英文原文
What is Solution-Focused Therapy: 3 Essential Techniques
Key Insights
Solution-focused therapy emphasizes identifying & building on strengths to foster positive change & achieve goals. By focusing on solutions rather than problems, clients are empowered to envision & create their preferred future. Techniques like the Miracle Question & scaling help clarify goals & track progress, encouraging a proactive approach to challenges.
Imagine this scenario: You work at a company that produces widgets. You’re at an important business meeting, and you’re there to discuss some problems your company is having with its production. At the meeting, you explain what’s causing the problems: The widget-producing machine your company uses is getting old and slowing down. The machine is made up of hundreds of small parts that work in concert, and it would be much more expensive to replace each of these old, worn-down parts than to buy a new widget-producing machine. You are hoping to convey to the other meeting attendees the impact of the problem, and the importance of buying a new widget-producing machine. You give a comprehensive overview of the problem and how it is impacting production. One meeting attendee asks, “So which part of the machine, exactly, is getting worn down?” Another says, “Please explain in detail how our widget-producing machine works.” Yet another asks, “How does the new machine improve upon each of the components of the machine?” A fourth attendee asks, “Why is it getting worn down? We should discuss how the machine was made in order to fully understand why it is wearing down now.” You are probably starting to feel frustrated that your colleagues’ questions don’t address the real issue. You might be thinking, “What does it matter how the machine got worn down when buying a new one would fix the problem?” In this scenario, it is much more important to buy a new widget-producing machine than it is to understand why machinery wears down over time. When we’re seeking solutions, it’s not always helpful to get bogged down in the details. We want results, not a narrative about how or why things became the way they are. This is the idea behind solution-focused therapy. For many people, it is often more important to find solutions than it is to analyze the problem in great detail. This article will cover what solution-focused therapy is, how it’s applied, and what its limitations are.
What Is Solution-Focused Therapy? Solution-focused therapy, also called solution-focused brief therapy (SFBT), is a type of therapy that places far more importance on discussing solutions than problems (Berg, n.d.). Of course, you must discuss the problem to find a solution, but beyond understanding what the problem is and deciding how to address it, solution-focused therapy will not dwell on every detail of the problem you are experiencing. Solution-focused brief therapy doesn’t require a deep dive into your childhood and the ways in which your past has influenced your present. Instead, it will root your sessions firmly in the present while working toward a future in which your current problems have less of an impact on your life (Iveson, 2002). This solution-centric form of therapy grew out of the field of family therapy in the 1980s. Creators Steve de Shazer and Insoo Kim Berg noticed that most therapy sessions were spent discussing symptoms, issues, and problems. De Shazer and Berg saw an opportunity for quicker relief from negative symptoms in a new form of therapy that emphasized quick, specific problem-solving rather than an ongoing discussion of the problem itself. The word “brief” in solution-focused brief therapy is key. The goal of SFBT is to find and implement a solution to the problem or problems as soon as possible to minimize time spent in therapy and, more importantly, time spent struggling or suffering (Antin, 2018). SFBT is committed to finding realistic, workable solutions for clients as quickly as possible, and the efficacy of this treatment has influenced its spread around the world and use in multiple contexts. SFBT has been successfully applied in individual, couples, and family therapy. The problems it can address are wide-ranging, from the normal stressors of life to high-impact life events. The only realm in which SFBT is generally not recommended is that of the more extreme mental health issues, such as schizophrenia or major depressive disorder (Antin, 2018).
Popular Techniques and Interventions Asking good questions is vital in any form of therapy, but SFBT formalized this practice into a technique that specifies a certain set of questions intended to provoke thinking and discussion about goal-setting and problem-solving. One such question is the “coping question.” This question is intended to help clients recognize their own resiliency and identify some of the ways in which they already cope with their problems effectively. There are many ways to phrase this sort of question, but generally, a coping question is worded something like, “How do you manage, in the face of such difficulty, to fulfill your daily obligations?” (Antin, 2018). Another type of question common in SFBT is the “miracle question.” The miracle question encourages clients to imagine a future in which their problems are no longer affecting their lives. Imagining this desired future will help clients see a path forward, both allowing them to believe in the possibility of this future and helping them to identify concrete steps they can take to make it happen. This question is generally asked in the following manner: “Imagine that a miracle has occurred. This problem you are struggling with is suddenly absent from your life. What does your life look like without this problem?” (Antin, 2018). If the miracle question is unlikely to work, or if the client is having trouble imagining this miracle future, the SFBT therapist can use “best hopes” questions instead. The client’s answers to these questions will help establish what the client is hoping to achieve and help him or her set realistic and achievable goals. The “best hopes” questions can include the following: What are your best hopes for today’s session? What needs to happen in this session to enable you to leave thinking it was worthwhile? How will you know things are “good enough” for our sessions to end? What needs to happen in these sessions so that your relatives/friends/coworkers can say, “I’m really glad you went to see [the therapist]”? (Vinnicombe, n.d.). To identify the exceptions to the problems plaguing clients, therapists will ask “exception questions.” These are questions that ask about clients’ experiences both with and without their problems. This helps to distinguish between circumstances in which the problems are most active and the circumstances in which the problems either hold no power or have diminished power over clients’ moods or thoughts. Exception questions can include: Tell me about the times when you felt the happiest; What was it about that day that made it a better day? Can you think of times when the problem was not present in your life? (Counselling Directory, 2017). Another question frequently used by SFBT practitioners is the “scaling question.” It asks clients to rate their experiences (such as how their problems are currently affecting them, how confident they are in their treatment, and how they think the treatment is progressing) on a scale from 0 (lowest) to 10 (highest). This helps the therapist to gauge progress and learn more about clients’ motivation and confidence in finding a solution. For example, an SFBT therapist may ask, “On a scale from 0 to 10, how would you rate your progress in finding and implementing a solution to your problem?” (Antin, 2018).
Do One Thing Different This exercise can be completed individually, but the handout may need to be modified for adult or adolescent users. This exercise is intended to help the client or individual to learn how to break his or her problem patterns and build strategies to simply make things go better. The handout breaks the exercise into the following steps (Coffen, n.d.): Step One Think about the things you do in a problem situation. Change any part you can. Choose to change one thing, such as the timing, your body patterns (what you do with your body), what you say, the location, or the order in which you do things; Think of a time that things did not go well for you. When does that happen? What part of that problem situation will you do differently now? Step Two Think of something done by somebody else does that makes the problem better. Try doing what they do the next time the problem comes up. Or, think of something that you have done in the past that made things go better. Try doing that the next time the problem comes up; Think of something that somebody else does that works to make things go better. What is the person’s name and what do they do that you will try? Think of something that you have done in the past that helped make things go better. What did you do that you will do next time? Step Three Feelings tell you that you need to do something. Your brain tells you what to do. Understand what your feelings are but do not let them determine your actions. Let your brain determine the actions; Feelings are great advisors but poor masters (advisors give information and help you know what you could do; masters don’t give you choices); Think of a feeling that used to get you into trouble. What feeling do you want to stop getting you into trouble? Think of what information that feeling is telling you. What does the feeling suggest you should do that would help things go better? Step Four Change what you focus on. What you pay attention to will become bigger in your life and you will notice it more and more. To solve a problem, try changing your focus or your perspective. Think of something that you are focusing on too much. What gets you into trouble when you focus on it? Think of something that you will focus on instead. What will you focus on that will not get you into trouble? Step Five Imagine a time in the future when you aren’t having the problem you are having right now. Work backward to figure out what you could do now to make that future come true; Think of what will be different for you in the future when things are going better; Think of one thing that you would be doing differently before things could go better in the future. What one thing will you do differently? Step Six Sometimes people with problems talk about how other people cause those problems and why it’s impossible to do better. Change your story. Talk about times when the problem was not happening and what you were doing at that time. Control what you can control. You can’t control other people, but you can change your actions, and that might change what other people do; Think of a time when you were not having the problem that is bothering you. Talk about that time. Step Seven If you believe in a god or a higher power, focus on God to get things to go better. When you are focused on God or you are asking God to help you, things might go better for you. Do you believe in a god or a higher power? Talk about how you will seek help from your god to make things go better. Step Eight Use action talk to get things to go better. Action talk sticks to the facts, addresses only the things you can see, and doesn’t address what you believe another person was thinking or feeling—we have no way of knowing that for sure. When you make a complaint, talk about the action that you do not like. When you make a request, talk about what action you want the person to do. When you praise someone, talk about what action you liked; Make a complaint about someone cheating at a game using action talk; Make a request for someone to play fairly using action talk; Thank someone for doing what you asked using action talk. Following these eight steps and answering the questions thoughtfully will help people recognize their strengths and resources, identify ways in which they can overcome problems, plan and set goals to address problems, and practice useful skills. While this handout can be extremely effective for SFBT, it can also be used in other therapies or circumstances.
Presupposing Change This is a handy technique for SFBT therapists and it doesn’t really apply to individuals who are not working with a therapist. The “presupposing change” technique has great potential in SFBT, in part because when people are experiencing problems, they have a tendency to focus on the problems and ignore the positive changes in their life. It can be difficult to recognize the good things happening in your life when you are struggling with a painful or particularly troublesome problem. This technique is intended to help clients be attentive to the positive things in their lives, no matter how small or seemingly insignificant. Any positive change or tiny step of progress should be noted, so clients can both celebrate their wins and draw from past wins to facilitate future wins. Presupposing change is a strikingly simple technique to use: Ask questions that assume positive changes. This can include questions like, “What’s different or better since I saw you last time?” If clients are struggling to come up with evidence of positive change or are convinced that there has been no positive change, the therapist can ask questions that encourage clients to think about their abilities to effectively cope with problems, like, How come things aren’t worse for you? What stopped total disaster from occurring? How did you avoid falling apart? (Australian Institute of Professional Counsellors, 2009).
A Take-Home Message Solution-focused therapy puts problem-solving at the forefront of the conversation and can be particularly useful for clients who aren’t suffering from major mental health issues and need help solving a particular problem (or problems). Rather than spending years in therapy, SFBT allows such clients to find solutions and get results quickly.
中文翻译
什么是焦点解决疗法：三个基本技巧
关键见解
焦点解决疗法强调识别和利用优势来促进积极变化和实现目标。通过关注解决方案而非问题，来访者被赋能去设想和创造他们偏好的未来。奇迹提问和评分等技巧有助于澄清目标和跟踪进展，鼓励对挑战采取积极主动的方法。
想象这样一个场景：你在一家生产小部件的公司工作。你正在参加一个重要的商务会议，讨论公司生产方面的一些问题。在会议上，你解释了问题的原因：公司使用的小部件生产机器正在老化并减速。这台机器由数百个协同工作的小部件组成，更换这些老旧磨损的部件比购买一台新的小部件生产机器要昂贵得多。你希望向其他与会者传达问题的影响，以及购买新机器的重要性。你全面概述了问题及其对生产的影响。一位与会者问：“那么，机器的哪个部分确切地说正在磨损？”另一位说：“请详细解释我们的小部件生产机器是如何工作的。”又一位问：“新机器如何改进机器的每个部件？”第四位与会者问：“为什么它会磨损？我们应该讨论机器是如何制造的，以便充分理解为什么现在会磨损。”你可能开始感到沮丧，因为同事的问题没有触及真正的问题。你可能会想：“当购买一台新机器就能解决问题时，机器是如何磨损的又有什么关系呢？”在这种情况下，购买一台新的小部件生产机器比理解机器为什么会随着时间的推移而磨损要重要得多。当我们寻求解决方案时，陷入细节并不总是有帮助的。我们想要结果，而不是关于事情如何或为何变成这样的叙述。这就是焦点解决疗法背后的理念。对许多人来说，找到解决方案通常比详细分析问题更重要。本文将介绍什么是焦点解决疗法、如何应用以及其局限性。
什么是焦点解决疗法？焦点解决疗法，也称为焦点解决短期疗法（SFBT），是一种更重视讨论解决方案而非问题的疗法（Berg，n.d.）。当然，你必须讨论问题才能找到解决方案，但除了理解问题是什么并决定如何解决之外，焦点解决疗法不会纠结于你所经历的每一个问题细节。焦点解决短期疗法不需要深入探讨你的童年以及过去如何影响现在。相反，它将你的治疗会话牢牢扎根于当下，同时致力于一个未来，在这个未来中，你当前的问题对你的生活影响较小（Iveson，2002）。这种以解决方案为中心的治疗形式起源于20世纪80年代的家庭治疗领域。创始人Steve de Shazer和Insoo Kim Berg注意到，大多数治疗会话都花在讨论症状、问题和问题上。De Shazer和Berg看到了在新形式的疗法中更快缓解负面症状的机会，这种疗法强调快速、具体的问题解决，而不是持续讨论问题本身。焦点解决短期疗法中的“短期”一词是关键。SFBT的目标是尽快找到并实施问题或问题的解决方案，以最大限度地减少花在治疗上的时间，更重要的是，减少花在挣扎或痛苦上的时间（Antin，2018）。SFBT致力于尽快为来访者找到现实可行的解决方案，这种治疗的有效性影响了其在全球的传播和在多种情境下的使用。SFBT已成功应用于个人、夫妻和家庭治疗。它可以解决的问题范围广泛，从正常的压力源到高影响的生活事件。SFBT通常不推荐的唯一领域是更极端的精神健康问题，如精神分裂症或重度抑郁症（Antin，2018）。
流行技巧和干预措施在任何形式的治疗中，提出好问题都至关重要，但SFBT将这种做法形式化为一种技巧，指定了一组旨在激发关于目标设定和问题解决的思考和讨论的问题。其中一个问题是“应对问题”。这个问题旨在帮助来访者认识到自己的韧性，并识别他们已经有效应对问题的一些方式。这种问题有很多表达方式，但通常，应对问题的措辞类似于：“面对如此困难，你是如何设法履行日常义务的？”（Antin，2018）。SFBT中常见的另一种问题是“奇迹提问”。奇迹提问鼓励来访者想象一个未来，在这个未来中，他们的问题不再影响他们的生活。想象这个期望的未来将帮助来访者看到前进的道路，既让他们相信这个未来的可能性，又帮助他们确定可以采取的具体步骤来实现它。这个问题通常以下列方式提出：“想象一下，奇迹发生了。你正在挣扎的问题突然从你的生活中消失了。没有这个问题，你的生活是什么样子？”（Antin，2018）。如果奇迹提问不太可能奏效，或者来访者难以想象这个奇迹般的未来，SFBT治疗师可以使用“最佳希望”问题代替。来访者对这些问题回答将有助于确定来访者希望实现什么，并帮助他或她设定现实且可实现的目标。“最佳希望”问题可以包括以下内容：你对今天的会话有什么最佳希望？这次会话需要发生什么才能让你离开时觉得值得？你怎么知道事情“足够好”到可以结束我们的会话？这些会话需要发生什么，才能让你的亲戚/朋友/同事说：“我真的很高兴你去看[治疗师]”？（Vinnicombe，n.d.）。为了识别困扰来访者的问题的例外情况，治疗师会问“例外问题”。这些问题询问来访者有问题和没有问题时的经历。这有助于区分问题最活跃的情况和问题要么没有力量要么对来访者情绪或思想影响减弱的情况。例外问题可以包括：告诉我你感到最快乐的时刻；那天是什么让它成为更好的一天？你能想到问题不在你生活中的时候吗？（Counselling Directory，2017）。SFBT从业者经常使用的另一个问题是“评分问题”。它要求来访者以0（最低）到10（最高）的等级对他们的经历（例如他们的问题目前如何影响他们，他们对治疗的信心如何，以及他们认为治疗进展如何）进行评分。这有助于治疗师评估进展，并更多地了解来访者寻找解决方案的动力和信心。例如，SFBT治疗师可能会问：“在0到10的范围内，你如何评价你在寻找和实施问题解决方案方面的进展？”（Antin，2018）。
做一件不同的事这个练习可以单独完成，但讲义可能需要为成人或青少年用户修改。这个练习旨在帮助来访者或个人学习如何打破他或她的问题模式，并建立策略来简单地让事情变得更好。讲义将练习分解为以下步骤（Coffen，n.d.）：第一步思考你在问题情境中所做的事情。改变你能改变的任何部分。选择改变一件事，比如时间安排、你的身体模式（你用身体做什么）、你说的话、地点或你做事的顺序；想一个事情进展不顺利的时候。那是什么时候发生的？现在你会对那个问题情境的哪一部分采取不同的做法？第二步想想别人做的让问题变得更好的事情。下次问题出现时，尝试做他们做的事。或者，想想你过去做的让事情变得更好的事情。下次问题出现时，尝试做那件事；想想别人做的让事情变得更好的事情。那个人的名字是什么，他或她做什么你会尝试？想想你过去做的帮助让事情变得更好的事情。你做了什么下次会做？第三步感觉告诉你需要做某事。你的大脑告诉你该做什么。理解你的感受是什么，但不要让它们决定你的行动。让你的大脑决定行动；感觉是很好的顾问，但糟糕的主人（顾问提供信息并帮助你知道你可以做什么；主人不给你选择）；想一个过去让你陷入麻烦的感觉。你想停止哪个感觉让你陷入麻烦？想想那个感觉告诉你什么信息。那个感觉建议你应该做什么来帮助事情变得更好？第四步改变你关注的东西。你关注的东西会在你的生活中变得更大，你会越来越注意到它。为了解决一个问题，尝试改变你的关注点或视角。想想你过于关注的东西。当你关注它时，什么会让你陷入麻烦？想想你会关注的其他东西。你会关注什么不会让你陷入麻烦？第五步想象一个未来，那时你没有现在遇到的问题。倒推找出你现在可以做什么来实现那个未来；想想当事情变得更好时，未来对你有什么不同；想想在事情未来变得更好之前，你会做一件不同的事。你会做哪一件不同的事？第六步有时有问题的人会谈论别人如何导致那些问题，以及为什么不可能做得更好。改变你的故事。谈论问题没有发生的时候以及你当时在做什么。控制你能控制的。你无法控制别人，但你可以改变你的行动，这可能会改变别人的做法；想一个你没有遇到困扰你的问题的时候。谈论那个时候。第七步如果你相信上帝或更高的力量，关注上帝来让事情变得更好。当你关注上帝或请求上帝帮助你时，事情可能会变得更好。你相信上帝或更高的力量吗？谈谈你将如何寻求上帝的帮助来让事情变得更好。第八步使用行动谈话来让事情变得更好。行动谈话坚持事实，只涉及你能看到的东西，不涉及你认为另一个人在想什么或感觉什么——我们无法确切知道。当你抱怨时，谈论你不喜欢的行动。当你提出请求时，谈论你希望那个人做什么行动。当你表扬某人时，谈论你喜欢的行动；使用行动谈话抱怨有人在游戏中作弊；使用行动谈话请求某人公平游戏；使用行动谈话感谢某人做了你要求的事。遵循这八个步骤并深思熟虑地回答这些问题将帮助人们认识到自己的优势和资源，识别他们可以克服问题的方式，计划和设定目标来解决问题，并练习有用的技能。虽然这个讲义对SFBT非常有效，但它也可以用于其他疗法或情况。
预设改变这是SFBT治疗师的一个方便技巧，它并不真正适用于不与治疗师合作的个人。“预设改变”技巧在SFBT中具有巨大潜力，部分原因是当人们经历问题时，他们倾向于关注问题而忽视生活中的积极变化。当你与痛苦或特别麻烦的问题作斗争时，很难认识到生活中发生的好事。这项技巧旨在帮助来访者关注生活中的积极事物，无论多么微小或看似微不足道。任何积极的变化或微小的进步步骤都应该被注意到，这样来访者既可以庆祝他们的胜利，也可以从过去的胜利中汲取经验以促进未来的胜利。预设改变是一种极其简单的使用技巧：提出假设积极变化的问题。这可以包括诸如“自从我上次见到你以来，有什么不同或更好？”之类的问题。如果来访者难以提出积极变化的证据，或者确信没有积极变化，治疗师可以提出鼓励来访者思考他们有效应对问题的能力的问题，例如，为什么事情没有变得更糟？是什么阻止了全面灾难的发生？你是如何避免崩溃的？（Australian Institute of Professional Counsellors，2009）。
带回家的信息焦点解决疗法将问题解决置于对话的前沿，对于没有遭受严重精神健康问题且需要帮助解决特定问题（或问题）的来访者特别有用。与其花多年时间治疗，SFBT允许这样的来访者快速找到解决方案并获得结果。
文章概要
本文介绍了焦点解决短期疗法（SFBT）的核心概念、技巧和应用。SFBT强调关注解决方案而非问题，通过识别和利用个人优势来促进积极变化和实现目标。文章详细阐述了三种关键技巧：奇迹提问帮助来访者设想无问题的未来；评分问题量化进展和信心；预设改变技巧关注积极变化。此外，文章还介绍了“做一件不同的事”练习，通过八个步骤帮助打破问题模式。SFBT适用于个人、夫妻和家庭治疗，能有效处理生活压力和高影响事件，但不推荐用于严重精神健康问题。文章最后总结了SFBT的实用性和快速见效的特点。
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：焦点解决疗法就像是一个超级英雄工具箱，里面有三个很酷的工具。第一个工具是“奇迹提问”，它让你想象如果问题突然消失了，你的生活会是什么样子，就像魔法一样。第二个工具是“评分问题”，它让你用0到10的数字来打分，看看你离目标有多近，就像游戏里的进度条。第三个工具是“预设改变”，它让你注意生活中已经变好的小事情，就像收集星星一样。还有一个练习叫“做一件不同的事”，教你通过改变一个小动作来让事情变得更好，就像换个方式玩玩具。这些工具都帮你关注怎么解决问题，而不是一直想着问题有多糟糕。
焦点解决心理学理论评价：焦点解决疗法展现了心理学中一种积极、前瞻性的范式转变。它基于“例外”理论，即问题的解决方案往往隐藏在问题不发生的时刻，这体现了对个体内在资源的深刻信任。SFBT的核心假设——变化是恒定的、个体是自身问题的专家、治疗应聚焦于未来——与建构主义和社会建构主义理论高度契合。通过奇迹提问和评分等技巧，SFBT不仅促进目标澄清，还强化了来访者的自我效能感和能动性。这种疗法将心理学从病理导向转向优势导向，赞美了人类固有的韧性和解决问题的能力。其短期、目标驱动的模式反映了对效率和人本价值的尊重，为心理干预提供了简洁而有力的框架。
在实践上可以应用的领域和可以解决人们的十个问题：焦点解决疗法在多个领域具有广泛应用潜力。在教育领域，它可以帮助学生设定学习目标、克服考试焦虑。在职场中，它能协助员工提升工作效率、改善团队沟通。家庭咨询中，SFBT可促进亲子关系和谐、解决夫妻冲突。社区服务方面，它支持个人应对生活压力、增强社会适应力。具体可解决的十个问题包括：1. 帮助个人设定并实现短期职业目标；2. 缓解日常压力带来的情绪困扰；3. 改善人际关系中的沟通障碍；4. 增强自信心和自我价值感；5. 应对学业或工作中的挑战；6. 促进健康生活习惯的养成；7. 解决家庭内部的小摩擦；8. 提升问题解决能力和决策力；9. 帮助个体从挫折中快速恢复；10. 支持人们规划并迈向更满意的未来生活。这些应用都聚焦于挖掘个体潜力，创造积极改变。