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Pre-session Change

Pre-session Change
🌱 Resource activation 🧠 Cognition

A question that sets the tone for the whole therapy: the client realizes that change does not start in the office — it has already happened or is happening. The work is built on this foundation.

Step-by-step guide

  1. The client enters the office
  2. The first question (after greeting): "What has changed since the moment you booked the appointment with me?"
  3. Listen carefully — this is often the most valuable material in the session
  4. Develop the answer: "What else? How did it happen? What helped?"
  5. Reinforce: "That matters. How did you notice this change?"

When to use

  • The very start of the first session (before describing the problem)
  • The client's motivation may be low
  • The client may have been referred by another professional
  • The client may doubt the usefulness of therapy
  • Any first meeting

Key phrases

Before we begin — what has changed since the moment you booked the appointment with me? What changes have you noticed that have happened or have begun to happen?

Follow-up questions

What else?
How did it happen?
What helped?
That matters. How did you notice this change?

Warnings

  • ⚠️ Do not skip this question (the solution-focused stance starts here)
  • ⚠️ Do not interpret the answer right away
  • ⚠️ If the client says "Nothing has changed" — this is also information (use coping questions)

Source: de Shazer, Berg (BFTC, Milwaukee)

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Materials are informational and educational and summarize publicly available scientific sources. They are not medical or psychological advice, are not intended for self-diagnosis or self-treatment, and do not replace consultation with a qualified professional.