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Family Centred Brief Solution‐focused Therapy with Chronic Schizophrenia: a Pilot Study
Abstract
The purpose of the study was to pilot a family centred brief solution-focused therapy model (BSFT) with families and clients diagnosed with schizophrenia. A control group of clients and their families received traditional outpatient therapy, while an experimental group of clients and their families were treated with a BSFT model. All participants were pre-tested and then post-tested with the Family Environment Scale after five therapy sessions over a ten-week period. Significant differences between the groups were found on expressiveness, active-recreational orientation, moral-religious emphasis and family incongruence. The participation of families and clients with schizophrenia in family centred brief solution-focused therapy produced encouraging results and demonstrated the need for expanded studies using BSFT with other chronically mentally ill clients and their families.
... When studies conducted in literature are reviewed, it can be seen that experimental studies have been conducted which examine the effects of solution focused brief therapy on depression (Sundstrom, 1993;Triantafillou, 1997), parental skills (Zimmerman, Jacobsen, MacIntyre and Watson, 1996), time for orthopaedic patients to return to work (Cockburn, Thomas and Cockburn, 1997), tendency to commit crime again in prison (Lindforss and Magnusson, 1997), decreasing antisocial thoughts and behaviours in adolescent criminals (Seagram, 1997), decreasing academic and personal worries (Littrell, Malia and Vanderwood, 1995), marital satisfaction (Zimmerman, Prest and Wetzel, 1997), alcohol problem (Polk, 1996), schizophrenia (Eakes et al., 1997), parent-adolescent conflict (Franklin, Corcoran, Nowicki nd Streeter, 1997), child's welfare (Sundman, 1997), exclusive student behaviour (Geil, 1998), mood, anxiety, adjustment disorders and substance addiction in adults (Lambert, Okiishi, Finch and Johnson, 1998). Gingerich and Eisengart (2000) who critically analysed all of these experimental studies in literature stated that although the studies had some deficiencies in fulfilling experimental conditions, they were important in terms of showing the efficiency of solution focused approach. ...
... According to the results of this study, it was also found that studies conducted with solution focused approach mostly had 6 sessions. There are similar studies conducted with 6 sessions in literature (Zimmerman, Jacobsen, MacIntyre and Watson, 1996;Cockburn, Thomas and Cockburn, 1997;Zimmerman, Prest and Wetzel, 1997;Polk, 1996;Eakes et al., 1997). ...
... Experimental studies conducted in literature support this finding. It can be seen that SFBT is applied in various fields, mainly educational institutions (Sundstrom, 1993;Eakes et al., 1997;Geil, 1998). ...
The aim of this study is to examine experimental studies conducted with solution focused brief therapy psychological counselling in Turkey. In this study in which descriptive method was used, the data were analysed with document analysis. In this respect, a total of 26 studies, 24 graduate theses and 2 articles, which were conducted experimentally with solution focused counselling approach, were analysed. According to the results of the study, it was found that there was an increase in studies conducted with this approach in recent years, the majority of the studies were conducted in the fields of education and nursing, and the sample groups of the study were mostly secondary school, high school and university students. It was found that mostly group counselling method and semi-experimental pattern were used in studies, a great majority of the studies were conducted with 6 sessions, all of the studies except one included control group, 3 of the studies included placebo group and follow-up test was conducted in 14 of the studies. It was found that the studies were applied on very different problem areas, mainly undesired behaviours and that 4 of the studies met all the criteria determined for solution focused approach. When the studies conducted were examined, it was found that there were no studies in which solution focused approach was compared with another psychotherapy approach. As a result of the study, it was found that in all studies except one, solution focused counselling had a significant effect on the experimental group.
... Unlike traditional therapy, which often focuses on problems, SFBI emphasizes building solutions through questions about hope, preferred futures, exceptions, coping, and scaling. Indian studies have suggested the effectiveness of SFBT, with one study specifically assessing its impact on family environments in schizophrenia care (Eakes et al., 1997). ...
Introduction: In Asian countries, about 70% of people with Schizophrenia live with their families or friends. Caregivers are the persons who have significant responsibility for the well-being of a person diagnosed with Schizophrenia. In developing countries, the joint family system and the sense of collectivism resist paid caregivers for a person with Schizophrenia. As a result, caregivers may experience psychological and emotional distress and have poor mental health.
Aim of the Study: To assess the caregiver's burden, Quality of life and coping patterns of caregiver's of persons living with Schizophrenia.
Materials and Methods: The researcher had used single case AB design pre- and post-assessment methods. The researcher administered Pai and Kapoor's Family Burden Interview Schedule, Brief Cope by Carver et al., and WHO Quality of Life-BREF. The scaling technique was used to assess the change in the post-assessment.
Results
The therapist took 10 sessions, each lasting for 45-60 minutes. The therapist organized the sessions into initial sessions, which included 2 sessions for building rapport, providing psychoeducation, developing a case conceptualization, and discussing the techniques that would be used. Additionally, there were 6 middle sessions focused on implementing core therapeutic techniques. After conducting psychoeducation sessions, utilizing the miracle questions, discussing preferred future outcomes, exploring exception questions, and implementing coping techniques with the mother, behavior management was taught to address the client's demanding behavior and emotional outbursts. Two sessions were dedicated to gathering feedback on the therapy process, preparing the mother for potential setbacks, and developing relapse prevention strategies.
Conclusion: At post-assessment, the caregiver reported amelioration in burden, coping pattern, and Quality of life. The mother learnt the management of the illness and was quite confident in handling the PLWS. The scaling question at the time of preassessment was 1, and at post-assessment was 7.
... Thus, spouses can have a better feeling towards each other and establish a better relationship with each other, reducing the gap between them and making them less inclined to seek good feelings and emotions outside the marital relationship. Moreover, solution-based therapy changes spouses' perspectives towards difficult situations and gives them a more positive view of issues, thereby increasing their ability to face life's displeasures (Eakes et al., 1997) and by strengthening the client in creating suitable solutions and structuring existing solutions, increases the client's sense of self-efficacy and autonomy (Corcoran & Pillai, 2007), and this assessment of solutions and structuring them warns them against unreasonable decisions such as infidelity. Solution-based therapy, in addition to examining what is currently being done and created, pulls out useless and inefficient patterns that do not have the necessary efficiency to solve marital issues or improve the relationship and replaces them with small and gradual positive changes (Walter & Peller, 2013). ...
Objective: This research aimed to compare the effectiveness of transdiagnostic and solution-based therapy on the tendency toward infidelity among married women in Isfahan. Materials and Methods: The research employed a quasi-experimental pre-test, post-test, and follow-up design, with a sample consisting of 48 married women selected through purposive sampling based on inclusion and exclusion criteria and then randomly assigned into three groups of 16 (two experimental groups and one control group). While the control group was on a waiting list and received no training, the transdiagnostic experimental group underwent 10 sessions of 90 minutes each according to the unified transdiagnostic treatment protocol of Barlow et al. (2010), and the solution-based experimental group underwent 8 sessions of 90 minutes each based on a protocol adapted from De Shazer's "Key Concepts in Solution-based Therapy" (1985). All three groups filled out relevant questionnaires at three stages: pre-test, post-test, and follow-up. The research instrument was the tendency toward infidelity. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (repeated measures analysis of variance and Bonferroni post-hoc test) with SPSS-25. Findings: Results indicated that both transdiagnostic and solution-based treatments were significantly effective in reducing the tendency toward infidelity compared to the control group, with transdiagnostic treatment being more effective. Hence, both transdiagnostic and solution-based therapy can be utilized to reduce the tendency toward infidelity among women. Conclusion: This study underscores the potential of both transdiagnostic and solution-based therapies in mitigating the inclination towards infidelity in married women, with transdiagnostic therapy showing a more pronounced effectiveness.
... 10.149). Examples include family therapy (McCollum & Trepper, 2001), couple therapy (Weiner-Davis, 1992), treatment of sexual abuse (Dolan, 1991), substance abuse (Berg & Miller, 1992;Shazer & Isebaert, 2004), and also as a treatment of schizophrenia (Eakes et al., 1997). The solution-focused approach proved its versatility-practitioners apply it in other nontherapeutic settings. ...
... 18,40 Moreover, the risk of relapse for patients with schizophrenia who live in highly expressed emotion environments (criticism is one of the three characteristics of expressed emotion) 41 is more than double compared to patients who live in low-expressed emotion environments. 42 It is also well established that Global Properties of the family system, i.e., conflict and cohesion, are related to the onset and/or relapse of patients with schizophrenia. 8 Specifically, patients who report poor levels of cohesion in their family have greater symptomatology, 43 whereas patients who report greater levels of family cohesion feel less distressed, 14 and high levels of family cohesion seem to protect against psychosis. ...
Family therapy for schizophrenia has been demonstrated to be effective and is recommended by international clinical guidelines. Reviews of family therapy research conclude that interventions may prevent relapse of the disease, when symptoms are already reduced under psychotropic medication, by reducing family factors associated with relapse. The purpose of this study was to examine the effectiveness of Brief Solution Focused therapy (BSFT) in patients with schizophrenia focusing on the impact of change in family characteristics such as cohesion, conflict, organization and control on patients' psychopathology measured with BPRS. Thirty patients diagnosed with schizophrenia were randomly assigned to the control or intervention group. The intervention group received treatment according to the BSFT model, whereas the control group received the standard care for schizophrenia. The BSFT is a future-oriented psychotherapy model which encourages clients to focus on ''change-talking'' instead of ''problem-talking'' and on instances where a successful solution has been achieved. The intervention was consisted of 5 sessions delivered in 3 months. Main outcomes were patient-rated family characteristics measured by the Family Environment Scale (FES), and psychiatrist-rated symptom severity measured with the Brief Psychiatric Rating Scale (BPRS). The two groups did not differ in terms of age, sex, number of relapses, previous hospital admissions, and BPRS score at baseline. At the end of treatment compared to baseline there was a reduction of the BPRS score in the intervention group (p<0.001) whereas no statistically significant changes were noticed in the control group after 3 months. Also, following treatment, patients in the intervention group displayed reduced scores on the Conflict FES scale (p=0.001) accompanied by increased scores on the Cohesion (p=0.004), Expressiveness (p=0.004), and Active Recreational subscales (p=0.001) according to patient's perspective. These preliminary findings suggest that BSFT in patients with schizophrenia, appears to be effective in altering the global properties of the whole family system, specifically cohesion, conflict, organization and control which, in turn, have an impact on reducing patient psychopathology.
... Gingerich and colleagues (2011) reviewed SFBT quantitative research in the United States and internationally and found SFBT to have small-to-medium positive treatment effects. Kim et al. (2018) noted several primary outcome SFBT studies in substance abuse and mental health clinics (Cockburn et al., 1997;Coe, 2000;Dahl et al., 2000;Eakes et al., 1997) with significant positive findings for internalizing problem behaviors, externalizing problem behaviors, and family-related problems. In their systematic review, Gingerich and Peterson (2013) found significant positive benefits from SFBT for adults suffering from depression and other behavioral and psychological disorders. ...
... Furthermore, the flexibility demonstrated by facilitators in their practice was felt to benefit engagement. This differs from other successful studies using BSFA in educational (Cepukiene & Pakrosnis, 2011;Daki & Savage, 2010;Franklin et al., 2008;Froeschle et al., 2007;Newsome, 2004;Springer et al., 2000) or family contexts (Chung & Yang, 2004;Eakes et al., 1997;Kenney, 2010;Huang 2001;Naude, 1999;Zimmerman et al., 1996), which were delivered through groups or family settings. The current study highlights the powerful impact that targeted one-to-one interventions can have in parental engagement in education, and more work is needed to identify key factors behind the intervention's success. ...
Parental responsibility is often the focus of research and policy surrounding closing the attainment gap between low-income students and their wealthier peers. This article describes a pilot intervention programme which aimed to enable better parental support of their children with their schoolwork and educational engagement. Through interviews with the parents and facilitators involved with the pilot, this article provides an example of how strength-based interventions can promote parental engagement in education in marginalised groups, such as families considered disadvantaged. The programme consisted of six one-to-one sessions with 25 parents. Semi-structured interviews with five parents and four facilitators revealed that parents reported increased self-efficacy and confidence in supporting their children’s education. Key features of the programme contributing to sustainable changes were the programmes person-centred approach and the use of strength-based strategies. The qualitative analysis provides only short-term accounts of behavioral change, but despite these shortcomings the results provide tentative evidence for the efficacy of a brief solution focused programme in supporting low-income parents’ engagement. More research is needed using larger sample sizes with longer data collection periods.
... As methods such as Motivational Interviewing and Solutions Focused counselling have been proven effective in persons suffering from chronic schizophrenia, obesity, alcoholism, and drug abuse [14][15][16][17][29][30][31][32][33][34][35] we are optimistic that such methods can be efficacious in chronic disease patient education such as diabetes. 25 This is also supported by the results of our study. ...
Foot care education is an important strategy in reducing lower limb complications. There is evidence that contemporary communication approaches can improve patient education outcomes. To inform the potential of such methods in diabetic foot education, we trialled a collaborative approach in patient education counselling in a podiatry clinic. We conducted a single‐blind pragmatic randomised controlled trial on 52 diabetes patients who had an active foot ulcer. Participants were randomised to either collaborative education or traditional didactic education. Outcomes on knowledge and self‐care behaviours were collected via a pre and post study questionnaire (max score: 75). The study ended at 12 weeks or when the wound healed prior. 42 (80.7%) participants completed the study. The collaborative patient education group had a significant increase in score post‐study (38.8 ± 8.5) compared to pre‐study (32.8 ± 6.9; P < .001). The control group had no significant increase in score post study. The difference in scores between groups had a moderate effect size (d = 0.54). The use of a collaborative approach in patient education was able to produce significantly greater increase in knowledge retention and self‐care behaviours, without the need for additional consultation time in a podiatry clinic.
... This notion indicates a key paradigm shift, from concentrating on the problems and shortfalls of an individual to explore how an individual marshals his or her resilient strengths to deal with problems in a time of hardship and subsequently, attains personal growth (63). Research studies indicates that SFBT is effective in the treatment of depression (18,(64)(65)(66)(67) and due to its effectiveness, it was used to help clients find solutions to marital problems, decision-making anxiety and stress (68), as well as people with substance abuse (69), schizophrenia (70). Solution-focused therapy is piloted with individuals, couples (71) and groups (72). ...
So many surveys have demonstrated that there are high degrees of morbidity due to mental turmoil among immigrants, mainly depression and apprehension. Few of these studies unveil that migrant bond mentally depressed for the reason that they are tensed with jobs that was not at par with their educational status. From this context, the likelihood of those individuals with a higher education qualifications to end up doing deadly jobs are high, hence lower their self-respect. Those Women who involved in reformation and increasing role in international labor migration presently amount to 49.6 percent of all labor migrants worldwide. At this time, Malaysia has 2.9 million acknowledged and about 3 million unacknowledged workers with the majority of them from Indonesia 50.9%. On Asia continent, the largest class of female employment is domestic workers. Nevertheless, the domestic sector is regularly not protected by labor and industrial relations laws in the host countries, which makes this set of migrants labor particularly vulnerable to mistreatment hence the depression. Studies have shown that stressful experiences increase one’s susceptibility to diseases and mental health trouble. This research aimed to assess the effectiveness of the interventions using Solution-focused brief group therapy (SFBGT). BDI, the Beck depression inventory tool is employed to the quasi pre-test and post-test methodology to evaluate the depression level of Indonesian women migrant workers in Penang state of Malaysia. The novel significance is that this study will benefit the Indonesian government in policy preparation that can validate her citizens who are principally searching for greener pasture offshore.
... However, earlier published articles were clinical case studies and not outcome studies. Several outcome studies have examined SFBT in substance abuse and mental health clinics (Cockburn, Thomas, & Cockburn, 1997;Coe, 2000;Eakes, Walsh, Markowksi, Cain, & Swanson, 1997) with significant positive findings for internalizing problem behaviors, externalizing problem behaviors, and family-related problems. More recently, Kim et al. (2018) examined the effectiveness of SFBT with substance using adults involved with the child welfare system and found positive, small to large treatment effects for parents receiving SFBT for substance abuse and trauma-related problems. ...
This study examined the effectiveness of solution-focused brief therapy (SFBT) on child well-being and family functioning outcomes for child welfare involved parents. A randomized controlled trial design was used to evaluate the effectiveness of SFBT as compared to treatment-as-usual in an outpatient substance abuse treatment center. Mixed linear models tested within and between-group changes using intent-to-treat analysis (N = 180). Hedges’s g effect sizes examined the magnitude of treatment effects. Both conditions reported improvements on the child well-being measures (Behavior Rating Inventory of Executive Function [BRIEF]-Parent Report and Child Behavior Checklist-School Age Form [CBCL-SA]) and family functioning measures (Adult-Adolescent Parenting Inventory [AAPI-2] and Center for Epidemiologic Studies-Depression [CES-D] Short Form) at posttest. While none of the between group analyses were statistically significant on either outcome domains, effect sizes did show improvements in the small to medium range for both groups. SFBT effect sizes for BRIEF subscales ranged from .024 to .267 and for control group ranged from .136 to .363. SFBT effect sizes on CBCL-SA subscales ranged from .059 to .321 and for control group ranged from .101 to .313. SFBT effect sizes on AAPI-2 subscales ranged from .006 to .620 and control group ranged from .023 to .624. SFBT effect sizes on CES-D measure were .428 and for control group were .317. Results show SFBT to be an effective intervention for helping parents around child well-being and family functioning outcomes similar to current empirically-supported therapies. SFBT provides a more strengths-based approach to help families improve family well-being and thus help improve their child’s well-being.
... We found only seven systemic intervention RCTs for psychotic disorder (17)(18)(19)(20)(21)(22)(23), and only one for patients at CHR state (22). This study (n = 40, China) compared only medication treatment with 10 sessions of structural family therapy (one school of ST) plus medication. ...
Psychosocial intervention trials for youth at clinical high risk (CHR) for psychosis have shown promising effects on treating psychotic symptoms but have not focused on psychosocial functional outcomes, and those studies have been conducted among help-seeking patients; there is a lack of research on non-clinical young CHR individuals. Systemic therapy (ST) is grounded in systemic-constructivist and psychosocial resilience theories. It has a number of advantages that makes it attractive for use with CHR individuals in non-clinical context. The present study evaluated the effect of ST for students at CHR on reducing symptoms and enhancing psychosocial function. This was a single-blind randomized controlled trial for CHR young people comparing ST to supportive therapy with a 6-month treatment. Psychotic and depressive symptoms (DS) as well as self-esteem and social support (SS) were assessed at pre- and posttreatment. 26 CHR individuals were randomly divided into intervention group (n = 13) and control group (n = 13). There were no significant differences in severity of symptoms, level of SS and self-esteem at baseline between the two groups (P > 0.05). At posttreatment, significant improvements in positive and DS as well as SS and self-esteem were observed in the ST group (P < 0.05); in the control group, these improvements were not significant (P > 0.05). The findings indicated that systemic intervention for university students at CHR for psychosis may have a positive effect on symptoms and self-esteem as well as SS in short term. More long-term research is needed to further evaluate this intervention.
... Work attendance during baseline has been as low as two days per week but increased to 4-6 days per week during treatment. Eakes, Walsh, Markowski, Cain & Swanson (1997) investigated the impact of SFBT on families with a member diagnosed as schizophrenic. The sample was composed of 10 patients and their families being served by a community mental health center. ...
... Lehtinen (1993) Von Grawe et al. (1994) wurde bemängelt, dass systemische Therapiestudien häufig eine potenzielle Stärke des Verfahrens -mögliche positive Behandlungseffekte auf die Familieninteraktion -nicht mit untersuchten. Eine Ausnahme ist eine kleine Pilotstudie (n=10) von Eakes et al. (1997) ...
inis article provides an overview or rct-studies on the efficaciousness of systemic therapy that have been identified since the comprehensive meta-analyses on systemic therapy was concluded in 2006. Based on this earlier expertise and supplementary studies presented here, the German Scientific Advisory Board has confirmed systemic therapy as a scientifically validated treatment approach with adults as well as with children and adolescents. After a discussion of the current research situation, the authors present some reflections on potential consequences for systemic practice, research and training in systemic therapy.
... Solution-focused therapy is showing promising results in controlled effectiveness studies with a variety of populations and in a great variety of settings (Gingerich & Peterson, 2012;Kim, 2008;Stams, Dekovic, Buist, & de Vries, 2006), including family therapy (Eakes, Walsh, Markowksi, Cain, & Swanson, 1997;Zimmerman, Jacobsen, MacIntyre, & Watson, 1996). In fact, solutionfocused therapy is one of the three approaches (together with Bowen family systems theory and cognitive-behavioral therapy) most often cited by North American family therapists as a perspective "valuable to their work" (Bradley, Bergen, Ginter, Williams, & Scalise, 2010). ...
In therapeutic conversations, questions can be considered as interventions in their own right. This study is a cross-cultural replication of Grant (Journal of Systemic Therapies, 2012, 31, 2, 21) study on the effects of different types of questions on various clinically relevant variables. A total of 204 students of a Spanish university described a real-life problem that they wanted to solve and were then randomly assigned to either a solution-focused or a problem-focused questions condition. Before and after answering the questions, they completed a set of measures that assessed positive and negative affect, self-efficacy, and goal attainment. Solution-focused questions produced a significantly greater increase in self-efficacy, goal approach, and action steps than problem-focused questions, and a significantly greater decrease in negative affect, providing further empirical support to solution-focused practices.
... There is now a growing body of empirical evidence suggesting that the solution-focused approach can be effective. in a comprehensive literature review Corcoran and Pillai (2009) found that solution-focused approaches were effective for a wide range of therapeutic situations including marriage counselling (Zimmerman, Prest, & Wetzel, 1997), suicide prevention interventions (Rhee, Merbaum, Strube, & Self, 2005), criminal offending (Lindforss & Magnusson, 1997), and with caregivers of people with chronic schizophrenia (eakes, Walsh, Markowksi, Cain, & Swanson, 1997). other reviews of solution-focused counselling and therapeutic interventions have found solution-focused approaches to be effective in relation to enhancing parenting skills and dealing with anxiety, stress, and depression (e.g., Kim, 2008;Stams, Dekovic, Buist, & de Vries, 2006). ...
This study compared the effects of problem-focused and solution-focused coaching questions on positive and negative affect, self-efficacy, goal approach, and action planning. A total of 225 participants were randomly assigned to either a problem-focused or solution-focused coaching condition. All participants described a real-life problem that they wanted to solve and set a goal to solve that problem. They then completed a set of measures that assessed levels of positive and negative affect, self-efficacy, and goal attainment. In the problem-focused coaching condition 108 participants then responded to a number of problem-focused coaching questions and then completed a second set of measures. The 117 participants in a solution-focused coaching session completed a mirror image of the problem-focused condition, responding to solution-focused questions including the “Miracle Question.” Both the problem-focused and the solution-focused coaching conditions were effective at enhancing goal approach. However, th...
... Because it is based on the resiliency, previous solutions, and exceptions of the client, it has been applied to most problems and populations that are of interest to social workers. These have included family therapy (McCollum & Trepper, 2001), sexual abuse (Dolan, 1991), substance abuse (Berg & Miller, 1992;de Shazer & Isebaert, 2003), and persistent mental illness (Eakes, Walsh, Markowski, Cain, & Swanson, 1997). ...
This article describes the process of having solution-focused brief therapy (SFBT) be evaluated by various federal registries as an evidence-based practice (EBP) intervention. The authors submitted SFBT for evaluation for inclusion on three national EBP registry lists in the United States: the Substance Abuse and Mental Health Services Administration (SAMHSA), What Works Clearinghouse (WWC), and Office of Juvenile Justice and Delinquency Prevention (OJJDP). Results of our submission found SFBT was not reviewed by SAMHSA and WWC because it was not prioritized highly enough for review, but it was rated as "promising" by OJJDP. Implications for practitioners and recommendations regarding the status of SFBT as an EBP model are discussed.
... SFBT significantly reduced family burden and expressed emotion in one study of families including members with diagnosed schizophrenia (Chung & Yang, 2004), and in another study significantly improved family environment and outperformed medication as an alternative treatment (Eakes et al., 1997). A multiple baseline study of three parents of children with autism spectrum disorder suggested that SFBT led to reduced parental stress (Kenney, 2010). ...
Objective: We review all available controlled outcome studies of solution-focused brief therapy (SFBT) to evaluate evidence of its effectiveness. Method: Forty-three studies were located and key data abstracted on problem, setting, SFBT intervention, design characteristics, and outcomes. Results: Thirty-two (74%) of the studies reported significant positive benefit from SFBT; 10 (23%) reported positive trends. The strongest evidence of effectiveness came in the treatment of depression in adults where four separate studies found SFBT to be comparable to well-established alternative treatments. Three studies examined length of treatment and all found SFBT used fewer sessions than alternative therapies. Conclusion: The studies reviewed provide strong evidence that SFBT is an effective treatment for a wide variety of behavioral and psychological outcomes and, in addition, it may be briefer and therefore less costly than alternative approaches.
... See Table 3 for the effect sizes ranked from highest to lowest. Using Cohen's (1977) standard for evaluating effect sizes (0.2 small, 0.5 moderate and above 0.8 strong), two studies had strong effect sizes (Cockburn et al., 1997;Rhee et al., (Lindforss and Magnusson, 1997 at follow-up;Springer et al., 2000;Zimmerman et al., 1996) and one had a small effect size (Eakes et al., 1997). The remaining four studies had negligible effect sizes (less than 0.2) according to Cohen's (1977) criteria. ...
Solution-focused therapy is a strengths-based approach, emphasizing the resources people invariably possess and how these can be applied to the change process. A review was undertaken on the treatment outcome research involving solution-focused therapy to determine empirically its effectiveness. The review involved experimental or quasi-experimental designs conducted from 1985 to 2006 and was limited to published studies written in the English language. Subject, intervention and methodological information on studies were collected, as well as statistical information necessary to calculate effect sizes. After searching the literature, ten studies were located and described. No particular characteristics emerged regarding studies with high versus low effect sizes. Implications for research are advanced based on the review, especially related to social work practice.
... Other studies have examined the effectiveness of SFT with a variety of client problems (DeJong & Berg, 1998), with different client populations (de Shazer & Isebaert, 1997;Eakes, Walsh, Markowski, Cain, & Swanson, 1997), and in a variety of settings (LaFountain, Garner, & Eliason, 1996;Zimmerman, Jacobson, MacIntyre, & Watson, 1996;Cockburn, Thomas, & Cockburn, 1997;Lindforss & Magnusson, 1997;Schorr, 1997;Zimmermann, Prest, & Wetzel, 1997). Varying results have been produced by studies with SFT. ...
This study attempts to investigate the use of one of the postmodern family therapy theories, solution-focused brief therapy (SFBT) in the medical setting. Although SFBT is being widely used in medical settings, a thorough theoretical investigation about its suitability to this area has not been presented. In order to discuss the use of SFBT in the expanding practice of medical family therapy (MedFT), the underpinnings of MedFT and SFBT are examined, in addition to the integrative potential of SFBT with the dominant theoretical perspectives guiding MedFT, as well as SFBT’s suitability to the medical setting based on the requirements Doherty and Baird suggested. Challenging features of implementing SFBT in medical settings are noted, along with relevant suggestions to resolve these obstacles.
Doing What Works in Brief Therapy first published in 1996, covering the development, theory, and techniques of the strategic solution focused approach. Since then, usage of brief therapy has increased dramatically among practicing psychotherapists, and the need for a book describing how to perform effective brief therapy is stronger than ever. While health care administrators like treatment brevity for cost containment, the beauty of this approach is that brevity occurs naturally while interventions are constructed flexibly. As before, the audience for this work is the practicing psychotherapist. For beginning therapists, the book describes how to perform brief therapy and includes a multitude of clinical examples. Experienced clinicians will be interested in the discussions of balancing client needs for change and acceptance/stability, speaking the client's language, and dealing with uncertainty and life dilemmas.
Objective
This study examined the effectiveness of solution-focused brief therapy (SFBT) intervention on substance abuse and trauma-related problems.
Methods
A randomized controlled trial design was used to evaluate the effectiveness of SFBT in primary substance use treatment services for child welfare involved parents in outpatient treatment for substance use disorders. Mixed linear models were used to test within- and between-group changes using intent-to-treat analysis ( N = 64). Hedges’s g effect sizes were also calculated to examine magnitude of treatment effects.
Results
Both groups decreased on the Addiction Severity Index-Self-Report and the Trauma Symptom Checklist-40. The between group effect sizes were not statistically significant on either measures, thus SFBT produced similar results as the research supported treatments the control group received.
Conclusion
Results support the use of SFBT in treating substance use and trauma and provide an alternative approach that is more strengths based and less problem focused.
In a critique of solution-focused brief therapy (SFBT), Stalker ct al. (1999) emphasized the lack of empirical evidence to support claims of the model's superior effectiveness relative to other treatment models. In a letter to the editor, Ginger ich challenged this conclusion. He alluded to 14 controlled outcome studies in the literature that provided support for the effectiveness of the model. In this reply to Gingerich, the issue of the empirical base for claims about the effectiveness of SFBT is revisited and it is argued that there is no basis to alter the conclusions reached in Stalker et al. (1999).
This second edition of Solution-focused Therapy remains the most accessible yet comprehensive case-based introduction to the history, theory, research and practice of solution-focused therapy (SFT) within mental health care and beyond. Drawing on contemporary research and the author's own extensive experience, the fully revised and updated new edition includes: discussion of recent developments relevant to research and training; a new chapter on challenges to SFT and the integration of SFT with other therapeutic approaches; extended discussion on ethical issues; topical exploration of the application of SFT with patients with personality disorders and dementias; contemporary research on solution-focused coaching and approaches to organizational change; new case material This highly practical guide should be on the desk of every student or trainee studying this strongly supported, growing approach. It is also a useful resource for practitioners wanting to update their core skills and knowledge.
This chapter presents an overview to the general structure of solutionfocused brief therapy (SFBT). The chapter inludes an overview, description, and rationale for SFBT, explanation of goals and goal setting in SFBT, a description of how SFBT is contrasted with other treatments, a look at specific active ingredients and therapist behaviors in SFBT, and a discussion on the nature of the client-therapist relationship in SFBT. The chapter also looks at format, session format and content; compatibility with adjunctive therapies; the target population; meeting the needs of special populations; therapist characteristics and requirements; and therapist training and supervision.
This chapter discusses the development and use of strengths-based instruments in the field of psychotherapy. It begins by summarizing the positive psychology movement and how it has set the stage for strengthsbased instruments. Next, the chapter presents an overview of strengthsbased assessments, including their psychometric properties. Published research studies using strengths-based assessments is also covered. The chapter concludes by discussing how strengths-based instruments can and should be used in SFBT research, as well as specific suggestions for implementation.
Solution-Focused Substance Abuse Treatment describes the standard of care for substance abuse treatment, demonstrates how solution-focused brief therapy exceeds this standard, and shows how it can effectively be used in substance abuse evaluation, case management, and both individual and group treatment. Beginning and advanced concepts are provided to address the questions of even the most advanced clinician, all placed in the context of cultural awareness.
This chapter reviews the development of SFBT outcome research chronologically, beginning with the first compilation of outcome studies by the European Brief Therapy Association (EBTA) described by Macdonald. It then discusses the first systematic review of controlled SFBT outcome studies published by Gingerich and Eisengart, followed by the meta-analytic reviews of Stams et al. and Kim. Finally, it reviews several important studies that have appeared since the meta-analyses and concludes with a summary of SFBT outcome research to date.
Solution-focused brief therapy (SFBT) is an evidenced-based, collaborative, strengths-based model developed in the 1980s by Steve de Shazer and Insoo Kim Berg and is now in use as an organizing treatment approach all over the world. This article examines the use of SFBT in family therapy. The history of SFBT, the major tenets as applied to family therapy, and the research in SFBT and SFBT for families are discussed.
Solution-focused brief therapy is a relatively new approach for Child and Adolescent Mental Health Services in the UK. While the approach lacks the support of outcome studies compared with more conventional approaches, it is argued that the model does offer some specific advantages, and relates well to the range of problems which present and the manner in which many clients use the service. An outline of the approach is provided, along with an overview of research and comments on contraindications. A variety of clinical examples is used to illustrate how the approach works in practice. Concluding comments question the manner in which new approaches gain acceptance.
Objective: A meta-analysis was conducted to evaluate the effectiveness of solution-focused brief therapy (SFBT). Method: Hierarchical linear modeling software was used to synthesize the primary studies to calculate an overall effect size estimate and test for between-study variability. Results: Solution-focused brief therapy demonstrated small but positive treatment effects favoring SFBT group on the outcome measures (d = 0.13 to 0.26). Only the magnitude of the effect for internalizing behavior problems was statistically significant at the p < .05 level, thereby indicating that the treatment effect for SFBT group is different than the control group. Conclusions: This study allows social workers interested in solution-focused brief therapy to examine the empirical evidence quickly and with more definitive information.
The data from 277 cases, 140 males and 137 females, from the case load of a clinical psychologist, with over ten years experience who used future oriented solution focused therapy was analyzed with re-gard to clinical variables that are related to the number of sessions attended and the degree of problem resolution. The number of presenting problems, number of stressors, and taking medications were found to be predictive of attending more sessions. Poorer functioning at intake and greater number of late cancels were predictive of poorer problem resolution, accounting for 18.7% of the variance. Those persons presenting with affective disorders attended an average of 4.14 sessions, with 60.9% partially or mostly resolving their presenting problem. Those who presented with non-affective/relationship problems attended an average of 2.34 sessions, with 76% partially or mostly resolving their presenting problem. This study, using a substantially greater data base than Lambert, Okiishi, Finch, & Johnson (1998), found similar percentages of symptom reduction with a relatively low average number of sessions that would fit within most managed health care session allotments and within many employee assistance program benefit caps.
Doing What Works, an up to five-session solution-focused therapy group for adult psychiatric outpatients, blends solution-focused methods, group process, and psychoeducation about solution-focused principles. Quantitative and qualitative data were analyzed for 108 participants who attended the group. As hypothesized, self-rated “control of the problem” increased after participation. In addition, participants who attended more of the five sessions reported more change. Qualitative analysis of subjects' written comments suggested that amplification of small behaviors, social interaction, acceptance, and the “doing what works philosophy” were perceived by group members as “ingredients of change.”
The national standard for addiction counselors is to view substance abuse as a disease (National Association of Alcoholism and Drug Abuse Counselors, 1996). Addiction is viewed as a lifelong affliction that is progressive and requires years of therapeutic intervention coupled with active participation in a 12-step oriented support group. It is a model in which the therapist is the expert. The purpose of this article is not to challenge the effectiveness of this model. Instead, it is to explore an alternative approach in which solutions are co-created by the client and the counselor. This article presents an innovative and empowering counseling approach for substance abuse treatment. An emphasis on the application of this model to the child welfare population is included to demonstrate its impact.
This preliminary study investigated the use of Solution-Focused Brief Therapy (SFBT) with older adults in Mexico. The three session SFBT treatment focused on a self-defined problem, such as relationship issues or psychological well-being. Compared with a waiting list control group, the treatment group showed significant posttest improvements as indicated by the Outcome Questionnaire, the participant and an independent assessor. There was a significant difference between groups on participants' perception of goal achievement and in pre-post change during therapy on the Outcome Questionnaire. This study provides preliminary tentative support for the use of SFBT with the geriatric population in Mexico.
The purpose of this article is to describe the use of solution-focused brief therapy (SFBT) as an approach to sex therapy. SFBT has been used to treat most clinical problems and populations, but until now has not been offered as an approach to sexual problems. This article describes SFBT and discusses its applications to sex therapy. A case example is included.
Solution-focussed brief therapy (SFBT) is a prominent psychotherapeutic approach that deals with a positive focus and promises brief interventions. In two experiments, a solution-focussed technique was compared with a problem-focussed intervention. By means of a structured questionnaire, subjects were encouraged to think about a standard (Experiment 1) or a facultative topic (Experiment 2). Subsequently, they generated either one or five exceptions or exemplary problem episodes. Dependent variables were confident in coping with the problem, ease of retrieval, psychic comfort and several phenomenological properties of the autobiographical memory. A solution-oriented intervention increased self-confidence and established a positive mood. Exception times had a more positive tone and were generally more easily retrieved than problem episodes.The study confirms the claims of the SFBT for empowerment and rapid reduction of current suffering. Copyright © 2009 John Wiley & Sons, Ltd.
Solution-focused brief therapy (SFBT) is a new and increasingly used therapeutic approach that focuses on helping clients construct solutions rather than solve problems. The approach evolved in a clinical context amid many anecdotal reports of success from both therapists and clients, but it has not been subjected to controlled empirical testing until very recently. In this article we critically review all of the controlled outcome studies of SFBT to date (N = 15) to assess the extent to which SFBT has received empirical support. Five studies were well-controlled and all showed positive outcomes—four found SFBT to be better than no treatment or standard institutional services, and one found SFBT to be comparable to a known intervention: Interpersonal Psychotherapy for Depression (IPT). Findings from the remaining 10 studies, which we consider moderately or poorly controlled, were consistent with a hypothesis of SFBT effectiveness. We conclude that the 15 studies provide preliminary support for the efficacy of SFBT but do not permit a definitive conclusion. Our critique highlights areas where methodology in future studies can be strengthened to provide more conclusive evidence of SFBT efficacy.
The efficacy of Solution-Focused Family Therapy (SFFT) for helping three families with aggressive and oppositional-acting children (aged 8-9) was examined. The N = 1 multiple-baseline design with three replications used validated measures, a treatment manual, and a treatment integrity measure. The interventions lasted from four to five sessions. SFFT appeared to be effective with the families at post-treatment and 3-month follow up.
Steve de Shazer who, along with Insoo Kim Berg, co-founded the Solution-Focused Brief Therapy (SFBT) approach, recently passed away. In this article we will offer a brief biographical sketch and then discuss the current state of the art of SFBT as it applies to practice, training, and research. Future directions for SFBT, such as the emergence of professional associations, the increased research interest in SFBT as evidenced-based practice, the recent focus on process-research to determine the mechanisms of change within SFBT, and the application of SFBT to education are discussed.
Discusses the stresses and burdens on families of mentally ill (MI) individuals, including stigmatization, and problems in dealing with mental health (MH) professionals. Converging historical events, new biogenetic research findings; widening recognition of the dimensions of family burden; deinstitutionalization, have led to a reconceptualization of the family role. The growth and influence of the National Alliance for the Mentally Ill have also been part of the historical process and have contributed to the new respect for families of MI individuals. The new and collaborative model of clinician–family relationships has done much to destigmatize families, to reorient the thinking of many MH professionals, and to alleviate the burden of families of MI individuals.
This book presents a respectful, often playful approach to serious problems, with groundbreaking theory as a backdrop. The authors start with the assumption that people experience problems when the stories of their lives, as they or others have invented them, do not sufficiently represent their lived experience. In this way narrative comes to play a central role in therapy.
BACKGROUND: Chronic sorrow was described by Olshansky (1962) to explain a perva sive, psychologic reaction that he observed in parents of mentally retarded children. He believed that the sorrow was a normal, not a neurotic, response to their situation and relatedly, thought clinicians would intervene differently with these parents if they held a similar belief. The Nursing Consortium for Research on Chronic Sorrow (NCRCS), of which the authors are members, has conducted multiple studies to ex pand the understanding of chronic sorrow as a normal state associated with chronic or life-threatening conditions, occurring both in the individual with the condition and in family members. These NCRCS investigators have provided evidence supporting the premise that chronic sorrow is likely to occur in various chronic situations. OBJECTIVES: This study explored whether women with chronically mentally disabled husbands experienced feelings of chronic sorrow in their lives.
DESIGN: Using content analysis, the transcriptsfrom interviews with 11 women were coded using the Burke/NCRCS Chronic Sorrow Questionnaire (Caregiver version) as a guide. RESULTS: All 11 women experienced feelings of chronic sorrow. Feelings of chronic sor row occurred periodically over an extended time when some event reminded partici pants of their long-term situation. Subjects identified personal strategies for coping with feelings of chronic sorrow and nursing activities that had been helpful to them. CONCLUSIONS: The findings of this study are consistent with those of other studies on chronic sorrow. Subjects identified the role of the nurse as teacher/expert as most important for helping women with chronic sorrow, specifically by providing them with knowledge that is current and specific. From these findings, interventions can be developed to increase the psychologic comfort of these caregivers. (J AM PSYCHIATR NURSES Assoc [1995]. 1, 120-124)
What happens when the barriers between therapists and clients are removed, when they all participate in a dialogue about change, and when therapists and clients even trade places?
Operating within the reflecting team format, professionals meet clients without preexisting hypotheses. Together they engage in a conversation that becomes a search for the not-yet-seen and the not-yet-thought-of, as well as for alternative understandings of what has been defined as problematic. As clients and therapists trade places and various members of the entire group participate in conversations, the possibilities for change open wide.
This book describes the evolution of this radical strategy in Tromsø, Norway, and its adaptation by various family therapists in the United States. It begins in Part I with a description of the setting in which the reflecting team developed and its history and evolution. Then basic concepts, practical considerations, and guidelines for practice are detailed.
Part II contains Dialogues About the Dialogues, that is, reflections on the client-therapist-consultant-team dialogues that distinguish this innovative approach to therapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
How do solutions develop? This question leads de Shazer to a provocative discussion of all the solution-related things that client and therapist do during a session, which ultimately points to a task that says, "Now that you know what works, do more of it."
An innovation is de Shazer's computer analysis of therapy sessions, which provides a map for analyzing situations and finding solutions. Pieces of the computer program are highlighted with individual cases, enabling the reader to move easily from the map to the territory and back again.
Both theoretically stimulating and clinically sound, de Shazer's investigation turns up clues with the potential to revolutionize the way psychotherapy is thought about and practiced. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This book is for those who "work in the trenches" of child welfare and family services. . . . By applying the principles of brief, solution-focused therapy to family-based services, social service workers can deliver treatment that is cost-effective, humane and empowering to families.
For professionals unfamiliar with the theory and concepts of brief therapy, Berg describes the process in a step-by-step fashion.
Case examples illustrate different techniques, and sample assessment forms are included. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The notions developed from viewing therapy as a conversation, as an activity involving two or more people, serve to counter-balance the traditional, dictionary meanings of the word "therapy" which . . . mislead us into thinking of the therapist as operating upon the patient or client.
Seeing therapy as a conversation seems to be a useful contradiction-in-terms, in that it leads us into seeing the "doing of therapy" and the "using" of the term "therapy" in ways that undermine and contaminate the usual dictionary definitions of "therapy." (PsycINFO Database Record (c) 2012 APA, all rights reserved)
There are three principal sections to this book. This first section is an introduction that provides the theoretical and political frame for the material presented in the other two sections.
In this first section, I have presented an overview of some of the more recent developments in social theory that David and I have found of compelling interest, and some of what we believe to be the implications of those ideas for therapy. The discussion of theory includes some of Michel Foucault's thought on power and knowledge.
It is our hope that the material that we have included in this book adequately reflects our exploration of practices of the literate tradition in a therapy that is situated in the text analogy and in Foucault's thought, and fairly represents the experience of these practices on behalf of those persons who have sought therapy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Incluye bibliografía e índice
After a brief inpatient hospitalization, 104 acute, young schizophrenics, stratified by premorbid adjustment, were randomly assigned to one of four aftercare conditions for a six-week controlled trial. Conditions involved one of two dose levels of fluphenazine enanthate (1 ml or 0.25 ml) and presence or absence of crisis-oriented family therapy. Relapses during the six-week period and at six-month follow-up were least in patients who received both high-dose and family therapy (0%) and greatest (48%) in the low-dose-no therapy group. Brief Psychiatric Rating Scale symptom ratings disclosed a significant family therapy effect at six weeks that was sustained at six months only for therapy patients originally receiving the high drug dose. Numerous interactions were found between premorbid adjustment status and response to the two treatment conditions.
living with a chronically ill schizophrenic can place great stress on individual family members and the family unit
Regardless of whether the onset of mental illness is insidious or acute, a psychotic episode creates a condition of disaster in a patient's family.
More than one-third of long-term mentally ill adults live with their families, most with aging parents, a situation that accentuates the need for residential alternatives to home care for deinstitutionalized patients who will out-live their caregivers. The role of parenting mentally disabled adults may also impose undue stress on elderly persons. Objective and subjective parental burden, including fears for the patient's future, are increased by the mental health system's failure to offer education, support, training in problem solving, and a collaborative role in discharge planning to family members. Social policy implications of considering families as primary caregivers include the danger that government will be relieved of responsibility for care of the mentally ill, the creation of a potentially at-risk population among aging parents and other family members affected by the stresses of caregiving, and the reduction of the patient's potential for independent living.
This article describes the form of brief therapy developed at the Brief Family Therapy Center. We have chosen a title similar to Weakland, Fisch, Watzlawick, and Bodin's classic paper, "Brief Therapy: Focused Problem Resolution" (20) to emphasize our view that there is a conceptual relationship and a developmental connection between the points of view expressed in the two papers.
Earlier studies of family psychoeducation and clinical reports on multiple family groups (MFGs) have reported substantial reductions in relapse rates for patients with schizophrenia. These groups offer an expanded social network and thereby may confer a margin of protection against relapse. However, to date, there has not been an empirical trial of this modality. The advent of family psychoeducational and behavioral management strategies provided the basis for an experimental, three-way comparison of psychoeducational MFGs to psychoeducation in a single-family format and to MFGs without psychoeducation, using symptomatic relapse as the outcome criterion. After 4 years, the psychoeducational MFGs were significantly more effective in extending remission than the single-family format, while the MFGs without psychoeducation approximated outcome in the psychoeducational MFGs. The respective relapse rates at 4 years were 50%, 78%, and 57%; MFGs averaged 12.5% and 14% per year. These results point toward an enhanced and independent, long-term therapeutic effect for multiple family groups, when combined with antipsychotic medication and psychoeducation, with especially promising cost-effectiveness.
This study investigated the incidence of chronic sorrow in parents of chronically mentally ill children. A convenience sample of 10 parents (four couples and two mothers) of adult children diagnosed with either schizophrenia or bipolar disorders were interviewed using the Burke/NCRCS Chronic Sorrow questionnaire (Caregiver Version). Findings showed that 8 out of 10 parents experienced chronic sorrow. These grief-related feelings were most often triggered by the unending caregiving responsibilities parents described. Those who evidenced chronic sorrow indicated that healthcare professionals could assist them by providing information about their child's illness and by involving them in the treatment process.
The multi-ple family group and psychoeducation in the treatment of schizophrenia: four year outcome in a small sample
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