Characterizing therapy focus and exploring client process : investigating therapeutic modalities from a narrative approach

Abstract

The aim of this exploratory study was a systematic investigation of three inter-related areas, a discovery-oriented macro to micro analysis of therapy discourse. The first study goal involved the application of the Narrative Processes Coding System (NPCS; Angus, Hardtke and Levitt, 1992) as a heuristic to explore, rather than to verify, possible differences in the reconstruction and co-construction of the self macro narrative both within therapy dyads exposed to the same treatment modality, as well as across therapeutic approach. Developed within the conceptual framework of the Narrative Processes Theory of Therapy (Angus & Hardtke, 1994), the NPCS is a comprehensive categorization system which first characterizes therapy transcripts according to shifts in topic content and then according to narrative process type. The NPCS also identifies the role of client and therapist in shifting therapy content and narrative process. The NPCS was applied to each therapy session of six good-outcome dyads recently involved in a National Institute Mental Health (NIMH) Study of Depression. Three dyads participated in short-term client-centred therapy while three were exposed to shrot-term process-experiential therapy. The second aim was the identification of the predominant relationship theme in one dyad from each therapy modality represented in this study. Emerging from this second objective, the third and final aim was to explicate this interpersonal theme from the therapy transcripts in order to conduct a comparative analysis of the clients' experience of self, and self in relation to other, by the application of the Client Experiencing Scale (Klein, Mathieu, Gendlin & Kiesler, 1970). Both descriptive and statistical analyses were used. Results from the macro analyses suggested differences in both frequency and pattern of narrative process across therapeutic approach. Differences regarding the role of client and therapist in shifting content and process were also found across approach. Results from applying the Client Experiencing Scale (Klein et. al., 1970) to the explicated interpersonal theme in the two dyads selected for the micro analyses of this study suggested that the process-experiential therapy dyad achieved a higher general level of experiencing of self in relation to order.