De Shazer And Insoo Berg Solution-Focused Therapy

In 1978, Steve de Shazer and Insoo Kim Berg developed solution-focused therapy (SFT). They knew there was a connection between a problem and its solution but looked at a more positive way to make gains. Therefore, de Shazer and Berg created a new perspective of the solution and the impact of the problem decreased. SFT is essential for social workers to use when working with youth clients who are experiencing substance abuse. This paper will discuss the effectiveness of using SFT with youth, ages 15-24, who are dealing with substance abuse, the essence of the therapy, evidence based practice, the area of practice, and how SFT incorporates person in environment. The essence of SFT is the emphasis on the solution rather than the problem.
Most therapists focus primarily on the problem. By shifting the focus, the therapist and client can find solutions and techniques to overcome the problems. This allows the therapist to put a positive spin on the client's future by spending time on realistic solutions. During the assessment, the focus is on the client's motivation level, the nature of the problem, and externalizing the problem. After the client has identified the problem, you move past it and go into problem articulation. Walsh (2013) states, "Problem articulation includes the client’s beliefs about the source of the problem, how it affects the client, how the client has coped so far, and what solutions the client has tried already" (p. 238). It is important to see what the client has done before to eliminate the problem, to evaluate what has worked and what has not. It shows the client that they have been making strides of ridding the problem and that it is not always present in their life. This increases his or her awareness of their strengths and resources. One benefit of SFT for treating emotional problems is the ability to externalize the problem. Externalizing the problem means taking the problem and disconnecting it from the person. It helps the client see the problem as something outside of themselves over which they can then have control over. For example, Jane is suffering from anxiety disorder. To externalize the anxiety you ask Jane, "How does anxiety cause a problem in Jane's life?" By doing this, it forces Jane to look at the anxiety as the problem, rather than seeing her associated with the anxiety. This rids the stigma and gives the client control over their outcome. Once the client gains control, they work collaboratively with the therapist to set and meet the goals. Since the client is the expert in this therapy, it is important to give the therapists the chance to give their input. In 2012, 30.4 percent of men 12 and older and 16.0 percent of women reported binge drinking, drinking five or more drinks per night, in the past month (Drug Facts, 2014). In addition, 50 percent of deaths involve substance abuse in ages 15-24. SAMHSA's National registry of evidence-based Programs and Practices outlines the effectiveness of using SFT (Kim, 2014). The research concludes that SFT is an efficient and effective approach to treat substance abuse, mood disorders, and psychological problems (Gingerich et al, 2012; Trepper & Franklin, 2012; Smock et al, 2008). Seagram conducted a meta-analysis on the effectiveness of SFT intervention with youth. The results found that after ten sessions the youth had decreased their drinking patterns in the test group. The significance was p < .05, so it was not a huge but still significant positive change (Seagram, 1998). Spilsbury's case study followed a client who saw treatment for depressive symptoms, alcohol-dependence and personality disorder. This study focused on three SFT sessions. The client's Depression Anxiety Stress Scale number and dark thoughts around being sober reduced (Spilsbury, 2012). Intervention for FST focuses on the collaboration between the therapist and youth, but the youth is the expert.
The therapist needs to trust that the youth wants to change and focus on solution talk. FST looks at the future goals and change that is taking place. The goal for intervention is to look for times where the youth is not using, be aware of their strengths, and look at the problem differently. The assessment looks at the youth's motivation level, reframing comments, strengths-reinforcing coping questions, and externalizes the abuse. Another focus is on De Shazer's miracle question. It is helpful to ask the miracle question, imagine that during the night while you were sleeping, this problem went away. What did you notice as you get up and go through your day that would let you know your problem has been resolved? (Walsh Ch.10,
2013). One unique part of SFT is that evaluation occurs at the end of each session. The facilitator will ask the youth a scaling question. From 1-10, where one is the worse the substance abuse has ever been and ten is after the miracle has taken place. Where are you now? If they say four, the therapist will ask why not a three and praise their progress. What will get you to move up to a five? After the youth's goal is achieved, the youth and therapist either set another goal or terminate the sessions. By focusing on the solution, SFT overlooks the person in environment.
SFT asks the client what the problem is but does not dig deeper in the background of the problem. To eliminate a problem, the social worker needs to look at what other factors contribute to this problem. Some of the factors include when it started, is it systemic, and potential barriers. If the youth does not get the opportunity to discuss the problem, it discourages him or her to evaluate the behavior that is causing it. In addition, the therapist misses valuable information on the youth's background when there is no assessment of the past. Without establishing problem resolution, it could result in behavior repetition. It is important to look at the environment when working with youth and substance abuse. Quinn and Fromme's research shows that if the youth's parents drink, it increases the likelihood of the youth drinking. It focused on a sample of high school graduates to look if environmental factors can delay the increase in drinking among those high in trait-level risk factors. The students completed self-report measures of alcohol
use,
The findings showed that an increase in problems with alcohol for students who has less protective environments. Therefore, the structure of your environment for students, who have recently graduated from high school and are starting college, has a direct positive correlation for increasing drinking. (Quinn & Fromme, 2011). De Shazer and Berg's solution-focused therapy is helpful, but it is missing the crucial assessment of the clients past. Some benefits are focusing on the solutions rather than the problem, externalizing the problem, and focusing on the strengths of the client. SFT is an effective therapy to use when working with youth who are dealing with substance abuse.