Socratic Questioning & CBT

What is Socratic questioning?

Socratic questioning is named after one of history's most influential philosophers, Socrates. It is based on how he asked questions that made people clarify or question their thoughts, perceptions, beliefs, assumptions, preconceived notions, and ideas.

Socratic questioning involves asking numerous open-ended questions about a topic; when Socrates did it, he would assume an ignorant mindset to compel the other person into thinking about answers. He would also use follow-up questions to make the other person contrast and compare their own beliefs and ideas.

This technique aims to help people gain a deeper understanding of themselves and unpack what they believe in until no more questions can be asked, all possible perspectives have been considered, and all bases have been covered. Asking them questions based on their own answers is a good way to discover nuances they might not have considered before, leading to better reasoning, decision-making, and problem-solving skills.

Socratic questioning is an effective way of determining whether a person truly understands what they think they know. If not, it aims to help them understand what they need to know to improve their knowledge and understanding.

Why is Socratic Questioning used in cognitive behavioral therapy?

Socratic Questioning is an integral part of cognitive behavioral therapy (CBT) because of its ability to unravel already-set beliefs. We already know that Socratic Questioning can help people develop critical thinking skills, but here are other things that Socratic Questioning can help with:

1. It can help CBT patients develop the attitude needed to challenge their negative thoughts and beliefs.
2. Persons with negative thoughts and beliefs may develop depression and anxiety over time. CBT employs the Socratic Method to help them identify these negative thoughts and beliefs, to be more specific about them and why they have these thoughts and beliefs, and to help them discover more positive ways of thinking to challenge these negative thoughts and beliefs.
3. Changing beliefs is harder if done externally.
4. If you tell someone what they should think, chances are they'll just ignore you; worst case scenario is that you'll get in a fight. Both of these outcomes are negative in CBT. On the other hand, with the Socratic questioning method, the patient is questioning their own thoughts because all of the questions you provide are mostly just follow-up questions to their answers; you are only posing questions out of genuine curiosity, questions that the patient may not have asked themselves yet.
5. It can lead to the development of coping strategies.
6. Socratic questioning is more about asking questions than giving answers, so it helps the client learn to find solutions for themselves, rather than you fixing their problem for them. By being able to challenge such thoughts and beliefs, they should also be able to discover new and positive ways to respond to their issues so that they can cope healthily and adapt more easily to situations.
7. It can help individuals discover things about themselves and empower them.
8. Since one goal of Cognitive Behavioral Therapy is to identify a person's negative thoughts and beliefs, Socratic Questioning can help them develop new insights and perspectives regarding their thoughts and beliefs. If they can discover more insights and perspectives about themselves, they might be able to see themselves in a different light and work to shape themselves for the better.

How to use Socratic Questioning in Cognitive Behavioral Therapy?

Now that you know why Socratic Questioning is essential to Cognitive Behavioral Therapy, you are probably wondering how exactly this technique of inquiry even applied. Here is how it is usually employed:

1. Ask your patient about their negative thoughts and beliefs.
2. One of the initial goals of CBT is to pinpoint the negative thoughts and beliefs a client has that are contributing to their mental health decline. The only way to identify them is to get them to talk about it, so, using Socratic method, you can ask: “What are you thinking about right now?” or “What thoughts are currently occupying/going through your mind?” As an example, let's say that the client answers, "I am anxious about losing my job because I think I am worthless." Do not dismiss their answer even if it is based on irrational beliefs. Your next question will be based on this statement.
3. Examine the supporting and refuting evidence.
4. Once your client answers the previous question, ask them to provide evidence that supports and refutes them. This is so you can help them find more nuanced perspectives. You can ask them: “Why do you think you will lose your job?” The client may answer, "I think I am not doing my job well."You may then probe further into that specific reason, asking them what that idea is based on. After examining the supporting evidence, try challenging assumptions by asking for refuting evidence: "Is there any reason to believe that you are not going to be fired?" For the sake of this example, they may answer, "I always hit the target output and the quality of my work is higher than that of my peers'."
5. Pose further questions that deeply examine their thoughts and beliefs.
6. As they provide more evidence, ask further probing questions. This is the best time to relate their different answers to each other. For example, ask "if your work is of good quality and you produce the right amount of output, why would you be fired?" By asking them these things, they will be able to find alternative ways of looking at their current thoughts and beliefs, which should create opportunities for them to find more nuanced explanations as to why they think the way they think and why they believe what they believe.
7. Because Socratic questioning does not necessarily try to sugarcoat issues, it may also uncover saddening truths for your client. For example, the client answered that a personal conflict is what is putting their job at risk. You may then ask more questions that allow them to find a solution on their own, set goals, and plan a course of action. “What do you think you need to do to fix that personal conflict?”
8. Have them work towards actualizing their positive thoughts and beliefs.
9. Socratic questioning also helps uncover positive thoughts and beliefs, which can encourage your client to actualize goals instead of doing nothing. And while leading questions are not necessarily good to use in Socratic questioning, remember: this is CBT, and you are trying to help your client become better. You can simply just ask them questions without being heavy-handed about it. Ask neutral-sounding questions like “What do you expect to happen once you resolve the conflict?" or "If the conflict is fixed, would there still be reasons for you to lose your job?"

Tips about applying Socratic questioning in CBT

In order to properly practice Socratic Questioning in CBT, here are some principles to consider:

1. Ask open-ended and non-judgmental questions. This means that whatever questions are asked, they should not nudge people to a specific answer or suggest any specific answers. These questions should instill a sense of curiosity in the person so they can unpack their thoughts and ideas.
2. The open-ended and non-judgmental questions should only revolve around the person's own thoughts. This means that whatever is being asked has to focus on the person's beliefs, ideas, and assumptions. Questions about the beliefs of other people or things they do not believe are not necessarily to be avoided; you may ask questions about these to at least know whether they'll be relevant in the conversation.
3. Last, these open-ended questions should be framed in a supportive way because the last thing you want is to make the person feel attacked, confronted, or judged. Make sure not to sound condescending, which may alienate your client. While Socratic questioning can be effectively used in argumentation, remember that that is not the goal in CBT. You cannot also be completely neutral and let the patient spiral downward since you are trying to help them.

26 examples of Socratic questions in CBT

CBT practices like decatastrophizing, combating intrusive thoughts, and showing self-compassion, use Socratic Questioning.

Here are 26 examples of Socratic questions that you can ask whenever you are treating patients using cognitive behavioral therapy. Do note that your questions will depend on what type of CBT assessment or exercise you are doing):

1. How does this thought, or belief affect your emotions?
2. How does this thought, or belief affect your behavior?
3. How does this thought, or belief affect your overall mood?
4. How does this thought, or belief affect your relationships?
5. How does this thought, or belief affect your physical health?
6. How does this thought, or belief affect your work?
7. What evidence supports this thought or belief?
8. What evidence contradicts this thought or belief?
9. If you are holding onto this thought or belief, what is the benefit of doing so?
10. If you are holding onto this thought or belief, what is the cost of doing so?
11. Did something happen to you that made you think this way/believe in this?
12. What is the best-case scenario if this thought or belief were false?
13. What is the worst-case scenario if this thought or belief was true?
14. What is the likelihood of the worst-case scenario?
15. What is the likelihood of the best-case scenario?
16. Regarding what happened to you, would you know of any other possible explanations as to why it happened?
17. What is a more balanced way of looking at what happened to you?
18. What is the most helpful belief you think you can hold onto while you are dealing with the challenges you are facing?
19. What are your values?
20. What thoughts and beliefs align with your values?
21. How does a particular thought or belief align with your values?
22. Why is this thought or belief helpful and how will it serve you in the short term?
23. Why is this thought or belief helpful and how will it serve you in the long term?
24. What's a more positive outcome to look forward to?
25. How would you feel if you are able to attain that positive outcome?
26. What do you need to do to reach that positive outcome?

These are just some of the Socratic Questions you can ask your patient. Their relevance to your patient will depend on what they are dealing with and how you plan to address it through Cognitive Behavioral Therapy.

Tips for using Socratic Questioning in Cognitive Behavioral Therapy (CBT)

If you are wondering about how you can effectively employ Socratic Questioning in your Cognitive Behavioral Therapy (CBT) practice, just keep in mind the following:

1. Begin by asking simple questions.
2. Remember that your questions are supposed to be open-ended and non-judgmental. Besides that, you should also refrain from asking more complex questions. Begin with simpler ones so you can establish rapport and trust. You might overwhelm your patient and cause them unnecessary stress if you go straight to discussing their problems.
3. Tailor-fit your questions.
4. Depending on what specific CBT-related problems you seek to address, the questions you should ask will differ from one person to the next. Once you have gotten to know them better through simple questions, slowly start asking questions related to their circumstance. Your clients would likely not be invested enough if you ask them templated questions. However, that doesn't mean making your questions overtly leading; leave them open enough that they can expound on their answers themselves.
5. For a productive dialogue, frame your questions to encourage reflection on both themselves and their current thoughts and beliefs.
6. Exercise patience and show empathy.
7. Given that you start out as a stranger to your patient, don't expect them to open up immediately. Some people may find it easy to communicate with strangers, but most people don't, especially if they are revealing things about themselves. Give them the space and time they need. If necessary, reframe or rephrase your questions or reiterate them. Try to convey empathy whenever you ask questions and respond to their answers. If there are misunderstandings, apologize and get clarification.