Health policy in New Zealand, as elsewhere, has articulated the notion of partnership to be achieved through developing policies and practices aiming to empower users and their families. The involvement of users, family, and significant others in decisions about users' health care points to a realignment of traditional power relations through its de-centring of professionals in some domains of health care. It is suggested that family meetings to discuss users' progress and discharge plans could constitute an important mode of empowerment on the individual plane. Working within Michel Foucault's concept of discourse, this article discusses the practices of multidisciplinary teams to empower users on the structural and individual plane. Achieving significant changes in practice will likely require health professionals' attention to how their discourses position users, and the development of a reflexive and analytical response to their work points to the need for training in teamwork focusing on these dimensions. Such work requires organizational support.
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References
1.
Atkinson, P. (1994). Rhetoric as skill in a medical setting. In M. Bloor & R. Taraborrelli (Eds.), Qualitative studies in health medicine (pp. 110-130). Aldershot, UK: Avebury.
2.
Atkinson, P. (1995). Medical talk and medical work: The liturgy of the clinic. London: Sage.
3.
Biggs, S. (1989). Professional helpers and resistances to work with older people. Ageing and Society, 9, 43-60.
4.
Castel, R. (1991). From dangerousness to risk. In G. Burchell, C. Gordon, & P. Miller (Eds.), The Foucault effect: Studies in governmentality (pp. 281-298). Herdfordshire, UK: Harvester Wheatsheaf.
5.
Chapman, A. (1994). Empowerment. In A. Chapman & M. Marshall (Eds.), Dementia: New skills for social workers (pp. 110-124). London: Jessica Kinsley.
6.
Diamond, I. , & Quinby, L. (Eds.). (1988). Feminism and Foucault: Reflections on resistance. Boston: Northeast University Press.
7.
Foucault, M. (1980). Knowledge/power: Selected interviews and other writings, 1972-1977 (C. Gordon, Ed.). Bury St. Edmonds, UK: St. Edmondsbury Press.
8.
Fraser, N. (1989). Unruly practices: Power, discourse and gender in contemporary social theory. Minneapolis: University of Minneapolis Press.
9.
Gordon, C. (1991). Governmental rationality: An introduction. In G. Burchell, C. Gordon, & P. Miller (Eds.), The Foucault effect: Studies in governmentality (pp. 1-51). Herdfordshire, UK: Harvester Wheatsheaf.
10.
Kritzman, L. D. (Ed.). (1988). Michel Foucault: Politics, philosophy, culture: Interviews and other writings 1977-1984. London and New York: Routledge.
11.
Lewis, J. , & Glennerster, H. (1996). Implementing the new community care. Buckingham and Philadelphia: Open University Press.
12.
Martin, L. , Gutman, H., & Hutton, P. (Eds.). (1988). The technologies of the self: A seminar with Michel Foucault. Amherst: University of Massachusetts Press.
13.
McClelland, M. , & Sands, R. (1993). The missing voice in interdisciplinary communication. Qualitative Health Research, 3(1), 74-90.
14.
McLean, A. (1995). Empowerment and the psychiatric consumer/ex patient movement in the United States: Contradictions, crisis and change. Social Science and Medicine, 40(8), 1053-1071.
15.
Means, R. , & Lart, R. (1994). User empowerment, older people and the UK reform of community care. In D. Challis, B. Davies, & K. Traske (Eds.), Community care: New agendas and challenges from the UK and overseas (pp. 33-43). London: Arena, in association with the British Society of Gerontology.
16.
Ministry of Health . (1994). Standards for needs assessment for people with disabilities. Wellington, New Zealand: Author.
17.
Mizrahi, T. , & Abramson, J. (1994). Collaboration between social workers and physicians: An emerging typology. In E. Sherman & W. J. Reid (Eds.), Qualitative methods in social work research (pp. 135-151). New York: Columbia University Press.
18.
Nocon, A. , & Qureshi, H. (1996). Outcomes of community care for users and carers: A social services perspective. Buckingham and Philadelphia: Open University Press.
19.
Oliver, M. (1990). The politics of disablement. New York: St. Martin's.
20.
Opie, A. (1995). Beyond good intentions: Support work with older people. Wellington, New Zealand: Institute of Policy Studies, Victoria University of Wellington.
21.
Opie, A. (1997a). Effective team work in health care: Issues in recent research literature. Health Care Analysis, 5(1), 62-73.
22.
Opie, A. (1997b). Thinking teams thinking clients: Issues of discourse and representation in the work of health care teams. Sociology of Health and Illness, 19, 259-280.
23.
Pollit, C. (1990, Winter). Doing business in the temple? Managers and quality assurance in the public services. Public Administration, 68, 435-452.
24.
Priestly, M. (1995, Autumn). Dropping "E"s: The missing link in quality assurance for disabled people. Critical Social Policy, 44/45, 7-21.
25.
Saltz, C. (1992). The interdisciplinary team in geriatric rehabilitation. Geriatric Social Work Education, 18(34), 133-143.
26.
Sands, R. (1993). "Can you overlap here?": A question for an interdisciplinary team. Discourse Processes, 16(4), 545-564.
27.
Sheppard, M. (1992). Contact and collaboration with general practitioners: A comparison of social workers and psychiatric nurses. British Journal of Social Work, 22(4), 419-436.
28.
Shipley, J. , & Upton, S. (1992). Support for independence for people with disabilities: A government statement on the funding and delivery of health and disability services. Wellington, New Zealand: Parliament Buildings.
29.
Smale, G. , & Tuson, G. (1993). Empowerment, assessment, care management and the skilled worker (National Institute for Social Work Practice and Development Exchange). London: HMSO.
30.
Smith, D. (1990). Texts facts and femininity: Exploring the relations of ruling. London and Canada: Routledge.
31.
Toseland, R. , Palmer-Ganeles, J., & Chapman, D. (1986). Teamwork in psychiatric settings. Social Work, 31, 46-52.
32.
Young, I. M. (1994). Punishment, treatment, empowerment: Three approaches to policy for pregnant adults. Feminist Studies, 20(1), 33-58.
