Solution Focused Therapy, the Common Factors, and PCOMS

....a ménage a trois made in heaven...

I had the great pleasure of returning to the beautiful city of Brugge this past week as part of my ongoing collaboration with the Korzybski Institute International, the largest psychotherapy training center in Belgium and one of the largest in Europe. It was an exciting time at Korzybski coming off the world Solution Focused Day on May 3^rd.  Korzybski is indeed solution focused, but with a very noticeable twist, hence its collaboration with me—the institute also embraces a common factors perspective.

Our relationship happened because the great Dr. Luc Isabaert, the founder of Korzybski, recognized that solution focused work embodies many aspects of the factors known to create positive outcomes, the so-called but not-so-common common factors. Moreover, Luc also saw the commonalities among his Bruges model of Solution Focused Brief Therapy (SFBT) and the Partners for Change Outcome Management System (PCOMS). Consequently, Luc asked me to teach in his training program for the past 9 years.

Our collaboration also resulted in my contribution to and introduction of Luc’s book, Solution-Focused Cognitive and Systemic Therapy: The Bruges Model.  I introduce Luc’s great book on the Bruges model of SFBT in a chapter I called, “Solution Focused Therapy, Common Factors, and the Partners for Change Outcome Management System: A Ménage à Trois Made in Heaven.”

I warn you it is a long chapter, but it covers the waterfront about all the three topics at hand.

Here is a summary:

SFBT’s interest in client resources and client goals proved remarkably on track with the most robust findings in outcome research—that client contributions and attending to client preferences and goals account for the lion share of outcomes in therapy. Solution focused pioneer Steve de Shazer introduced the radical notion that the solution need have no relationship to the problem, running directly counter to the medical model’s insistence that a discrete, diagnosed disorder then dictates a specific, matched intervention. An understanding of solutions as non-problem specific frees therapists and clients to travel multiple paths in a more client directed and creative search for problem resolution. In addition, SFBT’s attention to the future provides a natural enhancement of hope and expectancy factors replacing the dismal past with a possibility-filled future. Finally, solution focused therapy’s roots in Ericksonian ideas keep the client’s worldview center stage as well in an interest in learning and validating the client’s theory of change as a critical component of strengthening the therapeutic alliance and enhancing positive outcome. Solution focused models were prescient applications of what was later confirmed by the bulk of outcome research.

Similarly, monitoring client feedback via PCOMS is a natural fit with solution focused clinical work, a mere extension of the practice of scaling. SFBT partnerships are founded on the belief that clients are better positioned than anyone else to know what is best for them as well as what works best for them. In addition, solution focused approaches have a legacy of giving utmost attention to what works so both the client and therapist can do more of it. It also strongly believes in the Mental Research Institute (MRI) guiding principle—if it doesn’t work, do something different. PCOMS provides immediate feedback on what is working and what is not, only cementing a relationship between itself, the common factors, and SFBT, a ménage a trois made in heaven.

In my recent visit with Luc, we discussed once again the value of SFBT and what it brings to the table with regard to the common factors and how PCOMS provides a perfect match in both values and method. Our conversation concluded with our belief that any model is helpful to the extent that the therapist unequivocally believes in the client’s abilities for change, centers the client in the process, and harvests their resources in the context of true partnership.