A think piece about micro analysis of interaction AND co-production. Can it work?

‘Getting Things Changed’ is the short title for our current ESRC research project, which is essentially about social practices, how they may be disabling or excluding to disabled people, and how they can be changed. The whole project is co-produced with disabled people, and our fourth Ideas Workshop in this study was held at the end of September this year, led by Disability Rights UK (a partner in this project).  This got us thinking further about co-production and what it really means for our project. Here are some reflections about why co-production might be an important and innovative ingredient at the ‘micro’ level of change. We are writing in order to get some debate going – to see what others might think about these ideas, both from within the discipline of Conversation Analysis, but also from other parts of our project and beyond.

Our project about ‘Getting Things Changed’ is both with and for disabled people. That means we want co-production and disabled people’s voices to be present in the research, but it also means that we are interested in the effects that disabled people themselves can have in instigating changes in social practices. At the micro level, one ‘end’ of our spectrum of approaches is about the interactions that happen on an everyday basis, the human communications in which we all engage. We are planning to take a close look at some of the conversations that happen between support workers and people with dementia, and also those between young people with learning disabilities and their PAs, and we will be utilising the tools and insights of conversation analysis to help us unpick what is happening. So, first of all, what has conversation got to do with co-production and change?

Conversation Analysis (CA) is a thriving, academic and insightful discipline with a growing body of knowledge about the structures of social action, and we have some eminent scholars in the field to help us in our work, Charles Antaki and Celia Kitzinger.

CA has and still is discovering more about the basic structures of human interaction, the way conversations work – for instance turn-taking rules, the devices people have for hedging in a conversation, the ways questions and answers are interpreted. All this and much more is the basic stuff of CA. However, all along there has been a parallel and very large branch of CA which is commonly referred to as ‘Institutional CA’, looking at particular social practices that happen for instance in doctors’ surgeries, telephone conversations with helplines, classroom talk and so on. Nearly always, these institutional situations involve one ‘professional’ participant and a layperson – the person who may be receiving the service, the learner, the person being helped. Social practices at this level are things done in and through talk. Applying CA in these contexts can help us understand for instance how doctors routinely elicit information and offer advice to patients, or how support workers discuss activities with disabled people they are assisting. All of this is brought alive by the understandings we have of the basic structures of conversation – for instance, that questions not only elicit answers, but that they set the agenda, and determine the subsequent flow of the conversation.

It turns out that the asymmetries and inequalities in these ‘institutional’ conversations can be described and analysed, using the basic tools of CA. For instance, not only does the doctor ask the questions, but in some ways, he or she is enacting and occupying a position of power in doing their ordinary job. What does all this have to do with understanding how to change things?  Having carried out a detailed analysis of what is actually said or done, this knowledge can and is sometimes used to help people make changes to their practices. Charles Antaki and Celia Kitzinger, for instance, have both used their findings in this way, and so have many others. We looked at the creative work done by Liz Stokoe (http://www.carmtraining.org/) when discussing this approach in our second workshop.  This is the territory of ethical, engaged CA, and increasingly it has a place in the conferences and in the pages of academic journals and books. For instance, CA has helped us to see how audiologists can introduce the topic of hearing aids with their patients, and can use more effective strategies to persuade patients with hearing loss to use their hearing aids. Closer to home, one of our colleagues in Bristol analysed how fathers can be most successfully recruited to parenting courses. And all this knowledge may be taken into the field – i.e. applied and explored by those who can make changes in their own practices, the social care or health practitioners in these cases.

Now for the new and upcoming questions for ‘Getting Things Changed’, and particularly for the first strand of the research, where Sandra Dowling is leading the work with young people with learning disabilities. Of course, all the above is rich and challenging for us, and will engage us in collecting and exploring video data about what happens when a young person with learning disabilities starts to engage with personal assistants. However, we are aware that the type of conversation that happens in these circumstances can all too easily be dominated by the personal assistant, by the professional – and that disabled people can become sidelined or compartmentalized into positions which are less than powerful. We have seen this in much of our other work in this field, where disabled people regularly run their lives on the terms set by support staff, rather than exercising their own choice and control. Why is this?  Is there something intrinsically unequal in a conversation between a support worker and a disabled person? And may this be about power, shaped up and repackaged every time people engage with each other?

We know that support workers and personal assistants do not want it to be this way! And neither of course do young people with learning disabilities, as they take the first steps into adulthood.  Therefore, we want to be able to use our analysis not just for academic insights, but in order to make changes on the terms of  the young people themselves. It occurs to us that previous interventions using CA have mostly been about professional practices, whereas we want to engage with young people themselves, as well as their PAs, to find out what matters to them – and to help tilt the power imbalance back towards a more level and equalising conversational style. Easier said than done, of course!  But to help us in this, Sandra is recruiting some advice and active assistance from a disabled people’s drama group, The Misfits http://misfitstheatre.com/. These actors with learning disabilities draw on their own experience to literally act out and explore the way interaction works, and so they are well placed to advise us and to help us analyse and interpret our data. Through drama, we hope to be able to reflect on our findings, to take back our thoughts to our participants, and thus to see whether conversations can become literally more ‘co-produced’, both by the disabled person and by their personal assistant.

We’d love to hear from others in the project, or beyond, about the problems we might face. Others may well have adopted similar approaches, and we no doubt will meet criticisms which can help us ensure that we shape up our project in a robust way. However, right now, we are very excited by the entrance of The Misfits into the first strand of our research, and will look forward to working with them – as well as our future participants in this project.