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.

Collaboration has been a frequently used construct to describe the practices of different therapeutic approaches for working with clients. Missing, however, is a sense of how collaboration is enacted in dialogues between therapists and clients. After defining ‘collaboration’, we analyse the actual conversational practices of Karl Tomm in his work with a couple, using conversation analysis. Our aim is to highlight the conversational accomplishment of collaboration in observable ways that we feel may be linked to enhancing one's conversational and collaborative practice of therapy.

Despite the emphasis of systemic and constructionist approaches on discourse and interaction, to date there has been no comprehensive overview of how change process is performed within in‐session therapeutic dialogue. In this paper, we present a qualitative meta‐synthesis of 35 articles reporting systemic and constructionist therapy process data from naturally occurring therapeutic dialogue. The studies were selected following the screening against eligibility criteria of a total sample of 2,977 studies identified through a systematic search of PsycINFO and MEDLINE databases. Thematic analysis of the 35 studies’ findings identified four main themes depicting change process performance: (a) shifting to a relational perspective, (b) shifting to non‐pathologizing therapeutic dialogue, (c) moving‐forward dialogue, and (d) the dialogic interplay of power. Findings highlight the interactional and discursive matrix within which systemic and constructionist change process occurs. Findings illuminate the value of qualitative research studies sampling naturally occurring therapeutic discourse in bringing this matrix forth, particularly when utilizing discursive methodologies like conversation or discourse analysis.

Although problem gambling is becoming more prevalent, research shows that many problem gamblers do not seek help. Online social support forums have become an increasingly popular option for receiving support for problem gambling. Few researchers have explored how participants within these forums interact, or what is supportive about participation in online communities. Melding netnography (ethnographic approaches online), discourse analysis, and ethnomethodology, we analyzed the discursive interactions of self-identified problem gamblers on an online forum. We report on the characteristics of this unique setting, the common discourses that members used, and how they discursively accomplished various interactional tasks, including constructing identities, and negotiating membership, legitimacy, and support. We conclude with recommendations for practitioners and researchers interested in better understanding people trying to overcome problem gambling and other behavioral concerns.

Despite the considerable potential of qualitative approaches for studying the systemic and constructionist therapy process due to shared theoretical and epistemological premises, to date there is lack of a comprehensive qualitative synthesis of how change process is experienced and conceptualized by clients and therapists. To address this evidence gap, we performed a systematic meta‐synthesis review of 30 studies reporting clients’ and therapists’ retrospective narratives of change process across systemic and constructionist models and across a range of client configurations, including individuals, couples, families, and groups. The studies were identified following a systematic search in PsycINFO and MEDLINE resulting in 2,977 articles, which were screened against eligibility criteria. Thematic analysis led to the identification of four main themes: (1) navigating through differences, (2) toward nonpathologizing construction of problems, (3) navigating through power imbalances, and (4) toward new and trusting ways of relating. Findings illustrate the multifaceted aspects of systemic and constructionist change process, the importance for their reflexive appraisal, and the need for further research contributing to the understanding of the challenges inherent in the systemic and constructionist therapeutic context.