Men and Trauma: 5 Dynamic, Solution-Focused Questions to Use in Therapy

Guest author: Dan Lawson, LMHC, CASAC

Jung penned these words in 1965, and I find myself returning to them often in my work. The intention of this blog post is to provide clinicians with tangible and pragmatic tools to enhance treatment effectiveness with men who have with trauma histories.  As a solution-orientated therapist, the tools I use are questions.

My hope is that in using these questions effectively with the men you serve, they become more of who they are, and less of who they aren’t.

Whenever I do an initial intake, I spend at least five to ten minutes at the beginning of the appointment with this question.  Asking your client about what they have achieved, builds awareness of their patterns of success.  This also helps the client feel at ease and competent.

Naturally, this question also helps men build confidence.  Confidence in many ways is a requirement for successful goal formulation.  Confidence also decreases men’s fears about treatment and making change.

Sometimes, the client may respond saying that they have not achieved anything great in their life.  As the therapist, it’s important to add, “not yet.”  If a client gives that response, it becomes a very appropriate time to talk about goals and ask, “Well, what would you like to say someday is one of your great achievements?”

Often times our work as a therapist is to reframe the experience of our client.  This question alters the client’s perception from a place of being a “victim” to being a “survivor.”  This creates different expectations and also allows the client to see that in fact they have done something valuable.  It may also allow them to see other strengths that they possess as well as ways to build upon them.

It is important to note that male trauma survivors may habitually destroy their own self-worth, abusing themselves and ruminating on past failures. This question subtly harnesses the power of positive blame, demanding the client to take responsibility for their success and good decisions.

One crucial element in maintaining the therapeutic relationship and achieving positive treatment outcomes is respecting the client’s theory of change.  This question begins a conversation about what the client believes about their diagnosis/prognosis and their preferred method for recovery.  This also empowers male clients, offering them a way to collaborate and contribute to their own treatment process.

Sometimes the answers clients give reveal the client has very little hope in therapy in general.  In those cases, it becomes more important to explore ways to increase hope before more recommendations are made.

Clinicians can also use this as an opportunity to task clients to do some “research” and identify people who have recovered from similar situations.  Stories of others’ success increase hope and motivation for change.

Traumatic experiences can alter our observational skills.  Often times, periods when symptoms are less intense (or absent) remain outside of our client’s awareness.  If a client has no clearly defined goal, or they seem to “complain” habitually in session, it is very useful to provide the client with observational tasks.

This question increases the client’s awareness of what is working in their life and has a meditative quality, allowing them to be more present for greater periods of time.  It also enhances confidence and hope that may set the groundwork for the client to begin communicating about future goals for therapy.  Remember that attention is a limited resource, so whatever your client focuses on gets bigger.

David W. Smith coined the term “Friendless American Male” during the 1980’s recognizing the consequences associated with disconnected men.  Many healthy men prefer to connect and socialize with each other through experience rather than dialogue.  In building a positive post-traumatic identity, men can benefit from the company and friendship with other men.

This question helps to identity places of support and connection already in place in the client’s life.  Each client is different and therefore patterns and preferences for connection may be vastly different.  However, this is a respectful way to enhance the client’s support network and enhance their awareness of their process of connection. Once recognized, it may be replicated.

Sometimes, clients may respond saying that they are close to no one in their life.  In those cases, it may be useful to ask them if there was anyone they were close to in their past. If so, how did they go about that process?

Remember that all people are patterns that persist.  Change the pattern you focus on, change the life you lead.  Have the courage to ask better questions with your clients.  Our lives are the answers the questions we ask.  Better questions can mean a better life for your clients.