Abstract
Questions form the basis of mental health assessments and yet there is limited empirical evidence about the linguistic structure of question formats in these clinical environments. While many types of questions are used, the focus of this research was on why-prefaced questions asked to children. Interaction analysis was employed to interrogate the data, paying specific attention to the interactional organisation of how ‘why-prefaced’ questions were asked and responded to. Analysis demonstrated that when three core components were present in the question, then it was usual for a reason/ explanation to be provided in response, and when one or more components were missing, it rarely elicited a reason or explanation in response. The three components were; the sequential position of the question, how the question was indexically tied to the child’s prior statement, and the epistemic domain of the question. Implications for therapeutic communication and training were discussed.
Highlights
Mental health problems in children are being increasingly recognised as a priority area for health services
It was observed that in some of the data there were occasions where an answer was provided to a why-prefaced question that evidentially was subsequently treated as sufficient by the speaker asking the question
We have demonstrated the benefits of using this type of analysis to interrogate recordings of actual child and adolescent mental health assessments
Summary
Mental health problems in children are being increasingly recognised as a priority area for health services. Specialist mental health services have evolved to address this need and in the UK, and the National Health Service (NHS) provide specialist Child and Adolescent Mental Health Services (CAMHS) This service consists of multi-disciplinary teams of practitioners who conduct assessments, diagnose conditions, and deliver interventions (Karim, 2015). The first step in addressing the needs of a child or adolescent who has been referred to a specialist mental health clinic is to conduct an assessment Such mental health assessments have several interrelated purposes, including diagnosis or case formulation to determine the nature of the presenting problems, identification of risk, and treatment design and planning (Mash & Hunsley, 2005; Sands, 2004). There is little qualitative evidence that has investigated initial assessments in mental health (Hartzell, Seikkula, & von Knorring, 2009) and subsequently, limited examination of the communication and interaction within them
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