Therapists’ views on the use of questions in person-centred therapy

ABSTRACT

This study collated person-centred therapists’ views on their use of questions in person-centred counselling. It asked whether the therapists considered that questions are useful and how they seek to implement them. Six experienced person-centred therapists were interviewed and their comments analysed using Thematic Analysis. Therapy transcripts by Rogers and Mearns were also analysed to obtain examples of their questioning techniques. Results suggested that these person-centred therapists ask questions regularly for many reasons including; to check their understanding or to clarify an issue for the client; to challenge the client; to enable the client’s processing; and sometimes just out of curiosity. However generally, questions were used to represent the counsellor’s way of being and subtly facilitate progress in the counselling relationship.

KEYWORDS:

• Person-centred therapy
• questions
• directivity
• therapeutic process
• techniques

This study seeks to understand the extent to which person-centred (PC) therapists consider questioning to be an appropriate method to direct or focus their therapy. It also aims to establish the types of questions therapists consider useful and the purpose for which they are used. Firstly, some definition of the term “person-centred” is necessary, since the term is used to describe a variety of contemporary approaches. Then the methodological contradiction of questioning in what is a traditionally non-directive method needs addressing.

Non-directive therapy

Traditional Client-centred Therapy is a non-directive approach based on the principle that the counsellor “Holds a coherent and developing set of attitudes deeply embedded in his personal organisation” (Rogers, 2003, p. 19). These attitudes are contained within Rogers (1957, p. 96) six therapeutic conditions necessary for therapeutic change. They stipulate that "two persons are in psychological contact"; that "the client is in a state of incongruence, being vulnerable or anxious"; "the therapist is congruent or integrated in the relationship"; "the therapist experiences unconditional positive regard for the client"; "the therapist experiences an empathic understanding of the client’s internal frame of reference and endeavours to communicate this experience to the client"; and "the communication to the client of the therapist’s empathic understanding and unconditional positive regard is to a minimal degree achieved". In summary, the non-directive philosophy exists within the meaning of Rogers’ core attitudes of congruence, unconditional positive regard and empathy – they are the source of non-directivity (Levitt, 2005). Therapeutic change then occurs as a product of the tendency of the organism to actualise. According to Wilkins (2015, p. 9), this “non-directive attitude and intention have primacy, in that it is a mistake to wrest control of the change process from the actualising tendency in any way whatsoever”. The methodological and philosophical integrity of this classical approach has been supported by many, for example; by Moon and Rice (2012), Mearns (2003), Brodley (1997), Bozarth (2002) and Patterson (1990).

Directivity in PC therapy (PCT)

However, contemporary views of PC therapy (PCT), (Murphy & Joseph, 2015), have polarised, with some suggesting that directivity, far from being inappropriate, is in fact inevitable, (e.g. Sachse, 2004); Wood (2008) for example, proposes that client-centred therapists play a role, practising in a mechanistic way. Further, the sufficiency of the core conditions to facilitate therapeutic progress without direction has been questioned at length, notably by Hill (2007), who suggests that therapist techniques are able to influence PC outcomes. Over time, more criticisms of non-directivity (e.g. Parloff et al., 1978) have emerged, and further, Tudor and Worrall (2006) have emphasised the need for therapist freedom from the dogma of the approach. A common argument is that some clients need more than empathic reflection (Lazarus, 1969) and for Patterson (1980), some clients may need new skills or knowledge, for which even teaching may be necessary.

Other views on the PC approach suggest that directivity is, if not inevitable, at least acceptable. Wachtel (2007) suggests that sometimes direction or advice is exactly what the client seems to need, and Bohart (2012) recommends finding ways for the client and therapist to work collaboratively, which may involve directive methods such as sharing ideas and offering expertise. Takens and Lietaer (2004) consider that the core conditions suggest a task-oriented, or directive way of responding anyway. They recommend a subtle balance of steering and following, where there remains plenty of room for the self-propelling processes of the client. Further, Kahn (2012) suggests that just providing empathic understanding limits the intellectual and creative potential of the therapist. In fact, Holdstock and Rogers (1983), suggest that the PC approach can include techniques as long as the client is not coerced into the process.

Over time, greater clarity has been brought to specific forms of directivity in more focused PC approaches (Lambert et al., 2002). In these methods, direction is applied in order to focus on specific processes or outcomes, for example; Perceptual-Experiential Therapy (Combs, 1993); Dialogical Person-centred Psychotherapy (Schmid, 2006); Process-Experiential/Emotion-Focused Therapy (Elliott & Greenberg, 2007); and Counselling for Depression (Sanders & Hill, 2014). Further, many PC therapists ascribe to a more directive approach, particularly under the pressure of time (Renger, Macaskill, & Naylor, 2020).

Questioning in PCT

Directivity in the form of therapist questions is not, however, currently a defined and accepted technique within PCT. For example, Witty (2007) and Patterson (1990) are specifically against questions due to the compliance and therefore lack of agency likely generated in the client. However, Brodley (1997), although suggesting that therapists in PCT would not ask leading or probing questions, does allow for therapists to be led by the client in terms of their need to be questioned. Further, some contemporary authors consider questioning to be useful in PCT (e.g. Anderson, 2001; Cooper, 2004). Specifically, Elliot (2013) found that therapists tended to use more questions with anxious clients at the start of therapy. Even Rogers (Rogers & Carmichael, 1942), in his initial writings on PCT considered the usefulness of questions, suggesting that the counsellor may ask “ … specific questions of an information getting sort,” (pp. 124–125). Other PC practitioners also give support for the use of questions. Kahn (1999) for example, suggests that a tentative inquiry on a topic that a client is reluctant to bring up on his or her own may enhance the therapeutic dialogue (p. 108). Merry and Brodley (2002, p. 73) suggest that intended or not, the most common responses in PCT are empathic statements that are designed to check understanding. In addition, Mearns and Cooper (2005) in their development of PCT towards a relational approach have said:

If we think, … of person-centred therapy as an approach which is focused around meeting our clients at a level of depth, then the asking of questions is entirely appropriate if it has the potential to facilitate this encounter (p. 121).

In summary, Rogers’ original conception of Client-centred Therapy does not advocate the use of questions as a specific technique, but as the approach has developed, whilst there is limited literature addressing the subject specifically, there are those who suggest that use of the technique should not be discouraged.

Aims of the study

If more directive PC therapists wish to use questions in their therapeutic approach, there are currently no guidelines on what type of questions work, when to use them and with which clients. This study, therefore, seeks to collate views on the practice of questioning in PCT by contemporary practitioners. It aims to provide a picture of the beliefs and understandings of a group of experienced PC therapists on their idiosyncratic use of questions in therapy; their successes, failures, theories and experience. By implication, as therapists become more comfortable with the process of questioning, the more directive the PC approach inevitably becomes. We then begin to move away from the pure Rogerian client-centred approach (2003) towards a more integrated perspective such as Pluralism (Cooper & McLeod, 2010) for example, or a PC cognitive behavioural approach (Josefowitz & Myran, 2005). Here, questioning changes the dynamics of the therapeutic process so that the therapist becomes more of a diagnostician, an agent of change, or the expert. Therefore, if PC questioning is to become, or is already, a commonly used technique, our profession needs clear guidelines on appropriate usage, and a consideration of the way in which that impacts the PC understanding of what it is to be human, the development of the person and the catalysts for change in that process.

Methodology

Interviews with experienced therapists were considered appropriate for this study, with responses analysed using Thematic Analysis (Braun & Clarke, 2006). The dialogic foundations of Thematic Analysis enable the interviewer to pursue elements of a topic such as in-depth experiencing and affective or phenomenological aspects, in addition to elements which require a more positivist approach. This flexibility is therefore particularly useful with a concept such as questioning in counselling, as it may be addressed in very rational, theoretical terms, and in experiential terms. In addition to the analysis of interview material, examination of some more concrete data was also considered necessary. A set of transcripts of therapy sessions by both Rogers (Brodley & Lietaer, 2006a; 2006b) and Mearns (Mearns & Cooper, 2005) would give clarity to their use of questions and attempts to guide or direct the process. The epistemological underpinning of the study is that of Critical Realism (Bhaskar, 2015) which combines a realist ontological perspective with an epistemologically relativist view. An understanding of the elements of structures, power and agency could therefore be sought within the domains of the empirical, the actual and the real, ensuring that a merely semantic analysis was negated. Thematic Analysis fits comfortably within this perspective since it is compatible with both essentialist and constructionist paradigms (Braun & Clarke, 2006).

Method

In-depth, semi-structured interviews were indicated for this study since no existing template of questions used in PCT was available to provide the basis for a quantitative study. Interviews conducted from a Critical Realist perspective facilitate understanding at a semantic level revealing espoused theories, but also allow for questioning on what might actually occur and how it occurs, giving clarity to theories in use. This perspective aimed to clarify as much as was possible, the difference between the therapists’ beliefs and examples of their practice. Finally, an understanding of the purpose behind the use of questions was facilitated through this approach to data collection.

Reflexivity

The researcher is qualified in both learning and development, and in PCT, and is interested in the amalgamation of the two disciplines. A specific area of interest is the role that questions play in the learning process. Therefore, this research is conducted from the perspective that questions could be appropriate in PCT and that they could be useful to the client. An additional assumption brought to the research was that PC therapists probably utilise questioning more than they might consider methodologically appropriate. A bracketing interview with an experienced therapist was therefore conducted prior to the study based on Ahern’s protocol (1999, pp. 407–411) to identify and reduce these biases. For the researcher, research on this topic stems from an interest in developing material on therapeutically facilitative questions which may be of use to either therapists or for self-therapy. The researcher also hopes that there is the potential to utilise the results as training material for new trainees who often struggle with the notion of “just being”.

Participants

Initially, 25 PC therapist colleagues were contacted directly by phone to find a group of six who were closest to being Rogerian in their approach. All explained that with experience, they had modified their degree of person-centredness to fit their own preferences, which they described for example, as “walking with the client”, and “a facilitator of change”. All, however, considered themselves to be PC therapists. Those who had progressed towards a more integrative approach were not included in the study. Participants were therefore recruited in what was a purposive sample. All participants were known to the researcher as part of a wide network of colleague practitioners. Each received an information sheet and consent form for signature. All were white British therapists aged between 35 and 64. There were four females and two males, all based in the north of England with between six and 24 years’ experience. Ethical approval for the study was obtained from Keele University.

Data collection

Initially, a list of interview questions was generated by the researcher in conjunction with a fellow PC therapist, from which these basic questions were chosen as a focus for the interviews:

• What types of questions do you use, if any?

• Why do you use questions?

• Do you find that questions are beneficial/harmful to the process?

• What amount of questions do you use?

• How do you time the use of your questions?

• Do clients differ in their need for questions?

• Are there any specific ways that you use questions?

Forty-five to fifty-five minute interviews were conducted with each participant. These were at the offices of a counselling service with three of the participants, in the home-based practices of two counsellors, and at the researcher’s home for one counsellor. The interviews were conducted uninterrupted in each case, in a counselling room, without time pressure. Considerable effort was taken in the interviews to obtain examples of what the therapists actually did in practice, in order to close the gap between espoused theories and theories in use. The interviews were recorded and later transcribed.

Data analysis

Each interview was taped, transcribed, and then using Excel, comments were summarised at a semantic level, and where necessary, assumptions were made about meaning. This summary was emailed back to the respective participants for checking. Their responses were incorporated into the next level of analysis. For example, there were a number of comments along the lines of “I know I said … , but what I really meant was … .” The data corpus was then completely coded. Selective coding was not used since, although some comments did not have an immediate relationship to asking questions, they did explain related issues such as directivity. A mixture of semantic and latent codes was used, for example, “There is no agenda to challenge,” was taken at a semantic level, whilst a comment such as “You must be very careful not to personalise it too much for them,” was open to interpretation. The data were also coded on an active basis in that patterns were created rather than discovered.

The interpretations of each statement and their codes were collated and checked back for a fit with others in the same category. Category headings were then collated into themes. Themes were then ordered from the general to the specific. Each of 14 themes had up to 15 sub-themes. Each subtheme had between one and 39 data items associated with it. In total, 613 data items were coded and 1563 quotes were analysed. The main themes were in Table 1.

Table 1. Themes.

Beliefs about non-directivity Beliefs about directivity Being person centred Questions to meet the client’s needs Questions that enable the therapist to “Be” Questions relating to process issues Asking for both therapist and client Asking for the benefit of the client The therapist’s need to know Generally the way questions are asked Specifically the way questions are asked Questions often asked Questions used in integrating other approaches Questions for administrative purposes

The credibility of the analysis and subsequent findings was ensured by engagement, triangulation, member checks and progressive subjectivity. Thorough immersion in the data, and checking back with participants as to the accuracy of the analysis, validated assumptions. Triangulation of the results was achieved through the involvement of another PC therapist who was able to check assumptions and interpretations, however, the subjectivity contained in the analysis added to the richness of the data rather than substantially changing its meaning.

In order to add to the depth of the data on questioning in this study, a review was also undertaken of transcripts of Rogers interviews with Gloria, (Brodley & Lietaer, 2006a), Daniel, Reiko and Mrs G., (Brodley & Lietaer, 2006b), and the interview with “Dominic the Drunk” (Mearns & Cooper, 2005). All of these interviews demonstrate a PC approach and use questions. They were not analysed using thematic analysis, but reviewed for evidence of questioning.

Results

Questions in context

All participants were very clear that their practice was non-directive and further, that this idea was expressed as a belief, not just an approach, alluded to in this comment; “The client is potentially their own expert, and I would testify to that,” (Jo). Further, most participants were also clear that questions did not fit in a PC context citing unnecessary questions such as; those to collect background data; direct questions that were stopping the client’s flow; closed questions in general; and the direct “Have you got plans to kill yourself?” question. However, as participants began to consider the practical application of their belief in non-directivity, they all began to reflect on situations in which they did ask questions, for example in time-limited therapy. Gradually comments such as “Basic questions … are almost essential in every part of communication” (P) and “You couldn’t do it without questions,” (J) emerged.

Having been trained in PCT, participants felt that their training was “ … going to stay in the psyche,” (J) and “It’s like a foundation,” (J). The act of being congruent allowed participants to ask questions when they thought it was appropriate, and in addressing unconditional positive regard, a participant commented; “I realise questions are … a way of indicating that we are both in this,” (J). However, most participants viewed their use of questions in a more transpersonal sense. Another saw questions as musing, which demonstrated a deep connection, a complete empathic understanding. Participants also commented on reflecting back what they heard to check assumptions, which often came in the form of questions. These types of questions all reflected a typically PC philosophy and therapeutic approach.

The needs of the therapist and client for questions

Much consideration was given to focusing on the needs of the client in the therapeutic process and client’s needs were nearly always prioritised over the counsellor’s needs. Participants felt that clients often had needs which may benefit from specific questions such as; “I can think of a client that I challenge quite a lot and it was rewarding because in the end, I think he respected me for that,” (Jo). On a practical note, it was acknowledged that if the client’s safety was an issue, e.g.; “ … child protection policy, then yes, you’d ask a question,” (P). However, most participants also acknowledged their own needs in the therapeutic relationship seeing a bi-directional dynamic, and three participants described that they had become more courageous, more bullish or bolder in asking questions as their own personality and experiences had developed. One issue which had clearly been given some consideration over time was; “Is being curious person-centred?” with most concluding that it was acceptable to express “ … this question which is burning,” (M). Even so, the curiosity question was often presented in client-centred terms, so that, for example; “The client then knew that I was wanting something from them to help me with my process,” (M). In addition, it was acknowledged that this process could go too far; one participant felt the need for restraint and to “ … reign yourself in a little bit, – I love to ask questions,” (K).

Client process issues could be highlighted by questions, or an implied question such as “Something keeps happening here – I get very close and right alongside you and then suddenly I find that you’re somewhere else and I’m a bit lost,” (M). Further, participants brought attention to the need to be aware of their own personal processes in questions saying for example; “ … the questions are around me knowing what’s the client’s, and what’s my … baggage?” (D). Consideration was also given to the effect of questions on the power balance in the relationship; One comment was “I think they do like the idea that someone … is sort of giving them a sense of direction in the counselling process,” (Jo).

Questions were often asked for the sake of both counsellor and client. For example, a situation could be clarified by saying; “I am feeling uncomfortable, are you feeling the same?” or “I am feeling … stuck. Is this how it is for you?” (J). Another participant gave this example; “There seems to be a bit missing there … so I guess that’s where the clarifying questions come from,” (M). One therapist suggested that in order to get the whole picture and finally to gain agreement; “I would make a statement and then ask how they feel about it” (J). Consensus seemed to be an issue at times, so it was necessary to establish whether both counsellor and client were together in the process.

More often than not, however, questions were asked solely for the benefit of the client, often to help to clarify a situation from their point of view. “Sometimes the client needs help to describe their situation – or the pit” (D), or to make connections. An important issue also addressed was that of enabling the client to focus on their feelings, so participants might just say; “Anger?”, “Resentment?” (Jo), or “What bodily reactions did you have to that confrontation?” (P). Sometimes long silences could be broken by a question; “If … they’ve not said a word, I’ve got to ask a question,” (P), or encouragement to move on could be offered. Avoidance and blind spots were issues also dealt with through questions and a related area of stuckness was identified, where questions may get the ball rolling. Questions here often emerged as a tentative challenge, or occasionally a direct one such as “Why are you telling me all this, what is underneath it?” (J) and most participants felt that contradictions in the client’s story were worthy of the challenge. Specifically, questions were also used to develop the client’s internal locus of evaluation.

Questions were used occasionally for therapist purposes rather than that of the client, for background information and checking understanding for example. In some situations, the counsellors’ needs for information took precedence, although these questions could be very tentative such as “You look sad,” or “Have I got it right?” (J). Occasionally, questions were used to monitor processes, for example, one participant recounted saying “Hang on a minute now, are we dashing past this?” (M). Further, many questions were asked for administrative purposes such as completing assessments.

Styles of questioning

In terms of questioning style, one participant felt that it was important not to ask lots of questions in the first session, although another said that was exactly what they would do in the first session. Most participants, however, were concerned not to seem to interrogate the client by asking too many direct questions, particularly early on in the relationship. Questions were used when time-limited counselling was coming to an end, with a view to checking out where the client was. It was also considered necessary to avoid any judgments in the asking of questions and one element that nearly all participants agreed on was that questions were largely spontaneous, and that they were derived from the here and now experiencing the client rather than a pre-prepared stock of useful questions.

Another area of agreement for all participants was that questions should be asked with sensitivity to the client’s needs and consideration for whether it was a safe question. Additionally, participants felt that questions worked better when they were more tentative and specific for the client. Further, sometimes questions would “ … word for word reflect with a questioning tone,” (M), or just be an “ummmm?” or a pause. Occasionally questions were asked in the form of statements, for example; “I notice you have not answered the question even though I have tried to ask it three times in different ways,” (K). The question “why?” was discussed at length, with all participants recognising its inherent difficulties, although most agreed that they did not need to be too reticent in using it. Lots of specific questions emerged from the discussions, many of which were used time and again such as; “Is that an accurate description of your words?” (J); “If things could be different how would you like them to be?”(Jo); and “Really?” tested congruence (K). “Are you at risk here?” (K) was a softer suicide question and “What can you take away from this?” (K) was regarded as helpful towards the end of counselling.

Rogers’ use of questions

In Rogers’ interview with Gloria, a question which he readily asks is one which clarifies meaning to ensure that he is empathically attuned to the client, for example, “You realise that you are acting from guilt, is that it?” Later he uses a question that is typical of his intent be on the same page as the client; “Is that catching it or not?” he says. More challenging is a question later which asks; “It seems to me that perhaps the person you are not being fully honest with is you?” Clearly, Rogers has established that his relationship with this client is stable enough to be able to be this directive. Rogers also demonstrates another use of questioning which is to turn back a client’s question, so he asks “What is it you wish I would say to you?” And finally, he demonstrates his classic approach which is to focus on the client’s feelings, also through a statement/question; “Mhm, that really does touch you, doesn't it?”

In Rogers’ conversation with Daniel, he explains afterwards that there is “ … always the question, 'Am I right in sensing your world?'" So it is that – it's that double feeling of trying to be in the client's world, and also asking, “Am I really in your world?” Alternatively, Rogers’ conversation with Reiko demonstrates that sometimes he feels the need, for example, to move a client on with a question; “Can you say what some of the sharpest of those value differences are?” He then shows that sometimes he needs to clarify for his own purposes; “Does he have to take orders from you, or do you have to take orders from him?” The interview with Mrs G. demonstrates well the use of statements that are a question; “ … it looks like you’re saying, 'It isn't possible.'” This is a method used regularly by Rogers to check understanding. He also explains post-interview that he has a strong need to question the client; “I’ve got to find out, am I really there, where you are?”

Mearns’ use of questions

Finally, in Mearns’ interview with Dominic, he asks “Do you want to go or do you want to stay?” – a direct challenge which was asked in order “ … to centre the decision making process in the client”. Later, after a long silence Mearns asks directly “Are you stuck?” – a question to move things on. Dominic then describes the characters in a film and Mearns follows by saying “And you … what about you?” Here Mearns redirects the flow with a question and invites Dominic “ … to go back into his experiencing,” rather than continue with narrative. There is also a demonstration of the use of the direct “why?” question; “It is difficult to listen to that” says Dominic “Why is that, Dom?” asks Mearns. And later, he is equally direct and challenging; “Where are you with this right now?” Mearns justifies this challenge by saying that “Dominic … immediately moves to what may be the most important sentence of his life.”

Discussion

Is questioning acceptable in a PC approach?

Client-centred therapy was defined originally by Rogers (2003) as non-directive, but this group of therapists described directive questioning to be a significant part of their PC approach. There is increasing support for directivity in PCT in the literature; even Rogers suggested (in Kirschenbaum, 2012), that you don’t need to be 100% person-centred to be person-centred. Contemporary perspectives on PCT allow for a more directive approach (e.g. Cooper & McLeod, 2010) and, as Kahn notes, (2002, p. 93), the best approach to PCT is one you develop for yourself based on your way of being in the relationship. Further, it was interesting to note that the participants began to question whether it is possible to engage in therapeutic dialogue without questions and these views on the inevitability or necessity of directivity in PCT are also supported in the literature, (e.g. Parloff et al., 1978; Patterson, 1980; Sachse, 2004). In fact a study of Rogers’ responses in his own demonstrations of PCT reveal; an extensive use of questions about factual or situational matters; diagnostic questions about feelings; questions intended to check the client’s experiencing; and open exploratory questions (Lietaer & Gundrum, 2018).

The basis of PC questioning

Although questions were acknowledged as a directive by the participants, they were keen to assert that Rogers (2003) core conditions were generally the driver for questions asked. Questions that emerged were therefore on the whole, facilitative of an empathic, accepting and congruent relationship. Firstly, in terms of empathy, although Schmid (2001) regards a non-directive attitude as fundamental, Buber (1970) argues for more direct contact to be made in order to share fully in the “I-thou” experience (p. 63). Wilkins (2015) for example, suggests this process of empathising would use clarifying questions that get to the bottom of feelings experienced by the client in order to sense how it is to be the client at that moment. Further, Thorne (2007) has found PCT littered with questions in order to demonstrate empathy, and Bohart et al. (2002) point out that empathy necessitates the use of different kinds of interventions, such as questions. Secondly, there was a debate on whether the therapist’s need to know information could be described as being congruent, or rather inappropriately curious. However, Velasquez and Montiel (2018) note that Rogers demonstrates congruence by continually asking tentative questions. Thirdly, although unconditional positive regard for the client was considered important by the participants, they considered that challenging client comments or assumptions would not violate that particular core condition. Kahn (2012) agrees, suggesting that sometimes in being “up to other things,” the PC therapist may confront a particular client, as long as an attitude of non-directivity is still in place.

Questioning to deepen the relationship

What seemed to be driving the participant’s view that questioning could be appropriate, was the potential for it to deepen the relational nature of therapy. In order for that to happen, there necessitated a shift from passive participant to active agent where both had needs in terms of personal processes. As such, questions were not only allowable, but in fact necessary in order that the counsellor could truly be with the client (Schmid, 2001, p. 16). Therapy at relational depth (Mearns & Cooper, 2005) is a more recent development of PCT, and one participant’s comment about “floating together” alluded to this process. This relational depth was facilitated sometimes by musing, sometimes by checking assumptions, and sometimes by responding to Rogers’ idea of an altered state of consciousness. For example, in a study of client’s experience of relational depth in PCT, Knox (2008) reports that nearly all felt their therapist was inviting them to relate at a deeper level, and through that, felt held or supported.

The need for questions

Despite explaining their adherence to PC principles, the therapists also indicated that they asked many questions for their own purposes. For example, some were just too curious to stop themselves enquiring, and others wanted to check their understanding. Questions from the therapist’s frame of reference are considered appropriate in PCT for example by Rennie (1998) who suggests that questions in order to assess the client at the start of therapy may be important. Finke (2018) also discusses the need to assess for example if the client would benefit from therapy, or if the client might be suicidal. Further, the participants considered that questions may help them in terms of time efficiency, to move things on and focus processes. Whilst Rogers had the luxury of unlimited sessions, contemporary PC practitioners feel the pressure of time (Author, 2020). As Feltham (2010) suggests, the traditional perspective of relying on clients to accept themselves over the course of time opens the process up to time wasting and inefficiency. Accordingly, Cepeda and Davenport (2006) suggest an integration of PCT with solution-focused brief therapy in order to focus processes. Solution-focused therapy makes good use of questioning (De Shazer & Dolan, 2012) and in fact the miracle question described in this approach was mentioned by two of the participants, and alluded to by one to focus on client goals.

The participants considered that client’s processing is not always transparent, and questions were often used to shed light on the client’s thinking or experiencing. Cheung (2014) agrees that questions should be used in order to facilitate the therapeutic process. This type of discourse is based on a collaborative relationship in contemporary approaches (Anderson, 2001) where the questions are not intended to direct, but to invite, sustain and facilitate dialogue. This dialogic perspective on PCT is described for example, by Schmid (2013) and Mearns and Cooper (2005). In this approach, open-ended questions enable the client to clarify their thinking, to draw on the depth of their experience, to engage in a different way of processing (Rennie, 1998). Questions asked by participants seemed occasionally to be for the sole benefit of the client, usually for clarification purposes. Alternatively, connections were made, or blind spots were revealed, but generally, questions were asked to focus on effective experiencing. For example, Rogers’ questions such as “Where in your body is this feeling?” aimed at focusing on inner experiencing (Kirschenbaum, 2012, p. 25). Occasionally, clients were also moved on from their stuckness. Mearns (2003, p. 88), however, regards it as a naïve response when during a period of apparent stuckness not attributed to self-concept change processes, the counsellor begins to try to move the client on.

How to ask questions

In terms of the way that participants asked questions, they considered that their spontaneous enquiries in the moment aimed at adding to a deepening therapeutic relationship, allowing them to “be with” the client. Mearns and Cooper (2005) also reflect on “ … meeting in a more spontaneous and less patterned fashion,” (p. 59). Sensitivity in the asking of questions was therefore an issue touched on by the majority of participants. As Mearns and Cooper suggest (2005, p. 126), the intent is not “to force entry into the client's personal realm; in other words, genuinely respecting the client's defences and acknowledging the intelligibility behind them”. Specifically, the participants, therefore, suggested avoiding judgements by questioning tentatively or using softer terminology that encouraged a response. For example, Wilkins (2015, p. 191) explains the benefit of a tentatively implied question such as “You are sad?” rather than a more direct question such as; “I think you are telling me that you are sad. Am I right?”

Whilst there is scant research on the use of questions in PCT, there is some research on the use of questions in other therapeutic approaches (e.g. Bishop & Fish, 1999; Braun et al., 2015; Brown, 1997). In reviewing outcome research on questioning, Cooper (2008) suggests that clients generally do not rate questions as helpful therapist responses. However, they are still seen as more helpful than hindering. Closed questions, although likely to engender a feeling of being challenged, do lead to a deepening of experiencing. Further, whilst questions can be a helpful technique they should not be overused, and the results can be improved on the basis of collaboration (Hill et al., 1988). It does, however, remain unclear whether or not research on questioning in more directive methodologies is applicable to PCT.

Limitations

It is accepted that the results of this study were skewed in a number of ways since the researcher is a member of the population under scrutiny, who uses the technique being researched. For example, the questions asked in the interviews implied that questions were probably already in use by the therapists. Further, since the interviews were semi-structured, the discussion did not follow a protocol but enabled the researcher to develop self-defined topics of interest in the moment. No pre-existing template was used in the coding process, so the themes that were derived were also researcher generated. Braun and Clarke (2006) consider that biases should be coveted, allowing for wisdom to be brought to the thematic analysis process. However, there is no doubt that confirmation bias could have had an effect on the research process.

Further limitations to the study include the lack of certainty as to whether therapists’ theories in use matched their espoused views, particularly since the therapists contradicted themselves on the issue of directivity. There were not enough participants for true rigour in this research process, nor enough depth in the interviews. The settings were all very similar, with similar types of counsellors in respect of their cultural backgrounds, beliefs and educational levels. In terms of generalisability, six is a small sample, however, analytic generalisation is possible if not a statistical generalisation. Stake’s notion (Sparkes, 2014, p. 173) of naturalistic generalisation is also helpful here in that the description of the participants’ experiences can be reflected upon by the reader and connections made to their own practice.

Further research

There is a case for further research on this topic if only to validate these results through a larger sample. A qualitative piece would certainly be possible using the results as a basis for more structured questions. Ultimately, a model of questioning applicable to PCT may be a useful way to describe an element of the therapist’s way of being and may even contribute to greater efficiencies of time in the approach.

Conclusion

Given that contemporary PCT now comprises a “fuzzy set” of members who integrate various techniques and procedures into their practice (Bohart, 2012), the question is less to do with whether questions should be used in PCT, but how to make the best use of them. The participants expressed a wide range of views on their use of questions, and indeed, some began to realise that most of their work involved the use of questions. One even suggested that “Actually, it’s all questions isn’t it?” We therefore seem to be just beginning to understand the benefits that there may be in using questions as part of a PC approach.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Susan Renger

Susan Renger is an independent practitioner providing counselling services with learning theory as a foundation. She has a background in person-centred counselling, management training and organisational learning consultancy. Her post-doctoral research interests are focused on learning facilitation in counselling and the concept of the fully-functioning individual.