Using Microanalysis of Communication to Compare Solution-Focused and Client-Centered Therapies

Abstract

Microanalysis in psychotherapy is the close examination of the moment-by-moment communicative actions of the therapist. This study microanalyzed demonstration sessions by experts on solution-focused and client-centered therapies, specifically, the first 50 therapist utterances of sessions by Steve de Shazer, Insoo Kim Berg, Carl Rogers, and Nathaniel Raskin. The first analysis examined how the therapist communicated, namely, whether the therapist's contribution took the form of questions or of formulations (e.g., paraphrasing). The second analysis rated whether each question or formulation was positive, neutral, or negative. Two analysts demonstrated high-independent-agreement for both methods. Results showed that the solution-focused and client-centered experts differed in how they structured the sessions: The client-centered therapists used formulations almost exclusively, that is, they responded to client's contributions. Solution-focused experts used both formulations and questions, that is, they both initiated and responded to client contributions. They also differed in the tenor of their contributions: The solution-focused therapists' questions and formulations were primarily positive, whereas those of the client-centered therapists were primarily negative and rarely neutral or positive. Microanalysis can complement outcome research by providing evidence about what therapists do in their sessions.