Domestic violence is a major public health concern and has significant impacts on the health and well-being of victims and their families. Solution-Focused Brief therapy provides a therapeutic context for people who have experienced domestic violence (intimate partner violence) to recognize their agency in these harrowing situations. The application of SFT to clients experiencing trauma stems from compelling conceptual reasoning that a solution-focused approach is an effective means of treating trauma without exposing clients to the stress of directly focusing on traumatic memories.
Health practitioners are crucial to early intervention, given their pivotal role in domestic violence identification, safety assessment, response, and referral (Garcia-Moreno et al., 2015). According to the World Health Organization (WHO) estimates, 35% of women worldwide are at risk of domestic violence, and their spouses commit as many as 38% of women’s homicides (WHO 2013). In the USA, a review estimated that partner abuse of women accounted for 50% of all acute injuries and 21% of all injuries requiring urgent surgery (Guth 2000).
Individuals exposed to violence require comprehensive, gender-sensitive healthcare services that address the physical and mental health consequences of their experience and aid their recovery from a traumatic event. Healthcare providers who come into contact with women facing violence need to be able to recognize signs of it and respond appropriately and safely. Advocacy and empowerment interventions have increased referrals to services and are the mainstay of response to DV (Rivas et al., 2015). In a previous WHO systematic review, mother-child interventions have had the most robust evidence for assisting women [World Health Organization 2013).
Solution-Focused Brief Therapy embraces a strength-based, developmentally informed trauma perspective that acknowledges the individual and family’s capacity in the face of adversity. SF interventions enhance an individual’s resilience, decrease distress and minimize the potential risk of re-traumatization. SFBT assists in counterbalancing intense emotions, collaboratively supporting people in developing meaningful coping strategies, cultivating competencies, and navigating gradual next steps for the immediate future.
In the wake of crisis and trauma, the solution-focused practitioner fundamentally listens to and recognizes clients’ agency and resourcefulness. Appreciating what clients have already done to manage incredible challenges provides privileged conversational moments that are often very different from what clients have experienced. These uniquely privileged conversational spaces show clients how they have coped and dealt with their distressing and harrowing experiences. Solution-focused practices can also simultaneously elicit positive emotion, kindle hope and evoke a feeling of empowerment. Recognizing moments when clients have harnessed their uniquely adaptive behaviors, cognitions, and social context that characterize their experience of relative well-being or “moments of tolerability” underscores and magnifies what they have already done to cope. Because these uniquely personalized behaviors are already present within clients’ existing behavioral and social repertoire, they can be more readily accessed and utilized to develop effective treatment plans and solutions that clients can readily embrace. The solution-focused practitioner invites the client to voice their agency and resourcefulness. Clients learn to realize, acknowledge, and appreciate their capacity, fostering their potential to replicate what has worked and helped them cope with adversity.
What does the Solution-Focused literature say about treating survivors of trauma?
The existing outcome literature provides initial evidence of the overall effectiveness of Solution-focused therapy for treating survivors of trauma (Eads and Lee, 2019). In particular, within-subjects treatment effects showed moderate to large effect sizes on direct trauma symptoms and recovery measures and large effect sizes for post-traumatic growth and sleep problems (Eads and Lee, 2019).
Solution-Focused therapy has also been utilized with domestic violence offenders (Lee et al., 2004). Building on a strengths perspective, a solution-focused approach holds a person accountable for solutions while not denying or minimizing aggressive behaviors. The solution-focused approach harness external VIPS such as the legal system, community support, and social service agencies to address safety concerns and negotiate goals integrating the clients’ unique social context.
The Solution-Focused approach operationalizes trauma-informed care. Questions are formulated from the clients’ language, conveying a belief in them while fostering their agency. The solution-focused practitioner assumes that clients have the necessary resources to live a more satisfying life and have the capacity to endure adversity and even move beyond their circumstances to experience post-traumatic stress growth. This belief in the client’s resilience and power is harnessed throughout the conversation and can be productively utilized to help cope with the aftermath of a crisis and build a healthy, satisfying future (Dolan, 1998; Froerer et al., 2018).
SFBT provides both clients and therapists an ability to look beyond the way things are and envision desirable options for how things can be. Solution-focused therapists use carefully constructed questions to activate the client’s resources. SF questions trigger the client to answer, remember and discover the resources within their cognitive, behavioral, and social repertoire in their real-life experiences. This therapeutic approach is compelling because clients find a compassionate, collaborative guide to help them work toward their best hopes for their preferred future.
A Video Demonstration Of A Solution-Focused Approach To Domestic Violence
Dolan, Y. (1998). One small step: Moving beyond trauma and therapy to a life of joy. New York: IUniverse.
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.
Froerer, A., von Cziffra-Bergs, J., Kim, J., & Connie, E. (Eds.). (2018). Solution-focused brief therapy with clients managing trauma. Oxford University Press.
Garcia-Moreno C, Hegarty K, d’Oliveira A, Koziol-McLain J, Colombini M, Feder G. The health-systems response to violence against women. Lancet. 2015;385:1567–79
Guth AA, Pachter L. Domestic violence and the trauma surgeon. American Journal of Surgery 2000;179(2):134-40.
Lee, M. Y., Uken, A., & Sebold, J. (2004). Accountability for change: Solution-focused treatment with domestic violence offenders. Families in Society, 85(4), 463-476.
Lutz, A. B. (2013). Learning solution-focused therapy: An illustrated guide. American Psychiatric Pub.
Responding to Intimate Partner Violence and Sexual Violence Against Women: WHO Clinical and Policy Guidelines. Geneva: World Health Organization; 2013. Available from: https://www-ncbi-nlm-nih-gov.umassmed.idm.oclc.org/books/NBK174250/
Rivas C, Ramsay J, Sadowski L, Davidson L, Dunne D, Eldridge S, et al. Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse. Cochrane Database Syst Rev. 2015;3(12):CD005043.
World Health Organization. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO; 2013.