Constructive questions : how do therapeutic questions work?




McGee, Daniel Raymond

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In this dissertation, I examined how questions function in psychotherapy. While the Milan group (Selvini-Palazzoli, Boscolo, Cecchin, & Prata, 1980) were the first to recognise explicitly that questions could be more than simple information-gathering tools, many of the newer interactional therapy models also rely extensively on questioning. While there have been many attempts at classifying such questions, these taxonomies remove questions from their context, obscuring the ways in which they function interactionally. One of the main functions of questions is to introduce embedded presuppositions as common ground. That is, while many questions seem to be primarily requesting information, they are also indirectly introducing assumptions. In a functional analysis of the process initiated by a therapeutic question, 10 sequential, frame-by-frame steps were identified and advanced: First, questions require answers; clients cannot easily ignore them. Second, the answerer must make sense of the question and its embedded presuppositions. Third, the question constrains and orients the answerer to a particular aspect of his or her experience. Fourth, in order to answer the question, the answerer must often do considerable on-the-spot review work. Fifth, in formulating an answer, the answerer does not ordinarily comment on the embedded presuppositions. Sixth, an embedded presupposition is malleable and can be corrected. Seventh, once the answerer has responded, the very act of answering the question implicitly accepts the embedded presuppositions as common ground. Eighth, the answer is owned by the client, not the therapist. That is, because the client must provide information that the therapist does not have, he or she discovers and presents information consistent with the embedded presuppositions. Ninth, when the question has been answered, the initiative returns to the questioner (the therapist). And tenth, as conversations move ahead rapidly, it becomes increasingly difficult to return to earlier embedded presuppositions. Therefore, the answerer cannot challenge them, even though they were never explicitly discussed. These steps were applied to questions in a wide variety of traditional and interactional psychotherapy sessions. It was clear that traditional therapies typically ask questions that embed presuppositions about pathology, chronicity, and inability, whereas questions in the interactional therapies introduce a more positive, option-enhancing perspective in that they embed presuppositions about agency, ability, and other positive qualities.



Psychotherapy, Therapeutics