title: Therapist interventions and client ambivalence in two cases of narrative therapy for depression.
abstract: We understand ambivalence as a cycle of opposing expressions by two internal voices. The emergence of a suppressed voice produces an innovative moment (IM), challenging the dominant voice, which represents the client's problematic self-narrative. The emergence of the IM is opposed by the dominant voice, leading to a return to the problematic self-narrative. This study analyzed therapist and client responses to each other in episodes of ambivalence.
  
  
  
  The therapeutic collaboration coding system (TCCS) assesses whether and how the therapeutic dyad is working within the therapeutic zone of proximal development (TZPD) by examining client responses to therapist interventions. We applied the TCCS to episodes in which a good- and a poor-outcome client in narrative therapy expressed ambivalence.
  
  
  
  In both the good- and poor-outcome cases, the therapist responded to the emergence of ambivalence similarly, balancing challenging and supporting. The good-outcome case responded at the developmental level proposed by the therapist when challenged, while the poor-outcome case lagged behind the level proposed.
  
  
  
  This supports the theoretical explanation that the therapist did not match client's developmental level in the poor-outcome case, working beyond the client's current TZPD and contributing to the maintenance of ambivalence.
authors: a Psychology Research Center, School of Psychology , University of Minho , Braga , Portugal.
authors: António P
authors: AP
authors: Ribeiro
authors: a Psychology Research Center, School of Psychology , University of Minho , Braga , Portugal.
authors: Cátia
authors: C
authors: Braga
authors: b Psychology , Miami University and Appalachian State University , Oxford , OH , USA.
authors: William B
authors: WB
authors: Stiles
authors: a Psychology Research Center, School of Psychology , University of Minho , Braga , Portugal.
authors: Poliane
authors: P
authors: Teixeira
authors: a Psychology Research Center, School of Psychology , University of Minho , Braga , Portugal.
authors: Miguel M
authors: MM
authors: Gonçalves
authors: a Psychology Research Center, School of Psychology , University of Minho , Braga , Portugal.
authors: Eugenia
authors: E
authors: Ribeiro
mesh_terms: D000328:Adult; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D062525:Narrative Therapy / Q000379:methods*; D011369:Professional-Patient Relations; D055815:Young Adult
keywords: ambivalence; assimilation; narrative; process research