Socratic Questioning in Healthcare
Published: 19 November 2017
Published: 19 November 2017
Braun et al.’s (2015) study showed the ‘first empirical support for a relation of therapist use of Socratic questioning and symptom change in CT (cognitive therapy) for depression.’ This study (Braun et al. 2015) suggested that Socratic questioning could foresee symptom progress for the next session.
The University of Michigan (n. d.) describe the role of Socratic questioning in enhancing critical thinking skills such as reflection, assessment and evaluation of the assumptions behind the behaviours and thoughts of the self and others.
Their definition recognises R. W. Paul’s six types of Socratic questions. These are as follows:
(The University of Michigan n. d.; Changing Minds 2016)
Socrates, a Greek philosopher who lived from 470-399BC utilised questioning like those above to challenge the correctness of thoughts, and thereby assist his students (or in healthcare, your patient/client) to progress towards their goal.
Socrates’ questioning continued until a contradiction was made; thereby disproving the initial belief. The Law School of The University of Chicago (2017) highlight the usefulness of this Socratic Method in creating critical thinking skills, engagement in discussion, and reaching the core of the issue at hand.
Burrell (2014) expresses that critical thinking is a crucial nursing skill and definitely vital for nurse educators, therefore, the nursing curriculum incorporation of critical thinking skill development currently includes uses of reflection, concept maps and questioning best practice (Burrell 2014). It can, therefore, be considered that Socratic Method is another important critical thinking skill for nurses to learn, master, and continue to practice or keep-up-to-date with (Burrell 2014).
Farmer et al. (2017) suggest that therapists with high competence using the Socratic questioning method may have better results in helping clients to improve the severity of their PTSD (post-traumatic stress disorder). The narrative review by Clark & Egan (2015) convey that the Socratic Method is an important part of CBT (read: Cognitive Behavioural Therapy – Understanding CBT), an evidence-based treatment for various psychological conditions such as anxiety disorders.
Overholser (2015) recognises that Socratic questioning is compatible with positive psychology. This is due to the common goal of achieving a positive perspective of self and others. Additionally, the Socratic Method and positive psychology both share the objective of creating life-long, sustainable changes; as opposed to short-term ‘quick fixes’. Thirdly, positive psychology and Socratic questioning both involve a collaborative and exploratory approach to therapy. Overholser reveals that these common approaches for Socratic Method and positive psychology help to increase the relevance of treatment for the client.
Briggs (2014) of InformEd at Open Colleges puts forward that it is important not to ask questions that are: too vague, loaded, general, or closed.
Interestingly, Clark and Egan (2015) demonstrate concern that due to the time needed to effectively apply the Socratic Method, some clinicians may neglect its use when delivering CBT. They assert that there should be more empirical research outlining the benefits and cost-efficiency of the Socratic Method in CBT.
A later study by Heiniger, Clark and Egan (2017) supported the application of Socratic Method in CBT. This study indicated that clients preferred Socratic questioning over didactic therapy and that Socratic questioning was found to be ‘helpful, empathetic and autonomy supporting’.
Stoddard and O’Dell (2016) raise concern that some medical students or learners may be under the impression that Socratic questioning attempts to embarrass them. This is sometimes referred to as ‘pimping’ according to Stoddard and O’Dell (2016). However, Stoddard and O’Dell separate Socratic questioning from ‘pimping’ in the difference that ‘pimping’ questions aim to humiliate the learner, whereas Socratic questions aim to expand the learner’s knowledge and perspective.
Evidently the former (‘pimping’) appears unprofessional and unethical and should not be an approach used by health professionals or educators. Conversely, the latter, Socratic questioning, provides psychological safety in that it does not aim to threaten the dignity of the learner, but rather to probe their understanding in order to improve their education (Stoddard & O’Dell 2016).
Madeline Gilkes, CNS, RN, is a Fellow of the Australasian Society of Lifestyle Medicine. She focused her master of healthcare leadership research project on health coaching for long-term weight loss in obese adults. In recent years, Madeline has found a passion for preventative nursing, transitioning from leadership roles (CNS Gerontology & Education, Clinical Facilitator) in hospital settings to primary healthcare nursing. Madeline’s vision is to implement lifestyle medicine to prevent and treat chronic conditions. Her brief research proposal for her PhD application involves Lifestyle Medicine for Type 2 Diabetes Mellitus. Madeline is working towards Credentialled Diabetes Educator (CDE) status and primarily works in the role of Head of Nursing. Madeline’s philosophy focuses on using humanistic management, adult learning theories/evidence and self-efficacy theories and interventions to promote positive learning environments. In addition to her Master of Healthcare Leadership, Madeline has a Graduate Certificate in Diabetes Education & Management, Graduate Certificate in Adult & Vocational Education, Graduate Certificate of Aged Care Nursing, and a Bachelor of Nursing. See Educator Profile