Solution-Focused Brief Therapy: The Case of Jim

Abstract

A case is presented featuring a clinical social worker in a free medical clinic, utilizing solution-focused brief therapy (SFBT) while integrated into primary care. Jim, a 57-year-old black male, was referred by one of the clinic’s primary care physicians with concerns related to his alcohol and crack cocaine use. Application of the SFBT approach is demonstrated by conveying the successful moments and challenges while delicately navigating the unique aspects of this case such as the free medical clinic setting, primary care environment, Jim’s extensive history of substance use, and complicating biopsychosocial factors. Specific SFBT techniques such as presuppositional language, identifying pre-session change, recognition of exceptions, scaling questions, and collaborative goal setting are exhibited throughout treatment with Jim from the initial assessment to managing follow-up appointments. Applicability is relevant to both beginning and seasoned clinicians learning the SFBT approach and desiring to integrate into a healthcare setting such as primary care.