Solution-Focused Brief Therapy for Improving Couple Dyadic Relationships in Iran: A Systematic Review

Despite the popularity of Solution-Focused Brief Therapy (SFBT) in Iran, the existing literature synthesis has limitations due to the reliance on studies published primarily in Farsi. This systematic review addresses these gaps by synthesizing and evaluating the effectiveness of SFBT on the marital outcomes of couples in Iran, incorporating both Farsi and English sources. The search for this review yielded 1523 records, from which 26 randomized controlled trials were included. The participants across the included studies (n = 1110) were predominantly married women and couples experiencing marital discord, from varied educational backgrounds across multiple Iranian cities. SFBT, primarily delivered in a group format, demonstrated medium to large effect sizes in improving marital outcomes such as dyadic adjustment, satisfaction, and intimacy. However, the presence of bias in study design and reporting necessitates caution in interpreting findings. This review highlights the potential of SFBT to improve marital relationships within the Iranian context.

The current evidence of solution-focused brief therapy: A meta-analysis of psychosocial outcomes and moderating factors

PURPOSE

Solution Focused Brief Therapy (SFBT) focuses on the strengths and resources of clients, and is assumed to achieve positive results on various psychosocial outcomes. This meta-analysis is an extension of previous meta-analyses on SFBT, and examines if the effectiveness of SFBT is influenced by participant, intervention, study and publication characteristics.

METHODS

Experimental and quasi-experimental studies were included. A three-level meta-analysis was performed on 72 studies and 489 effect sizes, accounting for within and between study differences.

RESULTS

The overall effect of SFBT on psychosocial problems was large (g = 1.17). Moderator analyses revealed larger effects of SFBT in non-clinical samples (g = 1.50) than in clinical samples (g = 0.78). Studies with treatment-as-usual (TAU) as control condition reported smaller effects (g = 0.58) than studies with a no-treatment control condition (g = 1.59). Relatively large effects were found for couples (g = 3.02) compared to other client groups (0.41 < g < 1.70), and marital functioning (g = 3.02) compared to other outcomes (0.23 < g < 1.31). Group therapy (g = 1.64) yielded a larger effect than individual therapy (g = 0.48).

CONCLUSION

The findings indicate that SFBT is applicable for a variety of clients and psychosocial problems.

Effectiveness of solution-focused brief therapy: An umbrella review of systematic reviews and meta-analyses

OBJECTIVE

This umbrella review of systematic reviews and meta-analyses evaluates the effectiveness of Solution-Focused Brief Therapy (SFBT) across various populations and settings.

METHOD

A total of 25 systematic reviews, including 15 meta-analyses, were analyzed. Reviews were included if they used systematic search methods and quality assessments and focused on the effectiveness of SFBT as a therapeutic approach.

RESULTS

SFBT demonstrated significant positive outcomes across different issues, settings, and cultural contexts, with no evidence of harm. High confidence in evidence of effectiveness was established for depression, overall mental health, and progress towards individual goals for the adult population. In addition, findings indicated mainly moderate confidence in evidence of SFBT effectiveness for a wide variety of outcomes for all age groups. No difference was found in the confidence in the evidence by world region, though Western and Eastern studies researched some different aspects.

CONCLUSION

SFBT is an effective therapeutic approach for various psychological, social, school, medical, couple, or self-related issues. Further research with rigorous methodologies and comprehensive reporting is needed to strengthen the confidence in these findings and provide evidence for the brevity of the intervention.

A Path to Inclusiveness - Peer Support Groups as a Resource for Change

Being bullied is associated with anxiety, depression symptoms, and long-term negative health outcomes. The aim of this qualitative pilotstudy was to explore bullied children's experiences of support groups and how participating in a group affected the children. The sample consisted of 24 children aged 11-13 years. Four of them were bullied, while 20 participated in support groups. Individual and focus group interviews were conducted. The main theme identified was that support groups provide an opportunity for change and can help children to be included among peers. The changes were achieved through encouragement and support from peers. The children participating in the support groups reported a feeling of being selected. The groups provided fellowship, and an opportunity for change. Both getting support from and being part of a support group contributed to inclusion, strength, and valuable experiences. The findings suggest that a systemic approach to bullying is advantageous.

Efficacy of systemic therapy on adults with depressive disorders: A meta-analysis

OBJECTIVE

This meta-analysis evaluates the efficacy of systemic therapy approaches on adult clients with depressive disorders.

METHODS

The illness-specific systematic review updates a previous meta-analysis on the efficacy of systemic therapy on psychiatric disorders in adulthood. It integrates the results of 30 randomized controlled trials (RCTs) comparing systemic psychotherapy for depression with an untreated control group or alternative treatments. Studies were identified through systematic searches in relevant electronic databases and cross-referencing. A random-effects model calculated weighted mean effect sizes for each type of comparison (alternative treatments, control group with no alternative treatment/waiting list) on two outcomes (depressive symptoms change, drop-out rates).

RESULTS

On average, systemic interventions show larger improvements in depressive symptoms compared to no-treatment controls at post-test (g = 1.09) and follow-up (g = 1.23). Changes do not significantly differ when comparing systemic interventions with alternative treatments (post-test g = 0.25; follow-up g = 0.09). Results also vary, in part, by participant age, publication year, and active control condition.

CONCLUSION

This meta-analysis indicates the potential benefits of systemic interventions for adult patients with depression. Future randomized clinical trials in this area should enhance study quality and include relational and other relevant outcome measures.

Clinician Knowledge, Confidence, and Treatment Practices in Their Provision of Psychotherapy to Autistic Youth and Youth with ADHD

Autistic youth have an increased risk of mental health problems. Despite the efficacy of various psychotherapeutic approaches for autistic youth, they often do not receive these interventions. Research is needed to identify patterns of effective treatment for autistic youth and whether they differ from those used for youth with other neurodevelopmental conditions (e.g., attention-deficit hyperactivity disorder; ADHD). We compared clinicians' (N = 557) knowledge, confidence and practices when treating autistic youth and youth with ADHD. Although ratings were moderately high overall and similar interventions were used for both groups, clinicians were significantly less knowledgeable and confident when supporting autistic clients compared to clients with ADHD. Thus, improving clinician perspectives may help facilitate treatment for autistic youth with mental health problems.

An online solution focused brief therapy for adolescent anxiety : A randomized controlled trial

In this randomized clinical trial, we investigated the efficacy of an online solution focused brief therapy (SFBT) for adolescents' anxiety symptoms during the COVID-19 period. Eligible participants were between the ages of 11 and 18 years, scored a 10 or above on the Generalized Anxiety Disorder-7 (GAD-7). The results found that compared to adolescents who did not receive any treatment, the intervention yielded significant results in alleviating adolescents' anxiety and depressive symptoms while promoting problem oriented coping strategies at immediate post-intervention. The therapeutic benefit has persisted, as shown in our results from the 1-month follow-up.

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.

Mechanisms of change for a family intervention in Kenya: An Integrated Clinical and Implementation Mapping approach

To increase cultural relevance and maximize access for historically underserved populations, there is a need to explore mechanisms underlying treatment outcomes during piloting. We developed a mixed-method approach, Integrated Clinical and Implementation Mapping (ICIM), to explore clinical and implementation mechanisms to inform improvements in content and delivery. We applied ICIM in a pilot of Tuko Pamoja, a lay counselor-delivered family intervention in Kenya (10 families with adolescents ages 12-17). ICIM is a 3-phase process to triangulate data sources to analyze how and why change occurs within individual cases and across cases. We synthesized data from session and supervision transcripts, fidelity and clinical skills ratings, surveys, and interviews. Outputs included a comprehensive narrative and visual map depicting how content and implementation factors influenced change. For Tuko Pamoja, ICIM results showed common presenting problems, including financial strain and caregivers' distress, triggering negative interactions and adolescent distress. ICIM demonstrated that active treatment ingredients included communication skills and facilitated, prescribed time together. Families improved communication, empathy, and hope, facilitated improved family functioning and mental health. Key implementation mechanisms included provider clinical competencies, alliance-building, treatment-aligned adaptations, and consistent attendance. Results guided manual and training refinements and generated hypotheses about mechanisms to test in larger trials.

Effects of Brief Interventions on Internalizing Symptoms and Substance Use in Youth: A Systematic Review

Internalizing problems (e.g., depression, anxiety) and substance use are common among young people and often co-occur. However, youths face myriad barriers to access needed treatment, and existing evidence-based interventions tend to focus on internalizing problems or substance use, rather than both simultaneously. Brief interventions that target both problems may, therefore, be an efficient and accessible resource for alleviating youth difficulties; however, this possibility has been insufficiently evaluated. This systematic review evaluated the intervention characteristics and quality of six studies spanning 2015 to 2019 that examined intervention effects on internalizing and substance use outcomes. Based on independent calculations and author reports (respectively), 3-4 interventions significantly reduced youth internalizing symptoms; 3-5 reduced youth substance use; and 2-3 reduced symptoms in both domains. All six interventions identified substance use as a primary target. Four interventions were administered by interventionists to youths in inpatient, outpatient, primary care, or school settings. The remaining two studies delivered content through voicemail messages or an online design. Interventions ranged from ~ 15 to 240 min. Results highlight the sparsity and heterogeneity of youth-focused brief interventions that have evaluated program effects on both internalizing problems and substance use outcomes, suggesting a clear need for integrated supports that are also designed for accessibility. Future investigations of brief youth-focused interventions should assess program effects on both internalizing and substance use outcomes; examine mechanisms driving the varied efficacy of identified interventions; and create, refine, and test interventions with potential to address co-occurring internalizing problems and substance use in young people.

A Counseling Application as an Alternative Tool in Increasing Coping Self-Efficacy Among University Students With Academic Distress During Coronavirus Disease 2019 Pandemic in Indonesia: A Study Protocol for a Randomized Controlled Non-Inferiority Trial

The coronavirus disease 2019 (COVID-19) pandemic increased education-related distress among University students globally, including in Indonesia. Psychological factors, such as academic demands, limited opportunity to meet their peers, problematic use of technology, and domestic problems, influenced the well-being of the students, leading to poor academic performance. A mobile-based counseling application was developed to address the distress among University students. The application was meant to reach students living remotely to enable them to access psychological assistance. Therefore, the purpose of this study was to describe a protocol aimed to evaluate the equivalence of the application when compared to the Treatment-As-Usual (TAU) in increasing the coping self-efficacy (CSE) and resilience of students as well as in decreasing their level of depression. A two-armed parallel randomized control non-inferiority trial will be conducted among approximately 430 students with selected academic problems. The participants will be randomly allocated into the TAU and the intervention groups. The primary and secondary outcomes will be measured by the Indonesian versions of the Coping Self-Efficacy (CSE) Scale, the Resilience Scale (RS-14), and the Patient Health Questionnaire (PHQ-9). The data will be collected at baseline, at the end of each session, and after 3 months. The outcomes will be analyzed using repeated-measures ANOVAs, intention-to-treat, and per-protocol analysis. If proven, the application will be used as an alternative media in helping the students.

Clinical Trial Registration: Thailand Clinical Trials Registry (TCTR20200530001); Date of registration: May 28, 2020.

The effect of a solution-oriented approach in depressive patients on social functioning levels and suicide probability

PURPOSE

This study was conducted to evaluate the effect of a solution-oriented approach in depressive patients on suicide probability and the social functioning level.

DESIGN AND METHOD

The research was designed as a randomized controlled trial with a pretest and posttest control group and repeated measures. A Solution-Oriented Approach Intervention (SOAI) was performed for a total of 6 to 10 sessions with the experimental group.

FINDINGS

The SOAI in depressive patients effectively increased the social functioning level and decreased suicide probability.

PRACTICE IMPLICATIONS

The SOAI in depressive patients should be implemented by psychiatric nurses within the scope of psychiatric care services.

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.

Solution-focused brief therapy for Chilean primary care patients: Exploring a linguistic adaptation

Solution-focused brief therapy (SFBT) is a resource-based, future-oriented therapeutic approach that focuses on finding exceptions to problems and identifying coping strategies to build solutions. SFBT has been efficacious with individuals with alcohol use disorders. Chile experiences high levels of alcohol consumption and alcohol-related health consequences. Despite the international dissemination of SFBT, this is the first study to attempt a linguistic adaptation of SFBT in a Latin American country. We conducted 9 cognitive interviews to examine 13 translated main SFBT tools and 3 focus groups to gather information on cultural aspects of alcohol use in primary care. Results suggest that Chileans understood most SFBT tools, albeit with some linguistic modifications of original translations, and that family, gender, and meaningful issues should be considered when working with individuals with alcohol use disorders.