Betina Dybbroe

Introspection as intra-professionalism in social and health care

Abstract This article analyses two cases from health and social care, adopting a psycho-societal approach. The analysis highlights how professionalism evolves and develops through an introspection of the relational and scenic processes between professionals, as well as between the professional and the client or patient. As a phenomenon at the core of professional practice, it will be argued that introspection needs to recognize and encompass the intra- and inter-psychic responses and understandings of professionals and their clients and patients. The first case places supervision as a learning space, where framing and complex exchanges of loss and confirmation, and of denial and displacement take place between a group of social workers and their supervisor. In the second case, it becomes apparent how the research interview opens up an opportunity for processing the emotions and socially critical experiences involved in hospital work.

The psycho-societal in social and health care: implications for inquiry, practice and learning in welfare settings

I always feel bad if I know that I leave personsclients in the wake of my professional work. Usually they don’t get what I think they are in need of because I am driven by what the politicians have decided. Or someone in charge thinks that I am capable of doing everything between heaven and earth . . . and I know that if I haven’t had time for my last patient’s client, if and they have been sitting and waiting for me all day then I have ruined their day. But I don’t know what the heck I should do . . . that I find deeply frustrating. It really bothers me. So I’ll just have to run . . . (Hospital nurse cited from Dybbroe, 2006)

Teams, tests og tværprofessionelle relationer – arbejdet i psykiatrien i forandring

Tværfagligt teamarbejde er en praksis, hvor forskellige fagligheder bidrager til at skabe viden, enten ved at supplere hinanden eller ved at arbejde på tværs af forskellige forståelser og skabe nye typer viden. Samtidig er det en proces, hvor fagidentitet og mening er i spil og under forhandling. I denne artikel sættes fokus på de ofte ambivalente og konfliktfulde aspekter af dette samarbejde. Udgangspunktet er psykiatrien, der som andre områder indenfor sundhedssektoren præges af moderniseringsog rationaliseringsprocesser, som blandt andet indebærer et stigende fokus på gennemsigtighed, kontrollerbarhed og evidensbaseret viden. I Artiklen undersøges, hvordan den stigende anvendelse af psykiatriske tests – der kan ses som en mediering af disse moderniseringstendenser er med til at udfordre og forandre vidensidealer, og dermed også grundlaget for det tværprofessionelle samarbejde.

“So under ‘cause for concern’, I’ll write that…”: Class, parenting and risk prevention in public health practices in schools: A question of moral worth?

This article explores how risk, moralisation and class intertwine in prevention work targeting parents. The analysis is based on an ethnographic study at three Danish schools, from which two exemplary cases have been selected, consisting of observations of two introductory consultations between families and school health nurses. We focus on how the professional assesses whether a family is at risk. The outcome of the consultations is distinctly different. The privileged family is able to display the legitimate risk practices. In contrast, the disadvantaged family is regarded as irresponsible and at risk. This is not so much due to the complexity of their social situation, but because of what the professional identifies as a major risk: the child’s overweight. Our methodological approach is to explore how the consultations are framed. Our analysis reveals how a focus on ‘lifestyle choices’ results in dismissing the structural conditions that shape not only the hazards facing families, but also their risk practices. Consequently, the privileged parents are celebrated as morally worthwhile, while the disadvantaged parents are judged to be of less moral value. This, we argue, is grounded in symbolic class distinctions, revitalising ‘respectability’ as a central aspect of the discretionary assessment.