A Comparative Conversation Analytic Study of Formulations in Psychoanalysis and Cognitive Psychotherapy

Abstract

The uses of formulation in cognitive psychotherapy and psychoanalysis were compared, by means of conversation analysis, using 53 audio-recorded sessions as data. Two formulation types were found in both approaches: highlighting formulations, which recycle the client's descriptions and recognize therapeutically dense material, and rephrasing formulations, which offer the therapist's version of the client's description and focus on subjective experiences. These formulations may be interactional bearers of common factors in psychotherapy. Two other formulation types were exclusive to one or another approach. Relocating formulations, found only in psychoanalysis, propose that the experiences in the client's narratives are connected to experiences at other times or places. Exaggerating formulations, found only in cognitive psychotherapy, exaggerate the client's talk by recasting it as something that is apparently implausible. The contrast between relocating and exaggerating formulations suggests that, despite recent theories in the two approaches being more compatible, interactional differences still exist between cognitive psychotherapy and psychoanalysis.

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