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Therapists on Questions in Therapy

This document discusses therapists' views on the use of questions in person-centered therapy. It provides context on the non-directive approach of person-centered therapy and debates around directivity. The study interviewed 6 experienced person-centered therapists and analyzed therapy transcripts from Rogers and Mearns to understand therapists' perspectives on questioning. Key findings included that therapists ask questions to check understanding, clarify issues, challenge clients, enable processing, and out of curiosity. However, questions are generally used to represent the counselor's way of being and subtly facilitate the counseling relationship.

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0% found this document useful (0 votes)
87 views14 pages

Therapists on Questions in Therapy

This document discusses therapists' views on the use of questions in person-centered therapy. It provides context on the non-directive approach of person-centered therapy and debates around directivity. The study interviewed 6 experienced person-centered therapists and analyzed therapy transcripts from Rogers and Mearns to understand therapists' perspectives on questioning. Key findings included that therapists ask questions to check understanding, clarify issues, challenge clients, enable processing, and out of curiosity. However, questions are generally used to represent the counselor's way of being and subtly facilitate the counseling relationship.

Uploaded by

Norus Liza
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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British Journal of Guidance & Counselling

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/cbjg20

Therapists’ views on the use of questions in


person-centred therapy

Susan Renger

To cite this article: Susan Renger (2023) Therapists’ views on the use of questions in
person-centred therapy, British Journal of Guidance & Counselling, 51:2, 238-250, DOI:
10.1080/03069885.2021.1900536

To link to this article: https://doi.org/10.1080/03069885.2021.1900536

© 2021 The Author(s). Published by Informa


UK Limited, trading as Taylor & Francis
Group

Published online: 24 May 2021.

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https://www.tandfonline.com/action/journalInformation?journalCode=cbjg20
BRITISH JOURNAL OF GUIDANCE & COUNSELLING
2023, VOL. 51, NO. 2, 238–250
https://doi.org/10.1080/03069885.2021.1900536

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


therapy
Susan Renger
Faculty of Medicine and Health Sciences, Keele University, Keele, UK

ABSTRACT ARTICLE HISTORY


This study collated person-centred therapists’ views on their use of Received 14 February 2020
questions in person-centred counselling. It asked whether the therapists Revised 5 January 2021
considered that questions are useful and how they seek to implement Accepted 2 March 2021
them. Six experienced person-centred therapists were interviewed and
KEYWORDS
their comments analysed using Thematic Analysis. Therapy transcripts Person-centred therapy;
by Rogers and Mearns were also analysed to obtain examples of their questions; directivity;
questioning techniques. Results suggested that these person-centred therapeutic process;
therapists ask questions regularly for many reasons including; to check techniques
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.

This study seeks to understand the extent to which person-centred (PC) therapists consider question-
ing 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 contempor-
ary 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 coun-
sellor “Holds a coherent and developing set of attitudes deeply embedded in his personal organis-
ation” (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

CONTACT Susan Renger [email protected]


© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://
creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the
original work is properly cited, and is not altered, transformed, or built upon in any way.
BRITISH JOURNAL OF GUIDANCE & COUNSELLING 239

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 philosophi-
cal 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 collabora-
tively, 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 thera-
pist. 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); Dialogi-
cal 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 tech-
nique 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 ques-
tions, 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 writ-
ings 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
240 S. RENGER

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 direc-
tive 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 appro-
priate 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 Analy-
sis 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 ques-
tions 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 the-
ories, but also allow for questioning on what might actually occur and how it occurs, giving clarity to
BRITISH JOURNAL OF GUIDANCE & COUNSELLING 241

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 devel-
oping 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 thera-
pists. 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’ experi-
ence. 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 unin-
terrupted 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.
242 S. RENGER

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. Selec-
tive 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.
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 ques-
tions did not fit in a PC context citing unnecessary questions such as; those to collect background

Table 1. Themes.
1. Beliefs about non-directivity
2. Beliefs about directivity
3. Being person centred
4. Questions to meet the client’s needs
5. Questions that enable the therapist to “Be”
6. Questions relating to process issues
7. Asking for both therapist and client
8. Asking for the benefit of the client
9. The therapist’s need to know
10. Generally the way questions are asked
11. Specifically the way questions are asked
12. Questions often asked
13. Questions used in integrating other approaches
14. Questions for administrative purposes
BRITISH JOURNAL OF GUIDANCE & COUNSELLING 243

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 prac-
tical 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 ques-
tions,” (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 assump-
tions, 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 chal-
lenge 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 “Some-
thing 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 state-
ment 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
244 S. RENGER

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 encourage-
ment 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 back-
ground 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 con-
sidered 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, some-
times 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?”
BRITISH JOURNAL OF GUIDANCE & COUNSELLING 245

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 some-
times 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 perspec-
tives 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 relation-
ship. Firstly, in terms of empathy, although Schmid (2001) regards a non-directive attitude as funda-
mental, 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 clar-
ifying questions that get to the bottom of feelings experienced by the client in order to sense how it is
246 S. RENGER

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 inappropri-
ately 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 com-
ments 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 poten-
tial 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 check-
ing 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 prac-
titioners 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 question-
ing (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 col-
laborative 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
BRITISH JOURNAL OF GUIDANCE & COUNSELLING 247

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 enqui-
ries 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 encour-
aged 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 gen-
erated. 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
248 S. RENGER

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 tech-
niques and procedures into their practice (Bohart, 2012), the question is less to do with whether ques-
tions 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 there-
fore 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).

Notes on contributor
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.

ORCID
Susan Renger http://orcid.org/0000-0001-5805-785X

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