Chapter 9: Asking Questions

I admittedly have a bit of OCD tendencies.  One of those is a need to make a list for everything.. a list for a list for a list.  Turns out I'm not so weird after all; I live in a world where there are instructions for asking questions!  Love it!

Curiosity is a natural part of being human and those of us entering the helping or case management field will certainly experience an abundance of stories that peak our desire to inquire.  While generally the questions are well intended, the client tends to see them as prying.  And while the proverbial cat remains alive and well, the client/helper relationship will likely have exhausted the final of it's nine lives.

When questions are important:
Just because questions can be detrimental to the helping relationship does not mean that they have to be.  At times, questions are an important and necessary part of the relationship.  Specifically, there are three times when questions must be asked:

1. To gather identifying information when you are opening a new case or chart on a person
2. To compile the necessary facts and information for assessment or referral purposes
3. To encourage the client to talk freely about the situation in order to better understand what aspects are the most important to the client.

Types of Questions
Generally, there are two types of questions:

• A Closed Question is one that only requires a single answer.  These questions are most beneficial when opening a new case on a client or when putting together information for either an assessment or a referral.  While closed questions do serve a purpose, i.e. ascertaining basic information, asking too many closed questions can make the client feel as thought the helper is merely searching for a solution rather than listening to the concerns.
• An Open Question is one that gives the client more opportunity and leeway to talk about what is important to them; it opens the door to discussion.  Open questions put the client at ease because it puts them in the drivers seat; they are in control of the conversation as well as the pace and direction the conversation takes.

Questions That Make The Client Feel Uncomfortable

Coming to an office for help is a scary experience no matter who you are or what kind of helping you are requesting.  Here are some questions to avoid increasing the level of discomfort felt by the client; why make matters worse?

1. Avoid the use of "why" questions
2. Avoid asking multiple questions
3. Do not change the subject
4. Do not imply there is only one answer to your question
5. Do not inflict your values on clients
6. Do not ask questions that make assumptions

A Few Pointers About Asking Open Questions

• Avoid asking questions in the same manner every time; instead, try interchanging different words from the figure below:

• Asking open questions takes time and practice; often times we are well intended but inadvertently close the question due to a poor choice in wording.  Words that "snap" the question close include the following and should be avoided whenever possible:
• how
• why
• what
• when
• where

According to others in the field...

With on going fiscal problems at the local, state and federal levels case management is an on-going, ever evolving concept.  This is clearly evidenced by the Oregon Department of Human Services policy update to the Family Services Manual in April 2012.  The move tends to be toward a brokering model for services in which actual meetings between case manager and client are limited as the client is taught how to be their own broker for resources.  I found it interesting that, at the top of its list of utilized skills for the most effective case manager, was asking open-ended questions.  The policy update herein gives a good overview of the inner workings in the case managers life and is a good read for gaining that real-life insight.

How much wood could a wood chuck chuck...
In so much of my research in looking for an article to accompany this blog, I came across stories about cutting number of visits, cutting funds, moving the client quickly toward self-determination actualization... How does it leave time for real, honest to goodness effective case management?  With time being limited, is there really time for open-ended questions any more?  They are deeply important to the process but it seems that with policy changes and fiscal pressures, the field is turning into more of a cattle corral with the case manager just herding them through the gate...