Linguistic Expert Creation in Online Health Practices

  • Marie-Thérèse Rudolf von RohrEmail author
  • Franziska Thurnherr
  • Miriam A. Locher


In this chapter, we explore how the construction of an expert identity varies across online e-health settings with different socio-technological features. Our methodology is qualitative in nature and draws on insights from discourse analysis and positioning theory. Results show four aspects of creating expertise: the embeddedness of the positioning strategies in the online health context, the interplay between these strategies within each setting, the interactivity of the medium, and the fact that professionals, clients, and laypeople alike construct their expertise. The results confirm previously found strategies to create expertise (e.g. using jargon or showing empathy), and reveal that the interplay of several strategies is in fact needed to create credible and trustworthy expert identities for all participants involved. This interplay varies according to the practice.



We wish to thank the Swiss National Science Foundation for funding the project ‘Language and Health Online’ (100016_143286/1) and especially the counselor and clients who consented to be part of this study. We also thank Patricia Bou-Franch and Pilar Garcés-Conejos Blitvich, who gave us the opportunity to present an early version of this work in Valencia at the first ADDA conference, and the reviewers for their constructive feedback.


  1. Armstrong, N., Koteyko, N., & Powell, J. (2011). ‘Oh dear, should I really be saying that on here?’: Issues of identity and authority in an online diabetes community. Health, 16(4), 1–19. Scholar
  2. Bigi, S. (2011). The persuasive role of ethos in doctor-patient interactions. Communication & Medicine, 8(1), 67–76.CrossRefGoogle Scholar
  3. Bucholtz, M., & Hall, K. (2005). Identity and interaction: A sociocultural linguistic approach. Discourse Studies, 7(4–5), 585–614.CrossRefGoogle Scholar
  4. Davies, B., & Harré, R. (1990). Positioning: The discursive production of selves. Journal for the Theory of Social Behaviour, 20(1), 43–63.CrossRefGoogle Scholar
  5. Eichhorn, K. C. (2008). Soliciting and providing social support over the Internet: An investigation of online eating disorder support groups. Journal of Computer-Mediated Communication, 14(1), 67–78. Scholar
  6. Ess, C., & the AoIR Ethics Working Committee. (2002). Ethical decision-making and Internet research: Recommendations from the AoIR Ethics Working Committee. Approved by AoIR, November 27, 2002. Retrieved from
  7. Fage-Butler, A.-M., & Jensen, M. N. (2013). The interpersonal dimension of online patient forums: How patients manage informational and relational aspects in response to posted questions. Hermes, 51, 21–38.Google Scholar
  8. Furedi, F. (2008). Medicalisation in therapy culture. In D. Wainwright (Ed.), A sociology of health (pp. 97–114). Los Angeles: Sage.CrossRefGoogle Scholar
  9. Green, J. (2010). Creating the therapeutic relationship in counselling and psychotherapy. Exeter: Learning Matters.Google Scholar
  10. Gross, A. (2015). Asymmetrie und (Patienten-)Expertise in der HIV-Sprechstunde. In A. Busch & T. Spranz-Fogasy (Eds.), Handbuch Sprache in der Medizin (pp. 282–299). Berlin and Boston: de Gruyter.Google Scholar
  11. Hall, K., & Bucholtz, M. (2013). Epilogue: Facing identity. Journal of Politeness Research, 9(1), 123–132. Scholar
  12. Harrison, S., & Barlow, J. (2009). Politeness strategies and advice-giving in an online arthiritis workshop. Journal of Politeness Research, 5(1), 93–111. Scholar
  13. Harvey, K., & Koteyko, N. (2013). Exploring health communication: Language in action. London: Routledge.Google Scholar
  14. Heaton, L. (2011). Internet and health communication. In M. Consalvo & C. Ess (Eds.), The handbook of internet studies (pp. 212–231). Malden, MA: Wiley-Blackwell.CrossRefGoogle Scholar
  15. Herring, S. C. (2007). A faceted classification scheme for computer-mediated discourse. Language@Internet, 4. Retrieved from
  16. Herring, S. C. (2013). Discourse in Web 2.0: Familiar, reconfigured, and emergent. In D. Tannen & A. M. Trester (Eds.), Georgetown University Round Table on languages and linguistics 2011: Discourse 2.0: Language and new media (pp. 1–25). Washington, DC: Georgetown University Press.Google Scholar
  17. Kouper, I. (2010). The pragmatics of peer advice in a LiveJournal community. Language@Internet, 7(article 1). Retrieved from
  18. Locher, M. A. (2006). Advice online: Advice-giving in an American Internet health column. Amsterdam: Benjamins.CrossRefGoogle Scholar
  19. Locher, M. A. (2010). Health Internet sites: A linguistic perspective on health advice columns. Social Semiotics, 20(1), 43–59. Scholar
  20. Locher, M. A. (2013). Internet advice. In S. Herring, D. Stein, & T. Virtanen (Eds.), Pragmatics of computer-mediated communication (pp. 339–362). Berlin: Mouton de Gruyter.Google Scholar
  21. Locher, M. A., & Hoffmann, S. (2006). The emergence of the identity of a fictional expert advice-giver in an American Internet advice column. Text and Talk, 26(1), 69–106. Scholar
  22. Markham, A., Buchanan, E., & the AoIR Ethics Working Committee. (2012). Ethical decision-making and Internet research recommendations from the AoIR Ethics Working Committee (Version 2.0). Retrieved from
  23. Morrow, P. R. (2006). Telling about problems and giving advice in an Internet discussion forum: Some discourse features. Discourse Studies, 8(4), 531–548.CrossRefGoogle Scholar
  24. NHS SmokeFree. Retrieved May 1, 2012, from
  25. No Smoking Day Stop Smoking Forum. Retrieved May 1, 2012, from
  26. Prior, L. (2003). Belief, knowledge and expertise: The emergence of the lay expert in medical sociology. Sociology of Health and Illness, 25, 41–57.CrossRefGoogle Scholar
  27. Richardson, K. P. (2003). Health risks on the internet: Establishing credibility on line. Health, Risk and Society, 5(2), 171–184.CrossRefGoogle Scholar
  28. Rudolf von Rohr, M.-T. (2015). “You will be glad you hung onto this quit”: Sharing information and giving support when stopping smoking online. In C. A. Smith & A. Keselman (Eds.), Meeting health information needs outside of healthcare: Opportunities and challenges (pp. 263–290). Waltham, MA: Chandos/Elsevier.CrossRefGoogle Scholar
  29. Rudolf von Rohr, M.-T. (2017). Persuasion in smoking cessation online: An interpersonal pragmatic perspective. Unpublished doctoral dissertation, University of Basel, Basel, Switzerland.Google Scholar
  30. Sarangi, S., & Clarke, A. (2002). Zones of expertise and the management of uncertainty in genetics risk communication. Research on Language and Social Interaction, 35(2), 139–171.CrossRefGoogle Scholar
  31. Seale, C. (2002). Media and health. London: Sage Publications.Google Scholar
  32. Seale, C. (2003). Health and media: An overview. Sociology of Health & Illness, 25(6), 513–531. Scholar
  33. Segal, J. Z. (2005). Health and the rhetoric of medicine. Carbondale: Southern Illinois University Press.Google Scholar
  34. Sillence, E. (2010). Seeking out very like minded others: Exploring trust and advice issues in an onlinc health support group. International Journal of Web Based Communities, 6(4), 376–394.CrossRefGoogle Scholar
  35. Sillence, E., & Briggs, P. (2015). Trust and engagement in online health: A timeline approach. In S. Shyam Sundar (Ed.), The handbook of the psychology of communication technology (pp. 469–487). Chichester: Wiley Blackwell.Google Scholar
  36. Sillence, E., Briggs, P., Harris, P., & Fishwick, L. (2006). A framework for understanding trust factors in web-based health advice. International Journal of Human-Computer Studies, 64(8), 697–713. Scholar
  37. Thurnherr, F., Rudolf von Rohr, M.-T., & Locher, M. A. (2016). The functions of narrative passages in three written online health contexts. Open Linguistics, 2(2), 450–470. Scholar
  38. Veen, M., te Molder, H., Gremmen, B., & van Woerkum, C. (2010). Quitting is not an option: An analysis of online diet talk between celiac disease patients. Health, 14(1), 23–40. Scholar
  39. Warnick, B. (2007). Rhetoric online: Persuasion and politics on the world wide web. New York; Bern etc.: Peter Lang.Google Scholar
  40. Wright, K. B. (2015). Computer-mediated support for health outcomes: Psychological influences on support processes. In S. S. Sundar (Ed.), The handbook of the psychology of communication technology (pp. 488–506). Chichester: Wiley Blackwell.Google Scholar
  41. Ziebland, S., & Wyke, S. (2012). Health and illness in a connected world: How might sharing experiences on the Internet affect people’s health? The Milbank Quarterly, 90(2), 219–249.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2019

Authors and Affiliations

  • Marie-Thérèse Rudolf von Rohr
    • 1
    Email author
  • Franziska Thurnherr
    • 1
  • Miriam A. Locher
    • 1
  1. 1.Department Language and LiteraturesUniversity of BaselBaselSwitzerland

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