How to Use "The Miracle Question" in Health & Wellness Coaching

 

The miracle question is a powerful health coaching intervention adopted from Solution-Focused Brief Therapy (SFBT), an evidence-based counseling technique in positive psychology.

In contrast to the use of the miracle question in psychotherapy to treat mental health disorders, the miracle question in health and wellness coaching is used to help clients create a positive vision of their best possible yet realistically healthy selves, unleashing deep levels of motivation and forming the basis for a structured goal setting.

A 2018 meta-analysis of 9 randomized controlled trials (1) explored the effectiveness of solution-focused brief therapy (SFBT) in medical settings. The study found that SFBT led to significant improvement in health-related psychosocial outcomes (e.g., depression, psychosocial adjustment to illness) and in behavior outcomes (e.g., physical activity and nutrition score).

So how do you ask the miracle question in health-coaching correctly?

Well, to start with, let's look at how the founders of (SFBT) initially framed the question:

"Now, I want to ask you a strange question. Suppose that while you were sleeping tonight and the entire house is quiet, a miracle happens. The miracle is that the problem which brought you here is solved. However, because you're sleeping, you don't know that the miracle has happened. So, when you wake up tomorrow morning, what will be different that will tell you a miracle has happened and the problem which bought you here is solved? (DeJong and Berg, 1998, pp. 77–78, cited in Pichot, 2009, p. 27)."  (2)

The miracle question can be tailored specifically to your behavioral health goals, allowing you to tap into a deeper level of motivation. For example, you might re-phrase your miracle question to include: 

• "The miracle is that the problem which brought you here is solved" to something like 'The miracle is that you've reached your goal of losing 20 pounds of body fat" or: 

• "you've completely mastered your PMI training and you're able self-invoke a deep state of calm whenever you want in just minutes" if the primary goal is stress-management related, or: 

• "you've just slept a full 8 hours and your Fitbit shows that you've had 90 minutes of REM stage and 90 minutes of Deep-Stage Sleep, you've had the best night sleep of your life" .. if the client needs to build a healthy regular sleep habit. 

Some great follow questions to the miracle question include: 

• How will you know the miracle has happened?
• What will others (parents, partner, children, work colleagues, etc.) notice about you that makes them aware things are different or better?
• What would their reaction be? What would they do?
• What would you do next?
• What would we see (feelings, thoughts, and behavior) if we compared a before and after picture?
• Have you ever seen elements of this happen before?

             (modified from Yu, 2019, p. 1931) (3)

In summary, the miracle question is a potent behavioral health coaching tool to help clients envision and create a brighter, healthier future. It encourages them to step into the possibilities of what they can be and provides them with the motivation to set goals and take action.

Hope that helps! - @YourCoachDavid

Your Coach David is a former Cognitive Behavioral Psychotherapist and Clinical Behavior Consultant turned Certified Stress Management & Sleep Science Coach. He's also an International Sports Science Association (ISSA) Certified Personal Fitness Trainer and Nutritionist.

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Sources: 

(1) Zhang A, Franklin C, Currin-McCulloch J, Park S, Kim J. The effectiveness of strength-based, solution-focused brief therapy in medical settings: a systematic review and meta-analysis of randomized controlled trials. J Behav Med. 2018 Apr;41(2):139-151. doi: 10.1007/s10865-017-9888-1. Epub 2017 Oct 3. PMID: 28975531.

(2) Secrets of the Miracle Question in Counseling: Part I

https://www.counseling(dotorg/news/aca-blogs/aca-counseling-corner/aca-member-blogs/2012/12/04/secrets-of-the-miracle-question-in-counseling-part-i

(3) How to Use the Miracle Question in Therapy: 3 Examples: https://positivepsychology(dot)com/miracle-question