Model Description. Solution Focused Brief Therapy

Content

Overview

Role of the Therapist

Theory of Change

Target of Intervention

Examples of Assessments in SFBT

Ideas of Normalcy, Health and Pathology

Interventions

Possible Legal/Ethical Issues

References

Solution Focused Brief Therapy:

Overview

SFBT, or Solution Focused Brief Therapy, was developed by Steve de Shazer and Insoo Kim Berg during the 1980’s. The approach attempts to address the concerns by looking at the client’s future by using effective solutions and strengths (Gehart, 2014). SFBT does not spend much therapy time on looking at the past or the steps leading up to the presenting issues. SFBT uses methods to help the client see or envision a future that can be. SFBT therapists offer the opportunity for clients to formulate solutions and help them get there in small steps.

Role of the Therapist

O’Hanlon and Weiner-Davis (2003) stated that the therapist using SFBT must have a “beginners mind.” (p. 8). This means that the therapist is listening actively to the client, seeing the client’s case as unique and different, and “not filling in the blanks” (Gehart, 2012, p. 337) with what the therapist may already have an idea about. The role of the therapist is also a collaborator, working with the client towards what they envision. The therapist focuses on what the client wants to see different in their lives.

The therapist also echo’s the client’s language and as DeJong and Berg (2002) state, the therapist “carefully attend to client word choice and echo their key words whenever possible” (p. 57). Word choice is also use in the form of the language of the therapist and can be helpful in building rapport with the client.

The SFBT therapist also looks at the client as already having the possibility of solutions to the issue. The therapist believes that the client is capable of changing, growing and recovering. This is often displayed by making statements that include changing the tense, for example: Instead of saying “if the problem stops…” the therapist tells the client “when the problem stops….”. By changing the one word, it shows the client that a solution is indeed possible.

Theory of Change

The theory of change from a SFBT approach is, as described by O’Hanlon and Weiner-Davis (2003) “changing the viewing of a situation or frame of reference, changing the doing of the problematic situation, and tapping into the client’s strengths and resources” (p. 120). SFBT therapists focus on small steps to reach changes. The goals for change are focused on the interactions with others, situational terms, and should be meaningful to the client (Corey, 2013). Goal setting is a way of starting the solution work to the problem. Ultimately, the goal of the change should be that the client feels differently about their situation at the end of the therapy.

Target of Intervention

The SFBT therapist asks the client miracle or solution generating questions. These questions “will help the client envision a future without the problem, generating hope and motivation” (Gehart, p. 341). This helps start to set the clear, attainable, realistic goals that are the stepping stones to creating change. Finding out what has worked in the past is also a way to create goals based on solutions.

Client motivation can help to make some progress in therapy. de Shazer (1985) says, “In most cases, making this one small change starts a cascade of change events that are inspired by the client’s own motivation rather than a prescription of the therapist” (p. 267).

Examples of Assessments in SFBT

The therapist can also use scaling questions, for example, On a scale of 1-10, 1 being how you felt before you came here and 10 being how you want to feel, where are you today? These scaling questions can help measure progress and define interventions. The miracle question can begin the process of seeing what change the client wants and goals are designed in small steps towards that vision. The therapist and the client can co-create goals. These steps are assessed by asking the scaling questions about the progress towards the goals.

Exception questions are also a way to assess the client’s problem. These types of questions will “provide clues” to what works and what the client should be doing more of to reach results (Gehart, 2014). An example of an exception question is: Are there times when the problem isn’t a problem? What is happening when it’s less of a problem? The therapist will also ask the client what is happening that is going well in the client’s life to determine strengths.

Ideas of Normalcy, Health and Pathology

SFBT does not pathologize the client. The therapist does not see the client as a problem, yet views the client as having strengths, resources, and the means to overcome. The assumption is that the client already has to solution and can reach it easily with collaboration. The client from this perspective is capable of change and can improve using the resources they already utilize. The therapist does not listen for medical model diagnosis symptoms and has a systemic perspective that pathology is not the issue.

Interventions

Steven de Shazer has basic principles for the SFBT interventions. They are: If it isn’t broken, don’t fix it. If it works, do more of it. If it’s not working, do something different. Small steps can lead to big changes. The solution is not necessarily related to the problem. The language for solution development is different from that needed to describe a problem. No problem happens all the time; there are exceptions. The future is both created and negotiable (2007, p. 2).

Therapy usually begins with what is described as a formula first task. This task can include something such as “Look for one thing in your life you want to remain the same and look for ways that that one thing is working for you.” (Gehart). These tasks help start the process of looking for strengths and what is working in order to help build the solutions for change. Giving small tasks every week and monitoring the progress of these tasks with scaling questions will also determine client motivation.

Therapists that use SFBT approach also engage in giving compliments, validations and encouragement. These help to motivate and encourage the client. DeJong and Berg (2002) state however that “compliments should not be used to be nice to the clients. They should only be used to reinforce progress towards goals that clients have set for themselves rather than rely on an outside authority figure to do so.” (p. 180).

Possible Legal/Ethical Issues

Understanding of the state laws and requirements of therapists is important no matter the approach. The code of ethics for therapists is to be adhered to as well as responsibilities therapists have to the client.

References

Corey, G. (2013). Theory and practice of counseling and psychotherapy. Belmont, CA: Brooks/Cole.

De Jong, P., & Berg, I.K. (2002). Interviewing for solutions (2nd ed.). New York: Brooks/Cole.

de Shazer, S., & Dolan, Y. (2007). More than miracles: The state of the art of solution-focused brief therapy. New York: Haworth.

de Shazer, S. (1985). Keys to solutions in brief therapy. New York: Norton.

Gehart, D. (2014). Mastering competencies in family therapy. Belmont, CA: Brooks/Cole.

O’Hanlon, W.H., & Weiner-Davis, M. (2003). In search of solutions: A new direction in psychotherapy. (Rev. ed.). New York: Norton.