A conversation analysis of asking about disruptions in method of levels psychotherapy

Abstract

Background: Method of Levels (MOL) is a cognitive therapy with an emerging evidence base. It is grounded in Perceptual Control Theory and its transdiagnostic nature means techniques are widely applicable and not diagnosis-specific. This paper contributes to psychotherapy process research by investigating a key technique of MOL, asking about disruptions, and in doing so aims to explore how the technique works and aid the understanding of related techniques in other psychotherapies. Method: Conversation Analysis (CA) is applied to asking about disruptions in twelve real-life therapeutic interactions. Findings: Analyses explore how and when therapists ask about disruptions, with examples presented according to their degree of adherence to the MOL approach. The majority of identified instances project responses consistent with MOL aims; encouraging further talk, focused on the client’s problem, and with a shift to meta-level commentary. Also presented are examples of therapist and client influence on disruptions. Conclusion: The paper provides support for a number of MOL practices, with clinical implications and links to other psychotherapies highlighted.