Who has the Right to Know? Negotiating Epistemic Authority in Constructionist Therapies

Objectives

Constructionist therapies challenged therapists’ authority and advocated the non-hierarchical participation of all members of the therapeutic system in the therapeutic dialogue. However, therapy is institutionally constructed as an asymmetrical process, with the therapist being assigned epistemic authority, that is, the right to know, as compared to clients. Accordingly, clients may evoke therapists’ expertise by asking for advice or straightforward diagnostic assessment. Within such a context, a normative conversational pattern is the therapist being the one formulating questions and the client being the one answering such questions. However, clients may deviate from such a pattern by formulating their own questions to the therapist. The present study's aim was to investigate how participants negotiate epistemic authority, in instances where such deviations occur.

Methods

Drawing from discursive psychology and conversation analysis, we analysed 19 audiotaped therapy sessions, conducted by 3 therapists following the post-Milan systemic approach.

Results

By focusing on a conversational pattern where clients address questions to therapists and therapists respond with questions, analysis illustrates the dilemmatic ways in which therapists and clients challenge and affirm epistemic asymmetry. By addressing a question to the therapist, clients appear to resist asymmetry, while at the same time they invoke therapists’ authority, thus challenging therapists’ adherence to constructionist premises. On the other hand, therapists, by replying with questions, seem to restore the normative order of therapeutic conversation, but also resist such an invoking by not responding from a position of authority.

Conclusion

Our findings highlight the dilemmatic aspects of epistemic authority negotiation in constructionist therapies.