在住房优先提供者中创造团队文化和恢复导向的话语过程

Stacey L. Barrenger, V. Stanhope, K. Atterbury
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引用次数: 3

摘要

心理健康服务必须以康复为导向。虽然项目的结构方面可以影响服务提供者对康复原则的取向,但以员工态度、价值观和信仰为例的团队文化是将康复原则纳入日常实践的核心。本研究采用Fine(1979)的文化框架,考察了住房优先项目团队会议中的话语过程。研究人员观察了团队会议,并对来自两个自信的社区治疗团队的病例管理人员进行了深入的半结构化访谈。开放编码识别了以康复语言为基础的话语过程的类别,更高层次的编码派生了与团队会议期间使用康复导向文化相关的主体间主题。话语过程包括给予怀疑的好处,保留判断,庆祝小事情,强调积极的一面,软化消极的一面。通过这些话语实践,团队通过使用缓和情况、规范行为和认可居民成功的语言来引导房东和提供者引发的事件,这有助于促进对居民的积极讨论,而不是将他们的行为病态化。了解有助于团队文化的潜在过程可以告知并促进以恢复为导向的实践的实施。
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Discursive Processes Creating Team Culture and Recovery Orientation Among Housing First Providers
A recovery orientation is imperative in mental health services. While structural aspects of programs can influence service providers’ orientation to recovery principles, team culture as exemplified by staff attitudes, values, and beliefs is central to the incorporation of recovery principles in everyday practice. Using Fine's (1979) idioculture framework, this study examined the discursive process in team meetings at a housing first program. Researchers observed team meetings and conducted in-depth, semistructured interviews with case managers from two assertive community treatment teams. Open coding identified categories indicating discursive processes grounded in the recovery language and higher-level coding derived intersubjective themes related to the use of recovery oriented culture during team meetings. Discursive processes included giving benefit of the doubt, withholding judgment, celebrating small things, and accentuating the positive and softening the negative. Using these discursive practices, the team navigated triggering events from landlords and providers by engaging in language that defused situations, normalized behaviors, and recognized residents’ successes, which served to facilitate positive discussions about residents rather than pathologizing their behaviors. Understanding the underlying processes contributing to team culture can inform and facilitate the implementation of recovery-oriented practice.
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