Social Work Solution-Focused Therapy
by
Jacqueline Corcoran
  • LAST REVIEWED: 06 May 2015
  • LAST MODIFIED: 29 October 2013
  • DOI: 10.1093/obo/9780195389678-0088

Introduction

Solution-focused therapy (SFT), also called solution-focused brief therapy and solution-oriented therapy, is a short-term, strengths-oriented practice model that identifies and enhances clients’ resources for coping with life’s difficulties. Solution-focused therapy arose from the field of family therapy, although several social workers were key to its development. An essential family therapy concept, which is also heavily touted within social work, involves a systemic notion of causality that a change in one part of a routine sequence will result in further change for the system. Solution-focused therapy is a collaborative approach in that worker and client are seen as partners in the change process. Conversations between worker and client, stimulated by key questions, are a pathway to changes in client perception, subsequent behavior, and the responses of other people to these small changes. Behavioral, as well as perceptual, change is implicated since the approach is focused on concrete, specific behaviors that are achievable within a brief time period. Solution-focused therapy has attracted attention internationally and is used for a variety of problems of living throughout the world.

General Overviews

Visser 2008 provides a readable summary in an article on his blog of the history of solution-focused therapy, describing the role of each of the developers. The first journal article to capture attention for solution-focused therapy was de Shazer, et al. 1986, a few of whose authors—Insoo Kim Berg, Michele Weiner-Davis, and Wallace Gingerich—were social workers. de Shazer, et al. 1986 reported how the model arose out of the field of family therapy, with Mental Research Institute (MRI) brief therapy as a specific influence. In both MRI and solution-focused approaches, the pattern around a problem is altered as opposed to discovering its underlying cause, although the emphasis in solution-focused therapy is on solutions rather than problems. De Shazer wrote three texts on the development of solution-focused therapy (de Shazer 1985, de Shazer 1988, and de Shazer 1994), as well as theorizing and analyzing about the change process that became solution-focused therapy. de Shazer 1985 and de Shazer 1988 detail how much of an influence the psychiatrist and hypnotist Milton Erickson was to the author’s work. Erickson believed that individuals have the strengths and resources to solve their own problems and that the practitioner’s job is to uncover these resources and activate them for the client. In his early cases, de Shazer described how he used formal hypnosis but later came to see the hypnotic qualities inherit in interventions, such as complimenting and taking inter-session breaks to develop “suggestions” for the client to follow (de Shazer 1985 and de Shazer, et al. 1986). Insoo Kim Berg, de Shazer’s wife, was more pragmatic in her orientation, and was often the therapist whom de Shazer and their other colleagues studied for her interaction patterns with clients. Her first book with Scott Miller applied solution-focused therapy to drinking problems (Berg and Miller 1992, cited under Substance Use). Berg 1994 (cited under Child Maltreatment) centers on a solution-focused approach for home-based child protective services. With De Jong, she went on to write a textbook for the counseling professions that was updated multiple times, with the latest, De Jong and Berg 2012 (cited under Relevance to Social Work), published after her death. The following techniques are described in these and subsequent works: exception-finding, focusing on times when the problem is either not a problem or is lessened in terms of duration, severity, frequency, or intensity; scaling questions to formulate behaviorally specific goals and tasks and to measure progress; the miracle question, first described in de Shazer 1988, which is a signature intervention to develop in the client’s mind a future without the problem; and relationship questions, which ask clients questions that help them to see themselves from the perspective of another person involved in the problem. O’Hanlon and Weiner-Davis 1989 is an easy-to-read introduction to the assumptions underlying solution-focused therapy, which include the focus on the present and the future, for the most part, rather than the past, which distinguishes it from practice approaches that came before and its social constructionist basis, in which knowledge about reality is constructed from social interactions and is relative to the social context. The language the worker uses and the way key questions are phrased are assumed to lead to changes in client perception. When clients view themselves as resourceful and capable, they are empowered toward future positive behavior. O’Hanlon later collaborated with Bertolino in Bertolino and O’Hanlon 2002, a text with some unique presentations of the standard techniques.

  • Bertolino, Bob, and Bill O’Hanlon. 2002. Collaborative, competency-based counseling and therapy. Boston: Allyn & Bacon.

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    This excellent guide to techniques in solution-focused practice offers the reader many ideas for strengths-based questioning. A particular contribution are the assessment questions, taking typical agency-based intake questions and transforming their wording to enable the worker to find client strengths.

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    • de Shazer, Steve. 1985. Keys to solution in brief therapy. New York: Norton.

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      De Shazer explores his background thinking on the development of solution-focused therapy at the Brief Therapy Center, with Erickson as a primary influence as well as the strategic family therapy models. At this point, he writes of the “crystal ball” technique rather than the “miracle question” and most of the interventions he describes in his case studies are strategic/paradoxical in nature. Only in the conclusion does he make mention of what became some of the classic techniques, such as scaling and the first formula task.

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      • de Shazer, Steve. 1988. Clues: Investigating solutions in brief therapy. New York: Norton.

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        Provides readers with a sense of the history of solution-focused therapy and the development of the theory. Here, he still speaks at length about the influence of Erickson on his own work. Introduces the miracle question, which has become a signature intervention of solution-focused therapy.

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        • de Shazer, Steve. 1994. Words were originally magic. New York: Norton.

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          Further discussion about the theoretical development of the solution-focused approach, here emphasizing its social constructionist basis. The concept of the “expert” practitioner, who categorizes, diagnoses, and solves client problems objectively, is viewed with skepticism. Sharing perceptions with others through language and engaging in conversational dialogues is the medium by which reality is shaped.

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          • de Shazer, Steve, Insoo Kim Berg, Eve Lipchik, Elam Nunnally, Alex Molnar, and Wallace Gingerich. 1986. Brief therapy: Focused solution development. Family Process 25.2: 207–221.

            DOI: 10.1111/j.1545-5300.1986.00207.xSave Citation »Export Citation »E-mail Citation »

            The initial journal article about solution-focused therapy, which emerged from Mental Research Institute (MRI) brief therapy at the Brief Family Therapy Center. Available online for purchase or by subscription.

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            • O’Hanlon, William Hudson, and Michele Weiner-Davis. 1989. In search of solutions: A new direction in psychotherapy. New York: Norton.

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              One of the early writings on solution-focused therapy with a clear and understandable description of the assumptions underlying solution-focused therapy and its techniques.

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              Data Sources

              Several active websites are available to provide a place for dialogue for practitioners about solution-focused therapy, as well as resources and training. The European Brief Therapy Association, and the Solution-Focused Brief Therapy Association offer further information, networking, and training. Dr. Alasdair McDonald (Solution-Focused Approaches) also has a number of resources, such as an up-to-date list of SFT treatment outcome studies conducted worldwide.

              Relevance to Social Work

              Corcoran 2008 discusses the compatibility of solution-focused therapy and social work and their shared assumptions, such as the systems orientation and the emphasis on strengths and relationships rather than individual pathology. Although solution-focused therapy is classified as a “therapy” approach, it is actually applicable to the wide range of settings and problems with which direct practice social workers are involved; therefore, the authors of De Jong and Berg 2012, social workers keenly involved in the model’s development, discuss solution-focused interviewing in a text for helping professionals. Greene and Lee 2011 is specifically on solution-focused therapy in social work. In an earlier work, the authors of Greene, et al. 1996 discuss the use of solution-focused therapy in crisis intervention, with many examples of relevance to social work, such as intimate partner violence, suicidal crisis, and family and alcohol problems. A longstanding commitment in social work is to impoverished, socially diverse, and otherwise vulnerable and oppressed populations. When discussing how to work with clients from other cultures, the literature frequently mentions “the importance of incorporating a client’s worldview, empowering the client, and utilizing a client’s strengths in cross-cultural social work practice” (Lee 2003, p. 387). Lee 2003 explores the ways solution-focused therapy operationalizes these ideas. An additional byproduct of working with vulnerable and oppressed clients is that social workers often work in public agencies with people who have been ordered by the courts to attend services or are pressured to attend by partners, spouses, supervisors, or under some threat of future punishment. De Jong and Berg 2001 presents ways to use solution-focused therapy with mandated clients.

              • Corcoran, Jacqueline. 2008. Solution-focused therapy. In Theoretical perspectives for direct social work practice: A generalist-eclectic approach. 2d ed. Edited by Nick Coady and Peter Lehmann, 429–446. New York: Springer.

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                This chapter, which comes from an edited volume, uses the eclectic-generalist framework for examining a variety of theoretical models employed in social work; describes solution-focused therapy against this framework.

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                • De Jong, Peter, and Insoo Kim Berg. 2001. Co-constructing cooperation with mandated clients. Social Work 46.4: 361–374.

                  DOI: 10.1093/sw/46.4.361Save Citation »Export Citation »E-mail Citation »

                  Outlines in a major social work journal the way solution-focused therapy is ideally situated to work with clients who have been mandated for services. Available online for purchase or by subscription.

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                  • De Jong, Peter, and Insoo Kim Berg. 2012. Interviewing for solutions. 4th ed. Belmont, CA: Brooks Cole.

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                    Written by two social workers, one of them an originator of solution-focused therapy (Insoo Kim Berg), this book helps graduate students learn helping skills according to solution-focused principles and techniques. The focus on “interviewing” means that the techniques can be applied in different client situations and contexts rather than only in clinical psychotherapy. The ancillary materials include a workbook for students and a training videotape.

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                    • Greene, Gilbert, Mo-Yee Lee, Rhonda Trask, and Judy Rheinscheld. 1996. Client strengths and crisis intervention: A solution-focused approach. Crisis Intervention 3:43–63.

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                      Makes the argument that solution-focused techniques are ideal for crisis intervention because of the short-term focus and the emphasis on restoration of functioning. Solution-focused techniques are applied and illustrated with various types of crises.

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                      • Greene, Gilbert, and Lee Mo-Yee Lee. 2011. Solution-oriented social work practice: An integrative approach to working with client strengths. New York: Oxford Univ. Press.

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                        The authors have written a textbook about the place of solution-focused therapy in social work practice, outlining the common assumptions and techniques. At the end of the book, the authors have chapters on cultural diversity, group work, families, crisis intervention, and severe mental illness.

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                        • Lee, Mo Yee. 2003. A solution-focused approach to cross-cultural clinical social work practice: Utilizing cultural strengths. Families in Society 84.3: 385–395.

                          DOI: 10.1606/1044-3894.118Save Citation »Export Citation »E-mail Citation »

                          Solution-focused therapy emphasizes collaborative work with clients, eliciting and building upon client strengths and helping clients find solutions that fit their worldviews. A short-term, goal-focused approach that attends to interactional patterns and context rather than individual dynamics also makes solution-focused therapy compatible with the worldviews of clients from many ethnic minority backgrounds. Available online for purchase or by subscription.

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                          Special Populations and Problems

                          Several areas of practice have developed a solution-focused focus. Many of these involve youth, which is a logical progression given that solution-focused therapy originated from family therapy. Because solution-focused therapy has not advanced in terms of its theoretical basis or techniques since its earliest writings, the original sources rather than more recent ones are generally emphasized.

                          Children and Adolescents

                          More writing on solution-focused therapy has focused on adolescents (Corcoran 1997, Selekman 2002) than children likely because adolescents have the cognitive ability to plumb the past for exceptions and to project themselves into a future without the problem. The authors of Berg and Steiner 2003, Selekman 1993, and Selekman 1997, understanding the need for more concrete tools in terms of art, games, and activities, have written books on using SFT with children.

                          • Berg, Insoo Kim, and Therese Steiner. 2003. Children’s solution work. New York: Norton.

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                            The styles and content of the coauthors don’t always gel, but in addition to the usual discussion on solution-focused therapy, there are ideas on exercises and activities that the practitioner can do with children based on the second author’s clinical work in focusing on client strengths. Adaptations involving games and art are described in the many examples.

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                            • Corcoran, Jacqueline. 1997. A solution-oriented approach to working with juvenile offenders. Child and Adolescent Social Work Journal 14:277–288.

                              DOI: 10.1023/A:1024546425621Save Citation »Export Citation »E-mail Citation »

                              Shows how solution-focused techniques can be tailored both in individual and in group sessions for work with adolescents presenting with conduct problems. Available online for purchase or by subscription.

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                              • Selekman, Matthew. 1997. Solution-focused therapy with children: Harnessing family strengths for systemic change. New York: Guilford.

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                                As well as the adolescent focus of his earlier work, Selekman expands into how work with children in this book.

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                                • Selekman, Matthew D. 1993. Pathways to change: Brief therapy solutions with difficult adolescents. New York: Guilford.

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                                  Targeted toward work with adolescents who are referred for behavior and conduct problems. Provides a hopeful orientation to working with a tough population.

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                                  • Selekman, Matthew. 2002. Living on the razor’s edge: Solution-oriented brief family therapy with self-harming adolescents. New York: Norton.

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                                    Selekman inspires with this work targeted at a difficult problem increasingly seen in clinical practice settings, self-harm among adolescents. Work with adolescents and their parents is outlined in this volume for practitioners with plenty of examples that explain the techniques in greater detail. Focuses a chapter on centering and grounding techniques as well as cognitive-behavioral skills, such as cognitive restructuring. See Adaptations. There is a separate treatment manual available as well.

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                                    School

                                    Many of the books on youth center on applying solution-focused therapy are targeted toward practitioners who are employed in school settings (Durrant 1995; Franklin, et al. 2007; Murphy 2008). Several books address the use of solution-focused therapy in the school system, but Murphy 2008 is the most succinct, practical, and clear guide for school social workers. Franklin, et al. 2007 discusses how to adopt a solution-focused approach for an entire school.

                                    • Durrant, Michael. 1995. Creative strategies for school problems: Solutions for psychologists and teachers. New York: Norton.

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                                      A simplified and easy-to-read guide to helping students who suffer from behavioral and academic problems in school and how to work with their teachers.

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                                      • Franklin, Cynthia, Calvin L. Streeter, Johnny S. Kim, and Stephen J. Tripodi. 2007. The effectiveness of a solution-focused public alternative school for dropout prevention and retrieval. Children and Schools 29.3: 133–144.

                                        DOI: 10.1093/cs/29.3.133Save Citation »Export Citation »E-mail Citation »

                                        The authors describe the adoption of a solution-focused approach on a school-wide basis and their initial evaluation of its effects. Available online for purchase or by subscription.

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                                        • Murphy, John J. 2008. Solution-focused counseling in schools. 2d ed. Alexandria, VA: American Counseling.

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                                          Written by a school psychologist, this book is of immense value to school social workers in maintaining a concrete orientation toward strengths in practice with children and adolescents in the school system.

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                                          Child Maltreatment

                                          Although there are later solution-focused works on this topic, Berg 1994 is a classic—easy to read and inspiring—and was followed later by Berg and Kelly 2000. Christensen, et al. 2007 is not solely about solution-focused therapy, but the strengths perspective is there in reframing people’s intentions and working on developing new behaviors rather than focusing on blame and responsibility. The chapter on goal setting is a helpful guide to developing goals with parents in the child welfare system. Dolan 1991 is an excellent resource for those working with adult sexual abuse survivors.

                                          • Berg, Insoo Kim. 1994. Family based services: A solution-focused approach. New York: Norton.

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                                            One of the early solution-focused writings, this easy-to-read book clearly describes how solution-focused interventions can be used when social workers are delivering home-based services to families with maltreatment.

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                                            • Berg, Insoo Kim, and Susan Kelly. 2000. Building solutions in child protective services. New York: Norton.

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                                              In this later work, Berg and her coauthor discuss the use of SFT in child welfare systems, a little unevenly with the two coauthors’ style and content often not being consistent.

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                                              • Christensen, Dana, Jeffrey Todahl, and William Barrett. 2007. Solution-based casework: An introduction to clinical and case management skills in casework practice. New Brunswick, NJ: Aldine Transaction.

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                                                Discusses how to arrive at individualized goals in a collaborative fashion with parents in the child welfare system and how to reframe parents’ intentions. See Adaptations.

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                                                • Dolan, Yvonne. 1991. Resolving sexual abuse. New York: Norton.

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                                                  Shows readers how to work with sexual abuse survivors in a way that is respectful of client pain and suffering, as well as emphasizing strengths. A particular contribution is a checklist assessment that shows how practitioners can use item responses in a strengths-based way.

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                                                  Substance Use

                                                  Berg has authored two books on using SFT with alcohol problems (Berg and Miller 1992 and Berg and Reuss 1998), and the techniques could be easily adapted to drug problems and either inpatient or outpatient modalities. This revolutionary approach to substance use treatment is one in which people do not have to accept the label of “alcoholic” and face their denial before they can recover.

                                                  • Berg, Insoo Kim, and Scott Miller. 1992. Working with the problem drinker. New York: Norton.

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                                                    Although other books subsequently discussed solution-focused applications to substance use treatment, this book defines the approach with plenty of realistic case examples.

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                                                    • Berg, Insoo Kim, and Norman H. Reuss. 1998. Solutions step by step: A substance abuse treatment manual. New York: Norton.

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                                                      This authored book is not truly a treatment manual but is organized by techniques and their examples.

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                                                      Mental Health

                                                      The few discussions using solution-focused therapy with mental health problems typically acknowledge that solution-focused therapy involves adjunctive approaches, stating that medication can be one potential solution (Trautman 2000). Corcoran 2009 is a self-help manual that can also be used by social workers as a guide to strengths-based treatment for depression. Softas-Nall and Francis 1998 is an intriguing article on how to see and enhance strengths using a solution-focused approach to suicidal intent. Beyond depression, psychotic symptoms are the topic of Rowan and O’Hanlon 1999. From Finland, Knekt, et al. 2011 is a five-year randomized, controlled study, comparing solution-focused therapy to psychodynamic therapy, both short and long term, for depression or anxiety in adults.

                                                      • Corcoran, Jacqueline. 2009. The depression solutions workbook: A strengths and skills-based approach. Oakland, CA: New Harbinger.

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                                                        A strengths-based model for treatment of depression featuring motivational interviewing, solution-focused therapy, and cognitive-behavioral techniques. Also see Adaptations.

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                                                        • Knekt, Paul, Olavi Lindfors, Maarit A. Laaksonen, Camilla Renlund, Peija Haaramo, Tommi Härkänen, et al. 2011. Quasi-experimental study on the effectiveness of psychoanalysis, long-term and short-term psychotherapy on psychiatric symptoms, work ability and functional capacity during a 5-year follow-up. Journal of Affective Disorders 132.1–2: 37–47.

                                                          DOI: 10.1016/j.jad.2011.01.014Save Citation »Export Citation »E-mail Citation »

                                                          Results were that two short-term therapies, solution-focused and psychodynamic therapy, were equally effective for symptom improvement in the first year, but solution-focused was delivered in even fewer sessions. Only at long-term follow-up (three years) did the long-term psychodynamic therapy emerge as more effective than the short-term therapies, and this was maintained at five years. Despite its effectiveness, the long-term therapy was three times more costly than the short-term therapies. This study earned SFT level II effectiveness for depression from the Australian Psychological Society. Available online for purchase or by subscription.

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                                                          • Rowan, Tim, and Bill O’Hanlon. 1999. Solution-oriented therapy for chronic and severe mental illness. New York: Wiley.

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                                                            This book maintains a hopeful and inspiring outlook for work with people with severe mental illness.

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                                                            • Softas-Nall, Basilia C., and Perry Francis. 1998. A solution-focused approach to suicide assessment and intervention with families. Family Journal: Counseling and Therapy for Couples and Families 6.1: 64–66.

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                                                              This article describes how providers can use strengths-based techniques even with serious problems such as suicidal intent. Available online for purchase or by subscription.

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                                                              • Trautman, P. 2000. The keys to the pharmacy: Integrating solution-focused brief therapy and psychopharmacological treatment. Journal of Systemic Therapies 19.1: 100–110.

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                                                                Presents psychopharmacological treatment as one potential solution for people suffering from mental health problems and presents questions that can be asked of clients so that they understand how they can actively work with their medication to feel better.

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                                                                Research

                                                                Solution-focused therapy has struggled to establish itself as a research-based therapy, although lately it has gained some foothold. Dr. Alasdair McDonald keeps a comprehensive and up-to-date list of treatment outcome studies on solution-focused therapy worldwide and reports over 1,600 publications in 2012 alone. Gingerich and Eisengart 2000, a narrative review, was the first of this kind. Corcoran and Pillai 2007 and Kim 2008 followed with more stringent review methods. More recently, Franklin, et al. 2012 devoted an entire edited book to the research basis of solution-focused therapy.

                                                                • Corcoran, Jacqueline, and Vijayan Pillai. 2007. A review of the research on solution-focused therapy. British Journal of Social Work 39.2: 234–242.

                                                                  DOI: 10.1093/bjsw/bcm098Save Citation »Export Citation »E-mail Citation »

                                                                  The authors argue that, due to the different populations and problems targeted in the primary studies of solution-focused therapy, conceptually there are too many differing constructs and dissimilarities of studies to suggest combining them as a whole. Social work practitioners in studies were typically students, and professionals may produce better outcomes. Available online for purchase or by subscription.

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                                                                  • Franklin, Cynthia, Terry Trepper, Wallace Gingerich, and Eric McCollum, eds. 2012. Solution-focused brief therapy: A handbook of evidence-based practice. New York: Oxford Univ. Press.

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                                                                    This edited volume explores reviews of the research literature, treatment outcome studies (some of which have not been published previously), and the measurement of solution-focused therapy and strengths-based clinical work.

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                                                                    • Gingerich, Wallace J., and Shari Eisengart. 2000. Solution-focused brief therapy: A review of the outcome research. Family Process 39.4: 477–498.

                                                                      DOI: 10.1111/j.1545-5300.2000.39408.xSave Citation »Export Citation »E-mail Citation »

                                                                      A widely cited article that reviews both published and unpublished (dissertations) solution-focused therapy outcome studies. Available online for purchase or by subscription.

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                                                                      • Kim, Johnny S. 2008. Examining the effectiveness of solution-focused brief therapy: A meta-analysis. Research on social work practice 18.2: 107–116.

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                                                                        In this meta-analysis, effect sizes were averaged for each major symptom domain—internalizing, externalizing, and family and social functioning—combining studies that involved children, adults, and the elderly. Available online for purchase or by subscription.

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                                                                        • Solution-Focused Approaches, Dr. Alasdair McDonald.

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                                                                          Dr. McDonald keeps a comprehensive and up-to-date list of treatment outcome studies on solution-focused therapy. He reports that there were over 1,600 publications on solution-focused therapy worldwide, with 100 of these written not in English and 60 publications from Taiwan. He also indicates that SFT is now in the Office of Juvenile Justice and Delinquent Prevention Model Programs Guide.

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                                                                          Adaptations

                                                                          As discussed, solution-focused therapy has been used as an adjunct in working with chronic and severe mental illness. It has also been used with cognitive-behavioral approaches as described in Christensen, et al. 2007; Corcoran 2005; Corcoran 2009 (cited under Mental Health); Clark-Stager 1999; and Selekman 2002. Finally, Lipchik 2002 argues persuasively for more integration of emotion within the solution-focused approach, which traditionally emphasizes behaviors and perceptions.

                                                                          • Christensen, Dana, Jeffrey Todahl, and William Barrett. 2007. Solution-based casework: An introduction to clinical and case management skills in casework practice. New Brunswick, NJ: Aldine Transaction.

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                                                                            Although the title reads “solution-based,” there is, in addition to emphasis on collaborative work with clients, emphasis on “triggers,” particularly for physical abuse of children, and how practitioners can help parents with this aspect of the problem.

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                                                                            • Clark-Stager, W. 1999. Using solution-focused therapy within an integrative behavioral couple framework: An integrative model. Journal of Family Psychotherapy 10.3: 27–47.

                                                                              DOI: 10.1300/J085v10n03_03Save Citation »Export Citation »E-mail Citation »

                                                                              Discusses the integration of solution-focused therapy with behavioral couples therapy for optimal effect when working with couples. Available online for purchase or by subscription.

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                                                                              • Corcoran, Jacqueline. 2005. Building strengths and skills: A collaborative approach to working with clients. New York: Oxford Univ. Press.

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                                                                                This book poses an integration of strengths-based models (solution-focused and motivational interviewing) and skills training through cognitive behavioral therapy (CBT) and shows how this integration can be applied to a variety of mental health (depression, substance abuse, adolescent conduct disorders) and social service (physical abuse, sexual abuse, intimate partner violence) problems.

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                                                                                • Lipchik, Eve. 2002. Beyond technique in solution-focused therapy: Working with emotions and the therapeutic relationship. New York: Guilford.

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                                                                                  Makes a good case for the integration of emotions into solution-focused techniques with more of an emphasis on the relational aspects of the worker-client relationship.

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                                                                                  • Selekman, Matthew. 2002. Living on the razor’s edge: Solution-oriented brief family therapy with self-harming adolescents. New York: Norton.

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                                                                                    Although solution focused for the most part, the author recognizes that with such a potentially dangerous problem there may be a need to teach coping and grounding skills; hence, a chapter is devoted to this topic.

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