Conversational pursuit of medication compliance in a Therapeutic Community for persons diagnosed with mental disorders*

Purpose: In this article, we contribute to the debate on medication compliance by exploring the conversational ‘‘technologies’ ’ entailed in the process of promoting clients ’ adherence to psychopharmacological prescriptions. Using a case study approach, we explore how medica-tion-related problems are dealt with in conversational interaction between the staff members and the clients of a mental health Therapeutic Community (TC) in Italy. Method: Four meetings between two staff members (Barbara and Massimo) and the clients of the TC were audio-recorded. The data were transcribed and analyzed using the method of Conversation Analysis. Results: Barbara and Massimo recur to practices of topic articulation to promote talk that references the clients ’ failure to take the medications. Through these practices they deal with the practical problem of mobilizing the clients ’ cooperation in courses of action that fit into the institutional agenda of fostering medication adherence. Conclusions: Barbara and Massimo’s conversational practices appear to reflect the assumption that medication-related problems can be reduced to compliance problems. This assumption works to make the clients accountable for their failure to take the medications while shaping a conversationa