Advertisement

Clients’ Practices for Resisting Treatment Recommendations in Japanese Outpatient Psychiatry

  • Shuya KushidaEmail author
  • Yuriko Yamakawa
Chapter
  • 17 Downloads
Part of the The Language of Mental Health book series (TLMH)

Abstract

Clients’ orientation to professional authority has been proposed as a way to explain their reluctance to participate actively in medical decision-making. This study describes some of the practices clients use to resist psychiatrists’ treatment recommendations in outpatient psychiatric consultations in Japan. It focuses on how the clients’ resistance practices influence the way the psychiatrist proceeds with the decision-making. The data analysis shows that while clients consistently avoid intruding into psychiatrists’ professional authority, clients methodically navigate the decision-making sequence toward a decision that is sensitive to their preference and concerns. This study argues that clients exert agency in treatment negotiations through practices to resist recommendations, and that these practices can be regarded as important opportunities for enhancing client participation in decision-making.

Keywords

Resistance Client participation Agency Authority Medication adjustment Outpatient consultation Japan 

Notes

Acknowledgments

This study was funded by JSPS KAKENHI Grant Numbers 20200043, 21530496, 23330183, and 24530623.

References

  1. Adams, J. A., Drake, R. E., & Wolford, G. L. (2007). Shared decision-making preferences of people with severe mental illness. Psychiatric Service, 58(9), 1219–1221.CrossRefGoogle Scholar
  2. Angell, B., & Bolden, G. B. (2015). Justifying medication decisions in mental health care: Physicians’ accounts for treatment recommendations. Social Science and Medicine, 138, 44–56.CrossRefGoogle Scholar
  3. Angell, B., & Bolden, G. B. (2016). Team work in action: Building grounds for psychiatric medication decisions in assertive community treatment. In M. O’Reilly & J. Lester (Eds.), Handbook of adult mental health: Discourse and conversation studies (pp. 371–393). London: Palgrave Macmillan.Google Scholar
  4. Barton, J., Dew, K., Dowell, A., Sheridan, N., Kenealy, T., Macdonald, L., … Stubbe, M. (2016). Patient resistance as a resource: Candidate obstacles in diabetes consultations. Sociology of Health & Illness, 38(7), 1151–1166.Google Scholar
  5. Bolden, G. B., & Angell, B. (2017). The organization of the treatment recommendation phase in routine psychiatric visits. Research on Language and Social Interaction, 38(4), 451–479.Google Scholar
  6. Bolden, G. B., Angell, B., & Hepburn, A. (2019). How clients solicit medication changes in psychiatry. Sociology of Health & Illness, 41(2), 411–426.CrossRefGoogle Scholar
  7. Costello, B. A., & Roberts, F. (2001). Medical recommendations as joint social practice. Health Communication, 13(3), 241–260.CrossRefGoogle Scholar
  8. Deegan, P. E., & Drake, R. E. (2006). Shared decision making and medication management in the recovery process. Psychiatric Services, 57(11), 1636–1639.CrossRefGoogle Scholar
  9. De las Cuevas, C., & Peñate, W. (2014). Preferences for participation in shared decision making of psychiatric outpatients with affective disorders. Open Journal of Psychiatry, 4(1), 16–23.CrossRefGoogle Scholar
  10. Eliacin, J., Salyers, M. P., Kukla, M., & Matthias, M. S. (2014). Factors influencing patients’ preferences and perceived involvement in shared decision making in mental health care. Journal of Mental Health, 24(1), 24–28.CrossRefGoogle Scholar
  11. Frosch, D. L., May, S. G., Rendle, K. A. S., Tietbohl, C., & Elwyn, G. (2012). Authoritarian physicians and patients’ fear of being labeled “difficult” among key obstacles to shared decision making. Health Affairs, 31(5), 1030–1038.CrossRefGoogle Scholar
  12. Goss, C., Moretti, F., Mazzi, M. A., Piccolo, L. D., Rimondini, M., & Zimmermann, C. (2008). Involving patients in decisions during psychiatric consultations. The British Journal of Psychiatry, 193(5), 416–421.CrossRefGoogle Scholar
  13. Hamann, J., Leucht, S., & Kissling, W. (2003). Shared decision making in psychiatry. Acta Psychiatrica Scandinavica, 107(6), 403–409.CrossRefGoogle Scholar
  14. Heritage, J. (1984). A change-of-state token and aspects of its sequential placement. In J. M. Atkinson & J. Heritage (Eds.), Structures of social action: Studies in conversation analysis (pp. 299–345). Cambridge: Cambridge University Press.Google Scholar
  15. Joseph-Williams, N., Edwards, A., & Elwyn, G. (2014). Power imbalance prevents shared decision making. British Medical Journal, 348, g3178.CrossRefGoogle Scholar
  16. Koenig, C. J. (2011). Patient resistance as agency in treatment decisions. Social Science and Medicine, 72(7), 1105–1114.CrossRefGoogle Scholar
  17. Kushida, S. (2011). Confirming understanding and acknowledging assistance: Managing trouble responsibility in response to understanding check in Japanese talk-in-interaction. Journal of Pragmatics, 43(11), 2716–2739.CrossRefGoogle Scholar
  18. Kushida, S. (2015). Using names for referring without claiming shared knowledge: Name-quoting descriptors in Japanese. Research on Language and Social Interaction, 48(2), 230–251.CrossRefGoogle Scholar
  19. Kushida, S., Hiramoto, T., & Yamakawa, Y. (2016). Patients’ practices for taking the initiative in decision-making in outpatient psychiatric consultations. Communication & Medicine, 13(2), 169–184.CrossRefGoogle Scholar
  20. Kushida, S., & Yamakawa, Y. (2015). Fitting proposals to their sequential environment: A comparison of turn designs for proposing treatment in ongoing outpatient psychiatric consultations in Japan. Sociology of Health & Illness, 37(4), 522–544.CrossRefGoogle Scholar
  21. Kushida, S., & Yamakawa, Y. (2018). Steering interactions away from complaints about persistent symptoms in psychiatric consultations. East Asian Pragmatics, 3(1), 91–123.CrossRefGoogle Scholar
  22. Matthias, M. S., Salyers, M. P., Rollins, A. L., & Frankel, R. M. (2012). Decision making in recovery-oriented mental health care. Psychiatric Rehabilitation Journal, 35(4), 305–314.CrossRefGoogle Scholar
  23. Quirk, A., Chapin, R., Lelliott, P., & Seale, C. (2012). How pressure is applied in shared decisions about antipsychotic medication: A conversation analytic study of psychiatric outpatient consultations. Sociology of Health & Illness, 34(1), 95–113.CrossRefGoogle Scholar
  24. Schegloff, E. A. (1982). Discourse as an interactional achievement: Some uses of “uh huh” and other things that come between sentences. In D. Tannen (Ed.), Analyzing discourse (pp. 71–93). Washington, DC: Georgetown University Press.Google Scholar
  25. Stivers, T. (2005). Parent resistance to physicians’ treatment recommendations: One resource for initiating a negotiation of treatment recommendation. Health Communication, 18(1), 41–74.CrossRefGoogle Scholar
  26. Stivers, T. (2007). Prescribing under pressure: Parent-physician conversations and antibiotics. New York: Oxford University Press.CrossRefGoogle Scholar
  27. Stivers, T., Heritage, J., Barnes, R. K., McCabe, R., Thompson, L., & Toerien, M. (2017). Treatment recommendations as actions. Health Communication, 33(11), 1335–1344.CrossRefGoogle Scholar
  28. Stivers, T., & Rossano, F. (2010). Mobilizing response. Research on Language and Social Interaction, 43(1), 3–31.CrossRefGoogle Scholar
  29. Thompson, L., & McCabe, R. (2018). How psychiatrists recommend treatment and its relationship with patient uptake. Health Communication, 33(11), 1345–1354.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2020

Authors and Affiliations

  1. 1.Osaka Kyoiku UniversityKashiwaraJapan
  2. 2.Ibaraki Prefectural University of Health SciencesAmiJapan

Personalised recommendations