The Pie of Inspiration: Positioning the Therapist’s and Client’s Knowledge in Solution-Focused Brief Therapy

When Anderson (1997) encourages therapists to put aside their knowledge in a conversation with clients, she justifies this by saying that the therapist will then be able to hear what the client brings to the conversation: i.e., what is unique and special. This creates local knowledge as opposed to universal knowledge (Anderson, 1997; Peller & Walter, 2000). In the unique and special that manifests itself in local knowledge, it is easier to see the client’s resources that can be used in the process of change (Keeney & Keeney, 2013). At the same time, the whole work with the client becomes individualized, and the relationship between the therapist and the client takes the form of a partnership, rather than a dependent relationship towards authority (i.e. the therapist as an expert on client’s life). This is connected particularly with the principles of cooperation, honoring individuality, and growing of solutions mentioned above.

In terms of a solution-oriented approach, two main forms of “knowledge” or “expertise” are distinguished: expertise on content and expertise on process (Berg & Miller, 1992; De Jong & Berg, 2012; de Shazer et al., 2007; Guterman, 2014). While process refers to what therapists do to facilitate change (e.g., methods, techniques), content refers to the objects of change in any given clinical theory (Guterman, 2014). Content-related expertise thus refers to the life of the client and meanings of life events etc. Clients can describe different problem situations (fear of the dark, relationship problems, eating disorders, etc.), they can mention different professional or “folk” classifications of problems (e.g., depression, low self-esteem, lack of communication, anorexia), or various professional concepts (system, boundaries, cognitive scheme, self-actualization, projection, etc.); or they can describe various previous attempts to solve the situation (e.g., “I tried to reprogram the thinking,” “I practiced meditation”). In all these areas, therapists can also think of many things based on their own experience, the experience of their other clients, professional literature, etc. All these ideas can be classified as expertise on content, led by the question “what?”, when exploring topics that the client somehow mentions.

Another type of expertise is process-related expertise, which is connected with asking “how?”. In this case, the therapist’s knowledge concerns how to conduct a helping conversation. This knowledge is again based on expertise, training and experience with clients, and each therapeutic or counseling approach offers its own systems of knowledge on how to lead the process of change in consultation. In SFBT, process expertise mainly involves how to join the clients and develop cooperation (a therapeutic relationship) with them; how to collaboratively set direction of their work together with clients (a preferred future); and how to help the client use the resources available to move towards his/her desired change (De Jong & Berg, 2012).

The way in which therapists handle their expertise in content and process has a great influence on the course of cooperation with clients. The above-mentioned attitude of “not-knowing” or “constructive curiosity” referred to the therapist’s ability to put aside his/her knowledge of content (content expertise) in order to enhance local “knowledge” formed together with the client, including his or her unique resources.

During close observing of SFBT therapeutic sessions one can notice that SFBT therapists usually occupy a certain “conversational position”Footnote 1, in which they try to lead the client’s ability to develop a solution with as little therapist’s content expertise as possible. Narrative therapy author Michael White distinguishes the four positions of a therapist in a conversation, according to whether he/she has an influence and is at the “center” of therapy or is “de-centred” (White & Morgan, 2006). I put it in the simple scheme inspired by this typology and White’s own scheme (see Fig. 1). This scheme may be useful for reflecting on the therapist’s position and particularly reflecting on content and process expertise of therapist.

Fig. 1figure 1

Therapist’s positions (based on White & Morgan (2006))

Presented scheme clearly shows that the therapists should move in the upper half of the scheme, i.e., in the area where they have some influence. If therapists had no influence on the conversation and the process of change, it would be useless for the client to go to them for consultations. If the therapists find themself in a situation during the conversation where they have no influence on the process of change (i.e., they don’t contribute to the desired change at all), they should reflect on this fact and take some steps to make themselves again beneficial for the client. Routine outcome monitoring or feedback from clients play a crucial role here as well as supervision and deliberate practice of therapists (Miller et al., 2020; Prescott et al., 2017).

The second dimension of White’s scheme shows whether the therapist is in a central or decentralized position in the process of change. If the therapist is in the imaginary “center” of therapy, then he/she is the main actor of change. The therapist’s experience and knowledge are also privileged in this position, while the fact that the client is an expert on their life is neglected and their “voice” is less audible (Anderson, 1997; Peller & Walter, 2000; White & Morgan, 2006). This position corresponds to a certain cultural image of psychotherapy: the therapist is often perceived as an expert on how to arrange change and how to conduct “the right intervention” (whether in the form of advice, questions, interpretations, or other techniques), and as the most important factor in the process of change. If the intervention “does not work,” the therapist remains at the center, but at the same time loses influence and may be held accountable and blamed for failure. If, on the contrary, the intervention of the therapist occupying a central position is effective, the therapist becomes the main “hero” in the process of change. However, this is associated with the fact that the client automatically takes the position of someone who is not competent, someone who has a deficit and needs support. Client’s knowledge is neglected as well in such case. In this context, it is interesting that psychotherapy research shows the vital importance of client resources and client participation in the process of change; thus, the therapist should strive to make the client the main “hero” of therapy not himself (Duncan et al., 2004, 2010).

The preferred position of a therapist using SFBT is (similarly to the narrative approach) in the quadrant of influence associated with decentralization, where the main “hero” of the whole process is the client, whose role in the change process is emphasized more than the therapist’s. Therefore, SFBT usually places great importance on expertise regarding the process, which is knowledge of procedures and conversational tools and the ways how to contextualize them to the sessions so that they allow the clients to develop the change they want and be the main figures of this change. Content-related expertise can very easily place a therapist at the center of events (due to their “knowledge”) and weaken the client’s competencies. By contrast, expertise in the process allows the therapist to find creative ways to enable the client’s unique way of creating change (Lipchik, 2018).

These ideas suggest it may be inadmissible in SFBT to have or show any content-related expertise. However, such a view is too simplified. In general, while SFBT prefers expertise to the process for the reasons given above, this does not mean that SFBT therapists should never come up with their own ideas and inspirations, or that they should not appear in a central position for a moment (de Shazer et al., 2007). Lipchik states: “I do not think we should provide information up front until we have tried to help clients find their own solutions. But when it seems evident that we have information clients lack, it can be offered in a respectful manner that allows for choices” (Lipchik, 2018, p. 86). Two complementary skills are essential in SFBT in this respect: the skill of being curious and not-knowing, as well as the skill of raising the therapist’s content ideas in respectful and useful ways, and with good timing. Paradoxically, trying to give up content-related expertise in some contexts may be a sign of the therapist’s insufficient flexibility and low levels of SFBT skills - similar to offering content-related expertise in a context where pure process expertise would be more useful.

In the following part of the article the focus will be on the ways of working with content-related expertise of not only the therapist, but also of various other people involved, in accordance with the principles of SFBT. This especially involves efforts to provide an individual approach, effectiveness (including the central position of the client in the change process), and process expertise (i.e., how to consult so that different perspectives can be utilized in conversations).

Playful ways of introducing different “voices” into conversation (Peller & Walter, 2000) can help to overcome the dilemma of content/process related to the expertise of the therapist. Conversation can be enriched by different perspectives including client’s own perspective as well as therapist’s perspective. There might be presented various perspectives like special “menu” for the client who can choose what makes sense to him or her (see case example 1).

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