Language use in therapy by phone

The study in a sentence

“The NHS has a fantastic technology that they don’t use - conversation.”  

(James Sanderson, Director of Personalised Care NHS England, Creative Health Conference in 2019)

Psychological therapy is a 'talking therapy', delivered through in-person meetings and by telephone. This research focusses on language use in telephone interactions between patients and Personal Wellbeing Practitioners (PWPs) in NHS Improving Access to Psychological Therapies (IAPT) calls. 

The question

There is some evidence that the quality of interaction in therapy delivered by phone can be just as good as in therapy delivered face-to-face (Irvine et al 2020).  However, patients often have misgivings about the prospect of receiving support by phone rather than in person. 

What sort of issues might arise when offering therapy by phone and under time pressure?

This research explores two factors: personalisation and patient choice.

Key concept

Conversation Analysis recognises categories of preferred and dispreferred responses, to something that a speaker has said.  

In these studies of language use in a workplace setting, we see responses which do not match the patterning of preferred/dispreferred responses in ordinary conversation.

Does the language used to give patients treatment options really give them a choice?

How personal is the experience of telephone therapy for patients, given the strict protocols that have to be followed?


These studies use the techniques of Conversation Analysis, which explore in detail:

In a short telephone therapy call: what does the Personal Wellbeing Practitioner want to achieve, what linguistic choices do they make, and how does the patient respond to those choices? 

The answer(s)

The main findings of the two studies are:

Classroom activities

Lead in task

Understanding the context: how does the IAPT service work and who is it for?

Extension task

Exploring data extracts from telephone therapy calls using the techniques of Conversation Analysis


Glossary of transcription conventions used in the transcripts

In more detail

A longer explanation of the research study

Pre-Workshop Talk by Annie Irvine and Paul Drew [11 mins]

Toolkit CPD 2021 Paul Drew + Annie Irvine Pre-Workshop Talk slides.pptx

Slides for the Pre-Workshop Talk

Live Webinar Talk [25 mins]

CPD2021 PD presentation.pdf

Slides from the Live Webinar talk

CPD2021 PD handout.pdf

Handout from the Live Webinar talk

Meet the authors

Paul Drew & Annie Irvine

Paul teaches and researches Conversation Analysis in the Department of Language and Linguistic Science at the University of York. 
Annie is a researcher at Kings College London, but previously worked for many years at the University of York, where her research focused on ill health, disability and employment in the context of UK social security policy.

Read the papers

Irvine, A., Drew, P. et al. (2020) ‘So just go through the options’: Patient choice in the delivery of the NHS Improving Access to Psychological Therapies (IAPT) services. Sociology of Health & Illness, 43, 1: 3-19  pdf
Drew, P, Irvine, A. et al. (2021) Telephone delivery of psychological therapies: Balancing protocol with patient-centred care. Social Science & Medicine, 277, 113818. pdf on request