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Formulation and Clients’ Agency in Cognitive Behavioral Therapy

The experience of loss of agency is one of the reasons for clients to go for psychotherapy. Enhancing clients’ agency has been considered a fundamental factor for successful treatment in psychiatry and psychotherapy, yet few studies have investigated the interactional realization of how therapists d...

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Autores principales: Yao, Xueli, Dong, Boyu, Ji, Weining
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960440/
https://www.ncbi.nlm.nih.gov/pubmed/35360596
http://dx.doi.org/10.3389/fpsyg.2022.810437
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author Yao, Xueli
Dong, Boyu
Ji, Weining
author_facet Yao, Xueli
Dong, Boyu
Ji, Weining
author_sort Yao, Xueli
collection PubMed
description The experience of loss of agency is one of the reasons for clients to go for psychotherapy. Enhancing clients’ agency has been considered a fundamental factor for successful treatment in psychiatry and psychotherapy, yet few studies have investigated the interactional realization of how therapists do this in authentic psychotherapeutic encounters. Drawing on audio-recorded talk-in-interaction between clients and psychotherapists in cognitive behavioral therapy (CBT) encounters at a mental health center in China, this paper uses the method of conversation analysis to demonstrate how therapists ascribe agency positions to clients by issuing formulations of what the clients have just said. Two types of formulation were identified: affirmative formulations and challenging formulations. In the first type, the therapists highlight the positive aspect of the clients’ description of their experiences and ascribe an agentic position to the clients. In the second, the therapists challenge the clients’ implausible views and their non-agentic positioning of themselves. This study shows that the therapists’ formulation could be employed to manage the epistemic difficulties associated with claiming knowledge about the clients’ inner states and assessing their feelings. In this sense, the formulation is a robust interactional device in negotiating epistemic problems in addressing the clients’ experiences and promoting their agency in therapy. However, it is noteworthy that in the challenging formulation, therapists claim privileged access to the clients’ knowledge domain and challenge their prior epistemic status, which might run the risk of engendering clients’ resistance.
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spelling pubmed-89604402022-03-30 Formulation and Clients’ Agency in Cognitive Behavioral Therapy Yao, Xueli Dong, Boyu Ji, Weining Front Psychol Psychology The experience of loss of agency is one of the reasons for clients to go for psychotherapy. Enhancing clients’ agency has been considered a fundamental factor for successful treatment in psychiatry and psychotherapy, yet few studies have investigated the interactional realization of how therapists do this in authentic psychotherapeutic encounters. Drawing on audio-recorded talk-in-interaction between clients and psychotherapists in cognitive behavioral therapy (CBT) encounters at a mental health center in China, this paper uses the method of conversation analysis to demonstrate how therapists ascribe agency positions to clients by issuing formulations of what the clients have just said. Two types of formulation were identified: affirmative formulations and challenging formulations. In the first type, the therapists highlight the positive aspect of the clients’ description of their experiences and ascribe an agentic position to the clients. In the second, the therapists challenge the clients’ implausible views and their non-agentic positioning of themselves. This study shows that the therapists’ formulation could be employed to manage the epistemic difficulties associated with claiming knowledge about the clients’ inner states and assessing their feelings. In this sense, the formulation is a robust interactional device in negotiating epistemic problems in addressing the clients’ experiences and promoting their agency in therapy. However, it is noteworthy that in the challenging formulation, therapists claim privileged access to the clients’ knowledge domain and challenge their prior epistemic status, which might run the risk of engendering clients’ resistance. Frontiers Media S.A. 2022-03-10 /pmc/articles/PMC8960440/ /pubmed/35360596 http://dx.doi.org/10.3389/fpsyg.2022.810437 Text en Copyright © 2022 Yao, Dong and Ji. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychology
Yao, Xueli
Dong, Boyu
Ji, Weining
Formulation and Clients’ Agency in Cognitive Behavioral Therapy
title Formulation and Clients’ Agency in Cognitive Behavioral Therapy
title_full Formulation and Clients’ Agency in Cognitive Behavioral Therapy
title_fullStr Formulation and Clients’ Agency in Cognitive Behavioral Therapy
title_full_unstemmed Formulation and Clients’ Agency in Cognitive Behavioral Therapy
title_short Formulation and Clients’ Agency in Cognitive Behavioral Therapy
title_sort formulation and clients’ agency in cognitive behavioral therapy
topic Psychology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960440/
https://www.ncbi.nlm.nih.gov/pubmed/35360596
http://dx.doi.org/10.3389/fpsyg.2022.810437
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