This article describes a general view of the nature of human problems and their effective resolution and of related specific procedures, growing out of our prior work in family therapy, that have developed during six years of research on rapid problem resolution. With treatment limited to a maximum of ten sessions, we have achieved significant success in about three‐fourths of a sample of 97 widely varied cases, and this approach to problems appears to have considerable potential for further development and wider application.

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Brief, strategic, family-oriented approaches are particularly suited to a number of the problems seen in primary care medicine. Careful historytaking often makes evident ways in which apparently un-understandable behavior in fact makes sense. Of particular interest are the ways in which efforts to change unwanted behavior operate to sustain and maintain it. A logical intervention plan can then be devised that provides family members with acceptable alternate behaviors that do not maintain the symptom.As they should be, physicians in family practice are usually the first professional recourse for most families encountering any somatic-and many psychosomaticdifficulties. In the course of this, however, primary care physicians are often presented with problems that "don't make sense" as standard medical problems, and in ways that make diagnosis and treatment puzzling and difficult.A relatively simple example of such a situation -though not necessarily simple to deal with -might involve a man who is found by his physician to have hypertension. Conventional treatment, including hypertensive medication, dietary changes, and avoidance of stress are prescribed. However, after brief initial improvement, blood pressure levels continue to be elevated, although the patient reports that he is faithfully adhering to the medical regimen, and no physiological defects can be found to account for the problem. In a more extreme example, an obese mother brings an obviously overweight child to the doctor with the complaint that "he doesn't eat," and insists that this is the problem, angrily brushing aside the doctor's attempts to suggest that, if anything, the child must be overeating. Or another mother brings her child because he is passing black stools. On careful examination, the physician finds that the child is basically quite healthy, but this does not allay the mother's concern, and the symptom persists (2).Other examples, while less blatantly confusing, still involve situations difficult to understand and deal with effectively: A man comes for his physical checkup accompanied by his wife. She exhibits marked concern about his physical condition, but the patient himself appears strangely passive, unconcerned, and uncooperative-he gives minimal information, discounts the seriousness of any findings, and so on. Or