Managing dissensus in family therapy supervision: a conversation analysis



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Texas Tech University


Supervision in marriage and family therapy can be seen as a collaborative effort between supervisors and trainees about the course and process of psychotherapy. Within such a view, it is central to be able to identify moments of dissensus, segments of talk in which participants appear to lack shared understanding or agreement, and to understand the process of working beyond dissensus to consensus. This descriptive observational study identified 120 episodes of dissensus from 23 supervision sessions involving 6 supervisors and 23 trainees. Episodes of dissensus were identified by two trained raters from audiotape and transcription. Qualitative analysis considered the antecedents, tactics, and consequences of the identified episodes. Assumptions are rooted in social influence theory and family systems theory.

Dissensus emerges as supervisors seek to exert influence and fault finding regarding the trainee's clinical actions and as trainees seek to modify the supervisor's actions. Supervisors' fault finding and influence refer to assessments about the trainee's clinical actions and attempts to solicit change in future action. This study found 10 supervisory tactics of influence and fault finding. Trainees' responses attempt to minimize or qualify the supervisors' tactics by giving the impression of compliance or seeking to place compliance outside voluntary control. This study found 10 trainee modification tactics.

Ambiguity is a consistent feature of talk in supervision. Supervisors' tactics ambiguate fault finding or influence. Trainees' tactics offer responses that are less than compliance, yet make noncompliance ambiguous.

Of central interest to this study was how the episodes of dissensus were resolved. Participants almost never resolve dissensus with any strategies of remediation. This study found three strategies in which trainees and supervisors collaborated to pass over dissensus without reaching consensus about the matters they were discussing.

Dangling dissensus characterizes most episodes of dissensus. The dissensus is left dangling as participants pass over the dissensus without reaching consensus or reaching an acceptable remediation. Three common tactics that create dangling dissensus are candidate remediation, supervisor monologue, and cut to next videotape, case, or trainee. Theoretical and practical implications relate to power and hierarchy in supervision and isomorphism with psychotherapy.