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Solution focused brief therapy

Last update: 6 May 2016

► Solution focused brief therapy can help people take an active role in improving their mental health, personal life, emotional stability, relationships and behaviour
► It achieves improvements in fewer sessions than other interventions

Who is it for?

Solution focused brief therapy may be suitable for family members and carers as well as children and adults with cerebral palsy who have the following characteristics:
Age: Preschoolers, School-aged, Adolescents, Adults, Older adults, Family members and carers
Type of cerebral palsy : Bilateral cerebral palsy, Diplegia, Hemiplegia, Quadriplegia, Triplegia, Unilateral cerebral palsy

More information about cerebral palsy is contained in the What is CP? section.

Mobility : GMFCS I, GMFCS II, GMFCS III, GMFCS IV, GMFCS V

Gross Motor Function Classification System (GMFCS) – classifies severity of mobility difficulties of children and adolescents with CP.

GMFCS Level I
Walks without limitations in the home and community, climbs stairs and can run and jump, difficulties with speed and coordination.

GMFCS Level II
Walks with limitations, difficulties with long distances and uneven surfaces, uses a railing for climbing stairs, limited running and jumping.

GMFCS Level III
Walks using a hand-held mobility device such as crutches or walking frame, may use wheeled mobility for long distances.

GMFCS Level IV
Usually relies on wheeled mobility with assistance, may use powered mobility, usually needs special seating and assistance with transfers.

GMFCS Level V
Usually transported in a manual wheelchair, requires specialised seating and full assistance for transfers.

Arm ability : MACS I, MACS II, MACS III, MACS IV, MACS V

Manual Ability Classification System (MACS) – classifies severity of upper limb impairment: how children with cerebral palsy use their hands to handle objects in daily activities in the home, school, and community settings.

MACS Level I
Handles objects easily and successfully.

MACS Level II
Handles most objects but with somewhat reduced quality and/or speed of achievement.

MACS Level III
Handles objects with difficulty; needs help to prepare and/or modify activities.

MACS Level IV
Handles a limited selection of easily managed objects in adapted situations.

MACS Level V
Does not handle objects and has severely limited ability to perform even simple actions.

Communication ability : CFCS I, CFCS II, CFCS III, CFCS IV

Communication Function Classification System (CFCS) – classifies severity of everyday communication of people with cerebral palsy.

CFCS Level I
Effective Sender and Receiver with unfamiliar and familiar partners.

CFCS Level II
Effective but slower paced Sender and/or Receiver with unfamiliar and/or familiar partners.

CFCS Level III
Effective Sender and Receiver with familiar partners.

CFCS Level IV
Inconsistent Sender and/or Receiver with familiar partners.

CFCS Level V
Seldom effective Sender and Receiver even with familiar partners.

Movement disorder : Ataxia, Athetosis, Dystonia, Hypotonia, Spasticity

More information about movement disorders can be found on our websites.

Intellectual ability : No intellectual disability, Mild intellectual disability, Moderate intellectual disability, Severe intellectual disability

A person’s thinking skills – ability to understand ideas, learn and solve problems. People with intellectual disability have difficulty with intellectual functioning which may influence learning, communication, social and daily living skills. Intellectual disability may be mild to very severe.

Who can assist?

Therapists using solution focused brief therapy include social workers and psychologists who have specialist training in this approach. Therapy may be completed in various settings including the client’s home or a therapist’s workplace.

Cerebral Palsy Alliance offers a service where social workers and psychologists skilled in solution focused brief therapy can help you decide if this is a good approach for you and your family.

Find a Cerebral Palsy Alliance service

Fees

Fees will apply to see a health care practitioner for solution focused brief therapy and will depend on the provider and the number of sessions needed. Check with the practitioner whether fees will also apply for development of a home program, report writing or practitioner travel.

Ask the practitioner if you are eligible for funding to assist with fees. If you live in Australia you may be eligible for a health care rebate through Medicare or funding from the National Disability Insurance Scheme.

Time

Solution focused brief therapy is completed over the short term, usually 6 to 10 sessions or weeks.

More about solution focused brief therapy

Children, adolescents and adults participating in solution focused brief therapy take an active role in identifying their own strengths and resources. Solution focused brief therapy can assist individuals and their family to address mental and emotional health and wellbeing, behaviours of concern or relationship difficulties. It can be used with children and adults who have the capacity to reflect on their own situation, take an active role in identifying their own strengths and resources, work towards how they want things to be different and the achievement of positive outcomes.

Features of solution focused brief therapy

Solution focused brief therapy focuses on people’s strengths, looks towards a positive future and shifts the therapeutic emphasis from problems to solutions and strengths. Based on the assumptions that people are resourceful and resilient, the approach focusses on future hopes and what people want to be different - as well as what is already going well. The therapist and the client explore what progress or success might look like, both in the present and in the future, and what they may have done in the past that has already worked. By focussing on the client’s goals and hopes, solution focussed brief therapy aims to build the client’s confidence, sense of control and competency so they can successfully deal with challenges.

Therapy approach

This therapeutic approach:

  • is completed in a short time, usually in 6 to 10 sessions or weeks
  • can be used with individuals, couples, or in family or group settings
  • can be used together with other therapeutic approaches and behaviour management strategies.

Assessments

A client’s progress towards their desired future is reviewed throughout the therapeutic process, often using discussion and scaling questions. An example of a scaling question might be: ‘On a scale of zero to 10, how confident are you that you can achieve this goal?’ Scaling questions are also used at the end of the intervention to summarise achievements that have been made. In addition, therapists will often provide clients with a written record of their progress and successful results. These records are sometimes called therapeutic letters.

Best available research evidence

Where did we search?

We searched the social sciences and psychology literature, and the solution focused brief therapy Evaluation List1 to find studies evaluating the effectiveness of this therapeutic approach for people with cerebral palsy and their families and caregivers.

What were we looking for?

The search aimed to find studies evaluating the effects of solution focused brief therapy on children’s anxiety, depression and self-esteem (internalising behaviours), children’s behaviour including aggression and oppositional behaviour (externalising behaviours) and their academic achievement. Adult outcomes of interest were mental health symptoms, marriage and family outcomes. After finding no studies specific to cerebral palsy, the search was extended to locate high level studies (systematic reviews and randomised controlled trials) of solution focused brief therapy used with other groups of children and adults.

What did we find?

The best available evidence about the effectiveness of solution focused brief therapy is two systematic reviews (Level I evidence) of this therapeutic approach used with i) children2 and ii) all age groups3. One additional study was located which used solution focused brief therapy with families of children with disabilities; amongst these were children with cerebral palsy4.

Overall, moderate quality evidence supports solution focused brief therapy as an intervention for children, adolescents and adults. Although no research has been completed specifically with people with cerebral palsy and their families, solution focused brief therapy is a flexible intervention, effective in relatively few sessions, across a range of age groups, and to help manage a wide variety of challenging outcomes. In the absence of known adverse events, solution focused brief therapy appears a worthwhile intervention to consider for addressing challenging internalising and externalising behaviours in children and adolescents, as well as family stress, relationship and mental health concerns of families and carers of children and adolescents with cerebral palsy.

This approach is effective for reducing symptoms, particularly depression in adults

Gingerich and colleagues’ systematic review3 of all age groups concluded that solution focused brief therapy is effective for reducing symptoms, particularly depression, in adults with mental illness. The review also suggested there was preliminary evidence supporting solution focused brief therapy as an intervention to assist families experiencing stress.

This approach is useful for children and adolescents with moderate anxiety, low self-esteem and depressive symptoms

Both systematic reviews2,3 concluded that solution focused brief therapy was a useful intervention for children and adolescents, aged seven to 18 years old, with anxiety, low self-esteem and depressive symptoms (internalising symptoms). Solution focused brief therapy was more effective for children and adolescents with moderate, rather than severe, levels of difficulty2, and may be more effective for girls2.

This approach can reduce challenging behaviours, especially at school

Both systematic reviews also concluded that solution focused brief therapy reduced challenging behaviours (externalising behaviours) particularly in a school environment. The evidence is less clear for children and adolescents with complex difficulties2, that is, with both internalising and externalising behaviours.

This approach can achieve improvements in fewer sessions than other interventions

The reviews concluded that solution focused brief therapy was more effective than no intervention and as good as, and sometimes better than, an alternative and proven intervention. Another important conclusion is that solution focused brief therapy achieved improvement in fewer sessions than other interventions with good effects evident in five to 10 sessions3.

Although no research has been completed on people with cerebral palsy and their families, people are encouraged to seek support if they or someone in their family is having personal, mental health, emotional, relationship or behaviour difficulties. The decision to use solution focused brief therapy will be based on the needs and preferences of the person and their family, and the clinical expertise and knowledge of the therapist.

Date of literature searches: October 2014

  1. Macdonald, A. Solution Focused Brief Therapy Evaluation List. Accessed October 2014 at: http://www.solutionsdoc.co.uk/sft.html
  2. Bond, C., et al. (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. See abstract
  3. Gingerich, W.J., & Petersen L.T. (2012). Effectiveness of solution-focused brief therapy: A systematic qualitative review of controlled outcome studies. Research on Social Work Practice, 23(3), 266-283.
  4. Baldry, E., Bratel, J., Dunsire, M. & Durrant, M 2005. Keeping children with a disability safely in their families. Practice: a Journal of the British Association of Social Workers 17(3):143-156. See abstract
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