Promoting Client Participation and Constructing Decisions in Mental Health Rehabilitation Meetings

Abstract

The chapter analyses practices by which support workers promote client participation in mental health rehabilitation meetings at the Clubhouse. While promoting client participation, the support workers also need to ascertain that at least some decisions get constructed during the meetings. This combination of goalspromoting participation and constructing decisionsleads to a series of dilemmatic practices, the dynamics of which the chapter focuses on analyzing. The support workers may treat a client's turn retrospectively as a proposal, even if the status of the client's turn as such is ambiguous. In the face of a lack of recipient uptake, the support workers may remind the clients about their epistemic access to the content of the proposal or pursue their agreement or commitment to the proposed plan. These practices involve the support workers carrying primary responsibility over the unfolding of interaction, which is argued to compromise the jointness of the decisionmaking outcome.

Mental health rehabilitees’ agency construction and promotion in community-based transitional work programme

“…In addition to interactive agentic positioning, the staff members take part in the rehabilitees’ agency construction by actively interpreting the rehabilitees’ turns as I-formatted action proposals (see Excerpt 1) – even when the status of the turn as an action proposal is unclear (see also Stevanovic et al, 2020b ). Excerpt 5 is from a TE meeting in which S1 has introduced an upcoming seminar on transitional work.…”

“…S1”s interpretation is interesting, as R2”s turn could easily be interpreted as a hint that the shop would make a suitable TE option for him—not that he would like to contact Lidl. With the action proposal interpretation, S1 thus promotes R2”s agency as a discourse user (Stevanovic et al, 2020b ) but impedes his agency as a future employer contactor. Much the same way in Excerpt 4, S1 invites everyone to validate his and R1”s agentic positions—and thus promotes their agency as discourse users but impedes their agency as future meeting participants.…”

“…Stevanovic et al ( 2020b , 2020 , 2020a ) have studied joint decision-making in the Clubhouse context and identified the practices by which the Clubhouse staff promote mental health rehabilitees’ agency in joint decision-making processes. First, the staff encourage rehabilitees’ responsiveness to the proposals they make.…”

“…First, the staff encourage rehabilitees’ responsiveness to the proposals they make. For example, the staff may remind the rehabilitees of their prior experience and knowledge, which enables them to comment on the proposal (Stevanovic et al, 2020b ). The staff may also fine-tune the openness as opposed to the closedness of the form of their proposal, to provide the rehabilitees with genuine opportunities to contribute to the content of the decisions, while making participation easy enough for them (Stevanovic et al, 2020a ).…”

“…Second, in cases in which the rehabilitees make proposals, the staff may encourage further participation by enthusiastically elaborating on these proposals (Stevanovic et al, 2020 ). The staff may also occasionally retrospectively treat rehabilitees’ turns as proposals—even if the status of the turn as a proposal is not clear (Stevanovic et al, 2020b ).…”