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Conversational pursuit of medication compliance in a Therapeutic Community for persons diagnosed with mental disorders

By Luigina Mortari and Marco Pino


This is an Open Access article distributed under the terms of the Creative Commons Attribution\ud License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the\ud original work is properly cited.Purpose: In this article, we contribute to the debate on medication compliance by exploring\ud the conversational ‘‘technologies’’ entailed in the process of promoting clients’ adherence to\ud psychopharmacological prescriptions. Using a case study approach, we explore how medication-\ud related problems are dealt with in conversational interaction between the staff members\ud and the clients of a mental health Therapeutic Community (TC) in Italy. Method: Four meetings\ud between two staff members (Barbara and Massimo) and the clients of the TC were audiorecorded.\ud The data were transcribed and analyzed using the method of Conversation Analysis.\ud Results: Barbara and Massimo recur to practices of topic articulation to promote talk that\ud references the clients’ failure to take the medications. Through these practices they deal with\ud the practical problem of mobilizing the clients’ cooperation in courses of action that fit into the\ud institutional agenda of fostering medication adherence. Conclusions: Barbara and Massimo’s\ud conversational practices appear to reflect the assumption that medication-related problems\ud can be reduced to compliance problems. This assumption works to make the clients\ud accountable for their failure to take the medications while shaping a conversational\ud environment that is unreceptive to their complaints about side effects. Implications for the\ud understanding of mental health rehabilitation practice in TCs are discussed

Topics: Communication, Compliance, Medication, Mental health and illness, Therapeutic Community
Publisher: Taylor & Francis (© 2014 The authors)
Year: 2014
DOI identifier: 10.3109/09638288.2013.834987
OAI identifier:

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