A Structured, Evidence-Based Approach for Clinical and Professional Conversations
Stamina Lab trains health and performance professionals in the evidence-based Solution-Focused approach — a disciplined conversational approach that improves engagement, follow-through, and measurable outcomes.
Why Most Behavior-Change Conversations Fall Short
Most professionals are trained to start conversations by identifying the problem — what's wrong, what isn't working, what needs to change. It's logical, and it's the standard in clinical education.
But decades of research show that problem-focused conversations tend to produce insight without progress. They can inadvertently reinforce helplessness, shift responsibility for change onto the professional, and contribute to disengagement.
Start with what's wrong
Assess the problem. Identify barriers. Explain risks. Offer a plan. Hope the patient follows through.
- Amplifies deficits and failures
- Can induce shame, guilt, or defensiveness
- Defines the professional as the source of solutions
- Produces insight and plans — but not necessarily progress
Start with what's wanted and working
Help the patient describe their preferred future, surface what's already contributing to progress, and define observable signs of near-term progress and an immediate next step.
This kind of future-focused conversation invites mental rehearsal and helps prime neural pathways for action.
- Builds on existing competence and successes
- Increases hope, confidence, and self-efficacy
- Positions the patient as the agent of their own change
- Produces engagement, ownership, and follow-through
The Dialogic Orientation Quadrant (DOQ)
A core tool you'll learn how to use is the DOQ — a practical framework that helps professionals track where a conversation is in real time and respond in ways that consistently move it toward progress.
The DOQ maps every moment of a conversation along two dimensions: time orientation (past vs. future) and focus (problems vs. goals). This gives practitioners a reliable way to listen, orient, and respond — even in brief or complex interactions.
Conversations that stay "above the line" are grounded in the patient's resourceful past and hopeful future, which produces measurably better outcomes faster: stronger patient engagement, clearer next steps, and higher follow-through.
The DOQ is not a script. It's a navigational tool that sharpens clinical judgment and makes every conversation more purposefully, without adding time, more effort, or complexity to your workflow.
Graphic adapted from Haesun Moon (2021)
The Three-Part Solution-Focused Structure
Solution-Focused conversations follow a consistent, repeatable structure that works whether it's 5-minute check-ins or 30+-minute consults. Professionals learn to guide every interaction through the three parts:
What's Wanted
Help the patient or client define their preferred future in concrete, personal, observable terms — what life looks like when things are better, and the difference it will make for them and the people in their lives.
What's Working
Surface exceptions, successes, and evidence of progress that already exist — often invisible to the patient until the conversation helps reveal them.
What's Next
Help the patient with small, observable, near-term next steps — grounded in the patient's own language and connected to the future they described — that make follow-through a natural extension of the conversation.
Built on a Substantial Evidence Base
The Solution-Focused approach is supported by multiple systematic reviews, meta-analyses, and randomized controlled trials across clinical, behavioral, and organizational settings.
Engagement & Adherence
Research demonstrates that solution-focused conversations increase patient engagement, treatment adherence, and self-reported well-being across chronic conditions including diabetes, cardiovascular disease, and mental health.
Self-Efficacy & Agency
Solution-focused interactions strengthen internal locus of control, self-efficacy, and agency — consistently identified in the literature as the strongest predictors of positive health outcomes and sustained behavior change.
Communication Quality
Systematic reviews show that clinician communication directly affects adherence, self-management, and health outcomes — yet many conversations leave little room for the patient's voice, priorities, and lived reality to shape what happens next.
A Stance, Not Simply a Technique
The Solution-Focused approach is more than a set of questions or a conversational script. It is a disciplined professional stance — a way of thinking and orienting to people that presupposes competence, surfaces what's working, and consistently anchors conversations in the direction of the patient's preferred future.
This stance holds across contexts: a 5-minute clinical check-in, a coaching intake, a leadership conversation, or a complex care planning discussion. It doesn't replace clinical expertise — it makes that expertise more effective by ensuring the conversation creates the conditions for follow-through.
Professionals trained in this approach consistently report that conversations become more time-efficient, patients become more engaged, and the professional burden of "convincing" or "motivating" people to change is replaced by a collaborative process where patients own their own solutions and progress.
Gain Solution-Focused Skills That Make a Difference
Foundations in Solution-Focused Health Coaching is a self-paced, CME-approved certification that gives healthcare and fitness professionals a structured, immediately applicable approach to creating conversations that produce the outcomes that count — with AI-powered practice and expert assessment.
6.0 AMA PRA Category 1 Credits™ · Indiana University School of Medicine · 30-day satisfaction guarantee
Dr. Deborah Teplow
Co-Founder & Chief Program Architect, Stamina Lab
Dr. Teplow earned her doctorate from Stanford University and has spent decades translating behavior-change science into structured professional practice. She was introduced to Solution-Focused brief therapy by its creators, Steve de Shazer and Insoo Kim Berg, and has completed advanced practitioner and supervisor training with BRIEF, Elliott Connie, Adam Froerer, Teri Pichot, Linda Metcalf, and Dr. Jacqui von Cziffra-Bergs.
Dr. Teplow co-founded the Institute for Wellness Education, where she and co-founder David Mee-Lee created the U.S. national occupational standards and training curriculum for the Department of Labor's Registered Apprenticeship in Wellness Coaching. She has trained practitioners for organizations including Healthy Start (HRSA/HHS), Blue Cross Blue Shield of North Dakota, the Los Angeles County Department of Public Health, and Medica.
She is a long-standing educational partner with Indiana University School of Medicine, where she has developed CME programming across major medical specialties. She leads all faculty development and program quality at Stamina Lab.
References
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Gong, H., & Xu, W. (2015). A meta-analysis on the effectiveness of solution-focused brief therapy. Studies of Psychology and Behavior, 13, 799–803.
Grant, A., & Gerrard, B. (2019). Comparing problem-focused, solution-focused and combined problem-focused/solution-focused coaching approach: Solution-focused coaching questions mitigate the negative impact of dysfunctional attitudes. Coaching: An International Journal of Theory, Research and Practice, 13, 1–17.
Grant, A. M., & O'Connor, S. A. (2018). Broadening and building solution-focused coaching: Feeling good is not enough. Coaching: An International Journal of Theory, Research and Practice.
Jordan, S. S. (2014). Asking different questions: Validation of the solution building inventory in a clinical sample. Journal of Systemic Therapies, 33(1), 78–88.
Jordan, S. S., Froerer, A. S., & Bavelas, J. B. (2013). Microanalysis of positive and negative content in solution-focused brief therapy and cognitive behavioral therapy expert sessions. Journal of Systemic Therapies, 32(2), 46–59.
Kim, J. S., Smock, S., Trepper, T., McCollum, E., & Franklin, C. (2010). Is solution-focused brief therapy evidence-based? Families in Society, 91, 300–306.
Kitai, A., Shimada, Y., Tagoo, M., & Otomo, M. (2023). Can a solution-focused coaching approach go beyond the ocean and campus? Comparing solution and problem-focused approaches for Japanese students and business people. Journal of Solution Focused Practices, 7(1).
Korman, H., Bavelas, J. B., & De Jong, P. (2013). Microanalysis of formulations in solution-focused brief therapy, cognitive behavioral therapy, and motivational interviewing. Journal of Systemic Therapies, 32(3), 31–45.
Moon, H. (2021). Efficacy of training in solution-focused coaching: Process study of learners' progress in response choices (Doctoral dissertation).
Richmond, C. J., Jordan, S. S., Bischof, G. H., & Sauer, E. M. (2014). Effects of solution-focused versus problem-focused intake questions on pre-treatment change. Journal of Systemic Therapies, 33(1), 33–47.
Solms, L., Koen, J., van Vianen, A. E. M., Theeboom, T., Beersma, B., de Pagter, A. P. J., & de Hoog, M. (2022). Simply effective? The differential effects of solution-focused and problem-focused coaching questions in a self-coaching writing exercise. Frontiers in Psychology, 13, 895439.
Zhang, A., Franklin, C., Currin-McCulloch, J., Park, S., & Kim, J. (2018). The effectiveness of strength-based, solution-focused brief therapy in medical settings: A systematic review and meta-analysis of randomized controlled trials. Journal of Behavioral Medicine, 41, 139–151.