Your Therapy Client Wants You to Solve Their Problem… Now What?

There’s been a lot of discussion in my online training community recently about how to handle one of the most difficult situations that people find themselves in when they’re practicing Solution Focused Brief Therapy. And that is when the client comes in asking for you to solve a specific problem. For example, anxiety. And that’s what I want to talk about here in this week’s episode of the SFBT Moments.

Now, anxiety is very, very tricky when you approach it as a problem. So, for example, clients will come in and they’ll say, “I really need you to show me how to stay calm because I’ve had three panic attacks in the last week.” And it’s really tempting to be like, “Okay, let me teach you some breathing techniques. Let me teach you some, [whatever].”

But I’m going to give you two little pieces of information that I think will help you be able to work with these clients. Because if you take on the responsibility of trying to solve their problem, then the pressure is on you and not them, and the responsibility is on you and not them. And so will the blame if it doesn’t go away.

Number one, anyone who struggles with something like anxiety, they get really, really anxious, but they also calm themselves down. So I will always ask clients like that, “Wow, I know you’re really worried about this anxiety, and how it’s popped up like three times in last week. But, each time it pops up, what did you start to do to keep yourself calm and to bring it back down?” Because there’s always an answer. They’re going to say something.

Now it might sound like, “Well, eventually it just kind of wore out.” “Well, how did you notice it was wearing out?” “I went and sat down, I turned off my phone, or whatever it is.” So help them point to, if I’m really good at getting anxious, that means I’m also really good at winding myself down.

The second thing is always, always, always remember, and I cannot stress this enough, you have to follow the same Solution Focused Brief Therapy process that you would with anything else. The problem does not change the process. Okay, that’s very important. I’m going to say that again. The problem does not change the process.

So if I’m going to ask my client, “Suppose you woke up tomorrow and and you were no longer anxious, what would you be instead?” And they say, “Well, I’d be nice and calm and relaxed.” “Well, suppose you woke up tomorrow and you’re nice and calm and relaxed. What would you notice?” Just do the description and that will very, very frequently lead towards change.

I remember working with a client, and this client, he was a very successful business person, and his job required him to go to Europe every week. He would go to London, I believe, every single week. And he came to therapy because he said “One day, out of nowhere….” (he’s never had an anxiety problem, never had a panic attack problems).

He said, “One day I was getting on the plane, and I just had a full blown panic attack, and I could not get on the plane. I could not do it.” And he said, “The next week I tried again, I couldn’t do it. I called in sick. I made excuses.”

And he said, “But, now my job is in danger. I’ve got to go this week on my trip.” So I didn’t say, “Alright, so here’s some techniques and some strategies.” What I said was, “Suppose it’s the day after you’ve returned home from the trip. How would you describe the things you did as you went on this trip successfully?” And that was the description.

He said, “Well, I would have walked on the plane like I normally do, and I would have read a magazine.” (Cell phones were around back then, obviously, but they weren’t what they are now [smartphones].) And he said, “I would have read a magazine, and I probably would have just kind of dozed off.” We literally just did a description on the day after he returned home from the trip.

And he sent me a really excited text message, from England, with a picture of him in front of the Big Ben area. (You’d have to know London a bit, but the Big Ben area, where there’s a big river right there). A picture of him, and he never had another problem. Again, I didn’t teach him any skills. I just did the description.

Very often as therapists, we get really nervous ourselves, and we think, “Oh, my God. I have to solve this problem, because the client has asked me to, and the problem is really big.” And then we step away from doing Solution Focused work.

You don’t have to do that.

Just remember the problem does not change the process, just do the work.