The Best Question You Can Ask
Last week on LinkedIn I shared some of the learnings from a recent client project. One of the outcomes was a revised patient/client intake form. The client was using the ACE Questionnaire to screen for trauma as part of their new patient intake. But after reading this post from me, they decided to make changes. While the client wanted to do a better job with their intakes, they were hesitant to get rid of a tool that "everybody uses".
Everyone also used to use a common phrase when dealing with a new client for the first time: "what's wrong with you?" It was basically a "what brings you here today?" type question. But there are problems with that question:
"Wrong" could mean anything i.e. what a provider sees as "wrong", a patient may see as "normal".
It ignores the prevalence & impact of trauma.
It focuses on diagnosis i.e. the problem.
So "what happened to you?" replaced the "what's wrong with you?" and everyone rested easier.
"What happened to you?" connotes a willingness to hear the story, to take into consideration possible trauma prior to the visit. It also is seen as less traumatizing. The idea being you are trauma-sensitizing your work by asking a more big picture question.
Can you read my doubt?
Both questions ("What's wrong with you?" and "What happened to you?") still have more in common than they do different.
They both imply blame. The new version is less overt but it's still there. (Practice both phrases in the mirror and see if you can't hear the blame in both.)
They both stigmatize the client as someone who is broken or damaged.
They both see the client as the problem.
They both center the provider in the discourse.
Because everyone is a trauma survivor, simply re-phrasing a question is not enough to trauma-sensitize your practice.
Trauma survivors need to feel more choice and more respect from their provider. They need to be seen as the expert of themselves. This may seem fairly obvious to some but most of us do not feel like the expert when it comes to conversations with our care provider. But we are always the expert on ourselves, regardless of the kind of trauma we have experienced.
As a provider, you are in a greater position of power than your client or patient. Before you even utter a word, that imbalance of power is already counting against you. Even you are white or present as white and you are dealing with any non-white client, you have an even harder road ahead of you.
"What can I do for you?"
(Try that one in the mirror too.)
"What can I do for you?" shares power with the client. It states that you, the provider, are here to serve them. "What can I do for you?" connotes respect as well as kindness. The focus of the visit, then, has shifted to client as problem to client as solution. This is very powerful for trauma survivors who are often made to feel at fault for their own health or challenges. This question says "you know what you need,". It offers choice and support all in one. And of course it is also open ended, non-blamey.
Bottom line? “What can I do for you?" is the best question because it empowers patients. If you want quality information you can work with in the most time efficient way possible, you need to ask better questions--whether on an intake or in person. And you can do that quite simply by shifting focus from you, the provider, to them, the patient.
What do you think? Which question do you like better? Leave a comment below.