The Discursive Performance of Change Process in Systemic and Constructionist Therapies: A Systematic Meta-Synthesis Review of In-Session Therapy Discourse

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 2977

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.