A Recursive Frame Qualitative Analysis of MFT Progress Note Tipping Points

Medically oriented psychotherapists typically record progress notes by articulating client symptoms, diagnoses, functional status, progress, and adherence to treatment plans. This orientation can challenge marriage and family therapists working from discursive or post-modern perspectives. Although there are discursive therapy friendly treatment planning guides, no published research on such practice exists. To address this gap the researchers conducted a recursive frame qualitative analysis of 206 de-identified progress notes from 30 completed cases seen by MFT master’s students learning discursive approaches to therapy in a university-based training clinic. Researchers found students noted problem to solution-focused discourse tipping or turning points in 20 cases with positive outcomes and no comparable shifts in 10 cases with negative or unclear outcomes.