Clarification means asking for more depth or detail without challenging the patient's narrative. Ask both surface questions about events and depth questions about feelings and wishes, because living through something does not mean seeing it clearly.
What it is
Clarification is any question or move that gets the patient to go into more depth or detail about what they are talking about. It may redirect the narrative, but it does not challenge or change it; once you challenge it, it is no longer a clarification.
“This is basically asking any kinds of questions or doing anything that gets the patient to go into more depth or detail about what they're talking about. But even if it redirects the narrative, it doesn't challenge the narrative”
10:24Psychodynamic Technique and Therapeutic Intervention: Mirroring, Clarification, Confrontation, InterpretationJun 2026 Also said in 1 more episode
“Simply asking questions to get more information about something without challenging or changing the narrative. That's a little bit tricky because if you challenge or change the narrative, that's not really a clarification anymore”
18:29Detecting Subtle Signs of Psychosis: Assessment of Voices, Delusions, and PsychosisFeb 2026
How we use it
Surface clarifications ask for concrete details: the surrounding events in sequence and context. Where were you with your friend? How did you get into that discussion?
“Surface level details would be surrounding events in sequence and context, right? Concrete stuff. Where were you with your friend? How did you get into that discussion”
12:59Psychodynamic Technique and Therapeutic Intervention: Mirroring, Clarification, Confrontation, InterpretationJun 2026 Depth clarifications go to fantasies, wishes, imaginations and emotions. When you got into that, what were you feeling?
“When you get clarifications with depth, I like to think of it as fantasies, wishes, imaginations, emotions. When you got into that, what were you feeling? What kind of emotions were you having there”
13:34Psychodynamic Technique and Therapeutic Intervention: Mirroring, Clarification, Confrontation, InterpretationJun 2026 Paraphrase and check: let me make sure I understood that correctly. Even repeating back almost exactly what the patient said can help them notice where the words do not capture what they are experiencing.
“let me make sure I understood that correctly. So the reason why you got into this conflict with your friend was at first you were kind of having a dispute about debt, right”
15:44Psychodynamic Technique and Therapeutic Intervention: Mirroring, Clarification, Confrontation, InterpretationJun 2026 Also said in 1 more episode
“a therapist would repeat back almost exactly what I would say and then I would disagree with it. And it helped me in that. I was like, oh no, what I'm describing isn't perfectly capturing what I'm experiencing”
16:39Psychodynamic Technique and Therapeutic Intervention: Mirroring, Clarification, Confrontation, InterpretationJun 2026 Think of the narrative as a river. If it is flowing evenly and the patient suddenly stops talking or changes the subject, the river has dammed up or changed direction, and that is worth clarifying.
“If it's an evenly flowing river and then suddenly they stop talking or suddenly they change the subject, right? You might think of the river damming up or the river changing direction”
12:00Psychodynamic Technique and Therapeutic Intervention: Mirroring, Clarification, Confrontation, InterpretationJun 2026
Pearls
Just because someone went through something does not mean they can see it clearly. Help them put it into words with both surface and depth clarifications.
“just because someone went through something doesn't mean that they can see it clearly. Try to put it into words, get those surface and depth clarifications”
15:22Psychodynamic Technique and Therapeutic Intervention: Mirroring, Clarification, Confrontation, InterpretationJun 2026
From these episodes
Every point above is something said on the Psychofarm podcast, with the words as spoken and a link to the moment in the episode. It is education, not medical advice, and an episode reflects what we thought when we recorded it.