Psychology

Lesson 4

QUESTIONING

Aim
To introduce the student to different questioning techniques and their usefulness in the counselling process.
Questioning is an important part of counselling, but should be kept to a minimum. The idea is that when seeking to deal with a client’s emotional material, the counsellor should not need to ask too many questions. Rather, they will be able to glean most of the information they need by reflecting content and feeling and using the other skills mentioned so far.
Within the counselling process the counsellor should restrict themselves to asking questions that are of therapeutic value, i.e. questions that acknowledge, explore or challenge the client rather than just seeking factual information.
It is important not to ask too many questions, so as to avoid the client from feeling that they are being interrogated. If this happens, the clients are less likely to freely submit information. It is important to allow the client to go in the general direction that their feelings take them.
It is also possible that by asking too many questions, you do not permit the client to think for themselves so that they become reliant on being asked questions to proceed. Most clients will also be aware when the counsellor is asking questions as fillers, where the answer bears little or no relevance to the counselling process. Even experienced counsellors will occasionally find themselves asking these types of questions. The counsellor needs to avoid questions that are intrusive and which produce information of little value.
Therefore, asking questions is really only appropriate when it is necessary for the session to continue.

Open & Closed Questions
Closed Questions
These types of questions generally have a specific answer, e.g. yes or no. They are useful when the counsellor is after a specific piece of information.
There are, however, problems with this mode of questioning:
• The client may go ahead and expand on the question
• The client is restricted in the sort of response that they can give.
• It can also act as a leading question making the client think that they have to go into a particular direction in order to satisfy the counsellor.

Open Questions
These allow the client far more scope in terms of adding information, typically requiring several sentences to answer. The information supplied by the client could be unexpected by the counsellor and hence revelatory leading the counselling process into a new direction.
Open ended questions allow the client to express what is most significant to them with regard to a subject area or problem, rather than what is most important to the counsellor.

Other Types of Questions
Although it is suggested that questions be used sparingly, when used appropriately they can be extremely powerful in accessing information.

Linear Questions
These types of questions are used to probe for information that helps to assess the client’s problems. For example, ‘What are the things that are troubling you right now?’

Information-seeking Questions
Caution should be recognized when asking questions that attempt to seek information. It is only necessary to ask such questions when they are going to be of benefit to the counsellor’s

knowledge. If they are not going to reveal anything that will help the counselling relationship, then they should not be asked. They should certainly not be asked in order to satisfy the counsellor’s curiosity.
Strategic Questions
These are used to encourage a client to challenge their beliefs, values or behaviour.

Questioning for Clarification
This is useful when clients offer vague or ambiguous statements. It allows them to be more specific so that it becomes clear to both the counsellor and the client exactly what is being described.

Questions to Heighten Awareness
This type of questioning is most useful for helping a client to understand what is happening inside them, both mentally and emotionally. They are then able to deal with these feelings and associated thoughts.

Reflective Questions
These are used to assist the client to generate new possibilities and consider making changes to their lives.

Transitional Questions
This type of question is used to draw the conversation back to an earlier part of the discussion. They tend to begin to begin with a statement about an earlier topic and then raise a question pertaining to this.
When using these questions the counsellor is steering the conversation into a direction that they wish to take it. It is important therefore to ensure that it is only introduced at a point where it is not going to prevent the client from imparting important emotional material.

Choice Questions
These are similar to reflective questions but have been used mostly when dealing with adolescents. They infer that the client has a choice about past / present and future actions, and enable them to consider what the different consequences of their behaviour are likely to be:
e.g. ‘In what other ways could you respond to that?’

Guru Questions
These types of questions invite clients to step outside of themselves and consider someone in their situation, and ask what advice they would give to this person.

Career Questions
These sorts of questions help the client to see that they have choices that they can make in their present lifestyles that could have a profound impact on their future.
They normally have an exaggerated or paradoxical content that helps the client to see beyond their present behaviour.
Care should be taken to only use these questions where the client can interpret the paradox, rather than take it literally as a suggestion.

Circular Questions
These can be useful for helping clients to understand their own feelings, thoughts, attitudes and behaviour. Instead of asking them directly about how they feel or what they think, the questions ask about how the client thinks someone else feels or thinks about something. This may be less threatening than asking the client directly how they feel about something.

Exploratory Questions
These are also circular in nature, but tend to focus on identifying patterns and connections in a client’s behaviour, problems, thoughts and ways of coping.
For example the counsellor might ask;

‘What type of situations make you feel really angry?’

Questions to Avoid
It is preferable in counselling to avoid ‘why?’ type questions. The reason being, that they tend to open up intellectual explanations rather than invite clients to disclose what is happening internally. ‘What?’, ‘How?’ and ‘When?’ questions are generally more productive as they focus more on feelings and emotions.

Goals of Questioning
It is important to restrict questioning during counselling sessions so that the client does not feel interrogated. Questioning should only be used as an addition to the main tool of reflection. Timing is also important. The counsellor needs to know when to and when not to ask a question. The counsellor can master timing by learning the therapeutic value of the question, and the likely response of the client.

Case Study
Ellen comes into the counselling room. She is obviously agitated. C = counsellor E = Ellen
C “Hello, are you OK?” E “No”
C “Is there something I can help you with?” E “No”.
C “Are you upset about anything in particular?” E “No.”
C “Is there something you want to talk about?” E “No”.
The counsellor is not encouraging Ellen to talk by asking these closed questions. Go through the questions again and think of ways that the counsellor could have used other questions for encourage Ellen to talk about what was bothering her.
These are not definite answers. You may have come up with different questions to these, but these are some suggestions.
C “Hello, are you OK?”
Perhaps – “you don’t look very happy today … followed by a pause to allow Ellen to talk” Or “you don’t look very happy today, can you tell me why?”
C “Is there something I can help you with?”
“I think there is something the matter, so talk to me about it and we’ll see if I can help”.
C “Are you upset about anything in particular?”
“Tell me what you are upset about in particular” or “What in particular are you upset about?”
C “Is there something you want to talk about?”
“What is it you want to talk about?”
These new questions or statements encourage Ellen to make a response that is not a yes/no response. They encourage her to talk, even if only with one sentence. But this one sentence will also allow the counsellor to open up the conversation more.

Activity
As you go through your day, when you are talking to other people, look at your own use of open and closed questions and theirs. Are there times when you use closed questions to end a conversation? Or open questions to prolong a conversation? Try to make a conscious note to use more open questions when talking to people. The more counselling skills are practised within our daily lives, the more natural they become to us.

Example – Questioning in Crisis Counselling
The following article gives you some idea of how questions may be used in crisis counselling.

Reproduced with permission from www.ericdigests.org.

ERIC Identifier: ED405535
Publication Date: 1995-00-00
Author: Stevens, Brenda A. – Ellerbrock, Lynette S.
Source: ERIC Clearinghouse on Counselling and Student Services Greensboro NC.
Crisis Intervention: An Opportunity To Change. ERIC Digest.

Crisis intervention is emergency first aid for mental health (Ehly,1986). This digest provides a brief, conceptual overview of crisis intervention, and summarizes the steps a worker may use to identify, assess, and intervene with an individual experiencing crisis.
The Chinese language contains two characters which, taken together, connote the concept of crisis. The first character, “wei,” indicates a critical or dangerous situation, while the second one, “ji,” means an opportunity for change. Thus, these characters together indicate that crisis is a point in time that allows the opportunity to change.
Crisis intervention involves three components: 1) the crisis, the perception of an unmanageable situation; 2) the individual or group in crisis; and 3) the helper, or mental health worker who provides aid. Crisis intervention requires that the person experiencing crisis receive timely and skilful support to help cope with his/her situation before future physical or emotional deterioration occurs.
A crisis may occur when an individual is unable to deal effectively with stressful changes in the environment. A stressful event alone does not constitute a crisis; rather, crisis is determined by the individual’s view of the event and response to it. If the individual sees the event as significant and threatening, has exhausted all his/her usual coping strategies without effect, and is unaware or unable to pursue other alternatives, then the precipitating event may push the individual toward psychological disequilibrium, a state of crisis (Caplan, 1964; Smead, 1988).
Psychological disequilibrium may be characterized by feelings of anxiety, helplessness, fear, inadequacy, confusion, agitation, and disorganization (Smead,1988). At this point, the individual experiencing this disequilibrium may be most receptive to outside assistance, thus providing an opportunity for behavioral change and a return to balance. To summarize, a crisis results from a person’s negative perception of a situation.
Psychologists, counsellors, social workers, mental health personnel, and therapists are trained to provide services to individuals in crisis. These workers can assist an individual or group in crisis by providing direct intervention, by identifying alternative coping skills, or by consulting with others. A helper’s primary goals in a crisis are to identify, assess, and intervene; to return the individual to his/her prior level of functioning as quickly as possible; and to lessen any negative impact on future mental health. Sometimes during this process, new skills and coping mechanisms are acquired, resulting in change.
IDENTIFICATION
Identification recognizes that a problem exists and it focuses on 1) the event’s significance in the person’s environment, and 2) the person’s current functioning. The event or crisis may be categorized as either developmental or situational (Smead,1988). Developmental crises result from predictable change, and are due to normal growth or development, such as the onset of adolescence. Situational crises are either predictable, arising from certain events, such as divorce or failing a grade, or are unpredictable, such as an accidental death or natural disaster. Both types involve a change in circumstances, usually accompanied by a loss, which can precipitate a crisis reaction in an individual.
Therapists must promptly identify a person in crisis, as well as assess the degree to which his/her functioning is impaired. In addition to psychological disequilibrium, other signs and symptoms may indicate a problem for those experiencing a crisis. Physical symptoms such as changes in overall health, energy, or activity level, as well as in eating or sleeping patterns, may point to a problem. Emotional signs that may indicate a person in crisis include increased tension or fatigue, and changes in temperament, such as angry outbursts or depression.

Behavioral signs such as the inability to concentrate, being preoccupied with certain ideas, or social withdrawal may also indicate a person in crisis (Ehly,1986; Greenstone & Leviton, 1993).
ASSESSMENT
After identifying a crisis situation and a person in crisis, workers assess the crisis’s impact on the individual. This assessment usually takes the form of an interview, during which the worker strives to convey an atmosphere of acceptance, support, and calm confidence about the future. Communication with the person experiencing a crisis is vital; this involves establishing eye, and sometimes, physical contact. Questions addressed to the individual may include his/her perception of the problem, the frequency and sequence of events, his/her feelings, and a history of attempts to deal with the problem. Forced choice or open-ended questions may be used to assess the individual’s ability to communicate, as he/she may experience difficulty in expressing him/herself, in making decisions, or in solving problems.

Assessment may include what the individual is saying as well as his/her nonverbal communication, i.e., facial expression, posture, body and eye movements, and mannerisms. An essential part of this assessment is an evaluation of the person’s current safety as well as any risk to his/her own or someone else’s life. Additionally, factors such as alcohol and drug use, current stress level, and emotional affect, such as hopelessness and helplessness, should be identified.
INTERVENTION
After identification and assessment of the crisis and the person involved, the intervention occurs. While specialists (Hoff, 1989; Greenstone & Leviton, 1993; Sandoval, 1988; Sandoval, 1991; Zins & Ponti, 1990) in this area may differ on the name and number of steps involved, they agree that certain points are integral to intervention and are basic to a best-practice, problem-solving approach. First, while supporting and empathizing with the individual in crisis, the worker should listen and avoid using the phrase “I understand” so as to allow the individual full and open expression of feelings and emotions. Second, the individual in crisis should answer the worker’s questions so as to define and clarify the incident and acknowledge any social and cultural factors which may relate to the crisis. This second step places the problem in a framework. As Burak (1987, p. 1) states, “Understanding of and respect for the differences inherent in each culture are needed for rapid, effective, and sensitive treatment of emergency situations” (p. 1). Third, the worker develops an awareness of the significance of the crisis from the individual’s point of view. These first three steps may have been partly completed during the identification and assessment stages of the crisis; it is important that they be finished before going on to the fourth step.
Fourth, mutual brainstorming of alternatives and discussion of available resources are jointly carried out by the individual in crisis and the worker. At this point, the worker may need to be more directive, by focusing on the current situation, proposing ideas and strategies for action, as well as suggesting other resources for support, instead of just listening and reflecting. (Sandoval, 1988). Fifth, the individual in crisis and the worker choose one or more specific, time-limited goals which take into account the person’s significant others, social network, culture, and lifestyle. Complete planning, including recognition of all the steps involved, as well as consideration of any barriers to success, should be completed before the solution is attempted. Some brief education, modelling, role playing or rehearsal of potential situations may be done in this step to empower the individual further. Sixth, the worker and individual implement their plan and, if possible, evaluate its effectiveness. They then adjust the plan as necessary. Seventh, the worker provides for follow-up or refers the individual in crisis to a resource that can provide ongoing support. The worker then terminates the established crisis relationship.
SUMMARY
In summary, crisis intervention provides the opportunity and mechanisms for change to those who are experiencing psychological disequilibrium, who are feeling overwhelmed by their current situation, who have exhausted their skills for coping, and who are experiencing personal discomfort. Crisis intervention is a process by which a mental-health worker identifies, assesses, and intervenes with the individual in crisis so as to restore balance and reduce the effects of the crisis in his/her life. The individual is then connected with a resource network to reinforce the change. Thus, as the Chinese characters suggest, crisis truly holds the opportunity for change.

REFERENCES
Burak, P. A. (1987). Crisis management in a cross-cultural setting Washington, D.C.: National Association for Foreign Student Affairs. (ERIC Document Reproduction Service No. ED 329 870).
Caplan, G. (1964). Principles of preventive psychiatry. New York: Basic Books.

Ehly, S. (1986). Crisis intervention handbook. Washington, D.C.: National Association of School Psychologists.
Greenstone, J. L. & Leviton, S. C. (1993). Elements of crisis intervention: Crises and how to respond to them. Pacific Grove, CA: Brooks/Cole Publishing Co.
Hoff, L. A. (1989). People in crisis: Understanding and helping (3rd ed.). Redwood City, CA: Addison Wesley Publishing Co.
Sandoval, J. (Ed.). (1988). Crisis counselling, intervention, and prevention in the schools. Hillsdale, NJ: Lawrence Erlbaum Associates.
Smead, V. S. (1988). Best practices in crisis intervention. In A. Thomas & J. Grimes (Eds.), Best practices in school psychology (pp. 401-414). Washington, D.C.: National Association of School Psychologists.
Zins, J. E. & Ponti, C. R. (1990). Best practices in school-based consultation. In A. Thomas, &
J. Grimes (Eds.), Best practices in school psychology II (pp. 673-693). Washington, D.C.: National Association of School Psychologists.
SET TASK
You will need to repeat this set task several times asking different types of questions.
Get together with a friend, relative, or colleague, etc. Simulate a counselling situation. Ask them lots of closed questions about an emotional issue (but not something that is going to upset them, or that is going to stir up feelings that you cannot deal with) so as to try and get to the heart of a problem that they have. (If you find it easier you could always not disclose that you are researching your counselling techniques, until you have pursued with your questioning, though you should disclose this information to them afterwards)

Try to balance your questioning with reflection, and other techniques, so as not to upset your ‘client’ by bombarding them with too many questions. Make notes of their responses.
ASSIGNMENT

1. Report on your set task. How did your ‘client’ respond to your questioning? Did they become defensive or avoid talking about the main issues that were bothering them? Submit approx 200 words.

2. Repeat the task using open questions and comment on your findings. Submit 200 words.

3. Compare your use of open and closed questions in your set task, and the information that these 2 types of questions produced. Submit ½ to 1 page.

4. What do you see as being the main risks involved in asking too many questions? Why is it important to avoid questions beginning with ‘why?’ (If you asked any ‘why’ questions in your set task site them as an example in your explanation). Submit 200 – 300 words.

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