Solution Based Brief Therapy

1.0 Introduction

As the name suggests, it is about being brief and focusing on solutions, rather than on problems. We learned a long time ago that when there is a problem, many professionals spend a great deal of time thinking, talking, and analyzing the problems, while the suffering goes on. It occurred to a team of mental health professionals at the Brief Family Therapy Center that so much time and energy, as well as many resources, are spent on talking about problems, rather than thinking about what might help us to get to solutions that would bring on realistic, reasonable relief as quickly as possible.We discovered that problems do not happen all the time. Even the most chronic problems have periods or times when the difficulties do not occur or are less intense. By studying these times when problems are less severe or even absent, we discovered that people do many positive things that they are not fully aware of. By bringing these small successes into their awareness and repeating the successful things they do when the problem is less severe, people improve their lives and become more confident about themselves.And, of course, there is nothing like experiencing small successes to help a person become more hopeful about themselves and their life. When they are more hopeful, they become more interested in creating a better life for themselves and their families. They become more hopeful about their future and want to achieve more. Because these solutions appear occasionally and are already within the person, repeating these successful behaviors is easier than learning a whole new set of solutions that may have worked for someone else. Thus, the brief part was born. Since it takes less effort, people can readily become more eager to repeat the successful behaviors and make further changes.Solution-Focused Brief Therapy has taken almost 30 years to develop into what it is today. It is simple to learn, but difficult to practice because our old learning gets in the way. The model continues to evolve and change. It is increasingly taken out of the therapy or counseling room and applied in a wide variety of settings where people want to get along or work together.

2.0 Background Solution-Focused Brief Therapy

Solution focused Brief Therapy (SFBT) (Pichot, 2003) 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. (De Shazer, 2007) Based upon social constructionist thinking and Wittgensteinian philosophy SFBT focuses on addressing what clients want to achieve exploring the history and provenance of problems. Solution Focus 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 clients concerns (Berg I. K., 2002) 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, Insoo Berg, Jim Derks, Elam Nunnally, 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 respective deaths. 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 quite differently. Informed by the observations of Steve de Shazer, recognizing that although "causes of problems may be extremely complex, their solutions do not necessarily need to be". Questions and compliments are the primary tools of the solution-focused approach. SF therapists and counselors deliberately refrain from making interpretations[ and rarely confront their clients. Instead, they focus on identifying the client's goals, generating a detailed description of what life will be like when the goal is accomplished and the problem is either gone or coped with satisfactorily. In order to develop effective solutions, they search diligently through the client's life experiences for "exceptions," e.g. times when some aspect of the client's goal was already happening to some degree, utilizing these to co-construct uniquely appropriate and effective solutions. Solution Focus therapists typically begin the therapeutic process by joining with client competencies. As early in the interview as respectfully possible to do so, SF therapist/counselors invite the client to envision their preferred future by describing what their life will be like when the problem is either gone or being coped with so satisfactorily that it no longer constitutes a problem. The therapist and client then pay particular attention to any behaviors on the client's part that contribute to moving in the direction of the client's goal, whether these are small increments or larger changes. To support this approach, detailed questions are asked about how the client managed to achieve or maintain the current level of progress, any recent positive changes and how the client developed new and existing strengths, resources, and positive traits; and especially, about any exceptions to client-perceived problems. Solution focused therapists believe personal change is already constant. By helping people identify positive directions for change in their life and to attend to changes currently in process they wish to continue, SFBT therapists help clients construct a concrete vision of a preferred future for themselves. SFBT therapists support clients to identify times in their life when things matched more closely with the future they prefer. Differences and similarities between the two occasions are examined. By bringing small successes to awareness, and supporting clients to repeat their successful choices and behaviors, when the problem is not there or less severe, therapist facilitates client movement towards goals and preferred futures they have identified. One way of understanding the practice of SFBT is displayed through the acronym MECSTAT, which stands for Miracle questions, Exception questions, Coping questions, Scaling questions, Time-out, Accolades and Task. (Solution Focused Brief Therapy, n.d.)

3.0 Concepts of Solution Focused Therapy (SFBT)

Solution-focused brief therapy was atheoretical, and the focus was on finding “what works in therapy.” Wary of the potentially limiting effects of assumptions or presumptions of theory-based practice approaches pertaining to clients, problems, and diagnoses, these pioneers of solution-focused brief therapy took a new and different approach in exploring the treatment process by asking one simple question: “What works in treatment?” They were interested in listening to what clients have to share, noticing what actually happens in session that helps positive improvement, and distancing themselves as much as possible from presumptions about what works as proposed by diverse treatment approaches. The original team regularly met and observed therapy sessions using a one-way mirror. While observing the therapeutic dialogues and process, the team behind the mirror diligently attempted to identify, discover, and converse about what brought beneficial positive changes in clients and families. In other words, the early development of solution-focused brief therapy was antithetical to the modernist epistemology of understanding human behavior and change based on a presumed understanding of the observed phenomena. Instead of taking a positivistic, hierarchal, or expert stance, the understanding is accomplished by a bottom-up and grounded approach, which strives for a contextual and local understanding of what works in therapy. (Lee, 2013). 3.1 The core concepts of Solution Focused Therapy (SFBT)

3.1.1 Postmodern Approach

Rather than believe themselves to be experts who can solve client problems, therapists using a postmodern approach view the client as the expert. Such therapists want to enter the client’s experience of life and explore his thoughts. The story is an important theme. How a client narrates his or her own life is indicative of any problem he or she may be experiencing. It is not so much that a client experiences depression as that he considers himself to be depressed. Social constructionists challenge conventional perspectives and believe that knowledge is socially created and that language is culture-bound. Therapists explore client language and story, at times challenging the client’s view, to help him become “unstuck”; that is, to help him find a different point of view and a new set of actions. A client narrates his or her story in new ways to form new meanings.

Many postmodern therapies attempt not to focus on a specific problem, but rather on a solution. Clients are encouraged not to wallow in the past but to live in the present. Clients have the power to live and view their lives as they see fit; counselors encourage them to do so in ways that are “useful.” Postmodern therapists highlight what works for the client and encourage continuation of the same. The problem is that postmodernism does not define“useful.” Theoretically, a serial killer could view his actions as acceptable because they make him feel better, and the postmodern therapist would have to agree.

Rather than affirm problems, therapists and clients look for exceptions. Therapy is not oriented toward pathology but toward growth. Clients make and reach positive goals with the therapist’s assistance. Some therapies aim at concrete actions, and others are oriented toward forming a new life narrative. (Got Questions, n.d.)

4.0 Conceptualisation of problems in SFBT

Social Constructionism is a term used for introducing the awareness of how our ways of life are constantly socially developing and changing over time. The way we communicate with each other, how we get our needs met, how we organize ourselves, are all constructed relationally and are continually being redefined. From this point of view the troubles and symptoms from which the patient seeks relief, and the unconscious factors behind them, cease to be merely psychological. They lie in the whole pattern of his relationships with other people and, more particularly, in the social institutions by which these relationships are governed: the rules of communication employed by the culture or group. These include the conventions of language and law, of ethics and aesthetics, of status, role, and identity, and of cosmology, philosophy, and religion. For this whole social complex is what provides the individual's conception of himself, his state of consciousness, his very feeling of existence. What is more, it provides the human organism's idea of it's individuality, which can take a number of quite different forms. Social Constructionism holds the view that there are no underlying processes at work; everything is in view and nothing is hidden. In other words, there is nothing beneath human struggles; no problem or issue that is not intimately tied to our cultural ways and stories. Therapy, then, becomes a way in which our social constructionism.

5.0 The Role Of The Therapist In SFBT

SFBT is an approach that is easy to learn, but requires a lot of self-discipline and can be difficult to apply in the therapeutic setting. Therapists must not focus on client pathology or analysis of the problem- often a very different approach to other therapeutic models. The therapist takes the stance that the client is the expert and refrains from providing advice or interpretations. It takes practice to learn to view and describe situations from a different perspective, which is solution focused and future oriented. Clients play an active role in goal setting as they can visualize how they want their future to be. SFBT requires a therapist to be flexible.

There are many important tasks for a therapist to undertake in SFBT with clients.

1. Positive stance: Therapists have an attitude that is respectful, positive and hopeful. A belief that people are resilient and have the strength and resources to change.

2. Solution seeking: Therapists are looking for times when the problem wasn’t present

3. Exception seeking: Therapists are looking for times when the problem could have occurred but didn’t

4. Questioning: Questions play an important role in SFBT and therapists will rarely interpret, challenge or confront their client

5. Future focused: Therapists strive to direct the client towards future oriented goals and what is working at present rather than focusing on the past and how the problems transpired.

6. Compliments: Encouraging clients to continue doing what is already working for them and highlighting their strengths.

6.0 Contrast To Other Treatments

Solution Focused Brief Therapy is systems based approach which focuses on solutions and pre-existing client strengths. It is similar to other competency based approaches such as motivational interviewing.

Traditional treatments focus on exploring problematic thoughts, emotions and behaviors through assessment, interpretations and education. In contrast, SFBT helps clients see a desired future where the problem no longer exists and explores the client’s strengths and resources in the search for solutions. The client takes the lead in defining the goals and identifying strengths. SFBT focuses on how clients change rather than diagnosing and treating problems.
SFBT is also different in the sense that there is no formalized assessment of the client. Therapists do not gather information about the symptoms, pathology or family structure nor make diagnoses. This is a shortcoming of working from this model if your workplace requires these formalities.

Assessment in SFBT involves asking a series of questions to formulate goals and client outcomes are assessed through scaling questions at various intervals during the clinical relationship. This will be further explored later in the course.

7.0 Solution Base Brief Therapy Theraputic Process

7.1 Stages of Change

When working with clients from a SFBT model, it is important that the therapist is in tune with what stage the client is at in their motivation to change. Diving straight into action about what a client can do to change may be a little further along than where they are at in the present moment. There are various elements that are referred to as the ‘stages of change’ that clients may move in and out of during therapy.

7.1.1 Pre-contemplation

At this stage, clients have no intention to change or take any action towards the near future. They are unaware of the consequences of their behavior and avoid talking about their behavior. They are likely to underestimate the advantages of changing and will overestimate the costs. Clients at the pre-contemplation stage are unlikely to initiate therapy unless it is mandated or strongly encouraged by family members.

7.1.2 Contemplation Clients intend to change in the next six months or so. They are somewhat more aware of the advantages of changing and more accurately informed about the cons. They may be ambivalent about their situation and are not quite ready for action-oriented treatment programs. Clients at the contemplation stage usually know what they need to do but struggle to follow through with the change. 7.1.3 Preparation At this stage, clients are planning to take action in the near future, usually within a month. They tend to be aware that they can change and ready to act on this. They may have taken some action in the preceding year towards their goal and are now ready to use SFBT. 7.1.4 Action Clients have taken specific actions to modify their lifestyle within the preceding six months. They are in the process of making changes.

7.1.5 Maintenance Clients are working to maintain changes in their life and prevent relapse. They have developed strategies to continue their changed lifestyle and are feeling more confident to continue. 7.1.6 Termination Clients are now at the stage where they have no temptation to revert back to previous behaviors and feel confident and self-efficient.

Clients move through these stages of change at various times of their lives about various issues that they face. It is common for clients to move back and forth throughout the process before reaching maintenance and termination. For example they may move from action stage back to contemplation and preparation as their ambivalence about change reemerges.

8.0 Applications of Solution Focused Brief Therapy

This module will cover the typical session structure employed in Solution Focused Brief Therapy as well as goal development and the specific interviewing techniques that are unique to this model of therapy. Common challenges therapists face in SFBT are also considered.

8.1 Session structure

Although session content is mostly structured by the client, there is a loose structure integral to the solution-focused model. There are a series of interviewing techniques that must be used for the model to be considered solution focused brief therapy. Therapists use their own judgment about the timing and exact wording of these elements to the approach.

As a brief intervention approach, the number of therapy sessions required typically ranges from 1-12 sessions over a 3-4 month period. It is not the number of sessions that is important for the model to be successful, but whether the goals developed by the client are being achieved.

There are essential requirements that must feature in a solution-focused session and following sessions. It is the role of the therapist to expand on these techniques to assist the client in developing goals and identifying solutions.

8.2 First session Pre-session change Ask what the client is good at Ask and follow up on the miracle question Ask and follow up on the progress scale question Compliment the client at the end of the session

8.3 Second session Ask and follow up ‘what is better’ at the beginning of the session Ask and follow up on the progress scale question

9.0 Compliment The Client At The End Of The Session

Each of these components will be discussed in further detail throughout this module. It is the role of the therapist to identify opportunities throughout each session to incorporate SFBT techniques and steer the client towards solution focused behavior. It is essential that at least the miracle question, a scaling question and homework experiment forms part of the session for it to be considered a session based on the SFBT model

9.1 Goal Setting Most therapeutic approaches aim to develop clear, specific and achievable goals for a client. In SFBT, the therapist attempts to make small goals rather than larger ones. Clients are encouraged to frame goals in a solution focused way. For example:
“I want to eat smaller food portions throughout the day” is better than “I want to stop overeating” Keeping in line with SFBT, goals are framed to incorporate the positive results desired as opposed to the absence of problem behavior. When a goal is framed in terms of the solution, it makes it easier to measure change through the use of scaling questions. At first it can be difficult for clients to think in a solution focused way and it is the role of the therapist to shape the session to promote solutions wherever possible.
For example if a client’s goal is:
“I don’t want to feel depressed” When problems are identified, the therapist can ask a question that steers the client towards the solution.
“If you weren’t feeling depressed how would you feel instead?” This question elicits a solution and positive framing of the goal. A common answer would be “I would be happier.” Below is a scenario of the conversations between client and therapist in reframing a goal.

Client : I don’t want to feel depressed Therapist : If you weren’t feeling depressed how you would feel instead? Client : I would be happier Therapist : If you were happier, what would be different about you? Client : I would get out of the house more and see my friends Therapist : So getting out of the house and seeing your friends would make you happier? (And less depressed)

The therapist can return to the initial goal of feeling less depressed and ask:
“Other than being happier, is there anything else that would be different about you if you weren’t depressed?”

Goals are elicited early in the first session through various interviewing techniques. Once a goal has been established, through this line of questioning the therapist can determine where the client is currently in terms of meeting their goal and what they have to do to work towards the goal. For example, in the scenario above, the therapist could explore how often the client currently gets out of the house, how often they see friends and what resources are being utilized.

9.2 Pre-Session Change

It is common for clients to notice that between the time that they have phoned and scheduled the appointment with a therapist and when the first session occurs that things already appear different for them. A solution-focused therapist will take this opportunity to identify current solution behavior the client is engaging in: “What changes have you noticed since you called to schedule this appointment?”
There are two possible answers to this question. Firstly, they may say that nothing has changed. Therefore the therapist simply moves on to commence the session by asking open-ended questions such as: “How can this session be helpful?” “What would need to happen today for this session to be really useful? “What needs to happen in this session for you to say that it was a good idea to come and talk to me?” Alternatively, if the client reports that things are about the same. Then the therapist can explore the client’s strengths about how the situation has not worsened. This line of questioning can lead to previous solutions and exceptions. “How have you managed to keep things from getting worse?” Secondly, the client may say that things have been different or better. The therapist seizes this opportunity to ask numerous questions about what is different to obtain a lot of detail. Solution-talking then commences which involves emphasizing the client’s strengths from the very beginning. It also provides an opportunity to develop a specific and affirmative goal.
So, if these changes were to continue, would this be what you would like to achieve? Asking clients about pre-session change sets up the framework that strengths and solutions will be highlighted not problems during SFBT. This approach can be quite a different experience for clients who are used to being asked about their problems rather than what they are doing well at.

9.3 Strength seeking

An important role of the therapist in the SFBT model is to identify the client’s strengths and resources. When a therapist enquires about what the client is good at, this usually sets up a very different therapeutic experience for them. It introduces a strengths based approach with an inherent belief that the client has good qualities and skills. This is contrast to other approaches of therapy which enquire about what is wrong and what problems they are experiencing. It is also a light and fun way to build rapport with a client as they have an opportunity to talk about what they value in themselves.
“What are you good at?”
“What would your wife/ father/ child (etc) say that you are good at?”

The client may be stumped by this question, but generally they will come up with something that the therapist can work on. The therapist must be thorough in exploring the client’s strengths as the earlier you start to talk about things in a positive way the easier it will be for you and the client to use these techniques in sessions. Developing affirmations facilitates cooperation in the counseling process.

Identifying strengths and complimenting the client are crucial to SFBT and the smooth progress of change towards the client’s goal. Positive goal directed behavior is amplified and complimented which highlights to the client the importance of their past successes and the skills they already have to achieve their goal.

9.4 Miracle question

The Miracle question is the leading technique in Solution Focused Brief Therapy. As some clients have difficulties articulating a goal, the miracle question is a way to ask for a goal that the client comes up with themselves by considering their preferred future. The miracle question is a technique that assists client to think broadly about new possibilities for the future and to imagine how their life would be changed if the problem was solved.

The question is best asked directly and dramatically. Clients may seem puzzled by the question or have difficulties thinking about what life would be like but usually they will come up with something.

Q. Now, I want to ask you a strange question. Suppose that while you are sleeping tonight and the entire house is quiet, a miracle happens. The miracle is that the problem that prompted you to talk to me today is solved. However because you are sleeping, you don’t know that the miracle has occurred. So, when you wake up tomorrow morning, what will be different that will tell you that a miracle has happened and your problem has been solved?

Follow up questions are important after the miracle question has been asked. A description of the preferred future needs to be broken down into detailed, specific and smaller ‘wants’ that can be translated into goals.

“How will that be different?” “What will be different about you?” “What will you be doing instead when you are not…?” “When you stop…. What will you do then?” “When you are feeling…. What will you be doing?” “How will s/he notice that you are feeling…?” “Who else will notice your being more….?” “What will they do when you…?” “What will you do when s/he….?” “What would be the first sign that s/he…?”

Each question can be followed up with ‘what else?’ for further alternatives.

Here is an example transcript after the client was asked the miracle question: Client : My husband and I wouldn’t fight anymore. Therapist : If you and your husband weren’t fighting anymore what would you be doing instead? Client : We would be talking happily and listen better to each other. Therapist: How will that be different? Client : We would be happier together and communicating better. Therapist : What will be different about you? Client : I would be more relaxed. Therapist : What would your husband notice about you? Client : He would see that I am relaxed and know that we could talk more openly without me getting angry at him. Therapist : What would your husband do if you were more relaxed? Client : He would talk to me more. He wouldn’t shut himself off, he would stop avoiding me. Therapist : If that was happening what would be different about how you feel? Client : I would feel more connected to him. We would have a better relationship.

What the client is able to construct in conjunction with the therapist is the goals of therapy which can usually be taken from the answers in the miracle question. In the example above, the questioning reverts back to what the client would be thinking/ feeling/ doing and what would be different about them, keeping in mind that she cannot change her husband’s behavior. It emerges that if the client felt more relaxed then she would be less angry at her husband and they would likely talk more and connect better. A goal of therapy that has been identified is for the client to be more relaxed. This could be broken down into more specific, smaller goals using scaling questions
9.5 Scaling Questions

Scaling questions invite clients to see their problem on a continuum and evaluate their progress towards goals. Scaling questions ask the client to rate their position on a scale of 1 to 10, where one is the least desirable and 10 is the most desirable situation. Usually the scaling question will emerge from the goals identified in the miracle question discussion.On a scale of one to ten, where one is the worst the problem has ever been and teen is when things are at its best, where would you rate things today? What I want to do now, is scale the problem and the goal. If one is as bad as the problem can be and ten is the best it can be, where would you rate your current situation? When the client rates their position, the therapist then explores what the rating looks like in action. For example: “Tell me what a three looks like?” “What is happening to indicate that you are at a three?” From there the therapist and client determine the goals and preferred outcomes. The therapist asks the client where things are currently and where they would like to be to feel that therapy was successful. For example:
“You say you are currently at a 3, what would you like to be for you to feel that therapy has been successful?”
“You say you are currently a 3. What would need to happen so that you could say things were a 4 or 5?” Inviting the client to view their future at smaller points along the continuum, allows the goal to appear more achievable and less overwhelming. It also sets up a measure for the therapist and client to observe changes that occur. Here is an example transcript of a scaling question following the miracle question. This follows on from the miracle question example above, about the woman who gets angry at her husband.

Therapist : Now, I would like you to rate this goal on a scale of one to ten. With one being the least relaxed you could be and ten being the most relaxed you could be. Where do you see yourself now? Client : Probably a five. It helps talking about it. Therapist : So what is specifically happening for you at the moment for you to be at a five? Client : Well I’m not at home worrying about getting all the cleaning done and running around after the children.

Therapist : What is different about that? Client : I guess I’m doing something for myself, being here. I don’t want to be angry and complaining all the time. When I do things for myself I feel more relaxed, less tense and angry about doing things for everyone else. Therapist : So when you do specific things that focus on yourself, it helps you feel more relaxed? Client : Yeah. I give myself to everyone all the time and hardly ever have time for myself. Therapist : So if you are currently at a five, where on the scale would you be satisfied? What would you like to get to on the scale to feel that your time with me has been helpful? Keeping in mind that ten is the ideal. Client : I would be happy with an eight. Therapist: And what would an eight look like? Client : I would be doing something for myself like taking a class or getting a casual job. If I had time out from home and was doing something just for me I think I would be a lot more relaxed. Therapist : So at an eight you would be taking a class or working and you would feel more relaxed. What would people notice about you if you were at an eight? Client : They would see that I am happier. I would yell less. I would be easier to be all Therapist : So if you were more relaxed, your family would see you acting differently? Client : Yeah, if I was happier then they would be too. Therapist : So, if you are currently at a five, what would need to happen for you to move to a six? Client : I think if I enrolled in a class that I could go to each week, even if it is only for fun. I would feel a lot better in myself and a lot more relaxed.

The scaling question serves many purposes. It is an important assessment device in Solution Focused Brief Therapy and provides an ongoing measure of the client’s progress and the changes made. This type of questioning also promotes the importance of the client’s evaluation, rather than the therapist being an expert on the situation. Additionally, scaling questions focus on previous solutions and exceptions and endorses changes that occur.

9.6 Progress Questions

In subsequent sessions, the initial scaling question is re-explored. The therapist asks the client again where they are on the scale to see if there has been progress. For example:
“What is different since the last time we met?”
“What has changed since our last meeting?” If the scale increases, then the therapist gets a detailed description of what is better and how they were able to implement the changes. The following questions can be asked:
“Now that you are at a (rating on scale), how are things different? What are you doing differently?”
“Who else may have noticed your being at a…..?”
“How did it happen, that you went from a three to a four on the scale? How did you decide to do that?”
“How do you know you can do more of it?”
“What needs to happen so you can do more of it?”
“As you continue to do these good things for yourself, what difference will that make to you from tomorrow?”

The therapist takes this opportunity to compliment the client on being able to make things better which solidifies the change. For example, the therapist could ask:

“Wow, you did that? Tell me more…” “How did you know that would help?”
“What is it about you that helped you do that?”
“It was impressive that you took that step on your own, when did it occur to you that it was the right thing to do?”

If things have remained the same, then the client can be complimented on maintaining their changes and for not letting things get worse. This will sometimes lead to instances where the client has actually made some small changes. For example:
“How did you keep it from going down?”
“How did you stop things from getting worse?” Progress questions serve as a tool for finding positive changes and encourage the client to continue what they are doing that is working. When used in a follow up session, the progress question is followed up by a discussion about the next steps towards the goal. The therapist will ask what needs to happen for them to move one point up the scale towards their preferred position. For example:

“What needs to happen so that you can go up to a 6?”
“What will you be doing differently when you are at a 7?” This line of questioning keeps the focus on the goal and continues to break it down into smaller achievable steps.

9.7 Coping Questions

Coping questions can be used to steer the client towards solution behavior when they report that their situation has not improved or that they do not feel any better. This is an important strategy that can be used when a therapist feels stuck by the client’s immobility in the change process. It can be pointed out to a client that although things have not improved, they have also not gotten any worse. This means that there are resources and strengths at work here to prevent the problem from getting worse. The following questions can be used to prompt the client towards solution behavior:
“How have you coped with this situation to the degree that you have? How have you managed to stop it from getting worse?” When a client identifies behaviors that are maintaining the problem and preventing its deterioration then this is amplified by the therapist. The client is complimented and enquiries are made about the solution behavior, if this were to continue would they be getting closer towards their goal. From here, the client can be re-directed back to the scaling question. What would it take for them to move up a point on the scale towards the goal? Coping questions help the client to identify that although their problem has not improved they have the resources to maintain their situation from worsening.

9.8 Exception Questions

Exception questions aim to empower clients to find solutions for their problems. Through the use of specific questioning, the therapist can help the client to identify times when things have been different for them. Exception questions often flow on from the miracle question once a detailed picture of the preferred future has been attained. It is important that in the role of the therapist you are continually screening the client for talk about previous problem solving and exception behavior. This requires attentive listening and a lot of practice to skillfully identify the client’s previous solution behavior.
“Tell me about the times when you haven’t been depressed When was the last time that you feel you were coping better?”
“Was there ever a time where you and your partner communicated well?”
“Can you think of a time when the problem was not in your life?” It is important that the therapist gets details about the exception to help the client explore how they have managed to be without the problem in the past.
“What do you suppose you did to make that happen?”
“What do you think friends/ family would say about how you made that happen?” When exploring the exception the therapist genuinely compliments the client on the previous solution behavior.
“Where did you get the idea to do that?”
“That makes a lot of sense. Have you always been able to come up with ideas like this when you have been in difficult situations?”
In relation to exception questions, the therapist has three main tasks: 1. Listen carefully for exceptions to the problem- when the problem could have occurred but didn’t. 2. When an exception has been identified, the therapist amplifies it by getting more details about it and congratulating the client. 3. Connect the exception to the client’s goal

It is the therapist’s role to skillfully link the exception back to the goal or miracle picture. For example:
“If this exception were to occur more often, would your goal be achieved?”
“What will it take for that to occur more in the future? What do you need to make it happen again?”
“What would you say your husband/ wife/ partner would say about the chances of this happening again?”
“On a scale of one to ten, where ten means you are very confident and one is not at all confident, what are the chances that a time like the exception will happen again in the near future?”

When an exception is linked back to the goal it highlights to the client that their preferred future is achievable and that they have the skills to solve their problem. This is very encouraging for your client and they will feel empowered to take steps towards achieving their goal.

9.9 Homework

Many types of therapy use homework assignments to solidify changes begun during therapy and is mostly assigned by the therapist. In SFBT, therapists may suggest a possible ‘experiment’ which is usually based on something the client is already doing that is getting them closer towards their goal. SFBT follows the principles that the client is more likely to change if the change emanates from them rather than the therapist. So in some cases, the therapist may ask the client to set the homework. This allows the homework to be tied in with their own goals and personally relevant to the changes they want to see. Therapist : Before we end our session today, I would like you to think about a homework assignment. If you were to give yourself something to work on in the next week, what would it be? Client : I would like to set some time aside for myself this week. Even if it is just an hour. Therapist : Can you tell me more? Client : Well, I feel more relaxed when I have some time out to do something just for me, rather than worrying about everyone else all the time. I always put off doing things I want to do, so I’d like to try and have an hour to myself this week. Therapist : What do you plan to do in this hour? Client : Well, I’d love to continue reading a book I started months ago. Therapist: That sounds like a great relaxing activity that you can spend an hour doing. Client : Yeah, I’m sure I can set aside an hour since I’ve been able to talk to you today for an hour. Therapist : That’s great. You have already been able to set aside an hour for yourself this week, by coming and talking to me about what changes you would like in your life. So I think it’s a great homework assignment to have another hour to do something you enjoy such as reading.

What stands out in this transcript is that the client identified their own goal and it flowed on from previous solution behavior that leads towards achieving her goal. The therapist compliments the client on this decision and links it back to how they already have the skills to make this happen. However, even if the client identified something that wasn’t based on solutions, the therapist would probably still support it.

The therapist will check in with the client about how the assignment went at the next session. If the client did the assignment and it was helpful then the therapist compliments the client and encourages the client to explore ways of how they can continue with this solution behavior to achieve their goal. The therapist also revisits the coping scale, to see where the client now rates themselves in progress towards their goal. If the assignment was not completed, then this is not explored further. Rather they are asked by the therapist what else the client did between sessions. Homework is not essential in SFBT, rather it is marketed to clients as an ‘experiment’ something to try without the pressure or expectation that it must be completed and achieved. Homework suggestions usually flow on naturally from the discussions that emerge from exception behaviors. For example “how can you do more of that?” This can be revisited at the end of the session to discuss homework.

10.0 Summary
Solution-focused brief therapy (SFBT) is goal oriented, targeting the desired outcome of therapy as a solution rather than focusing on the symptoms or issues that brought someone to therapy. This technique emphasizes present and future circumstances and desires over past experiences. The therapist encourages the client to imagine the future that he or she wants and then the therapist and client collaborate on a series of steps to achieve that goal. This form of therapy involves developing a vision of one’s future, and then determining what skills, resources, and abilities a person already possesses that can be enhanced in order to attain the desired outcome. SFBT was developed by Steve de Shazer, Insoo Kim Berg, and their team at the Brief Family Therapy Family Center in Milwaukee, Wisconsin in the early 1980s.
SFBT contends that people are equipped with the skills to create change in their lives, though they may need help in refining and identifying those skills. Similarly, SFBT recognizes that people already know, on some level, what change is needed in their lives, and SFBT practitioners help clients to clarify their goals. In particular, the therapist will help the client to identify a time in life when the present problem was either less detrimental or more manageable, and evaluate what factors were different or what solutions may have been present at that time. SFBT practitioners empathize with the struggles of their clients and guide clients to see what is working for them, to continue those practices that work, and to acknowledge and celebrate their successes. They also encourage clients to experiment with new approaches to problems. SFBT aims to help people find tools they can employ right away to manage symptoms and face challenges. This type of therapy can be used in individual therapy and with families and couples.
In solution-focused brief therapy, counsellors ask specific types of question to guide the session. Coping questions, for example, help demonstrate to clients their resiliency and the number of ways in which they are capable of coping with challenges in their lives. An example might be, “How do you manage in the face of such difficulty to fulfil your daily obligations?” This can help a person to see his or her skill in coping with adversity. Miracle questions help people envision a future in which the problem is absent. In essence, this line of questioning allows people to explain how their lives would look different if the problem did not exist, and this helps them to identify small, practical steps they can take immediately toward change. For example, the client might describe a feeling of ease with family members if the present problem were absent, and this serves as a reminder that these kind so behavioural changes are possible. Scaling questions use a scale from 0–10 to assess present circumstances, progress, or how one is viewed by others. These kinds of questions are often used when there is insufficient time to explore the miracle question and to gain insight into the hopefulness, motivation, and confidence of clients. In addition, people who have difficulty verbalizing their experiences find this approach less challenging.

References

Berg, I. K. (2002). Tale of Solution. New York: WW Norton.
Berg, I. K. (n.d.). SFBTA. Retrieved from SFBTA: http://www.sfbta.org/about_sfbt.html de Shazer, S. &. (2007). More Than Miracles: the State of the Art of Solution-focused Brief Therapy. New York: Routledge.
Got Questions. (n.d.). Retrieved from Got Question: http://www.gotquestions.org/postmodern-therapy.html
Lee, M. Y. (9, 2013). Social Work. Retrieved from Social Work: http://socialwork.oxfordre.com/view/10.1093/acrefore/9780199975839.001.0001/acrefore-9780199975839-e-1039#acrefore-9780199975839-e-1039-div1-2
Pichot, T. &. (2003). Solution-focused Brief Therapy. . New York: Haworth.
Social Contruction Therapy. (n.d.). Retrieved from http://socialconstructiontherapy.com/what-are-social-construction-therapies.php
Solution Focused Brief Therapy. (n.d.). Retrieved from Wikipedia: https://en.wikipedia.org/wiki/Solution_focused_brief_therapy#cite_note-Pichot-1