An update on strengths-based, solution-focused brief therapy

A Clinical Case Study of Solution-Focused Brief Therapy for Young Adult Cancer Patients’ Psychological Distress: Focusing on Positive Emotions

Psychological distress is highly prevalent among adolescent and young adult (AYA) cancer patients, an age-defined population (15–39) disproportionately impacted by their cancer diagnosis. Solution-focused brief therapy (SFBT) is a strength-based and evidence-supported approach for youth with medical conditions. The use of SFBT in young cancer patients, however, has been rarely described. Building on the broaden-and-build theory of positive emotions, this study describes how SFBT clinicians intentionally foster positive emotions, especially hope, in an AYA cancer patient to foster therapeutic change. We found improvements in the patient’s psychological distress as well as growth in levels of hope both in the immediate post-intervention assessment and in the 2-week follow-up. The findings of the study suggested that SFBT is a promising approach to the unique challenges confronting AYAs with cancer. It was not feasible for this case study to match the sex and racial identities for a therapist with the client’s preference, which is considered a main limitation of this study.

Solution Focused Brief Therapy Telemental Health Suicide Intervention

One of the innumerable impacts of the coronavirus has been the change in how individuals provide services. For mental health providers, the pandemic required a sudden shift from in person to online service delivery. As therapists learn and embrace a new modality for providing therapy, crisis situations may present with some anxiety. With the pandemic increasing crisis situations for so many individuals, and teletherapy as a mode of service delivery being unlikely to go away after the pandemic, therapists require support in navigating crises situations online, in a medium that feels like the therapist has less control with their clients due to being in different physical locations. The authors believe that regardless of the primary model(s) therapists utilize in session, solution-focused brief therapy is an integrative model that uniquely captures client's resources and reasons for living and when clients are in crisis. The purpose of this paper is to present recommendations for applying solution-focused language in teletherapy practice, to provide ethical, evidenced based care for clients in crisis. A clinical vignette is used to illustrate the application of solution focused brief therapy for working with clients in crisis. Future directions and limitations are discussed.

Solution-focused brief therapy for adolescent and young adult cancer patients in China: a pilot randomized controlled trial

OBJECTIVE

This pilot clinical trial investigated solution-focused brief therapy (SFBT) for psychological distress among adolescent and young adult (AYA) patients with cancer in China.

METHODS

Fifty Chinese AYA patients diagnosed with cancer were randomized into the treatment group (SFBT) and control group (active control). Psychological distress was measured by the brief symptom inventory and hope was measured by the Herth-Hope-Index. Treatment effects were analyzed using analysis-of-covariance and between-group small-sample-size corrected Hedges' g.

RESULTS

The results indicated that SFBT resulted in a significant reduction in the psychological distress and improvement in hope of AYA patients with cancer. Analyses of the 4-week posttreatment score suggest the short-term sustainability of SFBT for psychological distress among AYAs diagnosed with cancer.

CONCLUSIONS AND IMPLICATIONS

This study has demonstrated that SFBT's impact is statistically significant and clinically meaningful. The inclusion of positive emotions, i.e., hope, as part of the investigation also highlighted the significance of promoting positive emotions among AYA patients with cancer.

The Utility of Solution-Oriented Strategies to Support Grandparents Raising Grandchildren

Objectives: The purpose of this article is to evaluate the effectiveness of a psychosocial intervention program to improve the health and social psychological outcomes for grandparents raising grandchildren using the theory of Selection, Optimization, and Compensation (Baltes, P. B., & Baltes, M. M. (1990). Psychological perspectives on successful aging: The model of selective optimization with compensation. In P. B. Baltes & M. M. Baltes (Eds.), Successful aging: Perspectives from the behavioral sciences (pp. 1-34). Cambridge University Press. doi:10.1017/CBO9780511665684.003). Methods: Fifty-two grandparents were randomly assigned either to a 6-session solution-oriented goal-setting program or to a waiting list control condition who subsequently received the intervention. Results: Grandparents in the intervention group, in comparison to the waiting list control group, reduced their level of depression, improved their parental efficacy, overall psychosocial adjustment, and increased their ability to choose effective goals. For the most part, findings were replicated in the waiting list control analyses. Discussion: While these findings are consistent with previous studies using psychosocial interventions with parents and grandparent caregivers, they also provide support for strength-based proactive behavioral approaches to improve the quality of life of grandparent caregivers.

Solution-Focused Brief Therapy (SFBT) with individuals with brain injury and their families

BACKGROUND

Brain injury is considered a chronic condition and the medical model has long been the traditional paradigm underlying rehabilitation programs for people after acquired brain injury (ABI). In recent years, strengths-based approaches have been increasingly proposed, but little has been written about specific psychotherapeutic application in ABI rehabilitation.

OBJECTIVE

To describe a strengths-based model, Solution-Focused Brief Therapy (SFBT) and its clinical application to individuals with ABI and their families.

METHODS

The author describes the assumptions, tenets, and principles of SFBT, a competency-based and resource-based model that orients to the future and focuses on strengths and successes. A direct comparison is made between the traditional medical paradigm and the solution-focused paradigm.

RESULTS

Key ingredients of SFBT are described, including specific strategies, techniques, and its clinical application with individuals with ABI and their families. Limitations around using SFBT and the need for further research with ABI populations are reported.

CONCLUSIONS

SFBT is a welcome shift away from the problem-saturated stories that underlie traditional rehabilitation approaches. The strengths-based underpinning of SFBT is a promising psychotherapeutic intervention that merits further investigation with ABI populations.

The effectiveness of solution-focused brief therapy for psychological distress among Chinese parents of children with a cancer diagnosis: a pilot randomized controlled trial

PURPOSE

Given the critical role of parental care for pediatric cancer patients, this pilot study evaluated the feasibility and effectiveness of a hospital-based solution-focused brief therapy (SFBT) intervention for reducing psychological distress among parents of pediatric cancer patients in China. Differences between treatment and active control (AC) groups were assessed on dimensions of psychological distress. Parents' level of hope was also assessed.

METHODS

Participants (N = 44) were randomly assigned to SFBT or AC. Parents received four sessions of SFBT twice a week delivered by graduate-level hospital social workers. Pre- and post-intervention assessments measured change in distress (depression, anxiety, and somatization symptoms) of parents as well as their level of hope.

RESULTS

Analysis of covariance (ANCOVA) indicated the SFBT group had better outcomes than the AC group on overall distress of somatic, anxiety, depression symptoms and level of hope. Within- and between-group treatment effects reported significantly greater effect of the SFBT group than of the AC group.

CONCLUSIONS

Considering the inherent limits of a pilot feasibility study, results suggest that SFBT is a feasible, culturally compatible, and promising intervention for alleviating distress among Chinese parents of children with cancer. Additional comprehensive trials are needed to draw more definitive conclusions.

RELEVANCE

SFBT may be beneficial for improving the critical support systems of parents of pediatric cancer patients. Thus, SFBT may have the potential to enhance children's well-being during cancer treatment and recovery.

Efficacy of Solution-Focused Brief Therapy for Distress among Parents of Children with Congenital Heart Disease in China

Chinese parents of children with congenital heart disease (CHD) experience significant psychological distress due to the child's illness and hospitalization. Unfortunately, there are few psychosocial interventions for parental distress in China. This pilot study aimed to examine the efficacy of solution-focused brief therapy (SFBT) in a Chinese hospital for parental distress using a randomized controlled trial design. The participants included 40 Chinese parents of a currently hospitalized child diagnosed with CHD who were assessed to have psychological distress. Parents were randomized into either the intervention (n = 25) or the hospital medical social work treatment as usual (TAU) (n = 28) group. The Chinese Brief Symptom Inventory-18 and Chinese version of Herth Hope Index were administered before and after the interventions. Results of the intent-to-treat analysis indicated a significant decrease in parental distress and increase in parents' levels of hope in the intervention group compared with the TAU group. This study supported SFBT administered in a hospital setting as a promising intervention for reducing distress among Chinese parents with children diagnosed with CHD.

The effectiveness of strength-based, solution-focused brief therapy in medical settings: a systematic review and meta-analysis of randomized controlled trials

This meta-analysis synthesized randomized controlled trials of solution focused brief therapy (SFBT) in medical settings for patients' health-related psychosocial (e.g., depression, psychosocial adjustment to illness), behavioral (e.g., physical activity, nutrition score), and functional health (e.g., BMI, individual strength) outcomes. Medical setting is defined in this study as any healthcare setting that primarily focuses on patients' physical wellbeing. A comprehensive search strategy across five electronic databases, four academic journals, three professional websites, and reference lists of included articles resulted in a final sample of nine studies for meta-analytic synthesis. Combining outcomes indicated an overall significant effect of SFBT for health-related psychosocial outcomes (d = 0.34, p < .05.) and a nearly significant outcome for health-related behavioral outcomes (d = 0.28, p = .06), but not for functional health outcomes. Results indicated SFBT being an effective intervention for psychosocial outcomes and a promising approach for behavioral outcomes in medical settings.

The Magic Wand Question and Recovery-Focused Practice in Child and Adolescent Mental Health Services

BACKGROUND

This paper uses a case study to describe the implementation of the Magic Wand Question (MWQ), also known as the miracle question, in a child and adolescent mental health service (CAMHS) in Scotland. The MWQ, a common intervention, is based on a Solution-Focused Brief Therapy (SFBT) approach. This intervention was undertaken by a third year student nurse with the intention of demonstrating how practice can be more closely aligned to a recovery-focused, strengths-based approach, which is in line with national policy.

METHODS

SFBT has a growing evidence base for use with children and young people. However, there are still some common uncertainties about its use; therefore, a literature review has been undertaken to further explore the evidence base for the use of SFBT, with a focus on the MWQ. Furthermore, an exploration of the planning, implementation, and evaluation of the effectiveness of the MWQ is provided with a 15-year-old girl experiencing symptoms of low mood.

RESULTS

Although limitations have been identified, giving careful consideration to posing the MWQ, through detailed planning prior to implementation, led to an increased understanding of factors supporting the use of the MWQ and reduced any uncertainty around when to use the MWQ in practice. In this clinical intervention, with a 15-year-old girl experiencing symptoms of low mood, the use of the MWQ was successful.

CONCLUSION

The effectiveness of any treatment is best judged by the individual receiving care, and positive results have been achieved in this case study. Use of this approach ensured professionals were looking beyond diagnosis, illness, and problems in line with the principles of recovery-focused practice (Scottish Recovery Network [SRN] and NHS Education for Scotland [NES], 2007). The use of the MWQ in this case enhanced the knowledge of evidence-based practices, in line with the Nursing and Midwifery Council (NMC, ) and improved overall outcomes for individuals receiving care.

Brain injury family intervention for adolescents: A solution-focused approach

BACKGROUND

Strengths-based approaches are increasingly utilized in health care, but little is known about their practical application in rehabilitation with families after pediatric acquired brain injury (ABI).

OBJECTIVE

To describe a strengths-based model, Solution-Focused Brief Therapy (SFBT) and its clinical application to family intervention for adolescents with ABI.

METHODS

A literature review highlights a growing movement towards resilience and strengths-based approaches to family intervention after pediatric ABI. The authors introduce the assumptions, tenets, and clinical application of SFBT, which is a competency-based and resource-based model that focuses on family strengths and successes. A direct comparison is made between the traditional medical model and the solution-focused paradigm.

RESULTS

Key elements of SFBT are described, including specific strategies, techniques, and its clinical application in the Brain Injury Family Intervention for Adolescents (BIFI-A). The BIFI-A, designed for adolescents with ABI and their families, is a 12-session manualized intervention that encompasses education about ABI, skill building, and emotional support.

CONCLUSIONS

Given the increased interest for research regarding strengths-based approaches in pediatric rehabilitation, the utilization of SFBT with families of adolescents with ABI warrants further attention and investigation. The BIFI-A, with its underpinnings of SFBT, is a promising new family system intervention that also merits further research.