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

Elina Weiste, Sari Käpykangas, Lise-Lotte Uusitalo and Melisa Stevanovic
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Elina Weiste: Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Helsinki, Finland
Sari Käpykangas: Finnish Institute of Occupational Health, P.O. Box 40, FI-00032 Helsinki, Finland
Lise-Lotte Uusitalo: Faculty of Social Sciences, University of Helsinki, P.O. Box 54, FI-00014 Helsinki, Finland
Melisa Stevanovic: Faculty of Social Sciences, University of Helsinki, P.O. Box 54, FI-00014 Helsinki, Finland

IJERPH, 2020, vol. 17, issue 16, 1-19

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.

Keywords: client involvement; client participation; cultural change; co-development; conversation analysis; social and health care professionals; interaction; qualitative research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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