CDS3004

Solution-Focussed Therapy

CDS3004

Counselling Theory and Practice 2

Dr Nathan Beel

University of Southern Queensland

Assignment 1

1,648 words

Introduction

Solution-focussed therapy (SFT) has quickly become one of the widest, most portable therapeutic approaches and is credited to the success of an extensive range of clients. This essay explores the history of SFT and reviews the key assumptions and interventions which inform the application of the model. The strengths and weaknesses of SFT are considered, along with research and findings to support claims. Suitable clients for SFT are identified, and recommendations made for future study in order to establish efficacy of the model.

What is Solutions-Focussed Therapy?

SFT is a widely used therapeutic intervention which focuses on the clients strengths and abilities, rather than their weaknesses and shortcomings (Cepeda, 2006; de Jong & Berg, 2013). The therapist assumes a position of not-knowing to allow the client to direct the session, facilitating the co-creation of small, achievable therapeutic goals (de Jong & Berg, 2013; Gingerich & Eisengart, 2000; Kim et al., 2018; Roeden et al., 2009). SFT places a strong focus on solutions, rather than on problems, which sets the therapy apart from many traditional therapeutic methods (de Jong & Berg, 2013; Gingerich & Eisengart, 2000; Quick & Gizzo, 2007). The theory maintains that people can change and that moving from a position of weakness to a position of change fosters self-belief, hope, resilience, and autonomy (Kvarme et al., 2013; Quick & Gizzo, 2007).

History

In 1978, Steve de Shazer and Insoo Kim Berg launched the Milwaukee Brief Family Therapy Centre (BFTC) (Choi, 2019; de Jong & Berg, 2013). Throughout the 1980s, de Shazer and Berg collaborated with their colleagues, pioneering in the field of family therapy and co-founding the Solution-Focused Brief Therapy (SFBT) approach (de Jong & Berg, 2013; Gingerich & Eisengart, 2000; Trepper et al., 2006). Evolving out of a Brief Family Therapy approach and underpinned by the work of Milton Erickson, SFT practice was brief and focused on small changes which were connected to the clients goal (de Jong & Berg, 2013). De Shazer and Berg reflected on their own techniques in order to determine what worked best in practice (Bond et al., 2013; de Jong & Berg, 2013). Initially, research carried out at the BFTC relied on client data and clinical observations, which were later supported by evidence-based practice and research (Franklin et al., 2011). In 2008, the first treatment manual for SFBT was developed by the Solution-Focussed Brief Therapy Association, to be later updated in 2013 (Franklin et al, 2011).

Key Assumptions

The fundamental concepts which underpin a solutions-focused perspective include the assumption that each person possesses unique potential, strengths, and capabilities which can be amplified to bring about change (Corcoran, 2006; de Jong & Berg, 2013). At the centre of SFT is the notion that the person should do more of what does work and less of what doesnt work (Cepeda & Davenport, 2006; de Jong & Berg, 2013). Rather than placing an emphasis on problems, the therapist focuses on client strengths and possibilities for the future. (Cepeda & Davenport, 2006). A consistent focus on strengths as defined by the client increases client motivation and results in positive change (Gingerich & Eisengart, 2000). The therapist takes a future-oriented, goal-focussed approach and assumes that clients possess the resources and strengths needed to implement change (de Jong & Berg, 2013; Trepper et al., 2006). Further, the client is regarded as the expert on their own lives and goal forming is largely directed by the client. SFT recognises the importance of setting small, obtainable goals and upholds that small achievements result in a continuance of positive change. (Corcoran, 2006; Roeden et al., 2009; Wand et al., 2018).

Interventions and Applications

To implement these assumptions in therapy, the therapist uses language which communicates anticipation of change and takes a solutions-focussed perspective, rather than focussing on problems (Cepeda & Davenport, 2006; de Jong & Berg, 2013). In doing so, the therapist can foster hope and a positive view toward change (Corcoran, 2006). Therapists ask solution-focussed questions and works within a clients frame of reference, taking a position of not knowing to co-create an image of what the clients ideal future looks like (Cepeda & Davenport, 2006; de Jong & Berg, 2013; Gingerich & Eisengart, 2000). By exploring what has worked for the client in the past, small steps towards the overall goal can be identified. (Roeden et al., 2009). The client is encouraged to recognise sources of support in their lives to assist them in recognising that the resources of others can form part of the solution and that others may also notice impacts of the change. (Cepeda & Davenport, 2006).

The Miracle Question is one renowned strategy of SFT, which prompts clients to consider endless possibilities. By asking the client what their life might look like if a miracle had occurred resulting in the problem being solved, both therapist and client are able to envision a solution based on what the client wants, rather than what the therapist wants. (Bond et al., 2013; Cepeda & Davenport, 2006; de Jong & Berg, 2013). This allows the client to step outside the problem, and to focus on the future to facilitate change. By having a clear image of the desired outcome, the therapist is able to guide the client in developing positive goals towards what the desired change (Cepeda & Davenport, 2006; de Jong & Berg, 2013).

Progress towards goals can be measured using scaling questions, where 1 is the lowest and 10 is the highest. Scaling allows clients to clearly identify their current position and to track future progress, enabling the client to notice even small degrees of change. (de Jong, 2013; Gingerich & Eisengart, 2000). It encourages clients to dissect their perception of their circumstances and assists them in stepping outside of their experience and into solutions (Trepper et al., 2006; Wand et al., 2018). Scaling is also a valuable tool in developing an understanding of the clients confidence and can assist the therapist in discovering new information (de Jong, 2013). This can help the client in expanding on their desired outcome, and can assist in identifying elements of the solution which may already be occurring (Gingerich & Eisengart, 2000).

To foster hope for the client, the therapist may ask for exceptions; times in the clients life where the problem did not exist or was less severe (Cepeda & Davenport, 2006; de Jong & Berg, 2013). By exploring scenarios where the client was able to overcome a challenge, the client explores who or what made the exceptions happen (Cepeda & Davenport, 2006; de Jong & Berg, 2013). This assists the client in recognising strengths and building on them (Banting et al., 2017).

Strengths

SFT is usually brief, inexpensive and effective for a wide range of problems (Trepper et al., 2006; Wand et al., 2018). It focuses on fostering resilience and optimism and by promoting strengths over weaknesses, clients develop control over their mindset (Roeden et al., 2009; Gingerich & Eisengart, 2000). Rather than being viewed as though they are broken, clients are seen as learning and growing, fostering a sense of respect and compassion in the therapeutic relationship (Cepeda & Davenport, 2006; de Jong & Berg, 2013). By developing their sense of self-awareness, clients are able to focus on their strengths over their weaknesses, including their social support connections (Choi, 2019; Franklin et al., 2011).

Limitations

Despite the flexibility and portability of SFT, some research suggests that in placing a strong focus on solutions rather than problems, clients may be missing the opportunity to make strong therapeutic connections with their therapist (Choi, 2019). The model has received criticism for forcing solutions and thus ignoring clients feelings. In some cases, it is possible that the client is not yet ready to deal with future-oriented issues. (Miller, 1992; Quick & Gizzo, 2007). Some experts argue that by neglecting client weaknesses and only focusing on client behaviours, the therapist is missing the opportunity to address underlying causes of behaviours (Long & Young, 2007).

Findings for Model

SFT has quickly become a widely used therapeutic tool, however much of the models proficiency has been based on anecdotal reports of success (Quick & Gizzo, 2007). Gingerich and Eisengart (2000) conducted a comprehensive review of available research to explore the extent of empirical support for the study (Gingerich & Eisengart, 2000). The review found that while current studies reported quantitative data which supports claims that the model is beneficial, more extensive investigation is needed to establish efficacy (Gingerich & Eisengart, 2000). Further analyses support the need for additional research based on larger sample sizes and more rigorous standardisation and follow-up measures (Corcoren, 2006; Quick & Gizzo, 2007; Roeden et al., 2009).

Who is the model most suited for?

SFT has shown promising results in a wide range of clients (Cunanan & McCollum, 2006; Gingerich & Eisengart, 2000; Kim et al., 2018). The model has been successfully applied in settings including hospitals, schools, and prisons which may be largely as a result of its brief, inexpensive nature (Gingerich & Eisengart, 2000; Kvarme et al., 2013). SFT is also commonly used in social support and welfare systems, including family support, domestic violence, and trauma care (Banting et al., 2018; Cunanan & McCollum, 2006; Gingerich & Eisengart, 2000; Kim et al., 2018). The model has also delivered positive results when working with people with a disability (Banting et al., 2018).

Conclusion

SFT is a valuable therapeutic tool which is effective in the treatment of a wide range of client problems in a variety of populations and therapeutic settings. By focusing on client strengths over weaknesses, the model fosters hope, resilience, and self-esteem and enhances clients ability to face future problems. SFT is portable, flexible, and inexpensive and while current studies appear insufficient in establishing the efficacy of SFT, extensive anecdotal feedback suggests that the model is useful and effective. Further studies are required to provide objective, empirical evidence supporting the effectiveness of the therapy.

References

Banting, R., Butler, C., & Swift, C. (2018). The adaptation of a solution focused brief therapy domestic violence perpetrator programme: a case study with a client with a learning disability. Journal of Family Therapy, 40, 489-502. https://doi.org/10.1111/1467-6427.12186

Bond C., Woods, K., Humphrey, N., Symes, W., & Green, L. (2013). Practitioner review: The effectiveness of solution focused brief therapy with children and families: a A systematic and critical evaluation of the literature from 1990-2010. The Journal of Child Psychology and Psychiatry, 54(7), 707-723. https://doi.org/10.1111/jcpp.12058

Cepeda, L. M., & Davenport, D. S. (2006). Person-centred therapy and solution-focused brief therapy: An integration of present and future awareness. Psychotherapy: Theory, Research, Practice, Training, 43(1), 1-12. https://doi.org/10/1037/0033-3204.43.1.1

Choi, J. J. (2019). A microanalytic case study of the utilization of solution-focused problem talk in Ssolution-fFocused Bbrief Ttherapy. The American Journal of Family Therapy. 47(4). 244-260. https://doi.org/10.1080/01926187.2019.1637392 Corcoran, J. (2006). A comparison group study of solution-focused therapy versus treatment-as-usual for behavior problems in children. Journal of Social Service Research, 33(1), 69-81. https://doi.org/10.1300/J079v33n01_07

de Jong, P. & Berg, I. K. (2013). Interviewing for solutions (4th ed.). Brooks/Cole.

Franklin, C., Trepper, T. S., McCollum, E., & Gingerich, W. J. (2011). Solution-focused brief therapy: A handbook of evidence-based practice. Oxford Scholarship Online. https://doi.org/10.1093/acprof:oso/9780195385724.001.0001

Gingerich, W. J., & Eisengart, S. (2000). Solution-focused brief therapy: A review of the outcome research. Family Process, 39(4), 477-498.

Kim, J. S., Brook, J., & Akin, B. A. (2018). Solution-focused brief therapy with substance-using individuals: A randomized controlled trial study. Research on Social Work Practice, 28(4), 452-462. https://doi.org/10.1177/1049731516650517

Kvarme, L. G., Aabo, L. S., & Saeteren, B. (2013). I feel I mean something to someone: solution-focused brief therapy support groups for bullied schoolchildren. Education Psychology in Practice, 29(4), 416-431. https://doi.org/10.1080/02667363.2013.859569

Long, L. L., & Young, M. E. (2007). Counseling and Therapy for Couples. Thomson Brooks/Cole.

Miller, S. D. (1992). The symptoms of solution. Journal of Strategic and Systemic Therapy, 11(1), 1-11. https://doi.org/10.1521/jsst.1992.11.1.1

Quick, E. K., & Gizzo, D. P. (2007). The doing what works group: A quantitative and qualitative analysis of solution-focused group therapy. Journal of Family Psychotherapy, 18(3), 65-84. https://doi.org/10.1300/J085v18n03_05

Roeden, J. M., Bannink, F. P., Maaskant, M. A., Curfs, L. M. G., & Hardenberg, B. (2009). Solution-focused brief therapy with persons with intellectual disabilities. Journal of Policy and Practice in Intellectual Disabilities, 6(4), 253-259.

Trepper, T. S., Dolan, Y., McCollum, E. E., Nelson, T. (2006). Steve de Shazer and the future of solution-focused therapy. Journal of marital and family therapy, 32(2), 133-139.

Wand, T., Acret, L., & DAbrew, N. (2018). Introducing solution-focussed brief therapy to mental health nurses across a local health district in Australia. International Journal of Mental Health Nursing, 27, 774-782. https://doi.org/10.1111/inm.12364