Evidence‐based medicine (EBM) is a technical and scientific paradigm in clinical practice that has delivered major improvements in the outcome of care in medicine and…
Evidence‐based medicine (EBM) is a technical and scientific paradigm in clinical practice that has delivered major improvements in the outcome of care in medicine and surgery. However, its value in psychiatry is much less clear. The purpose of the paper is thus to examine its value by subjecting empirical evidence from EBM to a conceptual analysis using the philosophy of Thomas Kuhn.
The authors examine evidence drawn from meta‐analyses of RCTs investigating the efficacy of specific treatments for depression in the form of antidepressant drugs and CBT. This shows that the non‐specific aspects of treatment, the placebo effect and the quality of the therapeutic alliance as seen by the patient, are more important in determining outcome than the specific elements (active drug, specific therapeutic elements of CBT).
Using the philosophy of Thomas Kuhn, it is shown that these non‐specific and non‐technical elements are anomalies that indicate that the technological paradigm in the treatment of depression is fundamentally flawed.
Non‐specific elements of mental health care are essential in fostering hope, trust and meaning. They constitute non‐technical factors that are central to the concept of caring, and vital for recovery, and which resonate strongly with the growth of survivor and user‐led systems of support for people who experience distress and madness. As such they pose a major challenge to scientific psychiatry and mental health services based in this. The analysis has major implications for the primacy of the natural sciences in the education and training of those involved in mental health work, and demonstrates the importance of an open debate about the value of the scientific imagination in mental health work.
This paper is important because it supports user‐led self‐defined notions and understandings of recovery, and does so using a philosophical conceptual analysis.
This conceptual analysis is highly original. To the authors' knowledge no one has subjected EBM to a detailed conceptual analysis using the ideas of Thomas Kuhn.
In this chapter, the author critically examines the relationship between sociology and the identities/experiences of disability and ‘mental illness’ (referred to…
In this chapter, the author critically examines the relationship between sociology and the identities/experiences of disability and ‘mental illness’ (referred to throughout as distress). The author argues that despite sociology having an ethos of social justice and frequently producing critical accounts of inequalities – such as anti-racism and gender equality – it nonetheless uncritically reiterates the marginalisation of disability and distress. As such, sociology not only reflects the increasing ‘medicalisation of everyday life’ and shores up the essentialist discourses of genetics and neuroscience, but also consigns research and knowledge production about disability and distress to the medical sciences. The author challenges these sociological conventions and highlights the ways in which both disability and distress are socially structured, embodied experiences. The author argues that a sociological account of distress and disability are important not only in and of themselves, but also because they highlight the ways and means to challenge essentialism, inequality and the ever-narrowing definition of what is considered a normal or acceptable part of human experience. Furthermore, vibrant streams of user-led research, activism and practice-interventions – resulting in widespread social, legal and identity transformations – have emerged from the experiences of disability and distress. These user-led perspectives highlight the importance and potential of knowledge produced from the margins, not only for those experiencing disability and/or distress but also for the ways in which we perceive, theorise and research the social world more broadly.
People who come to the UK seeking asylum from wars and persecution may sometimes be perceived as having mental health problems. This article examines a project which…
People who come to the UK seeking asylum from wars and persecution may sometimes be perceived as having mental health problems. This article examines a project which attempted to address the wider determinants of mental health and well‐being in a non‐stigmatising, culturally appropriate manner.
This article considers the effectiveness of two one‐day events designed to raise awareness of The Mental Capacity Act 2005 (MCA) in BME communities. The events were held…
This article considers the effectiveness of two one‐day events designed to raise awareness of The Mental Capacity Act 2005 (MCA) in BME communities. The events were held using specially developed materials and were evaluated with the help of a 12‐item questionnaire. The results of the evaluation showed that there was an increase in the proportion of correct responses for 10 of the 12 questions after attending awareness‐raising events. The total score for all correct responses on the 12‐item questionnaire significantly increased after attending the awareness‐raising events. Collectively, the findings suggest that the awareness‐raising events were able to improve awareness of the MCA among representatives of BME communities. Such awareness‐raising events should be encouraged by health and social care providers
This article deconstructs the hagiography surrounding British mental health policy and provides a critical analysis of the ‘New Labour’ Government reforms of the Mental…
This article deconstructs the hagiography surrounding British mental health policy and provides a critical analysis of the ‘New Labour’ Government reforms of the Mental Health Act 1983 grounded in Foucauldian insights. Smart (1985) suggests that a Foucauldian perspective deconstructs “common sense assumptions” that lie at the heart of policies formulated by the State. A cogent discussion grounded in Foucault’s work can illustrate how surveillance and discourses of power impact on the positioning of service users as objects of control, domination and subordination.
Inclusion is meant to address the needs of all students in the classroom including those who are identified as gifted and talented. Unfortunately, this population is often excluded from funding and differentiated support. This chapter addresses the disparities of definitions and legislation for gifted students. Common characteristics including strengths and concerns of the students and gifted education in general will also be discussed. Teachers must learn to effectively implement differentiated instruction as well as choose appropriate curricular models and instructional strategies to make their classroom truly inclusive of all learners. Pull-out, push-in, self-contained setting, cluster grouping, and enrichment programs have all been found to be effective service models for gifted students. Within the environment strategies such as independent study, learning stations, tiered lessons, and problem-based learning can further individualize student learning. Final recommendations on the future of gifted education will be addressed.
Peter Relton is employed as a service user development worker in the Bradford Home Treatment Team. His job is to challenge and develop the team ‐ to bring his insights and…
Peter Relton is employed as a service user development worker in the Bradford Home Treatment Team. His job is to challenge and develop the team ‐ to bring his insights and perspectives to bear on the way they do their work. While some ‘user workers’ operate from a position somewhat apart from the local team, Peter describes an approach that has the potential to knit a service user perspective right into the fabric of mental health services.
The purpose of this paper is to report on the prioritisation of different corporate social identities (CSIs) by the banking sectors in India to endorse the corporate…
The purpose of this paper is to report on the prioritisation of different corporate social identities (CSIs) by the banking sectors in India to endorse the corporate branding process. To substantiate the effect of corporate social responsibility (CSR) on banks’ profitability, the paper establishes a causal relationship between CSI scores and banks’ profitability. The study defines the CSI scores as measures of different CSR initiatives available on the websites and annual reports of leading public and private schedule commercial banks in India.
The study discusses the key role that CSR plays in building the corporate personality of a firm, which is a key ingredient of a corporate brand. Therefore, the main dimensions and sub-dimensions of CSR are analysed by using content analysis method. The data undergo multiple experiments such as “Percentage of Agreement”, “Scott’s π”, “Cohen’s κ”, and “Krippendorff’s α” to check the validity and the inter-coder reliability of the content. Furthermore, the quartile approach of statistical data analysis, weighted average method of prioritisation and simple linear regression methods are used to examine and discuss the study objectives.
There were three major outcomes from this study. First, Indian banks institutionalise their credibility of corporate personality by maintaining the CSR principles and goals as the core elements of their corporate statements. Second, the CSI scores of different CSR initiatives indicate variations in the stakeholder prioritisation among different banks. The result shows that the public sector banks give the highest priority to the community-related CSR initiatives followed by environment and customer among others, whereas the private sector banks emphasise on customers as their top priority followed by environment and community. The overall score depicts the environment-related initiatives to be the highest priority, which follows customer, employees, community and suppliers. Third, the research indicates that the relationship between CSI disclosures and profitability is significant in India.
The social aspect of building corporate identity will help in the decision-making process for developing a strong social image through their websites. However, the results suggest that the banking sector should adopt a global standard of CSR reporting and strategic positioning of the social identities among the stakeholders in the value chain. The results are limited to only the Indian banking sector and can be validated and applied to other industries and cross-cultural contexts.
This study is one of the pioneering attempts to focus on the role of CSR in the stakeholder-company relationship through the mean-end approach in the development of CSI.
The management of children′s literature is a search for value and suitability. Effective policies in library and educational work are based firmly on knowledge of materials, and on the bibliographical and critical frame within which the materials appear and might best be selected. Boundaries, like those between quality and popular books, and between children′s and adult materials, present important challenges for selection, and implicit in this process are professional acumen and judgement. Yet also there are attitudes and systems of values, which can powerfully influence selection on grounds of morality and good taste. To guard against undue subjectivity, the knowledge frame should acknowledge the relevance of social and experiential context for all reading materials, how readers think as well as how they read, and what explicit and implicit agendas the authors have. The good professional takes all these factors on board.
Through a survey of 200 employees working in five of the thirty establishments analysed in previous research about the microeconomic effects of reducing the working time (Cahier 25), the consequences on employees of such a reduction can be assessed; and relevant attitudes and aspirations better known.