Solution Focused Therapy

Solution Focused Therapy also known as Solution-Focused Brief Therapy or SFBT, was developed in the late 1970s and clinical social worker Steve de Shazer, along with his wife, Insoo Kim Berg, are credited with developing this therapy.

Solution Focused Therapy is an alternative to long-term insight-based therapies that focus on the source of the problem rather than the solutions that would help the client move forward. Its concentration on the future was radically different for the time and, along with cognitive-behavioral therapy, set the stage for a new generation of therapies.

What is the main concept of Solution Focused Therapy?

Solution-focused brief therapy aims to build tools within the individual to counter present and future difficulties. It is a collaborative treatment, with the therapist primarily assisting in two ways: 1) helping the client recognize and develop the strengths they already possess and 2) managing these inner resources to successfully cope with problems and reach future goals. 

Solution Focused Therapy is designed to work quickly, usually within eight sessions. Although it can be used as a stand-alone therapy, it is commonly used as an adjunct treatment. The ultimate goal of Solution Focused Therapy is to empower the client to use their skills most effectively and achieve the life they deserve.

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Essential concepts of Solution Focused Therapy

The following concepts are hallmarks of Solution Focused Therapy:

• Emphasizes the client’s future goals: One of the main objectives of Solution Focused Therapy  is to identify what the client desires for their future and to help them develop solutions to make their goals a reality. This future focus is very different from psychodynamic therapy, which focuses more on the past, and cognitive-behavioral therapy, which concentrates primarily on the present.

• Focused on solution-building more than problem-solving: Most therapies ask you about your presenting problems and attempt to solve them. Solution Focused Therapy is more concerned with finding solutions that a person can use for any problems that will come along. As such, not all solutions are necessarily linked to a specific difficulty. This is not to say that present troubles will be ignored, but adaptive solutions are valued more than solving a particular problem.

• Clients already possess the necessary tools: Another departure between Solution Focused Therapy and other therapies is the belief that the individual already has the skills to develop solutions to meet their goals. In fact, it is likely the client has already used them in the past; they just may not realize it. It is the job of the therapist to help the client recognize these tools and refine them for future use. Undesirable thoughts and behaviors—that have led to negative consequences—are discarded and the client’s strengths are highlighted as tools that lead to more desirable outcomes.

• Let the good times roll: In most therapies, the client talks about times in their life that were particularly difficult. In Solution Focused Therapy, the therapist encourages the client to discuss parts of their life that went well. The theory is that if the person can continue to do what they were doing during the good times, it will lead to a more advantageous situation. In other words, if it ain’t broke, don’t fix it.

• Small changes are big changes: In Solution Focused Therapy, any positive change is a big deal. This is because the therapy wants to emphasize whatever the person is doing that is effective. As a result, the therapist will reinforce the client for any behavior that leads to a positive (or non-negative) outcome. It is believed that small changes will build upon each other and lead to long-term productive solutions.

Techniques of Solution Focused Therapy

These four techniques are commonly used in Solution Focused Therapy :

• The miracle question: You may have used this technique in therapy and not realized it came from Solution Focused Therapy. The miracle question asks the client to envision their life if their troubles went away. It has several variations but the basic question is something like this: “If a miracle occurred while you were asleep tonight, what differences would you notice in your life tomorrow?” Follow-up questions often include: “How would the miracle affect your life? How can you achieve that outcome? Is there anything you can do right now to start to get there?”. The miracle question helps the client recognize their goals and the steps they need to undertake to achieve them.

• Scaling: Scaling asks the client to assess an aspect of their life or their progress towards their goals on a scale from 1-10. For example, the therapist might ask, “On a scale from 1-10, how much would your life improve if the miracle occurred?” Or, “On a scale of 1-10, how would you rate your progress in finding a solution to your problem?”. Not only does scaling measure progress, it makes clear that the client’s evaluation is more important than the therapist’s.

• Coping questions: Coping questions help clients, especially those who may feel discouraged, recognize their strengths. An example of a coping question might be, “How have you managed, despite your troubles, to meet your responsibilities?” A coping question shows people that they already have the ability to deal with challenges and instills hope that they will be able to accomplish their goals.

• Exceptions: Exception questions ask clients to focus on times when something negative could have happened but didn’t. Undoubtedly, the client is going to have some good days and the therapist wants to explore what the client did that made them positive. For example, a therapist may say, “You told me about that fantastic day you had last week. What did you do that made that day so great?” Questions like this help the client stay focused on solutions and remind them that they have been able to behave in a way that resulted in positive outcomes.

Effectiveness of Solution Focused Therapy

Solution Focused Therapy was not designed to treat any specific psychological problem. Instead, it is best viewed as an overall treatment approach, similar to motivational interviewing.

That being said, it has considerable anecdotal and research evidence exhibiting its effectiveness:

• A treatment review of outcome studies established Solution Focused Therapy as an effective treatment for a variety of psychological and behavioral problems, including depression, criminal behavior, and marital difficulties.

• One study found that Solution Focused Therapy is an effective treatment for depression, anxiety, and other internalizing disorders.

• A 2019 meta-analysis exhibited the flexibility of Solution Focused Therapy. Its effectiveness was demonstrated for a diversity of psychological issues, such as externalizing child behavior, addiction, and family conflict. Additionally, the authors note the large amount of research that has been conducted outside the United States. Not only is Solution Focused Therapy a successful treatment for a broad swath of problems, but it appears to be effective across many countries and cultures.

Unfortunately, It is not all good news. Solution Focused Therapy is not easily operationalized. As such, its measurement can be problematic, and clear conclusions cannot always be drawn. Plus, its research has not always possessed strong psychometric qualities even though it has shown improvement over the past 15 years. Due to these factors, it does not have the breadth of strong research support as some other treatments, and some may see its viability more as a complementary therapy.