How do we work towards sustainable change? Evan George explores one little question which seems to make a difference.
There are now over 32 published research studies in solution focused brief therapy which show successful outcomes in 65 - 83% of cases. The highest satisfaction ratings come from clients themselves. Some of the research studies relate to very serious mental health problems, drug and alcohol use, criminal behaviour and domestic violence.
The most common follow-up studies are when clients are asked their opinion. Some of these have been continued for several years and show that in more than 75% of cases the client is satisfied and the problem if not completely resolved is no longer a dominant influence.
BRIEF conducts this sort of follow-up as well as collaborating with independent researchers to establish more detailed information about the approach, how it works and who it works for.
At the moment researchers have found no significant outcome difference between the different problems or people who come for solution focused brief therapy. All that can honestly be said to anyone who comes through the door is that there is a 65 - 83% chance of the problems the person has come with being resolved or significantly reduced in an average of 4 to 5 sessions.
Beyebach M, Morejon AR, Palenzuela DL, Rodriguez-Arias JL Research on the process of solution-focused brief therapy. In: Miller SD, Hubble MA, Duncan BL (eds) (1996)
Handbook of Solution-Focused Brief Therapy. Jossey-Bass: San Francisco (p 299-334). 39 outpatients at mental health clinic; 80% goal achieved, avg 5 sess, mean 33 min / session; concrete goals and pretreatment change important. (firstname.lastname@example.org)
Beyebach M, Rodriguez Sanchez M S,Arribas de Miguel J, Herrero de Vega M, Hernandez C,Rodriguez Morejon,A (2000) Outcome of solution-focused therapy at a university family therapy center.
Journal of Systemic Therapies 19:1 116-128. 83 cases; telephone follow-up, most 1 yr +. 82% satisfied; better outcome for 'individual' problems than for 'relational'; more dropout for trainees; avg 4.7 sess.
Burr W (1993) Evaluation der Anwendung losungsorientierter Kurztherapie in einer kinder- und jugendpsychiartischen Praxis (Evaluation of the use of brief therapy in a practice for children and adolescents). Familiendynamik, 18: 11-21. (German: abstract in English).
55 cases; follow-up avg 9 mon. 34 replies - 26 (77%) improved. Avg 4 sess; new problems reported in 4 with improvement and 4 without. (email@example.com)
Cockburn JT,Thomas FN, Cockburn OJ (1997) Solution-focused therapy and psychosocial adjustment to orthopedic rehabilitation in a work hardening program.
Journal of Occupational Rehabilitation, 7, 97-106. 25 experimental: 6 sfbt sess vs 23 controls:standard rehabilitation. 68% experimental at work within 7 days at 60-day follow-up vs 4% controls. (Fthomas@twu.edu)
Cruz J, Littrell JM (1998) Brief counseling with Hispanic American college students.
Journal of Multicultural Counseling and Development, 26, 227-238. 16 students; 2 sess; follow-up 2 wk. 10 achieved 54.7% of goal.
DeJong P, Hopwood LE Outcome research on treatment conducted at the Brief Family TherapyCenter 1992-1993.
In: Miller SD, Hubble MA, Duncan BL (eds) (1996) Handbook of Solution-Focused Brief Therapy.
Jossey-Bass: San Francisco (p 272-298). 275 cases: age 50%<19, 93%<45; avg 2.9 sess; follow-up avg 8 mon; 141 contacted. 45% goal achieved, 32% some progress. Equal outcomes by age, gender, race, economic status. (firstname.lastname@example.org)
de Shazer S (1985) Keys to Solutions in Brief Therapy. Norton: New York. (p147-157).
6 mon follow-up of 28 cases who had received formula first session task. 23 (82%) improved; 25
solved other problems. Avg 5 sess. (Briefftc@aol.com)
de Shazer S (1991) Putting Differences To Work. Norton: New York. (161-162).
29 cases: 23 (80%) reported that they had either resolved their original difficulty, or made significant progress towards resolving it. At 18 mon success rate was 86%; 67% reported other improvements also. Avg 4.6 sess: 4 sess or more did better.
Eakes G,Walsh S, Markowski M, Cain H, Swanson M (1997) Family-centred brief solution-focused therapy with chronic schizophrenia: a pilot study. Journal of Family Therapy, 19, 145-158.
Experimental and control groups: 5 clients and families each. Reflecting team present; no miracle question. Experimental group: Family Environment Scale showed significant increase in expressiveness, active-recreational orientation and decrease in incongruence. Controls: moral religious emphasis increased.
Franklin C, Biever J, Moore KC, Clemons D, Scamardo, M (1998) (submitted) The effectiveness of solution-focused therapy with children in a school setting.
19 cases: 7 investigated. 1 mon baseline (objective measures); avg 7 sess. Some improvement in all;4 of 5 better at 1 mon followup. (email@example.com)
Franklin C, Corcoran J, Nowicki J, Streeter CL (1997) Using client self-anchored scales to measure outcomes in solution-focused therapy.
Journal of Systemic Therapies, 16, 246-265. Pilot study (3 cases) of this measure as a test of outcome.
Gingerich W, Eisengart S (2000) Solution-focused brief therapy: a review of the outcome research.
Family Process, 39, 477-498. Fifteen outcome studies traced and reviewed. (firstname.lastname@example.org)
Isebaert L,Vuysse S (in preparation) 4 yr telephone follow-up of 131 alcoholics after inpatient episode: 100 (76%) stable, 9 alcohol deaths.
Only relevant variable was therapy; social class was not a factor. (email@example.com).
Johnson LD, Shaha S (1996) Improving quality in psychotherapy. Psychotherapy, 33, 225-236. 38 cases, OQ-45 checklist (symptoms, relationships, social role).
Improvement after avg. 4.77 sess. (firstname.lastname@example.org)
Lambert MJ, Okiishi JC, Finch AE, Johnson LD (1998) Outcome assessment: From conceptualization to implementation.
Professional Psychology: Research & Practice, 29, 63-70. 22 cases from Johnson & Shaha (1996) compared with 45 at university public mental health center. Both methods achieved 46% recovered by objective criteria (OQ-45) ('Improved' cases not reported); sfbt by 3rd sess, center by 26th.
LaFountain RM, Garner NE (1996) Solution-focused counselling groups: the results are in.
Journal for Specialists in Group Work, 21, 128-143. Exp. 27 sfbt counsellors, 176 students; control 30 non-sfbt counsellors, 135 students. Exp. students better on 3 of 8 measures, 81% goal achievement in exp (controls no report). Less exhaustion and depersonalisation in sfbt counsellers at 1 yr.
Lee MY (1997) A study of solution-focused brief family therapy: outcomes and issues.
American Journal of Family Therapy, 25, 3-17. 59 families; 6 mon telephone follow-up, independent raters. 64.9% improved (goal achieved 54.4%; part goal 10.5%) avg 5.5 sess. (Report soon on sfbt in depression using standard outcome measures) (email@example.com)
Lee MY, Greene GJ, Uken A, Sebold J, Rheinsheld J (1997) Solution-focused brief group treatment: a viable modality for domestic violence offenders?
Journal of Collaborative Therapies, IV, 10-17. Sciotto study: 117 clients, 1993-1997; standard 6 sess completed by 88. 7% (6) reoffend. Plumas study: 1994-1996: 34 clients completed 7 of 8 standard sess. 3% (1) reoffend. (Not yet published: 17% reoffend at 6 yr followup) (firstname.lastname@example.org) (email@example.com)
Lindforss L, Magnusson D (1997) Solution-focused therapy in prison.
Contemporary Family Therapy, 19, 89-104. Randomised: 30 experimental and 29 controls; 16 mon follow-up. 18 (60%) reoffend in exp., 25 (86%) in control; more drug offences and more total offences in controls. Pilot study 14/21 (66%) exp. and 10/12 (90%) controls reoffended at 20 mon. Avg 5 sess; 2.7 million Swedish crowns saved by reduced reoffending. (firstname.lastname@example.org; email@example.com)
Littrell JM, Malia JA,Vanderwood M (1995) Single-session brief counseling in a high school.
Journal of Counseling and Development, 73, 451-458. 61 students; 19 problem focus and task, 20 problem focus only, 22 solution focus and task. 69% better at 6 wk follow-up in all groups but shorter sessions in sfbt. (firstname.lastname@example.org)
Macdonald AJ (1994) Brief therapy in adult psychiatry
Journal of Family Therapy, 16:415-426. A study which looks at the application of Brief Therapy in a Psychiatric Service in a hospital in Scotland. 70% good outcome. Average 3.71 sessions.
Macdonald AJ (1997) Brief therapy in adult psychiatry: further outcomes.
Journal of Family Therapy, 19, 213-222. 36 cases; 1 yr follow-up. 23 (64%) improved; other problems solved in 10 with good outcome and 2 in the other group. Longstanding problems did less well; equal outcome for all social classes; avg 3.3 sess.
Nelson T, Kelley L (2001) Solution focused Couples Group
Journal of Systemic Therapies, 20: 4 47 - 66. Marital satisfaction measured on RDAS and KMS. 70% participants reported improvement. On a self-report goal sheet 80% participants reported progress. Small group with no control.
Springer DW, Lynch C, Rubin A (2000) Effects of a solution-focused mutual aid group for Hispanic children of incarcerated parents.
Child and Adolescent Social Work, 17, 431-442. 5 schoolchildren offered 6 session group using sft /interactional / mutual aid approaches vs 5 waiting list controls. Possibly significant increase in selfesteem in experimental group.
Stoddart. K., McDonnell, J., Temple, V. Mustata A (2001) Is brief better? A modified brief Solution-Focused approach for adults with a Developmental Delay.
Journal of Systemic Therapies 20: 2 24 - 40. Approach more successful for clients who were higher functioning, self-referred, and who were supported in the therapeutic process by others. Work significantly briefer than standard approach. Mean 118 days compared to mean 372 days. Clients and caregivers satisfied at 6-month email@example.com.
Sundmann, P (1997) Solution-focused ideas in social work. Journal of Family Therapy, 19, 159-172.
9 social workers in the experimental group received basic training in solution-focused ideas while 9 controls worked as usual. Session tapes and questionnaires were analysed at 6 mon. More positive statements, more goal focus and more shared views were found in the experimental group. (firstname.lastname@example.org)
Thompson R, Littrell JM (2000) Brief counseling for students with learning disabilities.
The School Counselor (in press). 12 students; 2 sess; follow-up 2 wk. 10 achieved 100% of goal.
Triantafillou N (1997) A solution-focused approach to mental health supervision.
Journal of Systemic Therapies, 16, 305-328. Residential staff training. 5 adolescent clients: 66% less incidents, less medication use vs 7 controls: 10% less incidents, medication increased at 16 wks. (email@example.com)
Vaughn K,Young BC,Webster DC,Thomas MR A continuum-of-care model for inpatient psychiatric treatment. In: Miller SD, Hubble MA, Duncan BL (eds) (1996)
Handbook of Solution-Focused Brief Therapy. Jossey-Bass: San Francisco (p 99-127). 688 cases before sfbt model avg stay 20.2 days; 675 cases after avg stay 6.6 days.
Wheeler J (1995) Believing in miracles: the implications and possibilities of using solution-focused therapy in a child mental health setting.
ACPP Reviews & Newsletter, 17, 255-261. 3 mon follow-up of 34 (traced) sfbt referrals and 39 (traced) routine referrals: 23 (68%) vs 17 (44%) satisfied; other clinic resources used by 4 (12%) vs 12 (31%) . (John@jwheeler.freeserve.co.uk)
Zimmerman TS, Jacobsen RB, MacIntyre M,Watson C (1996) Solution-focused parenting groups: an empirical study.
Journal of Systemic Therapies, 15, 12-25. 30 clients, 6 sess; 12 controls no treatment. Improvement on Parenting Skills Inventory; no change on Family Strengths Assessment. (firstname.lastname@example.org)
Zimmerman TS, Prest LA,Wetzel BE (1997) Solution-focused couples therapy groups: an empirical study.
Journal of Family Therapy, 19, 125-144. Six weekly groups; 23 experimental and 13 controls; groups comparable on Marital Status Inventory. Experimental clients improved on Dyadic Adjustment Scale.
Thanks to Dr Alasdair Macdonald (email@example.com) for his invaluable help in compiling this summary of outcome studies.
We are always interested in further solution focused brief therapy research studies. If you know of any please let us know. If you attach a brief summary, we may place it on this site. E-mail us at firstname.lastname@example.org.
How do we work towards sustainable change? Evan George explores one little question which seems to make a difference.