Thompson-McCabe2018

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Thompson-McCabe2018
BibType ARTICLE
Key Thompson-McCabe2018
Author(s) Laura Thompson, Rose McCabe
Title How psychiatrists recommend treatment and its relationship with patient uptake
Editor(s)
Tag(s) EMCA, Psychiatraic consultations, Treatment Recommendation
Publisher
Year 2018
Language English
City
Month
Journal Health Communication
Volume 33
Number 11
Pages 1345–1354
URL Link
DOI 10.1080/10410236.2017.1350916
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Consultations for patients with chronic mental health conditions are conceived as meetings of experts: medical and experiential, respectively. Treatment decisions, in these terms, become a joint responsibility rather than handed down ex-cathedra. One resource for constituting decisions as ‘shared’ is the treatment recommendation – decisional authority can be invoked through its design. There is concern that people diagnosed with schizophrenia are infrequently involved in treatment decisions. However, the methods psychiatrists actually employ remain undefined. This article advances our understanding of psychiatric practice by mapping alternative methods used by psychiatrists to recommend treatment in outpatient consultations in situ. First, we unpack the types of treatments psychiatrists recommend. Then, we ask how psychiatrists recommend treatment? Applying a novel coding taxonomy, informed by the conversation analytic principle that recommendations represent different social actions, we identify the distribution of alternative formulations for psychiatrists’ recommendations (pronouncements, suggestions, proposals, and offers). We also propose one linguistic dimension, personal pronouns, on which recommending actions often depend, implicative for who is projected as ‘accountable’ for the decision. Finally, we examine the relationship between action type and patient uptake: is a particular type of recommendation more likely to attract acceptance/resistance from patients? And how does this relate to decisional accountability?

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