Brief strategic therapy

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Giorgio Nardone · Arezzo, Italy

What it is

BST is a short, directive, problem-focused psychotherapy. It does not search for causes. It works out how a problem keeps itself going here and now, then breaks that cycle with planned maneuvers. These are reframings delivered through a structured "strategic dialogue", plus prescriptions the client…

Format

• The advanced model has four stages. The CTS describes them in game terms, from "start of the game" to "end of the game". The first session covers stage 1 and usually begins stage 2. The detailed "sequential scheme of the advanced model" (Nardone & Portelli 2005, ch. 4) is not drawn on here. The…
• Session count and format.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• slots creeping longer. Use a timer.
• steps that are too large. Shrink them.
• if writing intensifies distress, shorten it or stop.
• rigid rule-making around the treat. Keep it flexible.
• guilt-driven skipping of meals. Restate the reframe in C6.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.