Verbal exchange structure of general practice consultations with patients presenting psychological problems.

The consultations of 88 patients presenting with psychological problems to primary care medical practitioners were tape- recorded, coded, and factor- analyzed to identify their constituent verbal exchanges. A verbal exchange is a set of speech act categories that tend to occur together and are used for some subtask within an encounter. The verbal exchange structure of these consultations replicated that of previously studied medical consultations except that they had some distinctive features in common with previously studied psychotherapy sessions. Patient- centered exchanges called Social Exposition and Emotional Exposition, which may serve psychotherapeutic purposes, were relatively prominent in those consultations rated relatively positively by patients and by external raters.