Therapists on Questions in Therapy
Therapists on Questions in 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
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
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).
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.
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:
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.
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.
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?”
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).
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.
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.
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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