Does Solution Focused Brief Therapy address problems?

One way to think about solution focused brief therapy is to take the view that at the heart of the approach lies a conversational shift. The therapist, using all the skills at her command, attempts to move with the client out of a problem-dominated conversation into a solution-oriented conversation. This involves the therapist in maximising opportunities for developing solution talk with the client and thereby reducing the amount of time in sessions that the client spends in problem-talk. Problem-amplification questions therefore play no part in the solution focused process. The fact that the problem is not obviously the focus of attention can lead to some concern and disquiet. If the model does not deal with the problem then will not the problem recur? Is solution focus any more than a plaster that will in time be revealed as superficial, building a feel-good factor with the client but leaving the 'real problem' untouched, submerged and ready to re-emerge at some point of crisis in the client's life?

This concern, real and important though of course it is, fails to understand, or at least to take seriously the nature of the problem/solution dichotomy. Whilst it is impossible to predict what the solution will look like on the basis merely of knowing what the problem is (and vice versa), yet problem and solution are inextricably intertwined, they are inseparable - problem implies solution and solution implies problem. Indeed it is this thought that leads solution focused brief therapists to make the distinction between problems and life-situations or limitations. A problem is a situation that has a potential solution. If the situation that the client presents as a problem does not have a possible solution then the approach will choose to think about that presented situation as a life situation or a limitation. Obvious examples are bereavements, permanent bodily injuries, separation and other losses. None of these can be solved, at least not within the ambit of therapy. The best that the client can do is to find a way of coping with, living with or managing the problematic situation. Thus part of the definition of a problem is that it should have a solution.

However not only do the problem and the solution imply each other but their relationship is one of mutual exclusivity, just like night and day, hot and cold, black and white. If it is night then it cannot be a bit day. If we agree to leave out the liminal periods, dusk and dawn, then most of us recognise the relationship clearly. It is this or that. It cannot be both one and the other. Now if we return to the miracle question it is exactly this night/day type distinction that lies at the heart of the question. "Suppose you go home, you do what you do this evening and then at some point you go to bed and go to sleep. And suppose that while you are asleep a miracle happens and the problems that brought you here are resolved. But since you are asleep you do not know that the miracle has happened. When you wake up tomorrow how will you find out. What will you notice that will say to you 'goodness life is different - a miracle must have happened while I was asleep'." This question is precisely not a three wishes or a magic wand type question. It does not ask the client to tell us what their ideal world would be like. It asks the client something very specific. It asks 'how will you know that the problems that brought you here have been resolved?' The question asks the client to specify the criteria whereby the client will know that the problem has been solved and as we have already noticed it is not possible for the client to have the problem and the solution to the problem. The client must have one or the other.

Having specified the preferred future, the solution, the criteria whereby the client will know that the problem is resolved, the solution focused brief therapist then sets out to talk with the client in such a way that the client comes to report that enough of the solution is happening for the client to be able to say that the problem is not happening. However the talking in the therapy centres on the construction of the solution rather than the deconstruction of the problem. It is thus that the solution focused brief therapist can say that the therapist does not focus on problems, indeed she focuses on the obverse, but that in so doing she does address the problem that the client has brought to the therapy. Talking about and addressing are thus seen to be different things.

Most important of all we must recognise that the client understands, and accepts, the inextricability of problem and solution. If he did not then solution focus would indeed be a nonsense, a through-the-looking-glass, therapy. The client would find himself talking with the therapist about something that bore no relation to the issue that he had initially brought. And of course if this were to be the case then it is unlikely that the client would experience the process as helpful and indeed he would be unlikely to return for a second session. Clients would continually report of the process that it made no sense and when, as happens frequently, the solution focused client asked for feedback "are we talking about the right things here of are important issues getting left out" the client would tend to report that indeed important issues were not being addressed. This is not the case. Thus it can be argued that clients, in experiencing the approach are at a marked advantage over trainee therapists who may just have read about or heard about the approach.

Whilst therefore deconstructing problems and constructing solutions can be seen to be both different and yet related there is one additional point in relation to the difference that can be made. Traditionally problem-solving approaches have done precisely that, they have solved the client's problem. Generally it has been assumed that the problem is blocking the client from being able to move forward towards his goal. Therefore if the problem is solved then the client will be enabled to move forward in a more productive direction in his or her life. The way that the client and worker will typically agree to know together that the problem is solved is when the problem behaviour is extinguished. The client will be no longer depressed, no longer arguing with his or her partner, no longer doing drugs or drinking. Thus a successful therapy will track the gradual reduction in the problem in the client's life. This particular modus operandi does however bear dangers for the client. If the therapy focuses solely on the extinguishing of the non-desired behaviour then the client might not yet have replaced it with specified desired behaviour. The danger of finishing therapy at a point where something is not happening rather than a point when the preferred future is happening lies solely in the potential lesser stability of the 'vacuum' option. Clearly it is potentially easier for the client to carry on seeing new friends, going to the gym, doing his computer class and continuing to meditate, rather than to continue not doing drugs. Continuing to not do things is tough, as most of us know from our own experience of the world. This may be the basis for Steve de Shazer's claim that solution focused brief therapy is particularly good at change maintenance. This claim however remains to be substantiated by more research.

© Brief Therapy Practice 2003. Please feel free to copy this and to refer to it, always, naturally, acknowledging your source.