Institutional Logics and Contradictions: Competing and Collaborating Logics in a Forum of Medical and Voluntary Practitioners

Institutional logics and professional change has challenged researchers to identify in micro terms the empirical evidence for change in day-to-day working practices and professional practices. This lack of evidence is not made any easier by the professional boundaries which can bedevil openness between professionals, even where they may be working in the same teams. Nowhere is this clearer than among medical teams where it is accepted that professional knowledge is to be defended from outsiders and where treatment of patients is to be defended from alternative practices. The present study offers empirical evidence drawn from a mixed group of practitioners responsible for the care of the adult survivors of childhood sexual abuse. Meeting together they have shared their insights into effective patient care and are prepared to question some of the taken for granted beliefs inherent in their training and traditional practice. Not only do they find much which they hold in common about good practice, but they devise guidelines for those following them into practice, whether they be doctors or counsellors. They are even prepared to exchange patients where this will facilitate treatment.