An ethnographic study of the strategic therapy process

Cognitive ethnography was introduced as a research method which views the behavior of individuals as having many contextual variables. Ethnography views human behavior and thought as a complex process which cannot be broken into discrete entities separate from the system of which they are a part. Therefore, ethnography was used to investigate strategic therapy which is derived from systems theory. Three strategic therapists were chosen as informants and interviewed over a series of sixteen to eighteen sessions. Through these in-depth interviews, a model of hierarchical and sequential goals and activities of the therapy process was developed. This model was compared to a general theory of problem solving (Randall, 1987). The data from the informants about the therapy process accommodated the major goals of the problem solving theory. The model was then validated with cases from the primary informant and then tested across informants. The model was validated by all three informants. As the model was being created, one of the major goals identified in the therapy process was that of developing a working hypothesis. Informants defined the working hypothesis as the "shared" reality, or view of the problem behavior that is co-evolved between the client and the therapist. "Acting out child" problems were commonly identified across informants, therefore, the study centered on the formation of hypotheses in this problem area. Decision tables were developed for the routine selection plans of hypotheses by discovering the selection criteria therapists considered. Once all possible routine paths for selection were identified, the decision tables were tested for accuracy in prediction of hypotheses selection. When tested with actual therapy cases, decision tables for routine selection plans of hypotheses of "acting out child" problems were found to have a 92% and 89% rate of accuracy in prediction. This study demonstrated that cognitive ethnography could be successfully applied to an investigation of the strategic therapy process.