What is solution focused therapy used for?

Solution-focused therapy, also known as solution-based therapy or solution-focused brief therapy, entered mainstream psychotherapy practices in the 1970s and 1980s. What began as an aspect of systems therapies has morphed into its own counseling practice entirely, which has increasingly grown in popularity in modern times.

What is solution-focused brief counseling?

When we experience a life challenge, it can take a long time to pinpoint the cause of the problem and devise a solution. That’s where solution-focused brief therapy with a therapist or counseling center may help. When an individual or group of people attend SFBT sessions, the experience is usually brief. 

SFBT centers on the idea of honing in on solutions rather than problems. With previous solutions, a therapist may have spend many hours processing concerns with clients, managing trauma, and talking about the possible origins of the problem. After learning SFBT, the therapist tends to spend far less time talking about the problem to promote efficient, mentally healthy solutions to a client's life experiences and problems. This is the reason why solution-focused brief therapy may be effective for families who are experiencing a major trial in their relationships with one another. 

In 2011, Oxford University Press published a handbook called Solution-Based Therapy: Evidence Based Practice that both analyzes research and offers interventions on this psychiatric treatment. It includes meta analyses of treatment of the SFBT approach on various mental health conditions such as major depressive disorder and substance abuse disorders, as well as offering an illustrated guide of therapeutic approaches for the SFBT practitioner.  Additionally, according to Counseling Outcome Research and Evaluation, SFBT may also be effective in treating internalizing disorders in children. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

SF therapists have discovered over the years that clients can experience highs and lows with their problems and life events. They may go a year without the recurrence of a certain concern, but then they may deal with it for weeks on end. With SFBT, a therapist aims to help the client with tangible resolutions via a variety of questioning techniques. 

Principles of treatment

The effectiveness of solutions-focused treatment may rely on using several principles to generate solutions for clients: 

• Change will always happen; it's inevitable. Clients are asked to embrace change and want it
• Clients have the power to create their own goals and feel more confident
• Clients have their own strengths and skills to solve their problems
• Focusing on the past is not as relevant
• It's more short-term than other treatments

Benefits

With a solution-focused approach to counseling, one of the key concepts is that a client may quickly learn to move away from negative thinking patterns and feel empowered to find solutions to their problems by making behavioral changes. When the present problem arises, they may already know how to solve it from the first session.

It can help you set goals

You may likely have overall goals and objectives before sitting down during a session. However, your sessions may help you formulate specific goals for your main concern. For example, if you are finding that you can't speak your mind during staff meetings at your job, the therapist may ask you why you feel that way, using scaling and other techniques. Then, you can set goals to find a solution to the problem. These goals might include getting over your fear of speaking in public, being more assertive in getting your points across, and using tips on how to appear more confident in your job position.

You can focus on your strengths

While many people do not go to counseling to be told what they are good at, this type in particular often discusses the client’s strengths for change. SFBT is usually based on a complimentary system in which the therapist listens to the client and answers with indirect praises. These may include general-interest questions or indirect compliments, such as "How did you manage that?", in a friendly tone. The goal here is usually to help the client build confidence and remind them that even though they feel anxious about a particular problem, there are many positive things they can do and they have already overcome many other obstacles. This focus on their capacity to overcome problems in the past may help them tap into their natural problem-solving and solution building abilities 

It’s short-term and cost-effective

Because of its goal and future oriented nature, the therapeutic approach of SBT works often by jumping right in to focus on the here and now and how you can achieve your future hopes and goals. You are likely not going to spend sessions talking about your history and digging into old wounds and traumas, or past child behavioral problems if it is not necessary. Some people who seek mental health help need longer-term support to revisit old traumas. Solution-based treatment is not meant to discount the value in recovering from past events, but it is not necessary for everyone. Many people who benefit from this are going through a specific challenge or a major life transition, such as experience short-term relationship problems that don’t necessarily require long-term treatment. Individuals experiencing major psychiatric conditions that are chronic in nature may benefit form a more long-term focused therapy. 

Therapy techniques

Scaling methods

SFTB therapists often use scaling methods through scaling questions during sessions to ensure that the clients put value on their experiences, thoughts, and emotions. According to the International Journal of Brief Therapy and Family Science, therapists may analyze client’s answers and interactions between how they respond to different questions. Scaling tends to be a more logical approach to mental health, using numbers to quantify emotions and feelings attached to a client’s situation. Using numbers can help clients feel calmer during a session. They may be more prone to talk about what is bothering them, which can be a quicker approach to therapy. When therapists utilize scaling, they aim to help their clients identify and create feelings of control and confidence.

An individual experiencing stress or other related symptoms may think their concerns about obligations in everyday life are overwhelming, overshadowing their happiness with negativity and doubt. Scaling can help people recognize that their problems are something they can manage, either on their own or with help. They may feel more hopeful and confident that their current situation will pass. Hope-inspiring stories can also help alleviate such difficulty with many clients. Scaling exercises may lead to increased critical thinking, helping clients to look outside their point of view and see the big picture, thinking objectively about their own lives and situations.

During the first session, therapists often break down the steps of scaling to more manageable chunks of information. This can reduce the burden and overwhelming feelings associated with handling information overload.

During scaling, a therapist may ask a patient:

"On a scale of 1 to 10, how anxious do you feel about your upcoming presentation?"

"You said you are a 6 on the scale. What makes you not a 5 or a 7?"

These questions aim to identify a cause and how to help a client change. They give the client flexibility to make their own decisions when investigating solutions. Some people are more visual, so drawing a staircase or showing a photo with the numbers may help them visualize how they feel about the number. A therapist may use this as a constructive collaboration tool to gauge addiction severity or trauma symptoms at any give point in time. 

SFBT: coping and exception questions

In addition to scaling methods, therapists also tend to use coping and exception questions while helping clients learn SFBT. Examples of coping questions are:

• What motivates you during times of stress?
• How do you usually cope with this situation?
• How do you solve this problem?
• If someone else experienced this problem, what advice would you give them?

Exception questions also are sometimes used to highlight when a person does not experience the problem in question due to various changes:

• What has changed since our last session?
• When does the problem not occur?
• How do you feel when the problem does not occur?
• Are you doing anything differently when the problem doesn't occur?

Miracle question

This question format is designed to allow the client to create a detailed description of a future tailored to their life. The miracle question can be helpful when a client does not know what they want in the future. An SFBT therapist could say, "A genie grants you three wishes. What would you wish for that would make your life better?" 

Alternatively, they might state, "You fall into a deep sleep, and when you wake up the next morning, a miracle has made your life better. What has changed?" 

This goal directed miracle question allows the client to step outside the box and create their desired future—with freedom and a focused approach from the therapist. 

Using SFBT at a brief family counseling center

These methods can also be used for solution-based marital and brief family counseling. To create solutions for the entire family through a family process, a solution-focused therapist may remind the family of their previous successes but dwell more on finding solutions for the present and future. This may garner hope as the family gains resources and other tools needed to progress toward their joint goal.

Accepting that each family is different and that there is not a strict guideline on how a family should think and act can be a key element of marital and family therapy. For children with classroom behavioral problems, when SFBT practitioners act as if the child were the expert in their own life, then the child may be more receptive to therapy. Visual representations, including diagrams, coloring sheets, and worksheets, can also give children a clear way to understand the goals and objectives lined out in front of them. 

Trying online treatment

If you’re interested in trying solution-focused therapy but feel hesitant to go to a therapist’s office, you might try online therapy, which outcome research shows to be just as effective as in-person sessions. With an online service like BetterHelp, you can try solution-focused therapy from home or anywhere with an internet connection. You can connect with a therapist via phone or video chat at a time that works for you. Also, if you’re interested in solution-focused family therapy, this may be more convenient for your family if you have busy schedules.