From turn-by-turn to larger chunks of talk: An exploratory study in psychotherapeutic micro-processes using conversation analysis

Abstract

Independent of theoretical orientation therapies of all kind are talk-in-interaction. Influential overall conceptualizations (as e.g. intervention) belong to a certain model of medicalizing the psychotherapeutic endeavor. Talk-in-interaction is the base for applying Conversation Analysis (CA) in psychotherapeutic process research. CA is a powerful tool originating from social science taking data, hypotheses and theories from careful observing in a similar way as infant observers did. The common discovery is that conversation precedes language. Some features of infantile proto-conversation survive in adult life. CA has directed careful attention to processes like turn-taking, repair, conditional relevances, etc. in observing the rules of interaction. However, in studying psychotherapy process turn-by-turn analysis alone does not suffice. It can be completed by a new model of common ground activities and package-by-package analysis turning attention to new objects of observation in therapeutic conversation (allusions, metaphorical framing activities). We propose a methodology for both kinds of analyses based on transcribed examples from the CEMPP-Project. This exploratory designed project (Conversation analysis of empathy in Psychotherapy Process; supported by the Köhler Foundation, Germany) compared psychoanalytic, psychodynamic and cognitive-behavioral treatments in five dyads each taking transcribed sessions from the beginning, the middle phase and the end; our database includes 45 transcribed sessions.

Conversation Analysis and Psychotherapy: Identifying Transformative Sequences

“…Since then, the study of emotion, empathy, and affiliation have become even more central in conversation analysis of psychotherapy (see, e.g., Voutilainen et al, 2010a;Ekberg, Shaw, Kessler, Malpass, & Barnes, 2016;Muntigl & Horvath, 2014a, 2014bMuntigl, Knight, Watkins, Horvath, & Angus, 2013;Weiste & Peräkylä, 2014). Furthermore, conversation analytical research is increasingly addressing questions and concerns of clinical relevance (see, e.g., Buchholtz, Spiekermann, & Kächele, 2015;Buchholz & Kächele, 2017;Lepper, 2009;Sutherland, Peräkylä, & Elliott, 2014).…”

Managing Distress Over Time in Psychotherapy: Guiding the Client in and Through Intense Emotional Work

“…Research has already demonstrated that, to achieve an elaborate understanding of how therapeutic projects actually unfold over time, it is important to examine longer stretches of interaction, to ascertain whether certain therapeutic interventions are functioning in a more (or less) productive way (e.g., Voutilainen et al, 2011;Muntigl, 2013;Buchholz and Kächele, 2017). This paper has shown that a client's distress may need to be managed over many sequences and that the ways in which distress is dealt with in one interactional phase may occasion different responses from the therapist.…”

Exploring Conversational and Physiological Aspects of Psychotherapy Talk

“…In this study we expanded the focus of analysis from brief interactional sequences to longer stretches of talk spanning the whole session in an attempt to track the development of meanings over time (Buchholz and Kächele, 2017). This 'zooming out' allowed us to observe what, from a psychoanalytic perspective, would be considered the process of free association.…”