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Mental Health Theory

Solution-focused Brief Therapy

Solution-focused Brief Therapy is a mental health theory that helps clients change by co-constructing solutions based on their existing ‘toolkit’ rather than dwelling on problems. Co-created goals are established through a carefully structured questioning process that revolves around ‘the miracle question’ and then extracting and complimenting any movement towards that goal.

Solution-focused Brief Therapy

SFBT was developed by Steve de Shazer (1940-2005), and Insoo Kim Berg (1934-2007) in collaboration with their colleagues at the Milwaukee Brief Family Therapy Center beginning in the late 1970s.

The attributes of SFBT are that it is:

  • Short-term
  • Goal-focused
  • Evidence-based
  • A therapeutic approach
  • Hope friendly
  • Positive emotion eliciting
  • A future-oriented vehicle
  • Formulating, motivating, achieving, and sustaining desired behavioural change.

How to use Solution-focused Brief Therapy

SFBT is centred around asking ‘the miracle question’ in a specific manner. The miracle question works through future visualisation, asking what your life would be like with the problem resolved if a miracle had happened without you noticing.

Through questioning, the therapist works to find existing tools and skills within the client’s existing repertoire – looking for ‘exceptions’ to falsely generalised ‘rules’ that the client arrives with.

For example, if a client says that they have always faced conflict with a particular person then the therapist works with the client to try and recall a time where the conflict was lessened or had less of an impact.

They then try to work out what contributed to this exception and then through emphasis, highlighting, and compliments, the therapist gets the client to try and build upon this exception – thus using the client’s existing skills and behaviours and amplifying them to increase the exception and decrease the obstacles to reaching the goal.

Although forward-facing with the SFBT approach, it can be useful for the therapist to start with the actions that lead up to them seeking support. By asking “Has anything changed already as a result of you seeking support?”, the therapist can help the client see that they have already made progress.

Negatives of the approach

As with any mental health theory, there are positives and negatives to be considered before starting the therapy.

  • The therapy takes place at the client’s pace which can be considered negative or positive depending on the intended outcome and process.
  • SFBT ignores underlying causation – so there is no “I wonder if his childhood contributed” exploration to take place which means that underlying issues can go unexplored and untreated.
  • It is client-led. This can lead to clients ceasing the programme of therapy prematurely, either because they feel that they wanted to make progress more quickly or because they assume that they have reached the conclusion early.