Summary - Questioning

Socratic for Therapists

Elements that contribute to the treatment:
Therapeutic alliance: focused on goals, tasks, and relationship.

Structure: initial, intermediate, and final phase.

Training approach: through concrete experience, reflective observation,

abstract conception and active experimentation.

Self-monitoring: it promotes awareness of how thoughts,

feelings and behaviors are interconnected and how to intervene.

Application of Socratic strategies:

Focus on the strongest thoughts and beliefs.

2. Understand the patient's perspective.

3. Collaborative curiosity.

4. Summarize the entire story to create new learnings.

Socratic questioning = deconstruction (analysis) + reconstruction (synthesis)

Summary - Socratic Questioning for Therapists 1

 Focusing on key content:
Hot thinking: is more likely to have the greatest impact, as it is
linked to anxiety and avoidance patterns. But it is not as entrenched as your
emotional meaning of belief.

First of all, it is necessary to break down a situation and validate each difficulty.

different parts of history

the most disturbing part and the interconnected thoughts

What is the most disturbing thought? What does it mean?

If-then statements: rules or attitudes. It has more to do with expectations,

processes or implications.

identify intermediate beliefs and link them to conceptualization

observe distortions and irrational beliefs

define the target collaboratively

create a universal definition for the target

Phenomenological understanding:
Understand the patient's argument of why the belief is true.

evaluate the evidence, facts, without distortions.

The process to understand the subjective and objective foundations of belief must
being collaborative and emotionally engaged.

Even though feelings are not facts, they must be validated.

Holistic understanding → emotional experience.

How does the client believe in the belief and what supports it?

events that led to development

facts that support

consistent evidence in context

effects of believing in belief

Summary - Socratic Questioning for Therapists 2

 time: before and after belief

how much do you believe more and/or less

behavioral response when the belief is activated (strategy)

compensatory)

Collaborative curiosity:
An authentic curiosity, to discover together with the patient all the biases of
belief.

Identify interpretations based on reality and the underlying assumptions.

verify the real and interpreted meaning

to assess how terrible the conclusion, the resulting behavior or the

scope/permanence of the conclusion

Metacognition and scientific reasoning to evaluate and test thoughts.

Scientific reasoning refers to a hypothesis testing mindset that

involves gathering and examining evidence to test hypotheses (Huhn, 2002,
Sandberg & McCullough, 2010).

Loose-wire strategy: there are gaps in the evidence - "How do you know?"

Strategy evidence not distorted: decompose the components of a

evidence, between appropriate to cognition and alternative explanations - "If the
If thought were not true, what would be the indicators of that? And can we
search for this evidence?

Strategy of temporality and permanence of your conclusions: for being

going through a current problem, the patient believes that it will last. It is necessary
Show him a general context of the situation - "Has it always been like this? Does it have to always be like this?"

like this?

Strategy contextualizing the evidence: the context can influence in

development and maintenance of the belief - 'How well the environment in which this
Does belief align with the overall framework?

Summary - Socratic Questioning for Therapists 3

 Strategy distortions and irrational beliefs: understand the distortions (without
disqualify the patient) and evaluate the elements of belief.

What are we not noticing?

pay attention to when the patient focuses only on what confirms their belief

look for exceptions when the patient generalizes

evaluate the impact and utility of belief

identify if the behavior (compensatory strategy) that the client has for
the cause of belief is shaping the environment to reinforce it

unknown evidence: it is necessary to experiment with new behaviors for

to have new evidence → when the patient avoids

refuting something by proving its opposite

Summary - Socratic Questioning for Therapists 4

 Choose a target → understand why the patient believes this →
expand the point of view together

Why summarize and synthesize?

Explain the emotional cost of the process → consolidate experiential learning.

Contract the attention filters that contribute to the maintenance of belief.

Verify if the patient understood an intervention.

Reconsolidate memory → activate painful elements and synthesize information

corrective.

Adjust new information to the scheme without distorting them

Engage the patient in new behaviors according to the new

perspectives, to extract behavioral implications.

Reinforce the use of skills.

Creation of a new belief:

compare with the initial belief

balance with the subject's reality

develop a targeted action plan with goals to gather evidence

for new belief

Decompose → understand → synthesize → create something new

Solving problems:
Understand and evaluate the situation well before selecting a target.

To foster understanding and curiosity, not to provide the discovery, but to guide the patient.

Develop realistic thoughts and not positive ones.

Do not be immediate in summarizing and synthesizing.

Explore the context.

Summary - Socratic Questioning for Therapists 5

 Contemplate the pre-consultation strategies - how to leverage success?

Records of thoughts, behavioral experiments and

Socratic questioning:
Through collaborative empiricism (therapist and patient together to discover the
It is possible to seek change.

New behaviors generate new perspectives and with that, it is possible to evaluate the
new beliefs.

Record of thoughts:

teaches the cognitive model

situation

understand the relationship between the components

cognitive change → emotional response, identify distortions, new

behaviors

after filling in the first columns it is necessary to understand the whole context
to identify the key contents

to gain a better understanding of thought

expand understanding with collaborative curiosity

summary and synthesis

assess the impact

Behavioral experiments:

testing a specific forecast

identify forecast

identify alternative forecasts - other characteristics

define the experiment question

design the experiment

list obstacles

conduct the experiment

Summary - Socratic Questioning for Therapists 6

 analyze the resources

take note of the conclusions

reassess the degree of belief in beliefs and alternatives

define an action plan based on the conclusions

Summary - Socratic Questioning for Therapists 7

Summary - Socratic Questioning for Therapists 8
 Recording thoughts → new perspective → new response
behavioral → test the new perspective or gather more evidence to
evaluate them

Working with core beliefs and schemas:

Summary - Socratic Questioning for Therapists 9

 Modal activation is when the belief is activated and the patient responds to it.
a certain way (emotionally, behaviorally...)

It is necessary to prepare the client before working on beliefs and schema, because it is a
emotionally difficult process, but the way is through.

Strategies during the sessions:

continuum helps to reduce the rigidity and extremism of beliefs.

the mental image serves as an induction of a more positive affect and combats
of the modal activation.

it is necessary to break the cycle that reinforces the belief through creation of
behaviors compatible with the new beliefs.

to endure suffering with skills that facilitate behavior

competent.

the empty chair technique provides an experience for change in

scheme with emotional engagement, fulfilling past needs.

the letter helps in the emotional and cognitive correction of a schema

maladaptive.

the rewriting of memories can be done to soften a memory or create

new images.

Strategies between sessions:

evidence registration

central belief A and B

reinforcement/self-reinforcement

changes in the environment that reinforce the new belief

abandon the old mode and use new response

creating a valued life with goals, objectives, values, and visions

Socratic strategies in Dialectical Behavior Therapy:

The emotional dysregulation of patients with borderline influences their thinking.
exaggerated. Furthermore, the invalidation/sensitivity complicates questioning.

Summary - Socratic Questioning for Therapists 10

 Socratic with these patients.

Cognitive techniques:

cognitive self-observation

fact-checking

myths about emotions

dialectical thought

chain analysis

Recording of thought in the dialectical method:

verify regulation

define proposal

identify oppositions

verify facts

curiosity

synthesis

consolidation of learning and connection with behavioral goals

Socratic strategies in Acceptance and Commitment Therapy:

Rules: compliance (social consequences), tracking (rules and contingencies)
direct) and amplification (creation of new consequences).

Six psychological processes of ACT:

acceptance: reduce escape and avoidance behavior of pain

defusion: distancing of thought and observation of the process of

to think

awareness in the present moment: do not focus on the past or the future

I as context: to show the patient that he is not yours

thought/emotion

values

Summary - Socratic Questioning for Therapists 11

 committed action: establish goals → behaviors to achieve
these goals → commitments to these behaviors

Socratic strategies for doctors and prescribers:

To not forget to take the medication - 'What can be useful to remind you
to take your medication?

Facilitate the replacement of the medication - 'What difficulty do you have that you maintain'
your constancy?

Chaotic agenda - "How does your routine influence your adherence to medication?"
How to improve this?

Difficult periods of life - "Can we create a strategy during this period?"

Side effects - "Do you have any idea what might be interfering with your
desire to take the medication? What are the pros and cons of the effects?
Misinformation - 'Where did you find that information? How confident are you in the source?'

High individual - "Has this happened before? What happened? How were they?
symptoms before starting?

Socratic strategies for teaching Socratic strategies:

Skills training:

concrete experience: description of the skill and justification for its use. The
Dramatizations are made between the supervisor and the supervisee.

abstract conceptualization → consolidation of learning

active experimentation

Key competencies:

identify the hot thoughts to intervene

understand the perspective of the subject

collaborative curiosity to find the non-confirmatory evidence

provide new learning with summary and synthesis

The autocratic method:

Summary - Socratic Questioning for Therapists 12

 Focusing: there are common types of thoughts related to emotions.
How do I define my thoughts? Is there a pattern in the way I think and feel?

Understanding: a phase of self-assessment, to understand yourself and the

target thought. Why do I believe this?

Curiosity:

perceived evidence: assess whether it is a fact, feeling, assumption, or distortion

known evidence: that does not support thought

unknown evidence: evidence that needs to be experienced

Summary and synthesis: integrating new learnings and behaviors, comparing

with the initial assumptions and experiences. In addition to solidifying the gains,
transforming cognitive change into new behaviors.

Summary - Socratic Questioning for Therapists 13