Claudia Van Zuiden on Solution Focused Therapy in Nepal

What is: SOLUTION FOCUSED THERAPY?

SFT is a form of counseling psychotherapy based on solution-building rather than problem solving.

SOLUTION FOCUSED THERAPY is used with the therapeutic treatment of:

• Depression
• Anxiety
• Relationships problems
• Parenthood
• Work problems
• Setting up a business
• Burnout
• PTSD
• Other life challenges

During a Solution Focused Therapy session the therapist will identify the problem that the client brings to the session and will explore solutions and strategies that will help to produce fulfilling results in the client’s personal and professional life. The focus in the therapeutic session will be on enhancing the client’s resources, skills and strengths that they already have. The therapist and client will be working together towards the client’s preferred future or goal.

Introduction: Claudia van Zuiden

 Claudia van Zuiden was born in the Netherlands and has been living in Scotland, UK, for the last twenty one years. She works full-time in the community as a psychiatric support worker as part of a mental health team and has completed the COSCA modules 1,2,3,4 in Counseling Skills and a post-graduate course in Solution Focused Brief Therapy Skills at Robert Gordon University at Aberdeen.

Claudia has been a SFBT practitioner since 2001. Claudia is a member of the United Kingdom Association of Solution Focused Practitioners and will be speaking on June 15^th 2012, at the UKASFP Annual Conference in Edinburgh, Scotland, UK, about ‘The Application of SBTF in Developing Countries.

She has trained health professionals, youth workers, teachers, guidance teachers, counselors, volunteers, parents and classroom assistant in the application of SFBT techniques which can be included to their already professional and personal existing repertoire of skills. Claudia van Zuiden has also introduced and facilitated trainers in SFBT intervention skills in Nepal.

In 2012 she has trained staff for the Aberdeenshire Council and mental health team members of NHS Grampian, Scotland UK.

Last year in Nepal

Claudia introduced Solution-Focused Brief Therapy in Nepal. The first workshops were held in Department of Psychology, Tribhuvan University on 26 and 28 April 20011. It was organized on invitation by Sujen Man Maharjan on behalf of Central Association of Psychology Students and Psychology Department.

She also facilitated workshops in SFBT for the Nepal Mental Health Foundation, NMHF, and for Himalayan Healers staff members, both in Lazimpat, Kathmandu, Nepal.

Further reading:

http://www.thehimalayantimes.com/fullNews.php?headline=Grade+XII+exams+begin+&NewsID=286402

Reflection on her decision to come to Nepal with SFBT

Claudia reflects, “After reading the article such as ‘Poor and Depressed’ by Surbrath Shrestha (2008) and talking to people in Nepal about the lack of mental health support in Nepal, I decided to facilitate workshops in this technique in Nepal. The feedback afterwards in sharing the SFBT technique in Nepal has been extremely positive. The evolution forms used for feedback reflected a 100% yes on the question if participants think they will apply the used skills in their work. Requests have been made for further training in this technique. I feel very happy about this and learned that small changes can lead to big changes and that participants of the workshops could very much relate to this particular technique as some of its origins, such as the application of the practical aspects of positive psychology originates from Eastern philosophy.”

Reference:

http://himalaya.socanth.cam.ac.uk/collections/journals/newsfront/pdf/Newsfront_049.pdf [Accessed 03.06.2012]

Future Plans

Claudia is aiming to continue to share the theory and application of SFBT skills in Nepal and other countries where there is a need for the development in mental health support and where support of governments in this sector is limited. Claudia continues to raise funds to be able to share the workshops free of charge in developing countries. She is hoping to visit Nepal again in the end of 2012.

Few words before our conversation

Claudia loves Nepal and has been visiting since many years. She has a Nepali/Tibetan daughter who studies in Kathmandu. She has been practicing Solution-Focused Intervention for many years. Following is the transcription of the interview done with her by Sujen in which they talk about many things like how she got into this technique, what inspired her to do social work in Nepal and what does she think about politics in Nepal. Could politics be done in a solution-focused way?

The above text was worked on together by Claudia and Sujen. The interview (below) was transcribed by Sujen and edited with help of Claudia.

The Interview (Text & Audio Links)

April 28, 2011

New Orleans Café, Thamel (music playing in the background)

Sujen (S): Let’s start with the introduction. About you and solution-focused therapy?

Claudia (C): My name is Claudia Van Zuiden, from Holland originally but I stay in Scotland. I work in mental health with the NHS since the last 10 years. And I apply the technique of solution-focused therapy in my work.  At the same time, I am doing a post-graduate in the application of solution-focused practice and we are also looking at cross-cultural influences or applications and do research on that. A solution-focused approach is not necessarily for the trained professionals in the medical field or mental health field, it can be taught to volunteers, teachers, nurses, school staffs, etc. It is an approach that is goal-oriented and future-oriented. As I became aware that mental health support from the government (in Nepal) is very little compared to other funding, other needs in the country. I thought this technique might help to train trainers or at least create awareness about it. I discussed with you, if you knew about it but  as you are not aware how to use this technique yet and as you are studying psychology, it might help you and others in your country.  Of course, there is more research needed, not much research has been done in the developing countries in SF. A lot of research has been done in developed countries and it has been very helpful and has been applied in many areas from mental health to domestic violence to drug problems, alcohol problems and many things. I also teach solution-focused approach to teachers and parents in the schools, both then become aware of different way of communicating with the children. And this has been very helpful with the feedback and evaluation forms we have received so far. It has been very positive, so we are very passionate about sharing the technique. I raised money at Scotland to start a project; a lot of people from my university have supported me with that. We had also not much funding for mental health projects and especially not for the government so, we decided, my colleagues, and  one of the professors of RGU, Health and Science Department in Aberdeen, Robert Gordon’s was in there to raise money for the project. He too was very keen for me to take this forward and my lecturer Mr. Smith even said that maybe we could teach the whole course to the people in Nepal, of course, (smiling) our goal is future-oriented. First of all we have to find out if by what I am doing now is to organize workshops (and I am doing some other ones in Nepal in the next few days,) to see if it is possible to apply this technique in your culture. That’s it, the little bit. (Laughing)

S: Is this the first time you have come to Nepal to organize the workshops? How is it going? What kind of responses are you getting? (coughing)

C: I have been few times in Nepal therefore, I think I know a little bit about the culture but the stay has been very short of course. I have not lived in Nepal. I have quite a few Nepali friends. Because of that I could see a little bit why technique could work. Because of that I have been now organizing the workshops with professionals, students, teachers and so on and it is very interesting for me to be here, it is by me sharing this technique with them I am also getting to learn much more from them about the culture and how they work and how they feel and what they need to support the clients they work with. For me, it has been very productive. Because my aim was to bring SF to the country and even if I find out it did not work, that would be successful. Because before this, we did not know anything. However, I do feel in some ways, it might be applied by the participants in their work and they might try to practice it. And also because it can be possibly effective. Often we are taught in the nursing course, we want to help and it is mostly problem-solving oriented. We want to put plaster into wounds, on mental health issue as well, we want to help the client, and we have  a kind, compassionate urge to help them. Now, with this technique, we have been taught to step back and learn to ask skillful questions that might lead the client to the empowering position. The clients become aware of their skills and strengths, instead of us ‘putting the plaster on it’. This can be taken as collaboration between medical and future-focused approach. Not only looking at a client in a medical way but also learn a new technique in which a client might come forward and say this could be very helpful for me. Then, the medical professional can say ok we can look at this and how can we help you with that instead of into professionals saying straightforward ‘what if we do this?’

8:10 mins

Listen to record: http://soundcloud.com/sujen-man-maharjan/recording-sfbt-nepal-cvz1

(Interview interrupted by a call on Sujen’s mobile)

S: Sorry. Let’s continue. You were telling it was ten years before when you came to know about SFBT?

C: Yes, I was telling it helps me by being a mother also, naturally we want to make things better. So when your children grow older, they become teenagers and you ask them some questions ‘how was the day?’ And they go ‘okay’ (expressing care freeness). And with a SF way of communication, a little bit more in-depth, you can really find out  more and how they are, these kind of questions might help so, by applying them with my own children, in my work in mental health, I find it becomes much more helpful to find out about people and the communication is much better. I think it is good to teach other parents also how to communicate with their children this way.

S: So, being a mother, for you it has been very helpful

C: Yeah, it has been very helpful. And my children, my daughter who is going to read Psychology, even she learnt this technique at school and she started a peer support group, support for other children at school and they were trained in solution-focused technique also to apply it for their study problems, peer pressure, etc. They have somebody to talk to, not teachers but students and they were then interviewing their fellow students in a solution-focused way. SF is very well applied therefore it would be interesting to see if it works here as well.

S: What got you really interested in this technique?

C: The history of solution-focused therapy has been here long time, its philosophy goes back to even Buddha’s teachings. You know Buddha used to say, “Nothing is permanent,  things will always change.” Change is always happening all the time that is one of the main themes in solution-focused therapy. There is always an exception to the problem so we can look in the session when the problem is not happening. Things change so when is the problem not happening and what does your client do differently then and how could he do more of that. So, when I was interested in Buddhism about the understanding of mindfulness years ago, I found it was very compassionate and empathetic, being kind to fellow human being is important in Buddhism. So when I read about this technique, there was a lot of this in the technique; empathy, kindness, supported way of working with clients. I was very interested in that and it was also very positive. They were looking at future, they were looking at goals, and how they could make things better. Yeah, we have a lot techniques there I could relate to. So, it all came in a single bowl and I teach what I believe in. I am personally positive, so, I got attracted to this technique. And there is no way back (laughing).

S: So, you moved forward with it.

C: Yes, and you see the results around you. You can apply this in your community. I am in the community council in my little village, interviewing the council members with this technique is much more productive. So it can be applied to the way of living, the way of thinking.

S: It reminds me of a metaphor we often hear about glass being “Half Full or Half Empty”. How we choose to look at it? We choose the paradigm.

C: However, in this way, we are out to finding with client what they are at. We always look at only what does the client bring to the session so, if the client is saying that he/she is seeing it as half empty rather than half full then we try to find out if the client is happy with that. But if you see if the client expresses he/she would like to see it full then we go on to when is he/she able to see it as full. Often the client is not aware of this so, we are trying to guide them gently from behind, gently pushing towards their goal. They decide their future, not how we think but they should feel. So, it is up to them. We are trying to work with what the client brings to the therapy by asking them skillful questions and making them aware of the alternatives that are there. So, it is us who are following them, gently guiding them from behind.

S: How has the experience been so far?

C: Here or at home?

S: Anywhere

C: It has been very supportive. It is positive you did see the change, when we did the workshops, when we were doing the role-plays, we were talking about what could be better and how could you apply more in your life. Your body language changed,  of this you smiled. Then you became lighter in mood. So, it is really good to see SF work this way. Instead of focusing on the problem all the time, the therapist encourages the client to look out for the solutions.

Both laughing (the laugh break)

S: As you said, in Nepal, we know the mental health support from the government is very little.  Less than 1% of the health budget is allotted for mental health and we don’t have a national mental health policy yet. So, aware of this situation, you decided to come here with a project. When did this idea come to you?

C: It came to me few years ago. I was in Pokhara at that time, and a friend of mine suffered from depression. He was a businessman. He said mental health support was so little available for this, and we had some deep discussions about it. Then, he was very concerned about this. As a businessman, he could afford private mental health support financially but people from lower-incomes or no-income cannot afford the support like that and especially in the villages, far away from Kathmandu or any city. He encouraged me, “Claudia, you should come and teach this technique.” I said, “It is a great idea.” But I was always busy, now my children are growing up. I have more time now and thought about it long time ago, one and half year back, and I thought I can do it. Even if I can train one person, he/she can help one more person after that. That’s how the idea sort of came in!

S: How is your friend doing now?

C: I did not speak to him as a therapist. Hahaha (laughing)… because he was already doing very well then. So, we sort of wanted to help others.

S: He had that experience.

C: Very much and he suffered very much. He was able in his way to find things that made him better but he thought people need much more. So, he inspired me to do this project. And I looked how much mental health support is there in Nepal. I have come to Nepal privately before by sponsoring a daughter. I want to continue to keep supporting her as well. And I am coming here anyway, so, why not put these two together?

S: So you are also doing the course right now. Tell us about it.

C: In the beginning of the course, it is about learning SF process, the background and what it is based on. Then, we focus on the application, and reflect on the practice. So, every time we work, for 10 hours of work, we have 1 hour of supervision. We discuss our work with another practitioner which is very helpful. We do that in a solution-focused way, what went well and what can work better, what could you have done better with your client. So, even supervision is done in a solution-focused way. We know when we interview staff members in the workplace in a solution-focused way; we are looking for the positive things and also are encouraging them.

So, at the next course that I am doing now is to reflect on practice all the time, why I did certain things and doing research with that. It is really being aware of what you do. So, you get deeper feelings.  After you have done something, you reflect on how you could have done it better. And at the next level, we are looking at now Masters level in SFBT in that. That would be really research and so on. So, more in-depth. The first course could be fantastic to teach here and see how it can be taken further. This is what my course is all about.

S: It sounds really interesting. And the supervision in a solution-focused way, that’s a very good idea.

C: Yeah. It works very well with us. We have a lot of fun. Maybe I can show you one of the teaching DVD’S,

in there the lady being interviewed, she came to therapy, she has a problem. But the way she is interviewed, it creates laughter. It creates lightness, helps the client to look at the problem from the distance and in a different manner. What can I do instead of looking so deeply into the problem? It is often when you see something very close, it becomes blurred but if we step back and take a look again, it is much clearer.

S: As you said, when we look at something too closely, our frame is fixed but when we step back and look at it from different perspective, it becomes more clear.

C: In that way, we can look at what is supportive and what resources do we already have and how can we start tapping into them again. Clients are often in the dark, they don’t know what strengths they have so, they come to the therapy, and then we can create the space where they can look at their support also. They become more aware of how they can reach out to them. Often they are not aware of it.

S: This is a very out of track question for this interview actually but I think it might be interesting to ask you. What would you suggest the solution-focused way for politics in Nepal?

C: I would love to answer that question. I would like to suggest Solution Focused Interventions  to the political parties in Nepal. How wonderful it would be, if politics would be in a solution-focused way. There is a grandmother from Alaska, she is one of the International Council of Thirteen Indigenous Grandmothers who are spreading the message for Peace into the World, she gave some great advice, I am supporting their message as, I am quite politically inclined activist. She said to me that positive dialogue is the way forward for politics at present. One of the Thirteen Grandmothers is Nepalese, her name is Buddhi Maya Lama, or Aama Bombo as she is also known, I have spoken to her too here in Nepal, she is a remarkable woman and supports my work here too, which is very special to me. People need to be more open and honest with each other and look at ways that are working and how more can be done of this in a collective way. More transparency in politics and listening to what is needed and how this can be implemented. In a Solution Focused way we could find out what is already working and how to do more of this. If something is not working on a large scale, things can be changed. This will look at the society as a whole rather than looking what is working for some. If people communicated in a Solution Focused way with each other, there would be much more understanding. It would be empowering, respectful and non-judgmental. Accepting people who they are, acknowledging  power and strength within themselves and supporting them with that. I also try to do that with my children. We all make mistakes. It is real life. Of course, in politics also, we should  aim for better solutions. It would be much better.

S: If Nepali politics would be solution-oriented, I think things can be way better. So we hope…

C: Laughing…yeah, Sujen, you are the new generation.

S: So, now what are your future plans with this technique in Nepal and elsewhere?

C: First of all, we need to find out how it goes, how people take to the course, what we discuss in the workshops. We give them some of the technique and we need to do some research. If people say yes, I would love to give more training and help with the confidence building. Of course, yes, with the SF technique, I would love to come back and do more workshops.  I need to read more and prepare for it. I am doing it in a way that it is not just by myself. I am training trainers so, they can also train other volunteers and professionals.  One of my dreams would be to establish ‘walk-in volunteer centers’ where people can walk in and they can have therapeutic solution-focused session with trained volunteers.

S: Like drop-in centers (DICs)

C: Exactly!

S: That would be really great. We have very few places in Kathmandu where people can get free counseling.

C: Yeah, that could be possible through setting up a charity and I am raising money for this project called ‘The Mental Health Project Nepal’ now. We can even continue to do for this project called ‘The Mental Health Project Nepal’. If people think this technique appropriate, we can take it a step further. And I would love to be able to help with that. I think you are also very interested in it.

S: Yeah. It has been a good experience to work with and learn from you. I hope we will continue to work together in the future.

C: Wonderful!

S: Thank you!!

C: Thank you so much. Was it helpful for you?

S: Of course.

C: Well done! Maybe your next job, will be as a interviewer for a Kathmandu’s television channel. You would be very good with that. Thank you for organizing the workshops.

22:00 mins

Listen the record: http://soundcloud.com/sujen-man-maharjan/recording-sfbt-nepal-cvz2

Total interview duration: 30 minutes

Get updates on Claudia’s work from her blog: http://solutionways.wordpress.com

Related Files:

The_Himalayan_Times_-_SF-event_-_Detail_News_-_Nepal_News_Portal

Newsfront_049-subrath-article-2008