Solution-focused brief therapy for behavior problems in children and adolescents: A meta-analysis of treatment effectiveness and family involvement

Objective: Research evidence and clinical observation support the importance of family involvement in the treatment of childhood behavior problems, and strengths-based, solution-oriented treatment offers an alternative to a problem-focused treatment approach. The current study provides a systematic review of solution-focused brief therapy (SFBT) for behavior problems in children and adolescents, and conducts meta-analyses regarding the effectiveness of SFBT compared to control conditions, the moderating role of family involvement in SFBT, and the effects of SFBT for internalizing versus externalizing behaviors. Methods: SFBT studies from January 1, 1990 to February 21, 2019 were retrieved from major databases and included published and unpublished studies and dissertations. Twenty studies with control or comparison groups (9 randomized, 11 non-randomized) met all inclusion criteria and were analyzed using robust variance estimation (RVE). Results: The RVE meta-analysis found a small to medium positive effect size favoring SFBT over control conditions for child behavioral problems (g = 0.43, 95% CI [0.20, 0.67], p = .001). The study did not find evidence of a moderating effect from family involvement in SFBT interventions, and there was no statistically significant difference between the effect sizes of family-involved SFBT (g = 0.37, 95% CI [-0.46, 1.211) and family noninvolved SFBT (g = 0.61, 95% CI [-0.30, 1.52]) for child behavior problems. For externalizing behaviors, SFBT showed greater effectiveness than comparison groups with a small to medium effect size (g = 0.43, 95% CI [0.18, 0.68]), but the small effect size favoring SFBT for internalizing problems was not significant (g = 0.18, 95% CI [-0.01, 0.38]). Conclusions: The evidence supports the overall effectiveness of SFBT for addressing behavior problems in children and adolescents, with evidence of greater effectiveness for externalizing rather than internalizing behaviors. Findings indicated no significant effect of including a family-involvement component in solution-focused interventions for child behavior problems, suggesting the need for further research on moderating factors that may enhance the effectiveness of SFBT with children and families.