英文原文
Solution-focused brief therapy in schools: A review of the outcome literature. The application of solution-focused brief therapy (SFBT) with students and in school settings has grown over the past 10 years and has been applied to a number of behavioral and academic problems. This review of the research literature examined the most rigorous outcome studies on SFBT conducted in schools, given its promise within this specific setting and population. In addition, effect size estimates were calculated to further examine the effectiveness, thereby providing more quantitative information for each study. This review found mixed results but SFBT did show promise as a useful approach in working with at-risk students in a school setting, specifically helping students reduce the intensity of their negative feelings, manage their conduct problems, and externalizing behavioral problems. SFBT is a strengths-based intervention that is founded in the belief that it is important to build on the resources and motivation of clients because they know their problems the best and are capable of generating solutions to solve their own problems. Originating in the early 1980s, solution-focused brief therapy was developed inductively by social workers Steve de Shazer and Insoo Kim Berg and colleagues who wanted to study effective and brief therapeutic techniques for helping clients change. SFBT uses carefully posed questions that purposefully use communication tools from communication science that change perceptions through co-constructive language, combined with collaborative goal setting, and the use of solution-building techniques that occur between therapist and client. These carefully constructed communication processes are believed to be key components to helping client's change. Solutions emerge in perceptions and interactions between people and problems are not to be solved solely by the therapist but rather solutions are co-constructed with the client(s). The Research Committee of the Solution-Focused Brief Therapy Association developed a treatment manual to help standardize the implementation of SFBT by practitioners and increase treatment fidelity of the model. The committee identified three general ingredients of SFBT: (1) use of conversations centered on clients' concerns; (2) conversations focused on co-constructing new meanings around client concerns; (3) use of specific techniques to help clients co-construct a vision of a preferred future and drawing upon past success and strengths to help resolve issues. Previous articles further categorized SFBT by the following techniques and core components: 1. The therapist uses the miracle question; 2. Use of scaling questions; 3. A consulting break and giving the client a set of compliments; 4. Assigning homework tasks; 5. Looking for strengths or solutions; 6. Goal-setting; 7. Looking for exceptions to the problem. Currently, these core components remain important techniques for change in SFBT and are an integral part of doing SFBT. The practice of SFBT with children in school settings has grown over the past 10 years and continues to be of interest to researchers and school-based professionals such as school social workers, counselors, and psychologists. SFBT has been applied in school settings to a number of problems including student behavioral and emotional issues, academic problems, social skills, and dropout prevention. The brief nature of SFBT and its flexibility in working with diverse problems suggest this approach is a practical intervention that can be easily applied and sustained in a school setting. The application of SFBT in school settings, in some ways, is an apposite fit. Similar to therapists that serve clients in social agencies, for example, school-based professionals are inundated with large caseloads and time restrictions to serve all the students that need help. In these situations, SFBT may be useful for school-based professionals because SFBT is usually a brief intervention that tries to engage and focus on quick change with children, families and teachers. Furthermore, many school-based professionals deliver their services to students who have yearly goals for treatment, usually through an Individualized Education Plan (IEP). SFBT is well-suited to helping school-based professionals write those goals and collaborate with their students to meet those goals successfully. By identifying discrete changes, school-based professionals can easily integrate SFBT-thinking into their IEP goals. Public schools frequently serve high-risk populations such as homeless teens, immigrants, and teen parents. Many children referred for therapy in the school may also be considered mandated or involuntary clients and SFBT is a therapy that was developed for the purposes of being effective with involuntary client populations. Despite the increase in social workers and counselors using SFBT in schools, no review of research studies has been conducted examining its effectiveness for this particular setting. The aim of this present article is to review and examine the most rigorous outcome studies on SFBT conducted in schools, given its promise within this specific setting and population. In addition to reviewing the research literature, effect size estimates were calculated to further examine the effectiveness, thereby providing more quantitative information for each study. Given the scarceness of empirically supported interventions targeting both academic and mental health problems in school settings, the examination of SFBT as a potentially effective intervention for children in schools warrants further consideration and examination. For this review, published studies on SFBT in schools were identified through literature searches in various electronic databases using the keywords, “solution-focused brief therapy” and crossed referenced with “schools.” Outcome studies on solution-focused brief therapy have only been around since 1988 with most early studies using non-experimental designs with self-reported measures. Therefore, a time frame from 1988 to August 2007 was used in the literature search. Studies needed to be conducted in the United States and studies that were in press were also included in this review. To be included in the review, only primary studies using experimental designs that examined the effectiveness of SFBT conducted in either a school setting or with students were reviewed. For this study, SFBT will be operationalized based on the criteria set by de Shazer and Berg's article, Gingerich and Eisengart's systematic qualitative review, and the recent treatment manual as stated in the previous section. It was determined that at least one of these core components listed earlier must be utilized in order for a study to be considered SFBT and the authors of the primary studies must have identified the intervention as solution-focused. This decision was based on the Gingerich and Eisengart's article, which used this similar selection criterion. Additionally, if a study did not contain at least one of these core components, then it was excluded from this review. When the studies did not report effect sizes (d), the authors of this review calculated effect sizes when enough statistical information was provided. The authors used Morris and DeShon's recommended effect size sample estimator formulas for independent-groups pretest–posttest design and then used Hedges' unbiased correction estimate to correct for upward bias in effect size estimates. When a study reported no significant differences between experimental and control groups, then effect sizes were not calculated by the authors. Results from the literature search initially identified 14 studies with only seven meeting the criteria to be included in this review. Of the studies included in this outcome review, one study employed an experimental design, six were quasi-experimental designs, and one used a single-case design. Sample size ranged from 7 to 86 students with four studies conducted with middle school age students, one study with elementary school age students, one study with high school age students, and one study crossing all three school age levels. Below is a summary of the outcome studies on SFBT in schools and their effect size estimates calculated by the authors when not reported in the original study. Results are organized and summarized in relation to targeted outcomes, which focused on: self-esteem; student behavior; and academic outcomes. Both self-esteem and academic outcomes had three studies that examined these problems while student behavior had four studies that examined this outcome. The study by Froeschle et al. (2007) had all three outcome categories measured while Franklin et al. (2008) had two of the three outcome categories measured. Overall, the studies reviewed in this systematic review found mixed results regarding the outcome measures examined in the individual studies. Positive outcomes suggested that solution-focused therapy can be beneficial in helping students reduce the intensity of their negative feelings, manage their conduct problems, improve academic outcomes like credits earned, and positively impact externalizing behavioral problems and substance use. In one study it was also found that SFBT had equivalent results for impacting behavioral change as cognitive–behavioral therapy and had better outcomes for engaging clients and retaining them in the therapy process. Effect sizes calculated by the authors in the individual studies and also for this systematic review study showed that SFBT had medium and some large effect sizes. On the other hand negative outcomes suggested that SFBT was not successful in raising GPA or improving attendance rates of students. Froeschle et al. (2007) found no difference in GPA between groups and it doesn't appear that SFBT is effective with school attendance as evidenced by the results of two studies. It should be noted that though more than one study has shown positive behavioral change on standardized measures such as the Achenbach Child Behavior Checklist and Conners' Teacher Rating Scale, one study suggested that SFBT made no impact on behavior change as measured by negative behavioral referrals to the office. SFBT was also not successful at impacting the self-esteem of students as was evidenced by two studies. Mixed results and quality of the study designs preclude us from drawing definitive conclusions about whether SFBT as an effective intervention for certain outcomes with children and adolescents in school settings. The positive outcomes achieved in several studies examining externalizing problem behaviors, however, suggest that solution-focused brief therapy may be a useful approach for behavioral problems with at-risk students when applied in schools. The Franklin et al. (2008) study, for example, showed that SFBT improved the outcomes of children in a school setting that were having classroom and behavioral problems that could not be resolved by teachers, principals, or school counselors. After receiving the SFBT intervention, teachers and students reported on standardized measures (The Child Behavior Checklist and Youth Self-report Form) that the children's behavior problems significantly improved. Both teachers' and children's ratings improved and effect sizes were found to be in the medium to large range for the changes achieved. The positive findings for behavioral outcomes may have considerable clinical significance for school-based practitioners because of the size of the effect sizes achieved coupled with the fact that most of the studies involved salient issues for school practitioners (e.g. conduct problems, hyperactivity, substance use). In two other studies SFBT demonstrated school outcomes such as credits earned better grades and this also may be especially relevant to the school practice setting. Another advantage of SFBT for school-based practice is that it can be effective in helping to create change in the target problem quickly, as well as helping to identify specific goals collaborated on by both the client and therapist. This review indicates that SFBT may have significant positive impact on behavior using a brief therapy approach. The majority of studies examined in this review, for example, revealed that about four to eight sessions of SFBT were delivered to achieve favorable outcomes. Only two studies suggested that more than eight student sessions were delivered. Brief interventions suggest the clinical utility of SFBT for school settings that often require brief, practical responses for changing student behavior and academic problems. Negative and mixed findings are equally important to consider when deciding if SFBT is effective or not. Or in this case when deciding if SFBT has enough evidence to be considered as a relevant intervention for schools. The negative findings concerning attendance found in two studies is particularly important for school practitioners and deserves further explanation because the study designs and the measures used in these two studies may have confounded the results and therefore might be responsible for the non-significant findings. For example, Newsome's (2004) article found no difference between groups on attendance, but cites sample issues as a possible explanation for the non-significant results. Newsome states that while the students in the SFBT group had attendance problems the prior school year, these same students were actually attending school regularly during the academic year of the study. Therefore, school absences were not a problem with the SFBT sample prior to and at any point during the research study like they were the previous year when they were selected to participate but had not received the intervention yet. The lack of difference in absences between the SFBT and comparison group is not surprising since both groups were attending regularly. Similarly, Franklin et al. (2007) looked at attendance with at-risk high school students and found the comparison group did better in terms of school days attended for the semester. The results may be misleading due to the unique curriculum design of the high school where the SFBT students attended. In a regular high school, such as the comparison school, students can be seriously penalized academically for not attending class. The students receiving SFBT attended a school that uses a self-paced content mastery curriculum, where students can work at their own pace. This means that students who understand the course material well can complete their course requirements faster and finish before the school semester is officially over. These students who received SFBT could have finished their course work before the traditional semester was over and therefore would not need to attend classes anymore. The school district, however, counts the missed days in their database regardless, and considers these students absent. Therefore, the relationship between attendance and performance could possibly be mitigated by the nature of the curriculum. A follow-up statistical analysis correlating attendance and credits earned also supported this conclusion by showing that there was no relationship between attendance and credits earned in the solution-focused school group. What we can conclude from these two studies is that because of the flaws in the research designs and measures that more research needs to be completed before we know if SFBT is an effective intervention with attendance. Therefore a practitioner should not necessarily discount SFBT for attendance problems but at the same time no favorable evidence at present exists that supports using the approach either. This waits further study. The relevance and importance of outcomes measures used in the studies also have to be considered when examining those studies that found non-significant results on self-esteem. Springer et al. (2000) and Froeschle et al. (2007) found no difference between groups at posttest on the self-esteem measures in their studies. However, recently there is concern about the generalizability of using self-esteem as a dependent variable. It is not unusual for studies to provide interventions that try to improve self-esteem in adolescents with the hopes that this will lead to better school performance and behaviors. However recently research on the validity of using self-esteem as a measure for behavioral and academic improvements has been raised. Baumeister, Campbell, Krueger, and Vohs (2003) found that high self-esteem does not lead to improved school performance and may actually increase risky behaviors, such as smoking, drug use, and early sexual activity, in adolescents. They found little to no support for boosting self-esteem in an effort to improve academic and behavioral outcomes in adolescents. Hence, the use of SFBT to help increase self-esteem may not be an appropriate outcome for this intervention if the ultimate goal is to reduce risky behaviors and increase academic success. Self-esteem may not be the best measure to use if one is primarily looking at behavioral change. Caution should be used when interpreting the results from this outcome review due to the limited number of studies available. Along with the limited number of studies reviewed, sample sizes tended to be small in the individual studies, which limit statistical power to detect treatment effects and generalizability. Moreover, most of the studies examined used a quasi-experimental design with only one study employing a true experimental design with randomization, which has the highest controls for threats to internal validity. This is not unusual given the fact that all of these studies were conducted in school settings, thus increasing our confidence in generalization of clinical findings but making randomization difficult to implement. Despite these limitations, this review of the research literature shows that SFBT is achieving respectable outcomes when compared to other treatments that are being delivered in a community setting. Of particular note is the fact that most of the studies were conducted under real-world practice conditions and therefore the results show promise under typical school-based practice situations unlike the optimal clinical efficacy studies that have shown to be ineffective when the model is transferred into community practice settings. However, due to the non-significant results and mixed findings identified in this review, caution is warranted in drawing any definitive conclusions about the efficacy of SFBT in school settings. Based on the results of the studies examined in this review it is recommended that practitioners may wish to explore further the use of SFBT in their work with children and adolescents in schools. Studies reviewed suggest that SFBT may be effectively applied with a range of academic and behavioral problems in which schools struggle. Age ranges for applications in schools also appear to be flexible. Studies reviewed showed a range of age groups with one of the strongest designed studies showing positive outcomes with 5th and 6th graders. Positive results, however, were also achieved with adolescents suggesting that SFBT may be used effectively with both older children and adolescents. While SFBT shows promising findings, school-based professionals and researchers must work to provide more studies on this approach if a strong evidence-base is to be developed, especially with a grade point averages outcome since there were some non-significant and mixed results found in this review. Future studies need to examine more carefully which school-based populations and problem areas that SFBT are best suited to help. Researchers should also give attention to improving research designs on school-based studies of SFBT, and to continue using better measures as they replicate existing findings and explore new applications of SFBT in school-based settings.
中文翻译
焦点解决短期治疗在学校中的应用：结果文献综述。过去10年中，焦点解决短期治疗（SFBT）在学生和学校环境中的应用不断增长，并已应用于多种行为和学业问题。本研究综述了在学校环境中进行的SFBT最严格的结果研究，考虑到其在这一特定环境和人群中的潜力。此外，计算了效应量估计值以进一步检验其有效性，从而为每项研究提供更多定量信息。本综述发现结果不一，但SFBT确实显示出作为一种有用方法的潜力，适用于在学校环境中与高危学生工作，特别是帮助学生减少负面情绪的强度、管理他们的行为问题和外化行为问题。SFBT是一种基于优势的干预方法，其基础信念是建立在客户的资源和动机上很重要，因为他们最了解自己的问题，并且能够生成解决方案来解决自己的问题。起源于20世纪80年代初，焦点解决短期治疗是由社会工作者Steve de Shazer和Insoo Kim Berg及其同事归纳性开发的，他们希望研究有效且简短的治疗技术来帮助客户改变。SFBT使用精心设计的问题，有目的地利用沟通科学中的沟通工具，通过共同建构的语言改变认知，结合协作目标设定，以及治疗师与客户之间使用的解决方案构建技术。这些精心构建的沟通过程被认为是帮助客户改变的关键组成部分。解决方案出现在人们的感知和互动中，问题不是由治疗师单独解决，而是与客户共同建构的。焦点解决短期治疗协会的研究委员会制定了一份治疗手册，以帮助从业者标准化SFBT的实施并提高模型的治疗保真度。委员会确定了SFBT的三个一般要素：（1）使用以客户关注点为中心的对话；（2）专注于围绕客户关注点共同建构新意义的对话；（3）使用特定技术帮助客户共同建构一个偏好未来的愿景，并利用过去的成功和优势来帮助解决问题。之前的文章进一步将SFBT按以下技术和核心组成部分分类：1. 治疗师使用奇迹问题；2. 使用评分问题；3. 咨询休息并给予客户一系列赞美；4. 分配家庭作业任务；5. 寻找优势或解决方案；6. 目标设定；7. 寻找问题的例外情况。目前，这些核心组成部分仍然是SFBT中重要的改变技术，并且是进行SFBT不可或缺的一部分。过去10年中，SFBT在学校环境中与儿童的应用不断增长，并继续引起研究人员和学校专业人员（如学校社会工作者、辅导员和心理学家）的兴趣。SFBT已应用于学校环境中的多种问题，包括学生行为和情绪问题、学业问题、社交技能和辍学预防。SFBT的简短性质及其在处理多样化问题时的灵活性表明，这种方法是一种实用的干预措施，可以轻松地在学校环境中应用和维持。在某些方面，SFBT在学校环境中的应用是合适的。例如，类似于在社会机构中服务客户的治疗师，学校专业人员面临着大量的案例量和时间限制，需要服务所有需要帮助的学生。在这种情况下，SFBT可能对学校专业人员有用，因为SFBT通常是一种简短的干预措施，试图与儿童、家庭和教师快速参与并专注于快速改变。此外，许多学校专业人员向有年度治疗目标的学生提供服务，通常通过个性化教育计划（IEP）。SFBT非常适合帮助学校专业人员制定这些目标，并与学生合作成功实现这些目标。通过识别离散的变化，学校专业人员可以轻松地将SFBT思维整合到他们的IEP目标中。公立学校经常服务高危人群，如无家可归的青少年、移民和青少年父母。许多在学校被转介治疗的孩子也可能被视为强制或非自愿客户，而SFBT是一种为有效与非自愿客户群体工作而开发的疗法。尽管社会工作者和辅导员在学校中使用SFBT的增加，但尚未进行针对这一特定环境有效性的研究综述。本文的目的是综述和检查在学校环境中进行的SFBT最严格的结果研究，考虑到其在这一特定环境和人群中的潜力。除了综述研究文献外，还计算了效应量估计值以进一步检验其有效性，从而为每项研究提供更多定量信息。鉴于在学校环境中针对学业和心理健康问题的经验支持干预措施稀缺，将SFBT作为儿童在学校中潜在有效干预措施的检查值得进一步考虑和检查。对于本综述，通过在各种电子数据库中使用关键词“焦点解决短期治疗”并与“学校”交叉引用，识别了已发表的关于SFBT在学校中的研究。焦点解决短期治疗的结果研究自1988年才开始，大多数早期研究使用非实验设计和自我报告措施。因此，在文献搜索中使用了1988年至2007年8月的时间范围。研究需要在美国进行，并且正在出版的研究也包括在本综述中。为了被纳入综述，只审查了使用实验设计的主要研究，这些研究检查了在学校环境或与学生进行的SFBT的有效性。对于本研究，SFBT将基于de Shazer和Berg的文章、Gingerich和Eisengart的系统定性综述以及前一节所述的近期治疗手册中设定的标准进行操作化。确定至少必须使用前面列出的这些核心组成部分之一，研究才能被视为SFBT，并且主要研究的作者必须将干预标识为焦点解决。这一决定基于Gingerich和Eisengart的文章，该文章使用了类似的选择标准。此外，如果一项研究不包含至少一个这些核心组成部分，则被排除在本综述之外。当研究未报告效应量（d）时，本综述的作者在提供足够统计信息时计算了效应量。作者使用Morris和DeShon推荐的独立组前测-后测设计的效应量样本估计公式，然后使用Hedges的无偏校正估计来校正效应量估计中的向上偏差。当一项研究报告实验组和对照组之间没有显著差异时，作者未计算效应量。文献搜索的结果最初识别了14项研究，只有7项符合纳入本综述的标准。在本结果综述纳入的研究中，一项研究采用实验设计，六项是准实验设计，一项使用单案例设计。样本量从7到86名学生不等，其中四项研究针对初中年龄段学生，一项研究针对小学年龄段学生，一项研究针对高中年龄段学生，一项研究跨越所有三个学龄段。以下是关于SFBT在学校中的结果研究及其效应量估计的总结，当原始研究中未报告时由作者计算。结果按目标结果组织和总结，重点关注：自尊；学生行为；和学业结果。自尊和学业结果各有三项研究检查了这些问题，而学生行为有四项研究检查了这一结果。Froeschle等人（2007）的研究测量了所有三个结果类别，而Franklin等人（2008）测量了三个结果类别中的两个。总体而言，本系统综述中审查的研究在个别研究中检查的结果指标方面发现了混合结果。积极结果表明，焦点解决疗法可能有益于帮助学生减少负面情绪的强度、管理他们的行为问题、改善学业结果（如获得的学分），并对行为问题和物质使用产生积极影响。在一项研究中还发现，SFBT在影响行为改变方面与认知行为疗法有同等结果，并且在吸引客户和保留他们在治疗过程中有更好的结果。作者在个别研究中以及本系统综述研究中计算的效应量显示，SFBT具有中等和一些大的效应量。另一方面，负面结果表明，SFBT在提高GPA或改善学生出勤率方面不成功。Froeschle等人（2007）发现组间GPA没有差异，并且根据两项研究的结果，SFBT似乎对学校出勤率无效。应该指出的是，尽管不止一项研究在标准化测量（如Achenbach儿童行为量表和Conners教师评定量表）上显示出积极的行为改变，但一项研究表明，SFBT对行为改变没有影响，如通过负面行为转介到办公室的测量所示。SFBT在影响学生自尊方面也不成功，如两项研究所证明。混合结果和研究设计的质量使我们无法就SFBT作为儿童和青少年在学校环境中某些结果的有效干预措施得出明确结论。然而，在几项检查外化问题行为的研究中取得的积极结果表明，焦点解决短期疗法可能是一种有用的方法，适用于在学校中应用于高危学生的行为问题。例如，Franklin等人（2008）的研究表明，SFBT改善了在学校环境中儿童的结局，这些儿童有课堂和行为问题，无法由教师、校长或学校辅导员解决。在接受SFBT干预后，教师和学生在标准化测量（儿童行为量表和青少年自我报告表）上报告儿童的行为问题显著改善。教师和儿童的评分都有所改善，并且实现的改变的效应量在中等到大范围内。行为结果的积极发现可能对学校从业者具有相当大的临床意义，因为实现的效应量大小加上大多数研究涉及学校从业者的突出问题（如行为问题、多动症、物质使用）。在另外两项研究中，SFBT展示了学校结果，如获得的学分和更好的成绩，这也可能与学校实践环境特别相关。SFBT在学校实践中的另一个优势是，它可以有效地帮助快速改变目标问题，以及帮助识别由客户和治疗师共同协作的具体目标。本综述表明，SFBT使用简短疗法方法可能对行为产生显著的积极影响。例如，本综述中检查的大多数研究显示，大约四到八次SFBT会话可以实现有利的结果。只有两项研究表明进行了超过八次学生会话。简短干预表明SFBT对于学校环境的临床实用性，这些环境通常需要简短、实用的响应来改变学生行为和学业问题。负面和混合结果在决定SFBT是否有效时同样重要考虑。或者在这种情况下，决定SFBT是否有足够的证据被视为学校的相关干预措施。两项研究中发现的关于出勤率的负面结果对学校从业者尤为重要，值得进一步解释，因为这两项研究的研究设计和使用的测量可能混淆了结果，因此可能是非显著结果的原因。例如，Newsome（2004）的文章发现组间在出勤率上没有差异，但引用样本问题作为非显著结果的可能解释。Newsome指出，虽然SFBT组的学生在前一学年有出勤问题，但这些学生在研究学年实际上定期上学。因此，在研究期间，学校缺勤不是SFBT样本的问题，不像他们被选中参与但尚未接受干预的前一年那样。SFBT组和对照组在缺勤方面缺乏差异并不奇怪，因为两组都定期上学。类似地，Franklin等人（2007）研究了高危高中生的出勤率，发现对照组在学期出勤天数方面表现更好。结果可能具有误导性，因为SFBT学生所在的高中具有独特的课程设计。在常规高中，如对照组学校，学生可能因缺课而受到严重的学术惩罚。接受SFBT的学生就读的学校使用自定进度的内容掌握课程，学生可以按照自己的节奏学习。这意味着理解课程材料好的学生可以更快完成课程要求，并在学校学期正式结束前完成。这些接受SFBT的学生可能在传统学期结束前完成了课程作业，因此不再需要上课。然而，学区无论如何都在数据库中计算缺勤天数，并将这些学生视为缺勤。因此，出勤率与表现之间的关系可能因课程性质而缓解。一项后续统计分析关联出勤率和获得的学分也支持了这一结论，显示在焦点解决学校组中，出勤率与获得的学分之间没有关系。从这两项研究中我们可以得出结论，由于研究设计和测量的缺陷，在我们知道SFBT是否是出勤问题的有效干预措施之前，需要完成更多研究。因此，从业者不应必然否定SFBT用于出勤问题，但同时目前没有有利证据支持使用这种方法。这有待进一步研究。在检查那些在自尊方面发现非显著结果的研究时，还必须考虑研究中使用的结果测量的相关性和重要性。Springer等人（2000）和Froeschle等人（2007）发现组间在后测自尊测量上没有差异。然而，最近有人担心使用自尊作为因变量的普遍性。研究提供干预措施试图提高青少年的自尊并不罕见，希望这将导致更好的学校表现和行为。然而，最近关于使用自尊作为行为和学业改进测量的有效性提出了质疑。Baumeister、Campbell、Krueger和Vohs（2003）发现，高自尊不会导致学校表现改善，实际上可能增加青少年的风险行为，如吸烟、药物使用和早期性活动。他们发现几乎没有支持通过提高自尊来改善青少年的学业和行为结果。因此，如果最终目标是减少风险行为并增加学业成功，使用SFBT帮助提高自尊可能不是这种干预措施的适当结果。如果主要关注行为改变，自尊可能不是最佳测量指标。由于可用研究数量有限，在解释本结果综述的结果时应谨慎。除了审查的研究数量有限外，个别研究的样本量往往较小，这限制了检测治疗效果和普遍性的统计功效。此外，大多数检查的研究使用准实验设计，只有一项研究采用真正的实验设计并随机化，这具有最高的内部有效性威胁控制。鉴于所有这些研究都在学校环境中进行，这并不罕见，从而增加了我们对临床发现普遍性的信心，但使随机化难以实施。尽管有这些限制，本研究文献综述显示，与在社区环境中提供的其他治疗相比，SFBT正在取得可观的结果。特别值得注意的是，大多数研究是在真实世界实践条件下进行的，因此结果在典型的学校实践情况下显示出潜力，不像最佳临床疗效研究在模型转移到社区实践环境时显示无效。然而，由于本综述中识别的非显著结果和混合发现，在就SFBT在学校环境中的有效性得出任何明确结论时需要谨慎。基于本综述中检查的研究结果，建议从业者可能希望进一步探索在学校中与儿童和青少年工作中使用SFBT。审查的研究表明，SFBT可能有效地应用于学校中一系列学业和行为问题。在学校中的应用年龄范围也似乎很灵活。审查的研究显示了一系列年龄组，其中一项设计最强大的研究在五年级和六年级学生中显示出积极结果。然而，在青少年中也取得了积极结果，表明SFBT可能有效地用于较大儿童和青少年。虽然SFBT显示出有希望的发现，但如果要建立强大的证据基础，学校专业人员和研究人员必须努力提供更多关于这种方法的研究，特别是在GPA结果方面，因为本综述中发现了一些非显著和混合结果。未来的研究需要更仔细地检查SFBT最适合帮助哪些学校人群和问题领域。研究人员还应关注改进SFBT学校研究的研究设计，并在复制现有发现和探索SFBT在学校环境中的新应用时继续使用更好的测量。
文章概要
本文综述了焦点解决短期治疗（SFBT）在学校环境中的应用效果研究。SFBT是一种基于优势的简短疗法，强调通过共同建构的语言、协作目标设定和解决方案构建技术来帮助学生改变。综述发现，SFBT在减少学生负面情绪、管理行为问题和改善学业结果（如学分获得）方面显示出积极效果，效应量中等至大。然而，在提高GPA和出勤率方面效果不明显。研究设计多为准实验，样本量较小，但SFBT在学校实践中展现出实用性和灵活性，特别适用于高危学生和强制客户群体。未来需要更多高质量研究来进一步验证其有效性。
高德明老师的评价
用12岁初中生可以听懂的语音来重复翻译的内容：这篇文章就像在说，有一种叫SFBT的特别方法，可以帮助学校里遇到困难的同学。它就像一位聪明的朋友，不是直接告诉你该怎么做，而是问你一些有趣的问题，比如“如果明天一觉醒来，问题突然解决了，你会注意到什么不同？”这样，你自己就能找到解决问题的好办法。研究发现，用了这种方法，同学们的心情变好了，行为问题减少了，学习也更棒了。虽然有些地方效果还不明显，比如出勤率，但整体上它是个很有用的工具，让学校里的老师和同学一起合作，朝着更好的未来前进。
焦点解决心理学理论评价：从焦点解决心理学的视角看，这篇综述充分体现了SFBT的核心精神——聚焦于解决方案而非问题本身。研究强调了SFBT如何通过奇迹问题、评分问题等技术，激发学生的内在资源和目标导向思维。这种积极取向与SFBT的信念完美契合，即客户是自己问题的专家，能够共同建构有意义的改变。综述中提到的中等至大效应量，反映了SFBT在促进行为改变和学业进步方面的实际效能，这正是焦点解决理论所倡导的“小改变带来大不同”原则的生动例证。同时，研究对混合结果的坦诚讨论，也展现了SFBT实践中的灵活性和适应性，鼓励从业者根据具体情境调整策略。
在实践上可以应用的领域和可以解决人们的十个问题：SFBT在学校环境中具有广泛的应用潜力，可以应用于以下领域：1. 学生行为管理，帮助减少课堂干扰和冲突；2. 情绪调节，协助学生处理焦虑、抑郁等负面情绪；3. 学业支持，提升学习动机和成绩；4. 社交技能培养，改善同伴关系；5. 辍学预防，增强学校归属感；6. 高危学生干预，如无家可归或移民学生；7. 教师-学生协作，通过IEP目标设定促进成功；8. 简短咨询，适应学校时间限制；9. 强制客户工作，有效服务非自愿学生；10. 全校性心理健康促进，营造积极校园氛围。可以解决的具体问题包括：学生行为问题、情绪困扰、学业落后、社交困难、出勤率低、高风险行为（如物质使用）、家庭挑战、自我效能感不足、目标设定模糊以及师生沟通障碍。这些应用都指向一个充满希望的未来，即通过焦点解决的方法，学校可以成为学生成长和改变的强大支持系统。