The use of why questions in child and adolescent mental health assessments


  • Nikki Kiyimba University of Chester, UK
  • Khalid Karim The Greenwood Institute, UK
  • Michelle O’Reilly The Greenwood Institute, UK



questions, children, qualitative, conversation analysis, assessment, mental health


Questions form the basis of mental health assessments and yet there is limited empirical evidence about the linguistic structure of question formats in these clinical environments. While many types of questions are used, the focus of this research was on why-prefaced questions asked to children. Interaction analysis was employed to interrogate the data, paying specific attention to the interactional organisation of how ‘why-prefaced’ questions were asked and responded to. Analysis demonstrated that when three core components were present in the question, then it was usual for a reason/ explanation to be provided in response, and when one or more components were missing, it rarely elicited a reason or explanation in response. The three components were; the sequential position of the question, how the question was indexically tied to the child’s prior statement, and the epistemic domain of the question. Implications for therapeutic communication and training were discussed.

Author Biographies

  • Nikki Kiyimba, University of Chester, UK

    Nikki Kiyimba is a senior lecturer and programme lead for MSc in therapeutic practice for psychological trauma at the University of Chester. Nikki is also a Chartered Clinical Psychologist working in private practice. She works clinically with both adults and children and has research interests in child and adolescent mental health and trauma. She has published several articles, and recently co-authored (with Michelle O’Reilly) a book on engaging in mental health research with children and adolescents, Doing Mental Health Research with Children and Adolescents: A Guide to Qualitative Methods (Sage).

  • Khalid Karim, The Greenwood Institute, UK

    Khalid Karim is a consultant child and adolescent psychiatrist at Leicestershire Partnership NHS Trust, and a senior teaching fellow at the University of Leicester, the Greenwood Institute, UK. Khalid specialises in autism spectrum disorder, both in terms of clinical practice and in research. He also uses conversation analysis to examine autism and social interaction and has recently written a book chapter on a psychiatrist’s perspective on the value of conversation analysis.

  • Michelle O’Reilly, The Greenwood Institute, UK

    Michelle O’Reilly is a senior lecturer at the University of Leicester, the Greenwood Institute, UK. She works across the School of Media, Communication & Sociology, and the School of Psychology. Dr O’Reilly also provides research consultancy for clinical professionals within Leicestershire Partnership NHS Trust. She specialises in child mental health research as well as engaging in the pedagogical research of advanced qualitative research. She has recently co-edited two handbooks on discourse and conversation analysis and mental health with Jessica Lester.


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How to Cite

Kiyimba, N., Karim, K., & O’Reilly, M. (2017). The use of why questions in child and adolescent mental health assessments. Research on Children and Social Interaction, 1(2), 222-242.