Papers by Michelle O'Reilly
Research on Children and Social Interaction
This large volume encompasses a range of insights for those interested in the relationship betwee... more This large volume encompasses a range of insights for those interested in the relationship between text, talk, and social interaction and child mental health. As the editors highlight in their introduction, this handbook comes at a time when the World Health Organization estimates one in five children meet contemporary diagnostic criteria for mental health conditions. Mental health conditions, diagnoses and services are therefore either already playing a role in social lives of a significant minority of children, or have the potential to do so in the future. Understanding the social dimensions of this is critical. Contributions to the handbook include clinical perspectives and foundational research using critical, discourse or conversation analysis. Although the contributions are diverse, the sheer size of this volume means there are more than a dozen chapters focusing on social interactions with children and families that are likely to be of interest to this journal's readership. Scholars of social interaction who are new to collaborating with healthcare professionals will also find Khalid Karim's chapter on a clinician's view of conversation analysis informative.
Counselling and Psychotherapy Research
Over several years, we have been undertaking collaborative projects using language-based approach... more Over several years, we have been undertaking collaborative projects using language-based approaches to address research problems in mental health, with much of this work drawing upon conversation analysis (henceforth CA). Through our partnerships with a broad range of practicing professionals in psychiatry, psychology, counselling and allied health, we have worked to demonstrate the value of closely studying language as a means of: (a) better understanding social interactions that take place in clinical settings; (b) improving practice; and (c) utilising best practices to inform care. CA provides empirical evidence that demonstrates the process of therapeutic change (Strong, Busch, & Couture, 2008), as it allows researchers to closely attend to communication that impacts therapeutic practices and thereby patient outcomes (Priebe & McCabe, 2008). In this article, therefore, we argue for the value of using CA, specifically Applied CA, for the close study of therapy and counselling. The reason for this is that from our perspective, methodological approaches that focus on the close study of language make "intuitive sense" as therapy is fundamentally a form of conversation (McLeod, 2001, p. 91). Furthermore, it is well-accepted that clinicians need competencies in the art of good communication to facilitate positive therapeutic relationships (Priebe & McCabe, 2008). In therapeutic settings, the language used can become the focus for transforming everyday descriptions and re-contextualising them into therapeutically relevant understandings (Roy-Chowdhury, 2006). And, importantly, as Strong et al. (2008) noted: "conversation is usually seen as part of the therapeutic process and evidence is viewed as outcome. Process (conversation) affects outcome (evidence); both are intertwined and inseparable" (p. 388).
Journal of Marital and Family Therapy
The field of couple and family therapy has benefitted from evidence generated from a range of qua... more The field of couple and family therapy has benefitted from evidence generated from a range of qualitative approaches. Evidence developed from approaches relying on language and social interaction using naturally occurring recordings of real-world practice have the benefit of facilitating practice-based recommendations and informing practice. The aim of this article is to provide an overview of one approach to discourse analysis, Discursive Psychology (DP), while demonstrating how a social constructionist framework and focus on discourse can provide an important contribution to the field of therapy. To illustrate the methodological decision-making process for researchers and/or practitioners who aim to utilise DP, we draw upon a video-recorded therapeutic session involving Tom Andersen. To conclude, we make recommendations for practitioners using DP to explore and examine therapeutic practice.
Journal of interprofessional care, Jan 25, 2018
Children exposed to multiple adversities are at high risk of developing complex mental health and... more Children exposed to multiple adversities are at high risk of developing complex mental health and related problems, which are more likely to be met through integrated interprofessional working. Combining the expertise of different practitioners for interprofessional care is especially pertinent in low- and middle-income countries (LMIC) in the absence of specialist resources. The aim of this study was to work with practitioners who deliver care to vulnerable children in six LMIC (Turkey, Pakistan, Indonesia, Kenya, Rwanda, and Brazil) to understand their perspectives on the content of an interprofessional training programme in building resilience for these children. Seventeen participants from different professional backgrounds, who were in contact with vulnerable children were interviewed. A thematic analytic framework was used. Four themes were identified, which were the benefits of a tiered approach to training, challenges and limitations, perceived impact, and recommendations fo...
Health promotion international, Jan 30, 2018
The growing prevalence of adolescent mental disorders poses significant challenges for education ... more The growing prevalence of adolescent mental disorders poses significant challenges for education and healthcare systems globally. Providers are therefore keen to identify effective ways of promoting positive mental health. This aim of this qualitative study was to explore perceptions that social media might be leveraged for the purposes of mental health promotion amongst adolescents aged between 11 and 18 years. Utilizing focus groups conducted with adolescents (N = 54), educational professionals (N = 16) and mental health practitioners (N = 8). We explored their views about the value of social media for this purpose. Three themes were identified. First, social media appears to have potential to promote positive mental health. Second, adolescents frequently utilize social media and the internet to seek information about mental health. Finally, there are benefits and challenges to using social media in this way. We conclude that despite challenges of using social media and the risks,...
School Mental Health
The mental health of adolescents is a salient contemporary issue attracting the attention of poli... more The mental health of adolescents is a salient contemporary issue attracting the attention of policy makers in the UK and other countries. It is important that the roles and responsibilities of agencies are clearly established, particularly those positioned at the forefront of implementing change. Arguably, this will be more effective if those agencies are actively engaged in the development of relevant policy. An exploratory study was conducted with 10 focus groups including 54 adolescents, 8 mental health practitioners and 16 educational professionals. Thematic analysis revealed four themes: (1) mental health promotion and prevention is not perceived to be a primary role of a teacher; (2) teachers have limited skills to manage complex mental health difficulties; (3) adolescents rely on teachers for mental health support and education about mental health; and (4) the responsibility of parents for their children's mental health. The research endorses the perspective that teachers can support and begin to tackle mental well-being in adolescents. However, it also recognises that mental health difficulties can be complex, requiring adequate funding and support beyond school. Without this support in place, teachers are vulnerable and can feel unsupported, lacking in skills and resources which in turn may present a threat to their own mental well-being.
Clinical child psychology and psychiatry, 2018
Despite growing evidence of the effects of social media on the mental health of adolescents, ther... more Despite growing evidence of the effects of social media on the mental health of adolescents, there is still a dearth of empirical research into how adolescents themselves perceive social media, especially as knowledge resource, or how they draw upon the wider social and media discourses to express a viewpoint. Accordingly, this article contributes to this scarce literature. Six focus groups took place over 3 months with 54 adolescents aged 11-18 years, recruited from schools in Leicester and London (UK). Thematic analysis suggested that adolescents perceived social media as a threat to mental wellbeing and three themes were identified: (1) it was believed to cause mood and anxiety disorders for some adolescents, (2) it was viewed as a platform for cyberbullying and (3) the use of social media itself was often framed as a kind of 'addiction'. Future research should focus on targeting and utilising social media for promoting mental wellbeing among adolescents and educating you...
Journal of child health care : for professionals working with children in the hospital and community, 2018
The National Health Service (UK) offers initial screening appointments for children referred to c... more The National Health Service (UK) offers initial screening appointments for children referred to child and adolescent mental health services to determine clinical need and assess risk. Conversation analysis was utilized on 28 video recordings of these assessments, lasting approximately 90 minutes each with a multidisciplinary team. This article focuses on the agenda setting strategies used to establish relevant goals with children and adolescents; specifically, the technique of offering 'three wishes'. For example, ' if you had three wishes, what would you like to make happen?' In cases where children initially volunteered an assessment-relevant wish, they tended not to articulate further wishes. Non-assessment-relevant wishes (i.e. fantasy wishes, such as being 'rich') were treated as insufficient, with many approaches used to realign establishing assessment relevant goals. Where responses were not institutionally relevant, practitioners undertook considerabl...
Journal of Psychiatric and Mental Health Nursing
In community psychiatric nursing, asking questions about risk is a fundamental part of the mental... more In community psychiatric nursing, asking questions about risk is a fundamental part of the mental health assessment. This paper examines actual assessments in a Child and Adolescent Mental Health (CAMH) community setting, with a focus on the ways that questions about self-harm and suicidal ideation were composed. The research highlights the issue that in many cases self-harm and suicide questions were not routinely asked. Of those that were a particular way of asking was found to be successful. The relevance to psychiatric nursing practice is to demonstrate how to introduce conversations about self-harm and suicide with children and young people.
Child and Adolescent Mental Health, 2017
Reflecting on what 'you said' as a way of reintroducing difficult topics in child mental health a... more Reflecting on what 'you said' as a way of reintroducing difficult topics in child mental health assessments
Discourse Studies, 2017
His professional background is in speech and language therapy (SLT), and informed by his practice... more His professional background is in speech and language therapy (SLT), and informed by his practice experiences of working with children and their families, his current research aims to explore how alternative approaches to studying language and communication can generate critical/radical accounts of children's development and diagnostic categories such as autism.
Clinical Ethics, 2011
, I. (2011). Ongoing processes of managing consent: The empirical ethics of using videorecording ... more , I. (2011). Ongoing processes of managing consent: The empirical ethics of using videorecording in clinical practice and research. Clinical Ethics, 6(4),
Disability Studies Quarterly, 2009
The fundamental philosophy of family therapy is to "treat" the family as a unit... more The fundamental philosophy of family therapy is to "treat" the family as a unit. It sets out to provide assistance to families with troubles in a way to make them work together in a more functional way. Parents of children with difficulties however, do not necessarily consider the ...
Communication & medicine, 2014
The opposing positions of the social model of disability and the biomedical framework of impairme... more The opposing positions of the social model of disability and the biomedical framework of impairment have created tensions regarding what constitutes 'normality'. In this article, we drew upon focus group data of parents, professionals, and people with autism, to explore how the dilemmatic tensions of normality and abnormality and of disability and ability were managed. Our findings illustrate how the boundaries of normality in relation to autism are blurred, as well as how the autistic identity is fluid. The members of the focus group invoked their epistemic rights to assert their positions and delicately considered the limitations of the rhetoric of cure. Our findings have implications for professionals working with families of children with autism, specifically as they aim to maintain a balance between providing sufficient support and not being intrusive, and we show how a medical sociology can facilitate an understanding of autism as a social category.
Journal of autism and developmental disorders, Jan 28, 2015
Journal of Family Therapy, 2015
Systemic family therapy promotes a systemic reframing of individual problems to an understanding ... more Systemic family therapy promotes a systemic reframing of individual problems to an understanding of the familial processes influencing family functioning. Parents often attend therapy identifying their child as the key problem, which raises issues of accountability and blame. In this article, we explored the discursive practices used by parents for constructing themselves as ‘good parents’. Using the basic principles of conversation analysis and discursive psychology, we analysed actual therapeutic sessions and found that parents used a range of strategies to display their good parenting. This included directly claiming to be a good parent, illustrating how they act in their child's best interests, showing that they parent in appropriate ways and by making appeals to scientific rhetoric. It was concluded that family therapists have a challenging task in managing competing versions of events and we discussed implications for practice.
Qualitative Research in Psychology, 2015
While there is a small, growing literature that considers the psychological safety of researchers... more While there is a small, growing literature that considers the psychological safety of researchers, little attention has been paid in the qualitative literature to the wellbeing of transcriptionists. Transcriptionists play an integral and essential role in qualitative research but are often overlooked in terms of the emotional impact of the work. In the article we have interviewed transcriptionists and, using grounded theory, we illustrated that that they experienced emotional distress and feelings of helplessness. We showed that while they had some internal coping mechanisms they nonetheless also expressed a need to talk about their feelings. Furthermore the general lack of safeguarding protocols made the role more challenging. At the end of the analysis the core category we identified was the risk of secondary traumatic stress. We thus made some recommendations for safeguarding transcriptionists and called for further research in this area.
Patient Education and Counseling, 2015
Objective: The objective was to identify how children knowledge positions were negotiated in chil... more Objective: The objective was to identify how children knowledge positions were negotiated in child mental health assessments and how this was managed by the different parties. Methods: The child psychiatry data consisted of 28 video-recorded assessments. A conversation analysis was undertaken to examine the interactional detail between the children, parents, and practitioners. Results: The findings indicated that claims to knowledge were managed in three ways. First, practitioners positioned children as 'experts' on their own health and this was sometimes accepted. Second, some children resisted this epistemic position, claiming not to have the relevant knowledge. Third, some children's claims to knowledge were negotiated and sometimes contested by adult parties who questioned their competence to share relevant information about their lives in accordance with the assessment agenda. Conclusion: Through question design, the practitioner was able to position the child as holding relevant knowledge regarding their situation. The child was able to take up this position or resist it in various ways. Practice implications: This has important implications for debates regarding children's competence to contribute to mental health interventions. Children are often treated as agents with limited knowledge, yet in the mental health assessment they are directly questioned about their own lives.
Qualitative Inquiry, 2015
Although scholars have gone to great lengths to illustrate the value of qualitative research and ... more Although scholars have gone to great lengths to illustrate the value of qualitative research and ensure that it is well represented in all areas of academic life, there remains a gap of equality when compared with quantitative research, which is still viewed by many as superior, specifically in applied fields such as health. This has become particularly true as the evidence-based movement has continued to find its way into discussions around the legitimacy of qualitative research. In this article, we argue that the evidence-based movement, particularly in medicine and health, continues to pose challenges for us as a qualitative community—challenges that we will need to grapple with in the coming years.
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Papers by Michelle O'Reilly