Trouble-talk in therapist-resident encounters: A case-study of an individual with acquired brain injury

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This article focuses on what can be labelled ‘trouble-talk’, and in particular how it is initiated and responded to in therapist–resident encounters. It adopts the perspective of an individual with acquired brain injury. The study is based on a video ethnography of interaction, targeted at identifying trouble-talk and its interactional consequences, and it was carried out in a Danish care home facility for residents with this kind of injury. Encounters involving a case resident, an occupational therapist, a social worker (pædagog) and participant researchers were video recorded (totaling 30 hours) during fieldwork over one year, between 2012 and 2013. The dataset has been analyzed through a combination of discourse analysis and ethnomethodological conversation analysis.

The findings show that when the resident takes initiatives and/or makes criticisms, this may be heard by the occupational therapist as complaints about institutional life in general and/or as talking gibberish. Such perceived trouble-talk is responded to by the occupational therapist with misalignment and repair work. In general, trouble-talk is co-constructed; however, it is accentuated by the occupational therapist’s response, which suggests an undesired institutional ramification. In promoting awareness of the impact of impairments on interaction, I discuss how trouble-talk is emergent in the interaction itself and in what ways it can be resolved or minimized.
Original languageEnglish
JournalCommunication & Medicine - An Interdisciplinary Journal of Healthcare, Ethics and Society
Issue number3
Pages (from-to)143-156
Number of pages14
Publication statusPublished - 2022


  • Acquired Brain Injury
  • Alignment
  • Aphasia
  • Person-centered institutional care
  • Repair
  • Trouble-talk
  • Troubles talk


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