Solution Focused Brief Therapy to address “underlying issues”

One of the most commonly asked questions about the Solution Focused Approach is, “how does this approach work with “deep seeded” or “underlying” issues. This stems from one of the biggest hesitations in using this approach being the fear of missing the route cause of a problem or overlooking key details about the origins of a problem allowing the client to potentially not experience benefit from therapy.

When I was first introduced to this way of working with clients I had the same concern. Even though what I was reading about this approach was resonating with me deeply, I recall thinking, “how can you solve a problem that you are not talking about.” It wasn’t until I saw my mentors working first hand with clients that came into therapy with the most serious problems imaginable did my perspective begin to shift. I observed one such master while sitting in an observation team, watching live therapy with this master working with clients after client all of which in deeply troubling situations.

If you understand to be SFBT as an approach that is simply about avoiding talking about a problem then wondering how it works to help clients with “serious” problems is reasonable. However, this approach is much more than that. It is about having a conversation about what the client wants and asking questions that elicit a detailed and rich description of what their lives would look like if what they wanted became their reality.

Each and every time I watched my mentor open a session with one of his clients he asked the same question “what are your best hopes from our talk today”? He worked, sometimes it was quite challengingly, until each client had identified a desired outcome from therapy. Each client, regardless of the problem that brought them to therapy, he first worked to figure out what outcome they wanted. He then engaged each and every client, regardless of problem, into a detailed conversation about the presence of their desired outcome.

I was amazed, that was the day I realized that this approach is truly not about working with a client to solve a problem or develop a problem strategy. This is an approach about trust. Trust that the client truly knows what’s best for them and has the ability to make the requisite changes in their lives even if they are facing seemingly insurmountable problems.

In graduate school I learned about therapy from wonderful professors. However, it was clients, those I observed and others I worked with, that truly taught me to how to be a therapist. As I watched clients answer the questions in session and make changes immediately in their lives to drastically improve their situations I could not avoid the realization that therapy is about their abilities, not mine.

In school I learned to conduct assessments, develop treatment plans and help clients to solve problems. However, the most important lesson came after school was completed, I learned that I had to trust a person’s ability to change in order to be effective, and make sure to never lose that faith in a person, even if what brought them to therapy seemed to be a bit daunting. So how do we work with people who have seemingly deep seeded issues, people with deep problems? The same as we work with other clients, start with identifying a desired outcome from therapy and elicit a detailed description of the outcome. In essence, we trust them.

Note: There is a large amount of research supporting the use of this approach with many different client populations in many different settings. To view this research visit www.solutionfocusedbrieftherapy.com