THINKING TEAMS THINKING CLIENTS - ISSUES OF DISCOURSE AND REPRESENTATION IN THE WORK OF HEALTH-CARE TEAMS

The use of multi-disciplinary health care teams is an increasingly com mon aspect of service delivery in health care in Western countries. Wh ile the literature rehearses the putative benefits to practitioners an d clients of such teams, there appears to be an absence of extensive e vidence-based research on team practices to substantiate such claims. What evidence there is suggests that team work is in different ways pr oblematic. This article is a progress report on a qualitative research project into the operation of health teams with responsibility for cl ients in hospitals and the community in New Zealand. The first part of the article presents some of the main themes in current research on h ealth care teams. The second part argues that effective team work requ ires giving attention to a hitherto marginalised dimension of teamwork - the team's reflexive and representational practices. Attention to t hese practices appears to be particularly important in complex cases o r when the team believes that its work with the client is not progress ing as well as it might. The article concludes by highlighting the soc iological significance of representational issues in team work and by drawing some inferences about factors affecting effective teamwork.