Man on coast holds bike handlebarsSolution-focused brief therapy (SFBT) places focus on a person's present and future circumstances and goals rather than past experiences. In this goal-oriented therapy, the symptoms or issues bringing a person to therapy are typically not targeted.

Instead, a qualified therapist encourages those in treatment to develop a vision of the future and offers support as they determine the skills, resources, and abilities needed to achieve that vision successfully.

History and Development of SFBT

The need for an alternative approach to therapy was recognized as mental health practitioners began to observe the amount of energy, time, money, and other resources spent discussing and analyzing the challenges revealed during the therapy process, while the issues originally bringing an individual to therapy continued to have a negative impact. Steve de Shazer and Insoo Kim Berg of the Brief Family Therapy Center in Milwaukee, along with their team, developed solution-focused brief therapy in the early 1980s in response to this observation. SFBT aims to develop realistic solutions as quickly as possible, rather than keeping people in therapy for long periods of time, in order to promote lasting relief for those in therapy.

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SFBT developed into the fast, effective treatment modality it is today over approximately three decades, and it continues to evolve and change in order to meet the needs of those in therapy. Currently, therapists in the United States, Canada, South America, Asia, and Europe are trained in the approach. The principles of solution-focused therapy have been applied to a wide variety of environments including schools, places of employment, and other settings where people are eager to reach personal goals and improve interpersonal relationships. 

How Does SFBT Work?

SFBT, which aims to help people experiencing difficulty find tools they can use immediately to manage symptoms and cope with challenges, is grounded in the belief that although individuals may already have the skills to create change in their lives, they often need help identifying and developing those skills. Similarly, SFBT recognizes that people already know, on some level, what change is needed in their lives, and SFBT practitioners work to help the people in their care clarify their goals. Practitioners of SFBT encourage individuals to imagine the future they desire and then work to collaboratively develop a series of steps that will help them achieve those goals. In particular, therapists can help those in treatment identify a time in life when a current issue was either less detrimental or more manageable and evaluate what factors were different or what solutions may have been present in the past. 

This form of therapy involves first developing a vision of one’s future and then determining how internal abilities can be enhanced in order to attain the desired outcome. Therapists who practice SFBT attempt to guide people in therapy through the process of recognizing what is working for them, help them explore how best to continue practicing those strategies, and encourage them to acknowledge and celebrate success. In addition, practitioners of SFBT support people in therapy as they experiment with new problem-solving approaches.

Techniques Used in SFBT

In SFBT, counselors ask specific types of question to guide the session. Coping questions, for example, can help demonstrate to those in therapy their resiliency and the number of ways in which they are capable of coping with challenges in their lives. An example might be, “How do you manage, in the face of such difficulty, to fulfill your daily obligations?” This can help people recognize their skills in coping with adversity.

Miracle questions help people envision a future in which the problem is absent. In essence, this line of questioning allows people to explain how their lives would look different if the problem did not exist, which can help them identify small, practical steps they can take immediately toward change. For example, the person in therapy might describe a feeling of ease with family members and believe this ease can only be felt if the present problem were absent. Imagining a scenario where the present problem does not exist can remind people behavioral changes are possible and allow them to see what can be done to create change in their lives. 

Scaling questions use a scale from 0–10 to assess present circumstances, progress, or how one is viewed by others. These kinds of questions are often used when there is insufficient time to explore the miracle question and they can help a therapist to gain insight into the hopefulness, motivation, and confidence of people in therapy. In addition, people who have difficulty verbalizing their experiences may find this approach less challenging.

Issues Treated with SFBT

SFBT has been used successfully in individual therapy and with both families and couples. Developed with the primary intention of helping those in therapy to find solutions to challenges, the approach has expanded to address issues in other areas of life, such as schools and workplaces. Individuals from different cultures, backgrounds, and age groups have all been shown to benefit from this type of therapy. 

SFBT can be used to treat a wide range of issues. It is most often used to address challenges for which the person in therapy already has some idea of possible solutions. In SFTB, the person seeking treatment is considered the "expert" on their concerns, and the therapist encourages the individual to envision their solution, or what change would look like, and then outline the steps necessary to solve problems and achieve goals. Because this modality focuses on solutions to issues, rather than the reasons behind them, it may be more effective at treating some concerns than others. 

Research has shown SFBT may be a helpful intervention for youth who are experiencing behavioral concerns or academic/school-related concerns. It has also proven effective as an approach to family therapy and couples counseling. This method is often used in conjunction with other approaches.  

SFBT may not be recommended for those who are experiencing severe mental health concerns, 

Pursuing Training in SFBT

Those interested in becoming practitioners of SFBT may obtain certification from the International Alliance of Solution-Focused Teaching Institutes (IASTI).

Three levels of certification are offered:

  • Level 1: Solution-focused practitioner
  • Level 2: Advanced solution-focused practitioner
  • Level 3: Master solution-focused practitioner

To be eligible for consideration, all applicants must be able to practice solution-focused therapy in a professional setting. This means counselors, therapists, teachers, coaches, or other applicants who work with people to improve their mental health must have access to a professional environment deemed suitable by the training institute. Individual IASTI member institutes have specific requirements for acceptance into the certification program. 

Training in solution-focused brief therapy helps applicants learn core principles, master relevant therapeutic skills, and demonstrate competency in the practice of SFBT. At the end of training, each applicant must successful pass an IASTI-approved exam to earn certification. 

Limitations and Concerns of SFBT

While there are a number of people in therapy and practitioners who report the effectiveness of solution-focused brief therapy, some concerns have, over the years, presented themselves. One major criticism of the modality is that its quick, goal-oriented nature may not allow therapists the necessary time to empathize with what people in treatment are experiencing. As such, those in therapy may feel misunderstood if the therapist is not meeting them on their emotional level. 

A second concern is the way SFBT seems to simply discard or ignore information deemed important by other treatment modalities. For example, in this type of therapy a relationship between the adverse issues people face and the changes necessary to foster improvement is not assumed, and any underlying reasons for maladaptive thoughts and/or behaviors are not explored in a typical SFBT session. Individuals wishing to explore these reasons may find it more helpful to seek a type of therapy that addresses these concerns, though they may do so while also receiving SFBT. 

Though there are positive reports about the efficacy of solution-focused therapy and preliminary research findings suggest people who utilize this type of treatment often see better results than those who do not seek therapy, more research needs to be done in order to provide empirical support for the approach. Studies providing substantial objective validity of the effectiveness of SFBT will lend more credence to its establishment as a popular form of treatment.

References:

  1. Berg, I. K. (n.d.). About solution-focused brief therapy. Retrieved from http://www.sfbta.org/about_sfbt.html
  2. Dolan, Y. (n.d.). What is solution-focused therapy? Retrieved from http://www.solutionfocused.net/what-is-solution-focused-therapy
  3. International Alliance of Solution-Focused Teaching Institutes. (n.d.). Certification of trainees. Retrieved from http://iasti.org/?page_id=19
  4. Iveson, C. (2002). Solution-focused brief therapy. Advances in Psychiatric Treatment, 8(2), 149-156. DOI: 10.1192/apt.8.2.149. Retrieved from http://apt.rcpsych.org/content/8/2/149
  5. Trepper, T. S., McCollum, E.E., De Jong, P., Korman, H., Gingerich, W., Franklin, C. (n.d.). Solution focused therapy treatment manual for working with individuals. Retrieved from http://www.sfbta.org/research.pdf
  6. Yalom, V. & Rubin, B. (2003). Insoo kim berg on brief solution-focused therapy. Retrieved from https://www.psychotherapy.net/interview/insoo-kim-berg