SOLUTION-FOCUSED BRIEF THERAPY

Solution-Focused Therapy
-Designed to facilitate change by assisting clients in clarifying how they would like their lives to
be different, inviting new descriptions of what is possible in clients lives and by identifying
resources that clients might use in changing their lives.
-It is a strength-based approach, emphasizing the resources people invariably possess and how
these can be applied to the change process.
-A goal-directed collaborative approach to psychotherapeutic change that is conducted through
direct observation of clients' responses to a series of precisely constructed questions.
PROPONENTS
Steve de Shazer

Born on June 25, 1940, Milwaukee. Died at September 11, 2005, in Vienna while on a
consulting tour
Graduated with a degree in fine arts from the University of Wisconsin in Madison, and he
continued on at the university to receive his masters degree in social work.
Wrote six significant books, translated into 14 languages; wrote many papers; and
lectured international
Steve de Shazer was married to Insoo Kim Berg.
De Shazer was originally trained as a classical musician and worked as a jazz
saxophonist. He received a Bachelor in Fine Arts and an MSc in Social Work from the
University of WisconsinMilwaukee.
He was mentored by John Weakland, at the time he also experimented a lot with the socalled one-way screen, a mirror through which a team of therapists could observe a
therapy conversation without being seen by the client and the therapist. The purpose of
using the one-way screen was to learn by observing conversations. At the end of the
therapy session, the therapist went behind the mirror for a few minutes to talk with the
team. The therapist would get feedback and tips from the team and would then go back to
the client to give his feedback and tips and close the conversation.

In Soo Kim Berg

A young American therapist of Asian origin
Born on July 25, 1934, Korea and died on January 10, 2007, Milwaukee, Wisconsin,
United States
Pharmacy major at Ewha Woman's University in Seoul, but after taking interest in
psychotherapy, she completed her post-studies at the Family Institute of Chicago, the
Menninger Foundation, and the Mental Research Institute (MRI) in Palo Alto, California,
where John Weakland was her mentor.

Jim Derks, Elam Nunnally, Eve Lipchik, and Marilyn LaCourt. Other, Marvin
Weiner, Alex Molnar, Wally Gingerich, Michele Weiner-Davis, John Walter, Kate Kowalski,
Ron Kral, Gale Miller, Scott Miller, and Larry Hopwood are other contributors of these
therapy however, de Shazer and Berg played an exceptionally important role both in the
development of the solution-focused approach and as ambassadors, spreading it across the globe.
According to Berg (Kiser, 1995), de Shazer played a very creative and innovative role, while
Berg, according to de Shazer, had a great impact, being a master therapist (Norman, McKergow,
& Clarke, 1996)
HISTORY

Milton Erickson realized that a lot of people get better by figuring out why they want to
change rather than why and how the problem appeared.
He conceptualized the crystal bowl technique which is adapted by SFBT and made their
miracle question.
Erikson did not believe in the method of psychoanalysis. It can clarify and make the
client understand the source of the problem but generally, most of the time after they have
released all these negative emotion they still feel the negative feeling because the therapy
have only reinforced the pattern of thinking that the client have been doing
Gregory Bateson, an anthropologist who established the Gregory Bateson Project in
which formed the foundation of the Mental Research Institute.
Mental Institute is where several researchers like John Weakland, Jay Hayley and
William Fry observed videotapes and sessions of famous therapist.
MRI studied work of Erickson because he was able to achieve the progress that any other
intervention cant in a short time.
The MRI founded the Brief Therapy Center. In which started brief and more goaloriented therapies
De Shazer and Berg started working on the MRI then after experimenting and observing
several videotapes of therapy session they created the Family Service
The Brief Family Therapy Center is de Shazer and Berg started their first practice
together with other colleagues.
They didnt want to start with general theories instead, they got back to observing
videos of therapy and tried to looked through what works and eliminate whats not.
Eventually together with their other finding they have included social constructionism as
one of the foundation of the SFT
They started by identifying traditional elements of therapy and removing one element at a
time from sessions. Then they observed whether the client outcome had been affected by
the removal of this element.
SFT was first developed in the 1975 and 1985 by Steve de Shazer, Insoo Kim Berg and
their colleagues at the Brief Family Therapy Center in Milwaukee.

Was considered a radical departure, even from the mental research institutes Brief
therapy tradition in which it emerged.
Other theories that influenced the SFT are Social Constructionism that says that
understanding, significance and meaning are developed not separately within the
individual but in the coordination with other human beings.
Wittgensteins philosophy which is the Language Game that is considered as the home
base of words and concepts. It is the inspiration for the Scaling Questions and the Miracle
Questions.
These theories influenced de Shazer because these ideas are popular in the 70s and 80s
To strengthen their approach the proponents did occasional quantitative studies to find
out about the effectiveness of interventions (Weiner-Davis, de Shazer, & Gingerich,
1987), attempts to formalize the approach into an expert system2, and several qualitative
studies.
De Shazer published Patterns of Brief Family Therapy: An Eco systemic Approach (de
Shazer, 1982), Four Useful Interventions in Brief Therapy, which he co-wrote with Alex
Molnar (de Shazer & Molnar, 1984), Keys to Solution in Brief Therapy, de Shazer began
to emphasize the importance of creating an expectation of change (de Shazer, 1985),
Investigating Solutions in Brief Therapy, de Shazer (1988) and more which promoted the
solution-focused therapy.

BASIC CHARACTERISTICS AND ASSUMPTIONS OF

SOLUTION FOCUSED BRIEF THERAPY
1. If it isnt broken do not fix it.
All kind of theories, therapy, models, philosophies of interventions are irrelevant if an
identified problem has been solved already by the client. If there is no problem, there should
be no therapy.
2. If it works do more of it.
If a client is in the process of solving a problem, the primary role of the therapist should
be to encourage the client to do more of what is already working. SFBT therapists do not
judge the quality of a clients solutions, only whether it is effective. As a result of identifying
what works well, the client is able to repeat this success and the solution further evolves.
3. If it's not working, do something different.
If an attempted solution does not work then the client is encouraged to explore and try
alternative solutions in order to resolve the problem.

4. Clients are seen as competent: there are always exceptions to the problem behavior.
This orientation on strength rather than weakness focuses the therapist on identifying the
clients resources, enabling the person to solve their own problems. Solution-focused
therapists elicit from the client personal strategies and social situations that have helped them
avoid the problem in the past. Clients always display exceptions to their problems, even
small ones, and these exceptions can be utilized to make small changes (de Shazer & Dolan,
2007)
5. The focus is on solutions.
Focusing on the solution to the problem and not the problem itself is especially
emphasized. By stepping outside the problem (seeing problems as influences to be
overcome) and exception finding (identifying times when problems are absent), those
involved with the client are able to work together to defeat the problem.
6. Clients are experts on their own lives.
In addition, solution-focused therapists see the client as the expert on their own problems
and lives. Simply put, solution-focused therapists define the problem as what the client says
it is. For this reason, the therapist takes a not knowing position. This does not mean that the
therapist has no expertise, but rather that he or she does not know as much about the client
and his or her resources as the client does (De Jong & Berg, 2002).
7. The language for solution development is different from that needed to describe a problem.
The language of problems tends to be very different from that of solutions. (de Shazer &
Dolan, 2007).Problem talk is usually negative and past-history focused in order to describe
the origins of a problem, and often suggests the permanence of the problem. The language of
solutions however is usually more positive, hopeful, and future-focused, and suggests the
transience of problems. In this perspective we listen to the voice of Wittgenstein (1962) who
stated that the world of the happy is quite another than that of the unhappy. Rhrig (2005)
asks us to scale ourselves on a scale from 1 to 10 in terms of How good are you at criticizing
someone in such a way that he or she has accepted your criticism without being hurt or
insulted? When giving constructive criticism a first step to take is to talk about what already
is going well. That is solution talk. A solution-focused question during an interview could be:
You have probably thought about this situation and how to change it for the better. Tell me,
what do you suggest? What could be a first small step to achieve your goal?
8. Clients have the desire to succeed.
Consistent with an optimistic view of the client, solution-focused therapists do not
believe in the concept of resistance and lack of desire to succeed. In contrary, it is assumed
that all clients have the desire to change. When clients say no we see this as a healthy

response of the client to tell us that we should not push further than the client can bear. From
this perspective it is not right to criticize clients on their courage to present a clear opinion.
Instead we should draw the conclusion that we did not receive mandate from the client yet
and in order to join with a client we have to adapt our therapeutic intervention.
9. Future orientation.
A solution-focused approach is future-oriented. There is not much investigation into the
past except to inquire about those times when the client has been able to develop solutions to
the undesired behavior. Instead, the solution-focused therapist helps the client develop and
visualize behavior that is more desirable or adaptive. These assumptions can help to support
or reframe our present beliefs about co-construction and communication with our clients
when needed or useful. Constructing a different way of thinking can certainly have an impact
on our mental model leading us from a more problem-oriented stance towards a more
solution-focused one, making room for increasing empowerment of clients and encouraging
them by focusing on possibilities and strengths to create hope. Isebaert (2007), states, that it
is the humanity of the therapist (with his characteristics and background) who is able to
create hope. From this perspective we draw the question: How do we know and how can we
observe that our clients are hopeful, or becoming more hopeful? What is it that we see, hear
or experience when we are interviewing for solutions, using our communication skills with
clients?
HUMAN NATURE IN SOLUTION FOCUSED BRIEF THERAPY
1. SFBT is focused on finding solutions not problems and therefore does not look at a
person in the sense of being maladjusted.
2. It is behavior that causes maladjustment and not the innate qualities of the person.
3. The clients narrative determines much about the repeated patterns of dysfunctional
behavior.
THREE TYPES OF NARRATIVES
PROGRESSIVE: Indicates that clients are moving forward and acting on goals.
STABILITY: Indicates clients are keeping the status quo.
REGRESSIVE: Indicates clients are retreating from goals
THERAPEUTIC GOAL
Well-defined goals are keys not only for keeping therapy brief, but also to ensure a successful
outcome. Insoo Kim Berg and Scott Miller (1999) detail seven qualities comprising well-formed
goals:
1. Saliency to the Client

2.
3.
4.
5.
4.
5.

Small
Concrete, Specific and Behavioral
The Presence Rather than the Absence of Something
A Beginning Rather Than an End
Realistic and Achievable Within the Context of the Client's Life
Perceived as Involving "Hard Work"
HOW BRIEF SOLUTION FOCUSED BRIEF THERAPY IS?

Aim for 5 sessions

45 mins each session

Rarely beyond 8 sessions

Sometimes 1 session enough

Any improvements after 3 sessions?

Increase gap between sessions as time goes on

THERAPIST FUNCTIONS AND ROLES

Not knowing position: clients as experts about their own lives.

- Consistent with the postmodern and social constructionist perspective, solutionfocused brief therapists adopt a not knowing position to put clients in the position of
being the experts about their own lives. Therapists do not assume that by virtue of their
expert frame of reference they know the significance of the clients actions and
experiences (Anderson & Goolishian, 1992). The therapist-as-expert is replaced by the
client-as-expert, especially when it comes to what the client wants in life and in therapy.
It is important that therapists actually believe that their clients are the true experts on their
own lives. According to Guterman (2006) therapists have expertise in the process of
change, but clients are the experts on what they want changed.

Create a collaborative relationships

- Bertolino and OHanlon (2002) stress the importance of creating collaborative
therapeutic relationships and see doing so as necessary for successful therapy.
Acknowledging that therapists have expertise in creating a context for change, they
stress that clients are the experts on their own lives and often have a good sense of what
has or has not worked in the past and, as well, what might work in the future. Solutionfocused counseling assumes a collaborative approach with clients
in contrast to the educative stance that is typically associated with most traditional

models of therapy. If clients are involved in the therapeutic process from beginning to
end, the chances are increased that therapy will be successful. In short, collaborative and
cooperative relationships tend to be more effective than hierarchical
relationships in therapy.

Create a climate of mutual respect in which clients are free to create and explore
solutions
- Therapists strive to create a climate of mutual respect, dialogue, and affirmation
in which clients experience the freedom to create, explore, and coauthor their evolving
stories. A key therapeutic task consists of helping clients imagine how they would like
life to be different and what it would take to make this transformation happen.

Help clients to explore what they would like things to be different, how to make a
difference, and what signs to indicate the changes are happening.

Therapists ask questions and, based on the answers, generate further questions.
(questions are the main intervention) Examples of some useful questions are What do
you hope to gain from coming here? If you were to make the changes you desire, how
would that make a difference in your life? and What steps can you take now that will
lead to these changes?

Therapists assist clients in finding exceptions to their problems

- Solution-focused brief therapists assist clients in paying attention to the
exceptions to their problem patterns. They promote hope by helping clients discovering
exceptions, or times when the problem is less intrusive in their life (Metcalf, 2001).
SFBT focuses on fi nding out what people are doing that is working and then helping
them apply this knowledge to eliminate problems in the shortest amount of time possible.
Identifying what is working and encouraging clients to replicate these patterns is
extremely important (Murphy, 2008). A key concept is, Once you know what works, do
more of it. If something is not working, clients are encouraged to do something
different, which typically involves drawing on their unique strengths and successes.

Discover what the person was doing then that could be seen as a solution for the
present concern. Therapists simply support the client in doing that again--provide
encouragement, feedback, etc.

RELATIONSHIP BETWEEN THERAPIST AND CLIENTS

The therapeutic relationship is an important factor for change to occur.

 The therapeutic process works best when clients become actively involved, when they
experience a positive relationship with the therapist, and when counseling addresses what
clients see as being important (Murphy, 2008).
Help clients to use their strengths and resources to construct solutions
Three Kinds of Relationships in Solution-Focused Therapy
Customer-type relationship: 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.
Complainant relationship: 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 elses actions. In this situation, the client generally expects the therapist to
change the other person to whom the client attributes the problem.
Visitors: the client comes to therapy because someone else 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.
THERAPIST CHARACTERISTICS AND REQUIREMENTS

SFBT therapists should posses the requisite training and certification in mental health
discipline, and specialized training in SFBT.

The ideal SFBT therapist would possess the following:

a
b

a minimum of a masters degree in a counseling discipline such as counseling, social

work, marriage and family therapy, psychology, or psychiatry;
formal training and supervision in solution-focused brief therapy, either via a
university class or a series of workshops and training.

Therapists who seem to embrace and excel as solution focused therapists have these
characteristics:
a
b
c
d
e

are warm and friendly;

are naturally positive and supportive (often are told they see the good in people);
are open minded and flexible to new ideas;
are excellent listeners, especially the ability to listen for clients previous solutions
embedded in problem talk; and
are tenacious and patient.

THERAPIST TRAINING

Therapists who meet the above requirements should receive formal training and supervision
in SFBT. A brief outline of such a training program would include:
1. History and philosophy of SFBT
2. Basic tenets of SFBT
3. Session format and structure of SFBT
4. Video examples of Masters of SFBT
5. Format of SFBT
6. Video examples of SFBT
7. Role playing
8. Practice with video feedback
9. Training with video feedback
Therapists can be considered trained when they achieve an 85% adherence and
competency rating using standardized adherence and competency rating scales. There should
also be subjective evaluations by the trainers as to therapists overall ability to function
reliably and capably as solution focused therapists.
TECHNIQUES USED

Focusing on clients solutions is integral to solution-focused therapy. Therapists identify

possible solutions by asking clients what they value and want to maintain.

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?

Miracle Questions
- Main SFBT technique
- Suppose that one night, while you are asleep, there is a miracle and the problem
that brought you here is solved. However, because you are asleep you don't know that the
miracle has already happened. When you wake up in the morning, what will be different
that will tell you that the miracle has taken place? What else?
(de Shazer, 1988)
- Clients are encouraged to enact what would be different in spite of perceived
problems.
- De Jong and Berg (2008) identify several reasons the miracle question is a
useful technique. Asking clients to consider that a miracle takes place opens up a range of

future possibilities. Clients are encouraged to allow themselves to dream as a way of

identifying the kinds of changes they most want to see. This question has a future focus in
that clients can begin to consider a different kind of life that is not dominated by a
particular problem. This intervention shifts the emphasis from both past and current
problems toward a more satisfying life in the future.
2

Scaling Questions
- Solution-focused therapists also use scaling questions when change in human
experiences are not easily observed, such as feelings, moods, or communication, and to
assist clients in noticing that they are not completely defeated by their problem (de
Shazer & Berg, 1988).
- On a scale of zero to 10, where zero is the worst you have been and 10
represents the problem being solved, where are you now?, where do you need to be?
what will help you move up one point?
- To have the client evaluate his own progress.
- 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.

Exception Questions
- Direct clients to times in their lives when the problem they identify were not
problematic. These times are called exceptions and represent news of difference
(Bateson, 1972). 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 clients life when it would be reasonable to
have expected the problem to occur, but somehow it did not (de Shazer, 1985; Murphy,
2008). By helping clients identify and examine these exceptions, the chances are
increased that they will work toward solutions (Guterman, 2006).
Some exception questions:
Tell me about the times when (the complaint) does not occur, or occurs less than
at other times.
When does your partner listen to you?
Tell me about the days when you wake up more full of life.
When are the times you manage to get everything done at work?

Coping Questions
- If a client reports that the problem is not better, the therapist may sometimes ask
coping questions such as, How have you managed to prevent it from getting worse?
Some coping questions:
How do you cope with these difficulties?
What keeps you going?
How do you manage day-to-day?

Who is your greatest support? What do they do that is helpful?

This problem feels so difficult at the moment, yet you still managed to get here
today. What got you here?

Formula First Session Task

- 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, relationship) that you want to continue to have happen (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 present and future
situation.

ADVANTAGES OF THE APPROACH AND SHORTCOMINGS/DISADVANTAGES

Advantages of the solution focused brief therapy
In a short period of time, it gives pressure that provides an effective
counseling that fits in nicely with managed care.
Highlight and Focus in the positive/strength attributes of the clients
It can be used effectively with a variety of clients and issues.

Shortcomings/Disadvantages Emotional Freedom Therapy

Critics say it is too simplistic and does not have enough empirical research to
support it the fact that it was developed by Steve de Shazer (1940-2005), and
Insoo Kim Berg (1934-2007) contemporary it was not yet deeply explored or not
yet fully developed.
It may be contraindicated with dependent clients - particularly when such
dependency becomes so intense as to lead to client deterioration. Such client may
be more appropriately helped in group counseling where such intense dependency
is less likely to develop due to the fact that the therapist has to relate to several
other people.

 It may not adequately address clients with serious mental issues- due to the
fact that this is simple only those client that have mild mental issues can
effectively used this approach.
It may not develop the counselor/client relationship in enough depth to be
therapeutic- because of its one way approach that only focuses in the positive
attributes of the client(s)
it does not attend to many multicultural tenets.the fact that this does not spend
a lot of time understanding the client with his or her culture and worldview
COMPREHENSIVE EXPLANATION:
As is often the case disadvantages tend to be the converse of and closely related to
advantages. Some of the disadvantages of using solution focused brief therapy can be
summarised as follows:
The worker has to listen to the client and has to take what the client says seriously. What the
client says is what the client means. The worker cannot take the position that the client really
means something else or that if the client were well she would be saying something else. The
potential disadvantages of this are clear and varied. For example the worker has to accept the
clients goals for the piece of work, even if the worker feels that the goals are not
the right goals. A client may for example describe her wish to improve her relationship with
her partner. The worker in such an instance would need to put away her thought that the
client should work on her experience of childhood sexual abuse. For the worker who has
developed professionally in a culture dominated by the idea of underlying causation, this
change might be hard to make and the worker will tend to be constantly assailed with a worry
that her work is superficial and failing to get to the root of the problem.
Listening to the client also means that when the client says that the work is done the work
is done. The disadvantages of this, particularly to the worker in private practice, are clear and
obvious. However beyond this, listening to the client can mean having to tackle and get to
grips with the workers natural ambition for the client, her natural desire that the client make
the most of her undoubted skills, strengths, resources and abilities. Accepting that the
client could do more and yet is deciding, for the moment at least, that she is happy to accept
life the way it is, requires huge self-discipline on the part of the worker.
The worker who uses solution focused brief therapy can never take the credit. If the work
goes well it is always the client who has made the changes and who will be credited. For
example the client who says to the worker Whats helped me to make changes is coming
here and talking with you is likely to respond by saying many people come here and do not
make changes. What is it about you that means that you have made good use of our talking
together? Some therapy has at the heart of its self-description the image of the heroic

worker struggling with the clients pathology getting down into the bear-pit and fighting for
the clients health. Other therapies have the idea of the clever therapist, outwitting the clients
resistance, tricking the client into giving up his symptoms. At the heart of solution focused
brief therapy is the image of the heroic client. The worker disappears. One of Chris Ivesons
clients (George et al 1999) commented that when you ask the right questions you
disappear. The client at the end of the therapeutic process may remain puzzled about the
part that the therapy has played in the client making changes. The skill of solution focused
brief therapy is to work close to the clients position, close to the clients reality and yet
sufficiently distant to make a difference. Such a skill tends to be invisible.
The solution focused worker cannot be clever. If the worker is being clever it is likely that the
work is not solution focused. The early history of strategic family therapy was marked by
clever, intricate, even at times somewhat abstruse interventions. The tasks that the workers
developed seemed creative, extraordinary almost as if they had come from nowhere. This of
course was in fact because the task had come out of the world of the workers theory, out of
the workers head. In solution focused brief therapy the best suggestions are born logically
out of the talking that has gone on during the sessions and will have been co-created by the
worker and the client. Yet again the client will have to be given much of the credit and the
workers contribution may appear mundane to the outsider.
Using solution focused brief therapy will not even impress your colleagues. Case conferences
can be an arena within which the professional pecking order or hierarchy of esteem can be
negotiated. The worker whose approach allows for the possibility of hypothesising can
develop an impressive formulation which will, in all likelihood, relate the presenting
problems to underlying issues of causation developing a strikingly consistent new narrative
of explanation from the often limited facts available. Examples of this are commonplace, the
clients case history being presented to the conference and one of the group responding with
I wonder if this clients father wasnt a sailor? or I wonder whether (the client) wasnt
separated from her parents in her early life? or I wonder whether (the client) hasnt been
abused? Solution focused brief therapy of course allows no space for hypothesising and thus
little scope for impressing colleagues, except with the rather more mundane matter of good
outcomes.
Using solution focused brief therapy even prevents the worker from being helpful. Many of
us came into this sort of work precisely because we were motivated by the desire to be
helpful to others it certainly was not for the social esteem or the financial rewards. In
solution focused brief therapy the worker has to guard against this tendency trying to be
useful rather than helpful. Helpfulness might lead the worker hearing the client describe a
problem to suggest what about trying to . . . or have you ever thought of . . . In solution
focused brief therapy the worker, in attempting to be useful, will limit herself to asking useful
questions, questions which orient the client towards solutions. Indeed the worker will have to
develop the discipline of leaving her good ideas at the door of the consulting room, since if

the worker begins to say to herself I know what this client should do to resolve this problem,
then it becomes almost impossible not to try to get the client to do what the worker thinks the
obvious solution is. And this, of course, is the best recipe for building what can be thought of
as resistance in the client worker relationship, trying to get clients to do things that they have
not yet decided to do.
Solution focused brief therapy is inconvenient for the worker. What works for workers is
regular scheduling seeing clients weekly at the same time which means that the workers
diary can be managed in a neat and orderly way with the worker having some ability to
predict what might be happening on any one day. Since in solution focused brief therapy it
will be the worker and the client together who will decide on the scheduling of the next
appointment and since weekly appointments are unusual and since the gap between sessions
is likely to get longer as the client changes and since regular appointment times are frowned
upon for changing therapy into a question of habit rather than a purposeful activity it is clear
that solution focused diaries tend to be chaotic. The worker has to be able to cope with this.
The worker also has to be able to deal with lots of new clients. Since the average number of
sessions is likely to be around four, no client is likely to be seen for very long and the worker
will have to get used to working with lots of new clients. Working with new clients is hard
work, since there is never the time to slip into a routine.
Whats more the worker is not even likely to enjoy sitting with the client as the client
recounts the benefits of the changes that she has made to her life. As soon as the client is
confident enough of being able to made the changes she requires, before even achieving them
therefore the therapy is likely to end. No time at all to bask in the satisfaction of a job well
done.
And if the work does not go well the solution focused worker cannot even blame the client
by suggesting that there is something wrong with the client. There is no way that the worker
can argue that the client is lacking in insight or insufficiently psychologically minded, or
unmotivated or in any way other deficient. The worker has to face up to the lack of change
and acknowledge that however hard she has tried she has not managed to find a way of being
useful to the client. So if the work does go well it is the client who is to be credited and if it
does not then that is the responsibility of the worker.

Empirical Studies Supporting the Effectiveness of Solution Focused Brief

Therapy
A Gingerich, W.J., & Peterson, L.T. (2013). Effectiveness of solution-focused brief therapy:
a systematic qualitative review of controlled outcome studies. Research on Social Work
Practice 2013; 23(3): 266-283.

Objective: To review all available controlled outcome studies of solution-focused brief

therapy (SFBT) to evaluate evidence of its effectiveness.
Method: Forty-three studies were located and key data abstracted on problem, setting, SFBT
intervention, design characteristics, and outcomes.
The forty- three studies:
1

Child academic and behavior problems (14)

Adult mental health (10)

Marriage and family (6)

Occupational rehabilitation (5)

Health and aging (5)

Crime and delinquency (3)

Results: Thirty-two (74%) of the studies reported significant positive benefit from SFBT; 10
(23%) reported positive trends. The strongest evidence of effectiveness came in the treatment
of depression in adults where four separate studies found SFBT to be comparable to wellestablished alternative treatments. Three studies examined length of treatment and all found
SFBT used fewer sessions than alternative therapies.
Conclusion: The studies reviewed provide strong evidence that SFBT is an effective
treatment for a wide variety of behavioral and psychological outcomes and, in addition, it
may be briefer and therefore less costly than alternative approaches.

B Cockburn, Thomas, & Cockburn (1997). Solution-focused therapy and psychosocial

adjustment to orthopedic rehabilitation in a work hardening program. Journal of
Occupational Rehabilitation, 7(2), 97- 106
Objective: To evaluate the impact of SFBT on psychosocial adjustment and return to work
for patients with orthopedic injuries.
Method: The study sample was comprised of 48 patients and their spouses, referred by an
orthopedic surgeon to a rehab program designed to prepare patients for work re-entry.
Subjects had to be first-time recipients of a worker's compensation claim, married to a spouse
who is employed full-time, not currently on prescription drugs, and without other medical
problems that could compromise the study. Seventy-three percent of the final sample had
orthopedic injuries of the spine or upper extremities. Subjects were randomly assigned to one

of four groups, following a Solomon Four Groups design. The intervention for treatment
groups 1 and 3 consisted of 6 weekly one-hour sessions of SFBT plus the standard rehab
program. Treatment was implemented by the first author and followed a standard protocol
(Jack Cockburn, personal communication, April 18, 1999). Control groups 2 and 4 received
only the standard rehab program. Pre-test data were collected from treatment group 1 and
control group 2 using the Family Crisis Oriented Personal Evaluation Scales (F-COPES).
Post-test data were collected from all 4 groups using the F-COPES and the Psychosocial
Adjustment to Illness ScaleSelf-Report (PAIS-SR). Subjects' spouses also completed the
PAIS-SR at post-test. Because pre-testing was shown to have a consistent effect across
treatments, analyses were based on ANOVAs for the post-test data only. Analysis of FCOPES data indicated significant between-groups differences on all 3 subscales used in the
study. The two treatment groups were 913 points higher on Acquiring Social Support, 914
points higher on Reframing, 57 points higher on Mobilizing Family, and 45 points higher
on Seeking Spiritual Support than were the two control groups. Between-group differences
on the PAIS-SR were also statistically significant. Couples in the treatment groups were
about 4 points higher on the Health Care scale, 4 points higher on Domestic Environment, 9
points lower on Psychological Distress, and 5 points higher on Social Environment. There
was no significant difference between groups on the Vocational Environment scores.
Results: Within 7 days after completion of treatment, 68% of subjects in the treatment
groups had returned to work as compared to only 4% of subjects in the control groups. By 30
days after treatment, 92% of the SFBT patients had returned to work as compared to 47% of
control group patients.
Conclusion: The authors concluded that patients in the SFBT groups had significantly better
psychosocial adjustment and social supports than patients in the control group.

C Sean, N. (2004). Solution-focused brief therapy group work with at-risk junior
high school students: enhancing the bottom line. Research on Social Work
Practice, 14(5), 336-343.

Objective: Despite the preliminary studies that support solution-focused

brief therapy, limited research has examined the model as a group
intervention with students at risk for academic underachievement and
school nonattendance. Therefore, the purpose of this study was to
evaluate the impact of the model on school attendance and grade point
average.
Method: Solution-focused brief therapy was evaluated through a quasiexperimental pretest-posttest comparison group design in which 26

students receiving the intervention were compared to 26 students who

did not.
Results: Compared to students who did not receive the intervention,
students in the treatment group increased their grade point average from
pretreatment to post treatment. Conversely, no differences were found
between the two groups on attendance.
Conclusions: Solution-focused brief therapy shows promise as a group
intervention with at-risk students. Moreover, the findings suggest the
continued support of the model during a time in which K-12 education
emphasizes accountability, hard data, and the bottom line.

D Kim, J.S., & Franklin C. (2009). Solution-focused brief therapy in schools: A

review of the outcome literature. Children and Youth Services Review, 31, 464470. (Systematic review)

Objective: To assess the effectiveness of solution-focused brief therapy on

behavioral problems of children and adolescents in schools.
Results of the review: Seven studies were included (n=364): five quasi-experimental design
studies, one experimental design and one single case design. Sample size ranged from seven
to 86. Duration of follow-up was not reported.
Results were mixed for both within-group and between-group comparisons. Five studies
showed the benefit of solution-focused brief therapy for at least one outcome: reduced
intensity of students' negative feelings; managed conduct problems; improved academic
outcomes; and positively externalized behavioral problems and substance use. One study
found that solution-focused therapy had a similar effect on students' behavioral change as
cognitive behavioral therapy. Based on effect sizes calculated in individual studies, solutionfocused brief therapy had small to large effect sizes.
Three studies reported that solution-focused brief therapy was not effective in increased
grade scores or improved attendance rates of students. One study showed no effect of
solution-focused brief therapy on students' behaviour change. Two studies reported no effect
of solution-focused brief therapy on students' self-esteem.
Conclusions: Despite mixed results, solution-focused brief therapy showed promise in
working with at-risk students in school settings, specifically for reducing the intensity of

students' negative feelings, managing conduct problems and externalizing behavioral

problems.
E Shazer, S.D., & Isebaert, L. (2004). Special section: Solution- focused brief therapy
for alcohol and substance abuse. Journal of Family Psychotherapy, 14, 43-52.
Objective: This article offers a program description of a new approach to
the treatment of problematic drinking developed at St. John's Hospital,
Bruges, Belgium. The program is based on Solution-Focused Brief
Therapy, and is offered in both an inpatient and outpatient setting.
Method: Four-year follow-up telephone interviews were conducted for 118
inpatients and 72 outpatients who had completed the program.
Results: Eighty four percent of the inpatients and 81% of the outpatients
reported maintaining their goals of either abstinence or controlleddrinking four years after completion of the program.
Conclusion: Solution-Focused Brief Therapy has a benefit for the
treatment of drinking problem.

F Franklin C., Moore K., Hopson L. (2008). Effectiveness of solution-focused

brief therapy in a school setting, Children and Schools, 30(1), 15-26.

Objective: This American study evaluated the effectiveness of solutionfocused brief therapy with children who have classroom-related behavior
problems within a school setting.
Method: Five to seven sessions of solution-focused brief therapy services
were provided to 67 children, identified by school faculty and staff as
needing assistance in solving behavior problems. Teacher in-service
training and three to four consultation meetings were also provided.
Externalizing and Internalizing scores from both the Youth Self-Report and
Teacher Report Forms of the Child Behavior Checklist were used as
outcome measures. Outcomes were evaluated by using a pretest/posttest

follow-up design with a comparison group. Effect sizes and improved

percentage scores were calculated.
Conclusion: Findings provide support that solution-focused brief therapy
was effective in improving internalizing and externalizing behavior
problems.

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