Expandable Responses: How Clients Get Prompted to Say More During Psychotherapy

Abstract

In this article, we analyze question–response sequences in couples therapy sessions and focus on clients' responses that are oriented to as expandable because they fail to address the therapist's questions in a manner that is relevant to the exigencies of the interactional tasks at hand. Given the importance of clients' narration of personal experience for therapy success, we examine the interactional resources used by therapists and clients to elicit expansion. We propose that the conversational organization of turn expansion is locally and sequentially organized such that participants orient to the response as expandable in their subsequent actions. Following Schegloff, Jefferson, and Sacks' (1977) work on repair, we distinguish between self-initiation and other initiation of expansion and self-completion and other completion of expansion. Expansion was found to unfold in 4 distinct ways: (a) self(client)-initiated self-expansion, (b) other(therapist/spouse)-initiated self-expansion, (c) self-initiated other expansion, and (d) other-initiated other expansion.

Notes

1 For all examples coded as “64-,” M = Mark, S = Stacey. For all examples coded as “23-,” D = Dave, L = Lisa. T = Therapist in all examples.

2 For a discussion of subsequent versions following invitations, offers, requests, and proposals, see Davidson (1984). For a discussion of subsequent versions following questions, see Heritage (1984, p. 248).

3 We view this example as occurring on the borderline between expansion and some other activity such as getting the responder to alter her or his response. This is so because L does not seem to want D to say more about why he does not know or why he does not think that there exist other obstacles. Instead, L seems to simply want D to provide another reason (i.e., obstacle) as to why he is not attending to her needs.

4 A discourse unit includes a word, group/phrase, clause, clause complex, or move.

5 We thank an anonymous reviewer for pointing this out to us.

6 Schegloff et al. (1977) noted that in some cases, “other initiations occur after a slight gap, the gap evidencing a withhold beyond the completion of trouble-source turn—providing an ‘extra’ opportunity, in an expanded transition space, for speaker of trouble-source to self-initiate repair” (p. 374). For a detailed discussion on the “withholding of other initiation,” see Schegloff et al. (1977, pp. 373–375).

7 We thank an anonymous reviewer for bringing this point to our attention. This reviewer also noted that these types of responses tend to index a common client strategy of avoiding answering.

8 The continuer mm hm seemed to be the one most commonly used by the therapists. For an example of “yeah” functioning as a continuer, see (4), line 460.

9 The sequential placement of these response tokens contrast with the one found in (6), which occurs immediately following the client's answer (i.e., at the first possible transition relevance place). Because these latter tokens are not preceded by a pause and realize terminal pitch, they also serve as acknowledgements of the speaker's prior talk.

10 Heritage and Raymond (2005, p. 23) identified a similar conversational format in assessment sequences. Heritage and Raymond suggested that second assessments that delay an agreement of a first assessment through a [confirmation] + [agreement] turn format index upgraded rights to claim knowledge.

11 Although we found many instances of other expansions in which the therapist reformulated the client's prior talk, we felt that these instances were constitutive of an activity different from getting the client to say more (see Muntigl, 2004a, and Antaki, Barnes, & Leudar, 2005, for a comprehensive description of therapist reformulations). For instance, in the activity during which therapists would reformulate client's talk, there were no interactional resources that pointed to interactional trouble, nor did it seem that the participants were mainly oriented to providing the client with extra opportunities for speaking. Instead, the reformulation seemed to point to a different activity in which the therapist's take on what was said was being put under focus.

12 There is mixed indexicality in L's expansion such that she goes on as if it were D's continuation of his turn but does not use the first-person reflexive myself nor first-person I, indicating that the expansion is realized within L's role as speaker.

13 Sacks's (1992) example of a collaboratively produced sentence in group therapy is as follows:

Joe:	=	(cough) We were in an automobile discussion,
Henry:	=	discussing the psychological motives for
Mel:	=	drag racing on the streets. (pp. 144–145)