merran toerien

Recommendations can be implied by asserting some generalisation about a treatment’s benefit without overtly directing the patient to take it. Focusing on a collection of assertions in UK neurology consultations, this paper shows that these are overwhelmingly receipted as “merely” doing informing and argues that this is made possible by their ambiguous design: their relatively depersonalised formats convey that the neurologist is simply telling the patient what’s available, but the link made between the treatment and the patient’s condition implies that it will be of benefit. Thus, assertions, while stopping short of telling the patient what to do, are hearable as recommendation relevant. This delicates balance leaves it up to the patient to respond either to the implied or on-record action (recommending vs. informing). When treated as “merely” doing informing, assertions defer the decision point until the neurologist has done something more. Three main interactional functions of this are identified as follows: (i) indicating the existence of a solution to a concern, without making a decision relevant next; (ii) orienting to the patient’s right to choose; and (iii) making “cautious” recommendations.

This paper reports findings from the first study based on recordings of advisory interviews with benefits claimants in the United Kingdom.  Previous econometric analysis found that programmes for unemployed people delivered through private sector Employment Zones (EZs) were more effective than their public sector equivalents, delivered through Jobcentre Plus (JCP).  However, little was known about what occurred on the frontline.  In this paper, we describe a conversation analytic comparison of 40 EZ and 48 JCP interviews, showing that EZ and JCP advisers typically adopted different ‘interactional styles’.  We illustrate the five features that characterised the EZ ‘style’, arguing that they offer an important part of the explanation for the EZs’ outperformance of some JCP programmes.  Given their systematic patterning, we also argue that these differences are not best explained at the individual level.  Nevertheless, we conclude that there is no principled reason for the practices id...

This study investigates patient resistance to doctors' treatment recommendations in a cross-national comparison of primary care. Through this lens, we explore English and American patients' enacted priorities, expectations, and assumptions about treating routine illnesses with prescription versus over-the-counter medications. We perform a detailed analysis of 304 (American) and 393 (English) naturally occurring treatment discussions and conclude that American and English patients tend to use treatment resistance in different prescribing contexts to pursue different ends. While American patients are most likely to resist recommendations for non-prescription treatment and display an expectation for prescription treatment in these interactions, English patients show a high level of resistance to recommendations for all types of treatment and display an expectation of cautious prescribing. These behavioral trends reflect broader structural forces unique to each national context ...

ABSTRACT We report on a study commissioned by the UK government of the ways in which advisers conduct mandatory interviews with unemployment benefits claimants. Among other results, we identified practices in soliciting claimants’ job goals and job plans that were more, or less, effective in achieving desired outcomes during these interactions. Moreover, we found that making a calculation of how much better off a claimant would be by retaining some benefit and working part-time was ineffective. Our reports, recommendations, and presentation to officials of the Department of Work & Pensions were acknowledged to have influenced policy changes concerning Jobcentre service delivery. Data are in British English.

Women's body hair removal is highly normative across contemporary western cultures. Nevertheless, little is known about the production and maintenance of this norm. Drawing on qualitative survey data from 678 women in the UK, this study offers two explanations: First, hairlessness and hairiness are predominantly constructed as positive and negative alternatives, respectively. Consequently, the ‘options’ to depilate, or not, are unequally weighted. Second, should a woman fail to depilate, she is likely to be subject to interactional sanctions. These exact a social price for being hairy, and serve to ‘enforce’ the depilation norm. Depilation is, then, shown to be a matter not merely of personal preference, but of conforming to a social norm reflecting an imperative to ‘improve’ the body. Taking a feminist perspective, this study understands the depilation norm as an instance of the ‘policing’ of women's bodies within a narrow ideal of social acceptability.

The principle of personalisation is widespread across the UK's public sector, but precisely what this means is unclear. A number of theoretical typologies have been proposed but there has been little empirical study of how personalisation is translated into practice on the frontline. We address this gap through analysis of a unique dataset: over 200 audio and video recordings of work-focused interviews in Jobcentre Plus offices. Through detailed analysis of these recordings, we show that personalisation reflects two key dimensions: the substantive (what advisers do) and the procedural (how they do it). We illustrate these dimensions, showing how each represents a continuum, and propose a typology of personalisation in practice, reflecting how the dimensions interact. We conclude with some thoughts on the relevance of our findings for advisory practice in the future under the Coalition government's new Work Programme.

A report of research carried out by the Social Policy Research Unit and the Department of sociology/the Centre for Advanced Studies in Language and Communication and at the University of York on behalf of the Department for Work and Pensions ... © Crown Copyright 2010. ...

ABSTRACT This article examines the use of just-formulated advisings in ordinary, naturally occurring sequences of unsolicited advice giving when produced in response to troubles-tellings. Drawing on two examples from our broader collection, we demonstrate that such advisings are employed in response to advice resistance and function to minimize proposed courses of future action, attenuating their imposing nature. We show they place an interactional bind upon advice recipients that contributes toward further resistance. This article explicates this bind and its categorial, epistemic, and moral implications. Data are in American and British English.

Wanting to get married is, from one feminist perspective, like enjoying a piece of porn: intellectually, you can deride both as patriarchal, (hetero)sexist and a moment of collusion in your own oppression; yet a recalcitrant part of you is still turned on . . . Or so it seems to us as we grapple with the practical, personal and ideological dilemmas facing a feminist couple contemplating marriage; we still seem to be in knots . . . We have been to three white weddings this summer. The first was a formal Christian affair with a lively social club reception, the second a (largely) nonreligious service in a Welsh manor house surrounded by fields. The third, held in a chapel in the New Forest, entailed an adapted Christian ceremony and a lavish reception complete with piano accompaniment. At each wedding, the presumed inevitability of heterosexual marriage was apparent in the repeated banter about when it would be ‘our turn’. Despite protestations that we ‘did not believe in marriage’, we found ourselves enjoying each occasion; as David Wilson (1996) quipped: ‘Given that [we] were attending the chief ceremony of patriarchal oppression, everybody seemed to be bearing up remarkably bravely’ (p. 196). However, amidst the free food, dancing and imagining what it would be like if we were the principle players, each ceremony also sparked a new twist in our long-standing debate on the (im)possibility of feminist heterosexual marriage. A typical strand of our debate runs something like this:

Background We report follow-on research from our previous qualitative analysis of how neurologists offer patients choice in practice. This focus reflects the NHS’s emphasis on ‘patient choice’ and the lack of evidence-based guidance on how to enact it. Our primary study identified practices for offering choice, which we called ‘patient view elicitors’ (PVEs) and ‘option-listing’. However, that study was not designed to compare these with recommendations or to analyse the consequences of selecting one practice over another. Objectives To (1) map out (a) the three decision-making practices – recommending, PVEs and option-listing – together with (b) their interactional consequences; (2) identify, qualitatively and quantitatively, interactional patterns across our data set; (3) statistically examine the relationship between interactional practices and self-report data; and (4) use the findings from 1–3 to compare the three practices as methods for initiating decision-making. Design A mi...

Research on emotional labour in the workplace—including beauty salons—has relied on workers' reports of emotional labour; few researchers have examined workers' moment-by-moment workday experience to explicate the practices of emotional labour in action. Using conversation analysis (CA) of a single interaction between a client and a beauty therapist, we show how task-directed talk, and even aspects of the physical work itself, may be designed to perform a dual function: to complete, satisfactorily, the ...

From the earliest studies of doctor-patient interaction (Byrne & Long, 1976), it has been recognized that treatment recommendations may be expressed in more or less authoritative ways, based on their design and delivery. There are clear differences between I'm going to start you on X and We can give you X to try and Would you like me to give you X? Yet little is known about this variation, its contexts, or its consequences. In this paper, we develop a basic taxonomy of treatment recommendations in primary care as a first step toward a more comprehensive investigation. We take as our point of departure the observation that treatment recommendations such as those above represent not only different formulations but also different social actions. We distinguish five main treatment recommendation actions: pronouncements, suggestions, proposals, offers, and assertions. We ask: what are the main dimensions on which these recommendations vary and to what end? And what sorts of factors s...