This ethnographic study explored the orchestration of tasks by informal leaders in multidisciplinary addiction services in Northern Italy. It explains how informal leaders establish, share, and challenge authority based on their credibility. This is achieved by mobilizing situated expertise, influencing interactions, and adapting relationships within dual leadership settings. This study is situated within relational leadership theory, which examines how influence emerges through everyday interactions rather than formal roles.
This research adopted a seven-month ethnography combining participant observation of 22 clinical meetings, semi-structured interviews across four services, and a reflexive diary.
Three microprocesses structured informal leadership: First, actors seek situated expertise using “credibility tracing” (identifying who holds relevant knowledge) and “coordination artifacts”, such as documentation and meetings. This allowed experienced peers to shape their understanding of the case outside the formal hierarchy. Second, influence in interaction occurs through rule setting, silences, and consensus, accelerating coordination and imposing costs through voice suppression and an informal hierarchy. Third, relational adjustments and shifts between interpersonal warmth and professional distance supported emotional resilience, while structuring expectations and voice safety, particularly under dual leadership where formal and informal authority coexist.
This study advances relational leadership theory by detailing how credibility-based authority is assembled and travels via interactional pathways in multidisciplinary healthcare. Informal leadership is framed as an ambivalent distributed task orchestration, revealing how boundary work, interactional risk, and relational adjustment shape collaboration in resource-pressured addictive service settings.
