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Therapy talk and talk about therapy: Client-identified important events in psychotherapy
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
2013 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Capturing and studying the moments in psychotherapy that clients find most important can help us understand more about how psychotherapy works, what the curative ingredients are, and by what processes they are mediated. Qualitative research in this area has, so far, mainly focused on describing, and categorizing clients’ experiences of important factors and events. The methods employed to analyse the data have been rather limited in variation and are usually based on a realist epistemology, according to which data are basically treated as reflections of the clients’ actual experiences. This entails a risk of overlooking and obscuring other aspects of therapy and the therapy process that are equally important to explore, for example the microprocesses of interaction within important events, or how clients’ accounts of their experiences are shaped and limited by the context in which they are produced. The overall aim of this licentiate thesis was to explore client-identified important events in psychotherapy with a focus on studying therapy talk and talk about therapy from a social constructionist point of view, which would allow a closer exploration of the understudied areas mentioned above.

In Study I, Conversation Analysis was used to explore the interaction taking place between seven client-therapist dyads in 16 client-identified important events collected from their third sessions. The analysis identified that 12 of the events contained clients’ expressions of disagreement. Three different ways that the therapists handled the disagreement were discerned: The first, and most common, way was to orient to the client’s cues of disagreement by inviting the client to elaborate on his or her point of view and to establish a shared understanding acceptable to both participants. The second way was to orient to the client’s disagreement cues but define the therapist’s own point view as more relevant than the client’s, and the third way was a single case in which the therapist did not in any way orient to the client’s disagreement cues.

In Study II, two qualitative methods based on different epistemologies were used to analyse the same set of eight clients’ accounts of 18 important events. The aim was to first identify what types of events clients describe as important, and then explore how their accounts of these events were contextually shaped and  organized, and the consequences of this. The first analysis, a content analysis, yielded descriptions of five different types of events, which were similar to the ones found in previous research on important events. The second analysis, a discourse analysis, demonstrated how clients’ accounts were not only influenced by the participants’ ability to accurately remember and report their experience, but also by what was sayable within the context of the research interview. In conclusion, the two studies demonstrate how qualitative methods based on a socialconstructive perspective can contribute to our understanding of clientidentified important events by highlighting and describing participants’ use of language in interaction, and its forms and  functions within therapy sessions and in research interviews. The findings point out the need to broaden the range of qualitative methods used in psychotherapy research in general and indicate the potential value of methods like CA and DA to psychotherapy process research and research on important events in particular.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2013. , 42 p.
Series
FiF-avhandling - Filosofiska fakulteten – Linköpings universitet, ISSN 1401-4637 ; 112
Keyword [en]
Psychotherapy process, important events, clients’ experiences, conversation analysis, discourse analysis, qualitative methods
National Category
Applied Psychology
Identifiers
URN: urn:nbn:se:liu:diva-111919DOI: 10.3384/lic.diss-111919ISBN: 978-91-7519-452-3 (print)OAI: oai:DiVA.org:liu-111919DiVA: diva2:761940
Presentation
2013-01-11, I 207, Hus I, Campus Valla, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2014-11-10 Created: 2014-11-10 Last updated: 2016-05-04Bibliographically approved
List of papers
1. Client-identified important events in psychotherapy: Interactional structures and practices
Open this publication in new window or tab >>Client-identified important events in psychotherapy: Interactional structures and practices
2010 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381, Vol. 20, no 2, 151-164 p.Article in journal (Refereed) Published
Abstract [en]

This study describes interactional structures and practices in client-identified important events in psychotherapy sessions. Twelve of 16 events from seven client-therapist dyads were found to contain disagreement. A turn-by-turn investigation using conversation analysis displayed three different ways that therapists used to handle disagreement. The first was to orient to the client's disagreement cues by inviting the client to elaborate his or her point and to establish a shared understanding. The second was to orient to the client's disagreement cues but define the therapist's point of view as more relevant to the project at hand. The third was a single case where the therapist did not orient to the client's disagreement cues. The results suggest that disagreement patterns may be an interesting focus for further exploration of microprocesses within therapy sessions.

Place, publisher, year, edition, pages
Society for Psychotherapy Research, 2010
Keyword
conversation analysis; psychotherapy process; important events; client's perspective; disagreement
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-50954 (URN)10.1080/10503300903170939 (DOI)000277656500003 ()
Note

This is an electronic version of an article published in: Erika Viklund, Rolf Holmquist and Karin Zetterqvist Nelson, Client-identified important events in psychotherapy: Interactional structures and practices, 2010, Psychotherapy Research, (20), 2, 151-164. Psychotherapy Research is available online at informaworldTM: http://dx.doi.org/10.1080/10503300903170939 Copyright: Taylor & Francis http://www.tandf.co.uk/journals/default.asp

Available from: 2010-03-31 Created: 2009-10-15 Last updated: 2017-12-12Bibliographically approved
2. Two ways of analyzing clients’ accounts of important events in psychotherapy
Open this publication in new window or tab >>Two ways of analyzing clients’ accounts of important events in psychotherapy
2014 (English)Manuscript (preprint) (Other academic)
Abstract [en]

The aim of this study was to analyze clients’ accounts of important events in psychotherapy, by examining both what types of therapy events clients describe as important, and how their talk about the events is shaped and organized within the context of the research interviews. Semi-structured interviews were conducted with eight clients after their third session. A content analysis of the clients’ accounts yielded descriptions of five types of important events: feeling validated/understood, gaining insight/understanding/awareness, exploring feelings/experiencing emotions, therapist omission/therapeutic impasse, and advice/problem solving. In a second step, a discourse analysis identified one dominating interpretative repertoire that clients drew on to construct therapy as a special kind of talk that is different from everyday talk. Clients were also found to account for their experience and expertise as clients and to reject invitations to speculate about the therapist’s thoughts and feelings. These were strategies clients used to handle attempts to trouble their positions as clients, while at the same time maintaining the special-kind of talk-repertoire and addressing their accountability as clients.

Keyword
Discourse analysis; process research; important events; clients’ experiences
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-111918 (URN)
Available from: 2014-11-10 Created: 2014-11-10 Last updated: 2016-05-04Bibliographically approved

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