4.4) TECNICAS Y HERRAMIENTAS DE RECOGIDA DE DATOS

Evaluation is what Sarangi and Roberts (1999) refer to as a ‘critical site’ in client-therapist

interactions. As most evaluations occur immediately after clients complete a task, it is reasonable to assume heightened mutual orientation. Evaluations are also actions that emphasise the different roles of ‘client’ and ‘therapist’, as they are primarily produced by the SLT. Given these two aspects of evaluations, they are also sites where tensions between client perspectives and therapist

perspectives on progress of therapy are likely to be seen most clearly. Some of these tensions arise because of the ambiguous nature of many evaluations, while others relate to the centrality of speech and language to our notions of human self-hood (Taylor, 1985). Our sense of self-hood develops very early in childhood (Gee, 1985) and is partly sustained and modified through our interactions with different people in different contexts. Clearly then, there is a real potential for evaluations of client speech or language performances to be face-threatening.

Speech and language are uniquely human abilities. Any reduction in communicative competence has the potential to have significant negative impact on individual self-esteem and self-identity. Two of the patterns of evaluation identified in previous chapters attest to the ways in which SLTs orient to the potential impact of impairment on client identity. The frequent use of ambiguously indexical positive SCTs, prior to the initiation of a correction sequence, suggests SLTs are wary of the face-threatening potential of overt, more direct correction. The production of positive SLT evaluations that were designed to mitigate negative client evaluations is perhaps even more complex. These positive evaluations, as seen in chapter 7, do not deny the accuracy of client perspectives per se. However, by highlighting positive features of client performance, they suggest a desire to frame client performance in the highest possible positive light. I would go even further and argue that maintaining a positive frame around therapy seems more highly valued than clear descriptions of client performance; and that attention to client motivation and client self-image are more pressing concerns for SLTs than the degree to which the client understands the complex interplay of factors that might promote improvement.

It is partly through the action of evaluating that the SLT exerts control over the therapy task process. Evaluations mark the epistemic status of SLTs in that they provide opportunities for the display of expertise, and for control of activities, in so much as evaluations often mark the closure of one activity as a precursor to moving on to the next activity. Not surprisingly, the majority of evaluations are produced by the SLT, thus confirming the professional ‘right to know’ how well the client has performed, and when it is time to move on. Conversely, evaluations provide a valuable insight into the challenges facing clients in terms of understanding their own performances during therapy. Evaluations provide limited opportunities for client involvement. The closure-implicative nature of third-turn evaluations invariably terminates discussion of the task, thus limiting the client’s opportunity to discuss or disagree with the evaluation. Client responses to first-turn evaluations revealed that clients are not likely to extend discussion to details of their performance, and client evaluations in response to questions can result in SLTs countermanding the client’s views. The omnipresence of evaluation, which re-confirms the expert role of SLTs, may

inadvertently construct the client as passive (Kovarsky et al, 1999) and thus contribute to a process of disablement within the process of trying to ‘help’.

The focus of most talk in task-based therapy sessions is not on the achievement of inter-subjectivity, or the joint construction of meaning; it is on the accuracy of the talk vis-à-vis some kind of

benchmark. In therapy sessions focused on speech production, the talk of the client is something to be evaluated in terms of ‘how’ it is said, or in terms of some quality of what is said, seldom in terms of some interactional meaning. In therapy sessions focused on language, the talk of the client is something to be evaluated for what it shows about internal brain activities (comprehension,

semantic processing, memory, etc.) rather than for what the client contributes to the ongoing flow of talk. In both cases, talk is the site for professional judgement about speech or language

processing/production; the talk of the client is something to be modified or fixed rather than a joint area of attention. Thus, therapy tasks inherently focus on impairment. And yet there is an almost overwhelming silence in the data about the impairments with which clients present to therapy. The lack of overt reference to the impairment that brings the client into interaction with the SLT is intriguing. A communication impairment seems to be an example of an ‘elephant in the room’, an “obvious truth being ignored or going unaddressed” (Cambridge Dictionary, 2009:298).

Impairments of communication ability clearly represent ‘trouble’ for the client, and yet there were no features in the data of ‘troubles talk’ as defined by Jefferson (1988). The lack of overt reference to clients’ impairments is likely to link to the fact that none of the data sets involved interactions taken from the very start of a therapy relationship, and that the nature of impairment might become

‘common ground’ over the course of time. It is also plausible to suggest that the lack of any mention of difficulty might relate to a desire to support the maintenance of a client’s positive self- image (Goffman, 1967; Brown & Levinson, 1987). By saying little or nothing about the

impairment, SLTs are defusing any potential embarrassment that clients may have regarding their impairment. Social conventions, about how impairments (ailments, shortcomings, etc.) are referred to, are at play in shaping how people talk about problems of communication. Our communication skills enable us to participate energetically in the social construction of ‘who we are’ (social role/persona) and ‘what we are doing’ (social action) in interaction. It follows that social

conventions against overt discussion of the ways in which clients are not able to do something are powerfully at play in task-based therapy. The client’s impairment becomes almost invisible, at least in terms of any overt reference to it in the therapy interaction. This poses a clear dilemma for SLTs: if they regularly refer to the impairment, they run the risk of (re)constructing the client’s identity as one defined by the impairment; on the other hand, not mentioning it makes it harder to focus on changing the nature of the impairment, or on the possibility of the client learning to interact more fully despite the presence and nature of the impairment.