An analysis of mental health professionals' discourse : the role of the clinical psychologist

(a AD

AN ANALYSIS

OF

MENTAL TIEALTH PROFESSIONALS'

DISCOURSE:

TTIE

ROLE

OF TTIE

CLINICAL PSYCHOLOGIST

ANDERS JOHN SOYLAND

Submitted to the

University of

Adelaide Department of Psychology

in

fulfillments of

the requirements

for

the degree

of

Master

of

Arts.

University of Adelaide, September, 1988

Table

of

Contents:

Table of Contents

Abstract

Statement

Acknowledgements 1. General Introduction 2. Discourse Analysis

3. Verbal Accounting ^Practices 4. Therapeutic Discourse 5.

Initiation

and Methodology 6. Case Conference Discourse

7. The Relationship Between Theory and Practice 8. The Role

of

the

Clinical

Psychologist

List of Appendices Appendices Reference

List

Page It

iii

iv

v

1

6 24 35 52 59 88

1L4 L45

r46

268

1ll

Abstract:

This thesis introduces the use of discourse analysis to the

field of

mental health professionals' discourse.

It

involves the qualitative analysis

of

discourse

in functional

terms, and incorporates the use

of

verbatim transcripts of interviews

with two clinical

psychologists and four

multi-disciplinary

case-conferences held

within

^a psychiatric unit.

An exposition of the

work

in discourse analysis is given and, as a great deal

of

this

work

has concentrated on scientists' discourse, the current project is seen as an extension in which the language

of

the scientist-practitioner is examined. The importance of considering discursive variation as an analytical resource is raised.

Arguments are also given

for

using this approach to examine therapeutic language as an aspect of practitioners' discourse,

in

a review

of

the current analytic practices

in

this f,reld.

The case-conference transcripts are analyzed

in

terms

of

the professional roles def,rned by the priorities

of

the

clinical topics.

Particular emphasis

is

given to the

role of

the

clinical

psychologist

in

this

setting.

Aspects

of

turn-taking, the avoidance

of

verbal

conflict,

and the function

of

the case-summary are also examined.

The two interviews a¡e used to

try

to make

explicit

the relationship between psychological theory and practice as this is directly relevant to the way accounts are given to

justify

_the activities

of clinical

psychology.

Finally, the role

of

the

clinical

psychologist is examined using material

from

the

wo

interviews and the conclusions of the analysis

of

the case-conferences. The general conclusion attempts to assess the benefits

of

this

form of

analysis

in

the examination

of

psychology as a

field of

enquiry.

Statement:

This thesis contains no material offered

for

any other degree or material already published, to the best of my knowledge or belief, except where due reference is made

in

the

text. If

the thesis is accepted,

I

give my permission

for it

to be photocopied.

Signed,

September, 1988.

A.I.

v

Acknowledgements:

I

would

like

to thank

my

supervisor Professor Ian John for his

unfailing

support,

criticism,

and advice throughout this research.

I would

also

like

to thank

Dr.

Robert Barrett, Ms.

Felicity

Forster, Dr. Johnathan Potter, and

Dr.

Helen

V/inefield for

clarification, criticism,

and

motivation. I would like

to express my gratitude to the anonymous mental health professionals who were tolerant

of

me and my tape-recorder, and in particular, _the two

clinical

psychologists who were

kind

enough to give me interviews _{and act} as mediators

with

the psychiatric unit

in which

they

worked. Finally,

I

would

like

to acknowledge the Commonwealth Postgraduate Research

Award which

kept me alive.