An analysis of talk and interactions in initial sessions in the context of counseling and family medicine.

摘要

This study used conversation analysis, a method that directly investigates language use and interactions at both the thematic level and microanalytic level, to explore the processes of talk and interactions of initial sessions between trainees and their clients/patients in two professions, counselor education and family medicine. The naturally occurring, audio and/or video-recorded data regarding initial sessions conducted by trainees in both professions were used to explore three overarching questions: (1) How are the conversations between trainees and clients developed and maintained in their initial encounters? (2) How are therapeutic relationships and therapeutic discourses developed in initial sessions? (3) How do co-constructed, sequential interactions at the moment produce subsequent actions and interactions such as disclosures, presentation of challenging communications, and vulnerability? The results indicated that while professional practice was contextual and circumstantial, both professions in this study share a number of strategies and talk features with regard to the development of therapeutic relationships, the process of disclosures, and the presentation of unique interactions as a result of co-constructed therapeutic discourses. The study of talk and interaction provides authentic materials of clinical practices and a comprehensive analytic framework for supervision. Future studies regarding clinical encounters, working alliances, and therapeutic discourses that include analyses of talk and interactions will provide additional insight and enrich the methodological repertoires for current studies related to the best practices, effective therapeutic alliances, and communications.