REFLECTIONS ON THE REVISE OF THE PROTOCOL
material that comes from reading the profiles is very rich.
One senses in the collection of stories the echo of the relationship
between the operator has compiled her and the person whose profile
In some profiles this aspect it is felt in great measure, in some
less, but everyone is still present the personal dimension, which
sometimes also takes on a connotation of a relationship, necessarily
involving and challenging (also seen references not explicit but
present at the impatience and the burn-out of some working groups).
In the current format the
indications (thin) provided for the collection of profile give to
the same profile a narrative connotation. The material lends itself
to assume this characteristic. Both the life stories, both the ups
and downs concerning the interaction of these people with the system
of services or with volunteers, require an articulated, hardly
definable description, in survey instruments too standardized.
The key point is just
that. Profiles can be combined at ' life stories ', a ' subject '
that has an important position – given its specificity – in social
research methodology. Every survey on experiences and peculiar
stories about important parts of a biography, it can be done through
instruments that lie between two opposite polarities, represented by
the degree of structuring these same tools.
On one side of this
continuum lies the structured instrument, which guarantees a high
level of standardization and uniformity of procedures for data
collection, but at the risk of forcing complex topics in pre-defined
schemes too rigid; the other is unstructured tool, which allows you
to gather more information, but at the risk of requiring greater
effort during interpretation and recoding of collected material, not
necessarily uniform and homogeneous in the topics discussed.
The choice between these
two polarities, or the balance between these two opposing needs,
typically depends on several factors: the context of analysis, the
greater or lesser familiarity with their respective approaches,
people involved in the collection and interpretation of data.
this particular case it is my opinion that we should prefer a
formality collection of profiles in order to maintain open and
discursive structure of individual tabs. Make the instrument too
analytical – trying to translate into more or less dichotomous
variables the individual topics (for example: absence/presence of a
support network, absence/presence of other diseases) – appears in my
opinion too reductive.
The same biographical
information – basic data for each profile – are not always
available, or at least not always have a high degree of reliability
(being often second-and third-hand, or collected by voices of
acquaintances and contacts of various kinds).
Don't stiffen the tool and
lose a lot of information contained in the current rich profiles,
trying at the same time taking into account the need to maintain
uniform standards of compilation of the tabs, you can find some sort
of compromise between the two polarities as above. Such compromise
consists of discussing in shared way criterions of compilation of
the most articulated profiles of the actual ones, in such way that
those people who collect them have clear the thematic scope on which
we wanted to focus the attention. What I propose here is a list of
additions/new thematic proposals compared with mentions in the
compilation of tab profile.
Each of the new issues,
arising from reading the profiles, is located within one of the five
macro-areas previously defined by the Protocol.
The proposed themes could
be object of discussion and sharing in the next workshop, so that to
assure a great coherence in the formalities of collect of data of
the profiles and compilation of the tab ; such sharing, at the same
time, it already represents by itself a sort of selection of the
remarkable thematic nucleuses both for the final interpretation and
for the editing of a possible conclusive report.
In addition to the
supplements placed within each macro-area, it may make sense to
propose two additional thematic areas: a more explicitly related to
the evaluation of the pathway taken and one designed to detect the
representations of discomfort and stigma emerging from the job of
taking charge. These themes, currently present implicitly in the
tabs, they could/should take a relevant autonomy.
Hypothesis of integration
of the protocol for the compilation of the sheets /profile
The tri-partition of the
size indicated in the Protocol (time, abandonment, refusal) seems
effective because the presentations contained in the background
section are generally short but rich collection.
Maybe we should emphasize
more the need to provide basic information on net family
constellation, which in some tab / profiles do not seem adequately
into account (quite apart from the problem of unavailability–
evidently unsolvable – of information about family relationships and
presence/absence of their nature).
In this section the
aspects on which to focus more attention, in the integration of the
Protocol, seem to me to be three:
theme of comorbidity, namely the overlap between mental health and
other health problems, as well as the relationship between
co-morbidity and social disadvantage (in some cases people don't
seem to have any health problems, despite the kind of life they
fragmentary nature of the patterns of care and taken into care: the
profiles in some cases underline the interruptions and resumptions
of the interactions with the system of services or with the world of
volunteering; on this issue, and the orientation of the different
players towards the person we should focus a little more attention
(see after the topic on the attitude of the working team and on
representations); the interdependence of psychosocial distress or
otherwise in cases where it involves two people of the same family
circle (the case of the mother and son; that of two sisters).
For a more accurate
reconstruction of the history of the operations or attempts of
intervention implemented focus more attention on these issues:
circumstances giving rise to the first contact between a person
and an organization (voluntary, public etc.) bears – at least in
intention - to help; this part is already present in many ways, but
it's still important that the Protocol if they stress the importance
of understanding the way in which it has developed or is developing
the relationship of help or care;
clarification of the objectives of the intervention in its various
ever changing – necessarily – from case to case. The objectives vary
not only from person to person but also between the different
phases; It must be said here that in the current version of the
profiles this theme is already present, but it should be made
explicit and made clearer in completing, with a view to clarifying
what – specifically – can aim the intervention;
will be question of compulsory sanitary treatment, underline the
reasons of these
equivalent procedures used in other countries are described in some
cards; the prosecutor's order which is discussed in a profile I
think is some sort of TSO); this looks like an ethics question of
description of specific operational solutions
(net-working in the case of ASL in Rome, the family coach mentioned
in the profile of Polish woman).
WORKERS & NETWORKS
This seems to me the most
interesting section of the protocol in terms of possible thematic
areas to be developed. List them for points and sub points:
operation of the network of relationships
Net-working: it exists or doesn't exist?
The project is managed by a single actor?
This possible ' unique ' actor is public or private?
In case there are more parties, the coordination
between the actors there or not?
This scope is in fact a premise than the added
section concerning the final assessment;
availability of community resources to enable informal/team
(neighborly relations, informal networking);
institutional context of reference
whether there are limitations in access to services
due to regulatory barriers, cumbersome procedures or poorly defined;
whether there are ' vicious circles ' and
administrative problems (often arises the problem of documents, up
to the limit case of Serbian man declared dead at home for which you
can't get to the bottom of the issue of a passport or identity
the issue of resources and the possible impact on the
financial sustainability issues practice therapeutic path (ex:
impossibility to practice some options deemed useful or important).
The discretion of the operators
presence of practices employed on the basis of
discretionary guidelines (in access to certain provisions or
administrative procedures); the ' creativity ' of the operators as a
possible solution to the ' empty ' or confusing legislation.
In any listing may be
useful to leave the generality of proposals: it is better to
indicate concretely hypothesis related to the case described that
formulate descriptions of desirable but little concrete paths.
Possible additional scopes
(to sift through & discuss with other operators)
In each of these two
themes I would dedicate a specific section of the Protocol and of
representations and self-representations having
influence on taking charge
forms of stigma having incidence on taking charge or on application
for assistance services (which also concerns the TSO);
orientation of the operators and the support team: description of
the main orientation towards the person taking charge and from
others who follow the case (the person's source of stress or even
burn out; opening/closing towards cooperation with other entities
that are part of the support network); any changes of orientation of
staff over time;
presence of cultural aspects held remarkable from those people that
follow the taking in charge of the person (ex: in the history of
Nigerian woman refers to symptoms that seem to be expressed as a
culturally oriented); the issue is complex and to probe very
carefully, but a nod to this size wouldn't tab;
overall assessment of the case
Precisely because the
protocol has a narrative structure and therefore strictly
qualitative, I think it's okay to close it with a section more
evaluative. The assessment is of course subjective, but induces who
evaluate to take responsibility to describe the profile in terms of
strengths/critical points of both the context of the actions
The points at which you
articulate the section might be these
and weaknesses of support NET enabled and/or
judgment: the person's condition has
improved/worsened or remained unchanged?
The application must be placed in relation to the objective that we
have prefixes (see above) and commensurate with the achievement or
otherwise of this objective;
relevant ethical issues related to the work;
thoughts, free (leave an open space of a few lines to formulate any
in collaboration with the Foundation
Devoto – Jacopo Lascialfari