Transcript:
Dean McCoy:
Hello, I’m Professor Henrika McCoy, dean of the Graduate School of Social Work at the University of Denver. Welcome to Episode 18 of the school’s Brave Ideas for Social Change podcast, which draws on GSSW’s expertise for fast-moving discussions on emerging research, practice and policy innovations to spur social change. Today’s guest is Professor Johnny Kim, whose research focuses on clinical interventions to improve mental health outcomes for adolescents and families in community and school settings. He is a leading expert in solution-focused brief therapy, which is also known as SFBT, and he serves as chair of the research committee for the Solution-Focused Brief Therapy Association. Professor Kim, your work is so impactful, I’m excited to learn more, and happy to have you here.
Professor Kim:
Thank you Dean McCoy for having me here and for the opportunity to share my work.
Dean McCoy:
So since the pandemic, adolescent mental health has emerged as a national concern. According to the latest State of Mental Health in America report, almost 9% of youth reported a substance use disorder. More than 13% had serious thoughts of suicide. And more than 20% of young people ages 12 to 17 experienced a major depressive episode over the past year. But more than half of those received no mental health care, and that is shocking to many. What are some of the challenges behind those numbers?
Professor Kim:
Yeah. Adolescence can be a challenging time because kids are going through so many physical, emotional, and social developmental changes. And if they don’t get the right support and guidance, things can be exacerbated to the point where it starts to impact them negatively. So then you start to see problems show up at home and in the classroom. For example, kids might start struggling academically and missing school. And they might start using substances like alcohol, marijuana, they might start vaping and using tobacco. These are just some of the problems and challenges on top of the depression and anxiety, which are the two major mental health challenges youths face today. And all these things are interconnected and compound the challenges younger kids and teenagers must navigate. We know that many kids struggle alone, and the numbers you noted are often the most severe cases. The challenge is that there are thousands more kids who are struggling with their mental health, but who fly under the radar without any parents or concerned adults knowing about their struggles.
Dean McCoy:
You are doing really important work to expand access to SFBT, which could really help meet young people’s needs for mental health care, even if more social workers are trained to use it. GSSW is one of only a handful of schools offering an entire course in this intervention, so as a result, a large number of our audience may not know much about solution-focused brief therapy. So would you please tell us more?
Professor Kim:
Sure. Solution-focused brief therapy is an evidence-based therapy model developed in the early 1980s as a way to focus on clients’ strengths and goals. Two of the key developers, Insoo Kim Berg and Steve de Shazer, were social workers who traveled all over the world teaching clinicians about SFBT. Insoo and Steve passed away about 20 years ago, but I was fortunate to have met them when I was a doctoral student. SFBT has really started to become a popular therapy model in social work and other counseling professions like psychology as the research has grown demonstrating its effectiveness with a wide range of treatment problems and across a wide range of settings.
Dean McCoy:
So what is it about SFBT that makes it really useful for youth that are in schools?
Professor Kim:
Yeah. First is how different the approach is from more traditional problem-solving therapy models. SFBT believes that the client is the expert in identifying what the problem is as well as an expert in what the solutions are in solving the problems. The social worker’s job is really to ask the right questions to help the clients discover those solutions and help the clients figure out what’s going to work in their lives. Youth, particularly middle and high school, often aren’t asked what they think. It’s usually an adult who is telling them what to do, what not to do, how they should do it. And so the student’s voice is often lost. And SFBT is different because the collaborative way it works with youth is that it’s very empowering and judgment free. So the focus of the counseling session is identifying solutions rather than exploring details about the problem.
Dean McCoy:
So I will say as a social worker, I love that it makes the client the expert. That’s one of the fundamental things that we teach. And so it’s really interesting that this particular intervention focuses and uses the client as the expert.
Professor Kim:
So an SFBT clinician is really going to emphasize the client’s perspective in understanding things rather than the clinician being the expert in being the one to diagnose and to assess and to treat. Therefore, SFBT is probably the most collaborative therapy model that is out there that I know of. This approach is probably why SFBT is very popular and effective therapy model in other countries, particularly Asian countries where talking about your problems is very uncommon, culturally speaking, and not something that’s done. Instead, SFBT can ask questions that might be easier for them to answer since the focus is on possible solutions and the client’s preferred future without having to go into details about the problem.
Dean McCoy:
So this intervention has so much promise, and as I mentioned previously, we’re one of the few schools that offers a course that’s fully focused on SFBT. So why don’t you tell us a little bit more about the intervention?
Professor Kim:
Part of the reason is because SFBT was really developed by a group of clinicians wanting to know what worked in counseling sessions and how to be effective, given the limited time clients stay in therapy. So it did not start in academia, but rather locally with clinicians trying out different questions and techniques with their clients. Therefore, early on, SFBT was not taught in social work or master’s programs as a therapy model to use with clients. Also, clinical work was really emphasizing evidence-based treatments in the 1990s. And many colleges focused on teaching cognitive behavioral therapy, motivational interviewing, and dialectical behavioral therapy, which has more connections to universities and more research supporting its effectiveness.
But the research on SFBT was very limited during the 1980s and ’90s and didn’t really start to improve, especially studies using rigorous research designs, until the later half of 2000. Over the past two decades, research on SFBT has grown significantly and now has the empirical support for its effectiveness. To grow SFBT, Insoo and Steve offered trainings and wrote many books about SFBT. Unfortunately, their training center in Milwaukee closed shortly after they passed away. So there’s no longer a central SFBT training center for clinicians. Thankfully, Insoo, Steve and other early SFBT developers started the Solution-Focused Brief Therapy Association to grow SFBT. I’m currently a part of their board and research committee.
Dean McCoy:
Well, that’s excellent. So I know that you have a new book out now, it’s called Solution-Focused Brief Therapy With Families. What can readers expect to find in this book?
Professor Kim:
Yeah, I’m really excited about this one because it’s one of the first books on solution-focused brief therapy in [the] APA Publishing catalog. There really aren’t many books on solution-focused brief therapy in psychology, but they’ve found that a lot of psychologists are interested in learning this therapy model. And we wanted to write a book that was more of a training manual to really introduce them to how to do solution-focused therapy, when to ask questions, and how to navigate some of those difficult responses when clients don’t know what the answer is and clinicians often get stuck. So we provide lots of case examples, lots of detailed explanations for when to ask certain questions, how to respond if clients say, “I don’t know,” and how to keep the focus of the session really on helping the clients identify their solutions and their preferred goals and the strengths that they have to overcome them rather than focusing on details about the problems that they already know about.
Dean McCoy:
So I know that you also provide professional development trainings in solution-focused brief therapy. Is that correct?
Professor Kim:
Yes. While I developed SFBT here at GSSW and teach it as a course, I’ve started to partner with different organizations and school districts and train their clinical staff in solution-focused brief therapy. For example, I recently partnered with Aurora Public School districts to do a series of trainings on SFBT as part of their professional development education workshops this school year. I’ve also partnered with [the] Orange County, California, Department of Education for the past four years to do SFBT trainings for their clinical staff. This has been their most popular training they offer, and we’ve been getting typically 100 to 150 participants at this training each time.
One new training opportunity that came up that I’m really excited about is with a company called Psychwire. They develop online courses for mental health professionals. And what’s unique about their course is they partner with the developers and the international experts of the therapy model to produce extremely high-quality continuing education courses. It’s unlike anything else that’s out there. We’re currently creating the course now and it should be available later this year. This is a great opportunity for people who already completed their master’s program to gain in-depth training in solution-focused brief therapy.
Dean McCoy:
Wow. Okay. So SFBT has also been the subject of several of your research studies. What are some of the key findings and implications from that work?
Professor Kim:
Yeah. As I mentioned earlier, the research on SFBT has really grown, especially over the last 10 to 15 years. And not just in the United States, but really globally. Studies on the effectiveness of SFBT has shown high effectiveness in marital functioning, family dynamics, and mental health problems like depression and anxiety. Studies have also shown that it’s effective in school settings and effective in helping children and adolescents on school adaptation and coping skills. SFBT is often as effective as traditional therapy models like cognitive behavioral therapy, but with much fewer sessions. And I think that’s one of the reasons why people are really interested in learning more about this therapy model.
Dean McCoy:
Wow. Well, this has been quite an informative conversation. Thank you for the incredible work that you’re doing. And thank you for taking the time to share everything with me as well as our listeners.
Professor Kim:
Thank you Dean McCoy for having me here today.
Dean McCoy:
It’s certainly been my pleasure. So to our listeners, please subscribe to our Brave Ideas for Social Change podcast so that you can hear more conversations like this one. Learn more at socialwork.du.edu/change. There you will find resources related to this podcast, including a link to pre-order Dr. Kim.s new solution-focused brief therapy manual.
