Making psychotherapy visible: a conversation analytic study of some interactional devices employed in psychiatric interviews

Abstract

The objective of this study, based on eight psychiatric interviews recorded in a Spanish hospital, is to investigate how psychotherapy is made visible in psychiatric interviews. In particular, the focus is on how psychotherapy is provided in subsequent psychiatric interviews to hospitalized inpatients. Since much of what happens in psychiatric interviews is talk, psychiatrists (as professionals) are responsible for framing such talk as a distinctive type of speech exchange that differs from ordinary conversation. To fulfill their institutional mandate, psychiatrists need to design their speech as therapeutic and produce the necessary “explicative transactions” accordingly. The accomplishment of this task seems to require the employment of an array of third-turn utterance types like repair, assessments, or formulations. A particular word search is also shown to perform a similar job. Altogether, these interactional devices are initiated by the psychiatrist to (i) conduce patients to discover the beneficial effects of psychotherapy and (ii) highlight psychotherapy as a visible process. On the whole, these interactional objects enable the psychiatrist to constitute the psychiatric interview as a self-explicating phenomenon. This investigation utilizes the research tools developed in conversation analysis (CA).