Solution-focused brief therapy

Solution focused brief therapy (SFBT) (often referred to as simply 'solution focused therapy' or 'brief therapy') is a type of talking therapy that is based upon social constructionist philosophy. It focuses on what clients want to achieve through therapy rather than on the problem(s) that made them seek help. The approach does not focus on the past, but instead, focuses on the present and future. The therapist/counselor uses respectful curiosity to invite the client to envision their preferred future and then therapist and client start attending to any moves towards it whether these are small increments or large changes. To support this, questions are asked about the client’s story, strengths and resources, and about exceptions to the problem.

Solution focused therapists believe that change is constant. By helping people identify the things that they wish to have change in their life and also to attend to those things that are currently happening that they wish to continue happening, SFBT therapists help their clients to construct a concrete vision of a preferred future for themselves. The SFBT therapist then helps the client to identify times in their current life that are closer to this future, and examines what is different on these occasions. By bringing these small successes to their awareness, and helping them to repeat these successful things they do when the problem is not there or less severe, the therapists helps the client move towards the preferred future they have identified.

Questions

The Miracle Question

The miracle question is a method of questioning that a coach, therapist, or counselor uses to aid the client to envision how the future will be different when the problem is no longer present. Also, this may help to establish goals.

A traditional version of the miracle question would go like this:

"Suppose our meeting is over, you go home, do whatever you planned to do for the rest of the day. And then, some time in the evening, you get tired and go to sleep. And in the middle of the night, when you are fast asleep, a miracle happens and all the problems that brought you here today are solved just like that. But since the miracle happened over night nobody is telling you that the miracle happened. When you wake up the next morning, how are you going to start discovering that the miracle happened? ... What else are you going to notice? What else?"

There are many different versions of the miracle question depending on the context and the client.

In a specific situation, the counselor may ask,

"If you woke up tomorrow, and a miracle happened so that you no longer easily lost your temper, what would you see differently?" What would the first signs be that the miracle occurred?"

The client (a child) may respond by saying,

"I would not get upset when somebody calls me names."

The counselor wants the client to develop positive goals, or what they will do, rather than what they will not do--to better ensure success. So, the counselor may ask the client, "What will you be doing instead when someone calls you names?"

Scaling Questions

Scaling questions are tools that are used to identify useful differences for the client and may help to establish goals as well. The poles of a scale can be defined in a bespoke way each time the question is asked, but typically range from "the worst the problem has ever been" (zero or one) to "the best things could ever possibly be" (ten). The client is asked to rate their current position on the scale, and questions are then used to help the client identify resources (e.g. "what's stopping you from slipping one point lower down the scale?"), exceptions (e.g. "on a day when you are one point higher on the scale, what would tell you that it was a 'one point higher' day?") and to describe a preferred future (e.g. "where on the scale would be good enough? What would a day at that point on the scale look like?").

Exception Seeking Questions

Proponents of SFBT insist that there are always times when the problem is less severe or absent for the client. The counselor seeks to encourage the client to describe what different circumstances exist in that case, or what the client did differently. The goal is for the client to repeat what has worked in the past, and to help them gain confidence in making improvements for the future.

Coping Questions

Coping questions are designed to elicit information about client resources that will have gone unnoticed by them. Even the most hopeless story has within it examples of coping that can be drawn out: "I can see that things have been really difficult for you, yet I am struck by the fact that, even so, you manage to get up each morning and do everything necessary to get the kids off to school. How do you do that?" Genuine curiosity and admiration can help to highlight strengths without appearing to contradict the clients view of reality. The initial summary "I can see that things have been really difficult for you" is for them true and validates their story. The second part "you manage to get up each morning etc.", is also a truism, but one that counters the problem focused narrative. Undeniably, they cope and coping questions start to gently and supportively challenge the problem-focused narrative.

Resources

A key task in SFBT is to help clients identify and attend to their skills ,abilities, and external resources (e.g. social networks). This process not only helps to construct a narrative of the client as a competent individual, but also aims to help the client identify new ways of bringing these resources to bear upon the problem. Resources can be identified through scaling questions, problem-free talk,or during exception-seeking.

History of Solution Focused Brief Therapy

Solution Focused Brief Therapy is one of a family of approaches, known as systems therapies, that have been developed over the past 50 years or so, first in the USA, and eventually evolving around the world, including Europe. The title SFBT, and the specific steps involved in its practice, are attributed to husband and wife Steve de Shazer and Insoo Kim Berg and their team at the Brief Family Therapy Family Center in Milwaukee, USA. Core members of this team were Eve Lipchik, Wallace Gingerich, Elam Nunnally, Alex Molnar, Michele Weiner Davis, and Scott Miller. Their work in the early 1980s built on that of a number of other innovators, among them Milton Erickson, and the group at the Mental Research Institute at Palo Alto – Gregory Bateson, Don Jackson, Paul Watzlawick, John Weakland, Virginia Satir, Jay Haley, Richard Fisch, Janet Beavin Bavelas and others.

All these names are important, not just as pioneers of a new way of doing therapy but also because their various collaborations and writings represent nothing short of a revolution in the way we think about social functioning and mental health and well being. Solution Focused approaches are now in constant demand. Their efficacy is well established and supported by a solid and ever increasing body of research. Solution-focused thinking has earned its place and is widely accepted in the fields of therapy, social care, education and business.

The concept of brief therapy was independently discovered by several therapists in their own practices over several decades (notably Milton Erickson), was described by authors such as Haley in the 1950s, and became popularized in the 1960s and 1970s. Richard Bandler, John Grinder and Stephen Lankton have also been credited, atleast in part, with the inspiration for and popularization of brief therapy, particularly through their work with Milton Erickson.^[1]

Solution Focused Brief Therapy has branched out in numerous spectrums. Most notably, the field of Addiction Counseling has began to utilize SFBT as an effective means to treat problem drinking. The Center for Solutions in Cando, ND has implemented SFBT as part of their program, wherein they utilize this therapy as part of a partial hospitalization and residential treatment facility for both adolescents and adults.

Solution-Focused counseling

Solution-Focused counseling is a solution focused brief therapy model. Various similar, yet distinct, models have been referred to as solution-focused counseling. For example, Jeffrey Guterman developed a solution-focused approach to counseling in the 1990s. This model is an integration of solution-focused principles and techniques, postmodern theories, and a strategic approach to eclecticism.

References

I.K.Berg and S.deShazer: Making numbers talk: Language in therapy. In S. Friedman (Ed.), "The new language of change: Constructive collaboration in psychotherapy." New York:Guilford, 1993.
I.K.Berg, "Family based services: A solution-focused approach." New York:Norton. 1994.
B.Cade and W.H. O’Hanlon: A Brief Guide to Brief Therapy. W.W. Norton & Co 1993.
S.de Shazer: Clues; Investigating Solutions in Brief Therapy. W.W. Norton & Co 1988
E.George, C.Iveson, H. Ratner; Problem to solution; brief therapy with individuals and families. BT Press, 1990.
M.A. Hubble, B.L. Duncan, S.D. Miller; The Heart and Soul of Change; what works in therapy. American Psychological Association, 1999.
S.D. Miller, M.A. Hubble, B.L. Duncan; Handbook of Solution-focused brief therapy. Jossey-Bass Publishers, 1996.
B.O’Connell; Solution Focused Therapy. Sage, 1998.
B.O’Hanlon and S. Beadle; A Field Guide to PossibilityLand: possibility therapy methods. BT Press 1996.
J.T. Guterman; Mastering the Art of Solution-Focused Counseling. American Counseling Association 2006.
M.Talmon; Single Session Therapy; maximizing the effect of the first (and often only) therapeutic encounter. Jossey-Bass Publishers, 1990.
Peter De Jong, Insoo Kim Berg Interviewing for Solutions Brooks Cole Publishers, 2nd edition 2002
P.Ziegler and T. Hiller: Recreating Partnership: A Solution-Oriented, Collaborative Approach to Couples Therapy. W.W. Norton 2001.
Guterman, J.T. (2006). Mastering the Art of Solution-Focused Counseling. Alexandria, VA: American Counseling Association. ISBN 1-55620-267-9
Guterman, J.T., Mecias, A., Ainbinder, D.L. (2005). Solution-focused treatment of migraine headache. The Family Journal: Counseling and Therapy for Couples and Families, 13, 195-198.
Murphy, J.J. (1997). Solution-focused counseling in middle and high schools. American Counseling Association: Alexandria, VA.
Guterman, J.T. (1996). Doing mental health counseling: A social constructionist re-vision. Journal of Mental Health Counseling, 18, 228-252.
Guterman, J. T. (1994). A social constructionist position for mental health counseling. Journal of Mental Health Counseling, 16, 226-244.

^ See page 671 in Steenbarger (2002) "Single-session therapy: Theoretical underpinnings" In Elsevier Encyclopedia of Psychotherapy

External links

[Steenbarger_2002-1] See page 671 in Steenbarger (2002) "Single-session therapy: Theoretical underpinnings" In Elsevier Encyclopedia of Psychotherapy

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