Theory Series: Solution Focused Therapy
Solution Focused Therapy (SFT) was founded out of the Brief Family Therapy Center in Milwaukee, Wisconsin in the 1970s, by Steve de Shazer and Insoo Kim Berg. It was derived from social constructivist philosophy, with the core assumption that reality is constructed and identified through dialogue and agreement, with no truth truly being objective. It also has roots in family systems theory, which dictates that an individual’s family and social circle directly influences their outlook and actions. As such, SFT highlights two routes to change, as clients can either adapt to their environment, or adapt their environment to them.
There are two conditions that are considered integral to SFT. The first is that the counselor must be truly engaged with their client for positive change to occur. The second is that the client must be motivated towards change and the therapeutic process. This is because counselors are not considered experts, but rather, facilitators of the SFT process. In sessions, emphasis is placed on the future and on potential solutions, not the client’s character or past issues. Three guiding principles are used to guide SFT.
If it is not broken, do not fix it - this serves to avoid making excessive and potentially unnecessary changes in the client’s life and to focus on the most important challenges.
Once you know what works, do more of it - this serves as a pragmatic guiding light to determine effective ways forward.
If something does not work, do not do it again—do something different - again, a pragmatic and driven tactic to capitalize on solutions that are showing potential.
In SFT, change happens quickly (~3 sessions or less) and it usually does not last more than 7 sessions in total. Of course, each client has their own needs, but a typical SFT counselor might follow the following procedure:
Establish role as a facilitator by engaging fully and identifying genuine motivation on behalf of the client.
Identify strategies that have not worked and should be avoided in the future.
Determine the exceptions to client’s problem to get client thinking positively and solution oriented.
Intervene with “the miracle question” to determine what a positive outcome will look like. This is typically some version of “If your issue was solved tomorrow, what would be different in your life? How would you know?” This is designed to help clients identify solutions and consider ancillary areas their issue might be affecting.
Draw on clients’ external factors for motivation and help bring their vision to life.
Critics of SFT point out that when the counselor takes the role of a facilitator, power differentials and natural oppression are unable to be addressed in the therapeutic relationship. They also point out that SFT may be viewed as unempathetic, as it does not take the past into account to determine a solution. Furthermore, it may not be ideal for treating severe mental illnesses (trauma, abuse, schizophrenia) as well as some of the more time-committed approaches. Benefits include the fact that it is, in fact, brief! It is malleable enough to be useful and effective for people from a variety of backgrounds, and it shows benefits in boosting academic achievement. SFT is an effective treatment option for those struggling with substance abuse disorders, and it has also been shown to be beneficial in treatment of sexual disorders.
Personally, although I am wary of constructivist-based theories, I do gravitate towards models that are solution oriented. It is not lost on me that therapy has become an expensive luxury to many, and an approach that is solution oriented and time-bound may be appealing. SFT also assumes the client as an autonomous agent, which I agree with. On the flip side, it stays out of the weeds, which I feel is often where lasting change can occur.
For more on SFT, I recommend reading More Than Miracles: The State of the Art Solution-Focused Brief Therapy written by the founders of SFT and their colleagues. This book illustrates real examples of SFT put into practice, while also covering the overall landscape of the approach and its current applications worldwide. Happy reading!
