Originally published November 15, 2016. Updated October 20, 2022.

It's natural to sometimes get stuck in a rut with specific elements of therapy structure, such as what you use for an opening question.

I have a mentor that views every interaction with a client as part of the therapeutic relationship, and therefore, he interacts intentionally with his clients always, choosing his language and messages carefully based on their therapeutic value.

We don't all view our relationships with our clients in the same way, which means this type of scrutiny may not seem necessary to all of us; however, there is merit in evaluating the details of our sessions in order to become aware of habits that may not be yielding the results we desire.

For example, it’s common for opening questions to become casual greetings rather than relationally impactful interactions between therapist and client. Purposeful opening questions are the topic of this post.

To therapists I know, I recently posed the question, “What is your favorite question for opening a session?” A few examples on this list came from members of the group; the other questions are ones that I’ve used, or heard others use, in my years of practice and supervision. The following questions fall into three categories: goal-oriented, relationship-oriented, and evaluation-oriented.

1 | Goal-oriented opening questions

What are your best hopes for our talk today? (solution oriented)
What would you like to be different when you walk out of here today? (change oriented)
What is your main concern today? (problem oriented)

These questions spotlight an area of focus for the client that, when identified, will help the therapist have a sense of the clients' goal. In this way, the therapist begins the session by setting a specific topic (or goal) for the therapeutic conversation. In addition, each goal-oriented opening question assists clients in finding a subject for which they are customers.

2 | Relationship-oriented opening questions

Whose idea was it for you to be here today? (for an initial session)
Who is with you in this room today (figuratively speaking)?

With these questions, the therapist immediately invites the client's relational realities into the therapy room, and the therapeutic conversation, by addressing the relational influences that brought the client to therapy, as well as those that are significant for the client.

3 | Evaluation-oriented opening questions

So, what's been going well? (solution-oriented)
What is different today from the last time you were here? (change-oriented)
What, from last session, impacted you this week? (change-oriented)

Beginning the session with these questions allows the therapist to evaluate the clients' experience, including their perspectives on their lives and relational interactions (1), their observations of change between sessions (2), and their experiences of and relationship to the therapeutic process (3). All evaluation-oriented questions provide practical information for the therapist regarding how therapy, and clients' sense of the value of therapy, are developing.

Summary

I've listed 7 questions for opening therapy sessions that are useful for providing focus to the therapist and the subsequent therapy session. These questions are a reminder of the power of questions to bring forth information that generates and maintains therapeutic structure and progress. (For more information on the topic of structure, see Napier and Whitaker's, The Family Crucible).

Let's Chat

Let me know in the comments below:

What's your favorite question for opening a therapy session?
Which of these questions will you try this week?

Grab the free printable summary of this blog post, with a list of questions. in the Free Resource Library. Sign up, below:

References

Nelson, T. S., Fleuridas, C., & Rosenthal, D. M. (1986). The evolution of circular questions: Training family therapists. Journal of Marital and Family Therapy, 12(2), 113-127.

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Recently, I offered a training on discernment counseling, a pre- couple therapy approach, developed by Bill Doherty and Steven Harris, for helping couples who are presenting with mixed agendas; that is, one partner wants to work on the relationship, or is “leaning in,” and one partner is not sure, or is “leaning out.”

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Terry works intensely, for at least one hour, with each couple throughout the two days. He also answers therapists’ questions two hours per day: during a lunch hour, and for one hour at the end of the couple therapy time.

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An email subscriber in her first field experience emailed me recently to request an article on tips for first-time counselors. In this post, I cover tips that I’ve learned as a therapist and supervisor, as well as those offered to brand- new therapists, by members of the Get Refreshed Facebook Group.

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Dr. Anna Lynn Schooley, professor and family therapist, joined me recently for a conversation about therapy as a craft. AnnaLynn is a professor, clinical supervisor, licensed therapist in mental health and marriage and family therapy. She identifies as a family therapist; as a result, our chat leans toward a systemic view of therapy and clients.

Recently, I have been hearing more and more that master therapists view therapy as a conversational craft. Bill Doherty mentioned it in a talk he gave in November of 2016, and Elliott Connie also emphasizes this point. I invited AnnaLynn to discuss this topic, because she is a master therapist and teacher.

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As a therapist who loves working with couples, I am always interested in ways to enhance my couples therapy skills. For this reason, I invited Elliott to explain the reasons why SFBT is his choice for working with clients, as well as how it creates a contrasting experience for couples that have a history in therapy.

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A systemic approach for guiding clients through addressing, managing, and living well with anxiety takes into consideration not only clients’ relationships with themselves and significant others, but also their relationships with anxiety.

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Understanding is the foundation of Bowen Family Systems Theory (BFST). Bowen (1985) believed that if clients could understand themselves as members of their FOOs and as created by their histories, they could begin and continue significant change.

In today’s post, I offer the next step in developing understanding: Creating your genogram. I explain how to create a basic genogram that you can expand as you continue your exploration.

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In today’s post, I offer several strategies for keeping up with paperwork, so that you can stay on track and avoid the stress of falling behind.

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In this post, I cover steps for disrupting an argument occurring in a couple therapy session. Intervention on the part of the therapist is necessary during some conflicts, because the arguments can cause further damage in the couple relationship. And, if therapists allow arguments to continue for too long, they can affect the couple’s sense of safety when in therapy.

The main goals of intervention in this case are to:

1 | Goal-oriented opening questions

What are your best hopes for our talk today? (solution oriented)

What would you like to be different when you walk out of here today? (change oriented)

What is your main concern today? (problem oriented)

2 | Relationship-oriented opening questions

Whose idea was it for you to be here today? (for an initial session)

Who is with you in this room today (figuratively speaking)?

3 | Evaluation-oriented opening questions

So, what's been going well? (solution-oriented)

What is different today from the last time you were here? (change-oriented)

What, from last session, impacted you this week? (change-oriented)

Summary

Let's Chat

References