Pratiche di interazione nei contesti educativo-riabilitativi: tra ricerca e riflessione

This research explores the interactional practices that care workers employ in two different settings: a residential centre for psychiatric patients (“A” centre) and a daily service for drug users (“B” centre). Choosing interaction as the locus where care workers’ professional practices can be explored is motivated by the fact that spoken language constitutes one of the main vehicles that enables these professionals to implement their activities. The research answers the following questions. What language-mediated actions do the care workers accomplish in interaction with the service users? What are the effects of such actions? And what rehabilitation culture do they embody? The research approach employed to study the care workers’ interactional practices is conversation analysis (CA). This approach allows to describe the procedures that interactants employ to intersubjectively establish the structure and meaning of the events that they take part to. Its methodological underpinnings are: a focus on the language-mediated actions that participants deploy in interaction; attention to the methods that participants use to make available to one another their understanding of what is going on in every moment in the sequential unfolding of the interaction. Data where gathered on field through participant observation, writing of an ethnographic log and audio-recording of multi-person encounters between the care workers and the service users in both settings. The audio-recordings are the primary data source for this research. The analysis has concentrated on episodes of interaction where the service users talk about recently experienced events and voice concerns that are related to them. In the encounters that take place at the “A” centre, the care workers solicit the service users (patients diagnosed with schizophrenia) to talk about themselves and share recently experienced events. The service users utilize these spaces to voice feelings of discontent about states of affairs whose responsibility can be attributed to different subjects (family members, care workers, other patients) and organizations (such as the psychiatric service); by complaining, they project the expectation of being listened and understood by the care workers. In these situations, the workers are recurrently faced with a dilemma: while attending to the patients’ concerns is relevant to the type of activity that they are engaged in, the care workers are also incumbents of the role of supervisors, whose task is to foster the patients’ compliance to the treatment procedures of the psychiatric service. They can’t affiliate with the complaints by which the patients contest the normative order of the service, nor they can ignore them. They deal with this kind of dilemma by employing two sets of interactional devices: in some cases, the workers withhold alignment to the complaining activity and try to direct the talk elsewhere; in other cases, they deal with the complaints either by comforting the patients and trying to depict their concerns as exaggerate, or by overtly disaffiliating from them and trying to demonstrate that the assessments underlying the complaints are flawed. In the encounters that take place at the “B” centre, the care workers solicit the service users (young drug abusers) to share experiences that they lived in the last few days. The service users utilize these spaces to complain about parties (absent or co-present) that caused them some harm. The care workers deal with these complaints confrontationally, by trying to expose the assessments underlying them as faulty and in need of correction. Through this kind of practice, the workers encourage the service users to think of themselves as entitled to the right and obligation to exert control over their own lives. Complaint sequences are recurrently occupied by misalignment between the care workers and the service users: while the latter treat these conversational spaces as sites where they can receive listening and understanding for their grievances and where they can legitimately attribute responsibility for their troubles to ‘others’, the former treat it as a context where they can encourage the service users to deal with those troubles on their own and try to align them to values of personal responsibility and commitment. In both the rehabilitation services where the research was carried out, the care workers’ practices are shaped by multiple orientations: the task of promoting an improvement of the service users’ awareness of themselves and of their everyday experiences is inextricably linked to the task of securing their compliance to the treatment procedures that form the architecture of the rehabilitation services. The interactional practices described in this research allow the care workers to attend to both sets of goals: the care workers disaffiliate from the service users’ stances and try to substitute them with other perspectives, compatible with some institutionally relevant values and expectations. The weekly encounters thus constitute a site for the negotiation of relationships and identities, with attendant rights and obligations. In addition to the goal of describing the care workers’ practices, the research also pursued a goal that was transformative in character, by fostering the care workers’ awareness of the interactional resources that they employ in their everyday activities. A cycle of reflective workshops was carried out in both the rehabilitation centres, utilizing transcripts of the care workers-service users interactions and some preliminary analytical feedbacks as starting points for reflection and discussion. The analysis of this experience shows that the reflective process can be hindered when the care workers fail to consider face to face interaction with the service users as a context where important parts of their work are manifested and can be observed, when they think of their practices as the only available practical solutions given a set of contextual constraints and when they orient to the analytic feedbacks as evaluations of their performance. The analysis also shows that the care workers can use the analytic feedbacks that they receive to engender reflection when they manage to tie them to their needs for professional development and when they incorporate them in the interpretive framework that they use to make sense of their professional practice. In these cases, the reflective process moves beyond the mere scrutiny of observable interactional practices, and extends to their interactional effects; it also extends to consideration of the kinds of goals, interpretations and concerns that those practices embody. This process enables the care workers to progressively transform the values that form the infrastructure of their practice and the rehabilitation culture that their everyday actions embody.