Brief Therapy

What is inclusive solution-focused brief therapy?

Brief therapy is suitable for alleviating symptoms of depression and anxiety, for example, as long as they are not extremely severe. Typically, brief therapy is composed of 1 to 20 sessions, according to the needs of the client. The idea is that therapy ends as soon as the client no longer needs it.

My specialty is inclusive therapy, which aims to actively promote the equal access of all kinds of people to mental health services. I love to work with different kinds of people and problems, especially relating to coping and resilience, relationships, identities, neurodiversity, faith and spirituality.

The client-focused approach of SFBT offers a fruitful foundation for the implementation of inclusive therapy practices. Challenging the problem-focused idea of mental (un)health, SFBT maintains that the position of the therapist is one of not knowing. From a place of not knowing, the therapist is able to create a atmosphere of genuine acceptance for the client and their experience. Grounded in social constructionism, the approach questions expert power and diagnostic-centred thinking and believes the client to be the best expert on their personal life.

I am critical toward psychiatry. My work is not guided by diagnoses, unless they hold importance for the client (such as diagnoses related to neurodivergence). Although antidepressants are helpful for many, I hope to have a more active public discussion about their negative side effects. I am also strongly in favour of treating psychoses with the Open Dialogue approach in all of Finland.

The solution-focused approach does not believe in ‘client resistance’ or ‘treatment non-compliance’, which are instead seen as symptoms of malfunctioning collaboration between the therapist and the patient. This requires the therapist to check the client’s goals and modify their work accordingly. Sometimes, problems arise from poor chemistry, which should be addressed promptly. I am always happy to help clients find another therapist who is a better fit for them, if necessary.

Client-centred thinking and an emphasis on a good therapeutic alliance have been found to be crucial elements in efficient therapy in so-called ‘common factors’ research. Studies on the effectiveness of therapy have shown that good outcomes across all forms of therapy are related to the therapeutic alliance, the empathy of the therapist, positive regard, genuineness, and client expectations.

Inclusive solution-focused brief therapy aims to actively remove obstacles preventing people from accessing therapy. In my work, this takes the following forms:

• I take into account mobility disabilities and sensory sensitivities: I offer in-person therapy in an accessible location in Sipoo at the Söderkulla Manor. The manor is accessible by public transport. You can let me know about your individual needs when booking. Virtual therapy, camera on or off, is naturally also an option.
  
  
• Multilingualism: To reach non-Finnish speakers, I offer therapy also in English and French.
  
  
• Simple booking and paying: Booking is simple, even amidst great stress or concentration difficulties: access the Vello booking system here and book your appointment. Vello sends you two automated reminders of your upcoming booking (unavailable in August – September 2024). You can pay after the session with MobilePay or by invoice. I offer an extra discount for clients with limited finances (please describe your situation briefly in Vello when booking, currently no spots available).
  
  
• Feedback-informed treatment: I systematically collect feedback to track and understand any obstacles hindering efficient therapy. This helps me to tailor my services as much as possible to clients’ needs and expectations. You will receive a short feedback survey either in paper or automatically by email, but responding is, of course, voluntary. To better understand what works in the long run, I will also send you a survey 6 or 12 months after we end our collaboration. Responding is easy and fast, but naturally voluntary.
  
  
• Deconstruction of decolonising and oppressive practices: I am committed to decolonise the therapy setting and deconstruct oppressive practices in relation to power structures. I aim to be present to clients as a compassionate human being open about my backgrounds.
  
  
• Respect for diversity and commitment to educating myself: I ensure that clients with various backgrounds can concentrate on the service, i.e. therapy, by committing to educating myself about phenomena new to me. I make an effort to understand different identities and backgrounds and use respectful, inclusive language.
  
  
• Growth mindset: I am committed to continual critical self-reflection with a growth mindset. Self-compassion is an important part of the inclusive approach: the world is constantly changing and mistakes are unavoidable. It is important to be able to admit to one’s mistakes and do better in the future.

What can I expect in a session of solution-focused brief therapy?

Typically, SFBT sees problems as inherently intertwined with a hope for change. The client’s skills and abilities to actualise change are explored, as are the smallest steps of the process. In questions related to identities, such as sexuality and gender, the aim is usually to give oneself time and place to process the subject within a safe, therapeutic space.

SFBT is a relatively practical approach and clients are given tasks, sometimes also homework. For example, the client is asked to draw a mind map of their problems, including indications of interrelational aspects of the diagram (exercise created at Helsingin Psykoterapiainstituutti). Contrary to problem-focused forms of therapy centred around the root cause, the solution-focused approach centres on the problem that has the most impact on the other problems in the diagram. Solving this most influential problem is, therefore, often a good place to start the therapeutic work.

SFBT thinking also encompasses the idea of problems belonging to a system(s). The human mind is complex and often does not adhere to the medical model of illness. The problems of the highly social human species are often impacted by a range of factors, in other words, the system the human is part of. Change in only one part of the system, sometimes a surprising one, can alleviate the problem. The important people in the life of the client are seen as part of the solution and, thus, a solution-focused therapist is happy to work with several people in sessions. Seeking peer support is also encouraged in SFBT.

Identifying exceptions is another approach to problems that is the reverse of other forms of therapy: instead of considering how a past event affects a current problem, for example, when we take a solution-focused approach we analyse the situations in which the client’s problem is absent. This allows us to explore positive situations and activities that promote the client’s well-being and produce a sense of optimism. The analysis can also give surprising insights into the root causes of the problem.

The approach is future oriented and past experiences are typically explored in order to map the client’s skills and coping mechanisms. For me, creating an empathetic and safe therapeutic space for the client to delve into their history is an important value. I cherish the trauma-informed approach to mental health and personal growth. I use the lifeline technique, among others, in identity-related work: it can provide new insights about continuities and discontinuities, for example in sexual and gender self-expression.

The ability to change perspective and observe one’s own thought patterns are at the core of SFBT. The role of the therapist is that of an interlocutor with whom the client can explore their situation from as many angles as possible. The method formed part of Stoic philosophy as far back as Antiquity, and at its best, constitutes a profound discussion about human existence that helps develop resilience of the mind. In this respect, the SFBT approach resembles cognitive therapy and positive psychology.

Important to know about solution-focused brief therapy

Under current Finnish stipulations, solution-focused brief therapy is not considered either psychotherapy or brief psychotherapy. In Finland, the title ‘psychotherapist’ is a protected occupational title reserved for health care professionals and supervised by Valvira (the National Supervisory Authority for Welfare and Health). A brief therapist does not have the right to use this title. Whereas clients of psychotherapy are entitled to submit an objection to Valvira, brief therapy clients are covered by consumer protection: www.kkv.fi.

The brief therapy I offer is not subsidised by the Finnish government. Nevertheless, if therapy is provided at an early stage and the client is a suitable fit, brief therapy has the potential to work quickly, making it even more affordable than subsidised psychotherapy, which usually lasts for one to three years. You can read more about the efficiency of short- and long-term therapies: article on the Helsinki Psychotherapy Study and the results of the Helsinki Psychotherapy Study in their entirety.

As a brief therapist, I am committed to recognising the limitations of my expertise. I will refer clients needing more extensive and intensive care to a doctor or a psychotherapist. I am happy to collaborate with other professionals and experts, as well as different parties in the service system.

My work as a brief therapist is guided by high quality studies in the field, the broadest in Finland, and high ethical standards. I have a degree of 60 credits in solution-focused brief therapy from Helsingin Psykoterapiainstituutti. A total of 20 credits have been transferred from my 30 credits of psychology studies at the Open University at the University of Jyväskylä. The programme included more than 130 hours of client practice and I graduated in June 2024. In addition to this, I am a student member of Lyhytterapeuttiyhdistys ry (‘the Brief Therapist Association’), with my eligibility examined and approved by the board. The membership criteria include at least 40 credits of studies in brief therapy, incorporating a study module entitled ‘psychotherapeutic abilities’, in addition to a suitable previous degree or appropriate work experience https://www.lyhytterapeuttiyhdistys.fi/yhdistys/.

You are safe with me in brief therapy. I ensure your safety in the following ways:

• All discussions are 100 % confidential: As a therapist, I am bound by professional secrecy. In-person and virtual sessions are held in a soundproof office. I use secure video conferencing software.
• No electronic patient records: I make only necessary notes in session and store them securely in a lockable cabinet in an office. I do not use the Kanta patient register.
• No client register: I do not have a client register with personal details and I do not use names in my notes. The only registers associated with my clients’ personal information are those of the booking system Vello and the billing system OP Kevytyrittäjä (OP Light Entrepreneurship).
• Read about my privacy policy here, especially sections 4, 8, and 13. (Currently only in Finnish.)
• Minimizing risks with insurance. My work is covered by a liability and a legal insurance from IF Insurances. In Finland, brief therapy practitioners are not required to have a patient insurance (or any other insurance) like health care professionals supervised by Valvira.
• Consideration of ethical aspects, high-quality, and continuous learning: due to my work as a researcher in humanities for more than a decade, the consideration of ethical aspects and high-quality and continuous learning are part of my core values and guarantee high ethical standards in my work as a brief therapist, too. I follow both Finnish and international psychotherapy research as well as public discussions about the field. I have a special interest in international research on inclusive and decolonial therapy and the practices of international therapists providing such services. I am committed to educating myself constantly about the subject matter to better understand the needs of different clients with a variety of backgrounds and also to deconstruct the power dynamics inherent in the therapeutic relationship. My aim is to provide the best possible therapy experience to both minority and majority clients.

History of solution-focused brief therapy

The solution-focused brief therapy approach was developed in the US after the Second World War as part of a social movement supporting the disadvantaged. Early key figures included Psychiatrist Milton H. Erickson (1901–1980) and the therapists at the Mental Research Institute (MRI) in Palo Alto, California. Other important developers include the therapists of the Brief Family Therapy Center (BFTC) in Milwaukee, especially Insoo Kim Berg (1934–2007) and Steve de Shazer (1940–2005).

SFBT was brought to Finland in the mid 1980s by Psychiatrist Ben Furman and Social Psychologist and Director of A-klinikkasäätiö Youth Services Tapani Ahola, who had become acquainted with the BFTC in Milwaukee. In Finland, the adoption of the approach was linked to the social justice movement that was started in the 1960s by Marraskuun like, revolutionising the principles of mental health work in the country.