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Beneath the surface: collaboration in alcohol and other drug treatment. An analysis using Foucault's three modes of
1Nursing Department, University of Wollongong, Northfields Avenue, Wollongong, New South Wales 2522, Australia. janette_curtis@uow.edu.au
Aim Of Study:
This study investigated the perceptions of alcohol and other drug (AOD) clinicians and consumers regarding the concepts of collaboration and empowerment.
Background/Rationale:
Working collaboratively is seen as a cornerstone of empowerment, a concept used extensively over the last decade in an attempt to isolate power and control issues. It is generally assumed that health professionals strive to achieve collaboration, but little research has been undertaken.
Design/Methods:
The study was carried out in a variety of AOD treatment facilities in a large regional city in Australia. Facilities included an inpatient detoxification unit, an outpatients' clinic, a methadone maintenance clinic, a residential detoxification and rehabilitation unit using a 12-step treatment model and a residential unit using cognitive behavioural therapy (CBT). The nonprobability sample consisted of 57 staff and consumers who were interviewed using a semi-structured format. Data were analysed thematically using a Foucauldian analysis of discourse.
Research Findings:
Findings suggest that clinicians may be unwittingly imposing their beliefs and prejudices on consumers and in fact disempowering the very people they want to empower. Collaboration is not happening. Foucault's theory of objectification illuminates the processes involved.
Conclusions:
There is much more happening than originally thought between consumers and staff when Foucault's three modes of objectification are used to examine this practice area. Analysing discourse enables us to see how health workers interact with consumers and the effect this may have on treatment objectives, outcomes and self-esteem. It also illuminates the work environment where the therapeutic encounter takes place. The need for further effort in empowering both consumers and staff and working collaboratively becomes evident.