Family therapists face a number of challenges in their work. When children are present in family therapy they can and do make fleeting contributions. We draw upon naturally occurring family therapy sessions to explore the ‘pseudo-presence’ and ‘pseudo-absence’ of children and the institutional ‘gossiping’ quality these interactions have. Our findings illustrate that a core characteristic of gossiping is its functional role in building alignments’ which in this institutional context is utilized as a way of managing accountability. Our findings have a (...) number of implications for clinical professionals and highlight the value of discourse and conversation analysis techniques for exploring therapeutic interactions. (shrink)

The use of video for research purposes is something that has attracted ethical attention and debate. While the usefulness of video as a mechanism to collect data is widely agreed, the ethical sensitivity and impact of recording equipment is more contentious. In some clinical settings the presence of a camera has a dual role, as a portal to a reflecting team and as a recording device to obtain research data. Using data from one such setting, family therapy sessions, this article (...) shows how the role played by recording equipment is negotiated in the course of talk and other activities that constitute sessions. Analysis reveals that members of the therapy interaction orient in different ways and for different purposes to the value of recordings. The article concludes that there are layers of benefit to be derived from recording of clinical interactions, including for members themselves, and this has wider implications for the ways in which qualitative research designs in health sciences are evaluated. (shrink)

Integral to the diagnosis of autism spectrum disorder is the initial assessment through which the existence of a ‘problem’ is first ascertained. Despite this, there remains limited research on this early part of the diagnostic pathway. In this article, we utilised conversation analysis to examine relevant issues in relation to the practitioner–family interactions that take place within this initial assessment context. Our findings illustrated that parents typically first raised the possibility of the presence of an autism spectrum disorder diagnosis through (...) ‘building a case’, which professionals were then able to ratify or negate. Furthermore, we found that the assessments unfolded sequentially and clinical decisions were typically reached through a distinctive pattern of interaction. These findings have important implications for clinical practice, including for the study of autism spectrum disorder assessments and diagnosis. (shrink)

Central to ethical debates in contemporary mental health research are the rhetoric of parity of esteem, challenges underpinned by the social construct of vulnerability and the tendency to homogenis...

A distinction has been drawn between basic conversation analysis and applied CA. Applied CA has become especially beneficial for informing areas of practice such as health, social care and education, and is an accepted form of research evidence in the scientific rhetoric. There are different ways of undertaking applied CA, with different foci and goals. In this article, we articulate one way of conducting applied CA, that is especially pertinent for practitioners working in different fields. We conceptualise this as Reflective (...) Interventionist CA. We argue that this approach to applied CA is important because of its emphasis on the reflective stance that is valuable to an understanding of research data, its commitment to collaboration with practitioners, and its inductive style. In this paper, we outline the core premises and benefits of this approach and offer empirical examples to support our argument. To conclude, we consider the implications for evidence-based practice. (shrink)

In everyday conversations, people put forward versions of events and provide supporting evidence to build a credible case. In environments where there are potentially competing versions, case-building may take a more systematic format. Specifically, we conducted a rhetorical analysis to consider how in child mental health settings, families work to present a credible ‘doctorable’ reason for attendance. Data consisted of video-recordings of 28 families undergoing mental health assessments. Our findings point to eight rhetorical devices utilised in this environment to build (...) a case. The devices functioned rhetorically to add credibility and authenticate the case being built, which was relevant as the only resource available to families claiming the presence of a mental health difficulty in the child was their spoken words. In other words, the ‘problem’ was something constructed through talk and therefore the kinds of resources used were seminal in decision-making. (shrink)

Mental health practitioners, assessing children for possible psychiatric conditions, need to probe sensitive matters. We examine practitioners’ use of questions which try to clarify a given issue by offering alternative descriptions of how things are: one bland, and the other clearly undesirable in some way. The undesirable states of affairs can be described in serious terms or, while still undesirable, in less serious ones. We find that if an undesirable state of affairs is described in seriously negative terms, it tends (...) to be put as the first item in the pair of alternatives. We argue that this version of the familiar ‘optimistic questioning’ practice ensures that were the negative case to be chosen, it would be in spite of it being the more interactionally difficult answer to give. That makes the answer diagnostically more reliable. We discuss the pros and cons use of this practice in the environment of triage. (shrink)

This work adds to the growing literature on children’s talk and the extensive research on interruptions by combining the two. I investigate children in the institutional context of family therapy and their interactions with the parents and therapist. Drawing upon 22 hours of natural family therapy data and four families, I use a discursive approach. I note that children are not attended to when they try to interrupt unless they persist and then the acknowledgement is negative. I show that when (...) the main topic is about extremes of behaviour the child’s none relevant interruption is ignored. There are occasions however when the child interrupts with a topic relevant issue and these are usually attended to. This research has wider implications for therapeutic practice and children’s role in therapy. There is a need for further study of children’s interruptive discourse practice as research in this area is limited. (shrink)