How Does SFBT Work with Serious Problems?

One of the things that we, as a Solution Focused community have had a difficult time explaining, and I think this goes back historically, is how do you use the Solution Focused approach with clients who are struggling with real significance, and really impactful mental issues. And people ask me all of the time, like Elliott, what do you do with someone who is very, very, very depressed? Or what do you do with someone who is like very, very, very anxious? Or what do you do with someone who’s really, really struggling with like, whatever issue it may be?

Because I think we fear that if you’re doing Solution Focused Brief Therapy, you’re inherently ignoring the problem and thus not addressing the issue that the client has brought to you. And in some cases, the issue that the client has brought to you is significant, it is severe, and it is having a dynamic impact on their lives in a negative way. So how do you use the Solution Focused approach in a way that impacts them? That’s actually a very difficult concept to explain. And as a field, I’m not sure we’ve done a really good job of explaining it.

And this past weekend I was on a plane actually. And I was sitting and thinking about this concept. Someone had asked me this question while I was out in LA. And I was just thinking, how do I make this clear? How do I make this clear? And then this thought came to me that I want to express to you now because I think it makes it clearer than we’ve ever made it before. And here it is.

Now, whenever you have someone that has been struggling with something significant, and let’s just say for the case of this example, depression, now, I’m going, to be honest with you. I have had depression. I struggled with depression sometimes in my life currently. And there’ve been times in my life when the depression was so significant that it took every fiber of my being.

I had to call on every molecule of strength inside of me just to get up and get dressed. So when someone is like super, super, super depressed, they are simultaneously equal parts strong. So if you say like, what do you do with someone that’s super-duper, duper, duper depressed, then that means they are super duper, duper, duper strong.

Because it takes that level of strength to live a life with that difficulty. So how do you use Solution Focused Brief Therapy with someone who is struggling with that level of impact from a negative symptom? You have to acknowledge the strength in that person and make sure your questions evoke that strength to come alive. You have to remember that every single person that’s carrying a heavyweight, they’re carrying it like strength, like a muscle, like a resiliency that’s allowing them to carry that heavy strength.

And you have to talk to them in a very specific way to awaken that part of them. So for example, if someone says, you know, I’ve got serious depression, I can’t get out of bed. I want you to ask them, how did you manage to get out of bed today, wake up and get dressed and find your way into my therapy office? That’s going to wake them up a bit. That’s going to remind them that it wasn’t by coincidence that I got up and got dressed. It wasn’t by coincidence that I got to this therapist’s office. It was actually by me calling upon and drawing upon my strength.

Like clients, struggles are not to be run from when you’re using Solution Focused Brief Therapy. Solution Focused does not mean problem phobic. So if my client brings up the problem, I’m going to run from it. And I’m not supposed to talk about it because I do Solution Focused Therapy. Problems coming up the therapy office is your opportunity to remind your client how strong they are inherently and all of the things that they have accomplished in spite of their struggles.

And if they can become more aware of that strength that has allowed them to accomplish things in spite of their struggle, then it’s not that difficult to them to imagine themselves accomplishing that much more. It’s not that difficult for them to imagine and take one more step further. It’s not that difficult for them to imagine themselves going a bit beyond and living a life where they have taken over the problem and become their best selves.

I think people fear like Solution Focused Brief Therapy, can I solve the client’s problem? I’ll be honest with you. I don’t know if you can solve the client’s problem, but that is not actually the point. The point is, can we make it so the client’s problem is no longer running their lives. Instead, the client’s strength is running their lives.

And when you’re doing that, then the client is going to have a different existence and the therapy will be highly, highly effective. So how do you Solution Focused Brief Therapy with someone who’s struggling with severe mental health issues? By remembering that if they have severe mental health issues, that means they have an equal level of significant strength. And it’s our job to ask questions that call upon that. So the client can live their lives from their strengths and not their problem.

For more information on Solution Focused Brief Therapy, and for more inspiration for you in your life. Follow me on Instagram, Facebook, and Twitter @elliottspeaks.