Co-implicating and re-shaping clients' suggestions for behavioural change in cognitive behavioural therapy practice

Abstract

This article uses conversation analysis to examine Cognitive Behavioural Therapy (CBT) interactions with clients diagnosed with depression. The analysis explicates some routine conversational practices used by therapists in CBT to involve or co-implicate clients in the decision-making process regarding behavioural change. The article illustrates how the co-implication of clients in plans for behavioural change involves complex, therapist-guided sequences of interaction. Instances of co-implication are compared to those where therapists propose their own suggestions for change, resulting in different interactional consequences. The demonstration of therapists' use of systematic turn structures to co-implicate clients in the therapeutic process offers an interactional specification of the therapeutic relationship of collaborative empiricism that is encouraged in CBT practice and also shows how this relationship unfolds in the moment-to-moment interaction of therapy.