THE YOUNG THERAPIST HAD BEEN TAUGHT BEHAVIORAL AND psychodynamic theory in graduate school and, after graduation, had concentrated on training in family therapy. She had just launched her private practice when she began to feel that the increasing influence of managed health care was changing all the rules of the game. Anxious to present herself as a state-of-the-art therapist capable of doing brief but effective work, she decided to get training in solution-focused brief therapy. Far from being hostile to the idea, she liked the challenge of brief therapy, knew she was a good therapist and felt reasonably confident that she could quickly master the new skills that would make her more marketable. But to her surprise and disappointment, she found that an approach that had sounded so simple in theory and looked so effortless on videotape, was not at all easy to put into practice.

Her client today, for example, a mournful-looking young woman named Lorna, her eyes already red from crying, seemed unwilling to engage in any "solution talk." When the therapist asked Lorna what brought her into therapy, it was a struggle for the young woman to control her sobbing long enough to explain that her live-in boyfriend of two years had packed his bags and left her apartment three days ago. She had pleaded with him to return, but he finally admitted that he didn't love her and was, in fact, already deeply involved in another relationship.

The…