An Introduction into Solution Focused Therapy

In this paper, I have chosen to talk about solution-focused therapy. I have always liked this therapy due to its brief nature and how it focuses on solutions rather than the actual problem. I have worked in drug treatment and crisis intervention facilities in my short career, and I have a strong belief that solution-focused is a useful intervention for many clients. Overall, I believe that solution-focused therapy is a helpful and effective model to help clients think and act on change, rather than, dwelling on the problem that is causing them harm. I like that it is a brief intervention, which will be effective with most insurance agencies.

I will discuss the founders and the development of solution-focused therapy. I will also discuss some of the issues that solution-focused therapy would be effective with. Finally, I will go over the solution-focused model and discussed in a little more detail of how to appropriately apply this theory.

Founders and development of Solution-Focused Therapy

Steve de Shazer was a pioneer in the field of family therapy, and was in fact often referred to in his later years as the “Grand old man of family therapy” (Dolan et al, 2006).

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He was an iconoclast and creative genius known for his minimalist philosophy and view of the process of change as an inevitable and dynamic part of everyday life, he was known for reversing the traditional psychotherapy interview process by asking clients to describe a detailed resolution of the problem that brought them into therapy, thereby shifting the focus of treatment from problems to a solution. Beginning in the late 1970s, de Shazer along with his wife and long time collaborator, Insoo kim Berg, devoted nearly 30 years to developing and consistently refining the approach that haas become Solution-focused Brief therapy (Dolan et al, 2006).

Gingerich and Eisengart provided preliminary support for solution-focused brief therapy as an effective tool in helping individuals with psychological problems. The focus is on the client’s health rather than problems, on strengths rather than weaknesses or deficits, and on skills, resources and coping abilities that would help in reaching future goals (Fernando, 2007).

In solution-focused therapy, the counselor is less concerned with how the problem arose, and more concerned with working together with the client to arrive at a solution to the problem. It is important and more helpful for the clients to understand and counselors need to elaborate solutions rather than dwell on problems in the past. Clients are encouraged to believe that positive changes are always possible, and counselors also view their clients’ presenting problems in a positive light and compliment clients on their perseverance and resourcefulness, helping them to focus on what is going right in their lives rather than focus on what went wrong.

Encouraging clients to think of what needs to happen to make things better is also an essential concept in solution-focused therapy. Often clients are in counseling because they have continued to do whatever that is not working for them. It is important to help clients understand that when something is not working it is beneficial to stop doing it and also, if something is working, to do more of it (Fernando, 2007).

Solution-Focused therapy has become known has a practical approach to the treatment of may psychological problems (Fernando, 2007). During recent years, this approach has gained significant attention due to primarily cost-effectiveness.

The SFBT model contains no theory of problem causation. Rather, “complaints” as practitioners of the approach refer to problems, are viewed as the “tickets clients use to begin therapy” (Robbins et al, 2003). In contrast to traditional therapeutic practice, the solution-focused therapist assumes no necessary link between the problems that people bring into treatment and any resulting solutions. Therapists are free to dispense with conventional activities, such as intake and diagnosis. Little time is spent assessing or discussing the problems in solution-focused therapy (Robbins et al, 2003). According to Shazer, ” effective therapy can be done even when the therapist cannot describe what the client is complaining about.” I believe that the most important aspect of solution-focused therapy is that counselors utilizing SFT are free to move swiftly and directly to the process of solution-development, where the focus is on change and solutions, rather than on difficulties and problems (Robbins et al, 2003).

Issues useful with Solution-Focused Therapy

Solution-Focused brief therapy is one of the most popular and widely used psychotherapy approaches in the world. Because it is based on resiliency and clients’ own previous solutions and exceptions to their own problems, it is applicable to most difficulties faced by clients, and indeed has been applied to almost al problems seen by clinicians. These included family therapy, couples therapy, treatment of sexual abuse, treatment of substance abuse, sex therapy, treatment of schizophrenia, and self-help books written from a solution-focused perspective. The solution-focused approach has been applied beyond traditional psychotherapy practice to include intervention in social service agencies, education settings and model schools, and business systems (Dolen et al, 2006).

An increasing number of counseling, family therapy, and psychotherapy models have emphasized solution-focused conceptualizations of problems and change. Solution-focused therapy is a fitting model for families coping with suicide. The strength-based approach of solution-focused therapy is a corollary to an increasing research that suggests that famililies coping with suicide have natural resiliency. Solution-focused therapy allows therapists to tailor treatment to the family, apply a variety of techniques, and thereby foster a cooperative approach. (Castro, Guterman, 2008)

In recent years many practitioners have been exploring how solution-focused therapy can apply to work with clients who are suicidal or who have a history of self-harm. In particular, this author, has explored how solution-focused ideas particularly scaling questions, can be used to enhance traditional approaches to suicide risk assessment in order to establish a safety plan with clients and their families. Though there is a growing body of research for solution-focused therapy in general, there is at yet no empirical evidence for the effectiveness of the approach with suicidal clients (Darmody et al, 2002). Solution-focused therapy is not unique in engendering a strengths-based collaborative approach to working with suicidal clients and the ideas strongly resonate with other brief interventions, particularly those from the cognitive-behavioral tradition (Darmody et al, 2002). Some caution is expressed about using the solution-focused model with suicidal clients, especially given its lack of emphasis on risk assessment.

The Solution-Focused Model

In solution-focused therapy, the therapist and client collaborate to define a problem and goal. The problem definition is then subsumed by the problem/exception conceptualization. For example, if a client were to define the problem as ineffective coping skills for depression, then the problem would be conceptualized as ineffective coping skills/ effective coping skills (Castro, Guterman, 2008). The change process would be organized around helping the client identify and amplify exceptions (ie: times when he or she is able to cope effectively).

The practice of solution-focused therapy usually involves five stages. The first stage, co-constructing a problem and goals, involves clients and therapists working together to negotiate a solvable problem and an attainable goals. During this stage, it is important to formulate a problem definition and goal that fits with clients’ worldviews.

The second stage involves identifying and amplifying exceptions. Therapists help clients identify exception through questioning that creates expectancy for change. One of the main purposes of amplifying exceptions is to help client identify difference between the times they have the problem and the times when they do not. The third stage, assigning tasks, is aimed at clarifying and building on the problem, goal, exception, or potential exception identified in the previous stage. The forth stage involves evaluating the effectiveness of tasks. During this stage, therapists help clients identify and amplify exceptions derived from tasks that were given in the previous session. The fifth stage, re-evaluating the problem and goal, involves clients and therapists considering the extent to therapy is either continued or terminated. If the goals has been reached or client have made significant progress in the direction of the goal, then it might be appropriate for therapists to ask the clients if they think that further treatment is needed at this time (Castro, Guterman 2008).