8/21/2020 (PDF) Solution Focused Brief Therapy

SOLUTION-FOCUSED BRIEF THERAPY

Abstract

In understanding and assisting clients, psychologists will often use an eclectic approach, and

draw upon various theories of psychotherapy to guide them in the therapeutic process of

developing solutions. Of the many theories, and approaches to psychotherapy, this research

will focus on the theoretical model of Solution-Focused Brief Therapy (SFBT) - a postmode

humanistic systems approach, which is future-focused, and goal-oriented. This model associ

assumptions, and strategic techniques with the clinical process from a non-pathological view

and maintains a directed narrow focus of inquiry, and optimism based on a here-and-now

perspective. SFBT places great value on building solutions, rather than solving problems, it

collaborative talk-therapy that typically takes place over a short period of time. As part of an

evaluative study to subjectively determine the validity, cogency, effectiveness, and logic of th

assumptions, and methodologies employed by SFBT, this researcher will explore its history,

application, strengths, and weaknesses.

Keywords: solution-focused brief therapy, psychotherapy, therapeutic process, huma

systems approach, eclectic psychology, collaboration, evidence-based intervention, compete

resilience, goal-oriented, constructionism.

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 1/16
8/21/2020 (PDF) Solution Focused Brief Therapy

SOLUTION-FOCUSED BRIEF THERAPY

SFBT: A Miracle From a Minimalist Perspective

From the minimalist perspective of Solution-Focused Brief Therapy (SFBT) there ar

problems – only solutions. As the name suggests SFBT is a future-focused, goal-oriented ty

talk therapy that typically involves only three to five sessions. Unlike traditional therapy, SFB

emphasizes the assumption that people have the capacity to make rational choices, and cons

solutions that will enhance their lives. Unlike traditional therapy SFBT eschews the past,

advocating a non-pathological perspective, assuming that the client possess internal strength

and resources, that foster competency and resilience.

A foundational premise of SFBT is that the individual constructs his/her reality on th

basis of their subjective worldview. A client’s experience is viewed as a product of one’s ow

mental processes rather than representing that, which actually exists (Durrant, 1995; Lee &

Greene, 1999). Within this subjective framework there is no objective reality of right or wro

outside of the client’s independent interpretation or ability to make sense of the matter. SFBT

collaboratively engages clients in conversations, and progressive narratives to deconstruct

problems and manifest solutions (Corey, 2013); cognition is only essential to the extent it

generates the narrative and promotes action – in SFBT language creates the reality.

SFBT’s philosophy of social constructionism seeks the shortest, fastest, and most

parsimonious route to finding “the solution” - promoting supposed simplicity and minimal
https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 2/16
8/21/2020 (PDF) Solution Focused Brief Therapy

intervention. Steve de Shazer, the developer of SFBT states: “Never introduce complexity w

simplicity will do” (Thomas, 2007, p 8). While simplicity of life is an idealistic, desired qua

or condition of life, the fact is – life is complicated – of course it always looks simple when y

exclude the details. Those who suffer trauma, loss or grief continue to live in that complicate

state of existence - some from the perspective of victim, others as survivors.

SOLUTION-FOCUSED BRIEF THERAPY

In any therapeutic relationship, the goal must be to transport the client from victim, t

survivor, and from survivor to thriving. The validity, cogency, effectiveness, and logic of an

therapeutic model, and its assumptions, and methodologies are only proven if, and only if, th

therapeutic process succeeds in rendering hope. “Hope is like a journey: a destination, a ma

and a means of transport are needed” (Bannick, 2008, p 219). Without a destination, hope

flounders for lack of purpose; without a map, there is no clarity of which route to follow; wit

a means of transport there is no journey. If SFBT can facilitate, in a simplistic manner, a

destination, map and means of transport for the hopeless victim - then that would be a mirac

History of Theory

SFBT is a relatively new form of therapy, which was developed as an adjunct to othe

treatments in the early 1980’s by Steve de Shazer, his wife Insoo Kim Berg, and colleagues a

the Brief Family Therapy Center in Milwaukee, USA (de Shazer & Berg, 1997). It was an

experimental, research-oriented interest, which originated from a desire to identify the

inconsistencies found in problem behavior, and a driving obsession with “What works?” (de
https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 3/16
8/21/2020 (PDF) Solution Focused Brief Therapy

Shazer, 1997). Discontent with the impediments of strategic models, de Shazer (1997) and t

set out to discover “what differences made a difference” (p. 121). According to de Shazer

(1997), they were uninterested in proving anything to academia, much less subjecting thems

to the scrutiny, and measures of standard assessments evaluating the effectiveness of SFBT.

In developing SFBT the early emphasis was on exploring exceptions to the problems

which clients would present. As the practice of SFBT developed, the interest in the problem

replaced by an interest in what actions might achieve the solution. A basic assumption was t

the problem itself might not be relevant to finding effective solutions. This further led to the

optimistic assumption that all clients are healthy, motivated and competent to construct solut

SOLUTION-FOCUSED BRIEF THERAPY

that will enhance their lives. The issue of motivation prompted the construct of a classificat

system similar to motivational interviewing (Miller & Rollnick, 1991). Depending on the

client’s attitude toward the problem one would be classified as 1) a customer, 2) complainan

3) a visitor. This emphasis of the client’s attitude eventually became superfluous to the thera

process, and was replaced with the philosophy that all that was needed of a client was a desi

change (Iveson, 2002). Irrespective of the problem, SFBT reportedly become an effective

intervention across a diverse range of presentations.

As SFBT continued to develop, and became more accepted by academia, de Shazer

(1997) described his obsession with “what works,” with his surprising discovery that “diagn

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 4/16
8/21/2020 (PDF) Solution Focused Brief Therapy
does little to predict outcome” (p122). This was in fact, what led him to the “radical distinct
between “problems” and “solutions” (de Shazer, 1997). Interestingly, contrary to the

overwhelming acceptance of SFBT, de Shazer modestly admitted that “SFBT is not a panace

and is not the answer to all the many and varied ills to which human beings are subject” (p12

As the research process of SFBT continued, much was discarded as the minimalist approach

evolved into its characteristic form, featuring: 1) the Miracle Question, 2) the Scaling Questi

3) the Intermission, and 4) the Homework Experiment (Cotton, 2010).

Since its origins, researchers have conducted studies in various settings and location

review the reported benefits of SFBT. Gingerich and Eisengrat (2000) offered preliminary

reports to support the claims that SFBT could be beneficial to clients; however, a microanaly

research of the process is still needed to develop a deeper understanding to determine to wh

extent clients change. However, due to the compelling favor of cost-effective therapy, SFBT

gained significant popularity with policy-makers, and practitioners. In less than two decade

SFBT became the most widely used, unconventional therapeutic approach in the United Stat

SOLUTION-FOCUSED BRIEF THERAPY

and abroad (Gingerich & Eisengart, 2000).

Types of Problems Wherein Theory is Most Useful

Consequently, SFBT became a brief therapy model, and a major influence in addictio

counseling, business, child welfare, criminal justice services, education, pastoral counseling

residential treatments for adolescents and adults, as well as being implemented in social poli

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 5/16
8/21/2020 (PDF) Solution Focused Brief Therapy

SFBT became widely used in outpatient facilities, family mental health centers, school
counseling services, social services, and residential treatment centers (Miller, Hubble, & Du

1996).

SFBT stresses the importance of constructing solutions, and helping clients to “imag

themselves without problems; in this respect SFBT may be considered useful. SFBT assists

clients in creating goals that are positively stated, action oriented, and structured in the here-

now (Murphy, 2008). SFBT assists clients to tap into their strengths and resources (Corey,

2013), shifting their frame of reference from that of observer to that of participator. SFBT h

even been used as an approach in the treatment of sexual dysfunction, which is a paradigm s

from the problem-focused, label-dependent, and pathology-based therapies typically parallel

with sexual concerns (Trepper, 2012).

SFBT has been evaluated for efficacy in improving attitudes and behaviors of high-ri

anti-social populations, improving parenting skills, and the psychosocial adjustment of

Orthopedic patients to determine their re-entry status to the work force (Cockburn, Thomas

Cockburn, 1997). Data clearly demonstrated when SFBT was combined with standard

rehabilitation care, re-entry rates increased. Zimmerman, Jacobsen, MacIntyre, and Watson

(1996) utilized SFBT to evaluate parenting skills particularly related to difficult adolescent

behavior, demonstrating SFBT as most useful in generating a positive effect in less time than

SOLUTION-FOCUSED BRIEF THERAPY

traditional forms of therapy. Sundstrom (1993), wherein she compared SFBT to Interperson
https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 6/16
8/21/2020 (PDF) Solution Focused Brief Therapy

Psychotherapy (IPT) in treatment of depressed college students conducted one of the first

randomized studies of SFBT. Comparatively, Sundstrom was not able to demonstrate that SF

provided any significant difference for treatment of depression; however, this study is often

in support of SFBT’s success (Gruninger & Eisengart, 2000).

A limited scope of studies indicated SFBT might be useful in reducing problem drink

(Polk, 1996), and violent recidivism in adolescents (Seagram, 1997). Additionally, SFBT ha

been reported to increase marital contentment (Zimmerman, Prest, & Wetzel, 1997), and

improve coping skills, and increase self-esteem in children (LaFountain & Garner, 1996).

Triantafilou (1997) demonstrated that SFBT reduces behavior disorder symptoms in children

while Littrell, Malia, & Vanderwood (1995) demonstrated SFBT was helpful in assisting hig

school students to improve mood and meet goals. Daki & Savage (2010) demonstrated SFB

be efficacious as an intervention in addressing academic, motivational, and socio-emotional

needs of children with reading difficulties. Another study that evaluated, and supported the

effectiveness of SFBT within a classroom setting was conducted by Franklin, Moore, & Hop

(2008), confirming that SFBT is useful in an educational setting.

Early SFBT research reported promising results (de Shazer & Berg, 1997), as did

subsequent studies reported by De Jong & Hopwood (1996). Over the course of time, many

anecdotal reports have surfaced from therapists and clients alike, but SFBT has not been sub

to extensive empirical testing until recently. Future methodological studies would be most

helpful in strengthening the evidence of the efficacy of SFBT across a wide range of problem

What is needed is an objective, empirical approach that will provide evidence that SFBT is i

fact demonstrably helpful as a means of intervention. To date, with its widespread use, and

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 7/16
8/21/2020 (PDF) Solution Focused Brief Therapy

SOLUTION-FOCUSED BRIEF THERAPY

anecdotal reports of success, more studies are needed to provide an adequate basis of

demonstrable evidence (Gingerich & Eisengart, 2000), particularly in non-Western culturally

sensitive models, in which SFBT and other models are rarely seen (Hsu & Wang, 2011).

Strengths of Theory

SFBT was introduced during a time when managed care and budgetary restrictions w

of concern to the field of psychotherapy. Restrictions to curtail escalating health care expen

demanded that treatment and services be cost-effective (Thomas, 2007). Traditional therapy

to be modified to meet the ever-demanding restrictions of managed care. SFBT had an obvi

advantage over traditional therapies due to its brief approach, and was quickly applauded an

launched as the model theory of choice. In many ways the brevity of SFBT could be conside

a primary strength due to its cost-effectiveness.

Of primary relevance, when considering the strengths of SFBT, one should not disco

its dynamic nature. Since its inception this model has been far from static, it has lent itself to

various settings, and modifications; it is flexible and has proven adaptable in both scope and

function across numerous domains. Whether applied to groups or individual therapy, its

approach is easily integrated with other methods such as cognitive-behavioral and psycho-

educational programs (Corey, 2013).

Prided for its simplicity and minimal stance on intervention, SFBT is an attractive m

with numerous potential applications, particularly for health service providers (Thomas, 200

Its claim to fame is its brevity, and its ability to find the shortest route to facilitate change, cr

optimism, and positive expectations for the client. A significant strength, which correlates w

t ti i th i kd l t fh
https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy
h k li t t ti SFBT i8/16
8/21/2020 (PDF) Solution Focused Brief Therapy
expectations, is the quick development of hope - hope sparks client expectations. SFBT is a
approach that takes full advantage of utilizing hope and expectancy (Reiter, 2010). In additi

SOLUTION-FOCUSED BRIEF THERAPY

due to its brevity, and cost-effectiveness, SFBT becomes more readily available to clients wh

cannot afford long-term counseling, thus extending hope to an even greater demographic.

A final consideration, which may be viewed as a strength is the pragmatic way that S

is usually taught. Wellman (2009) reports of a study conducted in a community mental healt

care facility, wherein it was established that sixty-six voluntary staff members, who received

SFBT training, self-reported effective application and tested with sufficient knowledge, and

acquisition after receiving a modest 2-day training. SFBT training is fairly structured, short

whole-heartedly solution focused - much like the therapy process. No time is spent on tradit

problem-focused approaches or problem etiology. In reviewing the training program, Nelson

(2008) indicates facilitation and formation of concrete goals, and a commitment to do what

works, is demonstrated with clarity and simplicity – but of course, that is what one would ex

from SFBT.

Weakness & Criticisms of Theory

Interestingly, the very aspects for which SFBT is applauded, the same are also critici

proving the adage: one man’s pain is another man’s pleasure. While SFBT may be viewed as

ideal due to its simplistic approach, it is important that one keep in mind the potential

shortcomings of using an economical, and minimalist approach solely based on these qualifi

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 9/16
8/21/2020 (PDF) Solution Focused Brief Therapy

Being that SFBT is parsimonious, which many consider an appealing strength, can also be
considered a weakness, and even dangerous. Consider for instance those clients forced into

brief-therapy due to cost considerations, only to find the therapy has not been empirically

validated for their particular situation, or clients with suicidal concerns in need of acute serv

in such instances SFBT might prove to not only be ineffective, but dangerous and ethically

questionable. Due to its parsimonious appeal, SFBT may be inappropriately deemed and

SOLUTION-FOCUSED BRIEF THERAPY

promoted as a “one size fits all” type of therapeutic model (Beyebach, 2009), particularly by

administrative health care services.

SFBT is based on numerous assumptions, which Thomas (2007) warns could lead to

situational blindness. Of general concern is that the brief method does not utilize historical d

but rather relies only on present and future performance; it is solely preoccupied with ‘surfa

rather than deeply meaningful factors underlying the stress distress that drives a person to

therapy. SFBT does not provide, or account for the client’s salient desire to express and pro

strong negative emotions, as is necessary when dealing with the various stages of grief

(Emmelkamp, Hulsbosch, Kamphuis, & Emmerik, 2002). As a result, SFBT may be viewed

lacking sensitivity or consideration.

According to McKergow & Korman (2009) SFBT therapists fail to draw from

psychological theory as do most therapeutic traditions, which is not only viewed as a weakn

but often leads to the opinion that SFBT is naïve and superficial. McKergow & Korman furt

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 10/16
8/21/2020 (PDF) Solution Focused Brief Therapy

state: “When solution-focused techniques are extracted from the whole structure of solution
focused theory and practice and interpreted within traditional psychotherapeutic framework

solution-focused ideas and techniques become absurd, naïve, and even plain stupid” (p35).

Some of the more serious criticisms of SFBT including one of the most obvious, as

pointed out by Lipchik (1994), are the “focus on technique and the neglect of the actual flesh

and-blood client sitting before you” (pp 37-38). Lipchik further indicates other significant

criticisms may include:

• Exaggerated claims in the face of relative paucity of rigorous, empirical studie

• Omission of history, assessment and gender analysis

• Gross assumptions and over-zealous confidence

SOLUTION-FOCUSED BRIEF THERAPY

• Ethical concerns that therapists are too neutral, with insufficient attention to i

of influence and power

• Over-simplistic focus and presumption that cognitive shifts can work miracles

• Used to the exclusion of other theories and models

Although SFBT has been implicated to be effective across a diverse range of

applications, it lacks the comprehensive outline, and review corresponding to the potential f

which it has been applauded. The fact of the matter is that much of the research supporting

efficacy of SFBT fails to meet the American Psychological Association criteria for outcome

research (Chambless & Hollon, 1998).

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 11/16
8/21/2020 (PDF) Solution Focused Brief Therapy

Gruninger (2005) reports a considerable lack of specification of treatment concerns,

of control group, and post-hoc analysis, as well as vague and non-standardized measures, are

among the various methodological flaws in SFBT efficacy studies. These are critical

considerations that further weaken the perspective of SFBT.

Conclusion

It is the conclusion of this researcher that despite the assumptions, techniques, optim

perspective, progressive narratives, and goal-oriented collaboration of SFBT, when combine

with a narrow focus, limited subjective worldview, and minimalist approach it creates a myo

skewed frame of reference, which can often lead to frustration, and failure. Operating from

myopic, skewed or false perspective is commensurate with causing new problems. In seekin

the shortest route to change, SFBT inadvertently may overlook important details, which feas

could create more encompassing problems on the client’s path to change (Thomas, 2007).

Wendell Berry (1981) the essayist and ecologist, provides the following logic by way

definition, stating that a good solution should not “cause a ramifying series of new

SOLUTION-FOCUSED BRIEF THERAPY

problems…the new problems (can) arise beyond the purview of the expertise that produced

solution” (p. 135). Although clever interventions, and techniques may effectively gain accla

and popularity, most any undergraduate psychology student will tell you: techniques alone d

constitute good therapeutic practice (Thomas, 2013). A popular descriptive idiom that migh

f SFBT i th t f bl
https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy
th i l ti h f l id 12/16ti
8/21/2020 (PDF) Solution Focused Brief Therapy
apropos for SFBT is that for every problem there is a solution; however, of equal considerati
the idea that there are three solutions to every problem: 1) accept it; 2) change it, or 3) leave

If you can’t accept it, change it; if you can’t change it – leave it! It seems a simple enough

philosophy, and miraculously, one that facilitates a solution in just seconds.

In a world of fast food, fast cars, fast money and fast communication, is it no wonder

such a culture has devised a fast solution based approach to psychotherapy? In brief (pun

intended), this is what SFBT offers – a time efficient method of finding a solution to every

problem. SFBT portrays itself as a brief type of therapy – a fast alternative, comparatively

speaking to traditional methods of psychotherapy. From the very first solution-focused

interview, the therapist is mindful of working toward termination (Corey, 2013). On average

SFBT necessitates five sessions of no more than forty-five minutes, which might extend ove

period of several months, and rarely extends beyond eight sessions.

It hardly seems feasible that a solution can be found in such a brief time-span,

particularly when hoping to rectify or resolve deep-rooted emotional, cognitive, psychologic

and socio-cultural problems. In the Diagnostic and Statistical Manual of Mental Disorders

(DSM), the standard reference for psychiatry, there are over 400 different classifications of

mental disorders. Conditions such as acute stress disorder, addiction, antisocial behavior,

anorexia, anxiety, bipolar disorder, cognitive disorders, delirium, depression,

dyslexia…obsessive-compulsive disorders, paranoia, phobias, psychosis, relational disorder

SOLUTION-FOCUSED BRIEF THERAPY

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 13/16
8/21/2020 (PDF) Solution Focused Brief Therapy

schizophrenia…not to mention the 390 other acute or chronic emotional, and cognitive
disturbances that, in short (no pun intended), continue to persist seemingly with no sustainab

solution.

Despite, and in the face of, such paramount problems, SFBT proposes optimistic

assumptions that people are healthy, competent, and have the ability to construct solutions th

can enhance their lives, and resolve the challenges they are facing (Corey, 2013). An obvio

question in response to these assumptions is: if people are healthy and competent and have t

ability to resolve their challenges why is it they require therapy? An assumption is to suppos

take for granted, make a conjecture, surmise, reckon, think or believe something without pro

certain knowledge. It’s been said that to ass-u-me, “makes an ass out of you and me.” From

clinical perspective, another question arises in the mind of this researcher: is it ethical to ma

assumptions? Is it responsible to make assumptions? Do assumptions in fact lend themselve

a solution? These are questions that strike hard in the mind of this researcher.

In this focused exploration of SFBT, this researcher did not find a brief solution to th

problematic questions, or assumptions presented. Of course one can always resort to the po

1-2-3 Brief Solution (accept it-change it-leave it), which is closely reminiscent of the Sereni

Prayer, with a revised ending, which might read something like this: God grant me the seren

accept the things I cannot change, courage to change the things I can, and wisdom to know w

to leave it. Frank Thomas (2013) seems to think shifts happen, Heraclitus observed that the

constant is change, Aurelius espoused to the wise, life is a problem; to the fool, a solution, a

Einstein is dubiously quoted: “when the solution is simple, God is answering”… perhaps if o

recites the serenity prayer before turning in for the night, one might discover upon awakenin

problems once perceived, miraculously are gone – could it really be that simple? Ω

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 14/16
8/21/2020 (PDF) Solution Focused Brief Therapy

SOLUTION-FOCUSED BRIEF THERAPY

References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disor

(4th ed.). Washington, DC: American Psychiatric Association.

Bannick, F.P. (2008). Postraumatic success: Solution-focused brief therapy. Brief treatment a

crisis intervention. 8(3), 215-225. doi:10.1093/brief-treatment/mhn013

Berry, W. (1981). The gift of good land. San Francisco: North Point Press.

Beyebach, M. (2009). Integrative brief solution-focused family therapy: A provisional roadm

Journal of Systemic Therapies, 28(3), 18-35.

Chambless, D.L., & Hollon, S.D. (1998). Defining empirically supported psychotherapies.

Journal of Consulting and Clinical Psychology, 66, 7-18.

Cockburn, J.T., Thomas, F.N., & Cockburn, O.J. (1997). Solution-focused therapy and

psychosocial adjustment to orthopedic rehabilitation in a work hardening program.

Journal of Occupational Rehabilitation, 7(2), 97-106.

Corey, G. (2013). Theory and practice of counseling and psychotherapy (9th ed.). Belmont,

Brooks/Cole.

Cotton, J. (2010). Question utilization in solution-focused brief therapy: A recursive frame

analysis of Insoo Kim Berg's solution talk. The Qualitative Report, 15(1), 18-36.

Retrieved from http://search.proquest.com/docview/195555968?accountid=12085

Daki, J., & Savage, R. S. (2010). Solution-focused brief therapy: Impacts on academic and

emotional difficulties. The Journal of Educational Research, 103(5), 309-326. Retrie

from http://search.proquest.com/docview/760020637?accountid=12085

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 15/16
8/21/2020 (PDF) Solution Focused Brief Therapy

de Shazer, S. & Berg, I. K. (1997). ‘What works?’ Remarks on research aspects of solution-
focused brief therapy. Journal of Family Therapy, 19, 121–124. doi: 10.1111/1467-

https://www.researchgate.net/publication/283661581_Solution_Focused_Brief_Therapy 16/16