Solution-focused Brief Therapy

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Therapy

 

Solution-focused Brief Therapy

SFBT is a psychotherapy approach that is emphasized on the development of solutions through an exploration of the available resources and the hope lying in the future instead of the current problems and their past causes. SBFT typically involves three to five short sessions and may be a useful preliminary or even sufficient interventional approach (Kim, 2007). The approach can involve the observation of the patient’s response to a lot of accurately developed questions and may include an analysis of the past for the communication of empathy or to acquire a glimpse of the client’s concerns about the future.

History

Steve de Shazer and Insoo Kim Berg with a number of colleagues at the Brief Family Therapy Center pioneered SFBT in the early 1980s. Their work at the facility in Milwaukee, Wisconsin, aimed at establishing the therapeutic interventions that produced desirable results during therapy sessions (Bannink, 2007). The basic tenant of the approach was that clients have crucial knowledge on the ways to solve their problems. The attempt to solve the problem would most likely perpetuate instead of solving it, and acquiring knowledge about the past origins may not always be important in solution-building. According to de Shazer, the solution of a problem may have no relationship the problem itself. Although the approach holds the client as the expert, there is the need for co-construction of answers as a way to initiate change in the client (Visser, 2013). The development of solutions is dependent on the client’s ability to perceive the condition differently so as to interact with the problem from a different dimension. The principal purpose of the practitioner is to ask questions in a way that helps the client have a new perspective on the context and apply solution-focused strategies to facilitate the search for solutions (Kim, 2007).

The questions asked by the therapist should engage the client in a way that he/she thinks more of the solution and future rather than the cause and the past. deShazer and Berg found that there were three principal ways to get the client talking about the solutions and resources that included eliciting questions, questions for details, and verbal rewards (Bannink, 2007). The most important aspect in the development of solutions is speculation where the goals of the client have precedence in the determination of the possible solutions instead of using a diagnostic approach.

Milton Erickson was another notable contributor to the development of SFBT. Erickson argued that therapy should take the shortest time possible and that the initiation of the slightest change in the client’s understanding of the possible solutions should be enough to facilitate change in motion. He believed that the method formed a platform through which the client could solve future problems without the need for therapy. Like Berg, Erickson prescribed the use of the current resources, even the coincidental ones, as part of the solution (Visser, 2013).

The Mental Research Institute (MRI) in Palo Alto, California also played a significant role in the conception and development of SFBT. A number of doctors from MRI such as Richard Fisch, Jay Haley, and John Weakland were at the center of the creation of innovative theories in therapy; it was therapists from the MRI that started the Brief Therapy Center. The doctors believed that the causes of the current problem are in the present time, and so did their solutions and, as a result, learning about the past could be a waste of time. The principal aim of therapy should be to determine the client’s incorrect behavior and find a better alternative to replace it (Visser, 2013).

The Process

As pointed out earlier, SFBT should take up between three and five sessions and, as a result, it is of much importance to schedule the process. For the first session, the therapist should ensure that the client acquires an orientation towards the development of solutions by using solution-building questions. Initiation of questions concerning the pre-session change enables the clients to acquire the feeling that the success of therapy is dependent on them (Lee, 2003). On the other hand, the exception and miracle questions give hope to the individual about a better future with the absence of the current problem. Coping questions change the feeling of insecurity and helplessness in clients, especially when there is the perception that he/she does not have control over the current problem. Scaling questions enable the client develop a rank (1-10) for the situation, which can be a way of measuring progress; 1 represents the worst situation, and 10 is the most satisfactory outcome. Finally, the relationships questions enhance the interactional characteristic of problems that may support the client in the attainment of the desired change.

Before the end of the first session, it may be crucial to take a short break, which gives the practitioner an opportunity to organize ideas or consult with colleagues on the best applicable strategy to offer SFBT. The client also gets time to focus on the progress and get ready to receive the feedback, which should primarily consist of a compliment, and tasks (Lee, 2013).

For the second and subsequent sessions, the therapist helps the client reflect on the events that occur between sessions and their contribution towards the achievement of the desired behavior. Although tracking change is sometimes challenging, it helps the client visualize and perceive that he is moving closer to the target, which is adequate motivation to push the client further. It is also common that the change is small, which may demotivate the client; however, the practitioner should ensure that the client leaves with a sense of accomplishment. Even when the change is negative, it does not mean that the client has failed and, as a result, it may be important to adopt another approach by co-constructing other scenarios with the therapist (Lee, 2003). The use of trial and error to find solutions is a good approach, but the lack of any change by the second session may imply that the client should reprioritize the objectives.

Termination, the final stage, is important in the review of progress and goal achievement as well as ensuring that the clients take all credit for their improvement. The session should also help the client create a relationship between his/her actions and the desired outcomes besides being able to identify the signs of relapse and the follow-up techniques (Lee, 2013). In addition to complementing the client, the therapist should also initiate self-description where the clients define themselves with reference to the change during the treatment period. The final stage should also prepare the client to deal with problems in the future irrespective of their similarity to the current problem.

Common Types of Problems

SFBT is applicable in the solution of both short/long-term problems among clients, especially in social work based on the fact that its developers were professionals in the field. One of the most common problems that therapists solve using the intervention approach is addiction. SFBT aims at creating a better understanding of the situation and the solutions that exist in the present time through the initiation of a change in behavior. First, addiction problems have a loose connection to the past, which makes the development of contextually relevant solutions through SFBT easy. It is common that some poor lifestyles or social interactions, such as idleness and befriending drug users respectively, result in the first use and subsequent addiction (Spilsbury, 2012). Through the creation of the current picture, the client can speculate possible solutions by integrating better behavior such as going to the library or having other friends.

SFBT is also applicable in the school context, especially when dealing with the adolescence practice, and self-esteem issues. According to Taathadi (2014), a therapist’s speech that focuses on developing solutions for low self-esteem rather than its causes and meaning has much success in inculcating change in the individual. His study confirmed that by allowing the student to ponder on the achievable solutions, it was easy for him/her to find behaviors that can replace those leading to their esteem problems.

Trepper et al. (2010) found out that the use of SFBT was successful in the treatment of sexual disorders. The success of the approach in the treatment was because focusing on the past results in painful experiences, but the future brings more hope. The findings were almost similar to those obtained by Ford (2006) in a study that focused on erectile dysfunctional men. It is also possible to apply SFBT in solving problems related to domestic violence, schizophrenia, parenting, child welfare, family practice, mental illnesses, suicide prevention, and cultural competence as well as administration and management.

Strengths

  1. By focusing on the present opportunities and a brighter future, SFBT helps the client have some hope and determination in developing solutions remotely. It becomes easier for the patient to change behavior as he/she detaches from the past.

  2. SFBT is brief besides having a high success rate. Although it may take some clients up to five sessions, other clients achieve their goals after the first three sessions since the client assumes the responsibility of the problems and solutions.

  3. The client is able to choose the most achievable outcomes and suitable resources based on the fact that they are the experts in the treatment.

  4. It is possible to apply SFBT in a wide variety of problems and contexts, especially in social work.

  5. The creation of a relationship between actions and the desired outcome lead to the development of a long-term behavioral change in the client, which implies that SFBT has a long-term effect(Blundo, Bolton & Hall, 2014).

Weaknesses

  1. SFBT focuses on the development of solutions rather than an understanding of the problems, which may put off clients willing to talk about their past and their evolution of their problems.

  2. Clients may presume the professionalism of the therapist due to the tendency of treating the client as the expert. On the contrary, clients may fail to effectively develop objectives and solution due to their helplessness and reference of the therapist as the professional.

  3. SFBT lacks sufficient empirical support besides being too simple.

  4. It may not be effective in finding solutions for patients with chronic mental disorders as the problems have a connection to the past.

Conclusion

 

SFBT involves the development of solutions by leveraging the present resources rather than the causes of problems. The approach, developed by de Shazer and Berg, aims at reducing the time spent in therapy and developing solutions using the client’s knowledge and perception of the problem. The therapy mainly involves the use of questions that drive the client towards the development of goals and ways to reach the goals. The approach can solve various types of problem ranging from addiction, family issues, and teenage due to its flexibility. Other strengths of SFBT may include the ability to set precise goals, briefness, long-term effects, and the inculcation of hope in the future. Nonetheless, the approach has some limitations that may include the disappointment of clients willing to discuss the past, dysfunctional client-therapist relationship, lack of extensive empirical support, and the inability to cure chronic mental disorders.