Suggestion

Suggestion isn't usually discussed in introductory interviewing texts (Egan, 2002; Hutchins & Cole, 1997). This may be because suggestion is traditionally associated with psychoanalytic or hypnotic approaches (Erickson, Rossi, & Rossi, 1976; Kihlstrom, 1985; J. Watkins, 1992). It may also be because some authorities define suggestion as "a mild form of advice" and discuss it in the context of advice giving (Benjamin, 1981, p. 134).

Although sometimes interchangeable, suggestion and advice are two distinct and different interviewer responses. Specifically, to suggest means to "bring before a person's mind indirectly or without plain expression," whereas to advise is "to give counsel to; offer an opinion or suggestion worth following" (Random House Unabridged Dictionary, 1993, p. 187). Advice is a more directive approach than suggestion.

A suggestion is an interviewer statement that directly or indirectly suggests or predicts a particular phenomenon will occur in a client's life. Suggestion is designed to move clients consciously or unconsciously toward engaging in a particular behavior, changing their thinking patterns, or experiencing a specific emotion.

Suggestions are often given when clients are in a hypnotic trance, but they may also be given when clients are fully alert and awake (J. Watkins, 1992). For example:

Client: "I have never been able to stand up to my mother. It's like I'm afraid of her. She's always had her act together. She's stronger than I am."

Interviewer: "If you look closely at your interactions with her this next week, you may discover ways in which you're stronger than she."

Another suggestion procedure occurs when the interviewer suggests that the client will have a dream about a particular issue. This example is classic in the sense that psychoanalytic therapists use suggestions to influence unconscious processes:

Client: "This decision is really getting to me. I have two job offers but don't know which one to take. I'm frozen. I've analyzed the pros and cons for days and just swing back and forth. One minute I want one job and the next minute I'm thinking of why that job is totally wrong for me."

Interviewer: "If you relax and think about the conflict as clearly as possible in your mind before you drop off to sleep tonight, perhaps you'll have a dream to clarify your feelings about this decision."

In this example, suggestion is mixed with advice. The interviewer advises the client to relax and clearly think about the conflict before falling asleep and suggests a dream will subsequently occur.

We've found that suggestive techniques can be especially helpful when working with difficult young clients. For example, young clients are enthusiastically interested in "hypnosis" when, in contrast, they are opposed to "relaxation" (J. Sommers-Flanagan & Sommers-Flanagan, 1996). In addition, gentle and encouraging suggestions with delinquent young clients may have a positive influence (J. Sommers-Flanagan, 1998). We use the following suggestion technique when discussing behavioral alternatives with young clients:

Client: "That punk is so lame. He deserved to have me beat him up."

Interviewer: "Maybe so. But you can do better than resorting to violence in the future. I know you can do better than that."

Young clients sometimes view this technique as a vote of confidence in their problemsolving abilities. From an Adlerian (A. Adler, 1931) perspective, this form of suggestion is viewed as a method for encouraging clients.

Suggestion should be used with caution. Occasionally, it can be viewed as a sneaky or manipulative strategy. Additionally, sometimes suggestion backfires and evokes opposition. For example, each suggestion used in examples from this section could backfire, producing the following results:

The woman continues to insist that her mother is stronger.

The client does not recall his dreams or is unable to make any connections between his dreams and his decision-making process. (This might be viewed as resistance by psychoanalytically oriented therapists.)

The delinquent boy insists that physical violence is his best behavioral option. Giving Advice

All advice essentially contains the message, "Here's what I think you should do." Giving advice is very much an interviewer-centered activity; it casts interviewers in the expert role.

It is important to avoid advice giving early in the interview process because giving advice is easy, common, and sometimes coolly received. Usually, friends and relatives freely give advice to one another, sometimes effectively, other times less so. You may wonder, if advice is readily available outside therapy, why would interviewers bother using it?

The answer to this question is simple: People desire advice—especially expert advice—and sometimes advice is a helpful therapeutic change technique (Haley, 1973).

Nonetheless, advice remains controversial; many interviewers use it, and others passionately avoid it (Benjamin, 1981; C. Rogers, 1957).

In many cases, clients try to get quick advice from their interviewers during their first session. However, premature problem solving or advice giving in a clinical interview is usually ineffective (Egan, 2002; Meier & Davis, 2001). Interviewers should thoroughly explore a specific issue with a client before trying to solve the problem or render advice. A good basic rule is to find out everything the client has already tried before jumping in with prescriptive advice.

Sometimes it is difficult to keep yourself from giving advice. Imagine yourself with a client who tells you:

"I'm pregnant and I don't know what to do. I just found out two days ago. No one knows. What should I do?"

You may have good advice for this young woman. In fact, you may have gone through a similar experience or known someone who struggled with an unplanned pregnancy. The woman in this scenario may also desperately need constructive advice (as well as basic information). However, all this is speculation, because based on what she has said, we still do not even know if she needs information or advice. All we know is she says she "doesn't know what to do." If she discovered she was pregnant two days ago, she's probably spent nearly 48 hours thinking about the options available to her. At this point, telling her what she should do would likely be ineffective and inappropriate.

Giving premature advice shuts down further problem solution exploration. We recommend starting nondirectively:

"So you haven't told anyone about the pregnancy. And if I understand you correctly, you're feeling that maybe you should be taking some particular action, but you're not sure what."

You can always get more directive and provide advice later.

Some clients will push you hard for advice and keep asking, "But what do you think I should do?" In many cases, you should use an explanation and open-ended question when clients pressure you for advice. For example:

"Before we talk about what you should do, let's talk about what you've been thinking and feeling about your situation. I may have some good advice for you, but first, tell me what you've thought about and felt since discovering you're pregnant."

Or, in this case, simply an open-ended question might be appropriate: "What options have you thought of already?"

Clients are typically more complex, thoughtful, and full of constructive solutions than we think they are (and typically more resourceful than they think they are). It is an injustice to provide advice before exploring how they have tried solving their own problems. Solution-oriented interviewers emphasize client skills and resources by asking questions like, "How did you manage to change things around?" or "What's the longest you've gone without being in trouble with the law? How did you do that?" (Bertolino, 1999, pp. 34-35)

Providing redundant advice (i.e., advice to take some action that others have previously suggested or to take an action that the client has already unsuccessfully tried) can damage your credibility. To avoid providing redundant advice, ask clients what advice they've already received from friends, family, and past counselors. However, despite its liabilities, sometimes advice is both needed and helpful. In the words of Miller and Rollnick (1991), "Well-tempered and well-timed advice to change can make a difference" (p. 20; see also Putting It in Practice 4.3).

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