Inquiry
• Purpose of inquiry is for person to experience difference
• Invitation to discovery
• Use expertise to step out of expert position
• Make an inquiry and ready yourself for the answer
• Inquiry can make clinician knowledge available to the person

In traditional mental health work questions are often asked to elicit information which the clinician will hold and use to develop assessments of risk, formulations, diagnoses and treatment plans, the effect of the inquiry on the person receiving the question is prioritized. The question can function as an invitation to the person to join us in discovery, to open possibilities, to bring forward resource, sense of agency and knowledge into conscious awareness. This is in contrast to the 'detached observer' position whereby the clinician notices, makes sense and intervenes.

Inquiry is not naive, or from a 'not-knowing position'. Considerable clinician thoughtfulness and skill are needed to develop helpful questions. The focus for content is on agency, the ‘I’, active in the present moment with values, ideas and intentions, what’s working, what’s available, looking through the chaff for the grains. Questions are informed by our knowledge and experience and made with an attitude of discovery with openness to the possibility of an unexpected, rather than a confirming answer. We need to ask the question and ready ourselves to hear the answer - open to hearing an answer which surprises us, rather than waiting for the person to answer while we develop the next question.

Inquiry can be compared to an interpretation in psychodynamic psychotherapy in that it is a way of making clinician knowledge, experience and ideas available to the person. However, in informing an inquiry the clinician’s knowledge offered as tentative, in creating possibility and the person’s response is prioritized. If the person takes up a suggestion in an inquiry in a confirming way then they can hold some agency in the discovery of that knowledge, rather than being told. If the person does not take up an idea in an inquiry which is made in the spirit of discovery there need be no loss of rapport and alliance, as there might be with an unhelpful interpretation. The disconfirming answer contributes to the discovery process and may open further possibilities.

For instance, in a situation where a young woman had been engaged in partial hospitalization for Anorexia Nervosa, her father asked the clinician involved whether structure was needed in treating Anorexia. The clinician’s knowledge and experience indicated that structure was helpful. She had the choice of telling the family this, or making her knowledge available in a tentative way, combined with an inquiry to the young woman in question who had had some experience of structure:

“In my experience young people struggling with Anorexia often do find structure helpful, but everyone’s different, how have you found the structure that you have engaged in, Melanie?”

Another example is a conversation with a young man with Bipolar Affective Disorder. He had a relapse into a manic episode after late nights including an all night party (with only very modest alcohol ingestion). It seemed obvious to the clinician that sleep deprivation needed to be avoided. However offering this as an inquiry:

“Do you think there is a connection between the mania coming back and the lack of sleep?”

opened a conversation which brought forward the value he placed on being able to participate in all night parties. This enabled them to negotiate a plan whereby short term hypnotic and antipsychotic medications were used to ensure return to a regular sleep pattern after an all night party and late nights.