Systemic Limitations With Solution Focused Therapy
An Introduction to Solution-Focused Brief Therapy (SFBT)
Posted on: October 8, 2021
What is Solution-Focused Brief Therapy?
Solution-focused brief therapy (SFBT), also known as solution-focused therapy, is a method of psychotherapy that uses a goal-directed approach to find solutions to problems. This form of therapy is future-focused and prioritizes the discovery of current resources and strengths that the patient has, instead of fixating on the past or the problem.
How Did SFBT Develop?
Solution-focused brief therapy was developed in the early 1980s by Insoo Kim Berg, Steve de Shazer and their colleagues at the Milwaukee Brief Family Therapy Center. The technique was formed deductively, instead of inductively; Berg and Shazer spent hundreds of hours, across many years, observing therapy sessions and methodically noted the questions, behaviors and emotions that led clients to real-life solutions.
Based on this data, the SFBT approach incorporated only the questions that consistently demonstrated client progress and solutions. Meanwhile, any questions or statements that did not provide real growth or problem-solving were completely removed.
Who Is SFBT For?
Individuals, families and couples can all benefit from SFBT treatment. However, this type of therapy tends to be applied more frequently as systemic therapy. Since most problems involve other people (partners, families, friends, etc.), the SFBT therapist's objective will be to work with whoever shows up for the appointment — this can be one person or multiple.
Unlike most talk therapy, SFBT is solely focused on the present and the preferred future — not the past. This type of therapy doesn't focus on the why of a problem or underlying significance. Instead, it approaches each problem through small solutions that can be acted upon in the present day.
For the SFBT therapist, the aim is to find real solutions and apply them sooner rather than later; shorter periods of therapy are preferred for this type of approach. From a client perspective, an SFBT therapist acts as a guide, through coaching and questioning, to uncover what in your past solutions toolbox can be applied to the situation at hand. The focus is always on what the client can do to help a problem instead of the reasons why they can't.
Since it was first developed, SFBT has led the way in brief therapy to become one of the most popularly used models around the world.
Benefits of Solution-Focused Brief Therapy
SFBT is a short-term therapy that emphasizes real-time solutions for their clients' struggles. Below are four ways the SFBT stands out compared to other therapy approaches:
It's a short-term therapy, which makes it time and cost-effective
The aim of SFBT is to find solutions as soon as possible. Due to this, average sessions can last up to 10 weeks, but can even be as short as one, singular session. Regular talk therapy is more long-term and can last for months or even years.
It's built on empathy and open-mindedness
SFBT practitioners are trained to approach each case non-judgmentally. When the client shows growth or makes progress — no matter how small — they are praised for their resilience and encouraged to keep going.
It's client-led rather than therapist-led
SFBT empowers clients to make their own goals, rather than relying on the therapist to lead the way. This therapy approach allows clients to identify their own problem-solving skills to improve their self-esteem and forward-thinking.
It's future-oriented
Traditional therapy often revolves around past life events and problems to uncover deeper significance. SFBT aims to motivate clients to focus on the present to achieve future goals. This approach is built around optimism and positivity psychology. It identifies steps that can be taken today to improve the client's day tomorrow (or next week).
What Can SFBT Help With?
SFBT can be used to treat many different types of emotional mental health problems, including, but not limited to:
- Depression
- Anxiety
- Stress
- Substance Abuse
- Trauma
- Family Problems
- Relationship Problems
Solution-Focused Brief Therapy Techniques
An SFBT therapist guides the session but through a "leading from one step behind" approach that allows the client to make their own decisions and judgments. To achieve this, according to More than Miracles, there are several main interventions that SFBT practices engage in their sessions. These include:
- A positive, collegial, solution-focused stance.
- Looking for previous solutions.
- Looking for exceptions.
- Questions vs. directives or interpretations
- Present- and future-focused questions vs. past-oriented focus.
- Compliments.
- Gentle nudging to do more of what is working.
Alongside these techniques, SFBT uses specific interventions to identify and reach goals.
Pre-Session Change
At the start of the first therapy session, SFBT therapists will use a "pre-session change." This means asking, "What changes have you noticed that have happened or started to happen since you called to make the appointment for this session?"
This helps set the tone for the rest of the sessions as it focuses on real actions and behaviors that change the client's situation.
Solution-Focused Goals
SFBT is built around clear and specific goals set by the client. Important to note: the SFBT therapist will aim to focus on smaller goals instead of larger ones.
Therapists will also guide clients toward solution-framed goals, rather than what's wrong. An example is: "I want to have meaningful conversations with my daughter" instead of "I want my daughter to stop avoiding me."
The Miracle Question
Sometimes clients have nuanced and complex problems that can't be simplified or verbalized in a simple statement. In these cases, the SFBT therapist will use the miracle question, which helps to reframe a goal into a manageable idea.
The premise of the miracle question is to build a scenario where your client (theoretically) finishes this session, goes home, does their nightly routine and then goes to bed. At some point during the night, your client's problem that brought them to SFBT is completely solved — it's a miracle! However, it has happened while the client is sleeping and unaware. So, when the client wakes up in the morning, how do they notice that the problem has been fixed?
Scaling Questions
Once goals have been set, the next SFBT intervention technique is to scale the goal. The therapist will ask from 0 to 10, where was the client with the problem when they scheduled the appointment, now and the day after the "miracle."
In this technique, 0 would be at an all-time low, worst-case scenario and 10 would be a best-case, everything-is-solved scenario. This can help SFBT therapists measure ongoing progress and highlight growth and positive change for clients.
Constructing Solutions and Exceptions
Throughout the session, the SFBT therapist is listening for signs of solutions (previous and current), exceptions and goals. The therapist then centers the conversation around these moments to show support and warmth.
By doing this, solutions and progress are always prioritized in conversation unlike in traditional therapy, which is focused on events and underlying causes to problems.
Coping Questions
Sometimes during the SFBT session, the client may share that the problem is not improving. In this case, the therapist will reframe the situation with coping questions, such as:
- How are you managing to cope in this difficult situation?
- How have you kept the situation from getting worse?
- Is there anything else I need to know or that we haven't covered?
Taking a Break and Reconvening
This intervention occurs near the end of the session and allows the SFBT therapist to speak with their team, who have been watching the session, and gather notes and compliments for the clients. If there isn't a team, this can be a time for the therapist to go over their own notes to build their compliments for the family and possible experiments.
Experiments and Homework Assignments
At the end of the session, SFBT therapists will often recommend an experiment that the client can try before their next session. The idea is that the experiment is designed to build on something the client has already done, thought or felt that is solution-focused.
If the therapist doesn't suggest an experiment, they may also try giving a homework assignment that is determined by the client.
Solution-Focused Brief Therapy Training and Resources
The Institute for Solution-Focused Therapy (ISFT) is pleased to announce a new self-paced, online, book with exam course based on Routledge's new 2nd Edition of More Than Miracles: The State of the Art of the Solution-Focused Approach. Developed by More than Miracles co-authors, Yvonne Dolan and Terry Trepper and ISFT Director, Anne Lutz, M.D., the course is suitable for advanced SFBT practitioners and ambitious beginners. This course has 6 CE Hours/Credits available. Learn more about the More than Miracles Course here .
The Institute for Solution-Focused Therapy offers state-of-art online training in evidence-based Solution-Focused Brief Therapy in a readily accessible, self-paced online formats. Developed by long-time SF developers, practitioners and scholars, the courses are designed for practicing professionals in mental health, the social services, counseling, education, and health care disciplines. The Institute's self-paced on-line courses courses reflect the most recent advances in the evidence-based version of the SFBT approach.
Systemic Limitations With Solution Focused Therapy
Source: https://www.routledge.com/blog/article/an-introduction-to-solution-focused-brief-therapy