Social Relations and Innovation

David Hall spent several months studying the introduction of play therapy in children’s hospitals – the ways in which it is organized and introduced, and the way in which hospital staff, characteristically therapeutic in their orientation and disciplined in their approach, react to the deliberately informal approaches of play schemes in children’s wards. His observations form the basis for Social Relations and Innovation (originally published in 1977) of the process and impact of change in hospitals in England and Wales.

Taking the ward as a social unit, the author describes how the effects of change could be seen not only on the children themselves but also upon parents, doctors, nurses, and ancillary staff. He analyzes the degree of support or hindrance given to the schemes in terms of the power relations and value orientations among the participants at ward level. The problems for children in hospital through lack of information, meaninglessness and ambiguity about their situation are presented through observational data which reveal a predominantly laissez-faire system of authority in the wards.

In conclusion, comparative studies of hospitals and social organizations are discussed, and it is suggested that the approach to the problems of child patients presented in this study represented a corrective to the individualistic psychological view that had previously found favour, in explaining not only why children were unhappy in hospital, but also why attempts to remedy the situation were difficult and slow to put into practice at that time.