Managing the Therapeutic Relationship in Online Cognitive Behavioural Therapy for Depression: Therapists' Treatment of Clients' Contributions

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Published: Dec 31, 2013
Keywords:
Cognitive Behavioral Therapy, Conversation Analysis, thanking, commiseration, rapport

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Stuart Ekberg
Rebecca K. Barnes
David S. Kessler
Alice Malpass
Ali Heawood (nee Shaw)

Abstract

This article examines how therapists and clients manage the therapeutic relationship in online psychotherapy. Our study focuses on early sessions of therapy involving 22 therapist-client pairs participating in online Cognitive Behavioural Therapy (CBT) for depression. Using Conversation Analysis (CA), we describe two practices that therapists can use, at their discretion, following clients’ responses to requests for information. The first, thanking, accepts clients’ responses, orienting to the neutral affective valence of those responses. The second, commiseration, orients to the negative affective valence of clients’ responses. We argue that both practices are a means by which therapists can simultaneously manage developing rapport, while also retaining control of the therapeutic process.

Article Details

How to Cite
Ekberg, S., Barnes, R. K., Kessler, D. S., Malpass, A., & Heawood (nee Shaw), A. (2013). Managing the Therapeutic Relationship in Online Cognitive Behavioural Therapy for Depression: Therapists’ Treatment of Clients’ Contributions. Language@Internet, 10. Retrieved from https://scholarworks.iu.edu/journals/index.php/li/article/view/37644
Issue
Vol. 10 (2013)
Section
Special Issue on Institutional Computer-Mediated Troubles Talk
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Author Biographies

Stuart Ekberg

Stuart Ekberg is a Research Fellow in the Institute of Health and Biomedical Innovation at Queensland University of Technology (Australia). He specialises in conversation analysis, with particular interest in social interaction within health care settings. Until February 2013, he worked at the University of Bristol (UK) on the study reported here.

Rebecca K. Barnes

Rebecca Barnes is a Research Fellow in primary care in the School of Social and Community Medicine at the University of Bristol, specialising in applied conversation analytic methods with a particular interest in health care communication.

David S. Kessler

David Kessler is a Senior Lecturer in primary care in the School of Social and Community Medicine at the University of Bristol. His main research area is depression and anxiety, and he has a special interest in the use of information technology to deliver treatment.

Alice Malpass

Alice Malpass is a Research Fellow in the Centre for Academic Primary Care at the School of Social and Community Medicine at the University of Bristol. She has methodological expertise in the use of meta-ethnography for qualitative synthesis and cognitive interviewing. She teaches mindfulness based cognitive therapy (MBCT) to medical students and researches MBCT and its clinical applications.

Ali Heawood (nee Shaw)

Ali Heawood (nee Shaw) is a Senior Research Fellow in the Centre for Academic Primary Care, School of Social and Community Medicine at the University of Bristol. She is a qualitative health services researcher whose interests include practitioner-patient interactions, patients' experiences of health and illness, synthesis of qualitative research, and the integration of qualitative research within randomised controlled trials.