Managing the Session

1. Managing the Session Questioning & Encouragers Questioning & Encouragers Maranda Brown, AU Doctoral Student - Counselor Education Alabama Department of Mental Health ALCMHB Conference ~ May 12, 2010

2. Objectives • Identify the types of questions and encouragers that can be used in a counseling session. • Understand the appropriate use of questions and encouragers in a counseling session.

3. Why use questions • Retrieve information • Acquire insight • Move to a deeper understanding of the client’s story/perspective • Direct the discussion i.e. so client might consider things in a different way

4. When to use questions Conducting screening, intake or assessment Beginning a counseling session Clarifying a client’s statement Determining the accuracy of your perception or getting more information to enhance your understanding Sharpening the counseling focus in a particular way

5. Do’s & Don’ts of Questioning Use with mindfulness Have a clear & specific intent Ask with purpose Ask only one question at a time Respond to the client’s response before moving on Don’t overuse Don’t become reliant on them Don’t use just to fill time Don’t make it feel like you’re interrogating the client Don’t use leading questions

6. Client resistance or reluctance to answer a question can be due to: Embarrassment Lack of self-awareness Resentment due to unwillingness to participate in counseling

7. The Questioning Tree Miracle question Scaling question Checkout Triadic question Empowering question Probe Collaborative Empiricism Communication Clarification Open question Circular questioning Terrible question Clarifying question Implied question Externalizing the problem Forced choice question Closed question Cognitive Disputation

8. PURPOSE Promotes a lengthy response from the client. Question can’t be answered typically with one word. Usually begin with how, what, when, where, who, & why. Open Question EXAMPLES • What is it like to be so busy? • How might the family react if you suddenly stopped doing so much? • Can you tell me about a time when you were happy?

9. PURPOSE Seeks specific information that can be answered in one word or a short phrase. Promotes brief response. Usually begin with who, is, do , did, are, have, could, would, or does. Closed Question EXAMPLES • Do I understand that you do all of this alone? • Did anyone help you? • Are there times when you do get to relax?

10. PURPOSE Promotes self confidence, hopefulness, and awareness of strengths. Empowering Questions EXAMPLES • What will your life be like when you have resolved this difficulty? • It sounds like you and your son got along well yesterday. What did you do to make that happen?

11. PURPOSE Help client envision the world as if everything is okay. Helps counselor hear the core or critical issue of the client. Miracle Question EXAMPLES • If a miracle happened after you went to bed tonight, what effect would that have on your problem? • What would be the change in your life if a miracle happened right now that took away your problem?

12. PURPOSE Have client make overt any hidden agenda or intentions (many times unknown to them) that might cause them to return to the previous state. Terrible Question EXAMPLES • We need to discuss for a few minutes the fact that sometimes problems return to us even when we do not expect them. What will be the first thing to alert you to the fact that the problem is back in your life?

13. PURPOSE Help client articulate direction. Helps counselor embed positive reframes. Forced Choice Question EXAMPLES • As we talk about career options, I want to hear about which is most important to you right now – working with people, working with ideas, or working with things?

14. PURPOSE Bring to surface new insight and meanings to discussions and connections between and among individuals. Triadic Questioning EXAMPLES • Now, let’s take a minute and hear from someone who has been observing this interaction. Marg, what are you hearing Jim and Julio say to one another? • Okay, Monique, I want to hear from you about the way your mom and dad talk to one another. What are you hearing them saying?

15. PURPOSE Helps identify the level of intensity of the problem. Scaling Question EXAMPLES • Before we get going, I wanted to have you self-assess your level of effort in finding a job. On a scale from one to ten – one being low, ten being high – where are you?

16. PURPOSE To promote dialogue and self-exploration. Implied Question EXAMPLES • Could you tell me some more about that? • Why don’t you give me some details?

17. PURPOSE To ensure you are hearing the client correctly. Checkout EXAMPLES • Let me check something…did I hear that right? • In essence then, your feeling…right? • Okay, so what you would like is to…did I get that correct?

18. PURPOSE Help client understand faulty assumptions they may be making based on their beliefs or thoughts. Cognitive Disputation EXAMPLES • Can you give me some evidence to support your notion that you are the worst student in the class? • What proof do you have that you are correct in assuming that no one at the party would like you to dance?

19. PURPOSE Helps client focus on the function of the problem within the entire system. Circular Questioning EXAMPLES • Who among everyone in your family has the clearest picture of the issue? • What does the person who knows the most about the situation know that the rest of the family doesn’t.

20. PURPOSE Helps client see the problem as a separate entity from herself. Externalizing the Problem EXAMPLES • How did this problem convince you into believing it was a friend? • In terms of your relationship to being afraid of being in a large group of people, what name would you give it?

21. PURPOSE Brings to surface specific information relevant to the issue being discussed. Probe EXAMPLES • Who among everyone you know has a good sense of what is happening? • How many people do you know that have a similar set of beliefs? • When did you start to know that things were going to be alright?

22. PURPOSE Helps clients consider if what they are thinking is accurate and logical. Collaborative Empiricism EXAMPLES • So what I heard you say was that everyone at work hates you. Let’s see if we can find facts to support that. What evidence do you have to support that everyone hates you?

23. PURPOSE Helps clients hear each other better, improving interactions and exchanges among them. Communication Clarification EXAMPLES • Janie, what did you just hear Jimmy say? • What are the other members of the group hearing in this conversation? • Can you clarify that statement?

24. Considerations Culture • Power Distance - clients with high power distance may expect the counselor to ask many questions • Gender Roles - Clients from a masculine culture could be uncomfortable with a female counselor in a position of authority • Affiliation - Counselor needs to structure questions with awareness of the client's degree of collectiveness/individualism Theoretical Orientation • Be mindful theoretical orientations will differentiate the use of questions.

25. Encouragers Minimal Encouragers Accents/Restatements Summarization Paraphrase Reframe Exploring Alternatives Compliment Key Word Repetition Redefining Pat on the Back Identifying/Building Strengths

26. Minimal Encourager PURPOSE • Provides verbal cue to let the person know you’re listening. EXAMPLES • Okay • Uh-huh • Um-hmm • Right • Yes • Oh • Huh

27. Key Word Repetition PURPOSE • Helps direct client. EXAMPLES • Client: I started out the week being a little annoyed, then every day got worse…. • Counselor: Got worse

28. Accents/Restatement PURPOSE • Helps direct client. • Underscores or highlights an aspect of what the client said. EXAMPLES • Client: All in all, it just didn’t go that well. It was really a big disappointment and I won’t be going out with him again. • Counselor: It was really a big disappointment.

29. Paraphrases PURPOSE • Highlights key words or statements, focuses the session, encourages client self-expression, communicates support, interest & attentiveness. EXAMPLES • Client: The government seems to be falling apart. I can’t get any work done with all this bureaucratic mess around. • Counselor: That must be frustrating to you.

30. Summarization PURPOSE • Reflect back what the client discussed to ensure understanding, reinforce learning and effect a transition or closure. EXAMPLES • Sounds like you have gained quite a bit of clarity on your career direction today. You’ve decided to apply to graduate school for the fall and if you are admitted, to resign from your job in July. Perhaps next week we can continue our discussion of your choice of graduate schools.

31. Reframe PURPOSE • Take the deeper meaning of what the client is saying and frame it in a positive way. EXAMPLES • You are someone to be counted on. • A lot of people depend on you. • You have hope that things can be different.

32. Redefining PURPOSE • Decrease client reactance to the counselor and the problem by providing a new meaning for the behaviors. EXAMPLES • So the pain of your childhood could also be considered in terms of the time of life when you developed a sense of being stronger.

33. Exploring Alternatives PURPOSE • Helps client look at other possibilities. • Promotes thoughts, awareness, and new insights by encouraging the client to explore alternatives. EXAMPLES • Are there any other ways that you could accomplish that? • Give me at least three alternative explanations to your theory about your family. • Is there another version of this story…and what is it?

34. Identifying/Building Strengths PURPOSE • Highlights the strengths and assets the client has. EXAMPLES • So one thing you have going for you is a strong desire to help others. • It sounds like you are task-oriented, strong-willed, and hard-working. • When you were young, you feared nothing, right?

35. Compliment PURPOSE • Encourages the client to continue to do the work they are doing to overcome the problem. EXAMPLES • As a family you have persisted when other families might have crumbled. • You should feel very proud of this first step you have made toward addressing the problem.

36. Affirmation PURPOSE • Encourages further self-determination and personal insight. EXAMPLES • It sounds like you are aware of a number of big factors that promote your positive changes. • You seem to be getting a stronger grip on the problem. • All in all you have a lot more direction in your life than a few weeks ago.

37. Pat on the Back PURPOSE • Provide positive feedback.

38. Video Vignette Marital Issues http://www.youtube.com/watch?v=2aaaPMWSIuU&feature=related Job Dissatisfaction http://www.youtube.com/watch?v=9mv_0MYEuR8&feature=related

39. Video Vignette Accomplishing Tasks http://www.youtube.com/watch?v=HC6As-jzoQ0&feature=related Relationship / Separation http://www.youtube.com/watch?v=ReJhR4XIKh0&feature=channel

40. References Cormier, S. & Hackney, H. (2005). (6th Ed.) Counseling Strategies and Interventions. Boston, MA: Allyn and Bacon. McAuliffe, G. & Eriksen, K. (Eds.) (2001). Teaching Strategies for Constructivistand Developmental Counselor Education. Virginia Beach, VA: Donning Company. McHenry, W. & McHenry, J. (2007). What Therapists Say and Why They Say It: Effective Therapeutic Responses and Techniques. Boston, MA: Allyn and Bacon. McKeachie, W. J. (1994). (10th Ed.) Teaching Tips: Strategies, Research and Theories for College and University Teacher. Lexington, Massachusetts: D.C. Heath and Company Seligman, L. (2004). Technical and Conceptual Skills for Mental Health Professionals. Upper Saddle River, NJ: Merrill/Prentice Hall.