英文原文
What is Solution-Focused Therapy: 3 Essential Techniques
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. 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.
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.
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.
The solution-focused approach of SFBT is founded in de Shazer and Berg’s idea that the solutions to one’s problems are typically found in the “exceptions” to the problem, meaning the times when the problem is not actively affecting the individual. This approach is a logical one—to find a lasting solution to a problem, it is rational to look first at those times in which the problem lacks its usual potency.
For example, if a client is struggling with excruciating shyness, but typically has no trouble speaking to his or her coworkers, a solution-focused therapist would target the client’s interactions at work as an exception to the client’s usual shyness. Once the client and therapist have discovered an exception, they will work as a team to find out how the exception is different from the client’s usual experiences with the problem.
The therapist will help the client formulate a solution based on what sets the exception scenario apart, and aid the client in setting goals and implementing the solution.
You may have noticed that this type of therapy relies heavily on the therapist and client working together. Indeed, SFBT works on the assumption that every individual has at least some level of motivation to address their problem or problems and to find solutions that improve their quality of life. This motivation on the part of the client is an essential piece of the model that drives SFBT.
While there is no formalized “A leads to B, which leads to C” sort of model for SFBT, there is a general model that acts as the foundation for this type of therapy. Solution-focused theorists and therapists believe that generally, people develop default problem patterns based on their experiences, as well as default solution patterns. These patterns dictate an individual’s usual way of experiencing a problem and his or her usual way of coping with problems.
The solution-focused model holds that focusing only on problems is not an effective way of solving them. Instead, SFBT targets clients’ default solution patterns, evaluates them for efficacy, and modifies or replaces them with problem-solving approaches that work.
In addition to this foundational belief, the SFBT model is based on the following assumptions: Change is constant and certain; Emphasis should be on what is changeable and possible; Clients must want to change; Clients are the experts in therapy and must develop their own goals; Clients already have the resources and strengths to solve their problems; Therapy is short-term; The focus must be on the future—a client’s history is not a key part of this type of therapy.
Based on these assumptions, the model instructs therapists to do the following in their sessions with clients: Ask questions rather than “selling” answers; Notice and reinforce evidence of the client’s positive qualities, strengths, resources, and general competence to solve their own problems; Work with what people can do rather than focusing on what they can’t do; Pinpoint the behaviors a client is already engaging in that are helpful and effective and find new ways to facilitate problem-solving through these behaviors; Focus on the details of the solution instead of the problem; Develop action plans that work for the client.
SFBT therapists aim to bring out the skills, strengths, and abilities that clients already possess rather than attempting to build new competencies from scratch. This assumption of a client’s competence is one of the reasons this therapy can be administered in a short timeframe—it is much quicker to harness the resources clients already have than to create and nurture new resources.
Beyond these basic activities, there are many techniques and exercises used in SFBT to promote problem-solving and enhance clients’ ability to work through their own problems.
Popular Techniques and Interventions:
1. Questions: 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.
- 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. Example: “How do you manage, in the face of such difficulty, to fulfill your daily obligations?”
- 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. Example: “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?”
- Best Hopes Questions: 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. Examples: “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?”
- Exception Questions: 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. Examples: “Tell me about the times when you felt the happiest.” “What was it about that day that made it a better day?”
- 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. Example: “On a scale from 0 to 10, how would you rate your progress in finding and implementing a solution to your problem?”
2. Do One Thing Different: 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 eight steps, including thinking about what you do in a problem situation and changing one thing, thinking of something done by somebody else that makes the problem better and trying it, understanding feelings but letting your brain determine actions, changing what you focus on, imagining a future without the problem and working backward, changing your story to talk about times when the problem was not happening, focusing on a higher power if applicable, and using action talk.
3. Presupposing Change: 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?”
SFBT Treatment Plan: A typical treatment plan in SFBT will include several factors relevant to the treatment, including the reason for referral, a diagnosis (if any), list of medications taken (if any), current symptoms, support for the client, modality or treatment type, frequency of treatment, goals and objectives, measurement criteria for progress on goals, client strengths, and barriers to progress.
Limitations of SFBT Counseling: As with any form of therapy, SFBT has limitations and potential disadvantages. Some of the potential disadvantages for therapists include the potential for clients to focus on problems that the therapist believes are secondary problems, the client may decide that the treatment is successful or complete before the therapist is ready to make the same decision, and the hard work of the therapist may be ignored. Some of the potential limitations for clients include the focus on quick solutions may miss some important underlying issues, the quick, goal-oriented nature of SFBT may not allow for an emotional, empathetic connection between therapist and client, and if the client wants to discuss factors outside of their immediate ability to effect change, SFBT may be frustrating in its assumption that clients are always able to fix or address their problems.
Generally, SFBT can be an excellent treatment for many of the common stressors people experience in their lives, but it may be inappropriate if clients want to concentrate more on their symptoms and how they got to where they are today. As noted earlier, it is also generally not appropriate for clients with major mental health disorders.
What Does SFBT Have to Do with Positive Psychology? First, both SFBT and positive psychology share a focus on the positive—on what people already have going for them and on what actions they can take. While problems are discussed and considered in SFBT, most of the time and energy is spent on discussing, thinking about, and researching what is already good, effective, and successful. Second, both SFBT and positive psychology consider the individual to be his or her own best advocate, the source of information on his or her problems and potential solutions, and the architect of his or her own treatment and life success. The individual is considered competent, able, and “enough” in both SFBT and positive psychology.
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：三种核心技巧
焦点解决疗法，也称为焦点解决短期治疗（SFBT），是一种更重视讨论解决方案而非问题的疗法。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正在经历的每一个问题细节。
焦点解决短期治疗不需要深入探讨你的童年以及过去如何影响现在。相反，它会将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。
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。创始人史蒂夫·德·沙泽尔和茵素·金·伯格注意到，大多数治疗会话都花在讨论症状、问题和困难上。德·沙泽尔和伯格看到了在新形式的治疗中更快缓解负面症状的机会，这种治疗强调快速、具体的问题解决，而不是持续讨论问题本身。
焦点解决短期治疗中的“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，以最小化在治疗中花费的时间，更重要的是，最小化在挣扎或痛苦中花费的时间。
SFBT致力于尽快为客户找到现实、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中的应用。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，从生活中的正常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。
SFBT的焦点解决方法基于德·沙泽尔和伯格的观点，即问题的解决方案通常存在于问题的“例外”中，意思是问题没有积极影响个体的时刻。这种方法是一种逻辑方法——要找到问题的持久解决方案，首先关注那些问题缺乏其通常效力的时刻是合理的。
例如，如果一位客户正在与极度害羞作斗争，但通常与同事交谈没有问题，焦点解决治疗师会将客户在工作中的互动作为客户通常害羞的例外。一旦客户和治疗师发现了例外，他们将作为一个团队找出例外与客户通常的问题经历有何不同。
治疗师将帮助客户根据使例外情境不同的因素制定解决方案，并协助客户设定目标和实施解决方案。
你可能已经注意到，这种类型的治疗在很大程度上依赖于治疗师和客户的合作。事实上，SFBT基于这样的假设：每个人都有至少某种程度的动机来解决他们的问题或问题，并找到提高生活质量的解决方案。客户的这种动机是驱动SFBT模型的重要组成部分。
虽然SFBT没有正式的“A导致B，B导致C”之类的模型，但有一个通用模型作为这种治疗的基础。焦点解决理论家和治疗师认为，通常人们基于他们的经验发展出默认的问题模式，以及默认的解决方案模式。这些模式决定了个体通常经历问题的方式以及他或她通常应对问题的方式。
焦点解决模型认为，只关注问题并不是解决问题的有效方法。相反，SFBT针对客户的默认解决方案模式，评估其有效性，并修改或替换为有效的解决问题方法。
除了这一基本信念外，SFBT模型基于以下假设：变化是持续且确定的；重点应放在可改变和可能的事情上；客户必须想要改变；客户是治疗中的专家，必须制定自己的目标；客户已经拥有解决问题的资源和优势；治疗是短期的；重点必须放在未来——客户的历史不是这种治疗的关键部分。
基于这些假设，该模型指导治疗师在与客户的会话中执行以下操作：提问而不是“推销”答案；注意并强化客户积极品质、优势、资源和解决自己问题的一般能力的证据；与人们能做的事情合作，而不是关注他们不能做的事情；确定客户已经参与的有帮助和有效的行为，并通过这些行为找到促进问题解决的新方法；关注解决方案的细节而不是问题；制定适合客户的行动计划。
SFBT治疗师旨在发掘客户已经拥有的技能、优势和能力，而不是试图从头开始建立新的能力。对客户能力的这种假设是这种治疗可以在短时间内进行的原因之一——利用客户已有的资源比创造和培养新资源要快得多。
除了这些基本活动外，SFBT还使用许多技巧和练习来促进问题解决并增强客户处理自己问题的能力。
流行技巧和干预措施：
1. 提问：在任何形式的治疗中，提出好问题都至关重要，但SFBT将这一实践形式化为一种技巧，指定了一组旨在引发关于目标设定和问题解决的思考和讨论的问题。
- 应对问题：这个问题旨在帮助客户认识到自己的韧性，并确定他们已经有效应对问题的一些方式。例如：“面对这样的困难，你是如何履行日常义务的？”
- 奇迹问题：奇迹问题鼓励客户想象一个未来，在这个未来中，问题不再影响他们的生活。想象这个期望的未来将帮助客户看到前进的道路，既让他们相信这种未来的可能性，又帮助他们确定可以采取的具体步骤来实现它。例如：“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？”
- 最佳希望问题：如果奇迹问题不太可能奏效，或者客户难以想象这个奇迹未来，SFBT治疗师可以使用“最佳希望”问题。客户对这些问题的回答将有助于确定客户希望实现什么，并帮助他或她设定现实且可实现的目标。例如：“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？”
- 例外问题：为了识别困扰客户的问题的例外，治疗师会问“例外问题”。这些问题询问客户在有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对客户情绪或思想没有影响或影响减弱的情况。例如：“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？”
- 量表问题：它要求客户在0（最低）到10（最高）的尺度上评价他们的经历（例如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）。这有助于治疗师评估进展并更多地了解客户在寻找解决方案方面的动机和信心。例如：“在0到10的尺度上，你如何评价你在寻找和实施问题解决方案方面的进展？”
2. 做一件不同的事：这个练习旨在帮助客户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。手册将练习分为八个步骤，包括思考你在问题情境中做什么并改变一件事，思考别人做的让问题变得更好的事情并尝试它，理解感受但让你的大脑决定行动，改变你关注的事情，想象一个没有问题的未来并向后推，改变你的故事来谈论问题没有发生的时刻，如果适用则关注更高的力量，以及使用行动谈话。
3. 预设变化：这种技巧旨在帮助客户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都应该被注意到，这样客户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。预设变化是一种极其简单的技巧：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。
SFBT治疗计划：SFBT的典型治疗计划将包括与治疗相关的几个因素，包括转诊原因、诊断（如果有）、服用的药物清单（如果有）、当前症状、对客户的支持、治疗方式或类型、治疗频率、目标和目的、目标进展的衡量标准、客户优势和进展障碍。
SFBT咨询的局限性：与任何形式的治疗一样，SFBT有局限性和潜在缺点。对治疗师的一些潜在缺点包括客户可能关注治疗师认为是次要问题的问题，客户可能在治疗师准备好做出相同决定之前就认为治疗成功或完成，以及治疗师的辛勤工作可能被忽视。对客户的一些潜在局限性包括对快速解决方案的关注可能错过一些重要的潜在问题，SFBT快速、目标导向的性质可能不允许治疗师和客户之间建立情感、共情的联系，以及如果客户想要讨论超出他们直接影响能力范围的因素，SFBT可能因其假设客户总是能够修复或解决问题而感到沮丧。
总的来说，SFBT可以成为治疗人们生活中许多常见压力源的优秀方法，但如果客户更想关注他们的症状以及他们如何走到今天，它可能不合适。如前所述，它通常也不适合患有严重精神健康障碍的客户。
SFBT与积极心理学有什么关系？首先，SFBT和积极心理学都关注积极方面——关注人们已经拥有的优势以及他们可以采取的行动。虽然在SFBT中讨论和考虑问题，但大部分时间和精力都花在讨论、思考和研究已经良好、有效和成功的事情上。其次，SFBT和积极心理学都认为个体是他或她自己最好的倡导者，是他或她问题和潜在解决方案的信息来源，以及他或她自己治疗和生活成功的建筑师。在SFBT和积极心理学中，个体被认为是称职、有能力且“足够”的。
关键信息：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并需要帮助解决特定问题（或问题）的客户尤其有用。与其花数年时间进行治疗，SFBT允许这些客户快速找到解决方案并获得结果。
文章概要
本文详细介绍了焦点解决短期治疗（SFBT）的核心概念、理论基础、模型假设及实践技巧。文章强调SFBT是一种以解决方案为导向的短期心理治疗方法，由Steve de Shazer和Insoo Kim Berg在20世纪80年代创立，其核心理念是关注问题的“例外”时刻而非问题本身，通过发掘客户已有的资源和优势来快速实现目标。文章重点阐述了三种关键技巧：提问技巧（包括应对问题、奇迹问题、最佳希望问题、例外问题和量表问题）、“做一件不同的事”练习和“预设变化”技术。这些技巧旨在帮助客户设定明确目标、识别自身优势、打破问题模式并关注积极变化。文章还讨论了SFBT的治疗计划结构、与积极心理学的关联性以及该方法的局限性。整体而言，SFBT适用于解决日常压力和生活事件，但不推荐用于严重精神健康障碍，其目标导向的干预方式能够帮助客户在较短时间内实现积极改变。
高德明老师的评价
1. 用12岁初中生可以听懂的语音来重复翻译的内容
嘿，小伙伴们！想象一下，如果你有一个烦恼，比如考试前特别紧张，焦点解决疗法就像是一个超级英雄工具箱。它不会一直问你“为什么紧张”，而是会问“有没有哪次考试你不那么紧张？那时候你做了什么？”这样，你就能找到自己已经有的超能力，比如深呼吸或者提前复习，然后多用这些超能力，烦恼就会慢慢变小啦！这个方法特别快，不用一直说过去的事情，而是直接帮你看到未来的好样子，就像玩闯关游戏一样，一关一关解决问题！
2. 焦点解决心理学理论评价
从焦点解决心理学的视角来看，这篇文章精彩地展现了SFBT的核心魅力——它如同一座灯塔，始终照亮人们内在的资源与可能性。文章强调的“例外”原则，正是SFBT的精髓所在，它相信每个人即使在困境中，也拥有那些“问题不存在的时刻”，这些时刻就是改变的种子。SFBT不是去挖掘问题的根源，而是去放大那些已经存在的解决方案，这种视角的转换本身就是一种强大的赋能。文章提到的三种技巧——提问、做一件不同的事、预设变化，都是基于“客户是自身问题的专家”这一信念，这种尊重和信任能够激发客户的自信心行动力。SFBT的短期性和目标导向性，体现了对人们改变能力的深深信任，它相信人们不需要漫长的分析就能找到前进的方向，这种乐观和积极的基调，正是焦点解决心理学最动人的地方。
3. 在实践上可以应用的领域和可以解决人们的十个问题
焦点解决疗法在实践中可以广泛应用于多个领域，包括学校教育、职场发展、家庭关系、个人成长和社区服务等。它能够帮助人们解决以下十个常见问题：（1）学习或工作效率低下，通过设定小目标和利用例外时刻提升动力；（2）人际关系紧张，如与同学、同事或家人的冲突，通过焦点解决对话改善沟通；（3）情绪管理困难，如焦虑或压力，通过奇迹问题想象平静未来；（4）缺乏自信心，通过识别自身优势和成功经验重建自我价值；（5）目标模糊或拖延症，通过量表问题明确进展并制定行动计划；（6）生活过渡期适应问题，如换工作或搬家，通过预设变化关注积极调整；（7）亲子教育挑战，帮助家长和孩子聚焦解决方案而非问题行为；（8）团队合作障碍，在职场或小组项目中促进协作和问题解决；（9）健康习惯养成，如锻炼或饮食，通过“做一件不同的事”启动改变；（10）创伤后恢复，在安全环境下关注恢复资源和未来可能性。这些应用都体现了SFBT的目标导向和资源导向，帮助人们在各个生活领域实现积极转变。