July 2026: Asking Questions in Grief Counseling

by William G. Hoy

Those who have attended training workshops I present know my penchant for asking questions—both in groups and in individual work with bereaved people. Though I know there is some controversy regarding the value and appropriateness of therapeutic questions (Williams, 2023), I find there are few tools that I employ that have any greater effectiveness. This month and next, I want to review some of the current thinking in the literature especially related to outcomes research on question use in psychotherapy and to offer a perspective on how I develop the questions I use.

In communication studies, we generally think of questions as either open-ended or closed-ended. A closed-ended question is one that can be answered with a brief answer (yes, no, and almost always no more than a phrase or short sentence). “Were you able to have a conversation with your husband about that since we last met?” and “Are you having less anxiety episodes than last month?” are examples of closed-ended questions.

Closed-ended questions are used in assessment and history-taking but in my experience, work best for clinicians who are trying to control the pace of the interview. I suspect this is the reason they are so widely used by physicians in the history and physical part of the exam; they keep the conversation moving. Of course, those of us who practice on the behavioral health side of the aisle also long to keep conversations moving but we also have a different goal. In psychotherapy, we highly prize the individual’s story, and so for us, open-ended questions are much more useful, even in the assessment process. Eliciting the same information as in the closed-ended questions above, an open-ended question might ask, “Tell me a bit about the conversations you have had with your husband about x since we last met?” and “How have the number of anxiety episodes changed for you over the last month or two?”

In both of these examples, the clinician is gaining the same information (I would argue we are learning more in the open-ended questions), but we are doing so by privileging the individual’s experience. There are times when a brief clarifying question needs to be closed-ended; not every issue merits a story. But, as a general rule, I think in counseling we want to more frequently strive for open-ended questions. The context of the individual’s experience is as important in our work as the actual “symptoms” he or she reports. Though I cannot exactly discern from Williams’ (2023) survey of published research, I suspect that much of the resistance to questions on the part of patients is because the tone in which questions are asked and the “yes-no” nature of many questions cause them to feel more like they are enduring a police interrogation than participating in a conversation.

Early in my therapeutic relationship with bereaved individuals, I inquire about their feedback on the process in which we are engaged. In other words, during the last few minutes of our first or second conversation, I will simply ask, “How is our process working for you?” and “Do my questions help you articulate what you are thinking or do they stand in the way of saying what you want?” Seemingly, individuals will be honest if I create an environment where honest feedback is welcomed without a defensive response on my part when the client says something negative about our process. In the vast majority of experiences, bereaved individuals have responded to these evaluative questions with responses like, “Oh, yes. Your questions really help me think…” or “I would not otherwise have the chance to talk about some of these things.” One bereaved mother told me that my questions made her feel that it was okay to talk about her son’s death when often her friends would change the subject or even suggest that she not “dwell on” his death. 

When I ask an open-ended question, I strive most often to utilize these five interrogatives: who, what, where, when, and how. The sixth interrogative, why, is not one I generally use because it tends to raise defenses. The “why” question’s purpose is to understand the motives or choices that are driving a bereaved person’s decisions: “Why do you think that?” or “Why did you make that choice?” It is often important to explore motives and thinking strategies with the bereaved people we seek to help, but I find there are other ways to get there. For example, when I hear a person is practicing a behavior or a coping strategy that I expect to lead in an unhealthy direction, I might ask, “How did you come to that conclusion?” or “What were the steps that got you to that decision/conclusion?” This often provides opportunities for us to speak into behaviors and strategies that will not likely serve the bereaved person well long-term. 

In the same way, we can ask these kinds of questions during group interactions, too. Remember that in bereavement groups, the most important value is not the content or principles that are imparted but rather, the opportunity for people to have their stories heard by concerned others. Perhaps the greatest gift a good group gives is the chance to “bear witness” to another’s experience. In the process of hearing the stories and struggles that are shared, facilitators can affirm the grief journey and offer direction for the uncertain part of the pathway. Deliberate questions can help bereaved individuals think about their experiences with loss in ways they had never considered.

Here are some of my favorite questions along with a few explanatory notes about why I ask.

What has been the hardest part of the journey for you so far? Here, I want the bereaved person to offer his or her perspective on the individual experience with grief. This question privileges the bereaved person’s experience. I will often follow-up the individual’s response with a question like, “In what ways has the grief journey been harder than you expected? In what ways has it been easier?” Listen for themes: spiritual distress, financial difficulties, or fractured family relationships might have become important additional losses in themselves.

Who has most been “there for you” in your grief? What have they said or done to help you know they are walking this road with you? Whose presence has most surprised you? Whose absence from your support circle has most disappointed you? In these questions, I am assessing for the presence of supportive others and to begin measuring how the bereaved person perceives the community is supportive. Many people try to be supportive but they do not offer support in ways that are meaningful to the bereaved person; I want to measure what, in the bereaved person’s experience, is working. I would also much prefer bereaved individuals to have the opportunity to process with me what their disappointments are with people in their circle (who will often be family members) who have been less than stellar supporters. This line of questioning often leads to collaborative plans, and in this context, I have worked with individuals to consider a bereavement support group and the characteristics a group should have. 

When individuals confess that they have no one from whom they feel they are getting support, we talk about the difficulties of walking the grief journey alone. This is also the time I might engage the bereaved person regarding how he or she has coped with other major life crises (see below).

The last time something really bad happened in your life, how did you get through that? What resources seemed most helpful? What did you try then that you find didn’t work so you probably wouldn’t repeat it? Prior coping strategies are often an important element of working through the present loss. Be alert to changed circumstances that might mean the same support resources are no longer available. One new widower put it this way: “Well, when our son died 20 years ago, my wife and I got through that together; now that she is gone, I don’t really have anyone…” This is also the point at which many bereaved individuals discuss what has—and what has not—worked in their prior experiences with counselors and groups. Be aware that you might be starting from a deficit position in offering support if the last experience was not all positive.

When you allow yourself to be very quiet (and reflective), where do your thoughts go? Where does your mind take you? What do you most think about? Here, I am interested in how the bereaved person is coping outside of our conversations. It might be that thoughts about the loss consume every waking moment, but it is equally likely that the loss is not considered much outside of the conversations with counselors.

How do you think you are doing? Do others in your life seem to agree with your opinion about you? I want to know how bereaved individuals grapple with their self-expectations. I am regularly astounded by the number of bereaved people who think they “are not doing it right,” usually because they have been told that by a well-meaning friend or family member. When bereaved individuals indicate they don’t think they are moving fast enough, it is usually a good idea to find out what “fast enough” would look like. “What do you think it would look like for you to be at that point/further along?” can be a useful line of questioning because it gives us an opportunity to explore these self-expectations (which are probably quite unrealistic). 

While there are no “magic questions,” these examples provide a fruitful direction for conversation. Next month, we will explore some other questions that are useful in assessing progress and carrying on a therapeutic conversation with a bereaved individual. What these questions all share in common is they allow the bereaved individual space and time to share the elements of their story they believe are most significant. That is what it means, at least in part, to put the client in the center of the caregiving relationship.

Reference.

Williams, E.N. (2023). The use of questions in psychotherapy: A review of research on immediate outcomes. Psychotherapy 60 (3), 245-254. https://doi.org/10.1037/pst0000471

The Author : For more than 40 years, William G. Hoy has walked alongside the dying and bereaved. Since his retirement from Baylor University in 2024, he gives much of his time to helping colleagues connect more helpfully with bereaved individuals. can be reached at Bill_Hoy@baylor.edu .