Habilitation in focus - A human service organization and its challenges

Abstract: Abstract This dissertation explores intervention practices for children and young persons with developmental disabilities. It focuses especially health and medically related services provided by the local children habilitation centres (CHC: s), where everyday services are carried out by interprofessional teams of habilitation specialists. The objective was to critically examine the CHC as a human service organization. How did professionals describe their work and the methods of treatment that they made use of? How could their conceptions be explained ? The purpose was also to explore whether and in what way the recently introduced training method of conductive education (CE) has influenced the habilitation work at the CHC: s. The qualitative study was carried out inspired by a social constructionist perspective of the phenomenon of habilitation. Organizational theory and in particular neo-institutional organizational theory offered an analytical instrument. The empirical material consisted of observations of the ongoing habilitation work: interviews with professionals (25 interviewees); 13 interviews with key informants involved in the discussion about conductive education; observations and interviews with staff and families at training centres for CE. Closely studied, the main tasks of the CHC: s reveal important dilemmas and ambiguities. Three (main) themes have been used to structure the problems: 1) Frames of interpretation of the assignment; 2) Issues of influence; 3) Issues of competence and occupational qualification. In CHC: s, the opaque meaning of the habilitation concept can be used to handle the tension between the social and the medical logics and traditions, it can be a tool to claim jurisdiction for the habilitation experts; it can enlarge the areas of discretion for them and strengthen the legitimacy of the organization. When CE is offered as a complement/ alternative to habilitation services, this is an incitement for the habilitation organization to stress the qualities of the habilitation model. Gate-keeping and doing boundary work within the organization and in relation to the outer world are also important issues that are brought up by the interviewees.