A Critical Methodological Review of Discourse and

Conversation Analysis Studies of Family Therapy

ELEFTHERIA TSELIOU*

To read this article in Spanish, please see the articles Supporting Information on Wiley Online
Library (wileyonlinelibrary.com/journal/famp).

Discourse (DA) and conversation (CA) analysis, two qualitative research methods, have
been recently suggested as potentially promising for the study of family therapy due to common epistemological adherences and their potential for an in situ study of therapeutic dialog.
However, to date, there is no systematic methodological review of the few existing DA and CA
studies of family therapy. This study aims at addressing this lack by critically reviewing published DA and CA studies of family therapy on methodological grounds. Twenty-eight articles in total are reviewed in relation to certain methodological axes identified in the relevant
literature. These include choice of method, framing of research question(s), data/sampling,
type of analysis, epistemological perspective, content/type of knowledge claims, and attendance to criteria for good quality practice. It is argued that the reviewed studies show
glimpses of the methods potential for family therapy research despite the identification of
certain shortcomings regarding their methodological rigor. These include unclearly
framed research questions and the predominance of case study designs. They also include
inconsistencies between choice of method, stated or unstated epistemological orientations
and knowledge claims, and limited attendance to criteria for good quality practice. In conclusion, it is argued that DA and CA can add to the existing quantitative and qualitative methods for family therapy research. They can both offer unique ways for a detailed study of the
actual therapeutic dialog, provided that future attempts strive for a methodologically rigorous practice and against their uncritical deployment.
Keywords: Methodology; Review; Discourse Analysis; Conversation Analysis; Qualitative
Research; Family Therapy
Fam Proc 52:653672, 2013

INTRODUCTION
all methodologies, even the most obvious ones, have their limits. (Feyerabend, 1993, p. 23)

uring the past decades a very limited, though growing number of studies have
deployed discourse (DA) and conversation analysis (CA) in family therapy research.
Furthermore, it has been argued that DA and CA hold promise for the study of
*Department of Early Childhood Education, University of Thessaly, Volos, Greece.

Correspondence concerning this article should be addressed to: Eleftheria Tseliou, Department of Early
Childhood Education, University of Thessaly, Argonafton & Filellinon str., Volos 38 221, Greece.
E-mail: tseliou@uth.gr
I would like to acknowledge Georgios Abakoumkin, Dave Harper, and Maria Diorinou for their thoughtful
comments and suggestions in earlier drafts of this manuscript. Also many thanks to the anonymous reviewers and
in particular to the reviewer whose detailed comments provided me with invaluable help toward the improvement
of the manuscript. Finally, many thanks to Noel Slesinger for her help in editing the manuscript.
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DISCOURSE/CONVERSATIONAL ANALYSIS AND FAMILY THERAPY

psychotherapy and systemic family therapy and that they are epistemologically fit with
the latter (Avdi & Georgaca, 2007; Strong, Busch, & Couture, 2008; Sutherland & Couture, 2007). Both methods are rooted in the hermeneutic qualitative research tradition
and were originally developed decades ago (see Wooffitt, 2005, for a historical account).
However, they have both been utilized for psychotherapy research to a small extent (e.g.,
Per
akyl
a, Antaki, Vehvil
ainen, & Leudar, 2008). In the field of family therapy, there is a
long-standing search for methods suitable for the study of the complexities of therapeutic
dialog in family therapy sessions (e.g., Gurman, 1983; Schwartzman, 1984). Unfortunately, this has been linked with polarized debates over what constitutes an epistemologically fit methodology (e.g., Sprenkle, 1991, 1994), often resulting in the parallel existence
of competing languages (Eisler, 2003, 2004). To date there is no systematic examination of
whether DA and CA can be of use for family therapy research. There is a review of DA
studies in psychotherapy including family therapy (Avdi & Georgaca, 2007), a theoretical
article highlighting the epistemological affinity between constructionist research and constructionist therapies (De Haene, 2010), and a methodological review in which only three
DA/CA studies are identified (Gehart, Ratliff, & Lyle, 2001). However, there is no review
that examines the existing CA and DA studies on methodological grounds. This lack
makes it even more difficult to draw conclusions in relation to the methods potential. It is
further enhanced by an overall paucity of methodological studies in the fields leading
journals despite contrary suggestions (Snyder & Kazak, 2005). My aim in this study was
to address this lack by presenting a critical methodological review of DA and CA studies of
family therapy to date. I will argue that the reviewed studies show glimpses of these
methods potential for family therapy research, although there is a danger of premature
conclusions due to the limited number of the reviewed studies and certain identified
methodological shortcomings. Nevertheless, I will argue that DA and CA constitute a
developing methodology for family therapy research, which can add to the already available quantitative and qualitative methodologies. Along with others (e.g., Strong et al.,
2008) I believe that they can offer unique methods for a detailed, in situ study of the therapeutic dialog.

BACKGROUND
DA and CA have a close affiliation with the discursive turn, introduced by constructionist epistemological perspectives, which locate knowledge and the quest for it in peoples dialogic practices (for the latter, see Burr, 1995; Gergen, 1999; see also McNamee &
Hosking, 2012, for a social constructionist perspective on research).
Sacks, Schegloff, and Jefferson originally developed CA in the early 1960s (1974; Atkinson & Heritage, 1984; Levinson, 1983). CA also has roots in the tradition of ethnomethodology. Some of its basic tenets bear a striking resemblance to the postulates of the
systemic pragmatic theory of communication (Watzlawick, Beavin-Bavelas, & Jackson,
1967).
As in the case of the latter, CA treats talk-in-interaction as the main terrain of study. It
further places a particular emphasis on pattern and context for the understanding of
communicative exchanges. CA approaches language as a form of social action in the sense
that it is constitutive of social interaction. All conversational interactions are considered
as exhibiting a structure, which is intersubjectively, that is, between and not within
subjects, accomplished on a turn-to-turn basis (see, e.g., Wooffitt, 2005). Each speaker contributes to the conversational structure by his/her turn. This is dependent on what has
been previously uttered. It is also indicative of the way he/she has interpreted his/her cointerlocutors preceding turn. In a circular manner, his/her turn then constitutes the context
for what will follow, while a number of turns can build a pattern (Sacks et al., 1974).
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CA research has extensively studied conversational structures. It has also shed light on
a number of psychological phenomena and the ways that they are intersubjectively constructed in the course of dialogs, for example, the making of accusations (Drew, 1978) and
complaints (Drew & Holt, 1988). Antaki (2008) deployed CA to study the use of formulations by therapists. Formulations are statements in which a speaker summarizes what
the other speaker has previously said, whereas at the same time he/she also introduces a
change in its content (for formulations, see Heritage & Watson, 1979). He discusses how
therapist formulations seem to be the powerful rhetorical constructions, which can function as a means for the offering of an interpretation. They also facilitate the management
of the course of interaction (e.g., as a way to close down talk about a topic). Finally, they
constitute a means by which the therapist can shape talk about the clients symptoms. In
particular, while he/she explores the clients past, talk is shaped in such a way that it can
facilitate the subsequent delivery of an interpretation.
DA is a widely deployed term, which is often used to denote both theoretical and epistemological approaches to discourse, as well as various methods for its analysis. Discursive
psychology (DPsy) is one DA trend closely affiliated with the tradition of CA with Austins
speech act theory and Wittgensteins philosophical approach (Willig, 2008). Like CA, DPsy
emphasizes the performative aspect of language, the importance of context, and the intersubjective construction of any phenomenon. For DPsy, there are no psychological phenomena outside discourse. Language is not a means to express attitudes or feelings. Instead, it
is itself the arena in which these concepts are constructed while people engage in everyday
discursive transactions (Edwards & Potter, 1992). Talk is rhetorically designed so as to
strengthen our arguments. Simultaneously, this design also facilitates the management
of accountability issues related to our points-of-view. As a consequence, even the same
persons account may vary depending on the rhetorical context (Billig, 1996; Edwards &
Potter, 1992). For example, DPsy research has identified a number of rhetorical devices,
like vivid description. These are deployed when the speaker wants to construct his/her
account as factual, that is, as existing independently of his/her personal view. This construction thus functions as a way to undermine potential accusations that the speakers
account is motivated by interest (for a more extensive reference to such devices, see
Edwards & Potter, 1992). DPsy also emphasizes the role of wider systematic ways of talking about phenomena. These are considered as rooted in cultural, ideological, and social
practices (Billig et al., 1988; Potter & Wetherell, 1987). In DA terminology, they are
known as interpretative repertoires (Potter & Wetherell, 1987) or as discourses. For example, Potter and Wetherell (1995, cited in Willig, 2008, p. 101) identified the repertoires of
Culture-as-Heritage and Culture-as-Therapy, in their study of how people from New
Zealand talked about the Maori culture.
DPsy research has focused on various psychological phenomena, such as memory
(Edwards & Middleton, 1986), cognition, and attributions (Edwards & Potter, 1992).
Edwards (1995) studied couples counseling sessions and focused on how event descriptions operate while partners engage in talk about their troubles. He identified a number of
linguistic devices, for example, the use of modal verbs (she would) and the use of
if-then structures. It seemed that partners deployed them to construct what he terms
script formulations. These are descriptions of events in ways which construct them as
being routine or exceptional to routine. Such script formulations seemed to help partners
manage accountability issues in relation to trouble talk.
DPsy and CA have been juxtaposed with the top-down approach trend to theoretically
and methodologically approaching DA (Wetherell, 2001; Willig, 2008). DA of this type is
more affiliated with the French rather than with the British linguistic tradition, such as
with Foucaults poststructuralist thinking. Furthermore, it is affiliated with psychoanalytic theorizing (Willig, 2008). It is also largely associated with the work of Parker and
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Burman (e.g., Burman & Parker, 1993; Parker, 1992). CA and DPsy highlight the ways
that people use discourse to accomplish their interactional agendas and manage their
everyday interactions. In contrast, poststructuralist DA emphasizes the oppressive, constraining, and constitutive aspects of discourse in relation to our subjectivities and everyday lives. It aims at bringing forth the interrelation between power and knowledge, like in
the case of postmodern developments in the field of family therapy (e.g., White & Epston,
1990). Its main interest lies in the study of how material conditions shape our realities
via language (Willig, 2008). It thus attempts to unravel the ways in which discourses
shape our talk and restrain our choices while we engage in interactions. In that sense,
they make certain subject positions available while excluding others and also shape both
everyday and institutional practices. Certain discourses are considered as supporting and
legitimizing certain institutional practices and power relations and vice versa. For example, Hollway (1989) explored talk about heterosexual sex and identified discourses like, for
example, the male sexual drive discourse. Her analysis highlighted the different subject
positions constructed for men and women in its context, which are also related to power
differentials in everyday practices. In the context of the male sexual drive discourse,
male sexuality is linked with natural and compelling sexual urges. Men are positioned as
pursuers of womenobjects whose sexuality is approached as either lacking or motivated by a need for reproduction (Hollway, 1989).
CA, DPsy, and DA seem particularly suited for pursuing research questions of interest
for family therapists. These include the study of the structure of psychotherapeutic conversations or the conversational accomplishment of certain phenomena or psychotherapeutic tools/techniques. They further include the study of the discursive construction of
subjectivities and the critical scrutiny of institutional psychotherapeutic practices.
Recorded or videotaped family therapy sessions can constitute valuable data. These fit
both with CAs and DPsys preference for naturally occurring conversations, but also with
DAs choice of any text as data. CA and DPsy offer the potential for a microdetailed analysis, which is conducted on a turn-to-turn basis. It also includes the simultaneous attendance to the operation of ideological matters in the case of the latter. In this sense, there is
an attempt to ground each analytic claim on the way that participants treat each utterance as evident in the next turn (next-turn-proof) (Sutherland & Couture, 2007, p. 213).
This is juxtaposed with DAs preference for a macroanalytic perspective and the grounding
of interpretation on the analysts preexisting theoretical framework. Furthermore, DA
and CA can fit with a wide range of epistemological perspectives. The task of deciding
upon each methods orientation is not a straightforward one. CAs affiliation ranges from a
realist to a relativist orientation (Rapley, 2012). DPsy is closer to a social constructionist
perspective, whereas it has been suggested that DA adheres to a critical realist one (Willig, 2008). Finally, DA, DPsy, and CA have been discussed in relation to securing good
quality research practice. This has been done in the context of fervent debates (Billig,
1999; Schegloff, 1997) as to what constitutes rigorous analysis. For example, supporters of
the CA/DPsy tradition have accused supporters of the poststructuralist DA trend of lack of
methodological soundness and the treatment of discourses in a solidified manner (Potter,
Wetherell, Gill, & Edwards, 1990; Wooffitt, 2005). In addition, suggestions have been
made in favor of a both/and type of approach (e.g., Wetherell, 1998). Such debates reflect
wider issues regarding the delineation of criteria for qualitative research (e.g., see Elliott,
Fischer, & Rennie, 1999). These are related to attempts to move away from the positivist
adherence to strictly defined criteria and toward a more postmodern orientation. The latter includes arguments in favor of the development of criteria which fit with a constructionist epistemology. It also includes arguments which support the idea that no criteria
are needed at all (Willig, 2008). Some of the suggested criteria include the aforementioned
seeking of next-turn-proof, mostly favoured by CA and DPsy approaches (Wooffitt,
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2005). Other criteria are the use of exemplars, that is, the inclusion of transcribed extracts
of discourse and the inclusion of disconfirming cases (deviant case analysis) (Willig, 2008).
Finally, a frequently suggested criterion is reflexivity, that is, the reflexive appraisal of
the ways in which the researcher has shaped the whole process (see, Finlay & Gough,
2003).
To date, the deployment of CA and DA for the study of family therapy remains a relatively marginal venture. This is perhaps striking if we consider Batesons seminal
research and his sound past in ethnography (Krause, 2003), the overall welcoming of
qualitative research methodologies (Burck, 2005; Gilgun, 2005, 2012; Singh, 2011), and
the existence of hybrid attempts for a discursive analysis of family therapy sessions
(Troemel-Ploetz, 1977; Watzlawick et al., 1967). On the other hand, the majority of the
existing DA and CA studies of psychotherapy use transcribed family therapy sessions as
their data (Avdi & Georgaca, 2007). However, an appraisal of these studies in terms of the
ways they have methodologically deployed DA and CA is lacking. Avdi and Georgaca
(2007) have reviewed only DA and not CA studies of psychotherapy and do present a very
informative sketch of the reviewed studies. They critically discuss them by focusing on
their pursued research interests in relation to the overall stance they adopt toward
psychotherapy. This different focus possibly accounts for the limited and unsystematic
examination of the studies in relation to methodological issues pertinent to the practice of
conducting DA studies. On the other hand, Gehart et al. (2001) have conducted a systematic and critical methodological review of qualitative studies of family therapy. They present
an overview of studies and discuss them in relation to methodological axes, such as the type
of research questions used, sampling procedures, epistemology, method, etc. However, their
review provides a very limited picture of the scene due to the broader focus of their review
and to the limited number of DA and CA studies they identify at the time (n = 3).
Thus, in this review I will attempt to critically examine both CA and DA studies of family therapy under the light of CA and DA literature from a methodological point of view. I
will, therefore, attempt to review the studies in relation to methodological issues and
choices pertinent for conducting CA and DA research.

METHOD
Data Sampling
To trace DA and CA studies of family therapy, I followed a process of gradual screening.
I started with an initial search in the PsycInfo database for articles indexed with the keywords discourse, discourse analysis, conversation analysis, systemic family therapy, and family therapy. In parallel, I conducted a search with the same keywords in
three of the leading journals in the field (Family Process, Journal of Family Therapy, and
Journal of Marital and Family Therapy) from 1970 onwards. Following an examination of
the identified studies abstracts, I came across both with theoretical contributions and
empirical studies. I conducted a further process of selection following two criteria: the
existence of an empirical orientationthat is, analysis of transcribed extracts of actual
sessions of either systemic, family, systemic/family, or solution-focused/narrative/
constructionist therapyand the claim of deployment of either CA or DA as method or
approach (actual use of term by author(s) in both cases). I conducted a further search by
means of the reference lists of the studies for further articles fitting the criteria. The final
number of the selected studies amounted to 28. Consequently, the whole process led to the
exclusion of studies reporting recent attempts for the development of innovative methodologies for the study of psychotherapy discourse (Olson, Laitila, Rober, & Seikkula, 2012;
Seikkula, Laitila, & Rober, 2012) or alternative types of linguistic analysis (Muntigl,
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DISCOURSE/CONVERSATIONAL ANALYSIS AND FAMILY THERAPY

2004). Furthermore, I excluded studies that deployed the notion of discourse or dialog as a
heuristic one and argued for a discursive approach to issues pertaining to clinical practice
in the context of thought-provoking theoretical discussions (e.g., De Haene, Rober, Adriaenssens, & Verschueren, 2012; Foreman & Dallos, 1992; Sinclair & Taylor, 2004; Weingarten, 1991). Finally, studies in which the author(s) conducted CA or DA but did not
explicitly claim that they did so were also excluded (Buttny, 1996; Guilfoyle, 2003).

Method of Analysis
My method of analysis entailed the following processes. First, I selected the main methodological axes which are relevant for any type of empirical research (e.g., Robson, 2011)
and would serve as my analytic focus. These included the choice of method, the content/
type of research question(s), the data/sampling, the type of analysis, the epistemological
theoretical perspective, the content/type of knowledge claims, and attendance to criteria
for good quality research practice. I then examined my data, that is, the selected studies under the light of the literature on conducting DA and CA with the aim to develop
codes in relation to each axis. The constructed codes delineated the methodological choices
in the studies in relation to each methodological axis. In cases where a studys content did
not fit already existing codes, I would then construct further codes in an effort to include
the existing variability to the maximum extent. For example, I included the code methodological for the case where the research question(s)/interest(s) aimed at pursuing the
exploration of the methods potential (see Table 1 for an overview).

FINDINGS
Table 2 presents an overview of each study in relation to the main methodological axes.
Study page numbers indicating the section each code refers to are also provided1.
The deployment of DA and CA methods for the study of family therapy seems a relatively recent venture. Most of the reviewed studies have been published from 2000
onwards (n = 20), with 15 of those published from 2005 onwards. Furthermore, the actual
number of original studies seems very limited. In most cases, two or more articles originate from the same author(s) and from the same study. For example, in the case of
Couture, Strong, and Sutherland, the same data are analyzed in seven different articles
(articles: 4, 5, 6, 7, 25, 26, 27).

Deployed Method and Type/Content of Research Question(s)

The choice of method seemed split between the choice of either CA or DA (n = 14)
and the choice of a mixed type. As regards the framing of research questions, in 11 of
28 studies three practices were identified. These include the choice of a broadly and/or
unclearly defined area of study instead of a defined research question, the choice to
explore the methods potential, and finally the pursuit of providing further evidence for
a preexisting theoretical argument. As regards the rest of the studies, most (n = 13)
seemed to pursue the exploration of how a phenomenon (e.g., collaboration) or a
therapeutic strategy (e.g., neutrality) is conversationally constructed in the context of
therapy discourse. A limited number (n = 4) seemed to pursue how this may be
constrained by wider discourses. However, given the already mentioned overlap
between certain studies (see, e.g., articles 4, 5, and 6), there is a very limited number
in which research questions of DA/CA type as proposed by the literature are actually
1
In the case of old, archived articles the page numbers correspond to the page numbers of the downloaded document and not to the page numbers of the original article.

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TABLE 1
Overview of Methodological Axes and Analytic Codes

Axis
Method

Type/content of
research question(s)

Type of analysis

Epistemological theoretical
perspective

Content and type of

(knowledge) claims

Attendance to
quality criteria

Code
CA: Conversation analysis (16)
DA: Discourse analysis (Foucault type) (13)
DPsy: Discursive psychology (12)
GTh: Grounded theory (3)
Unclear (lack of clearly defined question/broad area of research interest) (8)
Conversational construction of phenomenon (pursuing of construction in the
local context) (9)
Conversational construction of theoretical concept (1)
Discursive construction of phenomenon (pursuing of construction in relation
to wider discourses) (4)
Conversational construction of therapeutic strategy/tool (3)
Methodological (exploration of methods potential) (2)
Theoretical (pursuing of preexisting theoretical argument) (3)
CA/DPsy type (15)
DA type (5)
Mixed CA/DPsy type (emphasis on CA/DPsy methods) (3)
Mixed DA type (emphasis on DA methods) (5)
Unstated (14)
Indirectly stated (4)
Constructivist (1)
Social constructionist (7)
Postpositivist (1)
Poststructuralist (Foucauldian) (1)
Content: analytic (explication of ways of construction of phenomena)
(21)/methodological (claims regarding methods potential) (18)
Type: Tautological (cyclical arguments, no adding of new knowledge) (5),
Realist (15)/Relativist (9), Tentative (acknowledgment of limitations and
local type of knowledge) (9)/Generalizations (13)
None (10)
Reflexivity (8)
Use of exemplars (8)
Deviant case analysis (3)
Next turn proof (2)
Reflexive discussions with audience/readers (4)
Other (1)

Numbers in brackets indicate the number of articles assigned to each code.

pursued. Stancombe and Whites (2005) study of the conversational accomplishment of

neutrality constitutes an example of the latter.

Data/Sampling
The reviewed studies seem to have mostly deployed CA and DA in an experimental
manner. The methods potential for conducting rigorous empirical studies, which could
advance theory, seems only partially explored. However, it should be noted that the studies preference for a case-study type of design and the sampling of a limited range of textual data constitutes frequent practices mostly identified in the DA literature. The choice,
however, may vary depending on the research question and design (Wooffitt, 2005). The
reviewed studies followed the CA and DA literature in their choice of texts/discourse and
not individuals, for example, family members or the therapist as their sample. However,
in most cases (n = 17) data were derived from a single therapy session (this includes the
case of the different articles, where the same single session was used). Furthermore, in a
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CA & DPsy

CA & DPsy

5. Couture
(2007)

6. Couture and
Strong
(2004)

Unclear (talk
about therapy
outcome) (p. 27)
Conversational
construction of
phenomenon
(impasse)
(pp. 6465)
Unclear (process/
outcome)
(multiparty
talk/impasse)
(p. 287)
Conversational
construction
of phenomenon
(impasse)/
Methodological
(p. 91)

CA & DA

CA & DPsy

Unclear (process)
(new meanings:
control) (p. 255)

DA & GTh

2. Burck, Frosh,
StricklandClark,
and Morgan
(1998)
3. Charles
(2012)

4. Couture
(2006)

Unclear (process/
outcome/diagnosis)
(p. 497)

DA

Method

1. Avdi (2005)

Reference

Type/Content
of Research
Question(s)

CA/DPsy
type

Total no. of sessions

unclear (p. 93)
One family therapy
session of K. Tomm

Unstated

Unstated

Unstated

CA/DPsy
type

CA/DPsy
type

Unstated

DA type

Two sessions of one

case of family
therapy (6, notes)
One family therapy
session of K. Tomm

One family therapy

session of K. Tomm

Unstated

Indirectly stated
(social
constructionism,
poststructuralism)

DA type

Mixed/
DA type

One family therapy

case (30 sessions)

One family therapy

case (12 sessions)

Sampling/Data

Type of
Analysis

Epistemological
Theoretical
Perspective

TABLE 2
Overview of Studies in Relation to Methodological Axes

Methodological,
realist,
generalizations
(p. 98)

Methodological,
analytic, realist,
generalizations
(p. 78)

Methodological,
relativist
(pp. 4041)
Analytic, realist,
generalizations
(p. 300)

Methodological,
analytic,
relativist,
generalizations
(pp. 507508)
Methodological,
analytic, realist,
tentative
(pp. 266267)

Content and
Type of
(Knowledge)
Claims

None

Reflexive
discussions
with readers
(p. 66)

None

Reflexivity
(p. 40)

None

Reflexivity
(pp. 507508)

Attendance
to Quality
Criteria

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CA & DA

CA & GTh

DA & GTh

CA

DA, DPsy

8. Friedlander
et al. (2000)

9. Frosh et al.
(1996)

10. Gale and

Newfield
(1992)

11. Guilfoyle
(2002)

Method

7. Couture and
Sutherland
(2006)

Reference

Fam. Proc., Vol. 52, December, 2013

Theoretical
(promoting of
self-contained
individual)
(p. 304)

Conversational
construction of
therapeutic
strategy
(offering
advice) (p. 331)
Conversational
construction of
therapeutic
strategy
(response to
blame) (p. 135)
Unclear (process)
(attitude to
change) (p. 143)
Unclear (process)
(achievement of
therapeutic
outcome) (p. 153)

Type/Content
of Research
Question(s)

Unstated

Constructivism
(p. 163)

Unstated

DA type

CA/DPsy
type

Mixed/DA
type

One first session of

one case of family
therapy (8 sessions)
One session of
solution-focused
therapy (OHanlon)

First two sessions

of constructionist
family therapy
conducted by
author

Constructionist
(p. 138)

Unstated

CA type
mixed
with GTh

CA/DPsy
type

Type of
Analysis

Epistemological
Theoretical
Perspective

7 sessions of different
expert constructivist
therapists

One family therapy

session of K. Tomm

Sampling/Data

TABLE 2
Continued

Methodological,
tautological,
realist,
generalizations
(pp. 313314)

Analytic,
relativist,
tentative (p. 143)
Methodological,
analytic,
relativist,
tentative
(pp. 162163)

Analytic, realist,
tentative
(pp. 142144)

Methodological,
analytic, realist
generalizations
(pp. 339340)

Content and
Type of
(Knowledge)
Claims

Deviant case
analysis,
constant
comparison
method, use
of exemplars,
reflexive
discussions
with readers
(p. 157)
None

None

Other

Deviant case
analysis
(p. 338)

Attendance
to Quality
Criteria

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CA, DA, DPsy

14. Kogan and

Gale (1997)

DPsy & CA
Narratology

CA, DA, DPsy

13. Kogan (1998)

15. Kurri and

Wahlstr
om
(2005)

DA

Method

12. Karatza and

Avdi (2011)

Reference

Discursive
construction
of phenomenon
(process/
outcome)
(shifts in
subjectivity
in case of
psychosis)
(p. 218)
Conversational
construction
of phenomenon
(therapist
strategies for
restraining
meaning
power) (p. 230)
Unclear
(postmodern
therapists
conversational
practices) (p. 1)
Conversational
construction of
phenomenon
(moral
reasoning in
problem talk)
(p. 353)

Type/Content
of Research
Question(s)

Mixed/CA/
DPsy
type

Social
constructionism
(p. 353)

Postpositivist
(p. 15)

Mixed/CA/
DPsy
type

One session of
narrative therapy
(M. White)

One (of seven)

couple therapy
session

Poststructural
(p. 251)

Mixed/CA/
DPsy
type

One session
(solution focused)

Social
constructionism
(positioning
theory)
(p. 217)

Mixed/DA
type

Type of
Analysis

Epistemological
Theoretical
Perspective

7 sessions (from
beginning, middle,
and end of two
therapies of
reflecting team
format)

Sampling/Data

TABLE 2
Continued

Analytic,
relativist
(pp. 362365)

Analytic, realist,
generalizations
(pp. 1415)

Analytic,
relativist,
generalizations
(pp. 246248)

Methodological,
analytic,
relativist,
generalizations
(p. 226)

Content and
Type of
(Knowledge)
Claims

Use of
exemplars
(p. 354)

Reflexivity,
use of
exemplars
(p. 5)

Use of
exemplars
(p. 233),
reflexivity
(pp. 250251)

None

Attendance
to Quality
Criteria

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DISCOURSE/CONVERSATIONAL ANALYSIS AND FAMILY THERAPY

www.FamilyProcess.org

DPsy

DPsy

DA

DA

DA

17. OReilly
(2007)

18. Roy-Chowdhury
(2003)

19. Roy-Chowdhury
(2006)

20. Roy-Chowdhury
(2010)

Method

16. OReilly
(2005)

Reference

Conversational
construction of
phenomenon
(complaints)
(p. 373)
Conversational
construction of
phenomenon
(label of
naughtiness)
(p. 234)
Discursive
construction
of phenomenon
(power and
culture)
Discursive
construction
of phenomenon
(therapeutic
relationship)
(p. 154)
Theoretical
(subjectivity
social
constructionism)
(p. 344)

Type/Content
of Research
Question(s)

Fam. Proc., Vol. 52, December, 2013

Unclear, one
extract
(Roy-Chowdhury,
2003)
4 families (three
different
therapists)

Unclear, one case

(of 4 of family
therapy) (three
different
therapists)
Unclear, therapy
sessions

One session
(3 cases: 22 hours)
(two different
therapists)

Sessions
(3 cases: 22 hours)
(two different
therapists)

Sampling/Data

TABLE 2
Continued

Social
constructionism,
relativism
(p. 236)

Indirectly
stated
(critical realism)

Unstated

Indirectly
stated (critical
realism,
poststructuralism)

Mixed/DA
type

Mixed/DA
type

DA type

Unstated

CA/DPsy
type

CA/DPsy
type

Type of
Analysis

Epistemological
Theoretical
Perspective

Realist,
tautological,
generalizations
(pp. 354356)

Analytic, realist,
generalizations
(pp. 167172)

Methodological
tautological
(pp. 8081)

Methodological,
analytic, realist
(pp. 241242)

Analytic,
relativist,
tentative
(pp. 388389)

Content and
Type of
(Knowledge)
Claims

Use of
exemplars
(p. 345)

None

Reflexivity
(p. 65)

None

Reflexivity
(p. 389)

Attendance
to Quality
Criteria

TSELIOU

/ 663

DPsy

23. Stancombe
and White
(1997)

DPsy& CA)

CA

22. Stamp
(1991)

24. Stancombe
and White
(2005)

DA

Method

21. Singh
(2009)

Reference

Discursive
construction of
phenomenon
(family in
intercultural
sessions)
(p. 362)
Conversational
construction
of theoretical
concept
(interactional
pattern) (p. 4)
Conversational
construction
of phenomenon
(blamings)
Secondary
analysis
(rhetorical
analysis of
Frosh et al.,
1996 data)
Conversational
construction of
therapeutic
strategy
(neutrality)
(p. 333)

Type/Content
of Research
Question(s)

CA/DPsy
type

Unstated

Unstated

CA/DPsy
type

First session of
one case of
family therapy
(Frosh et al.,
1996)

Unclear number,
therapy sessions
and team
discussions

Indirectly
stated
(pragmatic)
(p. 1)

Social
constructionism
(p. 363)

CA/DPsy
type

DA type

Type of
Analysis

Epistemological
Theoretical
Perspective

1 minute &
8 seconds of
one family
therapy session

11 sessions
(British and
South Asian
7 families/
5 therapists)

Sampling/Data

TABLE 2
Continued

Methodological,
analytic, realist,
generalizations
(pp. 348349)

Methodological,
analytic, realist,
tentative
(pp. 38739)

Methodological,
analytic,
relativist
(pp. 1314)

Analytic, realist,
tentative
(pp. 378380)

Content and
Type of
(Knowledge)
Claims

None

Reflexivity
(p. 27, 37)

Use of
exemplars
(p. 13)

Reflexivity
(p. 368)

Attendance
to Quality
Criteria

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DISCOURSE/CONVERSATIONAL ANALYSIS AND FAMILY THERAPY

www.FamilyProcess.org

CA & DPsy

CA

CA

CA

26. Sutherland
and Couture
(2007)

27. Sutherland
and Strong
(2011)

28. Viaro and

Leonardi
(1983)

Method

25. Strong
et al. (2008)

Reference

Fam. Proc., Vol. 52, December, 2013

Conversational
construction
of phenomenon
(collaboration)
(p. 261)
Unclear
(directive
interviewing
techniques of
Milan
therapists) (p. 1)

Conversational
construction
of phenomenon
(alliance)
(process/
outcome)
(p. 212)

Theoretical,
methodological
(outcome
evaluation)
(p. 388)

Type/Content
of Research
Question(s)

CA/DPsy type

Unstated

Unstated

CA/DPsy
type

One family
therapy session
of K. Tomm

10 sessions
(different
therapists,
Milan team)

Social
constructionism
(p. 211)

Social
constructionism
(p. 400)

CA/DPsy
type

CA/DPsy
type

Type of
Analysis

Epistemological
Theoretical
Perspective

One family
therapy session
of K. Tomm

One family
therapy session
of K. Tomm

Sampling/Data

TABLE 2
Continued

Methodological,
analytic, realist,
generalizations
(p. 11)

Methodological,
analytic, realist,
tentative
(pp. 273274)

Methodological,
realist,
tautological,
tentative
(p. 216)

Methodological,
tautological
(p. 400)

Content and
Type of
(Knowledge)
Claims

None

Reflexive
discussions
with readers,
use of
exemplars
(p. 404)
Reflexive
discussions
with readers,
use of
exemplars,
deviant case
analysis,
next turn
proof
(p. 213)
Use of
exemplars,
next turn
proof (p. 264)

Attendance
to Quality
Criteria

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DISCOURSE/CONVERSATIONAL ANALYSIS AND FAMILY THERAPY

number of studies (n = 4), one can identify a lack of a clearly stated number of sessions
and of the explication of sampling procedures (again three of these originate from the
same author). Only in three cases, the author(s) selected data from 7 to 11 sessions
derived from more than two different therapy cases.

Type of Analysis
The majority of studies (n = 22) seemed to include either a CA/DPsy type or a mixed
type of analysis with an emphasis on either a CA/DPsy or DA orientation. This preference
for CA/DPsy could be related to the fields affiliation with systemic communication theories, which fit more with CA and DPsy. It could also denote a preference for a less critical
approach to the practice of family therapy from a deconstructive perspective of a DA type.
Finally, it could constitute an attempt to pursue the rigor in analytic practice introduced
by a CA/DPsy orientation. Only 5 of 28 studies followed an analysis of a DA type. The latter entailed the identification of discourses or broadly speaking themes in ways which
signified a preference for an emphasis on the content of talk rather than on process and
function. In this sense, the analysis resembled more a kind of thematic analysis rather
than DA. In addition, the relationship between the deployed theoretical perspective, the
participants discourse, and the analysts interpretation remained unclear (see also the
meta-analysis of the data of Frosh, Burck, Strickland-Clark, and Morgan (1996) by Stancombe and White (1997) for a similar perspective).

Epistemological Theoretical Perspective and Content/Type of Knowledge Claims

Despite urging the importance of explicating the researchers epistemological perspective (e.g., Gehart et al., 2001), few of the reviewed studies addressed this level of description. In more than half of the cases the author(s) epistemological perspective was
unstated (n = 14) or indirectly stated (n = 4). The latter means that the authors discussed their method in relation to a certain theory, but they did not explicitly state their
epistemological preference. In the rest of the cases the stated epistemological preferences
included the hermeneutic tradition of post-positivist, constructivist, social constructionist, and post-structuralist perspectives.
As regards knowledge claims, most of the studies (n = 21) presented findings that explicated the phenomena under study. In an ample number of cases (n = 18), the author(s)
argued that DA and CA methods have potential in relation to a series of issuesincluding
the potential to reveal what is actually going on in the therapeutic dialog (e.g., Guilfoyle,
2002), to enhance therapist reflexivity (e.g., Kogan, 1998), and finally to introduce alternative methodologies to the study of psychotherapy process and/or outcome (Strong et al.,
2008). However, such claims were not adequately backed up given the choice of method
and the research design of the studies. Furthermore, the analysis seemed to entail a type
of a tautological process in relation to the production of knowledge claims in the cases
where the support of theoretical arguments (n = 5) was pursued. This means that the
findings did not seem to add much to what had already been argued for in the context of
the undertaken theoretical perspective, for example, in the case of the argument that therapy talk is interwoven with power.
Given the overall tendency to adhere to a postpositivist epistemology and the limitations regarding data sampling (e.g., the selection of one session), it is at least striking that
in nearly half of the studies (n = 13) one can detect attempts for generalizations and in
more than half (n = 17) a realist type of claim. In the case of the latter, the author(s)
claimed the existence of certain phenomena or discourses independent of their interpretation. This indicated that they were approached as solidified/reified entities. Furthermore, it is possibly linked with wider tensions regarding the potential of qualitative
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research for generalizations (Willig, 2008). It further reflects what has been identified as a
realistrelativist continuum regarding epistemological preferences in qualitative research
(Harper, 2012; Madill, Jordan, & Shirley, 2000).

Attendance to Quality Criteria

In DA and CA literature, one can identify quests for attending to criteria securing good
quality practice (Potter & Wetherell, 1987; Willig, 2008). However, in a number of studies
(n = 10) there was no mention of attempts to attend to such criteria at all. In addition to
criteriasuch as the seeking of the next-turn-proof, the use of exemplars, the inclusion
of deviant case analysis, and reflexivitya limited number of cases (n = 4) reported further practices, for example, reflexive discussions with others (e.g., Gale & Newfield, 1992).
Also, other ways, such as the use of judges and preexisting validated coding systems, were
reported in one case (Friedlander, Heatherington, & Marrs, 2000).

CONCLUSIONS
The reviewed studies allow us to see glimpses of the potential of DA and CA for family
therapy research. On the other hand, they entail a number of methodological shortcomings. The latter include a lack of systematically defined research questions and a limited
number of empirical studies with designs other than case studies. They also include inconsistencies between choice of method, stated or unstated epistemological orientations, and
knowledge claims, as well as limited attendance to methodological practices for ensuring
attendance to criteria for good quality practice. However, there are a number of ways in
which one could make sense of this possibly disappointing sketch of the reviewed studies.
First, this review is itself an interpretative, discursive construction, revealing of my
prejudices. My choice to review DA and CA studies of family therapy is possibly related
to my dual background in systemic therapy and training (Tseliou, 2010) and the application of DA to its study (Diorinou & Tseliou, 2012). Also, my epistemological orientation
and academic interest in research methodology possibly account for my preference to
retain systemization, method, and rigor when conducting qualitative research. Furthermore, this review has its own limitations. Any process of categorization inevitably entails
the inescapable trap of minimization of difference and variability and that of partiality.
Certain choices, for example, the assignment of a code or deciding upon criteria for the
evaluation of analysis, were neither unproblematic nor easily manageable. For example,
in certain cases (e.g., Roy-Chowdhury, 2003; Strong et al., 2008) it was difficult to decide
upon the assignment of a code denoting the studys epistemological orientation. Despite
the existence of relevant DA and CA literature, the delineation of criteria for evaluating
DA and CA studies is possibly a project in itself. It also extends the boundaries of the present review.
Second, there is a lack in the relevant literature of clear and specific guidelines of how
to proceed with conducting a CA and DA study. Reference is often made to the necessity
for a good deal of improvisation on behalf of the analyst (e.g., Wood & Kroger, 2000).
Having experimented with conducting and reporting DA studies (Tseliou, 2003; Tseliou
& Eisler, 2007), I am fully aware of the difficulties involved in attempting to secure
methodological rigor in the sense that this reviews critical perspective has suggested. I
also acknowledge the hurdles of reporting DA/CA studies, when one is confronted with the
limitations of the usual format of journal articles, such as word limit (see also LaRossa,
2012).
Finally, perhaps there is also a wider issue of relevance here. I think it is linked with
the history of the controversial relationship between research and clinical practice in the
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DISCOURSE/CONVERSATIONAL ANALYSIS AND FAMILY THERAPY

field and also with wider debates considering the practice of (scientific) query. Both relate
to what we perceive as constituting knowledge in relation to clinical practice and in what
ways we think it can be created. They also relate to the role, if any, we believe research
and method should play in relation to that knowledge. In that sense, perhaps the frequently stated quest for finding research methodologies, which would fit our epistemological adherences in relation to clinical practice, should be reconsidered. Instead, perhaps it
would be more meaningful to reflect upon what we believe constitutes (scientific) knowledge, irrespective of the choice of method/methodology (see also, Eisler, 2002). I believe
that pursuing methodological rigor in constructionist research might better serve the aim
of transparency and thus facilitate the critical appraisal of ones claims to knowledge.
These issues and the relevant debate, however, extend the limits of this study.
So far, my emphasis on the identification of methodological shortcomings possibly constructs the scope of the reviewed studies as an endeavour in its infancy. However, on the
basis of this review I would like to risk an affirmative answer to the question of whether
CA and DA are worthwhile exploring for family therapy research. This may entail a risk
as I believe that to address such a question we need comparative research projects
designed specifically with the aim to explore the methods potential. This review has identified studies which show potential ways in which CA and DA can add to family therapy
research by identifying attempts for rigorous analysis (e.g., Kogan & Gale, 1997; OReilly,
2005; Stancombe & White, 2005). For example, OReilly (2005) analyzed 22 hours of family
therapy sessions from three different cases seen by two different therapists. The purpose
was to explore the conversational construction of complaints that family members report
to their family therapist about other professionals who have previously been involved in
their treatment. OReilly aimed at exploring how such complaints happen in the context of
the dialogic interaction between therapist and family members. Her report includes a clarifying theoretical discussion of the phenomenon of interest and a clearly defined research
question of a CA/DPsy type. Thus, the choice of a CA/DPsy approach is adequately justified and explicated. On the basis of a rigorous analysis of CA/DPsy type documented on
exemplars, OReilly presents valuable and interesting findings. These have to do not only
with the function of complaints in family members talk, but also with the ways that therapists respond to them. Complaints in family members discourse seem to facilitate the
management of accountability and responsibility issues in relation to the presenting problems. The therapists responses seem structured in ways that attempt to construct complaint talk as unhelpful. Complaint talk is simultaneously constructed as a topic in
relation to which the therapists cannot offer advice or provide help. OReilly concludes by
proving a critical appraisal of the findings of the study and their significance for family
therapy practice, which also includes a little reflexivity (OReilly, 2005, p. 389), that is, a
reflexive discussion of the undertaken methodological choices.
I believe that examples like this allow us to see the potential of CA and DA for the study
of research questions of possible interest to the field. These include the detailed study of
theoretical concepts or therapy practices in the actual context of the here and now of therapists and family members patterned interaction while in therapeutic dialog (see also
Sutherland & Couture, 2007). In that sense, CA and DA can possibly add to existing ways
of studying family therapy process and outcome (Strong et al., 2008) and to existing
contributions regarding treatment evaluation (e.g., Sexton et al., 2011). Furthermore, the
deployment of CA and DA methods can provide ways of scrutinizing the therapists dialogic contribution which contributes to a critical appraisal of institutional aspects related
to the practice of family therapy. Perhaps most importantly, though, they can contribute
to bridging the gap between research and clinical practice, due to their potential to
enhance therapist reflexivity (e.g., Roy-Chowdhury, 2003; Stancombe & White, 1997,
2005). Finally, for those of us who are trained as systemic clinicians, there is also the asset
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of our familiarity with pragmatic and constructionist approaches to discourse and, thus,
with some of the methods main adherences.
In conclusion, I would like to argue in favor of a critical deployment of CA and DA methods for the study of family therapy. Thus, I hope that this review will not have a discouraging effect. Instead, I do hope that it will be received as an invitation to pursue the further
development of the application of CA and DA methods for the study of family therapy by
means of promoting more rigorous methodological practice. I think that future practice
can be greatly enhanced, provided that certain traps are avoided. Just like any research
method, CA and DA methods are suitable for the study of certain questions. These are in
turn weaved in certain epistemological backcloths and, thus, offer certain possibilities
for data sampling, analysis, and the making of inferences. In a way similar to Gehart
et al.s (2001) suggestion, I think that the methodological axes delineated in this review
can possibly provide ideas for future practice. For example, one such idea can be to pursue
a fit between research question(s), method, epistemological perspective, and resulting
claims. As also argued before (Diorinou & Tseliou, 2012), I think we have only minimally
addressed so far what I perceive as a methodological challenge for family therapy
research, and we should not let it pass by.
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