Negotiating Trouble: The Social Construction and Management of Trouble in a College Psychiatric Context

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Abstract
In examining the way college students and their campus psychiatrists define and manage troubles, we identify specific aspects of the interpersonal situation critical to that process. The labels eventually attached to troubles and the plans of action that are instituted derive their plausibility from the social assumptions of the collegiate community. Furthermore, the way the situation is defined involves a process extending beyond the face-to-face negotiations of professionals and their clients. The influence of situational features such as the time and place of events, the structure of the social network, and specific persons involved are shown to exercise direct effects on how trouble is socially understood and managed. Attending primarily to the ideas and behavior of professionals, inside and outside the college, we discuss the importance of differing frames of reference emerging from membership. We also explicate some of the ways contextual features become defined as “contingencies” and are relegated to the background of practitioners' thinking. In so doing, they achieve an orderly reaffirmation of their professional ideas and the ability to act on the situation as they see it, sometimes at the cost of gross conceptual over-simplification. Considered as negotiated achievements of the persons involved, trouble and its management emerge as highly plastic social phenomena containing a multiplicity of potential alternative interpretations and rich possibilities for therapeutic improvisation.

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