Healthcare interaction as an expert communicative system
In this paper I argue that interaction – as a communicative system – is central not only to forms of everyday social encounters but also to professional-client relationships in institutional settings. The role language plays in these interactional trajectories has to go beyond the dichotomous <i>language as system</i> and <i>language as behaviour</i> divide, and focus on the phenomenon of interaction itself, but not necessarily reducing interaction to language practice. This means that as interaction analysts we can utilise linguistic insights when interpreting professional-client encounters, but not be limited by them. Healthcare interaction, as an institutional and professional site, can be seen as an expert communicative system, with complex variations – along different modalities – reflecting different specialities and participant frameworks. I focus here on the linguistic dimension in the counselling domain, where communicative expertise is to be conceptualised in terms of hybrid interactional competencies for the management of different initiation-response frames, including aspects of uncertainty, risk, self- and other-initiated diagnostic and prognostic scenarios. Interaction analysis – what I refer to as activity analysis – should take as its starting point the structural, interactional and thematic maps of whole encounters, while aligning with the agenda of the professionals and the clients in a given setting in order to make any findings uptake-oriented in practically relevant ways.