The buzz of the emergency department whirls around us as I pull my chair closer to the middle-aged woman sitting on the gurney. I know she was brought here by her concerned husband, who told the triage nurse she just has not been herself. Her husband is concerned about what she might do to herself, as she has struggled with depression for years.
I introduce myself, and offer, “It sounds like things have been rough lately.”
“I just can’t do it anymore,” the woman says. Tears spring to her eyes, and she reaches quickly for a tissue. “I tried to go to work, but I can’t focus. I’m making mistakes and people are starting to notice. I can barely manage to get dressed in the morning to take the kids to school — sometimes I don’t. And then my husband has to pick up the slack. I feel so guilty.”
Her voice fades, as though the simple act of speaking has drained her. We talk through what has been going on lately — her mother was just diagnosed with cancer, her father is drinking too much, her boss wants her to take on more responsibilities. Over and over she reiterates, “I just can’t do it anymore. I can’t do it.” Even in the busy emergency department, her hopelessness is palpable.
When treating someone with depression, it can become easy to focus on the negative, emphasizing how the disorder has removed their vitality and zest for life. The low mood, the trouble with sleep, the lack of appetite. But it extends beyond the mere diagnostic symptoms. Depression is the calls not returned, the invitations deferred, the friends rebuffed. Whereas in the initial interview it is important to understand the breadth and depth of the person’s mood, in therapy, it is critical to shift the focus away from the struggles of the past and toward the promise of the future.
Yet this is easier said than done. In 101 Solution-focused Questions for Help with Depression, clinical psychologist Fredrike Bannink offers insight into an approach that works to move clients forward. The book is part of a three-book set in which Bannink also offers guidance in treating individuals with trauma and anxiety.
Solution-focused brief therapy emphasizes outcomes rather than symptoms. It takes a goal-oriented approach that looks to help the client reach specific goals. The belief is that clients already possess many of the life skills they need to create change in their lives, but that they may need help identifying and implementing these skills. That is where the therapist comes in.
Bannink has more than thirty years of experience in psychotherapy and has published multiple articles and books. Her prior work in this series includes 1001 Solution-Focused Questions, a well-received book that offers an overview of the solution-focused method. Her new books offer the same readable style and can serve as companion texts or stand on their own.
While each book does offer the 101 questions advertised in the title, each goes far beyond a simple list of questions. Instead, Bannink opens by laying the foundation for the solution-focused approach. This includes the research-based evidence behind the principles, which she manages to include without compromising the readability of the text.
In one section of the book on depression, Bannink helps the therapist focus on his or her client’s strengths. “Shining the spotlight on change illuminates clients’ existing strengths and resources,” Bannink writes. “Despite life’s struggles, all clients possess strengths and competencies that can help to improve the quality of their lives and their well-being.” The questions in this particular chapter encourage the client to talk about their abilities. Bannink provides questions such as “What strengths do I have to stand up to this depression?”, “What have I done to stop things from getting worse?”, and “What are some of the things that I have thought, said or done that have helped me move from where I started to where I am now?”
She also offers case studies, sharing examples of how clients may respond to this approach. In addition, she includes a variety of exercises in each chapter that help clients explore and build upon their skills. One exercise entails coming up with three things that worked before in difficult situations; another helps the client brainstorm fifty ways of coping.
Overall, these books offer a concise, solution-focused approach to addressing difficult, all-too-common issues. Bannink provides a treasure trove of ideas for working with clients. I’ll be referring to these texts in the future.
101 Solution-Focused Questions Series Set
W. W. Norton & Company, October 2015
Paperback, 624 pages