Article was found at
Conversational Ethics in Psychological Dialogues: Discursive and Collaborative Considerations

Canadian Psychology,  May 2007  

by         Strong, Tom,              Sutherland, Olga


With the linguistic turn in the social sciences have come increased sensitivities to language use. In this paper, we examine such sensitivities as they relate to the conversational practices of psychologists seeking collaborative relationships with clients. In particular, we link ethical practice with developments in discourse theory and research, presenting arguments and evidence for enhanced forms of collaboration and client-centred practice. We conclude with considerations for what we consider "conversational ethics" in psychological practice.

The social constructionist movement in psychology is now a generation old. Premised primarily on developments in linguistic theory, the key insight spurring on this movement has been the notion that language is incapable of correctly representing experience in any absolute sense. For some, the movement seemed to invite linguistic anarchy; for others, it ushered in a new era of critical reflection and potentials for reauthoring understanding. Regardless, there has been a recent proliferation of research methods, therapeutic practices, pedagogies, and critically inspired reflections within psychology derived from ideas and practices associated with social constructionism. Attempts to reconcile these developments within mainstream psychology have been occurring for over 30 years now (Gergen, 1985; Shotter, 1975).

For us, a social constructionist epistemology refers to a view of meaning as the product of human interaction in relational and broader cultural circumstances; that is, meaning owes something to its use in social contexts. The Canadian Code of Ethics for Psychologists (the Code hereafter; Canadian Psychological Association [CPA], 2000) offers one such example of socially constructed meaning. It also shows a function of meaning we feel merits particular consideration: how meaning is consequentially interpreted and put to use. With social constructionist practice in psychology has come a concern for meanings and practices used without critical reflection (i.e., taken for granted; e.g., Parker, 1999). Psychological practice itself can be seen as a socially constructive activity (McNamee & Gergen, 1992), shaped and reshaped over time. Our focus here is on how social constructionist perspective can further inform ethical practice, particularly in discussions psychologists want to see as collaborative with clients.

Recent developments in social constructionist practice (e.g., Gubrium & Holstein, in press; Strong & Paré, 2004) emphasize a premise highly compatible with some aspects of ethical practice, as promoted by the Code (CPA, 2000): respect for the dignity and preferences of clients. This respect can be shown in how client-psychologist interactions occur in a collaborative manner when that is the aim of the psychologist. Specifically, the ethics to which we refer focus on how conversational differences are worked out between clients and psychologists. They also refer to how issues of power and dominance are collaboratively resolved in the manner by which such psychological dialogues are conducted. That clients consult psychologists for their expert knowledge, of course, does not extend to psychologists' expertise overriding the understandings or preferences of clients. Instead, the first principle of the Code (CPA, 2000), particularly the first ethical standard, asks psychologists to demonstrate respect for the knowledge, experience, and expertise of others. For social constructionists, since there is no correct meaning made possible by language, a primary issue is the fit or appropriateness of meanings for those with whom psychologists interact. Meanings not taken up by clients serve neither client nor psychologist in addressing concerns that clients present.

Arguably, psychologists have developed a more refined discourse than others from which to discuss clients' concerns and what can be done about them (Danziger, 1997). At worst, this thinking privileges psychologists' discourse, forcing clients to converse in ways that do not adequately reflect their lived meaning or sense of what is useful to them. A growing critical psychology literature suggests that psychologists (usually unknowingly) hold clients to normative understandings and ways of being - through exercising their expert knowledge (e.g., House, 2003; Rose, 1990; Parker, 1999). Such normative understandings and ways of being thus reflect a dominant social order some psychologists are therefore seen as upholding. The social constructionist approaches to psychotherapy have focused on client knowledge, preferences, theories of change, and resources (e.g., Duncan & Miller, 2000), and on the discourses or ways of talking and understanding used by clients (Freedman & Combs, 1996). Thus a corresponding focus is on how psychologists use their knowledge to incorporate the knowledge and preferences of clients. Clients' meanings and preferences for mutual work could be important assessment dimensions in working with clients but our concern does not stop with considering these client particulars, it extends to how psychologists engage with them collaboratively.

Conversational Ethics?

Whether one turns to the training literature or the CPA Code of Ethics, there is no shortage of prescriptions about how psychologists ought to relate to their conversational partners. For us, such prescriptions are often premised on metaphors of communication that are less than dialogic (Lakoff & Johnson, 1980; Sampson, 1993). By dialogic we differentiate relationally responsive dialogues regarded as mutual or collaborative by both participants from talk occurring in uncoordinated and sometimes competing monologues (Shotter, 2006). Researchers studying discourse regard the rhetorical and interactive aspects of conversation as obscured in common information transmission models of communication (Maranhâo, 1986). For most social constructionists, communication involves relational (how to proceed together) as well as informational (what) aspects (Watzlawick, Bavelas, & Jackson, 1967). Talk "performs" (Austin, 1962) relational functions that speakers cannot decide for each other and these rhetorical aspects of dialogue are matters to be worked out by speakers as they talk. Therefore, on "conversation's shop floor" (Garfinkel, 2002), psychologists need flexible and responsive discussions with clients. They clearly cannot hold clients to their ways of talking and meaning exclusively. Their respect extends to how they engage with clients' meanings and ways of talking.

Consistent with our focus on the "whats" and "hows" of professional conversation, we have chosen to narrow our focus to two types of professional ethics: content ethics and process ethics (Swim, St. George, & Wulff, 2001). Content ethics include standards outlined in professional ethical codes specifying what helping professionals should do in accountably working with clients (e.g., confidentiality, dual relationships, competence). However, their uniform application presents responsive and collaborative challenges given the cultural, contextual, and emergent features of specific professional encounters (e.g., Donovan, 2003; Pedersen, 1997). For this reason, we feel it is important to consider process ethics - or what we term "conversational ethics" - to refer to psychologists' practical reasoning and situation-specific ways of talking with clients (Gergen, 2001; Swim et al., 2001). So, we are proposing ethical considerations for fostering psychologists' contributions to collaborative dialogue.

To a varying extent, psychologists practice in improvised ways, balancing professional knowledge with modifications required to reflectively and sensitively interact with clients and circumstances (Schön, 1983). Said differently, psychologists practice in relationally and contextually responsive ways informed by their ethics and knowledge. Conversational ethics refer in part to these informed improvisations in a way others refer to as "dialogic" (Sampson, 1993; Shotter, 2006). Psychologists face ethical tensions in balancing their professional knowledge and intentions with clients' intentions and preferences in professional interactions. Intentions, for us, are what Anscombe (2000) has referred to as "action under a description," action articulated in descriptions one can recognize and act on privately, or share interpersonally.

Participating inside a dialogue is different from third-party accounts of such participation. For Goffman (1967), participating in dialogue is a comanagement task requiring speakers to be intelligible, understanding, and influential with each other in the immediacies of their talking together. For some, this co-management task comes down to enacting clear role definitions: Clients consent to providing professionally relevant information and assent so that they can be appropriately assessed and directed by psychologists. However, close examination of professional dialogues shows that clients are anything but docile in or outside of such narrow depictions of their role (e.g., Buttny, 1996; Maynard, 2003). Clients shape all aspects of professional dialogue and our concern in this paper is partly with how their influence in turn influences the psychologists talking with them.

Underscoring our social constructionist approach to conversational ethics is a view that outcomes in professional dialogue are accomplished much the same as are other outcomes between speakers. People work out such matters between them in negotiated dialogues, and these negotiations serve as their basis for later mutual actions. Negotiation, in how the term is commonly used, can seem anything but collaborative, but as we use it here it refers to the notion that any meaning or action needs to be understood as the product of interactions with social or physical reality. The added dialogic piece is that these interactions occur in ways that adequately reflect the intentions and preferences of psychologists and clients as each deems "adequacy."

To examine our concern with negotiated dialogues in reverse, an ample literature on clients' nonadherence with treatment recommendations shows when such negotiations have gone awry (Leahy, 1993; Meichenbaum & Turk, 1987). Expertise in conveying professional diagnoses or prescriptions seems to have been eroded by an Internet and self-help book savvy clientele (Starker, 2002). More likely, psychologists are now seen as consultants offering contestable knowledge and less so as ultimate authorities on clients' lives (e.g., Bergmann, 1992; Heritage & Sefi, 1992). Paralleling such shifts in clients' ways of thinking and relating has been a rise in approaches to psychotherapy informed by client preferences, not only on treatment goals but on the shared processes by which these might be attained (e.g., Duncan & Miller, 2000; Freedman & Combs, 1996; Madsen, 1999). Such psychologists are to a varied extent "resistance-informed" in how they converse with clients to arrive at shared and "adequate" outcomes (Strong & Zeman, in press). Client refusals of therapist's interventions thus constitute feedback the therapist can use in adapting interventions to client preferences and circumstances (Selekman, 2005).

There are striking examples where what we have been raising is relevant, if not disconcerting, for psychologists. How clients' concerns are named offers one such example. While a DSM-IVTR diagnosis may help to translate clients' concerns into symptomatic shorthand useful to the psychologist, it offers but one representation of clients' concerns and aspirations. Our concern is with the exclusory use of professional discourse for both naming clients' concerns and for avoiding other ways clients might want to talk and be understood. Feminist and social constructionist writer, Kaethe Weingarten (1992), spoke of "intimate interactions" in therapy, which, for us, can extend to referring to collaborative interactions. For Weingarten, conversational violence occurs when meanings are imposed, ignored, or misconstrued purposefully in noncollaborative interactions with clients. She was not suggesting, for example, that therapists could not disagree with clients; at issue is how their differences in meaning and talking are reconciled. In psychological interactions, careful responsiveness to clients' descriptive language is a key aspect of the conversational ethics we are articulating. Ferrara (1994) suggests that collaborative interactions in psychotherapy are best conducted and reflected in a descriptive language shared by client and therapist. Where this matters most is in shared efforts to describe intentions for therapy's goals and proceedings. Putting language to intentions is a conversational and descriptive challenge (Anscombe, 2000) but without such discussions people can fail to coordinate their intentions. Articulating shared goals is common ethical practice, but how such goals are accomplished in the back and forth of dialogue is less considered, particularly in psychology.


Conversational Ethics Up Close

The micro-interactions of professional dialogue show how speakers' intentions are worked out as they take turns in dialogue (e.g., Pomerantz, 1984; Sacks, Schegloff, & Jefferson, 1974; ten Have, 1999). Those words which come to be spoken as shared, for the discourse analyst, "ground" (Clark, 1996) speakers in a language of common intention and articulation. Getting to a language of shared intention requires conversational work and it is in this sense that dialogue can be seen as negotiated across turns taken in speaking. Such negotiations are highly evident when micro-analyzing any passage of therapeutic interaction - in junctures such as problem-description (Buttny, 2006), understanding (Strong, 2005), identity implicating diagnoses (Antaki, 2001), client narrative constructions (Ferrara, 1994), advice-giving (Couture & Sutherland, 2006), and even confronting (Strong & Zeman, in press). The ethic we wish to underscore relates to Weingarten's (1992) concern that psychologists see their conversational interactions with clients as the means to work out meanings, in words acceptable to both parties.

We do not wish to restrict our considerations here to the role words play in conversational interaction. Often conversation involves not only a negotiation of descriptive terms, but a negotiation of styles of discourse. Discourse, as we are using the term, refers to not only the activities of talking but to culturally systematized understandings and ways of talking prevalent in society. Critical discourse analysts, for example, see the discourses used by clients and therapists requiring some reconciling, otherwise the psychologist's discourse can be privileged in ways clients might not take up, or take up unhelpfully (e.g., Guilfoyle, 2003; Kogan, 1998). Such differences in discourse are not simply about semantics, they comprise significant differences in values, understandings, and cultural affiliations that can dominate social interaction (Fairclough, 1989). Therapists relating to clients in symptom terms, while clients relate to their circumstances in vocational or relational terms, illustrate one example of this point.


There is, however, another stylistic difference we wish to raise here, one pertaining to talk as a performance. Talk as a dialogic performance has also been referred to as talk-in-interaction (ten Have, 1999) to contrast this kind of talking with talk of a more monologic nature. How talk occurs - its speed, gestural accompaniments, vocal inflections, and responsiveness - are also aspects of dialogue to be worked out between speakers in conversational interaction. When, for one speaker, conversation goes too fast, or too slow - while the other speaker will not change speed - such stylistic differences can conversationally matter. Close scrutiny of dialogue shows not only these differences in styles of talking, but how such differences affect speakers as they talk. Our concern extends to how speakers repair junctures in talk where misunderstandings or differences are worked out, not only in words, but in ways of uttering them (Sacks et al., 1974). Alongside negotiating meaning we see conversational ethics extending to how psychologists and clients coordinate differences in their conversational styles.

For us, conversation involves people making practical (i.e., responsive in the moment) evaluations and interpretations of each other. Our social constructionist perspective borrows a micro-interactional sense from ethnomethodology (Garfinkel, 1967) and conversation analysis (Sacks, 1995). seen this way, speakers build on each other's utterances, or depart from them should better fitting utterances be accomplished through dialogues co-managed by clients and psychologists. These efforts have the following ethical dimensions:

* they show psychologists welcoming and engaging with (i.e., taking up) clients' meanings and descriptive language.

* they show clients and psychologists continuously working out a shared language of intentions through negotiating terms acceptable to both parties.

* they show psychologists conversationally working with clients to reconcile and coordinate stylistic differences in the ways of talking used, to find shared ways of talking.


We will now show how this co-management occurs in actual passages of therapeutic dialogue. If psychological practice involves the kind of "conversation shopfloor" Garfmkel (2002) spoke of, one should see evidence of the kinds of interactions we have been describing.


Examining Some Micro-Practices in Psychological Dialogues

In studying how speakers take turns at talk, conversation analysts show what speakers actually do in relation to each other and how their talking shapes their dialogues. Conversation analysts claim that people tend to take such micro-features of communication for granted (Heritage, 1988) and heuristically attend to such micro-features as consequential within dialogue. Slight differences of intonation in a speaker's utterance may convey vast differences of meaning for the recipient. Conversation analysis (CA) transcription enables practitioners to capture these messy, ungrammatical, and seemingly accidental features of talk. Speakers co-manage their rapport while and through making utterances to each other, something evident in transcripts painstaking detailing how they respectively contribute to and influence their dialogues.


Conversational ethics, as we envision them, should be evident in these mostly taken-for-granted aspects of dialogue, in how speakers take their turns at talk and attend to each other. Microanalyses of talk highlight the choices available to speakers as they take conversational turns and present opportunities to consider alternatives. The ethics at stake in these interactions relate to how intentions are articulated, how meanings are negotiated, and how stylistic differences (ways of talking) are reconciled between client and therapist. Communication researchers (e.g., Ferrara, 1994) note that clients and psychologists observably treat seemingly irrelevant details of talk (e.g., changes in intonation, overlapping talk, pauses) as significant for their next responses, and as evidence of the quality of their developing relationships.

In the following segment (see Appendix A for the transcription notation), the therapist and client jointly search for mutually fitting descriptions of the client's experience. The therapist takes great caution in ensuring that language she introduces meets with the client's approval for its descriptive adequacy. The therapist seems attuned with the client's emergent discursive preferences and, recognizing them, uses them to shape her further contributions to dialogue.

Conversation analysts would argue that "being in tune" is a practical, interactive accomplishment. The therapist displays her "in-tuneness" by welcoming the client's participation ("Tell me more," "Mmhmm"), completing the client's utterance (Line 7), mirroring his language (Lines 1, 6, 8, and 9), and offering possible language to build on the client's original metaphorical description. The therapist presents her contributions as food for thought (Anderson, 2001) without having a final say on the client's meanings. Her collaborative orientation is evident through her openness to being corrected by the client (end of Line 6) and tentativeness of her interpretation ("kinda"). She responds sensitively to the client's modifications by passing on her previously stated understanding of the client's utterance (Line 7) in receiving client feedback that such understanding did not adequately reflect his experience.

In the exemplar below, the therapist does not insert his professional advice arbitrarily, but negotiates a place in the dialogue into which such advice may be fitted (Maynard, 1991; Vehviläinen, 2001). Without such negotiation, the client may fail to understand the relevance of a particular intervention, or feel it sufficiently adapted to the client's circumstances, which, in turn, may decrease the probability of the client joining the professional in taking up a proposed intervention and thus benefiting from it (Couture & Sutherland, 2006; Heritage and Sefi, 1992).

To maximize the relevance and impact of his intervention, the therapist "aligns" with the client's stated position (Lines 4 and 7-10) and simultaneously transforms or reformulates that position (Lines 11 and 13; Antaki, Barnes, & Leudar, 2005; Davis, 1986; Grossen & Apotheloz, 1996; Hak & de Boer, 1995). Professionals often prefer to first elicit their interlocutors' perspectives on the discussed matter and then fit their ideas or advice into how they offer such information (Maynard, 1991; Vehviläinen, 2001). The therapist's idea (i.e., that the client should heal slowly) is first broached by him with the original material presented by the client ("I don't feel comfortable about it >at all

When inviting clients to talk from potentially problematic experiential and relational understandings, therapists (at least initially) tend to talk tentatively and cautiously (Bergmann, 1992; Lobley, 2001). To accomplish "tentativeness" therapists formulate their utterances by permeating them with pauses, repetition of words, uncertainty markers (e.g., "maybe"), and various particles ("uhm," "eh[four dots above]"). By using tentativeness and uncertainty, therapists are able to be interventive while remaining less authoritarian (Guilfoyle, 2003; Kogan & Gale, 1997; Roy-Chowdhury, 2006). Consequently, clients are offered, via this tentativeness, opportunities to contest therapists' ideas and proposed courses of action. Sometimes therapists openly request clients' feedback on the value of their professional conclusions and interventions (Buttny, 1996), as in the segment below. The therapist tries to elicit the clients' responses to his interpretation (Lines 5-6). Repetition of words and various particles ("uh[four dots above]," "ah[four dots above]") serve to prompt the clients' evaluations of the therapist's interpretation.

Interestingly, even when therapists attempt to collaborate with clients by presenting their conclusions tentatively and cautiously, clients still may resist and refuse such offerings. In the following exemplar, both partners disagree with the therapist's assessment of their experience, in spite of extensive efforts on the part of the therapist to downgrade his evaluative authority.

The therapist incorporates, as a part of his formulation, multiple pauses, repetition of words, rising intonation, and other devices ("ah[four dots above]:." "Yeah?" "if I understand correctly") designed to convey hesitancy and uncertainty. Instead of reasserting his authority over the disagreement from both clients, the therapist builds on these clients' responses to further co-construct an account of this couple's understanding that fits all parties (Line 24).

Couture (2004) provided an example of how a therapist and client negotiate shared intentions, pertaining to a particular topic under discussion, that afford participants' joint movement forward in a dialogue. The therapist attempts to elicit the son's perspective on the "no suicide" contract established by this client and a nurse upon the son's discharge from the hospital. The safety contract may be viewed as an "institutional" way of dealing with clients who are presumed to pose a danger to themselves. Previously in this session, the parents positioned themselves as certain that their son will follow the contract. While parents and professionals may join efforts in getting children to commit to "institutional discourses," children may oppose such socio-cultural constraints placed upon them and thus assert their social competence (Silverman, Baker, & Keogh, cited in Couture, 2004).

The adolescent in this segment of talk may be said to resist an institutional agenda by providing ambivalent or minimal responses (e.g., "I don't know," "*Mhmm*"). Instead of challenging the client's position in relation to the safety contract, the therapist acknowledges the client's statement ("Don't know ya (1.2)" and validates it ("well that is probably an honest statement because you don't know for sure right?"). The therapist collaborates with the client in co-articulating this client's position of increased certainty, in relation to the safety contract, by legitimizing the position initially articulated by the client. The therapist then tentatively ("I guess") invites the client to join in the position of honouring the contract. Consequently, the client remains an active contributor to the dialogue, as demonstrated through his stronger acceptance of the therapist's statement in Line 11, as compared to his previous responses.

To summarize, the professionals in the provided segments tended to take a circuitous (dialogical) rather than a straightforward (unilateral) interactive pathway in their communication with clients (Maynard, 1991). This circuitousness can be seen as dialogic responsiveness, ways in which psychologists incorporate the emergent developments in their interactions with clients into what they would next say. They mostly elicited, acknowledged, and in varied ways incorporated clients' perspectives in conversationally evident developments prior to and as part of offering their own professional conclusions and assessments (Exemplars 2, 3, and 5). Therapists affirmed the status of clients as competent and credible tellers of their troubles, identities, and experiences (Exemplars 1 to 5) and downgraded their professional expertise to provide conversational space for the development of clients' accounts (Exemplars 1 and 3). This does not imply that counsellors withheld their opinions and suggestions. On the contrary, most segments feature a provision of expertise by professionals. Such expert knowledge, however, was brought forth and put to use in ways that conveyed sensitivity to clients' potentially differing preferences and perspectives (Exemplars 1, 2, 3, and 5). Uncertainty (Hoffman, 1995) and tentativeness (Anderson, 2001) aided therapists (and was evident) in this process.

While we do not have the responses of clients participating in these passages to draw from for their judgments of how collaborative the passages were for them, a couple of notions inform our reasons for using these passages. For Clark (1996) and Ferrara (1994), collaboration is evident in the interweave of common terms and ways of speaking, a phenomenon Clark refers to as sharing "common ground" in discourse. A further concept from CA, relates to "uptake" of one speaker's discourse by another (ten Have, 1999). A simple example relates to a question being responded to with a relevant answer or being joined with similar language (Clark, 1996). For those who relate to professional dialogue as critical discourse analysts (e.g., Davis, 1996; Guilfoyle, 2003), an asymmetric tilt favours the therapist's discourse, however. Collaboration, for these analysts, is a suspect concept because the stakes of conversation - what is deemed therapeutically appropriate - are seen as the psychologist's prerogative, something clients could readily defer to, feign agreement with, and so on. A full embrace of such a view of professional dialogue, however, can default psychologists to the very concern being critiqued. Therapists have many ways of exerting their dominance over the professional dialogue; who most asks and answers questions is a further aspect of this dominance often taken for granted (Wang, 2006). A key social constructionist tenet, however, can be considered relevant to conversational ethics: Professional dialogues can be where the meaning and talk have some element of contestability or negotiability (Gergen, 2001). Of course, there are some nonnegotiables in psychologist-client dialogues. Our concern is with meanings and ways of talking that can be shared.

Conversational Ethics: Some Training, Supervisory, Research, and Other Implications

We believe discursive research and a social constructionist perspective on psychological practice point to considerable ethical implications for how psychologists' converse with clients. Discursive evidence, the kind we have shown in our previous exemplars, permits a "slowing down" of professional interaction, so that psychologists can witness and evaluate their influence at work (Strong, Busch, & Couture, in press). Recommendations regarding ethical professional practices can be best derived from close empirical examination of the use of such practices (Donovan, 2003; Gergen, 2001; Pedersen, 1997). For Donovan (2003),

Ethics [are] integral to every passing moment of our work rather than something to be visited on special occasions. Ideas about maximizing the "good" become ideas about maximizing opportunities for "good" conversations and the starting point for ethical debate about what might constitute a "good" conversation, (p. 302)

A CA-informed, constructionist lens on psychological practice offers a useful means to more finely attune one's conversational practice to collaborative or other professionally sought outcomes (Gale, Dotson, Lindsey, & Negireddy, 1993; Strong, 2003). Literally, videotapes or transcripts of one's practice should show how the psychologist's contributions to dialogues with clients fare, in terms of how clients respond. Are clients showing in their responses that they are taking up what psychologists offer via their suggestions, responses to clients, or presuppositions in their questions? How are "delicate" discussions, ones that put possibly client-sensitive meanings to client experiences or considerations of identity, co-managed as discussions (Silverman, 2004)? What might be getting passed over as clients and psychologists talk that might be relevant to revisit as a result of certain topics or ways of talking dominating the interview (Gale & Lawless, 2004) ? These are examples of the kinds of questions we feel are brought to the fore by considering the micro-dynamics of psychological dialogue, and how psychologists contribute to them.

By looking closely at how psychologists and clients respond to each other as they construct client-preferred outcomes in their conversational efforts, our microanalyses point to dialogue as a co-management task in keeping with Principle 1 of the CPA Code of Ethics. The dialogues clients have with psychologists are conducted for them. However, psychologists face tensions in bringing their expert knowledge and ways of practice to these co-management efforts. Good intentions, skillful and knowledgeable practice, and sound ideas that do not fare well in psychological dialogues, can occur when our expertise is not collaboratively transacted with clients. The days when expertise alone should translate to information or interventions well received by clients seem to be passing. In the social constructionist approaches to therapy, some have gone so far as to pronounce the "death of resistance," seeing collaborative conversational practice as prerequisite to good professional relationships and their outcomes (de Shazer, 1984).

In the immediacies of psychological dialogues, psychologists do things with their words and ways of talking that clients respond to, and that they, in turn, responsively adapt to based on how clients respond to them. All this is done while drawing on their professional skills, knowledge, and understandings of ethical practice. Schön's (1983) "reflective practitioner" responsively acts based on feedback arising in the immediacies of interactions between professional, client, and circumstance. Hopper (2005) articulated a distinction related to our conversational ethics. Specifically, for Hopper there are "pre-strategy" professionals: those who practice from well and alreadyarticulated strategies that they apply to client circumstances. Conversely, there are professionals whom he terms "emergent-when" professionals: Those who can knowledgeably, flexibly, and constructively interact with the people and circumstances they aim to influence. It is the former professionals who ethically concern us most, whose fidelity to prescripted dialogue can be experienced as nonresponsive, if not impositional, by clients. It is the psychologist's ability to be responsive, to co-develop meanings, ways of talking, and customized interventions befitting how clients respond to them that we are promoting. Regardless, our review of discursive research on psychotherapy suggests both clients and psychologists actively contribute to such developments. And by this, we are not referring to clients merely cooperating with psychologists' directives or following closely what they say.

With respect to training and supervision of psychologist trainees, we see great advantage in adding microanalytic examinations of videotaped passages of the trainees' professional dialogues. To foster a sense of the responsive nature of dialogue, we see the focus as much on the psychologist trainee's communication as on how clients respond to their communications (Strong, 2003). As trainees recognize that clients do things with their talk that they in turn must respond to - while trying to attain client goals - a more responsive trainee often emerges than one focused on her or his communication skills alone. This can be especially recognized when reviewing videotapes as a means of self-supervision (Gale et al., 1993). There one can attend to how outcomes are dialogically accomplished in the back and forth of client-psychologist dialogue. An example might be: how do client and psychologist start then complete a passage where the psychologist proposes an intervention that a client willingly takes up? But, trainees can observe also how their use of language dominates or collaboratively features in the professional dialogue, and to note the effect this has on clients and what develops from their contributions. We feel that psychologists track conversational evidence for such developments or accomplishments, in how clients respond to them, and in how the psychologist sometimes does a "mid-course correction" in customizing an intervention to make it more likely to be taken up by clients (Strong et al., in press). We see such activities as useful sensitizing tools for trainees who are often insufficiently attentive to clients' contributions to the dialogue because of a preoccupation with their own communications.


Discursive inquiry offers a unique perspective on professional conversations as a two-way interactional process. For language-focused psychologists, clients are active participants in the constitution, maintenance and negotiation of therapeutic understandings and relationships (Anderson, 1997; Buttny, 1996; de Shazer, 1994; Huffman, 1995). Psychologists routinely encounter situations in which clients display commitment to certain meanings and perspectives. A frequent ethical dilemma faced by professionals relates to how to engage with, and respond to, meanings asserted by clients - how to invite clients into alternative understandings without undermining their competence or infringing on their autonomy. The artful conversational work that goes into delicately negotiating shared meaning is frequently overlooked by both psychologists and researchers interested in professional interaction. Yet, our ethics are clear (CPA, 2000; e.g., Ethical Standards 1.3,1.16,1.17, II. 21, III.10) that we are to use respectful, culturally appropriate, and engaging language to promote consensual relationships with clients.

By exposing the "seen but unnoticed" (Garfinkel, 1967) details of professional communication, we aim to highlight the interactional context that shapes psychologists' knowledge and that is simultaneously shaped by this knowledge. Those who practice from a social constructionist perspective claim that they cannot influence clients but only influence the context of their interaction with clients through their own contributions to such interactions (Hoffman, 1995; Lipchik, 2002). Such discursively informed psychologists locate their knowledge and interventions in a particular time and place, and present them as relative and contestable rather than objective and undisputable. While this does not negate their well-informed suggestions or opinions, they also invite clients to modify or contest their meanings for life events, as part of opening up new options for action and self-understanding (Anderson, 1997; Goldner, 1993; Walter & Peller, 1992). They invite clients to be "active mediators, negotiators, and representatives of their own lives" (White, 2004, p. 20), a stance we see as being in keeping with the CPA's (2000) ethical principles and standards. The Code encourages psychologists to be reflective of their contributions to interactions with clients and to guard against imposition on clients, whether intentional or unintentional, of these professionals' knowledge and values.


Anderson, H. (1997). Conversation, language and possibilities. New York: Basic Books.

Anderson, H. (2001). Postmodern collaborative and person-centered therapies: What would Carl Rogers say? Journal of Family Therapy, 23, 339-360.

Anscombe, G. E. M. (2000). Intention. Cambridge, MA: Harvard University Press.

Antaki, C. (2001). "D'you like a drink then do you?" Dissembling language and the construction of an impoverished life. Journal of Language and Social Psychology, 20, 196-213.

Antaki, C., Barnes, R., & Leudar, I. (2005). Diagnostic formulations in psychotherapy. Discourse Studies, 7, 627-647.

Austin, J. L. (1962). How to do things with words. Cambridge, MA: Harvard University Press.

Bergmann, J. R. (1992). Veiled morality: Notes on discretion in psychiatry. In P. Drew &J. Heritage (Eds.), Talk at work: Interactions in institutional settings (pp. 137-162). Cambridge, UK: Cambridge University Press.

Buttny, R. (1996). Clients' and counselor's joint construction of the clients' problems. Research on Language and Social Interaction, 29(2), 125-153.

Canadian Psychological Association (2000). Canadian code of ethics for psychologists (3rd ed.). Ottawa, ON: Author.

Clark, H. H. (1996). Using language. Cambridge, UK: Cambridge University Press.

Couture, S. (2004). Moving forward: Therapy with an adolescent and his family. Unpublished dissertation, University of Calgary, Canada.

Couture, S., & Sutherland, O. A. (2006). Giving advice on advice-giving: A conversation analysis of Karl Tomm's practice. Journal of Marital and Family Therapy, 33, 181-194.

Danziger, K. (1997). Naming the mind: How psychology found its language. Thousand Oaks, CA: Sage.

Davis, K. (1986). The process of problem (re) formulation in psychotherapy. Sociology of Health and Illness, 8, 44-74.

de Shazer, S. (1984) The death of resistance. Family Process, 23, 11-21

de Shazer, S. (1994). Words were originally magic. New York: Norton.

Donovan, M. (2003). Family therapy beyond postmodernism: Some considerations on the ethical orientation of contemporary practice. Journal of Family Therapy, 25, 285-306.

Duncan, B., & Miller, S. (2000). The heroic client. San Francisco, CA: Jossey Bass.

Fairclough, N. (1989). Language and power. London: Longman.

Ferrara, K. (1994). Therapeutic ways with words. New York: Oxford University Press.

Freedman, J., & Combs, G. (1996). Narrative therapy: The social construction of preferred realities. New York: Norton.

Gale,J., Dotson, D., Lindsey, E., & Negireddy, C. (1993). Conversation analysis: A method for self-supervision. Paper presented at AAMFT's 51st Annual Conference, Anaheim, CA.

Gale, J., & Lawless, J. (2004). Discursive approaches to clinical research. In T. Strong & D. Paré (Eds.), Furthering talk: Advances in the discursive therapies (pp. 125-144). New York: Kluwer Academic/Plenum Press.

Garfinkel, H. (1967). Studies in ethnomethodology. Englewood Cliffs, NJ: Prentice Hall.

Garfinkel, H. (2002). Ethnomethodology's program: Working out Durkheim's aphorism. Lanham, MD: Rowan & Littlefield.

Gergen, K. (1985). The social constructionist movement in modern psychology. American Psychologist, 40, 266-275.

Gergen, K. J. (2001). Relational process for ethical outcomes. Journal of Systemic Therapies, 20, 7-10.

Goffman, E. (1967). The interaction order. New York: Pantheon.

Goldner, V. (1993). Power and hierarchy: Let's talk about it! Family Process, 32, 157-162.

Grossen, M., & Apothéloz, D. (1996). Communicating about communication in a therapeutic interview. Journal of Language and Social Psychology, 15,101-132.

Gubrium, J., & Holstein, J. (Eds.) (in press). The handbook of constructionist research. New York: Guilford.

Guilfoyle, M. (2003). Dialogue and power: A critical analysis of power in dialogical therapy. Family Process, 42, 331-343.

Hak, T., & de Boer, F. (1995). Professional interpretation of patient's talk in the initial interview. InJ. Siegfried (Ed.), Therapeutic and everyday discourse as behavior change (pp. 341-364). Norwood, NJ: Ablex.

Heritage, J. (1988). Explanations as accounts: A conversation analytic perspective. In C. Antaki (Ed.), Analyzing everyday explanations: A casebook of methods (pp. 127-144). London: Sage.

Heritage, J., & Sefi, A. S. (1992). Dilemmas of advice: Aspects of delivery and reception of advice in interactions between health visitors and first time mothers. In P. Drew &J. Heritage (Eds.), Talk at work (pp. 359-419). Cambridge: Cambridge University Press.

Heritage, J., & Sefi, S. (1992). Dilemmas of advice: Aspects of delivery and reception of advice in interactions between health visitors and first time mothers. In P. Drew &J. Heritage (Eds.), Talk at work: Interactions in institutional settings (pp. 359-417). Cambridge, UK: Cambridge University Press.

Huffman, L. (1995). Exchanging voices: A collaborative approach to family therapy. London: Karnac.

Hopper, R. (2005). A cognitive agnostic in conversation analysis: When do strategies affect spoken interaction? In H. te Molder &J. Potter (Eds.), Conversation and cognition (pp. 134-158). New York: Cambridge University Press.

House, R. (2003). Therapy beyond modernity: Transcending profession-centered therapy. London: Karnac.

Kogan, S. (1998). The politics of making meaning: Discourse analysis of a 'postmodern' interview. Journal of Family Therapy, 20, 229-251.

Kogan, S. M., & Gale, J. E. (1997). Decentering therapy. Textual analysis of a narrative therapy session. Family Process, 36, 101-126.

Lakoff, G., & Johnson, M. (1980). Metaphors we live by. Chicago, IL: University of Chicago Press.

Leahy, R. L. (1993). Overcoming resistance in cognitive therapy. New York: Guilford.

Lipchik, E. (2002). Beyond technique in solution-focused therapy. New York: Guilford.

Lobley, J. (2001). Whose personality it is anyway? The production of 'personality' in a diagnostic interview. In A. McHoul & M. Radley (Eds.), How to analyse talk in institutional settings: A casebook of methods (pp. 113-123). New York: Continuum.

Madsen, W. (1999). Collaborative therapy with multi-stressed families. New York: Guilford.

Maranhão, T. (1986). Therapeutic discourse and Socratic dialogue: A cultural critique. Madison, WN: University of Wisconsin Press.

Maynard, D. W. (1991). The perspective-display series and the delivery and receipt of diagnostic news. In D. Boden & D. H. Zimmerman (Eds.), Talk and social structure: Studies in ethnomethodology and conversation analysis (pp. 164-192). Cambridge, UK: Polity Press.

Maynard, D. W. (2003). Bad news, good news: Conversational order in everyday talk and clinical settings. Chicago, IL: University of Chicago Press.

McNamee, S., & Gergen, S. (Eds.), (1992). Therapy associai construction. Newbury Park, CA: Sage.

Meichenbaum, D., & Turk, D.C. (1987). Facilitating treatment adherence. New York: Springer.

Parker, I. (Ed.). (1999). Deconstructing psychotherapy. New York: Routledge.

Pedersen, P. B. (1997). The cultural context of the American Counseling Association code of ethics. Journal of Counseling and Development, 76, 23-29.

Pomerantz, A. M. (1984). Agreeing and disagreeing with assessments: Some features of preferred/dispreferred turn shapes. InJ. M. Atkinson &J. Heritage (Eds.), Structures of social action: Studies in conversation analysis (pp. 57-101). Cambridge, UK: Cambridge University Press.

Rose, N. (1990). Governing the soul: The shaping of the private self. New York: Routledge.

Roy-Chowdhury, S. (2006). How is the therapeutic relationship talked into being? Journal of Family Therapy, 28, 153-174.

Sacks, H. (1995). Lectures on conversation (2 vols.). Oxford, UK: Oxford University Press.

Sacks, H., Schegloff, E., & Jefferson, G. (1974). A simplest systematics for the organization of turn-taking for conversation. Language, 50, 696-735.

Sampson, E. E. (1993). Celebrating the other: A dialogic account of human nature. Toronto, ON: Harper Collins.

Schön, D. (1983). The reflective practitioner: How professionals think in action. New York: Basic Books.

Selekman, M. D. (2005). Pathways to change: Brief therapy with difficult adolescents (2nd ed.). New York: Guilford.

Shotter,J. (1975). Images of man in psychological research. London: Methuen & Co.

Shotter.J. (2006). 'Getting it': Withness-thinkingand thedialogical in practice. Unpublished manuscript.

Silverman, D. (2004). The construction of 'delicate' objects in counselling. In M. Wetherell, S. Taylor, & S. J. Yates (Eds.), Discourse theory and practice: A reader (pp. 119-137). London: Sage.

Starker, S. (2002). Oracle at the supermarket: The American preoccupation with self-help books. Vancouver, BC: University of British Columbia Press.

Strong, T. (2003). Engaging reflection: A training exercise using conversation and discourse analysis. Counselor Education and Supervision, 43, 65-77.

Strong, T. (2005). Understanding 'understanding': An upclose examination of client and counselor discourse, and the experience of understanding in counseling. British Journal ofGuidance and Counseling, 33, 513-533.

Strong, T., Busch, R. S., & Couture, S. (in press). Conversational evidence in therapeutic dialogue. Journal of Marital and Family Therapy.

Strong, T., & Pare, D. (Eds.). (2004) Furthering talk: Advances in the discursive therapies. New York: Kluwer Academic/Plenum.

Strong, T., & Zeman, D. (in press) Dialogic considerations of "confrontation" in counseling: Micro-analyzing the use of a microskill. Journal of Counseling and Development.

Swim, S., St. George, S. A., & Wulff, D. P. (2001). Process ethics: A collaborative partnership. Journal of Systemic Therapies, 20, 14-24.

ten Have, P. (1999). Doing conversation analysis. Thousand Oaks, CA: Sage.

WalterJ. L., & PellerJ. E. (1992). Becoming solution-focused in brief therapy. New York: Brunner/Mazel.

Wang, J. (2006). Questions and the exercise of power. Discourse & Soaety, 17, 529-548.

Watzlawick, P., BavelasJ. B., & Jackson, D. (1967). Pragmatics of human communication: A study of interactional patterns, pathologies, and paradoxes. New York: Norton.

Weingarten, K. (1992). A consideration of intimate and non-intimate interactions in therapy. Family Process, 31, 45-59.

White, M (2004). Folk psychology and narrative practice. In L. E. Angus & J. McLeod (Eds.), The handbook of narrative and psychotherapy (pp. 15-51). London: Sage.

Please address all correspondence to Dr. Tom Strong, Associate Professor, Registered Psychologist, Division of Applied Psychology & the Campus Alberta Applied Psychology: Counselling Initiative, Faculty of Education - University of Calgary, 2500 University Drive NW, Calgary, Alberta, Canada T2N 1N4 (Phone: 403-220-7770; Fax: 403-282-9244; E-mail:

Copyright Canadian Psychological Association May 2007
Provided by ProQuest Information and Learning Company. All rights Reserved

Make a free website with Yola