Experiences of Members of a Crisis Resolution Home Treatment Team: Personal history, professional role and emotional support in a CRHT team

Abstract

The main aim of this thesis was to explore the characteristics of the work done in a CRHT team, from the point of view of staff members. After an initial literature review, we conducted interviews and participant observation to approach this aim. The interviews were semi-structured and all team members in a specific CRHT team were interviewed. An interview protocol was applied, with a few open questions regarding the participants’ personal stories, professional role and their thoughts, if any, on connections between the two. The analysis explored if and how the team members in a CRHT team experience a connection between their personal and professional roles. For the participant observation I accompanied the same CRHT team for 19 days over a period of approximately 4 months. The setting for the observation was at the office and in the car going back and forth to see patients on home visits. Interviews and observations from both studies were analysed from a hermeneutic-phenomenological approach in order to understand the participants’ experiences and what was going on in the CRHT team. In this thesis overview I will discuss how their personal and professional backgrounds, and how they give each other emotional support within the team, might enable them to meet the challenges and see the opportunities within the specific framework of CRHT work. The first article of this dissertation seeks to give an overview of the literature available on CRHT teams by reviewing and systematizing national and international knowledge about the teams. In the literature review, three main themes are drawn from the systematization of reviewed literature: 1) structure of the characteristic organizational aspects of CRHT teams and services; 2) processes of how the service is provided, and 3) outcome that highlights the effect of the CRHT team work. The second article is based on interviews. In this article we find five themes that the participants describe, which connect their personal stories to their professional roles: 1) experiences related to the participant as an individual, specified by a) personal qualities, and b) personal interests; 2) profound personal experiences in a work-related context, and 3) family-related experiences, specified by a) having family members with mental health problems, and b) having family members that have worked in mental health services. The third article is based on data from the participant observation. It aims to explore the emotional support and “work” with emotions that takes place in a CRHT team. The findings indicate that the team members’ emotion work has the five following features: 1) there seemed to be an informal rule that “vulnerable” emotions could be expressed; 2) emotional expression was common when working through and digesting challenging events; 3) emotional expression seemed to fulfill three supportive functions: validation, regulation of emotions, and help in mentalizing and developing a reflexive stance towards her own and the patient’s emotions; 4) emotional support was freely given among team members, and 5) this support seemed to fulfil a function that could only be performed by other team members with the same specific background knowledge as the speaker. The findings in the articles are discussed and related to established theory, research, and practice. Researcher reflexivity is explored, as well as strengths and limitations of the studies. There is a paucity of studies of the staff perspective for CRHT team members. This study adds to our knowledge via one literature review and two empirical articles. Very few empirical studies have been conducted on CRHT team members’ view of their work. This dissertation aims to contribute two such studies.