Requests for concrete actions in interaction: How support workers manage client participation in mental health rehabilitation
Abstract
In this study, we examine how support workers produce requests for concrete actions and, in this way, manage client participation in mental health rehabilitation. Drawing on Finnish rehabilitation group meetings as data and on conversation analysis, we examine how support workers design their requests for concrete action from clients, how clients respond, and how support workers deal with clients’ responses. The results reveal that support workers tend to use verbs indicating willingness when implementing their requests, whereas clients resort to the modality of possibility. By orienting to willingness, the support workers invoke clients’ sense of responsibility to contribute to group activities and simultaneously avoid questioning their capabilities. On the other hand, clients orient toward the underlying assumptions of social responsibility rather than to their own personal preferences. To conclude, our study demonstrates how support workers address the dilemma of increasing client participation and showing respect for client self-determination.
Keywords:
Publication history
Table of contents
Participation is a major element of a happy and fulfilling life. It is both a key ingredient in tackling the challenges faced by present-day society (e.g., Brodie et al. 2009; Parker 2007) and a crucial building block in the development of a healthy sense of self (Corrigan et al. 1999; Kirby and Keon 2006). It is known that the active participation of mental health clients in their own lives and care increases their levels of empowerment and enhances their satisfaction with their treatments and overall levels of health (Corrigan et al. 1999; Hibbard and Greene 2013; Kirby and Keon 2006). Current international mental health policy recommendations thus emphasize the importance of client participation (Hibbard and Greene 2013; Royal College of Psychiatrists Social Inclusion Scoping Group 2009; WHO 2010). Participation brings not only social recognition but also awareness of one’s social worth as a person who has something to say on common matters. Notably, however, participation as a goal is something that can only be constituted intersubjectively through interactions with other people. The primordial site of life in which participation is realized is therefore the face-to-face real-time interaction between individuals. Our aim in this paper is to examine concrete interactional practices – requests for concrete tasks – that are used to encourage participation in the context of mental health rehabilitation. Our data are from community meetings in Finland, and the language used is Finnish.
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