Solution-focused brief therapy

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Steve de Shazer, Insoo Kim Berg · 1986 · Milwaukee, USA

What it is

Solution-focused brief therapy (SFBT) is a competency- and resource-based conversational therapy. Steve de Shazer and Insoo Kim Berg developed it at the Brief Family Therapy Center (BFTC) in Milwaukee, with colleagues. It is not a problem-specific protocol. It is a way of interviewing that can be…

Format

• SFBT has no fixed phases across a course of therapy. It has a recurring session structure that differs between the first and later sessions, plus an ending procedure.
• First session

Who practises it, and how they are trained or regulated

• SFBTA 2013 names an 85% adherence and competency threshold. It requires a master's-level clinician with formal SFBT training and supervision, preferably live supervision.
• How change happens. The model holds that change comes from solution building, not problem solving. Therapist and client co-construct detailed descriptions of the client's preferred future and of times when parts of it already happen (exceptions). The client then does more of what already works. The manual locates the therapeutic process in the dialogue itself. The therapist listens for fragments of what the client…
• Historical note: the 1986 BFTC paper was still exceptions-driven and began from the complaint. The later model (miracle question, preferred-future first) grew out of it.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• : Agree whether to end with the client. Don't end on your own schedule.
• : Don't impose your own goal. If an external party, such as a court, sets the goal, see 4.18.
• : Ask "What's better?", not "Is anything better?". If the client says "nothing", see section 5.
• : Avoid making promises about what you will report. Be transparent about any reporting duties from the start.
• : The client should nod or agree. Iveson's BRIEF ends with compliments but prescribes no homework. [Iveson 2002]

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.