Formulations in Psychotherapy: Admission Interviews and the Conversational Construction of Diagnosis

Abstract

In this article, we contribute to understanding the interactional aspects of making clinical diagnosis in mental health care. We observe that therapists, during the "problem presentation" sequence in clinical encounters, often use a specific form of diagnostic formulations to elicit more diagnostically relevant information. By doing so, they often substitute one type of verb with another, following a diagnostic hypothesis. Specifically, in interviews that arrive at a diagnosis of neurosis, therapists formulate with behavioral verbal processes; in interviews that arrive at a diagnosis of psychosis, they do so with material ones. Such formulations often prove useful to define clinical diagnoses. They can, however, also be dangerous in that they may favor the therapist's agenda over the patient's. Our analysis helps therapists not only better understand the diagnostic process but also reflect upon their own use of diagnostic formulations and become aware of the clinical effects of their interactional performance.

Professionals’ involvement of relatives – only good intentions?

“…As shown in other studies, this exclusion of relatives is supported by the very organization of healthcare. Relatives are seldom present in situations, where patients and healthcare professionals meet, e.g., at the ward rounds, during personal hygiene (Laursen et al , 2015; Walton et al , 2016) or at admission interviews (Bonnin, 2017; Højskov and Glasdam, 2014). Most working hours are allocated specific tasks, associated with a patient’s diagnosis or treatment needs and/or to documentation.…”

Struggles Over Antibiotics: Physicians’ Stance-Taking Toward a Nonconforming Policy in an Intensive Care Unit

“…The transcription was double-checked by different researchers in data sessions and dedicated meetings. Original transcripts in Italian have been analyzed using a Conversation Analysis (CA) informed approach widely used for the analysis of medical encounters (see, among others, Antaki, 2011; Robinson & Heritage, 2014) as it offers a “sequential approach to meaning-making” (Bonnin, 2017, p. 3). For reason of space, in this article, we only provide the English translation and do not use the three- or two-line format of transcription normally required in CA informed studies.…”

Validación de protocolo para transversalizar la perspectiva de género en las prácticas de diagnóstico de la carrera de psicología

“…En el uso moderno se comprendió bajo la idea de discriminación científica y, por lo común, como el reconocimiento que se hace de una enfermedad a partir de sus síntomas. A principios del siglo XX, el uso psiquiátrico de la noción común de diagnóstico fue problematizada, o al menos comprendida como un proceso, especialmente desde el psicoanálisis (Bonnin, 2014;2017). Actualmente, el diagnóstico en Psicología es concebido como un proceso que involucra múltiples metodologías e instancias de interacción con la entidad social (individuos, escuelas, procesos organizacionales, comunidades) a ser diagnosticada (Bonnin, 2013;Woolgar y Scott, 2014).…”