Transitioning to the business of a session in collaborative-dialogic meetings: a conversation analysis

Psychotherapy meetings contain a transition from the opening phase of greetings/small-talk to the official business. We examine how this transition is managed by therapists and families following a collaborative-dialogic approach to family therapy. Using conversation analysis, we analysed the openings of 10 meetings from a public child and youth mental health service in Western Sydney, Australia. Therapists introduced the official business of the session using a turn characterised by pauses, re-starts, self-repairs, and a question form of “what would be useful/important to talk about?” In response, there was a lack of uptake from families as they negotiated both the topic and who would speak. Therapists responded by proposing topics that families could either accept or decline or by nominating the next speaker though gaze, thereby prompting that person to speak. While promoting family discussions about topics may have therapeutic utility though transferring responsibility from therapist to family, a more active speaker nomination by the therapist may minimise disruption and transition more quickly to therapeutic topics.