Medically oriented psychotherapists typically record progress notes by articulating client symptoms, diagnoses, functional status, progress, and adherence to treatment plans. This orientation can challenge marriage and family therapists working from discursive or post-modern perspectives. Although there are discursive therapy friendly treatment planning guides, no published research on such practice exists. To address this gap the researchers conducted a recursive frame qualitative analysis of 206 de-identified progress notes from 30 completed cases seen by MFT master's students learning discursive approaches to therapy in a university-based training clinic. Researchers found students noted problem to solution-focused discourse tipping or turning points in 20 cases with positive outcomes and no comparable shifts in 10 cases with negative or unclear outcomes.

To address a gap regarding how clinicians record progress in therapy, the researchers conducted a qualitative study of de-identified progress notes from a universitybased brief therapy training clinic. The researchers described trainees' stability and change documentation with respect to problem-oriented and solution-oriented talk in their progress notes. The patterns were (a) problem-oriented stability and problem to solution change within first sessions; (b) problem-oriented and solution-oriented stability within last sessions; and (c) stability (e.g., problem to problem) and change (e.g., problem to solution) across first and last sessions. Findings suggest that first session problem and solution outcomes do not necessarily predict last session outcomes (i.e., problem continuation or change to solutions).