Understanding Solution-Focused Brief Therapy

It is a common myth that because SFBT is a brief therapy, that it is only helpful for less-challenging cases. SFBT is practiced with clients who range in severity from less severe situations to very severe. For example, cases where there are behaviour problems in children, depressive and anxiety symptoms, substance use, criminal justice involvement, and child abuse. SFBT has been found in research studies to be an effective practice when applied in mental health clinics, schools, and child protective services. The change process and techniques of SFBT are similar across cases and the success with challenging issues are contingent on the skill of a therapist to know how to collaborate with clients in a therapeutic conversation. Skills such as the co-construction process, how to ask questions and to make the best use of SFBT techniques are essential. Several SFBT techniques such as the cooperative relationship stance, relationship questions, miracle questions, and scaling questions are very useful in work with challenging issues. Opportunities for more training can be found at the Solution Focused Brief Therapy Association https://www.sfbta.org/

Several research studies have shown that an average of 4-6 sessions is pretty typical. In a review of over 251 outcome studies, Neipp & Beyebach reported a range of sessions from 1-24 and a mean across studies of 5.66 (SD 3.59).

Marie-Carmen Neipp & Mark Beyebach (2022): The Global Outcomes of Solution-Focused Brief Therapy: A Revision, The American Journal of Family Therapy, DOI:10.1080/01926187.2022.2069175

SFBT and MI differ in theory and in origins and therapeutic background. SFBT is a strengths-based, mental health intervention that came out of family systems therapy and evolved into an approach that uses language in a co-construction process to facilitate change in brief therapy. SFBT uses the therapeutic conversation and purposeful use of questions that are co-constructed between client and therapist and the major change process. This is different than Motivational Interviewing, that evolved from research on how people change while studying smoking cessation and other substance use into an intervention that could help resolve ambivalence and move people toward a change process using the transtheoretical model and stages of change theory. All therapies however, have common factors that they might share that make them similar and effective.

Constructing homework or a task to do between is used but is not absolutely a mandatory part of SFBT. When the task is used, it evolves out of the session and is co-constructed between client and therapist for the purposes of facilitating solution building.

SFBT has been used across ages and stages of life, from children to old age. It has been used consistently with adolescents and adults to resolve mental health issues such as depressive symptoms, anxiety and stress, school-related problems and academic issues, and problems with behaviour.

SFBT is an evidence-based approach and there are numerous studies and meta-analyses that show it is effective.

Available for purchase: Kim, J.S., Smock-Jordan, S., Franklin, C., & Froerer, A. (2019). Is solution-focused brief therapy evidence-based? An update 10 years later. Families in Society: The Journal of Contemporary Social Services, 1-12. https://doi.org/10.1177/1044389419841688

Solution-focused brief therapy sessions are about solution building conversations. Sessions focus on client concerns and strengths, setting goals, and discussing a preferred future. The therapist discusses with the client what will be different when that person reaches their preferred future and specific ways what they want is already happening in their lives.

SFBT is used often to help students in K-12 schools and has been used in dropout prevention by social workers, counsellors and teachers who learn the approach. SFBT techniques have been used in teams within alternative schools to help students graduate. School studies show that it can be useful in groups and in the classrooms to address the different concerns that may lead to school failure and dropout. The best example of dropout prevention is illustrated with several case examples in the book. Solution Focused Brief Therapy in Alternative Schools by Franklin et al. (2018). https://www.amazon.com/Solution-Focused-Therapy-Alternative-Schools/dp/1138735930

Therapists focus on listening and validating the client's concerns and can use coping questions to help the person. A coping question such as. How have you managed these regrets so far? Coping questions can help clients think about their competencies in the midst of crisis and loss and to see themselves differently. A question such as, how will your life be different when you get past these feelings of guilt, may be useful to help someone to think about their future.