The use of why questions in child and adolescent mental health assessments

Authors

  • Nikki Kiyimba University of Chester, UK
  • Khalid Karim The Greenwood Institute, UK
  • Michelle O’Reilly The Greenwood Institute, UK

DOI:

https://doi.org/10.1558/rcsi.30280

Keywords:

questions, children, qualitative, conversation analysis, assessment, mental health

Abstract

Questions form the basis of mental health assessments and yet there is limited empirical evidence about the linguistic structure of question formats in these clinical environments. While many types of questions are used, the focus of this research was on why-prefaced questions asked to children. Interaction analysis was employed to interrogate the data, paying specific attention to the interactional organisation of how ‘why-prefaced’ questions were asked and responded to. Analysis demonstrated that when three core components were present in the question, then it was usual for a reason/ explanation to be provided in response, and when one or more components were missing, it rarely elicited a reason or explanation in response. The three components were; the sequential position of the question, how the question was indexically tied to the child’s prior statement, and the epistemic domain of the question. Implications for therapeutic communication and training were discussed.

Author Biographies

  • Nikki Kiyimba, University of Chester, UK

    Nikki Kiyimba is a senior lecturer and programme lead for MSc in therapeutic practice for psychological trauma at the University of Chester. Nikki is also a Chartered Clinical Psychologist working in private practice. She works clinically with both adults and children and has research interests in child and adolescent mental health and trauma. She has published several articles, and recently co-authored (with Michelle O’Reilly) a book on engaging in mental health research with children and adolescents, Doing Mental Health Research with Children and Adolescents: A Guide to Qualitative Methods (Sage).

  • Khalid Karim, The Greenwood Institute, UK

    Khalid Karim is a consultant child and adolescent psychiatrist at Leicestershire Partnership NHS Trust, and a senior teaching fellow at the University of Leicester, the Greenwood Institute, UK. Khalid specialises in autism spectrum disorder, both in terms of clinical practice and in research. He also uses conversation analysis to examine autism and social interaction and has recently written a book chapter on a psychiatrist’s perspective on the value of conversation analysis.

  • Michelle O’Reilly, The Greenwood Institute, UK

    Michelle O’Reilly is a senior lecturer at the University of Leicester, the Greenwood Institute, UK. She works across the School of Media, Communication & Sociology, and the School of Psychology. Dr O’Reilly also provides research consultancy for clinical professionals within Leicestershire Partnership NHS Trust. She specialises in child mental health research as well as engaging in the pedagogical research of advanced qualitative research. She has recently co-edited two handbooks on discourse and conversation analysis and mental health with Jessica Lester.

References

Beauchamp, T. L. & Childress, J. F. (2001). Principles of biomedical ethics, 5th edn. Oxford: Oxford University Press.

Bolden, G. B. (2009). Implementing incipient actions: The discourse marker ‘so’ in English conversation. Journal of Pragmatics, 41(5), 974–998. https://doi.org/10.1016/j.pragma.2008.10.004

Bolden, G. & Robinson, J. (2011). Soliciting accounts with why-interrogatives in conversation. Journal of Communication, 61, 94–119. https://doi.org/10.1111/j.1460-2466.2010.01528.x

Buston, K. (2002). Adolescents with mental health problems: What do they say about health services? Journal of Adolescence, 25, 231–242. https://doi.org/10.1006/jado.2002.0463

Butler, C. W., Potter, J., Danby, S., Emmison, M. & Hepburn, A. (2010). Adviceimplicative interrogatives: Building ‘client-centered’ support in a children’s helpline. Social Psychology Quarterly, 73(3), 265–287. https://doi.org/10.1177/0190272510379838

Carey, T. & Mullan, R. (2004). What is Socratic questioning? Psychotherapy: Theory, Research Practice, Training, 41, 217–226. https://doi.org/10.1037/0033-3204.41.3.217

DeVoe, E. (2002). Questioning strategies in interviews with children who may have been sexually abused. Child Welfare, 81(1), 5–31.

Ehrlich, S., and Freed, A. (2010). The function of questions in institutional discourse: An introduction. In A. Freed and S. Ehrlich (eds), ‘Why do you ask?’: The Function of questions in insitutional discourse (pp. 3–19). Oxford: Oxford University Press.

Fox, B. A. & Thompson, S. A. (2010). Responses to wh-questions in English conversation. Research on Language and Social Interaction, 43(2), 133–156. https://doi.org/10.1080/08351811003751680

Givry, D. & Roth, W. M. (2006). Toward a new conception of conceptions: Interplay of talk, gestures, and structures in the setting. Journal of Research in Science Teaching, 43(10), 1086–1109. https://doi.org/10.1002/tea.20139

Grigg, M., Herrman, H., Harvey, C. & Endacott, R. (2007). Factors influencing triage decisions in mental health services. Australian Health Review, 31, 239–245. https://doi.org/10.1071/AH070239

Hartzell, M., Seikkula, J. & von Knorring, A. L. (2009). What children feel about their first encounter with child and adolescent psychiatry. Contemporary Family Therapy, 31, 177–192. https://doi.org/10.1007/s10591-009-9090-x

Hartzell, M., Seikkula, J. & von Knorring, A. (2010). Parent’s perception of their first encounter with child adolescent psychiatry. Contemporary Family Therapy, 32, 273–289. https://doi.org/10.1007/s10591-010-9119-1

Heritage, J. (2010). Questioning in medicine. In A Freed and S Ehrlich (eds), ‘Why do you ask’: The function of questions in institutional discourse (pp: 42–68). New York: Oxford University Press.

Hutchby, I. (2002). Resisting the incitement to talk in child counselling: aspects of the utterance ‘I don’t know’. Discourse Studies, 4(2), 147–168. https://doi.org/10.1177/14614456020040020201

Hutchby, I. & Wooffitt, R. (2008). Conversation Analysis, 2nd edn. Oxford: Blackwell Publishers.

James, I., Morse, R. & Howarth, A. (2010). The science and art of asking questions in cognitive therapy. Behavioural and Cognitive Psychotherapy, 38, 83–93. https://doi.org/10.1017/S135246580999049X

Jefferson, G. (2004). Glossary of transcript symbols with an introduction. In G. H. Lerner (Ed.), Conversation analysis: Studies from the first generation. Amsterdam: John Benjamins, pp. 13–31. https://doi.org/10.1075/pbns.125.02jef

Jordan, B. & Henderson, A. (1995). Interaction analysis: Foundations and practice. Journal of the Learning Sciences, 4(1), 39–103. https://doi.org/10.1207/s15327809jls0401_2

Karim, K. (2015). The value of conversation analysis: A child psychiatrist’s perspective. In M. O’Reilly and J. N. Lester (eds), The Palgrave handbook of child mental health: Discourse and conversation studies (pp. 25–41). Basingstoke: Palgrave Macmillan. https://doi.org/10.1057/9781137428318_2

Koshik, I. (2003). Wh-questions used as challenges. Discourse Studies, 5, 51–77. https://doi.org/10.1177/14614456030050010301

Koshik, I. (2005). Beyond rhetorical questions: Assertive questions in everyday interaction. Philadelphia, PA: John Benjamins. https://doi.org/10.1075/sidag.16

Mash, E. J. & Hunsley, J. (2005). Special section: Developing guidelines for the evidence-based assessment of child and adolescent disorders. Journal of Child and Adolescent Psychology, 34, 362–379. https://doi.org/10.1207/s15374424jccp3403_1

Merikangas, K., Nakamura, E. & Kessler, R. (2009). Epidemiology of mental disorders in children and adolescents. Dialogues Clinical Neuroscience, 11, 7–20.

Nelson, T., Fleuridas, C. & Rosenthal, D. (1986). The evolution of circular questions: Training family therapists. Journal of Marital and Family Therapy, 12, 113–127. https://doi.org/10.1111/j.1752-0606.1986.tb01629.x

O’Reilly, M., Karim, K., and Kiyimba, N. (2015). Question use in child mental health assessments and the challenges of listening to families. British Journal of Psychiatry Open, 1(2), 116–120. https://doi.org/10.1192/bjpo.bp.115.001503

Pomerantz, A. (1980). Telling my side: ‘Limited access’ as a ‘fishing’ device. Sociological Inquiry, 50, 186–198. https://doi.org/10.1111/j.1475-682X.1980.tb00020.x

Sacks, H. (1992) Lectures in conversation (ed. G. Jefferson). Oxford: Blackwell.

Sands, N. (2004). Mental health triage nursing: An Australasian perspective. Journal of Psychiatric Mental Health Nursing, 11, 150–155. https://doi.org/10.1111/j.1365-2850.2003.00697.x

Schegloff, E. A. (1986). The routine as achievement. Human Studies, 9(2–3), 111–151. https://doi.org/10.1007/BF00148124

Stafford, V., Hutchby, I., Karim, K. & O’Reilly, M. (2016). ‘Why are you here?’ Seeking children’s accounts of their presentation to child and adolescent mental health services. Clinical Child Psychology and Psychiatry, 21(1), 3–18. https://doi.org/10.1177/1359104514543957

Stivers, T. & Robinson, J. (2006). A preference for progressivity in interaction. Language in Society, 35, 367–392. https://doi.org/10.1017/S0047404506060179

Thompson, L. & McCabe, R. (2016). ‘Good’ communication in schizophrenia: A conversation analytic definition. In M. O’Reilly & J. N. Lester (eds), The Palgrave handbook of adult mental health: Discourse and conversation studies (pp: 395–418). Basingstoke: Palgrave Macmillan. https://doi.org/10.1057/9781137496850_21

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Published

2017-12-18

Issue

Vol. 1 No. 2 (2017)

Section

Articles

License

© Equinox Publishing Ltd.

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How to Cite

Kiyimba, N., Karim, K., & O’Reilly, M. (2017). The use of why questions in child and adolescent mental health assessments. Research on Children and Social Interaction, 1(2), 222-242. https://doi.org/10.1558/rcsi.30280

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