Circular Questions: A Family Interviewing Strategy by Loos & Bell
- circular questioning method effective family assessment and intervention.
Nurses gather data by asking exploratory questions.
e.g. Linear question: how is your family managing?
e.g. Circular question: Who is managing best?
Circular questions describe a difference. It is less useful to know if the family is
managing (linear question) than to know whether there is a difference in their ability to
manage now as compared to before, or to know who is handling the situation best or
worst (circular questions).
- Differences enable the nurse to use a circular way of thinking to clarify how families are coping
with the critical illness. To identify a difference is to necessarily define a relationship between
whatever is being compared.
Individuals are best understood in the context of their relationships rather than alone.
Differences between perceptions/objects/events/ ideas etc. are regarded as the basic
source of all information and consequent knowledge
Relationships are always reciprocal and circular. If one member of the family is defined
as being bad, then the others are being defined as being good. Even at a very simple level,
a circular orientation allows implicit information to become more explicit and offers
alternative points of view.
Alinear orientation is narrow and restrictive and tends to mask important data
circularity devalues the importance of arriving at the “right” diagnosis of the family's
needs. The nurse formulates provisional hypotheses about family relationships based on
observation of and information about the family and on the nurse's previous experience
and knowledge. The hypotheses change as new information is provided by the family.
Circularity allows the nurse to investigate and accept the perception of each family
member. This prevents the nurse from taking sides and thinking about the member's
views as “correct” or “right” and allows the family to see the nurse as neutral.
Circular questioning about relationships and beliefs also provides the family with new
information. This new information enables the family to think and act in a new way.
Types of circular questions:
Difference-type questions: differences between people, relationships, and times (e.g. Who
is the most upset about father's illness?)
Behavioral effect-type questions: connections between the effect of one's behavior on
another specific interaction process (e.g. what do you do when your mother shows she is
Hypothetical-type questions: possible alternate actions or meanings (e.g. what will
happen if your sister does not get better?)
Triadic-type question: question addressed to third person about the relationships between
two other people. “gossiping in the presence of those being described”. (e.g. who
between your mom and dad do you think is most worried?) By asking “Is mother...” invites any family member (e.g., father, mother or child) to
answer the question. The use of “mother” rather than “your mother” or “the mother” is
less restrictive and shows respect for mother's position in the family.
In using circular questions, the nurse respects the family member's answers and does not
try to second-guess them. The feelings, thoughts and concerns expressed by each family
member are accepted as “truth” and used to generate new hypotheses or direct subsequent