Table 3 Persuasion

Non-Coercion

Professional Information

E.1

(NO208, nurse) No, I don’t agree with that (it refers to the case vignette presenting persuasion as coercion) […] I believe they should get the information from us then that they get it from somewhere else, but that we can then go in and explain and provide good information and meet them with the concerns they have

Assessment

E.2

(CH315 psychiatrist) (the patient) perceived it was his own decision. The argument I used has been essentially the confidence, I mean, it’s like to say the doctor doesn’t lay me, but she just tells me about something can harm me […] of course, this is persuasion

Motivation

E.3

(CA404, psychiatrist) So that’s kind of persuasive, it’s not saying: “If you cannot do this, then you have to do that.” It’s saying, “These are what your choices are,” but you show whatever you want for the patient, or whatever they want, you say to them “If you want this, then you’ve got to do that.” […] I don’t think we typically consider that persuasion (he refers to persuasion as presented in case-vignette as coercion), as much as… encouragement, offering hope

Coercion

Informational manipulation

E.4

(CR208, psychiatrist) Withholding information. In the example, a patient has psychotic symptoms, and he doesn’t perceive them, but rather reports only depressive symptoms. And then I tell him for a cure that has antipsychotic as well as anti-depressive activity. I underline this anti-depressive part to persuade him to take the care and keep this

Deceit

E.5

(IT103, psychiatrist) because I could say persuasion has an enormous grading of options. If I’m a good persuader, I can deceive a patient in a few seconds. In that sense persuasion became a kind of psychological violence If I have the skills because the simple information is poor communication, there’s not the option to propose a specific choice to the patient: information is neutral, persuasion is taking you away in your best interests

Manipulation

E.6

(MX104, psychiatrist) you are hooking the patient […] you are using alternatives to mislead and hook the patient […] it means manipulation but at the unconscious level

Threat

E.7

(EN316, social worker) You know, the more unwell they are, the more likely you’re going to use [murmurs of agreement, indecipherable talking over each other] the bigger, more questionable form of persuasion, “Do this or, you know…” in the hope that they get some insight and their mental health stabilises

Conditional offer

E.8

(SW416, psychiatrist) Then I use persuasion. I say things like: “I think you get worse if you don’t take your medicine, and if you don’t take your medicine, you know how it can end up.” My intention is not to threaten them, but to remind them