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How do you use open-ended questions to elicit trauma narratives?

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Trauma is a complex and sensitive topic that can affect people in different ways. If you work as a counselor, therapist, or coach, you may encounter clients who have experienced trauma and need your help to cope and heal. One of the skills that can help you facilitate this process is motivational interviewing (MI), a collaborative and client-centered approach that aims to elicit and strengthen intrinsic motivation for change. In this article, you will learn how to use open-ended questions, one of the core techniques of MI, to elicit trauma narratives from your clients in a respectful and supportive way.

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1 What are trauma narratives?

Trauma narratives are personal stories that describe the events, thoughts, feelings, and reactions related to a traumatic experience. They can help clients process and make sense of what happened, reduce the emotional impact, and identify strengths and resources. However, trauma narratives can also be challenging and distressing to share, especially if the client feels ashamed, guilty, or fearful of being judged or retraumatized. Therefore, it is important to create a safe and trusting environment where the client can choose when and how to share their trauma narrative.

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Kit Hill, Ed.D.
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Two ways, of the many, you can elicit responses from trauma patients: Ask them what they're feeling about their story/take educated guess at the feelings and or ask them to narrate the event(s) in the hear and now.

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José Luis Vicente Rodrigo

Psicólogo social
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La pregunta abierta se hace para poder escudri?ar la narrativa del paciente y buscar la escena fundante del trauma... Y de esa forma poder empezar en abordaje terapéutico

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Dr. Joey (The Traveling Social Workers)? Pagano, DSW, LSW, CRS, FPS, Life Coach

?? 2024 Mental Health America, Pittsburgh Recovery Walk Advocate, NASW Emerging Leader, & PA Peer Support Coalition Award Winner?? | 2 X #1 Best-Seller & Pulitzer Contender ??? | Pioneer in SUD Education ??
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Using open-ended questions to elicit trauma narratives involves creating a safe, non-judgmental space for sharing. Questions should be gentle and inviting, like "Can you tell me about your experience?" or "How did that event make you feel?" Avoid leading or specific questions; instead, allow individuals to share their stories at their own pace. Encourage expression of thoughts and feelings without pressure. Active listening and empathetic responses are crucial to validate their experiences and encourage further sharing.

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2 Why use open-ended questions?

Open-ended questions are questions that cannot be answered with a simple yes or no, but require the client to elaborate and reflect on their own perspective. They are useful for eliciting trauma narratives because they allow the client to have more control and autonomy over the content and pace of the conversation. They also show interest and curiosity, without imposing your own assumptions or interpretations. Open-ended questions can help you explore the client's goals, values, beliefs, and ambivalence about change, as well as their coping strategies, challenges, and achievements.

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Tammara S.

Social Worker
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Therapy is a human- to-human interaction that should not be replaced with artificial intelligence. It is important to understand the difference between providing information and providing a human interaction process which is part of the therapeutic process.

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3 How to ask open-ended questions?

Asking open-ended questions is not just a matter of adding "how" or "what" to the beginning of a sentence. To ensure effective questioning, consider the timing, tone, and purpose of your questions. Speak with a gentle and empathic voice, follow the client's lead, and ask one question at a time. Utilize reflective listening to demonstrate understanding and validation. Avoid questions that imply a right or wrong answer or suggest what the client should do or feel. Instead, use open-ended questions to elicit specific details, emotions, meanings, and implications of the trauma narrative, as well as the client's readiness and willingness to change.

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Michelle Drapkin, PhD ABPP

Behavior Scientist ? Award-Winning Author ?Speaker ? Innovator ? Trainer ? Board-Certified Psychologist
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I always think of open-ended questions as "open-minded" questions. You have an open mind about how someone is going to answer the questions. "How was your day?" is more open-minded than "Did you do well on the test?" You have an open mind of how someone can answer the first question - can be about the test or any number of things. The second closed question limits the scope. Think about how to leverage this in your work with trauma.

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4 What are some examples of open-ended questions?

Open-ended questions can be used to elicit trauma narratives from clients, depending on the stage and goal of the conversation. To build rapport and trust, you could ask what brought them to the session and what they hope to get out of it, as well as what makes them happy. To assess the impact and severity of the trauma, inquire about how it has affected their life, what challenges they face, and how they cope with stress or pain. Exploring their perspective and meaning can be done by asking what this experience means to them, how they see themselves as a result, and what beliefs or values guide them. Additionally, identifying strengths and resources can be done by asking about skills or qualities that help them deal with this, people they can rely on for support, and any positive things that have come out of this experience. Lastly, to enhance motivation and confidence for change, ask about reasons they want to change or heal from this, how their life would be different if they make this change, and what steps they are willing to take to achieve it.

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Debbie P.

Certified Spirituality and Addiction Recovery Coach, Reiki Master, Reiki Space Clearing Practitioner, Animal Reiki Master
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After asking an open ended question, LISTEN!!! You may be the very first person this individual opened up to. When someone knows you are truly listening to them, that’s when the foundation for trusting begins.

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5 What are some potential benefits and risks of using open-ended questions?

Using open-ended questions can have several benefits for both you and your client, such as establishing a rapport and understanding their unique experience and perspective of the trauma. It can also encourage your client to express and explore their emotions and thoughts, as well as foster their intrinsic motivation and confidence for change. On the other hand, using open-ended questions can also have some potential risks or challenges, such as triggering or exacerbating emotional distress or trauma symptoms. Additionally, it can create confusion or frustration if the questions are too vague or ambiguous, lead to resistance or defensiveness if they are perceived as intrusive or judgmental, or overwhelm your client if they are too many or too complex. Therefore, it is important to monitor your client's reactions and responses, adjust your questions accordingly, balance your questions with other MI techniques, and be aware of your own reactions and biases.

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Kerry Arnold

Assistant Professor at Community College of Philadelphia
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I've seen a benefit to using open-ended questions, particularly when a meaningful reflection statement (also a key element to evoke exploration in Motivational Interviewing) is used as a bridge to pose the question. For example: "I am hearing from you that any kind of interaction in which an authoritative tone is used can be very activating for you" (reflection) - bridge - "What are you aware that happens within you when you hear an authoritative tone? Can you describe the sensations?"

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Debbie P.

Certified Spirituality and Addiction Recovery Coach, Reiki Master, Reiki Space Clearing Practitioner, Animal Reiki Master
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Never forget when you are monitoring their reactions and responses, they are monitoring yours. Be very aware of your biases and prepare yourself to be non-judgmental no matter what they might share with you. If they ask you a question and you are unsure of the answer, be honest with them. If you try to make things up, they will see right through you.

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6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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How do you use open-ended questions to elicit trauma narratives?

1

2

3

4

5

6

1 What are trauma narratives?

2 Why use open-ended questions?

3 How to ask open-ended questions?

4 What are some examples of open-ended questions?

5 What are some potential benefits and risks of using open-ended questions?

6 Here’s what else to consider

Motivational Interviewing

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How do you use open-ended questions to elicit trauma narratives?

1

2

3

4

5

6

1 What are trauma narratives?

2 Why use open-ended questions?

3 How to ask open-ended questions?

4 What are some examples of open-ended questions?

5 What are some potential benefits and risks of using open-ended questions?

6 Here’s what else to consider

Motivational Interviewing

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