ABSTRACT
Pre-treatment change is when clients notice that change has already started to happen before the first appointment. The encouraging changes reported in first sessions often take the form of exceptions. Clients describe two types of exceptions: deliberate and random. Identifying and building on exceptions is a powerful tool in therapeutic conversations. Whether the exceptions are deliberate or random, they can be built out to be a valid part of the solution. When the present is especially difficult an imaginary time machine might help families find exceptions from the past, when things were pleasant, enjoyable, or less stressful. The therapist has the responsibility to keep his clients safe and does take the lead in orchestrating the therapy appointment. Therapy is hierarchical, so there is a power difference. Co-creating goals, therapy outcome, and the methods for achieving these goals is a respectful client-centered model for therapy.
