuous improvement.
These was driven by the pragmatist approach of grounded theory and
the constant comparative method described by Glaser and Strauss (2007),
and it sought to discover a relevant theory for teacher-​student interactions.
Data collection stopped when incoming data had reached the point of
saturation (Morse, 1995; Timmermans & Tavory, 2012), meaning that the
categories could be “fully accounted, [with] the variability between them
[being] explained and the relationships between them … tested and vali-
dated” (O’Reilly & Parker, 2012, pp. 190–​197). The final model represented
the overarching core category and subthemes from the teacher interviews
(Hallberg, 2006)  and the researcher revisited individual narratives in the
results section to enhance the richness of the data (Ayres, Kavanaugh, &
Knafl, 2003; Szlyk, 2016).
Of 58 potential staff members, 10 teachers participated in individual,
semistructured interviews, and four teachers participated in a focus group.
All teachers were trained in SFBT, in accordance with the school’s mission.
The teachers had varying years of experience with SFBT but no other mental
health experience. Teachers described at-​r isk behaviors including truancy,
substance abuse, suicidal ideation, and self-​harm as being the most preva-
lent problems of their students. Teachers reported being confronted with
these issues daily but expressed a confidence and calmness in the way they
interacted with the students around their emotional concerns and external

68 Solution-Focused Brief Therapy in Schools


 69

threats to the student’s well-​being. Teachers also described building strong


relationships with their students, which served as a foundation for address-
ing both academic and emotional concerns that arise in the classroom.
Results from this study specifically demonstrated how teachers were able to
focus on the academic and emotional needs of their students using skilled
decision making, thoughtful interactions, and continued awareness of the
presenting problems. A core construct was identified to be social respon-
sibility created by the faculty’s teaching philosophy, as driven by the SFBT
approach, daily student-​teacher interactions, and the values of the school
itself. The findings of this research suggested that teachers had a great sense
of social mission and a caring, committed teaching philosophy that influ-
enced their daily interactions with students. Specifically:

This teaching philosophy was often one of the reasons that


the participants were attracted to the alternative high school.
Teachers discussed having a previous desire to “put students’
strengths first,” “to treat students as if they were [their] own
children,” and to give students “gifts” to make the world a bet-
ter place. As one teacher put it, … I think that part of being a
teacher is caring about people in general. I don’t think it is a very
selfish profession. I think you will be miserable if it’s just about
you all the time.

(Szlyk, 2016, p. 13).

The results from the core category of social responsibility suggested


that teachers nurtured the growth and independence of their students.
Student independence is fostered as a result of collaborative problem solving
between the student and teacher during times of crisis or emotional distress.
Teachers relied on the SFBT skills to facilitate the collaborative problem-​
solving process, making it possible for them to help students with the daily
setbacks and distress that often occurred in the classroom.

Data Collected by the School District


The AISD and the Texas Education Agency have also collected data on the
characteristics and academic achievement of Garza High School. According
to the latest data from the Texas Education Agency (2014), 75.9% of Garza
students from the class of 2014 were classified as being at risk, but in 2014,
88.7% of students on the four-​year graduation plan graduated, received a

SFBT Within the Tier 1 Framework69


70

GED, or continued enrollment in school. In 2014, Garza had a dropout rate


of 4.2% and an attendance rate of 81.6%. That same year, 42.4% of Garza
graduates were deemed to be college or employment ready, and the aver-
age SAT scores of Garza students were higher than the average SAT scores
of the school district and the state of Texas. It is common for Garza’s stu-
dents and staff to be recognized at a district, state, or national level for their
efforts and successes. In February 2016, Garza’s chess team took first place
at regional competition, with several students on the team taking home indi-
vidual awards. In the 2013–​2014 school year, Garza received exemplary rat-
ings in every category of the 2013–​2014 Campus Community & Student
Engagement Ratings. Additionally, in 2015, Dr.  Linda Webb received the
Principal of the Year Award from the AISD. Two other staff members have
been recently recognized: one of the counselors as a Counselor That Change
Lives for 2015, and a social studies teacher featured on the district website
for Garza’s blended curriculum.

Start Your Own Solution-​Focused School


Garza High School serves as a model program for how a public, alterna-
tive school makes the shift to a strengths-​based school that uses the behav-
ioral change procedures offered by SFBT. By using the solution-​focused
approach, Garza became a place that provides emotional support, social
support and engages students who receive limited support from family,
friends, and neighborhood. This type of social support and individualized
attention appears to be critical for retention and graduation of some at-​r isk
students. Research indicates that family problems, mental health, and sub-
stance use issues are associated with high school dropouts (Aloise-​Young &
Chavez, 2002; Nowicki, Duke, Sisney, Stricker, & Tyler, 2004; Rumberger
& Thomas, 2000), and this is the daily experience of school social workers
and teachers working with students at Garza High School. Other schools
may also experience the greatest severity of these types of problems because
of the developmental issues confronting adolescence and the worsening over
time of trauma and unresolved problems. Without strategies to assist stu-
dents with complex behavioral health issues, it is unlikely that schools will
be able to successfully graduate every student. SFBT is an approach that
school social workers can use to train all staff in schools to help at-​risk
students with severe social and behavioral health problems. In particular,
teachers can be equipped in the philosophy and techniques of SFBT and
adapt it for use in their classrooms. That Garza High School has maintained

70 Solution-Focused Brief Therapy in Schools


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the solution-​focused approach for 15 years also suggests that teachers and
school staff not only can be trained in this approach but that the SFBT
approach has the potential to sustain itself over time. This, coupled with
the fact that the school is successful at graduating and sending high-​risk
students to postsecondary education, indicates that SFBT will be worth the
investment for a school district to create an SFBT program.

Summary
This chapter opened by briefly describing an RtI and Tier 1 approach to
interventions and how SFBT can be used to create a Tier 1 intervention for
dropout prevention. A  transdisciplinary team model to train educators in
SFBT was also described. With the use of case examples, the chapter next
described how SFBT techniques were utilized in Tier 1 interventions within
Gonzalo Garza Independence High School, a solution-​focused, alternative
high school in Austin, Texas. The techniques and case examples exemplified
challenges commonly observed in at-​risk students with behavioral health
challenges such as suicidal ideation, self-​harm, violence, and aggression.
The examples also demonstrated school-​based mental health services and
discipline and how the Garza staff operate as a team. The school’s principal,
Dr. Linda Webb, notes that “Garza takes a collaborative approach to finding
solutions.” This is why staff members are trained in solution-​focused tech-
niques, including identifying strengths, looking for small and measurable
solutions, and seeking exceptions to the problem. These skills can be used,
in most situations, by the entire staff, who undergo extensive training in the
application of these methods. After receiving such training, it is possible for
all school staff surrounding the students to be involved in their goals and
their successes. This campuswide involvement and investment, achieved
through SFBT, is a central part of a successful Tier 1 intervention.
Both evaluation research on Garza High School and data collected from
the school district provide evidence for the positive academic achievement
and success of Garza. Garza has maintained high achievement and gradua-
tion success despite over 75% of the students being considered at risk. The
school, its staff, and its students also have won numerous awards. Students
are active in their education, participating in various districtwide events and
creating useful projects in their classes that continue being used after their
graduation. Examples of these projects can be viewed on Garza’s website
(http://​garzaindependencehs.weebly.com). This solution-​ focused, student-​
faculty engagement continues after high school as many students enroll in

SFBT Within the Tier 1 Framework71


72

a university (Garza raises substantial scholarship funds to support the stu-


dents’ postsecondary goals) or become employed. It is feasible for school
social workers to assist school districts in learning from the success of Garza
and developing their own SFAS that may improve their graduation and post-
secondary enrollment of at-​r isk students.

References
Allen-​Meares, P., Montgomery, K. L., & Kim, J. S. (2013). School-​based social work inter-
ventions: A cross-​national systematic review. Social Work, 58(3), 253–​262.
Aloise-​Young, P. A., & Chavez, E. L. (2002). Not all school dropouts are the same: Ethnic
differences in the relation between reason for leaving school and adolescent sub-
stance use. Psychology in the Schools, 39(5), 539–​547.
Ayres, L., Kavanaugh, K., & Knafl, K. A. (2003). Within-​case and across-​case approaches
to qualitative data analysis. Qualitative Health Research, 13(6), 871–​883.
Franklin, C., & Hopson L. M. (2007). Facilitating the use of evidence-​based practices
in community organizations. The Journal of Social Work Education, 43(3), 377–​4 04.
doi:10.5175/​JSWE.2007.200600027
Franklin, C., Kim, J.S., Ryan, T. N., Kelly, M. S., & Montgomery, K. (2012). Teacher
involvement in mental health interventions:  A  systematic review. Children & Youth
Services Review, 34, 973–​982. doi:10.1016/​j.childyouth.2012.01.027
Franklin, C., Montgomery, K., Baldwin, V., & Webb, L. (2012). Research and develop-
ment of a solution-​focused high school. In C. Franklin, T. Trepper, W. Gingerich, &
E. McCollum (Eds.), Solution-​focused brief therapy: A handbook of evidence-​based practice
(pp. 371–​389). New York, NY: Oxford University Press.
Franklin, C., Moore, K., & Hopson, L. (2008). Effectiveness of solution-​focused brief
therapy in a school setting. Children & Schools, 30(1), 15–​26.
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century. Austin, TX: The Hogg Foundation for Mental Health, The University of Texas
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Franklin, C, Streeter, C. L., Kim, J. S., & Tripodi, S. J. (2007). The effectiveness of a solu-
tion focused, public alternative school for dropout prevention and retrieval. Children
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Hallberg, L. R. (2006). The “core category” of grounded theory: Making constant com-
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Anderson, D. (2009). Solution-​focused brief counseling: Guidelines, considerations,
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Lagana-​R iordan, C., Aguilar, J. P., Franklin, C., Streeter, C. L., Kim, J. S., Tripodi, S. J.,
& Hopson, L. M. (2011). At-​r isk students’ perceptions of traditional schools and a
solution-​focused public alternative school. Preventing School Failure, 55(3), 105–​114.
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high school students. Children & Schools, 27(2), 83–​90.
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of the notion of saturated sample sizes in qualitative research. Qualitative Research,
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Sabatino, C. A., Kelly, E. C., Moriarity, J., & Lean, E. (2013). Response to interven-
tion: A guide to scientifically based research for school social work services. Children
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Streeter, C. L., Franklin, C., Kim, J. S., & Tripodi, S. J. (2011). Concept mapping: An
approach for evaluating a public alternative school program. Children & Schools, 33(4),
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5
■ ■ ■

SFBT Within the Tier 2 Framework


Coaching Teachers to See the Solutions
in Their Classrooms
Michael S. Kelly, Johnny S. Kim, & Cynthia Franklin

Educational research on student behavior and classroom achievement


increasingly shows that creative, engaged teachers are able to manage
classrooms more effectively than burnt-​out teachers or teachers who feel
overwhelming pressure to teach to tests (Evertson et al., 2006; Responsive
Classroom, 2006). The WOWW program (“Working on What Works”)
strives to empower teachers in regular and special education settings to rec-
ognize their own strength as well as those of their students in setting goals
and developing a shared focus as learners. It was first developed by SFBT
pioneers Insoo Kim Berg and Lee Shilts in Florida in 2002 (Berg & Shilts,
2004). After being piloted in urban schools in Fort Lauderdale, Florida, the
program has been implemented in other cities, including several schools
we have worked with in Chicago (Berg & Shilts, 2004; Kelly & Bluestone-​
Miller, 2009)  and several school contexts within and other parts of the
United States and the United Kingdom. In this chapter, we share some of
our own preliminary findings on WOWW’s success in helping students and
teachers along with other pilot data on WOWW.

Looking for Solutions in the Teachers’ Lounge


One of the toughest places to sit as a school social worker can be the teach-
ers’ lounge. A story from Michael Kelly illustrates this:

I got my pasta out of the microwave and sat down with some
teacher colleagues one day before a holiday break. Before I could

74
 75

take my first bite, one teacher colleague grilled me about what


I thought about her class. “You work with half of them in your
office, aren’t they wild?” asked Betty. “Jeannie (her second-​grade
teacher colleague) told me that these third graders were going
to be hell on wheels for me, and she was right! And the worst
two are Sal and Carlos; oh, why did I have to get those two?”
Outwardly, I was speechless, as I could tell Betty was just get-
ting started. Inside, I was thinking that it might be time for me
to offer more to Betty and her class than just pulling out the kids
in her class who had social work services on their individualized
education plans.
Soon, other teachers at the table joined in with their stories
of Sal and Carlos, one sharing that she works lunch duty on
Fridays and thinks that Sal “shouldn’t be out at lunch until he
can get himself together.” Another told a story about how Carlos’
dad dropped him off at school, and she heard from another mom
that she smelled alcohol on his breath. “There you go, that’s what
I have to deal with,” Betty said, and turned back to me. “So what
do you think?”
I took a deep breath, agreed with her that the kids in her
class were tough, and told her that I was interested in trying this
new program in her class. It was called WOWW, and I thought
it might be a good way for me to help get her class under con-
trol. She said she’d think about it but quickly added, “But you
make sure that the principal knows that she better be ready for
me to start sending Sal and Carlos down to her if things don’t
change soon!”

The negative energy in the teacher’s lounge can be thick, as good-​natured


venting and laughing about job stress can give way to colleagues turning
to you and asking questions about the kids you work with (“What’s wrong
with Billy, anyway?”) or offering not-​so-​professional takes on what makes it
hard for some kids at school (“Those Smith boys are all the same. I taught
their dad, too, and he was just as crazy”). Being in these situations pushes
many of our professional and ethical buttons as we struggle to figure out
how to respond (and finish our lunch as well). Although we’re still not fans
of kicking back in the lounge and gossiping about kids, we have, through
SFBT coaching interventions like WOWW, learned to see our teacher col-
leagues more sympathetically as they grapple with the many demands on
their time and the complicated nature of the kids who come through their
door each day.

SFBT Within the Tier 2 Framework75


76

Teachers Are People, Too


It is tempting (and even easy) to see the story of the teacher’s lounge as
evidence that teachers are perhaps as crazy as the kids they call crazy. It is
also tempting to view the role of the school social worker as one where you
work with the primary client in most referral situations—​the student—​in
an environment that you largely control (i.e., your own office) and leave the
behavioral acting-​out and general craziness that occur in the classroom for
teachers, principals, and disciplinarians to handle. After all, most of us in
the schools are in no obvious position to supervise, discipline, or correct
behaviors exhibited in classrooms. Most of us would not want the dual role
of disciplining the very students we are also trying to counsel, either, but
what about our feelings toward our teaching colleagues? How many of us
have had “those” classrooms, where we know that kids are likely to be yelled
at and have their particular social/​emotional needs ignored or minimized?
Wouldn’t it be satisfying if we could just stop the restrictive behavior of
these teachers and see whether the kids respond any differently?
Teachers are not monsters, not any more than the kids are. Teachers enter
schools excited to give their students a love for learning and to be a person
students can look up to. Again and again, teachers fresh to the field report
a “love of children” and “a passion for teaching” as part of their reasons
for choosing the profession (Kelly & Northrup, 2015; Roehrig, Presley, &
Talotta, 2002). Yet research also shows that as many as 50% of those same
excited, idealistic teachers will leave the profession altogether after 5 years
(Burke, Aubusson, Schuck, Buchanan, & Prescott, 2015; National Education
Association, 2007)  and this turnover has negative consequences for stu-
dent achievement, particularly for students in low-​income communities
(Ronfeldt, Loeb, & Wyckoff, 2013). Something is happening in those initial
years to bring so many teachers to the same conclusion that teaching is not
for them. What can we learn from the research on teacher retention and
burnout?
First and foremost, we would do well to think of all our teacher col-
leagues in the same way we might think of our clients: as complicated and
interesting individuals who bring a multitude of strengths and challenges to
their work. In short, teachers are human, and if anything, by doing an SFBT-​
based intervention like WOWW with them, we help more of that humanity
to emerge in their teaching practice while also giving them a chance to share
the stresses of the classroom in appropriate, solution-​focused ways with the
WOWW coach and the students.

76 Solution-Focused Brief Therapy in Schools


 77

Just as we are largely not occupying disciplinary roles in schools, we


are usually not involved in supervising and evaluating teacher performance
(Constable, 2006). This could be viewed as a burden (having to put up with
teachers and a school environment that at times seems hostile to kids), or
it could present its own SFBT opportunity. We offer the WOWW program
as one way to aid multiple levels of the school contextual system: helping
teachers to see their own strengths, students to work together more effec-
tively as a group, and both teachers and students to learn how to be more
respectful and accountable to each other in ways that preserve the ultimate
authority of the teacher while also empowering students to speak out and
act intentionally in positive ways.

The History
As Berg and Shilts (2005) recount, the idea for WOWW came from Shilts’
wife, Margaret, sharing her concerns about some of the students she was
teaching and the different challenges they presented as she tried to man-
age the classroom and cover the curriculum. After starting in Florida, the
program has been piloted in other states, including several schools we have
worked with in Chicago. Later in this chapter, we share some of our own
preliminary findings on WOWW’s success in helping students and teachers
as well as other pilot data on WOWW.

The Skills
WOWW is a coaching intervention, meaning that the solution-​focused
practitioner operates primarily in a consultative role with the teacher and
the classroom. The WOWW coach will both observe the classroom and
facilitate group discussions, but the coach never really leads a group inter-
vention in the way that many other group treatment approaches do—​that
is, the coach is not delivering a specific therapeutic intervention in a specific
sequence. Right away, in WOWW, the basic tenets of SFBT are revealed
in contrast to other more manualized approaches: the clients (in this case,
the teacher and the teacher’s students) are put squarely in charge of set-
ting the goals for the WOWW class discussions. Just like in other SFBT
interventions, the initial session is full of questions, which are organized
around asking the students to notice changes that have already taken place
in their class. The difference from a more conventional SFBT clinical session
is that the WOWW coach has already observed the class and is able to share

SFBT Within the Tier 2 Framework77


78

observations directly in the form of compliments, exception questions, and


coping questions. This aids the eventual final task of the first WOWW ses-
sion, the setting of classroom goals that relate to the learning environment.
Box 5.1 shows examples of learning goals in our WOWW sessions.
The WOWW coach (in our work, usually the school social worker)
observes the class functioning for a 20-​to 30-​minute period and later offers
compliments and questions rooted in the SFBT framework. The class is
invited to recognize their own strengths and devise solutions to class dis-
cipline problems together, rather than singling out a few defiant students.
One of the major goals of WOWW coaching is to remove the tendency for
classrooms with “a few” difficult students to lose cohesion and a sense of
mutual purpose. By bringing the conversation back to what the whole class
sees as things they want to change, the effort is made to reach out to more
challenging students as well as validate students who are already following
the teacher’s rules and working well with others.
The following conversation is typical of a WOWW classroom discus-
sion after the coach has observed and worked with the class for a few
sessions. This case example comes from our work with a third-​g rade
classroom:

School Social Worker (SSW): Hi, everyone, my name is Mr.


Kelly, and I’m going to be coming to your class every week
for the next couple of months. I wanted to start by get-
ting a show of hands from all the kids here that can count
to 10. Everybody? Good. Now, who knows what the word
“perfect” means?
Student 1: It means really, really good. So good that you can’t
do any better.
SSW: Good, that’s it. What I want us to think about for a min-
ute is our class here. Is this class perfect?
Students: No! [laughter]
SSW: That’s fine; no class I’ve visited is perfect. But what
would you say the class’ behavior has been in the past week,
on a scale from 1 to 10, with 10 being perfect?

At this point, the SSW had students write down their score and pass
them up anonymously, and the SSW and the classroom teacher then tabu-
lated the results. During this time, the SSW was noticing strengths in the

78 Solution-Focused Brief Therapy in Schools


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Box 5.1  Phases for the WOWW Coaching Process

WOWW Details
Program
Phase
Phase 1: Introduce yourself to students, saying “I’m
Observation going to be visiting your classroom to
phase (Weeks watch for all the things the class does that
1–​3 for an are good and helpful. I will report back to
hour) you what I see.”
Note class strengths, and wait for the class to
begin pointing out their own strengths to
you, indicating their readiness for the next
phase.
Share what you saw, and prepare the class for
creating classroom goals.
Phase 2: Creating With the teacher and the class, set goals for
classroom the class to work toward (e.g., show respect
goals with to each others), and ask them to scale the
students and level of respect they have at present on a
teachers (Week scale from 1 to 10.
4 or 5)
Ask the class to describe what it will take for
the class to go from a 7 to an 8 or a 9, and
ask the class to look for those behaviors in
themselves and others over the next week.
Scale other goals that the class is interested
in working on.
Phase 3: Scaling Once the scaling questions are understood,
classroom teachers may put the scaling goal on the
success and board as a reminder, and the class will be
amplifying more focused on reaching the goals set for
(remainder of each week. Amplify the class’ progress on
sessions) their goals, and repeat as needed.

Source: Adapted from Berg and Shilts (2005).


80

class’ behavior and asking for exceptions to the major behavior problems the
teacher has identified, mostly related to how the class behaves after lunch.
Continuing our case example:

SSW: Thanks for voting: the class average was a 6.5, defi-


nitely not perfect, but pretty good. What do you think your
class would be doing if next week your votes were an 8?
What would be different and better about the behavior in
this class?
Student 2: We would line up better and be able to sit in our
seats after lunch more.
SSW: Okay, what else?
Student 3: We would listen to our teacher the first time she
says something and not make her have to raise her voice
after lunch so much. [class laughs, including the teacher]
SSW: Great, what else would you need to do?
Student 4: Be nicer to each other; we yell a lot in this class
sometimes after lunch.

At this point, many of the questions and approaches in the WOWW


program will be familiar. As the earlier example shows, WOWW coaches
are keen on asking students first to honestly assess their classroom on a
particular issue (e.g., how well they listen or how well they line up) and
then give themselves a scaled rating between 1 and 10. The next step the
WOWW coach takes is to ask more questions from the scaling sequence to
help the classroom move toward setting a goal for future classroom sessions.
In the case example, students said they were at about a 6.5 in terms of their
listening to the teacher after lunch. This seemingly small part of the day was
actually a huge destabilizer for the afternoon, as many students failed to get
on track and others said they wished that the teacher didn’t have to yell so
much to get the class settled. Improving this part of the day was identified
by both teachers and students as a key area to focus on, and by asking scal-
ing questions, the WOWW coach was able to assess how much progress the
class thought was realistic for the coming week.
In addition to the importance placed on getting students to mobilize
around their inherent strengths, ample attention is paid to what the teacher
hopes to change about the classroom. In class discussions as well as debrief-
ings with the WOWW coach after school, teachers are invited to share their

80 Solution-Focused Brief Therapy in Schools


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perceptions of the students’ behavior and their goals for change. Unlike other
classroom management models that try gimmicks or external rewards, the
WOWW coaching intervention is interested in teachers and students dis-
covering what small gains they are making and then “doing more of what’s
working” to turn those successes into larger gains for the whole classroom
environment.
The teacher debriefing times are crucial to maximize the impact of the
WOWW program. In these confidential sessions, the teacher is given the
same opportunities as the students to reflect on the classroom and identify
his or her own capacities and strengths. Here is an example of a WOWW
coach debriefing, from the same third-​grade classroom discussed earlier:

SSW: Thanks for meeting with me today. How’s the day been?


Mrs. Smith (MS): Really good; the kids have been great. It’s
one of those days where you keep wondering when the
other shoe’s going to drop when they get back from lunch.
It’s almost too perfect …
SSW: Those kinds of days are amazing, but also a little nerve-​
wracking. Have you noticed anything you were doing differ-
ently this morning to help the kids be so well behaved?
MS: No, I can’t think … well, I did wind up singing to them
this morning.
SSW: Wait, you … sang?
MS: Yeah, today the principal made an announcement about
the class song contest for the spirit day, and I was telling the
class about my favorite song, “Dancing Queen” by ABBA.
The kids said they’d never heard of it, and I told them that
they needed to hear it before they got to fourth grade. Billy
dared me to sing it, so I did. The kids just fell out laughing,
and then they gave me a standing ovation.
SSW: You just sang, just like that?
MS: I did; I’ve never done that before. I mean, I like to sing
with my family and at church, but I don’t think the kids
ever heard me sing before.
SSW: That’s awesome. What makes you think that might have
affected their behavior today?
MS: I’m not sure. Maybe because the kids were having fun,
and it was only 8:15 in the morning! Or maybe they were

SFBT Within the Tier 2 Framework81


82

able to see that I was in a good mood and that they could
relax with me today.
SSW: What do you mean by “relaxing with you”? Are there
times when you’re more relaxed that you notice you get a
different response from the kids?
MS: Totally. The kids totally take their cue from me; if I’m
loose and having fun, we all do better together.

The Research
Developed in 2004, WOWW uses the components of SFBT to facilitate posi-
tive interactions in the classroom between teachers and students. The men-
tal health practitioner serves in a consultative role with the teacher and the
classroom. Initial pilot studies indicate that WOWW has the potential to
impact teachers’ sense of self-​efficacy and their capacity to avoid burnout. In
terms of student outcomes, some promising initial data support the inter-
vention’s ability to increase student attendance and engagement in learning.
To date, results of five pilot studies based on the current version of WOWW
have been published.
The first study (Kelly, Liscio, Bluestone-​Miller, & Shilts, 2011) was con-
ducted by one of WOWW’s creators (Shilts) and a doctoral student (Liscio)
and looked at increasing attendance, improving student behavior, and
improving teacher classroom management behavior in 12 special education,
middle school classrooms in Florida. Data were collected from 105 students
in the WOWW group (based on their teachers volunteering to be in the
treatment group) and 101 students from six classrooms that were selected to
serve as the comparison group. The generalized estimating equation model
was used to test differences between groups on grades, absences, tardi-
ness, school suspensions, and state academic test scores. Results showed
statistically significant differences favoring WOWW on decreasing excused
absences and tardiness but significant differences favoring the comparison
group on unexcused absences. No differences between groups were found
on grades, state academic test scores, and school suspensions.
A second WOWW pilot study (Kelly & Bluestone-​Miller, 2009) was con-
ducted in 20 urban elementary school classrooms in Illinois and aimed to
improve class behavior and teacher self-​efficacy. A  pretest-​posttest design
was used with a convenience sample of 21 teachers to examine their per-
ceived classroom management skills as well as how they perceived their

82 Solution-Focused Brief Therapy in Schools


 83

students’ behavior. The researchers developed a five-​point scale for the


participating teachers and analyzed data using repeated-​measures t-​tests
to examine differences. Results showed a statistically significant increase
in teachers’ perceptions of their class as better behaved [t(20)  =  2.6, p <
.01], increase in teachers’ view of students as better behaved [t(20)  =  3.2,
p < .05] and belief students would also report better behavior [t(20) = 2.8,
p < .05], and increase in teachers’ positive perceptions of their classroom
management skills [t(20) = 1.9, p < .05]. While these results show promise
in improving teacher’s classroom management, the lack of a comparison
group, small sample size, strong social desirability effects due to teachers
not being masked to the intervention, lack of validated measures, and lack
of student reports limit the ability of this study to show causality from the
WOWW intervention.
A recent WOWW pilot study in Massachusetts (Berzin, O’Brien, & Tohn,
2012) involved second-​grade classrooms in a suburban school district using
a cohort control design with pre-​and posttests. All interested classrooms
were eligible to participate, with a final sample of nine teachers and 200
students agreeing to receive the WOWW intervention. Student data on aca-
demic performance (e.g., report cards) and behavior (e.g., office referral and
guidance counselor visits) were collected for the WOWW group and com-
pared with the previous year’s administrative outcomes for second graders.
Data on teachers were collected using a series of subscales from the Teacher’s
Sense of Efficacy Scale, Teacher Stress Inventory, and Student-​ Teacher
Relationship Scale. Positive postintervention trends were found on teacher
efficacy questions related to motivating students, establishing a classroom
management system, and adjusting lessons. However, no postinterven-
tion differences were found on teachers’ stress or teacher-​student relation-
ships. Results also showed the ability for students in the WOWW program
to improve their on-​task behavior and increase their academic effort based
on district report card data, but no differences were found in behavioral
outcomes. Despite the limitations of the study (e.g., no direct comparison
group, no random assignment at the classroom level, and limited compari-
son data), positive trends were found around improving classroom dynam-
ics and student outcomes.
Additionally, WOWW has made some impact in the United Kingdom,
where at least two studies of WOWW in elementary-​age classrooms have
been conducted during the past few years (Brown, Powell, & Clark, 2012;
Fernie & Chebbedu, 2016). These studies have continued to show promise

SFBT Within the Tier 2 Framework83


84

for WOWW as a teacher coaching intervention, with both finding that the
classroom behavioral and social-​emotional goals set by the teachers and stu-
dents together were met and maintained at follow-​up.
Although these early findings show promise for the intervention, some
of the mixed results across the different sample sites suggest more work is
needed in refining the intervention protocol and evaluating WOWW using
a more systematic research design. The studies noted above have been pilots
in nature and thus have not been rigorous enough to collect fidelity and pro-
cess data that could demonstrate the promise of the intervention as well as
be used to improve the intervention protocol. Additionally, more evidence is
needed about the potential multiple school contexts in which this interven-
tion could be used successfully.

The Future
WOWW has an intuitive appeal to school social workers trying to find posi-
tive and non-​threatening ways to help teachers and students function better
together in a classroom setting. It is a promising new idea that is trying to
use the active ingredients of SFBT to make meaningful impacts on class-
room behavior, teacher resilience, and student achievement. Currently, it is
far too early to say whether WOWW can positively impact such important
variables in schools. We hope to bring the WOWW program to more class-
rooms in Chicago and the surrounding suburbs and study the program in
those settings, with larger sample sizes and classes acting as control groups.
One major issue that has already become clear is how best to “sell” this
program to schools. The initial WOWW program in Florida was explicit
about being completely voluntary in terms of teacher participation, and
we followed that same idea in our recruitment of the seven teachers who
participated in our pilot study (Kelly & Bluestone-​M iller, 2009). In two
of our three schools, however, the principals clearly were eager to expand
the WOWW program by requiring that all teachers participate, particu-
larly the ones the principal thought might be burned out or even at risk
of being fired. This caused challenges for our research team. We wanted
to respect the wishes of the principal while avoiding the possibility that
WOWW would become yet another thing forced onto teachers’ already
busy plates. Eventually, we were able to avoid a conflict with the princi-
pal by agreeing to do a larger version of the WOWW program in a future
year and, at that time, consider the principal’s wishes that the program

84 Solution-Focused Brief Therapy in Schools


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be expanded to cover more troubled teachers. An obvious concern we


had was that WOWW not be seen as an extension of the school’s teacher
evaluation program and the WOWW coach be somehow viewed as a “spy”
for the principal and administrative team.
Future larger-​scale implementations and evaluation of the WOWW pro-
gram will have to contend with these issues. Teachers are likely to view any
mandatory classroom management program with suspicion, and principals
are likely to want the results of the WOWW program to be available to them.
This has been a problem with other teacher classroom management training
programs (Marzano, 2003), and as we study WOWW on a larger scale, we
expect to contend with these implementation challenges for a while to come.

Summary
Savvy school social workers have long known that one of the primary cli-
ent populations in schools is their teacher colleagues. The WOWW pro-
gram is a teacher coaching intervention that helps school social workers
target their interventions at a classroom level with the teacher and class-
room as the “client.” This intervention has shown some initial positive
outcomes in pilot studies, and in the coming years, we hope to see larger-​
scale studies on WOWW’s impacts on teacher classroom management
styles, teacher burnout, and student variables like academic achievement
and attendance. With the ever-​increasing pressure on both teachers and
students to be productive, we believe that school social workers need to
use classroom interventions such as WOWW to identify the strengths
of classrooms and help both teachers and students work together more
effectively.

References
Berg, I., & Shilts, L. (2005). Classroom solutions:  WOWW coaching. Milwaukee, WI:
BFTC Press.
Berzin, S., O’Brien, K., & Tohn, S. (2012). Working on what works: A new model for col-
laboration. School Social Work Journal, 36(2), 15–​26.
Brown, E. L., Powell, E., & Clark, A. (2012). Working on what works:  Working with
teachers to improve classroom behavior and relationships. Educational Psychology in
Practice, 28(1), 19–​30.
Burke, P. F., Aubusson, P. J., Schuck, S. R., Buchanan, J. D., & Prescott, A. E. (2015). How
do early career teachers value different types of support? A scale-​adjusted latent class
choice model. Teaching and Teacher Education,47, 241–​253.

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Constable, R. (2006). 21st century school social work: Plenary address at the Family and
Schools Partnership Program, July 2006.
Evertson, C. M., & Weinstein, C. S. (2006). Handbook of classroom management: Research,
practice, and contemporary issues (pp. viii, 73–​95, 1346 pp). Mahwah, NJ: Lawrence
Erlbaum Associates Publishers.
Fernie, L., & Cubeddu, D. (2016). WOWW: A solution orientated approach to enhance
classroom relationships and behavior within a Primary three class. Educational
Psychology in Practice, 32(2), 1–​12.
Kelly, M. S., & Bluestone-​Miller, R. (2009). Working on What Works (WOWW): Coaching
teachers to do more of what’s working. Children & Schools, 31, 35–​38.
Kelly, M. S., Liscio, M., Bluestone-​Miller, R., & Shilts, L. (2011). Making classrooms more
solution-​focused for teachers and students: The WOWW teacher coaching interven-
tion. In Franklin, C. (Ed.), Solution-​focused brief therapy: A handbook of evidence-​based
practice (pp. 354–​370). New York, NY: Oxford University Press.
Kelly, S., & Northrop, L. (2015). Early career outcomes for the “best and the bright-
est”:  Selectivity, satisfaction, and attrition in the Beginning Teacher Longitudinal
Survey. American Educational Research Journal, 52, 624–​ 656. doi:10.3102/​
0002831215587352.
Marzano, R. J. (2003). What works in schools: Translating research into action. Alexandria,
VA: Association for Supervision and Curriculum Development.
National Education Association. (2007). Attracting and keeping quality teachers.
Retrieved August 4, 2007, from http://​w ww.nea.org/​teachershortage/​index.html
Responsive Classroom. (2006). Social and Academic Learning Study (SALS). Retrieved
August 1, 2007, from http://​w ww.responsiveclassroom.org/​research/​index.html
Roehrig, A., Presley, M., & Talotta, D. (2002). Stories of beginning teachers: First-​year chal-
lenges and beyond. South Bend, IN: Notre Dame Press.
Ronfeldt, M., Loeb, S., & Wyckoff, J. (2013). How teacher turnover harms student
achievement. American Educational Research Journal, 50, 4–​36.

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6
■ ■ ■

SFBT Within the Tier 3 Framework


Case Examples of School Social Workers Using SFBT
Michael S. Kelly, Johnny S. Kim, & Cynthia Franklin

This chapter presents a series of case studies showing how school social
workers have adapted SFBT to their school contexts. Using a variety of treat-
ment modalities (family, small group, and macro practice), these school
social workers show how flexible and powerful SFBT ideas can be in a
school setting and how they apply nicely across all three tiers of interven-
tion through the Multi-​tiered System of Supports/​Response to Intervention
framework.
Ultimately, the research on SFBT in schools can only give so much direc-
tion, context, and inspiration. Based on the feedback we have received from
teaching SFBT ideas, we know that school social workers need and want to
hear how others have “done it” and adapted SFBT to their own school social
work practices. This chapter offers a series of brief case studies in which
school social workers:

1. Used SFBT techniques to change the direction of a case study evaluation


meeting to focus more on student and family strengths (Tier 3).
2. Conducted a session of SFBT family therapy led by a school social
worker in a school-​based mental health clinic (Tier 3).
3. Led SFBT group treatment for students struggling with anxiety (Tier 2
or Tier 3).
4. Mapped out a solution-​focused needs assessment that helped a
school social worker create a family health and employment fair in an
impoverished community (Tier 1).

87
88

5. Organized and conducted an eight-​week SFBT group session for


grandparents raising grandchildren (GRGs), drawing on grandparents’
“old-​school wisdom” for raising their grandchildren (Tier 2) (Newsome
& Kelly, 2004).

Where available, we also provide additional resources for SFBT school


social workers on how they can adopt these practice ideas themselves. Key
identifying information about the schools have been changed to protect con-
fidentiality, but all of the case examples are based on real practitioners’ work
and show how SFBT can be incorporated into school social work practice.

A Solution-​Focused Case Study Process


School social workers nationwide often participate in case study evaluations
(Gleason, 2007; Watkins & Kurtz, 2001)  to discern eligibility for special
education placement and services. These evaluations are based on diagnostic
criteria outlined in the Individuals with Disabilities Education Improvement
Act (IDEA) rules and regulations (Altshuler & Kopels, 2003; Constable,
2006) and reflect a deficit model common to diagnostic criteria used in spe-
cial education (Gleason, 2007; House, 2002). The case example that fol-
lows shows how a school social worker used the ideas of resilience and the
strengths perspective in SFBT to conduct a routine case study evaluation.

Jenny was practicing in her elementary school for 5 years when


she decided to do something different with her special education
evaluations. For years, she had been the person to speak after
the classroom teacher and the nurse had given their reports and
before the school psychologist shared the results of her testing.
Most of the reports Jenny gave tried gamely to focus on the stu-
dent’s strengths and capacities for succeeding in both regular
and special education, but something always seemed to fall flat.
The clinical and family information she was collecting focused
primarily on what was not working with the student and his
or her family, and though she tried to soften the more diagnos-
tic language inherent in assessing child and family function-
ing, she wondered whether families heard any of the strengths
she was presenting or just words like “deficits” and “disorder”
instead. Working as a white school social worker with a major-
ity African American student population, she also worried about
the tendency of her special education team to focus on family

88 Solution-Focused Brief Therapy in Schools


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and student problems rather than on any of the family system’s


strengths.
After attending some SFBT trainings offered by the Loyola
Family and School Partnerships Program, Jenny learned of two
rating scales that might help fulfill her report-​w riting respon-
sibilities but also move the special education eligibility pro-
cess to one more focused on student capacities and strengths.
These two rating scales, the Behavior & Emotional Rating Scale,
Second Edition (BERS-​2), and the School Success Profile, are
contained in the chapter’s reference section (Bowen, Rose, &
Bowen, 2005; Epstein & Sharma, 2004).
To change her special education assessment process, Jenny
started with her own interviews. Using some material from
SFBT, she reshaped her student interview and the family social
development form to reflect more solution-​focused and strength-​
based ideas (Gleason, 2007; Murphy, 1996). After completing the
student interview and receiving the written social developmen-
tal study paperwork from each student’s parents, she followed up
with a phone call to the parents to confirm the information and
explore what other information might indicate the student had
begun making changes in academic or behavioral performance
during the interval between the initial consent for the case study
and the case study meeting (pre-​session change). Finally, Jenny
would ask the parents and the student’s classroom teacher to
each complete a copy of the BERS-​2, and then use these BERS-​2
data to help frame the student’s difficulties in terms of strengths
that he or she had already exhibited and other areas that needed
more work or were “emerging.” Based on the student’s motiva-
tion and cognitive levels, she would also often ask the student to
complete his or her own student version of the BERS-​2, so that
she had three sets of strength-​oriented data on the student to
triangulate and share.
The next all-​important step involved fashioning these new
data and new perspectives into information that could be shared
concisely at the student’s special education eligibility meeting.
This was no easy task: each meeting was only scheduled for an
hour, and there was never any shortage of “problem-​talk” to get
through regarding why the particular student wasn’t behaving
appropriately or learning at grade level. Jenny elected to forego
her usual read-​through of her social history and instead use
the BERS-​2 data to help her focus on what she saw as the stu-
dent’s strengths and how those strengths might be enhanced

SFBT Within the Tier 3 Framework89


90

to improve the referral problem specified for the case study


evaluation.

SFBT Family Therapy


The literature on schools as “community schools” is growing, with attention
being paid to helping whole families access services at schools after regular
school hours (Anderson-​Butcher, Iachini, & Wade-​Mdivanian, 2007). Some
of those services include after-​school tutoring programs, ESL classes for par-
ents, job training programs for teens, and mental health services (Hammond
& Reimer, 2006). In the case example that follows, one school social worker
who we have worked with describes the family of a student at her school
that she saw for a six-​session SFBT course of treatment.

Carol is a school social worker in the large suburban district of


Forest Side, outside Chicago. Fifty percent of the students in
this district are on the free lunch program; 80% of the district’s
students are black, 15% are Latino, and 5% are white. Carol has
worked in the district for 15 years, and over this period, she has
seen minimal improvement in the availability of family-​based
mental health services in the community, hampering her ability
to make solid family therapy referrals for her neediest students.
This past year, as part of her professional development goals,
she decided to implement an intensive evening family therapy
program utilizing SFBT ideas with the students on her caseload
who appeared to have significant family struggles. She shared
details of one of her cases with us.
Shantel Thomas is a seventh-​g rade African American who
lives with her mother, stepfather, and two younger brothers
in Forest Side. Mrs. Thomas (now Mrs. Daniels, after mar-
rying Mr. Daniels 5 years ago and having her two children
with him) has lived in Forest Side for all of Shantel’s life.
Shantel only recently moved back to Forest Side to live full-​
time with her mother and stepfather, however. For the past
2  years, she had been living with her father and his girl-
friend in Chicago, after having run away to her dad’s house
following a particularly bitter argument with her mother
and stepfather. Now she is back at the school social work-
er’s (Carol’s) school and is having a number of behavioral
and academic adjustments, resulting in several referrals for
discipline. Carol observes that Shantel seems to be isolated
from other girls in the school’s lunchroom. What follows is

90 Solution-Focused Brief Therapy in Schools


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the first family session where the school social worker uses
scaling questions and the miracle question to mobilize the
family around some new solutions for resolving the family’s
and Shantel’s struggles.

School Social Worker (Carol): Hello and welcome back to


school! I hope you were able to get to my office with no
hassle.
Mr. Daniels (Mr. D): Sure, the school secretary buzzed us in
and pointed us up here.
Shantel: And I knew where it was, so I could show them!
Carol: That’s great, you could be the tour guide for your par-
ents. Did you show them anything else on your way up
here, maybe like where your classroom is?
Shantel: No, I just came here. They can find Ms. Frederick’s
room on their own time—​ooh, I hate her!
Mrs. Daniels (Mrs. D): Shantel! Don’t let me hear you talking
about your teacher that way. It’s only been a month since
you started here and already you’re talking badly about
your teacher. [turning to Carol] See, this is her way. She
doesn’t given anybody a chance, just makes her mind up
and well …
Carol: I’m wondering about that, too, Shantel. If you had to say
on a scale of 1 to 5, with 1 being not at all comfortable here
in your new school and 5 saying that you were totally com-
fortable here, what would you say your rating is for being at
our school?
Shantel: [without hesitation] Oh, a 2, definitely. I mean, it’s
not like the school totally stinks, but it’s nothing like my old
school Washington.
Carol: So a 2 is what you would rate our school. What would
you have said comfort scale was at Washington?
Shantel: Definitely a 4, maybe even a 5. Yeah, I was real
good there.
Mrs. D: You know, she’s right about that. My ex-​husband told
me that Shantel never got any calls home while she was
there, and she was even doing … what was that club you
were in?

SFBT Within the Tier 3 Framework91


92

Shantel: Wasn’t a club, mama. I was in plays and I also did this


after-​school dance class, too.
Carol: So not only did you rate your school time at Washington
higher, you were doing after-​school stuff as well?
Shantel: Yeah, it was a great place.
Carol: What would be a way that you could do something at
our school to make it feel more like you felt at Washington?
Shantel: Hmm … I don’t know.
Carol: Is there anything that you did at Washington that you
think you could “bring” here?
Shantel: I got it. I think I left something at Washington, with
my old acting teacher.
Carol: Excuse me?
Shantel: My acting teacher always talked about how we had
to hold on to our wisdom while we were doing our parts.
He said we all knew more about our characters than the
audience did, and we had to hold on to that wisdom
and pull it out when we were up there, to make us do a
better job.
Carol: That’s fascinating. He said you had wisdom, and how
old are you?
Shantel: You know how old I am. A lot younger than those two
[pointing to mom, everybody laughs].
Mrs. D: Shantel, you are crazy, joking about all this, and we’re
here to talk about your problems!
Carol: You know, Mrs. Daniels, I think in some ways we are
starting to talk about Shantel’s problems here at our
school. Can I tell you what I’ve seen happening at school,
Shantel?
Shantel: I guess.
Carol: I’ve talked to your teachers, and they all told me—​even
Ms. Frederick!—​that you are clearly one of the smartest
kids in their class. You raise your hand a lot and have good
things to contribute. They say that if you did their work,
your first-​quarter grades would be all A’s and B’s.
Shantel: Really? I thought they all hated me. They’re always
looking at me like I did something wrong.

92 Solution-Focused Brief Therapy in Schools


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Mr. D: What about the problems after school and in the lunch-
room? I know it’s only been a month, but my wife and
I have gotten something like five calls from the school ask-
ing us to talk to Shantel and to come get her. Getting into
fights, back-​talking … This has got to stop.
Shantel: They’re always getting me into trouble! I told you,
nobody likes me here! [puts head down, seems ready to
either leave the room or cry]
Carol: Shantel, hold on a minute. What your stepdad is say-
ing is true, right, about you getting into some trouble at our
school?
Shantel: Yeah, but what else can I do? These other girls are
always acting like they own the school or something, tellin’
me where to sit, and, oh man, don’t get me started on those
lunch supervisors … they’re evil!
Carol: Okay, I think I’m getting a better picture of why you
rated our school a 2 for you. I want you to try something
with me for a minute. Let’s imagine that after we leave here
today you go home with your parents, play with your little
brothers, do your homework, and then go to sleep.
Shantel: That’s pretty much what I would do.
Carol: Great. But this is a different night of going to sleep
because while you are sleeping, a miracle happens to you,
and when you wake up and come back to school, everything
that was a problem for you here is different, all the things
that have been bothering you here are different somehow.
Shantel: So … like all those mean girls and teachers are gone?
Carol: No, the miracle happens with everybody still at
school, including you. What’s different is that the problems
are gone.
Shantel: Hmm.
Carol: So, my question to you first, and then I’ll ask your par-
ents their answer, is “What would you notice first that was
different?”
Shantel: [thinks for a long time] I know: I’d have my
wisdom again.
Carol: Tell me more about that.

SFBT Within the Tier 3 Framework93


94

Shantel: All that wisdom I had at Washington, when I was act-


ing and just being myself, I’d be able to get that back and
use it to fight back here.
Carol: Can you give me an example of what you mean by using
your wisdom to fight back?
Shantel: Sure, with my wisdom, I would be able to see through
the things the girls are saying to me, and just go off and
make my own friends.
Carol: What else?
Shantel: I’d be better at holding on to my comebacks when
those evil lunch supervisors come around yelling at me, just
look at them and smile or something and say, “Yes,” and
then get away from them and go sit somewhere else.
Carol: Wait, with your wisdom you’d be able to do that? “See
through” the other girls’ comments and not get all mad back
at the lunch supervisors?
Shantel: Yeah, that’s what I did at Washington. There were
mean girls there, too. I just liked being there more,
I guess.
Carol: So, let’s take the miracle one step further, and let me
ask your parents the same question. What would be the first
sign that the miracle had happened and things were better
for Shantel at school?
Mrs. D: Shantel would be happy to go to school and wouldn’t
be so hard to live with at home. [everybody laughs] I’ve got
to be honest …
Mr. D: You got that right, Shantel, if you got some wisdom
somewhere that you lost, you really need to go get it. I’ll
drive you to go pick it up! [laughter again]

Solution-​Focused Needs Assessment


One of the gaps in the present SFBT literature involves the application of
SFBT to organizational and community contexts. One of the most prominent
examples of a solution-​focused community organization is Gonzalo Garza
Independence High School, which we discussed in detail in Chapter 4. The
notion of a solution-​focused community organizer may sound far-​fetched,
but in fact, this is just what one of our colleagues became when she engaged
in a series of solution-​focused groups designed to help parents describe their

94 Solution-Focused Brief Therapy in Schools


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goals for their children and the ways that they hoped that their neighbor-
hood school could begin to address those needs.

Sarah is a social worker employed by a local community men-


tal health agency in an urban Midwestern city. The goal of her
community outreach unit is to facilitate partnerships with local
schools in inner-​ city communities to increase parent/​ school
involvement and also to generate more use of the agency’s
family-​based mental health and vocational services. Despite
having conducted needs assessment and service outreach for
two years as part of a grant-​funded project, Sarah and her col-
leagues were finding that their parent clients, many of whom
had multiple challenges related to living in poverty, remained
hard to reach and were not fully using the services offered by
the agency. In a similar vein, school officials reported frustration
with parents who did not participate in their child’s education
and seemed to only come to school when they “felt like it.” These
complaints are common to educators and practitioners trying to
engage and involve parents coming from impoverished back-
grounds (Comer, 2005).
As part of her startup work in a new neighborhood elemen-
tary school, Tillman, Sarah decided to conduct her agency’s
needs assessment in a new way. She spent a few days visiting
local neighborhood businesses, churches, and organizations
and compiled a list of 15 community stakeholders who were
parents of students at Tillman and interested in coming to a
focus group to discuss the agency’s outreach program. When
Sarah convened the group, she used the SFBT miracle question
to help facilitate the discussion:  “If a miracle happened over-
night and Tillman became a place that was more welcoming to
parents, what would be different?” The answers did not take
long to surface. These parents said they spent most of their non-​
working time taking care of young children, looking for employ-
ment, dealing with their own health issues at a range of different
health care providers, or waiting at social welfare agencies to get
their families services. Focus group members said the first thing
that would be different is that the school would have agencies
offering them help at school; in this way, they could also be
more present at school for the students.
Sarah and the agency team then brainstormed with the par-
ent focus group about the range of services that would be ideal to
have available at Tillman and what format would best help them

SFBT Within the Tier 3 Framework95


96

engage those services. The group agreed that having monthly


“service fairs” on a particular day would help them to prioritize
that day, and they also wondered whether this would help the
school design a day or evening program for parents involving
parent-​teacher conferences and other activities. Significantly,
Sarah decided not to include school faculty and administra-
tion in this initial meeting; the thinking was that parents would
not be open in their comments and that school officials would
be immediately put on the defensive. Subsequent meetings,
however, did involve members of the focus group and school
administration.
Sarah contacted several agencies that provided welfare and
health care services to the community and was surprised at how
eagerly they embraced the idea. (They wanted to do innovative
outreach for their services and thought this was a fresh idea.)
Within a month, the miracle question had helped create a little
miracle at Tillman: a day-​long “service fair” where parents could
get health screenings, contact local social welfare agencies, and
meet with their children’s teachers. The service fairs have been
held each month for the past year and are helping the adminis-
tration at Tillman think about other ways they might reach out
to parents whom they had previously thought of as indifferent to
their children’s education (Anderson-​Butcher & Ashton, 2004).

SFBT Groups in Schools


Solutions to Anxiety
National survey data and health experts identify childhood anxiety as a
growing and under-​researched problem (American Academy of Child and
Adolescent Psychiatrists, 2007). The literature on effective treatments for
childhood anxiety emphasizes a combination of cognitive-​behavioral ther-
apy and pharmacological intervention (Chorpita & Southam-​Gerow, 2006),
though most researchers in this area acknowledge the need to further study
the long-​term impacts of anti-​anxiety medication for children (Pollock &
Kuo, 2004). One of the most promising areas of our recent practice has been
efforts to work with students identified as having learning disabilities but
also a host of anxiety symptoms associated with their school performance.
Box 6.1 describes an eight-​week, solution-​focused group intervention
designed to help students coping with generalized anxiety disorder and
those grappling with test anxiety. The group session was conducted with

96 Solution-Focused Brief Therapy in Schools


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Box 6.1  Eight-​Week SFBT Group for Student Anxiety


Session 1:  Introductions. Obtain informed consent for participa-
tion. Discuss group expectations. Discuss the goals of the group (i.e.,
to help students identify ways to manage their anxiety at home and
school and to cope with test anxiety).
Session 2: In-​session assignment. “What academic/​school goals do
you have this semester?” and “What do you hope to achieve by par-
ticipating in this group for the next 8 weeks?” Use of the miracle
question.
Session 3: Use of the scaling question (i.e., “On a scale from 1 to 10,
with 1 being your academic/​school goals not achieved 10 meaning
all your goals have been achieved, where would you rate yourself
as a student today?”) Homework assignment for next week: “Where
would you like to be on the scale at the end of the semester?” Appraise
the group on “What are the ways in which you will accomplish this
increase?” (Goal and future orientation.)
Session 4:  Review Session 3 homework assignment. Group dis-
cussion on “signs of success” in achieving academic/​ s chool
goals. Homework assignment for next week:  First, “If I  asked
Mr./ ​M s._​_​_​_​_​_​_​_​_​, your _​_​_​_​_​_​_​ teacher, how he/​she had wit-
nessed these signs of success in your academic/​s chool goals, what
do you think he or she would say?” (i.e., the relationship question).
Second, write down your signs of success in which you came closer
to reaching your end of the semester score on the scale of 1 to 10.
Session 5:  Review Session 4 homework assignment. Use the SFBT
technique of EARS (i.e., Elicit, Amplify, Reinforce, and Start over).
Use of the exception-​finding question to amplify and reinforce pres-
ent and future change.
Session 6: Revisit the scaling question. Homework assignment: A let-
ter from the “older, wiser self” (Dolan, 1995). “Imagine that you have
grown to be a healthy, wise old man or woman and you are looking
back on this period of your life. What would this older and wiser man
or woman suggest to you, which helped you get to where you are now
in your academic/​school goal(s)?”
98

Session 7: Review Session 6 homework assignment. Discuss how the


“new” self has emerged: Employ EARS.
Session 8: Review Session 7 homework assignment. Discuss setbacks
as being normal. Pass out certificates of success.

Source: Adapted from Newsome (2004).

students at a suburban, K-​6 elementary school with a group of five fifh-​and


sixth-​grade girls who either had been diagnosed with generalized anxiety
disorder by outside mental health providers or had described significant
anxiety to us during weekly sessions as part of their individualized educa-
tion plan minutes. The group session was conducted at lunchtime for eight
consecutive weeks, and sessions took place as students ate lunch and social-
ized with each other.

A Solution-​Focused Parent Group for GRGs


The number of school-​aged children living with their grandparents has
increased in the past 20  years, with the 2000 US Census data report-
ing more than 4.5  million children in grandparent-​ headed households
(Davies, 2002). This population of new “parents,” who thought they had
already finished being responsible for young children, is often assuming
this new challenge under trying family, professional, and health circum-
stances (Fuller-​Thomson & Minkler, 2000). To address the growing number
of GRGs in our school community, we began to offer eight-​week, solution-​
focused parenting groups specifically designed for GRGs, and we summa-
rize of the content of those group sessions here.
The group model discussed here is an eight-​week GRG “Solution Group.”
The group meets on school grounds, preferably at a time when most grand-
parents could attend. Although it is not absolutely essential that GRGs
always be grouped separate from other parents/​caregivers, we suggest that
novice SFBT practitioners try to implement a group program for this specific
population first, both to learn the specific needs of GRGs and to apply and
test SFBT ideas with them.
The groups had the following topics for each week. Also included here are
sample questions that we asked them at each weekly session as well as some
examples of SFBT group interactions drawn from our previous work in this

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 99

area (Newsome & Kelly, 2004). The first three weeks are held consecutively;
after that, GRG groups take place on a two-​week/​monthly basis to empha-
size the belief that GRGs can both support each other and act creatively and
effectively on their own, without the aid of “experts” (Selekman, 1993).

Week 1: Introductions and Orientation to SFBT GRG Ideas

• What is the most important part of the problem that brought you here?
• What part of that problem would you like to work on first?
• What are your thoughts about the problem you’re having with your
grandchild?
• What is the one thing you would like to learn from this group as it
relates to this problem?

As with any new group venture in a school, the first session is crucial. In
this first session, we give grandparents a chance to get to know us, the other
members in the group, and the basic ideas behind the SFBT approach. It is
important to normalize both their particular circumstances as GRGs and
the model collaborative problem solving between group members. Because
change is going to be the focus of the group, we’re also eager to discuss
how SFBT views the change process and to contrast that with other, more
deficit-​based approaches. This approach allows us to immediately validate
the GRGs for their experience and wisdom and to truly say that we believe
they are the experts on matters concerning their grandchildren and that we
hope to draw on their expertise over the course of the program.

Week 2: Identifying Your Signature Strengths as a Grandparent and Applying


Them to Your Mission as a GRG

• What are your signature strengths as a grandparent raising your


grandchild? (Peterson & Seligman, 2004)
• How do you use your signature strengths as a grandparent raising a
grandchild?

In our second session, we ask group members to complete a strengths


questionnaire to help us frame future discussions of their strengths as
grandparents. Peterson and Seligman (2004) offer a taxonomy of “signature
strengths” and virtues to complement the categories of psychopathology

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100

described in the Diagnostic and Statistical Manual of Mental Disorders, Fourth


Edition and an instrument called the Values in Action (VIA) questionnaire
that can be taken by the GRGs online. In this second session, we begin to
use the VIA, along with written exercises and discussion, to help the group
members analyze where and how they are using their strengths as a GRG.
Recently, the benefits of using the VIA were quite helpful with a GRG
who had become the primary caregiver of her grandchildren. As such, the
grandparent stated to the second author (Michael Kelly) that she was hesi-
tant to use her artistic and imaginative ability (e.g., drawing, painting, build-
ing things, or making games out of chores) with her grandchildren because
her daughter had raised them much more rigorously and harshly before
she passed away. Through use of the VIA and a discussion that helped the
grandparent identify her signature strengths, the GRG recognized that she
could still honor her daughter’s memory while also applying her creativity
with her grandchildren (Newsome & Kelly, 2004, p. 73).

Week 3: Starting Small—​How Small Changes Can Become


Big Solutions

• Since our group has started, what have you noticed that is already
different about the main problem you came in with?
• What did you do to make those changes?
• What do you need to do to maintain those changes with your
grandchild?

An example of a conversation that took place with a GRG during the


SFBT group process illustrates the use of the aforementioned questions:

Group Leader (GL): Welcome back, everyone. Tonight, we


want to start by discussing a time in the last three weeks
that the problem or problems affecting your grandchild were
not so overwhelming, and what you did as a grandparent
to help ease or lessen those problems. Do we have anybody
who can share with us tonight?
Ms. Valdez (MV): I will. I think my grandson is getting better
at school.
GL: Really? Tell us how you know that.

100 Solution-Focused Brief Therapy in Schools


 101

MV: Well, my grandson was having trouble on the playground,


getting in fights and all that, and they called me in.
GL: Who is “they” here that you’re talking about?
MV: The school staff, they wanted him to stay off the
playground.
GL: And all that was because they didn’t think your grand-
son could handle being on the playground? Have you seen
times when Juan could handle being on playgrounds with
other kids?
MV: Yes, I told them he’ll find his way, we just have to pay
attention. To prove it I went to school to watch him play on
the playground. I saw that he was alone, and nobody was
playing with him. I thought, “No wonder he’s getting in
trouble; he’s trying to find any way possible to fit in.” I told
him to go see if he could play soccer with some of the kids
on the playground—​he loves to play—​and he did!
GL: And you were able to show the school that some kids can
find their own way. You recalled how much your grandson
loved playing soccer, and you helped him get in a game.
And all that fighting stuff on the playground went away.
MV: Yep. All it took was a little attention. That’s what these
kids need, our attention.

The above vignette highlights how small changes can become big solu-
tions. More importantly, the dialogue illustrates how the group leader and
Ms. Valdez uncovered an exception of how the problem (i.e., fighting on the
playground) became less debilitating to her grandson (i.e., when he started
playing soccer with other kids on the playground). Similarly, it helped to
increase the hope and resilience of Ms. Valdez as a primary caregiver to
her grandson as she faces the many challenges and opportunities presented
to her throughout the academic school year (Newsome & Kelly, 2004,
pp. 75–​76).
The first three weeks are held consecutively; after that, GRG groups take
place on a two-​week/​monthly basis to emphasize the belief that GRGs can
both support each other and act creatively and effectively on their own,
without the aid of “experts” (Selekman, 1993).

SFBT Within the Tier 3 Framework101


102

Week 4: What’s Already Working? Identifying Exceptions to Presenting GRG


Parenting Problems

• If you can imagine our final meeting and being able to rate your
problem as being low, what will have changed between then and now?
• What is the first thing you might do as a grandparent raising a
grandchild to make this change happen?
• On a scale from 1 to 10, with 1 being not coping at all with your new
role and 10 being coping very well with your new role, how well would
you say you are coping?
• What would be different in your life if you went from a 6 to a 7 or from
a 7 to an 8?

A portion of a conversation we had with a GRG during a group session


several years ago illustrates the use of the scaling question as a way to find
exceptions:

Group Leader (GL): Tonight, I’d would like you to think of


something you’ve been working on changing with your
grandchild. It can be something you’ve been working on at
home or at school. I want you to rate how well you think
your grandchild has been doing on a scale from 1 to 10,
with 1 being very poor and 10 being very excellent. Would
anyone like to start us off?
Ms. Wilson (MW): My granddaughter, she has been fighting
with her older brother too much, especially when it’s time
for them to get down to their schoolwork.
GL: How would you rate her level of fighting with her brother
in the last few weeks on a scale of 1 to 10, with 1 being very
excessive and 10 being not excessive at all?
MW: You know, I was thinking before you asked me. Early
on, I would have said it was very excessive, I would have
given her a 1, but lately, I’d say she’s been making an effort.
I think I would rate her at a 5, maybe a 6.
GL: And that 5 or 6 is better than it was before?
MW: Oh, yes! She was down around a 1 for too, too long.
GL: What do you think brought her up from a 1 to 5?

102 Solution-Focused Brief Therapy in Schools


 103

MW: I’ve been just telling her to go to another room, and leav-


ing it at that. I gave up yelling and cussing back at her—​it
didn’t work. Besides, doing this gives her nobody to talk to
and soon after she shapes up and starts saying, “Grandma,
I’ll be good, I promise.”
GL: That’s great. So, you’re doing something different helps her
decide to behave differently. What do you think needs to
happen for your granddaughter to get to a 7 or 8?
MW: That would be amazing to see her at a 7 or 8. I think if
she figures out that I’m serious about not letting her mess
with her brother, she’ll calm down. I can see her getting to
that 7 or 8 someday.

In this vignette, the group leader used the scaling question with Ms.
Wilson as a way to recognize the proactive change that had occurred
over the last few weeks. More than that, however, the scaling ques-
tion helped to open up a discussion of the progress and growth made
by Ms. Wilson and her grandchild. By using the scaling question, the
group leader was also able to tap into Ms. Wilson’s practical wisdom
in addressing a very common issue between two siblings (Newsome &
Kelly, 2004, pp. 77–​78).

Week 5: The “Doing Something Different Day”: Using SFBT Interventions


in Daily Life with Your Grandchildren

• What are two things you could do differently this week as a grandparent
raising a grandchild as it relates to your problem?
• What are a few impacts you might imagine happening as a result of
“doing something differently”?

Week 6: Maintaining Change: Ways to Keep Change Going as a GRG

• What are two things you did differently this week as a grandparent
raising a grandchild that helped?
• What difference did it make as a result of you “doing something
differently?”

SFBT Within the Tier 3 Framework103


104

Week 7: GRG Wisdom Night—​A Panel of Elders Share Their Life’s Lessons

• Looking back at your experience in this group at Week 1, what is


different about your “parenting role?”
• Who in your life views you as a person who has wisdom to share?

For this session, we invite other GRG “elders” in the school community
to share their wisdom in a panel discussion.

Week 8: Change Party: A Celebration of the Changes Already Made with the


Help of SFBT and of Those Changes to Come

• What is new and powerful about you as a grandparent raising a grandchild?


• How can you maintain this new part of you as a grandparent raising a
grandchild?
• What have you learned about your grandchild’s strengths and capacity
to change?
• What is the most important lesson you learned in this group, and who
taught you this lesson?

In keeping with the SFBT philosophy, we choose to deal with group end-
ings and termination issues by focusing on the positive aspects of the group.
As a result, we have a “change party.” In using the change party technique,
each GRG brings his or her grandchildren to the group and shares one thing
that has changed in the past three to four months as well as one strength
they most admire about each of their grandchildren. (Each of the GRGs will
have done a signature-​strength VIA with each of his or her grandchildren at
this point, to have that instrument to draw on.)
While the majority of this final group meeting is spent socializing and
having fun, we do encourage the GRGs to consider forming some kind of
informal network, with us or with other group members, to help build
on the positive solutions and relationships that the group helped to foster
(Newsome & Kelly, 2004, p. 80).

The Future
This is just a sampling of what a solution-​focused school professional can
do with SFBT ideas. What are your ideas after reading this chapter? Can you
think of a place or population in your school community that might benefit

104 Solution-Focused Brief Therapy in Schools


 105

from some solution-​focused interventions? Starting small is a good idea; find


a classroom or group of students and get started. After all, as we learned in
Chapter 2, solution-​focused practice teaches us that small changes can lead
to big ones. Start small, start now; have fun with solution-​focused work in
your school!

References
Altshuler, S. J., & Kopels, S. (2003). Advocating in schools for children with disabili-
ties: What’s new with IDEA? Social Work, 48(3), 320–​329.
American Academy of Child and Adolescent Psychiatrists. (2007). Facts on anxi-
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advances_​in_​child_​and_​adolescent_​anxiety_​disorder_​research
Anderson-​Butcher, D., & Ashton, D. (2004). Innovative models of collaboration to serve
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Anderson-​Butcher, D., Iachini, A., & Wade-​Mdivanian, R. (2007). School linkage proto-
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University.
Bowen, G., Rose, R. A., & Bowen, N. K. (2005). The reliability and validity of the school suc-
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Chorpita, B. F., & Southam-​G erow, M. (2006). Fears and anxieties. In E. J. Mash & R. A.
Barkley (Eds.), Treatment of child disorders (3rd ed., pp. 271–​335). New York: Guilford.
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& B. Duncan (Eds.), Handbook of solution-​focused brief therapy (pp. 184–​204). San
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7
■ ■ ■

SFBT in Action
Child Abuse and Neglect
Robert Blundo & Kristin W. Bolton

Kids Are More than Victims: Abuse and Trauma in Schools


School social workers are faced with the important responsibility of help-
ing students through many of life’s current challenges, such as community
violence, divorce, poverty, maltreatment, drug abuse, sexual abuse, sexting,
and bullying. This chapter demonstrates ways of approaching and working
with children who are faced with child maltreatment.
First, it is important to emphasis that the school social worker is not the
primary treatment person in cases of neglect, abuse, or trauma. Yet, given that
the school environment is one of the most significant settings for students
outside of their home, school social workers do have an important part in
reporting abuse and neglect, as well as in supporting students’ ability not
just to move on with their lives but also to thrive. An overarching respon-
sibility of the school social worker is to help school staff better understand
and appreciate the need for safety and trust within the school for all students
and to assist the school in embracing a less authoritarian and zero tolerance
atmosphere. Helping the students to feel safe and trusted by teachers, staff,
and the school social worker will make it more likely that students will
feel comfortable enough to reveal possible neglect and abuse and will aid
in supporting the child once neglect or abuse has been verified (Bannink,
2014; Olson, 2014). Rather than focus on the abuse or neglect itself, pro-
viding a feeling of safety, along with helping the student to build trusting
and supportive relationships within the school, is a significant event for any
child confronting the trauma of neglect or abuse. Not only is this a potential

107
108

restorative factor, it also creates a better chance that students will reveal
something about their situation to a teacher, social worker or staff member.
This chapter also covers the following matters to better understand the
position of a school social worker and students: 1) the context and pressures
within school settings on student and staff, 2) how neuroscience research
provides evidence for the need to create a school environment that provides
a real sense of safety and caring within both the school and the social work-
ers relationships with students, 3)  a new appreciation of the student’s life
context and consequential developmental behaviors while in school, 4) the
age distribution of students being engaged by school social workers, 5) the
range of neglect and abuse issues to be considered, and 6) the challenges of
being a designated reporter as well as a support for these children while in
school.

Child Maltreatment in the United States


There are four major types of child maltreatment: 1) physical abuse, 2) sex-
ual abuse, 3)  emotional abuse, and 4)  neglect. The National Child Abuse
and Neglect Data System collects and analyzes data submitted by all 50
states, the Commonwealth of Puerto Rico, and the District of Columbia,
and the data are reported to Congress by the US Department of Health and
Human Services, Administration for Children and Families, Administration
on Children, Youth, and Families Children’s Bureau. The most recent data
(from 2013)  found that in the Unites States, there were 670,000 cases of
child maltreatment (9.2 children per 1,000), and approximately 3.9 million
children were the subjects of at least one report. Additionally, data revealed
that in 2013, 9.0% of children classified as victims of maltreatment were
found to be sexually abused, 79.5% were neglected, 18% were physically
abused, and 8.7% were emotionally abused (Children’s Defense Fund, 2014;
US Department of Health and Human Services, 2013).
Bryant and Milsom (2005) found that school social workers are report-
ing the majority of cases, with elementary school social workers reporting
significantly greater numbers of cases than high school social workers. The
average age for first abuse 9.6  years for girls and 9.9  years for boys (US
Department of Education, 2004). In response to the need for better protec-
tion, the Child Abuse and Treatment Act was passed by Congress in 1974.
This law initiated the requirements for mandated reporting and definitions
of abuse. Finally, the rates of abuse vary greatly state by state. For example,

108 Solution-Focused Brief Therapy in Schools


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in 2013, child maltreatment rates ranged from 1.2 per 1,000 to 19.6 per
1,000 (CDF, 2014; US Department of Health and Human Services, 2013).

Neuroscience and Solution-​Focused Engagement with Students


The consequences of neglect and abuse produce profound changes in the
structure and functioning of the brain, with consequences for behavior and,
in particular, relationships. A  neurological perspective shifts the view of
these behaviors to something more likely to be a defense against perceived
threats. The hope here is that teachers, child protective workers, and school
social workers are also shifting in how they view such behaviors. Rather
than thinking “What is wrong with that child?” the neuroscience findings
point to “What has happened to that child?” Beyond “what happened” is
how the child will make it today and the following days, or how she or he
might thrive in school and other settings. This is the area of supportive work
where school social workers have an important role.
The descriptive term neuroception was coined by Stephen Porges (2011)
to describe the non-​ conscious and instantaneous responses that occur
every moment with regards to safety. All human beings are wired to detect
safety or danger. The autonomic nervous system is on constant alert for safe
and unsafe situations every quarter of a second. This enables the person to
respond to unsafe situations faster than the thinking apparatus can make
a decision whether to respond. This applies to all interactions with others,
whoever they might be. Olson (2014) describes the neuroception of safety
to occur when an individual senses other people as being accepting, non-​
judgmental, and helpful. When our neuroception registers a sense of being
criticized, being rejected, or even just a sense of tension, anger, or fear from
those round us, the experience of feeling vulnerable and unsafe is generated
(Olson, 2014). We quickly experience a heightened sense of not being safe
and not having trust in those around us. This is an idiosyncratic response of
an individual who has been living with abuse or neglect. It is an automatic
response and calls for defensive behaviors, such as yelling, hitting, fighting,
shutting down, or running away. Thus, when students are living in an abu-
sive, neglectful, or highly stressful environment, the experience is one of the
world being unsafe and untrustworthy, even in the school.
When students lash out in anger or become withdrawn and unable to
speak or talk, they are expressing a response to feeling unsafe. Abuse and
neglect are obviously experiences that prime a student to one or all of these

SFBT in Action: Child Abuse and Neglect109


110

reactions. These actions on the part of the student are reflexive protective
reactions that are initiated in a moment as fight, flight, or shutting down
and withdrawing. More often than not, these responses are seen as dis-
ruptive classroom behavior: fighting or passivity, not responding, or seem-
ingly being unable or just unwilling to speak. These are also behaviors and
attitudes that draw the attention of school social workers. They may very
well be signs of neglect or abuse as well as a consequence of living within a
critically stressful community. The possible symptoms or signs of abuse and
neglect are the same as those for students growing up in a dangerous com-
munity setting. Thus, the very behaviors that are seen as disruptive can be
hints of neglect and abuse and/​or adjustments to a traumatic environment.
As noted, the conditions within the community are very likely confounding
factors of physical and sexual abuse.
Finally, school social workers can benefit from continuing to under-
stand the latest knowledge regarding neuroscience and trauma. Knowledge
regarding the impact of trauma on the human brain is growing exponen-
tially and provides insight for those who work closely with children exposed
to trauma.

Importance of Safety and Trusting in Recovery and Thriving


SFBT is a key element in establishing a safe working relationship while
dealing with issues of neglect or abuse and with students living in stressful
communities. For now, the focus will be on a solution-​focused approach to
reporting suspected neglect or abuse and working to support students who
have been found to be neglected or abused.
The issues of trust and safety are of prime importance in working with
any student, particularly students experiencing child maltreatment. The
solution-​focused school social worker is especially suited for the forma-
tion of a safe setting by working with the student and his or her teach-
ers. Solution-​focused practice has an inherent capacity to create a safe
working relationship. By attending to client strengths rather than prob-
lems, seeing children as having possibilities of recovery and thriving,
and considering students as experts on their own life experiences and
then creating a focus on movement toward successes, survivorship, and
thriving, the school social worker helps students create their own pic-
ture of the desired outcome and better future, even if in very small ways.
Contrary to many forms of trauma treatment, solution-​focused practice,
while acknowledging the pain and fear of neglect and abuse, shifts its

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attention to those moments, exceptions, or instances when the student


is able, in small ways, to demonstrate the ability to thrive in the midst
of the chaos. Significantly, solution-​focused practice appreciates the per-
ceptions of students and acknowledges the anger and pain expressed in
their behaviors in school. It believes in the student’s ability to conceive of
a better life as the expert on that life. At the same time, solution-​focused
practice trusts in the student’s ability to focus on those moments when
things have been or are going a little better, a little safer, and the student
is more likely to feel trust.
SFBT provides a student with a safe conversation by being carefully lis-
tened to, having ideas and beliefs affirmed as being the student’s sense of the
situation, and having hints of possibilities noticed by the social worker and
reinforced, both by the acknowledgment and by looking closer at the stu-
dent’s perceptions as a means of working within the student’s own frame of
awareness. The following are keys to affirmative relationships with students
(Berg & Steiner, 2003, p. 131):

1. Rather than a lecture, challenge, or attempt to persuade … develop


a trusting relationship or one in which the school social worker truly
believes the child to have he capacity to thrive and trusts in the child.
2. Trusting the student’s ideas of what they think would be best or helpful
now while at school.
3. Focus on the present and immediate future.
4. Keep focus on actions and not on gaining insights.
5. Pay attention to what is working, even a little bit, to help create possible
solutions or better outcomes. (p. 131)

Although therapy to treat abused children is not the school social worker’s
function, the following solution-​focused factors can be very helpful in build-
ing a sense of trust and safety, leading to increased possibilities for thriving:

1. Even abused children, no matter how badly they have been abused, still
have areas that are functioning well.
2. You should begin with the healthy part of the child.
3. You should ask children about what is their idea of how they want their
life/​situation to be different so that life is a little bit better for them;
sometimes they, too, like all children, have an idea of what they want
their life to be like.

SFBT in Action: Child Abuse and Neglect111


112

Although Berg and Steiner (2003) are referring to actual treatment work
with abused children, the same supportive and relationship building skills
are a key to supportive work done by school social workers.

Being a Mandated Reporter


The complexities of identifying possible abuse make the position of teach-
ers and school social workers very difficult. The social worker may need
to act as the mandated reporter and/​or as support for students maintain-
ing themselves within the school setting after having been engaged in child
protective services and possible foster care. These factors change the nature
of the work being done by the school social worker and the relationship the
social worker may (or may not) have with the student. The responsibility
of either making or not making a report can be problematic for teachers
and social workers. If reports turn out to be erroneous, the reporters can
face court action for making false allegations; if reports are not made, the
reporters can face court action not making a report as well (Brown, Brack, &
Mullis, 2008).
Therefore, this position presents a daunting task to any school social
worker. Two related elements are the ongoing relationship a school social
worker had with the child before any incidence of abuse or neglect and
maintaining that relationship following a substantiated or unsubstantiated
report. Both conditions of having made a report will have an impact on the
student’s relationship with the school social worker and the parents.
Reporting a possible neglect or abuse incident challenges the relationship
between the student and social worker. Maintaining a working and trusting
relationship is important, as we have seen, to the social worker remaining
a supportive and trusted adult in the school setting. When in a position of
being a mandated reporter, it is important to have a set of simple standards
that would justify reporting. These standards would vary depending on the
age of the student and the nature of the available information. Berg and
Steiner (2003) state that it is important not to be overly protective in an effort
to avoid making things worse. At the same time, it is important that any con-
tact with the student not be confrontational or argumentative. They add that
if the situation is immediate and extremely cruel or violent, in which by the
student needs immediate attention and protection, the mandated reporter
must engage the authorities right away and provide for the care of the child
until protection is made possible.

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In many cases, the school social worker is faced with limited information
and possibly conflicting stories. Obviously, the school social worker needs
to follow whatever guidelines have been established with their local child
protective services. The decision to report a suspicious set of information
should be made in consultation with the teacher and other staff. Berg and
Kelly (2000) provide several basic assessment points that the school social
worker would need to be prepared to answer:

Is the reported neglect or abuse one of a crisis, such as the child


comes to school with physical marks of abuse, a child reports
that he or she was physically abused, or (there is some corrobo-
ration of the abuse) by a witness.
Has the (social worker) witnessed the actual events or signs
of abuse or neglect? (p. 58)

Otherwise, it is important for the school social worker to view students’ in


the following ways:

1. Every abused child, no mater how badly they have been abused, still
have areas that are functioning well. (Berg & Steiner, 2003, p. 131)
2. You should begin with the healthy part of the child first. (Berg &
Steiner, 2003, p. 131)
3. You should engage students in terms of what will make their experience
better during school. Remember that as a school social worker, you are
not there to provide treatment but, rather, to offer what might better be
called SFBT coaching. Coaching is focused upon supporting the student
in creating a more positive, safer atmosphere and success in school.
Building on his or her strengths and abilities along with support during
difficult moments would be most helpful effort during these times.
4. Rogers (1951) stressed that with genuine trust, empathy, and
authenticity expressed in the contact with the social worker, the client
gains a sense of feeling felt, a sense of being heard and appreciated. It
is very important the social worker is not disingenuous but, rather, has
learned to truly trust and believe in the client’s ability to make it and
succeed. Given the tumultuous nature of schools and classrooms, where
performance evaluations loom over teachers and school social workers,
it is not easy to maintain this position. (Carkuff & Berenson, 1967)

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114

Mandated Reporting and Beyond


Whether the situation involves neglect, physical abuse, or sexual abuse
changes the work that is done with the students and others who may be
involved, such as child protective services, courts, families, and treatment
facilities. These students will be unduly impacted by the pressure to per-
form academically and behaviorally and may already be experiencing dif-
ficulties, which may have brought them to the attention of the school social
worker in the first place. If the school social worker has been having contact
with these students, the possibility of initiating an abuse report challenges
the relationship between the social worker and student.
Ratner and Yusuf (2015) state that at times when there is probable harm,
the school social worker may be required to step out of the SFBT approach.
To determine if the situation of the child meet the basic requirement for
mandated reporting will require specific non-​SFBT questions about the cir-
cumstances. They demonstrate this by providing an example of a child’s
response to the best hopes question. In this case, the child answered that
“It would stop,” and to further future-​oriented outcome questions, the same
response was given. Stepping away from SFBT, the child was asked what “It”
meant. When the child revealed bullying, assessment questions followed to
determine what specifically was happening to help protect the child from
further harm: As Ratner and Yusuf (2015) explain:

When safety is an issue, whether from bullying, self-​harm, sub-


stance misuse and so on, [the school social worker] has to make
a decision as to whether he or she needs to refer on to some-
one who can deal more effectively with the situation. … Serious
decisions should where ever possible be taken in conjunction
with another colleague [also, in case of abuse, to the mandated
services]. (p. 19)

As a mandated reporter, the solution-​focused school social worker has an


obligation to report suspected abuse or neglect. The reporting process var-
ies and is based on the gathering of facts and possible evidence that creates
suspicion. If abuse, in particular sexual abuse, has been verified, a specially
trained therapist will take on the actual trauma work necessary for the child’s
recovery. Importantly, however, the solution-​focused school social worker
can assist in the child’s survivorship through ongoing conversations focused
on competencies as well as maintaining normal expectations and support

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of day-​to-​day accomplishments. SFBT offers an opportunity to engage stu-


dents and teachers in a positive and appreciative manner during the briefest
contact. The interaction turns from focusing on problems and weaknesses
to strengths and possibilities built around positive, supportive relation-
ships. SFBT is particularly unique in that its use encourages the affirmative
relationships necessary for meaningful change as well as a sense of safety
and trust, allowing for the revealing of suggestive material to the school
social worker. Relationships are the very essence of human development and
required throughout life for there to be meaningful growth in any working
relationship (Frank & Frank, 1991; Hubble, Duncan & Miller, 1999).
Given this, the question becomes how to maintain a supportive and
compassionate relationship while obtaining information to help substanti-
ate making a report and/​or while being supportive of survivorship. Every
student is different, and students at every age are different in how they are
able to communicate or respond to inquiries about what they have been
experiencing that involves important people, such as family members or
other “trusted individuals.” One important way to do what, specifically, is
to maintain the SFBT position of accepting the student’s perceptions and
trusting the student to share what is comfortable at the time while recogniz-
ing the likely feelings of guilt and shame in revealing the trauma narrative.
The school social worker need not become the interrogator in an attempt to
verify the report. That is the work of the child protective services worker
and the child’s future therapist. Much will depend on prior relationships
between the school social worker and the student, if one existed before this
conversation. Let the student realize that you are not embarrassed, ashamed,
upset, or disbelieving of what they are telling you through body language,
facial expressions, and comments. Your focus is on supporting the student
by acknowledging how hard it must be to reveal this situation. It is impor-
tant that the student feel listened to and trusted.
In the following interview, a student, Beth, is assisted in revealing an
incident of sexual abuse:

School Social Worker (SSW): I’m glad we could meet; you


sounded very concerned about something important to you.
How can our meeting be helpful to you?
Beth: Umm … yea … [looking around the office] you know
I have never been a really good student. I haven’t been

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116

coming to school that much lately, and I’m not doing good
in my classes, like we talked about last week.
SSW: Yes, you’ve been able to get to school sometimes but not
as much as you may want. I’m impressed, though, with how
you are at least trying to make it to school these last few
weeks since we talked. There must be a lot going on that
makes it harder for you to come to school as much as you
would like. I’m curious; is there anything that would be
helpful to talk about that might help even a little bit?
Beth: Maybe … I don’t know if I can … not sure …it is very
hard and I don’t know what will happen if I talk about it.
SSW: Well, in what way do you think it might help if you did
share it with me or someone else? Do you think it would
make things better for you … like feeling like coming to
school?
Beth: I don’t know. It might make things even worse.
SSW: It must be very important to you if it might make things
worse. Even though it sounds like if you were to get some
help with this issue, it might make your life easier in doing
the things you seem to want to do, like school. That is a
tough place to be. What would be the most helpful for us to
do that might help move you to a better place and feeling
better?

At this point, notice how the student jumps in and starts to share her experi-
ence, as if possibly the social worker’s acceptance and support gave her the
trust to jump into the situation.

Beth: It’s my older uncle … He comes over a lot and stays


with us, and sometimes my mom leaves us with him when
she goes out. I liked him, but last semester he stayed over
and he wanted to kiss me. I didn’t know what to do. My
mom likes him a lot, and they are close. Now, he says he
loves me, and he has put his hands on me, you know, my
breasts. I just stood there and didn’t know what to do.
I don’t want to let mom know; she would be mad at me.

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SSW: Thank you for taking the chance and trying to help your
situation by sharing it with me. I understand how difficult
it must have been for you keeping this secret and trying to
protect your mom’s relationship with her brother. I admire
your courage to take care of yourself given the very diffi-
cult situation you’ve been in. Do you have any ideas about
how you would want to make this better and not have this
happening?
Beth: I’m aware of child protective services. They see some of
my friends and their families. I don’t want to have to leave
my mom, and I don’t want her to be mad at me.
SSW: I agree that you should be able to stay in your home and
also to have a good relationship with your mom. You are
aware of child protective services. It is their job to help pro-
tect you and any other young person. I agree with you that
it is best when you stay at home and make it a safe place
for you and your brothers and sisters and your mom, too.
From what you have shared, it would be important to con-
tact child protective services. I know several people there,
and I would like for you to help me make this contact so
that you can make your home safe. Will you help make that
happen?
Beth: I guess … But I’m still afraid of what mom might say
and of her brother.
SSW: I understand your not wanting to upset your mom or
even your uncle. It’s not an easy decision to make. What do
you think would be the best way to handle this so that you
don’t have to deal with your uncle’s behavior and you can
feel safe?
Beth: Do you think the service worker would help me
tell my mother and help make things easier after she
finds out?
SSW: I can only say that that is exactly the work they do with
families in these situations. It’s important that you are
safe and that your family can continue to be close. And it’s
important that the worker understand what happened and
then has your help in finding the best way to work with

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118

your mom. You can meet and talk with the worker here at
school and help her understand the situation. Is that okay
with you?
Beth: Yes, if I can see her first … Okay.
SSW: Let me call her right now and let you know how this
is going to work. The basic idea is to be able to let your
mother know what has happened and help her deal with her
brother and be supportive of you. I will be available here at
school so that I can help support what you have decided to
do to make things better.

First and foremost, being a mandated reporter, the social worker would
need to make the report even if the child did not want that to happen. Yet,
it is always important to help the student have a say in what may happen
and be aware of the help being initiated. If or when substantiation occurs,
the social worker’s challenge is maintaining an appreciative and helpful
relationship with the student. Contact would generally acknowledge the
difficulties but focus on what the child can confirm as being helpful in
making their life more manageable during school. By having the student
state what it will take to keep going at this point, the social worker has
validated the student’s competencies at whatever level Beth is able to man-
age. Whether those competencies are attending classes, doing homework,
talking with friends, not fighting as much, or being less sad, all can be
appreciated for what they mean for recovery. Using scaling question may
or may not feel appropriate; if used, they can provide additional supportive
evidence of success.
The next case example illustrates how to use relationship and scaling
questions for a high school student who was removed from her biologi-
cal parents due to abuse and neglect and has recently been placed in her
second foster care home. Since the student has a social service caseworker
and a therapist, the responsibility of the school social worker is to focus on
success in school rather than on the abuse and neglect the student experi-
enced at home. The school social worker also should assist the student in
forming supportive relationships with others. This high school student has
been trying to study for a test but is struggling with confidence issues and
worried about passing the test. The following example shows how to help
with her gain confidence and, more importantly, how scaling questions can

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help reinforce the supportive relationships that exist in the student’s school
environment:

Jackie: I’m not sure if I can pass the test. I have trouble


thinking clearly. Ms. Jason, my teacher, says I can. I just
don’t know.
SSW: So, Ms. Jason says she thinks you can do it. What do
you think she knows about you that tells her that you can
do this?
Jackie: I don’t know. I couldn’t say.
SSW: You have known Ms. Jason for, what, about three semes-
ters now? If we were to ask Ms. Jason, what do you think
she would say?
Jackie: Yea, I’ve had her for most of my English classes. She’s
usually nice, and I’ve done okay in her classes.
SSW: I’m wondering where you think Ms. Jason would place
you on a scale. What I mean is if she were to use a scale
from 1 to 10, with 1 meaning that there is no way at all for
you to just pass and 10 meaning she believes you can do
very well on the exam, where do you think she would place
you on that scale?
Jackie: Umm, not sure, maybe at a 7. She really believes I can
do a lot better than I do.
SSW: So, a 7. That’s pretty good. Ms. Jason must think very
highly of you and your abilities. What do you think gives
her that idea?
Jackie: I guess I’ve done pretty well in her classes, even when
things at home were not very good. I like English, and I like
Ms. Jason. I’ve tried harder in her class. Most of the time I’ve
been able to get a good grade.
SSW: How would you make that happen? I mean, try harder
and make a good grade, not the highest grade but one you
would say was a good effort.
Jackie: It would help if I talked over my material with Ms.
Jason. That’s helped before, and I think she would do it.
I just need to ask her.
SSW: So, how would you make that happen?

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120

Jackie: I can just talk with her before or after class. She’s
usually available then.
SSW: That sounds like a good plan. Let’s see what you can
do, and maybe we can talk later this week, if that is okay
with you.
Jackie: I’ll give it a shot today. I have her class in fourth period.
SSW: Sounds good, see you later this week.

The above example probably sounds like an avoidance of the issues of


neglect or abuse. But remember, the school social worker is not engaging in
treatment; rather, the effort is to build on the student’s strengths and abilities
to thrive and do as best she can. Using scaling and having the student focus
on what she thinks the teacher would rate her is intentional. Not only does
the school social worker help the student to provide a sense of her own place
on the scale, the student is also being helped to strengthen her relationship
with an important person who cares about her and believes in her ability. In
the example above, it is a favorite teacher who provides her with safety and
with possibilities of success. This is a necessary experience for a child who
has been neglected in many ways and most likely feels abandoned by oth-
ers. Losing a sense of trust and safety must be addressed by helping to build
trust and support and safety in the school—​or even by just one teacher and/​
or the school social worker. The very fact of being focused on a potentially
positive effort and, importantly, helping the student to build a stronger and
supportive relationship with an adult is a significant factor in building the
sense of trust and safety that is reparative of the unsafe experiences in her
home placement experiences.
What about the lingering consequences of verified abuse at home and
several foster care homes, however? Ironically, if this student has remained
within the same school district, then that school likely is the only consistent
and familiar place she has. What is important for this young woman is the
ability to move on in her life and to feel supported and cared about by other
adults. By acknowledging the difficult circumstances in a manner suitable
for the student’s age and focusing on how the child is making it, at least in
school and obviously not without pain, the idea of survivorship is being laid
down, and school can be seen as a respite from the possible turmoil at home
or foster care.
The school social worker clearly has restrictions on what he or she can do.
When a report has been made and substantiated, the school social worker

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must focus on the child in the context of the school setting. Protective ser-
vices will be involved with the family, and a professional therapist or agency
specializing in abuse counseling will be working with the child on recov-
ery. However, the child may prefer the only person who has been there for
them in other ways: the solution-​focused school social worker. Students who
come to the attention of the school staff concerning neglect or abuse more
often than not have had some form of contact with the school social worker.
This may provide an initial sense of safety for sharing material that becomes
the cause of a report, and following a report, the school social worker may
be is recognized as a safe person to talk with about having some success at
school, even if just a little bit.
The age of the student will change the nature of practice, with different
forms of interaction and levels of understanding on the part of the student and
the school social worker. With an elementary-​age cohort, the school social
worker will be faced with a wide range of maturity and communication skills.
These students differ from middle school students, and even more so from
high school students. The growing transitions in physical, emotional, and
social development reflect the elementary, middle, and high school grades.
Berg and Steiner (2003) as well as Berg and Kelly (2000) demonstrate
in their work that even the youngest child has some idea about what will
make his or her life better and safe. These authors list such ideas as children
wishing for a parent or a grandparent to be with them more often at home,
not to have to stay with an aunt, to have friends, not be bullied, not have to
come to school … and the list goes on. It is very important to try to find out
their desired outcome by asking them clarifying questions. The following
session with James, a 10-​year-​old boy and the oldest child in a family with
four children, provides an example:

SSW: Hi, James, good to see you here today. Thanks for com-
ing down from class to see me.
James: Am I in trouble or something?
SSW: Not at all. You are not in any trouble. Your teacher, Ms.
Jason, told me that you had hurt yourself somehow. She saw
the bruises on your arms and wanted the nurse and me to
make sure you are okay. Ms. Johnson [the school nurse],
will see if she can help make them feel better. I haven’t seen
you for a few weeks. I see that you have a Star Wars shirt on;
who is your favorite person in the movie?

SFBT in Action: Child Abuse and Neglect121


122

James: I like Chewbacca.


SSW: Yeah, I like him, too. What do like about him?
James: He’s real strong and a friend of the other guy in the
spaceship.
SW: He is a good friend and helps his friend. Who would you
say is your best friend?
James: I guess it was Will. We moved away last summer, and
I haven’t been able to see him.
SSW: I’m sorry that you had to move away from your friend.
I bet he is missing you, too. What happened that you had to
move away from Will?
James: My father left and my mom and us had to move to
another house.
SSW: That’s a lot of changes. How have you been able to make
new friends?
James: I haven’t really made friends like Will. I play with some
of the guys my age. Mom wants me to stay more with my
brothers and sister because she is working a lot now since
my Dad left.
SSW: It sounds like you have more responsibilities now, too,
watching over your brothers and sister. Taking care of them
must not be easy. How do you do that?
James: Well, sometimes it doesn’t work out, and I get into
fights with my brothers. That’s how this happened [pointing
to his arm]. They don’t want to listen. They get mad, and we
fight a lot.
SSW: So you got the bruises from fighting with your brothers.
James: Sometimes with my sister, too.
SSW: Wow, do they get hurt, too?
James: Sometimes, but it is mostly me. The are hitting me, and
they hit my arms.
SSW: Wow, I can see how hard that must be for you. So, what
do you think would make things better? You know, so that
you would not have to fight with your brothers and sister.
James: I guess if mom didn’t have to work so much, and she
would be home.
SSW: So, how would mom being home earlier help you keep
from fighting with your brothers and sister?

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James: I wouldn’t have to keep them from going outside, keep-


ing them in the house.
SSW: That must be very hard to do. I can see how it might
turn into a fight. So, what would be different if mom was
home earlier?
James: Most of the time they listen to her, and she can get
them stop playing and eat.
SSW: I can see that you have a lot to do when your mom
is working late. How did you learn to try and help out
like that?
James: I don’t know. I just do it, I guess.
SSW: Well, it’s not easy to try and keep your brothers and sis-
ter in the house. Most kids like to run around outside after
school. Are you trying to help your mom by trying to keep
the kids inside?
James: Yeah, she works a lot.
SSW: I can see that you care about your mom a lot and are
trying to help. Kind of like Chewbacca. That is a very
important responsibility for a young man to take on. I’m
wondering, James, can you think of anything that would
help you and your mom to take care of the home when she
is working?
James: I don’t know.
SSW: Well, has there been any time when your mom is work-
ing that you didn’t have to fight with your brothers and sis-
ter to stay inside?
James: Maybe when my cousin comes over. She’s older, and
they listen better to her.
SSW: So, when your older cousin comes over, it sounds like
she is a lot of help for you and your mom.
James: Yeah, I can do what I want to and not fight my brothers
and sister.
SSW: That sounds like a much better situation for you and
your brothers and sister. I would like to ask you if it would
be alright to contact a person I know that works with fami-
lies to help out in making things little better. If I call her,
she would like to speak with you and your mom to see how
things might be a little better for you and your mom.

SFBT in Action: Child Abuse and Neglect123


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James: I guess so.
SSW: I can see that your mom loves all of you and is working
very hard to take care of you all. I’m sure that the person
I call can meet with you and your mom to see what can be
done to make it so you don’t need to get into fight with your
brothers and sister. Is that okay with you?
James: I guess.
SSW: I will get a note to you after I call and let you know what
is happening. I’m sure that Chewbacca would want that,
too. I’ll see you later today to let you know what will hap-
pen. I’ll walk you back to class now.

The interview just described could be more direct—​that is, by asking


James how he got the bruises first and gone from there. For instance: “James,
what happened? How did you get all those bruises?” Then, the work would
become focused on understanding the problem by gathering details of and
facts about what was taking place in the home. This seems to be the typical
way to have the conversation. Yet, Bannink (2014) notes that it is a “mis-
conception that there can only be sufficient acknowledgment if the problem
is wholly dissected and analyzed or if the client is afforded every opportu-
nity to expatiate [or expound] on his or her view of the problem” (p. 75).
Importantly, it might not have been such a full story as we just had with
James. The solution-​focused approach attempts to build a relationship that
makes it more likely the student will reveal more information. This can
lead to a better understanding and to potential resources, such as James’
cousin. It appears that James is a responsible child, even though he gets into
fights with his siblings. He does provide a reasonable description of what
might be considered neglect and has given a possible focus on what child
protective services might want to look into. Connecting with child protec-
tive services might also help James’ mother in terms of child care and other
family services.

Conclusion
The fundamental posture of the school social worker is one of acceptance
and support of all students. This is especially important for children who
grow up within a neglectful or abusive home environment since they are
very likely to demonstrate a range of behaviors. SFBT can be a useful

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approach when engaging students who are victims of child maltreatment.


The solution-​focused techniques have the potential to create positive expe-
riences for children who have mostly experienced maltreatment at home.
Finally, it is critical that the school social worker focus on creating a safe
support system for the students, which can play an important role in helping
students to move forward in their lives.

References
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Berg, I. K., & Steiner, T. (2003). Children solution work. New York, NY: Norton.
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Hubble, M. A., Duncan, B. L., & Miller, S. D. (1999). The heat & soul of change: What works
in therapy. Washington, DC: American Psychological Association.
Olson, K. (2014). The invisible classroom. New York: Norton.
Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological foundations of emotions,
attachment, communication, and self-​regulation. New York, NY: Norton.
Ratner, H., & Yusuf, D. (2015). Brief coaching with children and young people:  A  solution
focused approach. New York, NY: Routledge.
Rogers, C. R. (1951). Client-​centered therapy: Its current practice, implications and theory.
Boston, MA: Houghton Mifflin.
US Department of Education, Office of the Undersecretary. (2004). Educator sexual mis-
conduct: A synthesis of existing literature. Washington, DC: US Department of Education.
US Department of Health and Human Services, Administration for Children and
Families, Administration on Children, Youth and Families, Children’s Bureau.
(2013). Child maltreatment 2012. Washington, DC: US Department of Health and
Human Services. Retrieved from http://​w ww.acf.hhs.gov/​s ites/​default/​fi les/​cb/​
cm2012.pdf

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8
■ ■ ■

SFBT in Action
Mental Health and Suicidal Ideation
Carol Buchholz Holland

Prevalence of Youth Mental Health Issues


Child and adolescent mental health issues continue to be a major concern
for schools throughout the United States. After reviewing youth mental
health statistics, it is understandable why schools are diligently searching for
effective ways to meet student mental health needs. For example, in 1999,
the US Department of Health and Human Services (USDHHS) published
the Mental health: A report of the Surgeon General, which found that approx-
imately “20% of children are estimated to have mental disorders with at
least mild functional impairment” (p. 46). Friedman et al. (1996; as cited in
USDHHS, 1999, p. 46) also estimated that approximately 5% to 9% percent
of children ages 9 to 17 would meet the criteria for “serious emotional dis-
turbance.” A 2013 report by the Centers for Disease Control and Prevention
(CDC) additionally found that “a total of 13% [to] 20% of children living in
the United States experience a mental disorder in a given year” (p. 2).
A comprehensive study conducted by Merikangas et al. (2010) presented
a breakdown of mental health disorders experienced by US adolescents
(ages 13–​19) and found that 31.9% of adolescents in their study met the
criteria for an anxiety disorder, which included Agoraphobia, Generalized
Anxiety Disorder, Social Phobia, Specific Phobia, Panic Disorder, Post-​
traumatic Stress Disorder, and Separation Anxiety Disorder. Merikangas
et al. also found that 8.3% of the total adolescent study sample met the crite-
ria for severe anxiety disorders. In addition, 14.3% of the adolescents in the
study were affected by mood disorders, such as Major Depressive Disorder,

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Dysthymia, and Bipolar I or II, and 11.2% of the total sample were consid-
ered to have severe cases of mood disorders. Prevalence of behavior disor-
ders, such as Attention-​Deficit Hyperactivity Disorder, Oppositional Defiant
Disorder, and Conduct Disorder, was also assessed. The researchers noted
that 19.6% of the adolescents in the study met the criteria for a behavior
disorder and that 9.6% of these adolescents were considered to have severe
behavior disorders.
Merikangas et al. (2010) also reported information regarding the average
onset of specific mental disorders for adolescents in the study who met the
criteria for a disorder. Their results indicated that 50% of the adolescents
who met the criteria for anxiety disorders had their onset by age 6, 50% who
met the criteria for mood disorders had their onset by age 13, and 50% who
met the criteria for behavior disorders had their onset by age 11. In addi-
tion, the incidence rate for major depression and dysthymia nearly doubled
from 13 to 14 years of age to from 17 to 18 years (Merikangas et al., 2010).
Furthermore, the National Alliance on Mental Illness (NAMI) (2014) issued
a report stating that “half of all long-​term mental illness begins by age 14
and three quarters emerges by age 24” (p. 17). These statistics demonstrate
the importance of providing comprehensive mental health prevention and
intervention programs in schools because the age of onset for mental health
disorders often occurs during the elementary or middle school years.
In the latest national Youth Risk Behavior Survey (YRBS) report of stu-
dents in grades 9 through 12 who attend either public or private schools
in the United States, 29.9% of the surveyed students indicated that they
“had felt so sad or hopeless almost every day for 2 or more weeks in a row
that they stopped doing some usual activities” sometime during the 12
months before completing the survey (USDHHS, 2014, p. 11). In addition,
survey results indicated that “17.0% of students had seriously considered
attempting suicide during the 12 months before the survey” and that 13.6%
of the students “had made a plan about how they would attempt suicide”
(USDHHS, 2014, pp. 11–​12). Although survey results between 1991 and
2009 showed decreases for these statistics, results between 2009 and 2013
revealed increases in the percentage of students who indicated that they
had seriously considered attempting suicide (13.8% to 17%) and that they
had made a suicide plan (10.9% to 13.6%). The 2013 survey also reported
that 8% of students “had attempted suicide one or more times during the
12 months before the survey,” an increase from the 2009 survey that had
revealed 6.3% of students indicated they had attempted suicide (CDC, n.d.-c,

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128

p. 1). It is uncertain whether data collected from the 2015 YRBS will con-
tinue to show increases in student responses for these survey items. Recent
statistics provided by the National Center for Health Statistics, however,
show that suicide is now ranked as the second-​leading cause of death for
individuals ages 15 to 24 (the leading cause being unintentional injury)
(CDC, n.d.-a). Before 2011, suicide had been ranked for several years as the
third-​leading cause of death for individuals ages 15 to 24 (CDC, n.d.-b).
The number of students who need additional services is a growing con-
cern for schools. Because the stigma associated with mental health prob-
lems still exists in our society, some students and their families may be
reluctant to seek these services outside of the school setting (Murphey,
Barry, & Vaugh, 2013). This continued reluctance strengthens the case for
providing school-​based mental health services. Although most schools do
not have unlimited resources, they are often the main provider of mental
health services for children (Hoagwood & Erwin, 1997). In many cases,
schools are the first place where student mental health issues are identified
and addressed. Erford, Newsome, and Rock (2007) stressed that students
with mental health needs who do not receive assistance may develop more
serious issues, which could have significant negative impacts on their edu-
cation. For example, untreated mental health problems could result in poor
academic performance or even the decision to drop out of school. In addi-
tion, untreated mental health issues could result in even more serious safety
concerns, such as harm to self or others. The December 2014 report by the
NAMI noted that “children and youth who receive prompt, effective mental
health care demonstrate surprising resilience, overcoming major challenges
to thrive in school, home and the community” (pp. 17–​18). As a result, it is
important for schools to take the lead in providing effective prevention, early
identification, and early intervention of student mental health concerns.

Student Risk and Protective Factors


After a serious review of youth mental health statistics, bills for the Mental
Health in Schools Act of 2015 were introduced in the U.S. House of
Representatives (H.R. 1211)  and Senate (S. 1588)  during 2015 (Congress.
gov, 2015a, 2015b). These bills proposed an amendment to the current
Public Health Service Act. Part of this amendment included the requirement
of comprehensive school-​based mental health programs that use a public
health approach and are designed to assist children who have experienced

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trauma and violence. Fortunately, there has been movement away from
using the traditional disease model in schools, which only provides treat-
ment after an illness has occurred (O’Connell, Boat, & Warner, 2009).
Instead, schools have shifted more toward utilizing prevention and inter-
vention models, which are designed to strengthen resiliency by building
capacity and to identify risk and protective factors.
Rak and Patterson (1996) defined resiliency as “the capacity of those
who are exposed to indentifiable risk factors to overcome those risks and
avoid negative outcomes such as delinquency and behavioral problems,
psychological maladjustment, academic difficulties, and physical complica-
tions” (p. 368). In addition, Galassi and Akos (2007) noted that “resiliency
research has repeatedly demonstrated that, contrary to popular belief, most
people are not permanently overwhelmed by and irreparably damaged by
exposure to life circumstances” (p. 33). Strengths-​based approaches such as
the solution-​focused approach are bolstered by resiliency research findings
supporting the belief that human beings have “self-​r ighting tendencies that
move children toward normal adult development under all but the most
persistent adverse circumstances” (Werner & Smith, 1992, p. 202). These
“self-​righting tendencies” align with the solution-​focused assumption that
all people are capable of change. In other words, resiliency is a part of the
“healthy human development” process (Bernard, 1991, p. 18).
While examining methods for developing the capacity of individuals,
risk factors and protective factors are also considered. The Massachusetts
Executive Office of Health and Human Services (MEOHHS) identified five
domains in which risk and protective factors are categorized. These domains
include individual, peer, family, school, and community/​society (MEOHHS,
n.d.). O’Connell et  al. (2009) defined a risk factor as “a characteristic at
the biological, psychological, family, community, or cultural level that
precedes and is associated with a higher likelihood of problem outcomes”
(p. xxviii). Examples of risk factors associated with adolescent suicidal
behavior include aggressive and violent behavior (Walrath et  al., 2001),
alcohol and other illicit drug use (King et al., 2001; Wichstrom, 2000), anxi-
ety (Groholt, Ekeberg, Wichstrom, & Haldorsen, 2000; Ruchkin, Schwab-​
Stone, Koposov, Vermeiren, & King, 2003), experiencing or witnessing
violence (Brown, Cohen, Johnson, & Smailes, 1999; Ruchkin et al., 2003),
family distress (Breton,Tousignant, Bergeron, & Berthiaume, 2002; King
et al., 2001), hopelessness (Csorba et al., 2003; Perkins & Hartless, 2002),

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and risk behaviors (Beautrais, 2001; Fergusson, Beautrais, & Horwood,


2003; Gray et al., 2002; King et al., 2001).
O’Connell et al. (2009) also defined a protective factor as “a characteristic
at the biological, psychological, family, or community (including peers and
culture) level that is associated with a lower likelihood of problem outcomes
or that reduces that negative impact of a risk factor on problem outcomes”
(p. xxviii). Protective factors can work in different ways, such as “shield-
ing” a child from “experiencing a risk factor,” reducing a child’s “exposure
to risk,” and reducing “the impact of a risk factor” (Kids Matter, n.d., pp.
3–4). In addition, the National Association of Social Workers (NASW, n.d.)
noted that protective factors have the ability to 1) serve as building blocks
for developing resilience, 2) “protect and nurture adolescents in high risk
situations,” 3) “promote well-​being,” and 4) “reduce the likelihood of teen-
age suicide” (p. 1). Examples of protective factors against suicidal behaviors
include connectedness to community or school (US Public Health Service,
1999), coping and problem-​solving skills (Piquet & Wagner, 2003), family
support (Perkins & Hartless, 2002), and positive self-​concept or self-​esteem
(Fergusson et al., 2003).
Walsh and Eggert (2007) conducted a study that involved 730 US high
school students who were experiencing school problems. These students
were assessed for suicidal behaviors, risk factors, and protective factors.
Based on data from the suicidal behavior assessment, students were divided
into two subgroups:  suicide risk (SR) and non-​suicide risk (NSR). Data
pertaining to risk and protective factors from the two subgroups (SR and
NSR) were further analyzed. The statistical analysis revealed that SR youth
reported significantly higher levels of risk factors pertaining to emotional
distress (depression, anxiety, hopelessness, and anger) compared with NSR
youth. Although no statistically significant difference in alcohol and mari-
juana use was found between the SR and NSR groups, a significantly higher
level of other illicit drug use by the SR group was observed. Walsh and
Eggert also reported that the “SR youth were significantly more likely than
NSR youth to have engaged in high-​risk behaviors, and to have reported
witnessing or being a victim of violence” (p. 355). In regards to protective
factors, SR youth reported significantly lower levels of all protective factors
(self-​esteem, personal control, problem-​solving coping, amount of support,
support availability, and family support satisfaction) compared with the
NSR youth.

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Walsh and Eggert (2007) recommended that an “examination of pro-


tective factors” be included in SR assessments (p.  357). This inclusion of
protective factors in SR assessments has a great deal of potential and merits
additional research. Although traditional suicide assessments tend to focus
only on risk factors and levels of suicidal ideation, strengths-​based suicide
assessments acknowledge students’ existing protective factors. The NASW
(n.d.) stated that “targeting and eliminating risk factors may reduce the
occurrence of suicide,” and that prevention efforts are more effective when
protective factors are strengthened concurrently while reducing risk factors
(p. 2). To bolster protective factors, however, they must first be identified.
The solution-​focused approach is well suited for helping increase students’
protective factors. Solution-​focused school social workers assist clients in
building their own capacity by focusing on the clients’ strengths, coping
skills, exceptions, and past successes. Due to the high number of students
with mental health issues, it is not surprising that the solution-​focused
approach in school settings continues to grow in popularity because it is
time limited, student focused, and strengths based.

How the Solution-​Focused Approach Differs from


Other Counseling Approaches
Most traditional counseling approaches focus efforts on discovering the
explanations for why problems occur in order to resolve those problems
(Birdsall & Miller, 2002). Unfortunately, uncovering the reasons why prob-
lems occur is not always helpful to students. For example, when the causes
of problems are identified and/​or highlighted, they are sometimes used by
students as a “scapegoat to inhibit personal growth” or as reasons for why
they cannot succeed (Sklare, 2005, p. 14). When students are dealing with
multiple issues or experiencing suicidal ideation, they might become over-
whelmed if therapeutic conversations focus primarily on their problems
and the reasons for them. After hearing some of their personal stories, it
is not surprising why some students feel even more hopeless or helpless,
and why they shut down in counseling sessions. In addition to focusing
on the reasons why problems occur, many counseling approaches such as
cognitive-​behavioral therapy (CBT) focus on “avoid goals” (Bannink, 2012,
p.  14). For example, a traditional CBT school social worker might help a
student develop avoid goals that involve the student identifying what he or
she no longer wants in life, such as “I don’t want to be depressed anymore.”

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The CBT school social worker often takes the role of an expert and makes
recommendations about how the student could solve his or her problem(s).
On the other hand, a typical solution-​focused school social worker would
facilitate a conversation with the student and assist that student in developing
“approach goals” (Bannink, 2012 p. 14). Approach goals are formed when a
student describes the preferred future and what he or she wants in life, such
as “I want to be happier” or “I want to make more friends.” The solution-​
focused approach redirects attention and energy toward identifying what
possible solutions may already exist instead of concentrating on problems.
The inductive process incorporated within the solution-​focused approach
is similar to the trial-​and-​error method that students use to learn. Based
on her experiences working with children, Insoo Kim Berg concluded that
children do not need or want to know what caused their problems (Berg &
Steiner, 2003). Instead, children would rather experiment to see what does
and does not work for them. Use of the solution-​focused approach in schools
has been found to be effective because it is congruent with “how children
think and view the world” (Berg & Steiner, 2003, p.  xv). Its time-​limited
nature is especially useful for school-​based mental health school social
workers who might have large caseloads but not large amounts of time to
work with students (Littrell, Malia, & Vanderwood, 1995). In addition, stu-
dents are more likely to become engaged in a counseling session that focuses
on their positive traits instead of their deficiencies (Sklare, 2005). Engaging
students in the counseling process is especially important when working
with students who are in crisis.

The Case of Brie and the Identification of Suicidal Ideation


Knowing how to recognize and respond to students’ suicidal ideation is one
of the biggest concerns and challenges for many school-​based mental health
school social workers. The following case study of Brie illustrates how the
solution-​focused approach may be used with a student who is experiencing
suicidal ideation.

Brie is a 16-​year-​old sophomore. Brie’s mother has encouraged


her to see Ms. Burns, a school social worker. Last year, Brie had
worked with a different school-​based mental health counselor
who retired at the end of last year. Prior to their scheduled meet-
ing, Ms. Burns had not worked with Brie. Although Brie has
dealt with anxiety and depression in the past, she has become

132 Solution-Focused Brief Therapy in Schools


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more withdrawn and more resistant about going to school over


the past couple of months. In addition, her grades have dropped
significantly. Brie shuts down whenever her mom asks about
why Brie doesn’t want to go to school. Brie’s mom is hoping Ms.
Burns can find a way to get Brie to open up so that Brie can get
the help she needs.

The following recommendations are used to help explain how Ms. Burns
will approach her first session with Brie. These recommendations are also
designed to be used with any student who is experiencing suicidal ideation.
Although it is not discussed within the recommendations described below,
please note that the solution-​focused school social worker, Ms. Burns, has
already gone through the informed consent process with Brie.

1. Develop Rapid Rapport with the Student by Using “Problem-​Free Talk”


at the Beginning of the Session
When working with a student who is in crisis, it is important to develop
rapid rapport and find a way to join with the student (Berg, 1994). Fiske
(2008) also pointed out that it is essential to get a client’s attention in order
to join with the student in the counseling process. She suggested that the
solution-​focused school social worker begin a session by focusing on “what-
ever is salient, relevant, and important” to the client (p. 7). This information
could be discovered by using “problem-​free talk” with the student (Henden,
2008, p.  77). Henden (2008) stressed that the first 10 minutes of a ses-
sion are critical in the development of a counseling relationship. A student
can either become engaged in the counseling process or begin to withdraw
internally. It is imperative not to rush into talking about the student’s prob-
lem before some level of rapport has been established. Without rapport,
trust between the student and the solution-​focused school social worker is
difficult to develop. Conveying the core conditions of unconditional posi-
tive regard, empathy, and congruence can also have a significant impact
on a counseling relationship (Rogers, 1951). Sharry, Darmody, and Madden
(2002) noted that an effective solution-​focused school social worker is one
who “communicates empathic understanding, while also communicating a
belief in the strengths of the client and in the possibility that they can make
things different” (p. 387).
Because of the developmental stage they are in, some adolescents may
be distrustful of adults when they begin the counseling process (Hopson &

SFBT in Action: Mental Health and Suicidal Ideation133


134

Kim, 2004). It is helpful for solution-​focused school social workers to be


aware of this potential challenge when they work with students, especially
adolescents. Fortunately, “solution-​focused therapy is well-​suited for work
with adolescents in crisis because their stage of development may cause
them to feel resentful of a more directive or problem-​focused approach to
therapy” (Hopson & Kim, 2004, p. 97). Henden (2008) noted that mak-
ing a shift from a problem-​focused conversation to a problem-​free talk is a
“great way to tap into the client’s strengths, personal skills and resources
before even the first detail of the problem is heard” (p. 77). Most solution-​
focused social workers will ask students about their interests, things they
like to do, or activities/​teams they are involved in both at and outside of
school.
Here is an example of a problem-​free question that can be used to elicit
this useful information:

Brie, what do you like to do in your free time when you are not
in school?

For case students who are very depressed and state that they are no longer
doing anything that they enjoy, the mental health school social worker could
ask this follow-​up question:

So, before you started feeling really down, what did you used to
do that you enjoyed?

Henden (2008) also discussed that problem-​free talk can serve four
different purposes: 1) It can normalize the interaction between the stu-
dent and the mental health school social worker because “it is an even
relationship; not ‘one up’ ”; 2) it allows the solution-​focused school social
worker and the student to acknowledge the student’s “strengths, skills,
and resources”; 3)  it “creates a context of competence” for the student
because the focus is not on the student’s challenges or problems; and 4) it
provides an opportunity for the solution-​focused school social worker to
engage with the student, and not the student’s problem (pp.  78–​79). In
addition, it is helpful to remember that problem-​f ree talk is not small talk
with a student. It is actually a valuable therapeutic tool used to increase
client engagement.

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2. Ask for a Brief Description of the Student’s Concern


After initially engaging in problem-​free talk with a student, a solution-​
focused school social worker may ask a student who has self-​referred for
counseling one of the following questions:

Brie, what are you hoping that we can accomplish by working


together?
Brie, what were you hoping would happen when you asked to
meet with me? (Hess, Magnuson, & Beeler, 2012)

By asking one of these questions, the school social worker is placed in a


“not knowing” position, which may help to counter any preconceptions that
might arise about the student’s situation and what the student might need
from school social worker (De Jong & Berg, 2008, p.  215). To clarify the
student’s primary concern, the solution-​focused school social worker can
ask follow-​up questions such as:

What concerns you most about this situation?


What is the hardest part of this for you? (Hess et al., 2012,
p. 150)

If a student was referred to counseling by someone else, such a teacher


or a parent/​g uardian, the school social worker may need to approach these
initial questions a little differently. For example, the solution-​focused school
social worker could ask the student:

What do you think [person who referred the student] is hoping


that you and I accomplish by working together?

Students who are referred by other people may be more reluctant to engage
in the counseling process or voluntarily share information, which is under-
standable, especially since these students were not the ones who initially
asked for help. Solution-​focused school social workers strive to be respect-
fully curious when working with students. One simple way of demonstrat-
ing respect to a student is simply by asking the student for permission to
ask a question, especially if asking about a sensitive topic. For example, a
solution-​focused school social worker could ask:

Brie, would it be okay if I asked you about … ?

SFBT in Action: Mental Health and Suicidal Ideation135


136

Although this question might seem redundant and simplistic, it actually


conveys a great deal of respect because some students may view unsolicited
questions from mental health school social workers as very intrusive. In
addition to demonstrating respect for the student, this question may help to
develop a strong therapeutic relationship.
To encourage the student to give a brief problem description, the school
social worker could ask:

Brie, what would be most helpful for me to know about your


situation?

This question is also respectful because it allows the student to decide what
information he or she feels is most important for the mental health school
social worker to know. When working with clients who had experienced
trauma, Dolan (1991) would ask them disclose “only what was necessary
for healing” (p. 142). It is important that students feel like they still retain
substantial control over the content of information shared in counseling ses-
sions. In addition, solution-​focused school social workers need to convey to
their clients that they are interested in identifying what would immediately
benefit the student, not in identifying and focusing on the causes of their
problems (Fiske, 2008). When solution-​focused school social workers are
successful in communicating this, they are more likely to see clients who
1) open up more freely, 2) engage in the counseling process, and 3) return for
follow-​up sessions if they need additional assistance (Fiske, 2008).
Henden (2008) noted that some critics of the solution-​focused approach
believe that solution-​focused school social workers “are not interested in
hearing about problems” (p. 80). Henden countered this criticism by stating
that solution-​focused school social workers do spend time listening to cli-
ents’ problems. In fact, Sharry et al. (2002) stated that the solution-​focused
approach “is not problem or pain phobic” (p. 387). Furthermore, “clients need
to feel that their problems and difficulties are taken seriously, that their suf-
fering is acknowledged and that they are not blamed for the problem” (Sharry
et al., p. 387). Solution-​focused school social workers also realize, however,
that too much time spent focusing exclusively on client problems can be coun-
terproductive for students (Henden, 2008). In addition, Henden (2008) com-
mented that clients will return to “problem talk” if they felt that their mental
health school social workers had heard enough about their problems (p. 105).
Sharry et al. (2002) also recommended that while a client is describing his or

136 Solution-Focused Brief Therapy in Schools


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her problems, a solution-​focused school social worker should actively listen


for the strengths and coping skills that the client has already used.

3. Assess for Incongruence
Although some students may provide verbal and non-​verbal communication
that clearly indicates they are experiencing suicidal ideation, others may not
provide congruent information. In addition, it is possible for a student with
suicidal ideation to initially tell a school social worker that he or she is not
suicidal when asked a direct question about such ideation. Therefore, it is rec-
ommended that a solution-​focused school social worker simultaneously assess
for any incongruences between the student’s verbal and non-​verbal commu-
nication while the student is describing his or her problem (Henden, 2008).
Incongruence may be a warning sign that the student is dealing with suicidal
ideation that has not been explicitly expressed to the school social worker.

4. Ask Questions Designed to Elicit Suicidal Ideation if Present


When a solution-​focused school social worker has concerns (even if just be
at a gut-​feeling level) that a student might be experiencing suicidal ideation,
the social worker needs to ask one or two questions designed to elicit any
hidden suicidal ideation that the student is experiencing. For example:

Brie, I’m sensing that you are going through a really tough time
right now. Am I understanding your situation correctly?

If the student expresses that he or she is, in fact, going through a difficult
time, it is helpful for the solution-​focused school social worker to ask a scal-
ing question to quickly assess the situation. For example:

Brie, on a scale of 1 to 10, with 1 being not well at all and 10


being very well, how well do you feel right now as you are talk-
ing with me?

If the student then indicates that he or she is not doing well, or if the solution-​
focused school social worker senses that the student may have deeper con-
cerns, the social worker could ask the student one of the following questions
for clarification:

Brie, on a scale of 1 to 10, with 1 being close and 10 being not


close at all, how close do you feel right now to ending your life?

SFBT in Action: Mental Health and Suicidal Ideation137


138

Brie, on a scale of 1 to 10, with 1 being very suicidal and 10


being not suicidal at all, how suicidal do you feel right now?

It is surprising how honest many students are about revealing their


suicidal ideation when asked a scaling question. Since some students may
struggle to choose descriptive words to convey their personal pain, they
may find it easier to use a number on a scale to represent how they are feel-
ing. This basic number can provide a great deal of information and even
help prompt a meaningful conversation between the student and the mental
health school social worker.

5. Engage the Student in a “Coping Dialogue” if the Student Is Not Ready


to Start the Goal Formation Process
De Jong and Berg (2008) stressed that after suicidal ideation has been iden-
tified, the solution-​focused school social worker needs to get a sense of
whether a client has the “immediate capacity” to move into the goal forma-
tion process (p. 233). In addition, they pointed out that “the major difference
in working with clients in crisis is that fewer of them accept the invita-
tion to engage in goal formation” (p. 233). Instead of jumping into the goal
formation and solution-​building process, some clients in crisis seem more
entrenched in focusing on their problems. As a result, De Jong and Berg rec-
ommended that in these cases, solution-​focused school social workers put
the goal formation process on hold and shift their attention to asking their
clients coping questions. When the timing is appropriate, solution-​focused
school social workers can shift back to the solution-​building process.
Coping questions help “uncover small, undeniable successes that a
shaken, overwhelmed client is experiences in day-​to-​day or moment-​by-​
moment coping” (De Jong & Berg, 2008, p. 233). For example, a solution-​
focused school social worker might highlight a student’s small coping
success by asking:

Brie, I have question you. What helped you get out of bed this
morning so that you could make it to school on time and we
could meet together today?

De Jong and Berg (2008) stressed the importance of identifying a client’s


“microsuccesses,” especially when the client might be extremely over-
whelmed or feeling very defeated (p. 233). These microsuccesses build over
time, which in turn can help increase a client’s confidence and energy level.

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Once the client’s confidence and energy have increased a little, the school
social worker can return “to goal formation on a more limited basis by
using scaling questions to help clients formulate their next steps in coping”
(p. 233). Fiske (2008) also pointed out that an important role of solution-​
focused school social workers is to help their clients “develop longer lists of
coping strategies, including more life-​affirming alternatives” (p. 157)
The following coping questions and statements have been slightly modi-
fied from Henden’s (2008) original versions. These questions are presup-
positional in nature and designed to help build on hope. In addition, they
are designed to be empowering and affirming of the student. An opening
question could be:

Brie, tell me about a time in the last couple of weeks when you
felt the least suicidal.

This question can be used as a lead-​in for asking coping questions such as
the following:

Brie, what has stopped you from ending your life up to this point
in time?

This question is designed to identify possible reasons for living. Fiske (2008)
stated that “identifying, highlighting, and reinforcing reasons for living is
key to engaging in helpful conversations with individuals who are viewing
suicide as a solution to their problems” (p. 8). The solution-​focused school
social worker may also ask:

Brie, what have you done in the last couple of weeks that has
made a positive difference on dealing with your tough situation?

If the student shares with the solution-​focused school social worker that
he or she has experienced suicidal ideation in the past, the solution-​focused
school social worker could ask the student the following coping question:

Brie, what did you do back then when you had suicidal ideation
that helped you make it through that difficult time?

This coping question encourages the student to explore coping skills that he
or she already possesses and to identify times when the student successfully

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140

dealt with a difficult period (in other words, highlighting a “past success”).
The solution-​focused school social worker might also ask a scaling ques-
tion designed to elicit information about the student’s current coping ability
such as:

Brie, on a scale of 1 to 10, with 1 being very weak and 10 being


very strong, how strong do you think your coping skills are now
as you are talking with me?

This coping question is very important because the solution-​focused school


social worker can use it to encourage students to self-​evaluate whether they
feel capable of using their current resources (coping skills) or need addi-
tional resources. De Jong and Berg (2008) stated that “if you have engaged a
client in a coping dialogue and the dialogue reveals few if any current cop-
ing capacities, the client often comes to realize that he or she needs more
intensive care and monitoring” (p.  233). Student who come to their own
realization that additional help is needed may be more likely to accept help
and engage in the solution-​building process.
In traditional suicidal ideation assessment, great emphasis is placed on
the problem assessment, which is designed to get as many details about
the student’s suicidal ideation as possible. For example, a CBT school
social worker might use a common suicide assessment acronym PLAID
(Plan, Lethal means, Attempts, Intent, Drugs/​alcohol) to formulate ques-
tions for the student (Granello & Granello, 2007, p.  47). Gathering these
details is often the main focus of the conversation between the traditional
school social worker and the student. As discussed earlier, and in contrast,
solution-​focused school social workers spend more time focusing on stu-
dents’ coping skills and strengths instead gathering a detailed description of
the problem. Sometimes, however, a solution-​focused school social worker
may need to gather more detailed information about a problem. In those
cases, the solution-​focused school social worker might ask:

Brie, if you decided to go ahead with the option to end your life,…


a. How prepared are you if you decided to do this? (This
question could also be turned into a scaling question.)
b.  What method would you use? (Henden, 2008, p. 129)

Ironically, students are likely to share more information about their prob-
lems during coping dialogues than during formal problem assessments.

140 Solution-Focused Brief Therapy in Schools


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De Jong and Berg (2008) strongly believed that the best chance for helping
clients/​students who are experiencing suicidal ideation is to “mobilize their
strengths and reestablish a sense of control over their emotions and circum-
stances” by asking “coping questions” and by encouraging the students to
“amplify their answers” (p. 224).

6. Acknowledge, Validate, and Normalize a Student’s Feelings


If a student’s suicidal ideation has been identified, it is important to acknowl-
edge, validate, and normalize the student’s feelings.

Acknowledge
Henden (2008) believed clients who are suicidal have an “intuitive radar”
and can detect whether a mental health school social worker is being “genu-
ine, and has some degree of appreciation of their pain and suffering” (p. 91).
It could also be argued that many adolescents by nature are very percep-
tive and can sense if adults are being sincere. Therefore, it is very impor-
tant for the school social worker to acknowledge the adolescent’s pain in an
authentic manner. For example, the solution-​focused school social worker
could state:

Brie, from what you’ve told me about your situation at home,


you have given me a pretty good idea about how difficult it is for
you right now.

By their problems acknowledged, student are more likely to feel understood


by the solution-​focused school social worker and engage in a therapeutic
relationship (Henden, 2008).

Validate
In addition to acknowledging students’ pain and challenges, it is impor-
tant to validate their feelings and their suicidal thoughts. De Jong and Berg
(2008) noted that the first impulse of some beginning school social work-
ers is to try convincing suicidal clients that “suicide is illogical, dangerous,
and hurtful to others, or an otherwise distorted response to their situation”
(p. 223). Unfortunately, taking this approach with a student who is suicidal
may unintentionally increase the risk of suicide (Henden, 2008). By refuting
or challenging the student’s ideas, the school social worker may cause the
student to feel even more isolated, which obviously has a negative impact the
therapeutic relationship (De Jong & Berg, 2008). Adolescents may already

SFBT in Action: Mental Health and Suicidal Ideation141


142

be distrustful of adults, so invalidating their perceptions could have poten-


tially serious consequences.
A traditional school social worker might be tempted to ask:

Brie, why would you consider suicide when you have so much
to live for?

However, asking students “Why” they did (or are doing) something can often
put students on the defensive and shut them down from sharing more infor-
mation. In addition, “Why” questions inadvertently convey that a judgment
is being made by the school social worker (Sharry et al., 2002). Instead, a
solution-​focused school social worker finds it more productive to validate a
student’s thoughts or actions by stating:

Brie, based on everything that you’ve shared with me, it’s under-
standable that you are having some suicidal thoughts.

By validating and viewing a student’s suicidal ideation as an attempt to find


a solution to an overwhelming problem, the solution-​focused school social
worker strives to reduce the student’s feelings of shame or inadequacy about
his or her coping skills (Hawkes, Marsh, & Wilgosh, 1998). In addition, the
solution-​focused school social worker hopes to engage the client in a collab-
orative process of identifying more effective coping methods that the client
has used in the past.

Normalize
Henden (2008) noted that “many suicidal clients express the view that, as
a result of having suicidal thoughts and ideas, they must be going mad”
(p. 92). Normalizing a student’s suicidal ideation or feelings is an important
part of helping someone who might also be feeling that he or she is losing
control over life or his or her mind. Henden (2008) provided this helpful
example of how to normalize a student’s suicidal ideation:

Most people who are feeling trapped or defeated by a challeng-


ing situation in their lives, have suicidal thoughts from time to
time. It is a normal response, by normal people, to abnormal set
of circumstances. (p. 92)

142 Solution-Focused Brief Therapy in Schools


 143

These powerful words could be very comforting and affirming to a client


who might be afraid to seek assistance in coping with suicidal ideation.

7. Assist the Student with the Goal Formation Process


Remember that students who are suicidal or in crisis build solutions through
the same process used by other clients (De Jong & Berg, 2008). As noted
earlier, however, a coping dialogue may need to take place before a suicidal
student is ready to move into the goal formation process. When it is time
to start developing goals, solution-​focused school social workers commonly
ask a miracle question. But the typical miracle question often used to help
form goals with students who are not in crisis may need to be adapted for
students who are experiencing suicidal ideation.
Henden (2008) recommended the miracle question be “adapted in such
a way that the exclusion of suicidal thoughts and feelings is the miracle”
(p. 141). Here is an example based on Henden’s (2008) suggestion:

Let’s suppose that while you are sleeping in your bed tonight, a
miracle happens. The miracle is that all of your suicidal thoughts
and feelings are gone. However, you don’t know this miracle
has taken place because you were sleeping. When you wake up
the next morning, what would be the first sign to you that this
miracle happened?

After asking this miracle question, the solution-​focused school social worker
tries to get as many details as possible about what the student is doing. The
richness of these details will provide valuable information that can be used
to assist the client in developing his or her “SMART+” goals (“small, mea-
sureable, achievable, realistic, and time limited”), which also include the
presence of “some positive behavior, rather than the absence of negative
behaviors” (Henden, 2008, p. 81). For example, the solution-​focused school
social worker could ask:

Brie, what would you be doing? … What else? … Okay, and


what else?

The focus here is on identifying the student’s positive behaviors and actions.
It is also helpful to ask a relationship question such as:

Brie, what would other people notice you doing?

SFBT in Action: Mental Health and Suicidal Ideation143


144

By asking a relationship question that encourages the student to view things


from a third-​person perspective, it may be easier for the student to provide
richer details and ideas that can in turn be used to help develop goals.
When solution-​focused school social workers use the miracle question
to shift the focus to what a student wants or is trying to achieve through
suicide, the school social worker subtly encourages the student to evaluate if
suicide is the best alternative to getting it. De Jong and Berg (2008) also rec-
ommended tailoring the miracle question to fit each client’s situation. They
explained that “it is important to scale down the miracle” if the client had
experienced a “major disruption” in his or her life (De Jong & Berg, 2008,
p. 220). For example, the miracle might involve the student being able to
sleep a little better or make it to school on time.
After collaborating with the student to set a goal, it is helpful to ask a
scaling question to assess the student’s motivation or confidence about com-
pleting his/​her goal. For example:

Brie, on a scale of 1 to 10, with 1 being not confident at all


and 10 being extremely confident, how confident are you about
achieving this goal?

This question can easily be modified to ask the student how “motivated” he
or she is to accomplishing the identified goal.

8. Encourage the Student to Go Slow and Take Very Small Steps


Sharry et  al. (2002) explained that developing goals with clients “who
have felt so immersed in their problems that they attempted suicide” can
be challenging and may take time (p.  392). The solution-​focused school
social worker needs to take things slow, however, and look for other ways
of encouraging students to develop positive goals. Metcalf (1995) also
noted that “change takes time” and that “the best changes occur over time”
(p. 86). As a result, she encouraged students to “take small steps” (p. 86).
Furthermore, Metcalf recommended that solution-​focused school social
workers caution their students to go slowly through the counseling process.
With this caution in mind, students might be less likely to perceive their
slow progress as a failure. Henden (2008) also described the importance
of encouraging clients to take “small steps or ‘baby steps’ ” in counseling
(p. 148). When working with clients who are suicidal or in crisis, Henden
adapted this recommendation by encouraging clients to take “very, very
small steps” (p. 148).

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 145

9. Assist the Student in Identifying Exceptions


One important task of the solution-​focused school social worker is to work
collaboratively with a student to “tap into hope” (Fiske, 2008, p. 16). Since
hopelessness is a major risk factor for suicidal behavior, building hope
within a student dealing with suicidal ideation is even more imperative
(Csorba et al., 2003; Perkins & Hartless, 2002). A basic assumption of the
solution-​focused approach is that no problem is constant and the intensity
of the problem fluctuates (Murphy, 1997). One effective method for tapping
into hope and building upon it is to aid students in identifying exceptions
(times when the problem is not occurring, is less frequent, or less severe).
Hendon (2008) noted that it is helpful to look for exceptions after infor-
mation is gathered by asking a miracle question. For example:

Brie, I’m curious to know if a small part of your miracle has hap-
pened, or if a small part of it is happening today. Tell me more
about the last time you felt a little better.
So, Brie, I’m curious about the last time you were feeling a
little less suicidal. What were you doing (or thinking) differently
than you are today?

Follow-​up questions may include:

How did you make that happen? … What else? … Okay, and
what else?
How did you decide to do that?
What did you discover by doing that?
What would happen if you tried that again?

Other options of exception-​finding questions include:

What was different about the time you were in emotional crisis
but did not consider suicide as an option? (Fiske, 2008, p. 46)
What is different about those times that you are not thinking
about suicide? (Fiske, 2008, p. 46)

Follow-​up questions amplify the exceptions. Murphy (1994) described


the 5-​E method, which was designed to recognize and use exceptions that
exist in students’ lives. Solution-​focused school social workers using the 5-​E
method can assist students to 1) elicit times when the problem is absent, less
intense, or less frequent; 2) elaborate on the conditions and features of these

SFBT in Action: Mental Health and Suicidal Ideation145


146

times; 3) expand these identified exceptions to other contexts; 4) evaluate


these exceptions using pre-​established goals; and 5) empower the client to
maintain positive change over time (Murphy, 1994). Since exceptions are
often overlooked, solution-​focused school social workers need to be very
intentional in identifying and amplifying these “microsolutions” (Sharry
et al., 2002, p. 392).

10. Compliment the Student
Complimenting students is an effective method for highlighting and reinforc-
ing students’ strengths and resources. Remember, however, that solution-​
focused compliments should be based in reality and are not given just to be
“nice” or “kind.” There are also different forms of solution-​focused compli-
ments, such as direct verbal compliments and indirect verbal compliments
(Fiske, 2008). A direct verbal compliment is a positive reaction or evaluation
by the solution-​focused school social worker in response to what the student
has shared in a session. For example:

Wow, Brie! I’m sure that must have been difficult for you to
confront your friend about her hurtful comments and yet your
found the courage to do it.

An indirect compliment involves inviting the student through the use of


a question to describe what the student did and what worked well for the
student. For example:

Wow, Brie, how did you manage to get the courage to confront
your friend about her hurtful comments?
What did your friend notice that you did well in how you
approached this situation?

Both types of compliments encourage students to reflect on their own com-


petence. In addition, they may result in students giving a self-​compliment
when explaining how and what they did to make things happen.
Compliments that are given near the end of a session can also get a stu-
dent’s attention and encouraging the student to become more receptive to
carrying out therapeutic tasks after the session (Henden, 2008). For example:

Brie, a couple of things that really stand out to me from our


conversation today is how determined you are to feel better and

146 Solution-Focused Brief Therapy in Schools


 147

how willing you were to share some of your coping mechanisms


with me. I’m impressed by your actions especially since I know
it isn’t easy for you to open up to adults.

11. Provide Bridging Statements, and Identify Tasks


After the solution-​focused school social worker has given compliments
and begins the process of wrapping up the session, he or she will use
bridging statements that link to therapeutic tasks. Henden (2008) noted
that a “bridging statement at the end of a particular session is most likely
to refer to something which has arisen during the session that can be used
as a small step in their homework before the next session.” (p. 101). For
example:

Brie, today you mentioned that you felt a little better when you
volunteered at your grandmother’s nursing home. Would you be
interested in having arrangements made for you to spend some
more time helping out there again?

If it is the first session in which a student’s suicidal ideation has been


identified, it is also important to notify the student’s parent/​g uardian
about the suicidal ideation. In this situation, a bridging statement could
be used to involve the student in helping with this notification. For
example:

Brie, at the beginning of our session, we discussed confiden-


tiality and the reasons for when I need to break it. Well, I’m
sure it won’t come as a surprise when I  say that we need to
let your mom know about your suicidal ideation. It is really
important that you are safe. I want make sure we provide you
some additional support since you are experiencing a lot of
strong emotions right now. How would you prefer to contact
your mom? Would you like to call your mom in my office right
now, or would you like me to call your mom while you are
here with me?

Although the school social worker tells Brie that they need to contact her
mom, the school social worker still gives Brie the choice on how to do this.
During the conversation with Brie’s mom, the school social worker not only
shares Brie’s suicidal ideation but also emphasizes Brie’s coping skills and
exceptions when things have gone a little better for her.

SFBT in Action: Mental Health and Suicidal Ideation147


148

12. Wrap Up the Session
After the conversation with Brie’s mom, the school social worker (Ms. Burns)
makes a point of wrapping up the session. Part of this summary includes
highlighting Brie’s current coping skills and her ability to deal with chal-
lenging times in the past. The school social worker also confirms with Brie
possible therapeutic tasks that she plans to complete. The session wrap-​up is
an important part of the counseling process and should not be overlooked.
The severity of Brie’s suicidal ideation will determine whether she will need
outside assistance or will continue working with Ms. Burns in the school.
Either way, this initial solution-​focused counseling session is designed to
build hope, to empower Brie, and to encourage further solution-​building
activities.

Conclusion
“The wise person doesn’t give the right answers, instead the wise
person poses the right questions.”

This adapted quote by French anthropologist, Claude Levi-​Strauss, does a


wonderful job of summarizing the inherent value of the solution-​focused
approach. Solution-​focused school social workers are not the experts of their
students’ lives, nor are they required to provide all the right answers even
when working with students who are experiencing crises. Instead, solution-​
focused school social workers are fortunate to have access to a wide array
of powerful and effective therapeutic questions that can be used during the
collaborative solution-​building process with their students. In addition, the
solution-​focused approach helps facilitate the “hope-​building” process that
is so important when working with students who are struggling or are feel-
ing hopeless.
Henden (2008) posed some important questions to mental health school
social workers when he asked:

Is it not better to look on hope, rather than despair? Is it not


better to ask questions about what is working, rather than what
is not? And, is it not better to empower people to take steps
towards building their own solutions to their difficulties, rather
than trying to do things unto them? (p. 196)

After reviewing solution-​focused research and literature, it would be hard


not to answer a strong “Yes” to all three of his questions.

148 Solution-Focused Brief Therapy in Schools


 149

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9
■ ■ ■

SFBT in Action
Substance Use
Adam S. Froerer & Elliott E. Connie

Overview of Substance Abuse Nationally and in Schools


Substance use is common among teens and adults, and this issue continu-
ally impacts laws as well as school policies and procedures. School officials
and mental health professionals working within school settings frequently
encounter substance use among students. Young people may use for pur-
poses, experimentation, or more seriously and/​or because of dependence.
Although the prevalence rates for adolescent substance use overall have
decreased slightly in the past few years, as many as 14.2% of adolescents
between the ages of 12 and 17 are still reporting some substance use within
the past month of being surveyed (US Department of Health and Human
Services, 2013). This significant value indicates that both school officials
and mental health professionals will likely interact with students who are
actively using or have recently used substances. This chapter explains one
effective approach, SFBT, to working with these substance-​using students.

Definitions
The US Department of Health and Human Services (2008) advocates that
professionals view substance involvement on a continuum with six anchor
points:  1)  abstinence, 2)  use, 3)  abuse, 4)  abuse/​dependence, 5)  recovery,
and 6)  secondary abstinence. Abstinence means to refrain from using. In
the case of substance use, it means to refrain from using alcohol and/​or
drugs. Use involves minimal use of substances and generally results in few
and/​or minimal consequences. Abuse occurs with regular use and results in

153
154

consequences that become more significant and severe. Abuse/​dependence is


regular use over a sustained period of time and results in physical depen-
dence and accompanying withdrawal symptoms. Recovery is returning to
a state of abstinence. Secondary abstinence is returning to abstinence after
relapse. In addition, experimentation is when an individual tries something
new or uses for the first time. Experimentation is generally undertaken to
have a new experience.
These definitions are complemented by the new conceptualization
within the fifth edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-​5). The DSM-​5 no longer uses categories or diagnoses of
substance abuse and substance dependence. Now, these disorders are clas-
sified as substance use disorders and can be further specified by which sub-
stance the individual is using (e. g., Alcohol Use Disorder or Marijuana Use
Disorder). In addition, classifiers (mild, moderate, or severe) are added to the
diagnosis to indicate the level of severity; these classifiers are determined
by the number of diagnostic criteria the individual meets. Some symptom
indicators taken into consideration for diagnostic purposes are 1)  level of
recurrent use, 2) amount or severity of impairment, 3) potential health prob-
lems related to substance use, 4) disability, and/​or 5) failure to meet major
responsibilities at work, school or at home. Overall, substance use disorders
are determined based on evidence of impaired control, social impairment,
risk of use, and pharmacological criteria. Holding this view of use should
help to inform school social workers regarding appropriate assessment and
treatment options and appropriate intervention strategies.

Prevalence Rates of Substance Use Among School-​Aged Persons


Adolescents report having used many different substances, including alco-
hol, anabolic steroids, bath salts, cocaine, ecstasy, GHB, hallucinogens,
heroin, inhalants, ketamine, marijuana, methamphetamine, nicotine, opi-
oids, over-​t he-​counter drugs, PCP, pain relievers, prescription medication,
Rohypnol, stimulants, synthetic cannabis, and tobacco, among others.
Table 9.1 outlines the 2013 data (most recent available) regarding sub-
stance use for adolescents (9th–​12th graders) according to the National
Youth Risk Behavior Study conducted by the Centers of Disease Control
and Prevention.
Although usage rates have decreased since 2011, with the exception of
marijuana use (and most not statistically significantly lower), a significant
proportion of teenagers have used drugs/​alcohol sometime in their lives

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Table 9.1  Adolescent Substance Use Percentages

Substance Ever Used in Percent


(2011 statistics)

Marijuana 40.7 (39.9)


Cocaine 5.5 (6.8)
Hallucinogenic drugs 7.1 (8.7)
Inhalants 8.9 (11.4)
Heroin 2.2 (2.9)
Methamphetamines 3.2 (3.8)
Alcohol 66.2 (70.8)
Tobacco 41.1 (44.7)

(Office of Applied Studies, 2013). If we look closer at alcohol use (the high-
est prevalence rate), 35% of teenager surveyed reported drinking “some
amount of alcohol” during the past 30 days, with 21% reporting they had
at least one episode of binge drinking within the past 30  days and 10%
reported having driven after drinking. In addition to the substances listed
in Table 9.1, it should be noted that 2.2% of school-​aged teens also reported
non-​medical use of prescription-​type drugs, and one in eight teens reported
that they were approached by someone selling drugs in the past month of
being surveyed.
These statistics do not provide an exhaustive overview of the current
state of adolescent substance use, and we acknowledge that the numbers
could be inaccurate due to the reliance on self-​reporting. These numbers
do, however, highlight that many adolescents have used drugs/​alcohol, are
currently using substances, or are at risk for future substance use. It is vital
for school personnel and mental health professionals to be aware of these
statistics (and more importantly, the individuals at risk represented by these
statistics) and the risk/​protective factors for our youth.

Risk and Protective Factors


School-​aged children are navigating a time of peer pressure and exploration
of personal identity. Between the ages of 12 and 18, children are seeking to
develop autonomy from parents and gaining personal freedom, while simul-
taneously seeking to gain approval and social acceptance from their peers and
classmates. This time of life can be challenging, and some adolescents may

SFBT in Action: Substance Use155
156

Table 9.2  Risk Factors for Adolescent Substance Use

Biological factors • Genetic profile


• Family member with an addiction
• Personal/​family history of mental disorders
• Family history of affective disorders and emotional
disturbance (e.g., depression or anxiety)
Psychological factors • Depression or other psychiatric illness
• A history of suicide attempts
• Low self-​esteem
• Risk taking behaviors
Social factors • Parenting style or problems in relationship with
parents
• Loss of loved ones
• Minority status (e.g., gender, race, sexual orientation,
or physical/​mental disability)
• Early sexual experiences
• School problems
• Problems with peers

Source: Adapted from Doweiko (2002, p. 296) and Sanjuan and Langenbucher (1999, p. 481).

turn to substance use for help in coping with challenges or difficult situations.
Others may use for pro-​social reasons, and still others may simply experiment
with substance use to determine if it is something they would like to incor-
porate into his or her personal identity. Several risk factors may impact the
likelihood of adolescent substances use. Table 9.2 provides examples.

Research About SFBT with Substance Use


The research supporting SFBT as an evidence-​based approach continues to
grow (Franklin, Trepper, Gingerich, & McCollum, 2012). Several studies now
illustrate that SFBT is effective in working with adolescents (Bakhshipour,
Aryan, Karami, & Farrokhi, 2011; Franklin, Moore, & Hopson, 2008; King &
Reza, 2014), and additional studies demonstrate the effectiveness of SFBT
in treating substance use/​abuse (Froeschle, Smith, & Ricard, 2007; Smock
et  al., 2008). One study (Froeschle et  al., 2007)  specifically illustrated
that adolescent females who experienced a 16-​week SFBT group showed
improvements in drug use, improvements in attitudes toward drugs, and a
decrease in home and school behavior issues. SFBT is an effective treatment
that meets school-​aged children who are using substances where they are
and can effectively help to decrease negative effects of such use.

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Case Example
Many things make the solution-​focused approach different from traditional
problem-​focused ways of conducting psychotherapy. One of the key differ-
ences occurs not only in what the school social worker says to the student
but also in how the school social worker listens. While most training materi-
als on this approach focus on the techniques commonly used by solution-​
focused practitioners, this chapter shifts the focus toward the language used
to co-​construct a session. Put more simply, knowing about the questions
and knowing how to develop them in a conversation with someone who is
struggling with a significant issue (in this case, substance use/​abuse) are two
completely different things. This chapter highlights the later by reviewing
a difficult case involving a teenager and his family that involves substance
abuse and other defiant behaviors. We include direct portions of the first
session in this chapter, summarize what happened in subsequent sessions,
and conclude by describing the events that occurred with this teen and his
family after therapy was over.

Overview of the SFBT Approach


Before reviewing of the first session, a short overview of the SFBT approach
as used by these authors will help readers fully understand what the school
social worker is doing in the session and why these activities are helpful to
the student. SFBT is very different from traditional problem-​focused psy-
chotherapy approaches. The differences are not just in the theory itself but
also in what the school social worker is doing in the session with the stu-
dent, what language the school social worker is specifically using, and what
the school social worker is listening for. The language of these sessions is
significantly different than the language of traditional counseling sessions.
The best way to see this difference is to observe and analyze the sessions
being done in this way.
When learning this approach, it is key to study more than the sim-
ple techniques (e.g., scaling questions or the miracle question), or the
questions commonly asked during counseling. Because SFBT is a co-​
construction process that develops a description of the student’s pre-
ferred future, the school social worker will miss the most important
part of this way of working—​the language—​if he or she only pays atten-
tion to the techniques themselves. The SFBT approach is about devel-
oping questions that utilize the student’s exact language, utterance by
utterance. This may seem obvious and easy, but in practice, it is not.

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158

There is a quote that says, “There is a difference between knowing the


path, and walking the path.” This is certainly true in using the SFBT
approach:  knowing about the miracle question does not necessarily
equip someone with the ability to develop a miracle question that is
unique and useful to the individual student sitting with the school social
worker in a session. The most frequently asked question from attendees
to lectures is often “How do you ask the miracle to a client who is …?”
This question arises because most people spend a lot of time focusing
on learning the techniques and not on language. Yet, the language is
what holds the key to mastering this approach, for the language is where
this approach happens. SFBT advocates that a school social worker lis-
ten to and use the student’s individual language from each utterance to
effectively build individualized questions for each of his or her speaking
turns. A better question to ask might be “How do you ask a question if
the student says …”? When we focus on what we say next instead of on
what we do next, our learning expands, and we evolve into using this
approach beyond just the techniques.
Since the SFBT approach was adequately reviewed earlier, we will not
spend too much space here going over the well-​k nown details of this way of
working. Instead, we focus on the different facets of a SFBT conversation,
what the SFBT school social worker is listening for, and how that informa-
tion is used in the session. This is done by reviewing the work with a teen
who is struggling with substance abuse/​m isuse issues. It should be noted
that the authors of this chapter outline a SFBT session in a fairly structured
way. This structure, although different than the one used by many other
SFBT clinicians, is consistent with how we work in all SFBT sessions.

The Story of Shawn


Shawn and his family came to counseling after Shawn’s recent stay at an
inpatient hospital due to several issues that were taking place in his life.
Aged 16, Shawn was using marijuana almost daily and occasionally experi-
mented with other, harder drugs. Shawn also had a habit of threatening to
kill himself when his parents did not let him do something he really wanted
to do, although no actual attempts were reported. These threats were often
made for very small, insignificant reasons (e.g., if Shawn wanted to play
video games or use marijuana). In short, if Shawn wanted to do it and his
parents said no, he would explode. Even though these explosions would

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occur over just about anything, nothing set him off more consistently or sig-
nificantly than when his parents did not let him hang out with his friends.
These incidents would include yelling, loads of screaming, and on occasion,
some pushing and grabbing between Shawn and his father. This was the
case in the incident that sent Shawn to the hospital and led his family to
counseling.
When the family arrived for the first session, it was immediately clear
that Shawn did not want to be there, and his parents looked as if they were
at their wits’ end. The parents entered the room first and informed me (E.C.)
of all of the things they have been dealing with. Shawn informed his parents
that he would not talk to me with the parents present, so the family asked if
I would be willing to see the teen alone. I agreed. What follows is a review
of that conversation.

Stage 1: Establish the Desired Outcome from the Talk


As Shawn walked in to the room, he clearly was not very pleased to be in
my office. The first task of the SFBT counselor is the same, however, despite
the level of motivation of the client: ask questions to identify what the teen’s
desired outcome is from the session. Attending to this task focuses the con-
versation on the future and the changes the student would like to see, rather
than focusing on the problem that led the student to come to counseling.

Elliott: Can I call you Shawn? Is that okay?


Shawn: Yeah, that’s fine.
Elliott: So, what are your best hopes from our talking?
Shawn: Umm, I don’t know.
Elliott: Umm.
Shawn: I mean to be honest, I really don’t want to be here.
Elliott: Well, since you are here and we will be talking for a
bit, what is your best hope from our talk?
Shawn: What do you mean?
Elliott: Well, if you and I were to have a helpful conversation,
what difference would you like it to make in your life?
Shawn: As in what way?
Elliott: Not sure. I suppose that would be up to you.
Shawn: Umm, I don’t know
Elliott: What do you think?
Shawn: But what will we be talking about?

SFBT in Action: Substance Use159
160

Elliott: Not sure yet. I guess whatever differences you’d be


pleased to see in your life.
Shawn: Okay. I guess anything helps.
Elliott: Umm, and if it does help, what differences would you
like it to make for you?
Shawn: Umm, I guess I could be more positive.
Elliott: Okay, so how would you notice yourself becoming
more positive?
Shawn: I don’t know, but I think it would be a good thing.
Elliott: A good thing. Well, how would you know it was a good
thing? What would you notice taking place that would tell
you that this good thing is happening?
Shawn: Just a positive change, I guess.
Elliott: What positive change?
Shawn: Umm, I don’t know.
Elliott: What do you think Shawn?
Shawn: Umm, I don’t know. It all depends on what we are
talking about, I guess.
Elliott: That makes sense. I am not quite sure yet, either,
but you did say becoming more positive would be a good
thing, right?
Shawn: Yes.
Elliott: So, how would you notice you are, in fact, becoming
more positive?
Shawn: Umm, not using drugs.
Elliott: What would you be doing instead of drugs?
Shawn: Umm, I’m not sure. Maybe spending more time work-
ing on my school work.
Elliott: Really?
Shawn: Yeah.
Elliott: And if you found yourself, somehow, not quite sure
how yet, but somehow, after our talk involved in more
school work and less drugs, would you consider that more
positive?
Shawn: Yeah.
Elliott: Umm, what would the impact be of you spending more
time working on schoolwork?

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Shawn: I’m pretty sure my grades would be higher.


Elliott: Okay, how high might they be able to get?
Shawn: I don’t know. Very high I think. [laughs]
Elliott: [laughs] How long has it been since you worked on
your schoolwork in this way?
Shawn: A long time.
Elliott: But you’ve done it before?
Shawn: Yeah.
Elliott: So, if you find yourself spending more time doing this,
that would be a good change for you?
Shawn: Yeah, it would be.
Elliott: What other changes would you notice that would be in
line with being more positive?
Shawn: Umm, more freedom.
Elliott: Umm, and where would this freedom come from?
Shawn: My parents.
Elliott: Are they the only ones that would be pleased to see you
more positive?
Shawn: At the moment, yeah.
Elliott: Okay, okay, and what would you do with the freedom
that would come along with being more positive?
Shawn: Umm, hang out with friends and that sort of stuff.
Elliott: Okay, so if somehow our chatting lead to you being
more positive and hanging out more with your friends, you
would look back and be pleased that we have met?
Shawn: Yeah.
Elliott: You would look back and be pleased that we had
this chat?
Shawn: Yeah.
Elliott: And how would you know that your parents had
noticed you being more positive?
Shawn: I don’t know. They would probably be more happy,
I suppose.
Elliott: How would you notice they were happy?
Shawn: They would be smiling.
Elliott: And how would you respond to their smiling?
Shawn: I would smile as well.

SFBT in Action: Substance Use161
162

Elliott: And what do you imagine each of you smiling more


would do to your household?
Shawn: It makes us all so much more happy.
Elliott: So, if our talking not only lead to being more positive
and spending more time with friends and you being more
focused on schoolwork instead of using drugs, if it also
caused you to be happier and caused happiness to come out
of your parents, would you be pleased that we had chatted?
Shawn: Yes, for sure.

As you can see from this segment of the session, I was able to ask ques-
tions that shifted the focus of the conversation away from the student’s frus-
tration and toward Shawn’s desired outcome for the session. Although it was
originally difficult at first to get Shawn to express what he was hoping to get
out of the session, I persisted in doing two important things: 1) trusting the
student’s ability to answer the questions about what his best hopes were, and
2) using the student’s exact language to continually move the session away
from problem-​talk and toward an identification of his best hopes. Although
a student may be using drugs, the SFBT counselor will not overtly ask about
this issue (unless the student mentions it, like Shawn does) but, rather, will
trust that having a solution-​building conversation about the student’s pre-
ferred future will help that student make changes leading to the fulfillment
of this preferred future. For school-​aged youth, this process can help reduce
anxiety and/​or “resistance,” and it can help them to know the SFBT coun-
selor is interested in their uniqueness and desires rather than pushing a
preconceived plan for what will be useful and helpful. This approach also
individualizes the treatment for each unique student.

Stage 2: Picking Up the Client Language


After the desired outcome has been identified, the next task in the process
is for the school social worker to educate him-​or herself about the student’s
language. Notice that I did not say anything about the student’s problem,
or even their strengths during the first portion of the session. The SFBT
counselor is interested in the specific language the student uses as well as
the names of key people in the student’s life. This attention to and use of
the student’s language helps the school social worker be a more informed
professional and more able to develop helpful questions for each individual
student as the session unfolds.

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The session continues:

Elliott: Awesome. Well, before we chat about that stuff, can


I get to know you a little bit, is that okay?
Shawn: Yeah.
Elliott: What is your best friend’s name, Shawn?
Shawn: Mike.
Elliott: Mike? Wonderful. And umm, what do you do for fun?
Shawn: Umm, I’m not sure. I’m not allowed to do much at the
moment.
Elliott: Not allowed?
Shawn: Yeah, I’ve been punished for a while.
Elliott: Oh, wow.
Shawn: That’s why I mentioned wanting freedom.
Elliott: Oh, I see.
Shawn: I’d like to get back doing stuff with Mike and hanging
out, but my parents never let me do anything.
Elliott: Okay, that makes since.
Shawn: Yeah, they overreact a lot.
Elliott: [laughs] Perhaps. What is the best thing I should know
about you and Mike?
Shawn: Umm, he keeps me positive.
Elliott: How does he do that?
Shawn: I don’t know. We’ve just been friends a long time, and
he can calm me down.
Elliott: Has he always had this ability with you?
Shawn: Yeah, as long as I’ve known him anyway.
Elliott: Very nice. And you mentioned doing more school
work, what is your favorite class?
Shawn: Umm, History.
Elliott: What is it about that one?
Shawn: I don’t know. I just like it. Sort of always fascinated me.
Elliott: What is your favorite thing about history?
Shawn: Hmm, not sure. I just like learning about different
people and places.
Elliott: Have you ever thought about what you would like to be
do for a living when you get older?
Shawn: Nah, not really.

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164

Elliott: If you take a moment to think about it now, what


comes to mind?
Shawn: Who knows, college, maybe, I guess.
Elliott: Really? What makes you say that?
Shawn: I guess if things worked out I’d like to go and would
probably like it. I just haven’t thought about it much until
you just asked me.
Elliott: How often do you focus on schoolwork these days?
Shawn: Umm, lately, not too much to be honest.
Elliott: Okay, and at your best, how much time might you
spending?
Shawn: Not sure. More time than I spending now for sure, at
least some time per day.
Elliott: Would you be pleased to be doing this?
Shawn: No, no, umm, it would be boring, but it would feel
good I think to be doing something productive.
Elliott: And what type of skills do you possess that would
allow you to be able to do this?
Shawn: I used to do this all of the time, so I know I can do it.
Plus, I’m smart enough. I just haven’t tried.
Elliott: So you know you have it in you.
Shawn: Yeah, so I just have to make some changes.
Elliott: Okay, I see.
Shawn: Yeah.
Elliott: Umm, so what would you say is your best quality? For
somebody who is just getting to know you, like I am today,
what is the very best thing about you, the thing you’re
proudest of or pleased with?
Shawn: I’m different.
Elliott: How so?
Shawn: I’m just different. I don’t know. I’m just different from
a lot of people at my school.
Elliott: Do you like being different?
Shawn: Umm, I don’t want to be like everybody else, just an
everyday person. I wanna be different.
Elliott: Have you always been like that?
Shawn: Yeah, always.

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Elliott: And you’re pleased about that?


Shawn: Yeah.
Elliott: And what do you know about yourself that lets
you know that one day you can live without drugs in
your life?
Shawn: Because I could do it before, so I can do it.
Elliott: How did you do it before?
Shawn: Umm, I think the social scene I was in. I got myself
out of the social scene. I’m just trying to find friends who
are not into that sort of stuff, are more positive and make
me do stuff. Do you know what I mean?
Elliott: Yes.
Shawn: I think it is more about, having people behind you
that push you to doing the positive things instead of doing
the drugs.
Elliott: And has it worked for you? Have you gotten away from
that social group?
Shawn: Yeah, mostly.
Elliott: That has worked well for you. How did you do that?
How did you know how to do that?
Shawn: I’ve been talking to my school counselor about the
whole thing, too, but I suppose it is just, umm, you just
know in yourself that it is the wrong thing to do, the wrong
type of people. And the more you associate yourself with
those types of people, then you are going to keep using, and
it’s going to repeat itself.
Elliott: And you don’t want to be like everyone else, right?
Shawn: Right. I started drugs a while ago. and it just got more
and more.
Elliott: Yeah. and somehow you knew it was wrong?
Shawn: Yeah, plus I started behaving in a way that wasn’t like
me. Skipping school, failing classes, things like that.
Elliott: Was Mike coming along with you?
Shawn: No, he got mad at me, and we lost touch for a while.
Elliott: Did that bother you?
Shawn: Yeah.
Elliott: Does he know how important he is to you?

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166

Shawn: I don’t think so. I think he’s still upset with me, but we
text sometimes.
Elliott: Would he be pleased to see you being more positive
and doing your schoolwork and things like that?
Shawn: Yeah.
Elliott: How would he let you know he was pleased?
Shawn: Umm, he’d probably talk to me more and want to hang
out and stuff.
Elliott: Would you be pleased if you talked more and hung
out again?
Shawn: Yes, very!

Notice that in this part of the session how I  learned a lot of informa-
tion that increased my skill in asking questions of Shawn, including specific
things I  needed to ask Shawn that would be inappropriate to ask anyone
else about. For example, I was able to uncover names of key people in the
student’s life (Mike), information about what the student enjoys (hanging
out and history), as well as what the student likes most about himself (being
different). I also now know what the student believes about drug use (that
having people behind you will help) as well as what thoughts he has about
his current use (Mike does not like it; drug use has changed his behavior).
These details may seem like insignificant information, but in this
approach, this sort of information is key. It helps the school social worker
develop more tailored, specific questions that are just for one unique cli-
ent. In turn, this allows the conversation to feel less like an onslaught of
techniques and much more like a helpful and therapeutic, co-​constructed
conversation.

Stage 3: The Preferred Future Description


Even if you are only minimally familiar with the solution-​ focused
approach, you have probably heard of the miracle question. This is the
part of the session when the student is asked a future-​focused question to
elicit a detailed description of his or her preferred future. This is the most
important part of the SFBT session. In the session with Shawn, which
continues here, notice that the question is asked using information that
was learned in the previous stages and that it involves the presence of the
student’s best hopes.

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Elliott: Can I ask you an unusual question? So, umm, suppose


tonight, as you sleep, a miracle happens that somehow kind
of changes your life in all positive ways and makes you the
very best version of Shawn that you want to be, the type
of guy who is being more positive, doing his school work,
earning more freedoms, and being just the kind a guy you
want to be. But this miracle happened as you slept, right? So
you couldn’t know it happened.
Elliott: So, when you woke up the next day, what would be
the first thing you noticed that would tell you “I am in this
different world where I am the very, very, very best version
of myself and moving in a different, much more positive
direction”?
Shawn: I wouldn’t think of drugs when I woke up.
Elliott: Would you think of instead?
Shawn: I don’t know.
Elliott: What do you think?
Shawn: Umm, it’s a hard question. I don’t really know.
Elliott: Yeah, it’s hard, an odd question even. But what do you
think? You would wake up and wouldn’t be thinking of
drugs, so what would you be thinking of instead?
Shawn: School, maybe.
Elliott: School? What about school would you be
thinking about?
Shawn: I don’t know. What I had to do on that day, I think.
Elliott: What types of things would you have to do for school
on this day?
Shawn: Not really sure. I have a lot of work to do.
Elliott: Really?
Shawn: Yeah, it’s been a while since I’ve thought about
this stuff.
Elliott: What is the first thing you would do?
Shawn: Get up, I guess?
Elliott: And how would you know you were getting up as the
very best version of you?
Shawn: I don’t know. I’d have energy, maybe.
Elliott: What time would you be waking up?

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168

Shawn: Hmmm, around 7 AM I think.


Elliott: And after waking up at 7 AM as the very best version of
yourself?
Shawn: The fact that I would be awake at all at this time would
be the first sign.
Elliott: So, it would be unusual for you on this day to wake
up at this time, and instead of thinking about drugs, to be
thinking about school and what you have to do?
Shawn: Yes, very.
Elliott: And what is the first thing you would do?
Shawn: I’d get dressed, I think.
Elliott: And what would be different about the way you got
dressed when you were at your very best and had energy?
Shawn: I would turn on the radio as I got dressed.
Elliott: What would you listen to?
Shawn: Not sure. Whatever I was in the mood for.
Elliott: What might you be in the mood for do you think?
Shawn: Rap. Maybe Lil Wayne or Drake.
Elliott: What one might you be leaning toward?
Shawn: Drake.
Elliott: What else would you notice about yourself as you were
getting dressed listening to Drake?
Shawn: I would be smiling and singing along as I was getting
dressed, maybe even loudly.
Elliott: Would you be pleased by this?
Shawn: Yeah, I think so.
Elliott: You’d be loud. Would anyone hear?
Shawn: [laughing] Yeah, my mom.
Elliott: Would she find this to be a big surprise or a little
surprise?
Shawn: Big, definitely big.
Elliott: And how would she respond?
Shawn: I don’t know. I think she’d think I was on something.
Elliott: How would you notice that in fact you are not on any-
thing, you are just back to being your very best?
Shawn: It would be on my face.
Elliott: In what way, what would be different about your face?

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Shawn: I would be smiling for real. You know, like the type of
smile that let’s people know you’re for real happy.
Elliott: Would she be pleased to see this?
Shawn: I don’t know. I mean. I think so. She hasn’t seen me
like that in a while, but I think she would be very happy.
Elliott: How would she let you know she was happy?
Shawn: She’d smile back at me. She might ask me to turn
the music down or stop singing, but she would be smiling
as she said it. Not mad, you know?
Elliott: Yeah. How would you respond to that?
Shawn: I would do what she asked, but not with an attitude.
I would just do it.
Elliott: And would that surprise her?
Shawn: For me not to have an attitude? Yeah, she would be
very surprised. It would change the whole morning.
Elliott: In what way?
Shawn: Well, we wouldn’t be fighting. There’d be no yelling. It
just wouldn’t be so negative around the house.
Elliott: Would anyone else notice?
Shawn: It’s just me, my mother, and my father in the house, so
I’m sure my father would notice.
Elliott: How would he notice?
Shawn: He would notice we weren’t fighting.
Elliott: What would you and your mom are doing on this
morning?
Shawn: Just getting along, being nice to each other.
Elliott: How would he let you know he was pleased?
Shawn: He would definitely say something.
Elliott: Like what?
Shawn: He would come in and talk with us. He would say how
happy he was we weren’t fighting. He’s like that, he says
stuff like that.
Elliott: Would you be pleased with this interaction with him?
Shawn: Yeah.
Elliott: How would you let him know you were pleased?
Shawn: Honestly, I would ask him if he wanted to have break-
fast with me. We used to do that sort of thing.

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170

Elliott: What would you two have for breakfast on this day?


Shawn: Toast or something.
Elliott: As you had this breakfast, what would be different
about the way you interacted?
Shawn: We’d be talking. You know, talking like friends. Liking
each other.
Elliott: Would you be pleased by this?
Shawn: Yeah.
Elliott: How would you let your father know you were pleased?
Shawn: I would tell him how nice it was to be interacting the
way we used to.
Elliott: How would he respond to this?
Shawn: He’d probably cry, you know. I might, too.
Elliott: How long would this meal last?
Shawn: Ten or 15 minutes or so. I have to get to school, and he
has to get to work.
Elliott: How do you get to school?
Shawn: My mom.
Elliott: Before you know, how would your mom and dad know
that Shawn-​at-​his-​best was heading to school?
Shawn: I’d grab my books, and during breakfast, I would have
been talking about all I planned to accomplish in the day.
Elliott: Really? How much of a change would that be?
Shawn: Huge.
Elliott: And as you and your mom head toward the school,
how would she notice that the changes she saw in the
morning were still a part of you?
Shawn: We’d be talking in the car about my schoolwork.
I wouldn’t be mad or frustrated by her questions. I would
just answer them.
Elliott: How long is the drive to school?
Shawn: Not too long. We live close to school. They just drive
me because they don’t trust me to go all of the time.
Elliott: Okay, and when you got to the school, who would be
the first person to notice something was different about you?
Shawn: Mike.
Elliott: How would he notice?

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Shawn: Because I would not hang around the bad kids and


I would walk right up to him, before the first class.
Elliott: How would he know that he was talking to the very
best version of Shawn?
Shawn: He would just know.
Elliott: But how?
Shawn: I don’t know.
Elliott: What do you think?
Shawn: I think I would apologize honestly. I think I would
even ask him to be friends again.
Elliott: How would he respond?
Shawn: I think he’d like it.
Elliott: Really?
Shawn: I’d have to promise him I would stay away from the
bad kids and not use drugs.
Elliott: Would you?
Shawn: Yeah, if I were my very best, I wouldn’t even want to
do those things.
Elliott: Cool. What would happen next?
Shawn: Mike and I would walk to class together like we used to.
Elliott: You guys are in the same class?
Shawn: Yeah, we have the same homeroom class, the first one
of the day.
Elliott: When you got to class, how would the teacher notice
that you were different? That you were the best version of
yourself.
Shawn: I would sit next to Mike. He sits in the front of the
class and pays attention to what she says. He really is a good
student, a good kid really.
Elliott: Would she be pleased to see you sitting in the front of
the class?
Shawn: Yeah. She would say “Welcome!” or something
like that.
Elliott: What would be different about the way you conducted
yourself while sitting in the front of the class?
Shawn: I would be focused and paying attention instead of on
my phone or goofing around.

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172

Elliott: What difference would that make for you?


Shawn: Huge. It would feel good to be acting the way I used to.
Elliott: Would other teachers notice?
Shawn: Yeah, all of them would.
Elliott: Would any of the others say anything?
Shawn: Maybe. I would just have to see. I know my history
teacher would for sure, though.
Elliott: How would your history teacher notice?
Shawn: I’d be enthusiastic about it again. I really do like
that class.
Elliott: Yeah. It is your favorite right?
Shawn: Yeah.
Elliott: So how would you show the history teacher that your
enthusiasm was back?
Shawn: I would be interacting, asking questions and raising
my hand. You know, that sort of stuff.
Elliott: What else?
Shawn: You know, just back being involved.
Elliott: So what would be different about when the school
day ended?
Shawn: I’d find Mike again for sure.
Elliott: Really? Then what?
Shawn: I’d see if he wanted to hang out after school.
Elliott: What would you suggest the two of you do?
Shawn: Honestly?
Elliott: Yeah. What would you like to do with him?
Shawn: I’d ask him if he wanted to come over and do our
homework together and then maybe play video games.
Elliott: Would he be surprised to hear you suggest this?
Shawn: Yeah.
Elliott: How would you guys get back to your house?
Shawn: We’d walk. He lives in my neighborhood, too.
Elliott: What would be different about the way the two of you
walked home? Like, what would you be talking about?
Shawn: To be honest, it wouldn’t feel different at all. We used
to do this everyday, and it would just feel normal to be
doing it again. We would be talking about new video games
and stuff like that.

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Elliott: Would this be another version of the positive changes


you mentioned earlier?
Shawn: Yeah, definitely.
Elliott: When you reached your house, would anyone
be home?
Shawn: No, not for the first 30 minute or so. We would be
there alone when my mother got home from work.
Elliott: And when she got home, what would she find that would
look to her like evidence that her son was still at his very best?
Shawn: Me and Mike would be sitting at the dining room table
doing our homework.
Elliott: And would this be a big surprise or a little surprise to her?
Shawn: Huge!
Elliott: Would she be pleased by this huge surprise?
Shawn: Yes, definitely.
Elliott: How would she let you know that she was pleased?
Shawn: She would be very nice to Mike. My parents love him.
She would offer us something to eat, I think.
Elliott: Really? Like what?
Shawn: A snack or something. She may even ask him to stay
for dinner.
Elliott: Okay, is that a good thing, do you think?
Shawn: Yeah, man, we used to do this all the time. Wow.
Elliott: How long do you think it would take you guys to finish
your homework?
Shawn: Umm, maybe an hour or so.
Elliott: Really?
Shawn: Yeah.
Elliott: Then what would you guys do?
Shawn: I’d ask my mom if I could play video games with Mike
while she was cooking dinner.
Elliott: What do your think she’d say?
Shawn: I am not too sure. I think she’d say yes to be honest.
Elliott: Really?
Shawn: Yeah. I mean, I’ve been grounded for a while, but if all
of this happened, I really think she would let me and Mike
play the game. Plus, I think she would be happy that he is
back around.

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174

Elliott: Okay, that makes sense. What would you and


Mike play?
Shawn: Madden, definitely.
Elliott: PlayStation or Xbox.
Shawn: I like the PlayStation. He has an Xbox.
Elliott: Who would win?
Shawn: [laughing] Me, for sure.
Elliott: What difference would it make for you to be back
playing video games with Mike in the way that you guys
always have?
Shawn: It would make a big difference. Even as I sit here, it
seems so normal. Like something I should be doing all of
the time.
Elliott: So, that would be a good thing?
Shawn: Yeah, for sure.
Elliott: What might your mother make for dinner on that day?
Shawn: She makes a lot of things. My favorite is spaghetti.
Elliott: What would be different about dinner on this day?
Shawn: To be honest, nothing. This is all just so normal, just
like the way things used to be. My dad would come home
right about the time dinner was ready, and we would all eat
together.
Elliott: And how would your father notice that things were
back the way they used to be?
Shawn: It would be obvious, I think. Mike would be there, my
mom would tell him I had already done my homework. You
know, just normal.
Elliott: What else would you discuss during the dinner?
Shawn: Nothing really. We would talk about sports, TV. You
know, fun stuff.
Elliott: Would you enjoy this?
Shawn: Yeah, I’d love it.
Elliott: How would you show this to Mike and your parents?
Shawn: I’d be smiling the whole time.
Elliott: I see. What would happen after dinner?
Shawn: Well, Mike would have to head home. I’d walk him to
the door and plan on meeting him in the morning. Either

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we’d walk to school together, or if my parents don’t let me


walk he would ride with me.
Elliott: Okay, I see. Then what would happen?
Shawn: Well, it would be getting pretty late, I think, so I would
help my parents clean the kitchen and start getting ready
for bed.
Elliott: How different would this be?
Shawn: It would be huge because we always fight and there
is always a lot of yelling at night. This night would just be
peaceful and quiet. Just a good way to end the day.
Elliott: I see. What would be different about the end of your
day and the way you got ready for bed?
Shawn: I would just have peace and be relaxed. It would be
nice to be so calm.
Elliott: Well, thank you, Shawn, for answering all of my
questions. Do you mind if I take a minute to write my
thoughts down?
Shawn: No, that’s fine.

Notice how at this point of the session, the emphasis is on the description
related to the detailed presence of the student’s preferred future, not how
the student can make the changes that lead toward this becoming a real-
ity. It is simply about the description. This is one of the major distinctions
between solution building and problem solving. SFBT is not an approach
that involves problem solving. By engaging in a solution-​building conversa-
tion, the client is more likely to experience, in the moment, the thoughts,
feelings, and emotions that he or she will likely re-​experience when the best
hopes occur. In this conversation, the school social worker will experience
with the student a change in how the mood of the conversation shifts. The
school social worker will also notice how the student begins to express that
the changes seem “like normal.” This comes about due to the great details
elicited while answering the questions and makes it more likely the student
will make changes that lead toward the desired future.
Also notice that the focus is not using drugs and that this is hardly
mentioned during this conversation. In a SFBT session, the focus should
remain on what will be present rather than on what will not. By focus-
ing on what Shawn will be doing on a day when his best hopes occur,

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176

we avoid all problem-​talk—​even if that problem-​talk is the reason for the


referral. Instead of this problem-​talk, we have an enjoyable conversation
about Shawn at his best. This is a conversation that Shawn is interested in
having, thus eliminating the need to worry about what to do with a “resis-
tant” client.

Stage 4: Session Wrap Up


The key to this part of the session is to provide feedback in line with the
information that has been discussed. It is important to provide feedback that
allows the student to remain the “expert” of the session, that is significant to
the student, and that is in the student’s own words. During this part of the
session, the school social worker also may offer a task to the student. In this
approach, however, it is important to make a suggestion that is simple and
usually just about noticing the discussed changes. This kind of suggestion
does not remove the student’s autonomy.
The session concludes:

Elliott: Sorry to keep you waiting.


Shawn: That’s alright.
Elliott: Umm, Shawn, first I want to say what a pleasure it was
to talk with you. I know you did not want to be here at first,
but I appreciate that were patient with me and answered all
of my questions.
Shawn: I enjoyed it, actually.
Elliott: Great, I’m glad to hear that. You know, there were a
few things about you that stood out to me. The first is that
you seem to be so much more than the troubles that have
been bothering you. It seems to me that you like being at
your best much more than having the problems that have
plagued you recently. The more you talked about your par-
ents being happy and spending time with Mike, the more it
felt like that is the real you. Sort of like who you really are
and who you’d like to be.
Shawn: Yeah, I’ve just been so stupid lately.
Elliott: Well, how do you feel about noticing some of the
changes we discussed today and when they actually happen,
and see what difference that would make for you?
Shawn: I’d like that.

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Elliott: Excellent. Would you mind if I talked to your parents


for a second?
Shawn: Not at all.
Elliott: It was a pleasure to meet you.
Shawn: Likewise.

At the end of the session, I had a brief chat with the parents and informed
them that Shawn’s mood seemed to shift during the session, and that he was
more interested in making changes in his life. I asked the family to notice his
changes and praise him for them.
The family attended one more session two weeks later and could not
believe the changes Shawn had made in his life. He had been hanging
around with Mike and doing his homework daily. His grades and mood had
drastically improved as well. To the family’s surprise, they did not think
they needed another session.
It is important to remember when working with youth who are using
substances that we cannot be scared or intimidated by their presenting
problem. Instead, we need to remember that if we have a meaningful con-
versation about what the student’s best hopes are and what he or she will
notice when those best hopes happen, we are being solution focused. We
need to remember that this kind of conversation allows us to speak to the
real kid, not just a kid using drugs.

Resources
Bakhshipour, B., Aryan, S.K., Karami, A., & Farrokhi, N. (2011). The effectiveness of
solution-​focused therapy on reducing behavioral problems of the elementary and
brief therapy and high school students at Sari. Counseling Research and Development,
10(37), 7–​24.
Doweiko, H. E. (2002). Concepts of chemical dependency (5th ed.). Pacific Grove,
CA: Brooks/​Cole.
Franklin, C., Moore, K., & Hopson, L. (2008). Effectiveness of solution-​focused brief
therapy in a school setting. Children and Schools, 30(1), 15–​26.
Franklin, C., Trepper, T. S., Gingerich, W. J., & McCollum, E. E. (2012). Solution-​
focused brief therapy:  A  handbook of evidence-​based practice. New  York, NY:  Oxford
University Press.
Froeschle, J. G., Smith, R. L., & Ricard, R. (2007). The efficacy of a systematic substance
abuse program for adolescent females. Professional School Counseling, 10, 498–​505.
King, Z., & Reza, A. (2014). The effectiveness of training solution-​focused approach to
increasing the level of social adjustment of adolescent identity crisis. Journal of Women
and Society, 17(5), 21–​4 0.

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Office of Applied Studies. (2013). Results from the 2008 National Survey on Drug Use and
Health. Rockville, MD: Substance Abuse and Mental Health Services Administration.
Sanjuan, P. M., & Langenbucher, J. W. (1999). Age-​limited populations: Youth, adoles-
cents, and older adults. In B. S. McCrady & E. E. Epstein (Eds.). Addiction: A compre-
hensive guidebook (pp. 477–​498). New York, NY: Oxford University Press.
Smock, S. A., Trepper, T. S., Wetchler, J. L., McCollum, E. E., Ray, R., & Pierce, K. (2008).
Solution-​focused group therapy for level 1 substance abusers. Journal of Marital and
Family Therapy, 34(1), 107–​120.
US Department of Health and Human Services. (2008). Treatment of adolescents with sub-
stance use disorders. Substance Abuse and Mental Health Services Administration,
Center for Substance Abuse Treatment: Rockville, MD.

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10
■ ■ ■

SFBT in Action
Eating Disorders
Karrie Slavin & Johnny S. Kim

Definitions and Descriptions


Eating disorders are not very widespread among the general population
(Smink, van Hoeken, & Hoek, 2012)  but have been identified as one of
the most frequent issues encountered by school social workers (Kelly et al.,
2015). Eating disorders are mostly associated with mental health problems
that can negatively affect a student’s physical, emotional, and mental health
(Stice, Marti, & Durant, 2011). While eating disorders are mostly preva-
lent in Caucasian females, increases in eating disorders have been reported
among African Americans, Latinos, and Asian Americans (Alegria et  al.,
2007; Heller & Lu, 2015; Shuttlesworth & Zotter, 2009). Additionally, males
now account for anywhere between 10% and 25% of all cases, with male
athletes at higher risk (Heller & Lu, 2015). The three most central types
of eating disorders are anorexia nervosa (AN), bulimia nervosa (BN), and
binge-​eating disorder (BED).
Prevalence rates for AN are estimated at 0.4% among young females
(American Psychological Association, 2013). The Diagnostic and Statistical
Manual of Mental Disorders, Fifth edition (DSM-​5) defines AN using the follow-
ing three criteria: 1) significantly low body weight due to restriction of energy
intake given age, gender, and physical health; 2) intense fear of gaining weight,
or persistent behaviors to hinder weight gain; and 3) disturbance in the way one
perceives the self’s body weight or shape, undue influence of body weight or
shape on self-​evaluation, or absence of recognition of the seriousness of current
low body weight. In essence, a student maintains an unhealthy body weight

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that is below the normal level for age, gender, and physical health. Within
AN are two subtypes called restricting type and binge-​eating/​purging type.
Restricting type involves weight loss through dieting, fasting, and/​or excessive
exercise. Binge-​eating/​purging type involves binge-​eating or purging behavior,
such as self-​induced vomiting, misuse of laxatives, diuretics, or enemas (APA,
2013).
The second common eating disorder school social workers frequently
encounter is BN. Prevalence rates for BN are slightly higher than those for
AN and are estimated at 1% to 1.5% among young females (APA, 2013). BN
involves three essential features:

1. Recurrent episodes of binge eating (i.e., eating large amounts of food


in a short period of time, lack of control on amount or type of food
consumed).
2. Reoccurring inappropriate behaviors to prevent weight gain (i.e.,
purging behaviors).
3. Self-​evaluation overly influenced by body shape and weight.

To meet the DSM-​5 criteria for BN, the binge-​eating and purging behaviors
need to occur an average of once per week for three months (APA, 2013).
Unlike AN, students suffering from BN are typically of normal weight to
overweight for their age and gender (Frank, 2015).
The third type of eating disorder school social workers are likely to
encounter is BED. The prevalence rates for BED among adult (18 years and
older) females are estimated at 1.6%, with rates of 0.8% among adult males
(APA, 2013). According to the DSM-​5, BED must occur at least once a week
for three months, and the student must experience marked distress regard-
ing binge eating. Additionally, there must be recurrent episodes of binge
eating, as described earlier for BN. The key distinguishing criteria for BED is
that binge-​eating episodes are associated with three or more of the following:

• Rapid eating beyond normal for the student.


• Eating until feeling uncomfortably full.
• Eating large quantities of food when not hungry.
• Eating by oneself due to embarrassment over the large amount of food
being consumed.
• Feeling disgusted with oneself, depressed, or guilty after binge eating.

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All these criteria need to be met in order have the diagnosis of BED (APA,
2013).

What Causes Eating Disorders


Eating disorders typically occur during adolescence and young adulthood
and can continue into adulthood (Frank, 2015). Currently, we have little
understanding about the exact cause of eating disorders, but many ideas
have been posited to help understand this problem. Recent research shows
that some students may be more genetically predisposed to eating disor-
ders than others (Pomeroy & Browning, 2013). An article by Frank (2015)
reviewed two recent studies on AN and BM using magnetic resonance imag-
ing to compare brain images from girls and women diagnosed with one of
the two eating disorders with brain images from a group of healthy girls
and women. Frank reports, “The studies highlight that acute AN and BN are
associated with widespread alterations in cortical structure across the brain,
primarily reductions in cortical volume or thickness, but the BN sample
also showed areas of larger volume, raising the question whether this condi-
tion is associated with white matter reorganization or altered development”
(p. 602). The understanding of eating disorders from a genetic and physi-
ological perspective is still in its infancy, however, and limited due to incon-
sistent definitions of diagnoses and symptoms, but it continues to gain much
attention as science advances (Trace, Baker, Penas-​Lledo, & Bulik, 2013).
Most research has focused on examining psychosocial factors, which has
provided a more robust understanding of eating disorders. Several research
studies have pointed to concerns around body image and pressures to follow
an ideal of thinness (Frank, 2015) as a cause. Students exposed to an ideal
body image that is thin often internalize this ideal, and the resulting weight
concerns contribute to developing an eating disorder (Keel & Forney, 2013).
A research article by Stice, Marti, and Durant (2011) further elaborates:

This model posits that perceived pressure to be thin from fam-


ily, peers, and the media and internalization of the thin beauty
ideal produce body dissatisfaction. This body dissatisfaction
theoretically promotes unhealthy dieting behaviors that may
progress to anorexia nervosa. Further, individuals may think
dietary restrictions for circumscribed periods permits them to
binge eat but not gain weight, which might promote a cycle of
acute restriction punctuated by overeating.” (p. 623)

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Besides body image influences, other risk factors also have been identi-
fied and are useful for understanding eating disorders. Weight concern is
considered to be a common and consistent risk factor for eating disorders
(Keel & Forney, 2013). For example, adolescent girls in the upper 24% of
body dissatisfaction group were four times more likely to develop an eating
disorder (Stice et al., 2011). Additionally, 11.2% of college-​aged woman who
reported high levels of weight concern developed an eating disorder within
three years (Jacobi et al., 2011).
Peer groups are another important risk factor for eating disorders among
students. It is common for students to socialize and interact with other stu-
dents who share similar interests and values. This peer socialization has the
potential to reinforce or exacerbate concerns about body weight and shape
among girls and boys, creating a climate that influences behaviors that can
lead to students developing eating disorders (Keel & Forney, 2013). For
example, a longitudinal study by Zalta and Keel (2006) examined the effects
of peer selection and socialization on bulimic symptoms in college students
and found that personality factors played a significant role in peer selection,
which then led to those selected peers influencing bulimic symptoms.

Reasons for Using the SFBT Approach


There are many ways to help students suffering from eating disorders,
and treatment interventions come from the medical, mental health, public
health, and social work perspectives. Pomeroy and Browning (2013) note
the different types of interventions used to address eating disorders, such
as pharmacological interventions, psychoeducational programs, experien-
tial therapies (e.g., art and movement therapy), nutritional therapy, family
therapy, cognitive-​behavioral therapy, dialectical behavioral therapy, and
training in social problem-​solving skills. The ultimate goal for many of
these interventions is to restore a healthy body image by correcting distorted
thinking and providing psychoeducation to help clients change behaviors
that will lead to healthy physical functioning (Pomeroy & Browning, 2013).
SFBT provides an alternative way to engage students with eating dis-
orders and can be used as the sole treatment modality or in conjunction
with other treatments (e.g., psychoeducation, family therapy, or nutritional
therapy). Rather than dwelling on students’ negative thoughts or beliefs,
SFBT focuses on helping students identify what they want (their preferred
future) when the problem is no longer there and how they’ve made that

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happen in the past (exceptions). This can be especially useful for students
with eating disorders because, when traditional therapy modalities are used,
it is reported that many students try to conceal or deny their problems and
avoid seeking counseling help (Smink et al., 2012). Because of its collabora-
tive nature and its emphasis on the client’s worldview, goal definitions, and
resources, SFBT enhances cooperation during the change process (Martin,
Guterman, & Shantz, 2012). It engages students in a non-​defensive manner
and allows students to detail what they want their goals to be and the con-
crete steps to make their goals happen.

Case Example
The following is a case example of a school social worker utilizing SFBT in a
first session with a student experiencing an eating disorder.

Background Information
Jessica is a 16-​year-​old junior at Central Valley High School. A  straight-​A
student, she competes on the varsity cross-​country team and the varsity
swim team, and she designs sets for Central Valley’s drama club. She has
always done well in school and has seemed happy and well adjusted, so this
is her first time speaking with the school social worker.

Section 1: Starting the Conversation

School Social Worker (SSW): Hi, Jessica, it’s nice to see you


today. Thanks for coming in.
Jessica: You’re welcome. Thanks for seeing me.
SSW: You’re welcome! So, it looks like from your file that your
grades are excellent—​good for you. And you made varsity
this year for swimming, wow.
Jessica: [shyly] Yeah, and for cross country.
SSW: Oh, my gosh, how did you get to be such a good athlete?
Jessica: Well, lots of practice, I guess, and it’s in my genes. My
mom was a tennis champ in high school, and my dad was
on the football team.

In Section 1, the school social worker focuses on starting the conver-


sation in a way that connects with the student and immediately conveys
caring and respect. She does this by thanking the student for coming in

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184

and by asking about her strengths. By starting the conversation this way, the
school social worker is showing that she sees the student as a whole person
and wants to know things about her before finding out about the student’s
problem. She also has the opportunity to compliment the student, which is
an important SFBT technique that functions to “draw clients’ attention to
their strengths and past successes that might be useful in achieving their
goals” (p. 35), while also helping them to “grow more hopeful and confident”
(De Jong & Berg, 2008, p. 35).

Section 2: Beginning to Define what the Student Wants to Have Different

SSW: Oh, so genes and practice, huh? That’s great. So then,


before we go any further, let me just ask you, in terms of
your visit today, how are you hoping that I can be helpful
to you?
Jessica: Umm, well, I really came in because my friend Tia
wanted me to. She had um, noticed that I, well—​it’s dumb,
I feel dumb even saying it. I can’t say it.
SSW: Hey, that’s okay. I think it’s really cool that you were
brave enough to decide to even come in here today. How did
you get yourself to do that?
Jessica: Well, I guess I knew that Tia is right. I need some help.
SSW: Okay, so you need some help. If you don’t mind me ask-
ing, what are you noticing about yourself that is telling you
that you need some help?
Jessica: I’m not eating enough. Oh, my gosh, I can’t believe
I said that! [pauses] Like, I pretty much eat an orange for
breakfast, and a yogurt for lunch. I can’t believe I’m telling
you this!
SSW: Wow, okay. So, you feel like you’re really not eating
enough.
Jessica: No, I’m not. And the other part is … Well, I really
don’t know if I can tell you the other part.
SSW: Okay.
Jessica: Well, I work out a lot. Like, a LOT, like, way more
than my friends. I wake up at five and go to the gym for an
hour, then I go to school, then I go to practice, then I work
out at home for another hour before bed.

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SSW: Okay, yes, that does sound like a lot. I bet that’s


exhausting!
Jessica: [nodding] It is.

In this section, the school social worker asks questions such as “How
are you hoping that I can be helpful to you?” and “What are you noticing
about yourself that is telling you that you need some help?” to begin to elicit
the student’s understanding of the problem and what she would like to be
different. During this beginning stage in SFBT, we listen respectfully to the
“problem-​talk,” or the client’s description of the problem from her own per-
spective. We then guide the conversation toward “solution-​talk,” where we
begin to think about and describe what will be different for the client when
her problems are solved (De Jong & Berg, 2008).

Section 3: Beginning to Generate Solution-​Talk

SSW: Can I ask you a question that you may need to think


about for a minute?
Jessica: Okay.
SSW: Suppose we have a great conversation today, and it’s
really helpful to you. So helpful, in fact, that it really gets
you going on making some changes. Then let’s say maybe
even later today, tomorrow, the next day, or even later this
week, you start to notice these changes. What will be differ-
ent about you that will show you that talking with me today
really helped?
Jessica: Wow, that’s a hard question. [silence] Well, the prob-
lem is that I want to change, I know I need to eat more and
work out less, but I also don’t wanna change. I kind of feel
better when I’m doing things this way, you know? Even
though I know it’s wrong.
SSW: Hmm, so part of you wants to change, and part of you
doesn’t. I’m just curious, you know, about that part of you
that wants to change. Can I just ask you about that part for
a minute?
Jessica: Mmm-​hmm.
SSW: So, that part of you that wants to change, what is telling
that part of you that change is important right now for you?

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186

Jessica: That part of me knows that what I’m doing is


unhealthy, and it wants me to eat more and rest more and
not spend all my time working out. And it thinks that,
I don’t know, that those changes are just, like, the right
thing to do.
SSW: Wow, that part of you sounds really wise. The right
thing to do, huh? What tells you that eating more and
resting more and not working out so much are the right
thing to do?
Jessica: Well, that’s what normal people do. And what my par-
ents would want me to do, and Tia.
SSW: Oh, yeah, the people you care about. So, they would be
happy if you made some changes?
Jessica: Well, Tia definitely would. I’m not sure about my
parents because I think I’ve been hiding things from them
pretty well.

In Section 3, the school social worker begins to generate solution-​talk


by asking questions like “What will be different about you that will show
you that talking with me today really helped?” and “What is telling that
part of you that change is important right now for you?” These questions
are generally useful because they give the student the opportunity to begin
constructing a preferred future, where the problems that she is struggling
with have been solved. In this section, you can observe the student’s
ambivalence about change, which is often present in students with eating
disorders. The school social worker listens to her, affirms her experience,
and also chooses to ask her questions about the part of her that wants to
change.

Section 4: Continuing Solution-​Talk and Beginning to Develop Goals

SSW: Okay. Let’s say that you and I work together, and we


become a really great team, and we really get you making
some changes in your life. And then we turn out to be really
successful, so successful that you don’t even need to come
back and see me anymore because you’re doing great. When
that happens, what will we notice about you that will really
show us that you’re doing better?

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Jessica: Well … I would be happier. Yeah, I’d be a lot happier,


and a lot calmer. And I would be feeling good about myself.
[pauses] You know, I think maybe I’d love myself instead of
hating myself.
SSW: Wow, those sound like a lot of good changes. So let’s see,
you’d be happier, calmer, feeling good about yourself, and
loving yourself … Anything else?
Jessica: Yeah, I wouldn’t care what the other girls said about
me. And I wouldn’t worry so much about my grades, or
about if a boy will ever like me. Or about college.
SSW: So a lot fewer worries. And, um, what will we see you
doing instead of worrying?
Jessica: Well, I guess enjoying things. And … I probably
wouldn’t have so many problems with the eating and work-
ing out stuff.
SSW: Oh, really, wow, what do you think you’ll notice about
yourself that will show you that you’re having less problems
with that stuff?
Jessica: Well, I’ll just do it more like I did before. You know,
like a regular breakfast, a regular lunch, things that normal
people do. And probably just working out at practice and
nothing else. But that’d be really hard for me!
SSW: Yeah. Yeah. So … oh, I don’t want to miss this, you said
“like I did before”—​does that mean that you used to have
less problems with eating and working out?
Jessica: Yeah, I would say, like, freshman year I was pretty
normal, you know. I ate regular amounts and was just like
a regular high school girl athlete. I guess that was before
I got so worried, and then it just started feeling like doing
all that stuff was helping or something. I don’t know.
It’s weird.

In this section, the school social worker is asking the student questions
to focus her mind on further defining her preferred future when she is doing
well. The questions she asks and her follow-​up responses invite the student
to give further details about her preferred future. Through this process, the
school social worker and the student are able to begin defining some of the
goals that are important to the student—​feeling happier, feeling calmer,

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feeling good about herself, and so forth. At the end of the section, the school
social worker also asks an exception question and discovers that there was
a time when the student was doing better. Exception questions are useful
because they can “help clients become more aware of their current and past
successes in relation to their goals” (De Jong & Berg, 2008, p. 105).

Section 5: Amplifying what the Student Wants and Further Developing Goals

SSW: Yeah, okay. So that’s when things changed. You know,


can I ask you a strange question?
Jessica: Okay.
SSW: Let’s say you leave my office today and you go about the
rest of your day like normal. You finish your classes, you go
to practice, you go home, you have dinner, you go to sleep at
your normal time, and you happen to fall into a really deep
sleep. And while you’re sleeping, a miracle happens. And
the miracle is that the problems that brought you here have
been solved, so you’re happier, calmer, feeling good about
yourself, all those things are better. But the tricky thing is,
the miracle happened while you were asleep, so when you
first wake up, you don’t know that it happened. So, when
you wake up tomorrow and this miracle has happened,
what’s the first small thing you notice that lets you know
your miracle has happened?
Jessica: [thinking] Well, I wouldn’t wake up so early.
SSW: [encouraging] Okay.
Jessica: Yeah, I would wake up at six with my alarm instead
of at five, because my mind would be better, more calm, so
I would stay asleep.
SSW: Wow, so the first thing that will really show you that
your miracle has happened will be when you wake up at six
with a more calm mind.
Jessica: Yeah, my mind will be more calm, and actually waking
up at six would be a really big change because, then, well, if
it’s really a miracle, I won’t have worked out in the morning
before I go to school.
SSW: Yeah, you’re right. So, after your miracle has happened,
you’ll wake up at six, your mind will be calmer, and you

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won’t be working out before school. What will you be doing


instead?
Jessica: Well, probably just getting ready.
SSW: Yeah, and how will that go differently now that your
miracle has happened?
Jessica: Well, I would feel more calm, so I’d be thinking ahead
that maybe it would be a good day at school. And I’d be less
tired because I slept longer, so I would probably not be so
slow getting ready, so I could really sit down at the table for
breakfast.
SSW: Wow, yeah. And so we’ll see you sitting down at the table
for breakfast. And how will that change things?
Jessica: Well, it’s a miracle, so I will eat a healthy breakfast.
SSW: Oh, yeah, like what will we see you eating?
Jessica: Probably oatmeal with fruit and nuts. That’s what
I used to eat.
SSW: Great, so we’ll see you eating oatmeal with fruit and nuts
at the table. How will that make your day go better?
Jessica: Well, since it’s a miracle, it won’t make me feel fat.
SSW: Yeah, definitely, and how will that change things for you?
Jessica: Well, I won’t have to spend all morning thinking about
how fat I look because I ate that for breakfast.
SSW: Yeah, what will you be doing instead all morning?
Jessica: Well, really paying attention to things more at school.
Like I already pay attention, but it takes so much work
because there is this whole other thing going on in my brain
about what I ate and being fat and what I will eat and what
I look like to other people and stuff. So since that will be
gone, I’ll really just sort of pay attention and maybe even
enjoy my classes, at least the ones I like.
SSW: Wow, so you’ll really be able to just pay attention and
enjoy them.
Jessica: Yeah, and I’ll have more energy, too, because I won’t
have woken up so early, and I won’t be so tired from work-
ing out and not eating almost anything. It’s really hard!
[tears up]
SSW: Yeah. That sounds hard. [pauses] So, you’ll have more
energy?

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190

Jessica: [smiling a little] Yeah.
SSW: How will that make your day go better?
Jessica: Oh, a lot better. I’ll want to talk to my friends at
lunch, and then I guess since it’s a miracle I’ll eat more of a
lunch, and then I’ll maybe have some pep in my step in the
afternoon.
SSW: Great, more pep in your step. And what will you be
doing differently once you have more pep in your step?
Jessica: Well, I’ll just be handling everything more easily, so
if a teacher gives an assignment I’ll be like “I can do that”
instead of just starting to worry that I won’t do it perfectly.
SSW: Oooh, I love that, you’ll be like “I can do that”.
Jessica: Yeah, and I’ll be feeling more good about myself, like
I said before, loving myself. [tears up] That would be really
different for me.
SSW: Yeah, that sounds important to you. How will things be
different for you when you are feeling good about yourself
and loving yourself?
Jessica: [silent for a bit] I’ll just, you know, feel better inside.
I won’t want to do things to punish myself, like not eating.
SSW: What will you want to be doing instead of punishing
yourself when you’re feeling good about yourself?
Jessica: I guess being nice to myself, telling myself I’m
doing a good job, rewarding myself, like maybe by doing
something fun.
SSW: That sounds great.
Jessica: Yeah.
SSW: And after your miracle happens tonight, who do you
think will be the first person to notice the change in you?
Jessica: Oh, definitely Tia.
SSW: Oh, yeah? What will she notice about you that will show
her that your miracle has happened?
Jessica: [tears in her eyes] I’ll seem happy.
SSW: That’s great. What will Tia notice about you that will
really show her that you’re happy?
Jessica: I’ll be smiling. I’ll have pep in my step. I’ll be saying
good things about myself. And I’ll be eating my lunch and

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not saying I’m fat, and just, like … back to myself before.
Like, how I used to be.
SSW: Back to yourself.
Jessica: Yeah.

The miracle question is one of the most important techniques in


SFBT to further develop student goals and amplify what the student
wants. As described by De Jong and Berg (2008), “the miracle question
requests clients to make a leap of faith and imagine how their life will
be changed when the problem is solved” (p. 84). They further explain
that this is particularly useful because “it gives clients permission to
think about an unlimited range of possibilities” (p. 84) and “begins to
move the focus away from their current and past problems and toward
a more satisfying life” (p. 84).
In this section, the school social worker asked the initial miracle ques-
tion, and then asked a number of follow-​up questions that encourage the
student to create a more detailed picture of her miracle. During this process,
the school social worker and student are able to uncover a lot more infor-
mation about what the student would like to be different and how those
differences will be helpful to her. The school social worker asks questions
such as “How will that go differently?” and “How will that change things?” to
give the student the opportunity to elaborate more fully on how the desired
changes will positively impact her life. The school social worker also asks
the student the question “What will you be doing instead?” multiple times,
to give her the chance to consider what positive things will be in her life in
place of the things she is trying to move away from. In addition, the school
social worker asks for details about who would notice the change in the
student, and what that person would notice, to help the student begin to
imagine her changes in interactional terms. All of this detail helps to create
a more vivid picture of what the student wants to be moving toward, and
helps her goals to become more concrete, behavioral, and measurable. For
example, instead of just stopping at the more vague goal of “having more
energy,” the school social worker and the student are able to define that
when she has more energy, Jessica will want to talk to her friends at lunch,
eat her lunch, have pep in her step in the afternoon, find it easier to handle
things in class, and if a teacher gives her an assignment, she will feel like
she can handle it.

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192

Section 6: Scaling the Miracle

SSW: Jessica, would it be okay for me to draw you a small


picture?
Jessica: Sure.
SSW: [draws a scale on a piece of paper] Let’s say this is a scale
from 0 to 10, with 10 being your total miracle happening all
the time and 0 being the total opposite of your miracle hap-
pening all the time. Does that make sense?
Jessica: Yeah.
SSW: So, on this scale then, where would you say you are
these days?
Jessica: [pointing on the scale] Probably like a 2.
SSW: Okay, thanks. [draws the 2] And, um, what lets you
know you’re at the 2 instead of something lower, like a 0?
Jessica: What? Oh … Well, I’m still getting good grades.
SSW: Yes, you are. What else?
Jessica: I do eat some. And sometimes I feel okay about myself.
SSW: Great. What else?
Jessica: I have friends.
SSW: Yeah! What else?
Jessica: I think that’s all.
SSW: Okay, great. So, let me ask you, in terms of our work
together, what number will you be satisfied with in the end?
Jessica: Like, you and me working together? What number
when we’re done?
SSW: Exactly.
Jessica: [thinking] Well, I wanna be at a 10. But that sounds so
far off. Maybe a 7?
SSW: Sounds good. Let me draw that for you. [draws the 7] So,
what are the biggest things that you’ll notice about yourself
that will really show you that you’re at a 7?
Jessica: I’m happy. And calmer. And like I said, feeling good
about myself. Maybe even starting to love myself a little bit.
And you know, eating better and working out less. And also
talking to my friends more. And paying attention better
in class.

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SSW: That’s a lot of great stuff! Like you’ll be back to yourself?


Jessica: Yeah.

In this section, the school social worker utilizes scaling questions with
the student to begin to define where the student is and where she wants to
go within the frame of reference of her miracle. As described by De Jong and
Berg (2008), “scaling is a useful technique for making complex aspects of
the client’s life more concrete and accessible to both practitioner and client”
(p. 107). In this case, scaling the miracle is a useful process because it brings
the miracle back into reality and allows the student to identify the bits of her
miracle that are already happening. In addition, it helps the student to con-
sider how close she perceives that she will need to be to her miracle picture
in order to be satisfied, and also what changes will be the most important to
her success. This emphasizes to the student that she does not need to make
her miracle picture happen in its entirety to consider herself successful—​she
only has to get to a better place, as defined by herself. Asking about the point
on the miracle scale where the student will be satisfied also gives the school
social worker and the student an opportunity in the first session to imagine
the endpoint of therapy. This helps to emphasize the brief nature of SFBT—​
it assumes that the student will not be in therapy forever and, in fact, will
stop working with the school social worker when she is ready to continue
the change process on her own.

Section 7: Break, Feedback, and Task Setting

SSW: Excellent. So, usually toward the end of a visit, I like to


take a break for about two or three minutes. I actually leave
the room and think about everything we talked about today,
and then I come back and give you some things to think
about until I see you again. Would it be okay with you for
me to do that now?
Jessica: Okay.
SSW: Before I take my break, I always like to ask, is there any-
thing that you didn’t get to say today that you still wanted
to say?
Jessica: No, I actually said a lot more than I thought I would.
SSW: Okay, then I will see you in just a few minutes.
[The SSW leaves and then returns.]

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SSW: All right, here is what really stands out for me today.


I first just really wanted to compliment you for coming in
here today to talk with me about this stuff. I know it’s not
easy to talk about, so I’ve really been saying to myself, what
a brave young woman! I’m also impressed with the wise
part of you that is interested in making some changes, and
that you were able to really spell out those changes so well
for me today. In particular, I loved what you said about feel-
ing calm and happy, loving yourself, eating and working out
in ways that are healthier, which shows that you are back
to yourself. And I thought it was neat to see that you are
already at a 2 on your miracle scale, so we are not starting
from a 0. So, I wanted to give you a little task to do between
now and next time we meet, if that would be okay with you?
Jessica: Okay.
SSW: Can you please pay really good attention so that you
notice any times when you are at the 2 or even a little bit
higher sometimes?
Jessica: Like, notice when I’m doing a little better?
SSW: Yes. And really notice what is different that shows you
that you’re doing a little bit better. Maybe you’re thinking a
little better, feeling a little better, doing something a little bit
better.
Jessica: Okay, I think I can do that.
SSW: Great, you can even jot some of them down to help you
remember for next time if you want to.
Jessica: Okay.
SSW: Do you have any questions about anything we talked
about today?
Jessica: No.
SSW: Great. And my very last question, I promise, is what
was the most helpful to you today, from everything that we
talked about?
Jessica: [pauses] My miracle. Because it’s nice to think that
something like that might be able to happen to me.
SSW: Definitely.

194 Solution-Focused Brief Therapy in Schools


 195

In Section 7, the school social worker utilizes a break so that she can
reflect on the session and formulate feedback that will hopefully be helpful
to the student. During this break, the school social worker considers what
the student has said that she wants to have different, the things that social
worker is genuinely impressed with about the student that relate to what the
student wants to have different, and what the social worker thinks could be
a useful task for the student to complete between sessions. The school social
worker then returns, delivers the compliments, and follows with the task
request. In this case, the school social worker chooses the task of noticing
times when the student is doing a little bit better in an attempt to draw the
student’s attention to these times for multiple reasons. First, this will allow
the student to observe and experience herself doing better, which will build
her confidence in her ability to continue changing. Second, the student
will be able to make observations about what she is doing differently when
she is doing better, which will give her good clues about which behaviors,
thoughts, and feelings she would like to replicate. Lastly, simply by paying
attention to the times when she is doing better, the student may end up hav-
ing more times when she is doing better because her mind will be dwelling
in this reality more of the time.
At the very end of the session, the school social worker asks what was
most helpful to the student that day. This is useful because the student’s
reply may give the social worker some clues about what can be done in
future sessions that will be most useful to the student. It is also a nice way
to conclude the conversation because it leaves the student with something
positive to take away from the session.

References
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De Jong, P., & Berg, I. K. (2008). Interviewing for solutions (3rd ed.). Belmont, CA: Brooks/​
Cole.
Frank, G. K. W. (2015). What causes eating disorders, and what do they cause? Biological
Psychiatry, 77, 602–​603.
Heller, N. R., & Lu, J. (2015). Eating disorders and treatment planning. In K. Corcoran &
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Jacobi, C., Fittig, E., Bryson, S. W., Wilfley, D., Kraemer, H. C., & Taylor, C. B. (2011).
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Shuttlesworth, M., & Zotter, D. (2009). Disordered eating in African American and
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Smink, F. R. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disor-
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414. doi:10.1007/​s11920-​012-​0282-​y
Stice, E., Marti, C. N., & Durant, S. (2011). Risk factors for onset of eating disor-
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Research and Therapy, 49, 622–​627. doi:10.1016/​j.brat.2011.06.009
Trace, S. E., Baker, J. H., Penas-​L ledo, E., & Bulik, C. M. (2013). The genetics of eat-
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annurev-​clinpsy-​050212-​185546.
Zalta, A. K., & Keel, P. K. (2006). Peer influence on bulimic symptoms in college stu-
dents. Journal of Abnormal Psychology, 115, 185–​189.

196 Solution-Focused Brief Therapy in Schools


9╇17

Index

abstinence binge eating, 180


defined, 153, 154 binge-╉eating disorder (BED), 180
secondary, 154 diagnostic criteria, 180–╉81
abuse. See child abuse and neglect body image and eating
academic problems, 34–╉36t disorders, 181
acknowledging student’s bridging statements, providing, 147
feelings, 141 Brief Family Therapy Center
affirmative relationships with (BFTC), 32
students, keys to, 111 Britain. See United Kingdom
aggression, 60–╉61 broaden-╉and-╉build theory of
Akos, P., 129 positive emotions, 14–╉15
anorexia nervosa (AN), 179–╉80 Browning, P. Y., 182
diagnostic criteria, 179 bulimia nervosa (BN), 180
subtypes, 180 diagnostic criteria, 180
anxiety, solutions to, 96, 98
eight-╉week SFBT group for case study process, a
student anxiety, 96, solution-╉focused, 88–╉89
97–╉98b, 98 change
approach goals, 132 defining what the student wants
at-╉r isk students. See also risk factors to have different, 184–╉85
solution-╉based approach for, 57–╉61 SFBT theory of, 13–╉15
avoid goals, 131 change party, 104
child abuse and neglect, 124–╉25.
Baldwin, Victoria, 56 See also mandated reporting
Bannink, F., 124 abuse and trauma in
behavior problems, 34–╉36t schools, 107–╉8
Berg, Insoo Kim, 13–╉14, 74, 77, 79, child maltreatment in United
111–╉13, 121, 132, 138, 140, States, 108–╉9
141, 144, 191, 193 trust and safety

197
918

child abuse and neglect (Cont.) emotions. See also feelings


factors helpful in building a negative, 15
sense of, 111–​12 positive, 14–​15
importance in recovery and Erford, B. T., 128
thriving, 110–​12 European Brief Therapy
cognitive-​behavioral therapy (CBT), Association, 47
4, 131–​32 exception questions, 17–​18
CBT social worker model, 14b expectations, 19
contrasted with SFBT, 13, 14b, experimentation, defined, 154
17, 21, 131–​32
Communities in Schools (CIS), 59 family therapy, SFBT, 90–​94
community schools, 90 feedback, providing, 176, 193–​95
compliments of client by feelings. See also emotions
clinician, 21 acknowledging, validating,
congruence. See incongruence and normalizing
coping dialogue, engaging student student’s, 141–​43
in a, 138–​41 Fiske, H., 133, 139
coping questions, 21–​23, 138, 141 follow-​up questions, 145
cultural competence, gaining, 9 Frank, G. K. W., 181
Fredrickson, B., 14–​15
Darmody, M., 133 future description,
De Jong, Peter, 31, 138, 140, 141, preferred, 166–​76
144, 191, 193
de Shazer, Steve, 13–​14 Galassi, J. P., 129
doing something different, 23 Garner, J., 25, 27
Dolan, Y., 136 Garza High School, 52–​53, 71.
Durant, S., 181 See also Tier 1 framework
academic achievement and
eating disorders success, 65–​69
case example, 183–​95 data collected by school
causes, 181–​82 district, 69–​70
definitions and implementing SFBT in the alter-
descriptions, 179–​81 native school, 61–​63
reasons for using SFBT as model program, 70–​71
approach, 182–​83 schoolwide examples of SFBT
Eggert, L. L., 130–​31 principles, 63, 64b, 65
Eisengart, S., 32–​33 solution-​based approach for
elders. See GRGs at-​r isk students, 57–​61

198Index
9 1

training philosophy, 54–​55 incongruence, assessing for, 137


ways teachers used solution-​ individualized education plans
building intervention (IEPs), 9–​10
skills, 57
goal formation process Kelly, Michael, 74–​75
amplifying what the student Kelly, S., 113, 121
wants, 188–​91
assisting student with, 143–​44 language, client
beginning to develop picking up the, 162–​66
goals, 186–​88 Lévi-​Strauss, Claude, 148
students not ready to life lessons, panel of elders
start, 138–​41 sharing, 104
goal setting, 20–​21. See also task
setting Madden, B., 133
grandparents raising grandchildren. mandated reporting
See GRGs being a mandated
GRG ideas, orientation to, 99 reporter, 112–​13
GRG parenting problems, iden- and beyond, 114–​24
tifying exceptions to Marti, C. N., 181
presenting, 102–​3 mental health issues. See also
GRGs (grandparents raising specific issues
grandchildren) prevalence, 126–​28
identifying strengths as a student risk and protective
grandparent and applying factors, 128–​31
them to your mission as a mental health services,
GRG, 99–​100 school-​based, 5–​6
a solution-​focused parent group meta-​analysis, 33, 37b, 37–​39, 39t
for, 88, 98–​104 definition and overview, 37b
using SFBT interventions in daily Metcalf, L., 144
life with grandchildren, 103 microsuccesses, 138
ways to keep going as a Miller, S. D., 31
GRG, 103 miracle question, 166, 191
GRG wisdom night, 104 miracle scale, 192–​93
groups, SFBT, 96, 97–​98b, 98 Mix-​It-​Up Days, 63
motivational interviewing
Henden, J., 133, 134, 136, (MI), 16–​17
139–​44, 146–​48 moving forward, questions related
hope-​building process, 148 to, 18b

Index199
20

Multi-​tiered System of Supports/​ protective factors, 155–​56. See also


Response to Intervention under mental health issues
framework, 87. See also defined, 130
Response to Intervention psychotherapy, history of, 12–​13
(RtI) framework; three-​tier Public Health Service Act, 128–​29
system; Tier 1 framework;
Tier 3 framework; WOWW questions (to ask student in SFBT),
program 17–​18, 18b. See also miracle
Murphy, J. J., 145–​46 question
to elicit suicidal ideation if
needs assessment, present, 137–​38
solution-​focused, 94–​95 follow-​up, 145
neuroception, 109 "Why," 142
neuroscience and solution-​
focused engagement with Rak, C. F., 129
students, 109–​10 rapport, developing rapid, 133–​34
Newsome, D. W., 128 Ratner, H., 114
Newsome, S., 97–​98 recovery, defined, 154
resiliency, 128–​30
O’Connell, M. E., 130 defined, 129
Olson, K., 109 resistance, 23–​24
Response to Intervention (RtI)
parent group, solution-​focused, framework, 52, 53. See
88, 98–​104 also Multi-​tiered System
Patterson, L. E., 129 of Supports/​Response to
Peterson, C., 99–​100 Intervention framework
Pomeroy, E. C., 182 risk factors, 128–​31, 155–​56, 156t
Porges, Stephen, 109 Rock, E., 128
positive emotions theory, 14–​15 Rogers, Carl R., 113
positive psychology, 14
pre-​session change, 17 safety. See under child abuse and
problem-​free talk neglect
purposes, 134 Saleebey, D., 31
used at beginning of scaling, 193
session, 133–​34 school readiness factors, 61
problem-​solving discussions, 17 schools
problem-​talk, avoiding, 175–​76 community, 90

200Index
 210

solution-​building contrasted with other counseling


characteristics of, 27b approaches, 131–​32. See also
planning exercise for cognitive-​behavioral therapy
developing, 27b contrasted with other strengths-​
solutions (to problems) in, 3–​4 based interventions, 16
steps for determining readiness future of, 28, 104–​5
and helping them move historical background, 12–​13
toward use of SFBT, 61–​62 how it distinguishes itself, 16–​17
school social worker (SSW). See also overview, 28
specific topics reasons it is suited to school
task of, 16 social work practice, 4–​6
school staff steps for determining school’s
interprofessional training on readiness and helping school
SFBT, 54–​57t move toward use of, 61–​62
ways to improve competencies what it does and does not
of, 62–​63 teach, 24–​25
self-​harm, 58, 59b SFBT research, 25, 27–​28, 31–​32
Seligman, Martin E. P., 99 early research studies, 32
sexual abuse, 114–​18. See also child implications for practice in
abuse and neglect schools, 45–​47
SFBT (solution-​focused brief ther- meta-​analyses, 33, 37b,
apy), 1. See also specific topics 37–​39, 39t
advantages in a school in school settings, 40, 41–​44t
setting, 6, 6b systematic reviews,
SFBT as client centered, 7 32–​33, 34–​36t
SFBT as strengths based, 6–​7 SFBT session(s)
SFBT can be adapted to special establishing the desired outcome
education IEP goals, 9–​10 of the talk, 159–​62
SFBT can be as brief (or long) first session. See eating disor-
as you want, 8–​9 ders: case example
SFBT enables practitioners to goal setting and future, 20–​21
gain cultural competence, 9 taking a break during, 193–​95
SFBT is adaptable, 8 using problem-​free talk at begin-
SFBT is portable, 8 ning of, 133–​34
SFBT makes small changes wrapping up the, 148
matter, 7–​8 SFBT skills, 15–​16
application, 25 SFBT studies. See SFBT research

Index201
20

SFBT techniques, 17–​20. prevalence rates among school-​aged


See also specific techniques persons, 154–​55
Sharry, J., 133, 136–​37, 144 adolescent substance use
Shilts, Lee, 74, 77, 79 percentages, 154, 155t
Shilts, Margaret, 77 protective factors, 155–​56
social worker models of SFBT and research about SFBT with, 156
CBT, 14b. See also risk factors, 155–​56, 156t
cognitive-​behavioral symptom indicators, 154
therapy substance dependence, defined, 154
solution building, 16 substance use. See also
solution-​focused brief therapy. substance abuse
See SFBT defined, 153
Solution-​Focused Brief success, measuring your, 26b
Therapy Association suicidal ideation
(SFBTA), 15, 47 identification of, 132–​33
solution-​focused school, starting acknowledging, validating,
your own, 70–​71 and normalizing student’s
Solution Focused Therapy Treatment feelings, 141–​43
Manual for Working with asking for a brief description of
Individuals, 16 student’s concern, 135–​37
solutions, looking for, 18b assessing for
solution-​talk incongruence, 137
beginning to generate, 185–​86 assisting the student in identi-
continuing, 186– ​88 fying exceptions, 145–​46
Star Walk, 63, 64b case study, 132–​48
Steiner, T., 111–​12, 121 complimenting the
Stice, E., 181 student, 146–​47
Streeter, C. L., 25, 26, 55 developing rapid rapport
students. See also specific topics by using "problem-​free
how to view, 113 talk" at beginning of
substance abuse session, 133–​34
case example, 157–​77 encouraging student to go slow
definitions, 153–​54 and take small steps, 144
overview of SFBT engaging student in a coping
approach, 157–​58 dialogue, 138–​41
overview of substance abuse wrapping up the session, 148
nationally in schools, 153 normalizing, 142–​43

202Index
 230

questions designed to transdisciplinary approach to


elicit, 137–​38 solving problems, 55
suicide risk (SR), 58, 59b, 130–​31 trauma. See child abuse and
neglect
tasks, identifying, 147 trust. See under child abuse and
task setting, 193–​95. See also goal neglect
setting
teachers United Kingdom (UK), WOWW
are people too, 76–​77 in, 83–​84
ways of using solution-​building
intervention skills, 57 validating student’s
ways to improve competencies feelings, 141– ​42
of, 62–​63 Values in Action (VIA)
teachers lounge, looking for solu- questionnaire, 100
tions in, 74–​76 violence, 60–​61
therapist characteristics and
requirements, 47b Walsh, E., 130–​31
three-​tier system, 53. See also Multi-​ Watson, Sam, 61
tiered System of Supports/​ Webb, Linda, 56, 70, 71
Response to Intervention "Why" questions, 142
framework; Tier 1 frame- WOWW coaching, goals of, 78
work; Tier 3 framework; WOWW coaching process, phases
WOWW program for, 79b
Tier 1 framework, 53–​54, 71–​72. WOWW program (Working on
See also Garza High School What Works), 74–​77
designing a solution-​focused future of, 84–​85
school using, 54–​57 history of, 77
Tier 2 framework. See WOWW research on, 82–​84
program skills used in, 77–​78, 80–​82
Tier 3 framework, case studies
of, 88–​104 Yusuf, D., 114

Index203
204

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