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Teamwork and Team Talk - Decision-making across the Boundaries in Health and Social Care - Srikant Sarangi

Formulating problems in psycho-social rehabilitation: Narrative activity within the boundaries of an institutional framework

Teamwork and Team Talk - Decision-making across the Boundaries in Health and Social Care - Srikant Sarangi

Description

This article presents a study on team talk in psycho-social rehabilitation, with reference to collective decision making and in particular to problem formulation processes occurring during the weekly team meetings in a Swiss organization providing psycho-social rehabilitation to chronic mental patients. The corpus of team meetings (34 hours of recorded talk) was analyzed along 3 narrative dimensions: participation framework, timeline organization and forms of evaluation. The analysis was supported by ethnographic information (field notes collected during participant observation over 10 months), in order to access the local conception and organization of rehabilitation work, which is repeatedly referred to and reshaped through discourse. On the one hand, the discursive practices identified show that team members learn to formulate problems in a way that allows them to identify and plan interventions in line with the rehabilitation model and the actual opportunities they have. On the other hand, role-related forms of participation highlight how different professionals contribute to the problem formulation in specific ways. In sum, the interaction turns out to be strongly centralized around the role of a meeting coordinator, who is able to enhance the participation of the other team members and to build institutional narratives on the basis of individual contributions, carrying out discursive work that can be metaphorically described as the weaving and knotting threads resulting in a tapestry.

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