Solution Focused Therapy (A Comprehensive Guide)

Solution Focused Therapy also known as Solution Focused Brief Therapy (SFBT) was developed by Insoo Kim and Steve de Shazer, along with their colleagues in Milwaukee, Wisconsin during the late 1970s.  solution focused therapy as the name suggests, is goal-directed, future-focused and its main aim is to focus on solutions to situations that brought the client to look for therapy rather than focusing on the problems.

In this article, we will discuss Solution Focused therapy. 

This entire approach of solution focused therapy is to being more solution-focused was basically developed in an outpatient city mental health service where there was no previous screening of the patients that were accepted for treatment.

These researchers observed hundreds of cases between patients and therapists and what kind of activities had what kind of effect over the therapeutic outcome taking into account the questions, emotions, and behaviors of the whole session.

After the observation of several years, these therapists came up with the idea of solution focused therapy where the questions and activities done during this observation were kept on the report along with the client’s progress and incorporated within the approach of solution focused therapy.

Since that time,  solution focused therapy has become one of the main schools of brief therapy but it has also become one of the major influential treatments in diverse fields such as social policy, education, criminal justice, business, domestic violence, and child welfare offenders treatment. Described as one of the best goal-driven, practical approaches to treatment, solution focused therapy has its emphasis on concise, clear, realistic goal negotiations.

The main assumption of the solution focused therapy approach is the client is already aware of his situation and has some knowledge regarding what can be done to make their life better but might need help regarding this matter in detailing the approach.

The approach also assumes that every person who seeks help using this approach already has the minimum skills and tools that are needed to create solutions regarding their problems. 

Key Concepts and Tools

Every therapy is considered a form of conversation in a specific specialized way. 

In solution focused therapy this conversation is directed towards achieving and development of the solution already present in the client’s vision.

This can be done using multiple techniques, some of them are listed here below. 

Looking for previous solutions

 solution focused therapy therapists have learned with their experience that many people coming in for therapy have already solved several problems in their life and have some idea about the solution to their current problem but are not able to see it properly.

To help out their client to think of a potential solution, questions like “Was there something you did that was helpful ?” or “Were there any times when this issue was less ?” can help them see a clearer view of the solution.

Looking for exceptions

Even if the client does not have a solution that can be repeated in this scenario they are still experienced and might have some examples of exceptions related to their problem.

There might be some time or a certain scenario where that problem might not occur or might occur.

The difference might be very small but will be significant in working towards the solution to the problem.

Integrating this scenario with the previous solution might help eliminate the cause of the problem, in this case, questions like “Do you feel any difference when the problem is less ?” can help out chart a clearer view.

Present and future-focused questions vs. past-oriented focus

The questions that are mostly asked by solution focused therapy therapists are focused on either present or future which further reflects that the basic belief is in solving problems by focusing on what is already working or even helping out and which direction the client will like their life to go towards rather than focusing more on previous approaches or the origin to the problem.

In this matter questions like “Is there something you will do next week to indicate that you are making progress ?” can help out in the process.

Compliments

One of the other main parts of solution-focused brief therapy is a compliment.

Giving compliments to the client and acknowledging how difficult the problem is will encourage them to change their approach and make more open towards the therapists with this in mind that the therapists care about them and have been listening to their issues.

This can also help to single out the activities that the client is doing that is helping out in reducing the problem.

Compliments are mostly conveyed in questions using an appreciative tone like “How were you able to do it ?” which further helps the client to self compliment themselves for the work by answering the specific question.

Inviting clients to do more of what is working.

Once solution focused therapy therapists have created a cycle of positivity using compliments and discovered the previous solutions and the exceptions involved to the problem they can then gently invite the client to do the previous solution again with some modification or changes which they have brought up known as experiments. 

Miracle Question (MQ)

This is a powerful and unusually named tool that helps the client in generating the small steps towards their solution by describing realistic, doable, and small steps that they are able to take as soon as the next day.

This miracle question was developed when working with a suicidal woman who had four wild children and one alcoholic husband who always gave her grief and was desperately looking for a solution.

In her own thought, she will need a miracle to be saved from such a situation and since then the miracle question has been developed and tested on numerous cases in different cultures.

There have been some improvements over time, with the recent most version of the miracle question is as follows:

T: My next question is a little strange … as it would require you to have some imagination … Are you good with your imagination?

C: I try to have a good imagination and will try my best. 

T: Good, so the question is somewhat like this; After our talk is finished, you will go back to your work or home with a bundled lot of work still pending for the day, you finish with them and it is almost the end of the day with time to go to bed  …  so you go to sleep with everyone else present in your household is also in a deep sleep and the atmosphere is quiet … and there is a miracle in the middle of the night and it such happens that the problem you came to talk about is solved but as you are asleep in your bed you have no idea that the miracle had happened and the problem is all solved … so in the morning when you are coming out of your sleep … what will make your wonder as a first sign that there must have been a miracle in the night and the problem you were worried about is solved and all gone … How will you figure it out?

C: I suppose the first thing I will do is to get up and rather than hiding in my blanket will start preparing to face the day.

T: Suppose you do this and get up, ready to face the day. What will be the small changes in your life that you would do that you normally did not do this morning?

C: I suppose, I will not scream at my children and will greet them good morning in a more cheerful voice. 

T: And what will your children do as a response to hear your cheerful voice?

C: They will be surprised to hear me in a cheerful voice and might relax and calm down. It has been so long till it happened the last time.

T: So, what will you do as a next step that you have not done today?
C: I will tell them a joke and make their mood better.

These small questions and steps are taken in the end to become the main blocks of an entirely different day for the client as they will start implementing these steps and will result in seeing the behavioral changes they have envisioned.

This is the longest question that is asked during a  solution focused therapy session as it has a hypnotic touch to it.

 Scaling Questions

One more type of question in solution focused therapy is the scaling question which can be used where there is not enough time to use the miracle questions.

Scaling questions are also helpful for the client in assessing their situation and makes it easier for them to track and evaluate their progress on a scale of 0 to 10.

This method can be used in many ways even with clients who are impaired verbally or even with children.

In this set of questions, one can ask the client about their hopefulness, confidence, motivation, the progress they made and depression or different types of topics can be hosted which will help the therapist in determining their performance and what can be the next steps which can be taken to improve it.

Here, we are considering an example of a couple who are seeking help regarding their marriage.

Reportedly, they have been married for 20 years with the last 10 years in continuous fighting and have reached their limit. 

T: Since you guys have been married for around 20 years and know the situation of your marriage better than anyone else, I suppose I may ask you directly that on a scale of 1 to 10 where 1 stand for you have every confidence that this marriage will not make it and 10 the opposite of it that it will make it in the end. What number will you most likely give?
(After a little pause, they will think about it and then the husband replies first)

H: I think I would give my marriage a 7. (hearing the number the wife flinches)

T:  (Directed towards the wife) How about you? What number will you be giving to your marriage?
W: (After thinking about it for a long time) I think I would give our marriage a 1.1

T: (Surprised) So, how did you come up with 1.1 and what was the factor that made it into 1.1
W: I guess being here together tonight makes it a 1.1 better than a 1.

Coping Questions

Every client is always engaged in several useful things even when they are facing difficulties, coping questions are a strong reminder of this.

Even when in depression or in the middle of departing, the clients still manage to get up every morning, get out of their beds, get dressed neatly, make food for their children and do many other things in their daily life that require a major effort on their part.

Coping questions like “What are you doing to make things much worse ?”  or “How have you managed to hold on till now ?” can open up a completely different way to look at the determination and resiliency of a client.

FAQ related to solution focused therapy 

References

What is Solution-Focused Therapy? Landing Page