Supra-session courses of action in psychotherapy

• Analyses of talk-in-interaction are usually bounded to single encounters.
• We describe a large-scale interactional organization in two kinds of psychotherapy.
• Courses of action spanning over multiple sessions recur in psychotherapies.
• Courses of action in psychotherapy may end in a display of change by patients.
• Participants use techniques that tie past talk to the ongoing courses of action.

Analyses of talk-in-interaction in institutional settings have generally been bounded to the interactional organization of single conversations. In this paper we claim that in psychotherapies participants build up courses of action spanning over different sessions while pursuing the institutional aims of psychotherapy. In cognitive and systemic therapies such courses of action are based on two kinds of activities, enquiry and elaboration. In enquiry therapists elicit and co-construct patients’ tellings about their events. In elaboration therapists offer their versions of what has previously been told by patients, and patients regularly respond to them. Series of enquiry sequences prepare elaboration; subsequent elaboration sequences, possibly intertwined with further enquiry, can induce patients to modify their previous stances towards their problems and display such change within elaboration. We discuss two cases, one from a systemic and the other from a cognitive therapy, where this interactional process unfolds across several sessions. We describe tying practices by which participants resume past talk and link distant sequences into unitary courses of action accomplishing the institutional tasks of elaborating the patients’ problems and making the patients achieve a change of stance on them. Finally, based on our findings, we sketch an overall organization of activities in psychotherapy and provide suggestions for future research.