September 6, 2011

Do you think the word 'therapy' fits with the solution-focused approach?

In his book Words Were Originally Magic, Steve de Shazer quotes the following definition of the word 'therapeutic': serving to cure or heal; curative; concerned in discovering and applying remedies for diseases. That part of medical science which relates to the treatment and cure of diseases.

The word 'therapy' clearly refers to the medical context. In that sense it does not fit well with the solution-focused approach. Solution-focused helping does not follow a medical model in the way it views and aims to help clients. de Shazer clearly recognized this and said the following about the word 'therapy':
Through the writing of this book and the previous one (de Shazer, 1991), it has been with the greatest reluctance, hesitation that I have continued to use the word "therapy". I have used the word, even though it is not quite the right word, since it is the only word available to even begin to say what it is that I am talking about, what it is that my clients and I do. Unfortunately, "therapy" says both more and less than what I want to say when I use that term, but I have not yet thought of or heard any other word that could take its place. Throughout both books I should have written it this way: Therapy. (This sort of strikethrough indicates that a word is used but not really meant. Since the word is inadequate, it is crossed out; since the word is necessary, it remains legible.) 
I agree that the word 'therapy' is not adequate to describe what happens in solution-focused conversations. I think we are still in need of a better word. I think it is a pity that the word therapy is still so strongly associated with the solution-focused approach. In some cases the word 'therapy' is even used in a context in which it seems extra inappropriate. An example is this book title: Solution Focused Brief Therapy in Schools: A 360 Degree View of Research and Practice. I think this a good book but this application of the solution-focused approach - the school setting - , I think, has nothing to do with therapy whatsoever.

Question: what is your opinion about the use of the word 'therapy'? Is there a way to get rid of the word 'therapy'?  Is there a better word? Or do you think it is still the best word to use?


  1. Interesting question. For me, therapy is attached to a specific context, that of a "doctor" with a "patient". With respect to business settings, I'd rather talk of coaching?

    A coach helps people:
    - gather their own strengths
    - see their situation from other points of view (reframe)
    - solve their problem themselves

    Well, at least this is according to the definitions of coaching we have in France (US-based coaching looks more like mentoring to me).

    Aren't these three points similar to what happens with SF?

    In France we have a book titled "Le coaching orienté solutions" which really is about SF-based coaching. I've not read it yet, but I think it sums things up with respect to SF.

    Nicolas Stampf

  2. I guess that what SFC does is "assistance". Sometimes this assistance is therapeutic in the sense that the person using the assistance is suffering somehow. However, as noted, as soon as you get above zero, above floating, things become fuzzy.

    If using Positive Psychology, the new zero becomes Flourishing and this meaningless, mindless, automatic existence that most of us lead is treated as a form of suffering, then the word therapy becomes adequate again.

  3. I have similar issues with the term therapy. I train health and social care practitioners and find that whilst I am asked to "teach solution focused therapy" I'm not comfortable with this - firstly because I don't think 'teach' is the correct term - train, coach, facilitate knowledge and skills development, etc yes but 'teach' no and secondly because the term 'therapy' is one that comes with all sorts of practitioner presuppositions. I aim to facilitate practitioners to strive to have a general mindset that reflects the underlying principles and values. That means developing solution focused reflexive thinking skills before jumping on to 'techniques'. After a great deal of faffing around I have ended up simply referring to this as 'solution focused working'


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