Third-party turns and shared knowledge: Supports and challenges to disabled people in social care and research settings
Issue: Vol 12 No. 1 (2015)
Journal: Communication & Medicine
Subject Areas: Healthcare Communication Linguistics
Abstract:
Adopting a conversation analysis (CA) perspective, this paper explores data which include disabled people in three-party contexts, where the institutional goal is to focus on the wishes, voice and agency of the disabled person. It explores 274 occasions where a third party self-selects for a turn, during social care planning meetings and research interviews. Five broad action patterns are discussed, showing how third parties used their epistemic closeness to the disabled person in order to (1) clarify, (2) respond, (3) prompt, (4) expand and (5) challenge. The sequential consequence of these turns depended on how they were heard and taken up by other parties in the talk. The vast majority of third-party turns could be glossed as supportive to the disabled person. Third parties displayed their sensitivity towards the precise moment that they were ‘needed’ in the talk. Occasionally, there were challenges and counterinformings done by the third party, which could be analysed as ‘epistemic traps’. These moments signaled tensions between the best interests of the disabled person and the imperative to foreground their voice.
Author: Val Williams, Sue Porter
References :
Antaki, C., Finlay, W., Sheridan, E., Jingree, T. and Walton, C. (2006) Producing decisions in a self-advocacy group for people with an intellectual disability: Two contrasting facilitator styles. Mental Retardation 44 (5): 322–343. http://dx.doi.org/10.1352/0047-6765(2006)44[322:PDISGF]2.0.CO;2
Antaki, C., Walton, C. and Finlay, W. (2007) How proposing an activity to a person with an intellectual disability can imply a limited identity. Discourse and Society 18 (4): 393–410. http://dx.doi.org/10.1177/0957926507075473
Aronsson, K. and Rundstrom, B. (1988) Child discourse and parental control in pediatric consultations. Text 8 (3): 159–184. http://dx.doi.org/10.1515/text.1.1988.8.3.159
Baker, C. (2004) Membership categorization and interview accounts. In D. Silverman (ed.) Qualitative Research: Theory, Method and Practice, 162–176. Second edition. London: Sage.
Bolden, G. (2010) ‘Articulating the unsaid’ via and-prefaced formulations of others’ talk. Discourse Studies 12 (1): 5–32. http://dx.doi.org/10.1177/1461445609346770
Bolden, G. (2012) Across languages and cultures: Brokering problems of understanding in conversational repair. Language in Society 41 (1): 97–121. http://dx.doi.org/10.1017/S0047404511000923
Brouwer, C. (2012) Talking ‘cognition’ in the audiology clinic. In G. Rasmussen, C. E. Brouwer and D. Day (eds) Evaluating Cognitive Competencies in Interaction, 67–88. Amsterdam: John Benjamins. http://dx.doi.org/10.1075/pbns.225.09bro
Cahill, P. and Papageorgiou, A. (2007) Triadic communication in the primary care paediatric consultation: A review of the literature. British Journal of General Practice 57 (544): 904–911. http://dx.doi.org/10.3399/096016407782317892
Department of Health (2006) Our Health, Our Care, Our Say. London: Department of Health.
Department of Health (2012) Caring for our Future: Reforming Care and Support. London: Department of Health.
Drew, P. (1990) Conversation analysis: Who needs it? Text 10 (1–2): 27–35. http://dx.doi.org/10.1515/text.1.1990.10.1-2.27
Finkelstein, V. (2004) Representing disability. In J. Swain, S. French, C. Barnes and C. Thomas (eds) Disabling Barriers – Enabling Environments, 13–20. Second edition. London: Sage.
Franklin, A. and Sloper, P. (2009) Supporting the participation of disabled children and young people in decision-making. Children & Society 23 (1): 3–1. http://dx.doi.org/10.1111/j.1099-0860.2007.00131.x
Hayano, K. (2013) Question design in conversation. In J. Sidnell and T. Stivers (eds) The Handbook of Conversation Analysis, 395–414. Chichester, UK: Wiley-Blackwell.
Heritage, J. (2002) Oh-prefaced responses to assessments: A method of modifying agreement/disagreement. In C. E. Ford, B. Fox and S. Thompson (eds) The Language of Turn and Sequence, 196–224. Oxford: Oxford University Press.
Heritage, J. (2012) Epistemics in action: Action formation and territories of knowledge. Research on Language and Social Interaction 45 (1): 1–29. http://dx.doi.org/10.1080/08351813.2012.646684
Heritage, J. (2014) Turn-initial position and one of its occupants: The case of ‘well’. Plenary paper at the Fourth International Conference on Conversation Analysis, University of California Los Angeles, 25–29 June.
Kitzinger, C. (2013) Repair. In J. Sidnell and T. Stivers (eds) The Handbook of Conversation Analysis, 229–256. Chichester: Wiley-Blackwell.
Laidsaar-Powell, R. C., Butow, P., Bu, S., Charles, C., Gafni, A., Lam, W. W., Jansen, J., McCaffery, K. J., Shepherd, H. L., Tattersall, M. H. and Juraskova, I. (2013) Physician-patient-companion communication and decision-making: A systematic review of triadic medical consultations. Patient Education and Counseling 91 (1): 3–13. http://dx.doi.org/10.1016/j.pec.2012.11.007
Morris, J. (2003) Including all children: Finding out about the experiences of children with communication and/or cognitive impairments. Children & Society 17 (5): 337–348. http://dx.doi.org/10.1002/chi.754
Oliver, M. (1990) The Politics of Disablement. London: Butterworth-Heinemann. http://dx.doi.org/10.1007/978-1-349-20895-1
Pilnick, A., Clegg, J., Murphy, E. and Almack, K. (2010) Questioning the answer: Questioning style, choice and self-determination in interactions with young people with intellectual disabilities. Sociology of Health and Illness 32 (3): 415–436. http://dx.doi.org/10.1111/j.1467-9566.2009.01223.x
Pilnick, A., Clegg, J., Murphy, E. and Almack, K. (2011) ‘Just being selfish for my own sake…’: Balancing the views of young adults with intellectual disabilities and their carers in transition planning. Sociological Review 59 (2): 303–323. http://dx.doi.org/10.1111/j.1467-954X.2011.02006.x
Rapley, M. (2004) The Social Construction of Learning Disability. Cambridge: Cambridge University Press.
Raymond, G. (2003) Grammar and social organization: Yes/no interrogatives and the structure of responding. American Sociological Review 68 (6): 939–967. http://dx.doi.org/10.2307/1519752
Raymond, G. and Heritage, J. (2006) The epistemics of social relations: Owning grandchildren. Language in Society 35 (5): 677–705. http://dx.doi.org/10.1017/S0047404506060325
Rindstedt, C. (2014) Conversational openings and multiparty disambiguations in doctors’ encounters with young patients (and their parents). Text and Talk 34 (4): 421–442. http://dx.doi.org/10.1515/text-2014-0010
Robinson, J. (2006) Managing trouble responsibility and relationships during conversational repair. Communication Monographs 73 (2): 137–161. http://dx.doi.org/10.1080/03637750600581206
Robinson, J. (2009) Managing counterinformings: An interactional practice for soliciting information that facilitates reconciliation of speakers’ incompatible positions. Human Communication Research 35 (4): 561–587. http://dx.doi.org/10.1111/j.1468-2958.2009.01363.x
Robinson, J. and Kevoe-Feldmann, H. (2010) Using full repeats to initiate repair on others’ questions. Research on Language and Social Interaction 43 (3): 232–259. http://dx.doi.org/10.1080/08351813.2010.497990
Rogers, C. (2004) On Becoming a Person: A Therapist’s View of Psychotherapy. London: Constable and Robinson.
Roulston, K. (2006) Close encounters of the ‘CA’ kind: A review of literature analysing talk in research interviews. Qualitative Research 6 (4): 515–534. http://dx.doi.org/10.1177/1468794106068021
Roulston, K. (2010) Reflective Interviewing: A Guide to Theory and Practice. London: Sage.
Routledge, M. and Sanderson, H. (2002) Planning with People: Guidance for Implementation Groups. London: Department of Health.
Sacks, H., Schegloff, E. and Jefferson, G. (1974) A simplest systematics for the organization of turn-taking for conversation. Language 50 (4): 696–735. http://dx.doi.org/10.1353/lan.1974.0010
Sanderson, H. (2000) Person Centred Planning: Key Features and Approaches. York: Joseph Rowntree Foundation.
Silverman, D. (1973) Interview talk: Bringing off a research instrument. Sociology 7 (1): 31–48. http://dx.doi.org/10.1177/003803857300700103
Simonen, M. (2012) Mutual negotiation of the interviewee’s competence in interview interaction. In G. Rasmussen, C. Brouwer and D. Day (eds) Evaluating Cognitive Competences in Interaction, 119–144. Amsterdam: John Benjamins. http://dx.doi.org/10.1075/pbns.225.06sim
Stevanovic, M. and Peräkylä, A. (2012) Deontic authority in interaction: The right to announce, propose and decide. Research on Language and Social Interaction 45 (3): 297–321. http://dx.doi.org/10.1080/08351813.2012.699260
Stevanovic, M. and Peräkylä, A. (2014) Three orders in the organization of human action: On the interface between knowledge, power, and emotion in interaction and social relations. Language in Society 43 (2): 185–207. http://dx.doi.org/10.1017/S0047404514000037
Stivers, T. (2001) Negotiating who presents the problem: Next speaker selection in pediatric encounters. Journal of Communication 51 (2): 1–31. http://dx.doi.org/10.1111/j.1460-2466.2001.tb02880.x
Stivers, T. and Robinson, J. (2006) A preference for progressivity in interaction. Language in Society 35 (3): 367–392. http://dx.doi.org/10.1017/s0047404506060179
Svennevig, J. (2010) Pre-empting reference problems in conversations. Language in Society 39 (2): 173–202. http://dx.doi.org/10.1017/S0047404510000060
Tates, K. and Meeuwesen, L. (2001) Doctor-parent-child communication: A (re)view of the literature. Social Science and Medicine 52 (6): 839–851. http://dx.doi.org/10.1016/S0277-9536(00)00193-3
United Nations (2007) United Nations Convention on the Rights of Persons with Disabilities. Geneva: United Nations.
van den Berg, H., Wetherell, M. and Houtkoop-Steenstra, H. (2003) Introduction. In H. Van den Berg, M. Wetherell and H. Houtkoop-Steenstra (eds) Analyzing Race Talk: Multidisciplinary Approaches to the Interview, 1–10. Cambridge: Cambridge University Press.
Watson, D., Abbott, D. and Townsley, R. (2007) ‘Listen to me, too!’ Lessons from involving children with complex healthcare needs in research about multi-agency services. Child Care, Health and Development 33 (1): 90–95. http://dx.doi.org/10.1111/j.1365-2214.2006.00670.x
Wilkinson, R., Bryan, K., Lock, S. and Sage, K. (2010) Implementing and evaluating aphasia therapy targeted at couples’ conversations: A single case study. Aphasiology 24 (6): 869–886. http://dx.doi.org/10.1080/02687030903501958
Williams, V. (2011) Disability and Discourse: Analysing Inclusive Conversation with People with Intellectual Disabilities. Chichester, UK: Wiley-Blackwell. http://dx.doi.org/10.1002/9780470977934
Williams, V. (2013) Learning Disability Policy and Practice: Changing Lives? Basingstoke, UK: Palgrave-Macmillan.
Williams, V. and Porter, S. (2015) The meaning of ‘choice and control’ for people with intellectual disabilities who are planning their social care and support. Journal of Applied Research in Intellectual Disabilities: 1–12. http://dx.doi.org/10.1111/jar.12222
Williams, V., Porter, S. and Marriott, A. (2014) Your life, your choice: Support planning led by disabled people’s organisations. British Journal of Social Work 44 (5): 1197–1215. http://dx.doi.org/10.1093/bjsw/bct005
Williams, V., Porter, S. and Strong, S. (2013) The shifting sands of support planning. Journal of Integrated Care 21 (3): 139–147. http://dx.doi.org/10.1108/JICA-01-2013-0002