Constructing helpful questions
• Clinician effort, skill and knowledge are needed to develop useful, easy to answer questions
• Particular and practical
• Not too big
• Offering alternatives

Open questions have an important function in opening up an interview but offer the person little support in finding words for their experience. Receiving and answering questions can be stressful and require mental effort. To answer the question:

“How are you feeling?”

requires a great deal more effort than to answer the question:

“I notice you are looking down and shifting in your seat. I am wondering if the issues in this conversation are quite difficult to discuss, if some feelings of discomfort, sadness or regret are coming forward, or if you are just feeling tired. Is any of those partly right?”

Clinician effort and skill is needed to develop useful, easy to answer questions and a carefully constructed question can enable the person to benefit from our knowledge and expertise. From the knowledge we have we can offer possibilities as questions which can support the person to put language to their experience.

Making questions particular and practical is helpful:

“If I was watching from the side when the voices were getting stronger what would I see?”

Questions that are not too big are often more helpful. For instance, rather than:

“What has changed?”

use:

“Have there been any times when it has been a little bit easier to go out of the house?”

Structure and frame can focus questions:

“When you think of Kingseat (psychiatric hospital) as a place of shelter, can you tell me about the shelter it provided?”

Offering alternatives can support the person in going into detail:

“I’m interested in how you made the decision to stop the medicine, if it happened all at once, or if you wondered about it over a few days.”

Gathering threads
• In relational language, focusing on resource
• Slows conversation down
• Opportunity to consult
• Affirms person
• Use person’s own words

Gathering threads is as important as inquiry. It can be compared with summarizing and feeding back. As with careful listening and inquiry the contribution it makes to the conversation can be enhanced by use of relational language and focus on agency, knowledge, resource, etc. It slows the conversation down, gives an opportunity to consult and it can be affirming and centering for the person to hear what has been discovered spoken by the 'expert' in the room. Use of the person’s own words moved into relational language with a focus on agency and resource can open possibility for movement. To do this well, careful notetaking is needed in the interview to record the person’s words and themes which emerge. Here are two examples, one with a young man experiencing persecutory delusions and another with a young woman working to find other strategies to replace cutting: