Abstract
Relationship management is part and parcel of social interaction, especially in institutional helping settings. Linguistic studies have delved into practices of relationship management in organized helping, but most of them are confined to the particularities of certain helping formats (e.g. Locher and Thurnherr, 2017; Locher and Schnurr, 2017; Thurnherr, 2022; Zayts and Schnurr, 2014). What is missing from previous research, however, is a contrastive and systemic examination of practices for managing relationships across various organized helping contexts. This volume therefore aims to address this gap by exploring how relationships are negotiated and built via (non-)verbal practices both in online and offline settings of helping professional interactions.
Revolving around micro- and meso-level discursive practices, this volume aims to capture the similarities and differences in how different helping formats construct relationships in interactions. The contributions investigate the process during which discursive practices are designed to initiate, regulate or repair a relationship. In other words, this volume addresses ‘the progressive dimension of relationship building’ (p. 11). Particularly worthwhile to note is that the contributions focus on how experts and laypersons address the intricacy of relationship management and the pursuit of their institutional goals in interactions. Comprising 14 chapters, the book is organized into four thematic parts, with the exception of the introduction (Chapter 1) and concluding remarks (Chapter 14). The introductory chapter by the editors sets the stage for relationship management research in organized helping conceptually, methodologically, and theoretically. Part I (Chapters 2–6) examines relationship building in various therapeutic interactions. Initially, in Chapter 2, Muntigl claims that the relationship between therapists and clients is an ongoing interactional achievement. He explores how therapists form closer or more distant bonds with clients by using personal or role references. Particularly, troubles-telling activities are brought to the fore, during which the therapist-client relationship can be strengthened or stressed as therapists affiliate with the clients or the clients oppose the therapists. Also discussed are some ways that therapists re-affiliate with clients when clients disagree with the therapists’ initial affiliative response. For instance, therapists can retreat from their initial position by withholding a response or give another formulation that describes the clients’ feelings.
In Chapter 3, Buchholz addresses the challenging problem of ‘larger chunks’, that is, ‘the question how details of narratives and conversation can be brought together not only in, but also between sessions, within the context of the working alliance’ (p. 14). He proposes two approaches. Firstly, Buchholz treats hesitation markers (e.g. ‘do you understand?’) as pointing to ‘tacit comparisons’ (Buchholz et al., 2021), claiming that only when the therapist compares two contrastive episodic memories can he/she propose a proper solution. Secondly, Buchholz puts forward a four-step recursive model of cooperation in psychotherapy. Specifically, the four steps are: (1) pointing to a conversational object; (2) addressing it; (3) connecting it with other conversational objects; and (4) forming a metaphor. Through this recursion, participants can achieve a high level of shared experience. In Chapter 4, Guxholli et al. show that therapists sometimes turn the focus of talk from others whom patients complain about, such as their friends and families, toward the patients’ selves by making referential shifts with questions like ‘What about you?’. Furthermore, different focus-of-talk questions may threaten patients’ face to varying degrees, ranging from carefully mitigated face-threats, mitigated face-threats to challenging face-threats. When facing such threats, patients are placed in a dilemma between saving their face and the therapeutic relation. Findings reveal that patients usually prioritize saving their own face but also, with considerable effort, attempt to save both. In Chapter 5, Pawelczyk and Faccio investigate how gender is sequentially managed in achieving therapy sessions’ goals and what relational practices are deployed in therapeutic relationship building. Female patients attempt to employ gender as category-sharing to explicate their actions and gain female therapists’ understanding. Therapists, however, resist such category-sharing while seeking to accomplish re-affiliation with patients. This chapter resonates with Chapter 2, both of which hold the similar view that ‘therapeutic relationship is an ongoing accomplishment interactionally crafted out of moments of affiliation and disaffiliation’ (p. 121). In Chapter 6, Kabatnik et al. examine the design and position of Solution-Oriented Questions (SOQs) that are defined as therapists’ verbal interventions to find solutions for patients’ problems (p. 131). Specifically, there are five SOQs that are designed to ask about the patients’ desires, ideas, concrete perspectives and goals, and they frequently occur at the end of topic development when patients display low agency with regard to the current problem. The deployment of SOQs helps stimulate the patients’ agency in searching for solutions to the problem and concurrently strengthens the therapist-client trustful relationship in psycho-diagnostic interviews.
Part II (Chapters 7–8) examines coach-client relationship building in coaching interactions. In Chapter 7, Winkler examines the construction of the clients’ semi-responsive answers with a conversation analysis manual and how these answers are responded to by the coaches in third position (TPA). Results show that even though the semi-responsive answers offer useful information, they also pose a challenge to the coaches, who strive to strike a balance between promoting the ongoing process and maintaining a harmonious relationship with the coachees. Moreover, what is particularly fascinating in this chapter is the application of the CA-grounded formal coding approach that is affirmed by Stivers (2015) and the software tool MAXQDA, which could be extremely helpful for CA researchers doing future quantitative studies. In Chapter 8, Graf and Jautz claim that ‘client design is an essential prerequisite for the working alliance’ (p. 190). They illustrate that client design is locally established in ongoing interactions, and concurrently the working alliance is a locally negotiated product in coaching. Specifically, the coaches deploy discursive practices to not only display their institutional positioning as coaches but also attune to the clients in initiating, negotiating, and managing the working alliance along the coaching process.
Part III (Chapters 9–11) investigates relationship management in medical encounters. In Chapter 9, Günthner shows that German oncologists can use address terms (i.e. post-positioned, pre-positioned, and pivotal address terms) as communicative practices to align and affiliate with cancer patients during oncological consultations. The address terms as ‘tie-signs’ (Goffman, 1974) help to construct the doctor-patient relationship in highly challenging institutional interactions. This finding contributes to the linguistic research on relationship work and the construction of physician-patient alliances in highly sensitive consultations. In contrast to Chapter 9, apart from address forms, attitudinal deixis and metapragmatic comments are identified as communicative devices to build doctor-patient relationships in Chapter 10. Kuna and Scarvaglieri show that Hungarian junior doctors and senior doctors adopt different communicative practices to present distinct communication styles in consultations. While senior doctors prefer a paternalistic style of communication, junior physicians gravitate toward patient-centered communication. The differences are considered to be shaped by the transformation of Hungarian society. In Chapter 11, Džanko finds that Bosnian patients and German patients deploy different interactional practices of knowledge management indexed by epistemics in medical consultations, thus leading to different doctor-patient relationships. Specifically, Bosnian patients’ display of limited epistemic access to their illness-related information results in interactional obstacles and misunderstandings, whereas German patients’ display of functional knowledge management contributes to an affiliative doctor-patient relationship.
Part IV (Chapters 12–13) concentrates on helping relationships on social media. In Chapter 12, Thurnherr found that requests can foster clients’ participation in email counseling. She identifies that requests can serve to (1) improve joint understanding; (2) foster reflection; (3) elicit solutions; and (4) elicit feedback. Nevertheless, it should be noted that if the recipients’ responses to requests are taken into account, there would be more illuminating findings. In Chapter 13, Kabatnik holds that Twitter can be a very useful medium for individuals who suffer from depression in that patients can receive social support offered by the community under the hashtag #depression. Finally, in the ending chapter, six empirical dimensions of relationship research in organized helping are summarized by Scarvaglieri and Graf. Specifically, these dimensions are personal, linguistic and discursive, functional, temporal, medial, and identity.
Taken together, the volume can be acclaimed for its combined methods, multi-dimensional analysis, illuminating findings, as well as diversified helping discourse. First, it offers researchers a repertoire of methods (discourse analysis, conversation analysis, corpus-based analysis, interpersonal-pragmatic approach, etc.) to explore relationship building in health settings (therapeutic and medical encounters) and non-health settings (executive coaching). Secondly, it demonstrates multi-dimensional analysis, such as longitudinal studies (Chapter 10), comparative studies (Chapter 11), and corpus-based studies (Chapter 13), which adds to the existing literature on relationship management in organized helping. Thirdly, this volume presents findings of relationship building in helping professions among various countries (Germany, Hungary, Bosnia, Switzerland, etc.), which is helpful and enlightening for researchers conducting comparative research to examine whether the findings are true to other countries. Specifically, Chapter 10 shows that different types of doctor-patient relationships result from Hungarian societal changes. Whether the finding is restricted to Hungary or not, there is an urgent need to do a comparative study of healthcare communication in other countries. Finally, it is a comprehensive volume that addresses both face-to-face medical encounters and e-health communication, with implications for capturing differences between online and offline interactional practices of relationship management.
Practically, this volume’s findings provide guidance for therapists, coaches, and physicians to strike a balance between establishing affiliative relationships with their clients and pursuing institutional goals. Theoretically, this volume enriches relationship building from the perspectives of interpersonal pragmatics, conversation analysis, discourse analysis, pragmalinguistics, and linguistische Gesprächsanalyse. Overall, it is an immensely valuable contribution for practitioners and linguistic researchers interested in expert-layperson relationships in helping professions.