HANDBOOK OF SOLUTION-FOCUSED BRIEF THERAPY Scott D. Miller, Mark A. Hubble, Barry L. Duncan, Editors FB ors ube San Pancicocmte=0 CHAPTER THIRTEEN RESEARCH ON THE PROCESS OF SOLUTION-FOCUSED THERAPY Mark Beyebach, Alberto Rodriguez Morej6n, David L. Palenzuela, and Jose Luis Rodriguez-Arias his chapter offers an overview of the research undertaken by the Salamanca Group over the last ten years. This research has been developed around the brief family therapy program of the Universidad Pontificia in Salamanca, ‘here both clinical services and graduate and postgraduate training in solution- focused brief therapy are provided. This intersection of the academic and the profesional, of clinical practice and training, impacts our research efforts in sev- eral ways. On the one hand, it impacts our own therapeutic practice and train ing procedures, Our research emerges from specific questions that at one time or another members of our team have asked themselves; the research intends to pro- vide specific answers, or atleast to generate nevi useful questions. On the other hhand, given that students and trainees carry out many of the research task, the dual focus of the program also has an immediate impact on the skills of the trainees. For instance, using a coding scheme to analyze therapeutic interaction usually has the beneficial “side effect" of sharpening certain perceptual skills in real therapy situations, Finally, our academic environment has probably also had an effect on the kind of research we have undertaken. As this chapter shows, we are engaged in what could be deseribed as fairly traditional research: itis nonparticipative, un- dertaken “from behind the one-way mirrox,” and, albeit naively, tres not to in- fluence the therapeutic process itis exploring, It relies heavily on traditional scientific notions such as reliability and validity, and does not shun statistics. Within 239300 Handbook of Soluton-Focused Brief Therapy this traditional framework, howeve, we have clearly opted for what has been called “proces research (Kicales, 1973; Greenberg & Pinsof, 1986), which in our view hholds the greatest promise of becoming, as we like to call it, “useful” research In other words, we are basically interested in the process of change as it unfolds during the course of therapy, especially its relationship tothe interaction taking place between therapists and clients, “This interest has been translated into three different but complementary lines of inquiry, two of which we describe inthis chapter The first line addresses the teational proces of therapist-lient interaction and its astociation with therapeutic utcome andl with various clinically significant processes such as premature ter~ mination of therapy, task compliance, and patterns of conversation displayed by hhovice and expert therapists, Inthe frst section of this chapter we offer a gen- tral overview of our results and a more detailed description of one of the stud jes we have undertaken within this line of research. The second line of inquiry provides a copie reading of the process of change in solution-focused therapy. Tn the second section of this chapter we present our first results, taking into ac~ ‘count both traditional cognitive variables and variables generated within the solution-focused approach. “The third lin of investigation involves study of therapeutic conversation from the point of view not of the process but of the conten of the dialogue. We use two different coding schemes, one derived from Sluzki’s (1992) suggestions on how to research narrative transformations, and the other an adaptation of an instru ‘ment used originally atthe Brief Family Therapy Center, Milwaukee, Wisconsin (Gingerich, de Shazer, & Weiner-Davis, 1987), which in our version disriminates several forms of “problem-talk” and “solution-talk.” However, because we are ‘only now beginning to get results on this third approach (Beyebach et al, 1994), peutic outcome at termination. Conclusion ‘We have tried to provide an empirical account of certain therapeutic processes from three very dflerent perspectives: (1) the relational aspect of communication, (2) cognitive variables, and (3) solution-focused theory and practice, We hope we have shown the utility of using such divergent approaches in evaluating solu- tion-focused work, Overall, the research reported in this chapter provides some empirical sup- ‘port forthe idea that certain solution-focused topics of conversation (pretreatment change and goals) are indeed relevant to treatment outcome, and that certain ways cof approaching these topics (certain patterns of conversation) are related to both continuation in therapy and compliance with therapeutic tasks. This suggests that it is not only useful in therapy to focus on certain topics, but it ie also useful to do so ina presctibed way (tht is, both content andl conversation process do mater) ‘Moreover, our results provide a certain empirical underpinning for some of the cceniral tenets of solution-focused therapy. For example, they point tothe relation- ship of pretreatment changes and clear goals to therapeutic outcome, as well as to the negative effect of confronting clients, They also provide support for solution focused therapists? commitment to promoting client? internal locus of contro. In addition, the results confirm that compliance with tasks is best understood in relational terms and that therapy can be successful even when the clients do not comply withthe tasks they are assigned (Bailin, 1995). Finally, the data provide some new, tentative guidelines for clinical decision making. For instance, they sug- gest that in general focusing on pretreatment changes might be more productive ‘than working on goals. They also suggest the importance of what others have called nonspecific factors in therapy, and that too much agreement with clients might be less productive than previously thought. ‘We certainly expect that future research along these lines would improve and clarify these findings. In this regard, we suggest that future studies not only con- sider outcome at termination but also at follow-up. We also believe that some of | the tentative conclusions we have drawn should be subjected to a more focused228 Handbook of Solution Focused Brit Therapy research process. Specifically, it would be interesting to study the immediate im pact of certain conversational practices or therapeutic techniques on the variables ‘we studied, This should be done at different moments of the therapeutic process in order to obtain a more accurate account of the process of change as it un- folds over time. At the methodological level, statistical procedures such as se- quential lag analysis, and research paradigms such as event-analysis, seem to us to be the most promising for future research, They would help us to keep research connected to theory training, and clinical practice. Questions from the Editors 1. Given the constructivist eaings of some solution-focused thinkers, there has been a bias against empirical research. Could you please comment? We think that, in fact, this bias not only reflects the impact of constructivist ‘and constructionistc thinking in our feld, but itis also closely inked to the gen= eral distrust between researchers and clinicians that has existed almost from the beginning of psychotherapy research. We might even say (but we do not) that the narrow-minded reading of constructivistc ideas has simply provided an ele= gant alibi to those clinicians who dislike the idea of conducting research or of sub rmitting their practices to it In our view, constructivism and constructionism should notcast doubts on the ‘possibility of doing meaningful empirical research. They should, however, make tus wonder what kind of research we want to call “empirical” and what kind of re- search is meaningful for clinicians who describe themselves as constructivists or constructionists, We think we should not dismiss empirical research as a futile aca~ demic exercise but should try hard to find (or develop] research practices that fit into our theoretical models, 2. What are you investigating in your present research? We are studying the shifts from problem-talk to solution-talk and vice versa using a coding scheme we have adapted from earlier research by Gingerich and associates (1987). At the same time, we are taking a closer look at the shifts that ‘occur within problem-talk. For this we are using a measure developed by Sluzki (1992) 3, Horo do researchers deal vith a modal ie solution focused therapy that hes chang ing and evoloing oer tine?Notes Research onthe Process of Sluton Focused Therapy 320 On frst thought, we might say “badly” Indeed, the gut feeling is and we think itis a feeling shared by many researchers —that research is always lagging behind clinical practice, always trying to catch up in vain with the developments that take place in the therapy room. On second thought, however, it turns out {hat things are not so negative. In our view, the changes in the solution-focused model have not been so radical as to invalidate the present research efforts. Certain techniques or specific practices have kept on evolving, but the basic the- ‘retical assumptions have stayed stable. Therefore, one way to deal with the research-practice time lag is to keep the research focused not on specific tech~ tniques bu on those more general aspects of the approach— elements like the therapeutic relationship, communication processes, cognitive changes in the course of therapy, and so on. Finally, we should say that itis a good thing that the approach continues to evolve and change—not only om the basis of clinical and theoretical developments but also on the bass of research. ‘That is what we hope we are accomplishing with our work, 1. These denomination ae certainly inaccurate, because we se any therapeutic interse- ‘oma intervntion, Although tight be more accurate tall about the “conversation” and the “final message” pars of the interview; we wil stick to the shorthand “informa: tion gathering” and “intervention,” which we have sed in previous publications. 2 Itshouie be atrested here thatthe pragma conception of control edifrent fom the clas ‘sicnotion of "power:” Accordingly, the fellowing shouldbe taken into account, Fit, re lational contro is always an islepenenal phenomenon, codefined by the interacting participants. Therefore, its nota property of inven ut rather of social ayters (Rogers-Milar & Mila, 1979) In other words, asbjeet may propose a given manner fr ‘efning hs or her relationship with another person, but its the response ofthe ater the new response ofthe formes, and soon that determines the form the relationship wll take at each moment. One may therefore tate chat it not posible to determine a rela ‘ionship niall: Converse relational controls est understood sa cnt, ther ‘words all mesages within an interpersonal context somehow contri or lit the com= ‘munication options ofthe athe speakers. A message given to. (who we shoud remern= ber propos a certain defiton ofthe relationship) “lige” B to postion himself or heel ‘with spect oA (to aoe that definition arta prope acer) and may limit the options ‘of B, who incur wil impose a certain constriction onthe next maestage of A, an! 9 on ‘succestvely The implication underlying this form of controls that fren maneuvers of control may be equally controling and that “one down” message maybe es controling. for even more so-as 4 “one-up” mesage “This study showed that on comparing prepost measures, clients who a termination of treat ‘ment were rated therapeutic suceeses showed sgificant increases in their specifi ele ficacy and specific internal locus of contrel. 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