Engagement is the precondition for therapeutic work; without it, strategies, plans, and techniques do not translate into action. In substance use work, engagement refers to meaningful participation in the therapeutic process. It shows up in more than just attendance—in how people respond, reflect, and interact in the conversation, and in the small steps they take toward goals that matter to them.
In substance use conversations, engagement expands choice and agency by clarifying what actions are possible. People often arrive externally referred or mandated, uncertain about change, while families and support systems may already be worn down. In these moments, the clinician’s language and stance shape whether people participate, reflect, and take next steps. How does the clinician invite connection and engagement?
Solution-Focused Brief Therapy (SFBT) offers a brief, evidence-based, and pragmatic framework for building engagement early, even when people enter conversations uncertain about change. Research consistently shows that client and contextual factors, the therapeutic alliance, and expectancy or hope account for a substantial proportion of improvement (Lambert, 1992; Lambert & Barley, 2001). These findings support approaches that prioritize engagement, collaboration, and agency from the outset.
Engagement Through Agency and Resource Activation
A solution-focused clinician begins by activating agency. The conversation begins by inviting people to recognize, discover, and rediscover their existing resources. Clients are invited to notice what they enjoy, what has been better, and what is happening that they would like to continue to happen. Even small shifts are treated as meaningful. Questions such as “What’s happening that you want to continue?” and “What has been even a little more tolerable since we last met?” are brief, hope-eliciting questions that directly support the conditions associated with positive outcomes.
Coping is framed as evidence of competence. When the clinician asks, “How have you managed?”, resilience is articulated in the client’s own words. Relational questions—such as “Who would notice you coping?” or “When did you get through a moment, even briefly?”—situate that resilience within a social context, where it can be noticed, recognized, and strengthened.
Engagement Through Amygdala Whispering: The Language of Empathy
Amygdala whispering pairs emotional validation with solution-focused inquiry. Responses such as “for you,” “for me,” or “for us” name and affirm intense emotions—whether they belong to the individual, emerge between people, or are shared collectively. For example: “This sounds overwhelming for you,” “That was intense for me,” or “That was scary for all of us.” These acknowledgments are then followed by questions that reopen agency, such as “What do you need right now?” or “How have you managed?”
Naming and affirming emotions can help reduce amygdala reactivity. If people are responding from their amygdala, their responses are limited to survival patterns such as fight, flight, or freeze. Naming and affirming intense emotions softens amygdala-driven responses. When this validation is followed by carefully timed solution-focused questions, people begin to move out of the amygdala’s basement and upstairs toward the prefrontal cortex, where reflection, critical thinking, planning, and choice become accessible.
Amygdala whispering can be understood as building an emotional yes-set. Using “for you” statements to name and affirm emotion creates conversational space for agreement—often signaled by a nod or brief acknowledgment—which establishes attunement and signals empathy. When this validation is paired with solution-focused questions, clients are supported to move from trauma reactivity toward purposeful action.
Engagement Through Solution-Focused Languaging
Solution-Focused conversations rest on the understanding that language actively shapes change, especially how clients understand themselves and imagine their future. Questions are crafted from the client’s own words, which presuppose strengths and resources already present.
Rather than asking “Why can’t you stop drinking?”, the clinician asks “How did you manage to cut down last week?” Instead of focusing on deficits, the inquiry becomes “Who will notice first when you are managing better?” The distinction lies in where attention is directed: toward deficits or toward capacity.
Presuppositional questions often begin with ‘what’, ‘how’, ‘who’, ‘when’, and ‘where‘. These question forms assume that positive experiences have occurred, that relationships exist, and that safety or coping has been felt at some point.
Clients often express goals in negative or avoidance-based language—“I don’t want to get into trouble” or “I don’t want to feel so hungover.” The solution-focused clinician invites a shift by asking, “What would you be doing instead?” This redirects attention from what the client doesn’t want to verb-based actions that reflect what they want, need, and hope for.
Each presuppositional question form opens a different pathway to agency:
- What assumes that life without drinking is possible. “What do you notice about yourself on days when you drink less?”
- How assumes the person already has influence over their choices. “How have you managed to cut back, even a little?”
- Who assumes supportive or meaningful relationships exist. “Who would notice first if you were drinking less?”
- When assumes there have been moments of success before. “When was the last time you enjoyed a night without drinking?”
- Where assumes safety or relief has been experienced. “Where were you when you felt more in control of your drinking?”
Verb tense sharpens agency.
- Past tense questions uncover prior successes (“How did you manage that before?”).
- Present tense questions consolidate current strengths (“What is helping right now?”).
- Future tense questions translate hopes into plans (“What would you be doing differently this weekend when things went the way you hoped?”).
Engagement Through Curiosity, Compliments, and Positive Differences
A solution-focused clinician approaches substance use with curiosity, respect, and compassion, recognizing that people use substances for reasons that make sense in their lives. Substance use is explored as part of a person’s efforts to cope, connect, or get through difficult moments, rather than as something to be argued with or corrected.
Questions such as “What are your good reasons for using?” or “How have substances been helpful for you?” assume that substance use served an important purpose and invite reflection while preserving dignity and self-respect. Change emerges through compassion, understanding, and shared dialogue.
Compliments are a central intervention in this work. Direct compliments acknowledge effort and persistence—for example, “Wow – I’m impressed you managed to get through such intense cravings.” Indirect compliments, framed as questions such as “How did you manage to deal with the intensity of your cravings in the moment?”, invite clients to describe their own strategies, turning moments of progress into skills they can repeat and strengthen.
When clients describe even small shifts—using less, getting through a craving, choosing to stay home, or tolerating difficult feelings- the clinician slows the conversation and explores the difference. By asking whether it was different, how it was different, how it was helpful, and how they did it, brief moments are expanded into clear evidence of agency. These positive differences become foundations for confidence, learning, and continued change.
Engagement Through VIP (Very Important Presences) Mapping
Change unfolds within relationships. People make decisions about substance use alongside the people, roles, and influences that shape their daily lives. VIP mapping brings these relationships into focus and uses them as a foundation for engagement and change.
Very Important Presences (VIPs) include the people and influences that matter most to a client. These may include the client themselves, family members, partners, children, or other dependents, spiritual influences, friends, recovery supports, and community connections.
Some presences place significant demands on a client’s time, energy, and choices. Very Important Problematic Presences (VIPPs)—such as courts, probation, the substances themselves, schools, or licensing authorities—often hold decision-making power that shapes priorities. Naming these presences clarifies the client’s social world and the pressures within it.
Bringing VIPPs into the conversation helps translate pressure into clarity. Questions such as, “Who decides when you can get your license back?” and “What do they need to see you doing?” help clients identify expectations and focus on concrete actions that move them forward.
By mapping VIPs, the clinician situates substance use and recovery within relationships that carry meaning. Questions such as “What do you most appreciate about them?” “What would they say they most appreciate about you?” “Who would notice you taking even a small step forward?” or “What would the most important people in your life hope for you right now?” help clients clarify what they want to move toward and whose perspectives matter. Change is more likely to translate into action when others notice progress, appreciate effort, and respond to differences.
VIP mapping anchors recovery in lived relationships. It highlights sources of support, clarifies pressures and expectations, and helps clients identify the relationships that guide their next steps.
Engagement Through Best Hope Mapping
Best hope mapping is a future-oriented practice that helps clients describe what they want to be different in specific, actionable (verb) terms. In substance-use work, people often begin with broad hopes such as “a sober life,” “being in recovery,” or “feeling better.” The solution-focused clinician responds first with amygdala whispering—“It sounds like this has been challenging for you”—and then invites clarification: “What do you mean by a sober life?” or “What would you be doing instead?” Attaching verbs to abstract hopes translates them into actions that can be noticed and built upon.
Two question forms anchor this process: “What do you know?” and “What have you tried?” These questions assume knowledge and effort. They communicate that the client already holds expertise gained through experience, even when outcomes have been mixed. Asking in this way positions the client as competent and resourceful while surfacing strategies to guide next steps.
Best hopes often extend beyond abstinence. Clients may describe hopes such as finishing a semester, staying out of trouble with probation, or keeping a job. These hopes reflect what matters most to the client. Bringing Very Important Presences (VIPs) into the conversation strengthens this focus: “Who would notice you following through on this?” “What would they see you doing differently?” “What would they hope for you right now?” These questions place best hopes within relationships where change is recognized and valued.
Throughout the process, persistence is highlighted. When clients describe moments of success—“I stayed sober the week before court”—the clinician deepens the conversation with “How did you manage?” “Who noticed?” and “What else helped?” Each answer expands agency and planning. In this way, best hope mapping becomes an ongoing process of affirmation and discovery, guiding clients to name what they want in clear verbs and to see themselves as capable of moving toward a future that matters to them and to their VIPs.
Engagement Through Solution-Focused Scaling
Solution-focused scaling translates best hopes into visible progress. Rather than measuring problems, scaling highlights agency by focusing on what clients are already doing and what they want to do next. The number itself matters less than the conversation it opens.
Unlike problem-focused scales that measure severity—such as the intensity of cravings or frequency of use—solution-focused scales measure agency and action. A clinician might ask, “How well have you been managing your cravings, from 1 to 10?” shifting attention from symptoms to capacity. Scales are customized using verbs drawn directly from the client’s best hopes, grounding progress in observable actions such as showing up, choosing differently, or staying connected.
Scaling also supports motivation and readiness. Asking, “How much do you want to get clean and sober, from 1 to 10?” alongside “How much do you feel you need to get clean and sober, from 1 to 10?” surfaces personal meaning while acknowledging external expectations. Relationships are woven into questions such as, “What number would your sponsor or family member give you?” or “What would they notice if the number were higher?”, situating progress within the client’s relational world.
Working the scale activates agency and supports planning—both essential for strengthening hope. Questions such as “What keeps the number from being lower?” highlight what is already working, while “What would be a good enough number?” clarifies what matters most to the client and how they define success. Relational questions—“What number would your VIPs give you?” and “What accounts for the difference?”—deepen reflection by bringing in perspectives that matter.
Once agency is activated, planning follows. If the number feels good enough, attention turns to what the client wants to continue. If it is not good enough, “What would raise it by one point?” identifies small, achievable steps. Confidence can also be scaled, strengthening self-efficacy and supporting next steps.
Scaling creates a shared language between client and clinician. Numbers offer a clear reference point for reflection and planning and tend to shift attention away from emotional reactivity toward the prefrontal cortex, where thinking, choice, and planning are more accessible. When scales are built using the client’s own words and verbs—and when VIPs are included—change is anchored in both agency and social context.
Interested in learning more? Consider our course: Engaging Youth and Families Impacted by Substance Use: A Solution-Focused Approach.
Lambert, M. J., & Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38(4), 357–361.
