Constructivist therapy is an approach that assumes reality is not objective or

independent; rather, we construct our reality through our culture, language, and
perceptions. Instead of digging deeply into the origins or causes of problems, this
therapy focuses on creating solutions and facilitating change. These therapies are
often brief and highly value the client's unique, subjective perspective.

Two main approaches within constructivist therapy are:

◆ Solution-Focused Therapy ◆
Solution-focused therapists view clients as wanting to change, and therapists do
their best to help bring about change (de Jong & Berg, 2008; Kim, 2014; Lipchik,
2002; Macdonald, 2011; O’Connell, 2012). Because solutions are different for each
client, it is particularly important to involve clients in the process of developing
solutions. It is helpful to focus on the solution rather than the problem. In this
way, individuals can find exceptions to the problem, which then leads to solutions.
Solution-focused therapy is very practical. The therapist examines whether a
problem needs changing. If there is a solution to the problem, the therapist
identifies the solution the client is using and compliments the client for using it
(de Shazer, 1985; Lutz, 2013; Macdonald, 2011; O’Connell, 2012).
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◆ Goals ◆
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In solution-focused therapy, it is important that goals be clear and concrete (de
Jong & Berg, 2008; Kim, 2014; Macdonald, 2011). In the beginning of therapy,
questions make the goals clearer. It is also important that these goals be small so
that several small goals can be met rather quickly. Information about exceptions
and about “miracles” helps develop specific goals.
◆ Here are criteria for constructing well-defined goals (Berg & Miller, 1992; Walter
& Peller, 1992):
➤ Positive. Instead of having negative goals such as “I am going to get rid of
drinking, depression, or anxiety,” the goals should be positive. The key word here
is instead. Instead of drinking, being depressed or anxious, what positive things
are you going to do? A simple therapeutic question for setting goals is: “What will
you be doing instead?”
➤ Process. The key word here is how. “How will you be doing this healthier or
happier alternative?”
➤ Present. Change happens now, not yesterday and not tomorrow. The key phrase
here is on track. A simple question to help is, “As you leave here today, and you
are on track, what will you be doing differently or saying differently to yourself?”
Today, not tomorrow.
➤ Practical. “How attainable is this goal?” The key word is attainable. Clients who
want their spouse, employer, parent, or teacher to change are seeking
unattainable solutions and will set themselves up for more problems.
➤ Specific. “How specifically will you be doing this?” Global, abstract, or
ambiguous goals, such as “spending more time with my family,” are not nearly as
effective as: “Specifically I will take a 15-minute walk with my wife each evening,”
“I will volunteer to help coach my daughter’s soccer team,” or “I will take my son
golfing with me on Saturdays.”
➤ Client control. “What will you be doing when the new alternative happens?”
The key word is you, the client, because you have the competency, the
responsibility, and the control to make better things happen.
➤ Client language. Use the clients’ words for forming goals rather than the
therapist’s theoretical language. “I am going to have weekly adult telephone
conversations with my father” is more effective than “I am going to resolve my
oedipal conflicts with my father.”
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◆ Techniques ◆
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Solution-focused therapists use many different techniques to help their clients find
ways to solve their problems. The most common ones are described here.
All of these methods, in different ways, help the therapist work with the client to
find solutions to the problem.
➤ Forming a collaborative relationship. Therapists listen carefully to what clients
want to change. Asking about what has changed between the time that the
appointment was made and the first session is a way to both acknowledge the
client’s power to change on her own and to focus the session on change. As in
most therapies, counselors wish to be empathic with the client. Lipchik (2009)
describes her own solution-focused therapy as increasingly respectful of clients
through her years of practice. Solution-focused counselors may become more
empathic and respectful with clients through active listening, feeling reflections,
goal setting, focusing on the present, and asking questions (O’Connell, 2012).
Labeling the problem is often helpful. O’Connell uses the metaphor of the
problem island and the solution island. It is often helpful to go back and forth
between the two. As therapy progresses, more time is spent on the solution
island. The therapist assesses when it is appropriate, in terms of client readiness,
to go to the solution island.
➤ Complimenting. One way to make progress in moving from the problem to the
solution is to compliment the client (Berg & de Jong, 2005; de Jong & Berg, 2008,
Lutz, 2013; Macdonald, 2011). This is a method that is positive and helps clients
feel more encouraged. It is often helpful in the first session. Berg and de Jong
discuss three types of complimenting: direct, indirect, and self-compliments.
Direct compliments are based on observations of actions that clients have found
to be successful. They then bring the client’s success with the action to his
attention. Indirect compliments come from asking clients questions that are
similar to points of view of family and friends. Self-complimenting refers to asking
questions in a way that clients need to answer by talking about success or their
abilities. Complimenting helps clients become more focused on and open to
making changes. These definitions are more specific and therapeutic than the
common definition of complimenting which refers to praising someone.
➤ Pretherapy change. Solution-focused therapists examine change that has taken
place even before the client arrives at the therapist’s office. The act of making an
appointment is a positive indicator for change. Asking “What have you done since
you called for the appointment that has made a difference in your problem?” (de
Shazer, 1985; Macdonald, 2011) sets a tone for a focus on solutions and change. In
this way, the therapist focuses on the client’s own abilities to bring about change
rather than the therapist giving the client solutions. By taking the answer to this
question and amplifying it and developing it, the therapist has material to use to
move toward solutions to the problem.
➤ Coping questions. By finding out how clients cope, therapists can build on their
coping skills even when clients’ problems seem very difficult. Generally, it is better
for the therapist to use “When” rather than “If.” For example, “When you move up
on the scale from 3 to 5 …” is better than “If you move up the scale from 3 to 5 …”
The use of “When” suggests that changes are bound to happen (Berg, 1994). The
question “How did you do it?” (Berg, 1994) empowers the client by helping him
think about resources and methods he used to deal with a difficult situation. Berg
gives a brief example of a social worker using this question with a mother from a
difficult family background raising her own child:
Worker: So, how did you figure out that that you wanted to be a different kind of
mother to your baby than your mother was to you? Where did you learn to do
that?
Client: Well, I watched other people, read magazines, watched T.V. programs, and I
think about it all the time.
Worker: You are a very thoughtful person. Have you always been that way, or is it
something you learn to do?
Client: I had to learn myself. Nobody taught me how to do it.
Worker: That’s fantastic. I’m sure some day, your baby will learn that from you.
(Berg, 1994, p. 115)
➤ The miracle question. This is one of the most important techniques in
solutionfocused therapy. The standard question was developed by de Shazer
(1988):
“Imagine when you go to sleep at night a miracle happens and the problems we’ve
been talking about disappear. As you were asleep, you didn’t know that a miracle
had happened. When you woke up, what would be the first signs for you that a
miracle had happened?”
De Jong and Berg (2008) suggest that this question be given slowly so that the
client can think about it and discuss her preferred future. By answering this
question, the client is laying out goals for change.
➤ Scaling. Scaling is used frequently in many aspects of solution-focused therapy.
Scaling questions help clients set goals, measure progress, or establish priorities
for taking action. O’Connell (2012) gives several examples of scaling questions:
• On a scale of one to ten, with ten representing the best it can be and zero the
worst, where would you say you are today?
• Would staying where you are on the scale be good enough for now, given all the
pressures on you?
• What do you need to do, or not do, to prevent you from going down the scale?
• What was happening at the time when you were higher? (p. 64)
➤ Assessing motivation. Clients need to be motivated, at least to some degree, in
order to make changes. Scaling questions are often used to assess the motivation
for change. The counselor uses scaling questions to elicit estimates of motivation
from the client. When asking the client to quantify the level of motivation, the
counselor is also asking questions that elicit ideas of behaviors that the client will
do that are partial solutions to the problem.
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◆ The Message ◆
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“The Message” is a core technique where the therapist gives the client structured,
written feedback at the very end of the session. The main goal is to highlight the
client’s strengths and encourage them toward their goals.
➤ 1. The Break and Timing
• The therapist stops the session about 5 to 10 minutes early to take a short
break.
• During this break, the therapist might consult with colleagues or a supervisor (if
they are observing) to figure out the best feedback to give.
• The therapist then writes out “The Message” to give to the client.
➤ 2. The 4-Part Structure of “The Message”
For your exam, remember this specific sequence, as every standard message
contains these four parts:
• Positive Feedback: The counselor starts by praising the client for their strengths,
efforts, and any positive steps they have taken.
• Summary of Achievements: The therapist briefly summarizes the positive things
the client has already accomplished regarding their problem.