Interaction, Ideology, and Practice in Mental Health Rehabilitation

Abstract

This paper investigates how two ideologies of mental health rehabilitation—recovery ideology and communal approach—are realized in interactional practices associated with psychosocial rehabilitation. More spesifically, the paper discusses employee selection in the context of the Clubhouse-created Transitional Employment (TE) programme, which offers employment opportunities for rehabilitants. The paper describes how joint decisions are established during the moment-by-moment interactional processes at the Clubhouse. Drawing from the data set of 29 video-recorded rehabilitation group meetings, and Conversation Analysis as a method, the paper analyzes two questions: (1) How do the participants talk about the decision-making process associated with the TE on a “meta” level? And (2) how are the TE employees actually selected in the turn-by-turn sequential unfolding of interaction? When discussing the TE employee selection procedure on a “meta” level, the values of recovery ideology focusing on client empowerment and self-determination are prevalent. Also, the central ideals of the communal approach—openness and collaboration—are defended as decision-making guidelines. However, in the meetings where decisions on the TE employees are concretely made, there is a mismatch between the two ideological approaches to rehabilitation and the actual practices observable in the relevant interactional encounters.