Patient-focused research points to the necessity of continuously monitoring process and outcome in psychotherapy to supply service users and their therapists with feedback as a way of avoiding no change and detrimental development. At the Department of Child and Adolescent Mental Health, therapists implement monitoring in an intensive family therapy unit inspired by postmodern and language-oriented forms of family therapy using the Session Rating Scale and the Outcome Rating Scale. Research generated descriptions of users’ experiences of these scales as conversational tools are reflected upon using concepts from the work of Vygotsky and Bakhtin. Mediation, dialogicality, voice, the zone of proximal development and the metaphor of scaffolding are offered as conceptualizations that expand the inspirational sources of the unit by creating and enhancing further possibilities for collaboration between families and their therapists.
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