Problem-Solving Therapy vs SFBT
A side-by-side comparison: mechanism, evidence, the conditions each treats, philosophical roots, and where they actually disagree clinically.
At a glance
Problem-Solving Therapy
- Tradition
- Cognitive-Behavioral
- Founder
- D'Zurilla / Nezu (1971)
- Evidence
- Guideline-recommended
- Focus
- Skill-building
- Format
- Individual
- Duration
- Short-term
SFBT
- Tradition
- Postmodern
- Founder
- de Shazer / Insoo Kim Berg (1985)
- Evidence
- Guideline-recommended
- Focus
- Strengths-based
- Format
- Indiv + Family + Group
- Duration
- Very short (1-8)
How they work
Problem-Solving Therapy
Core mechanism: Structured problem-solving skills (define, generate, evaluate, implement) counteract hopelessness and behavioral inaction in depression
Ontology: Depression maintained by poor problem orientation (negative appraisal of problems) and deficient problem-solving skills
SFBT
Core mechanism: Identifying exceptions, preferred futures, and existing strengths amplifies what already works; solution-building vs. problem-solving
Ontology: Problems are not continuous; exceptions exist. Focusing on problems maintains problems; focusing on solutions builds solutions
Conditions treated
1 shared · 1 Problem-Solving Therapy-only · 3 SFBT-only
Both treat
Only Problem-Solving Therapy
Only SFBT
What each assumes — and misses
Problem-Solving Therapy
Philosophical roots: Dewey (reflective problem-solving); cognitive-behavioral tradition; D'Zurilla (social problem-solving model); pragmatism
Blind spots: Narrow skill focus may miss emotional depth; assumes problems are solvable — less suited for existential or grief concerns
Therapeutic voice: Let's list every possible solution, even the ones that seem impractical. We'll evaluate them after.
SFBT
Philosophical roots: Wittgenstein (language games — meaning is use); de Shazer (solution-focused); social constructionism (Gergen); pragmatism (what works matters more than why)
Blind spots: May minimize genuine suffering by focusing prematurely on solutions; limited depth for complex trauma or personality work
Therapeutic voice: Tell me about a recent time when the problem wasn't happening. What was different?
Choosing between them
Problem-Solving Therapy (Cognitive-Behavioral) and SFBT (Postmodern) come from different traditions, which means they assume different things about what a person is, what causes suffering, and what the therapeutic relationship is for. The choice between them is often less about "which works better" and more about which set of assumptions fits the client and the therapist.
For deeper coverage: see the full Problem-Solving Therapy and SFBT pages, or use the interactive comparison tool to add more modalities to this comparison.