Investigating question-answer sequences in child mental health assessments: Engaging children and families through declarative question design

Objective: In mental health settings, before a child can be diagnosed with a mental health condition, they must initially be assessed. These assessments are characterised by question-answer sequences with the child and family members, and our objective is to explore the function of declarative questions.

Methods: Video recordings of mental health assessments from 28 families were collected, each being approximately 90 min. Referred children were aged 6-17-years. Data were transcribed using the Jefferson approach and conversation analysis was used.

Results: Attention to question-answer sequences identified that one common type was the declarative question. We focus on three identifiable forms: clean language short declaratives, declaratives with extreme case formulations, and reformulation declaratives.

Conclusions: The response to these three types of declaratives formed the basis for subsequent question-answer elaboration sequences. The question functioned both to engage the child directly and align with other family members.

Practice implications: Implications for practitioners are that these types of declarative questions offer a resource to engage in fact-checking in a way that is non-face-threatening. Conversation analysis provides a methodological tool for practitioners to engage in reflective practice to enhance their clinical skills in relation to question design.