Healthcare interaction as an expert communicative system

In this paper I argue that interaction – as a communicative system – is central not only to forms of everyday social encounters but also to professional-client relationships in institutional settings. The role language plays in these interactional trajectories has to go beyond the dichotomous language as system and language as behaviour divide, and focus on the phenomenon of interaction itself, but not necessarily reducing interaction to language practice. This means that as interaction analysts we can utilise linguistic insights when interpreting professional-client encounters, but not be limited by them. Healthcare interaction, as an institutional and professional site, can be seen as an expert communicative system, with complex variations – along different modalities – reflecting different specialities and participant frameworks. I focus here on the linguistic dimension in the counselling domain, where communicative expertise is to be conceptualised in terms of hybrid interactional competencies for the management of different initiation-response frames, including aspects of uncertainty, risk, self- and other-initiated diagnostic and prognostic scenarios. Interaction analysis – what I refer to as activity analysis – should take as its starting point the structural, interactional and thematic maps of whole encounters, while aligning with the agenda of the professionals and the clients in a given setting in order to make any findings uptake-oriented in practically relevant ways.