Double actorship in community health work from the perspectives of presence and empowerment

This article is based on a qualitative case study that was carried out in a health community practice of 25 years’ standing. In this study ‘double actorship’ emerged as one of the most important elements in the health-based community approach. The people in this community are regarded as active individuals who are able, to a greater or lesser degree, to improve their health autonomously by engaging in sustainable, confidential and supportive relationships. When we analysed the strategies of the professionals and volunteers we found that they took account of both the limitations and potential of the clients. We conclude that both presence and empowerment are necessary factors in community-based health work. The strengths and the weaknesses of people are taken into consideration and attention is paid to how they can help themselves and each other. Double actorship occurs when a relationship develops in which worker and client are both subject and actor; a mutual relationship with a place for limitations and potential, for weakness and strength, even in the case of the most vulnerable people.