Propositions and alignment as constructs of cooperation in multiprofessional–client meeting interactions

Abstract

ABSTRACT Finland is currently amidst a significant national healthcare and social welfare reform, with the goals of multiprofessional-integrated work and client centredness, necessitating more detailed research on multiprofessional – client meetings as joint interactions. This study dissects these interactions as forums for clients and professionals to practise integrated work. As such, the data consist of seven audio-recorded team meetings concerning six clients’ cases, and the study aims to identify the propositions for client help from the meetings and to analyse how they are used as potential openings for cooperation. The analysis draws from the interaction study and utilizes concepts of alignment and misalignment to specify how cooperation is negotiated and constructed in the meetings turn-by-turn after propositions are displayed. The analysis reveals how the actors align or misalign, as well as who joins the process and how minimal interactional acts are powerful in shaping multiprofessional – client meeting interactions. The central finding is that propositions open an alignment process that evokes cooperation in meetings, but typically only between two actors, omitting multiparty cooperation. Therefore, the study suggests not only offering propositions but also reacting and responding to them constructively by all the other actors that is needed when aiming towards multiprofessional joint action.