Solution-Focused Brief Therapy (SFBT)

Solution-Focused Brief Therapy (SFBT) was developed by Steve de Shazer and Insoo Kim Berg and their colleagues beginning in the late 1970’s in Milwaukee, Wisconsin. The entire solution-focused approach was developed inductively in an inner city outpatient mental health service setting in which clients were accepted without previous screening (Institute for Solution-Focused Therapy, n.d.). The developers of SFBT spent hundreds of hours observing therapy sessions over the course of several years, carefully noting the therapists’ questions, behaviors, and emotions that occurred during the session and how the various activities of the therapists affected the clients and the therapeutic outcome of the sessions (Institute for Solution-Focused Therapy,
n.d.). These questions and activities regarding the client’s progress were incorporated into the SFBT approach.
SFBT is future-focused, goal-directed, and focuses on what clients want to achieve through therapy rather than on the problems that made them seek treatment.
It minimizes emphasis on past failings and problems focuses on clients’ strengths and previous successes. The approach focuses only on the present and future, not the past. SFBT emphasizes clear, concise, realistic goal negotiations. The SFBT approach assumes that all clients have some knowledge of what would make their life better, even though they may need some (at times, considerable) help describing the details of their better life and that everyone who seeks help already possesses at least the minimal skills necessary to create solutions (Institute for Solution-Focused Therapy, n.d.). Solution-focused therapy has been found successful in helping a vast array of people, including couples, families and children. It is thought to work very effectively for those who are keen to embrace change and have a goal-orientated mind-set, as these individuals are often more responsive to therapy techniques (Solution-focused brief therapy,
n.d.).
TECHNIQUES
Counselors/therapists use various effective techniques in SFBT. Some techniques used by counselors in SFBT include; goal setting, looking for previous solutions, using present/future-focused questions rather than past oriented focused questions, using compliments, encouraging the clients to do more of what is actually working, using scaling questions and the using the “Miracle Question” (MQ).
Setting specific, realistic goals is an important component of SFBT. Goals should be formulated by what clients want different in the future. SFBT focuses on reaching those goals set by the client. Counselors also encourage clients to look for previous solutions to the current problem. More than likely, the client has solved the current problem or similar problem in the past. Counselors ask questions that are focused on the present or the future rather than the past. This reflects the basic belief that problems are best solved by focusing on what is already working, and how a client would like their life to be, rather than focusing on the past and the origin of problems (Institute for Solution-Focused Therapy, n.d.).
Giving clients compliments is another technique used in SFBT. Ackowledging what clients are doing well and how difficult their problems are, can encourage the client to change. It also shows that the therapist understands and cares about the client. It is important for the counselor to encourage those positive behaviors. Scaling questions are used to determine how a client perceives a specific problem in terms of difficulty and to track progress. By identifying where an individual's problem lies in their mindset, a therapist can go about exploring where things would need to be for them to feel that the aims of therapy have been met (Solution-focused brief therapy, n.d.).
A key element within SFBT is the 'miracle question' - a question that encourages people to stop thinking about why they cannot achieve something and instead picture how their lives could be if a miracle occurred (Solution-focused brief therapy, n.d.).
“The miracle question has been asked thousands of times throughout the world. It has been refined as practitioners have experimented with different ways of asking it. The question is best asked deliberately and dramatically.
Now, I want to ask you a strange question. Suppose that while you are sleeping tonight and the entire house is quiet, a miracle happens. The miracle is that the problem which brought you here is solved. However, because you are sleeping, you don’t know that the miracle has happened. So, when you wake up tomorrow morning, what will be different that will tell you that a miracle has happened and the problem which brought you here is solved?” (de Shazer, 1988, p. 5.)
The miracle question asks the clients to imagine how their life will be changed when the “problem” is solved.
SUBSTANCE USE DISORDER
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home.
(Substance Use Disorders, n.d.). According to the DSM-5, a diagnosis of substance use disorder is based on evidence of impaired control, social impairment, risky use, and pharmacological criteria (Substance Use Disorders. (n.d.). Symptoms of substance use disorders may include; behavioral changes, physical changes, and/or social changes. Some behavioral changes may include lacking in motivation, appearing anxious or paranoid, mood swings, irritability, angry outbursts, suspicious or secretive behavior. Physical changes may include weight loss or gain, abnormal pupils, impaired vision or coordination, and overall deterioration of physical appearance. Social changes may include financial problems, legal problems, sudden change in friends and/or
hobbies.
SFBT & SUBSTANCE USE DISORDER
Substance abuse affects the abuser as well as family members and relationships. Addiction can create problems such as jealously, emotional trauma, separation, conflict with partner/children, conflict over money etc. When an abuser is ready for recovery, SFBT can be used as a technique when family counselors/therapists work with clients and their families. It is helpful to ask clients struggling with substance use disorder and family members how life will be different when the current problems are no longer present. This is the beginning process of working toward solutions and goals. When counselors are working with clients to look for previous solutions, questions like “Are there times in your life, when addiction has not been a problem?”. The answers will give the client an idea of how to solve this current problem of addiction. In SFBT, counselors encourage clients to do more of what has previously worked in past and compliment the clients on progress. SFBT is only one technique to be used with substance use disorders. Other techniques may be used in combination with SFBT depending on the client.