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Solution-Focused Family Therapy 1

Running head: SF FAMILY THERAPY

Solution-Focused Family Therapy

Carolyn Frances

Argosy University

PC 6700

J. Persing

April 2008
Solution-Focused Family Therapy 2

Solution-Focused Family Therapy

History

Steve de Shazer, Insoo Kim Berg, and a group of their

associates developed solution-focused therapy (SFT) in the early

1980s at the Brief Family Therapy Center in Milwaukee (de Shazer

et al., 2007; Kiser & Piercy, 2001; Goldenberg & Goldenberg,

2008). It grew out of the postmodern movement and is a social

constructionist view. In accordance with this Lee (1997)

observed,

Solution-focused brief family therapy views problems as

being developed and maintained within the context of human

interactions. The task of therapy, therefore, is to help

clients do something different by changing their

interactive behaviors or their interpretations of behaviors

and situations so that a solution can be achieved (de

Shazer et al., 1986).

The founders were influenced by the work at the Mental Research

Institute in Palo Alto, Milton H. Erikson, Wittgensteinian

philosophy, and Buddhist thought (de Shazer et al., 2007). The

approach was developed by viewing sessions to discover what

worked and why it worked (de Shazer et al., 2007; Kiser &

Piercy, 2001). It is considered brief therapy because it is a

focused approach on specific complaints that leads to an outcome

in 10 sessions or less 99.9% of the time (Kiser & Piercy, 2001).


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Developed during the time that the DSM III had been released,

the solution-focused approach was a reaction against the focus

on problems, diagnosis, and the pathologizing of behaviors and

people (Kiser & Piercy, 2001; Gingerich & Eisengart, 2000).

It is not either a person has a symptom or he does not.

That a certain behavior is labeled a symptom is arbitrary:

In some other setting or with a different meaning attached,

the same behavior would be both appropriate and normal (de

Shazer, 1985, p. 14).

Philosophy

The first evidence of the emerging solution-focused therapy

was an article written in 1978 by Don Norum titled “Brief

Therapy: The Family Has The Solution” (Kiser & Piercy, 2001).

The title of this article suggests the beginning philosophy of

taking a positive view of the client. SFT seeks to capitalize

on client strengths. Therapists who practice SFT believe that

the family already has all the resources they need to solve

their problem. The therapist’s job is to help the family see

things differently (Campbell, Elder, Gallagher, Simon & Taylor,

1999). The therapist aims to expand a family’s options by

helping the family shift their perceptions from a stance of

either/or to one of both/and (de Shazer et al., 2007). “Through

interaction and language, people enter into relationships where

they create certain meanings to situations. Part of the


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therapist’s position is, through language, change the meanings

that people have for events, behaviors, feelings, and thoughts

(Reiter, 2004).” This therapy style is minimalistic,

transparent and egalitarian in nature, emphasizing a

collaborative relationship with the client (Kiser & Piercy,

2001). The therapist takes an attitude of “not knowing” when

working with the clients. The focus of the session is on

solutions and not problems. The therapist will not ask

questions or attempt to flesh out the problem, its history, or

causes. The view is that clients will speak about their

problems as much as they need to and when they need to in the

session naturally without the therapist delving into them. The

therapist will follow the client’s lead, but takes an optimistic

viewpoint, guiding the session away from rehashing the problem

over and over again (de Shazer et al., 2007).

The idea is to direct your curiosity to where clients want

to go rather than where they have been, to what they do

right rather than what they do wrong, and to encourage them

to become the expert in their own life (Sharry, Madden &

Darmody, 2003, p. 95).

When working with a family, the SFT practitioner will see

whoever comes for the session and does not hold that all members

of the family are required for progress to be made (Lee, 1997;

de Shazer, 1985). They believe that any change in a part of the


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system will affect the rest of the system and cause a change in

the whole. They see clients as being of three types: visitors,

complainants, and customers. Usually, a family system has

members who are at different levels. Visitors are not looking

for change and may not see anything as being wrong.

Complainants are complaining about a problem and expecting

others to change. Customers are ready and motivated to make

changes themselves. These levels of motivation affect how the

therapist will interact with the client and what interventions

will be used (de Shazer, 1988).

The basic tenets of SFT are: if it’s not broken, don’t fix

it; if it works, do more of it; if it’s not working, do

something different; small changes lead to big changes;

solutions are not necessarily directly related to the problem;

solution language is different than problem language; there are

always exceptions to a problem; and the future is negotiable (de

Shazer et al., 2007). In accordance with these tenets are

several standard interventions and techniques: therapist use of

language, questions, compliments, homework, and exception

finding. Each session is looked at as if it could be the last

and in every session, the therapist inquires about and enlivens

progress (Hackett, 2006).

Techniques

Solution language is important for SFT. The therapist’s


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language and questions presuppose that change is happening and

that things will improve (Lee, 1997). In the course of the

session, the therapist will guide and model a shift in language

from problem talk to solution talk. Changing language

influences a change in thinking and in action (Taylor, 2005).

Language changes in five areas. Instead of talking about

what the client does not want, the talk is centered on what they

do want. Instead of focusing on what is going wrong, the focus

is on what is going right. Therapists seek to help the client

move from a place of feeling that things are beyond their

control to realizing what is within their control. Clients

start speaking about progressing instead of being stuck. The

view of the future is filled with possibilities instead of more

trouble (Taylor, 2005). These shifts in language are evident in

the structure of the session. Taylor (2005) refers to it as a

TEAM approach. First, the therapist uncovers the client’s goal

which he calls finding a title, T. This is focusing on what the

client does want. Then the session moves on to events, E, or

what is going right in their lives at this moment. These are

pieces of the goal already apparent in their lives. After

discovering what is going right, the client becomes aware of

being able to do more of what is going right which is agency, A.

The session then moves on to the results of these actions or

movement, M. From there the therapist can ask about what the
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next step is which takes the process back to goals, T. Sessions

generally follow a pattern of eliciting information about what

is better, what is working, or what is wanted; amplifying the

positive; reflecting; and starting over with eliciting more

information (Hackett, 2006).

All of this discovery and change in language is guided by

careful questions. There are several standard questions that

SFT is known for: the miracle question, relationship questions,

scaling questions, coping questions, and questions about pre-

session change (de Shazer et al., 2007; Taylor, 2005; Goldenberg

& Goldenberg, 2008; Gingerich & Eisengart, 2000; Lee, 1997).

The first question the therapist may ask is, “What kind of

changes have occurred between the time when the appointment was

made and the appointment itself?” This is a positive assumption

that progress is already being made. The therapist will also

ask the family how they will know that therapy has been

successful and what needs to happen in the session for it to

have been helpful. This is the beginning of searching for a

goal. To further define the goal, or discover it, the miracle

question is asked. The therapist begins the miracle question by

drawing a scene for the client in which they do their usual

routines and go to bed and during the night, a miracle happens

that solves their problem. However, the miracle happened while

they were asleep so no one knows about it. The question is, how
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would they recognize that the miracle had taken place? What

would be different in their lives? The therapist explores

behaviors and reactions of everyone in the life of the client.

These are the relationship questions. The questions are asked

of everyone present in the session. The therapist asks for

details and may continue to ask, “What else?” many times (de

Shazer et al., 2007; Goldenberg & Goldenberg, 2008; Gingerich &

Eisengart, 2000). Following the miracle question and at various

junctures during the interview, the therapist will ask clients

to rate their motivation or confidence on a scale of 1 to 10 and

then use that scale to help the clients talk about small steps

and recognize progress. If the client is doing poorly or worse,

coping questions are used to reframe the experience in a more

positive light. This exposes the client’s strengths in asking

how they were able to cope and keep things from getting worse.

Another distinctive aspect of SFT is compliments. This

theory does not believe in resistance and uses compliments to

counteract them. What others call resistance, SFT views as the

client communicating to the therapist that the suggestions being

made are not a fit for them (de Shazer, 1985). There are three

types of compliments employed by SFT: direct, indirect, and

self-compliments (Berg & DeJong, 2005). Direct compliments are

sincere statements or interpretation of positive observations

about what the client is doing. Clients do not always accept


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these types of compliments. Indirect compliments are obtained

by asking clients what positive things other people might say

about them. Because these compliments come from those who know

the client well, they are more readily accepted over those given

by a therapist who does not know them. Self-compliments are

solicited from the client by asking questions that require them

to talk about their successes and abilities. Self-compliments

are the most powerful because they come from the client

themselves and are more accepted and internalized (Berg &

DeJong, 2005).

Compliments serve various purposes. They normalize,

restructure, and affirm. They also act as a bridge to

suggestions. “Compliments serve to normalize the client’s

experience, restructure the meaning of the problem, and

highlight the client’s own solution-building competencies (de

Shazer, 1988).” Compliments also suggest next steps in the

process of solution development (Campbell, Elder, Gallagher,

Simon & Taylor, 1999). Normalizing helps the client to know

that their situation is not uncommon and is understandable.

This can help the client shift their understanding of the

situation or problem. Restructuring helps to open the

possibilities for the clients and counteracts the limits they

have set for themselves. Affirmations draw the client’s

attention to their strengths and resources. When making


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compliments, therapists use the family’s language by echoing

their phrases and metaphors. “The compliments usually include

validation of concerns, recognition of competencies, and a

suggestion for something to do between sessions (Campbell,

Elder, Gallagher, Simon & Taylor, 1999).”

The compliment leads the way to the homework suggestion

outside of the session. These suggestions are prefaced by a

bridging statement. “The bridging statement can frame

suggestions as research, experiments, crazy ideas, curiosities,

or anything else that will have meaning for the client

(Campbell, Elder, Gallagher, Simon & Taylor, 1999).” The

guidelines for suggestions are: “keep it simple, emphasize

possibilities, and design according to the client’s degree of

customership (de Shazer, 1985) (Campbell, Elder, Gallagher,

Simon & Taylor, 1999).” Some examples of common suggestions are

asking families to notice when things are better or notice what

allows you to cope. Another example is to ask the family to do

more of what they already know works. Sometimes the family is

asked to do something different, perhaps wild and crazy, than

what they have been doing in connection with a misbehaving

child. There is also a predictive task where the family is

asked to predict each night what kind of day the next day will

be and then watch for evidence of that prediction coming true.

In cases where a child is viewed negatively, the therapist might


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assign the child a surprise task where they are to do something

that will pleasantly surprise their parents between sessions.

The child is told privately not to make it too easy and not to

do something too outlandish and not immediately after the

session so as to keep the parents guessing. The parents are

told to try and figure out what the surprise is. In the next

session they make their guesses. In all these cases, most of

the task is left up to the client to create. The therapist

avoids being specific to allow more possibilities and a better

fit.

Tasks are based on what the client is already doing or

inclined to do. In this way, the task is more likely to fit the

family. Campbell, Elder, Gallagher, Simon & Taylor (1999)

further state that, “When working with families, we try to offer

suggestions that encourage them to discover each other’s

competencies.” Although common tasks have been mentioned,

therapists will borrow from other modalities if they fit the

family. For example, Selekman (1997) uses a stuffed animal team

with children where they bring in their favorite animals. The

therapist and child have a conference with the stuffed animals

about possible solutions and ideas. The child then has the

stuffed animal team on their side when they go home.

The nature of the intervention matches the level of client

motivation or customership. If someone is only a visitor, the


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therapist will compliment him or her, but give no tasks. If

someone is a complainant, he or she may be given a task that

involves only observing what is going on. If he or she is a

customer, then action tasks that change behavior are given

(Sharry, Madden & Darmody, 2003).

Research

This approach has been used in many venues including family

services, mental health, public social services, child welfare,

prisons, residential treatment centers, schools, and hospitals

(Gingerich & Eisengart, 2000). It has also been used with a

wide range of families of diverse backgrounds. Initial studies

show preliminary support for the method. SFT has been shown to

be better than no treatment and equivalent to some established

methods. Studies also support the SFT view of working with

whatever family members come for therapy instead of insisting on

seeing the whole family. Success rates as reported by clients

range from 64.9% to 80% (Lee, 1997). The approach is better

suited to concrete issues such as child behavior problems versus

family relationships. 62.5% of clients interviewed after

therapy was complete stated that the most helpful aspect of the

therapy was the approach and one-third said that the supportive

environment was the next most helpful aspect (Simon & Nelson,

2004).
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References

Berg, I. K., & DeJong, P. (2005). Engagement through

complimenting. Journal of Family Psychotherapy, 16(1-2),

51-56.

Campbell, J., Elder, J., Gallagher, D., Simon, J., & Taylor, A.

(1999, March 1). Crafting the "tap on the shoulder:" a

compliment template for solution-focused therapy. The

American Journal of Family Therapy, 27(1), 35-47.

de Shazer, S. (1985). Keys to solution brief therapy. New York,

NY: W.W. Norton & Company.

de Shazer, S. (1988). Clues: Investigating solutions in brief

therapy. New York, NY: W.W. Norton & Company.

de Shazer, S., Berg, I. K., Lipchik, E., Nunnally, E., Molnar,

A., Gingerich, W. et al. (1986). Brief therapy: Focused

soltuion development. Family Process, 25, 207-222.

de Shazer, S., Dolan, Y., Korman, H., Trepper, T., McCollum, E.,

& Berg, I. k. (2007). More than miracles: The state of the

art of solution-focused brief therapy. New York: The

Haworth Press, Inc.

Gingerich, W. J., & Eisengart, S. (2000, December 1). Solution

focused brief therapy: A review of the outcome research.

Family Process, 39(4), 477-498.

Goldenberg, H., & Goldenberg, I. (2008). Family therapy: An

overview (Seventh edition, pp. 341-355). Belmont, CA:


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Thomson Brooks/Cole.

Hackett, P. (2006). What happens between the E.A.R.S? Journal of

Family Psychotherapy, 17(2), 81-88.

Jordan, K., & Quinn, W. H. (1994, Spring). Session two outcome

of the formula first session task in problem- and solution-

focused approaches. The American Journal of Family Therapy,

22(1), 3-16.

Kiser, D. J., & Piercy, F. P. (2001). Creativity and family

therapy theory development: Lessons from the founders of

solution-focused therapy. Journal of Family Psychotherapy,

12(3), 1-30.

Lee, M.-Y. (1997, Spring). A study of solution-focused brief

family therapy: Outcomes and issues. The American Journal

of Family Therapy, 25(1), 3-17.

Reiter, M. D. (2004). The surprise task: A solution-focused

formula task for families. Journal of Family Psychotherapy,

13(3), 37-45.

Selekman, M. D. (1997). Solution-focused therapy with children:

Harnessing family strengths for systemic change. New York,

NY: The Guilford Press.

Sharry, J., Madden, B., & Darmody, M. (2003). Becoming a

solution detective: Identifying your clients' strengths in

practical brief therapy. New York: The Haworth Clinical

Practice Press.
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Taylor, L. (2005). A thumbnail map for solution-focused brief

therapy. Journal of Family Psychotherapy, 16(1-2), 27-33.