Interdisciplinary Reflections on Conversation Analysis, Power, and Open Dialogue

2021 ◽  
Author(s):  
Ben Ong
Keyword(s):  
Conversation Analysis ◽  
Open Dialogue

“Y, what do you think about what X just said?” Conversation analysis of stance‐eliciting questions in open dialogue network meetings

2020 ◽  
Vol 46 (4) ◽  
pp. 719-731
Author(s):  
Camilla Blach Rossen ◽  
Karen Nissen Schriver ◽  
Christel Tarber ◽  
Dorthe Vedel Nordahl ◽  
Grethe Thygesen Rasmussen ◽  
...  
Keyword(s):  
Conversation Analysis ◽  
Open Dialogue

Developing multiple perspectives by eliding agreement: A conversation analysis of Open Dialogue reflections

2021 ◽  
pp. 146144562110374
Author(s):  
Ben Ong ◽  
Scott Barnes ◽  
Niels Buus
Keyword(s):  
Mental Health ◽  
Conversation Analysis ◽  
Mental Health Problems ◽  
Epistemic Authority ◽  
Multiple Perspectives ◽  
Potential Source ◽  
The People ◽  
The Family ◽  
Positive Perspective ◽  
Open Dialogue

Open Dialogue is an approach to working with mental health problems that emphasises promoting dialogue between multiple perspectives within an individual person and between all the people present, including the therapists. Therapists’ own perspectives are often introduced during conversations called reflections, which present a potential source of different perspectives. Using conversation analysis we analysed 14 hours of video-recorded Open Dialogue sessions with a focus on therapists’ reflections. We noticed that therapists did not display explicit agreement with each other’s reflections. This absence of explicit agreement was displayed through a variety of verbal and non-verbal forms. Eliding agreement facilitated deference to the epistemic authority of the client, assertion of epistemic rights from second position, emphasis of a positive perspective or to voice multiple perspectives. Therapists avoided consensus and thus presented multiple perspectives to the family while also attending to issues of contingency. The implications of epistemic primacy and asymmetry connected to sequential structures in talk pose a challenge to the generation of collaborative reflective dialogues.

Counseling and new media technologies: A comparison of problem presentations in e-mail and in chat

2016 ◽  
Vol 12 (2-3) ◽  
Author(s):  
Wyke Stommel ◽  
Fleur Van der Houwen
Keyword(s):  
New Media ◽  
Conversation Analysis ◽  
Online Counseling ◽  
Counseling Program ◽  
Media Technologies ◽  
Email Counseling ◽  
Counseling Clients ◽  
E Mail ◽  
Shed Light ◽  
New Media Technologies

In this article, we examine problem presentations in e-mail and chat counseling. Previous studies of online counseling have found that the medium (e.g., chat, email) impacts the unfolding interaction. However, the implications for counseling are unclear. We focus on problem presentations and use conversation analysis to compare 15 chat and 22 e-mail interactions from the same counseling program. We find that in e-mail counseling, counselors open up the interactional space to discuss various issues, whereas in chat, counselors restrict problem presentations and give the client less space to elaborate. We also find that in e-mail counseling, clients use narratives to present their problem and orient to its seriousness and legitimacy, while in chat counseling, they construct problem presentations using a symptom or a diagnosis. Furthermore, in email counseling, clients close their problem presentations stating completeness, while in chat counseling, counselors treat clients’ problem presentations as incomplete. Our findings shed light on how the medium has implications for counseling.

Formulating another’s report of troubles in peer support

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Christopher Pudlinski
Keyword(s):  
Mental Health ◽  
United States ◽  
Community Mental Health ◽  
Conversation Analysis ◽  
Peer Support ◽  
Mental Health System ◽  
The United States ◽  
Telephone Support ◽  
Healthcare Settings ◽  
Professional Perspective

This study stems from an interest in peer support talk, an underexplored area of research, and in how supportive actions such as formulated summaries function in comparison to more professional healthcare settings. Using conversation analysis, this study explores 35 instances of formulations within 65 calls to four different ‘warm lines’, a term for peer-to-peer telephone support within the community mental health system in the United States. Formulations can be characterized across two related axes: client versus professional perspective, and directive versus nondirective. The findings show that formulations within peer support were overwhelmingly nondirective, in terms of meeting institutional agendas to let callers talk. However, formulations ranged from client-oriented ones that highlight or repeat caller reports to those which transform caller reports through integrating past caller experiences or implicit caller emotions. These tactics are found to have similarities to how formulations function in professional healthcare settings.

Managing uncertainty in healthcare interpreter-mediated interaction

2020 ◽  
Vol 15 (2) ◽  
pp. 150-164
Author(s):  
Claudio Baraldi ◽  
Laura Gavioli
Keyword(s):  
Systems Theory ◽  
Conversation Analysis ◽  
Social Systems ◽  
Analytical Framework ◽  
Social Systems Theory ◽  
Intercultural Mediators ◽  
Or History

This paper analyses healthcare interactions involving doctors, migrant patients and ‘intercultural mediators’ who provide interpreting services. Our study is based on a collection of 300 interactions involving two language pairs, Arabic–Italian and English–Italian. The analytical framework includes conversation analysis combined with insights from social systems theory. We look at question-answer sequences, where (1) the doctors ask questions about patients’ problems or history, (2) the doctors’ questions are responded to and (3) the doctor closes the sequence, moving on to another question. We analyse the ways in which mediators help doctors design questions for patients and patients understand and eventually respond to the doctors’ design. While the doctor’s question design aims at obtaining details which are relevant for the patients’ care, it is argued that collecting such details involves complex interactional work. In particular, doctors need help in displaying their attention to their patients’ problems and in guiding patients’ responses into medically relevant directions. Likewise, patients need help in reacting appropriately. Mediators help manage communicative uncertainty both by showing the doctor’s interest in what the patient says, and by exploring and rendering the patient’s incomplete, extended and ambiguous answers to the doctor’s questions.

Patients’ practices for taking the initiative in decision-making in outpatient psychiatric consultations

2017 ◽  
Vol 13 (2) ◽  
pp. 169-184 ◽  
Author(s):  
Shuya Kushida ◽  
Takeshi Hiramoto ◽  
Yuriko Yamakawa
Keyword(s):  
Decision Making ◽  
Conversation Analysis ◽  
Treatment Decision ◽  
Close Inspection ◽  
Important Resource ◽  
Treatment Decision Making ◽  
The Way

In spite of increasing advocacy for patients’ participation in psychiatric decision-making, there has been little research on how patients actually participate in decision-making in psychiatric consultations. This study explores how patients take the initiative in decision-making over treatment in outpatient psychiatric consultations in Japan. Using the methodology of conversation analysis, we analyze 85 video-recorded ongoing consultations and find that patients select between two practices for taking the initiative in decision-making: making explicit requests for a treatment and displaying interest in a treatment without explicitly requesting it. A close inspection of transcribed interaction reveals that patients make explicit requests under the circumstances where they believe the candidate treatment is appropriate for their condition, whereas they merely display interest in a treatment when they are not certain about its appropriateness. By fitting practices to take the initiative in decision-making with the way they describe their current condition, patients are optimally managing their desire for particular treatments and the validity of their initiative actions. In conclusion, we argue that the orderly use of the two practices is one important resource for patients’ participation in treatment decision-making.

Communicative practices in talking about death and dying in the context of Thai cancer care

2014 ◽  
Vol 10 (3) ◽  
pp. 263-271
Author(s):  
Pairote Wilainuch
Keyword(s):  
Conversation Analysis ◽  
District Hospital ◽  
Death And Dying ◽  
Family Members ◽  
Religious Support ◽  
Communicative Practices ◽  
Health Centres ◽  
Third Person ◽  
Thai People ◽  
Depth Interviews

This article explores communicative practices surrounding how nurses, patients and family members engage when talking about death and dying, based on study conducted in a province in northern Thailand. Data were collected from three environments: a district hospital (nine cases), district public health centres (four cases), and in patients’ homes (27 cases). Fourteen nurses, 40 patients and 24 family members gave written consent for participation. Direct observation and in-depth interviews were used for supplementary data collection, and 40 counselling sessions were recorded on video. The raw data were analysed using Conversation Analysis. The study found that Thai counselling is asymmetrical. Nurses initiated the topic of death by referring to the death of a third person – a dead patient – with the use of clues and via list-construction. As most Thai people are oriented to Buddhism, religious support is selected for discussing this sensitive topic, and nurses also use Buddhism and list-construction to help their clients confront uncertain futures. However, Buddhism is not brought into discussion on its own, but combined with other techniques such as the use of euphemisms or concern and care for others.

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