Do you know how powerful the right question can be?
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Issue 24, January 2016


Happy New Year and Welcome to the first Pavestone Issue for 2016!

Pavestones has hit the ground running and there are exciting plans filling the calendar for the months ahead. All February training events have sold out with large waiting lists. This is really confirming the demand for support in working within a client centered paradigm. Great to see! For those of you who missed out, the MI Core Skills and Spirit workshop will be running again in May. See the training box below for these details and more..........

Warm Congratulations are extended to CPD Quiz Book Competition winners:
Mary Hope
Louise Martin
Gemma Illis
Hellene Bakker
Becky Vaschak

These lucky subscribers have received a copy of Sue Zbornik's 'Find Your Happetite' for taking the 2015 CPD Quiz before December 18th. The quiz is permanently available so if you are an APD needing to supplement your assessed CPD hours for APD renewal check out the new quiz webpage here. 

Speaking of webpages....the website has had an update to reflect the scope of training activities that have blossomed over the past 6 months at Practice Pavestones. We have added a handy page with a training schedule so that you can view all of the events coming up at a glance. You are welcome to have a look here and cruise around some of the other informative new pages.
In This Issue
Following on from our last two issues introducing open questions (Issue 21) and forming open questions (Issue 22), this issue's editorial will be exploring directive open questions. In what direction do our questions take our clients ?  In what direction do we want our questions to take our clients when we are working collaboratively and client centred? Read on for a quick tour through some ideas to get you thinking
As always if you are short on time scroll down to the
Purple Pavestone Box at the end..........happy reading!


'Motivational Interviewing Core Skills and Spirit' 
MELBOURNE: Saturday February 20th 2016, Abbotsford        

Practice Pavestones Presents:
'Skills and Wisdom for Working with Appetite'
Facilitated by: Sue Zbornik MS APD 
SYDNEY: Friday February 5th 2016, Crows Nest 
MELBOURNE: Friday February 19th 2016, Abbotsford

Read more about Sue's event HERE


Motivational Interviewing Core Skills and Spirit

A great opportunity to attend a dynamic, one day learning format to reinforce or establish your core MI skills and stance.

SYDNEY MAY 6th  2016 




Motivational Interviewing Core Skills and Spirit

Learn more about workshop content HERE



The Essential Counselling Skills Workshop

Learn more about workshop content HERE

BRISBANE JUNE 23rd - 24th 2016

SYDNEY JULY 28th - 29th 2016


Questions that 'Feed the Good Dog'

A word is dead when it is said, some say.
I say it just begins to live that day

Emily Dickinson

The thought manifests as the word
The word manifests as the deed
The deed develops into habit
And the habit hardens into character

Gautama Buddha

The only solutions that are ever worth anything are the
solutions that people find themselves

Satyajit Ray


I'd like to start with a story from a book I am currently enjoying. The story is called The Dog I Feed Most. It goes like this:

A Native American elder described his inner struggle in this manner: 'Inside of me there are two dogs. One is mean and evil; the other dog is good. The mean dog fights the good dog all the time'. When his grandson asked him which dog won, the elder replied, 'The one I feed most'
From: 101 Solution Focused Questions for Anxiety. 2015 Fredrike Bannink 

This is a powerful wee story and leans nicely into our current exploration of the use of questions in facilitating behaviour change for our clients.

Back in Issue 21, I invited reflection on asking questions beyond the purpose of completing our intake form (which tend to be closed questions and data heavy). We explored asking questions that open up and welcome our client's experience and ideas....questions that honour the client's expertise in their own lives.

In this issue we are going a little bit further with this exploration and asking what sort of questions 'feed the good dog' in our client? ......questions that elicit information that is of most benefit to our client's forward movement and successful behaviour change process.


Can our questions create a new reality?

There is a school of psychotherapy and counselling that answers 'Yes' to this question. Solution Focused Brief Therapy (SFBT) invites practitioners to view questions as therapeutic interventions in themselves due to the direction they can take the client's thinking. What a fascinating idea!. 

A little background........
SFBT is largely credited to the work of American family therapists Steve de Shazer and Insoo Kim Berg in the 1980's so it is relatively young. Here is a definition in a nutshell:

'Solution-focused brief therapy is an approach to psychotherapy based on solution-building rather than problem-solving. Although it acknowledges present problems and past causes, it predominantly explores an individual's current resources and future hopes - helping them to look forward and use their own strengths to achieve their goals'.
The Counselling Directory

If you'd like to read the full article, it's an easy read, you can click through here .

SFBT has a lot to offer health professionals of all denominations who work with facilitating behaviour change with it's simple, pragmatic approach. Through this paradigm, if we consider that therapeutic conversation has the power to affect direction in the client's life, we may consider that spending time talking about resources, hopes and possibility will take our clients in a very beneficial direction both in session and importantly outside of session where their real life happens. The questions we ask the client have the power to channel the conversation in this preferred direction; the direction of positive change, self -determination and a better life. Give that good dog a bone!

What do these powerful questions sound like?

Bannink raises that SFBT questions are not about producing data for the practitioner to become an expert in their client's life. They are an invitation for the client to think differently, outside of the problem, to move them in their preferred direction

Just as reflections are referred to as the 'engine room' of Motivational Interviewing, questions may be considered as performing a similar role in SFBT.

So let's jump in and play with some examples.

As you read through these questions you are invited to visualise some recent or familiar clients. Pause a little between each question and imagine a couple of responses to the question in the words of these clients. What do you notice about the direction of these responses? You might also like to consider where the onus of the work of change sits? ..........with the client or the practitioner?
  • If your eating was where you wanted it to be, what would you be doing?
  • If getting there is entirely possible and started with just one change, what would you chose that one change to be?
  • How would you start?
  • When would you start?
  • What help do you need from me to assist this change?
Here are a few more.........
  • How will you know when your eating was starting to be better for you?
  • What will be some signs that you are beginning to overcome your emotional eating?
  • How will you be looking after yourself in a way that did not use food?
  • How will you be looking after yourself in a way that did use food?
Some ideas to experiment with at beginning of a session.....
  • What good things happened this week with your eating?
  • At the end of our meeting today, how will you know that this session has been helpful for you?
  • If we spend our time in a way that's productive for you, what will you be leaving with today?
And one for the end of a session......
  • If next session you were coming in and telling me that your eating had improved a little...or even a lot...what's most likely that you will be telling me about?

NTS Alert ! (New Toy Syndrome)


I am sure you are familiar with the cautionary phrase:
'To a man with a hammer every problem is a nail'
Wise words to bear in mind when incorporating any new counselling skill and  particularly true for questions. Too many of these 'hammers' and the client will likely feel hammered! There is probably another editorial in the wings on this point alone.

Those of you who are regular readers or who have attended a Pavestones' training will be comfortable with coming back to your core attributes and skills to get the balance right. Slowing it down, really listening to the responses to your questions and using your reflections to communicate this will hold the session in a collaborative, respectful space.  I wrote a little about this way back in Issue 3 when I introduced the hub and spoke analogy for counselling skill development.
In honour of Australia Day this month I've chosen a gorgeously melodic, toe-tapping, Ozzie pop classic for this issue's soundtrack . Replete with Sydney Harbourside picnickers, terry-toweling head bands and big BBQ tongs its a ripper of a song, spot on for our exploration in this issue.

Enjoy 'Make you Happy' by Josh Pyke. Click on the cool guitar boat!            


And there's a question on your lips
On your finger tips
Stabbing in the dark
Like you're cut, cut,
Cutting your fringe back
But it's grown out at such an angle
That the shears aren't sharp
You've got to straight, straight,
Straighten the blades up   

Issue 24 Pavestone
Solution Focused Questions


Nutrition is a science. Eating is a Behaviour. 
Behaviour change is difficult.

Active Listening is a fundamental skill, core to the process of understanding our client's experience, inviting their trust and building the helping alliance

Active listening is as much about how we respond to our clients' communications as it is about how we attend to our clients' communications.

The questions we ask our clients can open up opportunities to actively listen or close them down.

A closed question is typically a question which can be answered by a specific short answer, single word or a 'Yes' or a No'.

An open question is harder to answer and invites the client to think in order to respond. An open question is explorative and invites the client's expertise not the practitioner's.
Open question word stems include 'What', 'How', 'Why', 'When'  and 'Where' . The safest and most effective to start with are 'How' and 'What'

Caution needs to be exercised with the use of 'Why' as this can be experienced as intrusive and impact on our client engagement.

Open questions can be directive by guiding a client to talk about their hopes, ideas, solutions and strengths. Such questions are called Solution Focused questions

Solution Focused questions are concerned with solution-building rather than problem-fixing

Suggestions for Reflection

SFBT asserts that the answers you get from your client depend on the questions you ask. If you have experiences with clients who have a particular negative bias in their sessions, you may like to reflect on the type of questions you are asking. Just slow down and listen to where your questions tend to lead the conversation.

Play around with brainstorming questions that get your client talking about solutions, what they want, their hopes and strengths. Try a 10 minute brainstorm before each clinic in your practice journal, to see if you can produce 3 new questions each clinic. Use your clients' stories to inspire the question content.

I'd love to hear your thoughts, curiosities, insights. Please email me to let me know.

Enjoy experimenting!
Keep reflecting!

Tara MacGregor

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Counselling Skills Training for Health Care Agencies & Hospital Departments


PLAN NOW for 2016

If you are interested in organising training for your department come on over to the new webpage to learn more, read great feedback and email Tara as the 2016 schedule is being planned now and is filling fast. 

'Thanks again for such a fantastic training day last week. Implementing counselling skills has been the hot topic around the office all week, and I have received lots of positive feedback on the day. We found it both rewarding and challenging (in a good way), and already we can identify so many patients who would benefit from our new skill kit. Hopefully we can have you back in the Central West sometime soon! R.B APD

This Month's Interesting Read

11 Reasons Why Your 'Concern' For Fat People's Health Isn't Helping Anyone

Linda Bacon and Melissa Fabello in Everyday Feminism Jan 24 2016



Supervision and Mentoring
A Great Way to Affirm Your Skills

To learn more about Supervision and Mentoring come on over to Tara's Supervision page HERE 

Looking for Past Issues of Practice Pavestones?

It's so easy to access past issues now through Tara's blog on the new website. Click here and do let Tara know if you have troubles finding what you are looking for

Affirm Your Knowledge!
Online CPD Quiz for APDs

You can turn your dedicated reading of Practice Pavestones into assessed CPD hours with on-line convenience using the 2014 & 2015 Quiz.

2014 Quiz Editions 1-11

Access the quiz Here for a fee of $9.95 
Access a revision issue featuring Editions 1-11 and more quiz details Here

2015 Quiz Editions 13 - 22

Access the quiz Here for a fee of $9.95 
Access a revision issue featuring Editions 13 - 22 and more quiz details Here

Tara MacGregor PACFA Reg. 21520

 BSc MSc H.Nut & Diet. G.Dip Couns

Tara MacGregor is a dual qualified Accredited Practising Dietitian and Counsellor & Psychotherapist in private practice. Graduating from Sydney University in 1991 she has worked in a broad spectrum of clinical areas in public and private hospitals until specialising in disordered eating in 2004. Tara works exclusively in the non-diet paradigm and is a committed teacher and promoter of the Health At Every Size (R) philosophy. Tara is a PACFA Accredited Supervisor, Member of the Motivational Interviewing Network of Trainers (MINT) and author of The Essential Counselling Skills for Dietitians Workshop. Tara provides skills training and mentoring in the form of clinical supervision for Health Professionals and enjoys tremendously the exciting opportunities, insights and growth this offers both herself and supervisees. 

Make an enquiry about supervision and mentoring with Tara.

Suite 3, 780a Pacific Highway Gordon NSW 2072
M 0459 991 788
Copyright © 2016 Tara MacGregor, All rights reserved.

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