Application of Solution Focused Brief Therapy
Teksti: Janet Lim
Generally, when working with clients who experience violence in their lives, the focus has been the use of psychotherapy approaches in assisting these clients to deal with the effects of trauma in their lives (Eads & Lee, 2019). However, such approaches may have drawbacks as they can lead to “re-traumatization rather than healing” and also there has been high attrition in trauma-related treatment approaches as cited by Schottenbauer, Glass, Arnkoff, Tendick & Hafter Gray, 2008 (in Eads & Lee, 2019).
Unlike trauma approaches, Solution Focused Brief Therapy (SFBT) is helpful in addressing trauma without having clients come face to face with traumatic memories but instead to recognise client’s agency and resourcefulness (Lutz, 2022). Besides, research has shown preliminary evidence that SFBT has significant impact on direct trauma symptoms and recovery indicators such as post-traumatic growth and sleep issues (Eads & Lee, 2019).
In view of these benefits, practitioners may draw upon SFBT to provide an empowering experience for persons who have experienced violence, as SFBT believes in the capacity of the client and it “brings forth greater possibilities and have a greater impact and change in client” (Hogan et al., 2017). This comes about as space is provided using SFBT approaches to uncover client’s sense of agency and resilience in standing up to the effects of violence in the lives of clients without re-traumatizing them. Hence, the focus of this article is about how SFBT can be applied to support clients who have experienced violence in Singapore as there are limited literature of application of SFBT in Singapore context.
The case to be discussed is Melissa, 28 years old, who is faced with violence from her 25 years old brother. The violence is mainly verbal abuse and there is a once-off incident of physical violence when they had an argument. The arguments started as Melissa’s brother perceived that Melissa is being disrespectful towards him such that he shouted at Melissa and then pushed her against the wall resulting in some injuries during dinner time when Melissa’s parents were around also. Melissa then applied for Personal Protection Order (PPO) at the Family Justice Court against her brother and she was eventually granted the PPO to protect herself from violence from her brother as it allows for the person who disobeys the order to be punished with a fine, imprisonment or both as it would be considered a criminal offence (SG Courts, 2023). The sharing below is extracted from my counselling sessions with Melissa.
Overview of application of SFBT
First and foremost, SFBT has helped me to treat each client as “expert of their own lives” (Connie & Froerer, 2023) as there is a great belief that clients know what is best for themselves. Upholding this stance, SFBT has taught me to value client’s sharing by hearing out what are their best hopes for coming to the sessions. This is in contrast to the practice of sharing expert knowledge and working with clients on what they ”should” be doing to ensure their safety. Secondly, eliciting client’s exceptions in SFBT helps to uncover client’s resources which client already have. Thirdly, the use of scaling also allows me to break down client’s goals into smaller steps. Besides, the use of miracle questions helps engage client in her preferred future as it helps client to imagine how she would be acting differently if she is able to have her desired future in her life. Lastly, the use of scaling of client’s motivation also allows exploration of ways to sustain client’s efforts. Henceforth, segments of my session with Melissa is shared below to demonstrate how I have applied SFBT during my session with her.
1. Clarifying client’s best hopes
In this segment, Melissa was asked what would be the most useful thing to talk about. Although she shared her ambivalence, it was still helpful to elicit her opinion instead of making assumptions on what Melissa would have found useful. This is illustrated in the segment below:
Extract of session
Practitioner: Since you are here, would there be anything you find it useful and helpful to talk to me, that at the end of the session [will be useful]?
Client: There has been not much interaction between me and him… no heated argument, nothing has happened ever since, because I have the PPO with me also, I have the safety net, I know I’m quite safe in that sense, nothing much…
Practitioner: Since there has been no violence, what would be something useful to talk about here? Would it be useful to talk about how you can maintain these boundaries or something else? (Note: Melissa has mentioned about how she wanted to set boundaries earlier in the conversation, thus I am making the link here whether she wants to talk about this since she hesitated when I asked her the question the 2nd time. I was mindful not to impose my view on my client. As such, I took a tentative approach in my questioning, and allowed Melissa to make a choice on what she wanted to converse about.)
Client: Yeah I think that would be the most helpful for now, how I can maintain it…
Practitioner: Ok, yeah sure… what difference does it make to you right, if you set the boundaries the way you want?
Client: Ok, one of the things I notice is that I got far more peace right now, it’s less stressful for me to think how he is going to react to all that and I have to think about his reaction towards me, but now that I have set these boundaries, I know that he cannot cross [the boundaries]. I still have lot more peace and [am] stress free for sure, that is one thing I will notice.
Practitioner: So let’s say, you mention the word “peace” how is this something important to you, or all along this has been something important to you?
Client: Yeah, because this is something I have not had for some time. Before I have this PPO, today I fight with him, tomorrow he tries to talk as per normal, then you know, the cycle goes on and I never could establish that line. For me I feel like I have always been going in this circle, but now with this PPO, I really felt that peace, now that I know I can experience this when I have this boundary. Yeah, it really makes a difference for me.
Practitioner: What difference did it make to you when you have those snippets of peace during your trip? (Note: I was referring to a recent family trip to Indonesia where Melissa experienced peace even though her brother had some anger outbursts.)
Client: Yeah, it is like I know that I do not have to worry, I do not have to care about how [he reacts]. I just know it will never affect me in a negative way, so it really makes a difference.
From the conversation, it can be seen that initially Melissa was talking about how she wanted to set boundaries. However, after further exploration, it is discovered that Melissa’s desired outcome was to achieve peace within herself even when her brother continued to use violence. Hence, the use of SFBT allowed space for further exploration of the significance of “boundaries” which led to a deeper understanding of what Melissa really wanted. This may not have been achieved if the practitioner had been using a more conventional risk-focused approach of doing risk assessment, case management and psychoeducation in ensuring client’s safety rather than having conversation about what were client’s best hopes.
2. Exploring exceptions
For this segment, I explored an incident when Melissa was able to manage her own emotions even though Melissa noticed that her brother had a heated discussion with her parents. Melissa did so with the intention of avoiding an argument with her brother in the hopes of achieving peace. This incident was unlike previous incidences when Melissa used to join in the argument and sided with their parents. During these occasions, Melissa’s brother would get so angry that he would commit acts of violence towards Melissa. This is illustrated in the segment below:
Extract of session
Practitioner: I hear that you have this experience that even though your brother, he was talking to your parents it didn’t lead to an argument?
Practitioner: How did it happened? How did things stop gotten worse?
Client: Like I mentioned previously, sometimes he will come and talk as if nothing has happened, but this time he knows that things have gone too far, so if there’s any conversation there is nothing more than that, because he also knows that we went for family trip in June, he didn’t overstep any boundaries that I have set, so he respected that in that sense. He does have his anger, it wasn’t verbal or physical [violence], he has his moments, but it wasn’t anything that I would feel unsafe.
Practitioner: So, I hear that you went for family trip and even though there’s this experience of anger towards the family, you were able to set the boundaries?
Practitioner: Tell me more, what boundaries did you set?
Client: As in because he knows that I would rather not engage in a long conversation with him, he would think that all things between us is fine, he would want to carry on like brother- sister normal relationship. But to me, is like I would rather just draw the line between us, would not want to have anything more, to cause emotional harm. He respected that.
Practitioner: Sounds like you have drawn boundaries to not go deeper, continue going deeper in the relationship?
Client: Yes, this is the current stand that I’ve put in place. My parents have tried to get me to talk to him again like to have this whole relationship with him, but even with them I draw the line because I don’t want to. You know like, I [have] already applied for PPO, I’ve gone to this extent that and not for me to be like normal with him, it just doesn’t seem right.
Practitioner: So it’s sounds like it is very important for you to have the boundaries with him
Client: Yeah so that at least he knows and changes his ways and like yeah, his first reaction to everything shouldn’t be anger that’s what I want him to be like. Other than that [there is] not much interaction… Every time we go for family function, he would like respect [others].
In this segment, the focus has been “emphasizing” the exception, “getting more details of it” (de Shazer et al., 2021). This is different from the usual problem-focused approach as the focus will be on the “missing signs of what has caused or is maintaining the problem”, while SFBT therapist is focusing on the improvements that have been overlooked (de Shazer et al., 2021). This is important as it allows us to uncover more of Melissa’s skills and resources that can be used to derive her own solutions.
3. Scaling of the desired outcome
In this segment, scaling is carried out with Melissa in the hopes of breaking down Melissa’s desired outcome into small steps. Melissa was first asked to rate her current level of peace on a scale of 1 to 10. She was then asked about the level of peace she wanted to achieve. Melissa mentioned that she wants to increase to level 8. There was also further exploration on how would she know if she had attained the desired level of peace. She shared that at that level, she would see herself being able to talk to her brother in a calm manner. This initial segment is illustrated below:
Extract of session
Practitioner: So let’s say now 0 being no peace at all, 10 is the peace that you want when your brother is around, where are you right now?
Client: If my brother is at home?
Practitioner: Yes, where would you rate yourself?
Client: 3 or 4. Not a 5, more of a 4.
Practitioner: What makes it 4 and not 3?
Client: Because I know that I would not have peace as he and mom would get into a fight and my mom would come to me to vent off additional stuff. I know he won’t come to me to vent off additional stuff. Yeah, so that’s why it is a 4.
Practitioner: It is a 4 as in he would not come and add on [stress]…
Client: He would not come and add on to me the additional burden.
The use of scaling here allowed Melissa to see that she was already able to achieve some level of peace currently even when her brother is still displaying violent behaviours. Melissa started to see that her situation was not as dire as she perceived as there are several periods of time when she was still able to retain a peace level of 4. Therefore, it helped client better understand what were the resources that helped make this possible for her.
4. Use of Miracle question
In this next session, I asked Melissa a ‘miracle question’ by asking her what were the signs she would noticed about herself if she achieved the peace she wanted even when there was no change in her brother’s behavior. Melissa shared that on the day of the miracle morning, she would be acting more peacefully when she wakes up. She also shared that her mother would be the first to notice that Melissa would be less engaged in conversations with her as compared to the past. Following that, Melissa shared that she would see her brother still being frustrated. However, she would be at peace and feel confident about reaching out to her brother. She would share her honest opinions and concern for him. Following that, Melissa shared that brother will listen to her and be quiet on the day of the miracle morning.
When probed further if there were any incidences of this miracle already happening now, Melissa shared that in the previous week, her brother came home being frustrated with work issues and was venting his anger towards his parents, Melissa felt at peace at that moment to give her brother honest feedback in a way that was objective and sensitive to his feelings. Melissa shared that her brother kept quiet and did not flare up. Melissa shared that it was one of the rare times she made a conscious effort to be careful with her choice of words. Hence, the use of miracle question provided the platform for clients to be able to visualize and experience changes within themselves even if problems continued to exist (Connie & Froerer, 2023). This is further amplified when we engage clients to imagine their preferred future which is discussed in the following segment.
5. Imagining the Preferred Future
In this segment, I invited Melissa to think about how her mother would be observing her behaviour if she is seen to have clearer boundaries and having more peace. This is illustrated in the segment below:
Extract of session
Practitioner: So, you are saying that your mom would see that you are not interfering, what do she see you doing, when she talks to you, does she see you doing anything?
Client: I will just tell her to leave. She will share with me and then I will tell her to stop.
Practitioner: That’s what she will be seeing you doing and responding.
Practitioner: And what else will your brother see you doing? Like when he is trying to engage your mom and she is not responding, what she sees you doing instead?
Client: For me, I would walk inside the room and lock the door to avoid witnessing and use my phone and avoid the conversation, so this conversation will just closed off.
Practitioner: So you will avoid and closed the door
Client: Yes, do not get involved
Practitioner: So, does your mom respond to you when you are doing that?
Client: She will just ignore and she would know that this is a choice, as in I have gone to the extent of applying for PPO , there is no going back now, so yeah she respects that.
In this segment, it offered Melissa the opportunity to visualize her mother’s responses, with whom Melissa has a close relationship. This visualization helped ensure that her actions of drawing clearer boundaries with her brother and intentionally not getting involved in any argument between her brother and mother were “anchored” in her daily life more precisely (de Shazer, 2007). Additionally, it provided a yardstick for how she has been making improvements in the area of developing peace through establishing clearer boundaries (de Shazer, 2007). Furthermore, it was helpful for Melissa to depict her actions in the context of her preferred future, as it also facilitated “virtual rehearsal” and allowed her to see the benefits of the preferred changes, which further enhanced her incentive to continue making these changes (de Shazer, 2007).
6. Sustainability of efforts
In this segment, scaling was done to assess Melissa’s motivation, given that her parents were unsupportive of her efforts to establish boundaries with her brother. They hoped that Melissa will maintain some level of closeness with him. However, Melissa did not feel safe doing so and had learned to establish boundaries in her relationship with her brother. Since Melissa consistently encountered a lack of support for her actions, it was essential to gauge her motivation levels in carrying out these actions to achieve her desired outcome. This is illustrated below:
Extract of session
Practitioner: How do you, with all these in the backdrop, try to maintain your peace? Does it affect your motivation in building your peace?
Client: In the household with him?
Practitioner: Yes. With your mom, trying to persuade you not to have too many boundaries, do you still have that motivation to keep to the boundaries?
Client: Yes, that one for sure because I’ve been in this cycle so many times right, I know that I do not want this cycle to repeat, so I know my boundaries will always be up, after he shows some change in actions. I will not change my days until I see him changing, this is my motivation.
Practitioner: If you rate yourself again, zero is having no motivation, 10 is the level of having a lot of motivation, how much is your motivation now?
Client: 6.5, 7, like a 7.
Practitioner: What makes you continue to have a motivation of 6.5-7?
Client: Because he’s barely home, there are instances, he has anger in India. His first reaction to everything is still anger. That’s why my motivation is at a 7.
Practitioner: So, you see that he still has that [anger], it tells you…
Client: Yeah, anger can lead to safety issues, for me and for everyone.
Practitioner: So, these reminders remind you to keep you motivated at 6.5 or 7. What makes your motivation not lower?
Client: All the more I want my motivation to remain high, how to give them free pass to make them do anything they want again?
Practitioner: Your mom sounds like giving in, you feel there is no one, [so] you need to do more. What am I asking [is that] it is not easy for you to make this decision.
Client: Honestly, I was exposed to the dynamics since I was 13 and more or less know the dynamics of my household. I see this and I want to deal with it and I don’t want them to be too old to make a change in my brother. I accepted that and I am not putting too much stress on my parents, [as I] know that nothing is going to change.
Practitioner: Sounds like there is this urgency to change everything.
Client: Yeah correct.
Practitioner: Where does this urgency comes from?
Client: Because he has raised his hand after so long, this drew the line for me. [There] have been a lot of verbal violence and a lot of threatening but this one is direct and would get a lot worse.
Practitioner: You were close to danger, realised you have to protect yourself… a wakeup-call for yourself. Now you are at a 6-7, what will help to keep to the motivation?
Client: It’s because of that, it helps me all the more I want to do it, still I will look at parents’ behaviour if that alone is anger towards me and everything…
Practitioner: You will take your brother’s behaviour as a gauge of whether you need to push so much?
Through the utilization of scaling questions, Melissa had come to realise that despite the lack of support, she was able to maintain a motivation level of 6.5–7. Understanding Melissa’s motivation level was crucial to comprehend the driving force behind her willingness to both speak out against and intervene in her brother’s acts of violence. It also helped in assessing the client’s current state and whether additional resources needed to be accessed in the event of a decrease in her motivation.
Looking back on the session, it became apparent that Melissa had asked a few times, ”Should be this right?” during the session. It seemed that Melissa might have been seeking confirmation whether her responses were correct or not. This may be influenced by Confucian values in Singapore that each individuals has defined “hierarchical roles” which should be respected and accepted so as to ensure a “harmony” society (Cultural Atlas, 2015). Researchers have found that the culture in Singapore is generally “hierarchical” whereby communication between each other is “tiered” which may “require a level of deference and respect from one party” such that one’s vocation is linked to one’s standing (Cultural Atlas, 2015). Besides, Singaporeans generally also demonstrate more respect towards those who are older than them in line with the value of “filial piety” (Cultural Atlas, 2015). Although Singapore has been influenced by Western values through the influx of expatriates over the years and non-citizen population comprise of 38.3% of the total Singapore population as stated by National Population and Talent Division (2022), it is found that these cultural values continue to have some form of influence among Singaporeans who hold a traditional worldview (Cultural Atlas, 2015).
In light of this, clients with traditional worldviews may then perceive practitioners as the experts and may seek out expert knowledge and advice. Therefore, the use of SFBT would be helpful as it holds the stance that clients are the expert of their lives and helps to increase sense of self-agency for clients in believing that clients have the solutions to their lives. When working with clients who hold such traditional values, they might require more time to attune to the stance of SFBT. Practitioners would then need to understand that these group of clients may need more guidance along the way during the process. It is therefore important to interpret client’s responses as a form of feedback for how SFBT fits or not fit the client’s cultural context and adjust accordingly along the way. Hence, it is important to adopt an “eco-systemic” perspective on how the client’s ethnic and cultural background influences treatment and to pay attention as to how to adjust Solution-Focused Brief Therapy (SFBT) to better suit the cultural context of the client as suggested by Hogan et al. (2017).
The use of SFBT in working with Melissa has overall helped her to increase her sense of self-agency to take proactive steps to ensure her own safety in response to her brother’s acts of violence. This is evident in Melissa’s continued efforts in setting clear boundaries with her brother, thereby maintaining peace within herself. Consequently, Melissa has become more peaceful and confident, enabling her to provide objective feedback, which her brother was able to accept without argument, despite differing views.
The use of SF helps reduce the stress faced by practitioners who may otherwise feel pressured to have all the right answers and knowledge to guide their clients. This is especially relevant as SFBT hold the stance that clients are the expert of their own lives and that there are always exceptions to problems as problems do not exist all the time. SFBT allows practitioners to uncover the resources that clients possess within themselves to address their problems, thereby reducing the burnt-out among practitioners (Eads and Lee, 2019).
Connie, E. and Froerer, A. (2023). The Solution Focused Brief Therapy Diamond: A new approach to SFBT that will empower both practitioner and client to achieve the best outcomes, Hay House Inc.: USA.
de Shazer, S., Dolan, Y., Korman, H., McCollum, E., Trepper, T., & Berg, I. K. (2007). More than miracles: The state of the art of solution-focused brief therapy. Haworth Press.
Eads, R., & Lee, M. Y. (2019). Solution Focused Therapy for trauma survivors: A review of the outcome literature. Journal of Solution-Focused Practices, 3(1), 9.
Hogan, D., Hogan, D., Tuomola, J., & Yeo, A. K. L. (2017). Solution focused practice in Asia. Routledge/Taylor & Francis Group.
Lutz, A. (2022, April 21). Recognizing the Power of a woman’s voice: A Solution Focused Approach to Domestic Violence. Institute for Solution-Focused Therapy. https://solutionfocused.net/domestic-violence-approach/
SG Courts. (2023). Understand the Outcomes of a Personal Protection Order application.https://www.judiciary.gov.sg/family/understand-outcomes-personal-protection-order-application
National Population and Talent Division. (2022, Sep 27). Population in Brief. NPTD. https://www.population.gov.sg/files/media-centre/publications/Population-in-brief-2022 pdf.
Cultural Atlas. (2015). Singaporean Culture. https://culturalatlas.sbs.com.au/singaporean-culture/singaporean-culture-core-concepts .
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