Harvard Mental Health Letter

Solution-focused therapy

Psychotherapy usually begins when a client or patient comes for help with a problem or symptom. Therapist and patient discuss the problem and its roots and how to eliminate or manage it. Solution-focused therapy, originally developed as a short-term psychotherapy technique at the Brief Family Therapy Center in Milwaukee in the late 1970s, takes a different approach — accentuating the positive, in a specific sense. Instead of concentrating on problems and their causes, the therapist gets the client to think about hopes and achievements. Attention is drawn to goals rather than obstacles and strengths rather than weaknesses.

Solution-focused therapists do not make diagnoses, try to promote insight, or analyze the past. Instead they encourage the client to recognize and implement alternatives. They work on the assumption that at the end of any successful psychotherapy, the situation of the client will have changed, so he or she will be doing something different. Solution-focused therapists start by helping the client think about what that difference would be. Once a solution is identified, client and therapist work toward it step by step.

The miracle question: This vividly named device is a way to discover what the client hopes for and what everyday life would be like if those hopes were realized. A common version goes as follows: Imagine that in the middle of the night, while you are sleeping, a miracle happens, and all the troubles that brought you here are ended. When you wake up the next morning, how will you know? What will you be doing that's different? Who else will know, and how and when will they know? What would indicate to me, the therapist, that you had a miraculous solution?

To continue reading this article, you must login.
  • Research health conditions
  • Check your symptoms
  • Prepare for a doctor's visit or test
  • Find the best treatments and procedures for you
  • Explore options for better nutrition and exercise
Learn more about the many benefits and features of joining Harvard Health Online »