Abstract
Inter‐professional collaboration remains a significant concern within healthcare and social care. However, there has been scant attention paid to practices at the interface of clinicians and carers, namely foster carers and residential carers. The present study considers child and adolescent self‐harm management and prevention practices as a site of empirical interest due to reports that multi‐agency teams are not effectively operating. Drawing upon a grounded theory approach, data were generated via semi‐structured interviews and focus groups with residential carers (n = 15) and foster carers (n = 15) in Wales. Themes were developed through axial coding. The results present two central themes to explain the nature and perceived causes of inter‐professional discord. First, there are clear contestations in expertise, with carers challenging clinicians’ propositional knowledge in favour of their own experiential expertise. However, participants simultaneously endorse medical dominance, which contributes to their sense of disempowerment and marginalisation. Second, is the preclusion of carers’ professional identity, primarily due to inadequate professionalisation procedures. Meanwhile, the privileging of their parenting role is perceived to support the perpetuation of courtesy stigma. Carers are then compelled to undertake the effortful labour of legitimisation. Together these thematic insights provide direction on mechanisms to improve inter‐professional interactions, notably around training and accreditation.
Highlights
Inter-professional collaboration remains a significant concern within healthcare and social care
While many accounts refer to specific interactions around child and adolescent self-harm management, participants often drew upon wider experiences of inter-professional practice in order to illustrate their perspectives and arguments
Interactions with clinicians often brought into sharp relief the divergences in understanding of self-harming practices, with participants juxtaposing their sociocultural understandings with the bio-medical discourse deployed by medical professionals
Summary
Inter-professional collaboration remains a significant concern within healthcare and social care. The intricate dynamics of inter-professional communication and collaboration remains of central interest within healthcare and social care Both in situ and reflective accounts of practices document seemingly entrenched challenges (Best and Williams 2019), including differences in professional vocabulary, inadequate resources and lack of commonality in outcome goals (Glaser and Suter 2016, Karam et al 2018, Mitchell et al 2011). Given that foster carers already report feeling disempowered, mistrusted and undervalued (Blythe et al 2011, Gilbertson and Barber James 2003, Rosenwald and Bronstein 2008), increased opportunities to commodify and critique their contribution may only serve to aggravate such sentiments, creating resentment and reifying tensions between agencies Within this context it is imperative to understand any particularities of working at the inter-professional boundary within this discretely constructed group
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