Richard Kahn, Ph.D., MS, RD
The Miracle Question (MQ) is an important tool in SFBT. Some practitioners, like me, have trouble asking the MQ. Help came from Cami Boyer, a psychotherapist. She offered a MQ workshop at the 2017 Solution-Focused Brief Therapy Conference in Santa Fe. Boyer likened using the MQ to bread baking. Bread baking is recipe-free when you understand the principles that underlie recipes. The essential recipe for the MQ, she proposed based on work with Teri Pichot, is a question that helps clients imagine their preferred future. About a dozen perplexed SBFT colleagues responded with MQ problems that turned into solutions with Boyer’s help.
One challenge the MQ presents is the amount of skill and time needed to prepare the client and the therapist.1,2 In a separate workshop, family therapist Brandon Eddy, PhD, confirmed the time challenges. He needs two sessions to ask the MQ with families with children on the autism spectrum. He uses the time for assessment and for the parents to establish goals.
In the nutrition program for low-income families, where I work, appointments last about 20 minutes with paperwork. We see most families every two or three months. Another colleague noted, with general agreement, that with some people of faith, the word miracle pulls in other feelings and ideas that create other pitfalls when asking the MQ.
Solutions soon appeared. One participant recalled that the MQ arose when Insoo Kim Berg responded to her patient’s saying, “Maybe only a miracle would help.”1 Berg and colleagues followed up with what became the MQ. From this perspective, the MQ itself was co-constructed, not invented. Another session participant said that asking for Best Hopes helps elicit a preferred future. From this perspective, the MQ is means rather than an iron clad end.
A stricter view of the MQ structure comes from the influential practitioners at The Center for Solution-Focused Practice in the UK. Their firmer view of MQ shows up in their adaptation called the Tomorrow Question (TQ).3 Here’s the TQ: “Suppose you achieved your hopes overnight, what would you be doing different tomorrow?” The Centre team maintains that (1) the time element, specifically night and tomorrow, the same ingredients in the MQ, and, (2) the pairing of the problem to the solution, together, like flint against steel, ignite the preferred future and are key to the MQ formula.
The broader view is taken by Pamela King, LFMT. She adapted the MQ for questions that spark a preferred future in children in Tools for Effective Therapy with Families and Children.4 One is the magic question: “Let’s pretend you have magical powers to make the future exactly how you want it to be. What will be happening in your just right future?” She also adapted a crystal ball question from Erikson and de Shazer. There is one ball for past successes, one for current encouraging signs and one for the preferred future. She has a three part wish game: “You have three wishes. What can you do to start the magic in yourself?” King also lists the Magic Wand Technique invented by Selekman for the child to cognitively immature to manage the MQ.5 Selekman zaps children with his magic wand to generate a preferred future. In my experience, the wand requires less build up and is less fraught than using the word ‘miracle.’ I declare my pen is a magic wand and tell the client I will wave it over their head 3 times to help elicit the child’s preferred future or solution. When I see the clients smile or some other body language tip-off, I know I can proceed. Other times, I sharpen a new pencil, perform the magic and give child or adult the ‘wand’ as a take home gift for future magic making. Perhaps, very little build up is needed with children who still live with magic.
Fort adults, the MQ requires some build up even when the time is short. Yvonne Dolan gave me some suggestions to help manage the known challenges of the MQ.6 Even with limits, she suggests that goal setting and scaling questions can prepare the patient for the MQ. The patient’s expressed goal is the steel against the problem-talk flint. Scaling creates the opportunity for some kind of refinement of the goal. At this point, Dolan suggests that we can ask something along the lines of, “Let’s suppose that sometime during the night tonight something wonderful happens, a sort of miracle, and when you awaken you are a 10. How would you discover this?”
Here’s a case vignette of using a magic wand during a first session in private practice.
The health goal was to have their 6 year old daughter restart weight gain and vertical growth after one year of no growth. Ceasing to grow taller for a 6 year old is most likely a grave sign of protein-energy malnutrition usually due to family stress or extreme poverty. A gastrointestinal evaluation was planned by the pediatrician to rule out any digestive disorder.
Prior to the first session, I asked for a 3-day diet history, the foods eaten in a three day period, and a list of Mary’s strengths related to eating. That prep might have led to the pre-session change. Mary, not her real name, had begun to eat more. Her diet history revealed insufficient protein and calories. After we reviewed diet changes that met the family’s lifestyle, I asked how mealtimes went. The parents reported common parenting errors in feeding children: electronics at the table, bribing, force feeding and mealtime chaos. Prior to my SFBT training, I would dig into the past. I took advice offered by McFarland and stuck with present strengths.7 If mealtimes changed, other things would change in the family system.
I gave the parents the basics on Mary’s nutritional needs based on Mary’s preferences and standard guidance on how to establish calm family meals. Some of these established tips matched Mary’s already present eating strengths written down on the pre-session list. She ate better, for example, when both parents ate with her on weekends or at extended family events. More expert-family pairs were discovered so I could confirm some practices rather than introduce new ideas. On the other hand, weekday meals were unproductive. Mary ate little at rushed breakfasts on schooldays. Mom’s profession often forced her to work past dinner time. There was little family life at the table during the work week. While we adults spoke about scheduling possibilities, Mary either sat on the couch or danced around the office.
When Mary next sat down between her parents, a good omen, I hoped she would have a good breakfast solution. In this case, there was little build up other than some short conversation about mealtime and breakfast. Declaring my pen a magic wand, I asked her to close her eyes and told her that I would wave the wand over her head three times. She would then tell me what would be a good breakfast for her. Out came the perfect dietary prescription of high protein and calorie breakfast. She then asked to woken up by her mother calmly. I could never invent that tip quickly! The discovery process would take forever. Mom and Mary embraced. Mom agreed to wake up that much earlier to support Mary’s wish. We agreed to meet 6 weeks later in order to see what was working.
Three weeks into the gap, I received an email. A pediatric weigh-in visit revealed a 1.5lb increase which eliminated the need for a GI evaluation. Dad, the primary caregiver, added that Mary is now a member in good standing in the clean plate club with no fussing. Mary’s weight continued to increase by the second appointment. Score one for the Magic Wand. We had a second meeting that included a further weight increase. Case closed!
- de Shazer S, Dolan Y, Korman H, Trepper T, McCollum E, Berg IK. More Than Miracles: State of the Art of Solution-Focused Brief Therapy. Oxon, UK: Routledge; 2012.
- Stith S, Miller M, Boyle J, Swinton J, Ratcliffe G, McCollum E. Making a Difference in Making Miracles: Common Roadblocks to Miracle Question Effectiveness. Journal of marital and family therapy. 2012;38(2):380-393.
- Brief Therapy Practice. How Brief is Brief? https://www.brief.org.uk/resources/faq/how-brief-is-brief. Accessed December, 2017.
- King PK. Tools for Effective Therapy with Families and Children. New York and London: Routledge; 2017.
- Selekman M. Solution-Focused Brief Therapy With Children. New York: Guilford Press; 1997.
- Dolan Y. MIracle Question. 2018.
- McFarland B. Brief Therapy and Eating Disorders. Jossey-Bass; 1995.
Richard Kahn, Ph.D., MS, RD
Richard Kahn, PhD, RD, is a nutrition therapist specializing in the needs of both typically developing and atypically developing infants and young children. Nutrition therapy is a counseling approach that places nutrition for children in the context of family life. He is the father of two, as well as a cook at an organic restaurant, specialty-food-store owner and manager at Fairway Market, a leading food retailer in New York City. He serves on the board of the New York Zero to Three, a nonprofit advocacy group that works to promote the optimal development of young children, their families, and their communities in the New York region. We were fortunate to have him be a part of our online certificate course. Thank you Richie for your wonderful contribution! He can be reached at: