What Is Solution-Focused Therapy?

Couples Counseling Pacific Heights

Solution-focused therapy, also called solution-focused brief therapy (SFBT), is a type of therapy that places far more importance on discussing solutions than problems (Berg, n.d.). Of course, you must discuss the problem to find a solution, but beyond understanding what the problem is and deciding how to address it, solution-focused therapy will not dwell on every detail of the problem you are experiencing.

Solution-focused brief therapy doesn’t require a deep dive into your childhood and the ways in which your past has influenced your present. Instead, it will root your sessions firmly in the present while working toward a future in which your current problems have less of an impact on your life (Psychology Today, n.d.).

This solution-centric form of therapy grew out of the field of family therapy in the 1980s. Creators Steve de Shazer and Insoo Kim Berg noticed that most therapy sessions were spent discussing symptoms, issues, and problems (Good Therapy, 2016).

De Shazer and Berg saw an opportunity for quicker relief from negative symptoms in a new form of therapy that emphasized quick, specific problem-solving rather than an ongoing discussion of the problem itself.

The word “brief” in solution-focused brief therapy is key. The goal of SFBT is to find and implement a solution to the problem or problems as soon as possible to minimize time spent in therapy and, more importantly, time spent struggling or suffering (Antin, 2016).

SFBT is committed to finding realistic, workable solutions for clients as quickly as possible, and the efficacy of this treatment has influenced its spread around the world and use in multiple contexts.

SFBT has been successfully applied in individual, couples, and family therapy. The problems it can address are wide-ranging, from the normal stressors of life to high-impact life events.

The only realm in which SFBT is generally not recommended is that of the more extreme mental health issues, such as schizophrenia or major depressive disorder (Antin, 2016).

Theory Behind the Solution-Focused Approach

The solution-focused approach of SFBT is founded in de Shazer and Berg’s idea that the solutions to one’s problems are typically found in the “exceptions” to the problem, meaning the times when the problem is not actively affecting the individual (Psychology Today, n.d.).

This approach is a logical one—to find a lasting solution to a problem, it is rational to look first at those times in which the problem lacks its usual potency.

For example, if a client is struggling with excruciating shyness, but typically has no trouble speaking to his or her coworkers, a solution-focused therapist would target the client’s interactions at work as an exception to the client’s usual shyness. Once the client and therapist have discovered an exception, they will work as a team to find out how the exception is different from the client’s usual experiences with the problem.

The therapist will help the client formulate a solution based on what sets the exception scenario apart, and aid the client in setting goals and implementing the solution.

You may have noticed that this type of therapy relies heavily on the therapist and client working together. Indeed, SFBT works on the assumption that every individual has at least some level of motivation to address their problem or problems and to find solutions that improve their quality of life (Psychology Today, n.d.).

This motivation on the part of the client is an essential piece of the model that drives SFBT.

Solution-Focused Model

While there is no formalized “A leads to B, which leads to C” sort of model for SFBT, there is a general model that acts as the foundation for this type of therapy.

Solution-focused theorists and therapists believe that generally, people develop default problem patterns based on their experiences, as well as default solution patterns. These patterns dictate an individual’s usual way of experiencing a problem and his or her usual way of coping with problems (Focus on Solutions, 2013).

The solution-focused model holds that focusing only on problems is not an effective way of solving them. Instead, SFBT targets clients’ default solution patterns, evaluates them for efficacy, and modifies or replaces them with problem-solving approaches that work (Focus on Solutions, 2013).

In addition to this foundational belief, the SFBT model is based on the following assumptions:

  • Change is constant and certain;
  • Emphasis should be on what is changeable and possible;
  • Clients must want to change;
  • Clients are the experts in therapy and must develop their own goals;
  • Clients already have the resources and strengths to solve their problems;
  • Therapy is short-term;
  • The focus must be on the future—a client’s history is not a key part of this type of therapy (Counselling Directory, 2017).

Based on these assumptions, the model instructs therapists to do the following in their sessions with clients:

  • Ask questions rather than “selling” answers;
  • Notice and reinforce evidence of the client’s positive qualities, strengths, resources, and general competence to solve their own problems;
  • Work with what people can do rather than focusing on what they can’t do;
  • Pinpoint the behaviors a client is already engaging in that are helpful and effective and find new ways to facilitate problem-solving through these behaviors;
  • Focus on the details of the solution instead of the problem;
  • Develop action plans that work for the client (Focus on Solutions, 2013).

SFBT therapists aim to bring out the skills, strengths, and abilities that clients already possess rather than attempting to build new competencies from scratch. This assumption of a client’s competence is one of the reasons this therapy can be administered in a short timeframe—it is much quicker to harness the resources clients already have than to create and nurture new resources.

Beyond these basic activities, there are many techniques and exercises used in SFBT to promote problem-solving and enhance clients’ ability to work through their own problems.

Popular Techniques and Interventions

While some of these techniques are used specifically in SFBT, others have applicability to a wide range of therapies, or even to individuals working on solving their problems without the guidance of a therapist. Working with a therapist is generally recommended when you are facing overwhelming or particularly difficult problems, but not all problems require a licensed professional to solve.

For each technique listed below, it will be noted if it can be used as a standalone technique.

Questions

Asking good questions is vital in any form of therapy, but SFBT formalized this practice into a technique that specifies a certain set of questions intended to provoke thinking and discussion about goal-setting and problem-solving.

One such question is the “coping question.” This question is intended to help clients recognize their own resiliency and identify some of the ways in which they already cope with their problems effectively.

There are many ways to phrase this sort of question, but generally, a coping question is worded something like, “How do you manage, in the face of such difficulty, to fulfill your daily obligations?” (Antin, 2016).

Another type of question common in SFBT is the “miracle question.” The miracle question encourages clients to imagine a future in which their problems are no longer affecting their lives. Imagining this desired future will help clients see a path forward, both allowing them to believe in the possibility of this future and helping them to identify concrete steps they can take to make it happen.

This question is generally asked in the following manner: “Imagine that a miracle has occurred. This problem you are struggling with is suddenly absent from your life. What does your life look like without this problem?” (Antin, 2016).

If the miracle question is unlikely to work, or if the client is having trouble imagining this miracle future, the SFBT therapist can use “best hopes” questions instead. The client’s answers to these questions will help establish what the client is hoping to achieve and help him or her set realistic and achievable goals.

The “best hopes” questions can include the following:

  • What are your best hopes for today’s session?
  • What needs to happen in this session to enable you to leave thinking it was worthwhile?
  • How will you know things are “good enough” for our sessions to end?
  • What needs to happen in these sessions so that your relatives/friends/coworkers can say, “I’m really glad you went to see [the therapist]”? (Vinnicombe, n.d.).
  • To identify the exceptions to the problems plaguing clients, therapists will ask “exception questions.” These are questions that ask about clients’ experiences both with and without their problems. This helps to distinguish between circumstances in which the problems are most active and the circumstances in which the problems either hold no power or have diminished power over clients’ moods or thoughts.

Exception questions can include:

  • Tell me about the times when you felt the happiest;
  • What was it about that day that made it a better day?
  • Can you think of times when the problem was not present in your life? (Counselling Directory, 2017).

Another question frequently used by SFBT practitioners is the “scaling question.”

It asks clients to rate their experiences (such as how their problems are currently affecting them, how confident they are in their treatment, and how they think the treatment is progressing) on a scale from 0 (lowest) to 10 (highest). This helps the therapist to gauge progress and learn more about clients’ motivation and confidence in finding a solution.

For example, an SFBT therapist may ask, “On a scale from 0 to 10, how would you rate your progress in finding and implementing a solution to your problem?” (Antin, 2016).

Do One Thing Different

This exercise can be completed individually, but the handout may need to be modified for adult or adolescent users.

This exercise is intended to help the client or individual to learn how to break his or her problem patterns and build strategies to simply make things go better.

The list breaks the exercise into the following steps (Coffen, n.d.):

Step One

Think about the things you do in a problem situation. Change any part you can. Choose to change one thing, such as the timing, your body patterns (what you do with your body), what you say, the location, or the order in which you do things;

Think of a time that things did not go well for you. When does that happen? What part of that problem situation will you do differently now?

Step Two

Think of something done by somebody else does that makes the problem better. Try doing what they do the next time the problem comes up. Or, think of something that you have done in the past that made things go better. Try doing that the next time the problem comes up;

Think of something that somebody else does that works to make things go better. What is the person’s name and what do they do that you will try?

Think of something that you have done in the past that helped make things go better. What did you do that you will do next time?

Step Three

Feelings tell you that you need to do something. Your brain tells you what to do. Understand what your feelings are but do not let them determine your actions. Let your brain determine the actions;

Feelings are great advisors but poor masters (advisors give information and help you know what you could do; masters don’t give you choices);

Think of a feeling that used to get you into trouble. What feeling do you want to stop getting you into trouble?

Think of what information that feeling is telling you. What does the feeling suggest you should do that would help things go better?

Step Four

Change what you focus on. What you pay attention to will become bigger in your life and you will notice it more and more. To solve a problem, try changing your focus or your perspective.

Think of something that you are focusing on too much. What gets you into trouble when you focus on it?

Think of something that you will focus on instead. What will you focus on that will not get you into trouble?

Step Five

Imagine a time in the future when you aren’t having the problem you are having right now. Work backward to figure out what you could do now to make that future come true;

Think of what will be different for you in the future when things are going better;

Think of one thing that you would be doing differently before things could go better in the future. What one thing will you do differently?

Step Six

Sometimes people with problems talk about how other people cause those problems and why it’s impossible to do better. Change your story. Talk about times when the problem was not happening and what you were doing at that time. Control what you can control. You can’t control other people, but you can change your actions, and that might change what other people do;

Think of a time when you were not having the problem that is bothering you. Talk about that time.

Step Seven

If you believe in a god or a higher power, focus on God to get things to go better. When you are focused on God or you are asking God to help you, things might go better for you.

Do you believe in a god or a higher power? Talk about how you will seek help from your god to make things go better.

Step Eight

Use action talk to get things to go better. Action talk sticks to the facts, addresses only the things you can see, and doesn’t address what you believe another person was thinking or feeling—we have no way of knowing that for sure. When you make a complaint, talk about the action that you do not like. When you make a request, talk about what action you want the person to do. When you praise someone, talk about what action you liked;

  • Make a complaint about someone cheating at a game using action talk;
  • Make a request for someone to play fairly using action talk;
  • Thank someone for doing what you asked using action talk.

Following these eight steps and answering the questions thoughtfully will help people recognize their strengths and resources, identify ways in which they can overcome problems, plan and set goals to address problems, and practice useful skills.

Presupposing Change

This is a handy technique for SFBT therapists and it doesn’t really apply to individuals who are not working with a therapist.

The “presupposing change” technique has great potential in SFBT, in part because when people are experiencing problems, they have a tendency to focus on the problems and ignore the positive changes in their life. It can be difficult to recognize the good things happening in your life when you are struggling with a painful or particularly troublesome problem.

This technique is intended to help clients be attentive to the positive things in their lives, no matter how small or seemingly insignificant. Any positive change or tiny step of progress should be noted, so clients can both celebrate their wins and draw from past wins to facilitate future wins.

Presupposing change is a strikingly simple technique to use: Ask questions that assume positive changes. This can include questions like, “What’s different or better since I saw you last time?”

If clients are struggling to come up with evidence of positive change or are convinced that there has been no positive change, the therapist can ask questions that encourage clients to think about their abilities to effectively cope with problems, like, How come things aren’t worse for you? What stopped total disaster from occurring? How did you avoid falling apart? (Australian Institute of Professional Counsellors, 2009).

SFBT Treatment Plan: An Example

A typical treatment plan in SFBT will include several factors relevant to the treatment, including:

  • The reason for referral, or the problem the client is experiencing that brought him or her to treatment;
  • A diagnosis (if any);
  • List of medications taken (if any);
  • Current symptoms;
  • Support for the client (family, friends, other mental health professionals, etc.);
  • Modality or treatment type;
  • Frequency of treatment;
  • Goals and objectives;
  • Measurement criteria for progress on goals;
  • Client strengths;
  • Barriers to progress.All of these are common and important components of a successful treatment plan. Some of these components (e.g., diagnosis and medications) may be unaddressed or acknowledged only as a formality in SFBT due to its usual focus on less severe mental health issues. Others are vital to treatment progress and potential success in SFBT, including goals, objectives, measurement criteria, and client strengths.

Limitations of SFBT Counseling

As with any form of therapy, SFBT has limitations and potential disadvantages.

Some of the potential disadvantages for therapists include (George, 2010):

  • The potential for clients to focus on problems that the therapist believes are secondary problems. For example, the client may focus on a current relationship problem rather than the underlying self-esteem problem that is causing the relationship woes. SFBT dictates that the client is the expert, and the therapist must take what the client says at face value;
  • The client may decide that the treatment is successful or complete before the therapist is ready to make the same decision. This focus on taking what the client says at face value may mean the therapist must end treatment before they are convinced that the client is truly ready;
  • The hard work of the therapist may be ignored. When conducted successfully, it may seem that clients solved their problems by themselves, and didn’t need the help of a therapist at all. An SFBT therapist may rarely get credit for the work they do but must take all the blame when sessions end unsuccessfully.

Some of the potential limitations for clients include (Antin, 2016):

  • The focus on quick solutions may miss some important underlying issues;
  • The quick, goal-oriented nature of SFBT may not allow for an emotional, empathetic connection between therapist and client.Empathy solution-focused therapy
  • If the client wants to discuss factors outside of their immediate ability to effect change, SFBT may be frustrating in its assumption that clients are always able to fix or address their problems.

Generally, SFBT can be an excellent treatment for many of the common stressors people experience in their lives, but it may be inappropriate if clients want to concentrate more on their symptoms and how they got to where they are today. As noted earlier, it is also generally not appropriate for clients with major mental health disorders.

What Does SFBT Have to Do with Positive Psychology?

First, both SFBT and positive psychology share a focus on the positive—on what people already have going for them and on what actions they can take. While problems are discussed and considered in SFBT, most of the time and energy is spent on discussing, thinking about, and researching what is already good, effective, and successful.

Second, both SFBT and positive psychology consider the individual to be his or her own best advocate, the source of information on his or her problems and potential solutions, and the architect of his or her own treatment and life success. The individual is considered competent, able, and “enough” in both SFBT and positive psychology.

This assumption of the inherent competence of individuals has run both subfields into murky waters and provoked criticism, particularly when systemic and societal factors are considered. While no respectable psychologist would disagree that an individual is generally in control of his or her own actions and, therefore, future, there is considerable debate about what level of influence other factors have on an individual’s life.

While many of these criticisms are valid and bring up important points for discussion, we won’t dive too deep into them in this piece. Suffice it to say that both SFBT and positive psychology have important places in the field of psychology and, like any subfield, may not apply to everyone and to all circumstances.

However, when they do apply, they are both capable of producing positive, lasting, and life-changing results.

By Courtney Ackerman