Being Heard, Exerting Influence, or Knowing How to Play the Game? Expectations of Client Involvement among Social and Health Care Professionals and Clients

Abstract

Contemporary social and health care services exhibit a significant movement toward increasing client involvement in their own care and in the development of services. This major cultural change represents a marked shift in the client’s role from a passive patient to an active empowered agent. We draw on interaction-oriented focus group research and conversation analysis to study workshop conversations in which social and health care clients and professionals discussed “client involvement”. Our analysis focuses on the participants’ mutually congruent or discrepant views on the topic. The professionals and clients both saw client involvement as an ideal that should be promoted. Although both participant groups considered the clients’ experience of being heard a prerequisite of client involvement, the clients deviated from the professionals in that they also highlighted the need for actual decision-making power. However, when the professionals invoked the clients’ responsibility for their own treatment, the clients were not eager to agree with their view. In addition, in analyzing problems of client involvement during the clients’ and professionals’ meta-talk about client involvement, the paper also shows how the “client involvement” rhetoric itself may, paradoxically, sometimes serve to hinder here-and-now client involvement.

Construction and validation of a self‐direction measure for mental health care

“…Firstly clinical, a recent article based on interviews with clients and therapists, emphasized the importance of dialogue about client involvement between clients and therapists. The study showed how therapists and clients both have different expectations about client involvement, for example, regarding decision‐making and clients taking responsibility over the care (Weiste et al, 2020). Client involvement is complex for both therapists and clients, having this questionnaire can help remind therapists to discuss this important topic and will help organize the dialogue.…”

Feeling heard: Operationalizing a key concept for social relations

“…In this literature, the central focus is on listening behaviors per se and less so on their perception by the speaker (see Worthington & Bodie, 2017 for a review). The experience of being listened to is treated as an important and positive yet largely undefined outcome (e.g., Ingersol et al, 2018;Meyers et al, 2000;Weiste et al, 2020). We suspect that to feel heard a speaker must perceive their interaction partner as an attentive listener.…”

Experiential expertise in the co‐development of social and health‐care services: Self‐promotion and self‐dismissal as interactional strategies

“…Snyder, 2014). For instance, when clients in co‐development workshops analyzed by Weiste et al (2020a) were asked for their views on what client participation entailed, they highlighted the importance of actual decision‐making power, but viewed it as often lacking. This is consistent with Meriluoto's finding (2018, 22) that none of the clients she interviewed, who were participating in development processes and professional driven committees, had ever taken part in actual decision‐making or even been present in environments relevant to decision‐making.…”