References Introduction In this unit you will be listening to the audio files: ‘Experiences of assessment’, where three people talk about assessment, with comments from a social worker and an occupational therapist. The audio clip was recorded in 2000. Participants in the audio clips: Helen Robinson is the presenter; Brian and Sylvia are a married couple who have experience of being assessed; Anne 3 Biographical perspective: using pathways You will shortly be hearing excerpts from interviews with four men, who were contacted through the Swansea Cyrenians. They are all from very different backgrounds, and talk about their own experiences of homelessness. The clips are only brief insights into life without a home, but they do demonstrate the importance of a biographical perspective in understanding the unique and diverse needs of individual homeless people. Looking at situations from a biological perspective is Acknowledgements Don't miss out: 1. Join over 200,000 students, currently studying with The Open University [http://www.open.ac.uk/ choose/ ou/ open-content] 2. Enjoyed this? Find out more about this topic or browse all our free 8 Conclusion In this course you have been introduced to a diverse range of ideas about health. To recap, the themes and ideas you have met in this course are: The diversity of accounts of health. An important theme of this course is that there is a great diversity in what people mean when they talk of health; sometimes these meanings conflict and sometimes they can coexist but health is a creative and multifaceted concept. The importance 6.2 Concepts of Illness Sontag (1979) wrote about the metaphors we use to describe illness. Metaphors are ways of speaking about something as if it were something else which is imaginatively but not literally applicable, for instance calling a new moon a sickle. Sontag was mainly concerned with life-threatening illnesses such as cancer and AIDS, and how the metaphors we use can serve to stigmatise the sufferers, for instance referring to AIDS as a gay plague. But people use metaphors to explain illness to themselves 3.5 People's views on health Health accounts, as well as being based in the experience of health, also relate to health behaviour. People's accounts of health are likely to be different at different stages in their lives. Two health promotion researchers, Backett and Davison (1992), have investigated the perceptions of health at different stages of life. Their work is based on two qualitative studies conducted in Edinburgh and South Wales. In these studies, health was also linked to health behaviours. The stage of life w 3.3 Health and ethnicity Clearly ethnicity, religion and culture have a great deal of influence on the way people view health. It was noted in the introduction to Section 2 that most of the early work was on health beliefs and that it was anthropological, focusing on ‘other’ cultures. Britain is a multicultural, multiracial society 1.4 A community resource centre in action It is clear that the well-being of communities and the well-being of the individuals within them are intrinsically linked. The Orchard Centre is a community resource centre for people with mental health problems in Bonnyrigg in Midlothian, Scotland. References References 1.1.3 Time The recommended duration of an aerobic exercise session is dependent on several factors, such as the participant’s goals and fitness levels, and the intensity of exercise. Obviously, the higher the intensity of the exercise, the shorter will be its duration. As a general guide the ACSM recommends between twenty and sixty minutes of aerobic exercise, which can be undertaken either continuously – i.e. all at once – or intermittently – i.e. in shorter bouts accumulated during the day (AC References Learning outcomes After studying this course, you should be able to: understand the complexity and dilemmas of diverse perspectives in the field of mental health and distress undestand the importance of service users/'survivors' experiences and perspectives understand how mental health issues affect everyone understand the range of risks faced by service users/'survivors' in their everyday lives. 3.18 Key ethical issues for CAM practitioners: maintain professional boundaries All practitioners have a duty to create and maintain safe boundaries, irrespective of their therapeutic orientation, training or individual way of practising. The therapeutic relationship is based on trust and practitioners must never exploit users for their own ends. Practitioners should be aware that they may be working with users who have difficulty respecting boundaries, whether emotional, sexual or financial. Practitioners also need to be very clear about making their own boundaries expl 3.6 Ethical practice and accountability: the role and function of professional bodies The UK's medical profession is regulated by the General Medical Council (GMC). One of the main ways in which the GMC, and other regulatory bodies, influences its members is through its code of ethics. This sets out broad principles, rather than detailed guidance, for how practitioners should behave in specific circumstances. This is necessary because a practitioner retains individual accountability and ultimate responsibility for decisions taken during professional practice. Not all br 2.12 The future of the therapeutic relationship As discussed earlier in this extract, therapeutic relationships are subject to constant review and reinterpretation. As the culture changed, the predominant shift in health care was away from paternalistic forms of relationships based on professional expertise towards partnership models in which the patient has more rights but also more responsibilities. This final section looks to the future and considers some of the factors that can impact on therapeutic relationships in CAM. 2.11 The failure of CAM therapeutic relationships: complaints The issue of complaints is uncomfortable for any health practitioner. CAM practitioners may be particularly reluctant to accept that their actions may give rise to complaints. Since many therapists do not perceive their therapy to be intrinsically harmful, they are unlikely to make provision for when it goes wrong. Moreover, the comparative absence of litigation against CAM practitioners may give a false sense of security, whereby therapists do not consider themselves above the law but see th 2.6 The failure of CAM therapeutic relationships Although therapeutic relationships have the capacity to heal, they can also harm. In reality, the outcome of most therapeutic encounters and relationships lies somewhere on a continuum between good and harm. Few therapeutic relationships are a complete success but, judging by the number of complaints, even fewer are a complete disaster. Studies of therapeutic encounters invariably show high levels of patient satisfaction (see, for example, Sharma, 1992; Kelner et al., 2000). None the less, it 1.9 Models of health care delivery: alternative or holistic models Many CAM modalities have grown from a wide range of concepts of the body and health and healing that differ from the models discussed so far. As Fulder notes: The body, in Chinese medicine, is energetic. In yoga and healing, the body is spiritual. In modern (conventional) medicine, the body is physicochemical. In homeopathy, it is phenomenological. In naturopathy it is vital, etc. All of these conceptions do not necess
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