HEALTH RISK ANALYSIS AND SOCIOMEDICAL TECHNOLOGIES OF THE SELF: PRIVATE HEALTH INSURANCE GETS INTO HEALTH PROMOTION

In October 1994 the then Australian Federal Minister for Health, Dr. Carmen Lawrence, announced that Medicare, the Australian universal national healthcare fund was considering introducing Healthtrac a computerised health promotion program. The change of government in 1995 put paid to this plan, however, lifestyle based health promotion programs, including computerised programs, are an increasing trend in contemporary health care. Research from the United States indicates a growing interest by private insurers and Health Maintenance Organisations (HMOs) in funding and encouraging members, particularly older members and retirees, to engage in healthy lifestyle programs, some of which provide written reports, periodic up-dates and checks to members as well as summary advice to employers and insurers. In this article we argue that while many of these programs are well researched programs that take cognisance of the contradictions surrounding scientific research related to lifestyle behaviours, disease and disability, they take a narrow approach to health promotion. Further, in the hands of private insurers and HMOs these programs have the potential to become sociomedical techniques (Stone 1989) of dominance, arising out of risk analysis that informs and refines techniques of governance of the self (Burchell 1993; Rose 1993). Consistent with Stevensen and Burke (1991) we see health promotion not as a new social movement, but as a political strategy of the state and capitalism to deal with among other things, escalating health care budgets. Given this, health promotion strategies that overly focus on risk analysis for the individual citizen reinforce techniques of self-governance by linking lifestyle behaviour to immorality as well as potentially creating a culture of anxiety - surely a public health problem in itself.     

An International Perspective of Field Instruction

Abstract

Social work educators and practitioners have long debated several issues confronting field instruction. For example, they have addressed the structure of field placement, school versus agency-based supervision, remuneration to agencies that accept student placements, and the use of employer agencies as field settings. Because problem-solving increasingly involves working with people in nations other than the United States, it is important to gain an international perspective on field instruction issues. To this end, an international study was conducted to examine social work field instruction and the educational context in which it occurs. This article reports the findings of that study, which involved 51 countries. The universality of field instruction as an integral part of educational program, is apparent, as are the similarity of issues, problems, and proposed solutions Moreover, the findings indicate areas in which social work education has greater international consistency than education for the professions within national and regional boundaries, whereas other areas are influenced more by national and regional factors than by a universal social work professional culture.     

TWENTY YEARS AND STILL IN THE DARK? CONTENT ANALYSIS OF ARTICLES PERTAINING TO GAY,LESBIAN, AND BISEXUAL ISSUES IN MARRIAGE AND FAMILY THERAPY JOURNALS

To what extent do marriage and family therapy journals address gay, lesbian, and bisexual issues and how does this coverage compare to allied fields? To answer these questions, a content analysis was conducted on articles published in the marriage and family therapy literature from 1975 to 1995. Of the 13,217 articles examined in 17 journals, only 77 (.006%) focused on gay, lesbian, and/or bisexual issues or used sexual orientation as a variable. Findings support the contention that gay, lesbian, and bisexual issues are ignored by marriage and family therapy researchers and scholars.     

Bridging refugee youth and children's services: a case study of cross-service training

Bridging Refugee Youth and Children's Services(BRYCS), a public-private partnership between the federal Office of Refugee Resettlement, Lutheran Immigration and Refugee Service, and the United States Conference of Catholic Bishops, provides national technical assistance to public child welfare. After a series of "community conversations," BRYCS identified a lack of knowledge among child welfare staff about newcomer refugees, negative stereotypes, and a fear of child protective services among refugees. BRYCS initiated a number of technical assistance initiatives, including a pilot cross-service training project in St. Louis to strengthen collaboration between child welfare and refugee-serving agencies. This article details the lessons learned from this training and recommends changes in policy and practice.     

Reduction of intimate partner violence in a gay couple following alcohol treatment

Although intimate partner violence among heterosexual couples is a growing topic of investigation, there remains a critical deficiency in the amount of research on violence and relationship functioning in gay men. This article presents baseline and follow-up data on a case study examining the effects of partial hospital alcohol treatment on one gay couple. This information may be helpful in understanding the relationship between alcohol use, violence, and relationship functioning in this population. On the basis of past research involving heterosexual couples as participants, we predicted that subsequent to one patient receiving alcohol treatment: 1) alcohol consumption would be reduced; 2) there would be a reduction in the amount of psychological aggression between partners; 3) there would be a reduction in the frequency of physically violent episodes; and 4) an overall improvement in relationship satisfaction would be evident. The couple was followed-up 6 and 12 months following the patient's alcohol treatment. The results indicate a decrease in alcohol use as well as reduced physical and psychological aggression, but no increase in relationship satisfaction. This case illustration may provide insight into the context surrounding intimate partner violence and relationship functioning in gay couples, with implications for further research and treatment.     

Maternal Affective Expression and Adolescents' Subjective Experience of Positive Affect in Natural Settings

This study investigated the association between maternal affective expression during laboratory‐based interaction tasks and adolescents' experience of positive affect (PA) in natural settings. Participants were 80 healthy adolescents and their mothers. Durations of maternal positive (PA) and negative affective (NA) expressions were observed during a conflict resolution task and a positive event planning interaction task. Ecological momentary assessment (EMA) procedures were employed to assess adolescents' momentary and peak experience of PA in daily life. Results indicated that maternal NA, but not maternal PA, was related to adolescents' EMA‐reported PA. Adolescents whose mothers expressed more NA experienced less PA in daily environments. Results suggest that adolescents' exposure to maternal negative affective behavior is associated with adolescents' subjective daily well‐being.     

Exploring the Link between Mindfulness and Relationship Quality: Direct and Indirect Pathways

This study serves to advance the empirical research on predictors of relationship quality by considering the role of trait mindfulness in combination with measures of stress and positive relationship behaviors among a diverse sample of men and women in couple relationships. Multi-group structural equation models tested both direct links and indirect pathways and found stronger evidence for an additive model of trait mindfulness, perceived stress, and positive couple behaviors uniquely associated with men's and women's reports of relationship quality. Furthermore, positive relationship behaviors are comparatively the most closely linked with relationship quality for both men and women in our sample. As more clinicians are incorporating mindfulness training with clients, these types of explorations can serve to inform practices on relative value of intervention strategies and possible pathways for enhancing couple relationship quality.     

When corporate actors take over the game: the corporatization of organic,recycling and breast cancer activism

Social change endeavors are increasingly shaped by corporate interests and, in some instances, large corporations take over ideas and practices initiated by social change advocates. We label this process ‘corporatization’ and argue that, while it is clearly a variant of co-optation, it has specific qualities that warrant a separate analytical framework. Using existing research to examine the cases of breast cancer activism, organic food, and recycling in the United States – all extreme examples of corporatization – we conceptualize corporatization as a subset of co-optation in which: (1) corporations come to dominate fields initiated by activists; (2) corporatized versions become widespread; and (3) alternative, ‘response,’ movements emerge to oppose corporatized versions. We posit that, in each case, ‘corporate takeover devices’ allowed corporate entities to ‘join the game’ and eventually come to dominate fields initiated by social movements.