Eating Disorder Pro

Solution Focused Therapy (SFT) is sometimes linked to general Brief Therapy, Problem-Focused Therapy, and Possibility Therapy… All share some common points of focus:

* Traditional therapy goes wrong by focusing on the cause of problems, the details of how they play out, the ways these events deviate from “normal” or the way couples are “supposed” to work, and having couples passively accept the expert therapists’ explanations of “what is wrong” with them. Doing this gets clients stuck in a passive and helpless role, locked into a problem narrative they rehearse over and over again

* A better approach moves client focus off of what’s wrong and onto what’s right, stresses the resources and skills clients have, and helps them take the role of expert (which they hold anyway) and take responsibility from there for setting their own goals and reaching them. It’s not about what’s missing and causes woe, but what’s present and can lead to happiness

* Solution building is the goal, and as you change the language that shapes how you think about the problem, you change the language that shapes how you think about the solution

* There is no theory behind this, and you need not fully understand the problem to fix it. The solution may not even look like it will fit or resolve the problem, and that’s fine – a small enough change will nudge the system in a different direction and that may be all that’s needed

* Therapists maintain a future focus, with language like “when this is fixed…” “notice when this problem doesn’t happen this week…” “write down what your partner does to fix the problem this week…”

* Rather than summing up what the therapist thinks the clients is saying, the therapist asks questions to focus and direct the client’s thinking and view

Basic Theory

de Shazer and Insoo Kim Berg developed this approach based on Milton Erickson and MRI models, and by watching what seemed to happen to families and couples right before they reported having had some break-through moment. This is key, as many studies of what works in therapy have been based on therapists views. When studies are done comparing therapist and client views of what happened in session and what was helpful… well, they disagree.

Metcalfe and Thomas (1994) did a study asking some SFT therapists and patients the same questions. Here’s what they found: Whereas MRI focuses on what you are doing wrong (more of the same) and how to change that, SFT focuses on exceptions to the problem, thinking that a change in behavior will naturally develop then. It’s sort of insight-oriented, but not in traditional ways, since it is future focused, and doesn’t get too deep into one member’s “pathology,” but rather focuses on what the system can do to adapt to it, and let’s the couple decide if that “pathology” is a problem or not…

Sessions last about an hour, include a short break, and are loosely scheduled, meaning couples may have 1 or more sessions, with the average being 3-4 sessions. What you do depends on the couple members’ status when they come in.