How therapist discourse shapes trauma narratives in immigrant clients

This study examined how therapist-client interactions during trauma therapy are associated with the interactional reconstruction of trauma narratives in immigrant clients, focusing on narrative coherence, temporal sequencing and cross-session stabilisation rather than objective memory accuracy. Sixty-two therapy sessions and 24 client interviews with participants from Iraq, Afghanistan, Syria and Lebanon conducted in Isfahan, Iran were analyzed. In the qualitative phase, micro-level discourse analysis explored therapist prompts, reformulations and client responses, while macro-level narrative analysis examined cross-session coherence and organisation of trauma narratives. Identified patterns were further coded to document their frequency and co-occurrence with narrative shifts. Results indicated that interpretive questions and reformulative practices appeared associated with changes in temporal sequencing, evaluative framing and narrative coherence, whereas open-ended prompts and reflective listening supported autonomous narrative elaboration. Multilingual resources and culturally patterned storytelling also modulated narrative co-construction and stabilisation. Findings highlight the ethical and clinical importance of attending to language, interaction and culture to support therapeutic processes while minimising unintended influences on clients' narrative construction during therapy. These findings contribute to ongoing discussions of how therapist-client interaction shapes narrative reconstruction in trauma-focused psychotherapy.