ABSTRACT

Using both statistical methods and conversation analysis, we examined how support workers in a mental health rehabilitation community encourage clients to participate in joint decision-making processes. Drawing on video-recordings of 29 community meetings as data, we considered support workers’ proposals (N = 449) and clients’ responsiveness to them. Support workers’ proposals were coded for their linguistic and other features and clients’ responsiveness was assessed by three independent raters. Multiple linear regression (MLR) analysis was carried out. A significant regression equation with seven predictor variables accounted for 24% of the variance in the data. Four variables predicted a higher level of client responsiveness: the use of explicit recipient address term, “quasi-open” proposal form, support worker’s long work experience, and the average level of client participation during a session. Three variables predicted a lower level of client responsiveness: grammatical complexity of proposal form, modal declarative proposal form, and the presence of only one support worker in a session. The qualitative conversation-analytic investigation highlighted the advantages of the careful fine-tuning of openness vs. closedness of proposal form, the reflexive awareness of which, we argue, may help mental health professionals to encourage clients’ responsiveness in joint decision-making processes and thereby their participation in communal life.

摘要

我们使用统计方法和对话分析，研究了心理健康康复社区的支持人员如何鼓励客户参与联合决策过程。以 29 次社区会议的录像作为数据，我们考虑了支持人员的建议（N = 449）和客户对它们的响应。支持人员的建议根据其语言和其他特征进行编码，并且由三位独立评估者评估客户的响应能力。进行多元线性回归（MLR）分析。具有七个预测变量的显着回归方程占数据方差的 24%。四个变量预测了更高水平的客户响应：使用明确的收件人地址术语，“准开放”提案形式，支持工人的长期工作经验，以及会话期间客户参与的平均水平。三个变量预测了较低水平的客户响应：提案表格的语法复杂性、模态声明性提案表格以及会话中只有一名支持人员的存在。定性对话分析调查强调了对提案形式的开放性与封闭性进行仔细微调的优势，我们认为，反思性意识可以帮助心理健康专业人员鼓励客户在联合决策过程中的反应和从而他们参与公共生活。并且会话中只有一名支持人员在场。定性对话分析调查强调了对提案形式的开放性与封闭性进行仔细微调的优势，我们认为，反思性意识可以帮助心理健康专业人员鼓励客户在联合决策过程中的反应和从而他们参与公共生活。并且会话中只有一名支持人员在场。定性对话分析调查强调了对提案形式的开放性与封闭性进行仔细微调的优势，我们认为，反思性意识可以帮助心理健康专业人员鼓励客户在联合决策过程中的反应和从而他们参与公共生活。