Shared Resources

Key Contexts
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<< Chapter 21 - Chapter 30
Chapter 41 - Chapter 50 >>

Chapter 31

Planning is a procedure which builds on the contextual material which we have set out in the previous chapter on assessment.

Chapter 32

This chapter relates to the vast range of theories and approaches which inform therapeutic activity and different therapies. These provide key contexts, which are used in specific circumstances. For instance, psychodynamic or behavioural psychology may be used as the basis for therapy, counselling or Cognitive Behavioural Therapy (CBT). Many of these approaches to intervention are medical not social. Some are surgical; others are based on diagnosis and prescription of pharmacological drugs. In some circumstances, the implementation of a person’s health and care plan may depend on complementary as well as conventional medicine. In that case, the complementary therapy may be rooted in Eastern rather than Western medicine and its theories and assumptions may have their origins in Eastern rather than Western philosophy.

The consequence for the practitioner is that this chapter potentially is the most demanding and far reaching in the book, in terms of the breadth of contexts on which it draws.

Chapter 33

Ideas about review and evaluation which drive this chapter are found in the context of organisational reviews and evaluations. Evaluation is an activity which derives most of its frameworks and thinking from research. Critical appraisal in qualitative methodology is the closest neighbouring set of ideas to evaluation of practice in the health and social care organisation. This may involve taking what evaluators would recognise as a case study approach. In rare cases this would not be used, as a set of objective data would be available from quantitative data sets already collected, analysed and ready to be interpreted.

Part V

Chapter 34

This chapter takes up the topic of personal and professional development which was developed in Chapter 1. Chapter 34 deals with the different but linked aspects of reflectiveness and criticality. They relate to the contexts of research, particularly qualitative methodology, examined in Chapter 35. Reflection, as we see in Chapter 35, has a more specialised meaning than in everyday life. Donald Schon has written the most significant work about this and most present-day books and articles refer back to him.

Criticality relates to critical theories in sociology and other medical and social sciences, psychology and social policy. You do not need to study the origins of these ideas, but it is important to adopt critical thinking as a habit, as you learn. This is at the heart of evidence-based practice and contains two actions:

(a) Questioning every idea put before you and not accepting it uncritically

(b) Seeking evidence for or against the particular idea you are questioning.

Chapter 35

The key contexts for this chapter are the huge and rapidly expanding literatures on quantitative and qualitative research, especially in the health and social services. The social sciences also provide a relevant context for theories, frameworks and ideas about socially and psychologically based research.

Chapter 36

Quality assurance has migrated to the health and social care field from its contextual position in the wider quality assurance literature in business and organisational studies. Research and practice on approaches to assuring quality have drawn on the knowledge base in the social sciences.

Part VI

Chapter 37

The contexts of ideas on which this chapter draws range as widely as the practice approaches and methods to which they refer. The mainstream of healthcare is medical treatments whilst social care derives from a formidable array of psychological and sociological insights drawn from research. The integration of theories with practice involves a synthesis (a meaningful compound formed from simpler components) of these different elements in a way which is not random but, hopefully, produces an outcome with greater significance and usefulness.

Chapter 38

Health promotion draws on a range of perspectives, mainly based in biology, medical studies, psychology and sociology. Some of the traditional approaches rooted simply in medicine have been marginalised in the light of research which suggests that people avoid making the healthiest choices of nutrition and lifestyle for a complex variety of reasons, many of which lie in social factors rather than just psychological and medical causes. For example, there are cultural reasons for the spread and prevalence of consumption of fatty ‘convenience’ foods, as well as these tastes being influenced by mass advertising.

Chapter 39

This chapter draws on a complex web of contextual ideas, reaching back into the nineteenth century and, if we take the history of the Friendly Societies (ancestors of many modern insurance societies), a century or more before that. In fact, if we take the participation movement and the history of self-medication before the doctors and nurses were professionalised back to their origins in the tradition of ‘mutual aid’, it could be said to be as old as society itself. The growth of movements towards greater participation by carers and people using health and social care services has resulted from a number of factors, not least of which are the increasing influence of pressure groups and social activism and consumer protest since the late 1960s.

Chapter 40

In this chapter, we continue a thread of ideas and contexts from the previous chapter. From the early 1990s, survivors of mental health treatments and survivors of sexual abuse as well as movements of disabled people contributed to policies aiming to empower people on the receiving end of health and social services. These policies were not driven exclusively by a ‘radical’ empowering impulse on the part of governments, but, ironically, resulted from a bizarre union of interests between this and the Right Wing assertion of Conservative governments that the best option for many people was self-help rather than treatment by the State.

Self-help itself is rather like self-advocacy. It has a peculiarly hybrid history as a reactionary British mid-Victorian principle of leaving the paupers to pull themselves up by their own bootstraps, partly as a way of sifting out those who show no effort and, therefore, are ‘undeserving’ of help from the State, from those who show some effort and, therefore, deserve at least some help, in the form of charity or a little ‘casework’ from the Charity Organisation Society, founded in 1869. Nowadays, the ‘expert patient’ is expected to acquire some knowledge about his or her condition and apply a little sensible self-medication, naturally, without trespassing into the territory of the medical or the mental health and clinical psychology (such as chartered psychologists www.bps.org.uk) professionals.