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Introduction
Compared to other approaches to therapy, solution-focused brief therapy (SFBT) is centered on an individual’s current and future situations and objectives instead of previous experiences. Since the therapy is goal-oriented, the target is not the issues or symptoms bringing the person to the therapy but rather the potential outcome(s). Therefore, the role of the counselor is to encourage Michael and Lisa in treatment, create a vision of their future and provide support. While supporting the two, the therapist also determines the potential abilities, resources, and skills essential to achieving the projected future.
History, development, and founders of the approach
Historically, the need for an alternative therapy approach was recognized as mental health practitioners started to observe the energy, money, and time amount, alongside other resources, spent analyzing and discussing revealed challenges in therapy procedures. Within the same line of thought, the developed procedure would bring an individual’s original issues to therapy in terms of the continuous negative impact (Abbasi et al., 2017). SFBT’s founders, Insoo Kim Berg and Steve de Shazer, from Milwaukee, alongside their team members, developed the therapy in the 1980s as a response to the established observations (Aminnasab et al., 2018). The aim of the therapy was then to create a realistic solution, in the fastest way possible, instead of keeping patients in session for longer. Moreover, the solution is also intended to promote lasting relief in therapy.
SFBT developed into an effective and fast treatment modality today in more than three decades. The therapy continues to change and evolve toward meeting the needs of the patients. With the technique formed deductively, rather than inductively, the hundreds of hours spent by Berg and Shazer, through several years methodologically noting questions and observing therapy sessions. With such observations, the therapy helps counselors lead their clients towards developing real-life solutions that are emotions and behavior-based (Zhang et al., 2018). Currently, the approach is trained in regions like Asia, Canada, Europe, South America, and the United States (Aminnasab et al., 2018). SFBT’s principles have been applied in various environments comprising employment places, schools, and associated settings, where people are eager to enhance interpersonal relationships and attain their personal goals.
Model characteristics
The technique(s) used for counselors applying the therapy allows them to ask specific questions that guide the patients throughout the session. The specific questions might be coping, miracle, or scaling questions to guide the patient to overcome challenges. For example, coping questions help therapists guide their patients to demonstrate their resiliency in different ways to cope with the faced challenges. An illustration of one such question is, how do you manage to accomplish your daily responsibilities in the face of difficulty? (Abbasi et al., 2017). With such a question, it becomes easy for the patient(s) to acknowledge their potential skills when coping with difficulty.
Through miracle questions, patients are helped to envision their preferred future where issues are absent. Essentially, using this line of questioning, patients can explain the potential differences their lives can have when the problem(s) are non-existent (Aminnasab et al., 2018). As such, miracle questions help patients identify practical, small steps that can be taken to effect immediate change in their current situation. By guidance, a patient describes how uneasy they feel in the presence of specific family members and what they believe their lives will be without such a feeling. Patients are guided to imagine a potential scenario where their existing problem(s) are non-existent, reminding them of behavioral changes that allow them to see what can be done to create change within their lives.
The third set of questions, scaling questions, utilizes a scale score of 0-10 to evaluate patients based on their current circumstances, others’ perceptions, and progress. The intervention’s technique aims to scale the set goal with 0 being an all-time low or worst possible scenario and 10 being the best-case scenario. Relevant in insufficient time scenarios, scaling questions explore the miracle questions, helping the therapist understand their patient’s confidence levels, motivation, and hopefulness (Zhang et al., 2018). An SFBT therapist can highlight positive change and growth and measure ongoing progress. Moreover, the technique becomes effective among patients with difficulty verbalizing their circumstances.
The main goal of SFBT is to establish clarity and specificity in the objectives set by the patients. Since the therapy works on short instead of long-term goals, the therapist’s responsibility is to focus on smaller objectives rather than larger ones. Through solution-framed goals, the counselor guides the patient toward establishing potential solutions instead of emphasizing what’s wrong (Franklin et al., 2017). Therefore, achieving positive outcomes with the therapy requires several key interventions engaged in every session. These key interventions include a collegial, positive, and solution-faced stance, looking for past solutions, exceptions, interpretations, directives, or questions (Abbasi et al., 2017). The other associate interventions are gently nudging the patient to do what is working, compliments, and future and present-focused questions vs. previous-oriented focus.
The theory of change associated with the therapy lies in the ability of the counselor to encourage the client(s) to describe their progress in specific, small, and behavioral steps. Moreover, the therapist suggests completing tasks to continue with what is considered to be already working towards maintaining or stimulating the preferred change(s) (Franklin et al., 2017). At the beginning of each session, variations in the associations with the clients are identified. Depending on the type of association, a different approach by SFBT is applied (Zhang et al., 2018). For example, in a complaint relationship, the client experiences emotions but still has difficulty accepting they are part of the problem and has a hard time considering themselves as part of the solution. In a visitor relationship, the client receives referrals from others to meet with the counselor (Aminnasab et al., 2018). Since the visit is not voluntary, help is not sought after, and there are no emotional challenges relative to the issue(s). In a customer relationship, the client eliminates themself from the problem and is motivated to change their behavior.
The specific roles of the therapist in the three relationships vary. In a visitor relationship, the counselor asks their consider the people that referred them, what they might want to see from the session, and to what extent is their cooperation to achieve their goal (Abbasi et al., 2017). In a complaint relationship, the counselor provides solutions based on the acknowledged challenges, and in a customer relationship, the therapist’s role is to provide a behavior assignment.
The use of solution-focused brief therapy in Michael and Lisa’s case
The major strength of SFBT is that it provides clients with a shorter therapy session, unlike other treatments. The other strength of the treatment is its ability to help clients clear their issue(s) in the shortest time possible and resume their lives. Achieving long-term goals set at the start of the therapy translates to the completion of the sessions and the treatment ends (Zhang et al., 2018). However, SFT is not a one size fits all treatment approach. Contrary to its benefits, it is a goal-oriented and quick treatment that may not allow counselors the appropriate time to identify the issue(s) with the clients. In addition to the possibility of misunderstanding, the approach seems to overlook or eliminate information that might be significant in other treatments (Franklin et al., 2017). No underlying issue(s) are addressed in a normal session with the treatment.
In Michael and Lisa’s case study analysis, SFBT will help them manage their issues of conceiving a child and blaming each other by using their immediate symptoms to cope with the challenge. The strengths that might be included in Michael and Lisa’s treatment are their strong and healthy relationship, shared vision and no cultural differences, and common and ready friends to support their therapy process. The other major strength that might positively contribute to how SFBT helps Michael and Lisa towards their preferred future is their significant financial background. Michael and Lisa’s strengths can be used as a grounded belief that changes their lives. What the therapy does is help Michael and Lisa identify and work with their strengths to change their perspective of child conception and blame.
By working collaboratively with the patients, the counselor will encourage Michael and Lisa to develop a series of steps that will guide them to achieve their preferred goal(s). Specifically, the therapist will assist Michael and Lisa in identifying a time in their life when a current symptom was either more manageable or less detrimental (Franklin et al., 2017). Moreover, the counselor helps the two evaluate the different factors or solutions that might have been present in the past. By guiding Michael and Lisa toward developing their preferred future vision and then determining how their internal abilities can be improved, the therapist will support them achieve their desired result. Zhang et al. (2018) show that counselors using SFBT aid their patients in the best way to continue practicing the identified strategies. In Michael and Lisa’s case, the counselor will encourage them to acknowledge and celebrate success. Moreover, the therapist will support Michael and Lisa as they experiment with new approaches to solving their problems.
With emphasis placed on real-time solutions to the patients’ struggles, the therapy ensures Michael and Lisa build on their open-mindedness and empathy. The latter’s benefit is that the two will experience growth as they progress into the preferred ten weeks of the session and will be encouraged to continue with their resilience (Franklin et al., 2017). With the counselor approaching the case non-judgmentally, it is the responsibility of Michael and Lisa to make their preferred future solutions. Further, they have to identify their skills to solve their problem(s) to enhance their forward-thinking and self-esteem.
Conclusion
In a therapy session with Michael and Lisa, the main attention is to encourage them to work with the hopes, strengths, resources, and positive exceptions to solve their issue. As already established, Michael and Lisa have four distinct strengths that will find their challenge and create a solution rather than focusing on the cause for their issue when considerably incorporated in their session. Since the therapy is scheduled for the next ten weeks, the counselor will ensure that solving the child’s conceiving and blaming challenges the two faces do not rely on their past two-year experience. Rather positive feedback is associated with what they envision for their future.
References
Abbasi A, Mohammadi M, Zahrakar K, Davarniya R, Babaeigarmkhani M. (2017) Effectiveness of solution-focused brief therapy (SFBT) on reducing depression and increasing marital satisfaction in married women. Iran Journal of Nursing, 30(105), 34–46.
Aminnasab, A., Mohammadi, S., Zareinezhad, M., Chatrrouz, T., Mirghafari, S. B., &
Rahmani, S. (2018). Effectiveness of solution-focused brief therapy (SFBT) on depression and perceived stress in patients with Breast Cancer. Tanaffos, 17(4), 272-279. PMCID: PMC6534804
Franklin, C., Zhang, A., Froerer, A., & Johnson, S. (January 01, 2017). Solution-focused brief therapy: A systematic review and meta-summary of process research. Journal of Marital and Family Therapy, 43(1), 16-30. Web.
Zhang, A., Ji, Q., Currin-McCulloch, J., Solomon, P.L., Chen, Y., Li, Y., Jones, B.L.,
Franklin, C., & Nowicki, J. (2018). The effectiveness of solution-focused brief therapy for psychological distress among Chinese parents of children with a cancer diagnosis: a pilot randomized controlled trial. Supportive Care in Cancer, 26, 2901-2910.
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