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Solution-focused brief therapy

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Solution-focused brief therapy

Solution-focused (brief) therapy (SFBT) is a goal-directed collaborative approach to psychotherapeutic change that is conducted through direct observation of clients' responses to a series of precisely constructed questions. Based upon social constructivist thinking and Wittgensteinian philosophy, SFBT focuses on addressing what clients want to achieve without exploring the history and provenance of problem(s). SF therapy sessions typically focus on the present and future, focusing on the past only to the degree necessary for communicating empathy and accurate understanding of the client's concerns.

SFBT is a future-oriented and goal-oriented interviewing technique that helps clients "build solutions." Elliott Connie defines solution building as "a collaborative language process between the client(s) and the therapist that develops a detailed description of the client(s)' preferred future/goals and identifies exceptions and past successes". By doing so, SFBT focuses on clients' strengths and resilience.

The solution-focused brief therapy approach grew from the work of American social workers Steve de Shazer, Insoo Kim Berg, and their team at the Milwaukee Brief Family Therapy Center (BFTC) in Milwaukee, Wisconsin. A private training and therapy institute, BFTC was started by dissatisfied former staff members from a Milwaukee agency who were interested in exploring brief therapy approaches then being developed at the Mental Research Institute (MRI) in Palo Alto, California. The initial group included married partners, Steve de Shazer and Insoo Berg, and Jim Derks, Elam Nunnally, Judith Tietyen, Don Norman, Marilyn La Court and Eve Lipchik. Their students included John Walter, Jane Peller, Michele Weiner-Davis and Yvonne Dolan. Steve de Shazer and Berg, primary developers of the approach, co-authored an update of SFBT in 2007, shortly before their deaths. SFBT evolved from the Brief Therapy that was practiced at MRI.

The solution-focused approach was developed inductively rather than deductively; Berg, de Shazer, and their team spent thousands of hours carefully observing live and recorded therapy sessions. Any behaviors or words on the part of the therapist that reliably led to positive therapeutic change on the part of the clients were painstakingly noted and incorporated into the SFBT approach. In most traditional psychotherapeutic approaches starting with Freud, practitioners assumed that it was necessary to make an extensive analysis of the history and cause of their clients' problems before attempting to develop any sort of solution. Solution-focused therapists see the therapeutic change process radically differently and informed by the observations of de Shazer, which recognize that although "causes of problems may be extremely complex, their solutions do not necessarily need to be".

SFBT might be best defined by what it does not do because SFBT presents an innovative and radically different approach from traditional psychotherapy. Traditional psychotherapy looks at how problems happen, manifest, and resolve. The problem-solving approach is influenced by the medical model, where the symptoms are assessed to diagnose and treat the malady. Outside of SFBT, the almost universal belief is that the clinician must define and understand the problem to help. To do this, the practitioner must develop some information about the nature of problems that they will help resolve and ask questions about the client's symptoms. The more common problem-solving approach includes a description of the problem, an assessment of the problem, and plan and execute interventions to resolve or mitigate the impact of the problem. This is followed by an evaluation determining the success of the intervention and follow-up if necessary.

SFBT posits that a therapist can help clients resolve their problems without identifying the details or source problem and completely avoids exploring the details and context of the problem. SFBT believes that an assessment of the problem is entirely unnecessary. Focusing on the problem actually may serve to shift the client away from the solution. This is because SFBT fundamentally believes that the nature of the solution can be completely different from the problem. So instead, SFBT focuses on building solutions by conceptualizing a preferred future with clients. SFBT is all about finding alternatives to the problem, not identifying and eliminating the problem.

SFBT is strengths-based and supports clients' self-determination. Using the client's language, SFBT uses the client's perspective and fosters cooperation. The focus on the strengths and resources of clients is a factor in why some social workers choose SFBT.

SFBT is designed to help people change their lives in the fastest way possible. By finding and amplifying exceptions, change is efficient and effective. Treatment usually lasts less than six sessions, and it can work in about two sessions. Its brevity and its flexibility have made SFBT the choice of intervention for many health care settings. Interventions in a medical setting many times need to be brief. Agencies also choose SFBT because its efficiency translates into monetary savings.

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