Management of therapist directiveness in integrative psychotherapy: A corpus-assisted discourse study
Vol.15,No.1(2022)
Healthcare practitioners often face the dilemma of whether to provide advice during medical consultations due to concerns around affecting patients’ autonomy in decision making. Healthcare practitioners’ directiveness in patient–practitioner interactions may influence the success of medical consultations. Research has revealed that healthcare practitioners employ various communicative strategies and linguistic patterns to manage directiveness in medical consultations, such as the notions of likelihood and uncertainty, use of information, and politeness. Nonetheless, few scholars have examined how psychotherapists manage directiveness in counseling or psychotherapy sessions. Directives are inevitable speech acts in counseling or psychotherapy. Therapists may encounter challenges when producing directives, such as preventing clients from seeking their own solutions or clients becoming excessively dependent on therapists’ suggestions. Drawing upon the systems of mood and modality in systemic functional linguistics, this article employs a corpus-assisted approach to investigate therapists’ directives in terms of phraseological patterns, use of modality, and corresponding interpersonal meanings. Results reveal that therapists tend to manage directiveness by forming indicative directives and using low-value modulation modality. This article is the first corpus-assisted study to contribute to an understanding of therapist directiveness in psychotherapy from a lexico-grammatical perspective.
corpus linguistics; discourse analysis; directiveness; systemic functional grammar; psychotherapy
Jesse W. C. Yip
The Chinese University of Hong Kong
Jesse W. C. Yip is currently a lecturer of English Linguistics at School of Humanities and Languages, Caritas Institute of Higher Education. His research interests include healthcare discourse studies, narrative inquiry, corpus-assisted discourse analysis and computer-mediated communication. He has published articles in journals including Journal of Pragmatics, Applied Linguistics Review, Health Communication, and Language, Culture and Curriculum.
Anthony, L. (2018) AntConc, version 3.5.7. Waseda University, Japan. www.laurenceanthony.net/software/antconc/
Aronsson, K. and Satterlund-Larsson, U. (1987) ‘Politeness strategies and doctor-patient communication on the social choreography of collaborative thinking.’ Journal of Language and Social Psychology 6(1), 1-27. https://doi.org/10.1177/0261927X8700600101.
Austin, J. L. (1962) How to Do Things with Words. London: Oxford University Press.
Berry, D. (2007) Health Communication: Theory and Practice. Open University Press.
Beutler, L. E., Harwood, T. M., Michelson, A., Song, X. and Holman, J. (2011) ‘Resistance/Reactance level.’ Journal of Clinical Psychology 67, 133-142. https://doi.org/10.1002/jclp.20753.
Brown, B., Crawford, P. and Carter, R. (2006) Evidence-based Health Communication. Buckingham, UK: Open University Press.
Brown, P. and Levinson, S. C. (1987) Politeness: Some Universals of Language Use. Cambridge: Cambridge University Press.
Cheng, W. (2012) Exploring Corpus Linguistics Language in Action. London: Routledge.
Crits-Christoph, P., Crits-Christoph, K. and Gibbons, M. B. C. (2010) ‘Training in alliance-fostering techniques.’ In: Muran, J. C. and Barber, J. P. (eds) The Therapeutic Alliance: An Evidence-based Guide to Practice. New York: The Guilford Press. 304-319.
Couture, S. J. and Sutherland, O. (2006) ‘Giving advice on advice-giving: A conversation analysis of Karl Tomm’s practice.’ Journal of Marital and Family Therapy 32, 329-345. https://doi.org/10.1111/j.1752-0606.2006.tb01610.x.
Culley, S. and Bond, T. (2011) Integrative Counselling Skills in Action. London: SAGE.
Defibaugh, S. (2014) ‘Management of care or management of face: Indirectness in nurse practitioner/patient interactions.’ Journal of Pragmatics 67, 61-71. https://doi.org/10.1016/j.pragma.2014.03.007.
Flores-Ferran, N. (2010) ‘An examination of mitigation strategies used in Spanish psychotherapeutic discourse.’ Journal of Pragmatics 42(7), 1964-1981. https://doi.org/10.1016/ j.pragma.2009.12.005.
Gaylin, W. (2000) ‘Nondirective counseling or advice?: Psychotherapy as value laden.’ The Hastings Center Report 30(3), 31-33. https://doi.org/10.2307/3528044.
Gilbert, M. and Orlans, V. (2011) Integrative Therapy: 100 Key Points and Techniques. New York: Routledge.
Handford, M. (2012) ‘What can a corpus tell us about specialist genres?’ In: O’Keeffe, A. and McCarthy, M. (eds) The Routledge Handbook of Corpus Linguistics. London and New York: Routledge. 255-269.
Halliday, M. A. K. (1973) Explorations in the Functions of Language. London: Edward Arnold.
Halliday, M. A. K. and Matthiessen, C. M. I. M. (2004) An Introduction to Functional Grammar. New York: Oxford University Press.
Heritage, J. and Lindström, A. (2012) ‘Advice giving – terminable and interminable: The case of British health visitors.’ In: Limberg, H. and Locher, M. A. (eds) Advice in Discourse. USA: John Benjamins. 207-225.
Kiesling, S. F. and Johnson, E. G. (2010) ‘Four forms of interactional indirection.’ Journal of Pragmatics 42(2), 292-306. https://doi.org/10.1016/j.pragma.2009.06.004.
Kinnell, A. M. K., and Maynard, D. (1996) ‘The delivery and receipt of safer sex advice in pretest counseling sessions for HIV and AIDS.’ Journal of Contemporary Ethnography 24(4), 405-437. https://doi.org/10.1177/089124196024004002.
Marteau, T. M. and Dormandy, E. (2001) ‘Facilitating informed choice in prenatal testing: How well are we doing?’ American Journal of Medical Genetics 106(3), 185-190. https://doi.org/10. 1002/ajmg.10006.
Matthiessen, C. M. I. M. (2013) ‘Applying systemic functional linguistics in healthcare contexts.’ Text and Talk 33(4-5), 437-467. https://doi.org/10.1515/text-2013-0021.
Pawelczyk, J. (2011) Talk as Therapy: Psychotherapy in a Linguistic Perspective. Germany: Walter de Guyter.
Pilnick, A. and Zayts, O. (2014) ‘“It’s just a likelihood”: Uncertainty as topic and resource in conveying “positive” results in an antenatal screening clinic.’ Symbolic Interaction 37(2), 187-208. https://doi.org/10.1002/symb.99.
Rautalinko, E. (2017) ‘Directiveness in psychotherapy: A phenomenological-narrative study of therapist attitudes.’ Psychology and Psychotherapy: Theory, Research and Practice 90, 600-616. https://doi.org/10.1111/papt.12128.
Russell, R. L. (1987) Language in Psychotherapy: Strategies of Discovery. New York: Plenum Press.
Searle, J. (1975) ‘Indirect speech acts.’ In: Cole, P. and Morgan, J. (eds) Syntax & Semantics. Volume. 3: Speech Acts. New York: Academic Press. 59-82.
Sarangi, S. (2002) ‘The language of likelihood in genetic counselling discourse.’ Journal of Language and Social Psychology 21, 7-31. https://doi.org/10.1177/0261927X02021001002.
Sarangi, S, Bennert, K., Howell, L. and Clarke, A. (2003) ‘“Relatively speaking”: Relativisation of genetic risk in counselling for predictive testing.’ Health, Risk and Society 5(2), 154-170. https://doi.org/10.1080/1369857031000123939.
Sarangi, S. and Clarke, A. (2002) ‘Zones of expertise and the management of uncertainty in genetics risk communication.’ Research on Language and Social Interaction 35, 139-172. https://doi.org/10.1207/S15327973RLSI3502_2.
Thompson, G. (2008) Introducing Functional Grammar. Abingdon: Routledge.
White, M. T. (1997) ‘“Respect for autonomy” in genetic counseling: An analysis and a proposal.’ Journal of Genetic Counseling 6(3), 297-313. https://doi.org/10.1023/A:1025628322278.
Yip, J. W. C. (2020) ‘Directness of advice giving in traditional Chinese medicine consultations.’ Journal of Pragmatics 166, 28-38. https://doi.org/10.1016/j.pragma.2020.05.016.
Zayts, O. and Schnurr, S. (2012) ‘“You may know better than I do”: Negotiating advice-giving in Down Sydrome screening in a Hong Kong prenatal hospital.’ In: Limberg, H. and Locher, M. A. (eds) Advice in Discourse. USA: John Benjamins. 195-212.
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