Clinicians as communication partners: Developing a mediated discourse elicitation protocol

This article presents the development and piloting of a mediated discourse elicitation protocol. Grounded in situated theories of communication and informed by mediated discourse analysis, this protocol selectively samples familiar discourse types in a manner designed to preserve interactional aspects of communication. Critically, the mediated discourse elicitation protocol conceptualizes the entire session (not just targeted tasks) and both client and clinician talk (not just client monologues) as clinical/research data. Using situated discourse analysis techniques, we present two pilot sessions. Surprisingly, in the first session the clinician had difficulty shifting from a clinical stance (e.g., offering prompts, directing talk) to a reciprocal conversational stance during target communicative activities (e.g., being an audience to client narratives). Thus, we revised the protocol to better specify the clinician's dynamic role and conducted a second pilot session with strikingly different results. Broadly, these findings reveal that complex interactional discourse can be elicited in clinical settings and that mediated discourse analysis provides rich theoretical and methodological resources to empower clinicians in examining, accounting for, and flexibly shifting their discourse roles in order to better achieve clinical goals.