This study employs multimodal conversation analysis to examine the precursors of resistance displays during Reminiscence Therapy (RT) sessions, the format of the resistance exhibited by Chinese older adults with mild cognitive impairment (MCI), and the ways it was managed by caregivers. It is found that older adults with MCI display resistance through behaviors like initiating repair, denying question premises, changing topics, refusing overtly, being silent, laughing, and giving minimal responses. Non-verbal cues such as gestures, head movements, averted gaze, and facial expressions are also employed to convey their resistance. In response, caregivers employ various facilitative practices to counter this resistance. Resistance occurs when the assumptions embedded in the caregiver’s question conflict with what the older adults have access to, or the question may infringe on the older adult’s epistemic rights. Our findings also highlight the dynamic and collaborative construction of power through negotiation of resistance and facilitation from epistemic perspective. These insights offer valuable guidance for enhancing the effectiveness of RT and fostering a more collaborative relationship between participants during RT sessions.
AlburyCWebbHZieblandS, et al. (2022) What happens when patients say “no” to offers of referral for weight loss? Results and recommendations from a conversation analysis of primary care interactions. Patient Education and Counseling105(3): 524–533.
2.
AntakiC (2023) A gradient of more and less demanding impositions: Reflections on the special issue on resistance. Journal of Language and Social Psychology42(5–6): 679–687.
3.
ArundaleRB (2010) Constituting face in conversation: Face, facework, and interactional achievement. Journal of Pragmatics42(8): 2078–2105.
4.
BergenCStiversTBarnesRK, et al. (2017) Closing the deal: A cross-cultural comparison of treatment resistance. Health Communication32(12): 1495–1506.
5.
BlochSAntakiC (2022) How professionals deal with clients’ explicit objections to their advice. Discourse Studies24(4): 385–403.
6.
BrownPLevinsonSC (1987) Politeness: Some Universals in Language Usage. Cambridge University Press.
7.
BryanKMcIntoshJBrownD (1998) Extending conversation analysis to nonverbal communication. Aphasiology12(2): 179–188.
8.
ChafeWL (1979) The flow of thought and the flow of language. In: GivónT (ed.) Syntax and Semantics: Discourse and Syntax. Academic Press, pp.159–181.
9.
ChiangS (2009) Personal power and positional power in a power-full “I”: A discourse analysis of doctoral dissertation supervision. Discourse & Communication3(3): 255–271.
10.
DiniusCJPocknellCECaffreyMP, et al. (2023) Cognitive interventions for memory and psychological well-being in aging and dementias. Frontiers in Psychology14: 1070012.
11.
DionneFFleischhackerMMuntiglP, et al. (2024) Resisting wh-questions in business coaching. Frontiers in Psychology15: 1240842.
12.
DrewP (1997) “Open” class repair initiation in response to sequential sources of troubles in conversation. Journal of Pragmatics28: 69–101.
13.
EmborgC (2024) Enduring the silence: High silence tolerance and other tools for promoting topic initiations of a man with autism. Clinical Linguistics & Phonetics38(9): 857–879.
14.
FaircloughN (1989) Language and Power. Longman.
15.
FoucaultM (1978) The History of Sexuality: Volume I—An Introduction. Pantheon Books.
16.
HarrisS (1989) Defendant resistance to power and control in court. In: ColemanH (ed.) Working with Language: A Multidisciplinary Consideration of Language Use in Work Contexts. De Gruyter Mouton, pp.131–164.
17.
HaworthK (2006) The dynamics of power and resistance in police interview discourse. Discourse & Society17(6): 739–759.
18.
HallKLindCYoungJAOkellEVan SteenbruggeW (2018) Familiar communication partners’ facilitation of topic management in conversations with individuals with dementia. International Journal of Language & Communication Disorders53(3): 564–575.
19.
HepburnAPotterJ (2011) Designing the recipient: Managing advice resistance in institutional settings, Social Psychology Quarterly74(2): 216–241.
20.
HeritageJ (1984) Garfinkel and Ethnomethodology. Polity Press.
21.
HeritageJ (2005) Conversation Analysis and Institutional Talk. In: SandersRFitchK (eds) Handbook of Language and Social Interaction. Mahwah NJ, Erlbaum, pp.103–114.
22.
HeritageJRaymondG (2005) The terms of agreement: Indexing epistemic authority and subordination in talk-in-interaction. Social Psychology Quarterly68: 15–38.
23.
HeritageJSefiS (1992) Dilemmas of advice: Aspects of the delivery and reception of advice in interactions between health visitors and first-time mothers. In: DrewPHeritageJ (eds) Talk at work: Interaction in institutional settings. Cambridge University Press, pp.359–419.
24.
HeritageJ (2010) Questioning in medicine. In: FreedAEhrlichS (eds) Why Do You Ask? The Function of Questions in Institutional Discourse. Oxford University Press, pp.42–68.
25.
HeritageJ (2012a) Epistemics in action: Action formation and territories of knowledge. Research on Language & Social Interaction45: 1–29.
26.
HeritageJ (2012b) Navigating epistemic landscapes: Acquiescence, agency and resistance in response to polar questions. In: de RuiterJP (ed.) Questions: Formal, Functional and Interactional Perspectives. Cambridge University Press, pp.179–192.
27.
HuangLHQiZZhouDY (2024) Self-identity construction and pragmatic compensation in a Chinese DAT elder’s discourse. Applied Linguistics Review15(1): 83–117.
28.
HuangLiheQuHuiyuZhouDeyu (2023) Elders’ refusal speech act in cognitive assessment: A multimodal pragmatic perspective. Frontiers in Psychology14: 1026638.
29.
HumaBJoyceJBRaymondG (2023) What does “resistance” actually look like? The respecification of resistance as an interactional accomplishment. Journal of Language and Social Psychology42(5–6): 497–522.
30.
IbrahimHH (1999) Language, gender, and power: Analysis of theme and topic management in Arabic conversational discourse. Doctoral dissertation, Georgetown University.
31.
JanuszBBergmannJRMatusiakF, et al. (2021) Practices of claimin control and independence in couple therapy with narcissism. Frontiers in Psychology11: 596842.
32.
JeffersonG (1984) On the organization of laughter in talk about troubles. In: AtkinsonJMHeritageJ (eds) Structures of Social Action: Studies in Conversation Analysis. Cambridge University Press, pp.347–369.
33.
JiaLDuYChuL, et al. (2020) Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: A cross-sectional study. The Lancet Public Health5(12): e661–e671.
34.
LiYChanWCHMarrableT (2024) “I never told my family I was grieving for my mom”: The not-disclosing-grief experiences of parentally bereaved adolescents and young adults in Chinese families. Family Process63(1): 379–391.
35.
MaZQHuangLH (2024) Power relations in older adults’ cognitive assessment interaction in clinical setting: A multimodal pragmatic perspective. Chinese Journal of Applied Linguistics47(4): 612–633.
36.
MondadaL (2013) Displaying, contesting and negotiating epistemic authority in social interaction: Descriptions and questions in guided visits. Discourse Studies15(5): 597–626.
37.
MuntiglP (2013) Resistance in couples counselling: Sequences of talk that disrupt progressivity and promote disaffiliation. Journal of Pragmatics49(1): 18–37.
38.
MuntiglPHorvathAO (2014) The therapeutic relationship in action: How therapists and clients co-manage relational disaffiliation. Psychotherapy Research24(3): 327–345.
39.
OngBTseliouEStrongT, et al. (2023) Power and dialogue: A review of discursive research. Family Process62: 1391–1407.
40.
PecanacKELeSageEStephensE (2023) How hospitalized older adults and physicians negotiate plan-of-Care decisions during daily rounds. Health Communication38(4): 681–694.
41.
PomerantzA (1980) Telling my side: “Limited access” as a “fishing” device. Sociological Inquiry50(3–4): 186–198.
42.
PomerantzA (1984) Agreeing and disagreeing with assessments: Some features of preferred/dispreferred turn shapes. In AtkinsonJ. M.HeritageJ. (eds) Structures of social action: Studies in conversation analysis. Cambridge University Press, Cambridge, UK, pp.57–101.
43.
RaymondG (2003) Grammar and social organization: Yes/no interrogatives and the structure of responding. American Sociological Review68: 939–967.
44.
SacksH (1992) Lectures on conversation. Volumes I and II. Blackwell Publishers, Oxford.
45.
SchegloffEA (1968) Sequencing in conversational opening. American Anthropologist70: 1075–1095.
46.
SchegloffEA (1982) Discourse as an interactional achievement: Some uses of “uh huh” and other things that come between sentences. In: TannenD (ed.) Analyzing Discourse: Text and Talk. Georgetown University Press, pp.71–93.
47.
SchegloffEA (1995) Discourse as an interactional achievement III: The Omni-relevance of action. Research on Language and Social Interaction28(3): 185–211.
48.
SchegloffEA (2007a) Categories interaction: Person reference and membership categorization. Discourse Studies9(4): 433–461.
49.
SchegloffEA (2007b) Sequence Organization in Interaction: A Primer in Conversation Analysis, vol. 1. Cambridge University Press.
50.
SchegloffEASacksH (1973) Opening up closings. Semiotica7: 289–327.
51.
SlocombeFPeelEPilnickA, et al. (2024a) Reminiscence respecified: A conversation analytic examination of practice in a specialist dementia care home. SSM – Qualitative Research in Health6: 100462.
52.
SlocombeFPeelEPilnickA, et al. (2024b) Keeping the conversation going: How progressivity is prioritised in co-remembering talk between couples impacted by dementia. Health28(2): 272–289.
53.
StevanovicM (2018) Social deontics: A nano-level approach to human power play. Journal for the Theory of Social Behavior48(3): 369–389.
54.
StiversTHayashiM (2010) Transformative answers: One way to resist a question’s constraints. Language in Society39: 1–25.
55.
StiversTMondadaLSteensigJ (2011) Knowledge, morality and affiliation in social interaction. In: StiversTMondadaLSteensigJ (eds) The Morality of Knowledge in Conversation. Cambridge University Press, pp.3–24.
56.
SueW (2025) Generating positive self-descriptions in a research context: A discursive psychological and conversation analysis of interview products and practices. Qualitative Research in Psychology. Epub ahead of print. DOI: 10.1080/14780887.2025.2489475.
57.
TateASpencerKL (2024) High-stakes treatment negotiations gone awry: The importance of interactions for understanding treatment advocacy and patient resistance. Journal of Health and Social Behavior65(2): 237–255.
58.
TremblettMWebbHZieblandS, et al. (2024) The basis of patient resistance to opportunistic discussions about weight in primary care. Health Communication39(11): 2333–2345.
59.
van DijkTA (2008) Discourse and Power. Palgrave Macmillan.
60.
WangJ (2006) Questions and the exercise of power. Discourse & Society17(4): 529–548.
61.
WebbJWilliamsVReadS, et al. (2024) A social practice theory approach to exploring the ubiquity of quizzes in dementia care settings. Ageing and Society44(8): 1809–1830.
62.
WuYYangS (2022) Power plays in action formation: The TCU-final particle ba (吧) in Mandarin Chinese conversation. Discourse Studies24(4): 491–513.
63.
ZhangHLiuPYingJ, et al. (2018) Evaluation of MESSAGE communication strategy combined with group reminiscence therapy on elders with mild cognitive impairment in long-term care facilities. International Journal of Geriatric Psychiatry33(4): 613–622.
64.
ZinielSI (2008) Cognitive aging and survey measurement. Doctoral Dissertation. University of Michigan. Ann Arbor, MI.
