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European Journal of Psychotherapy & Counselling

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Discourse analysis and psychotherapy: A critical review

Evrinomy Avdi & Eugenie Georgaca
a a a

Aristotle University of Thessaloniki, Greece

Available online: 08 Jun 2007

To cite this article: Evrinomy Avdi & Eugenie Georgaca (2007): Discourse analysis and psychotherapy: A critical review, European Journal of Psychotherapy & Counselling, 9:2, 157-176 To link to this article: http://dx.doi.org/10.1080/13642530701363445

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European Journal of Psychotherapy and Counselling, June 2007; 9(2): 157176

Discourse analysis and psychotherapy: A critical review

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EVRINOMY AVDI & EUGENIE GEORGACA

Aristotle University of Thessaloniki, Greece

Abstract This paper aims to render the research literature on discourse analysis of psychotherapy more accessible to researchers and clinicians, and to provide a concise presentation and evaluation of both the usefulness and the implications of this body of research for our understanding of therapy process. Included in the review are studies which use discourse analysis on actual session transcripts. The studies are organized according to the stance they adopt towards psychotherapy, ranging from studies which take for granted psychotherapeutic assumptions and aim to illustrate the discursive basis of therapeutic notions, to studies which take a critical deconstructive stance towards therapy and examine the links between psychotherapy as social practice, wider systems of meaning and institutions. The main issues addressed by the studies reviewed are: the processes of meaning transformation, aspects of the clients subjectivity, the function of the therapist, as well as issues relating to power and the role of wider socio-cultural discourses. The paper discusses the contribution of discourse analysis to our understanding of therapy process and the enhancement of therapy practice, mainly in terms of promoting therapist reflexivity.

Keywords: context

Discourse analysis, psychotherapy, process research, agency, power,

Social constructionism and the turn to language have influenced both the theory of psychotherapy and the research of therapy process. There is now a considerable body of literature applying a social constructionist and

Correspondence: Evrinomy Avdi, Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki 541 24, Greece. E-mail: avdi@psy.auth.gr
ISSN 13642537 print/ISSN 14695901 online/07/02015720 2007 Taylor & Francis DOI: 10.1080/13642530701363445

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a deconstructionist perspective to psychotherapy (Hook, 2003; McNamee & Gergen, 1992; Parker, 1999), but there are relatively few studies which utilize qualitative constructionist methods to study therapy process. Thus, although the notion of discourse is increasingly employed in discussions of therapy (Foreman & Dallos, 1992; Hare-Mustin, 1994; Kogan & Brown, 1998; Weingarten, 1998), there are few discourse analytic studies which analyse actual therapy session transcripts. Moreover, much of this research has been carried out without adequate acknowledgement of relevant studies already published (Soyland, 1995). In this review paper we attempt to organize studies which employ discourse analysis to examine psychotherapy process, with the aim of rendering the existing literature more accessible to researchers and therapists and providing a concise presentation and evaluation of both the usefulness and the implications of this body of research for our understanding of therapy process. For the purpose of this review we have included studies which use discourse analysis to analyse actual psychotherapy sessions. Thus, a number of interesting papers which employ the notion of discourse to theorize psychotherapy but do not actually analyse therapy sessions (e.g. Foreman & Dallos, 1992; Hare-Mustin, 1994; Kogan & Brown, 1998; Weingarten, 1998) or analyse sessions using a different constructionist methodology (e.g. Georgaca, 2001, 2003; Hodges, 2002; Hook, 2001) were excluded. The exclusive focus on discourse analytic studies of psychotherapy meant that we do not address the considerable body of conversation analytic studies of therapy sessions (e.g. Buttny, 1996; Gale, 1991; Gale & Newfield, 1992; Madill, Widdicombe, & Barkham, 2001; Perakyla & Silverman, 1991; Silverman, 1997). We have similarly not included the third main language-based approach to the study of psychotherapy, i.e. narrative analysis (McLeod, 2001), which we review elsewhere (Avdi & Georgaca, in press). Discourse analysis can be defined in general terms as the study of language in use (Wetherell, Taylor, & Yates, 2001a, p. 3), and it adopts a social constructionist view of language as context-bound, functional and constructive (for introductions to the notion of discourse and discourse analysis, see Mills, 1997; Van Dijk, 1997; Wetherell, Taylor, & Yates, 2001a, 2001b). The discourse analytic studies of psychotherapy that we review here are characterized by diversity with regard to the way discourse is conceptualized and analysed. More specifically, a few of the studies reviewed draw upon the concept of discourse as developed in linguistics, where discourse analysis refers to the study of speech beyond the sentence, with reference to the linguistic, interactional and wider social context of talk (Labov & Fanschell, 1977; Tannen, 1989; see also Mills, 1997). The vast majority of the studies reviewed, however, draw upon discourse analysis as developed in social psychology and increasingly used in other areas of psychology. Here, a distinction is commonly made between two strands of discourse analysis (Willig, 2001; Widdicombe & Wooffitt, 1995). On the one hand, discursive psychology (Billig, 1997; Edwards & Potter, 1992) draws from ethnomethodology and conversation analysis and produces fine-grained analysis of the

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function of talk in negotiating reality, agency and accountability. On the other hand, post-structuralist discourse analysis (Burman & Parker, 1993; Parker & the Bolton Discourse Network, 1999) investigates the ways in which broader culturally available systems of meaning are drawn upon in the construction and negotiation of accounts and is concerned with the role of power, culture and institutions in shaping talk. The notion that discourses entail positions for participants is central to both strands. Organization of this review We have organized the studies presented in this review according to the stance they adopt, implicitly or explicitly, towards psychotherapy, which ranges from a stance accepting of therapeutic principles to one critical of therapy as an institution. This conceptual axis allows for a discussion of the usefulness, the implications and the limitations of different approaches to the study of discourse to our understanding of therapy process. It is worth keeping in mind, however, that these positions represent two ends of a continuum and the majority of discourse analytic work on psychotherapy is located at different points along this continuum. More specifically, at one end of the continuum are studies that take therapeutic assumptions for granted and aim to demonstrate the linguistic and discursive phenomena that underlie psychotherapeutic processes, without questioning therapeutic conceptualizations of the nature and usefulness of therapy. In general, what these studies accomplish is to build bridges between the macro-level of therapeutic description and the micro-level of linguistic phenomena. In this way, they further our understanding of therapy process in linguistic terms and function towards developing therapy process research which is in line with the constructionist emphasis on language. Moreover, in approaching therapy as a process of meaning co-construction, most attend to the therapists contribution to the unfolding dialogue and thus point to the need for therapist reflexivity. On the other hand, this style of analysis, in focusing almost exclusively on the micro-level of language production, tends to overlook the social, cultural and institutional context of therapy talk, which in our view constitutes an important shortcoming of this body of research. At the other end of the continuum are studies that assume a critical position with regard to psychotherapy, in the sense that they question therapeutic assumptions and aim to make explicit the links between psychotherapy as a practice and wider systems of meaning, institutions and power relations. These studies offer a cogent deconstructive critique of therapy and attend to issues of power and ideology but they can be criticized for being of little use to clinicians, as their arguments may be seen to be removed from the concerns of actual clinical practice. The main body of the paper is organized on the basis of aspects of the psychotherapy process that have been examined by the studies reviewed. We will discuss, in turn, the process of meaning transformation within psychotherapy sessions, different aspects of the clients subjectivity and the function of the therapist. The two subsequent sections discuss how the

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discourse analytic studies of psychotherapy have addressed the issue of power and the role of wider socio-cultural discourses. Within each section we move along the continuum from studies which accept psychotherapeutic premises to those which are critical of them. The same trend can be traced throughout the paper, with the first sections discussing issues relating to therapy process from within a therapeutic frame and the latter sections presenting studies which tend to be critical of therapy. Another important aspect of the various studies reviewed relates to the focus of the analysis, that is whether it focuses on the client, the therapist or their interaction, and whether it focuses on the content of the talk or the underlying social structure and process. The few studies which focus primarily on the clients talk tend to examine the content of talk and to assume a representational view on language, whereby features of the clients talk are, often implicitly, treated as reflecting some inner state, experience or meaning. These tend to utilize discourse analysis drawing from the field of linguistics and generally adopt a pro-therapy stance. The majority of studies, however, focus on the client-therapist interaction. These analyses tend to give primacy to the study of interaction and social structure and assume a functional approach to language. Moreover, they utilize discourse analysis as understood in psychology (that is, discursive psychology and post-structuralist discourse analysis) and are located somewhere along the continuum between acceptance and critique of psychotherapy. It is worth stressing here that each of the trends described above generates different accounts of what psychotherapy is, producing, thus, certain descriptions of psychotherapy process, as well as what psychotherapy research should look like, generating specific versions of useful psychotherapy process research. Therapy as a process of meaning transformation In constructionist terms, therapy is conceptualized as a semantic process of meaning transformation whereby therapeutic resolution is seen to evolve from shifts in the ways clients describe their predicament, rather than from change in some underlying psychological mechanism (Madill & Barkham, 1997). Accordingly, most discourse analyses of therapy focus on the process of meaning construction and reconstruction that is assumed to take place in the clinical dialogue. In this section, we present examples of studies that examine the transformation of meaning, and in particular the transformation of accounts of the problem that brought clients to therapy, from within a psychotherapeutic frame and discuss their implications for our understanding of therapy process as well as their limitations. We will present studies of the process of meaning transformation which adopt a more critical approach towards therapeutic assumptions in later sections, when we discuss issues of power and the role of wider discourses in therapy. More specifically, some studies focus primarily on shifts in the discourses employed by the clients over time (e.g. Avdi, 2005; Burck, Frosh, Strickland-Clark, & Morgan, 1998; Burman, 1992, 1995; Guilfoyle, 2002;

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Kogan & Gale, 1997; Madill & Barkham, 1997; Madill & Doherty, 1994; Soal & Kottler, 1996). A typical example of this is a study by Burck, et al. (1998) where the authors examine how a systemic therapists interventions function to shift one familys construction of their difficulties (the parents lack of control over their children) from a discourse of being out of control to one of being in charge. The analysis demonstrates how this shift is achieved through the therapist re-contextualizing and reframing the clients accounts and, in this way, opening them to alternative meanings. The study, thus, demonstrates how an important systemic concept, that of change in constructions of the problem, is actualized in the psychotherapeutic encounter, and is therefore in line with clinical theory and the clinicians concerns. However, the lack of documentation of any interactional work in the analysis actually sidesteps the therapists role in shaping the unfolding talk and replaces it with a notion of a neutral therapist whose sole role is that of facilitating change in the desired direction. In this way, this type of analysis fails to examine important issues in the process of meaning transformation, such as ideology and power. This is, to our view, a crucial issue which could be fruitfully explored from a discourse analytic perspective, in contrast to other more descriptive qualitative approaches, a point which we elaborate later in this paper. In addition to the discourses used, several studies focus on the flexibility with which clients employ a diverse range of discourses and subject positions (Avdi, 2005; Frosh, Burck, Strickland-Clark, & Morgan, 1996; Madill & Barkham, 1997). These studies draw from the constructionist assumption that the establishment and maintenance of psychological difficulties relies on a recursive process which involves a narrowing of the repertoire of available narratives and the dominance of problem-saturated meanings, typically but not exclusively associated with psychiatric discourse (Avdi, 2005). As a consequence, it is assumed that change in therapy is related to an enhancement of the clients ability flexibly to adopt a wider range of discourses on the same theme, to hold more complex views and to accept others perspectives, an assumption which is in agreement with recent conceptualizations of the self as fluid, dynamic, reflexive and polyphonous (Rowan & Cooper, 1999; Stiles, 1997). For example, Madill and Barkham (1997) and Madill and Doherty (1994) postulate a relationship between the clients capacity to position herself in a wider range of subject positions and psychological improvement, based on the analysis of a brief psychodynamic-interpersonal psychotherapy. Taking this view further, Frosh et al. (1996) put forward the claim that flexibility of discourse use can be treated as a potential outcome variable in psychotherapy research. More specifically, Frosh et al. (1996) examined shifts in the way important themes were talked about in a systemic family therapy with a family dealing with parental separation. The analysis demonstrates a shift from the parents adopting symmetrically opposing constructions regarding their difficulties at the beginning of therapy, to the male partner moving in the direction of adopting the discourse preferred by the female partner (and, although not acknowledged in the study, also the therapists preferred

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discourse) and to both partners positions becoming more fluid, flexible and less polarized. This study is similar to the one by Burck et al. (1998) in that it also provides a reading of psychotherapy which is in accordance with systemic therapy principles, but sidesteps the rhetorical, persuasive and constraining aspects of therapy, and therefore does not consider the contextualized nature of therapy (Stancombe & White, 1997). Summarizing the above, several studies utilize discourse analysis to examine the transformation of meaning in therapy, thus furthering our understanding of therapy process. However, the almost exclusive focus on the clients talk precludes the full exploration of issues relating to the role of the therapist in the process of meaning transformation, although this is acknowledged. These studies start from a position of acceptance of therapeutic assumptions regarding therapy and their main contribution lies in demonstrating the micro-processes through which psychotherapeutic notions are applied in actual practice. Thus, the knowledge they generate is relevant to clinical concerns and directly applicable to clinical practice. On the other hand, in focusing primarily on the micro-level of linguistic interaction these studies fail fully to exploit the potential of discourse analysis as a deconstructive and critical approach to therapy process research. Shifts in the construction of subjectivity Another important issue relating to the transformation of meaning during therapy concerns the (re-)construction of subjectivity. In this section we discuss three interlinked aspects of subjectivity, which have been explored in discourse analyses of therapy sessions, namely self-reflection, the negotiation of agency and the attribution of responsibility and blame. Self-reflection Most traditional and constructionist conceptualizations of therapy view self-reflection, that is a persons capacity to reflect on their internal experience, their behaviour and its effects on others, as an important aspect of change. This is an aspect of therapy process that has been investigated in some studies. For example, Nye (1994) documents the development of the clients self-analytic function, based on the analysis of a successfully completed psychoanalytic psychotherapy. The self-analytic function was examined using the notions of referential and evaluative clauses, that is, sentences which express facts and sentences which express meaning respectively. In short, the analysis demonstrates how the client gradually becomes more active in trying to establish the meaning of her narratives, whereas the therapist becomes correspondingly less active. The arguments regarding the development of the self-analytic function are linked to psychodynamic theory regarding therapeutic change. Similar arguments are made by Wodak (1981, 1996), based on the analysis of group therapy sessions and individual interviews with group members and staff using discourse sociolinguistics and critical discourse analysis, regarding

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the development of linguistic awareness, a notion akin to self-reflection. The analysis suggests that linguistic awareness, which refers to the clients attitude towards their own speech behaviour as expressed in selfcontemplation and the degree of realistic assessment of their own speech, significantly correlates with therapeutic change. The studies discussed above assume that self-reflection is a useful concept in process research, that it potentially constitutes a bridging concept between theory and practice, and that it can be studied through analysing the clients talk, although each paper studies it in a different way depending on its theoretical underpinnings and analytic approach. These studies take for granted the psychotherapeutic assumption that self-reflection is an internalized, psychological capacity that the client gradually acquires through the process of therapy, and that this is associated with therapeutic change. In accordance with this, they focus on the clients talk and consequently downplay the interactional aspect of self-reflection. The inner-self orientation of such analyses sits uneasily, in our view, with the theoretical underpinnings and aims of discourse analysis. The negotiation of agency Another aspect of subjectivity examined in several of the studies reviewed concerns the negotiation of agency in therapy. Many studies share an assumption that the self-constructions which relate to psychological wellbeing are those that involve the notions of personal agency and self-definition, a view which is in line with self-contained individualism (Sampson, 1993). The studies reviewed could be conceptualized as lying along a continuum with respect to the position they assume with regard to agency. More specifically, at one end of this continuum are studies that take this assumption at face value, as for example the study by Burck et al. (1998) described above, in which the shift in discourse use by the family towards a more agentic position, i.e. that of being in control, is unquestionably considered to be therapeutic. Further along the continuum are studies that note the promotion of an agentic discourse in therapy talk, make reference to its links to a wider set of socio-cultural assumptions regarding selfhood but do not discuss the implications, on an ideological or political level, of therapy furthering such assumptions. For example, in a study of a systemic therapy with a family with a child diagnosed as autistic, Avdi (2005) investigates the process of de-centring the dominance of the medical discourse in the parents narratives and allowing alternative, less problem-determined narratives to emerge, including negotiating and discursively restoring some notion of the child as a competent social agent. Drawing on the analysis, it is argued that the negotiation of agency is an important feature in the therapy with families where a psychiatric diagnosis exists, as the diagnosis tends to objectify the person and to strip them of any notion of intention or motivation, while agency is often projected into their condition. In other words, it is assumed that the construction of the child as an agent in the parents talk as well as in their actual interaction in the sessions reflects an important aspect of change

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in therapy. In a similar vein, Madill and Barkham (1997) and Madill and Doherty (1994) demonstrate how a female client initially presents her account in terms of obligations to others, whereas the therapist, drawing upon a Western, masculine individualist account, constructs her as a passive recipient of other peoples wishes, which is represented as problematic. The therapist puts forward the notion of a duty towards oneself, which the client gradually adopts. In these studies, although the authors aim to demonstrate how culturally ordained meanings can be brought into the consulting room as intimately personal problems, the analysis falls short of discussing the values negotiated in the particular therapies in relation to culturally preferred systems of meaning, for example in relation to gendered views regarding ideal personhood. In the three studies mentioned above, analytic attention is paid to the way agency is negotiated in therapy talk; in this way, these papers point to the importance of studying therapy talk in terms of both the micro-processes that take place in the psychotherapeutic encounter and the macro-processes that involve culturally preferred ways of constructing selfhood. However, they do not take this argument further, in terms of considering the implications of therapeutic discourse in constructing subjectivity, in structuring relationships and in negotiating power. These are questions that are addressed by the final group of studies that assume a critical position towards therapy, approaching it as an institution, and discuss the implications this has for promoting certain ideals about the self. For example, in a discourse analysis of a family therapy, Guilfoyle (2002) argues that psychotherapy is an institutional site for the construction of selfhood in line with the contemporary Western ideal of self-contained individualism, that is to say, a self characterized by self-determination and clear boundaries with others. The analysis focuses on how speakers construct different accounts of the referred patients behaviour and on the functions of these constructions in terms of negotiating blame. In this context, the therapist is shown to promote actively the construction of narratives of selfcontainment, by reifying certain accounts and making them appear as objective, true or real, and by ironizing, criticizing and devaluing alternative conceptions of selfhood, so that they appear less convincing. More specifically, the analysis demonstrates how the family members repeatedly represent the sons problematic behaviour as driven by forces beyond his control, in accounts which minimize his agency. The therapist, on the other hand, persistently pursues a version of the young man as an agent and is very active in co-opting the family to accept this agentic discourse with a series of rhetorical strategies. Moreover, the fact that this version has been jointly produced is concealed and comes to be seen as a fact that the therapist enabled the family to see. This paper provides an example of a very competent analysis of many issues that critical deconstructive studies of psychotherapy address, such as the rhetorical and persuasive nature of therapy, the active role of the therapist in pursuing their agenda as well as the function of therapy as a social institution, promoting specific, culturally sanctioned modes of subjectivity.

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Recent studies of therapy process suggest that a central issue in therapy talk concerns questions around responsibility and blame regarding the clients difficulties. The attribution of responsibility and blame has been analysed primarily in the context of systemic therapy, a trend which reflects the constructionist and interactional focus of systemic therapy as well as its commitment to a professional ethic of neutrality or multi-partiality (e.g. Kurri & Wahlstrom, 2005; OReilly, 2005; Stratton, 2003a, 2003b). In this section, we discuss two papers by Stancombe and White (1997, 2005). In the first paper, Stancombe and White (1997) re-analysed the material initially analysed by Frosh et al. (1996) of a family therapy with a family facing parental separation, and focus on the rhetorical, interactional and situated features of talk rather than on its content. Their analysis emphasizes the management of blame, as evidenced through the different discourses in relation to the problem pursued by each partner; the female partner adopts a managing change discourse, according to which the separation is a problem that should be dealt with through therapy, and implicitly blames her husband for it, while the male partner adheres to an evolutionary change discourse, representing the separation as a natural process which will be consolidated by the family in time, thus exonerating himself from blame. The analysis demonstrates how the discourse that the male partner employs reflects the way he has been positioned as an irresponsible parent by the female partner and the therapist, both of whom adhere to the managing change discourse. It also highlights the complex role of the therapist as a social actor, who actively co-constructs accounts and manages the encounter in situations of possible conflict. In this way the analysis demonstrates how the therapist is far from neutral, in the sense that he adheres to certain psychotherapeutic (it is good to talk to sort things out) and other assumptions (divorce can be damaging to children), which he attempts to impose on the unfolding narrative. In the second paper, Stancombe and White (2005) investigate the rhetorical strategies that systemic therapists use in managing blaming accounts by family members and in crafting non-blaming accounts, as well as how these are responded to by family members. It is argued that, in their effort to accomplish multi-partiality, therapists inevitably make moral and practical decisions regarding the conflicting accounts they are faced with, both in their actual interaction with families and backstage, in the context of team discussions. In the above papers, Stancombe and White (1997, 2005) make some significant points regarding the usefulness of analysing therapy sessions with a focus on the rhetorical and performative aspects of talk. By assuming a performative focus on language, the analysis allows the examination of how blame is negotiated and avoids developing a cognitivist argument regarding the meanings and views that participants hold. Furthermore, they suggest that, in studying issues around blame as interactional accomplishments, the therapists active role in promoting certain versions of reality is revealed, and this in turn makes it possible to acknowledge and examine the therapists

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engagement with moral issues. This in turn points to the need to consider the ways in which therapy is embedded in a wider system of discourses relating to values, morality and ideology, and functions to reproduce them. These points are further discussed in the sections that follow. Examining the therapists role As already mentioned, most discourse analytic studies focus on the therapistclient interaction and examine the ways in which therapy is performed, the rhetorical strategies employed by therapists and the effects their interventions have on clients narratives (Avdi, 2005; Burck et al., 1998; Burman, 1992, 1995; Ferrara, 1992; Guilfoyle, 2002; Lewis 1995; Madill & Barkham, 1997; Madill & Doherty, 1994; Roy-Chowdhury, 2003; Soal & Kottler, 1996). Again, there exist a range of approaches to analysing the therapists contribution to the unfolding dialogue. In some studies the therapists contributions are analysed non-critically and they are assumed to promote therapeutic change when they are in line with basic therapeutic principles. Examples of such an approach are the studies by Burck et al. (1998), Ferrara (1992), Finlay and Robertson (1990), Frosh et al. (1996), Lewis (1995) and Nye (1994). The usefulness of these studies lies mainly in the fact that they provide detailed, language-based descriptions of the therapists interventions, a focus which is consistent with the constructionist view of the therapist as a master conversationalist or a friendly editor of clients narratives (Kogan & Gale, 1997). In this way, they generate knowledge regarding how the therapeutic stance is translated into linguistic practice, from within a therapeutic frame, which can be useful to clinical work, training and supervision. In addition, with regard to more traditional forms of therapy, such analyses highlight the relevance of a language-informed reading for all therapy, thus promoting the cross-fertilization between different approaches to therapy. For example, Finlay and Robertson (1990) draw upon Bakhtin and Foucault to explore the use of quasi-direct discourse in psychoanalytic psychotherapy and its therapeutic functions, thus providing a constructionist reading of psychoanalytic practice, which can broaden the theoretical basis of psychoanalytic therapy. Other examples of this approach are the studies by Ferrara (1992) and Lewis (1995) both of which focus on the linguistic strategies through which therapists pursue the creation of empathy, conversational involvement and coherence in sessions. In contrast to the above, several studies assume a more therapy-neutral stance, in the sense that they focus on the therapists agenda, i.e. the consistent influence of the therapist on the unfolding narrative. These studies adopt a position external to the therapeutic frame and sometimes offer a critique of therapeutic assumptions (e.g. Burman, 1992, 1995; Guilfoyle, 2002; Kogan, 1998; Roy-Chowdhury, 2003). We will discuss the implications and the usefulness of such analyses through reference to two papers, by Kogan and Gale (1997) and Kogan (1998). Both papers examine therapy sessions with a focus on the therapists agenda and the specific rhetorical strategies with which this agenda is pursued, and aim to examine the ways in which

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constructionist therapy is done in practice, to research the productive and restraining effects of therapy talk and to contribute to an understanding of the links between therapy talk and the socio-political context in which therapy operates. Each analysis is based on a videotape of one consultation session with the same couple and a different therapist; the therapists are distinguished experts in their respective orientation, namely narrative therapy and solutionfocused therapy. The couple comes to each consultation constructing the difficulties they experience in terms of the notion that the female partner exerts excessive control on the relationship and that, for change to occur, the male partner needs to adopt a more dynamic role. The paper by Kogan and Gale (1997) demonstrates how the couple pursues their agenda in terms of promoting their insight regarding their difficulties and the interventions through which the narrative therapist pursues a de-centring and co-authoring agenda, that is to say, facilitates the creation of multiple centres and authorial positions, thus promoting a multiauthored narrative. The analysis is very useful, theoretically and clinically, as it shows how the interventions of a politicized post-modern therapist can be attentive to power relations and the effects of dominant narratives, and can subvert them, thus accomplishing deconstruction in practice. In the second paper by Kogan (1998) the solution-focused therapist is shown to employ a set of strategies which constitute a discursive technology to control the unfolding narrative. The study also considers the restraining aspects of the therapists interventions and their effects on a socio-political level. More specifically, it is suggested that the solution proposed by the couple and pursued by the therapist functions to pathologize the female partners agency and pays no attention to her attempts to formulate a different agentic position; in this way, it conforms to and reproduces the traditional discourses of white, heterosexual marriage, where the man should be in control. Following from the analysis, solution-focused therapy is criticized for providing no means of examining dominant discourses and of interpreting power, something which may potentially lead to an unequal distribution of agency and the reproduction of existing power relations. Through careful examination of the therapists talk, the two studies above provide clear descriptions of the rhetorical strategies employed by constructionist therapists. In this way, they demonstrate how the principles of constructionist therapy are applied in practice and render these strategies open to examination and critique. Moreover, these studies examine the implications, on a socio-political level, of the therapists agenda from a vantage point external to therapy theory. In the first paper, the narrative therapists agenda is shown to be in line with the principle of deconstruction, whereas in the second paper the solution-focused therapists agenda is criticized for functioning in a way that maintains the status quo. It is worth noting that the two papers are markedly different with regard to their approach to the two therapies and the analysis is noticeably more critical of the solution-focused therapists (Kogan, 1998) than of the narrativetherapists interventions (Kogan & Gale, 1997). This difference presumably reflects the authors own position with regard to the two therapeutic

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approaches as well as the theoretical affinity between narrative therapy and discourse analysis as social constructionist approaches. It does, however, beg the question of whether a truly neutral research stance with respect to psychotherapy is achievable. The investigation of the therapists agenda inevitably brings to the fore concerns regarding power and the embeddedness of therapy in a wider context of culturally sanctioned discourses, issues that are elaborated in the sections that follow.

Investigating power in therapy

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The issue of power in psychotherapy is usually understood in terms of the therapist, due to their position of authority and expertise, having a significant influence in effecting change on the client. This is seen as benign to the extent that the therapist uses their power to move the client in the desired direction according to the aim of therapy, and as abusive when the therapists influence deviates from the prescribed therapeutic frame. More complex notions of power, which view it in relation to the production of a certain kind of knowledge, link it with wider social processes and highlight the intricate play of power and resistance, have entered the field of psychotherapy in the past few years (Guilfoyle, 2005). Moreover, the way power in therapy is conceptualized is intimately related to ones position with respect to psychotherapy, with the former stance adopted by those who adhere to psychotherapeutic discourse and the latter by those who take a more critical position towards psychotherapy as a social practice. The studies reviewed here can be classified in three broad strands with respect to the way they address issues of power, which parallels their position towards psychotherapy. Some studies analyse the therapists interventions in terms of the effects they are designed to have, or actually have on the client. This is usually seen as part of the therapists role in furthering the aim of therapy and is not explicitly discussed in terms of power (e.g. Avdi, 2005; Burck et al., 1998; Ferrara, 1992; Finlay & Robertson, 1990; Frosh et al., 1996; Lewis, 1995; Nye, 1994). Other studies examine how the therapists interventions are designed to pursue the therapists agenda, be it consistent with the therapists therapeutic orientation or reflecting other culturally dominant discourses, and sometimes examine the clients resistance to this imposition. These studies rely on the Foucauldian notion of power/knowledge and analyse power mainly in relation to the imposition of certain types of knowledge. Moreover, these studies tend to subscribe to a monolithic view of power as being exercised by the therapist and imposed on or resisted by the clients (Guilfoyle, 2002; Kogan, 1998; Madill & Barkham, 1997; Madill & Doherty, 1994). The main contribution of this body of research with regard to studying power in therapy is that it highlights the unavoidable interlinking between power and knowledge, thus pointing to the need for therapist reflexivity in terms of his/her theory, techniques and values and the effects these have on the clients reconstructed self-narratives and subjectivity.

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Finally, a third group of studies assume that power is an omnipresent, interactional, dynamic phenomenon, which is variable and under negotiation in every interaction (Burman, 1992, 1995; Roy-Chowdhury, 2003; Stancombe & White, 1997). We will illustrate this viewpoint through reference to two related studies by Burman (1992, 1995) in which she examines the negotiation of subjectivity, identifications and power in a feminist-psychodynamic therapy. Burman (1992, 1995) argues that analyses of therapy should take into consideration the various discursive positions available to participants and the power differentials that these entail. The particular analysis investigates the power dynamics linked to the multiplicity of positionings of the two participants, as therapist and client, as therapist and therapist-in-training and as women. Moreover, the positions adopted and struggled over derive from the broader discourses the participants draw upon. In this case the analysis demonstrates how the power struggles between therapist and client are linked to the therapeutic discourse they each subscribe to, namely psychodynamic for the therapist and humanistic for the client, as well as to the contradictions between these psychotherapeutic discourses and the feminist discourse that both parties adhere to. Finally, the study highlights the interactional strategies through which these positions and discourses are struggled over, including the various strategies of resistance employed by the client. Such a reading is, to our view, very useful as it transcends a unidirectional perspective on power and allows for power to be examined as an interactional and contextualized accomplishment. This makes it possible to develop more complex and subtle readings of therapy, taking into account the micro-level of actual interaction, the variety of subject positions available to participants in a therapeutic interaction, as well as the broader structural and institutional context of therapy. Examining the role of wider discourses in therapy Most discourse analytic studies argue the importance of acknowledging the social context of therapy and the wider discourses in which therapy operates and which it often reproduces. A number of hegemonic discourses have been investigated from this perspective, concerning dominant notions of subjectivity (e.g. Burman, 1992, 1995; Guilfoyle, 2002; Kogan & Gale, 1997), gender (e.g. Burman, 1992, 1995; Kogan, 1998; Madill & Barkham, 1997; Madill & Doherty, 1994), family relations (e.g. Madill & Barkham, 1997; Soal & Kottler, 1996), medicine (e.g. Avdi, 2005) and culture (e.g. RoyChowdhury, 2003; Soal & Kottler, 1996). From a constructionist viewpoint, such culturally preferred ways of constructing reality are seen to be implicated in the creation, maintenance and dissolution of psychological difficulties and, therefore, the examination of the ways these discourses are negotiated in actual sessions is considered a useful focus of process research. In one such example, Roy-Chowdhury (2003) analyses a family therapy with the aim of investigating the congruence between the therapists theoretical positions regarding power and culture and the application of these positions in practice. With regard to culture, given that the male partner

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is of Indian origin, the analysis suggests that his talk can be understood within the context of Indian discourses as well as of his experiences of migration and racism. More specifically, the analysis demonstrates that the male partners talk invokes Indian discourses regarding the therapist, who is constructed as an expert and akin to family elder, regarding mental illness, which is constructed as a physical illness and a source of shame, and regarding family interdependence, represented as an important value. The analysis suggests that the therapist sidesteps these issues and, in this way, decontextualizes the Indian clients speech from the cultural presuppositions that sustain it, resulting in silencing him and in reinforcing a Western view of the family. This analysis highlights the dangers involved when therapy fails to consider dominant discourses, regarding for example culture, whereby the therapists values are implicitly assumed to be universal and are imposed on the clinical dialogue. In another example, Soal and Kottler (1996) analyse a narrative family therapy with a black family in South Africa. The main problem-saturated narrative of the family is that they are damaged and deficient, and thus in need of expert help. For the purposes of this review, we will discuss only the discourse of civilization, one of the culturally preferred discourses which are shown to be implicated in the maintenance of this problem-saturated narrative, and consequently the familys difficulties. The family are shown to invest in this discourse, which assumes Western, middle class values as universal, in order to resist the claims of apartheid discourses of racial difference, which would render them unworthy. However, this same discursive investment contributes to the family being constructed as deficient in relation to the civilized ideal, and requires them to reject aspects of their culture in order to achieve civilization and healing. In addition, the disparity between the familys background and the values of the Western liberal discourse of civilization results in the familys difficulties being constructed as individual and internal to the family. This study provides a theoretically interesting and clinically relevant discussion of the role of discourses, positioning and contradiction in therapy. It is a good example of how constructionist analyses can be helpful in furthering our understanding of how hegemonic discourses are reproduced in families accounts of themselves and perpetuated through the micro-practices in which they engage, as well as in how these can be shifted through the therapeutic enterprise. Psychotherapeutic practice is permeated not only by culturally available discourses, of the kind analysed above, but also by psychotherapeutic discourses, that is systems of meanings that have been constructed by psychotherapy as an institution and which are maintained through psychotherapeutic practice. From a constructionist perspective it has been argued that psychotherapy, at both a local and an institutional level, attends selectively to the issues brought by the client and reformulates them in such a way as to transform them into psychological problems in need of expert intervention. This process usually entails the reframing of difficulties as psychological, individual and pathological and at the same time decontextualizes them from the interactional and social context of the clients

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life (Hook, 2001). A number of discourse analytic studies have explored the ways in which psychotherapeutic discourses about the sources of client difficulties, the desired direction of change, the ideal subjectivity, the nature of the therapeutic encounter, among others, are implicated in therapy sessions (Burman, 1992, 1995; Soal and Kottler, 1996) mainly with an emphasis on the strategies through which the therapist attempts to educate clients into adopting therapeutic discourses (Guilfoyle, 2002; Kogan, 1998; RoyChowdhury, 2003; Stancombe & White, 1997). Similar arguments, regarding the promotion of psychotherapeutic discourses, in relation to the way that the problem is re-formulated in clinical encounters have also been made in constructionist studies that employ analytic approaches other than discourse analysis, such as conversation analysis (e.g. Davis, 1986; Miller & Silverman, 1995), Foucauldian analysis (e.g. Hodges, 2002) and grounded theory (e.g. Hook, 2001, 2003). The contribution of discourse analysis to psychotherapy process research Summarizing the above, in this paper we argue that discourse analysis constitutes a very useful, if underused, approach in the study of psychotherapy process, with many theoretical and clinical implications. Like other qualitative approaches, discourse analysis is open-ended and discovery oriented, and produces thick and detailed descriptions of what actually takes place in therapy, rather than reducing the therapeutic process to pre-determined variables (Stancombe & White, 1997). It is also idiographic, often based on a detailed reading of a small number of sessions, yet rigorous, transparent and open to alternative interpretations (Frosh et al., 1996). In common with the other two language-based approaches, i.e. conversation analysis and narrative analysis (McLeod, 2001), discourse analysis investigates therapy as a collaborative semiotic process of meaning-making. Through highlighting the interactional and rhetorical nature of therapy, it produces an understanding of the therapy process based on language use and cultural meanings rather than psychological processes (Avdi, 2005; Madill & Barkham, 1997). Furthermore, as an approach that acknowledges and explores variability and contradiction, discourse analysis is particularly useful in highlighting the complexity of the therapeutic encounter (Burman, 1992, 1995). In addition to an emphasis on the immediate interactional context, which is common to many qualitative approaches, most forms of discourse analysis also examine the role of socially available discourses in shaping the therapeutic encounter, linking, thus, the micro-processes of interaction with wider societal macroprocesses (Kogan, 1998; Kogan & Brown, 1998). In this way, the analysis can highlight both the ways in which discourses are central in the production and articulation of the problems that bring clients to therapy and the ways in which therapists bring into the therapeutic encounter a series of, often unacknowledged, assumptions about society and subjectivity, which are drawn from both wider societal and from psychotherapeutic discourses. This, in the more deconstructive and critical forms of discourse analysis, extends to

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addressing issues of ideology and power, and to analysing therapy itself as an institution producing specific forms of subjects. However, it is our contention that the majority of discourse analytic studies of psychotherapy to date do not fully utilize the potential of the approach in terms of exploring and highlighting the links between subjectivity, interaction and wider social processes. This is an area that we would like to see further developed in future studies. With respect to the potential contribution of discourse analysis to psychotherapeutic practice, one of the strengths of discourse analysis is its view of therapy as a dynamic interactional encounter, which brings to the fore the active and constructive role of the therapist. Indeed, the vast majority of the studies reviewed analyse the interaction between client and therapist and a few focus specifically on the therapists interventions in terms of their contribution to the unfolding exchange, their compatibility with the clients contributions, the assumptions that underlie them and the effects they produce. This, it has been argued (Kogan & Brown, 1998), can enhance therapist creativity, since becoming attentive to the ways meaning is constructed facilitates devising ways to shift meanings constructively. Moreover, attending to the role of the therapist raises issues of authorship, power and authority and makes the adoption by the therapist of an informed and ethical position even more pressing. Most importantly, the analysis of the role of therapist facilitates therapist reflexivity in at least three ways: (1) therapists can become aware of the effects of their interventions, (2) they can monitor the extent of correspondence between the therapeutic assumptions they adhere to and their implementation in therapeutic practice and (3) they can become more attentive to the therapeutic and social discourses they draw upon and impose on their clients (Gale & Newfield, 1992; Kogan, 1998). Cultivating these forms of reflexivity can form an important part of clinical practice as well as of therapy training and supervision. As an approach, discourse analysis is particularly compatible with recent social constructionist, linguistic and deconstructive paradigms in therapy (Avdi, 2005; Burck et al., 1998; Frosh et al., 1996) and it is not coincidental that a lot of discourse analytic studies focus on the analysis of these therapies. In terms of psychotherapy process research, discourse analysis can contribute to filling the gap between constructionist therapy theory and psychotherapy process research, which has primarily developed within more traditional paradigms (Frosh et al., 1996). In terms of clinical practice, discourse analysis as an analytical approach makes sense to constructionist therapists, and the potential of discourse analysis to highlight the micro-processes through which the principles of constructionist therapies are applied in practice can turn it into a very useful tool for these clinicians. Discourse analysis can also be, and has been, applied to more traditional therapies, where it highlights the linguistic and interactional micro-processes through which psychotherapy takes place. However, the degree of relevance of discourse analytic work to these clinicians and its applicability to clinical work is more debatable. Conversely, there is an issue regarding the extent to which the common social constructionist and deconstructive background between discourse analysis

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and certain forms of therapy might lead discourse analysts to adopting a less critical stance regarding the function and effects of these therapies in comparison to their attempts to deconstruct the more traditional psychotherapeutic approaches. Perhaps the important issue emerging from this review is the tension within the corpus between the adoption by the researchers of a primarily psychotherapeutic stance and the adoption of a primarily critical analytical stance with regard to the material analysed. Some studies take for granted the usefulness of therapy, the benign role of the therapist, the desired direction of therapeutic change and use the discourse analytic reading in order to highlight the micro-processes through which therapeutic concepts are applied in the actual therapeutic practice. These studies are compatible with clinical thinking and can serve to enhance it, with the drawback that the assumptions that underlie clinical practice can remain unproblematized. Other studies adopt a more critical or therapy-neutral stance and employ a deconstructive reading of therapy as a form of social practice. These studies tend more often to address issues of power, to focus more explicitly on the discourses reproduced through the therapeutic encounter and to examine therapy as a social institution. These tend to be more analytically competent and more consistent with the social constructionist principles of discourse analysis, but they are somewhat removed from clinical thinking and the issues that clinicians face, and can appear to clinicians as counter-intuitive and irrelevant to their practice. It is our view that, to a certain extent, the tension between deconstructive research approaches to therapy and clinical practice is inevitable, partly because of the epistemological incompatibility between constructionist perspectives and most approaches to clinical work and partly because of the different aims of research and clinical practice. This tension, however, can be a source of critical reflection on ones therapeutic practices and values. Moreover, we contend that, if critical discourse analytic studies shift their focus from macro-processes to the interface between subjectivity, interaction and wider social processes, this would render them more useful to clinicians, while still retaining their critical edge. A final issue concerns the heterogeneity of approaches that constitute the field of discourse analysis. As evidenced in this review, discourse analysis is not a unitary, homogeneous approach to analysing language, and many trends exist with widely differing theoretical underpinnings and ways of analysing. This makes the field rather fragmented and its integration fraught with difficulties due to theoretical and methodological incompatibility between studies. Indeed, we found extremely limited acknowledgment of discourse analytic studies of psychotherapy by other such studies, resulting in a lack of dialogue, limited cross-fertilization and limited development of this field. We consider the diversity within this area as reflecting creative tensions and the wealth of analytic approaches as providing useful insights into different levels of the therapy process, from the micro-level of meaning transformation to the macro-level of therapy as an institution. The different conceptualizations of discourse and discourse analysis make this a particularly rich field, fraught with tension and contradiction, which means that integration is not only

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difficult but also, we would argue, not desirable. We would, however, like to see more acknowledgement of the work being done by the various researchers in this area, more cross-referencing and increased cross-fertilization between studies, and we hope that this review will work towards this end.

References
Avdi, E. (2005). Discursively negotiating a pathological identity in the clinical dialogue: Discourse analysis of a family therapy. Psychology and Psychotherapy: Theory, Research and Practice, 78, 119. Avdi, E., & Georgaca, E. (in press). Narrative research in psychotherapy: A critical review. Psychology and Psychotherapy: Theory, Research and Practice. Billig, M. (1997). Rhetorical and discursive analysis: How families talk about the Royal Family. In N. Hayes (Ed.), Doing qualitative analysis in psychology. Hove: Psychology Press. Burck, C., Frosh, S., Strickland-Clark, L., & Morgan, K. (1998). The process of enabling change: A study of therapist interventions in family therapy. Journal of Family Therapy, 20, 25367. Burman, E. (1992). Identification and power in feminist therapy: A reflexive history of a discourse analysis. Womens Studies International Forum, 15, 48798. Burman, E. (1995). Identification, subjectivity and power in feminist psychotherapy. In J. Siegfried (Ed.), Therapeutic and everyday discourse as behaviour change: Towards a microanalysis in psychotherapy process research (pp. 46989). Norwood: Ablex. Burman, E. & Parker, I. (Eds.) (1993). Discourse analytic research. London: Routledge. Buttny, R. (1996). Clients and therapists joint construction of the clients problems. Research on Language and Social Interaction, 29, 12553. Davis, K. (1986). The process of problem re(formulation) in psychotherapy. Sociology of Health and Illness, 8, 4474. Edwards, D., & Potter, J. (1992). Discursive psychology. London: Sage. Ferrara, K. (1992). The interactive achievement of a sentence: Joint productions in therapeutic discourse. Discourse Processes, 15(2), 20729. Finlay, M., & Robertson, B. (1990). Quasi-direct discourse in the psychoanalytic context: Dialogical strategies/strategic dialogue. Social Discourse, 3(12), 5781. Foreman, S., & Dallos, R. (1992). Inequalities of power and sexual problems. Journal of Family Therapy, 14, 34969. Frosh, S., Burck, C., Strickland-Clark, L., & Morgan, K. (1996). Engaging with change: A process study of family therapy. Journal of Family Therapy, 18, 14161. Gale, J. E. (1991). Conversation analysis of therapeutic discourse: The pursuit of a therapeutic agenda. Norwood, NJ: Ablex. Gale, J. E., & Newfield, N. (1992). A conversation analysis of a solution-focused marital therapy session. Journal of Marital and Family Therapy, 18, 15365. Georgaca, E. (2001). Voices of the self in psychotherapy: A qualitative analysis. British Journal of Medical Psychology, 74, 22336. Georgaca, E. (2003). Exploring signs and voices in the therapeutic space. Theory and Psychology, 13, 54160. Guilfoyle, M. (2002). Rhetorical processes in therapy: The bias of self-containment. Journal of Family Therapy, 24, 298316. Guilfoyle, M. (2005). From therapeutic power to resistance? Therapy and cultural hegemony. Theory and Psychology, 15, 10124. Hare-Mustin, R. T. (1994). Discourses in the mirrored room: A postmodern analysis of therapy. Family Process, 33, 1935. Hodges, I. (2002). Moving beyond words: Therapeutic discourse and ethical problematisation. Discourse Studies, 4(4), 45579. Hook, D. (2001). Therapeutic discourse, co-construction, interpellation, role-induction: Psychotherapy as iatrogenic treatment modality? International Journal of Psychotherapy, 6(1), 4765. Hook, D. (2003). Analogues of power: Reading psychotherapy through the sovereigntydiscipline-government complex. Theory & Psychology, 13(5), 60528. Kogan, S. M. (1998). The politics of making meaning: Discourse analysis of a postmodern interview. Journal of Family Therapy, 20, 22951.

Downloaded by [Universitaetsbibliothek] at 04:31 09 February 2012

Discourse analysis and psychotherapy

175

Kogan, S. M., & Brown, A. C. (1998). Reading against the lines: Resisting foreclosure in therapy. Family Process, 37, 495512. Kogan, S. M., & Gale, J. E. (1997). Decentering therapy: Textual analysis of a narrative therapy session. Family Process, 36, 10126. Kurri, K., & Wahlstrom, J. (2005). Placement of responsibility and moral reasoning in couple therapy. Journal of Family Therapy, 27, 35269. Labov, W., & Fanshel, D. (1977). Therapeutic discourse: Psychotherapy as conversation. New York: Academic Press. Lewis, B. (1995). Psychotherapeutic discourse analysis. American Journal of Psychotherapy, 49(3), 37184. McLeod, J. (2001). Qualitative research in counselling and psychotherapy. London: Sage. McNamee, S. & Gergen, K. J. (Eds.) (1992). Therapy as social construction. London: Sage. Madill, A., & Barkham, M. (1997). Discourse analysis of a theme in one successful case of brief psychodynamic-interpersonal psychotherapy. Journal of Counseling Psychology, 44(2), 23244. Madill, A., & Doherty, K. (1994). So you did what you wanted then: Discourse analysis, personal agency and psychotherapy. Journal of Community and Applied Social Psychology, 4, 26173. Madill, A., Widdicombe, S., & Barkham, M. (2001). The potential of conversation analysis for psychotherapy research. The Counseling Psychologist, 29, 41334. Miller, G., & Silverman, D. (1995). Troubles talk and counselling discourse: A comparative study. Sociological Quarterly, 36, 72547. Mills, S. (1997). Discourse. London: Routledge. Nye, C. H. (1994). Narrative interaction and the development of client autonomy in clinical practice. Clinical Social Work Journal, 22(1), 4357. OReilly, M. (2005). The complaining client and the troubled therapist: A discursive investigation of family therapy. Journal of Family Therapy, 27, 37091. Parker, I. (Ed.) (1999). Deconstructing psychotherapy. London: Sage. Parker, I., & the Bolton Discourse Network (1999). Critical textwork: An introduction to varieties of discourse analysis. Buckingham: Open University Press. Perakyla, A., & Silverman, D. (1991). Reinterpeting speech-exchange systems: Communication formats in AIDS counselling. Sociology, 25, 62751. Rowan, J. & Cooper, M. (Eds.) (1999). The plural self: Multiplicity in everyday life. London: Sage. Roy-Chowdhury, S. (2003). Knowing the unknowable: What constitutes evidence in family therapy? Journal of Family Therapy, 25, 6485. Sampson, E. (1993). Celebrating the other: A dialogical approach to human nature. Boulder, CO: Westview Press. Silverman, D. (1997). Discourse of counselling: HIV counselling as social interaction. London: Sage. Soal, J., & Kottler, A. (1996). Damaged, deficient or determined? Deconstructing narratives in family therapy. South African Journal of Psychology, 26(3), 12334. Soyland, A. J. (1995). Analysing therapeutic and professional discourse. In J. Siegfried (Ed.), Therapeutic and everyday discourse as behaviour change: Towards a micro-analysis in psychotherapy process research (pp. 277300). Norwood, NJ: Ablex. Stancombe, J., & White, S. (1997). Notes on the tenacity of therapeutic presuppositions in process research: Examining the artfulness of blamings in family therapy. Journal of Family Therapy, 19, 2141. Stancombe, J., & White, S. (2005). Cause and responsibility: Towards an interactional understanding of blaming and neutrality in family therapy. Journal of Family Therapy, 27, 33051. Stiles, W. B. (1997). Multiple voices in psychotherapy clients. Journal of Psychotherapy Integration, 7(3), 17780. Stratton, P. (2003a). Causal attributions during therapy I: Responsibility and blame. Journal of Family Therapy, 25, 13660. Stratton, P. (2003b). Causal attributions during therapy II: Reconstituted families and parental blaming. Journal of Family Therapy, 25, 16180. Tannen, D. (1989). Talking voices: Repetition, dialogue and imagery in conversational discourse. Cambridge: Cambridge University Press. Van Dijk, T. A. (1997). The study of discourse. In T. A. van Dijk (Ed.), Discourse studies: A multidisciplinary introduction (Vol. 1, pp. 134). London: Sage. Weingarten, K. (1998). The small and the ordinary: The daily practice of a postmodern narrative therapy. Family Process, 37(1), 315. Wetherell, M., Taylor, S. & Yates, S. J. (Eds.) (2001a). Discourse theory and practice: A reader. London: Sage.

Downloaded by [Universitaetsbibliothek] at 04:31 09 February 2012

176

E. Avdi & E. Georgaca

Wetherell, M., Taylor, S. & Yates, S. J. (Eds.) (2001b). Discourse as data: A guide for analysis. London: Sage. Widdicombe, S., & Wooffitt, R. (1995). The language of youth subcultures. London: Harvester Wheatsheaf. Willig, C. (2001). Introducing qualitative research in psychology: Adventures in theory and method. Buckingham: Open University Press. Wodak, R. (1981). How do I put my problem? Problem presentation in therapy and interview. Text, 1, 335. Wodak, R. (1996). Disorders of discourse. London: Longman.

Downloaded by [Universitaetsbibliothek] at 04:31 09 February 2012