Observing therapeutic interaction in the “Lisa” case

Abstract

This is the third of a series of pilot studies that seeks to validate a method for the identification and analysis of clinically significant interactions in the psychotherapy process. Using a combined method, the authors demonstrate that the therapeutic cycles model (Mergenthaler, 1996) can be used reliably to identify clinically significant events across sessions, which can then be analyzed at the level of the therapist-client interaction using conversation analysis, a discipline that has generated a substantial body of knowledge of how meaningful interaction is achieved by speakers on a turn-by-turn basis. The authors demonstrate that significant events can be compared within and across cases in order to understand how therapist interventions contribute to within-session micro-outcomes and, ultimately, to outcomes across populations of cases.

Psychotherapy Research Needs Theory. Outline for an Epistemology of the Clinical Exchange

“…Instances of this strategy of analysis are studies that analyze the patient's narrative (for a review of the narrative approach to psychotherapy, see Angus and McLeod 2004), or the linguistic markers associated with the clinical exchange (Reyes et al 2008), or the pragmatic regulation of the patient-therapist communication (Lepper and Mergenthaler 2008;Lepper 2011). Still, one can refer to Zittoun 2011, who interprets the psychotherapy change in terms of the transformation of semiotic sets-namely, clusters of generalized meanings through which persons shape their experience.…”

A theoretical and methodological proposal for the descriptive assessment of therapeutic interactions

“…We think that the descriptive methodology presented in this study could be a good choice for the analysis of the therapeutic interaction and that, although much work remains to be performed, this could be the first step toward a functional Psychotherapy Research 19 approximation of what occurs in therapy (Lepper & Mergenthaler, 2008). From there, we might be able to gain insight into change mechanisms that operate in an area as complex as the clinical context, knowing that understanding such mechanisms is the best way to improve psychological treatments (Kazdin, 2007).…”

The pragmatics of therapeutic interaction: An empirical study

“…A wide body of research demonstrates that clinical interactions are observable at many levels – in the non‐verbal rhythms of interaction, in the postures, gestures and movements of the speakers (Tschacher and Dauwalder, 2003); in their facial expression (Beebe, 2004; Beebe et al ,, 2005, Benecke et al ., 2005; Benecke and Krause, 2005); and at the verbal level, in the talk itself (Lepper and Mergenthaler, 2005, 2007, 2008). This study focuses on the turn‐by‐turn talk of a therapist and patient, using transcripts as data.…”