Using Ethnographic Methods to Explore Team Culture and Recovery Orientation
Methods: Over the course of a year, researchers followed 14 case managers from two treatment teams within a Housing First program. Researchers observed team meetings and took field notes on the social interaction between case managers. In-depth semi-structured interviews were also conducted with each study participant. Data analysis was guided by symbolic interactionism theory (Blumer, 1969). Open coding identified categories indicating discursive processes and higher level coding derived intersubjective themes related to representation of service users and meaning making.
Results: Team meetings allowed a space for staff members to translate and understand service users’ behaviors. The interactions showed discursive processes that accentuated the positive and softened the negative situations. Team members used techniques such as giving benefit of the doubt, normalizing behavior, avoidance of medical model terminology, employing humor, and being non-judgmental as alternate ways to frame what could be perceived as perplexing or difficult behaviors among service users. Small successes were celebrated and language served to heighten service user strengths. These discursive processes oriented providers to a recovery-oriented approach, representing service users as holistic individuals and creating a shared frame of reference for the team.
Conclusions and Implications: Through these discursive processes, case managers understood the life situations, hopes, goals, and needs of service users. The co-construction of narratives had a recursive quality: shaping a team culture that in turn influenced their future interactions with service users. While structural aspects of mental health programs can incorporate recovery principles, the essence of recovery-oriented practice is often embedded in team culture. Understanding the underlying processes that contribute to team culture can inform the implementation of recovery-oriented practice beyond structural reforms.
Blumer, H. (1969). Symbolic Interactionism: Perspective and Method. Englewood Cliffs, NJ: Prentice-Hall