Course introduction
Welcome to Analysing Therapy Talk!
I’m delighted you've chosen to explore the orderliness of everyday and clinical interaction, to gain insights from research evidence in therapeutic talk.
By the end of this course you will be able to:
Identify how sequences of turns are organised in talk-in-interaction;
Understand the mechanisms for repairing misunderstanding in interaction
Recognise how therapist formulations are heard by clients;
Interpret the collaborative work of (re)interpretations in therapy talk.
To make the most of this course you are invited to share your perspectives with colleagues, analyse data extracts (with feedback from me) and review and reflect on the content knowledge you develop in the course.
The brief welcome video explains what you will find in each part of the course and how this content can support your professional learning.
But first, let me explain the methodology used in this course, and why this type of evidence and approach is useful in understanding therapeutic talk.
Why conversation analysis?
This course is built on a body of research from conversation analysis. This field of study emerged from the University of California in the 1960s with the sociologist Harvey Sacks’ research on calls to a suicide prevention hotline. He noticed that at the beginning of calls, speakers would do particular things to avoid giving their name. Sacks did not start with an interest in language per se, but rather with the idea that one could systematically study how people construct social actions. Invariably people use language as the mechanism for social interaction, and Sacks and his colleagues found that talk-in-interaction was orderly and rule-governed, and that this orderliness is the resource people use to make sense of one another (Sacks, Schegloff & Jefferson, 1974; Schegloff and Sacks, 1973).
“We live our lives by talking to others. We build, maintain and end our personal and professional relationships. We buy and sell. We get and give help. We are excited, irritated, embarrassed and consoled in response to things others say to us. Yet psychologists have often shied away from studying talk, preferring to ask people to report on their communicative lives in interviews or questionnaires, or to simulate them in laboratories. Psychologists have argued that people’s talk is too idiosyncratic or too messy to capture and study systematically. But conversation analysts have shown that talk is, in fact, highly organised.”
The next section of the course will show you what conversation analysis is (the study of talk-in-interaction), and explain the rules of talk. You implicitly know these rules as an accomplished speaker, but we will come to see in this course that using a microscope to (forensically) understand the technical details of how talk works, allows us to identify particular practices that are useful in therapeutic interaction. You may know what works from your clinical experience, but this course will show you why it works from an interactional perspective.
Professor Elizabeth Stokoe (2011, 2014, 2018) explains that ‘what works’ can be found in the interaction itself. Rather than surveying ‘effectiveness’ after the intervention, relying on self-reporting or theorizing, we can see how clients respond to questions or advice in the moment-by-moment work of therapy. As a methodology, conversation analysis insists on using video- or audio-recordings of real interactions, to see how certain practices are achieved everyday exchanges.
Why conversation analysis for psychologists?
The intricacies of the formal study of linguistics may not seem immediately relevant to professional development in psychology, but there are a number of arguments for explicit teaching of the elements of talk for professionals who use conversation as a primary clinical tool.
All of the research and commentary in this course is informed by empirical evidence of what practitioners actually do and how clients typically respond to particular types of actions. The good news is that you don’t have to take my word for it; conversation analysis has a built-in ‘proof criterion’ (Sacks, Schegloff & Jefferson, 1974, p. 729) because analysts only pay attention to what speakers themselves pay attention to. We’ll learn more about this proof criterion in Module 1.
Rather than make assumptions about how talk works, better to rely on evidence of what actually happens. In other words:
“Our intuitions about language are typically strong but wrong.”
(And see here for Liz Stokoe busting communication myths on Twitter.)
Interviewing people about what they think works also fails to illuminate the practices that make particular outcomes possible. In other words, we can understand the process of therapy:
“not by questioning the participants, but rather through study in detail of the actions they perform as the talk itself emerges.”
Specifically in relation to psychotherapy:
“practice, textbooks may sometimes offer idealised examples but such idealisations can only get across what the author believes is the general ‘feel’ of an interaction, and may be wildly different from the specifics of actual talk.”
When you think about it, it’s kind of extraordinary that we insist on evidence-based practice in so many other aspects of our work and life, yet when it comes to talk – because we all know how to use it - we assume we know how it works.
“Conversation analytic research may seem psychologically shallow to the psychotherapy community: too removed from basic assumptions about human subjectivity and mute on questions of experiential change which are likely of interest to therapists. However, this therapy-neutral orientation may be a significant strength in allowing conversation analysis to complement and enhance process research through revealing what psychotherapy may not notice about itself. ”
Conversation analysis is an entirely data-driven, qualitative approach to studying interaction, because knowing how often something happens does not tell us how it is done. Research that informs this course is wholly concerned with the how: detailing the practices of therapy to identify features of the interaction itself that inform outcomes for clients. In other words, “CA helps us understand what the therapist is doing as a therapist, and without necessarily having looked through therapist’s theoretically informed eyes” (Antaki, Barnes & Leudar, 2007, p. 178).
The premise of this course is that sharing insights into the interactial practices of therapy informs professional learning across different approaches to therapy. Horvath & Muntigl support this approach to praxis:
“We start from the basic premise that all forms of psychotherapies, regardless of the particular theoretical framework that underpins the treatment are, at the core, discursive. Psychotherapy inevitably involves some kind of engagement and interaction between a client(s) and a help provider. And this engagement is essentially dialogical in nature involving the negotiation of shared meanings, common goals, and ways to make progress toward these common goals. From this perspective, the differences between treatments that are identified as discursive therapies (e.g., narrative (White, 2007) and those that usually are not labeled as such (e.g., psychoanalysis) refer to the theoretical assumptions with respect to the mechanisms of change but, in each case, the process of therapy, what actually happens during treatment is, universally, a series of discursive engagements.”
It is the emic perspective of CA, where findings can only be drawn from what the participants themselves pay attention to, that renders it useful for understanding the client’s experience of therapy. We can see what the client makes of what is talked into being during therapy sessions – the evidence is there for us to look at in the talk itself. So the aim of this course is to condense, consolidate and share some CA fundamentals for psychotherapy, to inform part of your ongoing professional development.
In this course we will explore interaction with the same set of tools available to both therapist and client. Rather than focus solely on what the therapists does, research in conversation analysis highlights the collaborative, co-constructed social reality of how talk is actually achieved.
“CA perspective can give clinical practitioners inspiration to observe the interactional side of the therapeutic process, and the ways in which the clinical work connects with the norms and expectations of conversation in general. ”
Okay, enough of me insisting on the methodological value of conversation analysis, and on with the course itself.
3. How will I successfully complete this course?
There are five key sections (Modules) in this course. Modules 1, 2, and 3 introduce fundamental principle of talk-in-interaction, so that we can see how these principles apply to therapeutic sequences of talk in Modules 4 and 5. The idea is that this foundation gives you access to ongoing research reviews to continue your professional learning.
Each section provides videos, explainers, activities, and data extracts (recordings and transcripts of face-to-face interaction) to illustrate practices in interaction.
The transcripts in this course use conversation analytic conventions (see here for the complete list) which mark qualities of the speech (e.g. volume, intonation, voice quality), timing (pauses, within and in-between turns, pace, overlap) as well as the verbal (i.e. word choice) and nonverbal (gesture, eye gaze, facial expression) content. There’s no need to study these conventions – they will be explained where relevant – but note that the transcripts will be a little messier than verbatim text you might be used to.
When we use the term ‘talk’ it means all the resources speakers draw on in interaction. Verbal and non-verbal (and these are not seen as distinct but coordinated) practices in talk-in-interaction/conversation/interaction – used as interchangeable terms here. ‘Talk’ is not limited to what is said, but rather refers to what is done as social practice to achieve particular social actions.
There are activities for you to engage in throughout the course: quizzes with feedback, analytic tasks, and commentary to note your reflections on course content. Whenever you see a green button, it’s an activity for you to complete. Instructions for every activity will be provided at the beginning of the task. If anything is unclear, or you have further questions about the topic, you can ‘Ask Amelia’ at any time.
At the end of each section, you will be asked to provide a short (guided) professional reflection, to consider how the course content relates to your professional practice. Final reflections in the course conclusion will be returned to you as a summary and as recognition of your completion of the course.
Summary
“In therapy, the problem and solutions are discursively formed through the clients’ and therapist’s talk.”
The aim of this course is to develop a deeper understanding of the interactional practices that are the vehicle for therapy. Now that you know what to expect, we’ll begin with the rules of turn-taking in conversation.
You can return to the course homepage here, or continue by clicking on ‘Turn taking’ below right.
