Solution-Focused Brief Therapy in Iran: A Scoping Review of the Outcome Literature

Background and Purpose: A considerable body of research literature on solution-focused brief therapy (SFBT) with clinically diverse populations in Iran has emerged over the past 15 years but has yet to be comprehensively reviewed. This scoping review was conducted to synthesize literature evaluating SFBT interventions in Iran to identify key areas for potential evidence-based recommendations and focus future research priorities.

Methods: We used a scoping literature review as our methodological approach, as there have been few prior studies synthesizing the outcomes research on SFBT in Iran. We reviewed the SFBT intervention literature by electronically searching the Academic Search Complete, The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Google Scholar, Health Source: Nursing/Academic Edition, Medline, PsycINFO, PubMed, and SocINDEX databases between December, 2019 – June, 2020. Hand searches were conducted for the Iranian Registry of Clinical Trials (IRCT) the Campbell Collaboration in addition to national and international solution-focused brief therapy organizations’ websites (Australasian Association for Solution-Focused Brief Therapy, European Brief Therapy Association, Institute for Solution-Focused Therapy, Solution Focused Brief Therapy Association, and SOLWorld). We used broad eligibility criteria to identify studies published before January 2020 in English or Persian/Farsi that investigated the effects of SFBT for populations in Iran. All experimental studies that that evaluated an SFBT intervention and were focused on addressing psychological, behavioral, or interpersonal difficulties among individuals, families, or small groups were included. Two reviewers independently screened all potentially eligible references and completed data extraction for all eligible studies. Intervention outcomes were analyzed, with a focus on identifying prevalent characteristics of studies reporting positive results.

Results: Of the 77 eligible outcome studies, 78% (n=60) reported positive intervention effects for a wide range of applications across ages and fields of practice. All remaining studies (22%; n=17) reported neutral or mixed results; none reported negative results. Iranians across the lifespan benefitted from SFBT interventions, which were frequently used to treat mental health conditions like depression, anxiety, and acute stress, as well as issues related to family functioning and marital intimacy. The most prevalent characteristics among the studies reporting positive intervention effects included: facilitation by a facilitated by a counselor, social worker, or midwife; delivery to individual clients; location in a social service agency; duration of 1-4 sessions. The most successful SFBT techniques used were consultation breaks/feedback (100% of studies), followed by the pre-session change question (85.7%), the miracle question, (78.6%), looking for exceptions (77.8% of studies), goal development questions (76.3% of studies), and looking for previous solutions (75% of studies). Studies that included cultural adaptations reported positive results at a rate of 80%.

Conclusions and Implications: These findings represent the first English-language study synthesizing the experimental literature on outcomes from SFBT intervention trials conducted in Iran. Our results demonstrate that solution-focused interventions in Iran can be effective among diverse groups on individuals from clinical and general populations, and across a variety of presenting issues. Future research identifying culturally specific mechanisms that make SFBT an intervention acceptable to and beneficial for Iranians is encouraged.