Advising without personalising: how a helpline may satisfy callers without giving medical advice beyond its remit

Abstract

Callers to telephone helplines often seek advice beyond the authorisation of those staffing the service. On health helplines, this poses a problem to the call-taker. How do they manage the dilemma between, on the one hand, exceeding their competence and authority to give medical advice, and, on the other, leaving the caller unsatisfied with the service? We offer a framework in which to set newly identified practices along with those identified in previous studies. Using a set of calls to a medical helpline run by Parkinson's United Kingdom, we show that the call-taker manages the problem by (i) only suggesting courses of action highly marked for impersonality or contingency (displaying a 'low deontic stance', Stevanovic and Per€ akyl€ a 2012), and (ii) limiting the interactional risks of tailoring the advice to callers' personal circumstances. We show how our suggested framework of 'advising without personalising' may guide research into the difficult job of delivering advice where the service provider must observe a limit on what they can say.

How professionals deal with clients’ explicit objections to their advice

“…The call-taker has advised the client (in the tentative manner described in Antaki and Bloch, 2020) to see a rheumatologist (lines 210-213); but after a delay of 1 second and a minimal acknowledgement (line 215), the client raises the objection that there would be a delay even in seeing their general practitioner (GP), let alone, they imply, seeing a specialist. This bureaucracy is squarely in the call-taker's domain of expertise; she is a nurse with long standing experience of the health system, so let us see how she finds a ready solution to the objection.…”

“… 1. This paragraph is closely based on the one published in Antaki and Bloch’s (2020) study of impersonalised advice, a different aspect of the Parkinson UK interactions. …”

Locations for advice‐giving and the production of neutrality in divorce mediation sessions

“…Recent conversation analytic studies of advice-giving in a wide range of institutional contexts has highlighted the delicate and sensitive nature of giving advice (e.g., Andelic, Stephenson, & Feeney, 2019;Antaki & Bloch, 2020;Bergen, 2020;Davidson &Edwards-Groves, 2020 andStommel &te Molder, 2018). Previous conversation analytic studies of talk in facilitative mediation sessions has described how the interaction is organized and how mediation work is done in that context (e.g., Greatbatch & Dingwall, 1997).…”

Lifestyle advice in UK Primary Care consultations: Doctors’ use of conditional forms of advice

“…Research on the interactions in which health care professionals give patients advice [16,17,18,19,20,21,21,22,23,24,25] has highlighted a number of themes coalescing around the sensitivities and difficulties associated with delivering advice to medical service recipients (patients, new mothers etc. ).…”

“…Seeking and responding to advice can be problematic by virtue of the implied admission of uncertainty [16]. Other factors are the social context in which advice is given, for instance whether advice was supplementary to the purpose of the consultation [16,17,18,19,22]; and the further implication that giving advice may signify the failure of further support (e.g. medication) [28,31].…”