Staff Perspective: CPT and the Use of Socratic Dialogue/Questioning

Staff Perspective: CPT and the Use of Socratic Dialogue/Questioning

Socratic Dialogue is a well-known and often used method of assisting clients to identify potentially harmful thoughts and then challenge their thinking.  This approach is based on the practice of disciplined, thoughtful dialogue devised by Socrates and delivered between therapist and client.

Many therapists define Socratic Questioning as any process in which open questions are used. This narrow definition misses the nuances of SQ and in doing so, misses the opportunity to both assist and teach the client in moving toward a more evidence-based and effective alternative thought.

While there are numerous definitions of Socratic Dialogue, they all appear to agree on some primary characteristics, including:

  • Clarification of the thought
  • Critical examination of the thought
  • Exploration of the origin or source of the statement
  • Examination of the implications and consequences of the statement
  • Examination of  alternative views

Antisthenes, a pupil of Socrates, succinctly described Socratic questioning this way:  “the most useful piece of learning for the uses of life is to unlearn what is untrue.”

In Cognitive Processing Therapy, clinicians are trained to utilize Socratic Dialogue effectively as a form of guided discovery and collaborative empiricism.  In addition, it is important to underscore that CPT clinicians educate and teach clients how to use Socratic questioning to foster awareness and curiosity about what they are telling themselves. 

It is vitally important that clinicians ask themselves process questions to both understand the method more fully and to practice it to the most effective level.

These questions should include:  what is guided discovery?  How does it differ in tone and question content from gently challenging a client to change their maladaptive thought to an alternative thought?

Turning to Dr. Aaron Beck for succinct answers to these questions, he states:

“The role of the therapist is to ask questions in order to elicit the meaning, function, usefulness, and consequences of the patient's beliefs. It is up to the patient to ultimately decide whether to reject, modify, or maintain personal beliefs by weighing the emotional and behavioral consequences. It is never the intent of the therapist to exhort or cajole the patient to adopt a new set of beliefs. Unlike what many people think, cognitive therapy is not the substitution of negative beliefs by positive ones.” (italics added) (Beck, A., & Weishaar, M., p.299).

By using Socratic Questioning, therapists promote independent thinking in their clients and give them ownership of what they are learning. Guided Discovery allows the client to consider new perspectives and adaptations of thoughts and collaborate with the therapist in examining the evidence to support or reject their cognitions. Clinicians ask questions that allow the individual to begin to perceive contradictions, inconsistencies, and decide where more information is needed in order to formulate a reasonable conclusion. The ultimate goal is to restore harmony on a more solid foundation.

The therapists asks questions in order to understand the client’s perspective and point of view.  Gently challenging their thinking allows the client to form new conclusions and arrive at a new belief. As Dr. Christine Padesky states so well: “we can ask questions which either imply there is one truth the client is missing or which capture the excitement of true discovery.”

This is where lasting change occurs.

Laura Copland is the Senior PTSD Treatment Trainer for the Center for Deployment Psychology.

Beck, A.T., & Weishaar, M.E. (1989). Cognitive Therapy. In Corsini D., & Wedding, D. (EDs), Current Psychotherapies (pp. 285-317). IL: Peacock Club.
Padesky, C. (1993) Socratic Questioning: Changing Minds or Guiding Discovery? Keynote Address.