The Co-Construction of Self-Talk and Illness Narratives: An HIV Intervention Case Study

by Bueno, Yvette

This case study investigates the co-construction communication patterns that emerged during an Human Immunodeficiency Virus (HIV) intervention designed to reduce negative and critical self-talk. The transcripts of eight sequential acupressure and behavioral (SAB) counseling intervention sessions between a therapist and two medically nonadherent HIV-infected women were analyzed using Giorgis (1989, 1994, 1997, 2006) phenomeonlogical method of inquiry. The analysis revealed three major themes: assessing the present, reviewing the past, and forging the future, and eight subthemes: safe atmosphere, disclosure, negotiating meaning, releasing the past, breaking the past-to-present pattern, reducing uncertainty, generating options, and projecting images. Prior to the intervention sessions, the women reported experiencing negative and critical self-talk and inconsistent medication adherence. Self-talk and illness narrative modifications were evident within and across sessions as the therapist used sequential acupressure and behavioral counseling techniques. During the one month follow-up, the participants reported no experience of negative and critical self-talk and described actions taken toward goals discussed and imagined during the intervention such as medication adherence, exercise, and reenrollment in school. The co-construction themes that emerged in the intervention were consistent with findings in the comforting message literature with specific parallels to the factor analysis findings of Bippus (2001). This work lends support to comforting message research and suggests that distinctions between everyday comforting messages and chronic illness support strategies may be more similar than anticipated. Other study conclusions include clinical and practical implications for people working with HIV-infected individuals.