Despite this fairly minimal level of involvement, at follow
up (9 months after discharge) Dave had not initiated any
incidents of physical aggression since he was first seen, due
to his application of his own resources to assert control over
his behaviour.
Discussion
Traditional SFBT can be a fairly structured affair, with a
range of techniques being used at certain points within a
session to help maximize the possibilities for change.
However, with the learning-disabled client group my
experience has been that this is usually unnecessary and
often confusing for the client. Rather I have found that most
clients who find SFBT helpful do so primarily because of the
use of a single technique. In Dave’s case this appeared to be
the idea of finding exceptions to the problem behaviour and
doing more of what helped create those exceptions. However,
I have found that the aspect of the approach that
people find works for them is different for each individual.
At first glance, the process of therapy used with Dave
may appear no different from that conducted when using
other models of therapy. However, what is distinct in the
use of SFBT is the underlying approach to the problem.
SFBT theory states that understanding the original cause is
not a necessary precondition to identifying an effective
solution to a problem. This is why far more time in therapy
sessions is spent focusing on the present and future (as
opposed to the past) and on the client’s strengths and
resources (as opposed to the problem) than in other
therapeutic approaches. Spending time on these types of
discussion can also have the practical advantage of helping
the therapist form an early therapeutic alliance with the
client that otherwise might prove difficult to establish. For
example, if my first session with Dave had been spent
discussing the problem in detail in an attempt to understand
its putative cause, he might well have been so embarrassed
that he may not have returned, or may have spent his
mental energies trying to escape from the session rather
than engaging with it.
SFBT also encompasses the philosophy that only the
minimum amount of intervention required in a person’s life
should be undertaken. This can be seen in the current case
in the fact that only Dave’s own strategies were utilized in
the intervention. This was intended to provide Dave with
feelings of self-efficacy and to enable him to commit to the
method that he used to change his behaviour. It should also
be noted that no assumptions were made at any of the
sessions that further help would be required. Allowing
Dave to determine the frequency and duration of sessions is
likely to have given him further ownership over any
changes, and also (as I tend to find with most people that
I use SFBT with) resulted in only minimal contact with the
therapist before discharge. Clients discharged from our