Solution-Focused Therapy (SFBT)
Solution-focused brief therapy (SFBT) is a type of talk therapy where the primary focus is on finding solutions to problems.
What is Solution Focused Therapy?
Solution focused therapy (SFT) is an evidence-based type of therapy that is aimed at improving a client’s ability to apply solutions rather viewing the situation from a problem perspective. Solution-focused brief therapy (SFBT) is a type of talk therapy where the primary focus is on finding solutions to problems. Many types of therapy focus on a current problem and how it relates to past problems or a client’s deficits. The mindset of SFT therapy is a little different from this.
Unlike many other therapy types, solution-focused therapy tends not to involve pulling apart the detail of the problem or understanding the underlying issues that led to the formation of the problem. Rather, solution-focused therapy is a short-term intervention. It is a brief therapy option which aims to rapidly generate workable solutions, and thus relieve clients of distress quickly.
SFT uses principles of “positive psychology” to focus on strengths, exceptions to the problem(s), and what has worked in the past to create a vision for what success looks like in the future.
The therapy highlights what is currently working in a patient’s life, what solutions have worked before, and what can be applied to the current situation. The process is collaborative, identifying goals that match the patient’s highest hopes and solutions that are consistent with these hopes.
Structure of solution-focused therapy sessions
Although it varies, SFBT therapist sessions tend to be around 45-50 minutes in length and involve a high level of participation on the client’s part.
In the initial session, you will usually work with your SFBT therapist to clarify the problem you are experiencing. The SFBT approach uses exception questions along with a detailed description of the issues, behavioral problems, or relationship problems, you and your therapist will agree on the goals for solution-focused brief therapy. The emphasis is on understanding the current problem enough to start building solutions and supporting problem solving solutions for future hopes.
In later sessions, you’ll review how successfully the solutions (which you apply in between sessions) have solved the problem. You might then need constructive collaboration and scaling questions to generate more solutions and treatment modalities. Solution building is based on your existing skills and strengths often learned through past life events, and review progress towards therapy goals.
Who Benefits from SFT?
SFT is best for those who want to address with issues such as trauma, depression, anxiety, child behavioral problems, substance use issues, and relationship problems. It’s important to note that a client undergoing SFT must have an open mind and willingness to be open to change in order to find success in this type of therapy. It is a great option for patients who have a specific goal in mind and who are focused on working with someone to obtain that particular goal.
How Long Does SFT Last?
This therapy is considered to be brief and often can require only 5-8 sessions. For this reason, SFT is attractive to many patients as it is less costly and may provide a quicker result as compared to other styles.
What happens in a typical solution-focused therapy session?
Throughout therapy, sessions tend to be focused on the present or future-oriented, with little past-oriented focus. The key concepts of a typical solution-focused therapy session might include the following elements, which require an elevated level of active participation on your part due to the goal-oriented nature of the short-term therapy:
- The therapist might ask you a lot of scaling questions, to both clarify the problem and to encourage the generation of potential solutions. A classic question commonly posed in solution-focused therapy is called “The miracle question,” which asks you to consider what you would be doing differently if a miracle occurred that solved your problem overnight. The aim of the miracle question and other future-focused questions is to encourage creative thinking about practical solutions.
- SFBT practitioners might help you to increase your awareness of what is changing, the progress made, and positive aspects of your current experience.
- SFBT therapists might ask coping questions that focus on your strengths, existing skills, and ability to solve problems.
- Before the end of each session, you’ll set goals and plans for implementing the solutions as part of your therapeutic process. You’ll probably also evaluate your progress towards solving the problem, perhaps giving a rating on a scale from one to ten.
What are the “Miracle Questions”
The miracle question is a technique that therapists use to assist clients to think "outside the square." It asks the client to consider life without the problem by setting up a scene where a miracle happens and the problem is gone. The exact language may vary, but the basic wording is this:
"Suppose that while you are sleeping tonight and the entire house is quiet, a miracle happens. The miracle is that the problem which brought you here is solved. But because you are sleeping, you don’t know that the miracle has happened. So, when you wake up tomorrow morning, what might be the small change that will make you say to yourself, 'Wow, something must have happened—the problem is gone!'"
Asked this way, miracle questions help clients open up to future possibilities.
What are the "Exception Questions"
Exception questions allow clients to identify times when things have been different for them. Finding times when the problem wasn’t so much of a problem.
Examples of exception questions include:
- "Tell me about times when you felt happiest."
- "What was it about that day that made it a better day?"
- "Can you think of a time when the problem was not present in your life?"
By exploring how these exceptions happened, a therapist can empower clients to find a solution.
What are the "Scaling Questions"
Scaling questions invite clients to perceive their problems on a continuum. They're also a helpful way to track progress toward goals and monitor change.
Generally, scales are from 1 to 10. When working with a client who is dealing with anxiety, for example, a therapist might say:
"If 10 is the most anxious and 1 is the most relaxed, what number would you put yourself on right now?"
Questions like these are usually followed with questions related to scaling, such as asking the client to explain why they chose the number they did and why their number is not one lower. They'll likely also ask the client how they will know they are moving up the scale.
Benefits of SFBT
The major advantage of SFBT is its brevity. SFBT is a form of "brief therapy," typically lasting between 5–8 sessions. Because of this, it is often less costly than other forms of therapy.
Instead of digging into old wounds, more time is spent focusing on resolutions, which makes SFBT great for people who have a specific goal in mind and just need a little help reaching it.
The efficiency of Solution-Focused Brief Therapy
Research shows that SFBT can effectively:
- Decrease addiction severity and trauma symptoms
- Decrease marital issues and marital burnout in women
- Improve classroom behavioral problems in children with special education needs
- Reduce externalizing behavioral problems, including conduct disorder, and conflict management
- Reduce internalizing behavioral problems, such as depression, anxiety, and self-esteem
SFBT can be just as effective (sometimes even more so) than other evidence-based practices, such as cognitive behavioral therapy (CBT) and interpersonal psychotherapy.
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