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Reed, Alexander
Publisher: Northumbria University
Languages: English
Types: Doctoral thesis
Subjects: B700, B900
Abstract Examination of the literature suggests that relationships between psychiatric staff and the families of service-users are often characterized as unsatisfactory, and that psychiatric hospitals provide an unconducive environment for the implementation of family and network-orientated approaches. This research focused upon the development in an adult psychiatric admissions unit of family- staff network meetings, that occurred when a person entered hospital. These network meetings, or 'reception meetings', were strongly influenced by the Finnish social network approach (Seikkula, Alakare & Aaltonen 2001), which focuses upon the creation of open dialogue between the service-user, family members and professionals. An overall aim of the study was to generate a body of practice-based narrative accounts which might act as a catalyst to practice developments in this field. Drawing upon a postmodern methodological framework, a range of methods were employed to engage with the multiple voices of service-users, family members and staff in the research site. Data sources included semi-structured interviews, participant observation, secondary data, and material from a research diary that was maintained as a reflexive tool in relation to the practitioner research process. A 'voice-centred relational method' (Brown and Gilligan 1992) provided a heuristic device for guiding data interpretation which facilitated multiple readings from different perspectives. A subsequent stage of data-analysis entailed developing more general connecting themes from across the data-set. A number of themes are developed in the research, which principally relate to the tensions associated with the introduction of a relationally orientated, reflective approach to practice within an individually-based medico-psychiatric organizational context. Practice approaches are discussed which appeared to facilitate an ethos of 'safe uncertainty' (Mason 1993) within network meetings, which is a necessary condition for dialogue. Connections are also drawn between themes generated in this study and the broader contexts of government policy, professional and organizational development, and practice-based research.
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