Solution-Focused Brief Therapy (SFBT)

Solution-Focused Brief Therapy (SFBT) is a short-term, goal-focused, evidence-based therapeutic approach that helps clients to create the change they want to see by constructing solutions rather than dwelling on the problems that they may be experiencing. SFBT is therefore a talking therapy where solution-focused conversation helps to facilitate change for the client. It is an inherently collaborative model, representing a dramatic yet pragmatic paradigm shift from most other historic therapeutic approaches, reversing the traditional order of the therapist and the therapeutic process by recognizing the client as the expert on their life and that problems do not need to be analysed in order to create change.

SFBT doesn’t involve focus on symptomology during the therapy process and supports the premise that there is no ‘right’ or wrong ways to experience issues or situations (Nelson & Thomas, 2007), because each client experiences the issue in their own unique way, hence it is the client’s own description and language that is important to the therapist.

Solution-focused therapists always work from a position of ‘not knowing’ and therefore solutions are facilitated and constructed by developing a detailed description of what the client’s life will be when either the problem no longer exists - the preferred future - or it is being coped with satisfactorily; noting and amplifying times when the client has had ‘instances of success’ - exceptions to the issue - when there has been either ‘less of’ or an absence of the problem. De Shazer observed that no problem was present in the same degree all of the time and therefore it was important to notice what was different at those times.

An important part of the SFBT process is a focus on identifying and amplifying strengths and resources that the client has already developed in life that might be useful in creating solutions.

Ratner, George, and Iveson (2012) stated

‘SFBT is a method for talking to clients...change comes from two principle sources: from encouraging people to describe their preferred future – what their lives will be like should the therapy be successful – and from detailing the skills and resources they have already demonstrated – those instances of success in the present and the past. From these descriptions, clients are able to make adjustments to what they do in their lives.’

While SFBT may appear to be minimalist in it’s approach and practice, to do it well requires great concentration and discipline by the therapist in order to keep the process simple, staying on the surface with a ‘not knowing’ stance, while listening to the language of the client, reflecting it in the strategic questions used in the solution-building conversation. Other SFBT tools include the ‘miracle question’ and scaling questions, again eliciting rich detail and description from the client about the present and future. SFBT is therefore disciplined, deliberate and requires careful attention to language, while adhering to the practical tenets - or principles -  established by De Shazer and the team at the MRI.

Tenets of SFBT

 De Shazer (1985) developed a number of tenets concerning the practice of SFBT:

• The client is the expert: The client is the expert on their life; they define the goals of the therapy and the therapist then works in collaboration, from the ‘same side of the net’ as the client, helping to facilitate and co-construct the finding of solutions.

• Looking for exceptions: Problems always have exceptions – a time, or times, when the problem could have happened but somehow didn’t occur to the same degree. Looking for those times when the problem did not arise provides clues to what client was doing differently.

• If it’s not broken, don’t fix it:  Theories, models and philosophies of intervention are not important or useful if the client has already found their solutions the problem. The therapist is not to judge what the client finds positive or helpful as a solution or part of a solution.

• If something works, do more of it: If a client has found something helpful, we notice and amplify it.
  

• If something doesn’t work, do something else: Repeating the same thoughts, behaviours or actions is unlikely to create the change the client wants to see. As Einstein stated: “We can’t solve problems by using the same kind of thinking we used when we created them”

• The solution is not always directly related to the problem. Previous to the development of SFBT, historic therapy models tended to assume that solutions would relate to the problems and therefore analysing the problems in great detail would somehow assist the client. De Shazer and the team at the MRI observed that a client’s solutions can be unique to their situation and not always connected, hence the client is regarded as the expert on their life – the therapist is not able to advise. The client simply does not yet know the solution; it is the role of the therapist to elicit detail, strengths and resources that will help facilitate their finding of these solutions.

Evolution of SFBT

Steve de Shazer, Insoo Kim Berg and their team at the Brief Family Therapy Center in Milwaukee originally developed the SFBT model during the early 1980’s (de Shazer, Berg, Derks, Nunally, La Court Lipchik). A private training and therapy institute, BFTC were interested in discovering and distilling ‘what works’ for clients in therapy; their aim was to establish a way of talking with clients where the therapeutic process to facilitate change is kept as efficient and effective as possible. It has since become one of the most widely taught and utilised therapy approaches in the world. Brief therapy represents a cost-effective combination of efficiency making it ideal for under-funded social services, mental health, education, counselling and medical settings.

 The development of SFBT took inspiration from a number of sources including:

• Systemic family therapy
  

• The work at the Mental Research Institute (Palo Alto) on developing brief therapy and changing behavioural patterns

• Milton Erikson and his views on the client, language and encouraging future-focus
  

• The philosophical ideas of Ludwig Wittgenstein on how people construct realities and new realities through language

 As popularity and recognition of the SFBT approach has increased, SF training programs have emerged and developed around the globe, with some evolving their own versions of the original approach. While the central tenets and tools remain the same, some evolution of the process continues, however adaptation and creativity are very much consistent with the approach of the original developers at the MRI, and would likely be encouraged by them as practitioners further distil and develop a pragmatic, effective and efficient therapeutic process which continues to keep the client, their preferred future, their resources and best hopes at the core of the intervention.

Is Solution-Focused Brief Therapy Evidence-Based? An Update 10 Years Later (Kim, Smock Jordan, Franklin, Froerer, 2019)

Elaine Way, Therapist - www.solutionfocusedstudio.com