The purpose of this paper is to explore whether and how workers in a crisis resolution home treatment (CRHT) team experience the relationship between their personal history and professional role. This paper is based on 13 in-depth interviews with health professionals working in CRHT. The interviews were analysed using a hermeneutic-phenomenological approach. Participants expressed that there is a relationship between their personal history and professional role, and three themes are highlighted as particularly important in, namely experiences related to the participants as individuals, work-related experiences and family-related experiences. The participants write meaning into the relationship between their personal history and professional role. By relating and exploring their own life stories in the interviews, they work on forming meaning and identity. 1. Introduction Crisis resolution home treatment (CRHT) is a work approach that may put high emotional, relational, and professional demands on the team members. It challenges some traditional professional roles within the mental health care field by moving crisis resolution away from in-patient care and into the patients’ home. In most western countries, the services for people with mental health problems have gone through major changes over the last decades [1–3]. Norway, like many other western countries, is experiencing a rapid transition from traditional institutional care to an expansion into community-based mental health care for people with mental health problems [4]. CRHT team workers’ experience of their personal background and how they think it may contribute to their interest and motivation for their work roles as professionals is relatively little explored. The following research question will be explored and discussed. How do CRHT team members experience possible relations between their personal histories and professional roles? A professional role consists of experiences based on working background, education, career [5–9], and personal experiences [5, 7]. At the same time, the construction of a personal self is closely related to one’s history, family background, and life experiences, including the narrative organization of everyday life and specific events that are memorable to them [10, 11]. If and how a professional role as a CRHT team member and the experience of one’s personal self may be interrelated is an interesting question. The aim of this paper is to gain a deeper understanding by exploring how the team members reflect upon the experiences of their own personal histories and
References
[1]
A. Beck, T. J. Croudace, S. Singh, and G. Harrison, “The Nottingham acute bed study: alternatives to acute psychiatric care,” British Journal of Psychiatry, vol. 170, pp. 247–252, 1997.
[2]
M. Fulford and J. Farhall, “Hospital versus home care for the acutely mentally ill? Preferences of caregivers who have experienced both forms of service,” Australian and New Zealand Journal of Psychiatry, vol. 35, no. 5, pp. 619–625, 2001.
[3]
R. Mezzina, “Paradigm shift in psychiatry: processes and outcomes,” in Mental Health at the Crossroads: The Promise of the Psychosocial Approach, S. Ramon and J. E. Williams, Eds., pp. 81–93, Ashgate, Hampshire, UK, 2005.
[4]
B. Karlsson, M. Borg, and H. S. Kim, “From good intentions to real life: introducing crisis resolution teams in Norway,” Nursing Inquiry, vol. 15, no. 3, pp. 206–215, 2008.
[5]
E. A. Chan and J. K. Schwind, “Two nurse teachers reflect on acquiring their nursing identity,” Reflective Practice, vol. 7, no. 3, pp. 303–314, 2006.
[6]
C. L. Carraccio, B. J. Benson, L. J. Nixon, and P. L. Derstine, “From the educational bench to the clinical bedside: translating the Dreyfus developmental model to the learning of clinical skills,” Academic Medicine, vol. 83, no. 8, pp. 761–767, 2008.
[7]
D. A. Sch？n, The Reflective Practitioner: How Professionals Think in Action, Basic Books, New York, NY, USA, 1983.
[8]
L. V. Monrouxe, “Identity, identification and medical education: why should we care?” Medical Education, vol. 44, no. 1, pp. 40–49, 2010.
[9]
M. J. M. Cohen, A. Kay, J. M. Youakim, and J. M. Balacius, “Identity transformation in medical students,” American Journal of Psychoanalysis, vol. 69, no. 1, pp. 43–52, 2009.
[10]
D. P. McAdams, “The psychology of life stories,” Review of General Psychology, vol. 5, no. 2, pp. 100–122, 2001.
[11]
J. S. Bruner, Acts of Meaning, Klim, ？rhus, Denmark, 1999.
[12]
S. Johnson, “Crisis resolution and intensive home treatment teams,” Psychiatry, vol. 6, no. 8, pp. 339–342, 2007.
[13]
European Commission, “Improving the mental health of the population: towards a strategy on mental health for the European Union,” Green Paper, EU Health and Consumer Protection Directorate-General, Brussels, Belgium, 2005.
[14]
S. Guo, D. E. Biegel, J. A. Johnsen, and H. Dyches, “Assessing the impact of community-based mobile crisis services on preventing hospitalization,” Psychiatric Services, vol. 52, no. 2, pp. 223–228, 2001.
[15]
L. Davidson, J. Tondora, M. J. O'Connell, T. Kirk, P. Rockholz, and A. C. Evans, “Creating a recovery-oriented system of behavioral health care: moving from concept to reality,” Psychiatric Rehabilitation Journal, vol. 31, no. 1, pp. 23–31, 2007.
[16]
C. B. Joy, C. E. Adams, and K. Rice, “Crisis intervention for people with severe mental illnesses (Review),” in The Cochrane Library, The Cochrane Collaboration, 2008.
[17]
D. S. Heath, Home Treatment for Acute Mental Disorders: An Alternative to Hospitalization, Brunner-Routledge, New York, NY, USA, 2005.
[18]
G. Glover, G. Arts, and K. S. Babu, “Crisis resolution/home treatment teams and psychiatric admission rates in England,” The British Journal of Psychiatry, vol. 189, no. 5, pp. 441–445, 2006.
[19]
K. B. Hultberg and B. Karlsson, “Professional partners' experiences with a crisis resolution home treatment team (norwegian),” Nordic Magazine for Health Research, vol. 5, no. 1, pp. 2–14, 2007.
[20]
S. Kvale and S. Brinkmann, Interviews: Learning the Craft of Qualitative Research Interviewing, Sage, Los Angeles, Calif, USA, 2009.
[21]
P. E. Binder, H. Holgersen, and G. H. Nielsen, “What is a “good outcome” in psychotherapy? A qualitative exploration of former patients' point of view,” Psychotherapy Research, vol. 20, no. 3, pp. 285–294, 2010.
[22]
M. Van Manen, Researching Lived Experience: Human Science for an Action Sensitive Pedagogy, State University of New York Press, Albany, NY, USA, 1990.
[23]
S. M. Laverty, “Hermeneutic phenomenology and phenomenology: a comparison of historical and methodological considerations,” International Journal of Qualitative Methods, vol. 2, no. 3, pp. 21–35, 2003.
[24]
L. Finlay, “‘Outing’ the researcher: the provenance, process, and practice of reflexivity,” Qualitative Health Research, vol. 12, no. 4, pp. 531–545, 2002.
[25]
L. Finlay, “Through the looking glass: intersubjectivity and hermeneutic reflection,” in Reflexivity: A Practical Guide for Researchers in Health and Social Sciences, L. Finlay and B. Gough, Eds., pp. 105–119, Blackwell Science, Oxford, UK, 2003.
[26]
M. Alvesson and K. Sk？ldberg, in Reflexive Methodology: New Vistas for Qualitative Research, Sage, London, UK, 2009.
[27]
Binder, P. E. H. Holgersen, and C. Moltu, “Staying close and reflexive: an explorative and reflexive approach to qualitative research on psychotherapy,” Nordic Psychology, vol. 64, no. 2, pp. 103–117, 2012.
[28]
K. Malterud, “Qualitative research: standards, challenges, and guidelines,” Lancet, vol. 358, no. 9280, pp. 483–488, 2001.
[29]
K. Malterud, Qualitative Methods in Medical Research: An Introduction (Norwegian), Universitetsforlaget, Oslo, Norway, 2003.
[30]
A. Schütz and H. R. Wagner, On Phenomenology and Social Relations: Selected Writings, University of Chicago press, Chicago, Ill, USA, 1970.
[31]
D. E. Polkinghorne, Narrative Knowing and the Human Sciences, State University of New York Press, Albany, NY, USA, 1988.
[32]
J. S. Bruner, “The narrative construction of reality,” Critical Inquiry, vol. 18, no. 1, pp. 1–21, 1991.
[33]
Directorate of Health and Social Welfare, “You have come to the right place...Mobile acute services at district psychiatric centres,” Report IS-1358, Directorate of Health and Social Welfare, Oslo, Norway, 2006.
