Counseling and Psychotherapy

Questioning, when done in an open manner, enables the counselor or therapist to gain important information and allows the client to remain in control of the information presented. Using open questioning, the counselor or therapist designs questions to encourage the broadest client responses. Open questions, as opposed to closed questions, generally cannot be completely answered by either yes or no, nor can they be answered nonverbally by shaking the head. This type of questioning places responsibility with clients and allows them a degree of control over what information will be shared.

1 Client: I’ve thought a lot about what we talked about last week, and I feel I have to work on changing my behavior.

Open Questioning

1 Counselor/Therapist: Would you tell me what you think needs to be done to change your behavior?

2 Client: (short pause) I need to stop screwing up my chances for a relationship. I need to face what it is that makes me run away.

Open Questioning

1 Counselor/Therapist: Would you please talk more about the “it” that makes you run away?

2 Client: I can’t tell you what it is. All I know is that I hear this voice saying, “Run, run.”

Probing and leading strategies enable a counselor or therapist to gather information in a specific area related to the client’s presented concerns (probing) or to encourage the client to respond to specific topic areas (leading). Each of these strategies enables the counselor or therapist to explore in greater depth areas that are seen as important to progress within the session.

Probing

1 Counselor/Therapist: I want you to be more specific about this “voice.” Whose voice is it? What does it say to you?

2 Client: (very long pause) I guess it’s my voice. It sounds like something I would do. I’m such a jerk.

Leading

1 Counselor/Therapist: You told me whose voice it is, but you didn’t tell me what the voice says. Would you talk about this?

2 Client: (raising his voice) It says, “Get out or you’re going to get hurt. She doesn’t like you and she’ll use you and drop you just like the rest.”

Some strategies are used to enhance and expand the communicative and relationship patterns that are established early in the counseling or therapeutic process. When used effectively, these strategies should open up deeper levels of communication and strengthen the relationship patterns that have already been established. Counselors or therapists using these strategies model types of behaviors that they wish their clients to emulate. Such behaviors include, but are not limited to, risk taking, sharing of self, demonstrating trust, and honest interaction. This set of strategies includes self-disclosure, confrontation, and responding to nonverbal cues. The following paragraphs present explanations and examples of these strategies.

Self-disclosure has implications for both clients and counselors or therapists. In self-disclosing, the counselor or therapist shares with the client their feelings, thoughts, and experiences that are relevant to the situation presented by the client. The counselor or therapist draws on situations from their own life experiences and selectively shares these personal reactions with the client. It is important to note that self-disclosure could have both a positive and a negative impact on the helping relationship, and care must be taken in measuring the impact it may have. From a positive perspective, it carries with it the possibility of modeling self-disclosure for the client or helping the client gain a different perspective on the presenting problems. From a negative perspective, self-disclosure might place the focus on the counselor’s or therapist’s issues rather than on those of the client. When self-disclosure is used appropriately, gains are made by all persons involved, and the relationship moves to deeper levels of understanding and sharing.

Self-Disclosure

1 Counselor/Therapist: (aware of the client’s agitation) The anger I hear in your voice and words triggers anger in me as I think of my own lost relationships.

2 Client: (smiling) I am angry. I’m also glad you said that. Sometimes I feel like I’m the only one who ever felt this way.

Self-Disclosure

1 Counselor/Therapist: (smiling) I am very pleased with what you just said. At this moment, I also do not feel alone with my anger.

Confrontation enables the counselor or therapist to provide the client with feedback in which discrepancies are presented in an honest and matter-of-fact manner. A counselor or therapist uses this strategy to indicate their reaction to the client, to identify differences between the client’s words and behaviors, and to challenge the client to put words and ideas into action. This type of direct and honest feedback should provide the client with insight into how they are perceived as well as indicate the degree of counselor or therapist caring.

1 Client: (smiling) I feel angry at myself a great deal. I want so much to find a person and develop a relationship that lasts.

Confrontation

1 Counselor/Therapist: You’ve said this several times in our sessions, but I’m not sure I believe you, based on what you do to keep it from happening. Make me believe you really want this to happen.

2 Client: What do you mean, you don’t believe me? I just told you, didn’t I? What more do you want?

Confrontation

1 Counselor/Therapist: Yes, I’ve heard your words, but you haven’t convinced me. I don’t think you’ve convinced yourself, either. Say something that will convince both of us.

Responding to nonverbal cues enables a counselor or therapist to go beyond a client’s words and respond to the messages that are being communicated by the client’s physical actions. Care must be taken not to overgeneralize every subtle body movement. The counselor or therapist is looking for patterns that either confirm or deny the truth in the words the client uses for self-expression. When such patterns become apparent, it is the responsibility of the counselor or therapist to share these patterns with the client. It becomes the client’s responsibility to confirm or deny the credibility of the perception.

Responding to Nonverbal Cues

1 Counselor/Therapist: What I said made you angry and, I would suspect, hurt a little. Did you notice you turned away before you began to speak? What were you telling me when you turned away?

2 Client: (smiling) What you said did hurt me. I was angry, but I’m also embarrassed not to be able to handle this part of my life. I don’t like you seeing me this way.

Responding to Nonverbal Cues

1 Counselor/Therapist: I’ve noticed that on several occasions when you talk about your feelings of anger, embarrassment, or hopelessness, you smile. What does the smile mean?

2 Client: (long pause) I guess I want you to believe that it isn’t as bad as it sounds or that I’m not as hopeless as I think I am.

3 Counselor/Therapist: It is bad, or you wouldn’t be here, and “hopeless” is your word, not mine. Our time is up for today. Between now and next week, I want you to think about what we’ve discussed. See you next week?