Contextual assessment of couples therapy: the Clinical Discourse Q-Sets

This article describes a method for creating highly contextual assessments of couples therapy interaction using concepts from Systemic Functional Linguistics (SFL). According to SFL, talk in interaction serves three primary functions: to mediate social relations, to negotiate representations of reality, and to organize and structure the event as coherent. These concepts are operationalized using observational q-methodology. The Clinical Discourse Q-Sets (CDQS) include three separate q-sets for use by trained observers in rating 12-min segments of couples therapy conversation. Each q-set captures one aspect of the communication process as defined by Systemic Functional theory. Good-to-high reliabilities for the q-set profiles over various (n = 16) couples therapy episodes were found. Preliminary evidence for the conceptual structure and clinical validity of the system was found.