What is Solution-Focused Brief Therapy (SFBT)?
Ilana Molkner, LCSW
Like its name implies, SFBT is a practice model that utilizes a short-term approach to actively seek solutions to current challenges. In this model, therapists foster a collaborative process with clients, who are seen as experts in their life experience, to recognize and tap into their strengths to make positive changes. Clients learn different ways to perceive a problem, explore times when their presenting problem is not happening, and focus on what is possible to change. This approach can be used in conjunction with other therapeutic modalities or as a stand-alone intervention.
Focusing on Exceptions
Therapists explore with the client situations or times when he or she is not experiencing the problem, such as when things are better or different; this approach helps to acknowledge and validate what is already working, emphasizes the client’s existing capacity, and also may help the client explore different perspectives or new ways of looking at a problem. Identifying realistic circumstances when the problem does not happen can help reduce a sense of overwhelm by realizing the problem may not be as pervasive as once thought.
Exploring exceptions may trigger thoughts and ideas for solutions. For example, clients may explore the following types of questions: “what was different in the past when the problem wasn’t there?”; “what’s better about your current situation?”; “identify times when you were able to stand up to the problem”; “tell me how, when and where you made that happen”; “what are you doing when you’re not feeling anxious?”; “describe some times when you don’t get angry”; “tell me a time in your relationship when you felt happy.”
Another key feature of solution focused therapy is to explore a “miracle question” to shift perspective from focusing on problems to considering goals. Clients are asked to imagine that their presenting problem disappeared while they were asleep at night and didn’t know the problem went away. Clients are then asked to notice what would be different the next morning or how they would think, feel or behave differently. A client’s answers to the miracle question may be transformed into specific task-oriented change behaviors and activities.
An example of a “miracle question” is as follows: “Imagine a miracle takes place while you’re sleeping tonight, and life is how you wish it to be. What would indicate to you the next day that this miracle happened? What would be different for you? How would you know you’re living your life on your terms?”
Exploring how clients have coped, such as “what have you done to manage so far”, or using presupposing change questions, such as “how did you avoid having a meltdown”, emphasizes clients’ resilience, enables individuals to see what works and how they might manage similar challenges. The shift in perspective from a focus on how or why the problem developed, to focusing on what is working, may instill hope and foster motivation to make positive changes.
Scaling and Future-Oriented Questions
Scaling questions provide an opportunity for clients to rate their current experience and track progress since coming to therapy. Clients may also explore their motivation and confidence to make changes; a therapist might ask “on a scale from 1 to 10, how confident are you that you will be able to resolve the problem?” The therapist may ask a future-oriented question, such as “what will be different for you in six months?” There is an underlying assumption that the client has the knowledge and capacity to improve his or her present and future life.
Therapists collaborate with clients to envision a future without the presenting problem. Exploring exception questions, a miracle question, coping and scaling questions can assist clients to develop their own goals that are aligned with their values and interests. Goals are broken down into specific, measurable, attainable, realistic, and timely objectives, tasks, or behavioral experiments, with shorter time frames than other approaches. Clients take small steps and actions in their daily lives, keep track of what works, and monitor their progress. When clients are able to accomplish one step, it can boost their confidence and motivation to take another step; ultimately, this can lead to an increase in positively rewarding, goal-directed activities.
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