Assessing clients' constructions of their problems in family therapy discourse

To study family members' narrative descriptions of their difficulties, we developed an observational coding system, the Cognitive Constructions Coding System (CCCS). In this system, 4 dimensions of clients' problem descriptions (intrapersonal-interpersonal) and causal explanations (internal-external, responsible-not responsible, linear-circular) are coded in the context of a Problem Elaboration Episode, a segment of psychotherapy discourse. In Studies 1 and 2 the reliability of the CCCS was assessed using transcripts from family therapy texts and interviews provided by 7 constructivist theorists. Across studies, mean interjudge agreements ranged from 56% to 98%; the mean reliability estimates were, however, more modest and variable (range .46 to .94). In Study 3, trained judges coded videotapes in which volunteers described personal problems that corresponded to specific CCCS codes. Results of this experiment showed that, on every dimension, the coding was more accurate than chance, all ps <.005. In Study 4, the CCCS successfully discriminated 6 of 8 family intake sessions in which the parents' descriptions of the presenting problem either did or did not shift from intrapersonal to interpersonal over the course of the interview. Directions for future research with the coding system are suggested, along with a discussion of its relevance for practice.