Who's Responsible? Clients in a Stress Management Clinic

This article examines how responsibility for health is generated in a primary nursing care clinic for stress management. The methodological perspective was that of symbolic interaction and interpretive research. Eighteen clients were interviewed at various points during their treatment trajectory, along with seven clinicians. From the extensive discourse around personal choice, self-management, and individual responsibility, one would expect that providers might stigmatize clients and induce guilt and blame for either their physical problems or inability to manage their stress. The expert nurses in this clinic, however, continued to absolve clients, and clients did not experience any guilt, stigmatization, or judgmentalism within the clinic. By balancing theoretical concepts of learning and unconscious motivation with deep compassion, the nurse clinicians absolved these clients from blame while continuing to emphasize personal responsibility.