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Solution-Focused Marathon Sessions Nova Southeastern University NSUWorks CAHSS Faculty Articles Faculty Scholarship 3-2010 Solution-Focused Marathon Sessions Michael D. Reiter Nova Southeastern University, [email protected] Follow this and additional works at: https://nsuworks.nova.edu/shss_facarticles Part of the Arts and Humanities Commons, and the Social and Behavioral Sciences Commons NSUWorks Citation Reiter, M. D. (2010). Solution-Focused Marathon Sessions. Journal of Systemic Therapies, 29 (1), 33-49. https://doi.org/10.1521/jsyt.2010.29.1.33 This Article is brought to you for free and open access by the Faculty Scholarship at NSUWorks. It has been accepted for inclusion in CAHSS Faculty Articles by an authorized administrator of NSUWorks. For more information, please contact [email protected]. Solution-FocusedJournal of Systemic Therapies,Marathon Vol. 29, No. 1, 2010, pp. 33–49 33 SOLUTION-FOCUSED MARATHON SESSIONS MICHAEL D. REITER, PH.D. Nova Southeastern University Solution-focused therapy has been around for approximately 20 years. It has been used in a variety of contexts including schools, agencies, and private practice and with a wide range of clients including chil- dren, adolescents, couples, and families. The current article addresses how solution-focused therapy can be used in a marathon session for- mat. The paper addresses how solution-focused therapy makes sense, in some circumstances, being conducted in a marathon-session format. The article details how various aspects of solution-focused therapy are amenable to the unique context of marathon sessions and what some contraindications are for this format. A case example is provided to exemplify the benefits of this unique format. Solution-focused brief therapy (SFBT) has been around for over 20 years. Developed by Steve de Shazer, Insoo Kim Berg, and colleagues (de Shazer et al., 1986), it has been used in a variety of contexts including schools, agencies, and private practice and with a wide range of clients including children, adolescents, couples, and families. This approach attempts to shift client’s focus from what is not working and the problems of life to what has worked, and then build upon these strengths and resources to move toward solutions. This article addresses how solution-focused therapy can be used in an extended-time format. Solution-focused marathon sessions (SFMS) enable therapists and clients to engage in an extensive and intense interaction, allowing unique opportunities for a switch from a problem- focused story to solutions. The present article focuses on How are various aspects of solution-focused therapy, such as the miracle question, excep- tions, and the use of therapeutic letters used in SFMS? With the use of a case example, we hope to demonstrate this unique format. Nova Southeastern University, 3301 College Avenue, Fort Lauderdale-Davie, Florida 33314-7796. 33 34 Reiter SOLUTION-FOCUSED MARATHON SESSIONS Psychotherapy tends to be conducted in one hour blocks. Managed care companies have shifted from reimbursing for a 60-minute hourly session to 50 minutes or even 45 minutes. However, this timeframe for how long a therapist meets with a client is arbitrary. By maintaining a standard one-hour session, the therapy might be limited. Shapiro (2000) explained, “Discus- sion regarding the expansion of the time frame in treatment is important because clinicians lock into a certain time schema that may be uncreative and not optimally responsive to a patient’s problems” (p. 18). The author has developed a format of contacting clients that alters the time schema while continuing to use the standard principles of solution-focused therapy. This approach is used primarily with couples and families in crisis. Solution-focusd marathon sessions tend to last four hours. After an ini- tial joining stage, the therapist focuses on the clients’ concerns. Although solution-focused therapists may veer away from problem-talk or quickly shift to solution-talk, in SFMS more time is spent discussing each par- ticipant’s perspective. Since the clients that this format is most useful for are usually in crisis—a couple who are contemplating divorce and giving their marriage one last chance, or a family dealing with intergenerational conflict—this initial time is used in hearing and validating each person’s concerns. This segment of the SFMS usually lasts about 30 minutes to two hours, depending on how much previous open discussion occurred in the couple or family. Approximately halfway through the session, the miracle question is asked. Before the clients provide answers to the miracle question, a break of about 10–15 minutes occurs. (The break might be longer if used for a lunch or dinner break.) After the break, the SFMS shifts into the details of the miracle picture. This part of the session usually lasts approximately 30 minutes to one hour as the miracle is broken down into small goals. The next 30 minutes to one hour are spent fleshing out the exceptions to their miracle picture. The last ten minutes of the session are used to present a task, usually the First Session Formula Task (FSFT). Approximately three days after the SFMS, the therapist sends the couple a therapeutic letter, detailing what occurred during the session as well as comments and ques- tions designed as interventions. Subsequent marathon sessions, if there are any, are used to discuss fol- low-up from the first session as well as highlighting the outcomes of the Solution-Focused Marathon 35 FSFT, the components of the miracle, as well as other exceptions. The subsequent sessions might also be used as a forum for participants to con- tinue to discuss areas of concern they have that might not have been brought up in the first marathon session or areas that seem not to be progressing. SFBT COUPLES THERAPY SFMS tend to be used primarily with couples, especially those who are con- templating separation or ending their relationship. SFBT is very appropri- ate for work with couples, even high conflict couples, as it helps the two individuals to focus on what they want out of their relationship. It can be used for premarital counseling (Murray & Murray, 2004), couples groups (Nelson & Kelly, 2001), divorce prevention (Weiner-Davis, 1992) or for any other type of couple issue. The Divorce Busting® work of Michele Weiner-Davis might be the most famous application of solution-oriented work with couples. Her work includes an average of four to six sessions designed for each partner to focus on what is working in the relationship and doing more of that. Her focus is on keeping the couple together so that they do not divorce. One of the primary differences, besides length of ses- sions, of the current application of SFMS and Weiner-Davis’ work is that SFMS is not focused on keeping the couple from divorcing, dissolving the relationship. In fact SFMS might also be used to help couples to end their relationship in a productive fashion, particularly if they have children to- gether. However, attempting to prevent divorce can fit nicely within a SFMS format. Hoyt and Berg (2000) explained the relationship between the problems that couples have and how SFBT can be useful to them: “A ‘problem’ arises and a couple seeks therapy (intervention) when the partners view their situ- ation in such a way that they do not have access to what is needed to achieve what they consider reasonable satisfaction” (p. 144). In work with couples, as well as for individuals and families, the same three general rules of SFBT hold. First, if it is not working, do something different. Second, if it isn’t broke, don’t fix it. Third, once you know what works, do more of it. These rules do not need to be overtly explained, but will demonstrate themselves in therapy. For the first SFMS, the conversation starts around finding out about the first rule, what has not been working for the client(s). When working with 36 Reiter couples and families during marathon sessions, this portion of the session allows each individual to feel heard by not only the therapist, but hope- fully the spouse and/or other family members. During this in-depth dis- cussion of what is not working, the therapist begins to explore what is working—what is not problematic—in the client’s life. This addresses the second rule about not changing patterns that are working. After the break in the SFMS, the therapist then focuses the clients around issues of the third rule; finding the exceptions to their complaints and then trying to find out how the client may start engaging in more exception times. For subsequent SFMS, time is mainly spent on rules two and three, where conversation centers on what clients have done differently and for those behaviors that are working for them, how they can do more. However, time may be also spent in further exploring aspects of their lives that are still not working and moving the conversation toward exceptions. One of the biggest deviations of a SFMS from a typical SFBT session is the extra focus on problem-talk. Having a future focus is a key for these clients, as the past will probably be mired in complaints. However, many couples come to therapy as a last resort and have many built-up frustra- tions and complaints they would like to vent. The goals of SFBT focus on what clients want to have happen in their future. Often, with high conflict couples and families, people have built up a wall because they have not received the acknowledgement of their concerns. Allowing a significant space in a solution-focused therapy session allows this process to occur. THERAPEUTIC LETTERS Bacigalupe (2003) explained, “Brief therapy demands that therapists focus on creating a context for change in every interaction with their cli- ents” (p.
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