In this section, you will learn to:
- Determine client suitability for solution-focused therapy.
- Work with clients using a solution-focused approach.
- Document and monitor progress in solution-focused therapy.
- Apply solution-focused therapy to particular client issues.
Supplementary materials relevant to this section:
- Reading F – The First, Second Session and Beyond
Now that you understand the key concepts and techniques of solution-focused therapy, let’s take a closer look at some of the key considerations involved in applying a solution-focused approach.
Like all other counselling approaches, solution-focused therapists must first assess that counselling is appropriate for the client and that the solution-focused approach is suitable for the client’s needs. For example, if the client appears to have significant mental health issues or other urgent needs (e.g., homelessness, domestic and family violence, suicide), counselling may not be
appropriate at that time. Where a referral to other services or professional is appropriate, counsellors must do this per their organisation’s policies and procedures.
Where counselling is appropriate, counsellors should also assess whether a solution-focused approach suits the client. A solution-focused approach offers much to clients or practitioners who prefer a brief, time-effective process, focussing on what can be done. Its strengths-based, person-centred nature also provides a positive, validating environment for clients to be recognised for their capabilities and strengths. Reviews of studies on solution-focused brief therapy suggest that there are potential benefits in using such an approach on a range of emotional, behavioural and interpersonal issues, such as child behavioural problems, parental stress, relationship issues, behavioural support for health-related issues, anxiety and depression, and substance abuse (Gingerich & Peterson, 2013; Kim et al., 2019; Schmit, Schmit, & Lenz, 2016).
Nevertheless, the solution-focused approach will not meet every client’s expectations or hopes for counselling. Some clients may be more comfortable with a problem-focused type of therapy. For example, if a particular client is particularly interested in exploring the causes or histories of their problems, they may not find a solution-focused suitable approach. Additionally, a client who is overwhelmed by their problems that they simply “cannot (or will not) allow even the slightest possibility that good moments might occur” is probably not likely to engage well with the solution-focused approach (McLeod & McLeod, 2022, p. 230). In these cases, referring clients to another counsellor who employs the client’s preferred approach or other approaches may be more appropriate.
There are times when the [solution-focused] approach is not appropriate. Some clients may have causal explanations that form a central and protected part of their worldview. Similarly, when clients have deeply-felt needs to explore aetiology, attempting to impose a methodology that feels incongruent is likely to be counterproductive. While clients often respond favourably to a well-presented rationale for the [solution-focused] approach, when they do not, referral or use of an alternative methodology may be indicated. To force a [solution-focused] perspective onto an unwilling client runs counter to the core principle of respecting the client.
(Grant & Cavanagh, 2018, p.47)
On the other hand, the successful application of a solution-focused approach also relies on certain client characteristics. According to Winbolt (2011), the success of a solution-focused approach is also dependent upon their levels of self-awareness, openness to change, cognitive style, ability to relate, self-esteem, and openness to the therapeutic process. Solution-focused therapy also requires clients to have obtained certain developmental milestones and able to articulate their preferred future as well as reflect upon their actions and how these actions are progressing them towards or holding them back from their preferred future. As such, clients without an appropriate level of self-awareness and desire to change their behaviours may have difficulty finding success with solution-focused therapy and may require referral to a more appropriate service. Depending upon the client’s specific circumstances, some counsellors may utilise several solution-focused techniques in combination with another counselling approach (an example of integrating solution-focused techniques with other approaches will be provided in a case study at the end of this section of the module).
Working with Hard Clients
This video discusses clients who either don't want to participate in sessions or can't for one reason or another.
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As previously discussed, solution-focused therapists do not employ a specific set of techniques in a specific order; however, solution-focused therapists do seek to utilise solution-focused techniques to work towards certain aims. For example, during the first session of solution-focused therapy, the therapist aims to form a therapeutic relationship, create a climate for change, clarify the client’s goals, uncover the client’s resources, and explore with the client how they can work toward goals; whereas the subsequent sessions generally aim to review the client’s performance, consolidate constructive change, and develop further strategies for change (O’Connell, 2012). Remember, unlike problem-focused approaches, the counsellor does not attempt to conceptualise the problem or identify the cause. Instead, the counsellor utilises techniques to help the client work towards solutions.
While there is not one specific process that solution-focused therapists must follow, the following extract summarises the typical process used to facilitate change in solution-focused brief therapy (this general process can be applied to any solution-focused therapy). Beginner counsellors can use this process as a general guide to the process of solution-focused therapy:
De Shazer (1991) believes clients can generally build solutions to their problems without any assessment of the nature of their problems. Given this framework, the structure of solution building differs greatly from traditional approaches to problem solving as can be seen in this brief description of the steps involved (De Jong & Berg, 2013):
- Clients are given an opportunity to describe their problems. The therapist listens respectfully and carefully as clients answer the therapist's question, “How can I be useful to you?”
- The therapist works with clients in developing well-formed goals as soon as possible. The question is posed, “What will be different in your life when your problems are solved?”
- The therapist asks clients about those times when their problems were not present or when the problems were less severe. Clients are assisted in exploring these exceptions, with special emphasis on what they did to make these events happen.
- At the end of each solution-building conversation, the therapist offers clients summary feedback, provides encouragement, and suggests what clients might observe or do before the next session to further solve their problem.
- The therapist and clients evaluate the progress being made in reaching solutions by using a rating scale. Clients are asked what needs to be done before they see their problem as being solved and also what their next step will be.
(Corey, 2017, pp. 374-375)
While most of the points in the (Corey) extract are fairly straightforward, let’s take a moment to review what is meant by “well-formed goals” in the context of solution-focused therapy. Ultimately, the counsellor’s initial goal is to help the client develop specific, clearly defined, solution-focused goals. These goals are elicited by questioning how the client’s life will be different once their problems are solved/removed. This type of goal setting replaces the ‘assessment’ process of problem-focused therapies (De Jong & Berg, 2013).
Solution-focused therapists can use a few techniques to facilitate the development of appropriate goals. For example, if the client is setting goals that are too broad or are unable to identify specific goals, the counsellor might help them refine their goals by asking the miracle question followed by exploration questions such as “What would be the first sign that you are moving towards the changes you want?” The counsellor should ensure that the client has developed clear, simple goals that they can work towards.
Solution-focused therapists also ensure that the client’s goals are expressed in positive terms (e.g., instead of a goal being “I want to stop being so disorganised”, the goal might be rephrased to “I want to be organised”). Most clients will originally state their goal in “negative” terms, and the counsellor will need to assist the client in transforming it into “positive” terms through further questioning, as demonstrated in the following extract:
The standard solution-focused response to negative statements like this is to ask another question:
| Negative: | My husband and I won’t be arguing the whole time. |
| Solution focused: | And what will you be doing when you are not arguing the whole time? |
| Negative: | I won’t be cooped up in the house all day. |
| Solution focused: | So what does ‘not cooped up’ mean, what will you be doing instead? |
(Winbolt, 2011, pp. 140-141)
Once the counsellor and client have a specific goal, the counsellor will work with the client utilising a range of other solution-focused techniques to explore exceptions, highlight the client’s strengths and resources, and help the client move towards their preferred future.
check your understanding of the content so far!
Role Play: Solution-Focused Therapy
After watching the following role-play on solution-focused therapy, answer the questions that follow.
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As with other forms of counselling, solution-focused therapists must keep records and document their work with clients. However, solution-focused therapy requires a different approach to documenting cases and writing case notes than problem-focused approaches. While many traditional case note formats follow a problem-solving stage approach (i.e., notes on initial assessment, treatment plan, progress notes, and closing summary, with a large focus on descriptions of the problem), documentation in solution-focused therapy should ideally seek to document the stages of solution building (De Jong & Berg, 2013). De Jong and Berg (2013) outline what should be included in three key documentation types within solution-focused therapy in the following table:
| Type of document | Included in the document |
|---|---|
| 1. Referral form |
|
| 2. Initial session record |
|
| 3. Session record |
(Adapted from De Jong & Berg, 2013) |
Counsellors working in organisations that only employ a solution-focused approach are likely to have specific templates for client notes that conform to the solution-focused framework; however, in cases in which counsellors are using a solution-focused approach with existing problem-focused templates, consideration should be given to recording notes in-line with solution-focused principles. This includes, at a minimum, documenting the client’s preferred future, current strengths and strategies, and information relating to scales.
[Counsellors must record] . . . concrete details about the meaning of “0,” “10,” the number the client is currently at, what will be different when things are one number higher, what steps the client is considering or will take to move up the scale, and what resources the client thinks will be most useful to him or her to move up.
(De Jong & Berg, 2013, p. 275-276)
As discussed in Section 1, one of the hallmarks of solution-focused therapy is the use of scaling questions. While scaling questions are useful as a therapeutic tool, they are also useful for counsellors to evaluate the progress and effectiveness of therapy. Keeping a record of where the client puts themselves on the progress scale can provide a quick and easy way of seeing how the client has progressed across sessions. Of course, it is important for the counsellor and the client to use scales in a common-sense fashion. For example, it would be inappropriate to expect a client to start at 2 and to be at 7 at the next counselling session. However, if they have moved from 2 to even 2.5, it indicates that there has been improvement and that the counselling is helping the client move in their preferred direction. While monitoring progress in counselling, there will be times when there are small changes and others when there will be significant changes, but the focus is on the movement between numbers.
Solution-focused therapists may also measure the effectiveness of counselling by employing other commonly used approaches, such as asking clients to report on their perceptions of whether progress has been made and by using pre- and post-measures of symptoms before and after the intervention. However, due to the nature of solution-focused therapy, using progress scaling is usually the most natural way to monitor client progress.
While monitoring client progress is vital, it is also important for solution-focused therapists to continually evaluate their own effectiveness. As with the other therapies, this can be done through self-evaluation, receiving client and peer feedback, and professional supervision (these techniques were discussed in more detail in module 6).
Read
Reading F – The First, Second Session and Beyond
Reading F offers an outline of the aims of first and second (and beyond) sessions in a solution-focused counselling process – as a guide instead of a definitive script. You will see be able to see a solution-focused counsellor in action, using various techniques and counselling skills to promote solution-focused conversations and facilitate change.
Solution-Focused Therapy with Insoo Kim Berg
In this video, well known therapist, Insoo Kim Berg, describes how she uses Solution-Focused Therapy with clients.
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Solution-Focused Couples Therapy with Insoo Kim Berg
Insoo Kim Berg demonstrates a Solution-Focused Therapy session with a couple. After watching the video, answer the questions that follow.
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Case Study
Reading through the following case studies will help you better understand the processes and techniques of solution-focused therapy. The first case study, adapted from De Jong & Berg (2013, pp. 14–16), involves a counsellor using a solution-focused approach to assist a client who feels overwhelmed by her role as a single mother and is anxious about her ability to parent effectively. Issues of parenting, mild anxiety, and time management are very common issues that bring clients to counselling, and a solution-focused approach has been shown to be effective with these.
Case Study 1: Parenting, Anxiety and Time Management
Sarah is a single mother to three children, Sam (aged 8), Jordan (aged 6), and Josh (aged 2). Sarah receives financial support from the children’s father, but he lives overseas and provides no practical support in raising the children. Sarah has come to counselling because she has been feeling increasingly overwhelmed by her role as a single mother and her ability to parent effectively. As the children are getting older, she finds that her home life is so hectic that she isn’t able to manage caring for all of her children in the way she would like to.
After completing the standard contracting process, the counsellor begins using a solution-focused approach with Sarah by first engaging in some problem-free talk. After the counsellor has learned a little about Sarah as a person, the counsellor shifts the focus of the conversation by exploring whether there has been any pre-session change in Sarah’s situation.
| Counsellor: | So, when you made the appointment last week, you said that you were feeling a little overwhelmed with trying to care for your three children. Tell me, what’s better since you called? |
| Sarah: | Ummm . . . well, I don’t think anything is better. I’m still feeling overwhelmed. I’m a single mum, and I have an 8-year-old, a 6-year-old and a 2-year-old. It’s always so hectic. My oldest two boys are both super energetic and can be a real handful, and I just can’t seem to get them under control. On top of that, I can’t seem to keep up with the household chores. I let things pile up, and then they never get done. |
| Counsellor: | Wow, I can see you really have your hands full. Handling two boys of 6 and 8 is challenging enough, but to also have a 2-year-old. Tell me, how come things aren’t worse? What have you done to stop it from becoming a complete disaster? |
| Sarah: | Sometimes I think it is a complete disaster! [laughs]. But . . . I guess I do have some control over my boys. I mean, they aren’t bad kids, and they do listen to me, and they like spending time with me. And I do keep them fed and clothed even if the house is a bit of a mess. I guess it could be worse. |
| Counsellor: | It sounds like you work hard to make sure they are well cared for. |
| Sarah: | Yeah, I do. |
| Counsellor: | So, what would you like to change? |
| Sarah: | Everything! |
| Counsellor: | Everything? |
| Sarah: | Well, I guess not everything . . . but I don’t know. I just want things to be better. Easier. |
| Counsellor: | Ok, let me ask you a different type of question. Suppose that you go to bed, as usual, tonight, and while you are sleeping, a miracle happens. The miracle is that all your problems are solved. But because you were sleeping, you don’t know right away that your problems have been solved. What do you think you would notice tomorrow morning that would be different? What would tell you that things have changed? |
| Sarah: | Wow . . . umm . . . well, everything would be different. |
| Counsellor: | What would be the first thing that you would notice that would tell you that this day is different – that the miracle has happened? |
| Sarah: | Breakfast. I’d be up before the boys, make them their favourite breakfast, and sit and eat it together. |
| Counsellor: | If you were to decide to do that – get up before them and make them breakfast – what would they do? |
| Sarah: | I think they would be happy to sit and eat with me, and they wouldn’t fight |
| Counsellor: | How would that be for you? |
| Sarah: | I’d be happy. I’d enjoy spending time with the boys, and the fighting wouldn’t make Josh start crying. |
| Counsellor: | What else? What else will be different when the miracle happens? |
The counsellor and Sarah continue to explore and develop other parts of Sarah’s miracle picture. Once this was clear, the counsellor then moves to exploring exceptions.
| Counsellor: | Sarah, I'm impressed. You have a pretty clear picture of how things will be different around your house when things are better. Now, are there times already, say in the last two weeks, which are like the miracle that you have been describing, even a little bit? |
| Sarah: | Well, about four days ago, it was better. |
| Counsellor: | Tell me about four days ago. What was different? |
| Sarah: | Well, I went to bed at about 10:00 the night before and had a good night of sleep. I had food in the house because I had done the shopping on Saturday. I had even set the alarm for 6:30 and got up when it rang. I made breakfast and called the kids. The boys ate and got ready for school, and left on time. (remembering) One even got some homework out of his backpack and did it—real quick—before he went to school. |
| Counsellor: | That sounds like a big part of the miracle right there. I’m amazed. How did all of that happen? |
| Sarah: | I’m not sure… I guess one thing was I had the food in the house, and I got to bed on time, so I woke up early and had some energy. |
| Counsellor: | So, how did you make that happen? |
| Sarah: | I managed to make sure all the boys were in bed on time so that I could then go to sleep. They were happy to go to bed because I read them a story for an hour. |
| Counsellor: | How did you manage that, reading to all three kids? That seems like it would be really tough. |
| Sarah: | No, that doesn't work—reading to all three kids at the same time. I have my oldest, Sam, read to Josh while I do the dishes and Jordan showers, and then I read to Sam and Josh once the baby was asleep. It’s also good because that’s the only way I can get Sam to practice his reading. |
| Counsellor: | That seems like a great idea—having Sam read to Josh. It helps you, and it helps him with his reading. How do you get him to do that? |
| Sarah: | Oh, I let him stay up a half hour later than the others on weekends because he helps me. He really likes that. |
The counsellor continued to ask questions to explore, in detail, what was different about the day that resembled Sarah’s miracle and how it happened – especially what she did to make it happen. Then the counsellor asked some scaling questions to understand better how Sarah viewed herself concerning her problems.
| Counsellor: | I'd like you to put some things on a scale from 0 to 10 for me. First, on a scale from 0 through 10, where 0 equals the worst your problems have been and 10 means the problems we have been discussing are solved, where are you today on that scale? |
| Sarah: | If you had asked me that question before we started today, I would have said about a 2. But now I think it’s more like a 5. |
| Counsellor: | Great! Now let me ask you how confident you are that you can have another day in the next week like the one four days ago—the one which was much like your miracle picture. On a scale of 0 to 10, where 0 equals no confidence and 10 means you have every confidence, how confident are you that you can make it happen again? |
The counsellor continued to explore with Sarah what else Sarah could do to increase the chances of her miracle happening in the future. The counsellor ended this first session with some final feedback for Sarah, which included pointing out to Sarah what she was already doing to make her miracle happen and suggesting that she do some of the additional things that might make miracle-type days more likely to occur.
The case study of Sarah demonstrates how a counsellor can use a solely solution-focused approach to help facilitate client change. However, solution-focused techniques and practices are often combined with other therapeutic approaches. Experienced counsellors often utilise complementary techniques from several different therapeutic approaches. It is important to understand that these techniques are not selected randomly; instead, the counsellor carefully considers the client’s issues, needs, and preferences to select an appropriate combination of techniques that will work for the client.
Let’s look at an example of how solution-focused techniques can be combined with aspects of some other counselling approaches you have learned about.
Case Study 2: Anxiety
George has sought out counselling to help with issues of anxiety. George believes that he worries too much and is impacting his life. For example, when shopping, he is often worried about his card being declined, that his car will be broken into, or that work will call him with an emergency, and he won’t hear his phone in the shopping centre. George wants to address his anxiety so that he can live without so much worry.
George’s counsellor decides that George would benefit from a combination of person-centred, CBT, and solution-focused techniques. For example:
- The counsellor intends to use the therapeutical alliance principles in person-centred therapy – empathy, congruence and unconditional positive regard – to build a supportive, effective client-counsellor relationship.
- The counsellor intends to use the cognitive behavioural model to explain to George how the interaction of thoughts and behaviour drive and maintain the emotional and physiological features of anxiety.
- The counsellor then intends to use techniques from solution-focused therapy to help George identify his goals, personal strengths and resources. For example, the counsellor will use the miracle question to help George identify his preferred future and exception questions to help him identify strengths and resources he can build on.
- The counsellor then intends to use a combination of concepts and techniques, cognitive behavioural and solution-focused therapies to help promote change. For example, the counsellor intends to work with George to establish behavioural experiments and homework tasks to help him build on exceptions and move towards his preferred future.
How Do You Use SFT With Grief and Loss Issues
This video will help you understand how to use SFT effectively with grief and loss issues, looking at specific words to use in the best hopes question.
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Solution Focused Brief Therapy (SFBT) Demonstration
The following video provides a demonstration on a SFT session. After watching the video, answer the questions that follow.
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In this module section, you have learned how solution-focused concepts and techniques can be applied in counselling practice. However, it is important to remember that solution-focused therapy is a specialist approach. Students interested in solution-focused therapy are encouraged to seek further training and skill development to broaden their understanding and enhance their practice capabilities.
Practice
Practice Your Solution-Focused Skills
Practice what you have learned in this module by doing a role-play.
Step 1: Ask a friend, study partner or family member to assist you with this exercise. They will act as the “client” for this exercise.
Step 2: Decide with your client on a topic to discuss within a role-play counselling session. Select a topic that is real-life but not emotionally complex, such as a work-related concern or motivation issue.
Step 3: Conduct a solution-focused counselling role-play, applying the solution-focused language and any techniques as appropriate, e.g.:
- Ask them the initial questions. Listen to what they want to change, their strengths, and their preferred future.
- Ask them to rate on a scale where they are concerning their preferred future; then ask follow-up questions (e.g., what would it take for them to move up the scale or what did they do not to slip down the scale).
- Ask exception questions and amplify the solution-talk.
Step 4: After the role-play, ask your volunteer the following questions, e.g.:
- How effective did you find the role-play?
- Did you feel listened to and responded to?
- Did you come to see the issue in a different light?
Step 5: Reflect on your experience as a solution-focused counsellor. Ask yourself the following questions:
- What did you do well/not well enough?
- What would you have done or said differently if you could go back?
- Did you find solution-focused techniques easy or difficult to implement?
- Remember, your focus of self-reflection is on learning instead of self-criticism.
Corey, G. (2017). Theory and practice of counseling and psychotherapy (10th ed.). Cengage Learning.
Gingerich, W. J., & Peterson, L. T. (2013). Effectiveness of solution-focused brief therapy: A systematic qualitative review of controlled outcome studies. Research on Social Work Practice, 23(3), 266-283. https://doi.org/10.1177/1049731512470859
Grant, A. M. & Cavanagh, M. J. (2018). The solution-focused approach to coaching. In E. Cox, T. Bachkirova, & D. Clutterbuck (Eds.), The complete handbook of coaching (3rd ed.) (pp. 35-51). Sage Publications Ltd.
De Jong, P. & Berg, I. K. (2013). Interviewing for solutions (4th ed.). Brooks/Cole, Cengage Learning.
Kim, J., Jordan, S. S., Franklin, C., & Froerer, A. (2019). Is solution-focused brief therapy evidence-based? An update 10 years later. Families in Society: The Journal of Contemporary Social services, 100(2), 127-138. https://doi.org/10.1177/1044389419841688
McLeod, J., & McLeod, J. (2022). Counselling skills: Theory, research and practice (3rd ed.). McGraw Hill.
O’Connell, B. (2012). Solution-focused therapy (3rd ed.). London, UK: Sage.
Schmit, E., & Schmit, M. K., & Lenz, A. S. (2016). Meta-analysis of solution-focused brief therapy for treating symptoms of internalizing disorders. Counseling Outcome Research and Evaluation, 7(1), 21-39. https://doi.org.au/10.1177/2150137815623836
Winbolt, B. (2011). Solution focused therapy for the helping professions. London, UK: Jessica Kingsley.
