Constructing shared understanding - A grounded theory exploration of team case formulation from multiple perspectives

BF Psychology

Herhaus, Jenny ; Gumley, Andrew

University:University of Glasgow

Department:Institute of Health and Wellbeing

关键词: team formulation, recovery, psychosis, grounded theory;   

Others  :  http://theses.gla.ac.uk/5726/1/2014herhausdclinpsy.pdf

来源: University of Glasgow

【 摘 要 】

Objectives: The use of formulation in teams is becoming increasingly established. Yet, research into this area is still limited. This study set out to explore team formulation from multiple perspectives in the context of an early intervention first episode psychosis service.Method: A social constructionist version of grounded theory was used to explore experiences of team formulation and care of fifteen participants (clinical psychologists, other multidisciplinary team members, and service-users), using semi-structured interviews. A phased approach to data collection and analysis facilitated theoretical sampling and triangulation. Transcripts were subjected to line-by-line and focused coding to support the development of categories grounded in the data. Results: An emerging model of team formulation arose from the data, comprised of two levels - ‘value and function’ and ‘processes’ - that were interrelated and made up of sub-themes. ‘Value and function’ of team formulation ultimately was to improve engagement and care for service-users at risk of arrested recovery. This was seen to be facilitated by ‘constructing understanding’ and ‘broadening perspectives’, resulting in ‘flexibility, consistency and empathy’ that allowed for person-centred care planning and the establishment of better relationships with service-users. Team formulation involved and required staff to ‘negotiate roles’ and ‘manage uncertainty’. The data indicated the importance of a system or space that promotes the development of mutuality of meaning and shared understanding. Conclusions: This study indicated the systemic value of team formulation in supporting people who have difficulties engaging with services and staff working with them. The emerging model derived provides a meaningful departure point to develop a more comprehensive theory of team formulation that could provide a foundation for improving, developing and disseminating this practice.