Trouble-talk in therapist–resident encounters

A case-study of an individual with acquired brain injury


  • Charlotte Marie Bisgaard Klemmensen Aalborg University



acquired brain injury alignment, aphasia, person-centered institutional care, repair, trouble-talk


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.

Author Biography

Charlotte Marie Bisgaard Klemmensen, Aalborg University

Charlotte Marie Bisgaard Klemmensen is Visiting Researcher at Aalborg University. She does research on interaction and institutional discourse within interdisciplinary discourse studies, language psychology and integrational linguistics. She is author of Integrating the Participants’ Perspective in the Study of Language and Communication Disorders: Towards a New Analytical Approach (2018, Palgrave Macmillan).


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How to Cite

Klemmensen, C. M. B. (2022). Trouble-talk in therapist–resident encounters: A case-study of an individual with acquired brain injury. Communication and Medicine, 17(3), 243–256.