Questions

This week's reading about Questions was quite thought provoking and related greatly to the bulk of my work at Samaritan Inns.  One of my responsibilities at the organization is to complete the assessment paperwork with the client.  Although there is a form, there are no given questions--simply topic areas and answer spaces.  I have found that open-ended, but specific questions are the most effective at eliciting the information necessary to complete the form.  

In the Questions reading, the idea that people structure experience in a narrative fashion was particularly salient to my assessment work.  Hypothetically, take two clients with a similar substance abuse, treatment, medical, and psych history and ask them the same group of questions.  Their answers will vary in how detailed the narratives are and how much context they feel is necessary for the response.  For some clients, they are simply unaccustomed to filling out paperwork on their own lives and have a more conversational style.  Others, contrastingly, give rigid, factual responses with little embellishment.  In my experience, the client's personal history, especially prison time and psychiatric diagnosis, impacts their answering style.  Those who have been institutionalized provide simple answers, as they are accustomed to doing.  Those with psychiatric diagnoses will often provide more context for their responses, as often times these events are symptomatic of and/or contributory to their illness.  

The degree to which a client provides a detailed, narrative story is also emblematic of their emotional connection with the answer.  Some clients may feel ashamed or bitter about their legal history.  That emotional content necessitates a desire to have the clinician understand and validate those feelings.  These are often the most complicated answers.

Speaking to another point in the Questions article, the disparity in power between client and clinician often impacts the question-answer dialectic.  Last week, I had a client ask me, when prompted about his family, why I needed to know this information.  Often times, clients at my placements are chided for their presumptuousness.  However, his question was entirely valid, and I responded that it helped us to get a sense of his support network for his recovery.  From his reaction, I gathered that this response made sense to him and the rest of the assessment continued unabated.  

Finally, although this does not relate to my field placement, I actually used a "circular question" with a visiting friend who is undergoing psychiatric treatment.  We were speaking idly in the car while driving to my house, and I spoke of how "what others envy in us" is an interesting question.  Breaking the back-and-forth, he remarked that he had never thought about that before.  Since we're on an equal playing field, as opposed to a client-clinician relationship, we both sat back and pondered it for a moment--exploring that idea privately.