Counseling Clients to Quit and Facilitating Groups
Motivational Interviewing
Motivational Interviewing Techniques
Reflective Listening
Recovery-Oriented Therapies
Solution-Focused Brief Therapy
Social Support
Behavior Modification
Relapse Prevention / Management
Components of Group Work
What Makes a Good Group Facilitator?
Intervening
Types of Interventions
Providing Constructive Feedback Tips
Open and Closed-ended Questions
Working with Client Behavior
 

Solution-focused brief therapy differs from instrumental therapy, in that the practitioner is not the expert, but one who joins with the client to discover and create meaning. Client motivation is created together through conversation between client and counselor (www.brief-therapy.org). The emphasis is shifted from focusing on the problem to creating solutions in the client’s life. Purposeful questioning is used to help clients construct workable solutions. Clients are encouraged to identify what they are already doing well and build upon those strengths. The client is viewed as self-resourceful, as the source of the solution
(Miller, Hubble & Duncan, 1996).
 

Guiding Principles of Solution-Focused Brief Therapy

• The problem is reframed, using paradox and analogy as helpful tools (Dormody, 1999).
   
• The treatment goal must be the client’s; the cessation provider refrains from going further than the client is willing to go.
   
• The emphasis is on the positive -- on what works, rather on what doesn’t work.
   
• Exceptions are identified (times the individual does not experience the difficulty).
   
• Questions are posed to promote spontaneous change.
   
• The attention is shifted to how the client would like to live; the client is encouraged to visualize healthy behaviors and success in being tobacco free.

How Solution-Focused Brief Therapy can be applied in treating tobacco dependent clients.
This treatment modality can be used in both individual and group settings to identify and transfer the successes in clients’ lives and create solutions for resolving their tobacco dependency. In groups, clients benefit from the solution-focused orientation and the therapeutic factors inherent in group work (www.ezonline.com/grafton/solution).

Solution-Focused Brief Therapy techniques

• Scaling questions

Because clients who are dependent on tobacco often “believe” that their cigarettes (or chew, etc.) are more important than anything else, the scaling question exercise can help put into perspective the relative importance of their tobacco use
(Rustin, 1998).

• “On a scale of 1 to 10, how important is your home (for example) in your life?"
   
• To client’s response, counselor asks: “In relation to your home, are your cigarettes more or less important?"
   
• Then the counselor continues with questions about other aspects of the client’s life (such as family, car, job, etc.).
  

• The “Miracle Question”

The use of the Miracle Question enables clients to visualize how different their lives would be if suddenly they did not have to deal with their tobacco dependency.
 
“Suppose while you are sleeping tonight a miracle happens. You wake up in the morning and you have no desire to smoke. How would you know this miracle happened? How would your life be different?” (Rustin, 1997).

Working with resistant or mandated clients
 
Often the motivation to quit tobacco use stems not from the client, but from someone else in the client’s life, such as a family member, a friend, an authority. In working with these clients, the counselor can ask certain questions to convey that the client is an expert on his or her own situation and that the counselor is interested in listening to the client’s definition of the problem.

An effective initial question to ask might be:

“So, how is your tobacco use a problem for you?”

Other good questions to ask, (assume in the following examples that it is the client’s daughter who has insisted that the client seek help to quit tobacco):

• "Whose idea was it that you come to see me today?"
   
• "How did your daughter get the idea that you need to come here today?"
   
• "So what would your daughter say how your tobacco use is a problem for you? Do you agree with their perceptions?"
   
• "How will your daughter know that the problem she thinks you have is solved?"
   
• "How will she be act differently then?"
   
• "What will be different between the two of you then?"
   
• "How will that be helpful?"
   
  (Insoo Kim Berg, www.brief-therapy.org; Miller, et al., 1996)