Guest, Malinda Jayne (2012) Treatment Recommendations: A Discursive Approach. Coursework Masters thesis, University of Southern Queensland. (Unpublished)
Abstract
This thesis applied discursive psychology to explore how treatment recommendations are interactionally accomplished in real-life psychological consultations. Clients typically respond to treatment recommendations with either acceptance or resistance. Previous research has found that resistance is seen by health professionals as a problematic client behaviour that contributes to negative treatment outcomes. For instance, health professionals have been found to alter, reverse or provide elaborate explanations for their treatment recommendations when faced with client resistance (see Bischoff & Tracey, 1995; Karno & Longabaugh, 2005). While these studies have identified the problematic nature of client resistance, they did not investigate how resistance is discursively accomplished in actual consultations. It was not clear how resistance was interactionally achieved between health professional and client.
Data used in this thesis consisted of three video recorded psychologist-client consultations. Analysis supported previous research (e.g., Stivers 2005a; 2006) in that a normative treatment recommendation phase was evident. This involves the psychologist proposing a treatment recommendation and then only when the client displays acceptance of the recommendation, does the psychologists change topic or move onto the next activity within the consultation. Analysis also revealed that resistance is collaborative process that involves both the client and psychologist. It appears that both parties orient to resistance which is again similar to Stivers (2006) findings. An unexpected finding of this research was that before a treatment recommendation is produced it appears that a warm up pre-treatment phase is entered into. This then leads to the actual treatment recommendation phase. With both the warm up pre-treatment and actual recommendation phases clients can engage in active and passive resistance.
A limitation of the findings of this study is that only psychological consultations were analysed. These findings may be idiosyncratic in that they may only apply to psychological consultations. This study may have been improved by analysing more consultations from a variety of treatment facilities and clinical populations.
This research demonstrates the importance of discourse and how it is situated, oriented to, and constructed in when a psychologist implements a treatment recommendation. This knowledge provides psychologists with an understanding of how resistance can influence treatment recommendations and shape therapeutic outcomes. This understanding may lead onto the better development and formulated treatment recommendations.
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| Item Type: | Thesis (Non-Research) (Coursework Masters) |
|---|---|
| Item Status: | Live Archive |
| Additional Information: | Current UniSQ staff and students can request access to this thesis. Please email research.repository@unisq.edu.au with a subject line of SEAR thesis request and provide: Name of the thesis requested and Your name and UniSQ email address |
| Faculty/School / Institute/Centre: | Historic - Faculty of Sciences - Department of Psychology (Up to 30 Jun 2013) |
| Supervisors: | Andrea Lamont-Mills |
| Qualification: | Master of Psychology (Clinical) |
| Date Deposited: | 01 Oct 2025 23:35 |
| Last Modified: | 01 Oct 2025 23:35 |
| Uncontrolled Keywords: | psychological consultation ; treatment recommendation ; client behaviour ; bias |
| Fields of Research (2008): | 17 Psychology and Cognitive Sciences > 1799 Other Psychology and Cognitive Sciences > 179999 Psychology and Cognitive Sciences not elsewhere classified |
| Fields of Research (2020): | 52 PSYCHOLOGY > 5299 Other psychology > 529999 Other psychology not elsewhere classified |
| URI: | https://sear.unisq.edu.au/id/eprint/52373 |
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