Dynamic Mapping of the Structures of Content in Clinical Settings (DMSC). A new coding system for analysing the patient's narratives

Objectives. The paper presents a method of content analysis framed within a semiotic and contextual model of the psychotherapy process as a situated dynamics of sensemaking: the Dynamic Mapping of the Structures of Content in Clinical Settings (DMSC). Design. DMSC is a system of content analysis focused on a generalized level of meaning, concerning basic aspects of the patient's narrative (e.g., if the narrative concerns herself or other than herself). Method. The paper presents the result of the application of DMSC to an intensive single-case analysis (Katja). The method has been applied by judges to the transcripts of sessions and is aimed at identifying patterns of combinations (defined: Patterns of content) of the categories characterizing the patient's narratives (pattern analysis approach) as well as at mapping the transition among these patterns (sequential analysis approach). Results. These results provide evidence of its construct validity. In accordance with the theoretical model grounding the method, we have found that: (a) DMSC provides a meaningful representation of the patient's narratives in terms of Patterns of content; (b) the probability of transition among the Patterns of content have proved to be significantly associated with the clinical quality of the sessions. Conclusion. The DMSC has to be considered an attempt paving the way for further investigations aimed at developing a deeper understanding of the role played by the dynamics of sensemaking in the psychotherapy process.