Development and validation of a Solution-Focused Group Therapy program for interpersonal relationships in adolescents with anxiety and depression: a Delphi-based consensus study.

Adolescent mental health has currently reached a global tipping point, with the rising incidence of anxiety and depression posing a formidable challenge to public health systems worldwide. Amid this crisis, interpersonal impairment emerges not merely as a symptomatic byproduct of emotional distress, but as a pathogenetic engine that sustains and exacerbates internalizing disorders (). Whether manifested through peer exclusion, social withdrawal, or pervasive familial conflict, these relational disruptions trap adolescents into a cycle of emotional vulnerability that often resists standard pharmacological or brief interventions (). Consequently, there is an urgent need to redirect therapeutic focus toward the interpersonal domain, which serves as both a primary stressor and a potential site for systemic recovery (). The landscape of adolescent distress in China is uniquely shaped by a socio-educational context defined by extreme academic competition and hierarchical family structures (). Within this environment, emotional fluctuations are frequently interpreted by parents through a strictly pathological lens () who often demand an immediate clinical cure to prevent academic derailment (). Paradoxically, this intense evaluative pressure reinforces adolescent’s psychological defenses and amplifies social stigma, rendering traditional etiology-focused therapies—which delve deep into the origins of problems—potentially counterproductive (). Such models may inadvertently intensify attributional conflicts between parents and children, contributing to high attrition rates in clinical settings as families struggle under the dual burden of academic demands and intensive psychotherapy (). Solution-Focused Brief Therapy (SFBT) emerges as a compelling alternative in this context, offering a postmodern, de-pathologized stance that aligns with the need for efficient intervention (). By shifting focus from problem analysis to resource activation, SFBT employs techniques such as exception-seeking and the Miracle Question to foster a sense of perceived control. For adolescents grappling with learned helplessness, this emphasis on micro-successes provides an immediate boost to self-efficacy without the stigmatizing weight of traditional diagnostic labels (). Crucially, the not-knowing stance inherent in SFBT helps neutralize the adversarial power dynamics prevalent in Chinese families, transforming the therapeutic space into one of collaborative exploration rather than expert-led correction ().