What is the Evidence for Solution-Focused Brief Therapy in Schools?

Solution-Focused Brief Therapy (SFBT) has made tremendous progress in the past ten years and is a practice that is based on evidence. SFBT has been applied in the community across schools, mental health clinics, and health care settings with a diverse population and age group (Kim et al., 2019). A meta-analysis of randomized controlled trials on SFBT for adolescent and adult clients that received services in outpatient, community-based settings showed that it was effective on depression, family functioning, behavioral health functioning, and psychosocial adjustment (Franklin et al., 2023).

Garza High School in Austin, Texas, was the first school in the United States to implement a school-wide solution-focused approach for at-risk students demonstrating the feasibility and effectiveness of SFBT with at-risk youth in public schools (Franklin et al., 2018). SFBT has been shown to be effective in reducing classroom-related behavioral problems and improving reports of externalizing behaviors and internalizing behaviors (Franklin et al., 2008). SFBT can support clients in addressing substance abuse and trauma among parents involved in the child welfare system (Kim et al., 2021). SFBT has shown effectiveness for child behavior problems among children and adolescents which are common in schools (Hsu et al., 2021).

A large literature on SFBT in schools has been done across disciplines and worldwide (Kim et al., 2017). SFBT is a promising and effective school-based intervention across K12 and post-secondary schools, including college settings and student counseling services in the English and Chinese literature for social workers and other mental health professionals. Reviews have shown that SFBT in schools favors internalizing, academic, social, and relationship outcomes and psychological well-being. The strongest treatment effect size was observed for group-based SFBT interventions (Franklin et al., 2020).

Solution-focused group therapy (SFGT) has been shown to have significant immediate and follow-up effects in ethnic Chinese School settings, 1.03 and 1.09, respectively (Gong & Hsu 2017). The meta-analysis on SFGT found a significantly large overall effect size for internalizing behavior problems such as depression, low self-esteem, and low self-efficacy. Family and relationship problems also achieved a large overall effect size. SFGT was effective for each school-level group. These effect sizes are considered large and indicated how group intervention therapeutic factors significantly affect group support, group learning, group optimism, opportunities to help others, and group empowerment (Gong & Hus, 2017).

Working on What Works (WOWW) is a manualized 10-week classroom intervention based on solution-focused brief therapy. A randomized experimental, posttest-only design of 30 fourth and fifth-grade classrooms studying WOWW showed that students in the WOWW group has significantly fewer days absent from school and that teachers’ ratings on WOWW classrooms’ performance improved significantly more than teachers’ ratings on the control classrooms (Hai and Franklin 2020).

A meta-analysis of randomized controlled trials on SFBT for adolescents and adult clients that received outpatient and community-based services supported the effectiveness of SFBT (Franklin et al., 2023). The results of this study showed medium effects for depression, behavioral health functioning, family functioning, and psychosocial functioning. This study was unique in showing that SFBT is most effective when four to nine SFBT techniques are used across three categories of SFBT techniques (cooperative language, therapeutic relationship questions, client strengths and resources, and future-focused questions and techniques. Using three or fewer SFBT techniques or only two categories of techniques did not achieve a statistically significant treatment effect in the study. (Franklin et al., 2023).

A review of SFBT in schools showed that SFBT may be applied to a range of academic and behavioral problems across ages and indicated that four to eight sessions were delivered to achieve favorable outcomes (Franklin & Kim, 2009). A review of global outcomes of SFBT showed that SFBT demonstrates a positive effect with relatively brief interventions with an average number of sessions under six (Neipp & Beyebach, 2022). The study also showed that SFBT yielded significantly higher results in school than in psychotherapy settings and supports the claims of using SFBT in schools. The study also showed that SFBT can be integrated with other techniques and approaches without weakening its impact (Neipp & Beyebach, 2022).

A quasi-experimental design aimed to evaluate the impact of a solution-focused approach to child protection by comparing the performance of a group of workers who received training in SFBT with that of child protection workers who employed treatment, as usual, showed that child protection workers who received training and supervision changed their self-reported practices in a solution-focused direction (Medina et al., 2022). This study demonstrated the feasibility of disseminating solution-focused principles and techniques in a child protection system. The cases in the solution-focused group achieved superior outcomes, including higher goal achievement rates from both caseworkers and parents. Importantly, children removals had dropped to one-fourth of the initial figure in the experimental group and that child protection teams in the solution-focused group became more able to help families without removing children from their homes. This is the first time a positive effect on this variable is documented for an SFBT intervention. The superior outcomes of the experimental group were achieved with significantly fewer sessions than those of the control group providing initial support for the cost-efficiency of a solution-focused child protection practice. The experimental group allocated fewer additional social services resources to the families, which may be related to the holistic, family-centered perspective of the solution-focused approach (Medina et al., 2022).

Results of a randomized controlled trial of solution-focused brief therapy in a college setting improved wellness and decreased stress among college students. Also, they showed that the solution-focused brief therapy intervention was more effective than treatment as usual. The intervention demonstrated how SFBT could be used multiple times per semester across multiple populations and contexts in improving wellness and decreasing stress (James D. Beauchemin 2018).

The great majority of outcome studies on SFBT have so far supported its effectiveness demonstrating effectiveness transculturally for various practices (psychotherapy, coaching, school counseling) in different formats – individual, group, family, and couples therapy and across the developmental age spectrum.