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Techniques for framing questions in conducting family meetings in palliative care

Published online by Cambridge University Press:  18 June 2009

Isabelle Dumont  and
David Kissane
Isabelle Dumont*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York
David Kissane
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York
*
Address correspondence and reprint requests to: Isabelle Dumont. E-mail: isab.dumont@gmail.com
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Abstract

Objective:

Family therapy has developed several approaches to framing questions within family meetings, but few of these techniques have been adapted for palliative care. We focus on the application of questioning techniques from systemic family therapy to palliative care. More specifically, we describe and give examples of the model of asking questions developed by Karl Tomm (1988) through its application in Family Focused Grief Therapy (FFGT), a preventive intervention delivered to high-risk families during palliative care and bereavement.

Methods:

First, the type of questions used across the course of therapy is explored based on the interventive questioning model. Then, a case example is provided to demonstrate the use and adaptation of this model in a palliative care setting.

Results:

At the beginning of therapy, the most frequent questions were linear and circular, moving around the family to build up a picture of events from everyone's perspective. As for the frequency of reflexive and strategic questions, these increased as the therapy progressed, bringing the family to new perspectives. The case example fleshes out the importance of each type of question, all of which have a proper place in the course of therapy.

Significance of results:

These illustrations highlight the value of having a model of questioning styles to guide the clinician when exploring palliative care issues, such as care provision, coping and grief, intimacy, and discussing death. This framework could be useful in guiding supervisors, trainees, and clinicians seeking to build skills and optimize their interventions in a palliative care setting.

Keywords

Questioning stylesSystemic family therapyFamily focused grief therapyPalliative care
Type
Original Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 2 , June 2009 , pp. 163 - 170
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

Beutler, L.E., Williams, R.E. & Wakefield, P.J. (1993). Obstacles to disseminating applied psychological science. Journal of Applied and Preventive Psychology, 2, 53–58.CrossRefGoogle Scholar
Couture, S.J. (2006). Transcending a differend: Studying therapeutic processes conversationally. Contemporary Family Therapy, 28, 285–302.CrossRefGoogle Scholar
Dozier, R.M., Hicks, M.W., Cornille, T.A., et al. (1998). The effect of Tomm's therapeutic questioning styles on therapeutic alliance: A clinical analog study. Family Process, 37, 189–200.CrossRefGoogle ScholarPubMed
Dumont, I., Dumont, S. & Mongeau, S. (2008). End-of-life care and the grieving process: Family caregivers who have experienced the loss of a terminal-phase cancer patient. Qualitative Health Research, 18, 1049–1061.CrossRefGoogle ScholarPubMed
Elliott, R. & James, E. (1989). Varieties of client experience in psychotherapy: An analysis of the literature. Clinical Psychology Review, 9, 443–468.CrossRefGoogle Scholar
Fleuridas, C., Nelson, T.S. & Rosenthal, D.M. (1986). The evolution of circular questions: Training family therapists. Journal of Marital and Family Therapy, 12, 113–127.CrossRefGoogle Scholar
Hill, C.E., et al. (1988). Development of a system for categorizing client reactions to therapist interventions. Journal of Counseling Psychology, 35, 27–36.CrossRefGoogle Scholar
Johnson, S. & Lebow, J. (2000). The “coming of age” of couple therapy: A decade review. Journal of Marital and Family Therapy, 26, 23–38.CrossRefGoogle Scholar
Kissane, D.W. & Bloch, S. (2003). Family Focused Grief Therapy: A Model of Family-Centred Care during Palliative Care and Bereavement. Buckingham, UK: Open University Press.CrossRefGoogle Scholar
Main, F.O., Boughner, S.R., Mims, G.A., et al. (2001). Rolling the dice: An experiential exercise for enhancing interventive questioning skill. The Family Journal, 9, 450–454.CrossRefGoogle Scholar
Penn, P. (1982). Circular questioning. Family Process, 21, 267–280.CrossRefGoogle ScholarPubMed
Pinsof, W.M. & Wynne, L.C. (2000). Toward progress research: Closing the gap between family therapy practice and research. Journal of Marital and Family Therapy, 26, 1–8.CrossRefGoogle Scholar
Robinson, W.D., Carroll, J.S. & Watson, W.L. (2005). Shared experience building around the family crucible of cancer. Families, Systems, & Health, 23, 131–147.CrossRefGoogle Scholar
Rolland, J.S. (1994). Families, Illness, & Disability: An Integrative Treatment Model. New York: Basic Books.Google Scholar
Ryan, D. & Carr, A. (2001). A study of the differential effects of Tomm's questioning styles on therapeutic alliance. Family Process, 49, 67–77.CrossRefGoogle Scholar
Selvini, M.P., Boscolo, L., Cecchin, G., et al. (1980). Hypothesizing—circularity—neutrality: Three guidelines for the conductor of the session. Family Process, 19, 3–12.CrossRefGoogle ScholarPubMed
Tomm, K. (1987 a). Interventive interviewing: Part I. Strategizing as a fourth guideline for the therapist. Family Process, 26, 3–13.CrossRefGoogle ScholarPubMed
Tomm, K. (1987 b). Interventive interviewing: Part II. Reflexive questioning as a means to enable self-healing. Family Process, 26, 167–183.CrossRefGoogle ScholarPubMed
Tomm, K. (1988). Interventive interviewing: Part III. Intending to ask lineal, circular, strategic, or reflexive questions. Family Process, 27, 1–15.CrossRefGoogle ScholarPubMed
Weeks, G.R. & Treat, S.R. (2001). Couples in Treatment: Techniques and Approaches for Effective Practice (2nd ed.). New York: Brunner Routledge.Google Scholar
White, M. & Epston, D. (1990). Narrative Means to Therapeutic Ends. New York: Norton.Google Scholar