Psychotherapy is fundamentally a linguistic enterprise. Therefore, therapists need to understand the basics of how language functions. In this theoretical analysis, we introduce the cybernetic concept of "conversational domains" and use clinical examples to illustrate its relevance in the clinic. Conversational domains determine the questions that can be asked and the ways in which they can be answered. Clients often get stuck in narrow domains that do not contain the answers they seek. The job of the therapist is to help clients see beyond the limits of the conversational domain in which they have become ensnared. This can be accomplished primarily in two different ways. The therapist can focus the client's attention on the framework of the current conversation rather than its contents or they can respond to client utterances in oblique ways that shift the conversational trajectory. In this article, we outline the major characteristics of conversational domains and provide examples of the two major strategies for helping clients move from one domain to another.

The term punctuation in psychotherapy refers to narrative decisions about when a problem started and who should be held accountable for it. The concept was once a staple of family and systems therapies, but it has largely fallen into disuse. Its near disappearance coincided with the declining interest in those therapeutic approaches rather than as the result of direct attacks on the concept’s validity or usefulness. In other words, punctuation seems to have been neglected rather than deliberately abandoned or supplanted. The authors argue for the continuing value of punctuation and its introduction to a new generation of clinicians. They also discuss several theoretical issues that were not well explored during the heyday of punctuation’s popularity. Finally, the authors explore and illustrate the practical utility of punctuation in psychotherapeutic contexts.

Motivational interviewing (MI), originally devised for the treatment of substance use disorders, was introduced by William Miller in 1983. Of the various attempts to explain its effectiveness, the best known is the "technical hypothesis" proposed by Arkowitz and colleagues (2015). It calls for clinicians to increase in-session change talk-client verbalizations that imply or suggest movement away from the status quo-and to soften sustain talk-client commitments to maintaining existing circumstances. Recently, however, the relationships between change talk, sustain talk, and therapeutic progress have been questioned and appear to be more complex than originally assumed. In this article, we invoke a core principle of structure determinism-orthogonal interaction (OI)-to provide an alternative and potentially more powerful conceptualization of when and why MI is effective. Structure determinism is a cybernetically informed version of constructivism; within that framework, OI is posited as the main mechanism of system change. It is defined as a change in the structure of a system component that, in turn, affects the operation of the whole system. Examples are provided to illustrate how this formulation pertains to, and helps explain, therapeutic interaction, both for practitioners of MI and those who favor other therapeutic modalities. Public Health Significance Statement Motivational interviewing is a popular and effective treatment modality that has lacked an adequate theoretical underpinning. In this paper, structure determinism-a constructivist theory about how we acquire and share knowledge-is used to help fill that gap, potentially clarifying the operation of the method and improving its utility.

Motivational interviewing is a widely used treatment, introduced by William Miller in 1983. The original target of the method was substance use disorders, but it has since been used to address a variety of other mental health concerns. Because it was developed inductively from clinical insights rather than deductively from a set of theoretical postulates, practitioners have had difficulty understanding how or why the method works. Previous attempts to fill that theoretical gap have not been fully successful. Thus, in this article, we apply principles of structure determinism, a constructivist model, in an attempt to clarify how core aspects of motivational interviewing function and how the method might be strengthened. Public Significance Statement Motivational interviewing is a popular and effective treatment modality that has lacked an adequate theoretical underpinning. In this article, structure determinism -a constructivist theory about how we acquire and share knowledge is used to help fill that gap, potentially clarifying the operation of the method and improving its utility.

Many consider Murray Bowen to be the father of family therapy. This book, written by his long-time collaborator, attempts to establish the continuing relevance of his unique—some would say idiosync...

We outline a context-centered therapy approach to helping clients cope with the coronavirus pandemic. Context-centered therapy is a constructivist approach that emphasizes shifts in an individual'scontextsas the best way to generate therapeutic change. Contexts are defined as sets of presuppositions that shape a person's experiences. We examine how two very common contexts,mindandself, can inform therapists' understanding of how their clients are responding to the coronavirus pandemic. The mind consists of a person's defensive and protective postures in the face of perceived threat, whereas the self takes a broader perspective and emphasizes human connections and interrelatedness. Therapists can use several mind/self contrasts-blame versus responsibility, insufficiency versus sufficiency, being at effect versus being at cause, and avoidance versus mastery-to assist people who are struggling in the face of the coronavirus pandemic.

Many consider Murray Bowen to be the father of family therapy. This book, written by his long-time collaborator, attempts to establish the continuing relevance of his unique—some would say idiosync...

In our response to Raskin, we caution that combining incompatible vocabularies usually results in a linguistic muddle from which it becomes increasingly difficult to escape. Although omnibus terms such as “psychosocial” and “biopsychosocial” sound reasonable, they function merely as slogans, without any clear meaning or explanatory power. We recommend tailoring a linguistically consistent system to meet our needs as psychologists. We also warn against the tendency for some to blur the distinction between client input and professional perspectives.

In this article, we draw on our experiences as therapists and supervisors to highlight the errors new clinicians tend to make and how they can be avoided. A critical issue is how to approach the client's narrative. We propose a stance of "respectful skepticism," in which the factors that shape the client's truth can best be appreciated. This represents a middle way between gullible listener and prosecuting attorney. We also discuss common problems with client motivation, as well as the changing role of feelings in therapy, the importance of the therapeutic contract, the high cost of defensiveness, the concept of conversational domains, and the advantages of avoiding therapeutic platitudes, explanatory fictions, and jargon.

This article presents a dialogue about personal construct psychology, radical constructivism, and social constructionism. The dialogue is based on a symposium conducted in July 2011 at the 19th International Congress on Personal Construct Psychology. Jay Efran, Sheila McNamee, and Bill Warren were the participants, with Jonathan Raskin as moderator. The dialogue addresses points of contact and divergence across these three theories, how these theories deal with the issue of relativism, and how theorists from these three perspectives might best “go on” together.