November 17, 2009

The Thinktank That Created The Solution-Focused Approach - Interview with Eve Lipchik

By Coert Visser (2009)

Eve Lipchik was one of the original core members of the Brief Family Therapy Center in Milwaukee, which created solution-focused therapy in the beginning of the l980's. She worked at the BFTC until l988, when she cofounded ICF Consultants. She is the author of the book Beyond Techniques in Solution-Focused Therapy: Working with Emotions and the Therapeutic Relationship and numerous chapters and articles. In this interview she looks back on the time the solution-focused approach was developed and she shares her memories of the process of developing the approach and of the people involved. She tells about the essential shift the team made from gathering information about the problem to focusing on constructing solutions with clients. Also, she reflects on recent developments and she explains the importance of describing the approach as encompassing both philosophy and techniques. Finally, she tells about some of her current interests and activities.

Coert: Could you tell me about some of your memories of the early times of the Brief Family Therapy Center? How did you get involved with that and how did you experience that starting period?

Eve: In 1978, I decided to sign on to a two year, 40 hour a week training in Marriage and Family Therapy at Family Service of Milwaukee. That is where I met Insoo Berg, who was my supervisor. As a result, I learned about some experimental work she, Steve de Shazer, and some other people at Family Service were doing after hours. They were experimenting with ideas they had learned at the Mental Research Institute (MRI) in Palo Alto, and from the literature of Jay Haley, the Milan Group, and other therapists on the cutting edge at the time. Before the Brief Family Therapy Center (BFTC) was founded in 1979, some therapists from Family Service would meet at Insoo and Steve's house after work, video-taping therapy sessions of friends of friends who volunteered as clients. They would then analyze and discuss these sessions until late at night. I soon became part of that group and eventually joined BFTC in 1980, after finishing my training. Interestingly, only people who were not the sole breadwinner of their family had the freedom to join, because we started out without a client base and knew it would take a year or two to build up enough business to provide salaries for everyone.

The BFTC group always saw cases as a team, with on therapist conducting the interview and the others behind a one-way mirror. The lack of business in the early days was a huge bonus. We would spend our whole day at the office and had the luxury of discussing a case for hours, because often there wasn't another one for a long time, if at all. It seems like yesterday that we would gather excitedly after a client family left, while Steve positioned himself at a blackboard to make notes about what we were saying. The purpose, after all, was to notice and understand why we did what we did, and what worked, so that we could do more of it.

That certainly was an exciting time, and I am most grateful to have had the opportunity to experience it. I could never have imagined that a collaborative process could feel so individually creative! Everyone's ideas were of equal value, even those of visitors who might drop by to sit behind the one-way mirror. When a message for clients was finally developed, or a new idea about what had just happened in a session was born, one could feel satisfaction as an individual, as well as a member of a group.

Coert: That sounds like an exciting and fulfilling work environment. A lot has been said and written about the important contributions of Steve de Shazer and Insoo Kim Berg to the development of the solution-focused approach. But I think many people relatively new to the field, are less aware of how much the development of the solution-focused approach has been a collective effort and of how different individual members with their own specific interests and qualities have all contributed importantly. Could you tell a bit more about some of those people and how they contributed?

Eve: When I think back upon the collaborative process we were all engaged in, it is really hard to separate out individual contributions. We did, however, have very different personalities and backgrounds. The five people who were the original core group at BFTC in 1980, were Jim Derks, Elam Nunnally, Marilyn LaCourt, Insoo Berg, Steve de Shazer and I.

Jim Derks was a Master Degreed Social worker who had been trained in behavioral therapy. He, like Insoo, also studied at the Chicago Family Institute, which had a psychodynamic bent, but also introduced its students to the new developments in Family Therapy. Jim had a most unusual way of thinking. First, he tended to explain his ideas by using a lot of metaphor, which added another dimension to the discussion. Secondly, his thinking was “outside the nine dots.” One could say his contribution to discussions was like a pattern interruption. We would be going over and over a point and he would come left field with a totally different perspective, or a metaphor, that would allow for a new direction of thinking.

Elam Nunnally was a Professor at the University of Wisconsin-Milwaukee at the School of Social Work. His PhD was in Family Studies, so he contributed a lot about stages of family development, family relationships, and, in particular, family communication. His thoughtful, quiet manner often grounded the group when imaginations would run wild.

Marilyn LaCourt had a Masters Degree in Communications and a background in education. She had not had any therapy experience before training at the Family Therapy Training Institute at Family Service. That was an advantage for the group because she was not prone to get involved in speculations like some of us did, but evaluated situations at face value. In this respect she and Steve were of one mind and could understand each other before some of us understood them. Her thinking contributed a lot to the minimalist aspect of Solution-Focused Therapy.

I had a Bachelor's Degree in English Literature and spent some time after college working in television production. After I married and had my children, I worked in a research project at the University of Rochester, N.Y. There I did play therapy and studied for a Masters Degree in Human Services before moving to Milwaukee and getting a Masters Degree in Social Work.

One of our first students at BFTC was Alex Molnar, a Professor at the University of Wisconsin-Milwaukee School of Education. He was adding a Masters Degree in Social Work to his PhD in Education, and came to us for his Practicum. He was instrumental in analyzing our therapeutic process and in helping to construct decision trees to illustrate it.

Later, Wallace Gingerich, also a Professor Social Work at the University of Milwaukee-Wisconsin, spent time at BFTC. His expertise in research and interest in computers contributed greatly toward articulating the process of solution construction in academic terms.

Michele Weiner-Davis, who was a trainee at BFTC originally, later joined the research team and is credited with having introduced the notion of pre-session change to the Solution-Focused approach.

Last, but far from least, we all learned from, and with, our many visitors. BFTC had not been established very long before we began to attract the attention of therapists interested in innovative ideas through a home publication called the “Underground Railroad.” We all contributed articles to it about what we did at BFTC. Soon we had a parade of visitors like Lyman Wynn, Brad Keeney, Bill O'Hanlon, Carl Tomm, Michael White, Yvonne Dolan, Brian Cade, John Weakland, and many others. They sat behind the mirror with us and shared their thoughts and ideas during lengthy discussions and even longer dinners at Insoo and Steve's house, or mine. Steve cooked great Chinese food and made his own beer. I liked to cook, too, so we shared feeding and putting up our guests at our respective homes.

Coert: Thank you. I'd like to hear a bit more about your own role if that is okay. One of the people who got involved with BFTC, in 1984, was Gale Miller. In a recent interview, he said: “I cannot stress enough how important Eve Lipchik was – she was willing to go the extra mile to make sure I understood what she was doing.” Could you tell a bit about your own role and specific style, interests and views?

Eve: Well, for one, the group called me “the psychodynamic one” when we first got together. That changed very quickly though, as we worked together and increasingly began to look for the same things and think along similar lines. However, I do think that I continued to be the one in the group most inclined to bring emotions into the case discussions, particularly at times when we seemed uncertain or stuck.

As I mentioned before, we started out without any client base. It was, therefore, decided that one of us had to go out into the community and find referral sources. I was unanimously elected to do this job even though I had never sold anything before in my life. I think I succeeded in this role only because my genuine enthusiasm for our group, and our work, must have come across to people , and they figured it may be worthwhile to give us a try.

As for Gale Miller's nice comment about me – by the time he came to BFTC I was aware that our core group had become so close, and the communication so idiosyncratic, that it must be difficult for an outsider to understand what is going on. So I tried to help him bridge that gap.

I also developed an interest in spouse abuse in 1981, while consulting with a womens' shelter. What I observed there made me question the dominant theory that women should always leave the men who abuse them. I noticed that the level of abuse occurred on a continuum, and that the majority of situations did not fit the stereotypical domestic violence case in which the man could be categorized as severely character disordered and power hungry. The majority of situations ranged from mutual pushing and name-calling to physical fighting, which many woman said they started. In other words, many of these cases looked a lot like the relationship problem cases we treated at BFTC. I began to wonder whether a client centered, future oriented approach like the Solution-Focused one might not help improve these relationships and save families, as long as we knew how to assess the safety of the women. Once again, I went out into the community. This time I talked with District Attorneys and Probation and Parole officers about my ideas. To my surprise they all agreed with me that couple treatment, rather than separation, is the better way to go in many of the situations. They began to refer cases to us and we were very successful in assessing and treating them. I then began to publish this work and to present our ideas nationally and internationally. One thing that really surprised me in the course of these presentations was the violent language often used against me when therapists, who treat violence, disagreed with my ideas.

In terms of my role in the development of Solution-Focused Therapy, I think that my specific contribution was in terms of the interviewing process. From the very beginning of my association with the group I questioned the belief that change occurred primarily as the result of the intervention message at the end of the session. The general understanding was that the interviewing therapist's job was to “gather information for the team behind the mirror so it can compose the intervention message!” This really confused me. I could not understand how to connect with clients in front of the mirror while I had my head behind the mirror with the team. I kept insisting that the interview is an intervention, as well, and began to explore this idea on my own. This difference of opinion became a mute point when we shifted from gathering information about the problem (Brief Family Therapy) to focusing on constructing solutions with clients (Solution-Focused Therapy). Solution construction undeniably occurred during the interview and the message at the end of the session served mainly to reinforce what had been constructed so far.

Coert: That's very interesting. I consider that insight and shift in focus essential because it made the approach more client-centric and effective. Now, could you tell a bit about your last few years at BFTC and the time and the reasons you founded your own practice, ICF Consultants?

Eve: During the last few years I spent at BFTC, our goal of developing a model, and teaching it nationally and internationally had been achieved. The close collaboration that produced such creative energy was no longer necessary. The core group had shrunk down to Steve, Insoo and me, with Elam Nunnally part time, and the research team meeting separately. Jim Derks and Marilyn LaCourt had left. My practice was very busy and I began to run the training program because Insoo and Steve started traveling more and more. The development of the approach had been incredibly exciting, but we also had expended a lot of time and energy on it. I began to feel that I want to cut back and spend more time with my family. It was very difficult for me to leave, particularly because Insoo and Steve asked me to stay and offered me various options. However, in l988, I decided to look for an office to rent somewhere where I could have a small private practice. Coincidentally, Marilyn Bonjean, who had a small private practice at BFTC, and had become a friend, decided to leave her full time job because of a change in management. When I mentioned that I was looking for office space she shared that she had decided to try building a full time private practice rather than looking for another job. She asked whether I would like to share office space. That seemed like a fine idea, and that is how ICF Consultants was born.

My intention to cut back my work schedule did not exactly work out as planned. My practice began to flourish rapidly and I received many invitations to talk about Solution-Focused Therapy, especially in the area of spouse abuse. It was very gratifying to be affirmed on my own, not only as part of an established group.

Coert: I can certainly imagine that. And just like you and the other core members have evolved, so did the approach, I guess. I am curious about your thoughts and feelings on how the solution-focused approach has evolved in, say, the last decade. Do you see any interesting new trends, insights or innovations? And what are your thoughts about the fact that SF is so well-known and broadly applied nowadays, also in many fields outside therapy?

Eve: Originally, the Solution-Focused approach was considered to be process oriented and therefore, applicable to any type of case. I believe that is still true. However, as time went on, people began to apply it to specific problems, as I did with spouse abuse. Over the past ten years I have noticed increasingly varied applications of the approach, such as for group work, for children, for addictions, for child welfare, etc. My impression is that at this time people's thinking has evolved in two directions: either, that Solution-Focused Therapy is foremost a philosophy that guides thinking about how to help people achieve their goals, or, that it is a model that has specific techniques that, when applied correctly, achieves that goal. The majority of books I have seen seem to fall into the second category. However, I am pleased that the Treatment Manual that the Research Committee of the Solution Focused Brief Therapy Association issued in 2008 clearly described the approach as encompassing both philosophy and techniques.

As for your comment that the Solution-Focused approach has been well accepted and propagated, my sense is that that may be more the case in Europe and other parts of the world than in the United States. The term "strength based" is used generically in many applications that obviously originated from Solution-Focused thinking but I do not see BFTC or Solution-Focused Therapy credited too often. I was recently asked to endorse a book written by a psychiatrist about his manner of Life coaching, which he said is rooted in Solution-Focused Therapy. He devoted two sentences to it, and I had to ask him to revise those two sentences because they did not describe the approach correctly. Also, if you look at the programs of therapy conferences lately, there are very few presentations listed about Solution-Focused Therapy and its applications, and Narrative Therapy, too, for that matter. Motivation interviewing, which is so similar to Solution-Focused interviewing, is currently gaining more and more attention, as is Mindfulness, and, of course, Neuroscience and its application to therapy. I think therapies tend to go "out of style" more in the US than they do in Europe and other countries. But it is quite possible that I am missing a lot of information about the legacy of BFTC in the US and elsewhere. I sincerely hope so!

Coert: Could you tell me about your current interests, activities and plans?

Eve: One of my current interests is Neuroscience. I was trained and certified in EDMR about twelve years ago and that opened up my mind to very different thinking than I was used to. I didn't seek this training, it was offered to me free of charge, and I thought it might be fun to experience. To my surprise, I was fascinated by it and wanted to know more and more about how the brain works. My subsequent studies of Neuroscience made me want to examine whether, and how, it can fit with Solution-Focused thinking. [See article in the reference list-CV]. I believe a valid connection is possible in some respects, particularly with regard to the regulation of emotions, a core concept in neuroscientific work. Another example would be in the area of the plasticity of the brain. Neuroscientific findings suggest repetition creates new neuronal pathways, e.g. new thoughts and behaviors. Therefore, Solution-Focused therapists could suggest to clients that they repeat exceptional behaviors or thoughts, or “miraculous” behaviors or thoughts that are already happening, on a daily basis, perhaps even several times a day.

Aside from my clinical practice, I supervise Masters Degree practitioners, as well as people who are working toward AAMFT Approved Supervisor certification. For the past decade, I have also worked for an organization that has a number of community based programs for emotionally disturbed children, such as treatment foster care, school based programs, a day treatment program and a residential program. My mission there is to give all the therapists a good grounding in Solution-Focused thinking and then to act as a consultant. The cases we work on are systemically so complex, and the therapists are often so green, that I have found that it is most effective to instill the Solution-Focused philosophy first, using basic assumptions, and then to start demonstrating the value of the techniques. The assumptions help them develop the relationship with clients that is such an essential underpinning for the success of Solution-Focused Therapy, as all therapy, for that matter.

My future? I would like to keep doing what I am doing as long as I can keep doing it.
Thank you for choosing to interview me.

References:
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2 comments:

  1. Congratulations on a brilliant interview! I particularly liked the description of Eve's own contribution to the development of SF - crucial indeed! I am also becoming fascinated with neuroscience at the moment, too. Thanks a lot for this,
    Sue Young

    ReplyDelete
  2. Thank you Coert for reminding usthis interview. Even now 4 years to date it still gives some really interesting insights.

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