How Do I Code for Black Fingernail Polish? Finding the Missing Adolescent in Managed Mental Health Care

Lester, Rebecca

doi:10.1111/j.1548-1352.2011.01210.x

Cited by 12 publications

(18 citation statements)

References 36 publications

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“…The situation investigated here invites further empirical research on how the realm of work intersects with and impacts the construction of identities and selves in the era of postindustrial transformation, on how emerging forms of work are perceived and experienced by native and immigrant populations, and on how transformations in the realm of work enter into and shape the dynamics of social inclusion and exclusion in contemporary Western societies. Focusing on the constellation of context, experience, and practice, this research presents an additional example (see Korbin and Anderson‐Fye ; Lester ; Weisner ) of how psychological anthropology perspectives can promote an understanding of social policies and programs and their impact on people lives, thereby driving change and contributing to the well‐being of vulnerable populations and to the betterment of people's quality of life.…”

Section: Resultsmentioning

confidence: 99%

All That is Just Ersatz: The Meaning of Work in the Life of Immigrant Newcomers

Roberman¹

2013

Ethos

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In this study, I present the case of middle‐age and late middle‐age Jewish immigrants from the former Soviet Union to Germany, who are attempting to rebuild their employment biographies and construct identities of social worth and status in the new country but are constrained from entering formal salaried jobs and are thus pushed into alternative work schemes. I explore the everyday experiences of these subjects and analyze why the alternative work projects fail to provide an equal substitute for formal salaried employment. Highlighting work as a crucial resource for the construction of immigrants’ self‐perceptions, identities, and sense of belonging in a new country, I challenge claims about the diminishing meaning of work—in particular what is considered to be standard (long‐term, salaried) employment—in the construction of identities and determination of social hierarchies in contemporary Western societies. [unemployment–underemployment, nonstandard work, immigrant experience, recognition, marginalization]

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Section: Resultsmentioning

confidence: 99%

All That is Just Ersatz: The Meaning of Work in the Life of Immigrant Newcomers

Roberman¹

2013

Ethos

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“…How can someone demonstrate an intention to get well if she continues to hurt herself? It is here that IFS offers clinicians a way to reconcile complex issues of agency within the flattened agentive space of the managed‐care system (Lester ).…”

Section: Ifs: Multiple Selves Systems Theories and Society Of The Mindmentioning

confidence: 99%

Self-governance, psychotherapy, and the subject of managed care: Internal Family Systems therapy and the multiple self in a US eating-disorders treatment center

Lester

2017

American Ethnologist

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A B S T R A C T"The self" has seen a surprising resurgence in recent anthropological theorizing, revitalizing interest in whether and how it can be studied ethnographically. These issues are brought to the fore by a newly popular psychotherapy technique, Internal Family Systems therapy (IFS), as practiced in a US eating-disorders clinic. There, clinicians and clients negotiate tensions between this model's understanding of a multiple, refracted self and managed-care companies' insistence on personal responsibility. In considering the moral and pragmatic work of IFS in the clinic, a new critical anthropology of selfhood illuminates the vectors through which economic and political commitments become imbricated in the self. They do so in ways that resist both psychologism and subjectivism while holding them in productive-albeit sometimes troubling-tension. [eating disorders, managed care, anorexia, self, neoliberalism, psychotherapy, United States] I nternal Family Systems therapy (IFS), a psychotherapy technique developed in the 1980s by psychologist Richard Schwartz, is increasingly popular in the United States for treating personality disorders, mood disorders, and eating disorders. The theory behind IFS is unusual among US therapies in that it envisions "the self" as a dynamic, evolving, adapting, and open system of subpersonalities or "parts" that operate in ever-changing relationships with one another and the outside world. The self in IFS is not a singular or bounded thing but, rather, a process that emerges from a complex of internal relationships among constantly changing "parts." Agency, accordingly, is not localized within a fixed, singular core but is distributed and mutable, shifting among different subpersonalities depending on the setting, circumstances, and interactions at hand. This figuring of the self and agency has profound implications for how IFS practitioners understand and treat psychopathology.Three aspects of IFS merit anthropological attention. First, the model's recent surge in popularity in the United States might tell us something about the clinicians and clients to whom it appeals, especially in the context of health-care policy reform. Second, the process of becoming an IFS therapist (which is both lengthy and expensive) speaks to the convergence of structures of care and structures of finance, as therapists are obliged to become "therapreneurs"-continually pursuing additional trainings, new certifications, and new specializations so that they can offer more marketable niche treatments. Third, the everyday practice of IFS foregrounds questions about how selves are locally enacted and understood within competing models of moral responsibility.Engaging with IFS, I ask two sets of questions: ethnographic and theoretical. The ethnographic questions are, how do tensions between the IFS model of distributed agency and the managed-care emphasis on personal responsibility unfurl in everyday practice? What might these tensions tell us about how economic processes shape understandings of p...

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“…Many argue that treatment is effective, or healing occurs to some extent, if individual distress is located within broader social contexts, including cultural meanings and power (for example, Anderson‐Fye and Floersch ; Dow ; Good et al. ; Han ; Kleinman ; Lester ; Mattingly ; Waldram ). Others find that the therapeutic process effectiveness is informed by persuasion, or transforming the meaning of illness and the assumptive world of the afflicted (Bourguignon ; Csordas ; Nguyen ; Saris ; Waldram ).…”

Section: The Therapeutic Process and Healingmentioning

confidence: 99%

“…In her work on end‐of‐life care, Elana Buch (, ) illustrates how life stage is a critical aspect of caregiving and interpersonal interaction in contexts in the US home health care industry. Others have illustrated how important adolescence is when understanding illness and disability (Carpenter‐Song ; Clark ; Daley and Weisner ; Lester ). For the boys of Havenwood, the process of coming of age within psychiatric custody shapes how they view their main treatment concerns—social problems like not having any family—and their goals when out of treatment—being able to talk to mom about feelings.…”

Section: Better People Outside Of Confinement: the Meaning Of Transfomentioning

confidence: 99%

“…In other therapeutic contexts, young people are shown to be active agents in the interpretation of their illness (Armstrong et al. ; Clark ) and treatment interventions (Anderson‐Fye and Floersch ; Carpenter‐Song ; Lester ). I turn now to the total institutional discourses and frameworks of treatment (therapeutic procedures) and the ways three boys talk about getting “better” or their healing (therapeutic outcome) and the reasons for this transformation (therapeutic process).…”

Section: American Adolescent Psychiatric Custodymentioning

confidence: 99%

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Care, Closeness, and Becoming “Better”: Transformation and Therapeutic Process in American Adolescent Psychiatric Custody

Hejtmanek¹

2016

Ethos

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In the United States, young people are remanded to psychiatric custody for the institutionalized treatment of mental illness, behavior disorders, and emotional disturbances, and forced to participate in this therapeutic system. Anthropological investigations of therapeutic process have focused on individuals actively seeking and engaging in treatment or a therapeutic process. Does transformation require a person fully accept the therapeutic system? Is a coerced therapeutic process still effective? This article engages with these questions by situating the therapeutic process in psychiatric custody for American adolescents. The youth in treatment accept that transformation and even healing take place but locate the etiology and form of this change differently than the official treatment paradigms. This case study illustrates that transformation and therapeutic process as multifaceted, especially in coercive contexts, and the efficacy of the therapeutic process as shaped by the life stage and political contexts of those engaged in the process.

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How Do I Code for Black Fingernail Polish? Finding the Missing Adolescent in Managed Mental Health Care

Cited by 12 publications

References 36 publications

All That is Just Ersatz: The Meaning of Work in the Life of Immigrant Newcomers

All That is Just Ersatz: The Meaning of Work in the Life of Immigrant Newcomers

Self-governance, psychotherapy, and the subject of managed care: Internal Family Systems therapy and the multiple self in a US eating-disorders treatment center

Care, Closeness, and Becoming “Better”: Transformation and Therapeutic Process in American Adolescent Psychiatric Custody

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