Solution-Focused Brief Therapy
Updated: Jan 20
Solution-Focused Brief Therapy (SFBT) is one of the world's most widely used therapeutic treatments (De Shazer, 2007, Hsu, 2011). Unlike traditional forms of therapy that take time to analyze problems, pathology, and past life events, SFBT concentrates on finding solutions in the present and exploring one’s hope for the future in order to find a quick and pragmatic resolution of one’s problems. This method takes the approach that you know what you need to do to improve your own life and, with the appropriate coaching and questioning, are capable of finding the best solutions.
SFBT was developed by Insoo Kim Berg, Steve de Shazer, and their colleagues in the late 1970s. Disillusioned by the results of traditional psychoanalysis, Berg and de Shazer wanted to create a new type of therapy that dealt less with the “why” behind challenges patients face, and more with the “how” of treating them. Originally begun out of Berg’s living room, the group went on to found the Milwaukee Brief Family Therapy Center in the early 1980s.
A review of 43 studies on SFBT found that there was “strong evidence that Solution-Focused Brief Therapy was an effective treatment for a wide variety of behavioral and psychological outcomes.”
SFBT has become particularly popular in non-Western countries, another study showed. Though the treatment started in North America, since 2013 the amount of research on SFBT in non-Western countries is twice that of Western countries.
The approach is particularly popular in Asia. In the 1980s, Berg was invited to speak and give workshops on the technique in Hong Kong. The treatment received attention and study, and soon after reached Mainland China.
Researchers suggest that the efficacy, practicality, and optimistic nature of the treatment translate well across cultures, and that the approach allows patients to maintain familial relations and personal dignity while addressing mental health issues.
When It's Used
Solution-Focused Brief Therapy can stand alone as a therapeutic intervention, or it can be used along with other therapy styles and treatments. It is not geared toward a particular population, but aims to treat patients of all ages and a variety of issues, including child behavioral problems, family dysfunction, domestic or child abuse, addiction, and relationship problems. Though not a cure for psychiatric disorders such as depression or schizophrenia, SFBT may help improve quality of life for those who suffer from these conditions.
What to Expect
Goal-setting is the foundation of Solution-Focused Brief Therapy. One of the first questions a therapist asks is called the “miracle question”: “If a miracle occurred while you were asleep tonight, what changes would you notice in your life tomorrow?” This opens up your mind to creating a plan to reach your goal. Along with your therapist, you will begin to chart small, pragmatic ways to make changes in your life to achieve your goals.
One of the tenets of SFBT is a positive, respectful, and hopeful outlook on the part of the clinician. Practitioners maintain the assumption that people have the strength, wisdom, experience, and resilience to effect change. What other models view as "resistance" is viewed in SFBT as people's natural protective mechanisms or a previous therapist’s error that does not fit the client's situation. These assumptions make for sessions that tend to feel collegial rather than hierarchical.
Solution-Focused Brief Therapy may vary for a given patient, treatment is typically complete after four to eight sessions.
How It Works
One of the original beliefs of Solution-Focused Brief Therapy practitioners was that the solution to a problem is found in the “exceptions,” or those times when one is free of the problem or taking steps to manage the problem. Working from the theory that all individuals are at least somewhat motivated to find solutions, SFBT begins with what the individual is currently doing to initiate behavioral and lifestyle changes. The therapist uses interventions such as specific questioning techniques, 0-10 scales, empathic support, and compliments to help a person recognize the virtues and strengths that have previously gotten the patient through hard times and are likely to work in the future. Individuals learn to focus on what they can do, rather than what they can’t do.
For example, a solution-focused approach would be to question the parents of a child exhibiting behavioral problems about when the child acts out and ask the parents to spot the exceptions—the occasions when the child shows good behavior—and would invite the parents to figure out how they contributed to these exceptions. Once parents discover what may be causing the exceptions, the therapists focuses them on continuing and amplifying what works.
Alternately, if parents have been taught a solution that therapists hold in high regard, but that isn’t working for them or for their child, they are invited to disregard the plan. Solution-Focused Brief Therapy suggests that no matter how good a solution might seem, if it does not work, it is not a solution.