Mental distress has typically been examined from a biomedical or biopsychosocial perspective with quantitative evidence (especially, randomised controlled trials) being favoured. Over the last few decades there has been a growth and greater acceptance of qualitative methods and an increasing emphasis on applied qualitative research, which has been useful in the field of mental health. However, qualitative evidence has been typically, and arguably inappropriately, placed at the bottom level of evidence in the field of health and medicine (Lester & O’Reilly, 2015). Nonetheless, there is a growing acceptance that qualitative approaches offer a great deal for understanding the complexities of mental distress. More specifically, qualitative methodologies, such as conversation and discourse analysis (henceforth DA), have the added benefit of involving a close examination of the realities of individuals diagnosed with mental health conditions and the many interactions that surround their everyday lives.

Underpinned by a micro-social constructionist position, CA is a qualitative approach that focuses on the study of interaction. With a variety of influences in the background – including ethnomethodology, Goffmanian sociology, linguistic philosophy, ethnography, and others (Maynard, 2013) – it is an emic and inductive methodology, which prioritises empirical evidence that involves the participants’ orientations (Bolden & Robinson, 2011). That is, conversational materials are assumed to exhibit orderliness for the participants and is made visible through the ways in which they assemble actions together (Sacks, Schegloff, & Jefferson, 1974; Schegloff & Sacks, 1978). In other words, CA aims to ‘describe, analyze and understand talk as a basic and constitutive feature of human social life’ (Sidnell, 2010, p. 1). Those using CA attempt to explore what kinds of social organisations are used as resources in interaction (Mazeland, 2006), with a focus on how participants within an interaction negotiate meanings between them on a turn-by-turn basis (Hutchby & Woofit, 2008; McCabe, 2006).

CA was pioneered by Harvey Sacks who originally trained in Law and began to develop this approach, in part through the influence of Harold Garfinkel (Maynard, 2013; Schegloff, 1992) during his investigations at the ‘Center for the Scientific Study of Suicide’ in the 1960s (Drew, 2015). His early work focused on telephone calls to a suicide prevention center, and he explored how the callers’ accounts of troubles were produced through the interaction with call-takers (Drew, Heritage, Lerner, & Pomerantz, 2015; Silverman, 1998). Through this, he began to investigate the generic practices of interaction, and the general elements of what CA is began to develop (Drew, 2015). Notably, the work on suicide prevention calls did not have an analytic interest primarily on suicide, or even on troubles-talk, but rather was focused on the organisation of talk-in-interaction (Drew et al., 2015). Also, Sacks (1984, p. 26) did not begin working with recordings because of ‘any large interest in language or from some theoretical formulation of what should be studied’, but because the tapes could be replayed and others also could review the data and Sacks’ analyses to see or hear how well analytic assertions would hold up.

For CA, claims are made in the observable orientations that participants display to one another. CA has a distinctive interest in how orderly characteristics of talk are accountably produced on a turn-by-turn basis (Maynard & Clayman, 2003). Therefore, CA reflects a fusion of Goffman’s and Garfinkel’s approaches through the creation of an empirical method in order to explore how people produce social order (McCabe, 2006). Because of the focus on interaction and the sequential organisation of talk, CA has been described as focusing on ‘talk-in-interaction’ (Drew & Heritage, 1992), with this understood to entail focusing on what talk is doing rather than what talk is about (Schegloff, 1999).

Recently, interactional linguistics has become a prominent part of CA for many scholars. This is because contemporary anthropologists, conversation analysts, and linguists have realised the value of coming together to combine their respective disciplinary strengths with the focus on language (Couper-Kuhlen & Selting, 2001). Interactional linguistics (different from interactional sociolinguistics, discussed later in the chapter) is an interdisciplinary approach to interaction and grammar in linguistics, anthropology, and the sociology of language. Scholars using this approach utilise CA, functional linguistics, and linguistic anthropology in order to describe the ways in which language features in normative interactions (Ochs, Schegloff, & Thompson, 1996). This is a perspective on language structure that goes beyond grammar and prosody to examine all aspects of language structure, phonology, phonetics, syntax, lexis, morphology, pragmatics, and semantics, as well as language acquisition, language variation, loss, and disorder (Couper-Kuhlen & Selting, 2001).

Those who utilise CA favour naturally occurring data. That is, conversation analysts have a preference for data that have not been deliberately generated by the researcher for the purposes of research. Rather, they record (in some format) interactions that occur in the ‘real-world’ as they would happen naturally, without the researcher intervening. In other words, naturally occurring data would still occur if the researcher had not been born (Potter, 2004) or if the researcher was unable to collect it (Potter, 1996). Conversation analysts favour naturally occurring data because it captures actual interactions while retaining the situated nature of the conversations. Thus, it is presumed to illustrate how participants orient to their setting without the abstraction of the researcher’s agenda (Potter, 2004).

In contemporary literature, there has been a distinction made between ordinary and institutional CA. Ordinary CA refers to the analysis of commonplace conversations, and institutional CA refers to investigations of legal, medical, and other professional settings (McCabe, 2006). Ordinary CA is epitomised by the work of Sacks and his colleagues. This form of CA investigates conversation as a domain in its own right and specifies the normative structuring and logics of particular courses of social action and their organisation into systems (Heritage, 2005). Second, as noted by Heritage (2005), institutional CA builds on the findings of basic CA in order to examine the operation of talk in social arenas that sociologists have called ‘formal organisations’. Institutional CA requires a shift in perspective, as talk and discourse in institutional settings may be historically contingent and subject to the processes of social change under the impact of power, culture, social ideology, economic forces, and intellectual innovation. Still another form of CA fits the category of ‘applied’ analysis. Applied CA has different meanings, which are described in Table 1.1, as they were outlined by Antaki (2011).