Building, Maintaining, and Assessing Trusted Influence: A Grounded Theory of Clinical Social Workers on Interprofessional Behavioral Health Teams

Background and Purpose:

This qualitative grounded theory study sought to generate a practice and policy-relevant grounded theory from conceptualized data of clinical social work professionals’ experiences and concerns about working on interprofessional behavioral health teams. Although there is a growing literature related to interprofessional teams, there is still a gap in understanding the perspective and experiences of licensed clinical social workers who are on these teams in behavioral health settings. And even less is known about the ways in which collaboration on these teams have the ability to address racial and economic inequality. Given that inequality is a central focus for social work, it is important to understand the ways in which social workers can gain trusted influence in order to highlight these concerns for the team.

Method:

Classic grounded theory (GT) methodology was used as a systematic process for discovering theory from data (Glaser & Strauss, 1967). Non-structured, adjusted, conversational interviews were conducted with 22 clinical social workers (LCSWs) who were employed in interprofessional behavioral health care teams. Purposeful, snowball, and theoretical sampling led to the selection of participants. This study involved the simultaneous collection of data, coding, and analysis with the constant comparative method that resulted in a set of conceptual hypotheses. Field notes were taken during each interview and then coded for conceptual categories that led to the development of a theory. The final sample included a diverse representation of social workers, with participants holding different level positions on their teams.

Results:

The main concern that arose out of research interviews was the need to develop trusted influence within the team in order to fully engage in their role and address issues related to racial and economic inequality. The research participants resolved this main concern through the social process of Building, Maintaining, and Assessing Trusted Influence. This process is composed of four circular strategies that work in tandem including: 1) clarifying value and role, 2) building trust and connection, 3) applying context agility and 4) expanding influence. Each strategy is illustrated by a basic social process of behaviors that support and inhibit one’s ability to develop trusted influence within a team.

Conclusions and Implications:

Interprofessional behavioral health teams typically serve persons who are at risk for chronic health conditions that include mental health concerns and addictions (The National Council for Behavioral Health, 2019). Many clients represent an underserved population that experience discrimination in health care due to racial and economic inequality. Thus, the trusted influence of social workers on these teams is critical to address these issues, which are typically overlooked by other professionals on the team. Finally, although this theory was developed from the experiences of LCSWs, it likely has a broader range of application to any position where teamwork is involved including other healthcare providers, educational teams, business teams, sports teams, community organizations, and anyone desiring engagement with others in a group setting.