Fresh Views

Doing things differently: Using solution focused questions to build a therapeutic alliance


Tami’s photos from the Chihuly glass sculptures exhibit at the Biltmore Estate in Asheville, NC. She did things differently by not only viewing the exhibit in the daylight, but also after dark, and got an entirely different perspective.

Doing things differently leads to something exceptional. – Anonymous

Our blog last week focused on being a human first.  There was so much information in that one blog post that we decided to highlight and reinforce a few concepts today. So here we go!

The strength in a therapeutic alliance

As you may know, we strongly believe in the concept of a “therapeutic alliance” (which you may also know as the “helping alliance” or the “working alliance”). This alliance refers to the relationship between a healthcare professional and the person with diabetes by which they engage with each other to bring about beneficial change for that person with diabetes. This relationship is a most important component.

The power of language

It’s near to impossible to create those connections and build that alliance without focusing on language. Language and word choice is one of the most powerful choices we have. Words can demonstrate respect, empowerment and support or words can shame and blame. Respecting the expertise and experience of the person living with diabetes is essential to develop a strong therapeutic alliance.

Focusing on solutions, not problems

You also probably know that we are using solutions focused brief therapy (SFBT) and coaching in our work. SFBT is a questioning approach with conversation focusing on the client’s vision and how he/she identifies potential solutions. The questions asked during the interaction focus on a desired future state, and on what is already working well for that individual in the present. We acknowledge that the client has all the skills necessary to achieve their goals. As we mentioned last week, our goal, through incorporating principles of SFBT and coaching in diabetes care and education, is to change the conversation, the interaction and the experience of the diabetes community to improve health.

10 questions practitioners can use to build a therapeutic alliance

If you are a healthcare practitioner, we want to share 10 questions that you might find useful when engaging in discussions with patients or clients to acknowledge and build the therapeutic alliance. These questions reinforce the human side of both parties. They demonstrate that you care about the person sitting with you and that the relationship between you is important. Moreso, the word choices and body language during the interaction can go a long way towards creating a relationship of mutual respect.

  1. Thank you for coming in. Tell me what’s been going on. What can I help you with today?
  2. What do you wish to achieve or learn by the end of this session so that you can say you’re glad that you were here?
  3. What is the best way for me to work with you? (For example, do you prefer talking on the phone or text messages?)
  4. So that I can learn more about you, what do you consider your assets and strengths?
  5. Is there anything else you’d like to share that I should know?
  6. When you are at your best, what does that look like? How is that different from the way things are now?
  7. How can you do more of what is making things go well?
  8. If we created a plan, what would you consider a start to your being on the right track? And what else?
  9. What can you take from this session that can help you in the coming weeks?
  10. What will you be doing differently after this visit?

Here are 3 additional questions that can be used to glean insight and feedback on the interaction:

  1. What feedback would you like to give me about today’s session?
  2. On a scale of 0-10, to what extent did you feel heard, understood, and respected during this session? 0 being you did not feel heard, understood or respected at all.
  3. On a scale of 0-10, to what extent did we talk about and work on the things that are important to you during this session? 0 being not at all.

If you try incorporating some of these questions, we’d love to hear from you about your experiences and if you felt differently during your client visits. We leave you with 3 things to consider:  

  • Do you feel more present and “conscious” during the visit?
  • Do you feel like a “human” first and a practitioner second?
  • Do you notice that your clients are achieving their goals, and most importantly, are they feeling more confident in their ability to live well while managing their diabetes?

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