What is Solution Focused Brief Therapy?
Solution Focused Brief Therapy (SFBT, solution focused therapy, brief therapy) is a type of talking therapy. As the name suggests, it is about focusing on solutions rather than problems and is a brief and contained kind of therapy.
Its key underlying principle is to focus on the outcomes you want to achieve for your future by attending therapy, rather than just on the issues that have caused you to seek help. An issue can be anything from relationship troubles, childhood abuse or bullying at school.
So How Does a Solutions Focused Brief Therapy Session Work?
While many therapists and counsellors spend the majority of sessions discussing and analysing past problems, SFBT is present and future focussed, and looks to find solutions that will help to bring you relief from distress. Not that Solution Focused Brief Therapy completely ignores past events.
While the main focus of SFBT is to have a client create their preferred future, SFBT uses conversations about the past to help you identify previous successes in your life. You SFBT therapist will explore these previously proven resources and strengths with you, helping you see the many positive choices and successes you are capable of and the resources you actually already have available to address your current issues with.
You will then be helped to identify any problems you see as preventing you from attaining your desired future. And you will be guided to look at times in your life when things matched more closely to your desired future and problems and difficulties were less intense, a process that offers you a more balanced life perspective.
Your therapist then works to help you recreate past successes in the present and to gain confidence that you are capable of managing your problems. The powerful thing here is that recognising and repeating formerly successful solutions and behaviours is easier than learning something completely new, and takes far less effort to put into place, too. You can quickly attain small successes that lead to more hope, more confidence about the future, and a desire to quickly achieve even more. Ideally all this causes change to happen quickly for you too, hence the ‘brief’ aspect of Solution Focused Brief Therapy.
The Basic Philosophy of Solution Focused Brief Therapy
Change is inevitable. Problems do not happen all the time.
Small steps can lead to big changes.
As the client, you are the expert and define your own goals.
We all have the resources and strengths to solve problems.
Focus on the future, not the past.
Emphasise what is possible and changeable.
Change can be accomplished with short term and brief therapy.
Key Aspects & Techniques of Brief Therapy
These are the chief tenets of SFBT:
1. The Therapeutic Alliance.
As with most therapies, the relationship between the therapist and the client is is seen as being of key importance. Qualities like empathic listening, genuine regard, and warmth are ingredients a therapist should bring to each session. By developing a strong and successful therapeutic alliance (the relationship between the therapist and you as the client) you can develop a mutual understanding and decide together how you’ll reach the goals you’ve chosen for your time in therapy.
2. Problem Free Talk.
‘Problem free talk’ is when a client spends time talking about aspects of their lives which are not problematic, creating an opportunity to discuss the more positive aspects of your life instead of simply focussing on what you see as your main issue. We are all more than just the problems we talk about, and by being seen holistically, as a balance of positives and negatives, we are more likely to feel valued and focused on change.
3. Unique Way of Cooperating.
This phrase describes the way in which clients resist their therapist, such as by not talking. Instead of putting you at fault, such as labelling you uncooperative, it is seen as the job of the SFBT therapist to understand and adapt to a client’s behaviour. They must realize that perhaps you are having difficulty in articulating your needs or feelings, or that you have learned your behaviour from previous negative experiences.
4. Identifying strengths, resources and skills.
The job of the therapist during SFBT is to identify a client’s existing resources (skills & strengths). By getting you to focus on more positives times in your life, your hidden strengths and coping resources may then begin to emerge and can be used to successfully target your specific problems.
5. Goal Setting.
By focusing on the future and the goals a client would like to achieve the therapist can create an appetite for change and break the idea that things must always stay the same. For example, with depression it can often feel as though things will never change and hopelessness can ensue. Visualising a future without the problem can be a powerful motivator. Of course goals must be within a SMART framework (Specific, Measurable, Achievable, Realistic and Timely) so that they continues to promote success rather than instigate feelings of failure.
What is MECSTAT?
One way of understanding the clinical practice of Solution Focused Brief Therapy is through the acronym MECSTAT, which stands for Miracle questions, Exception questions, Coping questions, Scaling questions, Time-out, Accolades and Task. These are all techniques your SFBT therapist might use to instigate positive change.
Miracle Questions: These questions are a technique for getting individuals to visualise a very near future without the problem they are facing, helping them see that change is possible. An example of a miracle question would be:
- “Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, what would be some of the things you would notice that would tell you life had suddenly gotten better?”
Exception Questions: A ‘previous solution’ is something that you have tried that has worked, but that you later discontinued. An ‘exception’ is when a problem could occur, but does not. Something happens instead of the problem and this alternate happening is often spontaneous and without conscious intent. If you can’t find a ‘previous solution’ for something, your therapist can use ‘exception questions’ to help you identify an exception. Examples of exception questions are:
- Has anything been better since the last appointment? What’s changed? What’s better?
- Can you think of a time in the past (month/year/ever) that you did not have this problem?
- What would have to happen for that to occur more often?
- When doesn’t the problem happen?
Coping Questions: These questions are powerful reminders that we all keep going in spite of the adversity we face. Even in the midst of despair or a crisis, many of us manage to achieve the basic activities of living such as getting dressed, eating, going to work, taking care of children etc. These questions help to highlight the resources you have to address a problem and can be a powerful and uplifting tool. Examples of coping questions are:
- How did you manage to get up this morning (make it to this appointment, get through yesterday, etc.)?
- How do you keep going day after day when there seems to be no hope?
Scaling Questions: These questions can be used in helping a client to assess their own situations, track their own progress, or evaluate how others might rate them on a scale of 0 to 10. They can be used in relation to a number of issues and can help you track your progress.
Examples of scaling questions are:
- On a scale of 0 to 10, with 10 meaning you have every confidence that this problem can be solved, and 0 meaning no confidence at all, where would you put yourself today?
- When it is, say, 8, what would you be doing that you are not doing now?
Time-Out: A SFBT therapist traditionally takes a brief break during the second half of each therapy session during which they reflect on what has occurred in the session. Following that, the individual is complimented (see below) and offered a therapeutic ‘message’. This is usually an idea for a practical experiment which can help you in achieving your identified goal.
Accolades: Compliments are another key aspect of Brief Therapy. Validating what clients are already doing well, and acknowledging how difficult their problems are, encourages change while giving you the message that your therapist has been listening (i.e., understands) and, more importantly, that they care.
Task: Once SBFT therapists have created a positive atmosphere via compliments and have discovered previous solutions and exceptions to your problem, they can gently invite you to do more of what has previously worked, or to try changes they would like to try – frequently called “an experiment” or “task”.
The History of Solutions Focused Therapy
SFBT originally developed out of a family of approaches known as system therapies, and was the result of work undertaken by psychologists Steve De Shazer and Kim Berg at the Brief Family Therapy Centre in Milwaukee, USA. A husband and wife partnership, De Shazer and Berg were interested in how problems in communication could be resolved effectively but also briefly during therapy. By spending hundred of hours observing therapy sessions they began to accumulate the successive behaviours, questions and emotions of therapists into a framework for therapy.
Out of this work came the key underlying principle of SFBT – to focus on solution building rather than problem resolution. From these early beginnings, Solutions Focused Brief Therapy has become one of the leading schools of short-term therapy, and its application can be felt across a range of fields including business, child welfare, education and criminal justice services.
Success rates of SFBT
SFBT has branched out into a number of different areas and fields. Research reports that SFBT accomplished 70% or better success rates for a wide range of problems including parent-child conflict, depression, suicidal thoughts, sleep problems, eating disorders, marital/relationship difficulties, sexual problems, sexual abuse, family violence, and self-esteem problems.
Most notably, the field of Addiction Counselling has taken up SFBT as one of the most cost-effective means to treat problem drinking.
Self Help/More Reading
Berg, I.K. & Dolan, Y. (2001). Tales of Solution: A Collection of ope Inspiring Stories. New York: W.W. Norton.
Berg, I. K., & de Shazer, S. (1993). “Making numbers talk: Language in therapy”. In S. Friedman (Ed.), The New Language of Change: Constructive Collaboration in Psychotherapy. New York: Guilford.
De Jong, P., & Berg, I.K.(2007). Interviewing for Solutions (3rd Edition). Brooks/Cole: Pacific Grove.
De Shazer, S. & Dolan, Y. with Korman, H ,Trepper, T. S., McCollom, E., Berg, I. K. (2007). More Than Miracles: The State of the Art of Solution-focused Brief Therapy. Binghamtom, N.Y: Haworth Press.
Rogers, C. R. (1942) Counselling and Psychotherapy. New York: Houghton Mifflin Co.
Sharry.J, Madden.B, Darmody.M. (2001). Becoming a Solution Detective. A Strengths Based Guide to Brief Therapy. BT Press. London.
If you are interested in exploring SFBT with a therapist or interested in how it can make a different to the problems you face, please call Harley Therapy: Psychotherapy and Counselling on 0845 474 1724. Our therapists and counsellors have extensive training in SFBT and are happy to offer their help.