A Case Against Making the Control of Clients a Negotiable Contingency for Interdisciplinary Teams
Tóm tắt
Most discussions of interdisciplinary teamsassume that cross-functional teams are desirable.Critical analyses of the fundamental contradictionsinherent in bringing together professionals with diverse ideologies, interests, contingencies, andtechnologies are rare. Even less common are discussionsof the negative consequences of these contradictions forclients. Based on observations in an institution for youth-in-trouble, this paper argues thatthe control of clients is one key process underlyingconflicts and dilemmas in interdisciplinary teams; itbuilds a case against making the control of clients a negotiable contingency for teams. Given theuniversal nature of control mechanisms, those mostdirectly responsible for control have a superiorbargaining position because, in order to be effective,their control routines must be consistent. Althoughthese workers may yield to other treatment ideologiesregarding particular clients, the overall outcome is theenhancement of their interests. Moreover, the outcome of negotiations may generate confusionfor clients because of inconsistencies in theapplication of control mechanisms. Three strategies tominimize interprofessional negotiations regarding the control of clients are discussed: theformulation of clear boundaries between thoseresponsible for control and those who are not; theestablishment of policies to address conflicts betweencontrol and competing treatments; and, client determinationof differential levels of interprofessional coordinationand cooperation.
Tài liệu tham khảo
ABBOTT, A. The system of professions: An essay on the division of expert labor. Chicago: The University of Chicago Press, 1988.
BOLMAN, L. G., & DEAL, T. E. Reframing organizations: Artistry, choice, and leadership. San Francisco: Jossey-Bass, 1991.
BUSH, M., & GORDON, A. C. The case for involving children in child welfare decisions. Social Work, 1982, 27, 309-314.
CLEGG, S. R. The theory of power and organization. London: Routledge and Kegan Paul, 1979.
COHEN, M. D., MARCH J. C., & OLSEN, J. P. A garbage can model of organizational choice. Administrative Science Quarterly, 1972, 17, 1-25.
DRESSLER, D. M., & NASH, K. B. Project team organization and its application to crisis intervention. Community Mental Health Journal, 1974, 10, 156-162.
DRINKA, T., & RAY, R. O. An investigation of power in an interdisciplinary health care team. Gerontology and Geriatrics Education, 1986, 6(3), 43-53.
EDWARDS, R. C. Contested terrain: The transformation of the workplace in the 20th century. New York: Basic, 1979.
FIORELLI, J. S. Power in work groups: Team members' perspectives. Human Relations, 1988, 41, 1-12.
FOUCAULT, M. Discipline and punish. New York: Random House, 1977.
GALBRAITH, J. (1977). Organization design. Reading, MA: Addison-Wesley.
GERSICK, C. Introduction. In C. Gersick (Ed.), Group management: Current issues in practice and research. The International Library of Management Series. Hampshire: Dartmouth Publishing Company, 1994, pp. xiii-xix.
GEORGE V., & WILDING, P. Ideology and social welfare. London: Routledge & Kegan Paul, 1985.
HALL, R. H. Interorganizational or interprofessional relationships: A case of mistaken identity. In W. R. Scott and B. L. Black (Eds.), The organization of mental health services: Societal and community system. Beverly Hills, CA: Sage, 1986, pp. 147-158.
HANDLER, J. F. Dependency and discretion. In Y. Hasenfeld (Ed.), Human services as complex organizations. Newbury Park, CA: Sage, 1992, pp. 276-297.
HASENFELD, Y. Power in social work practice. Social Service Review, 1987, 61(3), 469-483.
HAWKINS, R., & TIEDEMAN, G. The creation of deviance: Interpersonal and organizational determinants. Columbus, OH: Charles E. Merrill, 1975.
HAYES, S., & PATTERSON, M. Interaction between students in multidisciplinary health teams. Journal of Medical Education, 1975, 50, 473-475.
JOHNSON, T. Expertise and the state. In M. Gane and T. Johnson (Eds.), Foucault's new domains. London: Routledge, 1993, pp. 139-152.
KANE, R. A. Multidisciplinary teamwork in the United States: Trends, issues, and implications for the social worker. In S. Lonsdale, A. Webb, and T. L. Briggs (Eds.), Teamwork in the personal social services and health care: British and American perspectives. London: Croom Helm, 1980.
MEYER, J. W., & ROWAN, B. Institutionalized organizations: Formal structure as myth and ceremony. American Journal of Sociology, 1977, 83, 340-363.
MILES, R. E., & SNOW, C. C. Causes of failure in network organizations. California Management Review, 1992, 34(4), 53-72.
MORGAN, G. Images of organizations (2nd ed.). Thousand Oaks, CA: Sage, 1997.
PFOHL, S. J. Predicting dangerousness: The social construction of psychiatric reality. Lexington, MA: Lexington Books 1978.
QUEBEC, GOVERNMENT OF. Youth protection act. Statutes of Quebec, 1977, chap. 20.
RAINS, P., & TERAM, E. Normal bad boys: Public policies, institutions for youth and the politics of client recruitment. McGill-Queen's University Press, 1992.
SCHEID, T. L. An explication of treatment ideology among mental health care providers. Sociology of Health and Illness, 1994, 16, 668-693.
SINCLAIR, A. The tyranny of the team ideology. Organization Studies, 1992, 13(14), 611-626.
STRAUSS, A. L. Negotiations: Varieties, contexts, processes and social order. San Francisco: Jossey-Bass, 1978.
STRAUSS, A. L., BUCHER, R. EHRLICH, D., SABSHIN, M., & SCHATZMAN, L. Psychiatric ideologies and institutions. New York: Free Press, 1964.
TERAM, E. The Interorganizational Processing of Clients and Information: A Case Study. Unpublished doctoral dissertation. Montreal: McGill University, 1986.
TERAM, E. Interdisciplinary teams and the control of clients: A sociotechnical perspective. Human Relations, 1991, 44, 343-356.
TERAM, E. The Interprofessional Team as a Form of Organizational Control. A paper presented at the All Together Better Health Conference, London, July 16-19, 1997.
TERAM, E., & ERICKSON, G. The protection of children's rights as ceremony and myth: A critique of the review of institutional placements in Quebec and Ontario. Children and Youth Services Review, 1988, 10, 1-17.
WAITZKIN, H. The politics of medical encounters: How patients and doctors deal with social problems. New Haven, CT: Yale University Press, 1991.
WALTON, J. Making the theoretical case. In C. C. Ragin and H. S. Becker (Eds.), What is a case? Cambridge: Cambridge University Press, 1992, pp. 121-137.
WILDING, P. Professional power and social welfare. London: Routledge and Kegan Paul, 1982.