Formulations in occupational therapy: Managing talk about psychiatric outpatients' emotional states

- Occupational therapy encounters in psychiatric outpatient clinics are investigated.
- Occupational therapists' managed talk on clients' emotional states by formulations.
- The positive stance described by clients was endorsed by occupational therapists.
- The talk on negative emotional states was redirected to the less affective contents.
- The institutional features of such emotion-related sequences are discussed.

Working with clients' emotional states is important in psychiatric care. The clients' conditions often involve non-adaptive emotions or difficulties in emotion regulation. However, the clinicians in mainstream psychiatry also need to focus on other activities, such as solutions to problems of daily life. How do clinicians balance between emotional alignment with the client and other, more practical tasks? Based on conversation analysis of 15 video-recorded occupational therapy encounters at a psychiatric outpatient clinic, this article analyses two types of formulation sequences that the clinicians use for managing talk related to the clients' emotional states. In the first, the clients describe their emotional states from a perspective of competence and the clinicians endorse that perspective. In the second, the clients take a negative stance towards their experiences and the clinicians' formulations attend to the clients' troublesome experiences. Immediately after the formulations, the clinicians redirect the talk, often occurring through the clinicians' mention of a different topic to the one currently being discussed by the client. The article contributes to research on institutional interaction and emotions in interaction by describing how the management of talk on emotions in occupational therapy encounters of psychiatric care combines interactional features of psychotherapeutic and medical work.