Critical Thinking and Cognitive Therapy Techniques

This assignment delves into the intersection of critical thinking and cognitive therapy. It provides an overview of various references and studies that demonstrate the effective use of Socratic questioning and other critical thinking techniques in cognitive behavioral therapy (CBT) for anxiety disorders, including social anxiety disorder and panic disorder. The assignment also touches on the importance of critical thinking in effective decision-making and its application in clinical settings, such as nursing and psychiatry.

Running head: Socratic Questioning and Associated Methods 1
Application of Socratic Questioning and Associated Methods in Critical and Clinical Decision-
Making
Student’s Name
Course
Professor’s Name

Socratic Questioning and Associated Methods 2
The provisions of professional health care giving put the patients squarely in the hands of
the practicing medical professionals whose decisions directly impact on the patients they handle.
In given occasions, patients’ health conditions have been negatively impacted by wrong
decisions made by their caregivers. As such, it calls for critical reasoning and adequate decision
making skills in order to eliminate the adverse effects that would otherwise occur in patients
while under the care of nurses and other practitioners. One such skill involves an effective use of
Socratic questions, a method that was majorly used by Socrates as part of effective learning
guide for students. Whereas the first section of this study makes a critical review of the existing
literature on Socratic questioning and other associated methods that influence self-development
of critical and clinical decision-making skills, the second section identifies the key themes and
subsequently discusses how the Socratic questioning and the associated methods can impact on
clinical practice as it applies to advanced nursing practice.
Section A: A Critical Review of Literature on Socratic Questioning and Associated
Methods
Socrates developed the Socratic questioning whose main purpose was to challenge the
completeness and accuracy of thinking in a manner that moves the subjects to their ultimate
goals. The Socratic questions are basically grouped into six categories notably those that:
Instigate conceptual clarification; probe assumptions; probe rationale, evidence, and reasons;
question perceptions and viewpoints; probe the possible consequences and implications; and
question about the questions themselves (Changing Minds, 2018). Basically, an effective
thinking is driven by questions and not answers. Beck and Dozois (2015) assert that Socratic
method is a discovery-guided method in which a series of carefully organized questions are

Socratic Questioning and Associated Methods 3
asked by a therapist in a bid to define the problem at hand, help in identifying beliefs and
thoughts, give an examination to the meaning of events, or make an assessment of ramifications
of given behaviors or thoughts. The medical field, in essence, stays alive only to whatever extent
that new questions are developed and seriously considered as the force driving a clear process of
thinking. According to Newton, Darwin and Einstein (2017), questions play a significant role in
defining the tasks, problem expression and delineation of issues and as such, only practitioners
with questions do employ constructive thinking and develop proper answers in care giving. The
quality of thinking that the medical practitioners do is greatly determined by the quality of the
questions that they ask. Ideally, health providers need questions in order to turn their intellectual
engines and must themselves generate questions from the already existing ones in order to
achieve this.
An elaborate consideration a number of literatures shows that Socratic questioning has
led to the development of efficient treatment methods. A wide range of psychological disorders
have been treated through the intervention of diagnosis-specific CBT which practically makes
use of Socratic questions in delivery protocols (Hofmann & Smits, 2014; Robichaud & Dugas,
2016). It is notable that at the moment, CBT stands out as the most preferred treatment for a
variety of conditions related to psychological disorder (American Psychiatric Association, 2014;
NICE, 2013). By use of randomized controlled trials which practically assesses whether or not a
significant symptomatic change results from a CBT treatment package, the CBT efficacy has
been greatly demonstrated. On the flip side, however, Roth and Pilling (2017) argue that it has
not been very possible to determine to what extent the effects of the competencies of the
therapist are reflected on the efficacy of the treatment methods such as therapist questioning
style.

Socratic Questioning and Associated Methods 4
Comparatively, Socratic questioning has also received a fair share of criticism from a
number of researches. The critiques have questioned on whether Socratic Method is indeed an
essential component in patient evaluation and treatment. One such criticism is attributed to
Fairburn (2015) who argues that simpler and more effective means could be used to arrive at the
amicable results rather than using the Socratic Method in treatment. Fairburn attests that the
method is more complex and time consuming and as such, is not applicable in instances of
emergencies. DeRubeis et al. (2009) further argues that the development of therapist skills in
Socratic Method requires a significant amount of time and the clinical skills in this case are
technically hard to master. Contrary to these opinions, however, many other therapists argue that
Socratic Method is a cornerstone as far as an effective CBT treatment delivery is concerned.
They relate the method to the primary role it plays in developing the best approach in patient
handling. Basically, the achievement of competency in Socratic question usage is considerably a
primary goal of therapy training (Liness & Muston, 2015).
Whereas the Socratic questioning method has been effectively used in the delivery of
efficacious treatments over time, the evaluation methods give no prompt validity as to whether it
makes a significant contribution to the overall effectiveness of the treatment administered. As
such, the medical practitioners are advised that when faced with a therapy characterized by
limited time and the clinical reality organizational pressure, they should consider limiting the
usage of the technically difficult and time-consuming technique unless there is a well defined
rationale for its application (Beck & Dozois, 2011).
In addition to Socratic questioning, concept mapping also plays a significant role leading
to a more informed decision making by the clinicians and nurses. According to Al Ameen J Med
Sci (2014), the innovative nature of concept mapping enables it to help nurses and medical

Socratic Questioning and Associated Methods 5
educators in the promotion of their knowledge and skills for clinical decision making. Owing to
the fact that clinical decision making is a vital component in nursing practice, concept mapping
consequently ensures the establishment of correlation among processes that entail the interplay
between the knowledge of experimental learning, patient information, pre-existing pathological
conditions, and nursing care. O’Neill, Dluhy, and Chun (2015) justify that as nurses gain more
experience as care givers, the entire process becomes more manageable and easier and there
arises a notable intricacy in decision making forms. As such, concept mapping which is
considered as an enabler of critical thinking and problem solving becomes increasingly essential.
Thirdly, critical thinking also plays up as an essential concept in critical and clinical
decision making. At the moment, nurses are more exposed to ever changing and more
complicated health environments in their professional practice. In order for them to be able to
cope up effectively with such prompting conditions, there is no doubt that they should be good
decision makers. Through an effective use of critical thinking, the decision making process
becomes less complex. According to Salehi et al. (2014), a study conducted to evaluate how
critical thinking and clinical decision making were related gave a mean score of 10.67, 61.66 and
10.61, 63.27 for nurses of general units and critical care respectively. It can be deduced from this
study that the mean score for critical thinking was relatively low in nurses. To a given extent,
this could be a justifiable reason for wrong decision-making by the aforementioned. If critical
thinking were to be effectively applied in this concept, it would demonstrate an intentional high
level of reasoning delineated by a lot more factors, thereby providing guidance both for rational
judgment and efficient action.
Section B: How Socratic Questioning and Associated methods Impact on Clinical Practices
as Applied to ANP

Socratic Questioning and Associated Methods 6
Advanced nurse practice demands the application of several methods when it comes to
decision making in day-to-day clinical practice. Part of the effective methods that can be
practically used in the current medical care giving setup are Socratic questioning, concept
mapping, and critical thinking. The above-mentioned methods are best applied when aligned to
themes such as critical thinking and reasoning, clinical judgment, reflection and intuition, and
emotional intelligence.
Socratic questioning entails the act of applying a given set of questions to a particular
situation with an aim of determining the most essential information and discarding the
information that is not needed at the moment. Basically, nurses tend to get one on one with the
patients most of the time. It has been proven that when they freely interact with the patients and
ask them leading questions, the patients tend to open up; thereby giving the vital information that
would eventually assist the health practitioner in critical thinking and reasoning. The critical
thinking in this case would then help the care giver in putting the extent of their real learning into
the given perspective. By revealing the nature and the significance of gaps in information and
assumptions, critical thinking and reasoning would vividly illustrate what the care giver knows
and doesn’t know about a given situation, hence, instigating the need for effective decision
making. Ideally, the surprising outcome of critical thinking can positively illustrate the subject’s
level of ignorance, a problem analysis approach which is unnatural in most cases. It is, therefore,
notable that critical thinking can be objectively employed in balancing of reason, evidence, and
options by the care provider (Brian, 2010). As a matter of fact, the critical thinking skills of any
medical practitioner must be put into practice most often as it enables the effectuation of better
approach to patient handling.

Socratic Questioning and Associated Methods 7
Secondly, clinical judgment subsequently arises from Socratic questioning and concept
mapping. Through clinical judgment, one can make rational and logical decisions as a
prerequisite for deciding whether a given action would be right or wrong. Clinical judgment
helps a nurse decide on the kind of data to be collected from a particular patient, make an
informed interpretation of the collected data, arrive at a commendable nursing diagnosis, and
identify the most appropriate actions for nursing. Entirely, this entails decision making, problem
solving, and critical thinking. For the nurses practicing in the increasingly complex medical
environment, application of clinical judgment becomes extremely vital. The ultimate prescription
of medication for a patient squarely lies on the kind of data collected, the interpretation given to
the data and the diagnosis that ultimately follows. It therefore becomes mandatory for nurses to
consider critical judgment as a cornerstone for their daily practice.
Reflection and intuition, and emotional intelligence become handy in daily medical
practice. Whereas intuition in traditional nursing was primarily linked to experience, thereby
typifying the expert medical practitioner, the current climate of health service provision demands
evidence based care which is measurable. This instigates the need for involvement of intuition in
judgment and decision making process. To achieve this, the nurses must consider an effective
use of reflection and emotional intelligence. Basically, intuition occurs in response to already
accrued knowledge and this justifies its relationship with Socratic questioning that leads to
knowledge acquisition. The quality of reflection done by a nurse greatly influences the kind of
decision she ultimately arrives at. It entails linking the past experience to the current situation
and applying the best concept in response to the situation at hand. Through emotional
intelligence quotient, a nurse should be able to make a perception, assessment, and management
of her emotion and that of the patient. Upon understanding the emotional variation, the nurse can

Socratic Questioning and Associated Methods 8
then use these emotional perceptions in accomplishment of various tasks and medical
administration. Collectively, these components of clinical decision making become handy to the
nurses, considering they carry out the donkey work in patient handling. As a matter of fact, the
essential nature of intuition and reflection cannot be ignored in education, management, practice
and research of nursing.
In conclusion, nursing practice is a demanding profession that greatly calls for critical
reasoning and adequate decision making skills in a bid to eradicate the prevalence of adverse
health outcomes that are occasionally evident in the medical environment. Several researches
have been conducted to verify how an effective use of Socratic questioning, concept mapping,
critical thinking and many other methods relate to self-development of the medical practitioners
and their application in critical and clinical decision making. As a result, it has become evident
that when the aforementioned methods are blended with critical thinking and reasoning, clinical
judgment, reflection and intuition, and emotional intelligence, they can be successfully applied to
advanced nurse practice.

Socratic Questioning and Associated Methods 9
References
Beck, A. T., & Dozois, D. J. (2011).
Cognitive therapy: Current status
and future directions. Annual
Review of Medicine, 62, 397–409.
Al Ameen j Med Sci. (2014). 7(4):312-315. US National Library of medicine enlisted journal.
ISSN 0974-1143.
American Psychiatric Association. (2014). Treatment of Patients with panic disorder. Retrieved
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+Treatment+of+Patients+with+panic+disorder+(2nd+ed.).&hl=en&as_sdt=0&as_vis=1&
oi=scholart
Beck, A.T., & Dozois, D.J. (2011). Cognitive Therapy: Current Status and Future Directions.
Annual Review of Medicine, 62,397-409.
Brian, D.E. (2010). The Role of Critical Thinking in Effective Decision Making. Retrieved
August 25, 2018 from
https://articulosbm.files.wordpress.com/2010/03/criticalthinking.pdf
Changing Minds. (March 8, 2018). Socratic Questions. Retrieved August 25, 2018 from
http://changingminds.org/techniques/questioning/socratic_questions.htm

Socratic Questioning and Associated Methods 10
Clark, Gavin & Egan, Sarah. (2015). The Socratic Method in Cognitive Behavioural Therapy: A
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Socratic Questioning and Associated Methods 11
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