Monash Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University, North Ryde, New South Wales, Australia.
Fam Process. 2024 Mar;63(1):113-129. doi: 10.1111/famp.12852. Epub 2023 Jan 30.
Writings on Open Dialogue approaches to working with families experiencing mental distress emphasize the importance of the therapist repeating the family's words back to them verbatim. Repeats are theorized to display the therapist's listening and to encourage elaboration without imposing the therapist's own interpretations or conclusions on the family. These recommendations have not been subjected to rigorous interactional investigation. In this study, we used conversation analysis to analyze 160 examples of therapists repeating the prior talk of the family from 14 h of video-recorded Open Dialogue sessions. We found that these repeats had similar functions to those previously described in conversation analysis research such as initiating repair, marking receipt, and requesting elaboration as well as examples of therapist repeats occurring in overlap with the talk of the client. Open Dialogue writings thus present an oversimplified account of how repeats are utilized in clinical Open Dialogue sessions. Consistent with dialogical writings, repeats can elicit elaboration with limited input from the therapist, however repeats reflect selectivity and function to direct and guide the conversation to some extent. So, while therapist authority can be mitigated by repeating clients' words, when a therapist chooses to employ a repeat actively shapes the direction of the interaction.
关于开放对话方法处理经历精神困扰的家庭的文献强调治疗师逐字重复家庭话语的重要性。重复被认为可以展示治疗师的倾听，并鼓励家庭进一步阐述，而不会将治疗师自己的解释或结论强加给家庭。这些建议尚未经过严格的互动研究。在这项研究中，我们使用会话分析分析了 14 小时的开放对话会话视频记录中的 160 个治疗师重复家庭先前谈话的例子。我们发现，这些重复具有与会话分析研究中先前描述的相似功能，例如发起修复、标记接收和请求详细说明，以及治疗师重复与客户谈话重叠的例子。因此，开放对话文献对重复在临床开放对话中的使用方式的描述过于简单。与对话性文献一致，重复可以在治疗师输入有限的情况下引发详细说明，但是重复反映了选择性，并在一定程度上起到引导和指导对话的作用。因此，虽然治疗师通过重复客户的话语可以减轻其权威，但当治疗师主动选择使用重复时，它会主动塑造互动的方向。
