1. Solution-Focused Counseling
for Depression
Clayton V. Martin, M.S.
Jeffrey T. Guterman, Ph.D.
Education Session
Friday, March 28, 2014
Honolulu, Hawaii Convention Center
Copyright © 2014 Clayton V. Martin and Jeffrey T. Guterman

2. Principles of
Solution-Focused Counseling
• Solution-focus
• Collaborative approach
• Small changes can lead to big results
• Emphasis on process
• Strategic eclecticism
• Brief by design, but not always
• Responsive to diversity

3. Background on Depression
• 10% to 25% of population has experienced
some form of depression in their lifetimes
(Paradise & Kirby, 2005).
• Depression is considered primary cause of
disability in the world, second to ischemic
heart disease (Nierenberg, 2010).
• Depression is the most common disorder
among people who seek mental health
services (Gilroy, Carroll, & Murray, 2002).

4. Research for Depression
• Various treatment approaches have been found
effective for the treatment of depression, including
cognitive-behavioral therapy (Sudak, 2012), family
counseling (Beach, Jones, & Franklin, 2009), and
medication (Hollon, Thase, & Markowitz, 2002).
• An increasing literature has found solution-focused
approaches to be effective for treating depression in a
variety of clinical settings and for different populations
(e.g., Areán, Raue, Mackin, Kanellopoulos, McCulloch,
& Alexopoulos, 2010; Estrada & Beyebach, 2007; Knekt
et al., 2008).

5. Formula First Session Task
Between now and next time we meet, I want
you to observe so that you can tell me next
time, what happens in your life that you want to
continue to have happen (cf. Molnar & de
Shazer, 1987).

6. Implications of a Postmodern Position
for Solution-Focused Counseling
• Clinical reality as a social construction rather than an
objective reflection of reality.
• Counselors as participant-observers rather than
independent of clients and problems.
• Language as the distinction of treatment concern rather
than human systems as the locus of problems.
• A collaborative approach and an emphasis on cooperating
rather than viewing clients’ oppositions to change as
resistance.

7. Theory of Problems in
Solution-Focused Counseling
• Exception: Times when the problem is not
happening.
• Problem/Exception
• Depressed/Not Depressed

8. Theory of Change for
Solution-Focused Counseling
Problem / Exception

9. Common Change Factors
• Client factors (self-help): 40%
• Client-counselor relationship factors: 30%
• Expectancy factors: 15%
• Model factors: 15%

10. Stages of Solution-Focused Counseling
• Coconstructing problems and goals
• Identifying and amplifying exceptions
• Coconstructing tasks
• Evaluating the effectiveness of tasks
• Reevaluating problems and goals

11. S.M.A.R.T. Goals
• Specific
– Small
– Incremental
• Measurable
• Attainable
• Relevant
• Time-based

12. References
Areán, P.A., Raue, P., Mackin, R., Kanellopoulos, D., McCulloch, C., & Alexopoulos, G.S. (2010). Problem-solving therapy and
supportive therapy in older adults with major depression and executive dysfunction. The American Journal of Psychiatry, 167,
1391-1398.
Beach, S.R.H., Jones, D.J., Franklin, K.J. (2009). Marital, family, and interpersonal therapies for depression in adults. In I.H. Gotlib &
L. Hammen, C.L. (Ed.), Handbook of depression (2nd ed.). (pp. 624-641). New York: Guilford Press.
Estrada, B., & Beyebach, M. (2007). Solution-focused therapy with depressed deaf persons. Journal of Family Psychotherapy,
18(3), 45-63.
Gilroy, P., Carroll, L., & Murra, J. (2002). A preliminary survey of psychologists’ personal experiences with depression and
treatment. Professional Psychology: Research and Practice, 33, 402-407.
Hollon, S.D., Thase. M.E., & Markowitz, J.C. (2002). Treatment and prevention of depression. Psychological Science in the Public
Interest, 3(2), 39-77.
Knekt, P, Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., Laaksonen, M. A., Marttunen, M., Kaipainen, M., Renlund, C. (2008).
Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on
psychiatric symptoms during a 3-year follow-up. Psychological Medicine, 38, 689-703.
Molnar A., & de Shazer, S. (1987). Solution-focused therapy: Toward the identification of therapeutic tasks. Journal of Marital and
Family Therapy, 13, 349-358.
Nierenberg, A. (2010). Switch or augment? Lessons from STARD. Annals of Clinical Psychiatry, 22(4), 4-8.
Paradise, L.V., & Kirby, P.C. (2005). The treatment and prevention of depression: Implications for counseling and counselor training.
Journal of Counseling & Development, 83, 116-119.
Sudak, D.M. (2012). Cognitive behavioral therapy for depression. Psychiatric Clinics of North America, 35, 99-110.

13. Suggested Readings
de Castro, S., & Guterman, J.T. (2008). Solution-focused therapy for families coping with suicide. Journal of Marital and Family
Therapy, 34, 93-106.
de Shazer, S. (1982). Patterns of brief family therapy. New York: Norton.
de Shazer, S. (1984). The death of resistance. Family Process, 23, 11-17.
de Shazer, S. (1985). Keys to solution in brief therapy. New York: Norton.
de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: Norton.
de Shazer, S. (1991). Putting difference to work. New York: Norton.
de Shazer, S. (1994). Words were originally magic. New York: Norton.
de Shazer, S., Berg, I. K., Lipchik, E., Nunnally, E., Molnar E., Gingerich, K., & Weiner-Davis, M. (1986). Brief therapy: Focused
solution development. Family Process, 25, 207- 222.
Estrada, B., & Beyebach, M. (2007). Solution-focused therapy with depressed deaf persons. Journal of Family Psychotherapy,
18(3), 45-63.
Guterman, J.T. (2013). Mastering the art of solution-focused counseling (2nd edition) Alexandria, VA: American Counseling
Association.
Guterman, J.T., & Leite, N. (2006). Solution-focused counseling for clients with religious and spiritual concerns. Counseling and
Values, 51, 39-52.
Guterman, J.T., Mecias, A., Ainbinder, D.L. (2005). Solution-focused treatment of migraine headache. The Family Journal:
Counseling and Therapy for Couples and Families, 13, 195-198.
Guterman, J.T. (1998). Identifying pretreatment change before the first session. Journal of Mental Health Counseling, 20, 370-374.
Guterman, J.T. (1996). Doing mental health counseling: A social constructionist re-vision. Journal of Mental Health Counseling, 18,
228-252.
Knekt, P, Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., Laaksonen, M. A., Marttunen, M., Kaipainen, M., Renlund, C. (2008).
Randomized trial on the effectiveness of long- and short-term psychodynamic psychotherapy and solution-focused therapy on
psychiatric symptoms during a 3-year follow-up. Psychological Medicine, 38, 689-703.
Martin, C.V., Guterman, J. T., & & Shatz, K. (2012). Solution-focused counseling for eating disorders. VISTAS, 1-11.