Fisher, P and Owen, J (2008) Empowering interventions in health and social care: recognition through 'ecologies of practice'. Social Science and Medicine, 67 (12). 2063 - 2071. ISSN 0277-9536
Abstract
This article considers findings from two recent qualitative studies in the UK, identifying parallels in the ways in which 'ecologies of practice' in two high-profile areas of health-related intervention underpin processes of empowerment and recognition. The first project focused on policy and practice in relation to teenage motherhood in a city in the North of England. The second project was part of a larger research programme, Changing Families, Changing Food, and investigated the ways in which 'family' is constructed through policy and practice interventions concerning food and health. While UK Government health policy stresses that health and social care agencies should 'empower' service users, it is argued here that this predominantly reflects a managerialist discourse, equating citizenship with individualised self-sufficiency in the 'public' sphere. Drawing critically on Honneth's politics of recognition (Honneth, A. (2001). Recognition or redistribution? Changing perspective on the moral order of society. Theory, Culture and Society, 18(2-3), 43-55.), we suggest that formal health policy overlooks the inter-subjective processes that underpin a positive sense of self, emphasising instead an individualised ontology. While some research has positioned practitioners as one-dimensional in their adherence to the current audit culture of the public sector in the UK, our study findings demonstrate how practitioners often circumvent audit-based 'economies of performance' with more flexible 'ecologies of practice.' The latter open up spaces for recognition through inter-subjective processes of identification between practitioners and service users. Ecologies of practice are also informed by practitioners' experiential knowledge. However, this process is largely unacknowledged, partly because it does not fall within a managerialist framework of 'performativity' and partly because it often reflects taken-for-granted, gendered patterns. It is argued here that a critical understanding of 'empowerment', in community-based health initiatives, requires clear acknowledgment of these inter-subjective and gendered dimensions of 'ecologies of practice'.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2008, Elsevier . This is an author produced version of a paper published in Social Science and Medicine. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Adolescent; Family; Female; Great Britain; Health Policy; Health Promotion; Humans; Interviews as Topic; Male; Nutrition Disorders; Physicians, Family; Pregnancy; Pregnancy in Adolescence; Public Health; Public Policy; Self Efficacy |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Nursing Mental Health (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 07 Nov 2013 11:21 |
Last Modified: | 15 Sep 2014 02:48 |
Published Version: | http://dx.doi.org/10.1016/j.socscimed.2008.09.035 |
Status: | Published |
Publisher: | Elsevier |
Refereed: | Yes |
Identification Number: | 10.1016/j.socscimed.2008.09.035 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:76832 |