Formulating problems in psycho-social rehabilitation

Abstract

This article presents a study on team talk in psychosocial rehabilitation with reference to collective decision making. It focuses on problem formulation processes that occur during weekly team meetings in a Swiss organization providing psychosocial rehabilitation to chronic mental health patients. The corpus of team meetings (34 hours of recorded talk) was analyzed along three narrative dimensions: participation framework, timeline organization and forms of evaluation. The analysis was supported by ethnographic information (field notes collected during participant observation over ten months), in order to access the local conception and organization of rehabilitation work, which is repeatedly referred to and reshaped through discourse. 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 their rehabilitation model and the actual opportunities they have. Further, the 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 that make up a tapestry.