What is SFBT?

Solution-Focused Therapy (SFT) is an approach to therapy that was developed by Steve de Shazer and Insoo Kim Berg. While studying family therapy at the Mental Research Institute (MRI) in Palo Alto, CA, Steve de Shazer noticed that change was a constant in clients’ lives as a result of attending therapy. He focused on this trend for 15 years. He also noticed that the changes that occurred were almost always positive.

 

De Shazer later opened the Brief Family Therapy Center (BFTC) in Milwaukee, WI. The team at the BFTC, including wife Insoo Kim Berg, decided they would base their approach to therapy solely on the positive changes that occurred. The team noticed that by focusing on these changes, the problem that led the client into therapy became irrelevant. All clients seemed to benefit. In the years since the development of this model in the 1980’s, research has come to the same conclusion as over 250 research studies have supported this approach.

 

The key to this model’s effectiveness is the focus on the presence of the solution and not just the absence of the problem. This allows the client to envision what a future looks like without the problem and what steps are needed to make this a reality. A therapist that works this way is guided by a series of tenets.

 

  • If it is not broken, don’t fix it. This means that if the client does not report something as a problem then the therapist will not make it a problem. The therapeutic conversation will only focus on what the client says that the problem is and nothing else, no matter what.
  • If it works, do more of it. Solutions are occurring all around us and people are already solving the problem that led them into therapy. A solution-focused therapist does not judge the quality of a person’s solution, only whether the solution is effective. Also, once a desired change has begun, this type of therapist helps the client to maintain this change.

 

  • If it’s not working, do something different. No matter how good a solution sounds, if it does not work, it really is not a solution. As people, we tend to do more of what does not work just because it sounds good, or it feels comfortable. We must understand that if the comfortable thing we are doing is not working, then it is usually effective to do something different.
  • Small steps can lead to big changes. People often assume that when they come to therapy they will be expected to make large changes related to the problem. This is NOT true. All it takes is small steps in the right direction. These small steps will ripple through your life until the problem no longer exists. Once a small desired change is made, it will inevitably lead to a series of other desirable changes.
  • The solution is not necessarily related to the problem. Almost all other forms of therapy follow a format that requires the therapist to understand the problem so an intervention can be developed to solve it. In Solution-Focused Therapy, the therapist works with the client to develop the solution, a description of what life will be like without the problem. Once this ideal is described, the client and therapist will work towards finding the real life steps to developing this ideal. Since this model works backwards, often little to no time is spent discussing the problem that brought a client into therapy.
  • The language of solution development is different from that needed to describe a problem. People often come to therapy prepared to explain the problem to the therapist. This language tends to be negative and describes a past. A solution-focused therapist is more concerned with the future and how the future can be created without the problem. The task is to develop a solution instead of describing the problem.
  • No problems happen all the time; there are always exceptions that can be utilized. No matter how long a person has been struggling with a problem or how powerful that problem has been, there are always exceptions and those exceptions can be utilized to create a new future.
  • The future is both created and negotiable. People are not viewed as locked into a pattern of behaviors based on their past. The future is a hopeful place where we all can do something different.

 

The Miracle Question

“Suppose you went to sleep and a miracle occurred. What this miracle does is completely solve all of the problems that are troubling you today. But because this miracle occurred while you were sleeping, you don’t know that it happened. When you woke up the next morning, what would be the smallest first hint that something miraculous has occurred?”

 

This question is key to the type of therapy that I do. I ask my clients future-focused questions that allow them to envision a future without the problem with great detail. Often times this is the first time someone has thought about these things and just by describing the future in this way, it becomes more doable.

 

Searching for Exceptions

“Tell me about those times when the problem is not present, or at least not as bad.”

I tenaciously explore times in my client’s lives when the problem is not as powerful to get clues as to what the client is already doing that will lead towards a solution. In answering this question, clients begin to feel hopeful as they realize there are already times when they have solved the problem. Usually, these exceptions have gone unnoticed since so much time and energy has been spent paying attention to the problem. Shifting focus to these exceptions allows those times when the problem is not present to grow and become more pervasive until the problem is totally eliminated.

 

Goal Setting

In my practice, goal setting and assessment are constantly taking place. This is due to the fact that almost everything I say in session is a variation of the following three questions:

 

  • “What are your best hopes for today’s meeting?”
  • “What do those best hopes look like?”
  • “How will you know when those best hopes begin to happen?”

 

Solution-Focused Therapy (SFT) is also known as Solution-Focused Brief Therapy (SFBT). It is known as brief therapy because the constant assessment of the goals and progress in achieving these goals in the treatment process is significantly shorter than other approaches. Once the client’s goals have been achieved, therapy is over. In short, therapy does not last one session longer than the client thinks is needed in order to achieve their goals. This differs from more traditional psychotherapies where the therapist determines the length of treatment.