Wanting to work: managing the sick role in high-stake sickness insurance meetings

This article respecifies and develops Parsons's sick role theory, focusing on the postulate that the sick person must 'want' to get well. Using conversation analysis and discursive psychology to study how the psychological term 'want' is used in high-stake, multi-professional meetings with sickness benefit claimants in Sweden, the article shows how establishing that one 'wants' to get well requires extensive interactional work. In the examined meetings, the sick person's 'want' formulations make explicit the relationship between 'wants' and illness or inabilities, thus allowing for motivational character to be established without committing to its implications, and without appearing strategic or biased. By contrast, professional parties in the meetings invoke the sick person's 'wants' either to hold them accountable, or for establishing a desired course of recovery, confirming the centrality of such 'wants' in this setting as well as the risks associated with expressing them. The article suggests that analysing psychological matters as they are oriented to by participants renders sick role theory relevant for a wide range of settings and respecifies criticism of the model.