A Recursive Frame Qualitative Analysis of MFT Progress Note Tipping Points

Abstract

Medically oriented psychotherapists typically record progress notes by articulating client symptoms, diagnoses, functional status, progress, and adherence to treatment plans. This orientation can challenge marriage and family therapists working from discursive or post-modern perspectives. Although there are discursive therapy friendly treatment planning guides, no published research on such practice exists. To address this gap the researchers conducted a recursive frame qualitative analysis of 206 de-identified progress notes from 30 completed cases seen by MFT master's students learning discursive approaches to therapy in a university-based training clinic. Researchers found students noted problem to solution-focused discourse tipping or turning points in 20 cases with positive outcomes and no comparable shifts in 10 cases with negative or unclear outcomes.

Tangible Needs and External Stressors Faced by Chinese American Families with a Member Having Schizophrenia

“…Therapy session notes have been used in qualitative studies to capture the major themes in treatment and issues faced by clients (for example, Chenail, Somers, & Benjamin, 2009;Floersch, 2000). Therapy notes may provide a deeper ongoing understanding of clients' struggles.…”

Three Authors, One Client: A Qualitative Description of Marriage and Family Therapy Initial Case Documentation

“…In considering the possible directions therapy might take in cases with differing degrees of agreement, we also conducted a post-hoc analysis of the outcome of twenty cases at termination to see what patterns, if any, could be discerned between level of agreement and outcome as suggested by Amundson et al (2003). To accomplish this task, we reviewed the results from another study (Chenail et al 2009) which had been conducted by the fourth author of this article along with two other colleagues on the same data set as was used in this study.…”

“…We combined the results from the Chenail et al (2009) study with the results of our analysis and created a table showing the agreement and outcome determination for all 20 cases (see Table 5). This juxtaposition revealed the relationship between attunement (i.e., Grandmother, Mother, and daughter presented for therapy concerning living situation at present.…”

“…As seen from the review of the literature, although case documentation such as initial clinical intakes, client-generated information forms, and progress notes for sessions seen are normally required in therapy, there appears to be little to no research conducted on the topic (Chenail et al 2009;Harris et al 2009). Due to this lack of research, we were curious about the documentation of critical client information in the initial phase of therapy and how that impacted treatment.…”

How Master’s Students Document Stability and Change Within and Across Progress Notes

“…For every therapy session psychotherapists are required to write accurate progress notes documenting clients' presenting concerns, treatment modalities, suggested interventions, and reported changes (Cameron and turtle-song 2002;Chenail et al 2009;Fulero and has attempted to balance assumptions about a therapist's skills against requiring the therapist to demonstrate therapeutic and professional competence.…”