The construction of a hypothesis: 3 clinical illustrations

Although qualitative research can shed considerable light on the processes at work in the emergence of a clinical hypothesis, we feel it is nevertheless relevant to root our discussion in a clinical perspective. Depending on the context in which the clinical interview takes place, and on the moment in the interview when a hypothesis emerges, the perspective may be quite different. In addition to the singularity of the encounter between the clinician and the patient, the framework of this encounter and the temporality influence the function of the hypothesis in the understanding of the therapeutic system. The framework of the clinical interview is part of the elements that guide the clinician in what he/she will do with his/her hypothesis: keep it in mind for later, explore it immediately, try to disengage from it in order to maintain a certain neutrality, name it in front of the patient... Through our communication, we propose to present three clinical illustrations from three research studies on therapeutic processes. Firstly, Denis (2016), will enlighten us on the place of hypotheses in the work of expert crisis workers. Then, Meriaux (2020) will question the use of clinical hypotheses in the antecedents and in the very first moments of the patient's welcome. Finally, we will explore the link between the clinician's verbal intervention, the clinical hypothesis and the intuition of certainty.