Wyke Stommel

The online support group as a community: A micro-analysis of the interaction with a new member

Generally, online support groups are viewed as low-threshold services. We challenge this assumption with an investigation, based on Conversation Analysis and Membership Categorization Analysis, of contributions to an online support group on eating disorders. In this analysis we show how a new member interacts with existing members in order to display legitimacy for membership of the group. The group operates as a Community of Practice, since membership is organized as joined participation in a writing practice. It becomes clear that becoming a member involves subscribing to normative requirements, centrally, displaying the insight that you are ill. In the case we focus on, this involves the requirement to leave pro-anorexia as a membership category behind. The novice does not yet seem ready to subscribe to this norm and thus the threshold for seeking support is heightened.

The use of conversation analysis to study social accessibility of an online support group on eating disorders

We conducted a conversation analysis of 21 threads initiated by newcomers of an online support group (OSG) on eating disorders, to examine the discursive process of entering such a group. The analysis revealed three important issues. First, many newcomers articulate that the step to join the group is extremely difficult. Second, a presentation of the self in terms of a diagnosis works as a legitimization for joining the forum. The data suggest that participants who do not fulfil the conditions for such a legitimization do not join the forum. Third, the option of acquiring a serious symptom as a solution to the legitimization problem is offered by one of the regular members. Hence, the newcomers’ discourse reveals issues relevant to the accessibility for undiagnosed sufferers. We discuss these findings theoretically as a phenomenon of self-presentation in relation to community norms. The analysis generates the hypothesis that newcomers are confronted with implicit norms regarding membership legitimacy that they should obey in their self-presentation, although they may not be ready yet to actually do so. OSGs should find strategies to facilitate various possibilities for newcomers to present themselves to the group while becoming a member.

Mein Nick bin ich! Nicknames in a German Forum on Eating Disorders

This article demonstrates how nicknames that are used by participants in a German forum on eating disorders can be read as identity displays and how they may be related to eating disorders. A qualitative analysis of 83 nicknames of the Hungrig-Online forum reveals that denotational and stereotypical features, along with well-known referents of the names, interdependently characterize participants. Persona attributes such as smallness, weightlessness, childishness, negative self-evaluation, and depression, but also arguably self-confidence, are shown to be apparent in the nicknames; many of these attributes can be linked to multifaceted femininity. These findings are then related to general characteristics of eating disorders. In concluding, the far-reaching rules for registration of nicknames in the forum are taken into account and questioned, for it may be that in sensitive online groups, nicknames play an especially important role in identity construction.

Complaining and the Management of Face in Online Counseling

In this article, we analyze how clients in online counseling by email do complaining. Complaining is a “face-threatening act” and can jeopardize the relationship between interlocutors. In online health interventions, we see high dropout rates. We suggest that because the interaction between client and counselor is at the basis of counseling, it is important to understand how a communicative act (e.g., a complaint) that signals potential dropout is constructed sequentially. Based on a corpus of 20 email exchanges, we illustrate how clients constructed complaints over several sentences and sometimes various emails, and how they designed the complaints to minimize threat to the counselor’s face. Counselors, in their responses, used various strategies to manage face threats. We show how complaints were mitigated to protect the counseling relationship and suggest that this is useful knowledge for health professionals.

‘But How Often Does This Happen?’: Problem Reducing Responses by Coaches in Email Counselling

This chapter explores the interactional dynamics of email counselling from a conversation analytic (CA) perspective. The conceptual apparatus of CA has been successfully applied to study turn-taking and the sequential placement of email messages (cf., Stommel, 2012; Stommel & Van der Houwen, forthcoming; Vayreda & Antaki, 2009), as well as the ways in which accountability is managed in online talk to do with health (cf., Guise, Widdicombe, & McKinlay, 2007; Lamerichs & Te Molder, 2003). Participants’ interactional concerns in email counselling are therefore treated as an empirical matter and not a priori different from speakers’ orientations in spoken interaction.

Online Talk About Mental Health

There is a need to focus on research conducted on online talk about mental health in the domains of ethnomethodology, Conversation Analysis (CA), Discursive Psychology (DP), and Membership Categorization Analysis (MCA). We use the notion of “talk” in this article, as opposed to what could be considered a more common term such as “discourse,” to highlight that we approach computer-mediated discourse as inherently interactional. It is recipient designed and unfolds sequentially, responding to messages that have come before and building a context for messages that are constructed next. We will refer to the above domains that all share this view as CA(-related) approaches. A characterizing feature of interactional approaches to online mental health talk is their focus on in-depth analyses of relatively small amounts of data. With this focus at the center of their attention, they sit in the wider field of Discourse Analysis (DA), or Computer-Mediated Discourse Analysis (CMDA) who use language as their lens to understand human interaction. DA and CMDA research include a much wider set of both micro- and macro-analytic language-focused approaches to capture online discourse. Of all the CA(-related) work on online materials, a disproportionally large number of studies appear to deal with (mental) health talk. We aim to answer the question what the field of research on online mental health talk has yielded in terms of findings and methodologies. Centrally, CA (-related) studies of online mental health talk have aimed to grasp the actions people accomplish and the identities they invoke when they address their health concerns. Examples of actions in online mental health talk in particular are presenting oneself, describing a problem, or offering advice. Relevant questions for the above approaches that consider language-as-social-action are how these different actions are brought off and how they are received, by closely examining contributions such as e-mail and chat postings and their subsequent responses. With a focus on talk about mental health, this article will cover studies of online support groups (OSGs, also called online communities), and interaction in online counseling programs, mainly via online chat sessions. This article is organized as follows. In the historiography, we present an overview of CA(-related) work on online mental health talk. We discuss findings from studies of online support groups (OSGs) first and then move to results from studies on online counseling. The start of our historiography section, however, sets out to briefly highlight how the Internet may offer several particularly attractive features for those with mental health problems or a mental illness. After the historiography, we discuss what an interactional approach of online mental health talk looks like and focuses on. We offer examples of empirical studies to illustrate how written contributions to a forum, and e-mails or chat posts that are part of online counseling sessions are examined as interaction and which types of findings this results in. We conclude with a review of methodological issues that pertain to the field, address the most important ethical considerations that come into play when examining online mental health talk, and will lastly highlight some areas for future research.