Northwest Brief Therapy Training Center
Olympia, Washington
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A Brief Solution-focused Approach

Working with the Somatically Focused



Several types of somatically focused individuals

Clients with chronic illnesses/chronic pain, people who are exquisitely aware of body functions, individuals with fear of disease or disorder based on misinterpretation of bodily symptoms, others with multiple somatic complaints where no physical basis can be found (?).


Typical issues presented by somatically focused

Not feeling heard by medical system, negative self-definition, feeling overwhelmed by persistent symptoms, because of physical symptoms focus on body even more in problem-oriented ways, either-or thinking, drug and alcohol issues, unaware of personal resources.


Special challenges for solution-focused therapist

Being respectful and learning what to ignore and what to pay attention to with clients with lots of physical complaints: gripes vs. complaints, what client perceives he/she can change vs. what needs others’ help for, when and how to get family involved, recognizing potential solutions already present, staying “behind the client”.


Therapist tasks with somatically focused clients

Developing well-formed goals: reorienting patients to solutions rather than to problems, painting a realistic goal picture with a somatically preoccupied person, noticing what the therapist can use to compliment, deciding on an intervention, asking about connections between improvements/changes and somatic complaints/focus, using coping questions for setbacks or unchangeable physical problems and persistent complainant relationship about physical problems, projecting into the future and working back to the present.


Implications for the practice of solution-focused therapy

Emphasis on coping with what one cannot change in life, working towards clear and small goals, helping family/friends to be helpful and be resources for the client, persistence in staying with what client wants, creating web of connections between physical issues and what the client wants to solidify movement toward realistic goals, staying in a collaborative mode.


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