Narrative Processes Coding System: A Dialectical Constructivist Approach to Assessing Client Change Processes in Emotion-Focused Therapy of Depression

Tracking change in group interventions: a further adaptation of the innovative moments coding system for groups

In group psychotherapy research, there are few reliable measures for tracking members' change. This study proposes a further adaptation of the Innovative Moment Coding System for Groups (IMCS-G), a reliable method previously developed in one format of group intervention for detecting innovative moments (IMs). IMs are exceptions to the clients' problematic narratives, organized in different levels of complexity in terms of meaning elaboration (Level 1, 2, and 3). IMCS-G consists of 7 categories (Self-Directed, Other-Directed, Explicit Mirroring, 'Prompting change, Reinforcing change, Collective, Voice of Group) organized in two macro-categories: Individual (e.g., change was narrated by a single participant) and Group IMs (e.g., change was co-constructed by more than one participant). Two reliable coders applied the IMCS-G to analyse the transcripts of nine sessions of a counselling group addressed to underachieving university students (N=10) and eight sessions of a brief group psychotherapy targeted to substance abusers (N=8). Agreement and reliability for IMCS-G categories and their Levels were calculated. Consistently with previous studies, a strong agreement and reliability for IMCS-G categories and Levels were found in both group interventions. Furthermore, despite some differences in the frequency of IMCS-G categories and Levels, in both interventions, there was a higher frequency of Self-Directed IMs, a lower frequency of the Explicit Mirroring IMs, and a higher frequency of Level 3 Group IMs in comparision with Level 3 Individual IMs. This study confirmed the reliability of IMCS-G in different group interventions, but it also suggested rooms of improvement for some IMCS-G categories.

The Added Value of Studying Embodied Responses in Couple Therapy Research: A Case Study

This article reports on the added value of embodied responses identified through sympathetic nervous system (SNS) activity in couple therapy research. It focuses on moments of change and the timing of therapeutic interventions or therapeutic moves in a couple therapy session. The data for this single-case study comprise couple therapy process videotapes recorded in a multi-camera setting, and measurements of participants' SNS activity. The voluntary participants were a marital couple in their late thirties and two middle-aged male psychotherapists. The division into topic segments showed how the key issue of seeking help, which was found to comprise three separate components, was repeatedly dealt with in the session. SNS activity showed different degrees of synchronization between the couple, between the therapists, and between the couple and therapists during the dialogue pertaining to these three components. The issue of timing emerged as a complex, even ambivalent, phenomenon. Arousal in the therapists was in line with their therapeutic activity, whereas in the clients it was more anticipatory. The approach used here rendered visible some of the intensity that therapeutic dialogue can generate when dealing with issues of relationship change in the couple context and showed how this intensity can be dialogically regulated in the therapeutic system.

The form of the story: Measuring formal aspects of narrative activity in psychotherapy

OBJECTIVE

We ask which are the clinically relevant qualities of narratives in psychotherapy and how they can be measured.

METHOD

On the background of psychoanalytic assumptions and narrative theory, we propose to measure formal narrative processes which stay close to the linguistic surface, because these escape conscious control.

RESULTS

We propose five aspects of narratives to be especially sensitive to distortions and therefore prone to change in successful therapies: (1) The actual chronological, stepwise narrating of events, (2) the intentional structuring of events, or emplotment, (3) the immediate evaluation, (4) the reflected interpretation of events, and finally (5) the consistency and completeness of the narrative. For each aspect we discuss ways to measure them. Finally the aspects are illustrated with excerpts from a series of diagnostic interviews.

DISCUSSION

Implications for the analysis of the co-narrative role of the therapist are suggested.