Patient Education and Counseling 88 (2012) 196–202

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Patient Education and Counseling

journal homepage: www.elsevier.com/locate/pateducou

Communication Study

Clients as conversational agents

Helen F. Massfeller *, Tom Strong
Educational Studies in Counselling Psychology, University of Calgary, Calgary, Canada

A R T I C L E I N F O A B S T R A C T

Article history: Objective: Conversational agency is our invented term that orients us to ways in which clients participate
Received 11 May 2011 in therapeutic dialogues. In this study we examined how clients’ conversational correctives and
Received in revised form 22 March 2012 initiatives influenced collaborative therapeutic consultations.
Accepted 27 March 2012
Methods: Thirty-five single-session lifestyle consultations were videotaped in which adult clients
volunteered to discuss concerns of non-clinical severity with a counselor. We discursively
Keywords: microanalyzed excerpts where clients initiated topic shifts or corrected counselor misunderstandings
Conversational agency
and how counselors responded to them.
Psychotherapy
Discourse analysis
Results: Clients were actively involved in co-managing conversational developments during the
consultations. They influenced the content and course of the conversations with the counselors by
correcting, interrupting, or speaking from positions contrary or unrelated to those of the counselors.
Conclusion: Clients observably influenced the conversational agenda through their correctives and
initiatives if counselors were responsive during face-to-face consultations.
Practice implications: Clinicians should demonstrate increased sensitivity and relational responsivity by
intentionally engaging with clients’ agentive contributions to consultative dialogues.
ß 2012 Elsevier Ireland Ltd. All rights reserved.

1. Introduction metaphors [8], such conversation may be reduced to an information

Many views exist on what it means to appropriately engage
clients in counseling conversations. The extent to which clients
should be involved in shaping the counseling process can call into
question what counseling is. Beyond being a provider of
information and a willing recipient of professional directives the
role of the client is often depicted passively, unless the client is
seen as resistant. Client participation in counseling is frequently
described as being managed by counselors [1], a stance inviting
Foucault’s [2] stinging criticism that professionals need docility
from clients to help them. Some suggest that a profession-
centeredness can override clients’ involvement in shaping the
counseling process even with client-centered counselors [3]. In
such circumstances, a kind of deference by clients can result,
driving client intentions and responsiveness underground [4]. In
contrast, some counselors depict clients as ‘‘co-managers’’ of the
counseling process [5,6] or ‘drivers’ of that process [7].
Regardless of how clients’ participation in therapeutic dialogues
is described by counselors of different orientations to practice,
counseling is a process involving conversation. Depending on one’s
* Corresponding author at: 2500 University Drive NW, EdT 320, Educational
Studies in Counselling Psychology, University of Calgary, Calgary, Canada.
Tel.: +1 403 220 3866; fax: +1 403 282 9244.
E-mail address: hfmassfe@ucalgary.ca (H.F. Massfeller).
exchange and a medium for prescribing directives. But, it can also be
seen as a negotiated process of therapeutic accomplishments
conversationally worked up between client and counselor [9].
Our view of counseling is dialogically focused on what clients do in
talking with counselors, and we draw from discourse theory and
analyses [10–12].
Since the 1980s, hermeneutic and social constructionist views
of meaning and dialogue have found their way into counseling
approaches [13–15]. The conversational practices of these
approaches have sometimes been described as collaborative and
generative [16] in processes and outcomes seen as negotiated
between client and counselor [17]. ‘‘Dialogic’’ has been a central
construct in depicting how client and counselor negotiations elicit
and include client-preferred meanings and developments [5,6,18–
22]. Despite this stance, counselors have been ambivalent over
how the process expertise of the counselor should guide
counseling according to counselor maps [14,23] or intentions
[24]. For example, the questions counselors ask are seen as one
way for speakers to exercise control of any dialogue [25–27], or
intervene in the counseling process [28].
A tension can arise for counselors out of these new views on
meaning and dialogue. Specifically, what stance should counselors
bring to managing emergent developments in the immediacies of
their dialogues with clients? A new kind of client-centeredness has
been advocated [7,29]; one which arguably tilts such conversa-
tional management away from counselors. However, such a stance

0738-3991/$ – see front matter ß 2012 Elsevier Ireland Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.pec.2012.03.014
 H.F. Massfeller, T. Strong / Patient Education and Counseling 88 (2012) 196–202
runs counter to traditional professional expectations regarding the
counselor as the process or conversation manager. Our approach to
conversation management is micro-analytic and informed by
conversation analysis and ethnomethodology [9,10,25,26]. We pay
close attention to what occurs within the dialogues counselors
have with clients as they take turns talking. This micro-focus helps
us observe consequential conversational moves made by the client
or counselor in departing from prior talk (correctives), and in
shaping new directions for where the conversation may head
(initiatives). In the language of discursive psychologists, Edwards
and Potter [10], this is how the stakes of the developing dialogue
are negotiated.
The ‘stakes’ in counseling include insights that Rennie brought
to light in his qualitative research into clients’ experiences of
counseling – including their deference to counselors controlling
the conversational agenda and its emergent developments
[4,30,31]. Our view of these stakes is that, while shaped by larger
cultural and institutional factors [3,24,27], they are negotiated, but
typically with an asymmetric tilt in the direction of the counselor
[25,30]. Therefore, we feel a close examination of how particular
developments are negotiated in client–counselor dialogues is
warranted. In particular, we are interested in specific instances
where clients observably shape counseling’s conversational
agenda, disrupting the flow of dialogue with conversational moves
that show them taking the conversational agenda back from
counselors, in ways counselors are responsive.
2. Methods
The conversational data of this project was obtained over three
years at the University of Calgary. This research involved single-
session lifestyle consultations wherein adult volunteer ‘clients’
(n = 35) met with counselors who had graduate training and
supervision in dialogic counseling approaches. Individuals with
concerns of a clinical severity were referred to other services.
Thirty-five consultations of approximately 1 h in duration were
videotaped, and the range of issues included career, relationship
and stress concerns. No participants were seen more than once and
no attempt was made to either standardize these consultations or
evaluate the quality or equivalence of clients’ experiences in the
consultations. After data collection for this larger study was
complete, we approached the research ethics board at our
university for approval to re-examine our conversational data,
to look at how clients observably shaped the conversational
agenda in ways to which counselors became collaboratively
responsive. Ethics approval was granted and we report on our
secondary discourse analyses of this conversational data, to
examine passages where clients demonstrated correctives and
initiatives in the corpus of data.
The videotaped consultations were reviewed for particular
passages where, in Rennie’s terms [4], disjunctions in counselor–
client discourse observably occurred. Our analyses primarily focus
on two kinds of disjunctions: places where clients ‘corrected’ their
counselor and places where clients attempted to change (initia-
tives) the conversational topic. The frequency of such disjunctions
was rare (on average 1–2 times per consultation, and primarily
corrections). We chose such passages of dialogue as instances of
clients’ conversational agency to see how counselors responded to
what some might see as a conversational and professional role
reversal [see 1]. We were also interested in how such client
initiatives shaped, however momentarily, the consultative dialo-
gues they were having with counselors.
Our discursive analyses [10,32,33] of the consultations were
facilitated by the use of the ‘‘Transana’’ (Version 2.20) software
program [34]. This program uses a split-screen format, permitting
simultaneous transcription and analyses of digitized, audiovisual
197
passages of conversation. The transcribed micro-details enable
slow-motion (to tenths of a second) attention to empirical
developments in speakers’ responsive turn-taking. The assump-
tions behind our adaptation of conversation analysis [32] are that
speakers use their words and other paralinguistic features of talk to
negotiate and accomplish social outcomes as they talk [10,35,36].
We were interested in how (or if) passages of consultative
dialogue, involving a client’s corrective or initiative, had influenced
the course of dialogue for both client and counselor. Empirically,
what mattered to us is how clients and counselors observably
negotiate a language of understanding and action in the responsive
immediacies of their talking. For Garfinkel [37], such empirical
attention to ‘‘conversation’s shopfloor’’ can help make important
features of otherwise taken-for-granted aspects of counseling
‘‘instructably observable’’. Our discursive analyses focus on some
general features, and on some heuristic exemplars that we feel
show that ‘‘shopfloor’’ sense of how clients were conversationally
agentive.
3. Results
From general reviews of passages of client initiatives and client
correctives we noted some recurring ways clients exhibited agency
in the conversations:
1. A disjunction resulted between the counselor and client as they
talked.
2. The client then corrected or rejected the counselor’s response.
3. The client countered the counselor with her or his corrective
response, or with some initiative to differently go forward in the
conversation.
4. The client and counselor conversationally built on the client’s
corrective response, or client’s initiative.
This overview exemplifies the client’s departures from the
counselor’s discourse, in an initial disjunctive response, followed
by a change in discourse by both client and counselor (i.e., in the
client’s discourse). Most writing about therapeutic discourse offers
third party accounts with little sense of the relational immediacies
involved when client and counselor talk. In solution-focused and
narrative counseling approaches (i.e., those approaches used in our
research) one working assumption is that clients are agentive in
the change process [16]. In our view such claims should be evident
in how counselor and client negotiate their consultations – in an
observable ‘give and take’.
The following passage shows the turn-by-turn negotiations of
dialogue between a client (C) and counselor (T). Readers should
note that the transcribed passage aims to capture more than words
spoken, but also what we have been describing as the relational
immediacies, or performative dynamics, in how client and
counselor responded to each other (see transcript symbols in
Appendix A).
In Exemplar 1 a client and counselor discuss what it is like to be
in a long-distance relationship. The client’s agency is evident from
the outset (line 1). The client asks the counselor to repeat what she
said, ‘‘I’m kinda not really getting the gist of it’’ (lines 3–4). The
counselor suggests that she may have misinterpreted the client
(line 7). The use of ‘‘but I (.)’’ in line 7 discursively marks [38] the
counselor restating her interpretation of the client’s utterance
(over lines 7–17). Worth noting is how the counselor locates
herself in the utterance, by using the first person ‘‘I’’ as if she is
‘walking in the shoes’ of the client. In attempting to speak for the
client, the counselor meets an emphatic client rejection: ‘‘Oh" I
don’t see it that way at all::’’ (line 18). A dialogic disjunction results
until the client counters with, ‘‘>when I go back it’s not going
198 H.F. Massfeller, T. Strong / Patient Education and Counseling 88 (2012) 196–202

Table 1 to<(.) it (.) it might stay the same::" or it might get worse#’’ (lines
Corrective dialogue.
24–25).
Line #Speaker At line 22, the counselor initially responds to this client
1 C Can you say that again?"[ utterance, and later incorporates the client’s words ‘‘If you go::
2 T [Well[ back?’’ (line 26) which the client then responds, ‘‘If I move back#’’
3 C [I’m kinda not really getting the gist (line 27). The counselor extends this client response, by talking
4 of it about the client’s long-distance relationship, again in a first person
5 T During the begin[
(i.e., the client’s) voice. However, in contrast to the counselor’s
6 C [that last part {sniffed}
7 T Maybe I missed something but I (.) when when you brought it utterances in lines 7–17, she expresses professional cautiousness
8 up"(.1) this is just how I interpreted what you were saying" [41] as she tentatively shifts conversational footing between lines
9 C Okay" 28 and 37. This shift can be seen in a downgrade from her former ‘‘I
10 T was that (.) this distance" (.) you know
understand’’ to ‘‘>I hope I understand<’’ in line 28 and 29 followed
11 C Uhuh
12 T >they’re in Nova Scotia<I want to move back home"
by checking in with the client such as line 37’s ‘‘Right?’’ Such
13 C Uhuh tentativeness is sometimes deployed to show that a counselor’s
14 T >because I’m really excited about this relationship we’re utterance is offered in ways that are potentially contestable and
fostering revisable for clients [22].
15 here<(.) and maybe you could get to this really great place if I
The weak client uptakes in response to the counselor at lines 31,
16 was home you know and talk (.2) sort of talking like the
distance" 33 and 35, however, fail to deter the counselor from resuming her
17 is hindering that relationship from developing" earlier rhetorical strategy of speaking ‘for’ the client: ‘‘But when
18 C Oh" I don’t see it that way at all:: you first posed the question it was like (.) I want to move::" back
19 T Okay
home#’’ (lines 37–38). This ‘but’ prefaced utterance is again
20 C I don’t see the distance as (.) keeping our relationship from
getting
countered by the client, ‘‘>Here is where I should pick it up<’’ (line
21 better 39), showing the counselor his preference for how he wants to be
22 T Okay understood. The counselor then cedes the conversational floor to
23 C Not at all:: I (.1) I know" that the relationship that we have right the client who elaborates on wanting to ‘‘go home’’ in lines 39–60.
24 now (.) >when I go back it’s not going to<(.) it (.) it might
The speakers shift conversational footing to offer ‘‘acknowledge-
stay the
25 same::" or it might get worse# ment tokens’’ [32] in response to the unfolding co-narrative. Such
26 T If you go:: back" acknowledgment tokens are crucial to speakers’ efforts to share
27 C If I move back# what they are saying [39]. By lines 61–66 the counselor has
28 T Because I (.) I understand (.) I understand how (.) >I hope I
abandoned her earlier rhetorical practice and fully joined in
29 understand<how:: ahem:: it’s really (.) the relationship has
30 become (.) it’s grown to this new closeness
extending the client’s narrative about the paradoxical nature of his
31 C Uhuh long-distance relationship.
32 T because of your (.) In Exemplar 2 the counselor and client are discussing the
33 C Uhuh client’s plan for flying in an aeroplane and are negotiating a metric
34 T your experience
for evaluating the client’s experience – a solution-focused
35 C Uhuh
36 T of moving here (.) and we’ve talked a bit about how that intervention known as scaling [40]. A disjunction arises at the
37 developed" Right? But when you first posed the question it was start of this corrective sequence when the client emphatically
38 like (.) I want to move::" back home# states that ‘two’ is equivalent to ‘a maximum’ (line 1). The
39 C >Here is where I should pick it up<The reason" I feel that counselor’s response of ‘five’ (line 2) is clearly contested (i.e.,
way is
40 when I go home# I see that my parents are aging (.) I see that
corrected) by the client who ‘‘stands her conversational ground’’
41 they’re not the youthful people that they used to be in my (.) and persistently states ‘‘no" a two’’ (line 3). Then the client pauses
when and tentatively proposes ‘‘maybe I misunderstood’’ (line 3) thus
42 I (.) PHYSICALLY So when I go home my (.) what comes over creating space for the counselor to modify her response. The
43 me is the feeling that you know your parents are going to die"
counselor suggests what ‘five’ should mean to the client (line 4).
44 someday so if I’m out here and something should happen
45 T Uhuh The client rejects this apparent conversational strait jacket by
46 C its like I feel like there is time where I could have been there and correcting the counselor again and moderating the extreme
47 spent with them (.) so it’s more of a thing of (.) you know (.) position taken up by the counselor in lines 2 and 5. Instead the
48 knowing their time is limited (.) you know" I mean you know client states tenaciously ‘‘no I’m not worried to death’’ (line 5). The
49 generally speaking you know parents usually die before their
50 children (.) you know or (.2) so it’s a matter of (.) when I finish
counselor’s ‘okay’ denotes a shift towards the client (line 6) where
51 school for example (.2) >it’s not really right now"<but when I she shows her acceptance of the client’s evaluation with respect to
52 finish school should I move back there a proposed ceiling of ‘‘five’’ for the scale as she proceeds more
53 T Uhuh tentatively. The client actively negotiates the scale’s metric and the
54 C because I feel like (.) you know (.) >sometimes I don’t really
evaluation she would give herself on the negotiated scale. With a
think
55 about how they’re getting older<and I wouldn’t want to have re ceiling or upper limit negotiated for the scale, there remains a floor
56 (.1) I wouldn’t want to have any kind of regrets as far as when I to be talked through. Line 7 shows the client agreeing with the
57 had this opportunity (.) and let’s say I could have got a good job counselor’s qualitative indicators of a floor of ‘‘zero’’ (‘‘no worry
58 back there, maybe in Halifax or something whatsoever’’), and then offers her self-evaluation: ‘‘Yeah: I’m not at
59 T Right
60 C with this degree, why did I pass up that opportunity" Let’s
zero::"’’. Linell [12] points out that dialogue has an emergent
61 T There’s a real paradox going on here because if you didn’t move quality and speakers make sense of what is going on as they are
62 away talking together. This is a very active negotiation or co-construc-
63 C Uhuh tion of both a scale (to assess the client’s relative fears of flying) and
64 T and as you continue to have that distance, you’re (.1) you’re
the evaluations made possible by using the scale. Without the
65 appreciating that relationship and the grow (.1) the closeness is
66 growing client’s active and persistent participation in this negotiation, and
the counselor’s willingness to incorporate the client’s correctives,
the dialogue would have been unproductive. They achieve a more
coordinated dialogue in lines 9–12. Their scaling dialogue finds a
 H.F. Massfeller, T. Strong / Patient Education and Counseling 88 (2012) 196–202 199

Table 2 it’s way (.) a lot more complicated and I am not entirely sure which
Corrective dialogue.
one" (.hh) I feel most strongly about’’ (lines 1–3). Here, rather than
Line # Speaker the client, it is the counselor that does not know the agenda the
1 C Thoughts like ahem:: (.2) at:: a maximum a two client is working from [41]. The counselor responsively suggests
2 T So it would be a five" that the client has ‘‘different directions’’ (line 5) their conversation
3 C No" a two (.) so ahem:: (.5) I’m sorry >maybe can move toward. The client in turn latches onto the counselor’s
I misunderstood< suggestion (‘‘that’s correct’’, line 6) and ‘‘that’s right’’ (lines 9, 11).
4 T Five" is the top that’s if you worry most
What follows shows the client and counselor not only negotiating
5 C No I’m not worried to death
6 T Okay (.1) and (.) and zero is minimal (.) no words but a conversational footing [42] of shared understandings
worry whatsoever from which both can continue. The counselor continues to act
7 C Yeah: I’m not at zero::" tentatively, ‘‘So" (3.0) why don’t you begin" wherever it kind of
8 T Okay
makes sense ta (.) ta (.) begin in (.) in (.) that kind of conversation’’
9 C Ahem:: but I’m sort of at one or two
10 T One or two"
(lines 14–15) waiting for the client to move the agenda forward. At
11 C Yeah" this juncture in the conversation the client disrupts the conversa-
12 T Okay tional flow by declining the counselor’s invitation, observably
13 C Just because of the numbers of (.) and you know taking back the conversational agenda from the counselor. The
people flying (.)
client proceeds to negotiate space in the conversation by posing her
14 you know
15 T Uhuh okay own question (line 18), an unusual and powerful conversational
16 C We’ll have our masks" hopefully so I think it’s (.) move for clients [27]. As a consequence of this asymmetrical
a little closer to participation (lines 22–29) a role reversal of sorts occurs with the
17 one
counselor now responding to the client’s initiative and question.
18 T So shall we say one" Would that be appropriate"
19 C Okay" yeah:
The client declares that she would have ‘‘no problems dominating
the whole hour"’’ (line 23). During this negotiation the counselor
remains responsive to how the client is shaping the talk and
resolution (lines 16–19) when they observably agree that the client responsively designs her utterances to advance the client’s stated
is rating her subjective experience as ‘one’ on the scale. Notably the agenda. The client continues to hold the conversational ‘‘shopfloor’’
counselor seeks confirmation that the client’s evaluation is fitting, enlisting the counselor’s collaboration in a manner that is
by using the pronoun ‘‘we’’ in line 18 (‘‘so shall we say one" would inconsistent with how the client and counselor interaction is
that be appropriate"’’). typically viewed (lines 27–29).
In this early passage from a consultation (Exemplar3) we see a
client trying to find a dialogue focus and a responsive counselor Table 4
Corrective dialogue.
conversationally working with the client to move from this initial
tentativeness to a more robust discussion topic. The client begins Line #Speaker
with a disjunctive upgrading response to the counselor ‘‘it feels like 1 T Yeah"
2 C One of the days.
Table 3 3 T Okay# Ahemm"
Initiative dialogue. 4 C So you are saying it doesn’t sound so bad actually but
you know
Line # Speaker
5 what"
1 C After I guess# It feels like it’s way (.) a lot more complicated 6 T It’s all relative {laughing}
and I 7 C Yeah" I know" {laughing}
2 am not entirely sure which one" (.hh) I feel most strongly 8 T No.
about or 9 C I think what bothers me more I guess when I get down# to
3 anything like that so::[ it is that
4 T [So you have some choices you have a 10 I (3.0) I don’t know (.) is my lack of discipline with these
5 sense that there’s different directions that[ things and
6 C [That’s correct[ 11 feeling upset with myself that I (.2) don’t stick with what
7 T [you can (.hhh) I
8 go[ 12 >started wanting to do.< That’s probably it as much
9 C Yeah that’s right as anything
10 T and so just kind of pulling things together and[ 13 and maybe" (.hh) you know, it applies to some other areas
11 C ]That’s right of my
12 T Okay# Okay# 14 life as well.
13 C Yeah 15 T Right
14 T So" (3.0) why don’t you begin" wherever it kind of makes 16 C I don’t think that is the only one (.) but I think it fits ahem::
sense ta (.) if I
15 (.) ta (.) begin 17 was able to develop whatever that mindset is that says it’s not
16 C [Okay"] 18 only worth it but you actually carry through with the
17 T in (.) in (.) that kind of conversation actions (.) I
18 C Right okay ahem:: (.1) >well a question I have" too 19 think it would be a real boost to my own confidence and
< when I was my own
19 seeing this as exploring these different types of methods or 20 sense of (.) having some control" ahem:: (.hhh) you know not
20 whatever 21 letting things just happen" so I think it is a little bit of
21 T Uhuh a (.2) almost
22 C are the things that (.2) that ahem:: (.1) like I feel I could just 22 a symbol >I think in a way<
23 {laughs} I have no problems just dominating this whole hour" 23 T The exercise (.2)
24 T {laughs} 24 C Well"
25 C >Should I be concerned about that at all"< 25 T is a symbol of (.2) discipline#
26 T No 26 C of (.3) being fol (.) following through on commitments
27 C >You’ll get what you want out of this"< I made to
28 T I will 27 myself"
29 C Okay good" 28 T Okay#
200 H.F. Massfeller, T. Strong / Patient Education and Counseling 88 (2012) 196–202
Exemplar 4 demonstrates a feature of what Ferrara [43]
described as good therapeutic discourse, dialogue where clients’
and counselors’ words, corrections and initiatives become
‘‘interwoven’’. In such occurrences, the client’s corrections or
initiatives seldom pose a problem for the counselor or the working
alliance. Our interest is with the counselor’s flexibility in response
to such emergent client contributions to the dialogue. In the
exemplar above, there are several examples of client collaborative
completions. The client offers a mild corrective to the counselor on
the fourth and fifth line (‘‘but you know what"’’). The counselor
joins in articulating this corrective (‘‘It’s all relative’’) in ways the
client readily and laughingly accepts. The counselor’s line 8 ‘‘No’’
elicits a six line disclosure from the client; one that seems difficult
to put into words (note the long 3 second pause on line 10). A
counselor acknowledgment token (line 15) elicits a further seven
lines of talk (16–22) that extend the client’s unfolding narrative in
lines 9 through 14 in which the client identifies a potential resource
(‘‘a mindset’’) relevant to changes she wants to make. This kind of
conversational work is common in the social constructionist
therapies [16,45], where the interview is seen to help clients
identify and mobilize what they, rather than the counselor, find
useful to their change efforts (lines 20, 22–24).
4. Discussion and conclusion
4.1. Discussion
The purpose of this study was to focus attention on clients’
contributions to the course and content of consultative dialogue, to
look beyond a role-bound account of client and counselor
interaction. We micro-analyzed how clients actively co-managed
conversational developments in face-to-face consultations with
counselors. Our interactional analyses made evident what escapes
notice when studying speakers in isolation [42]. Thus, our micro-
analyses put pragmatic and conversational ‘legs’ on client agency,
in ways more abstractly described by Mackrill [45], or retrospec-
tively accounted for by Rennie’s [4] clients.
Clients co-managed the stakes of counseling by using conver-
sational practices such as correcting, interrupting, proposing new
topics, or speaking from positions contrary or unrelated to those of
their counselor. In effect, clients’ use of such conversational
practices place counselors in the role of responding to the client’s
correctives and initiatives, not the other way around, as is
commonly thought.
What these passages revealed is an improvised dynamism of
consultative dialogue, more than what normally is captured in the
crisp prosaic transactions of textbooks where client-counselor
dialogue is featured. Seen dialogically, this is where counseling
goes ‘off-script’ in interactions Schön [46] referred to as
transactional, or that Shotter [47] described as relationally
responsive. For ethnomethodologists [36,37] this is where
conversation becomes improvised in ways that can feel like role
violations, or that require different counselor responses, not unlike
what Strong [48] has described as ‘discursive flexibility’.
Within the discursively oriented therapies, such as narrative
and solution-focused approaches, a collaborative negotiation of
meaning and conversational process has become an important
ethic of practice [e.g., 22]. Responding to clients’ conversational
initiatives or correctives involves more than just ceding the
conversational floor to clients, or stalling for time before bringing
clients back to the counselor’s conversational agenda. Such
initiatives and correctives can inform an active negotiation of
meaning and process that we see as preference animated; for
example, in how post-consultation ‘homework’ is talked about
[49], in how understandings with counselors are arrived at [48],
and even in how counselors ‘confront’ clients [50].
In most depictions of counseling, clients are seen to furnish
aims and concerns while the counselor responds with process or
conversation management [1]. In modest ways we have drawn
attention to where clients have responded in ways that contest,
through corrections and unsolicited initiatives, how such typical
counselor prerogatives are conversationally exercised. Why such
attention matters to us relates to tensions counselors can feel
regarding how much their own initiatives and correctives of clients
should guide or inform the counseling process.
If the therapeutic dialogue is treated as binary - that counselors
should either control the conversational agenda or not – this can
upset the delicate balance that clients remind us of with initiatives
and correctives like those in our study. At worst, a counselor can
‘hijack’ the conversational agenda, putting their meanings or
management of the counseling process ahead of what matters for
clients [51]. However well-intended counselors may be; they can
momentarily feel justified in ignoring the kinds of correctives and
initiatives shown by our clients. A sense that clients have digressed
or deviated from what was earlier agreed to can, for example,
bolster a counselor’s persistence with a particular conversational
agenda, often successfully [52]. Conversely, we are not suggesting
counselors abandon their role in these negotiations either. Even
self-identifying client-centered counselors clearly shape counsel-
ing’s process and meanings [52]. Approached as a delicate
negotiation [53], in which clients’ initiatives and correctives are
welcomed, we see clients’ correctives and initiatives as important
resources in informing collaboration in counseling, something
many clients want [31,32,44].
We can only offer heuristically warranted claims of clients’
conversational agency. The consultations our ‘clients’ participated
in were, by design, non-clinical in nature and offered by counselors
who self-identified as practitioners of social constructionist
models of therapy, for which negotiation of meaning and
conversational practice are normal [5,16]. So, we have presented
instances of clients’ conversational agency in a context where that
agency was welcomed. Therefore, the broader question of whether
clients want a similar say in clinical discussions with counselors
using more prescriptive diagnostic and intervention protocols was
beyond our scope.
4.2. Conclusion
We have offered preliminary evidence of clients’ agentive
participation in face-to-face consultative dialogues that merits
further consideration and research. Our analyses suggest that
clients can make consequential contributions to counseling
through their correctives and initiatives [54] – if counselors are
responsive. Our microanalyses showed conversational junctures
where clients observably influenced the conversational agenda
with their counselors. For counselors interested in enhancing their
collaborative ways of practice with clients, our findings invite
closer consideration of what Duncan and Miller [7] have described
as ‘resistance-informed’ practice. We see clients’ correctives and
initiatives in this light, as emergent indications that our counseling
has gotten ‘off-track’ [14,30] for them.
4.3. Practice implications
A more nuanced kind of client-centeredness in counseling than
that which Carl Rogers [55] originally articulated has emerged in
recent years [7,56]. Where Rogers envisioned particular conditions
provided by counselors to promote such client-centeredness,
discursively oriented researchers and practitioners [9,10,17] see
such conditions literally talked ‘into being’ [57] between client and
counselor. Of course, it is not just the counselor’s talking that
accomplishes such conditions. So, following our analyses, we invite
 H.F. Massfeller, T. Strong / Patient Education and Counseling 88 (2012) 196–202
counselors to orient more closely to clients’ correctives and
initiatives as response-worthy contributions to collaborative
dialogue with clients. For Ferrara [43], good therapeutic discourse
oscillates between junctures where differences between client and
counselor are negotiated in ways that require conversational work
– and in other passages where one finds a fluid ‘interweave’ of
counselors’ and clients’ words and ways of talking. We have
focused on clients’ conversational work in these negotiations,
making ‘‘instructably observable’’ how they might contribute to
any consultation’s developments [37]. We have raised an aspect of
counseling that can fly below the conversational radar of many
counselors and hope our research prompts increased sensitivity
and responsiveness in engaging clients’ agentive contributions to
consultative dialogue.
Funding
This research was funded by a grant from the Social Sciences
and Humanities Research Council of Canada to the second author.
Ethics approval
Conjoint Faculties Research Ethics Board, University of Calgary,
Acknowledgements
We would like to thank the participants who agreed to be video-
taped for the purposes of this study and a special thanks to Murray
Anderson for his help with data management.
Appendix A
Transcription notation
Symbol Indicates
(.) A pause which is noticeable but too short to measure.
(.5) A pause timed in tenths of a second.
= There is no discernible pause between the end of
a speaker’s utterance
and the start of the next utterance
: One or more colons indicate an extension of the preceding
vowel sound.
Underline Underlining indicates words that were uttered with
added emphasis.
CAPITAL Words in capitals are uttered louder than surrounding talk.
(.hhh) Exhalation of breath; number of h’s indicate length.
(hhh) Inhalation of breath; number of h’s indicates length.
() Indicates a back-channel comment or sound from previous
speaker that
does not interrupt the present turn.
[ Overlap of talk.
(()) Double parenthesis indicates clarificatory information, e.g.
((laughter)).
" Indicates rising inflection.
# Indicates falling inflection
! Indicates animated tone.
. Indicates a stopping fall in tone.
** Talk between * * is quieter than surrounding talk.
>< Talk between > < is spoken more quickly than
surrounding talk.
{} Non-verbals, choreographic elements.
Source: Kogan [58].
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