What it is

Socratic questioning takes its name from the philosopher Socrates, who taught by questioning his students’ assumptions rather than lecturing them. In CBT it means a therapist asking open questions (“What makes you think that?”, “Is there another way to see this?”, “What would you say to a friend?”) so that the client reaches their own conclusions. It is valued because it respects the client’s capacity to think things through.

The research base is thinner than its reputation. A narrative review found that, although the method is widely described as important to CBT, “no direct evidence supports the premise that it is beneficial” (Clark & Egan, 2015). A later research review discusses how it may work and how it might be studied (Overholser & Beale, 2023).

Where disability changes the picture

Pace

A run of questions, each needing a considered answer, takes energy. For a client with fatigue, pain, a brain injury or slower processing, the pace of the questions can matter more than their content. Silence may mean the client is thinking, tired, or finding a way to answer, not that they are avoiding.

Abstraction

Questions such as “What is the evidence for that thought?” ask for abstract reasoning. Guidance on CBT with people with intellectual disabilities recommends concrete examples, short sentences, simple words and visual supports, and notes that being challenged on beliefs can be hard without a strong relationship first (Hronis et al., 2017). Some autistic and ADHD clients describe a similar strain when questions are fast, open-ended or implied rather than direct.

Answers that are not spoken

The method assumes answers come quickly and in speech. A client who uses AAC, writes, signs, or needs time to compose a reply is at a disadvantage in a rapid back-and-forth, and may be read as less insightful than they are.

Trauma and dissociation

Persistent questioning can feel like interrogation, particularly for someone whose experience of medical or care settings involved being questioned, doubted or tested. A well-meant question that arrives too soon can feel unsafe.

Accurate beliefs

Some beliefs a client brings are accurate: that a venue will be inaccessible, that an assessor will doubt them, that a symptom will flare. Questioning those as though they were distortions repeats the experience of being disbelieved. See Cognitive Restructuring.

Power

The therapist decides which contradictions to pursue. An open question can still steer. With a client who has spent years being assessed by professionals, it helps to name that, and to let the client choose what is worth examining.

Adapting it

• Ask before you question. “Would it help to look at that thought together, or would you rather stay with how it feels?”
• Slow down, and leave room. Fewer questions, more time, and permission to answer next session.
• Make it concrete. Use a specific recent example rather than a general belief.
• Offer other ways to answer. Written options, a scale, a card sort, a drawing, or the client’s AAC system.
• Check the facts first. Is this belief accurate, an interpretation, or both? Only the interpretation needs questioning.
• Accept “I don’t know”. It is an answer, not resistance.
• Ask how it is going. “Are these questions useful to you?”

A short example

Fictional teaching example

Róisín has a brain injury and tires quickly. Her therapist begins asking, “What evidence do you have that your colleagues think you’re slow?” She goes quiet. Rather than asking again, the therapist says: “That was a lot of question at once. Would it help if I wrote down two possibilities and you picked the one that’s closer?” Róisín points to one, and adds, after a pause, that one colleague did say it, once. The work moves from “Is this thought true?” to “What do you do with a comment like that?”