To address health disparities in HIV care for women, we developed Solution-Focused Wellness for HIV (SFWH), an evidence-based intervention that capitalizes on strengths to improve overall wellness. SFWH utilizes solution-focused brief therapy, a salutogenic wellness approach and HIV research with women. We created an intervention manual and recruited ( N = 6) women living with HIV to provide expert client feedback through focus groups. The findings included themes of relationships with children and other family members, physical accommodations, antiretroviral therapy information, and improving the accessibility of the intervention. The SFWH intervention for women was feasible to deliver and positively received by the participants. We adapted the SFWH manual to incorporate our findings, and a quantitative study is planned to evaluate the effectiveness of the intervention.

This pilot study was undertaken to assess whether a deliberate increase in eating frequency would cause an increase in overall energy intake and thus potentially contribute to weight gain. Ten adult male subjects were randomly allocated into two groups. One group consumed a given snack 30 minutes and the other 90 minutes before lunch and evening meals for a two-week period. After a washout period, the snacking regimes were reversed. Body weights were measured at baseline and at the end of the two intervention periods. Subjects completed a seven day semi-weighed dietary diary at baseline and a four-day diary during the second week of the two intervention periods. The insertion of snacks between meals resulted in a reduction in energy consumed at subsequent meals. Surprisingly snacks taken 90 minutes before meals resulted in a reduction in energy consumed at subsequent meals. Moreover, the magnitude of the adjustment was greater at evening meals than at lunch. This study provides preliminary evidence that snacking does not necessarily lead to overconsumption and thus contribute to obesity. However, a full-scale study is needed with a longer intervention period to thoroughly evaluate this issue.

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Women living with HIV experience a gender gap in wellness outcomes in the U.S., and women of color are particularly vulnerable to this gap. To address this, the Solution Focused Wellness for HIV (SFWH) intervention for women was created. In this paper, we report the quantitative results of the most recent SFWH pilot study. The seven-session, group intervention was provided to (N=14) women living with HIV to evaluate it for effectiveness. Results showed the intervention was associated with significant multidimensional wellness improvements between baseline and five-week follow up. Participants’ CD4 and Viral Load counts did not change significantly. To improve access to the intervention and increase retention in HIV care in the community, further adaptations of the SFWH are planned.

Solution Focused methods are often interpreted by different practitioners with a degree of flexibility and adaptation to specific practice settings (Lehmann & Patton, 2012). This flexibility is one of the features that makes SFBT a very client-centered approach and has been highlighted as one of the key aspects of successful co-construction of desired outcomes with clients (Franklin et al., 2017). This collaborative approach is possible due to SFBT’s utilization of social constructionist principals in the solution-building process (Blundo & Simon, 2015). While encouraging flexibility of implementation of SFBT, identifying the main tenets of the therapy, including specific techniques and mindsets is helpful to researchers who are interested in determining SFBT’s success in certain clinical and research efforts (Lehmann & Patton; Trepper et al., 2012). To help with this process, members of the Solution Focused Brief Therapy Association (SFBTA) created a treatment manual that outlined these major tenants to serve as a guide and to reach a consensus about how to understand and implement SFBT (Trepper et al.). In publishing their SFBT fidelity instrument, Lehmann and Patton recommended that the field of SFBT focus more seriously on the issues of treatment fidelity in SFBT practice and research. However, continued discussion on the topic has been limited in the peer-reviewed, published SFBT literature. To continue this discussion among SFBT researchers and practitioners, the process for planning, monitoring and reporting fidelity to SFBT in the Solution Focused Wellness for HIV Intervention for women (SFWH) will be presented. The SFWH fidelity monitoring process will be explained in the context of both common SFBT fidelity processes and the latest accepted behavioral intervention research guidelines for the fidelity process.