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From plan meetings to care plans: Genre chains and the intertextual relations of text and talk

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Abstract

Abstract This article examines care plan meetings between professionals and clients held in a mental health supported housing unit. The article asks what is discussed about the recording of the plan and how it is discussed in the meetings. The study focuses on intertextual institutional interaction. The methodical tools used are genre and the genre chain. As a result of the analysis, we gain information on how the plan form, as a product of joint discussion through the meeting interaction, becomes the basis of the care plan. In addition, the article highlights at which stages and for what purposes the care plan is discussed, and how earlier texts and discussions about the client’s situation serve as resources for making the plan. Plan forms have a significant role in directing the meeting conversation, the transferring of the information and producing and maintaining the care plan discourse.

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... In light of the nature of our data, we ask the following question: how does the structuration of client-oriented and system-oriented practice appear in social work with disabled people based on an examination of client documentation? Our interest is in making the structuration processes of social work practice more visible to increase critical consciousness and reflexivity, as well as awareness of important but partially hidden features related to client orientation (see Wheeler-Brooks 2009;Günther, Raitakari, and Juhila 2015;Kivistö and Hautala 2020). ...
... Despite the extent of the social work field, many established and institutionalized practices can be identified inside social work as 'structural principles' or 'structural features' (Giddens 1984, xxvii). For example, on a global scale, social work is guided by its common values, definition, goal and target (Günther, Raitakari, and Juhila 2015;Ornellas et al. 2019). Nationally, for example, the laws are strong social rules making impact on structuration (Giddens 1984, 23). ...
... We understand documentation as a structured practice linked to case-based and processual social work, and client documents as providing a possible recording of the social work performed and its client orientation (see Günther 2012;Kivistö and Hautala 2020). As a part of structured practice, standardized forms influence writing and interaction in social work, and a more active interviewer role for the social worker generally provides less space for the client's agency in documentation (Günther, Raitakari, and Juhila 2015;Martinell Barfoed 2018). Although studies have highlighted the idea that standardized forms add quality to social work documentation and ensure that limited resources are allocated to documentation that is based on necessity (Cumming et al. 2007;Skillmark and Denvall 2018), it is important to consider whether cases are documented from the client-oriented perspective of individual situations or whether system-oriented documentation forces those situations into a certain format shaped by standardized, mechanical and bureaucratic forms and practices (see Beresford and Croft 2004;Günther, Raitakari, and Juhila 2015;Martinell Barfoed 2018). ...
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Social work practice and related documentation are being challenged by the consumerist–managerialist discourse, which simultaneously emphasizes the aims of a client orientation and the demand for economical and efficient activity that reflects a system orientation. This article explores the structuration processes of social work practice in the context of case-based social work with disabled people in Finland. The theoretical framework is provided by Anthony Giddens’ structuration theory. By applying qualitative multiple case study research and analysing client documents from seven individual cases, two combined cases are reconstructed: a client-oriented case and a system-oriented case. Based on the analysis, the prevailing structure of social work practice is structured between the two dimensions, reflecting intersections of client orientation and system orientation. The findings show, that structuration of client-oriented social work practice throughout a case requires social work to increase its critical consciousness and reflection on the client’s need in addition to have various resources. The structuration of client-oriented social work practice should also be visible in client documents. The article concludes that every encounter between organizational structures, the social worker and the client represents a new opportunity to structure client-oriented social work practice.
... We investigate the intertextuality in IEPs, an analytical concept that follows the discourse analytic tradition (see, e.g., Fairclough, 1992aFairclough, , 1992bKamberelis & Scott, 1992;Linell, 1998). This is due to our understanding of IEPs as essentially intertextual: they are written, based on discussions with parents and specialists, and rooted in the institutional practices of writing (see also Günther, Raitakari, & Juhila, 2015;Ravotas & Berkenkotter, 1998). In addition to education, intertextuality in documents have been studied in many professional fields, such as psychiatry and therapy (e.g., Ravotas & Berkenkotter, 1998), criminal law (e.g., Komter, 2006), mental health care and social work (e.g., Günther et al., 2015), and pediatrics (e.g., Kelle, Seehaus, & Bollig, 2015;Schryer, Bell, Mian, Spafford, & Lingard, 2011). ...
... This is due to our understanding of IEPs as essentially intertextual: they are written, based on discussions with parents and specialists, and rooted in the institutional practices of writing (see also Günther, Raitakari, & Juhila, 2015;Ravotas & Berkenkotter, 1998). In addition to education, intertextuality in documents have been studied in many professional fields, such as psychiatry and therapy (e.g., Ravotas & Berkenkotter, 1998), criminal law (e.g., Komter, 2006), mental health care and social work (e.g., Günther et al., 2015), and pediatrics (e.g., Kelle, Seehaus, & Bollig, 2015;Schryer, Bell, Mian, Spafford, & Lingard, 2011). ...
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