Solution-Focused Therapy With Children: Harnessing Family Strengths for Systemic Change

In today's mental health care environment, the concept of "brief therapy" has attracted significant attention. Although definitions of "brief therapy" vary, the concept is more than 30 years old in the family therapy field. For instance, the Mental Research Institute in Palo Alto, California, established the Brief Therapy Center in 1967 (1).

Solution-focused therapy (2,3) is one of the more popular "brief" approaches. Interestingly, it was developed close to 20 years ago. Similar to many "brief" and other therapy approaches, it seems to be more of an adult approach to treatment without incorporating significant developmental considerations related to children. Yet core assumptions, including a focus on strengths and on exceptions to problem occurrence (that is, on what is happening when the presenting problems are not occurring), make solution-focused therapy a very different approach to facilitating change in clients.

Matthew Selekman is well known for his contributions to solution-focused therapy. Specifically, he has written about and presented workshops on its application to adolescents and now children. The purpose of this book is to "provide clinicians with the practical 'how-to's' for conducting an integrative Solution-Focused Brief Therapy approach with children and their families." Selekman appears to have accomplished his goal.

The ten chapters are written in a well-organized, clear, and readable style. Overall, the author presents a good synthesis of concepts, therapy techniques, and research. However, at times, discussion of therapy techniques and coverage of the relevant literature appear to be a bit cursory. For instance, developmental theory and research supporting the application of particular strategies are not comprehensively discussed, as developmental considerations never really progress beyond the idea that one needs to "concretize" interventions. Also, the frequent use of quotations might be distracting to some readers.

Yet this pragmatic book by an accomplished therapist succeeds in presenting an integrated solution-focused approach for children and their families. Practically every therapy intervention mentioned is followed by a brief case to illustrate how the strategy can be implemented. Many of the therapy techniques have good face validity as appropriate for children and have been used widely with children.

Chapter 1 functions as a good foundation for what follows. Therapists who are interested in reading more about solution-focused therapy might consider starting with the three references cited above. Chapters 2 through 6 discuss a wide array of solution-focused strategies plus other interventions that Selekman integrates into the solution-focused approach. Examples of such other interventions include art therapy techniques, family play interventions, and even Winnicott's squiggle game. Chapter 7 concerns strategies for collaborating with larger systems in the treatment of children and their families. Integrated solution-focused therapy with challenging cases is addressed in chapter 8, and practical guidelines for working with managed care companies using integrated solution-focused therapy are given in chapter 9. The final chapter serves as a summary of the major points in the book.

The book functions as an informative and practical how-to guide for the application of integrated solution-focused therapy with children and their families. Although some reference is made to solution-focused therapy's effectiveness, it should be noted that the approach does, in fact, have only limited empirical support. This situation may be due to the paucity of studies evaluating the approach and to significant methodological problems with most of investigations that have been conducted. Clearly, well-controlled outcome research is needed. With this caution, the book should be very helpful to child mental health clinicians, clinical supervisors, graduate school instructors, and graduate students interested in learning about an expanded solution-focused approach for children and their families.