This document provides an overview of solution-focused counseling for depression. It discusses key principles of solution-focused counseling including being solution-focused, collaborative, and emphasizing small changes. It also reviews research showing solution-focused approaches can be effective for treating depression. The document outlines the theory of problems and change in solution-focused counseling which focuses on exceptions to problems. It describes common stages of the approach including identifying exceptions and developing tasks. S.M.A.R.T. goals and the first session formula task are also summarized.

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.