The Solution Focused 

Brief Therapy Diamond

Book Review

The Solution Focused Brief Therapy Diamond

By Elliot E.Connie and Adam S.Froerer. Published by Hays Books (2023)

In A Few Words

Inspiring, thought provoking. Sets out a clear description of Solution Focused Brief Therapy. Provides examples of conversational and questioning styles that could be used, with good effect, by many therapists. Colleagues who had used aspects of the book in their work said that it had improved their practice!

Highly Recommended
Book Club Score 8.2 / 10

Summary

The book provides a detailed overview of Solution Focused Brief Therapy (SFBT), a form of Psychotherapy and draws together essential aspects of SFBT into The Diamond Model. 

SFBT, in all its forms, aims to help people see and realise transformation in their lives by articulating their best hopes for the future and acknowledging strengths and resources, they already possess, which can help them get there. SFBT is solution focused and pays little attention to problems, their origins or relevant diagnosis.

The book is an enjoyable and engaging read, deeply human and compassionate. It is courageous in advocating SFBT, a therapeutic approach which in itself is different from some longer standing,  more conventional talking therapies. It advocates some differences from other approaches to SFBT, for example in not summarising the session back to clients at the end, not suggesting or giving homework and not offering clients direct compliments.

The Diamond model itself is simple and powerful and provides a clear structure for therapy sessions. 

The book is highly recommended to anyone interested in SFBT or interested in how people can make positive change.

What we loved about the book

The writing feels authentic, humane and honest. It is easy to read and works well as an audio book. Uncommonly for books about psychological therapies it uses the language of love together with the language of respect, autonomy and belief in the people we work with.

The book reminds us to remain mindful of our position, to remain humble and to minimise power inbalances in the therapy room.

It sets out the history and evolution of SFBT and key contributors to its development which include, of course, Steve De Shazer and Inzoo Kim Berg (as part of the Family Therapy Centre in Milwaukeee in the 1980s) and Evan George, Chris Iveson and Harvey Ratern from Brief Uk. The authors encourage us to consider that SFBT is continually evolving.  

After years of research the authors have identified critical success factors for SFBT and shape these into a simple model, The Diamond Model.

The book includes case studies, actual session transcripts, many interesting anecdotes, 101 solution focused questions as well as the some of the authors’ personal journeys which clearly show why they were drawn to Solution Focused approaches.

The Diamond Model

The Diamond model incorporates a number of critical elements:

“The Stance” – This is a set of key principles and beliefs that are considered essential for therapists to hold in providing SFBT.  Fundamentally,  that ‘treatment..is not contingent upon understanding the presence of symptoms or relevant diagnosis’. Also that ‘even before the client walks into the office’, you view that person as ‘great, competent and capable’.

Best Hopes: These are the client’s preferred outcomes, the positive change that they seek and expressed in the client’s own langauge. The Best Hopes are the ‘anchor’, the corner stone for SFBT sessions.

Outcome descriptions: These help clients acknowledge past successes, their strengths and to envisage their preferred outcomes happening in future. In the Diamond Model these are termed ‘The History of the Outcome’, ‘Resources for the Outcome’ and ‘Future of the Outcome’. 

Closing: This sets out how the authors close therapy sessions, simply and briefly whilst maintaining the client’s autonomy and sense of agency. Importantly, the authors suggest that we do not summarise the session or suggest homework.

What we didn't like so much

Some colleauges felt that there was a little too much sharing of the author’s personal journeys and except for individual case examples there was no focus on the tracking or measurement of outcomes. We wondered if this was purposely left out of the book or not considered integral to the model? 

There was almost no reference to the neuroscience behind why SFBT can help people make rapid positive change, i.e. what is going on in the brain. This is potentially a very compelling aspect. 

Some colleagues consider the use of scaling to be more important than suggested by the authors. Some encourage clients to undertake homework in certain circumstances e.g. listening to hypnotherapy audios, and yet this is strongly discouraged by the others in that it may risk taking away the client’s sense of autonomy and agency.

Book Club members didn’t agree with the suggestion in the book that complimenting clients risked taking away their autonomy. We felt that it was essential to offer encouragement, positive reinforcement and praise (where appropriate to the person). Members also see great value in the use of some pycho-education (revision about the science of the brain and emotions) where relevant to the person because of the increased understanding, relief and empowerment that it can provide.

The Book And Our Therapy Practice

The Diamond model is simple and powerful and allows the therapist to know where they are in the session at any given time and why they might be asking a certain question at a particular time.

As hypnotherapists, and although not strictly SBFT practitioners, we felt that the Diamond Model could be integrated seamlessly with hypnotherapy aspects. Ideas about this, by the author, are set out in the diagram below.

The book provides powerful, useable questions and framing to use in sessions with clients and these include solution focused questions about the past, e.g. “can you tell me a time in the past where that confidence was there for you”.

The authors emphasise client autonomy and agency and consider it essential that we use the client’s own language.

There are superb sections about working with couples

Diagram illustrating a combined SFBT Diamond and Hypnotherapy session structures

Notes on diagram:

  1. In a typical Solution Focused Hypnotherapy session, the ‘How can we help + background + explanations would be ascertained during an Initial Consultion
  2. All the rest would take place during actual therapy session
  3. In a typical hypnotherapy session, the talking therapy part would take about 25 minutes and the hypnosis a further 25-30 minutes

Favourite quotes, questions and themes

“I understood that learning by invoking suffering wasn’t something I believed in, I believed that people learned by analyzing their brilliance”

“Treatment … is not contingent upon understanding … symptoms or .. relevant diagnosis”

“If you want to evoke change in a client, you should put that change into language”

“Pressuppose the best in your clients”, “Find the hero in their story”.

“Talk to your clients as if they are capable of change”, “Trust your clients’ capability”

“Your client has to leave each therapy session feeling more powerful than when they entered it”

“Co-construct their desired outcomes

Questions to ask your clients

“What’s been better since we met last”

“What are your best hopes (for us working together today)”

“What difference would (achieving your best hopes) that make to you”

“What would you do instead (of the unwanted behaviour, emotions, situation etc)”

“What would be the first sign (that the wanted change was present)”

“What would you notice then”, “What would others notice then”

Thanks

I would like to thank Ali Hollands Hook, Anna Thomas, Caroline Parsons, Davinder Sunner, Catherine O’Connell, Gerry Gingell and William Mcrea for joining me for a Book Club on 21st June 2023 to discuss this book. The summary above reflects some key points from our discussions.

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