What Is Solution Focused Brief Therapy (SFBT)?

Solution-focused brief therapy is a goal-oriented, collaborative approach that focuses on identifying and building upon a person’s existing strengths and resources to create practical solutions for their current concerns.

What is Solution-Focused Therapy?

Solution-Focused Brief Therapy (SFBT), also referred to as Solution-Focused Therapy (SFT), is a form of psychotherapy or counseling.

This form of therapy focuses on solutions to problems or issues and discovering the resources and strengths a person has rather than focusing on the problem like more traditional talking therapies do.

SFBT does not analyse how a problem arose or what it means. Instead, it concentrates on the issue in the here and now, and how to move forward with a solution (De Shazer, 1988; De Shazer & Dolan, 2012).

Origins of Solution-Focused Therapy

Solution-Focused Therapy was created in the late 1970s and early 1980s at the Brief Family Therapy Center in Milwaukee, by De Shazer and Berg (De Shazer et al. 1986).

De Shazer and Berg noticed that clients often talked about their problems without recognising their own resources for solving them.

They also noticed something else: the problems were not constant. Clients had moments, even brief ones, when they functioned without the problem being there at all.

Exploring these exceptions, De Shazer and colleagues concluded, was more useful clinically than a detailed history of the problem itself (Iveson, 2002).

What is Solution-Focused Therapy used for?

Solution-Focused Therapy is currently used for most emotional and mental health problems that other forms of counseling are used to treat, such as:

• Depression
• Anxiety
• Self-esteem
• Personal stress and work-related stress
• Substance abuse/ addiction
• Relationship problems

SFBT is best used when a client is trying to reach a particular goal or overcome a particular problem.

SFBT is not recommended as a stand-alone treatment for major psychiatric conditions such as psychosis or schizophrenia. It can still be used alongside a more suitable psychiatric treatment to help alleviate stress and build awareness of a person’s strengths and internal resources.

Research has shown that after a one-year follow-up, SFBT was effective in reducing depression, anxiety, and mood-related disorders in adults (Maljanen, et al., 2012).

A study on substance abuse in adults showed SFBT to be just as effective as other talking therapies in treating addiction. It reduced addiction severity and trauma symptoms by a similar amount (Kim, Brook, & Akin, 2018). The evidence spans many settings.

A systematic review found SFBT generally effective for children’s behavioural and emotional difficulties, especially as early intervention, though many underlying studies had real methodological limits (Bond et al., 2013).

A more recent meta-analysis confirmed a small-to-moderate benefit for child and adolescent behaviour problems, with no clear evidence that involving family members changed the result (Hsu et al., 2021).

SFBT has also moved into medical and primary-care settings. It does not require a lengthy assessment before treatment can begin, which suits services where psychosocial support has to run alongside physical treatment.

A systematic review and meta-analysis of randomised trials found a small-to-moderate benefit for outcomes like depression and adjustment to illness (Zhang et al., 2018).

Effects on measured physical outcomes were less consistent.

Solution-focused questioning has even moved into workplace and life coaching.

One pilot study compared solution-focused coaching questions against problem-focused ones and found the solution-focused version produced bigger gains in positive affect, self-efficacy, and goal-approach motivation (Grant & O’Connor, 2010). That result isolates the type of question itself as an active ingredient, separate from the wider coaching relationship.

Solution-Focused Therapy Techniques

In a solution-focused therapy session, the practitioner and client collaborate to set goals and find solutions together.

The practitioner asks questions that help the client recognise strengths and inner resources they had not noticed before.

The practitioner also uses complimentary language to highlight the client’s existing strengths. This builds a solution-focused outlook.

Sessions usually last 50–90 minutes, though brief 15–20 minute sessions are possible. Most run weekly for 6–12 weeks, but a single stand-alone session is also common.

SFBT keeps the client focused on solutions.

These techniques include the miracle question, coping questions, exceptions to the problem, compliments, and scaling, each explained below.

1. The Miracle Question

This is where the practitioner will ask the client to imagine that they have gone to sleep and when they wake up in the morning, their problems have vanished.

After this visualization, they will ask the client how they know that the problems or issues have gone and what is in particular that is different.

For example:

‘Imagine that when you next go to sleep, a miracle occurs during the night, so that when you wake up feeling refreshed, your problem has vanished. I want to ask you how do you know that your problem has gone? What is different about this morning? What is it that has disappeared or changed in your life?’

This question helps the client identify and understand the problem, and how it affects them. Imagining life without it can motivate them to move forward and overcome it (De Shazer et al., 1986).

2. Coping Questions

Coping questions are questions that the practitioner will use to gain an understanding of how the person has managed to cope.

Someone who has been suffering from depression or anxiety for a long time faces real strain. Coping questions ask how they have kept going despite the potentially degrading or depleting effects of such problems.

Examples of coping questions include:

• ‘After everything you have been through, I am wondering what has helped you to cope and keep you afloat during all this?’
• ‘I feel to ask you, what it is exactly that has helped you through this so far?’

These questions cause the client to identify the resources they have available to them, including noticing the internal strength that has helped them make it thus far, which they might not have been consciously aware of before (De Shazer et al., 1986).

3. Exceptions to the Problems

Solution-focused therapy assumes that exceptions exist: moments when the problem is absent, or present but causes no real harm (De Shazer et al., 1986). These exceptions matter.

The practitioner explores what was different during these moments. They ask the client to recall a specific time when the problem was not a problem, then investigate what made that moment different.

These clues can point toward a solution. Knowing the problem is not constant can also lessen its emotional grip.

People can feel consumed or ‘clouded’ by their problems. Noticing the times they were not can feel empowering.

4. Compliments

This involves the practitioner listening closely for the client’s strengths and achievements, then reflecting them back. It also validates how hard things have been.

This offers encouragement and values the strengths that the client does have.

The practitioner uses direct compliments, responding explicitly to something the client has said, for example, ‘that’s amazing to hear!’, ‘wow, that’s great.’

Indirect compliments are embedded in the practitioner’s own questions, such as asking ‘how did you manage that?’ in a tone of genuine curiosity. The credit lands without being stated outright.

5. Scales

The practitioner will ask the client to rate the severity of their problem or issue on a scale from 1-10. This helps both the practitioner and client to visualize whereabouts they are with the problem or issue.

Examples of scaling questions include:

• ‘On a scale of 1 to 10, where would you rate your current ability to achieve this goal?’;
• ‘From 1-10, how would you rate your progress towards finding a job?’;
• ‘Can you rate your current level of happiness from 1-10?’;
• ‘From 1-10, how much do you attribute your level of alcohol consumption to be one of the main obstacles or sources of conflict in your marriage?’.

Scaling questions can be used throughout sessions to track progress from the first session onward. They also show how close a client is to their ideal outcome or goal.

This helps both practitioner and client see what is left to reach a 9 or 10, and where to focus next.

Scaling gives clarity on the client’s feelings. It also gives sessions direction and shows whether something is still holding the client back.

Critical Evaluation

Advantages

• Short-Term: SFBT sessions typically run 6-10 weeks, or even one stand-alone session, making it more cost-effective than longer-term therapies (Maljanen et al. 2012).
• Builds Motivation: Identifying a goal and receiving compliments helps clients notice their strengths, boosting self-esteem and motivation to keep going.
• Future-Oriented: SFBT motivates clients to move forward rather than feel stuck in the past, and its positive framing gives clients optimism.
• Non-Judgmental: Clients choose their own goals and are praised for their strengths regardless of outcome, helping them stay encouraged even after setbacks.

Disadvantages

• Not for Everyone: SFBT’s brevity does not suit clients with more severe problems, or clients who need more time to build trust before working toward a solution.
• Less Room for the Past: Trauma and past events get less exploration time, which can leave some clients feeling their pain went unheard.
• Client-Led Limits: SFBT needs the client ready to focus forward, so it is hard to use with someone who wants to process past trauma in depth first.
• Early Endings: Clients decide when their goals are met and can end sessions early, even if the practitioner still has concerns.
• A Feminist Critique: Dermer, Hemesath, and Russell (1998) argued that ignoring a problem’s social context can leave power imbalances, particularly gendered ones, unexamined and unchallenged.

The Helsinki Psychotherapy Study

The strongest single trial on solution-focused therapy is Finnish.

Aim: Knekt and colleagues (2008) set out to compare one long-term and two short-term therapies, including solution-focused therapy, for treating mood and anxiety disorders over a long follow-up.

Method: This randomised controlled trial assigned 326 psychiatric outpatients with mood or anxiety disorders to long-term psychodynamic therapy, short-term psychodynamic therapy, or solution-focused therapy, then tracked symptoms for three years.

Results: Symptoms fell substantially across all three years. In the first year, solution-focused therapy and short-term psychodynamic therapy improved faster than the long-term therapy, but by the three-year mark, long-term psychodynamic psychotherapy had overtaken both short-term approaches.

Conclusion: Short-term therapies work faster. Long-term psychodynamic psychotherapy proves more durable, though solution-focused therapy matched short-term psychodynamic therapy throughout, a genuinely informative result, not a simple loss.

Evaluation: The trial’s size, three-year follow-up, and use of two active comparators make it unusually strong for this field, though its Finnish, insurance-funded sample limits how far the findings generalise.

Contemporary Research

The picture is more complicated than one number suggests.

A 2025 umbrella review by Żak and Pękala pooled 25 systematic reviews and meta-analyses of solution-focused therapy, grading each one’s methodological quality with the AMSTAR 2 tool.

The effect size across all these reviews was moderate overall (around g = 0.65). That headline figure hid a striking split: Western studies showed only a small effect (around 0.37), while East Asian studies showed a very large one (around 1.07).

A closer look explains why. Studies that compared solution-focused therapy against no treatment at all produced much larger effects than studies that compared it against another active therapy. That is the signature of a comparator effect, not a treatment effect.

The quality appraisal itself was stark.

Roughly a fifth of the 25 reviews rated as low confidence, and the rest as critically low, meaning every included review carried at least one serious flaw.

This is not new.

The first meta-analysis of the field appeared in 2008. It found only small effects (Kim, 2008). A systematic review five years later found broad support across studies but could not produce one combined effect estimate (Gingerich & Peterson, 2013).

Each synthesis since has produced a bigger number, without the underlying trials themselves growing any stronger. That pattern points to how the evidence is pooled, not to the therapy itself becoming more effective.

Practitioner and Client Perspectives

Even SFBT’s own founders admitted a tension in the model. As de Shazer and Berg (1997) explained, each SFBT case builds a solution individually with that client. That makes the model hard to test against a fixed comparator in a standard research design.

Clients themselves seem to notice the difference. A 2022 survey of 346 Polish SFBT clients found that most valued elements mapped onto the model’s own named techniques, rather than generic supportive conversation. Simply having room to talk mattered too (Żak, 2022).

References

Bond, C., Woods, K., Humphrey, N., Symes, W., & Green, L. (2013). Practitioner review: The effectiveness of solution focused brief therapy with children and families: A systematic and critical evaluation of the literature from 1990–2010 . Journal of Child Psychology and Psychiatry, 54 (7), 707-723.

Dermer, S. B., Hemesath, C. W., & Russell, C. S. (1998). A feminist critique of solution-focused therapy. The American Journal of Family Therapy, 26(3), 239–250.

De Shazer, S. (1988). Clues: Investigating solutions in brief therapy . New York: Norton & Co.

De Shazer, S., & Berg, I. K. (1997). ‘What works?’ Remarks on research aspects of solution-focused brief therapy. Journal of Family Therapy, 19(2), 121–124.

De Shazer, S., Berg, I. K., Lipchik, E., Nunnally, E., Molnar, A., Gingerich, W., & Weiner-Davis, M. (1986). Brief therapy: focused solution development. Family Process, 25(2): 207–221.

De Shazer, S., & Dolan, Y. (2012). More than miracles: The state of the art of solution-focused brief therapy. New York: Haworth Press

Franklin, C., Biever, J., Moore, K., Clemons, D., & Scamardo, M. (2001). The effectiveness of solution-focused therapy with children in a school setting. Research on Social Work Practice, 11(4), 411–434.

Grant, A. M., & O’Connor, S. A. (2010). The differential effects of solution-focused and problem-focused coaching questions: A pilot study. Industrial and Commercial Training, 42(2), 102–111.

Hsu, K.-S., Eads, R., Lee, M. Y., & Wen, Z. (2021). Solution-focused brief therapy for behavior problems in children and adolescents: A meta-analysis of treatment effectiveness and family involvement. Children and Youth Services Review, 120, Article 105620.

Iveson, C. (2002). Solution-focused brief therapy. Advances in Psychiatric Treatment, 8(2), 149–157.

Kim, J. S., Brook, J., & Akin, B. A. (2018). Solution-focused brief therapy with substance-using individuals: A randomized controlled trial study. Research on Social Work Practice, 28(4), 452–462.

Knekt, P., Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., Laaksonen, M. A., Marttunen, M., Kaipainen, M., Renlund, C., & Helsinki Psychotherapy Study Group. (2008). Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychological Medicine, 38(5), 689–703.

Maljanen, T., Paltta, P., Härkänen, T., Virtala, E., Lindfors, O., Laaksonen, M. A., Knekt, P., & Helsinki Psychotherapy Study Group. (2012). The cost-effectiveness of short-term psychodynamic psychotherapy and solution-focused therapy in the treatment of depressive and anxiety disorder during a one-year follow-up. Journal of Mental Health Policy and Economics. 15 (1), 13–23.

Sanai, B., Davarniya, R., Bakhtiari Said, B., & Shakarami, M. (2015). The effectiveness of solution-focused brief therapy (SFBT) on reducing couple burnout and improvement of the quality of life of married women. Armaghane danesh, 20 (5), 416-432.

Żak, A. M. (2022). What is helpful: The client’s perception of the solution-focused brief therapy process by level of engagement. Journal of Solution Focused Practices, 6(2).

Żak, A. M., & Pękala, K. (2025). Effectiveness of solution-focused brief therapy: An umbrella review of systematic reviews and meta-analyses. Psychotherapy Research, 35(7), 1043–1055.

Zhang, A., Franklin, C., Currin-McCulloch, J., Park, S., & Kim, J. (2018). The effectiveness of strength-based, solution-focused brief therapy in medical settings: A systematic review and meta-analysis of randomized controlled trials. Journal of Behavioral Medicine, 41(2), 139–151.