When No Is not an Option: The Immunization against Silence in a Motivational Interview about Marijuana Use

Niels Åkerstrøm Andersen*, Justine Grønbæk Pors

*Corresponding author for this work

    Research output: Contribution to journalJournal articleResearchpeer-review


    Many studies have documented how welfare service and professional practices increasingly depend upon the willingness of the citizen to engage actively in dialogues with professionals. This, however, produces the problem of how to deal with citizens who are silent. The framework of Motivational Interviewing presents itself as one solution to this problem. This article explores how Motivational Interviewing operates with a set of strategies to avoid the silence of citizens. We draw on theoretical concepts developed by Niklas Luhmann to analyse a particular instantiation of Motivational Interviewing produced by the Danish National Board of Health, namely a conversation concept entitled, the Marijuana Conversation. We ask thus: what is put at stake when health communication is designed to anticipate and make itself immune to the citizens’ refusal to have a dialogue. Our analysis identifies the different strategies of the conversation concept to make it difficult for the citizen to refuse continued communication. We conclude that by trying to make itself immune to the citizen’s ‘no’, the conversation undermines the possibilities of reaching its objective of empowering the citizen.
    Original languageEnglish
    JournalSocial Theory & Health
    Issue number4
    Pages (from-to)443–462
    Number of pages20
    Publication statusPublished - Dec 2019

    Bibliographical note

    Published online: 5. August 2019


    • Motivational interviewing
    • Health prevention
    • Silence
    • Niklas Luhmann
    • Social immune mechanisms

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