A Tale of two sectors : practitioner perspectives on rehabilitation and working with people with complex needs

The prevalence of people with complex needs in both the criminal justice sector and the alcohol and other drugs sector is high and rising. This thesis analyses these two sectors in terms of how professional cultures, interagency dynamics and workforce conditions shape the rehabilitative process of working with people with complex needs. Mixed research methods are used in keeping with a strengths-based perspective, including ethnographic observation and interviews with 30 practitioners in Tasmania, Australia. Extant literature on rehabilitation paradigms, theories and models is critically analysed in terms of capacity to understand and support people with complex needs. Practitioner narratives offer evocative insights into the goodwill and passionate commitment, as well as the professional politics involved in the 'doing' of rehabilitation. It becomes clear that the two sectors have been changing in ways which affect practitioners' capacity and capital to support individuals to change. Tensions are observed between relentless change management and workforce development efforts (professionalism from above‚ÄövÑvp) in both sectors, amid the reality that significant numbers of practitioners are leaving the alcohol and other drugs sector, while disproportionate numbers of criminal justice practitioners are on leave. A principal concern in this thesis is why and how practitioners navigate complexity and change, and the influence this may have on them and those with whom they work. Concepts from the sociologies of work and the professions and the work of Pierre Bourdieu are used to analyse the field. The findings of the thesis reveal distinct differences between the literature and official accounts of rehabilitation work and the models that practitioners use, and what they actually do in practice. 'Job crafting' and hybridisation of rehabilitation work is mediated by professional ideologies and values, symbolic capital and the habitus of the helping professions. Considerable strengths and potential are identified in the Tasmanian field. Practitioners are asked about their hopes for the future, sharing ideas on how positive change and innovation might be realised in the local context. The findings show that, despite workforce changes, much has already been done to understand the drugs-crime nexus and reduce rates of recidivism and relapse. Practitioners in both sectors have extensive 'professional toolkits' and practice wisdom in helping individuals to address these problems and reduce risks of their reoccurrence. However, more can be done to build professional and systemic capacity to support recovery and desistance and, in doing so, enable more integrated, coproduced responses. Improving collaborative alliances implicates the need to address inequalities between stakeholders and re-orient the structural ordering of the field. This thesis explores the interface between recovery and desistance, and the implications for theory, policy and practice.