Blame, responsibility and systemic neutrality: a discourse analysis methodology to the study of family therapy problem talk

Abstract

In this article we present discourse analysis of initial systemic family therapy sessions, focusing on family members' responses to therapists' attempts to introduce a systemically neutral, relational perspective on their troubles, by means of circular questioning and the final team message. The article draws from a qualitative study of family therapy problem talk with a sample of nine videotaped first and second sessions with six families and four therapists. The sessions were transcribed verbatim and subjected to discourse analysis following the discursive action model. Our analysis indicates that family members may decode the therapists' discursive moves as attributing blame or responsibility to them and engage in further blaming of the identified patient. We conclude by raising the implications of the present research study for the latent attributional work in clinical practice. We also stress the potential of discourse analysis methodology for studying blaming actions and for enhancing reflexivity about our models and practices.Practitioner points • Family members may decode therapists' attempts for introducing a systemically neutral perspective as allocating blame to them for the presenting problem(s). • Practitioners should be reflexive about their potentially blaming discursive contributions in therapeutic dialogue. • Discourse analysis methodology can enhance clinicians' reflexivity about their contributions in therapeutic dialogue.

Parents’ constructions of normality and pathology in child mental health assessments

“…Ever-present is the possibility that they will be constructed as an 'over-anxious' parent, and, in this institutional setting, this formulation is diagnostically relevant, as it risks the subsequent construction that it may be the parent, rather than the child, who is 'at fault' for the problems reported by the family. For instance, issues around stake are often foregrounded against the rhetoric of mother-blaming, which has historically been common in mental illness discourse (Patrika and Tseliou 2016).…”

“…) and/or risk being positioned as responsible for the problem (Blum , O'Reilly et al . , Patrika and Tseliou ). This is particularly relevant given that it is parents who bring their children to clinics and frequently occupy much of the clinical encounter (Strong ).…”

“…These are likely to be similarly complex. In institutional settings dealing with mental health, parental differentiations of normal children from their own child's difficulties is a fragile task, as they risk positioning their child as 'unfixable' (Lester et al 2015) and/or risk being positioned as responsible for the problem (Blum 2007, O'Reilly et al 2016, Patrika and Tseliou 2016. This is particularly relevant given that it is parents who bring their children to clinics and frequently occupy much of the clinical encounter (Strong 1979).…”

Discursive psychology as a method of analysis for the study of couple and family therapy

“…For example, DP has been used in researching the discourse of the therapist (for a review see Tseliou, ), including how questions are utilized by therapists in practice (Diorinou & Tseliou, ). DP has also been used to explore the ways in which families construct their versions of events to therapists as a way of managing blame (O'Reilly & Lester, ; O'Reilly & Parker, ) and how they exonerate responsibility and accountability (Patrika & Tseliou, ). This is also the case for discursive couple's therapy research, whereby analysis has highlighted the use of extreme case formulations for managing accountability regarding the accuracy of descriptions (Edwards, ).…”

Discursive Methodologies for Couple and Family Therapy Research: Editorial to Special Section

“…Overall, discursive and language‐based research methodologies in couple and family therapy research have facilitated the study of models, interventions, and master therapists’ practices (e.g., Diorinou & Tseliou, ; Kogan & Gale, ; Muntigl & Horvath, ), of the therapeutic relationship/collaboration (e.g., Sutherland & Strong, ), of problem talk in family therapy sessions (e.g., O'Reilly, ; Patrika & Tseliou, ; Stancombe & White, ), etc. As the articles of this special section will hopefully highlight, such methodologies seem to bear potential for the study of couple and family therapy as they can facilitate the study of therapeutic dialogue from a recursive perspective (Tseliou, in press 2018).…”