ABSTRACT
Rapport and cooperation are key features of many clinical interactions including those
of speech-language pathologists (SLPs) and clients. A desirable by-product of rapport
can be described as “engagement” where participants share a mutual focus while working
toward a common goal. Through an analysis of clinical discourse, this article maps
the trajectory of engagement as manifest in interactions between a SLP and a client
with right hemisphere damage and dysphagia. The analysis shows that, in response to
some apparently inappropriate comments made by the client, the SLP responded with
teasing or what she called “cajoling” behavior. Cajoling accompanied by humor and
laughter became the SLP's way of gaining and maintaining cooperation in this context.
Instead of such behavior being viewed as “unprofessional,” careful mapping of this
behavior across several interactions served to demonstrate its value in the ultimate
joint achievement of goals. Implications for how such constructions of engagement
may be manifest through talk in the SLP clinic are discussed.
KEYWORDS
Engagement - clinical discourse - cajoling - cooperation
REFERENCES
- 1 Collins English Dictionary. 9th ed. London, United Kingdom; Harper, Collins 2007
- 2
Plester B A, Sayers J.
“Taking the piss”: Functions of banter in the IT industry.
Humor.
2007;
20(2)
157-187
- 3 Straehle C A.
“Samuel?” “Yes, dear?”: Teasing and conversational rapport. In: Tannen D Framing in Discourse. Oxford, United Kingdom; Oxford University Press
1993: 210-230
- 4 Radcliffe-Brown A R. Structure and Function in Primitive Society. Foreword by Evans-Pritchard
EE, Eggan F. London, United Kingdom; Cohen & West 1952
- 5 Kovarsky D, Kimbarow M, Kastner D.
Group language therapy practice among adults with traumatic brain injury. In: Kovarsky D, Duchan J, Maxwell M Constructing (In) Competence: Disabling Evaluations
in Clinical and Social Interactions. Hillsdale, NJ; Erlbaum 1999: 292-312
- 6
Holmes J.
Politeness, power and provocation: how humor functions in the workplace.
Discourse Stud.
2000;
2(2)
159-185
- 7 Eggins S, Slade D. Analysing Casual Conversation. London, United Kingdom; Cassell
1997
- 8 DuPre A. Humor and the Healing Arts: A Multimethod Analysis of Humor Use in Healthcare. Mahwah,
NJ; Erlbaum 1998
- 9 Ragan S.
Sociable talk in women's healthcare contexts: two forms of non-medical talk. In: Coupland J Small Talk. London, United Kingdom; Longman 2000: 269-287
- 10
Simmons-Mackie N, Schultz M.
The role of humor in therapy for aphasia.
Aphasiology.
2003;
17(8)
751-766
- 11
Walsh I.
Small talk is “big talk” in clinical discourse: appreciating the value of conversation
in SLP clinical interactions.
Top Lang Disord.
2007;
27(1)
24-35
- 12 Goldberg S A. Clinical Skills for Speech-Language Pathologists. San Diego, CA;
Singular 1997
- 13 Logemann J A. Evaluation and Treatment of Swallowing Disorders. Austin, TX; Pro-Ed
1998
- 14
Blake M L, Duffy J R, Myers P S, Tomkins C A.
Prevalence and patterns of right hemisphere cognitive/communicative deficits: retrospective
data from inpatient rehabilitation unit.
Aphasiology.
2002;
16
537-547
- 15
Blake M L.
Clinical relevance of discourse characteristics after right hemisphere brain damage.
Am J Speech Lang Pathol.
2006;
15
255-267
- 16 Tannen D Framing in Discourse. Oxford, United Kingdom; Oxford University Press
1993
- 17 Bateson G. A theory of play and fantasy. Reprinted in Steps to an Ecology of Mind. New
York, NY; Ballantine 1972 [Original work published 1954]
- 18 Goffman E. Frame Analysis: An Essay on the Organization of Experience. London,
United Kingdom; Harper & Row 1974
- 19 Goffman E. Forms of Talk. Oxford, United Kingdom; Basil Blackwell 1981
- 20 Gumperz J J. Discourse Strategies. Cambridge, United Kingdom; Cambridge University
Press 1982
- 21 Fairclough N. Language and Power. London, United Kingdom; Longman 1989
- 22 Walsh I. Power-sharing in conversations with people with schizophrenia: Redressing
the asymmetry of healthcare discourse. Paper presented at: The Royal College of Psychiatrists'
Annual Meeting; July 2004; Harrogate, United Kingdom
- 23 Glenn P. Laughter in Interaction. Cambridge, United Kingdom; Cambridge University
Press 2003
- 24
Drew P.
Po-faced receipts of teases.
Linguistics.
1987;
25
219-253
- 25
Kovarsky D.
Discourse markers in adult controlled therapy: implications for child-centered intervention.
Journal of Childhood Communication Disorders.
1990;
13(1)
29-41
- 26 Holmes J, Stubbe M. Power and Politeness in the Workplace. A Sociolinguistic Analysis
of Talk at Work. London, United Kingdom; Logman 2003
- 27 Giles H, Coupland J, Coupland N.
Accommodation theory: communication, context and consequence. In: Giles H, Coupland J, Coupland N Contexts of Accommodation: Developments in Applied
Sociolinguistics. Cambridge, United Kingdom; Cambridge University Press 1991: 1-68
- 28 Tannen D, Wallat C.
Interactive frames and knowledge schemas in interaction: Examples from a medical examination/interview. In: Tannen D Framing in Discourse. Oxford, United Kingdom; Oxford University Press
1993: 57-76
Irene P WalshPh.D.
Department of Clinical Speech & Language Studies, 184 Pearse Street
Trinity College, Dublin, Ireland
Email: ipwalsh@tcd.ie
