Expert answer:smoking addiction and social construction therapie
Solved by verified expert:I need a research about quitting smoking by the Solution-Focused therapy which is a type of social construction therapies.the research is a 7-page research including the references page. I attached the article you need to useFor How Emotions Are Made – Lisa Feldman: you have to write at least one photograph about it. and relate it to the topicI also attached the research proposal, please use a paragraph or two in the research.Note: remember to focus on the Solution-Focused therapy, Also before you make a bid please read all the article and get to know the detals of it
effectiveness_of_solution_focused_brief_therapy.pdf
how_emotions_are_made___lisa_feldman_barrett.pdf
is_solution_focused_brief_therapy_evidence_based.pdf
solution_focused_group_therapy_for_level_1_substance_abuse.pdf
research_proposal.docx
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Systematic Review
Effectiveness of Solution-Focused Brief
Therapy: A Systematic Qualitative Review
of Controlled Outcome Studies
Research on Social Work Practice
23(3) 266-283
ª The Author(s) 2012
Reprints and permission:
sagepub.com/journalsPermissions.nav
DOI: 10.1177/1049731512470859
rsw.sagepub.com
Wallace J. Gingerich1 and Lance T. Peterson2
Abstract
Objective: We review all available controlled outcome studies of solution-focused brief therapy (SFBT) to evaluate evidence of its
effectiveness. Method: Forty-three studies were located and key data abstracted on problem, setting, SFBT intervention, design
characteristics, and outcomes. Results: Thirty-two (74%) of the studies reported significant positive benefit from SFBT; 10 (23%)
reported positive trends. The strongest evidence of effectiveness came in the treatment of depression in adults where four separate studies found SFBT to be comparable to well-established alternative treatments. Three studies examined length of treatment and all found SFBT used fewer sessions than alternative therapies. Conclusion: The studies reviewed provide strong
evidence that SFBT is an effective treatment for a wide variety of behavioral and psychological outcomes and, in addition, it may
be briefer and therefore less costly than alternative approaches.
Keywords
solution focused, brief therapy, review, outcomes, effectiveness
Since its development in the mid-1980s (de Shazer et al.,
1986), solution-focused brief therapy (SFBT) has become a
widely used therapeutic approach practiced in a broad range
of settings in North America, Europe, and Asia. SFBT evolved
from the innovative clinical work of a small group of therapists
at the Brief Family Therapy Center in Milwaukee, Wisconsin,
directed by Steve de Shazer and Insoo Kim Berg. They and
their colleagues used insights gleaned from disciplined
observation of therapy sessions along with descriptive and
follow-up studies of cases to develop and shape the approach
into what it is today (de Shazer et al., 2007; Lipchik, Derks,
LaCourt, & Nunnally, 2012). SFBT has become widely
accepted among social workers and other human service professionals because of its focus on strengths and solutions rather
than deficits and problems, and because it provides a rational
framework for doing therapy briefly (often less than six
sessions) in a managed care environment.
But, policy makers and funders need to know whether an
approach is effective before they fund it, practitioners need to
consider the evidence base for an approach before they use
it, and clients want to know whether the approach being recommended is effective. We decided to critically examine the
evidence base for SFBT to ascertain the extent to which SFBT
has been shown to be effective, in what settings, and with what
types of clients and presenting problems. Although evidence
consists of a broad range of descriptive, quantitative and qualitative research, as well as clinical observations, we decided to
limit our review to experimental and quasi-experimental
studies because they provide the strongest internal validity for
assessing intervention outcomes.
Previous Reviews
Five previous reviews of SFBT effectiveness have been
published to date. Gingerich and Eisengart (2000) conducted
the first systematic review of SFBT outcome research based
on 15 controlled studies. Five of the studies met their criteria
for well-controlled studies—random (or matched) assignment
to groups, sample size of 40 or more, use of objective measures,
and some assurance of treatment fidelity—and all five reported
significant benefit from SFBT, with four showing SFBT to be
significantly better than no treatment or standard institutional
services. The fifth study found no significant differences in
outcomes between SFBT and interpersonal therapy, considered
by many to be an empirically supported treatment (Weissman,
Markowitz, & Klerman, 2000). Gingerich and Eisengart concluded ‘‘the five studies provide initial support for the efficacy
1
Mandel School of Applied Social Sciences, Case Western Reserve University,
Cleveland, OH, USA
2
St. Catherine University/University of St. Thomas, St. Paul, MN , USA
Corresponding Author:
Wallace J. Gingerich, Mandel School of Applied Social Sciences, Case Western
Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA.
Email: wallace.gingerich@case.edu
Gingerich and Peterson
of SFBT’’ (p. 493). Although this review was important historically, its findings are now dated.
The first meta-analytic review was conducted by Stams,
Dekovic, Buist, and de Vries (2006) and included 21 studies
comprising a total of 1,421 participants. They found an overall
small to medium effect size (d ¼ .37), with somewhat larger
effects in more recent studies and in studies of behavioral
problems versus marital or psychiatric problems. Although
they found SFBT effects to be no larger than other approaches,
they found SFBT outcomes occurred sooner than with other
approaches. The 21 studies in this review included some
nonexperiemental studies, whereas other controlled studies
available at the time were left out, compromising the validity
of its conclusions.
Corcoran and Pillai (2009) located 10 experimental and
quasi-experimental studies of SFBT outcomes and computed
the overall effect size for each. Effect sizes ranged from 3.03
to 1.07; five of the studies had overall effect sizes above
.20, leading the authors to conclude that the evidence for SFBT
effectiveness is equivocal and more research needs to be
conducted. The exclusion of unpublished and non-English
studies, and studies with insufficient data to compute effect
sizes, led to the exclusion of approximately 20 studies available
at the time, which limits the overall generalizability of the
findings of this review.
A second meta-analytic review conducted by Kim (2008)
included 22 SFBT studies involving 1,349 participants. He
found a mean effect size of .11 for externalizing behavior outcomes, .26 for internalizing behaviors, and .26 for family and
relationship outcomes. Only the effect size for internalizing
behavior problems reached statistical significance. This review
included several nonexperimental studies, and studies in which
SFBT was used as an organizational intervention, or indirect
intervention such as parenting or coaching. As with all
meta-analyses, Kim had to exclude studies (n ¼ 13) because
of insufficient information to compute effect sizes, even though
these studies may have been well designed and produced useful
information in evaluating SFBT effectiveness. Although the
analysis of internalizing and externalizing outcomes is useful,
the exclusion of studies because effect size could not be computed and the inclusion of other nonexperimental studies limits
its value as a comprehensive assessment of controlled studies
of SFBT outcomes.
Finally, Kim and Franklin (2009) reviewed seven outcome
studies conducted in American school settings during the
period 2000–2007 and found that effect sizes were generally
positive although modest, averaging .50. Again, the selection
criteria for this review excluded dissertation studies, studies
conducted in other countries, and studies appearing before
2000, limiting the generalizability of findings somewhat.
These five reviews included a combined total of 44 studies.
Four studies were included in all four reviews, whereas 31
were included in only one of the reviews, suggesting that
the reviews used widely different selection criteria. More
specifically, some reviews included studies of within treatment outcomes as well as end of treatment outcomes, other
267
reviews included studies where there was minimal or no
experimental control, and most of the reviews appear to have
excluded unpublished studies. Reviewers also varied in what
they considered to be SFBT; some included studies where the
specification of SFBT was vague or general, and others
included studies where the SFBT intervention was indirect,
such as training staff and looking to see if client behavior changed as a result. A significant limitation of the meta-analytic
reviews is the necessary exclusion of studies for which effect
sizes could not be computed. Finally, none of the reviews
included the Helsinki Psychotherapy Study by Knekt and
Lindfors reported in 2004, the most rigorous study of SFBT outcomes yet conducted.
With such wide variability in selection criteria it is difficult
to reach reliable conclusions about the empirical support for
SFBT. Consistent with requirements for a systematic review,
we decided to include all controlled studies, published and
unpublished, as well as studies in any language to insure the
generalizability of findings. Such a comprehensive review
provides a sound basis on which to reach reliable conclusions
about the effectiveness of SFBT.
Method
Although we considered doing a meta-analytic review because
of the rigorous, systematic methodology employed in abstracting and synthesizing findings, we decided against it for several
reasons. There is considerable variability in the techniques and
modalities used to implement SFBT, the populations and problems with which it is used, and the measures of outcomes. We
felt this diversity was too great for a meta-analysis to produce
meaningful results (Higgins & Green, 2011; Slavin, 1995). A
single effect size would gloss over relative differences in effectiveness with different modalities, problems, and measures and
could also suggest more precision in results than is warranted.
In addition, we did not want to exclude otherwise excellent
studies that failed to report information needed to compute
effect sizes.
Perhaps most importantly, we wanted to gather, analyze,
and report information from our review in a format that would
be of practical value to practitioners and policy makers as they
make decisions about which intervention approach to use in a
particular field of practice and how best to implement it.
Synthesizing findings from many studies into a single number
as is done in meta-analyses is useful for making generalizations
about the overall effectiveness of a particular approach, but it
provides no information on the specifics of the intervention, the
problem addressed, or the outcomes achieved. Practitioners
need to know how an intervention was used, whether the
subjects studied were similar to the practitioner’s clients and
whether the outcomes and measures used are relevant for the
client’s situation. Effect sizes are useful for establishing
general conclusions about an intervention approach; qualitative
information about individual studies is needed to judge the
validity of those studies’ findings with clients in clinical
settings.
268
Accordingly, we decided to undertake a systematic qualitative review. A systematic review implies specific inclusion
criteria, a comprehensive and explicit search strategy, and to
the extent possible objective criteria in synthesizing and reporting study findings (Higgins & Green, 2011).
Selection Criteria
Our objective was to review (1) all available, (2) controlled
(high internal validity) studies of the (3) end-of-treatment
outcomes of (4) SFBT used in psychotherapy and behavior
change applications.
We reviewed all studies in any language, published or
unpublished, that met our search criteria. Systematic reviews
often include unpublished studies found in conference proceedings, dissertations, and research reports, and evaluate their
methodological quality and results just as they would any
published study (Higgins & Green, 2011; Lipsey & Wilson,
2001; Petticrew & Roberts, 2006). We felt it was particularly
important to include unpublished studies in our review since
much of the research on SFBT has been carried out in clinical
as opposed to academic settings, and as doctoral dissertations.
The inclusion of doctoral dissertations in particular helps
to reduce publication bias since dissertations are usually written regardless of their outcomes. Consequently, dissertations
often show lower effect sizes than published studies (Slavin,
1995).
We limited our review to controlled studies where subjects
receiving SFBT were compared with subjects who did not.
Some of the studies used random assignment to groups whereas
others used a nonequivalent control group design in which
subjects were thought to be comparable to the experimental
group. We also included single subject multiple baseline studies with six subjects or more. Whereas true experiments have
higher internal validity because they use random assignment,
nonequivalent control group, and single-subject studies are
often more naturalistic and therefore may have stronger
external validity.
By end-of-treatment outcomes we mean cognitive and
behavioral changes in the client observed at the end of treatment or later. This excludes studies where the outcome was
only subjective, such as client satisfaction, or where the assessment of outcomes occurred during treatment as opposed to the
end of treatment.
We constructed our operational definition of SFBT by
drawing from descriptions that have appeared in the literature
(Beyebach, 2000; de Shazer & Berg, 1997; de Shazer et al.,
2007; Gingerich & Eisengart, 2000; Smock, McCollum, &
Stevenson, 2010; Trepper et al., 2012). We defined SFBT as
including the following techniques, and studies had to explicitly mention one or more of these techniques to be included
in our review: (1) search for presession change, (2) goal setting,
(3) miracle question, (4) scaling questions, (5) search for
exceptions, (6) relationship questions, (7) consulting break,
(8) compliments, (9) homework assignment or task, and (10)
focus on what is better.
Research on Social Work Practice 23(3)
We further limited our review to psychotherapy and
behavior change studies focused on problematic conditions or
behaviors in individuals, families, or small groups. These are
the kinds of problems that are often treated in health and mental
health settings, and in other settings where treatment is supported by public funds (e.g., schools, corrections). We
excluded studies of organizational interventions, and indirect
interventions such as staff training and coaching.
Search Strategy
We used several strategies to create the initial pool of candidate
studies. First, we searched five electronic databases (PsycINFO, Medline, ERIC, Ebscohost: Megafile, Advanced
Search Premier, Social Work Abstracts, and Dissertation
Abstracts) using the terms solution focus* OR solution oriented*
AND research OR study for the period up to and including April,
2012. Then, if they were not already included, we added studies
that had been included in previous reviews noted above, and the
13 studies Kim (2008) excluded from his review because of
insufficient data to calculate effect sizes. Finally, we searched
an exhaustive list of SFBT research studies maintained by
Macdonald (2012), and queried members of the solutionfocused therapy Listserv (http://www.sft-l.sikt.nu/). Our search
resulted in a total of 1,452 candidate studies (Figure 1).
We then reviewed the title and abstract of the candidate
studies and discarded 1,391 that clearly did not meet one or
more of the selection criteria. Finally, we reviewed the full
reports of the remaining studies and excluded those that did not
meet our search criteria. When we had questions about a particular study we discussed them until we reached consensus based
on further specification of our selection criteria. Studies were
excluded if they did not include one or more components of
SFBT as defined above, directed the intervention toward someone (e.g., teacher) other than the person (e.g., student) whose
outcomes were measured, or measured within treatment rather
than end-of-treatment outcomes. Eighteen studies were
excluded at this step, leaving 43 studies for abstraction and
analysis.
Data Abstraction and Analysis
We extracted data from each of the selected studies using a data
abstraction form (available from the first author) that recorded
problem type, setting (including country if outside the United
States), SFBT techniques used, modality and duration of SFBT,
type of comparison group and treatment used, sample size, key
features of the study design, outcomes and measures used,
pre–post change in the SFBT group, and comparison of SFBT
with the control group.
The SFBT techniques used in a study can be used as a general indicator of treatment fidelity—the more techniques
employed the more complete the implementation of SFBT.
Likewise, the number of therapy sessions indicates the amount
of treatment provided, an important consideration since SFBT
is intended to be a short-term treatment.
Gingerich and Peterson
269
Records iden fied through
database searching
(n = 1398)
Addi onal records iden fied
through other sources
(n = 123)
Records a er duplicates removed
(n = 1452)
Records screened
(n = 1452)
Records excluded
(n = 1391)
Full-text ar cles assessed
for eligibility
(n = 61)
Full-text ar cles excluded,
with reasons
(n = 18)
Studies included in
qualita ve synthesis
(n = 43)
Figure 1. Flow diagram showing the number of studies at each step in the selection process.
The quality of the study design is an important factor in
assessing the trustworthiness of the findings, therefore key
design features of each study are reported including the use
of random assignment or matching, use of selection/exclusion
criteria, sample size, fidelity assessment, use of an alternative
treatment for the comparison group, therapist experience,
objective measures, and follow-up.
We decided to reduce the data on pre–post change and comparison group contrast to a categorical variable with three levels:
no change or difference (0 or ≈), a positive or negative trend
(þ or ), or a statistically significant change or difference
(þ* or *). Although information is lost in converting quantitative data to categorical, this format provides a shorthand way to
describe a study’s overall outcome that allows for comparison
among studies as well as aggregation across studies in a field
of practice. Interpretation of pre–post change is straightforward;
however, the comparison group contrast can be variously interpreted. When studies used a wait-list or ‘‘treatment as usual’’
comparison group, SFBT needs to outperform the comparison
group to be considered effective. However, when the comparison group received an alternative treatment known to be effective SFBT must be at least as good as (not significantly
different from) the comparison group to be considered effective.
To alert the reader to this important distinction, the comparison
treatment and group contrast are shown with a shaded background in the tables when an alternative treatment is used.
We report the abstracted information for each study in summary tables grouped by field of practice; these tables provide
the ‘‘raw data’’ for our qualitative analysis and synthesis of the
findings. The tables also give readers the essential information
about each study, so they can determine its applicability to their
situation and can consult the original source for more detail if
desired. In addition, the tables allow readers to make their own
judgments about the research evidence in a particular field of
practice.
Findings
Forty-three studies (one study appears in two groups) met our
selection criteria and fell into six fairly distinct groupings
according to field of practice:
Child academic and behavior problems (14 studies)
Adult mental health (10 studies)
Marriage and family (6 studies)
Occupational rehabilitation (5 studies)
Health and aging (5 studies)
Crime and delinquency (4 studies).
Child Academic and Behavior Problems (14 Studies)
Almost a third of the SFBT outcome studies have been
conducted with children with academic and behavior problems;
11 of the 14 were carried out in school settings (Table 1). Since
…
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