Client-identified important events in psychotherapy: interactional structures and practices.

This study describes interactional structures and practices in client-identified important events in psychotherapy sessions. Twelve of 16 events from seven client-therapist dyads were found to contain disagreement. A turn-by-turn investigation using conversation analysis displayed three different ways that therapists used to handle disagreement. The first was to orient to the client's disagreement cues by inviting the client to elaborate his or her point and to establish a shared understanding. The second was to orient to the client's disagreement cues but define the therapist's point of view as more relevant to the project at hand. The third was a single case where the therapist did not orient to the client's disagreement cues. The results suggest that disagreement patterns may be an interesting focus for further exploration of microprocesses within therapy sessions.