Does Your Depressed Client Even Want to Change?

David Burns on Using Paradoxical Agenda Setting

When clients seeks therapeutic help for depression, often the immediate response is to help them change certain aspects of their lives. But what if the client isn’t actively seeking change?

David Burns, author of When Panic Attacks and Feeling Good, has developed a technique called paradoxical agenda setting that he uses early on in his work with depressed clients to determine if they’re looking to make changes in their life.

In this brief clip, he talks about the first two steps of paradoxical agenda setting, drawing on an example from his own clinical work.




Rich Simon

Richard Simon, PhD, founded Psychotherapy Networker and served as the editor for more than 40 years. He received every major magazine industry honor, including the National Magazine Award. Rich passed away November 2020, and we honor his memory and contributions to the field every day.

David Burns

David D. Burns, MD, is an emeritus adjunct clinical professor of psychiatry and behavioral sciences at the Stanford University School of Medicine. His best-selling books, Feeling Good and the Feeling Good Handbook, have sold over five million copies worldwide. Although he was a pioneer in the development of cognitive behavior therapy (CBT), he also created a more powerful approach called TEAM-CBT.

More than 50,000 therapists have attended his training programs over the past 35 years. His website,, offers many free resources for therapists and clients alike, including his tremendously popular Feeling Good Podcasts which draw more than 50,000 downloads per month.