Solution-Focused Brief Therapy

Chris Worfolk
Welcome to the Solution-Focused Brief Therapy (SFBT) handbook. This handbook
is designed to accompany the course materials and reinforce the lessons. I also
encourage you to keep your own notes so that you can translate the concepts
into your own words.

What is SFBT?
Solution-Focused Brief Therapy, known as SFBT for short, is a form of
psychotherapy/talking therapy but one that has marked differences from other
forms of counselling.

First, it is solution-focused. It distinguishes between “problem-focused” therapies

that emphasise exploring and understanding the problem and its own approach
of focusing on the solution.

Second, it is brief. Traditional forms of therapy often run for extended periods
whereas SFBT proposes that therapeutic progress can be made from the first
session and significant results can be accompanied in just a few sessions.

A typical SFBT session may consist of:

• Problem-free talk and getting to know each other
• Establishing goals by asking about the client’s best hopes
• Eliciting strengths that the client can use to solve their problems
• Encouraging the client to describe the change they want to see (their
preferred future)

Comparing SFBT to other modalities

SBFT is goal-oriented just as Cognitive Behavioural Therapy (CBT) is. We
want to know what a client wants to achieve. We could suggest that SFBT is
a behaviourist approach in that it focuses on what clients do rather than what
they are thinking or feeling. However, the cognitive side of CBT attempts to
understand the problem and therefore is not solution-focused.

SFBT also shares multiple characteristics with person-centred counselling.

Both place the client’s agenda at the heart of the work and adopt a non-medical
model. Both emphasise the client being an expert in themselves. However,
SFBT does not believe that the therapeutic relationship itself is enough, nor is it
content to work without an agenda.

Solution-Focused Brief Therapy 2

We could also compare SFBT to solution-focused coaching. The two are very
similar but with therapy, we are typically working with vulnerable clients and
this requires an appropriate level of training and focus on therapeutic outcomes
rather than coaching goals.

Barriers to SFBT
The following may be barriers to people engaging in SFBT:
• Previous negative experiences of seeking help
• Expectations about what should happen
• A belief that only long-term therapy can work
• Severe mental health conditions that impact thinking or communication

History and development

SFBT grew out of the family therapy movement, particularly the work done at
the Palo Alto Mental Research Institute, USA. Elements of systemic and family
therapy can be seen throughout SFBT, such as the thinking break.

Steve de Shazer and Insso Kim Berg are considered the founders of SFBT. It
began life as the Brief Family Therapy Centre in Milwaukee, USA in 1978, before
transitioning to a solution-focused approach in the 1980s.

SFBT concepts
SFBT does not have a “grand underlying theory” as Steve de Shazer referred
to the concept. They saw Freud’s work of turning individual case studies into a
generalised theory as unscientific and so focused on developing the concepts
from clinical practice.

However, there is a clear philosophy behind SFBT.

Constructivist approach
Constructivism says that we create our reality. In traditional therapy, we may say
that a certain thought or behaviour is objectively a problem. However, in SFBT,
we work with the client’s agenda and they set the problem at hand.

Solution-Focused Brief Therapy 3

This can be difficult. Take an extreme example of a client who is being
domestically abused but comes seeking help with a different problem. Accepting
the client’s agenda can be challenging in such situations.

Non-medical model
The medical model treats a person as a diagnosis. It uses labels like depression,
schizophrenia or borderline personality disorder. This can sometimes lead to a
focus on treating the symptoms and ignoring the person. It also sets the therapist
up as an “expert” in the “disease” at hand.

SFBT rejects it. It says that the person is an expert in themselves and the
therapist’s job is to facilitate someone solving their problems themselves.

Major tenets
1. If it isn’t broken, don’t fix it
2. If it works, do more of it
3. If it’s not working, do something different
4. Small steps can lead to big changes
5. The solution is not necessarily directly related to the problem
6. The language for solution development is different from that needed to
describe the problem
7. No problem happens all of the time, there are always exceptions that can
be utilised
8. People engage more with an approach that builds upon their strengths
than one that highlights their deficiencies
9. The future is both created and negotiable

Assumptions
SFBT makes the following assumptions:
• Clients are motivated to change.
• Attempting to understand the problem is not necessary or useful.
• No matter how big the problem seems, there are always times when the
client is doing some of the solution.

Solution-Focused Brief Therapy 4

• Problems do not represent pathology.
• Small changes can lead to big results.

Customer types
In family therapy, we often divide clients into different customer types such as
visitors, complainants and customers. This might indicate that people do not see
a problem, do not want to work on the problem or think someone else should
solve it.

In SFBT, we say “everyone is a customer for something”. That means that even if
someone is there against their will (referred by school, prison service, courts, etc)
there is still a good reason for them being sat in front of us.

Doing SFBT
In this chapter, we will explore what it is like to do SFBT step-by-step. While you
won’t be familiar with the techniques at this stage, it will provide you with an
overview, and we will then dive into the techniques in later chapters.

Structure of therapy
SFBT adopts a simple model without a lot of the structure associated with other
modalities. There is no formal assessment: the work starts right away. Typically
3-5 sessions are enough and these can be spread out with several weeks passing
between sessions.

First session
A first session would typically include:
• Getting to know each other and some problem-free talk
• Building a working relationship (therapeutic alliance)
• Contracting and best hopes
• Eliciting the client’s preferred future
• Identifying instances of success already happening
• Thinking break and summary

Solution-Focused Brief Therapy 5

Contracting
Contracting is the process of agreeing on what will happen. Here we should
discuss ways of working and confidentiality but we don’t need to agree on a strict
structure (for example, the number of sessions or when those sessions will be).

We adopt the client’s agenda by asking “what are your best hopes for our work?”.
This then sets the therapeutic goals for the session.

Korman (2004) suggested a good goal would consist of:

• Something the client wishes to achieve
• Fits with the therapist’s legitimate remit
• The therapist and client working well together could reasonably achieve
By remit, we are referring to our work as a therapist. For example, we’re not
housing officers or social workers so wouldn’t have the power to return custardy
of children to someone.

Follow-up sessions
All sessions after the first are treated as follow-up sessions. These sessions look
at what is better since the last time the client came in and uncovering instances
of success that can be built upon to reach the preferred future.

Ending the work

SFBT does not require formal endings. You may wish to finish with “let me know
if you want another session” and encourage clients to space them more widely
than traditional therapy to allow time for the acquisition and practice of new
behaviours.

Techniques
In this chapter, we will break down the techniques used in SFBT.

Problem-free talk
SFBT uses a non-medical model in which we see the client as a person rather

Solution-Focused Brief Therapy 6

than a series of problems. The idea behind problem-free talk is to get to know the
person.

This technique, which might at first glance just seem like chatting, serves two
important purposes. One it builds rapport between the client and therapist. And
two it helps elicit the client’s strengths, the things they like and the things they
are good at. This starts the process of gathering resources that can be used to
build solutions.

Pre-session change
Often, things will improve between a client making an appointment and
attending the initial session. We call this pre-session change.

Why does this occur? It could be that setting a date to deal with the problem
helps generate solutions. Or that committing to finding a solution opens up the
possibility that there is one.

We can enquire about this with the question “what has changed?” Note that we
don’t ask “has anything changed?” but assume that the change is happening!
This encourages the client to consider their response as it makes it an open
question.

Based on the client’s answer we can respond appropriately:

• If things have got better, we can ask “how did you do it?”
• If things are the same, we can move on to best hopes
• If things are worse, we can ask “how did you manage to stop things getting
even worse than they are now?”

Best hopes
Generating therapeutic goals can be as simple as asking “what are your best
hopes for our time here today?”

Clients will often answer in the negative: “I don’t want to feel this way anymore.”
If so, we should encourage them to turn it into something positive. “What would
you feel instead?” This gives us something to work towards.

A good metaphor here is that of the taxi driver. If you got into a taxi at the airport,
the taxi driver will ask you “where to?” Or at least did in the days before we pre-
programmed our destination into a taxi app.

Solution-Focused Brief Therapy 7

In such circumstances, we wouldn’t say “not the airport”. We could, and we might
end up somewhere else, but it is unlikely to be where we wanted to end up.
Instead, want to give our work a concrete destination.

Questions
Questions are at the heart of the therapeutic conversation. In SFBT, clients do
most of the work and we predominantly ask questions. These include:
• Setting goals by asking about best hopes
• Getting to know the client with problem-free talk
• Asking about their preferred future (what will it be like when the problem is
gone?)
• Uncovering strengths (how did you do that?)
• Coping questions (how did you manage to get through that?)
• Using “what else?” to encourage clients to think deeply and uncover
ignored possibilities
Notice that we typically use “how” questions rather than “why” questions. Why is
used by problem-focused therapies. How is used in solution-focused therapies
to focus on eliciting the client’s skills and resources.

It is important to note that we shouldn’t focus on questions at the expense of

ignoring a client’s feelings. When a client talks about their feelings it is important
to acknowledge their pain before asking questions.

Exceptions
No matter how bad a problem seems, there are always times when it is less bad.
We call these exceptions or “instances of the future already happening”.

In these exceptions, the client is already mustering their available resources to

solve the problem. When we can help the client identify these, they form a basis
for future solution-building.

Lists
Lists can be a powerful way of helping a client think concretely and see the
change that is already happening. This is not about brainstorming new ideas as
much as it is about highlighting a client’s existing strengths.

Solution-Focused Brief Therapy 8

Examples of lists:
• A couple listing 20 ways they are interacting with each other in a positive
manner
• A parent listing 15 ways they are demonstrating being a good parent

Compliments
Compliments are a good way to draw attention to a client’s strengths. These
can be delivered directly or in the form of a question (“how did you find a way to
project so much confidence when you were feeling nervous?”).

Thinking break
In family therapy, the therapist would often take a break near the end of the
session to consult with the rest of their team.

While SFBT is typically done with just one therapist, this tradition of taking a
break is still encouraged. It provides a few minutes for both therapist and client to
gather their thoughts and summarise the session.

This could involve leaving the room, or simply breaking eye contact and sitting in
silence for a few minutes.

Summarising
A good summary will typically:
• Acknowledge the difficulty
• Qualities and capacities the client brings to their life that could be the basis
of progress
• Actions that the client has taken in the direction of their best hopes
• Signs of hope
• Suggestions (tasks)

Tasks
SFBT does set homework, but somewhat tentatively, in the form of suggestions.
This can be as simple as “between now and the next time we meet, you may
want to notice x”.

Solution-Focused Brief Therapy 9

Types of tasks:
• Noticing tasks (see if you notice x and then come back and tell me about it)
• Do something different tasks (break a pattern by suggesting the client
changes the way they do something)
• Pretend tasks (act as if the miracle has already happened)

Miracle question
We often talk about the client’s “preferred future”. This is the place they want
to get to where the problem is solved. The more vivid details we can draw out
about the preferred future, the better.

One way to do this is with the miracle question. There are several ways to ask it
but De Jong & Berg (2012) and suggest doing it like this:

“Now, I want to ask you a strange question. Suppose that while you
were sleeping tonight and the entire house is quiet, a miracle happens.
The miracle is that the problem which brought you here is solved.
However, because you are sleeping, you don’t know that the miracle
has happened. So, when you wake up tomorrow morning, what will
be different that will tell you a miracle has happened and the problem
which brought you here is solved?”

A good description of the preferred future is:

1. Positive, we’re describing something we gain rather than a negative (“I don’t
want to be anxious”)
2. Concrete, how will the feelings translate into observable actions?
3. Detailed, with time, place, actions, context. Make it as real and vivid as
possible.
4. Multi-perspectival, see the changes through the eyes of other people.
What will they notice about the client?
5. Interactional, how will the client interact with others? How will those
people respond to the client?

Handling different responses

A client may respond with a detailed description.

Solution-Focused Brief Therapy 10

However, it is also common for a client to respond with I don’t know. Gallagher
suggests this means “be quiet, I’m thinking”. So, a good starting point is to leave
10 seconds of silence, before acknowledging the difficulty of the question and
leaving even more silence.

If a client still cannot summon up an answer right now, we could ask about
alternative perspectives: how would the person who knows them best recognise
the change? Or, if they were referred by someone else, what would the referrer
say?

Another tricky response is I want to understand the problem as we do not

consider this important in SFBT. In such cases, we want to ask what would be
different if we did understand it? How would that free them and what would this
look like?

Unrealistic miracles
This may sound like an oxymoron but there is clearly a difference between a
realistic miracle (to recover from depression) vs an unrealistic one (a missing limb
growing back).

This is most likely to come up when working with terminally ill or recently
bereaved clients. In such cases, you may wish to steer clear of the miracle
question. However, do not write the question off altogether: often the client will
understand what you are really asking.

We can also steer the answer back to concrete actions. A parent who has had a
child removed by social services, for example, may say that the miracle is to have
their child back. How would this translate into actions? How would they behave
differently if this was the case?

Scaling questions
Scaling questions are another key technique that we need to examine in detail.
In such questions, we present the client with a 0 to 10 scale and ask them to rate
themselves.

It is worth saying from the outset that we don’t have to use a verbal 0-10. We
could draw it out. Or put two changes at each end of the room and use a walking
scale.

Solution-Focused Brief Therapy 11

Asking a scaling question
When we use a scaling question, we are typically asking a client to rate their
progress, or sometimes about how much hope they have that they will get there.

10 is their preferred future which 0 represents the opposite of this: the worst
outcome. For example, if we were working with a couple we might ask:

“If zero is a divorce, and 10 is regaining the passion you had at the start
of the relationship, where would you say you are today?”

Or a struggling parent:

“If zero is social services removing the child and 10 is being the world’s
best mum, where would you place yourself right now?”

What do we do with this information?

We can use it to uncover a client’s strengths. Let’s say a client rates themselves
as a four. Why is it a four and not lower? What are they already doing that is
working for them?

We could also ask “what is the highest you have ever been?” and drill down into
what they were doing differently at that time.

When a client rates themselves as particularly low, we might use a coping

question to ask “how are you stopping things from getting even worse?”

Clients at 0
Clients rarely rate themselves at 0. But if it does happen, the first thing we should
do is acknowledge the pain that they are in. We can then use a coping question
or even ask “why 0? How come it is not -1?”

Clients at 10
This is another rare scenario and usually only happens when a client does not
see a problem and has been referred to therapy against their will. In such cases,
we can ask about what their referrer would say.

Solution-Focused Brief Therapy 12

Signs of improvement
Once we know where we are on the scale, we want to help the client move
forward. For this, we ask about signs of improvement.

“You’ve said you’re a 5. How will you know when you reach 6?”

Notice that we don’t ask “what step would get you to six?” Therapy isn’t coaching.
Therapy clients often feel hopeless or powerless, or that it is our job as the
therapist to figure it out for them. However, only they can identify how they would
recognise they had reached a six.

Therapeutic alliance
The therapeutic alliance, also known as the therapeutic relationship, is the
professional relationship between therapist and client.

Different modalities place different levels of importance on it. For example,

person-centred suggests that the alliance is the magic that helps people change.
Other modalities, including SFBT, place less importance on it, but still view it as a
key part of a productive course of therapy.

Non-specific factors
Frank (1973) suggested there were a series of common factors that applied to
all forms of psychotherapy. Grencavage and Norcross (1990) came up with the
following list:
1. Therapeutic alliance
2. Opportunity for emotional relief
3. Acquisition and practice of new behaviours
4. The client having positive expectations
5. The therapist being a source of positive influence on the client
6. -Provision of rationale for the client’s difficulties-
While this mostly holds for SFBT, a key area where it differs from other therapies
is that it does not provide a rationale for the client’s difficulties. Indeed, we seek
to swiftly move on from the problem and focus on solution-building.

Solution-Focused Brief Therapy 13

Core conditions
Carl Rogers, the key figure in person-centred_, suggested there were several
factors that make a therapeutic relationship work. These are known as the core
conditions:
1. Empathy, the ability to see the world through the client’s eyes (from their
frame of reference)
2. Unconditional positive regard (UPR), offering the client acceptance so that
that the client could begin to accept themselves (self-acceptance)
3. Congruence, being genuine with the client

Climate of change
Although SFBT assumes clients are motivated to change, we also need to
acknowledge that change can be frightening and clients are unlikely to change
unless the positives outweigh the negatives.

There are several ways we create a climate of change:

• Using problem-free talk and the preferred future to highlight what is
missing from their life right now and what can be gained from changing
• Highlighting exceptions and pre-session change to demonstrate that
change is already happening
• Presenting a positive, confident attitude through body language, tone and
enthusiasm

Common skills for counsellors

Regardless of the therapeutic modality you work in, the following skills should be
developed:
• Active listening, giving your entire attention to the client.
• Silence, being comfortable allowing silence.
• Empathy, seeing the world from the client’s frame of reference.
• Goal-setting, setting effective goals and using goal-setting frameworks
such as SMART and INSPIRED.
• Problem solving, and understanding what effective problem-solving looks
like.

Solution-Focused Brief Therapy 14

• Immediacy, the ability to notice what is going in on the room such as
changes in tone or body language.
• Minimal prompts, such as “yes”, “umm-hmm”, “go-on” that encourage a
client to keep talking.
• Paraphrasing, understanding what a client has said and demonstrating that
understanding to them.
• Open questioning, asking questions that encourage more than simple one-
word answers.
• Reframing, encouraging the client to see something from a different, often
more positive, perspective
• Use of metaphors, and similes.

Working in SFBT
In this chapter, we will explore some of the practical and ethical considerations of
working as a Solution-Focused Brief Therapist.

Informed consent
We have discussed how SFBT is different from other forms of psychotherapy
and how clients may have fixed expectations of that therapy is like. How do we
manage these conflicting factors?

One way is to gain informed consent before starting. Simply put, this is explaining
to a client what SFBT is like and asking them if they would like to try it.

Most clients will say yes, but if they say no, your options are to use a different
modality if you are appropriately trained or to make an ethical referral to another
therapist if not.

Confidentiality
During the contracting stage, you should be clear on any limits to confidentiality.

There may be legal limits. For example, in the UK you are required to disclose any
information about acts of terrorism and can be compelled by a court to reveal
your private conversations with a client.

Solution-Focused Brief Therapy 15

There may be ethical limits. If a client talks about imminently harming themselves
or others, it may be ethical to break confidentiality at that time.

Therapists also discuss clients with their supervisor, which we will discuss in the
next section.

Supervision
All therapists work with a supervisor, regardless of their level of experience. A
supervisor is a fellow therapist who is also qualified in providing supervision.

What is supervision? It provides both ethical oversight and practical support for
a therapist. Because our conversations are confidential, we cannot offload onto
friends or relatives. Our supervisor provides a similarly-trained therapist that we
can discuss our difficulties with. They also provide valuable oversight to ensure
our work is in the client’s best interests.

Integrative approaches
Can SFBT be integrated with other approaches?

Steve de Shazer suggested that the broad answer was “no” because SFBT
embraced a non-medical client-as-expert model that was difficult to reconcile
with other modalities. Although other schools have now embraced this, another
barrier is that the language of solution-focused therapies is different to that of
problem-focused therapies.

That is not to say it is impossible, however. For example, training in person-

centred provides an excellent basis for working as a counsellor in any modality.

Another way to consider integration is that of technical eclecticism. This refers to

assessing a client and then offering them the most suitable modality. Rather than
integrating, CBT and SFBT, for example, you would assess a client and then offer
them either CBT or SFBT based on what would be most appropriate for them.

Questions about SFBT

In this chapter, we will answer some common questions and challenge some
misconceptions.

Solution-Focused Brief Therapy 16

Can brief therapy really work?
For therapists and clients alike, one of the first questions is “can you really do
meaningful therapeutic work in only a couple of sessions?”

The answer appears to be yes. Bloom (1992) argues that short therapies work
as well as long ones. And Talmon (1990) points out that 30% of clients only
attend one session anyway so attempting to achieve results from session one is
imperative.

it is also worth considering that SFBT typically spaces sessions out more widely
than other forms of psychotherapy. Therefore, five sessions of SFBT may take the
same period of time as 12 sessions of weekly CBT.

Does SFBT ignore emotions?

SBFT is of course solution-focused and therefore could be accused of ignoring
the client’s feelings.

The first thing to say is that we don’t strive to ignore emotions in the therapy
room. When they come up, it is important to acknowledge them and make the
client feel heard before moving on to developing solutions.

However, on a more fundamental level, Steve de Shazer rejected the idea of a

separation of inner private experience (emotions) and outer expression of that
experience (behaviour). Therefore, by tackling the outwards signs, we are tackling
the whole thing as it were.

Does SFBT ignore problems?

A tenet of SFBT is that you do not need to understand the problem to find a
solution. Does that mean that it ignores the problem?

Not so. There is space to talk about the problem. O’Connell suggests devoting
20% of the session time to problem description and 80% to solution talk. Why do
we do this? Several reasons:
• Clients are usually in therapy to solve problems, not just “understand” them
• The benefit of talking about a problem is unclear compared to the benefit
of talking about the solution
• New possibilities cannot come from an absence of negatives and therefore
talking about the solution is critical

Solution-Focused Brief Therapy 17

Does this lead to superficial work? Certainly not. When we highlight a client’s
strengths, resources and problem-solving abilities, we build their self-esteem
and change the way they fundamentally think about themselves.

Does SFBT miss the real issue?

Some may argue that SFBT’s focus on the solution, rather than the underlying
problem, means it misses the real issue. However, as we have already discussed,
de Shazer suggests that this boundary of private experience and outward signs
does not exist, and therefore it is not possible to miss the “real” issue.

Solution-Focused Brief Therapy 18

Solution-Focused Brief Therapy
Course handbook

Copyright Worfolk Media

All rights reserved