Solution-Focused Brief Therapy
Overview
Solution-focused brief therapy (SFBT)1 focuses on finding solutions rather than solving problems. It helps clients consider resources and hopes for the future based on present issues instead of past events. It gets its name, in part, because it usually only involves three to five sessions.
This solution focused approach to therapy can be used on its own or as an adjunct to other treatments. Solution-focused brief therapy originated from an interest in the inconsistencies found in problem behavior from person to person and the idea that these inconsistencies may be critical to finding solutions.
The founders of solution-focused brief therapy, Steve de Shazer and Insoo Kim Berg, also wanted to ensure people could determine specific goals for treatment so that they would know when treatment was complete. SFBT proposes that a solution is not necessarily related to the problem and that the client is the expert. If a technique works for them and doesn’t cause harm to themselves or others, they should continue it. If the behavior does not serve them, SFBT helps them come to new conclusions.
Six techniques are core to the SBFT method and may be a part of therapy sessions, including the following:
- Specific goals
- The miracle question
- Scaling questions
- Searching for exceptions
- Compliments
- Homework
This type of solution focused therapy is not meant to help people dissect their childhoods or gain profound insights into their lives, thoughts, and behaviors. Still, it may be a helpful choice for those ready to move forward or tackle a specific question, decision, or challenge.
How it works
SFBT, or solution-focused brief therapy, is rooted in the idea that change is a continuous process, resisting it is futile, and people can change positively. SFBT assumes that problems change over time and that a person doesn’t need to know much about them to move forward. The therapist uses the client’s strengths and resources and may focus on small successes instead of failures.
When people notice the value of small changes, they may accept other changes and start believing in the snowball effect. Often, clients may already know the beginnings of the changes they need to make, and talking to a therapist can help them gain insight and figure out a path forward. SFBT believes that because people often know what is best for themselves, finding their own solutions may be more suitable and long-lasting.
Therapists using solution focused brief therapy might ask questions like, “How did you do that?” “How did you decide to do that? and “How did you manage that?” These questions can help clients understand that they acted, made a decision, and had successes in the past, encouraging them to do so again.
Solution-focused therapists may also ask miracle questions. A miracle question might look like, “You wake up in the morning, and a miracle has made everything in your life better. What has changed?” or, “A genie grants you three wishes. What would you ask for to make your life better?” The point of these questions is to get the person to imagine their own future from outside the problems they’re facing in the present.
Another technique is searching for exceptions. The therapist may ask questions like, “When does the problem not occur?” or, “What are you doing when the problem does not occur?” These questions can be used to highlight when the person is not experiencing problems and how any changes they have made may contribute.
What to expect
SFBT is a short process and may only last three to five sessions, each focusing on the solution and being about 45 minutes long. In the first solution focused therapy session, the therapist talks to the client to find out what they want to achieve. They may ask what areas of the person’s life would improve if they met their goal and what they may already be doing or have done in the past to get them closer to their goal.
The therapist may ask the person to use a scale of one to ten to identify where they are in the journey of meeting their goal, with one equaling the worst possible scenario and ten equaling the achievement of all their goals. This process is known as scaling. It is a framework that may help both the client and the therapist determine where they are and what the next step might be. Multiple scales may be necessary if the person has more than one goal or problem.
In subsequent sessions, the therapist may ask the individual if there have been any improvements. What was different? How did it happen? Who noticed? What resources and strengths helped make that change? How can they continue? If the situation worsens, the therapist may be interested in whether the person coped with the difficulties and took any steps to prevent the situation from deteriorating further.
Therapists also use praise as positive reinforcement, which may help people see what is working and what is not, and assign homework, which can reinforce what was discussed and encourage the person to continue to make positive changes.
In solution-focused brief therapy (SFBT), these positive psychology1 principles help emphasize clients' strengths and resources.
Who it benefits
SFBT (solution-focused brief) therapy can support individuals with multiple challenges, including post-traumatic stress disorder (PTSD)3 and personality disorders. It may also be applied to adolescents and children, groups, education, coaching, management, and mediation, as well as family therapy sessions.
Other research shows that SFBT may also be effective at helping people with the following improve their quality of life in various ways:
- Post-stroke aphasia
- Depression and perceived stress in cancer patients
- Cancer-related fatigue
- Anxiety
- Cardiovascular disease
- Substance use
- Depression
Note that SFBT is not an effective counseling treatment for major psychiatric conditions or physical health problems. Still, it may help people living with these conditions alleviate stress and work toward goals.
Goals for therapy
Every person creates their own goal(s) for SFBT, and the therapist participates to help them meet them. During the first session, therapists may aim to discover the person’s overall goal and where they are in the process of achieving it.
Therapists focus on the person’s strengths and resources to help them see their successes, no matter how small, and what they can do to keep moving in that direction. In SFBT, the goal is to get the person to understand that change is continuous and that resistance is not useful. Instead, talking about change can help bring about change. When people notice minor improvements, the therapist aims to help them figure out what they did differently to ensure those changes continue and grow.
Research
Some recent research indicates that SFBT may be a helpful tool in suicide intervention. In addition to being an effective way to treat depression, SFBT is adaptable and can be applied in both in-person and online treatment. These researchers reference past case studies showing that SFBT can be a strategic intervention for people experiencing suicidal thoughts, increasing hope and agency.
They also point out that SFBT via teletherapy has already been studied as an effective method for treating alcohol-related challenges in college students and individuals living with postpartum depression, and a 2020 study of anxiety in young adults found that their symptoms decreased whether they engaged in SFBT online or in person.
According to this research, one reason SFBT via teletherapy may be helpful when discussing suicide is because of the language it uses. These researchers theorize that this may be because SFBT intentionally focuses on the person’s language and goals and avoids assumptions about what clients might not want to share.
For those with thoughts of suicide, contact the 988 Suicide & Crisis Lifeline at 988. Please also see our Get Help Now page for more immediate resources.
Finding therapy
SFBT can be a positive fit for some people. However, talk to a qualified solution-focused therapist or other mental health professional to help you determine if it is right for you. While there is plenty of research to substantiate SFBT, it is not without its criticisms, and it may not be a fit for people experiencing more complex mental health challenges.
You can contact a therapy center that employs professionals who are familiar with this type of therapy to see if it fits, or you might consider online treatment. With an online platform like BetterHelp, you can fill out a form and get matched with a therapist qualified to help you. Whether SFBT is the right approach depends on your needs. SFBT may be a fit for some people; others may benefit from a more emotional and past-focused approach.