Solution-Focused Brief Therapy for Substance Use: A Review of the Literature

Background and Purpose: Substance use is a prevalent public health issue. Most social workers may encounter substance use in their work with clients and need effective therapeutic strategies for this issue. Solution Focused Brief Therapy (SFBT) has been practiced with clients who have substance use problems since the 1980’s and clinical training materials have been developed to help practitioners learn and use SFBT in substance use treatment. Despite the longevity of the use of SFBT in practice, there are no published reviews of outcome studies to guide practitioners using SFBT. This article fills a gap in current literature on SFBT and substance use treatment by reviewing the published studies on SFBT’s effects on substance use and related psychosocial problems.

Methods: Studies to be included in the present review were focused on SFBT for individuals with substance use problems. Studies were not excluded based on countries where they were conducted, publication date, participant characteristics, or study design. However, studies were excluded if they were not written in English. We searched five databases including PsycINFO, SocINDEX, MEDLINE, PsycARTICLES, and Psychology and Behavioral Sciences Collection. Additionally, experts and reference lists of relevant studies were consulted to identify additional eligible studies. We designed a data extraction form to collect information on bibliography information, research design, participants and setting descriptors, intervention descriptors, and study findings. The data collection form was pilot-tested with a few targeted articles and was modified before formal data extraction.

Results: Nine studies were identified and included in the review. There was a range of quality in the studies from single case designs, quasi-experimental and randomized controlled trials (RCT). All nine studies reviewed found promising evidence on SFBT’s effectiveness in improving substance use behaviors and related psychosocial problems. Five of the nine studies showed that SFBT can change substance use and co-morbid mental health and psychosocial problems such as depression, trauma, and school and work-related behavior problems. Almost all studies reviewed were conducted with adult clients and the samples were diverse suggesting that SFBT is being effectively applied with good results with a range of ethnic groups including African-Americans, Latinos, and European populations.

Conclusions and Implications: SFBT holds promise to be effective in improving substance use behaviors and related psychosocial problems. More studies are needed to draw definitive conclusions. Future RCT studies on clients who have both substance use and psychosocial problems are needed. It is recommended that these studies build on current RCT studies and the practice settings where SFBT has been found most effective.