Solution Focused Interventions with Trauma Survivors

Editor’s note: This text-based course is a transcript of the webinar, Solution Focused Interventions with Trauma Survivors, presented by Kim Anderson, PhD, MSSW, LCSW​.

Learning Outcomes

After this course, participants will be able to: 

• Identify how trauma impacts the individual.
• Recognize how helping paradigms impact practice.
• Describe how to apply solution-focused strategies to effect change.

Introduction

The focus of today's presentation is solution-focused interventions. This has been quite popular and has become more mainstream within counseling, mental health, et cetera. However, it is often difficult as it is present-oriented. This lecture is about combining two frameworks of looking at solution-focused interventions with trauma theory. 

Paradigms/Worldviews

• Paradigms/Worldviews are the underlying:
  • explanations
  • theories
  • fundamental models or
  • frames of reference

used to organize our observations and reasoning to make sense of the world. (Babbie & Benaquisto, 2002, p. 32)

• How does one’s paradigm impact one’s practice?
  • Trauma-Informed—viewing survivors through the lens of trauma
  • Empowerment, Solution-focused, Strengths-based-viewing survivors through the lens of strengths

We will begin by talking about paradigms/worldviews. These are the underlying ways that we view the world. These can be shaped by explanations, theories of human development, or in the social world fundamental models or frames of reference. We basically use this to organize our observations and reasoning to make sense of the world. For instance, I have a great nephew who is two years old. I gave him a miniature toolset. One of the tools is a hammer, and I showed him how to use the hammer with the tools. As he started to understand the connection, he started to take the hammer and hammer not only the nails but also me and everything around the room. This is how paradigms sometimes work. We use a paradigm and apply it to everything. We need to think about how to use paradigms to view the world and how to impact the world. 

Let's now talk about a couple of different paradigms working with survivors of trauma. One of them is trauma-informed. This is very important in viewing the survivor and the pain and the suffering that they have endured. This is understanding their reactions and their worldview. Often, their worldview has been shaped by shattered assumptions. Shattered assumptions are that the world is safe, that you can trust people, and the people that you care about will not hurt you.

Another framework that we talk about particularly in social work is strengths-based practice. This is looking at and identifying people's strengths, assets, aspirations, skills, knowledge, et cetera. This is also understanding that people, regardless of the problems that they endure, have strengths. This goes along with some of our other theoretical frameworks, with a solution focus. Again, this is a way to not only look at individuals in the present but also to help them get beyond those shattered assumptions that occur due to trauma. With these shattered assumptions, they cannot make a change or achieve their goals or aspirations. Empowerment is not something that we give individuals. Instead, it is helping them once they connect with their strengths to feel empowered to make the changes they need or want in their life situations. 

What is Trauma?

• Traumatic events impact a person’s sense of control, connection, and meaning.
• Feelings of intense fear, helplessness, loss of control, and the threat of annihilation.
• Disconnection: negatively impact systems of attachment and belief systems that give meaning to the human experience. (Loss of trust in themselves, in other people, and in a higher power.)

What is trauma? A lot of this presentation comes from some of the seminal work in trauma and recovery by Judith Herman. She states that traumatic events impact a person's sense of control, connection, and meaning. Essentially, people feel like they have no control and have a loss of connection with individuals due to trauma and betrayal. They also have intense feelings of fear, helplessness, loss of control, and for some, the threat of annihilation or death. That disconnection then negatively impacts our systems of attachment and belief systems that give us meaning to the human experience. If we cannot trust people, for instance, in family bonds the people that love us, then it makes it much more difficult to also extend such trust to other people. This may even be connections outside oneself like a higher power. Questions that someone may ask, "If I'm a good person, why did this happen to me?" Or, "If there is a God, why is there suffering in the world?" 

Five Basic Needs Often Disrupted by Trauma

These basic needs are disrupted by trauma: 

• Safety
• Trust
• Control
• Esteem
• Intimacy

There is a loss of both physical and emotional safety. There can be post-traumatic stress symptoms such as not feeling safe because of flashbacks. We do not want to say to somebody that they can trust us. This is something that needs to be earned. We would not expect people, whose trust has been betrayed, to automatically then trust us or to feel safe. That is up to us to show that that is possible. We talked about the loss of control earlier. This loss of control can impact counseling. It is important to give them control, but sometimes when we ask for them to make decisions, they often say, "I don't know." That is a pretty normal response because they are coming to you for information and advice. However, their worlds have been shattered. Thus, when we give people choices sometimes this can be overwhelming, particularly when they themselves had to make choices that were life or death for them or for someone else. 

As far as esteem, they are impacted by shame and blame. These negative perceptions of self lead to helplessness and powerlessness. Their esteem is not only low, but it is also something that has such a significant impact on how they view the world. When we first meet with survivors to build trust, safety, and control, we do that by pointing out their strengths. However, this does not really fit with their worldview of themselves. They may say, "Well, that's not the way it is for me." We can respond, "All I want you to do is think about that that perhaps both could be true in the sense of how you see yourself. The strengths make-up who you are." You can also ask, "What don't you like?"  And, intimacy, whether that is sexual, physical, or emotional, is often disrupted.

All of these basic needs work together and can test relationships. Survivors of trauma are often labeled manipulative. Thinking in this way can negatively impact the work we do. We need to be solution-focused and use an informed framework that is based on trauma. 

Trauma-Informed Care

• A trauma-informed approach is based on the recognition that many behaviors and responses expressed by survivors and directly related to traumatic experiences.
• Traumatic reactions are Normal responses to Abnormal situations

Let's talk a little bit about trauma-informed care. A trauma-informed approach is very popular now. Trauma-informed care and trauma-informed frameworks go beyond the micro-level to also include the community. We see this happening on a larger scale, and it helps us to look at behaviors and responses expressed by survivors and how they are shaped by traumatic experiences. Traumatic reactions are normal even though they do not feel normal. The difficulty is that they try to use these same mechanisms where they are no longer under threat or are in a safe environment. Disassociation or separating someone from their feelings or experiences and the overwhelmingness related to that can be a good thing. However, to disassociate in a relationship with someone makes it difficult to build that intimacy. And, there are some reactions that we want to honor as that helps a person to strive and persevere. We might need to talk with them about modifying or adapting these reactions in situations that are no longer under threat.

• Basic understanding of trauma and how trauma impacts survivors
• Understanding trauma triggers and unique vulnerabilities of trauma survivors
• Designing services to acknowledge the impact of violence and trauma on people’s lives

Again, trauma-informed care is a basic understanding of trauma and how it impacts survivors. I think we have come a long way. Instead of labeling people as damaged or as incapable of knowing their situation, it is understanding that being victimized does not mean that you cannot make decisions about your life or change that life trajectory. This approach also helps us to understand trauma triggers and the unique vulnerabilities of trauma survivors. This is important when we start looking at survivors' ways of reacting rather than responding. Many triggers come from the senses as traumatic memories are encoded that way. For instance, a person can be disconnected from an image or event but then smelling alcohol can suddenly trigger a panic attack. This could be that when they were abused the person smelled like alcohol. And so, there are these unique vulnerabilities. We talk about how the body remembers. This is difficult for survivors as they feel that their bodies are betraying them or that there are things happening in their bodies that they do not understand.

With trauma-informed care, we want to design services to acknowledge the impact of violence and trauma on people's lives. We want to also understand those needs that are disrupted and the physiological aspects of how trauma can either shut someone down physically or make them hyper-alert or hyper-vigilant. They can have flashbacks, have difficulty remembering something, or have a hyper memory where they remember everything in every detail. There can also be a lack of feelings or emotions. They can have negative thoughts or feel numb. We want to help them to learn strategies and skills to manage these feelings to both survive and thrive.

Transforming Trauma

• “If you cannot get rid of the family skeleton, make it dance.” (George Bernard Shaw)
• “Extraordinary growth occurs when we cease to be ashamed or embarrassed by our hardships and no longer try to ward them off—but instead let ourselves experience them and be changed by them.” (Sanford, 1990)

As we look at the aspect of transforming trauma, one of the favorite quotes is from George Bernard Shaw, "If you cannot get rid of the family skeleton, make it dance." I think sometimes in trauma treatment, we want the trauma to go away. We cannot change what happened to people or change the trauma, but we can change the impact that has had with someone. We want to give survivors a choice on how much impact that family skeleton has on them and how to respond to it. 

The second quote is by Sanford from a book called "Strong at the Broken Places." "Extraordinary growth occurs when we cease to be ashamed or embarrassed by our hardships and no longer try to ward them off--but instead let ourselves experienced them and be changed by them." Instead of avoiding the experiences and the effects of trauma, it is sitting with it, navigating one's way through it, and finding oneself. This is an integration of the past, present, and future.

Recovery

• Helping survivor connect with his/her power:
  • Survivor’s self-determination in his/her recovery.
  • Survivor has expertise in his/her life and has strengths that need to be supported. (This fits with feminist/empowerment, strengths-based, and trauma-informed care.)

When we are looking at recovery with survivors, we are helping survivors with self-determination in their recovery by giving people information. When someone says "What should I do," we can say, "Here are the choices, and here are the implications of those choices. What do you think would work for you?" Survivors have expertise in their own life, and they have strengths that need to be supported. I have been in this field for 30 years and never cease to be amazed at the strength, resolve, resourcefulness, and compassion in people who have been mistreated in ways that are inhumane. We can see how this might fit with many perspectives such as feminist empowerment, a strengths-based approach, and trauma-informed care. 

The Strengths Perspective in Trauma Practice (Anderson, 2010)

• The strengths perspective emphasizes a helping framework that honors people’s abilities and potential for growth.
• Resilience and impairment are not necessarily opposites, but instead, appear to be different aspects of the overall experience of coping and adjustment.  
• Standing alongside the entire range of debilitating effects of trauma, most survivors display a stunning capacity for survival and perseverance.

I wrote a book called "Enhancing Resilience "in Survivors of Family Violence." This book looks at an extended version of this presentation and how we take these paradigms and integrate a strengths perspective into a solution-focused trauma approach to assist survivors in their journey of healing. This strengths perspective emphasizes a helping framework that honors people's abilities and potential for growth. The key to this is that you have to believe that no matter what someone's circumstances are they have the ability to grow. I think that sometimes we get lost in diagnosing rather than seeing their strengths. 

My mentor was Dennis Levy who was one of the key people that talked about the strengths perspective and trauma practice. He always said there should be a new DSM, and it should be the "diagnostic strengths manual." When we talk about the strengths perspective, we want to look at people's strengths first. Instead of asking people what is wrong with them, we want to start by asking them what their goals are and what is strong in them. Resilience and impairment are not necessarily opposites. I have studied resilience research and literature for most of my career. It started with looking at resilience, as either people have it or they don't, and how they face adversity and bounce back. I have found that many survivors are very resilient. However, it might not show up on standardized measures of self-esteem or coping, but they are extremely resilient to even show up and continue on with life, let alone taking steps towards changing that life. Most survivors display a stunning capacity for survival and perseverance. I have completed research with domestic violence survivors, and I often use a strategies index that is a standardized measure. "What did you do to survive and to protect yourself?" They often say "Nothing. I did whatever he said to me." Or, "I did whatever I needed to do to get it over with." Again, this is very powerful and impactful. I started digging deeper with questions like, "Did you ever hide the children? Did you ever, …” I found that within this sample of 38 women on average they used 22 different strategies to protect themselves or their children in the relationship. 

Operating from a Strengths Perspective

• Assumptions:
  • The worker’s role is to inquire, listen, and assist individuals in discovering, clarifying, and articulating their strengths.
  • Survivors’ life stories provide numerous examples of strengths as they use their struggles with overcoming their adversity as a catalyst for growth and change. 
  • The worker can minimize the power imbalance inherent in the helping relationship by stressing the importance of the survivor’s understandings and wants. 
  • Survivors, whether they volunteer for services or are mandated, are always striving toward healing albeit encountering frustration, obstacles, and missteps along the way.

Anytime that people are faced with adversity, they are also working at fighting that adversity and resisting that in person. Our assumption is that the worker's role is to inquire, listen, and assist individuals in discovering and articulating their strengths. It is not up to us to tell them what their strengths are, but it is up to us to help them navigate their stories and to shine the light on those strengths. Survivor's life stories provide numerous examples of strengths that they used to overcome adversity as a catalyst for growth and change. Oftentimes, they do not give themselves the credit that they deserve in relation to those strengths. They do not recognize or give themselves credit for everything that they have done. The worker can minimize the power imbalance, but they cannot make the power imbalance go away. No matter what, if someone is coming to you for services, there is a power imbalance. It is inherent in the helping relationship. However, we can stress the importance of the survivor's understandings and wants. 

As a caveat here, we do not want to say that we do not have the answers or that the answers are within them. Why come to somebody then if they are not going to assist you. It can be a pretty helpless feeling. When people ask, "Do you think I can change?", I say, "Yes. We will work together on that. You and I might not know right now what that looks like, but we will figure that out." This moves us into a solution-focused perspective. There is not only one solution but often many solutions. I have found in my work that any solutions I offer are not as good as the solutions that we work on together or that the survivor decides upon. Whether the survivor volunteers for services or is mandated, they are always striving towards healing. That does not mean, however, that they do not encounter frustration, obstacles, and missteps along the way. 

Solution Focused Practice (O’Hanlon, 2019)

• Acknowledge distress.
• Focus on success.
• Solution or goal talk is necessary and it is independent of problem processes.
• Building on the problem when it is not a problem—exceptions

One of Bill O'Hanlon's books is, "Do Something Different." If something does not work, instead of doing it over and over again, let's look at doing something different. Solution-focused practice acknowledges the stress and validates the pain. It focuses on managing and impacting that distress. Solution or goal talk is necessary, and it is independent of problem processes. For instance, somebody could be struggling with depression, and from a problem-centered perspective, the thought would be for us to look at the root cause of depression and how it is impacting their lives. A goal might not be lessening the depression, but rather, asking them about how they would like their life to be instead. They might say, "I want to have friends." We then start at what it is they want to add to their lives rather than what they want to remove from their lives. 

How Do We Build Solutions? (O’Hanlon, 2019)

• Joining With the Survivor
• Define what the survivor wants (rather than what he/she does not want). 
• Focus on “doing” – What are the action steps the survivor needs to take?

One of the main things in solution-focused practice is identifying exceptions to the problem. How do we build solutions with the survivor? We talked about joining with a survivor. Joining means believing and collaborating with them to provide information when asked and provide support to help the survivor to navigate their way towards their goals. We define what they want rather than what they do not want. We start with what the problem is. And, as they describe it, we then ask, "What would you like to happen instead if depression was no longer a part of your life?"

There is also a focus on doing. This is a little bit different in solution-focused treatment because it does not really focus on feelings. This does not mean that you do not acknowledge feelings or validate people's pain. Believe me, they will let you know when you are not doing that. It is really looking at what they would do differently. What are the actions and steps they need to take? It is focused on the present. And, when it is looking at the past, it looks at when the problem was less of a problem. What was the person like in this situation? As we look at these aspects, then we can look at these assumptions. 

Assumptions of a Solution-Focused Approach

• Small change is generative.
• Collaboration is possible.
• People are resourceful—are capable.

The belief system is that small change is generative. What that means is that it does not take a big grand gesture for change to occur. It can be something small that gets things moving. For instance, I worked with a client on the 12 step program. One of the steps is to do a personal inventory. This client said that she could not do it. When we were talking about it, I asked, "Do you have something to write with?" She said, "Oh yes, I have a notebook that I carry in my car but I have not used it in a long time." And, as we were talking about making one small change, I asked, "What do you want to do the next week?" She said, "I want to write in the book." This may seem like a small step, but that was a major step for this client. As she had not been able to do it for months, I did not think that in one week she would easily be able to do that. I suggested that she did not have to write but just open it. That was the step. It was concrete, specific, and it was in her control. When she came back the following week, she had written in it in the book. I think had we had the goal to write in the book, that may have been too overwhelming.

I do believe collaboration is possible even in mandated clients. When I am working with mandated clients, let's say for substance abuse issues, and they often say "I don't have a problem." I use this as an opportunity to say, "Oh, tell me more about that, I'd like to know when you know it's not a problem. Let me know when you're able to manage it." These interactions are even possible in court-ordered cases. "What has to change for you so that the judge will let you off?" "What do you need to do to be off of probation?

Lastly, people are resourceful and capable. I see that in everybody. Depending on our paradigms, we may not see things as resourceful when we see problems as opposed to the client being resourceful. 

Building Solutions

• Assumptions:
  • Focusing on solutions facilitates change in the desired direction.
  • Exceptions to EVERY problem can be created.
  • Change is happening all the time.

How do we build solutions? Focusing on solutions facilitates change in the desired direction. If we focus on solutions, then that will can help us to continue to focus on additional solutions, and that will pick up momentum. There are exceptions to every problem that can be created. For example, if you are stuck, you can talk with a supervisor or peers. There are solutions that we may not have figured it out yet.

The other aspect of this is that change is happening all the time. Even though people can have setbacks or they relapse, the relapse is never the same each time. Awareness is different, and there are things that have changed. Change is happening all the time. No one can abuse substances 24/7. There are these times when that is not happening. It may not look like change, but that generally is more of a problem with how we view the client and their work, as opposed to, whether we view them as changing or not. I often hear workers talk about resistant clients. I do not know that there are resistant clients from a solution-focused perspective. "Resistant workers" may not be doing what we want them to do, but this might mean that this does not fit in with their goals or that we are not listening to what it is that they feel is important.

Rules to Follow

• If it works don’t fix it!  Stay out of the person’s way.
• If everything you are doing is not working, do something different (instead of “If at first, you don’t succeed try, try, again!”).
• Keep it simple.

If something works, do not fix it. Stay out of the person's way. And if everything you are doing is not working, do something different. I worked in child welfare for a long time. We would have court reports with the same kinds of recommendations. In fact, the clients who had been involved with the system more than once could tell you all about the individual counseling, group counseling, parent education, and substance abuse assessments. However, this was not working. We thought if we kept doing it or if it was a court order that somehow it would change instead of trying something different. Nothing is really simple when you try to make changes in life. If it was, more people would be able to do that. So, any step that a person takes, even if you fall on your face, you are falling forward and still making progress. 

Modes of Cooperating

• Being supportive and future-oriented
• Supporting survivors who are barely coping:  “How are you managing as much as you are?”
• “Yes, but”  individual—advocate for the parts that are hurting or fearful
• Scaling (0-10)

Modes of cooperating include being supportive and future-oriented. Supporting survivors who are barely coping is important. "How are you managing as much as you are.?" There is also "the yes, but" individual. They are the folks that state, "I've tried that and it didn't work," or, "Yes, but I wouldn't be able to do that." A lot of this might be related to fear or from hurting. We want to advocate for that aspect of themselves that does want that change. Something that I find that has been helpful is looking at scaling. The scaling aspect of a problem looks at confidence or motivation. "On a scale from zero to 10, zero being you have no motivation to 10 being you're highly motivated, where do you fall?" When they say, "Four," I ask them, "Why not a two or three?" And then I ask them if they are a four, what would it take to go to a five? This is working in small steps. This is advocating for the parts of themselves that they want to move up that scale. This is also recognizing how far they have come. Wherever they start on the scale, we should ask about the next level. If zero, then we ask about a one. 

Language Makes a Difference

• Instead of saying:
  • “She’s a cutter."
  • “He’s manipulative.”

Language does make a difference. Instead of saying, "She is a cutter," we say, "She cuts herself under distress, and we haven't figured out why yet." Instead of  He's manipulative," we say, "He's usually indirect when asking for something. We tend to use language as a way to put everything together and define the client to makes things more manageable. However, this approach does look at other aspects. It is only one side of the story. We do not do this in other parts of our lives. For example, I do not go around and introduce "my depressed friend Kathy." That may be an aspect of her, but that is not the main aspect and that is not how I define my relationship with her. We do not want to define others by their behavior either.

What Hurts and What Helps?

• WHAT HURTS?
  • Interactions that are humiliating, harsh, impersonal, disrespectful, critical, demanding, judgmental
• WHAT HELPS?
  • Interactions that express kindness, patience, reassurance, calm and acceptance and listening
  • Frequent use of words like PLEASE and THANK YOU

What hurts and what helps in a relationship? Obviously, interactions that are humiliating, harsh, impersonal, disrespectful, critical, demanding, or judgmental are hurtful. We know what that is like in our own experiences, and that is not something we would want to promote in our relationships with survivors. However, sometimes, when we are not taking care of ourselves or perhaps we are suffering compassion fatigue, we might have interactions that are not necessarily hurtful but they are not helpful. In a genuine relationship, there are going to be ups and downs. I have found that when I acknowledged that and say, "I was distracted, and I wasn't listening as fully as I could have," that people are appreciative of that. We do not want to set it up that we have people taking care of us. If they pick up on something and ask me, I always say, "There is, however, I'm here for you. Thank you for asking." Interactions that express kindness, patience, reassurance, calm, acceptance, and listening are things that help. We need to use the words please and thank you frequently in our interactions with clients. 

The Importance of our Attitudes and Beliefs

• WHAT HURTS?
  • Asking questions that convey the idea that “there is something wrong with the person”
  • Judgments and prejudices based on cultural ignorance
  • Regarding a person’s difficulties only as symptoms of mental health, substance use or medical problem

From a solution-focused approach, we begin to ask, "What happened to you?" rather than "What's wrong with you?" We also want to know what makes them strong rather than what is wrong.

Initiating Goals

• “I am very sorry to hear how things are going. Can you tell me what about this you would like to change or handle differently?”
• “I am sorry to hear how bad things have been going. Can you tell me what about this I can help you with?”

How do we start initiating goals? We want to make sure to not invalidate people's pain and where they are at. But, we can ask, "Tell me about what you would like to change or handle differently." We can also acknowledge their pain by stating, "I'm sorry to hear how bad things have been going. Can you tell me what I can help you with?"

Well-Defined Goals

• Stated in the positive—What will you be doing instead?
• Stated in a process form—How will you be doing this?
• In the here-and-now—As you leave here today, and are on track…
• As specific as possible—How specifically…
• In the individual's control—What will you be doing…
• In the individual’s language

This helps us then move into developing well-defined goals. Oftentimes the goals that we work on with clients are missing one of these qualities above. It is helpful to look at those goals and incorporate these elements. The goal needs to be stated in the positive, and asking, What will you be doing instead?" If somebody says I want to lose weight, we ask, What would you like to be doing instead?" They might say, "I want to eat healthier." That is positive, and it may be stated in a process of how they will be doing this. It is still more "a want." We could say, "If you're eating healthier, what would you be doing?" 

We also need to make these goals in the here and now. We talked about we always look at each meeting as the last meeting. "As you leave here today, and you're on track, what would be the first step that you would take towards your goal? How specifically would you do that?" We may even talk about the time and the place. This is in the individual's control typically. Some may say, "I can't make a change until someone else makes the change." We can reply, "Let's say that they did make the change. How would you act differently?" And, "Is there any part of that that you could start doing now, regardless if that person changes?" We also need to use the individual's language when making the goals.

Problem Statement and Exceptions

• “When doesn’t the problem happen?”
• If they answer that the problem happens all the time then ask, “So when does the problem happen a little bit less?”

When a client first comes in, we ask about the problem. That is the paradigm that we have set up with problem-centered practice. However, what we are interested in more than how many times somebody is cutting is when they do not cut when they could have. What stops the problem? If they answer that the problem happens all the time, then we might ask, "When is a time when it has been a little bit less?

Exception Finding - Building on Strengths

• Who, what, where, when, and how of times when the problem was not a problem.
• Exceptions are praised and followed up on.
  • “How did you do that?”
  • “How did you get that to happen?”
  • “How have you overcome problems in the past?”

We talked about exception finding to build on these strengths. When we do find exceptions of when someone's not hurting themselves, for instance, we want to know the details about that like who, what, where, when, and how. We want to really acknowledge those exceptions. We ask questions like, "How did you do that?" And, "How have you overcome problems in the past?" I like to use humor, and I do this so much, that often they know that I am going to ask, "How did you do that?" They will say, "I don't know how I did that," but they know that that is not going to stop the conversation. I might then add, "Let's say if you did know what might be some ideas or theories on how you did that?" I try to get them to think about how things do not just happen.

Externalizing the Problem

• Separate the person from the problem
• “the anger,” “the blame,” “the craving”
• “When are you able to stand up to the self-blame, so it doesn’t take a hold of you?”

Another way is to stand up to the problem which is separating the person from the issue. If they have anger, relentless blaming of themselves, or craving, we can talk about the problem and label what is. This is standing up to this unwanted visitor. You can ask as an example, When are you able to stand up to XYZ so that it doesn't take a hold of you?"

The Hypothetical Solution Frame

• Creating invitations into possibilities—thinking about how the future, as opposed to the past, can impact the present
• Focusing on how life will be different
• Focus on “doing” rather than “feeling”
• Miracle questions “So tell me about sometimes when this (the hypothetical solution) may be happening a little bit now.”

We can also go the route of thinking about hypothetical situations and creating invitations to possibilities. Thinking about the future as opposed to the past can impact the present. This is focusing on how life might be different, but I want to caution people with this because you do not want to act like it never happened. The client may have been sexually abused and suffer from anxiety. We are not saying that in a hypothetical solution you were never sexually abused, but we are saying hypothetically what would your life be like if you were no longer anxious. What would you be doing differently? This is not asking how you would feel differently. You might ask, "If you were no longer anxious, what would you do in the morning?" "How would you interact with others?" "How would you go about your day?" Then, there are miracle questions. "Tell me about some times when the anxiety is no longer a problem." I found this question to be quite impactful. Survivors are relieved to think about a life where the problems that brought them in for counseling no longer are there, and what that life would be like. Again, the miracle is not that we have changed the past. The miracle is that anxiety, depression, and self-blame no longer exist, and what would that look like for them. 

If the Helper and Client/Survivor Are Not Progressing

• Who is the client?
• What is the client’s goal?
• Is the goal well-defined?
• Are you and the client looking for too much too fast?
• Maybe provide feedback to think about rather than doing.
• Maybe you and the client are in a negative pattern.

If the helper and the client are not progressing, there may be some other issues. Perhaps the client is really not the person that needs to change, but it might be somebody else in that system. Are we working on the client's goal? Is the goal well-defined? Maybe, you are trying to look at too much, too fast. Or, you are providing feedback to think about rather than doing. It could be that you and your client are in a negative pattern. You might be doing the same things over and over instead of determining that it is not working. Again, try something different.

Making an Action Plan for a Preferred Future

• What could you do in the near future that would be steps toward realizing your visions and dreams?
• What would you do as soon as you leave here?
• What would you do tonight?
• What feeling would you have in your body as you took those steps?
• What would you be thinking that would help you take those steps?
• What images or metaphors are helpful to you in taking these steps?

We want them to make an action plan, and these are questions that you can ask to help them to imagine a preferred future. Again, we are helping people look at the present, but then starting to steps towards their preferred future. 

References

Finally, here are lists of our references.

Anderson, K. M. (2010). Enhancing resilience in survivors of family violence. New York: Springer Publishing Company.  ISBN: 9780826111395

Anderson, K. M. (2011). Assessing strengths: Identifying acts of resistance to violence and oppression.  In D. Saleebey (Ed). The Strengths Perspective in Social Work Practice, 6th edition (pp.182-202).  Boston, MA:  Pearson.

 Anderson, K. M. (2019). Enhancing resilience in adult daughters of abused women. Social Work in Mental Health. DOI:10.1080/15332985.2019.1577789

Babbie, E., & Benaquisto, L. (2002). Fundamentals of social research (1st Canadian ed.). Scarborough, ON: Thompson Canada Limited.

Herman, J. (2019). Trauma and recovery: The aftermath of violence--from domestic abuse to political terror. Hachette Audio.

O'hanlon, B. (2019). Do one thing different: Ten simple ways to change your life. HarperCollins.

Renner, L. M., Driessen, M. C., & Lewis-Dmello, A. (2020). A Pilot Study Evaluation of a Parent Group for Survivors of Intimate Partner Violence. Journal of Family Violence, 35(2), 203–215. https://doi.org/10.1007/s10896-019-00118-3

Saleebey, D. (2011). Some basic ideas about the strengths perspective. Social work treatment: Interlocking theoretical approaches, 5, 477-4850.

Sanford, L. T. (1990). Strong at the broken places: Overcoming the trauma of childhood abuse. New York: Random House.

Schneider, F. D., Loveland Cook, C. A., Salas, J., Scherrer, J., Cleveland, I. N., & Burge, S. K. (2020). Childhood Trauma,   Social Networks, and the Mental Health of Adult Survivors. Journal of Interpersonal Violence, 35(5/6), 1492–  1514. https://doi.org/10.1177/0886260517696855

There are a few articles in there for myself that I've authored in relationship to resilience strengths-based practice et cetera. And then we also have additional references here in this regard to strengths perspective, trauma theory, and solution-focused practice. I want to thank you for participating in this webinar, and we'll conclude, at this point, unless there are additional questions.

Questions

In thinking about some of the solution-focused interventions that you've discussed, what would you say the success rate is when these have been applied with survivors?

Solution-focused interventions have been highly successful because of the ownership that survivors take. It really is through this collaboration that they find the solutions that work best for them to achieve their goals. It also works well for the worker because oftentimes we feel like we are responsible for helping that person directly and accomplish their goals in a timely manner. If we can always think about ourselves as workers and that there are always solutions, we are going to be able to figure something out. This will also carry over to the client themselves. They begin asking themselves those same questions. "If I was to do something different, what would I do?" I've seen some significant changes in people as they start small and make those steps towards a solution. They then generate more and more towards their goals.

We talked a lot about traumatic experiences, especially as they relate to family violence, but would you say that these interventions can be applied to clients regardless of the traumatic experiences?

I have found that it can except in the area of grief and bereavement. It is not appropriate to think about solutions in this case. Clients need to process that grief. Eventually, they can get through the process and move to the day to day aspects of how they would like to change. But initially, this paradigm is not a good fit for people who have suffered a loss as it feels invalidating and rushed. With other situations of trauma, whether that is family violence or environmental crises like hurricanes, it is all about starting with Maslow's hierarchy of needs. We need to have safety and security first, and we need to provide the resources. From there, once the crisis has been addressed, we can start looking at the day to day and the future aspects of their lives.

Summary

Katrinna Matthews: Dr. Anderson thank you for addressing those questions for me. Also thank you so much for sharing your expertise with us. Trauma is prevalent among the clients the social workers serve, and having the ability to identify how trauma impacts the individual, recognizing how helping paradigms impact social work practice, and understanding how to apply solution-focused strategies to affect change is critical to social work practice, especially as social workers work from a strengths perspective to positively impact change in survivors of family violence. Please note that cultural competence is essential to our work as social workers, therefore we must be cognizant of the role of culture in diversity, and its impact on practice.  For more information regarding culturally competent practice, please review the NASW resource Standards and Indicators for Cultural Competence in Social Work Practice. Again, thank you for joining us on social work at continued.com.