Clients’ Resistance to Therapists’ Proposals: Managing Epistemic and Deontic Status in Cognitive Behavioral Therapy Sessions

Abstract

Cognitive Behavioral Therapy (CBT), when applied to mood disorders, is designed to alleviate symptoms of depression and help clients learn more effective ways of dealing with the difficulties that contribute to their suffering. In CBT, therapists are encouraged to engage clients in a highly collaborative process in which there is joint responsibility for decision-making about therapy goals. This chapter explores sequences of interaction that involve decisions about clients’ future actions in a sample of recorded CBT sessions. In particular, the analysis compares sequences in which clients proposed their own ideas for future action with other sequences in which therapists proposed the action themselves. Clients typically resisted therapists’ proposals by indexing their superior epistemic authority in the domain of their experience, thereby invoking their ultimate right to reject the therapist’s proposed course of action. The findings highlight the complexities of implementing joint decision-making practices within therapy interactions.