Author: Gargi Singh, Counselling Psychologist
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How a counsellor asks questions, what questions the counsellor asks and when the counsellor asks these questions in a therapy space dictates how comfortable the client might feel in the therapeutic relationship. We do not want the client to feel that the therapeutic space is an interview for them. Coming for therapy might itself have been a challenge for an individual and on top of that having a therapist who asks questions without being mindful of the tone and timings of the questions sounds like a nightmare. In therapy, asking the appropriate question at the right time is like having a key that opens multiple doors to insights.
Let's look at different types of therapeutic enquiries and learn when and how to utilise them effectively.
1. Open Questions
It is like opening the windows to let in fresh air. They encourage clients to express their stories openly. Since open ended questions leave a lot of room open for the client to describe an event in their own fashion means that the therapist will get great perspective on the client’s worldview. Instead of receiving a quick yes or no from the client, open ended questions help the client to share their full story. Open ended questions are most suited for initial sessions, developing rapport, and exploring new themes in a therapy session.
For example asking the client in the first session - "What brings you here today?"
When a client is describing an event, asking them - "How did you feel when that happened?"
Open ended questions also go to show that the counsellor is curious to learn about the client more. For example - What does success look like for you?" and "Tell me about a time when you felt really happy."
When Sanjana first came to therapy feeling "stuck" in her job, instead of asking "Do you like your job?" (closed question which might also bring up the clients’ defences), the therapist asked, "How do you feel when you think about your work?" This would then provide a space for a rich discussion about Sanjana’s values, aspirations, and fears.
2. Closed Questions
Closed questions are usually looked down upon but I believe they serve their own purpose in a therapeutic setting if they are timed correctly. They're great for gathering specific information from the client or for clarifying details. They can be thought of as spotlight questions – they highlight one specific point. When to use closed ended questions would depend on the present moment requirement in therapy space however they are also mostly used for initial assessments and risk assessments.
For example, asking a client during the intake - "Have you been to therapy before?" or "Are you currently on any medication?". In risk assessment it might look like- "Are you having thoughts of harming yourself?"
3. Scaling Questions
Scaling questions can be thought to be the thermometers. They help clients measure their feelings, progress, or concerns on a scale. Usually it is a 0-10 scale. They help make abstract feelings more concrete. I tend to use scaling questions a lot with my teenage clients who often have difficulty opening up using words. Sometimes quantifying their emotions is a good start to exploring further. A good example of a scaling question can be let's say there is a client called Soham, who struggles with anxiety, helping him track his weekly anxiety levels helped him notice patterns and celebrate small achievements. "Last week I was at a 9, but today I feel I'm at a 7". This became a quantifiable and concrete way to measure progress for the client.
Some other examples of a scaling question could be - "On a scale of 0-10, where 0 is the worst you've ever felt and 10 is the best, how are you feeling today?" or when helping a client make a decision - "How confident do you feel about this decision, from 0 to 10?"
Miracle questions invite clients to imagine a future where their problems are solved. They're like opening a window into possibilities and hopes. Miracle questioning has its roots in the Solution focused therapy approach. The idea is to help the client imagine a life without where their concerns do not exist and to then think of how they would spend their time in that case. It is a good envisioning tool. It helps the client see the other side, like finding the light at the end of the tunnel.
For example - "If you woke up tomorrow and by some miracle all your problems were solved, what would be different?" or "If you had a magic wand, what three things would you change about your life?" or "Imagine we're meeting a year from now and everything has worked out perfectly – what's different?"
Circular enquiries are a common therapeutic technique used in family therapy, especially in systemic approaches. They help in figuring out group dynamics by prompting participants to consider how their behaviours and emotions influence one another in the system setting. Instead of direct questions, circular questions enable people to consider the viewpoints of others in the system, which fosters perspective taking and an understanding of interconnectedness.
For example, a therapist would enquire, "How do you think your brother feels when you react that way during an argument?" This encourages the individual to consider the broader context of their interactions. This might help highlight patterns without attributing blame to your client. It can lead to deeper insights for the client and improve communication between the family members.
Some more examples of a circular question would be like "What do you think your partner feels when you shut down like that?" or "What might your colleague say about these changes you've made in the past month?"
These questions look for times when the problem isn't present or is less severe. This type of questioning is, again, an example of helping the client find a positive thread. They help find clues to solutions in past successes. This can help challenge their negative cognitions and boost their self confidence as well. Naturally, these questions are best used when clients feel hopeless or stuck in problem-focused thinking.
For example, helping the client explore - "Tell me about times when anxiety doesn't control you” or a question like - "What's different about the days when you feel more energetic?"
This way of questioning is a powerful technique in the therapy space that encourages the clients to delve deeper into their cognitions. It persuades the clients to consider the reasons behind their emotions, thoughts or behaviour. These questions can facilitate self-awareness and insight.
For example, asking the client - "What do you think led you to feel that way?" invites clients to explore the factors contributing to their emotions. This can potentially reveal significant insights about their triggers, beliefs, or past experiences that influence their present feelings.
Remember, these suggestions are to be used as a reference point. In a therapeutic space, you would be the best judge to decide what kind of question will help your client the most. Again, good therapeutic questions are like keys—they unlock doors to restoration. It is not just about knowing what to ask, but when to ask it as well.
Being aware of the client's readiness is critical. Flexibility in a therapist’s questioning style can lead to a more warm and helpful atmosphere. Furthermore, creating a sense of safety and trust will allow the clients to be more open. Ultimately, the goal of therapy is to foster a collaborative journey in which clients feel empowered to explore their thoughts and emotions, resulting in transformative insights.
Disclaimer
All examples of mental health documentation are fictional and for informational purposes only.
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