英文原文
Solution Focused Practice: A brief summary of the health-related evidence base. Promoting health behaviour change: Using a Solution Focused Approach. There is overwhelming evidence that changing people’s health related behaviour can have a major impact on some of the leading causes of mortality and morbidity. Behaviour plays an important role in people’s health, for example smoking; being physically inactive or poor diet can cause a large number of diseases. NICE (2007) public health behaviour change guidance recommends that: ‘Policy makers, commissioners, trainers, service providers, curriculum developers and practitioners should provide training and support for those involved in changing people’s health-related behaviour so that they can develop a full range of competencies’. The NICE (2007) behaviour change guidance also recommends that: ‘Any interventions or programmes to change health-related behaviour should aim to develop and build upon peoples’ strengths and assets (that is, their skills, talents and capacity)’. The BHFNC’s Promoting health behaviour change course introduces professionals to key solution focused practice principles and techniques and equips professionals with the skills and competencies to integrate solution focused practice into routine consultations for promoting health-related lifestyle change. The underlying principles and techniques of solution focused practice are taken from Solution Focused Brief Therapy (SFBT). SFBT is practiced by a wide variety of practitioners from differing professional backgrounds. At the heart of this approach is sensitivity to individual differences, with what the individual brings to the work (i.e., their strengths and abilities) being placed at the centre of behaviour change conversations. Solution focused practice is a term used by medical and allied health professionals using SFBT principles and techniques. The use of solution focused practice has been recommended within several health publications. The evidence base: Until recently the majority of SFBT research has focused on the application and effectiveness of SFBT in family therapy and counselling in mental health and educational settings. However, there is now an emerging evidence base on the use of solution focused practice in health-related settings. Below is a selection of experimental research looking at the application of solution focused practice in a health-related/behaviour change context. Hendrick, S., Isebaert, L. &, Dolan, Y. (2011) Solution-focused brief therapy in alcohol treatment. Two studies examining the use of SFBT in alcohol treatment, both studies found significant improvements in drinking habits and health at 1 year follow-up. Vogelaar, L., Van’t Spijker, A., Vogelaar, T., van Busschbach, J.J., Visser, M.S., Kuipers, E.J. & van der Woude, C.J. (2011) Solution focused therapy: A promising new tool in the management of fatigue in Crohn's disease patients: psychological interventions for the management of fatigue in Crohn's disease. Patients with quiescent Crohn's disease and a high fatigue score were randomised to either Problem Solving Therapy (PST), Solution Focused Therapy (SFT) or to a Treatment As Usual (TAU) control group. The SFT group improved on the fatigue scale in 85.7% of the patients, in the PST group 60% showed improved fatigue scores and in the TAU group 45.5%. Although not significant quality of life increased in both intervention groups. Medical costs lowered in 57.1% of the patients in the SFT group compared to 45.5% in the TAU and 20% in the PST group. SFT seems a promising new tool in the management of fatigue in Crohn's patients. Rudolf, M.C., Hunt, C., George, J., Hajibagheri, K. & Blair, M. (2010) HENRY: development, pilot and long-term evaluation of a programme to help practitioners work more effectively with parents of babies and pre-school children to prevent childhood obesity. Twelve Children's Centres in Oxfordshire took part in the pilot involving 137 staff. HENRY--Health Exercise Nutrition for the Really Young--trains health and community practitioners to work more sensitively and effectively with parents of babies and pre-school children around obesity and lifestyle concerns. Underpinned by the Family Partnership Model, reflective practice and solution-focused techniques, it offers face-to-face training and e-learning. Questionnaires were administered at the end of training courses. Self-reported confidence ratings were obtained before and after training. Postal questionnaires were sent to Centre managers 2-6 months later to ascertain long-term effects. Nine managers participated in in-depth interviews. A further 535 learners completed the e-learning course and online feedback. One hundred and thirty-one staff (96%) completed the training course and valued it as a way of enhancing skills and knowledge. Self-reported confidence ratings increased. Long-term follow-up indicated ongoing impact attributed to HENRY on both Centres and staff. Ninety-eight percent of the e-learners would recommend HENRY; 94% thought it enhanced their skills as well as knowledge. HENRY is an innovative approach that offers some promise in tackling obesity through training community and health practitioners to work more effectively with parents of very young children. Further research is required to determine if there is a desired positive impact on young children's lifestyles and risk of obesity. Reinehr, T., Kleber, M., Lass, N. & Toschke, A.M. (2010) Body mass index patterns over 5 years in obese children motivated to participate in a 1 year lifestyle intervention: Age as a predictor of long-term success. Six-hundred and sixty-three children (aged 4-16 years) were offered an outpatient lifestyle intervention which included 6 solution focused practice consultations plus a nutrition and exercise programme. Annual changes in the BMI SD score (BMI-SDS) were analysed over a 5 year period. A significant mean decrease in BMI-SDS was reported at the end of the 1 year intervention and 4 years after the intervention. The best long-term effects were found in the younger aged children, which supports the need for early intervention in childhood obesity. Nowicka, P., Haglund, P., Pietrobelli, A., Lissau, I. & Flodmark, C.E. (2008) Family weight school treatment: 1-year results in obese adolescents. Seventy-two obese adolescents aged 12-19 years old were referred to a childhood obesity centre and offered a Family Weight School therapy programme provided by a multidisciplinary team. An intervention group was compared with an untreated waiting list control group. Body mass index (BMI) and BMI z-scores were calculated before and after intervention. Ninety percent of the intervention group completed the programme (34 boys, 31 girls; mean age 14.8 years, mean BMI 34, mean BMI z-score 3.3). In the control group 10 boys and 13 girls (mean age 14.3 years, mean BMI = 34.1, mean BMI z-score = 3.2) participated in the 1-year follow-up. Adolescents in the intervention group with initial BMI z-score < 3.5 (n = 49 out of 65, baseline mean age = 14.8, mean BMI = 33.0, mean BMI z-score = 3.1) showed a significant decrease in BMI z-scores (-0.09, p = 0.039) compared with those in the control group with initial BMI z-score < 3.5 (n = 17 out of 23, mean baseline age = 14.1, mean baseline BMI = 31.6, mean baseline BMI z-score = 3.01). No difference was found in adolescents with BMI z-scores > 3.5. Nowicka, P., Pietrobelli, A., & Flodmark, C. E. (2007). Low-intensity family therapy intervention is useful in a clinical setting to treat obese and extremely obese children. Fifty-four obese children, aged 6-17 years, were referred to an outpatient obesity clinic. Families received solution-focused family therapy provided by a multidisciplinary team. Height and weight were recorded; BMI and BMI z-scores were derived. Self-esteem was assessed with a validated questionnaire. Eighty-one percent of children (n =44, mean age 11.9 years, mean BMI z-score 3.67, range 2.46-5.48) and their parents participated in the follow-up. Eleven children were treated for 6-12 months, and 33 for more than 12 months. On average, the families received 3.8 family therapy sessions. Intervention resulted in a mean decrease in BMI z-score of 0.12 (p =0.0001). Self-esteem improved after intervention (p =0.002), and also on sub-scales, depicting physical characteristics (p <0.001), psychological well-being (p =0.026), and relations with others (p =0.046). Froeschle, J. G., Smith, R. L., & Ricard, R. (2007). The Efficacy of a Systematic Substance Abuse Programme for Adolescent Females. Sixty-five adolescent females with a history of substance abuse were identified as eligible to take part in the Solution focused, Action learning and Mentorship (SAM) programme. Thirty-two were assigned to the experimental group and 33 acted as controls. Substance misuse, attitudes towards substance use and knowledge of the consequences of substance use were assessed pre- and post the 16 week intervention. Solution focused therapy; action learning and mentoring were included in the 16, hour long weekly sessions. Results demonstrated decreased substance use, more negative attitudes towards substance use and increased awareness of the consequences of substance use. McCallum, Z., Wake, M., Gerner, B., Harris, C., Gibbons, K., Gunn, J., et al. (2005). Can Australian general practitioners tackle childhood overweight/obesity? Methods and processes from the LEAP (Live, Eat and Play) randomized controlled trial. Thirty-four GPs from 29 family medical practices attended training sessions on management of childhood overweight/obesity. Practice staff trained in child anthropometry conducted a cross-sectional body mass index (BMI) survey of 5- to 9-year-old children attending these practices. The intervention focused on achievable goals in nutrition, physical activity and sedentary behaviour, and was delivered in four solution-focused behaviour change consultations over 12 weeks. All GPs attended at least two of the three education sessions and were retained throughout the trial. Practice staff weighed and measured 2112 children in the BMI survey, of whom 28% were overweight or obese (17.5% overweight, 10.5% obese). Of the eligible overweight/obese children, 163 (40%) were recruited and retained in the LEAP RCT; 96% of intervention families attended at least their first consultation. Many families were willing to tackle childhood overweight with their GP, however further research is needed to determine whether this approach is beneficial. Viner, R. M., Christie, D., Taylor, V., & Hey, S. (2003). Motivational/solution-focused intervention improves HbA1c in adolescents with Type 1 diabetes: a pilot study. Seventy-seven subjects agreed to be assessed for a pilot non-randomized controlled trial. Subjects completed psychological questionnaires and were given feedback designed to encourage entry into the intervention. Twenty-one young people opted to enter the intervention and were offered motivational and solution-focused group therapy to improve glycaemic control. Two intervention groups consisting of 5 to 6 subjects were conducted in each age band 10-13 years and 14-17 years. Twenty individuals who opted out of the intervention were randomly selected as controls. Intervention cases and controls were well matched for age, HbA1c, duration of diabetes and socio-economic status. The intervention produced a significant improvement of 1.5% in HbA1c in intervention cases (P<0.05) at 4-6 months post intervention compared with no change in controls. This improvement was partly maintained at 7-12 months post intervention. These pilot data suggest that a motivational/solution-focused group intervention is promising in improving HbA1c in adolescents and should be investigated further in a randomised controlled trial. Evidence summary: The latest summary of SFBT outcome evaluation research has been compiled by MacDonald (2011) the Research Coordinator for the European Brief Therapy Association (EBTA). This summary shows that 109 experimental studies are reported in the literature. Two meta-analyses have been conducted and 19 randomised controlled trials examining the effectiveness of solution-focused approaches have been undertaken. Of these, 9 RCTs show solution focused has a greater effect compared to other approaches, e.g. cognitive behavioural therapy. Forty-three comparison studies are reported in the literature, of these 34 studies favour SFBT. Evidence is also available from over 4200 case studies, with a success rate exceeding 60%; requiring an average of 3 – 5 sessions of therapy time. Numerous reviews and feature articles have been written about the use of solution focused practice in a healthcare/public health context. A selection of these articles is listed below along with a brief extract of the author’s comments about the application of solution focused practice to health-related behaviour change. Nowicka, P. & Flodmark, C. (2010) Family therapy as a model for treating childhood obesity: Useful tools for clinicians. Author’s report that clinicians who work alone or in a multidisciplinary team (for example, school nurses or general practitioners) can benefit from using solution focused skills with families with obese children and adolescents. Hester, J.R., McKenna, J. & Gately, P.J. (2009) Discussion paper: Lifestyle behaviours with obese children. Education and Health, 27(2), 62-66. Authors report that solution focused practice provides a helpful framework for discussing lifestyle behaviours with obese children. Peterson, Y. (2005) Family therapy treatment: Working with obese children and their families with small steps and realistic goals. Peterson suggests solution focused therapy is a useful tool in helping overweight children and their families to set realistic weight management goals. Unwin, D. (2005) Why a solution focused approach is brilliant in primary care. Solution News, 1 (4) 10-12. Unwin is a general practitioner who describes SFBT as “brilliant for primary care” and emphasises its usefulness with physical and mental long-term conditions. Davis, E. D., Meer, J. M.V., Yarborough, P.C. & Roth, S.B. (1999) Using solution-focused therapy strategies in empowerment-based education. The Diabetes Educator, 25 (2). These author’s declare a preference for SFBT as a patient diabetes empowerment strategy. Browne, A.J., Shultis, J. D. & Thio-Watts, M. (1999) Solution focused approaches to tobacco reduction with disadvantaged prenatal clients. Journal of Community Health Nursing. 16, 165-177. Browne and colleagues praise solution-focused approaches for tobacco reduction with disadvantaged prenatal clients. Giorland, M. E. and Schilling, R. J. (1997) On becoming a solution-focused physician: the med-stat acronym. Family, Systems & Health, 15 (4): 361-373. These authors highlight that when SFBT is applied in primary care it increases patients’ active participation in their health related lifestyles. Dolan, Y. (1997) I’ll start my diet tomorrow: A solution focused approach to weight loss. Contemporary Family Therapy, 19 (1): 41-48. Dolan suggests that a solution focused approach is a potentially valuable resource for people seeking support and assistance with weight loss and weight control.
中文翻译
焦点解决实践：健康相关证据基础的简要总结。促进健康行为改变：使用焦点解决方法。有压倒性的证据表明，改变人们的健康相关行为可以对一些主要的死亡率和发病率原因产生重大影响。行为在人们的健康中扮演重要角色，例如吸烟、缺乏身体活动或不良饮食可能导致大量疾病。NICE（2007）公共卫生行为改变指南建议：“政策制定者、委托方、培训师、服务提供者、课程开发者和从业者应为参与改变人们健康相关行为的人员提供培训和支持，以便他们发展全面的能力”。NICE（2007）行为改变指南还建议：“任何改变健康相关行为的干预措施或计划都应旨在发展和建立人们的优势和资产（即他们的技能、才能和能力）”。BHFNC的促进健康行为改变课程向专业人士介绍关键的焦点解决实践原则和技术，并使他们具备将焦点解决实践融入常规咨询中以促进健康相关生活方式改变的技能和能力。焦点解决实践的基本原则和技术源自焦点解决短期治疗（SFBT）。SFBT由来自不同专业背景的各种从业者实践。这种方法的核心是对个体差异的敏感性，将个体带来的东西（即他们的优势和能力）置于行为改变对话的中心。焦点解决实践是医疗和相关健康专业人员使用SFBT原则和技术的术语。焦点解决实践的使用已在多个健康出版物中得到推荐。证据基础：直到最近，大多数SFBT研究都集中在SFBT在家庭治疗以及心理健康和教育环境中的咨询应用和有效性上。然而，现在出现了关于在健康相关环境中使用焦点解决实践的证据基础。以下是关于焦点解决实践在健康相关/行为改变背景中应用的实验研究选择。Hendrick, S., Isebaert, L. & Dolan, Y. (2011) 焦点解决短期治疗在酒精治疗中的应用。两项研究检查了SFBT在酒精治疗中的使用，两项研究均发现在1年随访中饮酒习惯和健康有显著改善。Vogelaar, L., Van’t Spijker, A., Vogelaar, T., van Busschbach, J.J., Visser, M.S., Kuipers, E.J. & van der Woude, C.J. (2011) 焦点解决治疗：克罗恩病患者疲劳管理的有前景的新工具：克罗恩病疲劳管理的心理干预。将静止期克罗恩病和高疲劳评分的患者随机分配到问题解决治疗（PST）、焦点解决治疗（SFT）或常规治疗（TAU）对照组。SFT组中85.7%的患者在疲劳量表上有所改善，PST组中60%显示疲劳评分改善，TAU组中45.5%。尽管不显著，但两个干预组的生活质量均有所提高。SFT组中57.1%的患者医疗费用降低，而TAU组为45.5%，PST组为20%。SFT似乎是克罗恩病患者疲劳管理的有前景的新工具。Rudolf, M.C., Hunt, C., George, J., Hajibagheri, K. & Blair, M. (2010) HENRY：帮助从业者更有效地与婴儿和学龄前儿童的父母合作以预防儿童肥胖的计划的开发、试点和长期评估。牛津郡的12个儿童中心参与了涉及137名工作人员的试点。HENRY——健康、锻炼、营养为真正年轻者——培训健康和社区从业者更敏感和有效地与婴儿和学龄前儿童的父母合作，围绕肥胖和生活方式问题。基于家庭伙伴关系模型、反思实践和焦点解决技术，它提供面对面培训和电子学习。在培训课程结束时进行问卷调查。在培训前后获得自我报告的置信度评分。2-6个月后向中心经理发送邮寄问卷以确定长期效果。九名经理参与了深度访谈。另外535名学习者完成了电子学习课程和在线反馈。131名工作人员（96%）完成了培训课程，并认为这是增强技能和知识的方式。自我报告的置信度评分增加。长期随访表明HENRY对中心和工作人员有持续影响。98%的电子学习者会推荐HENRY；94%认为它增强了他们的技能和知识。HENRY是一种创新方法，通过培训社区和健康从业者更有效地与非常年幼儿童的父母合作，在应对肥胖方面显示出前景。需要进一步研究以确定是否对幼儿的生活方式和肥胖风险有期望的积极影响。Reinehr, T., Kleber, M., Lass, N. & Toschke, A.M. (2010) 肥胖儿童参与1年生活方式干预的体重指数模式超过5年：年龄作为长期成功的预测因子。663名儿童（4-16岁）接受了门诊生活方式干预，包括6次焦点解决实践咨询加上营养和锻炼计划。在5年期间分析了BMI SD评分（BMI-SDS）的年度变化。在1年干预结束时和干预后4年报告了BMI-SDS的显著平均下降。在年龄较小的儿童中发现了最佳的长期效果，这支持了儿童肥胖早期干预的必要性。Nowicka, P., Haglund, P., Pietrobelli, A., Lissau, I. & Flodmark, C.E. (2008) 家庭体重学校治疗：肥胖青少年的1年结果。72名12-19岁的肥胖青少年被转介到儿童肥胖中心，并接受由多学科团队提供的家庭体重学校治疗计划。将干预组与未治疗的等待名单对照组进行比较。计算干预前后的体重指数（BMI）和BMI z评分。90%的干预组完成了计划（34名男孩，31名女孩；平均年龄14.8岁，平均BMI 34，平均BMI z评分3.3）。对照组中10名男孩和13名女孩（平均年龄14.3岁，平均BMI = 34.1，平均BMI z评分 = 3.2）参与了1年随访。干预组中初始BMI z评分 < 3.5的青少年（n = 49 out of 65，基线平均年龄 = 14.8，平均BMI = 33.0，平均BMI z评分 = 3.1）显示BMI z评分显著下降（-0.09，p = 0.039），而对照组中初始BMI z评分 < 3.5的青少年（n = 17 out of 23，平均基线年龄 = 14.1，平均基线BMI = 31.6，平均基线BMI z评分 = 3.01）则无此变化。在BMI z评分 > 3.5的青少年中未发现差异。Nowicka, P., Pietrobelli, A., & Flodmark, C. E. (2007). 低强度家庭治疗干预在临床环境中治疗肥胖和极度肥胖儿童的有用性。54名6-17岁的肥胖儿童被转介到门诊肥胖诊所。家庭接受了由多学科团队提供的焦点解决家庭治疗。记录身高和体重；计算BMI和BMI z评分。使用经过验证的问卷评估自尊。81%的儿童（n =44，平均年龄11.9岁，平均BMI z评分3.67，范围2.46-5.48）及其父母参与了随访。11名儿童接受了6-12个月的治疗，33名接受了超过12个月的治疗。平均而言，家庭接受了3.8次家庭治疗会话。干预导致BMI z评分平均下降0.12（p =0.0001）。干预后自尊改善（p =0.002），并且在子量表上也有所改善，描绘了身体特征（p <0.001）、心理健康（p =0.026）和与他人的关系（p =0.046）。Froeschle, J. G., Smith, R. L., & Ricard, R. (2007). 系统性物质滥用计划对青少年女性的有效性。65名有物质滥用史的青少年女性被确定为有资格参加焦点解决、行动学习和导师制（SAM）计划。32名被分配到实验组，33名作为对照组。在16周干预前后评估物质滥用、对物质使用的态度和对物质使用后果的认识。焦点解决治疗、行动学习和导师制被纳入16次每周1小时的会话中。结果显示物质使用减少、对物质使用的态度更负面以及对物质使用后果的认识增加。McCallum, Z., Wake, M., Gerner, B., Harris, C., Gibbons, K., Gunn, J., et al. (2005). 澳大利亚全科医生能否应对儿童超重/肥胖？LEAP（生活、饮食和游戏）随机对照试验的方法和过程。来自29个家庭医疗实践的34名全科医生参加了关于儿童超重/肥胖管理的培训课程。接受过儿童人体测量学培训的实践工作人员对参加这些实践的5至9岁儿童进行了横断面体重指数（BMI）调查。干预侧重于营养、身体活动和久坐行为中可实现的目標，并在12周内通过四次焦点解决行为改变咨询提供。所有全科医生至少参加了三次教育课程中的两次，并在整个试验期间保留。实践工作人员在BMI调查中称重和测量了2112名儿童，其中28%超重或肥胖（17.5%超重，10.5%肥胖）。在符合条件的超重/肥胖儿童中，163名（40%）被招募并保留在LEAP RCT中；96%的干预家庭至少参加了第一次咨询。许多家庭愿意与他们的全科医生一起应对儿童超重，但需要进一步研究以确定这种方法是否有益。Viner, R. M., Christie, D., Taylor, V., & Hey, S. (2003). 动机/焦点解决干预改善1型糖尿病青少年HbA1c：一项试点研究。77名受试者同意接受一项试点非随机对照试验的评估。受试者完成心理问卷，并获得旨在鼓励进入干预的反馈。21名年轻人选择进入干预，并接受动机和焦点解决团体治疗以改善血糖控制。两个干预组由5至6名受试者组成，分别在10-13岁和14-17岁年龄组进行。20名选择退出干预的个体被随机选为对照组。干预病例和对照组在年龄、HbA1c、糖尿病持续时间和社会经济地位方面匹配良好。干预在干预后4-6个月在干预病例中产生HbA1c显著改善1.5%（P<0.05），而对照组无变化。这种改善在干预后7-12个月部分维持。这些试点数据表明，动机/焦点解决团体干预在改善青少年HbA1c方面有前景，应在随机对照试验中进一步研究。证据总结：SFBT结果评估研究的最新总结由欧洲短期治疗协会（EBTA）的研究协调员MacDonald（2011）编制。该总结显示文献中报告了109项实验研究。进行了两项荟萃分析，并进行了19项随机对照试验检查焦点解决方法的有效性。其中，9项RCT显示焦点解决比其他方法（如认知行为治疗）效果更大。文献中报告了43项比较研究，其中34项研究支持SFBT。还有来自超过4200个案例研究的证据，成功率超过60%；平均需要3-5次治疗会话。许多评论和专题文章已经撰写关于焦点解决实践在医疗/公共卫生背景中的使用。以下是这些文章的选择，以及作者关于焦点解决实践应用于健康相关行为改变的评论的简要摘录。Nowicka, P. & Flodmark, C. (2010) 家庭治疗作为治疗儿童肥胖的模型：临床医生的有用工具。作者报告称，单独工作或在多学科团队中工作的临床医生（例如学校护士或全科医生）可以从使用焦点解决技能与肥胖儿童和青少年的家庭合作中受益。Hester, J.R., McKenna, J. & Gately, P.J. (2009) 讨论论文：与肥胖儿童的生活方式行为。教育和健康，27(2), 62-66。作者报告称，焦点解决实践为与肥胖儿童讨论生活方式行为提供了有用的框架。Peterson, Y. (2005) 家庭治疗治疗：与肥胖儿童及其家庭合作，采取小步骤和现实目标。Peterson建议焦点解决治疗是帮助超重儿童及其家庭设定现实体重管理目标的有用工具。Unwin, D. (2005) 为什么焦点解决方法在初级保健中很出色。解决方案新闻，1 (4) 10-12。Unwin是一名全科医生，他将SFBT描述为“对初级保健非常出色”，并强调其在身体和心理长期状况中的有用性。Davis, E. D., Meer, J. M.V., Yarborough, P.C. & Roth, S.B. (1999) 在基于赋权的教育中使用焦点解决治疗策略。糖尿病教育者，25 (2)。这些作者声明偏好SFBT作为患者糖尿病赋权策略。Browne, A.J., Shultis, J. D. & Thio-Watts, M. (1999) 焦点解决方法用于弱势产前客户的烟草减少。社区健康护理杂志。16, 165-177。Browne及其同事赞扬焦点解决方法用于弱势产前客户的烟草减少。Giorland, M. E. and Schilling, R. J. (1997) 成为焦点解决医生：med-stat缩写。家庭、系统与健康，15 (4): 361-373。这些作者强调，当SFBT应用于初级保健时，它增加了患者在其健康相关生活方式中的积极参与。Dolan, Y. (1997) 我明天开始节食：焦点解决方法用于减肥。当代家庭治疗，19 (1): 41-48。Dolan建议，焦点解决方法是寻求减肥和体重控制支持和帮助的人的潜在宝贵资源。
文章概要
本文基于关键词“焦点解决疗法在体重管理中设定目标”，总结了焦点解决实践在健康行为改变中的应用和证据基础。文章指出，改变健康行为对降低死亡率和发病率有重大影响，并引用NICE指南强调基于个人优势和资产的干预。焦点解决实践源自SFBT，注重个体差异和优势，已在多个健康领域得到推荐。证据部分包括多项研究，显示SFBT在酒精治疗、克罗恩病疲劳管理、儿童肥胖预防和治疗、青少年物质滥用、糖尿病控制等方面的有效性。例如，HENRY计划通过培训从业者有效与父母合作预防儿童肥胖，而多项研究证实焦点解决干预能显著改善体重指数和自尊。证据总结显示，SFBT在109项实验研究中得到支持，包括19项RCT，其中9项显示优于其他方法，成功率超过60%。文章还列举了多篇评论文章，强调焦点解决实践在设定现实体重管理目标等方面的实用性。
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：这篇文章讲的是，如果我们想变得更健康，比如减肥或改掉坏习惯，有一种方法叫焦点解决疗法。它就像玩游戏一样，不是总想着问题，而是看看我们有什么优点和能力，然后设定小目标去实现。研究显示，这种方法在很多地方都有效，比如帮助人们少喝酒、管理疲劳、预防儿童肥胖，甚至改善糖尿病。它让大人们更自信地帮助别人，也让孩子们感觉更好。
焦点解决心理学理论评价：从焦点解决心理学的视角看，这篇文章充分体现了该理论的核心原则，即关注解决方案而非问题，强调个体的优势和资源。文章中的研究和指南都赞美了个人在行为改变中的主动性和能力，例如NICE指南建议基于人们的技能和才能进行干预。证据部分展示了如何通过设定可实现的目标（如HENRY计划中的小步骤）来促进积极变化，这符合焦点解决的未来导向和目标设定理念。理论评价聚焦于赞美这些实践如何赋能个体，增强他们的自我效能感，并创造更多可能性。
在实践上可以应用的领域和可以解决人们的十个问题：焦点解决实践可以在多个领域应用，例如医疗保健、公共卫生、教育和社区服务。它可以解决人们的十个问题：1. 帮助超重儿童和家庭设定现实体重管理目标；2. 支持青少年改善物质滥用习惯；3. 管理慢性疾病如克罗恩病的疲劳症状；4. 促进糖尿病患者的血糖控制；5. 减少酒精消费并改善健康；6. 增强从业者在肥胖预防中的信心和技能；7. 提高儿童的自尊和心理健康；8. 协助家庭应对生活方式挑战；9. 赋能患者在健康决策中积极参与；10. 降低医疗成本并提高生活质量。这些应用都聚焦于赞美个体的进步，设定积极目标，并探索未来改善的可能性。