In this book, the author offers an analytical account of how counselling, as a process, is dynamically constructed through the interaction of counsellor and client. Drawing on research on counselling of clients undergoing an HIV test, the author explores the ways in which conversations between counsellors and patients reflect, embody and subtly alter assumptions about the purpose, method and practice of counselling. This text should be of interest to researchers and students of counselling, psychotherapy and associated helping professions as a critical appreciation of the modes of engagement between counsellor and client. Practitioners - particularly those within the domain of HIV and other health counselling - should be stimulated to reflect on and respond to Silverman's analysis in their own practice. This book should also be useful reading for researchers and students in the traditions of sociological work on interactionism, conversation analysis and ethnomethodology, applying these approaches in a sophisticated manner to the interactional and conversational analysis strategies adopted in a health promotion environment.
Table of Contents:
PART ONE: INTRODUCTION
What Is HIV Counselling?
Basic Methodological Issues
PART TWO: COMMUNICATION IN HIV COUNSELLING
Communication Formats in HIV Counselling
PART THREE: DELICATE DISCUSSIONS
The Construction of `Delicate′ Objects in Counselling
Offering the Agenda to the Patient
Delays in Delivering Test Results in Post-HIV-Test Counselling Interviews
PART FOUR: ADVICE-GIVING
Advice-Giving and Advice-Reception
Resisting Advice
Concealing Advice
The Advice-as-Information Sequence
PART FIVE: CONCLUSION
Counselling as a Discourse of Enablement
Implications for Practice
About the Author :
David Silverman trained as a sociologist at the London School of Economics and the University of California, Los Angeles. He taught for 32 years at Goldsmiths, University of London. He is interested in conversation and discourse analysis and he has researched medical consultations and HIV-test counselling.
He is the author of Interpreting Qualitative Data (Seventh Edition, 2024) and A Very Short, Fairly Interesting and Reasonably Cheap Book about Qualitative Research (Second Edition, 2013). He is also the editor of Qualitative Research (Sixth Edition, 2026) and the Sage series, Introducing Qualitative Methods. In recent years, he has offered short, hands-on workshops in qualitative research for research students and faculty at universities in Europe, Asia, Africa and Australia.
Now retired from full-time work, David aims to watch one hundred days of cricket a year. He also enjoys voluntary work in an old people’s home where he sings with residents with dementia and strokes.
Review :
`This study of the tacit communicative skills that inform verbal interaction between counsellors and clients in various kinds of HIV counselling... primarily informed by conversation analysis... is sensitive to the requirements of counsellors who will want to know the practical benefits for them which emerge from this kind of study of interaction in counselling sessions′ - British Journal of Sociology
`Many texts claim to be based in, or to be written for, the scientist-practitioner (or the practitioner-researcher), yet seldom have I read a book that reaches this audience in such a useful and effective manner. This book not only describes how research can inform practice, but offers the experience as you read it... I was particularly struck by the sensitivity to language that Silverman illustrates throughout the book. I found that, without trying, I was listening to my clients with a different attunement, somehow noticing subtle nuances with a greater range of possible interpretations... Regardless of paradigm, the professional who has a role as a listener will be enriched by reading this book and thinking seriously about their own practice′ - The Psychologist
`This book is the result of several years′ research into HIV counselling... a collage of intertwining and reflexive segments on different aspects of HIV counselling... Talk about sex and death can be highly absorbing, especially when presented with the fastidious exactitude of CA, and here the transcriptions... are of a rare quality. Introducing and addressing such "delicate" topics... is easier if the counsellor is "in control of" the agenda. Thus there is often an ambiguity in the interactive status of interviews which lean on the one hand towards the patient-centred approach, and on the other the retaining of control by the professional... While power and resistance may be ubiquitous in everyday life, it is through the detailed examination of their local reproduction in talk that we are able to gain empirical knowledge of their actual form and practical implications. In few areas of contemporary life could this assertion be made more precisely than in the discourses on sexuality which Silverman examines in this study′ - Journal of Sociolinguistics
`This book reports the author′s conversation analyses (CA) of counselling sessions, largely in HIV testing clinics in the USA and UK... Throughout, the text contains examples from actual interactions illustrating the sometimes clever and subtle skills deployed by the speakers... It is perhaps in this detail that the quality of the book lies. In this respect the author′s claims for the superiority of CA′s transcription techniques above the invented examples and tidied up transcripts of most existing accounts of counselling are borne out. For practitioners reading the book, it must be like looking into a mirror for the first time, perceiving just what it is they have always done without realising it... The view that meanings of utterances can be understood by attending to the preceding moves is also strongly supported, the relevant material being made fully available to the reader; herein lies the chief claim of CA to fulfil conventional standards of scientific quality′ - Medical Sociology News
