Therapeutic Practice (therapeutic + practice)

Distribution by Scientific Domains


Selected Abstracts


Dilemmas in kinship care: negotiating entitlements in therapy

JOURNAL OF FAMILY THERAPY, Issue 4 2007
Jeanne Ziminski
This paper considers how ideological dilemmas that arise in therapy can be analysed usefully for therapeutic practice. The focus is on the particular situation of kinship care families where family or friends are caring for children without birth parents being present. In the process of family members negotiating the entitlement to care and to be cared for, multiple possibilities about family constructions and authorities throw up many dilemmas for therapists and families. Based on the author's research study with kinship care families, a method for linking discourse theory and therapeutic practice through the use of discourse analysis and positioning theory is explored, with reference to the hierarchical method of the Co-ordinated Management of Meaning model. The paper contends that a consideration of ideological dilemmas in conversation is a core part of any therapeutic encounter, which needs to be recognized and considered in order that those involved in therapy may reflect on several possible futures and so open up the space for future decision-making. [source]


Holding hope and hopelessness: therapeutic engagements with the balance of hope

JOURNAL OF FAMILY THERAPY, Issue 3 2007
Carmel Flaskas
Hope and hopelessness are coexisting and powerful experiences in the human condition. The dynamics of hope and hopelessness within intimate relationships are complex, and individual and family experiences of hope and hopelessness are embedded within historical contexts and wider social processes. This article rests on a relational set of understandings about hope and hopelessness, and offers a dual exploration. It focuses first on the complexities of the patterns of hope and hopelessness within families, and then on the complexities of the therapist's relationship to hope and hopelessness and the family's experience. Orienting to the balance of hope in constellations of hope and hopelessness provides one compass point of therapeutic practice. Reflective practice enables the use of the therapist's involvement in the therapeutic relationship, and helps the therapist to witness the coexistence of hope and hopelessness in a way that nurtures hope and emotionally holds both hope and hopelessness. [source]


Persons, Places, and Times: The Meanings of Repetition in an STD Clinic

MEDICAL ANTHROPOLOGY QUARTERLY, Issue 2 2007
Lori Leonard
In this article we work the tensions between the way clinical medicine and public health necessarily construct the problem of "repetition" in the context of a sexually transmitted disease (STD) clinic and the ways patients narrate their illness experiences. This tension,between clinical and epidemiological exigencies and the messiness of lived experience,is a recurring theme of work conducted at the intersections of epidemiology, anthropology, and clinical medicine. Clinically, repeated infections are a threat to the individual body and to "normal" biological processes like reproduction. From a public health perspective, "repeaters" are imagined to be part of a "core group" that keeps infections in circulation, endangering the social body. Yet patients' accounts are anchored in particular social histories, and their experiences rely on different time scales than those implicated in either of these types of readings. Extended analyses are provided of two such accounts: one in which repetition can be "read" as part of a performance of recovery, and one in which repetition is bound up in the effort to avoid becoming the involuntary subject of institutionally administered intervention. We argue the need to open up the category of repeaters to include the social and draw on work by Cheryl Mattingly to suggest that one way to do this in the context of the STD clinic might be to adopt forms of therapeutic practice that make use of interpretive, in addition to technical, skills. [source]


A survey of the scope of therapeutic practice by UK optometrists and their attitudes to an extended prescribing role

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 3 2008
Justin J. Needle
Abstract Purpose:, Recent changes in medicines legislation in the UK have broadened the opportunities for optometrists to use and supply therapeutic drugs. We set out to investigate the current therapeutic practice of UK optometrists and to elicit their views on an extended prescribing role. Methods:, Members of the College of Optometrists were invited via email to take part in an online survey. The survey questions covered four areas: mode of practice, proximity and relationship to other providers of eye care, scope of current therapeutic practice and future plans regarding prescriber training. Results:, Of the 1288 responses received (response rate 24%), over 90% were from optometrists working in community practice. Common, non-sight-threatening conditions were managed frequently or occasionally by between 69 and 96% of respondents. Blepharitis and dry eye were the most common (managed routinely by >70%). In terms of therapeutic agents used, large numbers of optometrists reported that they commonly supplied or recommended over-the-counter (non-prescription) drugs, particularly lubricants and anti-allergic agents. However, fewer respondents supplied antibiotics (only 14% supplying chloramphenicol or fusidic acid frequently). Overall, relatively few respondents (14%) expressed no interest in undertaking further training for extended prescribing, although several barriers were identified, including cost and time taken for training, lack of remuneration and fear of litigation. Conclusion:, Significant numbers of community optometrists are currently managing a range of common ocular conditions using a limited formulary. Enabling optometrists to train as independent prescribers will further develop this role, allowing greater use of their skills and providing patients with quicker access to medicines. [source]


The Tyranny of Diagnosis: Specific Entities and Individual Experience

THE MILBANK QUARTERLY, Issue 2 2002
Charles E. Rosenberg
Diagnosis has always played a pivotal role in medical practice, but in the past two centuries, that role has been reconfigured and has become more central as medicine,like Western society in general,has become increasingly technical, specialized, and bureaucratized. Disease explanations and clinical practices have incorporated, paralleled, and, in some measure, constituted these larger structural changes. This modern history of diagnosis is inextricably related to disease specificity, to the notion that diseases can and should be thought of as entities existing outside the unique manifestations of illness in particular men and women. During the past century especially, diagnosis, prognosis, and treatment have been linked ever more tightly to specific, agreed-upon disease categories, in both concept and everyday practice. In fact, this essay might have been entitled "Diagnosis Mediates an Invisible Revolution: The Social and Intellectual Significance of Specific Disease Concepts." It would have been even more precise, if rather less arresting. The articulation and acceptance of specific disease entities constitute one of the most important intellectual and cultural events of the past two centuries. This notion is central to how we organize health care delivery, think about ourselves, debate and formulate social policy, and define and manage deviance. Diagnosis is indispensable to linking specific disease concepts with doctor and patient and the social and economic institutions shaping such clinical interactions. Disease is a social entity, not an array of ideal types. The history of medicine is partly the story of how disease entities have become social entities, accumulating the flesh of diagnostic and therapeutic practice, social expectation, and bureaucratic reification. Despite criticism of reductionist medicine in the West and less focus on disease entities and mechanisms, our social response still depends on this concept of sickness. But this concept can no longer remain invisible if we are to understand contemporary medicine as both a social and a technological system. The articulation and acceptance of specific disease entities constitute one of the most important intellectual and cultural events of the past two centuries. This notion is central to how we organize health care delivery, think about ourselves, debate and formulate social policy, and define and manage deviance. Diagnosis is indispensable to linking specific disease concepts with doctor and patient and the social and economic institutions shaping such clinical interactions. Disease is a social entity, not an array of ideal types. The history of medicine is partly the story of how disease entities have become social entities, accumulating the flesh of diagnostic and therapeutic practice, social expectation, and bureaucratic reification. Despite criticism of reductionist medicine in the West and less focus on disease entities and mechanisms, our social response still depends on this concept of sickness. But this concept can no longer remain invisible if we are to understand contemporary medicine as both a social and a technological system. The articulation and acceptance of specific disease entities constitute one of the most important intellectual and cultural events of the past two centuries. This notion is central to how we organize health care delivery, think about ourselves, debate and formulate social policy, and define and manage deviance. Diagnosis is indispensable to linking specific disease concepts with doctor and patient and the social and economic institutions shaping such clinical interactions. Disease is a social entity, not an array of ideal types. The history of medicine is partly the story of how disease entities have become social entities, accumulating the flesh of diagnostic and therapeutic practice, social expectation, and bureaucratic reification. Despite criticism of reductionist medicine in the West and less focus on disease entities and mechanisms, our social response still depends on this concept of sickness. But this concept can no longer remain invisible if we are to understand contemporary medicine as both a social and a technological system. The articulation and acceptance of specific disease entities constitute one of the most important intellectual and cultural events of the past two centuries. This notion is central to how we organize health care delivery, think about ourselves, debate and formulate social policy, and define and manage deviance. Diagnosis is indispensable to linking specific disease concepts with doctor and patient and the social and economic institutions shaping such clinical interactions. Disease is a social entity, not an array of ideal types. The history of medicine is partly the story of how disease entities have become social entities, accumulating the flesh of diagnostic and therapeutic practice, social expectation, and bureaucratic reification. Despite criticism of reductionist medicine in the West and less focus on disease entities and mechanisms, our social response still depends on this concept of sickness. But this concept can no longer remain invisible if we are to understand contemporary medicine as both a social and a technological system. [source]


Trepanations from Oman: A case of diffusion?

ARABIAN ARCHAEOLOGY AND EPIGRAPHY, Issue 2 2006
Judith Littleton
Trepanations have been described from various locations around the world leading to a suggestion that this is a cultural practice that has widely diffused from one or two centres (1). In the UAE the earliest trepanations date to the Neolithic, significantly earlier than trepanations in surrounding areas. The discovery of at least two crania in Oman, dating apparently to the early third millennium and resembling in technique and placement trepanations from north India may be evidence of the diffusion of a therapeutic practice from the Gulf to the subcontinent. However, the lack of any trepanation among the numerous contemporary skeletons from Bahrain suggests that any diffusion has distinct limits and that, as anthropological work from the South Pacific (2) indicates, practices like trepanation are often heavily embedded in broader, culturally located explanatory models. [source]


Socialist psychotherapy and its dissidents

JOURNAL OF THE HISTORY OF THE BEHAVIORAL SCIENCES, Issue 3 2001
Christine Leuenberger Ph.D. research associate/lecturerArticle first published online: 17 JUL 200
This article focuses on the history of psychotherapeutic theory and practice in socialist East Germany before the fall of the Berlin Wall in 1989. The "official" pre-1989 socialist history of East German psychology is juxtaposed to psychotherapists' post-1989 oral history of the development of Socialist psychological theory and practice. These reconstructive histories draw on embryonic therapeutic practices that diverged from the dominant socialist paradigm. Their existence exemplifies how a state-driven high modernist scheme for remaking society can fail as it does not account for the complex relationship between a state's abstract knowledge and local practices. Moreover, the emphasis therapists put on the prevalence of these alternative practices also reveals how the present post-socialist context becomes an interpretative resource for reconstructing their past. By emphasizing these practices they try to bridge the gap between their past and current practices so as to minimize the transformation that has taken place. © 2001 John Wiley & Sons, Inc. [source]


Gilles Deleuze: psychiatry, subjectivity, and the passive synthesis of time

NURSING PHILOSOPHY, Issue 4 2006
Marc Roberts rmn diphe ba(hons) pgce pgcrm ma phd student
Abstract, Although ,modern' mental health care comprises a variety of theoretical approaches and practices, the supposed identification of ,mental illness' can be understood as being made on the basis of a specific conception of subjectivity that is characteristic of ,modernity'. This is to say that any perceived ,deviation' from this characteristically ,modern self' is seen as a possible ,sign' of ,mental illness', given a ,negative determination', and conceptualized in terms of a ,deficiency' or a ,lack'; accordingly, the ,ideal',therapeutic' aim of ,modern' mental health care can be understood as the ,rectification' of that ,deficiency' through a ,re-instatement' of the ,modern self'. Although contemporary mental health care is increasingly becoming influenced by the so-called ,death' of the ,modern self', this paper will suggest that it is the work of the 20th century French philosopher, Gilles Deleuze, that is able to provide mental health care with a coherent determination of a ,post- modern self'. However, a Deleuzian account of subjectivity stands in stark contrast to ,modernity's' conception of subjectivity and, as such, this paper will attempt to show how this ,post- modern' subjectivity challenges many of the assumptions of ,modern' mental health care. Moreover, acknowledging the complexity and the perceived difficulty of Deleuze's work, this paper will provide an account of subjectivity that can be understood as ,Deleuzian' in its orientation, rather than ,Deleuze's theory of subjectivity', and therefore, this paper also seeks to stimulate further research and discussion of Deleuze's work on subjectivity, and how that work may be able to inform, and possibly even reform, the theoretical foundations and associated diagnostic and therapeutic practices of psychiatry, psychotherapy, and mental health nursing. [source]


Time, human being and mental health care: an introduction to Gilles Deleuze

NURSING PHILOSOPHY, Issue 3 2005
Marc Roberts RMN DiPHE BA(Hons) PGCE PGCRM MA PhD(c)
Abstract, The French philosopher, Gilles Deleuze, is emerging as one of the most important and influential philosophers of the 20th century, having published widely on philosophy, literature, language, psychoanalysis, art, politics, and cinema. However, because of the ,experimental' nature of certain works, combined with the manner in which he draws upon a variety of sources from various disciplines, his work can seem difficult, obscure, and even ,willfully obstructive'. In an attempt to resist such impressions, this paper will seek to provide an accessible introduction to Deleuze's work, and to begin to discuss how it can be employed to provide a significant critique and reconceptualization of the theoretical foundations and therapeutic practices of psychiatry, psychotherapy, and mental health nursing. In order to do this, the paper will focus upon Deleuze's masterwork, and the cornerstone to his philosophy as a whole, Difference and Repetition; in particular, it will discuss how his innovative and challenging account of time can be employed to provide a conception of human life as a ,continuity', rather than as a series of distinct ,moments' or ,events'. As well as discussing the manner in which his work can provide us with an understanding of how life is different and significant for each human being, this paper will also highlight the potential importance of Deleuze's work for logotherapy, for the recent ,turn' to ,narrative' as a psychotherapeutic approach and for contemporary mental health care's growing interest in ,social constructionism'. As such, this paper also seeks to stimulate further discussion and research into the importance and the relevance of Deleuze's work for the theory and practice of psychiatry, psychotherapy, and mental health nursing. [source]


Our Science is Better than Yours: Two Decades of Data on Patients Treated by a Kardecist-Spiritist Healing Group in Rio Grande do Sul1

ANTHROPOLOGY OF CONSCIOUSNESS, Issue 2 2009
SIDNEY M. GREENFIELD
ABSTRACT This article examines whether a group of Brazilian Kardecist-Spiritists are using the symbols of medicine and science to gain respectability and to better promote their beliefs and ritual activities or whether they are using the view of the world proposed by their founder to forge a new paradigm to replace science, as we know it. Their therapeutic practices, which range from the performance of surgeries without anesthesia and antisepsis to "teleporting" the astral bodies of patients to the spirit world where they are treated for illnesses acquired during previous lifetimes are described and analyzed in terms of their worldview which postulates reincarnation. Data indicating positive results from a sample of patients treated for illnesses they claim to be caused by experiences in previous lives are presented. [source]