Solution-focused (brief) therapy (SFBT) is a brief form of psychotherapy developed in the late 1970s and 1980s by Steve de Shazer and Insoo Kim Berg that focuses on helping clients identify goals and practical solutions rather than analyzing problems. SFBT focuses on addressing what clients want to achieve without exploring the history and provenance of problem(s).
SFBT is a future-oriented and goal-oriented interviewing technique that helps clients "build solutions." Elliott Connie defines solution building as "a collaborative language process between the client(s) and the therapist that develops a detailed description of the client(s)' preferred future/goals and identifies exceptions and past successes". By doing so, SFBT focuses on clients' strengths and resilience. Marilyn La Court and Eve Lipchik. Their students included John Walter, Jane Peller, Michele Weiner-Davis and Yvonne Dolan. Steve de Shazer and Berg, primary developers of the approach, co-authored an update of SFBT in 2007, spent thousands of hours carefully observing live and recorded therapy sessions. Any behaviors or words on the part of the therapist that reliably led to positive therapeutic change on the part of the clients were painstakingly noted and incorporated into the SFBT approach. In most traditional psychotherapeutic approaches starting with Freud, practitioners assumed that it was necessary to make an extensive analysis of the history and cause of their clients' problems before attempting to develop any sort of solution. Solution-focused therapists see the therapeutic change process radically differently and informed by the observations of de Shazer, which recognize that although "causes of problems may be extremely complex, their solutions do not necessarily need to be". because SFBT presents an innovative and radically different approach from traditional psychotherapy.
SFBT posits that a therapist can help clients resolve their problems without identifying the details or source problem SFBT believes that an assessment of the problem is entirely unnecessary. Focusing on the problem actually may serve to shift the client away from the solution. This is because SFBT fundamentally believes that the nature of the solution can be completely different from the problem. So instead, SFBT focuses on building solutions by conceptualizing a preferred future with clients. SFBT is all about finding alternatives to the problem, not identifying and eliminating the problem. and supports clients' self-determination. SFBT is influenced by social constructivist ideas, emphasizing how meaning and solutions are shaped through language and interaction.
SFBT is designed to help people change their lives in the fastest way possible. By finding and amplifying exceptions, change is efficient and effective. and it can work in about two sessions. Its brevity and its flexibility have made SFBT the choice of intervention for many health care settings. Interventions in a medical setting many times need to be brief. Agencies also choose SFBT because its efficiency translates into monetary savings. and Gale Miller joined a few years later as research assistants.
In the 1970s, de Shazer, Berg, and colleagues conducted Brief Family Therapy at Family Service of Milwaukee, Steve de Shazer, the director of BFTC, referred to this group as a "therapeutic think tank". Over time people began to request training, so BFTC became a research and training center. a type of family therapy practiced at the Mental Research Institute (MRI). In the 1970s, de Shazer, the primary creator of SFBT, studied the work done at MRI and founded BFTC to serve as "the MRI of the Midwest". – Gregory Bateson, Donald deAvila Jackson, Paul Watzlawick, John Weakland, Virginia Satir, Jay Haley, Richard Fisch, Janet Beavin Bavelas and others. SFBT gained tremendous popularity in the UK in the late 1990s and the 2000s. At that time, it also spread worldwide to be a leading brief therapy, The questions themselves serve as the intervention, directing clients toward a mindset that fosters positive change and reduces negative emotions. These questions help clients reinterpret their experiences, enabling them to recognize potential for change where they might not have seen it before. Instead, they concentrate on identifying clients' goals and developing a detailed description of life when the goal is reached, and the problem is either resolved or managed satisfactorily. By helping clients identify positive directions for change and focusing on changes they wish to continue, SFBT therapists assist clients in constructing a concrete vision of a preferred future. The "miracle question" is one such tool, asking clients to imagine that their problem was miraculously solved without their knowledge and to identify the first clues that would indicate the problem is resolved.
Therapists also ask questions that focus on previous solutions or "exceptions" to the problem. Identifying exceptions helps build solutions by highlighting what is working in clients' lives. By discovering and amplifying minor exceptions to the problem, therapists encourage clients to do more of what already works.
When seeking exceptions, the practitioner does not attempt to convince the client of their significance. Instead, the therapist adopts a genuinely curious stance and asks the client to explain the exception's importance. Therapists must maintain a not-knowing stance, which can be challenging for emerging SFBT practitioners.
SFBT practitioners use tools such as starting sessions with the question "What's been better since we last talked?" to help clients identify exceptions. Scaling questions are another tool, using a scale to measure clients' progress toward their goals. Central to SFBT is the belief that clients are the experts in their lives and possess the knowledge necessary to achieve their goals.
In authentic SFBT practice, resistance is rarely encountered. Maintaining a curious and not-knowing stance is vital for effective SFBT. Despite its apparent simplicity, SFBT is difficult to master. Conversely, new SFBT trainees may struggle with being overly optimistic and not genuinely validating clients' pain. By doing so, SFBT practitioners can effectively facilitate client movement toward their goals and preferred futures.
Evidence-based status
In the early days of the model, critics often said that SFBT does not have enough research. and today several meta-analyses show SFBT to be effective with internalizing issues. SFBT has a robust, broad, and growing evidence base and is recommended for use when deemed a good fit for the client and their problem.
SFBT has been examined in two meta-analyses and is supported as evidence-based by numerous federal and state agencies and institutions, such as SAMHSA's National Registry of Evidence-Based Programs & Practices (NREPP). The conclusion of the two meta-analyses and the systematic reviews, and the overall conclusion of the most recent scholarly work on SFBT, is that solution-focused brief therapy is an effective approach to the treatment of psychological problems, with effect sizes similar to other evidence-based approaches, such as CBT and IPT, but that these effects are found in fewer average sessions, and using an approach style that is more benign. The result is that SFBT provides interventions that are perfectly matched with the clients' way of understanding and acting.
SFBT works well with children and families pregnant and postpartum women, couples, and parents. SFBT was shown to be effective for families in the child welfare system, financial counseling, and with therapy groups.
SFBT has been applied to many settings, including education and business, and counselling. It is effective in schools and with college students. It was successfully used with populations in jails, inpatient addiction rehab centers, inpatient psychiatric facilities, and in a wide range of medical settings.
SFBT is effective with people in many countries and cultures, including people from Nigeria, Korea, Iran, and China.
SFBT works in treating people who experienced trauma. It has been suggested for use with patients that are suicidal or in crisis, families coping with suicide, substance use disorders, insomnia, and obesity. It was also suggested as a promising intervention for individuals with a brain injury and was helpful with those with intellectual disabilities. It has been shown to be effective in helping increase self-esteem self-efficacy hope, good behavior, and social competence among adolescents and children. It has been suggested that SFBT's ability to engender hope is what makes it effective for patients suffering from depression,
It has been shown to be effective at reducing perceived stigma and work-family conflict. It is effective at reducing vaccine refusal.
Workers with child protective services report in a qualitative study that SFBT training and supervision was helpful for them to work in a more cooperative and strength-based way and improved the overall mood and atmosphere of their encounters. There are models designed for child protection services that incorporate aspects of SFBT
See also
- Family therapy
- Future-oriented therapy
- Narrative therapy
- Response-based therapy