Finding Short-Term Treatment: The Principles Of Solution-Focused Brief Therapy
Therapy is personal, and each person may go into it seeking unique results. For some, extensive therapy on a long-term basis can seem overwhelming, especially if they’re attending therapy to find solutions for a temporary problem. In these cases, solution-focused brief therapy (SFBT) may be beneficial. Understanding the basis of this modality can help you make an informed decision on whether it would benefit you.
What is solution-focused brief therapy?
Solution-focused brief therapy or solution-focused therapy (SFT) is a model developed by Steve de Shazer in 1940. According to the Institute for Solution-Focused Therapy, SFBT focuses on concrete and applicable solutions, and less on the causes of problems or the thoughts and feelings one has about those problems.
Who benefits from SFBT?
For people who aim to get to the point and focus on their present healing, SFBT can be an effective method. SFBT focuses on hope, motivation, and the development of goals. The therapist may guide the client by presenting them with unique assignments, worksheets, or activities where they can visualize their future, find motivation, and start taking daily steps toward future-focused solutions.
How long is solution-focused brief therapy?
SFBT strives for short-term care and quick results; however, it can still be self-paced, and your therapist can work with you to decide how many sessions may be necessary to work on the goals you discuss in your first session. Sessions themselves may last around 30 to 60 minutes. On average, a client may have around five sessions with their therapist. However, SFBT can take only one session or around eight if necessary.
If clients do not find SFBT effective after a few therapy sessions, their therapist may discuss other treatment options. SFBT may not be effective for everyone, and it often targets specific, solvable problems rather than long-term or severe mental illness.
What does an SFBT session look like?
At your first session with a solution-focused therapist, you may be asked several questions about your goals and start developing a treatment plan with specific steps to achieve these goals. Instead of focusing on why the problem has occurred or what you’re thinking and feeling, your therapist may ask you to develop ideas for a solution. They can use interview-style questions to prompt answers for you and start coming up with a list of solutions.
Solution-focused therapy often takes only a few sessions, and you may dedicate your first session to taking a few steps toward these solutions. Your therapist may offer you homework to complete by the next session and can then ask motivational questions about what you did well and what you hope to improve on.
What is the format of a solution-focused brief therapy session?
If clients struggle to see positivity in their future, the therapist may guide them to look at times they succeeded in their past and how they might apply those skills to the present.
For example, if someone living with depression has previously responded well to case management services, the SFBT therapist may recommend signing up for case management again in the short term. The client can then start to focus more on taking steps in the areas they can control in their life. The format of SFBT may look like the following:
- Setting goals with a therapist
- Finding quick solutions to these goals or problems
- Taking steps toward the solutions, one at a time
- Utilizing motivational interviewing techniques
- Achieving a resolution
Techniques of solution-focused brief therapy
SFBT therapists use several techniques to help clients come to quick conclusions, including the following.
Coping questions in SFBT
Coping questions are questions about the client’s current and past coping mechanisms. SFBT runs on the principle that many people already know how to cope but may struggle to find the motivation. An SFBT therapist may ask questions like:
- What have you done in the past that worked?
- How do you manage your daily life?
- How have you found success?
- How do you prevent your situation from being worse than it is?
- What makes you feel resilient?
These questions can help the therapist develop coping ideas for the client and prompt them to consider the resilience and personal strength they may already have.
Scaling questions
Practitioners use scaling questions to understand the client’s situation and develop ways to prevent missteps or a lack of treatment progress. Below are a few types of scaling questions:
- On a scale of one through ten, what is your depression level?
- On a scale of one through ten, how anxious are you feeling right now?
- On a scale of one through ten, how solvable do you believe your problem is?
- On a scale of one through ten, how motivated are you to succeed?
These questions may prompt the therapist to understand the client’s current mindset and what might hold them back from moving toward solutions.
The “miracle” question in SFBT
The “Miracle” Question is a concept unique to SFBT. This question asks the client to consider a miracle that would solve their problem and provide a solution for the long term. The question is as follows: “If a miracle occurred while you were sleeping, and you didn’t know it occurred, how would you figure out that it had solved your problem when you woke up? How would you react to the problem being solved?”
How the client responds to this question may offer insight into the behaviors and thoughts they could experience if their problem were no longer a reality. For example, if their problem is a conflict with their partner, a miracle might mean they no longer feel in conflict with this person. Instead, they might communicate openly, respect each other, and trust each other’s judgment.
This miracle question leads the client to the steps they might take to solve the problem by acting as if it is already solved.
Consultation around mental health goals
After discussing goals and solutions, the therapist may set aside a portion of the session to consult with the client about the goals and solutions developed during the first half of the session. They can ask the client whether they have further insight or concerns and ensure\ the therapeutic process is helping. The therapist may recommend a different approach if the client feels uncomfortable with SFBT.
What does SFBT treat?
SFBT can be used to treat several conditions, challenges, and concerns. Some people attend SFBT sessions to consider one decision or problem in their life. Others might attend this therapeutic format for advice on coping with a mental illness. A few of the challenges that such sessions commonly address include the following:
- Anxiety and depression
- Low self-esteem
- Substance use disorders
- Chronic stress
- Relationship stress or marital challenges
- Significant life changes, such as moving
- Decision-making
- Child behavioral problems
You do not have to have a diagnosed mental health condition to see an SFBT therapist. SFBT can also be utilized through a solution-focused brief family therapy center or help clients manage trauma.
Benefits of solutions-focused brief therapy
There are a couple of benefits to SFBT that may be advantageous, with the treatment duration being one. If you’re uncomfortable with long-term treatment or have a challenge you feel would be best addressed with quick solutions, SFBT may benefit you.
Traditional therapy often takes up to 20 sessions or more. If you’re busy, don’t have a severe mental illness, or want to make a change immediately, SFBT can allow you to progress in fewer sessions instead of diving more profoundly into the past or the reasons you feel like you do.
Although you decide how to tackle your symptoms and challenges, a solution-focused approach is therapist-led. The therapist can guide you through their questions, offer their expertise in problem-solving, and help you unlock your motivation through motivational interviewing.
Your therapist may not tell you exactly how to set goals or where to go next, but they can tell you what has worked for others and what research says about these challenges to help you make the most informed decision possible.
Who shouldn’t seek therapy through SFBT?
SFBT is not recommended for those with severe mental illness, such as bipolar disorder, schizophrenia, borderline personality disorder (BPD), narcissistic personality disorder (NPD), antisocial personality disorder (ASPD), or long-term treatment-resistant depression.
As these conditions are often associated with long-term and severe symptoms, they may be best addressed by long-term psychotherapy or modalities specific to their psychiatric treatment.
Counseling options for SFBT
Finding a trained solution-focused brief therapist may be difficult if you live in a rural area or somewhere where many therapists don’t take your insurance. In these cases, you may be able to find an SFBT therapist online through a platform like BetterHelp.
Online therapy platforms offer an efficient sign-up process where clients can request specific modalities, specialties, or goals for treatment. During this process, you can indicate that you’re looking specifically for online SFBT. In addition, online therapy allows you to change therapists at any time or cancel therapy if you no longer find it necessary for your concerns.
What the research says about online therapy and mental health
Studies also back up the effectiveness of internet-based therapy. One study found that a web-based SFBT chat therapy treatment for depression was significantly more effective than a waiting list, with reduced depression symptoms. In addition, the results were more significant at follow-up than during the treatment.
Takeaway
Solution-focused brief therapy is a technique used to help clients problem-solve and devise goals that can help them quickly achieve results in their life challenges. This therapeutic modality may be most effective for short-term concerns like stress, a major life transition, or relationship challenges. It can also be effective in treating substance use disorders. If you’re ready to find an SFBT therapist, consider contacting BetterHelp for professional support.
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