While traditional therapeutic approaches can and are helpful, feminist therapy is distinct in its addressing the role of gender in psychological distress. Gender is a reality that shapes our behavior. Our world is organized through its influence. Feminist therapy recognizes that environmental pressures affect a woman’s identity. Women live in a world dominated by males and masculine patterns of thought and behavior, or the patriarchy. Until recently, studies of human behavior were almost always conducted by and on men.
So men’s ways of being often were — and are — used to describe women as well as men and therapy techniques useful for men are applied to women equally. Feminists argue that men and women are not the same and, indeed, have developed from early childhood in different ways. Men tend to view the world in terms of power and competition, or in a hierarchy. Women, on the other hand, view the world through relationship and connection to others. So most psychological theories and the therapy techniques derived from them may not fit women very well.
Feminist therapy, on the other hand, recognizes the central place relationship and connections hold in women’s lives. It considers the nature of sex-bias in a male-dominated culture. It honors women’s experiences as valid and unique. Focusing on the damaging effects of gender-role socialization, it seeks to address the inequalities in educational and career opportunities. Feminist therapy also helps women overcome barriers they experience in achieving their personal goals and assists them in recognizing and reaching their full potential.
It specifically addresses such questions as family and marriage relationships, reproductive concerns, career issues, the role of violence and fear in their lives, physical and sexual abuse, body image and eating disorders, and self-esteem Therapists literally must learn to see with solution-seeing eyes and hear with solution-hearing ears and feel with solution-feeling emotions. They must learn how to trust that solution seeking part of their clients and help the client find ways of letting that part have a bigger say in their day-to-day lives. Four principles undergird the work of the solution-focused therapist:
Now to look at the principles in more detail. Principle A: Meeting the client at his or her model of the world. The way the client makes sense of her life is very important to her. What she does helps her life hold together, and make sense. If the therapist meets her at that level, then the client can trust the therapist. Then some of the resistance is avoided, and a lot of the repetitive returning to “old issues” is avoided. For example, a therapist might accept any first goal a client wishes to work towards, however “out of order” it might seem to the therapist.
From this principle, a homeless drug-abusing pregnant client would be helped to solve her first priority first: getting housing, and not the therapist’s or society’s goal of getting her off drugs. The therapist must trust that in time, as successive goals are accomplished, the client will turn her attention to reducing her dependency on drugs. Meeting the client at her model of the world naturally helps with Principle B: Transform the client from being a “visitor” or “complainant” into a “customer. A “customer” for therapy is ready to do the “work” of therapy because he or she recognizes, in his or her own way, the benefits of actively participating in therapy. A “visitor,” at bottom, maintains a wariness or distance from the expectation that he or she might change. Sometimes when a client is sent by someone against his will, he arrives in a “visitor” mode, that is, he just physically shows up for his sessions without the intention of making any personal changes. A “complainant” comes into therapy complaining that someone else is responsible for their difficulties, or feels frustrated by their difficulties yet isn’t ready to change.
The client may feel no need to change. Visitors and complainants often are in therapy at the suggestion of someone and are less there out of their own choice or sense of needing help (Berg and Miller, 1992:22-29). This paper will focus on working with clients who are clearly “customers. ” Principle C, start with the end in mind, gives most of the therapy schools derivative of Bateson their power. It is built into the name of this approach: Solution-Focused Therapy. In my brief training I emphasized that the goal must be one that the client wants, despite whatever the therapist might believe needs attention.
In Berg and Miller’s terminology this is called the hidden customer (1992:239-31). One of the litmus tests for whether clients are in the role of visitor, complainant or customer is how well they can participate in framing a destination for their therapy. Customers know what they want and accept working to get it. But, a visitor or complainant might be a hidden customer. Hidden customers have goals that they want, but for which they might not have been referred by their well-wishing friend, boss, principal, lover, spouse, or relative.
The solution-focused therapist will follow the clients’ desires and help them frame a goal meeting their preferences. Principle D, if it ain’t broke (in the client’s mind) don’t fix it, is a reminder to the therapist to respect the rights and wishes of the client. How clients see their lives, and the order in which they approach solutions must make sense to them. Respecting a client’s wishes also neatly avoids a lot of “resistance” or “opposition offered by the patient to the orders, actions, recommendations, or suggestions of the therapist” (Harper, 1959:169).
Well-Formed Goals. SFT and other brief, client-based goal-oriented therapies take a lot of time developing and training practitioners in what makes a goal an achievable one and worthy of therapy. SFT has a set of guidelines for the therapist to measure the worthiness of a client-based therapeutic goal. A well-formed goal has seven qualities, according to Berg and Miller (1992, 32-44; de Jong and Miller, 1995:730-731). 1. The goal must be important to the client. This helps build on the cooperative atmosphere needed for successful therapy, respects the client, and brings the therapist into a dialogue with the client. . Keep goals small and achievable. This helps both client and therapist recognize progress. Within a therapy session, clients often begin with very large, vague goals, and one way the therapist can begin to help them think small is to ask what would be “the first small signs of success” on their way to the larger goal (Berg and Miller, 1992:36). Skilled therapists help clients name and accomplish a series of small goals which contribute to a bigger whole, since it is “easier to ‘fill out a job application’ than to ‘get a job'” (de Jong and Miller, 1995:730). . Make goals concrete, specific and behavioral.
John Grinder, one of the founders of Neuro-Linguistic Programming (NLP), often quipped in his training programs, “Would you recognize it if it tap danced on your foot? ” In our ordinary everyday world, we use the qualities of specific and concrete many times a day, as when we say “I’m looking for my car keys, not my house keys,” because just any key won’t do the job. Berg and Miller say that non-behavioral goals, such as having more self-esteem, living a sober ife-style, and getting in touch with feelings are difficult to achieve, mainly because success and progress are difficult to gauge (1992:37). A concrete goal, such as “praising my child twice this week when he makes his bed,” can be counted, which makes determining success towards its accomplishment possible. 4. Goals express the presence of something or of a behavior, rather than an absence. “Goals must be stated in positive, proactive language about what the client will do instead of about what she will not do” (Berg and Miller, 1992:38, emphasis in original).
Berg and Miller offer three reasons for defining goals in positive terms (:38-39). First, it helps clients and therapists determine when a goal has been met. Second, we are always doing something; if one behavior is absent something must be there to take its place. If a client will not be smoking, what will she be doing instead? Third, sometimes commanding ourselves not to think of something builds an obsessive cycle where we conjure an image of the forbidden activity and then try to ignore it.
The book White Bears and Other Unwanted Thoughts: Suppression, Obsession, and the Psychology of Mental Control (Wegner, 1989) is devoted to this particular trap we unwittingly spring on ourselves. 5. Goals are expressed as beginnings rather than endings. This helps clients and therapists find ways to be on “track” immediately (Walter and Peller, 1992:55). This supports a view of living and therapy as both being processes. The beginning and progress towards a goal can be better described and used for feedback than the ending or ultimate goal, which might be very far off in terms of time and effort.
Naturally arising from this quality of goals are questions during therapy that support small improvements and beginnings. Examples of these type of questions are: “What would be the first small signs of change? ” or “What small step could you take over the next week which could begin to move you towards your goal? ” 6. The goals are realistic and achievable within the context of the client’s life. This quality of well-formed goals reminds the therapist that a goal needs to nest well in the larger story the client calls his or her “life. “
7. The client sees the goal as involving “hard work. ” This quality helps the client build a positive “face” and protects and promotes the client’s feelings of dignity and self-worth (Berg and Miller, 1992:43). This allows the client to internalize personal responsibility for achieving the goal while having a self-respecting place to fall back to in case of failure. Constructing goals as involving “hard work” parallels the client’s perception of how difficult it has been previously to change. A goal needing “hard work” leaves the client and therapist in a win-win situation.
If they fail to reach the goal, it is still possible to achieve it if they can find how to work a little harder. If the client quickly gets to the goal, she can be complimented on being able to figure out such a difficult solution in a short period of time. Slow, steady progress can be accepted as normal and the client can be praised for her hard work (Berg and Miller:42). The Miracle Context The miracle question anchors the way solution-focused therapists conduct all interviews. It frames each session, and the entire process as one of constructing new behaviors for the near to indefinite future.
This specially designed interview process orients the client away from the past and the problem and toward the future and a solution” (Berg and Miller, 1992:13). Actually, the phrase “miracle context” better captures the central importance of this concept to the SFT approach than “miracle question” does. What is the miracle question? After some basic information gathering, the therapist asks Suppose that one night, while you are asleep, there is a miracle and the problem that brought you here is solved. However, because you are asleep you don’t know that the miracle has already happened.
When you wake up in the morning, what will be different that will tell you that the miracle has taken place? What else? (Berg and Miller, 1992:13) This neatly turns the client’s attentions away from that old, unsuccessful, past behavior towards a future where the problem no longer exists. It can easily be slipped into the therapeutic conversation as this example, from Steve de Shazer working with a client who wanted to stop drinking, shows: Client: I just caught myself just going to stay home and just quit cold turkey, but I ended up the same.
When the client answers, it’s important to listen for what the client will be doing differently, even though feelings are important. The goal, as Walter and Peller state it, is to elicit statements that “include some action, some behavior, some new framing, or something clients will say to themselves or others” (1992: 78). I held parts of the solution while she explored her future and found more pieces of it. I also carefully restated some of them so that they represented the presence of something rather than an absence, as when I restated “The house wasn’t filled with smoke” to “The house would smell better. Though trying to quit smoking can be a serious matter, Debbie humorously presented the balances and compromises she would face, as when she said she would be perceived as “fairly cheerful” in the morning.
At my presentation, I reminded the group that some clients might need help giving realistic answers to the miracle question. Usually, a casual acceptance of their first answer followed by a repetition of the hook of the miracle question serves to ground the client. For example, a client who answers that she won the lottery can be asked “And what would that allow you to do which would solve this problem? Five Useful Questions de Jong and Miller (1995) have described five useful questions that support, reinforce, highlight, and buttress this pull of the future state on the client. The first one takes advantage of the spontaneous improvements clients sometimes make during the time between their making of their first appointment and the appointment, as in, “Anything better since you made the appointment? ” The second type of useful questions, exception finding questions, help clients to locate and appreciate moments in their past when the present problem got handled.
For drinkers, this might be times when they went for a long period without drinking; for a couple that fights constantly this might be times when they got along well. The basic format is roughly, “Can you think of a time in the past [time period] that you did not have a problem with? ” this can be followed up with questions like “What would have to happen for that to occur more often? ” (Berg, 1992:no pagination) Berg and Miller place the miracle question as the third type of useful questions.
Their fourth type, scaling questions, ask clients to express their feelings about something on a scale ranging from 1 at the low end to 10 at the upper end. Berg calls it a “versatile, simple, and useful” tool which can be asked of anyone old enough to understand numbers. Scaling questions can help in many clinically difficult situations such as when a problem is vague or there are vast disagreements about issues, as might be the case in family situations (Berg, 1992:no pagination). The fifth type of useful questions, coping questions, is useful when clients seem really discouraged and mired in their difficulties.
It provides a way of “gently challenging the client’s belief system and her feelings of hopelessness while, at the same time, orienting her toward a sense of a small measure of success” (Berg and Miller, 1992:89). The form of this question is simply to listen to the client’s complaints and then ask, “With all of that going on, how do you manage to cope? ” In the ninety minute presentation I did, I had just a few minutes to briefly cover some of the five useful questions. We covered the miracle question, and discussed how to use exception-finding questions.
Practitioners of SFT begin all their sessions after the first one with, “What’s better? (Berg, 1992). Formally, this parallels their first questions in the first session about any changes between the arranging of the appointment and the appointment itself. SFT practitioners actively take control of the reins of their sessions. They are not holding a conversation, they are conducting therapy, and recognize the benefit to the client of the therapist keeping a firm hand on the reins of the process of what occurs within their shared therapeutic encounter. SFT recognizes that clients and therapists are engaged in a very real, but covert, struggle over who will control their encounter.
This happens not only in therapy, but in other types of relationships as well. When using the SFT approach the therapist takes charge right at the beginning. Getting that first question out fast, “What’s changed since you called and made the appointment? ” or “What’s better? ” begins to craft the session in a positive direction before the client realizes the struggle for the reins of the relationship has begun. Powerful therapists like Milton Erickson have been accused of being overly concerned with interpersonal power and manipulation (Haley, 1994:56).
But by assuming that power, and quickly establishing it as done in SFT, a therapist expedites the pace of therapy, that is, he or she keeps it brief. Perhaps these five useful questions, in their simplicity, can be compared to a drum, which is a hide drawn and tied around a hollowed out piece of wood. But this simple instrument, in the hands of a master drummer, can really get people up and moving. Narrative therapy holds that our identities are shaped by the accounts of our lives found in our stories or narratives.
A narrative therapist is interested in helping others fully describe their rich stories and trajectories, modes of living, and possibilities associated with them. At the same time, this therapist is interested in co-investigating a problem’s many influences, including on the person himself and on their chief relationships. By focusing on problems’ effects on people’s lives rather than on problems as inside or part of people, distance is created. This externalization or objectification of a problem makes it easier to investigate and evaluate the problem’s influences.
Another sort of externalization is likewise possible when people reflect upon and connect with their intentions, values, hopes, and commitments. Once values and hopes have been located in specific life events, they help to “re-author” or “re-story” a person’s experience and clearly stand as acts of resistance to problems. The term “narrative” reflects the multi-storied nature of our identities and related meanings. In particular, re-authoring conversations about values and re-membering conversations about key influential people are powerful ways for people to reclaim their lives from problems.
In the end, narrative conversations help people clarify for themselves an alternate direction in life to that of the problem, one that comprises a person’s values, hopes, and life commitments. Narrative approaches Briefly, narrative approaches hold that identity is chiefly shaped by narratives or stories, whether uniquely personal or culturally general. Identity conclusions and performances that are problematic for individuals or groups signify the dominance of a problem-saturated story. Problem-saturated stories gain their dominance at the expense of preferred, alternative stories that often are located in marginalized discourses.
These marginalized knowledges and identity performances are disqualified or invisibilized by discourses that have gained hegemonic prominence through their acceptance as guiding cultural narratives. Examples of these subjugating narratives include capitalism; psychiatry/psychology; patriarchy; heterosexism; and Eurocentricity. Furthermore, binaries such as healthy/unhealthy; normal/abnormal; and functional/dysfunctional ignore both the complexities of peoples’ lived experiences as well as the personal and cultural meanings that may be ascribed to their experiences in context. Common elements Common elements in narrative therapy are: The assumption that narratives or stories shape a person’s identity, as when a person assesses a problem in her life for its effects and influences as a “dominant story”;
• An appreciation for the creation and use of documents, as when a person and a counsellor co-author “A Graduation from the Blues Certificate”; • An “externalizing” emphasis, such as by naming a problem so that a person can assess its effects in her life, come to know how it operates or works in her life, relate its earliest history, evaluate it to take a definite position on its presence, and in the end choose her relationship to it. A focus on “unique outcomes” (a term of Erving Goffman) or exceptions to the problem that wouldn’t be predicted by the problem’s narrative or story itself. • A strong awareness of the impact of power relations in therapeutic conversations, with a commitment to checking back with the client about the effects of therapeutic styles in order to mitigate the possible negative effect of invisible assumptions or beliefs held by the therapist. • Responding to personal failure conversations 
Method In Narrative therapy a person’s beliefs, skills, principles, and knowledge in the end help them regain their life from a problem. In practice a narrative therapist helps clients examine, evaluate, and change their relationship to a problem by acting as an “investigative reporter” who is not at the centre of the investigation but is nonetheless influential; that is, this therapist poses questions that help people externalize a problem and then thoroughly investigate it.
Intertwined with this problem investigation is the uncovering of unique outcomes or exceptions to its influences, exceptions that lead to rich accounts of key values and hopes–in short, a platform of values and principles that provide support during problem influences and later an alternate direction in life. The narrative therapist, as an investigative reporter, has many options for questions and conversations during a person’s effort to regain their life from a problem.
These questions might examine how exactly the problem has managed to influence that person’s life, including its voice and techniques to make itself stronger. On the other hand, these questions might help restore exceptions to the problem’s influences that lead to naming an alternate direction in life. Here the narrative therapist relies on the premise that, though a problem may be prevalent and even severe, it has not yet completely destroyed the person.
So, there always remains some space for questions about a person’s resilient values and related, nearly forgotten events. To help retrieve these events, the narrative therapist may begin a related re-membering conversation about the people who have contributed new knowledges or skills and the difference that has made to someone and vice-versa for the remembered, influential person. Outsider Witnesses In this particular narrative practice or conversation, outsider witnesses are invited listeners to a consultation.
Often they are friends of the consulting person or past clients of the therapist who have their own knowledge and experience of the problem at hand. During the first interview, between therapist and consulting person, the outsider listens without comment. Then the therapist interviews them with the instructions not to critique or evaluate or make a proclamation about what they have just heard, but instead to simply say what phrase or image stood out for them, followed by any resonances between their life struggles and those just witnessed.
Lastly, the outsider is asked in what ways they may feel a shift in how they experience themselves from when they first entered the room Next, in similar fashion, the therapist turns to the consulting person, who has been listening all the while, and interviews them about what images or phrases stood out in the conversation just heard and what resonances have struck a chord within them. In the end, an outsider witness conversation is often rewarding for witnesses. But for the consulting person the outcomes are emarkable: they learn they are not the only one with this problem, and they acquire new images and knowledge about it and their chosen alternate direction in life. The main aim of the narrative therapy is to engage in people’s problems by providing the alternative best solution. Criticisms of Narrative Therapy To date, there have been several formal criticisms of Narrative Therapy over what are viewed as its theoretical and methodological inconsistencies, among various other concerns. 9]
• Narrative therapy has been criticised as holding to a social constructionist belief that there are no absolute truths, but only socially sanctioned points of view, and that Narrative therapists therefore privilege their client’s concerns over and above “dominating” cultural narratives.  • Several critics have posed concerns that Narrative Therapy has made gurus of its leaders, particularly in the light that its leading proponents tend to be overly harsh about most other kinds of therapy. 12] Others have criticized Narrative Therapy for failing to acknowledge that the individual Narrative therapist may bring personal opinions and biases into the therapy session.  • Narrative therapy is also criticized for the lack of clinical and empirical studies to validate its many claims.  Etchison & Kleist (2000) state that Narrative Therapy’s focus on qualitative outcomes is not congruent with larger quantitative research and findings which the majority of respected empirical studies employ today.
This has led to a lack of research material which can support its claims of efficacy.  Narrative therapy is a respectful and collaborative approach to counselling and community work. It focuses on the stories of people’s lives and is based on the idea that problems are manufactured in social, cultural and political contexts. Each person produces the meaning of their life from the stories that are available in these contexts.
A wider meaning of narrative therapy relates significantly to a relatively recent way of thinking about the nature of human life and knowledge which has come to be known as ‘postmodernism’ – which believes there is no one objective ‘truth’ and that there are many multiple possible interpretations of any event. Thus within a narrative approach, our lives are seen as multi-storied vs. single-storied. Stories in a ‘narrative’ context are made up of events, linked by a theme, occurring over time and according to a plot. A story emerges as certain events are privileged and selected out over other events as more important or true.
As the story takes shape, it invites the teller to further select only certain information while ignoring other events so that the same story is continually told. David Epston sees these stories as both describing and shaping people’s perspectives on their lives, histories and futures. These stories may be inspiring or oppressive. Often by the time a person has come to therapy the stories they have for themselves and their lives become completely dominated by problems that work to oppress them. These are sometimes called ‘problem-saturated’ stories.
Problem-saturated stories can also become identities (e. g. seeing someone as a sex offender vs. a person who has sexually offended). These kinds of stories can invite a powerful negative influence in the way people see their lives and capabilities (e. g. “I’m hopeless”). Counsellors and therapists interested in narrative ideas and practices collaborate with people in stepping away from problem saturated and oppressive stories to discovering the ‘untold’ story which includes the preferred accounts of people’s lives (their intentions, hopes, commitments, values, desires and dreams).
Counsellors are listening to stories of people’s lives, cultures and religions and looking for clues of knowledges and skills which might assist people to live in accordance with their preferred way of being. In essence, within a narrative therapy approach, the focus is not on ‘experts’ solving problems, … it is on people discovering through conversations, the hopeful, preferred, and previously unrecognized and hidden possibilities contained within themselves and unseen story-lines. This is what Michael White would refer to as the ‘re-authoring’ of people’s stories and lives.