Responses to indirect complaints as restricted activities in Therapeutic Community meetings

In this chapter I investigate how the staff members of a mental health Therapeutic Community in Italy avoid displays of affiliation in response to residents’ indirect (or third party) complaints. I show how this restriction can be embodied in different practices: ignoring a resident’s turn carrying a possible complaint, avoiding attending the complaint-components of a resident’s turn, and disaffiliating with a resident’s complaint. I also discuss a deviant case in which affiliation is produced and is later treated by the staff members as a problematic stance to be produced following a resident’s complaint. I argue that through a restriction on affiliation the staff members implement the institutionally-relevant identity of intermediaries, whose task is to encourage the residents’ compliance to the decisions of absent third parties

I-challenges: influencing others’ perspectives by mentioning personal experiences in therapeutic community group meetings

In this paper I examine the communicative practice of mentioning a personal experience as a vehicle for challenging a peer’s perspective. I study this in the context of Therapeutic Community (TC) group meetings for clients recovering from drug misuse. Using conversation analysis, I demonstrate that TC clients use this practice, which I call an I-challenge, to influence how their peers make sense of their own experiences, and to do so without commenting on those peers’ experiences and perspectives. This study highlights the power of talking in the first person as a means of influencing others–a notion previously made popular by Thomas Gordon’s work on ‘I-messages’. Additionally, this study illustrates a novel way of studying social influence. Whereas previous research in social psychology has focused on the cognitive constraints behind phenomena of social influence and persuasion, here I contribute towards understandings of the interactional norms underlying the organisation of influence as a structured and coordinated domain of social practice

Delivering criticism through anecdotes in interaction

Criticising someone’s conduct is a disaffiliative action that can attract recipient objections, particularly in the form of defensive detailing by which the recipient volunteers extenuating circumstances that undermine the criticism. In Therapeutic Community (TC) meetings for clients with drug addiction, support staff regularly criticise clients’ behaviours that violate therapeutic principles or norms of conduct. This study examines cases where, rather than criticising a client’s behaviour directly, TC staff members do so indirectly through an anecdote: a case illustrating the inappropriateness of the type of conduct of which the client’s behaviour is an instantiation. TC staff members design the anecdote to convey a principle or norm of conduct which the client has putatively violated, and they systematically pursue endorsement of that principle by the client. By constructing the anecdote as an exemplary case, distanced from the individual client’s personal experience, TC staff members make it an empirically unverifiable, elf-evident, and therefore hard to challenge, llustration of a norm

Challenging generalisations: Leveraging the power of individuality in support group interactions

Explicit generalisations are statements that attribute a characteristic to all members of a social category (e.g., drug users). This paper examines the tensions and negotiations that the use of generalisations prompts within support group interactions. Generalisations are practices for the cautious implementation of delicate actions. They can be used to convey perspectives on group members’ experiences by implication (without commenting on them directly), by virtue of those members belonging to the category to which a generalisation applies. At the same time, generalisations can misrepresent some individual cases within that category. Using conversation analysis, the paper investigates how generalisations are deployed, challenged, and then defended in support group interactions. These analyses identify a tension between utilising the sense-making resources that category memberships afford, and the protection of its members from unwelcome generalisations. Data consist of recorded support-group meetings for people recovering from drug addiction (in Italy) and for bereaved people (in the UK)

Invoking the complainer's past transgressions: a practice for undermining complaints in therapeutic community meetings

This paper examines how a person who is the target of a complaint can undermine the moral entitlement of the complainer to issue that complaint. They do so by invoking the complainer’s own past transgressions. By pointing out an incongruence between the complainer’s current moral stance, as reflected in the complaint, and their status, as evidenced in their past conduct, speakers orient to an expectation of moral status/stance congruence as a basis for the validity of a complaint. My data consist of complaints and rebuttals collected from recorded group meetings within therapeutic communities for the treatment of people recovering from drug misuse. Data are in Italian with English translation

Knowledge displays: soliciting clients to fill knowledge gaps and to reconcile knowledge discrepancies in therapeutic interaction

Objective To examine knowledge displays (KDs), a practice by which Therapeutic Community (TC) professionals exhibit previous knowledge about their clients' circumstances and experiences. Methods Conversation analysis is used to examine 12 staff-led meetings recorded in Italy (8 in a drug addiction TC; 4 in a mental health TC). Results The TC professionals use KDs within broader sequences of talk where they solicit their clients to share personal information and where the clients provide insufficient or inconsistent responses. In these circumstances, the staff members employ KDs to pursue responses that redress emerging knowledge gaps and discrepancies regarding the clients' experiences or circumstances. Conclusion KDs allow the staff members to achieve a balance between respecting their clients' right to report their own experiences and influencing the ways in which they report them. KDs help to reinforce the culture of openness that is central to many forms of therapeutic interaction, to forward the therapeutic agenda and to expand the staff members' knowledge of the clients' experiences and circumstances. Practice implications the use of KDs can to solicit clients to share personal information. This paper illustrates core features that underlie the function of KDs (where they are used and how they are constructed)

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

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

Problem formulation in mental health residential treatment: a single case analysis

This paper investigates an episode of interaction in a mental health residential centre in Italy, where a resident and a staff member manage a relational problem. The episode leads to an apparently paradoxical outcome: in spite of the fact that the resident has sought the staff members’ cooperation to make sense of the relational problem, she ends up being blamed for that problem. Adopting the approach of conversation analysis, the paper shows that this outcome is the result of the transition from a relational view, to a one-sided view of the problem. The practices employed to accomplish this transition reflect a set of contrasting concerns and goals, which the participants bring to bear on the interaction. Reflection about these aspects can sensitize the public to some of the intricacies and challenges entailed in the delivery of mental health residential treatment

Beyond neutrality: professionals’ responses to clients’ indirect complaints in a Therapeutic Community for people with a diagnosis of mental illness

Previous research has evidenced that in different institutional settings professionals are cautious when responding to clients’ indirect complaints and tend to avoid siding either with the clients/ complainants or the complained-of absent parties. In this article we use the method of Conversation Analysis to explore professional responses to clients’ indirect complaints in the context of a Therapeutic Community (TC) for people with diagnoses of mental illness in Italy. Although the TC staff members sometimes display a neutral orientation toward the clients’ complaints, as is the case in other institutional settings, in some instances they take a stance toward the clients’ complaints, either by distancing themselves or by overtly disaffiliating from them. We argue that these practices reflect the particular challenges of an institutional setting in which professionals engage with clients on a daily basis, have an institutional mandate of watching over them and are responsible for their safety. According to this interpretation, staff members’ non-neutrality toward clients’ complaints can be seen as a way of defending against the possibility, raised by the clients’ reports, that the staff members might be involved, albeit indirectly, in courses of action that have harmed or might harm the clients

Entire solutions to 4-dimensional Ginzburg-Landau equations and codimension 2 minimal submanifolds

We consider the magnetic Ginzburg-Landau equations in $\mathbb{R}^4$ $$\begin{cases} -\varepsilon^2(\nabla-iA)^2u = \frac{1}{2}(1-|u|^{2})u,\\ \varepsilon^2 d^*dA = \langle(\nabla-iA)u,iu\rangle \end{cases}$$ formally corresponding to the Euler-Lagrange equations for the energy functional $$E(u,A)=\frac{1}{2}\int_{\mathbb{R}^4}\varepsilon ^2|(\nabla-iA)u|^{2}+\varepsilon^4|dA|^{2}+\frac{1}{4}(1-|u|^{2})^{2}.$$ Here $u:\mathbb{R}^4\to \mathbb{C}$, $A: \mathbb{R}^4\to\mathbb{R}^4$ and $d$ denotes exterior derivative when $A$ is regarded as a 1-form in $\mathbb{R}^4$. Given a 2-dimensional minimal surface $M$ in $\mathbb{R}^3$ with finite total curvature and non-degenerate, we construct a solution $(u_\varepsilon,A_\varepsilon)$ which has a zero set consisting of a smooth 2-dimensional surface close to $M\times \{0\}\subset \mathbb{R}^4$. Away from the latter surface we have $|u_\varepsilon| \to 1$ and $$u_\varepsilon(x)\, \to\, \frac {z}{|z|},\quad A_\varepsilon(x)\, \to\, \frac 1{|z|^2} ( -z_2 \nu(y) + z_1 {\textbf{e}}_4), \quad x = y + z_1 \nu(y) + z_2 {\textbf{e}}_4$$ for all sufficiently small $z\ne 0$. Here $y\in M$ and $\nu(y)$ is a unit normal vector field to $M$ in $\mathbb{R}^3$