Family therapists' participation in therapeutic dialogue with clients is typically informed by evidence of how such dialogue is developing. In this article, we propose that conversational evidence, the kind that can be empirically analyzed using discourse analyses, be considered a contribution to widening psychotherapy's evidence base. After some preliminaries about what we mean by conversational evidence, we provide a genealogy of evaluative practice in psychotherapy, and examine qualitative evaluation methods for their theoretical compatibilities with social constructionist approaches to family therapy. We then move on to examine the notion of accomplishment in therapeutic dialogue given how such accomplishments can be evaluated using conversation analysis. We conclude by considering a number of research and pedagogical implications we associate with conversational evidence.
Prior research has shown that psychology-trained practitioners use homework assignments, but no prior research has sought to survey the clinical practice of other mental health professionals. Three hundred and thirty-three mental health professionals from counselling, medical, nursing, psychology, and social work training backgrounds were surveyed regarding their use of homework assignments in psychotherapy. The vast majority of the sample (83%) reported the use of homework assignments, and those practising cognitive-behavioural therapy indicated a greater frequency and degree of specificity in assigning homework. However, it was noteworthy that all theoretical and professional groups in the present study reported some use of homework assignments.
The publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) extends a profession and practice-defining direction for family therapy. Warranting and expediting this medicalised direction has been a scientific and administrative coupling of diagnosed symptomatic conditions with evidence-based treatments for addressing those conditions. For systemically or poststructurally oriented family therapists tensions can follow from this direction which we elaborate upon in this article. Specifically, we examine the premises behind this medicalised direction for family therapy, juxtaposing these premises with systemic and post-structural premises of practice. We relate these juxtapositions to tensions family therapists may need to reconcile in their work with families. We close with an overview of this special issue's contributions that pertain to the DSM-5 and family therapy.1 The continuing symptomological and individualistic focus of DSM-5 creates tensions for family therapists who practice from systemic and post-structuralist orientations. 2 A discursive approach enables us to understand how DSM-5 discourse both enables and constrains our understanding of human concerns. 3 DSM-5 does not address relational aspects of practice and creates "linguistic poverty" in limiting understandings of family concerns. 4 Evidence-based practice tied to a medicalised diagnostic classification framework is a seductively algorithmic practice, which reproduces normative, standardised conversations in mapping client concerns to DSM-5based diagnoses. 5 DSM-5-based algorithms of evidence-based practice ignore the importance of context and the ever-changing conversations of human concerns and multiple practices are required to reflect, articulate and work with family concerns effectively.So what is it about the biopolitics of life itself…that provides the spaces within which bioethical authority seems to be required and simultaneously circumscribes the issues to which such ethical concerns appear relevant? (Rose, 2007, p. 31) Welcomed or not, the American Psychiatric Association's (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) will influence the conversations therapists have with families. In writing about diagnostic language as it relates to relationships, Tom Andersen (1996) long ago wrote that "language is not innocent". The diagnoses of DSM-5 cannot be regarded as neutral scientific discoveries, nor can the expected diagnostic practices accompanying the DSM-5's use be
The fathers’ rights movement is a worldwide phenomenon that takes a particular form in our geopolitical region. Responding initially to an apparent judicial preference for mothers to have custody of children, the movement grew alongside, and in resistance to, the women’s movement. In this paper, we analyse how texts of fathers’ rights discourse strategically appropriate egalitarianism in the context of gendered struggles over rights within the nuclear family. Texts from four fathers’ rights websites are engaged to locate, construct and critique the discursive power of the movement in Aotearoa/New Zealand. We discuss examples of strategies that appropriate egalitarianism, engage quantifying logic, and demonise women and argue how the fathers’ rights sites exemplify resistance to the impact of the women’s movement on Family Court and criminal justice interventions into violence against women at home.
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