ABSTRACT. This article examines discourses of gender and sexuality that feature in the social work assessment of gay men who apply to foster or adopt in the United Kingdom (UK). Using data from interviews with social workers and managers, the author argues that three versions of the category gay were dominant. In the first of these, gay men were imagined to be maternal and/or feminine. In the second, they were seen as a source of perversion and sexual risk, and in the third, they were assumed to present problematic models of gender. The author critiques these ideas, and argues instead for social welfare practices that reconsider and expand our notions of gender, sexuality, parenting, and kinship. [Arti-cle copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: Website:

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• Summary: This article is a discussion piece on the idea of `sexuality' within social work. The author discusses dominant models of sexuality — including those within anti-discriminatory practice theory — before going on to raise a number of problems with this perspective. The article draws upon queer, feminist and Foucaultian theories to suggest less restrictive ways of thinking through sexuality and social work. • Findings: Social work has a tendency to define `sexuality' as an essential identity with a fixed set of characteristics and social welfare `needs'. This article argues for a reflexive account of sexuality within social work, and for the investigation of the production and use of sexuality categories within everyday professional settings. • Applications : The author discusses the assessment of sexuality in cases of foster care or adoption applications by lesbians or gay men in order to highlight the practical application of these ideas. The article discusses why new ways of thinking through sexuality may be productive for social work.

The paper examines the assessment of lesbians who apply to foster or adopt, using data generated from 30 interviews with local authority social workers. Using feminist and queer theories, the author suggests that lesbian applicants pose a challenge to the discourse of ‘compulsory gender and heterosexuality’ which structures fostering and adoption work. It is argued that this discourse relies upon a series of assumptions about the automatic fitness of heterosexual applicants, especially concerning the idea of gender and sexuality role models needed for children’s development. Further, this ‘heteronormative’ discourse relies upon the continuing need to make ‘other’ the categories ‘lesbian’ or ‘gay’. The article considers how ‘the lesbian’ is constructed as a ‘threat’, as ‘militant’, or as ‘automatically safe’ in assessments, and makes the point that social work is productive of versions of the lesbian subject. The author argues that only certain versions are likely to be approved to foster or adopt, particularly that which is termed ‘the good lesbian’.

Background: Cognitive Muscular TherapyTM (CMT) is an integrated behavioural intervention developed for knee osteoarthritis. CMT teaches patients to reconceptualise the condition, integrates muscle biofeedback and aims to reduce muscle overactivity, both in response to pain and during daily activities. This nested qualitative study explored patient and physiotherapist perspectives and experiences of CMT.Methods: Five physiotherapists were trained to follow a well-defined protocol and then delivered CMT to at least two patients with knee osteoarthritis. Each patient received seven individual clinical sessions and was provided with access to online learning materials incorporating animated videos. Semi-structured interviews took place after delivery/completion of the intervention and data were analysed at the patient and physiotherapist level.Results: Five physiotherapists and five patients were interviewed. All described a process of changing beliefs throughout their engagement with CMT. A framework with three phases was developed to organise the data according to how osteoarthritis was conceptualised and how this changed throughout their interactions with CMT. Firstly, was an identification of pain beliefs to be challenged and recognition of how current beliefs can misalign with daily experiences. Secondly was a process of challenging and changing beliefs, validated through new experiences. Finally, there was an embedding of changed beliefs into self-management to continue with activities. Conclusion:This study identified a range of psychological changes which occur during exposure to CMT. These changes enabled patients to reconceptualise their condition, develop a new understanding of their body, understand psychological processes, and make sense of their knee pain.