HUMSS - Anssi Peräkylä

Evolvement of patient-clinician relationship in psychiatry

Using conversation analysis of video recorded data, I will describe the evolvement of the patient-clinician relationship in psychiatric assessment process.  Such process takes place after the patient has come into contact with psychiatric services; its aim is to find the diagnosis and to decide about the proper treatment. In the university clinic that I have been studying, such processes involve 5-10 interviews between the patient and the clinicians.  I am engaged in a case study of the assessment process of one patient who eventually gets a diagnosis of personality disorder.  In this case, the clinician patient relationship oscillates between moments where the patient and the clinicians share concern for the patient’s problematic behaviours, and moments when the patient distances herself from the clinicians’ moral world for example by means of laughter and claims of non-agency. In particular, I focus on the interactional negoatiations through which patient’s engagement and accountability emerge, or fail to emerge, in this process.