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2.12.1 Integration

One factor which is already influencing the nature of the therapeutic relationship is the move towards greater integration with orthodox medicine. Whether or not CAM practitioners welcome this development, it is inevitable. The impetus for this is partly about providing health care that gives patient satisfaction, and also stemming the tide of the spiralling costs of hi-tech, orthodox medicine and medical litigation. Stacey (1988) points out that, when the state funds parts of the nati
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2.9 The failure of CAM therapeutic relationships: creating dependency to satisfy practitioners' emot

Although a failed therapeutic relationship is often assumed to involve a patient not returning, the case of a patient who attends repeatedly can also be highly problematic. This phenomenon can be seen as a breach of boundaries in that an inappropriately extended therapeutic relationship changes from being a healing encounter into a dependency relationship or friendship. Unlike the timescale contracts that may be negotiated in counselling and psychotherapy, there are no fixed timescales for mo
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2.7 The failure of CAM therapeutic relationships: breach of boundaries

In this section, failures caused by breach of boundaries are discussed under the following headings:

  • ‘wounded healers’

  • creating dependency to satisfy practitioners’ emotional and financial needs

  • sexual abuse and exploitation.

To reiterate a point made earlier, breaches of the therapeutic relationship cover a spectrum. Some breaches invariably thwart a successful therapeutic outcome (for example, when
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2.4.3 How CAM therapists impose their views on users

As most people do not have a wide knowledge of complementary perspectives and philosophies, the therapeutic relationship can break down because of a mismatch between what the practitioner offers and what the user of the service wants. The practitioner's ideas about health, illness, mind and body may be at odds with the user's, which can lead the user to find another therapist who offers therapy that is more congruent with their beliefs.

The scholar Ursula Sharma argues that users of CAM
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2.4.2 Holism and ideas about the body

Reductionist medical approaches have been criticised for providing a fixed, mechanistic view of the body, which fails to capture the patient's experience. The power associated with biomedical diagnoses and expertise means that patients’ explanations for their illnesses are often overlooked or dismissed. Does holism, which seeks to treat the mind, body and spirit, fare any better in giving patients a sense of control or ownership of what their illness means? This question is often reframed i
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2.4.1 Reductionism and ‘ownership’ of the body

Social scientists interested in changing relationships between workers and users of health care often draw attention to what is termed the loss of ownership or loss of governance of the body. These terms mean that a person's body is treated in some health situations as more important than the person themselves. It is almost as if they are purely a case, an example of a type of disease, or a set of symptoms. Traditionally, such criticisms were levelled against biomedical approach
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2.4 Ownership, control and ideas about the body

This section focuses on the extent to which a person becomes invisible when a practitioner rigidly adheres to a specific view of health and disease, and fails to accept that others (specifically the person they are treating) may have different ideas about illness or, indeed, about their body. The imposition of a fixed view of illness and disease can be extremely disempowering for people seeking help.

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2.3.1 Patients and therapeutic responsibility

Activity 6: Therapeutic responsibility

0 hours 15 minutes

Based on your own experience, and using the evidence you have read about and heard, answer the following ques
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1.3 Components and origins of health beliefs

Health beliefs, like other personal beliefs, are learned. Knowledge about health and illness is built up from childhood onwards, from diverse sources including family, social networks, community and religion, and through ‘official’ government health messages. Individual health beliefs, while rarely ‘scientific’ in themselves, none the less are grounded in experience, modified over time in the light of that experience, and rational in the light of people's wider belief systems and worl
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1.6 Valuing diversity

Social workers need to recognise diversity: valuing and respecting service users – irrespective of, for example, their ethnicity, gender or age – is central to good practice. It is also about working in a way that counters the unfair or unequal treatment of individuals or groups on the basis of their race, gender, class, age, culture, religion, sexuality or ability. There is a growing body of law that seeks to prohibit and punish a range of discriminatory behaviours in various kinds of so
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4.3 Indirect use of solar energy

The above examples illustrate the direct harnessing of the sun's radiant energy to produce heat and electricity. But the sun's energy can also be harnessed via other forms of energy that are indirect manifestations of its power. Principally, these are bioenergy and hydropower, already discussed in Section 3 above, together with wind energy and wave power.


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1.1.1 Where do we get our energy from?

The world's current energy systems have been built around the many advantages of fossil fuels, and we now depend overwhelmingly upon them. Concerns that supplies will 'run out' in the short-to-medium term have probably been exaggerated, thanks to the continued discovery of new reserves and the application of increasingly advanced exploration technologies. Nevertheless it remains the case that fossil fuel reserves are ultimately finite. In the long term they will eventually become depleted and
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6.4.2 A broad view of technology

This dual nature is not because machines or chemicals are inherently good or bad; it arises from the way societies decide to use them (or not). This makes sense if you take a broad view of technology, outlined at the beginning of this Introduction. This is the understanding that technology, and it's uses from artefacts to infrastructure, is the product of human and social action. It is a major driver of the development of societies and their economies, but the forms and directions thes
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6.4.1 The dual nature of technology

Exercise 5

List the main advantages to you of using a refrigerator in your home, then list some of the potential environmental hazards that using a fridge might entail.


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5.2 New Zealand's changing environment

In this study I want to explore some possible effects of this new trade on the environment of one of the countries involved. I've chosen New Zealand, partly because the developments we have just been discussing happened only a few decades after the first large-scale settlements of Europeans, and had a strong influence on the direction of its economy. Some background information will help to set the scene.

New Zealand consists of two mountainous islands with a total area similar to that
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4.6 Global climate change continued

Box 3: Some impacts of global climate change

Record global temperatures

The global mean surface temperature of our planet has been rising steadily for 30 years. According to climate scientists, who have constructed a reliable global temperature series from 1860, nine of
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Keep on learning

Study another free course

There are more than 800 courses on OpenLearn for you t
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1.3 Activity 1

Activity 1

Before you read on, I would like you to dwell for just a moment on the significance of this shift from direct investment by Western firms to the establishment of subcontracting ties with overseas partners. A
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Groups and teamwork
Are you always the quiet one when it comes to group discussion? This free course, Groups and teamwork, will help you improve your working relationships with other people in groups of three or more. The course also deals with project life cycles, project management and the role of the leader. First published on Mon, 10 Dec 2018 as Author(s): Creator not set

2.5 Living systems and information flows

Understanding the role of information flows in feedback relationships is often confusing. It is relatively easy to visualise flows of energy and matter (ecosystem food webs, water flowing through a rainforest ecosystem, etc). But how does information ‘flow’ within feedback loops, and how does this affect systems?

The first point to make clear is that information is only meaningful to those systems that can perceive it. In other words, these systems need to have components th
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