Solution Focused Brief

therapy

Dr. Pradnya Kulkarni

History
● De Shazer and his wife, Insoo Kim Berg
Established the Brief Family Therapy Center
in Milwaukee in 1978.
● The model has been developed inductively
based on 30 years of sessions with clients.
● Based on the hypnotherapeutic work of Milton H. Erickson and influenced
by the 1974 work of John H. Weakland, Paul Watzlawick, and Richard
Fisch of the Mental Research Institute.
Assumptions
● SFBT does not believe that you need to know the source of the problem to resolve the
problem. You can still create positive change without knowing the source of the
problem.
● Gathering information about a problem is not necessary for change to occur.
● If knowing and understanding problems are unimportant, so is searching for “right”
solutions.
● Clients can be trusted in their intention to solve their problems.
● Clients want to change, have the capacity to change, and are doing their best
to make change happen.
● Any person might consider multiple solutions, and what is right for one person may not
be right for others.
Theory of psychotherapy
● Clients often have a story that is rooted in a deterministic view that what has
happened in their past will certainly shape their future.
● Individuals who come to therapy do have the capability of behaving effectively,
even though this effectiveness may be temporarily blocked by negative
cognitions. Problem-focused thinking prevents people from recognizing
effective ways they have dealt with problems.
• There are exceptions to every problem. By talking about these exceptions,
clients can get control over what had seemed to be an insurmountable problem. The
climate of these exceptions allows for the possibility of creating solutions. Rapid
changes are possible when clients identify exceptions to their problems.
• Clients often present only one side of themselves. Solution-focused therapists
invite clients to examine another side of the story they are presenting.
5

Theory of Psychotherapy
● In solution-focused brief therapy, clients choose the goals they wish to accomplish, and little attention is
given to diagnosis, history taking, or exploring the problem
● It is a nonpathological approach that emphasizes competencies rather than deficits, and strengths
rather than weaknesses (Metcalf, 2001).
● Small changes pave the way for larger changes. Oftentimes, small changes are all that are
needed to resolve problems that clients bring to therapy.
● Therapists should adopt a cooperative stance with clients rather than devising strategies to
control resistive patterns.
● When therapists find ways to cooperate with people, resistance does not occur.
Client-therapist Relationship

Collaborative attitude
Therapists create a climate of mutual respect, dialogue, inquiry, and
affirmation in which clients are free to create, explore, and co-author their
evolving stories
The main therapeutic task consists of
Helping clients imagine how they would like things to be different and
what it will take to bring about these changes
Complimenting the strengths
Three Kinds of Therapeutic Relationships (De Shazer,1988)
Visitor:
The client comes to therapy because someone else (a spouse, parent, teacher, or probation offi cer)
thinks the client has a problem. This client may not agree that he or she has a problem and may be unable
to identify anything to explore in therapy.

Complainant
The client describes a problem but is not able or willing to assume a role in constructing a solution,
believing that a solution is dependent on someone else’s actions. In this situation, the client generally
expects the therapist to change the other person to whom the client attributes the problem.

Customer
The client and therapist jointly identify a problem and a solution to work toward. The client realizes that
to attain his or her goals, personal effort will be required.
Therapeutic Goals

● Changing the viewing of a situation or a frame of reference

● Changing the doing of the problematic situation
● Tapping client strengths and resources
● Engage client in change- or solution-talk, rather than
problem-talk
Therapeutic Technique
Pre-therapy changes
● Simply scheduling an appointment often sets positive change in motion. During the
initial therapy session, it is common for solution-focused therapists to ask, “What have
you done since you called for the appointment that has made a difference in your
problem?”
● By asking about such changes, the therapist can elicit, evoke, and amplify what clients
have already done by way of making positive changes.
Therapeutic Technique
Exceptional Questions

● Solution-focused therapists ask exception questions to direct clients to times when

the problem did not exist, or when the problem was not as intense. Exceptions are
those past experiences in a client’s life when it would be reasonable to have expected
the problem to occur, but somehow it did not
● This exploration reminds clients that problems are not all-powerful and have not
existed forever; it also provides a field of opportunity for evoking resources, engaging
strengths, and positing possible solutions
● [Link] Three ways of asking
exceptional questions
● [Link] exeptional questions
Therapeutic Technique
Miracle question
“If a miracle happened and the problem you have was solved overnight, how would you
know it was solved, and what would be different?”
“What changes will indicate that the miracle has happened?”
● Use the process of considering hypothetical solutions

✔ It opens the range of future possibility

✔ Promote out of the box thinking
✔ Make a leap of faith and
✔ Changes in life after the problem is resolved.
✔ Better understanding of the problem, its effects on client.
✔ [Link]
✔ _[Link]
Example:
● Therapist: So when you wake up tomorrow morning, what will be the first small clue to you... “whoa, something is

different”.

● Client: You mean everything’s gone

● Therapist: The problem is gone.

● Client:The gut feeling. The inside feeling. The monkey off the back so to speak.

● Therapist: O.K. So, after this miracle tonight, when the miracle happens, the problems are all solved, what would

be different in your gut feeling?

● Client : Maybe I’d feel a little lighter, a little easier to move. Being able to make decisions.

● Therapist : So you would like to make the decision. And would feel like saying “hmm, this makes sense, let’s do it

this way” without worrying: “ that someone going to look over your shoulder or not.”

● Client: Right!
Scaling questions
● For example, a woman reporting feelings of panic or anxiety might be asked: “On a
scale of zero to 10 with zero being how you felt when you first came to therapy and 10
being how you feel the day after your miracle occurs and your problem is gone, how
would you rate your anxiety right now?”
● Even if the client has only moved away from zero to one, she has improved. How did
she do that? What does she need to do to move another number up the scale? Scaling
questions enable clients to pay closer attention to what they are doing and how they
can take steps that will lead to the changes they desire.
● [Link]
Formula first session task
● The formula first session task (FFST) is a form of homework a therapist might give clients to complete
between their first and second sessions. The therapist might say: “Between now and the next time we meet, I
would like you to observe so that you can describe to me next time what happens in your (family, life,
marriage, and relationship) that you want to continue to have happened” (de Shazer, 1985, p. 137).
● At the second session, clients can be asked what they observed and what they would like to have happen in the
future. This kind of assignment offers clients hope that change is inevitable. It is not a matter of if change will
occur but when it will happen.
● According to de Shazer, this intervention tends to increase clients’ optimism and hope about their situation.
Clients generally cooperate with the FFST and report changes or improvements since their first session
(McKeel, 1996; Walter & Peller, 2000).
● Bertolino and O’Hanlon (2002) suggest that the FFST intervention be used after clients have had a chance to
express their present concerns, views, and stories. It is important that clients feel understood before they are
directed to make changes.
Coping questions
After everything you have been through,
I am wondering what has helped you to cope and keep you
Purpose afloat during all this?’;
• Gain understanding of how the person
‘I feel to ask you, what it is exactly that has helped you
has managed to cope. through this so far?’.

• Identify the resources that they do have How have you managed to come out of the situation ?

available to them

• Identify the strengths

Therapiest’s feedback to client
Three basic parts to the structure of the summary feedback:

Compliments are genuine affirmations of what clients are already doing that is leading toward effective
solutions. It is important that complimenting is not done in a routine or mechanical way but in an
encouraging manner that creates hope and conveys the expectation to clients that they can achieve their
goals by drawing on their strengths and successes.

Bridge links the initial compliments to the suggested tasks that will be given. The bridge provides the
rationale for the suggestions.

Suggesting tasks to clients, which can be considered as homework. Observational tasks ask clients to
simply pay attention to some aspect of their lives. This self-monitoring process helps clients note the
differences when things are better, especially what was different about the way they thought, felt, or
behaved. Behavioral tasks require that clients actually do something the therapist believes would be
useful to them in constructing solutions.
Terminating
● Once clients are able to construct a satisfactory solution, the therapeutic relationship can be terminated. The
initial goal-formation question that a therapist often asks is, “What needs to be different in your life as a
result of coming here for you to say that meeting with me was worthwhile?” Another question to get clients
thinking is, “When the problem is solved, what will you be doing differently?” Through the use of scaling
questions, therapists can assist clients in monitoring their progress so clients can determine when they no
longer need to come to therapy (De Jong & Berg,
2008). Prior to ending therapy, therapists assist clients in identifying things they can do to continue the
changes they have already made in the future (Bertolino & O’Hanlon, 2002). Clients can also be helped to
identify hurdles or perceived barriers that could get in the way of maintaining the changes they have made.
STRENGTHS
● Solution focused
● Collaborative, curious stance
● Client is in charge
● No dependency
● Cost effective, brief in effect.
● Positive psychology principles; boosting nature.
● Non judgemental, compassionate, future oriented.
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Application
● Interpersonal Relationship issues
● Depression
● Stress
● Anxiety
● Addiction
● Behavioral issues like Procrastination
LIMITATIONS
● Works well with psychologically minded clients.
● Very less or no focus on past.
● Trauma may not be explored.
● May be put off by the insistence on talking about exceptions to their problems.
● Looking at the therapist as an expert.