[Problems and strategies of qualitative psychotherapy research in clinical institutions]

The neglect of institutional codetermination in therapeutic decisions is exposed as a desiderative in research. Qualitative approaches as developed in the social sciences must come to grips with the social unconscious institutional procedures; therapy is proposed to be considered as a social event. Thus Reality Work is viewed as field and object of qualitative research in clinical institutions, a concept close to ethnographic and social constructionist approaches. The generative techniques (as dissonance reduction, narrative transformations and selection of rules of discourse) institutions use for the establishment of their social-emotional integration are illustrated by examples; they are instruments to produce a processible image of the patient. Images thus generated rule treatment, they can be formulated as metaphors und looked for at different levels.