SFBT Beyond the First Session

Among the most common questions about the Solution Focused Approach are those regarding how to conduct sessions after the first meeting. These questions usually come in 2 forms. The first is pragmatically about how to conduct sessions beyond the first session. The second is about the length of the therapy itself, as many people assume the Solution Focused Approach MUST end in one or two sessions and often wonder how this approach works in “long term” treatment. In this blog post I will share my thoughts on both of these topics and address each concern.

Let’s start with the pragmatic question of how to conduct sessions beyond the first meeting. I’ll start by saying that in SFBT there are 2 types of sessions; there are first sessions, and then there are all of the rest of them, which are called follow up sessions. When conducting follow up sessions, the process is not that much different than first sessions with the exception of a few adjustments. In first sessions we usually start the session by asking a question that establishes a direction for the conversation (best hopes), then we engage in a bit of resource talk (exceptions), then the preferred future description (miracle/tomorrow question), followed by the end of the session (closing). If you have seen some of my training videos or attended any of my events then you are aware that I refer to each stage as a “room in the Solution Focused Museum” (thanks to Chris Iveson for that metaphor). This is the normal flow of a first session.

Well follow up sessions are conducted very similarly with just a few changes. First, instead of starting by establishing a destination for the therapy, we begin the follow up session with the assumption of progress and start out with a question that begins to highlight the assumed progress. Follow up sessions are usually opened by the therapist asking, “what’s been even just a bit better?”. Another difference is that we are much more likely to ask a scaling question in a follow up session. For example, “after the week you’ve just had, where would you say you were on a scale of 0-10 where 10 is your best hopes being present all week and 0 being that they never appeared at all?”. I recently made a short video explaining this process in more detail. CLICK HERE to view it.

Now on to the other question. Many people assume that because of the presence of the word “Brief” in the name Solution Focused BRIEF Therapy that the therapy must end after just one or two sessions. This is not necessarily true. The origin of the word brief tracks back to the Mental Research Institute in Palo Alto, CA and simply means that the client is in charge of the termination of therapy. In essence, therapy ends when the client reports they have accomplished their goals. This means that if the client has accomplished their goal in 1 session, then we shall not schedule a second; if they say their goals have been accomplished in the 25th session then we shall not schedule a 26th. Just remember, sessions two and beyond are conducted as follow up sessions as illustrated above and in the video.

Hope this shines some light on a common query about SFBT.

Elliott