Between a rock and a softer place—A discourse analysis of helping cultures in crisis resolution teams. (March 2018)

• Record Type: Journal Article
• Authors: Klevan, Trude; Karlsson, Bengt; Ness, Ottar; Grant, Alec; Ruud, Torleif
• Is Part Of: Qualitative social work. Volume 17:Number 2(2018)
• Page Start: 252
• Page End: 267
• Publication Date: 2018-03
• Subjects: Discourse analysis -- discursive psychology -- crisis resolution team -- mental health crisis -- focus groups; Social service -- Periodicals; Social service -- Research -- Periodicals; Social service -- Evaluation -- Periodicals; 361.305
• DOI: 10.1177/1473325016668962
• Languages: English
• ISSNs: 1473-3250

Abstract

Crisis resolution teams are a community-based service, targeting adults experiencing acute mental health crises. The rationale for the development of crisis resolution teams is both value and efficacy-based: crisis resolution teams should contribute to the humanizing of mental health services and to enhanced efficacy. This diversity in purpose appears to affect the practices of help that are offered by crisis resolution teams, which research has shown to vary greatly. A discursive approach recognizes that practices are shaped by external paradigms and structures, and clinicians' construction of professional identities and practices through their talk and meaning making. Thus, this study used a discursive psychological approach to identify discourses through which crisis resolution team clinicians talk about and understand helpful help in mental health crises. Focus group interviews with clinicians from eight crisis resolution teams revealed two broad and contradictory discourses: helpful help as something "made" with crisis resolution team workers as creators of collaborative and innovative practices, and helpful help as something "given" with the crisis resolution team workers as representatives of a predefined specialist mental health service culture. The contradictions between these discourses reflect the diverse rationale for the development of crisis resolution teams and the possible tensions and pressures under which crisis resolution team work is conducted. In this overall context, the study further critically examined the tensions between the discourse of constructing new practices, and existing practices constituted by the specialist mental health services' traditional discourse. Failing to constantly reflect upon and question these tensions in collaboration with service users, carers, and other services can impair creativity and the development of humanizing helpful help.