Solution-focused brief therapy – SFBT is an approach inspired by Steve de Shazer and Insoo Berg in the 1970s. This goal orientated approach emphasizes the client’s present and desirable future rather than their past experiences. De Shazer and Berg created this modality to change the trend of dwelling on the problems but instead spend more time in the present to work on a desirable future with their clients. They find that their clients are less inclined to explore future possibilities when they are too focused on their problems.
The role of the counsellor or the therapist is to listen, select and build. Clients are experts of their circumstances. They have the solutions and need the space and time to examine their existing toolbox. SFBT tools consist of strategic and gentle questions to help draw out the solutions that the client had used in the past. Clients can make use of the therapy time to examine the answers and work collaboratively with the counsellor or therapist to construct a better future so that there is a relief to their problems.
SFBT is suitable for personal and also group therapy. Sessions can be conducted face-to-face or online via Zoom. For people that prefer to work on solutions and do not want to wait, SFBT via online counselling can be helpful.
Solution-Focused Brief Intervention Tools
1. Change the language. Language plays a big part in our thought processes. Asking the right positive question can help the client to transcend into positivity. For example, asking a mother: “What does your son say about your anger?” would invoke a negative response as they start to recall all the angry moments. “What does your son say when you are happy with him?” It will help the client bring forth the good moments to examine and construct desirable behaviours.
2. Goal setting through collaboration and negotiation. Setting goals gives purpose to the therapeutic process of SFBT. SMART and GROW models help facilitate the goal-setting process.
SMART – Specific, Measurable, Achievable, Realistic and Timely.
GROW- Goal-orientated, Reality, Options and Will or Way Forward.
SFBT is most effective when the goals are measurable to ensure an end in sight for all the effort the client put in to find the solutions.
3. Use Miracle questions. Miracles or the magic wand questions help invoke the client to think about a future where their problem did not exist. Inviting the client to use their imagination to describe what that day would look like can lead to an outline of a possible outcome. An overview of that vision is a good way for the counsellor to work with the client to gradually build the desirable future through a series of realistic, clear, concrete steps.
4. Ask about the exceptions. Problems do not happen the same way all the time. There will be instances where the client would have handled it differently. Clients may want more tools and may not know what they already possess. Finding exceptions is a valuable way to help reinforce the client’s ability to solve their problem and how to utilize those solutions for future issues.
5. Scaling questions. Scaling questions can help clients examine the severity of their current problems. It is the most vital tool in SFBT for its usefulness in encouraging clients to self-assess. Numbers are a handy medium to help clients determine their current uncomfortableness level. It is also helpful to help the client assess their motivation towards a goal they have set and how much dedication they can apply to achieve their goals.
Solution-Focused Brief Therapy Tenets
Solution-focused brief therapy uses a pragmatic perspective to help clients gain clarity on the goals they wish to achieve. The following tenets make up the foundation of the SFBT intervention model:
Prioritize the client’s desired outcome and goals—one of the most vital tenets of SFBT. Focus on the client’s desired outcome. Dwelling on past problems will not likely help them achieve their current goal.
Explore the exceptions to the problems. There will be times when issues are not likely to occur. Looking for exceptions in those circumstances can help the client find the solutions they may already know of to conceptualize a solution for the current problem.
Ask instead of directing. Using exploratory questions can help the client figure out how they can think or feel more or less about the problems in their life. Asking questions brings more structure for the client as they tell their story of who they are and where they would like to be. Using clients’ knowledge of their behavioural patterns is a way to help them envision the possible changes they can make to act and feel differently for the better.
Bring the future to the present. The past is not changeable, but we can work on the times ahead. The here and now is the best time to work with clients on their goals. It is more productive and motivating for the client to focus on finding solutions for the desirable future than looking back.
Validation through compliments. Compliments tell the client that we care. It encourages the clients to keep doing the excellent work that they are already doing and reinforces their positive behaviours. It also encourages them to share more about the changes they notice when they know they are valued.
Change is the only constant. Nothing stays the same. Minor changes are not always noticeable, but they are there. Highlight the small changes that are occurring. Frequent small changes will likely be more apparent in the times ahead.
Solutionsmay not relate to the problem. Logically, there is always a solution to a problem. In reality, we do not live in a black-or-white world. In Solution-focused brief therapy, solutions are drawn from client’s experience. Taking a fresh look at some of the solutions clients has used in the past may help the present issue.
Solution-Focused Brief Therapy application in current mental health issues
Solution-focused brief therapy can be helpful for people that want to talk more about finding solutions than dwell on the problems that they currently have. The therapy structure allows the client to work on one issue at a time to achieve the change and seeing the small changes through the process. Below is a list of concerns that works well with SFBT:
· Depression
· Anxiety
· Self-esteem
· Relationship issues and work-related stress.
· Substance abuse/ Addiction
· Parenting issues.
Limitations to Solution-Focused Brief Therapy
1. Solution-focused brief therapy format may result in missing the underlying issues.
2. There is no time to build an empathetic relationship to cater to the client’s emotional distress.
3. Solution-focused brief therapyprocess may get in the way of the client’s emotional journey if they bring up a problem outside the client’s ability to change.
All of the above are good points aiming at the issues of trying to fix a problem. Solution-focused brief therapy shares the same values that clients are experts in their own experiences and seeks to provide a safe place to see more positivity in their actions. Therapists and counsellors can use a variety of modalities, including SFBT, to help clients find relief, even if it is brief, to help them cope in this modern world. They may return with other problems, and that is ok. Problems can arise, and there is always a way to address the issue. It may or may not be the same solution, but finding a solution together is better than doing it ourselves.
CBT is one most effective therapies backed by scientific research that exists today. It is an effective therapy for people who suffer from anxiety, phobias, stress, & depression.
Cognitive Behavioural Therapy (CBT) Triangle
The CBT triangle shows that all emotions, behaviours and thoughts result from a person’s core belief. From a therapeutic perspective, this is important because how we think, feel and behave are all changeable, whereas an outside stimulus, such as an adverse event, may not be.
The goal of CBT
Help clients uncover cognitive distortions and dysfunctional assumptions. Help change the way experiences are interpreted. As clients become more aware of automatic thoughts, they can, if they so choose, replace them with coping thoughts.
The counsellor’s role in CBT is to:
The counsellor serves as a guide to help the client understand how beliefs and attitudes influence behaviours and feelings.
A catalyst for the client to make changes and learn new skills. They are moving the client from a closed belief system to an open one.
The counsellor’s primary therapeutic device is the use of questions. Homework for the client tests the validity of the behavioural experience.
Now let us look over some of the CBT techniques.
CBT interventions:
Questioning Automatic Thoughts.
1. What evidence is there to support this belief?
2. Are there any alternative explanations?
3. What is the worst-case scenario? Could I live through it?
What is the best-case scenario?
What is the most realistic outcome?
4. What is the effect of my thinking this way?
What could happen if I changed my thinking?
5. What would I tell a friend to do if they were in the same situation?
Questioning automatic thoughts can help clients. The client can then compare their automatic thoughts about a situation to a range of other possibilities. The client can then decide if their automatic thoughts are appropriate for the problem.
Listing evidence for and against an automatic thought
The therapist will ask a client what evidence there is from a previous experience to support the automatic thought and what evidence is against this.
The client will gain awareness of the situation and explore if the problem could be interpreted differently. During the process, the therapist must remain neutral and not jump to conclusions about the client’s hypothesis.
When finding evidence against the automatic thought is complex, the therapist may use evidence from their own or others’ experiences with that situation.
Client Self-monitoring of automatic thoughts
A client will record or chart automatic thoughts and shifts in mood. This works best with clients who suffer from anxiety, depression or pain.
By observing the shifts in mood or comfort level, the client will gain greater awareness that the discomfort is not constant.
It is then hoped that the client will be able to move through the period of discomfort with greater ease. This is due to the client’s new perception of pain as having a beginning, middle, and end rather than continuous.
Decatastrophising technique
The therapist and client explore what would happen if the catastrophised situation occurred. These types of problems often include exaggeration and generalisation. The therapist can ask the client about the extent and duration of the case. This encourages clients to be more specific and realistic with their projected outcomes.
Imagery technique
Clients experiencing anxiety often have images that occur shortly before or simultaneously with the anxiety experienced. By discussing the images with the therapist, the client should be able better to understand the images and their reactions to them.
Greater awareness about the images may help the client face any cognitive distortions.
Interpretation
Interpretation helps the client see the situation from other perspectives. The therapist can arrange the interpretation by role play. Getting the client to play someone else in the situation will help the client see different points of view. The therapist may introduce the interpretation through conversation and suggest other ways the data could be viewed and understood.
Homework assignments
Homework assignments can be set (I ask the client if they would like homework) because clients learn through practice and repetition. The client will start to put their new rational beliefs into practice. This will lead to further actions and behaviours. Repetition will help consolidate the new ideas, making the thoughts and actions more comfortable and automatic.
Here are 13 Thinking Traps that lead to negative feelings:
Thinking Traps help people identify cognitions (thoughts) that lead to negative feelings. When we identify our thoughts as thinking traps we can use disputation which is a Rational Emotive Behaviour Therapy technique. Disputation is described above as questioning automatic thoughts.
Self-Dowing – seeing yourself as a failure, unpopular, or unable to cope.
Must/Shouldn’t – seeing yourself and others through laws and rules.
Labelling – seeing yourself and others through one label.
Black and White – All or nothing type thinking.
Blame – Blaming everything on yourself or others.
Mind Reading – Knowing what someone else thinks and feels before asking them.
Fortune Telling – Knowing what adverse event will happen in the future.
Overgeneralisation – If something terrible has happened, it will always happen that way.
Emotional Reasoning – Feeling that something is true without looking for supporting facts.
Jumping to Conclusions – A quick conclusion with little to no information to justify it.
Magnification & Minimization – a person’s achievements are made smaller, while their mistakes are made more prominent.
Mental filter – focusing only on the negative aspects of a situation.
Catastrophizing – believing the situation is much worse than it is.
Learning through teaching
Clients sharing what they learn in therapy with family and friends can help them remember their learnings and strengthen their own rational beliefs.
By learning through teaching, the client becomes aware of areas of their learning, weaknesses, and strengths. This is gained through the levels of difficulty or ease as they teach and answer questions from friends and family members.
Areas of uncertainty can be addressed at the next session with the therapist.
CBT benefits and limitations
CBT helps clients address faulty thought patterns. CBT does not address the past about how and why the client established these thought patterns. Not dealing with the past may give fast and successful results, but does a client feel as whole, secure and integrated as a client who has dealt with their history in therapy?
The CBT therapist has a teaching role without as much value being put on the therapeutic relationship. This may affect the client’s ability to open up and be themselves. Some issues may not be addressed because of the weaker therapeutic relationship.
Even though the CBT counsellor is directive and takes on this teaching role, the client is not forced, and work is done at the client’s pace. The CBT counsellor helps empower the client and remains relational throughout the therapy.
CBT therapy addresses thoughts for clients to experience a change in their emotional issues. CBT requires much effort from the client, and sessions usually have homework attached. CBT Tends to be a short and structured style of therapy.
Glossary – Terms used in CBT and their meanings:
Cognition – The process of thoughts, ideas, images, and how we perceive things in response to an event.
Cognitive distortions – Thoughts which are misleading and may be considered exaggerated or irrational.
Schemata – Our brain’s way of organising thoughts and ideas gives us preconceived knowledge. An example of Schemata is thoughts about what a relationship should be.
Automatic thoughts – Thoughts that come into our consciousness in reaction to an event.
Core Beliefs – This term is interchangeable with Schemata & Schemas; they all mean the same thing.
