Abstract
This thesis examines how and in what ways user involvement is articulated in the “plan of action” and in the “plan of care”
In the first chapter we introduce the motivation for this thesis. The basis of the thesis is to question whether user involvement issues are still relevant and the historic relevance of asking this question. Then we move on to narrowing in to our focus on user involvement and the opportunities for people with mental disabilities to be fully accepted as members of society and to be able to live with the basic rights of deciding for themselves in matters concerning themselves, both at a long term perspective and at a day to day perspective. We introduce the statutory rights that have been agreed upon and introduce to which extend these rights give users in the care of others the rights to protest, if their wishes and articulations are not heard. This leads to the introduction of relevance in the “plan of action” and the “plan of care” in connection with user involvement and citizenship for users. This cohesion is especially related to how the “plan of action” is legally defined as a technology for user involvement. We introduce a connection with an ambition to deinstitutionalize and with user involvement initiatives like “plan of action” and “plan of care”. The purpose is to evolving away from disempowerment and use of force and toward empowerment and user involvement. Though the ambitions are pointed towards user involvement and empowerment, several studies show how the ambition in reality faces a lot of difficulties.
In chapter 2 we introduce our way of studying this problem through a social constructivist approach combined with discourse analysis as our methodology for the further study.
In chapter 3 we construct user involvement and the different connotations for further use and different perspectives on user involvement.
In chapter 4 we combine our empirical material which consists of three different types of material: “plans of action”, “plans of care” and a focus group interview. The “plans of action” and “plans of care” are from a place of living with professional support, while the focus group interview is from an interview with professionals from the place of living. In this chapter we argue how we find the construction of different discourses useful for answering our analysis of the initial question. The four discourses are “control technology discourse”, “care discourse”, “diagnosis discourse” and “employment discourse”. The “control technology discourse” contains in our construction both contractualization, goal management and the articulation of the necessity of personal development. The “care discourse” articulates how it is a care task to help the user towards “the good life” and to avoid stress caused by the user not being able to answer questions about what he or she wants or stress because of overstimulation. The “diagnose discourse” articulates the user as “unreasoning” and unable to make judgments in their own lives and someone who needs special regards. The “employment discourse” we have constructed into four subcategories: meaningful activities, treatment, moral disciplining and socioeconomic connotations.
In chapter 5 we introduce those four discourses and analyze how the articulations in relation to the discourses are constructing different spheres of user involvement. How articulations that are in conflict with the four discourses get excluded, and how articulations meat acceptance when they are articulating meaning in tune with the four discourses. We also try to clarify how articulations can be in tune with one of the four discourses, but where there is conflict with respect to future actions, “control technology discourse” and “employment discourse” seems to have a certain degree of hegemony.
In chapter 6 we argue how the constructions we have articulated seem to argue that discourses through articulations of different spaces of possibility can exclude user opinions and whishes, so user involvement only becomes possible in the constrains of the discourses. And because users rarely have the necessary resources to renegotiate meaning in a new ways, their articulations risk being left outside the decision making process.
In the first chapter we introduce the motivation for this thesis. The basis of the thesis is to question whether user involvement issues are still relevant and the historic relevance of asking this question. Then we move on to narrowing in to our focus on user involvement and the opportunities for people with mental disabilities to be fully accepted as members of society and to be able to live with the basic rights of deciding for themselves in matters concerning themselves, both at a long term perspective and at a day to day perspective. We introduce the statutory rights that have been agreed upon and introduce to which extend these rights give users in the care of others the rights to protest, if their wishes and articulations are not heard. This leads to the introduction of relevance in the “plan of action” and the “plan of care” in connection with user involvement and citizenship for users. This cohesion is especially related to how the “plan of action” is legally defined as a technology for user involvement. We introduce a connection with an ambition to deinstitutionalize and with user involvement initiatives like “plan of action” and “plan of care”. The purpose is to evolving away from disempowerment and use of force and toward empowerment and user involvement. Though the ambitions are pointed towards user involvement and empowerment, several studies show how the ambition in reality faces a lot of difficulties.
In chapter 2 we introduce our way of studying this problem through a social constructivist approach combined with discourse analysis as our methodology for the further study.
In chapter 3 we construct user involvement and the different connotations for further use and different perspectives on user involvement.
In chapter 4 we combine our empirical material which consists of three different types of material: “plans of action”, “plans of care” and a focus group interview. The “plans of action” and “plans of care” are from a place of living with professional support, while the focus group interview is from an interview with professionals from the place of living. In this chapter we argue how we find the construction of different discourses useful for answering our analysis of the initial question. The four discourses are “control technology discourse”, “care discourse”, “diagnosis discourse” and “employment discourse”. The “control technology discourse” contains in our construction both contractualization, goal management and the articulation of the necessity of personal development. The “care discourse” articulates how it is a care task to help the user towards “the good life” and to avoid stress caused by the user not being able to answer questions about what he or she wants or stress because of overstimulation. The “diagnose discourse” articulates the user as “unreasoning” and unable to make judgments in their own lives and someone who needs special regards. The “employment discourse” we have constructed into four subcategories: meaningful activities, treatment, moral disciplining and socioeconomic connotations.
In chapter 5 we introduce those four discourses and analyze how the articulations in relation to the discourses are constructing different spheres of user involvement. How articulations that are in conflict with the four discourses get excluded, and how articulations meat acceptance when they are articulating meaning in tune with the four discourses. We also try to clarify how articulations can be in tune with one of the four discourses, but where there is conflict with respect to future actions, “control technology discourse” and “employment discourse” seems to have a certain degree of hegemony.
In chapter 6 we argue how the constructions we have articulated seem to argue that discourses through articulations of different spaces of possibility can exclude user opinions and whishes, so user involvement only becomes possible in the constrains of the discourses. And because users rarely have the necessary resources to renegotiate meaning in a new ways, their articulations risk being left outside the decision making process.
| Original language | Danish |
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| Publication status | Published - 23 Mar 2015 |