Glossary

Brief Therapy Terms

Note: Terms in this glossary come from many sources. SEE bibliography. Mistakes in this glossary come from its author, Robert Cumming.

'Brief Therapy' here means the social constructionist brief therapies which have arisen from Milton Erickson, family therapy, The MRI, systemic theory, narrative theory, and so on. Psychodynamic and other brief therapies are not dealt with here.

At this time the glossary does not have biographical entries (apart from Erickson), and no doubt it lacks some terms which should be included. These will be added when time permits.

Agency, agentification: Helping clients to perceive that they are the agents of change in their lives - agentifying them - is/was seen as a way that some questions in brief therapy worked. This is done by the presuppositions which the question contains. For example, if a client says 'My bed was dry when I woke up today!' The therapist could say 'How did that happen?' But if they want to invite the client in to an agentifying conversation then they might instead say, 'How did you do that?' The presupposition being that the client had done something to cause the dry bed. When the client answers the question, they may be stepping towards being capable - in this case, capable of continence. (George et al,1995) NB Agency is also used as a generic term for the places where a lot of us work. Hopefully no confusion will arise.
Brief: the duration of truly brief therapy is defined differently by different authors. I would say brevity involves first, knowing techniques and holding assumptions which make brevity in therapy more likely, and applying these. Then, doing no more than is necessary to help the client achieve their stated aims.(See George et al,1999;De Shazer's forward in Dolan,1991.)
Brief Therapy: (in this glossary)the social constructionist brief therapies which have arisen from Erickson, family therapy, MRI, systemic theory, narrative theory, post-structuralist theories, and so on. Note that most therapy is brief whether that is planned or not. Also all the other theoretical gangs (schools) have brief versions of their therapies, too.
Cheering on: (Also cheerleading)A term less used nowadays. Relates to an activity in solution focused brief therapy of eliciting detailed descriptions of exceptions to the rule of the problem, news of change, news of progress, and complimenting the client (by your words, your tone, and so on) on having attained this progress. See also meaning, performance of. I like this term so I'm leaving it in this glossary. Michael White almost certainly would not like it(White, 1997, pp97-98, under the heading "The Applause").
Circular question: A large class of questions from systemic family therapy. Circular questions arise when you seek detailed descriptions of how persons connote, or operate within, relationships to each other and to the world. Circular questions are about perceptions of differences, past present or future. They can be asked from a position of curiosity about how things are lived in relationship. If you seek a truth, underlying principle, or diagnosis of a person's condition, circular questions won't work. Curiosity about things-in-relationship very much persists in brief therapies.(Cecchin,1987; O'Brian and Bruggen,1985.) See relationship question.
Collaborative: many recently-developed brief therapies - and some older therapies, such as cognitive therapy - are often called 'collaborative'. This word refers to joint, cooperative activity by therapist and client to help the client make the changes they want. Collaborative approaches presuppose desire for change on the part of the client, and a therapist who is active in the work. This does not mean that the therapist knows how the client should behave or that the therapist is going to give advice - rather, the therapist is expert at, and active in, applying a therapy process. Collaborative brief therapy approaches tend to de-emphasise concepts of motivation and unconscious process, which tend to put the therapist in an expert position and to put the problem inside the client.
Compliment: praise for clients, based accurately on their own accounts of dealing with problems/finding solutions. A widely used practice. The term comes from solution focused brief therapy. Compliments can be delivered in several ways, e.g. directly and indirectly. Indirect complimenting by asking a question which leads clients to find something praiseworthy about themselves is especially valuable.(De Jong and Berg,2002, pp.34-36)
Creative Inquiry: name given to their current practice of brief therapy by John Walter and Jane Peller (2000).
EARS: Elicit, Amplify, Reinforce, Start over. A mnemonic for talking with clients who are able to describe instances of progress towards their goals for therapy, or to report exceptions or unique outcomes (De Jong and Berg, 2002).
Empathy: The capacity to see as the client sees, 'walk in their shoes', i.e. understand accurately what they are experiencing. The term has been most extensively described and discussed in the theory of Person-Centred therapy, which is a humanistic therapy. Arguments continue as to its meaning and its value in therapy. As described here, it may seem a valuable aspect of joining with clients, and also of great value in understanding what they want The assumptions and practices that come along with 'empathy' from the humanistic field may need careful review. This author believes that empathy is worth striving for, but the idea that a true understanding exists in any conversation is probably false. Also,some person centred techniques and attitudes which are subsumed under the title of empathy may also serve to extort evidence of feeling (above thought, visualisation, and so on)and embed problems within the person. Rogers (1967) gives a good account of his notion of empathy; De Jong and Berg (2002)(pp.39-41) discuss empathy from a solution focused perspective.
Erickson, Ericksonian: Milton Erickson was an American psychiatrist who developed a range of direct and indirect hypnotherapy techniques. Ericksonian techniques are a major underpinning of the subsequent development of strategic family therapy, NLP, Solution Focused Therapy, and Solution Oriented Therapies(Cade, 1987; Also the interview with De Shazer and Weakland in Hoyt (1994, Chapter 2, pp. 11-40) is informative on this.)
Experiment: A way of naming a 'task' to be set within or between therapy sessions. Experiments have interesting (linguistic) properties - they can be done, and then they are finished; their results can be weighed up and conclusions drawn; they can show that certain things work, or that those things don't work - that is, they yield information, and don't amount to any kind of prescription for life (unless they work in a very pleasing way). They can be done from a stance of impartial observation, which some people with problems may find is a refreshing place to be. Other ways of proposing action may feel heavier and may not have a clear ending. In short, inviting yourself or your client to make an experiment reframes proposals for tasks, homework, etc. Steve De Shazer invariably used this term for the tasks he suggested for clients, at a two-day presentation of him working live, at the Brief Therapy Practice in London in September 2002.
Externalising the problem: From narrative therapy. An approach to questioning clients about problems which gives the problem a name, a character, acknowledges the influence of the problem, and seeks detail of how the problem may give itself away, and how client(s) counteract the problem and reclaim power over their own lives. Presupposes that problems are separate from people and are simply things which people would rather get rid of. See also relative influence questioning. (White and Epston,1990, Chapter 2.)
Family Therapy: Therapy in which more than one family member may attend sessions. This form of therapy partook of systemic ideas from its outset and while therapies such as solution-focused and narrative now claim different theoretical bases, they may be best understood as coming out of this tradition, while respecting that they have ended up different. Thus reading in to classic systemic and strategic papers(for example Selvini Palazzoli et al, 1980, Cecchin, 1987, Weakland et al, 1974)or review papers on systemic and strategic schools (for example Hayes,1991; Cade,1987)can greatly enrich understanding of the more recent post-structural therapies.
Goals: Desired outcomes of projects or processes in therapy or elsewhere. In solution focused and solution oriented brief therapy efforts are made to elicit goals for therapy and to make these well-formed. Goals are usually stated in the positive, i.e. stated as the presence of something rather than the absence of something. (De Shazer, 1988, pp. 93-96;1991, pp.110-113.) Some therapists dissent from goalsetting; see for example Walter and Peller (2000), Chapter 5 - where they discuss their idea of 'preference' - and (particularly interesting)Michael White in Hoyt(1996), pp.52-53. It is fairly clear that all brief therapists do ask rigorous questions about the possible futures of preferred events in their client's lives. This can be called goal development or not, as you please.
Joining: A beginning stage in family therapy, when the therapist(s) make an effort to communicate with each person present and draw all of them in to involvement in the session. Each person's language and way of viewing the world should be matched as well as possible; very mundane things such as their hobbies, work, play, etc. can be enquired about so that you not only join, but everybody gets reminded that they are people, not just problems on legs. A bit like having several rapports at once. Joning is a relatively old term, rarely used in recent texts. See Haley (1991)p.14ff.for a strategic view, and De jong and Berg (2002) pp52-54.
Language: In brief therapy, terms describing language are cited from a range of sources. For example, structural linguistics (e.g. Saussure, Chomsky-via-Bandler and Grinder), through to poststructuralist ideas about discourse and narrative from Foucault and others. And Wittgenstein. Many brief therapy authors tend to emphasise the verbal aspects of language while acknowledging the non-verbal and gestural aspects. Language is always viewed as much more than speech communication. It is assumed that how we put our words together, and the words we choose, and the meanings which may be assigned to these words, is pre-conditioned by our cultural, social, political, and other contexts. The language we use carries biases like these, without us noticing it. Receiving communication which carries such pre-conditions or biases, one is invited to conform to or agree with these biases. Further, these various preconditions cannot be 'finally' removed, although you may be able to notice and alter many of them. There is no bedrock of unbiased language out there! For example, you may feel uncomfortable when someone refers to young women as 'chicks'. You may then choose to avoid using that term yourself, or perhaps protest at what it implies - in terms of constricted choices of behaviour and attitude for women and men, and imbalanced power relations between the genders. For another example, most of us therapists are invited from time to time to join in conversations about persons called 'borderline'. This is not a neutral term or a specially useful piece of professional shorthand; it is laden with assumptions about mental illness, interpersonal difficulty, chronic deficit on the part of the person thus described. Brief therapists often have to dissent from these descriptions and seek other descriptions of persons which allow for more choices, better chances for clients to influence their own lives and identities, better ways to define themselves and their capabilities. That way you the therapist get a better chance to be efective - and maybe brief! Working towards choosing helpful linguistic practices and letting go of unhelpful or oppressive practices is difficult. It also brings many therapists in to a political engagement with their workplace, colleagues, and so on. We can be pragmatic about our assumptions and practice certain forms of questioning which are known to promote relatively rapid change, but pragmatics doesn't cover this whole issue. Choices of language practice have ethical implications. See also truth, performance of meaning, language game, presuppositions. (De Shazer, 1991, 1994; the introduction to Walter and Peller, 2000; and the introductory chapters to practically every major brief therapy textbook in the A href="http://www.gethelp.co.uk/shared/biblio.html" bibliography /A !
Language game: This term was coined by Wittgenstein and is used by some solution focused therapists such as Steve De Shazer. I don't know Wittgenstein's work well, so do read him for yourself to make sure this bit is correct! Language games appear to be practices in conversation where the use of one term, within a given cultural context, invites those present in to a way of thinking (and thus acting)which is constrained by this term and a second, perhaps implicit, term which is taken as its opposite. For example, talking about what is good implies the existence of something bad. If you talk with a client about something good which is happening, this can engage you in talking also, one might say naturally, about something bad. De Shazer and many solution focused therapists prefer to play a 'better-worse' language game, and not this rather absolute-sounding 'good-bad' language game. They invite people in to better-worse, with its implications that there are degrees between these opposites, by asking questions such as 'what is better?' at the start of sessions. Use of scaling questions also reinforces better/worse talk over good/bad talk. (Wittgenstein,1996.)
Meaning, performance of: In a social constructionist mindset the meaning of a word or event does not necessarily pre- exist the conversations in which that meaning is 'used'. Rather, meaning is performed in conversation. Narrative therapy comes from this position, and practices such as seeking detail of problem-free times, sparkling moments, or small attainments by clients, can be described as performing meaning which is intended to help clients get to the futures or stories they prefer. Most brief therapy conversation is informed by this idea in one form or another, and many brief therapy techniques could be seen as ways to perform meaning around the changes the client reports. (White & Epston,1990.)
Miracle Question: The miracle question is used in solution focused brief therapy. Its immediate aim is to help clients describe in detail a problem-free future, but its effects are wider than this suggests and can include boosting client morale and significant change in their perception of power over their problems. The question originated in De Shazer's adaptation of Erickson's crystal ball technique. It can be described and used as trance-induction (including for example establishing a yes-set) and it can be described as helpful in therapy and used without attention to ideas about trance. Either way works. An example of the miracle question (a long version): Suppose... that when we finish this meeting, you go home, and eventually, you go to bed and go to sleep. While you are asleep, a miracle happens and the effect of this miracle is, that the problems that brought you here today are gone. When you wake up the next day, what will you notice that tells you the miracle has happened? And a short version: Suppose a miracle happened while you were asleep, and it took your problem away; when you woke up, how would you know it had happened?
Narrative Therapy: form of therapy developed originally (in its social constructionist form) by Michael White and David Epston. Narrative therapy is often brief, but does not explicitly set out to be. (White and Epston, 1990; Combs and Freedman, 1996; Payne, 2000.)
NLP: Neuro-linguistic programming. Once described as a modeling technology trailing techniques in its wake. NLP is based on the observation and modeling of the behaviour and beliefs of people who are excellent in their field. It originates in the work of Richard Bandler and John Grinder, among whose first models were Milton Erickson, Fritz Perls, and Virginia Satir. Early works by these authors describe very brief therapies, and they and their students such as Robert Dilts continue to generate brief therapy methods. Many brief therapists have had NLP training and NLP patterns and presuppositions show up in their work. Bill O'Hanlon was involved in NLP during its development; Steven De Shazer has acknowledged the value of early NLP texts. (Bandler & Grinder, 1975, 1976.)
Not knowing: a term describing a brief therapist's position in respect of knowledge. The term is from Harlene Anderson and Harry Goolishian and their theorizing about therapy, which ended up as Collaborative Language Systems. Not knowing relates to the condition of your clients, what they want, what they should do. Mostly you ARE allowed to know how to help a therapy happen, i.e. conduct therapeutic conversation. Not knowing is thus about not having normative or developmental maps of what clients should do or be. It leads to curiosity which animates you to ask questions. Curiosity in this sense can be read as first, getting in to the client's frame of reference, and only then being curious.
Possibility Therapy: A name given by Bill O'Hanlon to some of his practices of brief therapy.
Preferred future, Preference: What clients want to reach. Preferred futures may be talked about by using the miracle question, for example, as well as many other sorts of question. Preference is used to signify something a client wants more than another thing. Conversing about preferences may be less dichotomous than conversing about problems and solutions. John Walter and Jane Peller (2000) treat preference this way, and the concept seems to get used in a similar way in some narrative therapy conversations (Combs and Freedman, 1996)
Presuppositions: Assumptions which are built in to statements. These can be extracted and considered and with practice statements can be made which carry many and refined presuppositions. The term is common in NLP. An example of presuppositions.
Problem: Something a client or referring agency would prefer to do without. In brief therapy, more complex, larger descriptions of problems, and assumptions about the aetiology of problems within the client, tend to be avoided. Narrative therapists do have things to say about the social origins of problems - dominat discourses, for example (White and Epston, 1990)
Rapport: A term commonly used in NLP which is also encountered in many brief therapies. It refers to the condition of getting tuned in to a client and having them tuned in to you. Very full discussion of rapport can be found in many basic NLP texts. It can go by other names - R D Laing used to refer to 'co-presence', for example. Rapport can be regarded as a fundamental requirement, without which therapy cannot be started. Do watch out for the logic of ideas like this. Getting on with therapy is a good way of gaining rapport, the rapport does not have to be done 'first'. Also, in my experience at least, good outcomes can be gained in awkward, stumbling relationships which seem to lack rapport. See also
Reframe: Altering the perceived context or meaning of a situation or act, so as to view it differently and to help someone to act differently in future. Example (a crude one, but I have known it to work): A: I just don't know who I am at the moment! B: Wow! What an opportunity! Who'd you like to be? (Bandler and Grinder,1982)
Relationship questions: this class of questions is a distinguishing mark of the brief therapies which are the subject of this glossary. They usually begin something like, 'If your horse was here now and listening to this, what would she say about the way you're dealing with this?' Or, 'How come your grandma liked having you around?' Or, 'What will your son notice about you on the morning of the miracle?' Questions like this can help deconstruct problem stories, give added valence to solution stories/progressive narratives, etc. Relationship questions might be seen by systemic therapists as a class of circular question.
Relative influence questioning: From narrative therapy. Questions which first, map the influence of a problem on all the domains of a client's life, and then map the influence which the client(s) are able to exert over their own life, perhaps at times or in some domains, winning some control back from the influence of the problem. Used in externalising conversations, for example. (White, 1988, pp.5-29.)
Safety: a condition acutely desired by many people who are exposed to violence and other forms of abuse. Conversations about safety and attaining more of it stand in sharp contrast to conversations about danger and avoiding it - the former are about what to do, and how to respond, the latter carry the risk of focusing on the abusive acts, focusing on what not to do, and focusing on effects, not responses. Generally brief therapists are looking for what will be there in the clients preferred future, rather than what won't, because looking at what won't be there conjures up the images of undesirable, frightening things, over and over again. Many clients come to brief and other therapists in search of safety. Authors such as Insoo Kim Berg (1991) Andrew Turnell and Steve Edwards (1999), have written about the issues this presents in social service settings and about the application of brief therapy thinking to issues of client safety.
Solution Focused Brief Therapy: name given (De Shazer et al., 1986)to the form of brief therapy developed by the team at the Brief Family Therapy Centre, Milwaukee. Clear antecedents of this therapy lie with Milton Erickson's work and the brief strategic therapy developed by John Weakland's team at the Mental Research Institute in California. Family resemblances, as well as differences,exist between Solution Focused therapy and therapies termed solution oriented.
Solution Oriented: a name given to their therapies by several authors, e.g. Philip Ziegler/Tobey Hiller(2001), Bill O'Hanlon (1998), Ben Furman(in Hoyt,1994), and others. Family resemblances, as well as differences, exist between these therapies and between them and Solution Focused therapy.
Statement Of Position Map: A questioning process in Narrative Therapy, intended to help a client new to therapy, or one presenting with a new concern, to describe that concern and take up a position, i.e. to spell out why that concern's influence or effect is unacceptable. The questions are in four steps: 1) Help the client describe their concerns in their own terms, valuing their own experiencing of it; 2) Map the effects of the concern through the areas of life where it causes problems. i.e. get a rich description of the operations of the problem; 3) Evaluate the effects or influence of the problem - is this OK for you? or eqivalent - and 4) Justify this evaluation about the extent of the effect of the problem. Why does this matter to the client? How come it merits their attention? Steps 3 and 4 above are like a Narrative hall-mark. The whole sequence makes sense in context of an externalising therapy, and step 4 takes you to the start of a conversation externalising the problem (q.v.) which also has a set of questions (sometimes known as Statement of Position Map 2).
Strategic therapy: a form of therapy derived from family therapy practices and including the influences of Milton Erickson as well as some systemic principles, depending on who's version you are looking at. The version developed by John Weakland and the team (Weakland et al.,1974) at the MRI is a fairly direct precedent of solution focused brief therapy (De Shazer et al, 1986). Jay Haley has also developed strategic therapy practices. (Haley,1991.)
Task, behavioral: Any task which will involve the client in doing things, and not merely noticing things... for example 'each time you can't sleep, get up and clean your house for two hours". Tasks are best based on things discussed at the session in which they are set. See also Experiment. (De Shazer, 1988; De Jong and Berg, 2002,especially pp.119-138; Selekman, 2002, Chapter 4 for example; Murphy and Duncan, 1997, Chapter 5 and the Appendix.)
Task, noticing: Any task in which the client is asked to notice something. For example the generic 'Notice what happens between now and our next meeting which you want to keep on happening'. Or, 'Notice what's happening when you resist the urge to smoke'. Tasks are best based on things discussed at the session in which they are set. See also Experiment. (References as for Task, behavioral, above.)
Time-Limited: time-limited therapy usually occurs within an agency or insurance set-up where there is a prescribed maximum number of sessions. This is done for several reasons - economy, to cope with high numbers of referrals, and so on. Most versions of brief therapy have been adapted to fit in to time-limited contexts and this is an established way of working. However many therapists - including brief therapists - are disquieted by time-limits. Brevity should mean 'as much as is necessary, and no more'. This definition does not allow for precise time-limits, which are frequently a source of stress for clients and therapists alike. (Hoyt, 1995 - especially the bits about working for HMOs)
Truth, the: conservatives such as myself would say that, for instance, when you sit on a chair, you will certainly not diffract through it and end up on the floor. (Mind you, I attracted a certain amount of heckling when I asserted this at a meeting once. That New Age has a lot to answer for.) However, at least in the social sciences and probably much further afield than that, the truth as a single, unified explanation of something, which carries genuine predictive value, is in fact extremely elusive. Thus when someone says, "People are X", or, "This Client is Y", it is best to take this as a claim to truth, or as a description, rather than as the final truth about the thing they are talking about, or as an explanation. This speaks of a skeptical attitude as to the availability (to people, even expert people) of a sort of understanding which is untainted by (or outside of) the biases placed upon them by historical, cultural, economic, gender, and other constraining discourses and assumptions. Here we approach skepticism about all metanarratives. See Language. The idea that I can only make a claim to know a truth, rather than understand a formal or fundamental truth, invites me to view the actions which might proceed from my truth in a different way. These actions are based on a partial description of the world, and not on the world as it actually is. This is ethically and practically complicated. For brief therapists, this way of thinking can contribute to pragmatism and flexibility in action, promote curiosity about the client's way of describing the world, and a tolerance of other people's ideologies, which is very valuable. But the absence of 'given' truths can seem nihilistic to some. (Combs and Freedman, 1996, pp.33-37; White and Epston,1990; De Shazer, 1991, pp48-53; Efran and Clarfield, 1992.)
Well formed: Used of goals or outcomes of therapy, and sometimes of statements and questions in therapy, this term has been annexed from linguistics. It is commonly used to signify: specific, concrete, achievable, multivalent. So for example 'happiness' may be a great idea, but it may not be a well-formed outcome until the new behaviours, changed sense of self, differences apparent to others, beliefs and abilities associated with it, are all explored. This then helps therapist and client to know when attainment of the outcome is approaching, and perhaps more importantly, it sets up signs of 'happiness' for the client to notice outside of therapy. This author (has found therapies often end when unexpected signs have been noticed by clients, and followed, and not when neat and tidy well-formed goals have been fully achieved. Note that the term well-formed can also be applied to any spoken or written piece of language. (Bandler and Grinder,1975)