Solution-focused therapy. Counseling model for busy family physicians.

OBJECTIVE To provide family doctors in busy office practices with a model for counseling compatible with patient-centred medicine, including the techniques, strategies, and questions necessary for implementation. QUALITY OF EVIDENCE The MEDLINE database was searched from 1984 to 1999 using the terms psychotherapy in family practice, brief therapy in family practice, solution-focused therapy, and brief psychotherapy. A total of 170 relevant articles were identified; 75 abstracts were retrieved and a similar number of articles read. Additional resources included seminal books on solution-focused therapy (SFT), bibliographies of salient articles, participation in workshops on SFT, and observation of SFT counseling sessions taped by leaders in the field. MAIN MESSAGE Solution-focused therapy's concentration on collaborative identification and amplification of patient strengths is the foundation upon which solutions to an array of problems are built. Solution-focused therapy offers simplicity, practicality, and relative ease of application. From the perspective of a new learner, MECSTAT provides a framework that facilitates development of skills. CONCLUSION Solution-focused therapy recognizes that, even in the bleakest of circumstances, an emphasis on individual strength is empowering. In recognizing patients as experts in self-care, family physicians support and accentuate patient-driven change, and in so doing, are freed from the hopelessness and burnout that can accompany misplaced feelings of responsibility.

[1]  P. Links,et al.  Preventing recurrent suicidal behaviour. , 1999, Canadian family physician Medecin de famille canadien.

[2]  P. Barker.  Solution-focused therapies. , 1998, Nursing Times.

[3]  C. Streeter,et al.  Using Client Self-Anchored Scales to Measure Outcomes in Solution-Focused Therapy , 1997 .

[4]  J. Barletta,et al.  Interviewing for Solutions , 1997, Australian Journal of Guidance and Counselling.

[5]  T. Zimmerman,et al.  Solution-focused couples therapy groups: an empirical study , 1997 .

[6]  A. Macdonald.  Brief Therapy in Adult Psychiatry – Further Outcomes , 1997 .

[7]  S. Shazer,et al.  ‘What works?’ Remarks on Research Aspects of Solution‐Focused Brief Therapy , 1997 .

[8]  V. Poon.  Short counseling techniques for busy family doctors. , 1997, Canadian family physician Medecin de famille canadien.

[9]  E. Park.  An Application of Brief Therapy to Family Medicine , 1997 .

[10]  M. Giorlando,et al.  On becoming a solution-focused physician: The MED-STAT acronym. , 1997 .

[11]  D. Hillyer.  Solution-oriented Questions: An Analysis of a Key Intervention in Solution-focused Therapy , 1996 .

[12]  M. Chandler,et al.  Solution-focused therapy: an alternative approach to addictions nursing. , 2009, Perspectives in psychiatric care.

[13]  Scott D. Miller,et al.  How to Interview for Client Strengths , 1995 .

[14]  J. Christie-Seely.  Counseling tips, techniques, and caveats. , 1995, Canadian family physician Medecin de famille canadien.

[15]  M. Borins,et al.  Role of family physicians in counseling and psychotherapy. , 1995, Canadian family physician Medecin de famille canadien.

[16]  W. Quinn,et al.  Session two outcome of the formula first session task in problem- and solution-focused approaches , 1994 .

[17]  R. McNeilly.  Solution oriented counselling. A 20 minute format for medical practice. , 1994, Australian Family Physician.

[18]  Swanson Jg.  Family physicians' approach to psychotherapy and counseling. Perceptions and practices. , 1994 .

[19]  M. Borins,et al.  Anxiety disorders in family practice. Diagnosis and management. , 1994, Canadian family physician Medecin de famille canadien.

[20]  J. Swanson.  Family physicians' approach to psychotherapy and counseling. Perceptions and practices. , 1994, Canadian family physician Medecin de famille canadien.

[21]  J. Prochaska,et al.  In Search of How People Change: Applications to Addictive Behaviors , 1992, The American psychologist.

[22]  B. Steenbarger.  Toward Science-Practice Integration in Brief Counseling and Therapy , 1992 .

[23]  R. A. Blattel.  Adverse effects of psychotherapy in family practice: Interfering with the physician-patient relationship , 1992 .

[24]  John L. Walter,et al.  Becoming Solution-Focused in Brief Therapy , 1992 .

[25]  M. Dworkind,et al.  Comparing Psychotherapies for Primary Care: Differences between short-term supportive and insight-oriented psychotherapies. , 1991, Canadian family physician Medecin de famille canadien.

[26]  D. C. Webster.  Solution-focused approaches in psychiatric/mental health nursing. , 2009, Perspectives in psychiatric care.

[27]  Williamson Ps.  Psychotherapy by family physicians. , 1987 .