What Is Solution-Focused Brief Therapy?

Spouses Steve de Shazer and Insoo Kim Berg developed SFBT in the 1970s and 1980s at the Brief Family Therapy Center in Milwaukee.

Techniques

SFBT is an approach that falls under the umbrella of constructive therapies. Constructivism posits that people are meaning makers and are ultimately the creators of their own realities. The SFBT therapist believes that change in life is inevitable. Because someone creates their own reality, they may as well change for the better.

In SFBT, the therapist is a skilled conversation facilitator. They do not present themselves as an expert but instead comes from a "not-knowing" point of view. 

Drawing upon the client's expertise in themselves, the therapist uses a variety of techniques and questions to demonstrate their strengths, resources, and desires. With the focus shifted to what is already working in a client's life, and how things will look when they are better, more room opens up for the solutions to arrive.

Miracle Questions

The miracle question is a technique that therapists use to assist clients to think "outside the square." It asks the client to consider life without the problem by setting up a scene where a miracle happens and the problem is gone. The exact language may vary, but the basic wording is this:

"Suppose that while you are sleeping tonight and the entire house is quiet, a miracle happens. The miracle is that the problem which brought you here is solved. But because you are sleeping, you don’t know that the miracle has happened. So, when you wake up tomorrow morning, what might be the small change that will make you say to yourself, 'Wow, something must have happened—the problem is gone!'"

Asked this way, miracle questions help clients open up to future possibilities.

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Exception Questions

Exception questions allow clients to identify times when things have been different for them. Finding times when the problem wasn’t so much of a problem.

Examples of exception questions include:

• "Tell me about times when you felt happiest."
• "What was it about that day that made it a better day?"
• "Can you think of a time when the problem was not present in your life?"

By exploring how these exceptions happened, a therapist can empower clients to find a solution. 

Scaling Questions

Scaling questions invite clients to perceive their problems on a continuum. They're also a helpful way to track progress toward goals and monitor change. 

Generally, scales are from 1 to 10. When working with a client who is dealing with anxiety, for example, a therapist might say:

"If 10 is the most anxious and 1 is the most relaxed, what number would you put yourself on right now?"

Questions like these are usually followed with questions related to scaling, such as asking the client to explain why they chose the number they did and why their number is not one lower. They'll likely also ask the client how they will know they are moving up the scale.

What SFBT Can Help With?

SFBT is best when a client is trying to reach a goal or overcome a particular problem. It can stand alone as a therapeutic intervention, or it can be used along with other therapy styles. It's used to treat people of all ages and a wide range of issues including addiction, child behavioral problems, and relationship problems.

This form of therapy is typically not used to treat major psychiatric conditions such as psychosis and schizophrenia.

Benefits of SFBT

The major advantage of SFBT is its brevity. SFBT is a form of "brief therapy," typically lasting between 5–8 sessions. Because of this, it is often less costly than other forms of therapy.

Instead of digging into old wounds, more time is spent focusing on resolutions, which makes SFBT great for people who have a specific goal in mind and just need a little help reaching it.

Effectiveness

Research shows that SFBT can effectively:

• Decrease addiction severity and trauma symptoms
• Decrease marital issues and marital burnout in women
• Improve classroom behavioral problems in children with special education needs
• Reduce externalizing behavioral problems, including conduct disorder, and conflict management
• Reduce internalizing behavioral problems, such as depression, anxiety, and self-esteem

SFBT can be just as effective (sometimes even more so) than other evidence-based practices, such as cognitive behavioral therapy (CBT) and interpersonal psychotherapy.

Things to Consider

If you are looking to dissect your childhood or come upon a great deal of insight about your life's trajectory, SFBT may not be the kind of therapy you are looking for. If, however, you want laser-focused help to move into a new area of your life without getting lost in the details, SFBT may be a good fit for you.

How to Get Started

If you have an issue you can't seem to solve and think you might benefit from SFBT, you can start by asking your physician for a recommendation. If you’re seeing a mental health practitioner for other reasons, they may be able to provide a recommendation as well. Local and state mental health agencies also often have resources you can turn to.

Once you have found a qualified professional, make an appointment and ensure they accept your insurance. Your first appointment will probably involve filling out the necessary paperwork, which can include details regarding your symptoms, medical history, and insurance plan.