From Engagement to Disengagement in a Psychiatric Assessment Process

In a longitudinal conversation analytical (CA) case study, we examined patient engagement in a psychiatric assessment process (nine clinical interviews) with a young woman who eventually received the diagnosis of personality disorder. Based on Goffman, we consider engagement in interaction as consisting of three facets: engagement in the action at hand, bodily engagement with the co-participant, and engagement with the local moral order of the encounter. The patient begins the assessment process with high engagement and ends it up in low engagement. Yet, during this process, the patient oscillates between moments of high and low engagement. We show how the Goffmanian idea of engagement can be elaborated by CA. On the other hand, the Goffmanian view enriches CA by bringing to the foreground the interconnectedness of the different facets of engagement. A video abstract is available at .