Have stuck clients keep a prospective diary

Ask clients stuck awaiting change to keep a prospective diary. An explicit account of life after the hoped-for change can help clients unstick themselves and start changing now.

Some clients (and some therapists) get stuck awaiting a single change which will solve all their problems at a stroke. “Once I’m rehoused…”, “Once I get my compensation…”, “Once you start taking your medication consistently…”.

A key feature of these hoped-for changes is that they are usually external to the person holding out for them: the client holds out for change at the Housing department or law court, the therapist holds out for change in the client. The implicit message is “it’s not my fault nothing is happening yet”.

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Remove the miraculous from the Miracle Question

The Miracle Question can elicit negative responses from some clients. These negative reactions can be avoided by rephrasing the question without the miraculous element.

The Miracle Question is used by Solution-Oriented Therapists to elicit the conditions which would lead the client to consider their problem solved:

Suppose that one night, while you were asleep, there was a miracle and this problem was solved. How would you know? What would be different?

The client’s answer generally contains the seeds of their own solution and can be used to set treatment goals and propose strategies. Used properly, the Miracle Question can be a powerful therapeutic technique, but it has several liabilities inherent in the phrasing of the question.

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How will you know you’re a better therapist?

Solution-Oriented therapists ask clients how they will know when they are better. Therapists often wish to be better in their role, but few ask the Miracle Question of themselves.

Solution-Oriented therapists often ask clients the Miracle Question:

Suppose that one night, while you were asleep, there was a miracle and this problem was solved. How would you know? What would be different? (de Shazer, 1988)

Stressed therapists might be asked a similar question:

Suppose that tonight, while you are asleep, there is a miracle and you become a better therapist. How will you know that this has happened? What will you notice has changed about the way you’re working?

I’ve asked this question many times, of my self and of others. The answers tend to be much the same.

  • Every intervention I make in therapy will work
  • My clients will never try to manipulate me
  • I will always be available for my clients whenever they want me
  • Nothing I say will ever upset my clients
  • All my clients will get better all the time
  • My clients will be grateful for the help I’ve given them
  • My clients will co-operate with my therapeutic strategies
  • If I see a problem, I will be able to address it and solve it
  • I will always know what to do in any situation arising in therapy
  • I will not feel frustrated, angry or anxious during therapy sessions

If our clients gave such unrealistic answers, we would renegotiate more practical, achievable goals. How will you know when you’re a better therapist?