The glass half-full or half-empty: a within-subject comparison of solution-focused versus problem-focused client descriptions on therapist emotions and hope for treatment.

Abstract

Background: Intake assessments vary in their focus on strengths and solutions compared with problems. They provide therapists with first impressions of their clients. Research shows that first impressions may have strong and lasting effects.

Aims: To compare how solution- versus problem-focused case descriptions influence therapists' emotions and initial expectations for successfully working with a client.

Methods: Vignettes describing clients were manipulated to focus either on solutions and strengths, or on problems. In a within-subject experimental design, 33 (Sample 1) and 29 (Sample 2) trainee therapists each read four case descriptions (two solution-focused and two problem-focused vignettes; order fully counterbalanced). After each vignette, participants rated their affect and expectations for successfully working with the client.

Results: In both samples, solution-focused vignettes were associated with significantly higher levels of positive affect and positive expectations for treatment, and with significantly lower levels of negative affect, compared with problem-focused vignettes. Effect size differences between conditions were generally large (Cohen's d between .63 and 1.22).

Conclusions: Focusing on clients' goals, their strengths, and actively highlighting better moments and areas of problem-free functioning may increase therapists' positive emotions and their hope for clients' successful treatment. A next step is to examine the degree to which these positive short-term effects are, in turn, predictive of better clinical outcomes in therapy. Future research could additionally examine whether supporting therapists to frame clients' initial assessments in solution-focused ways may be one way to contribute to workforce well-being.