How to do discovery-oriented psychotherapy research

How To Do Discovery-Oriented Psychotherapy ResearchÄ

Alvin R. Mahrer and Donald B. BouletUniversity of Ottawa

A discovery-oriented approach to psychotherapy research relies on discovery-oriented research questions. Four such questions are illustrated, togetherwith the logistics of this approach to research, and the practical workingsteps in carrying out a program of discovery-oriented research. A case ismade for the superior elegance of the discovery-oriented approach topsychotherapy research. © 1999 John Wiley & Sons, Inc. J Clin Psychol55: 1481–1493, 1999.

We have been trying to discover the secrets of what in-session psychotherapeutic workcan accomplish, and the new and better ways of being able to accomplish these excitingchanges. The purpose of this article is not to tell about the findings (see Mahrer, 1996bfor a summary), but rather to describe what we believe we are learning about how to doresearch for this purpose and to invite interested others to try doing and improving thisway of doing discovery-oriented research (Mahrer, 1985, 1988, 1996b).

What are the Research Questions?

This way of doing research starts by stating carefully the questions that research is to helpanswer. The questions come first, and they determine what the research strategy is to looklike. The discovery-oriented way of doing research is the best way we know to helpanswer these questions. Most research starts from hypotheses; discovery-oriented researchstarts from questions.

1. What are the impressive, significant, or valued changes or events that can occurin psychotherapy sessions?Picture a researcher pointing to some place in a ses-sion and saying that here is a change, here is an event that is impressive, signifi-cant, or valued. A way of doing research is good, helpful, or useful if it can enablethe researcher to discover answers to this question.

Correspondence concerning this article should be addressed to Alvin R. Mahrer, Ph.D., School of Psychology,University of Ottawa, Ottawa, Canada, K1N 6N5; e-mail: [email protected]

JOURNAL OF CLINICAL PSYCHOLOGY, Vol. 55(12), 1481–1493 (1999)© 1999 John Wiley & Sons, Inc. CCC 0021-9762/99/121481-13

2. Do impressive, significant, or valued in-session changes or events occur in somesequence or sequences?Are there discernible sequences, patterns, stages, or ordersto these impressive in-session changes? Does one kind of impressive change seemto pave the way toward, or to follow some other kind of impressive change? Aresearch strategy is to be able to help answer this question.

3. How can these impressive, significant, or valued in-session changes or events bebrought about?A research strategy is needed to help the researcher first discoverthese impressive changes and then to discover how they can be brought about,achieved, or produced. “Indeed, it can be liberating for a practitioner to ask him-self, ‘What, in my work, really gives me satisfaction?’ and then, ‘How can Iproduce more experience of that kind?”’ (Schon, 1982, p. 299).

4. How can the therapist use these impressive, significant, or valued in-session changesor events when they occur?A research strategy is good if it can help the researcherdiscover ways that the therapist can capitalize on and constructively use theseimpressive in-session changes when they occur.

The challenging suggestion is that the discovery-oriented way of doing research wasdeveloped to answer and is the best way we know of answering these four researchquestions.

What are the Logistics for Doing Discovery-Oriented Research?

Have a Large Research Team of People who are Enthusiasticabout Discovering how to do Psychotherapy

We prefer a large team of people, perhaps 8–14 or so, who share a common enthusiasmfor discovering the secrets of psychotherapy, who can be surprised and excited at findingout what psychotherapy can do and how it can be done (cf. Goldman, 1977, 1979; Hosh-mand, 1989; Mahrer, 1985; Mahrer & Gagnon, 1991; Mahrer, Paterson, Theriault, Roessler,& Quenneville, 1986). We find that the work is done better if the team includes a healthysprinkling of therapeutic approaches and even some members with no special approach atall. Accordingly, the team welcomes professors, practicing professionals, those with orwithout all sorts of degrees, trainees, undergraduate students, and interested people fromthe community.

Keep Adding to An Ever-Richer Library of Tapes of Psychotherapy Sessions

The precious requirement is a library of tapes of actual psychotherapy sessions, an oldidea that already was yielding such recordings in the 1920s and 1930s, well before CarlRogers’ pioneering tape-based studies (Dittes, 1959). Almost exclusively these are audio-tapes begged and borrowed from a large number of practitioners representing variousapproaches (Garfield, 1981) and various psychotherapy-related professions. Some of thecontributors are well known; many are simply fine practitioners. The pleading was andcontinues to be for tapes of any session, though the emphasis is on sessions where some-thing happened that was especially valuable, impressive, pleasing, special, distinctive,important, gratifying, unusual, or surprising. It is wonderful to have even one session anda special gift to receive a series of sessions.

What also is precious is protecting the client, the therapist, and the team in ways thatare considered professional, ethical, and legal. The protective measures range from what

1482 Journal of Clinical Psychology, December 1999

may be expected by common sense to some that a skilled technician can spin withaudiotapes.

Select the Tapes to be Studied Next

From the large pool of tapes in the library, a few team members listen to each tape tomake provisional judgements of whether it seems to offer even a reasonable likelihood ofcontaining something interesting. The team is usually invited when the study of one tapedsession is almost finished to offer suggestions about the next tape—for example, anothertape by the same or a similar therapist, or a session where the patient’s state or concern israther different.

When one project is coming to an end, the research team discusses what the nextproject might be. Perhaps it might examine a particular kind of impressive change, oranything else coming from the team’s current interests and enthusiasms.

The Whole Team Meets Weekly

One purpose of the weekly meeting is to assign the homework for the next week’s meet-ing. As will be described in the next section, each tape is studied by proceeding througha series of steps so that the next week’s homework follows a regularly repeated sequence.Each team member does the homework independently at one’s own convenience duringthe week. A second purpose of the meeting is to present and to discuss the individualhomework findings of each team member for that week. A third purpose is to provideroom for open discussion of problems and good, new ideas for improving the discovery-oriented method.

What are the Steps in Doing Discovery-Oriented Research?

1. Judges Study the Tape to Determine if There are Any Impressive Changes

A few of the team members already have done a very provisional labeling of a next tapeas probably containing impressive changes. Starting with that tape, each team member isto study the tape independently to answer this question: Do you believe this tape containsany impressive changes, or none at all? While the heavy emphasis is on each judge’s ownpersonal impressions, with as few as possible restrictions and as much as possible openreceptivity, the judges are provided with some helpful guides in the form of variouscategory systems of impressive, significant, or valued in-session changes and events(e.g., Mahrer, Gagnon, Fairweather, & Cote, 1992; Mahrer & Nadler, 1986). But these aremerely helpful guides with the primary criterion being anything at all that even touchesthe mere possibility of something good, new, different, or impressive. This is the meaningof impressive in the first step.

At the next team meeting, after hearing the yes or no impressions of each teammember, the team as a whole decides whether to study that tape or to go through the sameexercise with some other provisionally stamped tape.

2. Judges Study the Tape to Flag Where the Impressive Changes Seem to be

Once the team has decided that this tape seems to contain an impressive change, thehomework is to answer this question: Where and when on the tape do you believe an

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impressive change started, and when and where does it seem to end? During the week,each team member individually listens to the tape to answer the question in writing. Onceagain, the judge is to be as open as possible to any sign of an impressive change and todetermine if there is one or several impressive changes. The judge is also to note thecounter numbers of where each begins and ends and some of the verbatim words to helpidentify the beginning and end of each impressive change. Some impressive changes arerelatively short and some are rather long, involving a fair number of both patient andtherapist interchanges.

In this way, the door is open to admit any and all kinds of changes that impress anyjudges rather than preselecting your own particular categories of valued changes such asinsight, conflict reduction, or symptom reduction. The emphasis is on whatever touchesyou as something impressive happening here rather than relying on your theory, yourknowledge, and your being on the lookout for particular kinds of traditional significantin-session changes.

At the next team meeting, each judge’s answer is given, and the team determines howmany impressive changes there were on this tape and exactly where each began andended.

3. Judges Describe the Impressive Change and What Qualifies it as Impressive

Starting with the first identified impressive change, the homework is to answer this ques-tion: How would you describe what is happening in this impressive change, and what doyou believe qualifies it as impressive, significant, or valued? Each judge is to listenindividually to the tape, answer the question in writing, and emphasize the use of simple,concrete, nontechnical, and nonjargon words (cf. Giorgi, 1985; Glazer, 1978; Glazer &Straus, 1967; Keen, 1975; Schutz, 1964; Spiegelberg, 1972; Valle & King, 1978).

At the next meeting, each judge reads, and the team discusses and then hands in theirwritten answers. The task then is to collate the individual judge’s written answers into asingle composite (cf. Lietaer, 1992). This is done by having two researchers indepen-dently organize the components of each judge’s answer into a single composite and thento compare their composites. Almost without exception, these two are so close that a littlediscussion yields a single final composite that is presented to the entire team at the nextmeeting for their final refinement or approval. Here is a verbatim example of a final,team-approved composite: The patient has moved into a new state of openly undergoinga feeling of genuine real strength and certainty about one’s self and the ability to dealwith problematic matters.

4. Judges Study What the Therapist and Patient Seemed to do to HelpBring About the Impressive Change

Once the team arrives at a description of what the impressive change is and what makesit impressive, the next question is: What did the therapist, the patient, or therapist andpatient together, seem to do to help bring about this impressive change? Each judgelistens to the tape individually, starting from the impressive change and going back as faras the judge feels is helpful to answer the question. Judges are free to go back to thebeginning of the session, especially if this is the first impressive change, or usually to theantecedent impressive change on the tape.

In order to acknowledge the patient’s contribution to bringing about the impressivechange (Elliott, 1983; Messer, Tishby, & Spillman, 1992; Strupp, 1994) and the thera-


pist’s gauging of when and how to work with the patient in bringing it about, the morespecific question the judges answer is: Under what explicit patient conditions, when thepatient is in what particular state or is being what particular way, what does the therapistor therapist and patient do to help bring about this impressive change (cf. Hempel &Oppenheim, 1953)?

Judges have found that it is not especially helpful to describe what therapists do insuch traditional terms and phrases as interpretation, problem exploration, advisement,desensitization, support, clarification, guided imagery, discrimination training, two chair,and so on. Instead, judges are to provide written descriptions that get down to the specificways the therapist and patient seem to help bring about the impressive change, avoidingstock or jargon terms and phrases to emphasize simple and concrete descriptions(cf. Glazer, 1978; Glazer & Straus, 1967; Kazdin & Wilson, 1978; Strupp, 1977).

At the next meeting, each judge reads his or her written answer; it is discussed by theteam, and then the written answers are handed in. These are again collated by the tworesearchers who work to arrive at a single composite answer that is presented to anddiscussed by the team at the next meeting. Here is the final composite, verbatim, to theway in which the earlier cited impressive change was found to be brought about: Whenthe patient is predominantly living and being in a scene that is fraught with feeling, thetherapist (a) speaks with the voice of other key persons in the scene and as well as withthe voice of other relevant parts of the patient while (b) continually pressing the patientto undergo stronger and stronger feeling.

5. Judges Study How the Therapist Uses the Impressive Change Once it Occurs

The next question for the judges to answer is: How did the therapist seem to use thisimpressive change once it occurred? Each judge individually studies the tape, concen-trating on what happens after the impressive change. The judges are free to study as farforward as each judge deems useful in order to answer the question. The judge may focuson a relatively immediate use or perhaps one further along, on a single apparent use, or ona series or sequence of uses, a use that seems rather simple or somewhat complicated, oreven to conclude that there seems to be no apparent use at all.

In any case, the written answer is to emphasize words that are simple, concrete, andnot especially abstract or couched within the vocabulary of any particular approach.

At the next team meeting, each judge presents their answer; it is open for discussionand then handed in. The two researchers follow their procedure to arrive at a singlecomposite answer that is presented to the team at the subsequent team meeting. Here isthe verbatim example of the composite team answer to how the therapist seemed to usethe impressive change in which the patient has moved into a new state of openly under-going a feeling of genuine real strength and certainty about one’s self and the ability todeal with problematic matters: The therapist uses this impressive change by encouragingthe patient to find previous situations in which the patient was this way with satisfactionand pleasure.

6. Repeat Steps 3–5 for Each Impressive Change in the Session

If there were several impressive changes in the session, the team repeats steps 3 through5 for each of the impressive changes in turn. That is, first the judges describe the impres-sive change and what qualifies it as impressive. Then the judges study what the therapistand patient seemed to do to help bring about the impressive change, and finally the judges


study how the therapist seemed to use the impressive change once it occurred. Thiscompletes the study of this particular session.

7. Continuously Develop and Refine the Categories of Impressive Changes,How to Help Bring Them About, and How to Use Them When They Occur

After completing the study of each session, continuously develop and refine the catego-ries of impressive, significant, or valued in-session changes. One way to do this is to aska few judges to start with the descriptions of each impressive change and to combinethem into a small number of categories of impressive changes. As the study of each tapeis completed, the judges examine each described impressive change to see if the provi-sional set of categories is to be maintained or perhaps altered and revised. In this way, thecategory system of impressive changes is continuously subjected to modification. Two orthree judges do this independently.

By following this same procedure with the findings from how the therapist andpatient help to bring about the impressive change, and from the study of how the therapistuses the impressive change once it occurs, a continuously more careful and useful matrixdevelops. This matrix says that for this particular category of impressive change, here aresome useful ways to help bring it about, and here are some useful ways to use thisimpressive change once it occurs. Here is a continuously richer marketplace for practi-tioners to shop, generated from the continuous products of discovery-oriented psycho-therapy research.

8. Continuously Develop and Refine In-Session Sequences of Impressive Changes

Some sessions may have just one impressive change. Most sessions will likely haveseveral impressive changes. Suppose that the research has accumulated 20 or 50 or moresessions with multiple impressive changes and that each of the impressive changes hasbeen placed into the developing category system of impressive changes. It is then possi-ble to examine the sequences of categories of impressive changes over each of the ses-sions to discover various sets of in-session sequences of impressive changes (e.g., Cashdan,1973; McCullough, 1984). It is possible to see which categories of impressive changeseem to precede and to follow other categories of impressive changes. It is also possibleto see the various sequences of in-session changes that can occur over a session.

In other words, if a practitioner wants to get impressive changez, this research cansuggest that one way is to first achieve impressive changey; another way to arrive atimpressive changez is to first achieve impressive changem, then impressive changen.This research can offer practitioners choices of various in-session programs to follow,sequences of in-session changes, either within a single session or over a series of ses-sions. In essence, practitioners can be offered a relatively solid basis for choosing a wayof doing psychotherapy, a sequence of impressive, valued changes that the practitionermay like, which can essentially become that practitioner’s own preferred brand ofpsychotherapy.

9. Complete the Circle: Actually Try Out What the Research Has Discovered,and Add the Tapes to the Library

The progressively cumulative findings essentially offer a continual series of invitations tothe members of the research team and to those who read the published studies: Are any of


these findings of interest to you? Would you be interested in obtaining any of these kindsof impressive in-session changes? Would you be interested in adopting this program ofsteps in doing psychotherapy? Would you be interested in these methods of helping tobring about and to use these impressive changes? Experiential psychotherapy (Mahrer,1996a) came about in large part by nodding yes to these invitations, by letting discovery-oriented research findings determine what a psychotherapy could look like, what it coulddo, and how it could do it in a session.

The actual adoption and trying out of what the research discovers is probably bestdone by practitioners who, on their own and without being told to do so by some researchdesign, find the particular findings to be exciting, sensible, appealing, attractive, mean-ingful, workable, and useful (McCullough, 1984; Shapiro, 1957, 1964, 1969). The circleis completed when these tapes are then fed back into the library of tapes to be studied, andwe begin once again with Step 1, in which the judges study the tape to determine if thereare any impressive changes.

Discovery-Oriented Research Can be Elegant

It is common to think of most traditional research perhaps as starting with a phase thatfrequently is looked down upon as exploratory, pilot, observational, soft, naturalistic, orpreliminary. It is a way of possibly coming up with ideas that rigorous research turns intotestable hypotheses to be subjected to superior, careful, precise, scientific, controlledexperimental testing, verification, confirmation, and disconfirmation. The preliminarydiscovery-oriented phase can be of some use, but it is not the real thing.

The purpose of this section is to outline a case that discovery-oriented psychotherapyresearch can be elegant, that it can and should be far superior to ordinary hypothesis-testing research in terms of sheer elegance (Mahrer, 1988).

Here is an Elegant Way to Find and to Describe an In-Session Impressive Event,Change, or Phenomenon

The most common way of finding something impressive, interesting, or valuable to studyin a session is to start from some preselected list. Look for indications of insight andunderstanding, of symptom resolution, or of a good helping alliance. One problem is thatusing such a list almost forecloses the likelihood of discovering new ones. Another prob-lem is that each item on the list was almost certainly put there by someone who decidedthe particular event or in-session change is one that is impressive, important, or valued;it was not arrived at in a way that seems especially careful, rigorous, or elegant. A thirdproblem is that the description or nature of the supposedly impressive or valued in-sessionevent was determined before the event was carefully studied in actual sessions; it wouldbe much more elegant to arrive at its careful description by studying what it actuallylooks like in actual sessions.

The discovery-oriented approach offers a much more careful, sensitive, and elegantway of finding and describing in-session events and changes that are impressive, impor-tant, or valued.

(a) Judges study a tape to determine if the tape contains (or does not contain) impres-sive in-session events. Among the helpful guidelines are lists of previously deter-mined impressive in-session events and suggestions of the kinds of personalcues that signal the presence of impressive in-session events. But judges are


quite free to go well beyond these merely helpful suggestions. This first stepculminates in a simple judgement of yes or no.

(b) If the judgement is yes, judges study the entire tape to locate where impressiveevents seem to be on the tape and to note where each starts and ends. There is nofurther description of the impressive event itself.

(c) Judges study the impressive event to arrive at a careful description of its nature,content, and characteristics.

By carefully proceeding through these three steps, the challenge is that the discovery-oriented approach is a superior, rigorous, and elegant way of finding, discovering, andproviding descriptions of in-session events, changes, or phenomena that are impressive,important, or valued.

Here is an Elegant Way of Discovering How to Bring About, How to Use,and How to Program In-Session Impressive Changes

There are some questions that many practitioners face and that most researchers do notstudy (e.g., Spence, 1994). Here are a few of these questions: How can I help bring aboutthese impressive in-session changes? How can I use these impressive in-session changesonce they occur? How can I program or organize into steps these impressive in-sessionchanges?

One challenge is that the discovery-oriented approach is superior to currently com-mon research methods in answering these questions. A second challenge is that thediscovery-oriented approach is an elegant, careful, rigorous, and lovely way of answeringthese questions.

Just as Hypothesis Falsification is More Elegant Than Hypothesis Confirmation,Discovery of a Better Way is More Elegant Than Showing That a Way Works

One of the nagging problems in the traditional research strategy of trying to prove, con-firm, verify, and uphold an hypothesis is that the very attempt is fruitless. It is, philoso-phers of science contend, impossible to show that all reasonably possible instances willconfirm an hypothesis. At the other end, it only takes a few strong instances to disprove,disconfirm, and falsify the hypothesis. Popper (1980) went a long way in solving theproblem by showing the conceptual power and elegance in researchers actually trying todisconfirm, disprove, or falsify an hypothesis, in showing how theories can grow, develop,or improve when researchers shifted from trying to confirm and verify an hypothesis, andinstead shifted to trying to disconfirm and falsify an hypothesis.

In an extension of the spirit of this Popperian shift, discovery-oriented research invitesresearchers to look for better and better ways of achieving some goal, aim, or use ratherthan doing research to show that some particular way works. In this sense, discovery-oriented research is more elegant than most traditional strategies aimed at verifying,proving, and confirming that this particular way works, is effective, is successful, or ismore so than some other way.

Discovery-Oriented Research is Elegant Because it Includes (a) the Continual Testingof Hypotheses, (b) the Actual Trying Out of What was Discovered,and (c) the Continual Study of Further Instances

Compared to the common preference for doing hypothesis-testing research, discovery-oriented research can be more elegant because it allows for the testing of hypotheses. It


also allows for three things that hypothesis-testing has less of, namely, discovery of newthings, the adoption and use of what was discovered by practitioners who find the dis-coveries appealing and useful, and the continual feeding in and study of further instances.

Suppose that the study of one impressive change finds one way of helping to achievethat change. As additional instances of that kind of impressive change are studied, thefurther findings allow the researcher, at the same time, to (a) heighten the confidence ofpreviously found ways of helping to achieve that impressive change; (b) refine, modify,and advance the previously found ways of helping to achieve that impressive change; and(c) to discover alternative and additional ways of helping to achieve that change. Thecombining of hypothesis testing, confidence building, and further discovery seems elegant(cf. Edwards, 1998; Shapiro, 1951) and applies not only to ways of helping to achieveimpressive changes, but also to developing categories of impressive changes, sequencesof impressive changes, and ways of using impressive changes.

Furthermore, practitioners are invited to adopt and to use what is discovered, espe-cially if they find the discoveries appealing and useful; the second invitation is for thesepractitioners to contribute their taped sessions to an ever-growing tape library. Here seemsto be an elegant way of using the discoveries to enable further and further discoveries.

Discovery-Oriented Research is Elegant Because it Elevates the Searchfor Knowledge Over the Validation of What the TraditionalResearcher Already Believes is True

There is a kind of elegance in the researcher using careful methods in the scientificadventure of discovery, exploration, and the pursuit and extension of knowledge. There isa kind of elegance in the researcher’s discovery of the secrets of psychotherapy by askingthe following: What are the impressive changes to be found in this tape? Do the changesfall into identifiable sequences? What are the ways of helping to arrive at these changes?And how may these changes then be used once they occur? Asking these questions in aspirit of discovery provides a way of continuously advancing not only the actual meth-ods, but also what can be achieved in psychotherapy, as well as the conceptual sensemaking of psychotherapeutic change.

In contrast, most traditional research consists of the testing of hypotheses mainly toshow the truth of what the researcher already believes is true. The hypothesis usually isdressed in null language, but the vocabulary rarely disguises what the researcher believes.Indeed, whatever creative thinking might have been involved probably took place inarriving at the hypothesis to be tested rather than in the course of the study. The case isthat elegance resides more in the discovery of what is new than in the testing of what isalready believed.

There is an Elegance in Discovering the Secrets of Change by Directly Studyingthe Actual Change Phenomenon Itself

There seems to be a kind of simple and pure elegance in discovering the secrets ofwondrous change by a straightforward, simple, pure, direct focus on the prized changephenomenon itself. You may be intensely interested in the working practicalities of howto help bring about a particular change, or your special interest may be in making con-ceptual sense of how and why change occurs. In either case, perhaps the most fruitful andelegant way is to be curious and fascinated with a careful and close study of this won-derful change, that wonderful change, and what seems to occur inside and between each


of these wonderful changes. Elegance lies in the up-close, in-depth, naively open study ofthe actual change phenomenon rather than (a) studying the phenomenon by being farremoved, quite distant, generalized, or abstract, or (b) studying other things, like theoutcome of change instead of the actual change itself.

Research Elegance is Probably Higher When Research Questions Beget ResearchMethods Rather Than When Research Methods Beget Research Questions

Most fields of study start with research questions followed by the developing of researchmethods to help answer the research questions (Chalmers, 1982; Feyerabend, 1972; Koch,1959; Slife & Williams, 1995). However, the field of psychotherapy, to a large extent, hasreversed the matter by first embracing research methods, largely those dictated by exper-imental psychology, with the unfortunate consequence that the research methods deter-mine, limit, or restrict the allowable research questions. There are at least two ways inwhich psychotherapy researchers lose elegance by worshipping the research methodsdeveloped in and for other fields of study so the accepted research methods beget theresearch questions.

One is that there can be much greater room for figuring out and asking new andcontinually better questions if psychotherapy researchers accept that research questionscan beget research methods rather than the common stance that research methods begetresearch questions. This common stance truncates, restricts, and limits the range andscope of research questions.

A second is that there can be much greater room for developing new and betterpsychotherapy research methods if psychotherapy researchers adopted the more elegantstance that research questions beget research methods.

The Discovery-Oriented Method is Elegantly Replicateable Even ThoughDifferent Teams Will Likely Arrive at Different Impressive Changes

The discovery-oriented method is elegantly replicateable in that it lays out a preciseseries of steps for the research team to follow. However, the method allows differentteams to arrive at similar or different findings in the first two steps. A psychoanalyticteam and a behavioral team may well study the same tape and arrive at different answersto the first question, viz., does this tape contain any impressive changes, and each teammay well flag different places where the impressive changes seem to occur. The researchmethod is elegantly replicateable, and its very elegance sensitively allows for differentfindings from the first two steps depending on the judges of the research teams.

The Findings of Discovery-Oriented Research Can Provide EspeciallyFertile Ground for Elegant Conceptualization

If discovery-oriented research is successful, it ought to discover new things, and what isnew ought to be precious for conceptual sense making. These kinds of findings have thetwin virtues of: (a) constituting solid data for databased conceptualization, and (b) depart-ing from or extending what we believe we know, and that, too, begs conceptual sensemaking.

These kinds of research findings offer the conceptualizer a challenge that looks some-thing like this: How can you make elegant new conceptual sense of these discovered


impressive in-session changes, these sequences of impressive changes, and these ways ofhelping to bring about and to use these impressive in-session changes?

The relatively common position is that research on psychotherapeutic change startswith selecting or figuring out a theory of in-session therapeutic change (Kiesler, 1973;Marmar, 1990). Discovery-oriented research represents a more polar position: Elegantconceptualization of psychotherapeutic change can come from discovery-oriented find-ings that are used to help develop, stimulate, challenge, and guide the development of theconceptualizer’s inner notions of conceptualizing psychotherapeutic change.

Discovery-Oriented Research is an Elegant Means of Helping to Builda Science of Psychotherapeutic Practice

We respect and value the field of psychotherapy becoming more and more of a genuinescience. We believe that discovery-oriented research offers one elegant means of helpingto build such a science provided that these are some of the characteristics of a genuinescience of psychotherapeutic practice:

• A science discovers better and better ways of accomplishing more and more ofwhat psychotherapy can be.

• A science provides the practitioner with new and continually better programs,plans, and steps for carrying out a session.

• A science provides the practitioner with new and continually better ways of achiev-ing defined aims, purposes, and goals.

• A science provides careful, rigorous, and useful ways of discovering, generating,developing, and improving new and better aims and goals, programs and strat-egies, and methods and techniques.

• A science can point toward its track record of new discoveries.

• A science can point toward its identified breakthrough problems, unsolved issues,and unanswered questions.

Conclusions and Invitations

1. Here is a seasoned, workable, developing way for a researcher to study psycho-therapy to discover new things about how to do psychotherapy, about what psy-chotherapy can be, can do, can help accomplish. This discovery-oriented way ofdoing research is well-enough developed so that researchers can try it out if theyare so inclined.

2. A fairly good case can be made that this discovery-oriented approach to psycho-therapy research is elegant, sophisticated, and rigorous and can be used as oneroyal road to developing an elevated science of psychotherapy. Indeed, the chal-lenge is that this discovery-oriented approach is better than the more commonlyaccepted ways of doing research when the aim is to discover how to do psycho-therapy and to work toward developing an elevated science of psychotherapy.

3. The invitation is for interested researchers to adopt and to use this discovery-oriented approach to psychotherapy research and to help in its further refinementand development.


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How to do discovery-oriented psychotherapy research