Exploring the situational complexities associated practice change in health

Abstract

Purpose: The purpose of this paper is to critically examine multidisciplinary, group clinical supervision sessions and to extend current understandings of the barriers/enablers to the implementation of an innovative psychosocial intervention for distressed adults with cancer. Design/methodology/approach: Discourse analysis was used to analyse audio recordings from clinical supervision sessions delivered as part of a psychosocial intervention within the context of a randomised control trial (RCT). Findings: Examination of subject positions, representation and tensions reveals that Health Professionals can resists the pressures of systemic barriers to provide much-needed psychosocial support for distressed adults with cancer. Critical examination of multidisciplinary clinical supervision sessions describes how Health Professionals are able to construct new meanings and reposition themselves as being able to provide supportive care within the context of their everyday practices. Research limitations/implications: This paper reports only a small part of a larger analysis that aims to explore how discourse maps the current state of psychosocial care for adults with cancer and illustrates the fragility and potential for change in this area. Originality/value: Extension on the previous literature is seen within the data through the presence of positive resistance against systemic barriers. Previous exploration of clinical supervision has not collected data generated within the sessions. It is also novel in the use of discourse analysis being used in association with a randomised controlled trial to understand the situational complexities associated with bringing about practice change.