Arthur Kleinman is a medical anthropologist, psychiatrist and former chair of the Department of Social Medicine at Harvard Medical School. Some time ago, I came across a series of questions that he suggests asking clients to better understand how they view their difficulties.

Kleinman emphasizes understanding a patient’s perspective, or explanatory model, on his/her illness or problem. He advocates becoming therapeutic allies around treatment and expected outcomes. His questions offer a powerful bridge to understanding clients whose cultural backgrounds and assumptions may be different from our own. I really like his approach and find it to be humane, respectful and contemporary.

Here are some of the questions he suggests asking:

• What do you think has caused your problem?

• Why do you think it started when it did?

• What do you think your illness does to you?

• How does it work?

• How severe is your illness? Will it have a short or long course?

• What kind of treatment do you think you should receive?

• What are the most important results you hope to receive from this treatment?

• What are the chief problems your illness has caused for you?

• What do you fear most about your illness?

Kleinman’s books include Patients and Healers in the Context of Culture, Pain as Human Experience, and Rethinking Psychiatry.

Send a message with your comments and questions.