Perspective Clarifying Case Study

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Crepeau (2000) entitled "Reconstructing Gloria" attempts to unsettle rather than describe or confirm existing healthcare paradigms by using a narrative analysis of the team meetings of hospital workers at a mental health facility. Rather than choosing several examples or even a representative example, the author chose a single individual to analyze specifically because the patient elicited such negative responses from the staff. Over the course of the meetings, Crepeau records that Gloria was criticized for refusing to attend group sessions and was seen as being deliberately nonresponsive to treatment.

Throughout her essay, Crepeau criticizes the staff for what she sees as their inability to put their own needs and egos aside and to realize that Gloria's refusal to comply with treatment is itself a symptom of mental illness. "Their comparison to Robin Leach reflected the staff's disregard of Gloria as a person suffering from mental illness and was clearly illustrated in this interchange" (Crepeau 2000: 773). Gloria is viewed as malingering and refusing to participate out of stubbornness. There is talk of how Gloria is 'writing her ticket' to the state hospital because of her refusal to submit to treatment or participate in group activity. The negative bias of the team members results in a negative outcome for Gloria; based upon the 'story' they have chosen to tell about the patient's intractability.

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Crepeau places emotional and value judgments upon the participants and calls their actions and words unjust. At one point she says: "the attitude of the group toward Gloria was heartless" (Crepeau 2000: 773). She presents transcripts to criticize their practices in dealing with Gloria's mental health. The 'story' of Gloria had effectively been written by the practitioners, and no other evidence (such as Gloria's participation in some activities) was considered. An ecological or systems perspective may have been helpful in this instance simply to balance the perspective of Crepeau's writing: the reader is left to wonder why the caregivers seemed feel so negatively about Gloria and what types of stressors may have existed to motivate them to behave in such a fashion. How to cultivate the ability to have a more well-rounded debate about a patient is difficult to grasp from the article given the lack of context about the patient's illness, the healthcare setting, and factors which may have influenced the caregivers' perceptions.

Rebecca Rogers' article "Through the eyes of the institution: A critical discourse analysis of decision-making in two special education meetings" initially takes a more dispassionate tone, although Rogers concludes that the special education meetings she analyzed through discourse analysis did little to serve the child in question….....

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