Therapeutic Questioning

I wanted to send an email on something I’ve been thinking about sporadically for the past year. That is, “therapeutic questioning”.

I haven’t come across this in any textbooks, but I find that gentle exploratory questions that get a patient to reflect and share their feelings can be helpful. It helps a patient feel seen and understood (by others and themselves).

These can be woven into an interview at opportune moments to encourage reflection, rapport, and resilience.

Here are some examples:

• Identity:
  • How would you describe yourself to someone who doesn’t know you? 
  • What do you hope people understand about you? 
• Resilience:
  • What do you often underestimate about yourself? 
  • What moment made you feel proud of yourself? 
  • What has helped you get through today, even a little? 
  • What qualities in you helped you survive before? 
• Spirituality:
  • What religious or spiritual ideas were you taught growing up? 
• Challenges:
  • What aspect of things feels heaviest right now? 
• Comforts:
  • What would make today 1% more bearable? 
  • What do you do differently on days that feel slightly less heavy? 
• Agency:
  • What helps you feel a sense of control, however limited? 
  • What still matters to you, even if you’re exhausted? 
  • What feels unfinished about your story? 
• Hope:
  • If things didn’t get better, but got different, what might that look like? 
  • What would a tolerable future look like? 

Additionally: The Miracle Question

Schemide asked a version of the miracle question today, which I like a lot. The miracle question is often part of a form of therapy called “solution-focused therapy”:

Suppose tonight, while you’re asleep, a miracle happens and the problem that brought you here is completely solved. Because you were asleep, you don’t know the miracle happened.
When you wake up tomorrow, what would be the first small sign that lets you know something is different?

Follow up questions that deepen it:

• What would other people notice about you?

• What would you be doing instead of what you do now?

• On a scale from 0–10, where are you today compared to the miracle day?

• What tells you you’re not at 0 already?