A question of perspective.
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Biomedical subjects
Publications and source records attributed to K Tomm.
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Every question asked by a therapist may be seen to embody some intent and to arise from certain assumptions. Many questions are intended to orient the therapist to the client's situation and experiences; others are asked primarily to provoke therapeutic change. Some questions are based on lineal assumptions about the phenomena being addressed; others are based on circular assumptions. The differences among these questions are not trivial. They tend to have dissimilar effects. This article explores these issues and offers a framework for distinguishing four major groups of questions. The framework may be used by therapists to guide their decision making about what kinds of questions to ask, and by researchers to study different interviewing styles.
A clinical interview affords far more opportunities to act therapeutically than most therapists realize. Because so many of these opportunities remain outside the therapist's conscious awareness, it is useful to elaborate guidelines that orient his or her general activity in directions that are liable to be therapeutic. The Milan associates defined three such basic guidelines: hypothesizing, circularity, and neutrality. Hypothesizing is clear and easy to accept. The notions of circularity and neutrality have aroused considerable interest but are not as readily understood. These guidelines may be clarified and operationalized when reformulated as conceptual postures. This process is enhanced by differentiating a fourth guideline, strategizing, which entails the therapist's decision making, including decisions about how to employ these postures. This paper, the first in a series of three, explores these four interviewing guidelines. The other papers will appear in a subsequent issue. Part II will focus on reflexive questioning, a mode of inquiry oriented toward mobilizing the family's own healing capacity. Part III will provide a scheme for analyzing and choosing among four major types of questions: linear questions, circular questions, reflexive questions, and strategic questions.
Reflexive questioning is an aspect of interventive interviewing oriented toward enabling clients or families to generate new patterns of cognition and behavior on their own. The therapist adopts a facilitative posture and deliberately asks those kinds of questions that are liable to open up new possibilities for self-healing. The mechanism for the resultant therapeutic change in clients is postulated to be reflexivity between levels of meaning within their own belief systems. By adopting this mode of enquiry and taking advantage of opportunities to ask a variety of reflexive questions, a therapist may be able to augment the clinical effectiveness of his or her interviews.
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