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Voices in the text: The uses of reported speech in a psychotherapist's Notes and Initial Assessments

A psychotherapist's initial written assessment document (based on notes taken during an initial interview as well as material in the client's record) recontextualizes information provided by that client into an institutionally viable account. This assessment, designed to provide readers with a clinical picture of the client's problems, justifies the therapist's particular diagnosis of mental disorder which, in turn, supports the therapist's treatment choice. An analysis of reported speech in a therapist's notes written during a therapy session and the written assessment that followed reveal some devices used by the therapist for reporting client's speech in ways that would: (a) depict the client's experiential meanings, as represented in the therapist's notes, and (b) construct a clinical case to support her diagnosis, as can be seen in the assessment. We suggest that the devices function to recontextualize the client's lifeworld perspective, thereby subsuming this perspective (and implicit structure of meanings) into the therapist's psychiatric perspective