Solution focused brief treatment (SFBT) seeks to empower the client to “create and experience her own uniquely meaningful and effective therapeutic changes” (Dolan, 1991, p.30).
It is a unique treatment approach given that a central assumption is that the therapist does not really need to know all the details of a client’s problem in order to help that client build a better future. (Iveson, 2002)(Selekman, 2005).
Thus, it is largely focused on the desired changes for the immediate future, which separates it from most other treatment approaches.
Individualized goals are determined through the collaborative efforts of the therapist and the client. To begin the goal setting process, the therapist will typically ask “the miracle question.”
“You’ll go to bed tonight, like every other night, but tonight, while you’re sleeping, a miracle happens and all of your problems are gone. Now you don’t know that the miracle has happened, so when you wake up, what do you think the first thing you would notice that would cause you to think something is different today, something has changed?” (Pichot & Dolan, 2003)
The resultant conversation typically lends itself to articulating long term goals and a sharpening of the vision of what improvement looks like as defined by the client.
This process can be more challenging and take more time than one might expect because of the tendency for people to be more aware of and more focused on what they do not want to feel and want to stop doing versus what they do want to feel and what actions they do want to take.
In solution focused treatment, an assumption is that clients know themselves best and that they possess the “strengths and resources” required to solve problems and to make meaningful and positive change in their lives. (Selekman, 2005, p.38).
Thus, there is one area of history that is briefly explored after long term goals have been articulated. The client may be asked “What do you think gets in the way of you having the life you want?”
The purpose in this line of questioning is to assist the client in gathering information that will illuminate “the possibility of new effective action” (Friedman & Fanger, 1991, p.29). It seeks very specific information and is an integral part of the process.
After developing a future vision and identifying the roadblocks that have made that vision unattainable, the focus becomes short term goals that are concrete and measurable.There is an assumption in SFBT that one change often leads to another, even in the case of a very small change (Selekman, 2005).
To begin this stage of the work, the kind of question posed to client is “What is one thing you can do right now that will help you move one small step closer to the life you want?”
Therapy homework, tasks that are clearly articulated and challenge the client, but are still realistic, are essential. Each assignment is discussed in the following session on a consistent basis. If it was not completed, the reason or reasons are determined and the next assignment either breaks it down into more manageable tasks or is changed.
Solution focused brief treatment is attractive to many clients because of its tendency to be much shorter in duration than other treatment approaches. This can be explained by the fact that it is undoubtedly clear when the work has been completed. If the long term goals have been attained, which is simple to determine because they are concrete and measurable, the work is done and treatment ends.
It is important to note that it is not a one size fits all approach. It is going to be most beneficial to clients who have the necessary capabilities to fulfill their goals, but feel they need direction, support and to be held accountable.
References
Dolan, Y. (1991). Resolving sexual abuse: Solution-focused therapy and ericksonian induced hypnosis for adult survivors (1st ed.). New York: Norton, W.W. & Company, Inc.
Selekman, M (2005). Pathways to change: Brief therapy solutions with difficult adolescents (2nd ed.). New York: Guilford Press.
Friedman, S.E. & Fanger, M.T. (1991). Expanding therapeutic possibilities: Getting results in brief psychotherapy (1st ed.). Lanham, MD: Lexington Books.
Iveson, C. (2002). Solution-focused brief therapy. Advances in Psychiatric Treatment, 8, 149-157.
Pichot, T. & Dolan, Y. (2003). Solution-focused brief therapy: Its effective use in agency settings (1st ed.). New York: Taylor & Francis, Inc.
