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4.02: Counselors Manual for Relapse Prevention with Chemically Dependent Cri
Group counseling has proved to be the most effective way of treating chemical dependency. This chapter explains how to do group counseling. Patients in chemical dependency treatment programs learn best in group counseling, where patients learn about themselves by interacting with others. They also come to understand that they are not alone in their problems. In addition, they learn social and communication skills that allow them to make better use of self-help programs such as Alcoholics Anonymous and Narcotics Anonymous.
How Is Group Work Different From Individual Counseling?
Group counseling and individual counseling are both important tools for treating chemical dependency. Group counseling uses many of the same intervention strategies as individual counseling. There are, however, some important distinctions between the two modalities. A common mistake for beginning group counselors is to focus an entire group meeting on one patient, while the others in the group simply look on.
Group counseling is different from individual counseling in the following ways:
• Group counseling focuses on the present; the here and now. In group counseling, patients do not delve into long accounts of personal history that preceded the problems of chemical dependency. Group counseling provides a forum to understand current behavior, to learn about chemical dependency, to discuss new ways of behaving, to learn new ways to solve problems, and to develop relapse prevention skills.
• Group counseling makes use of the interactive process within the group. That is, the counselor focuses on how the group members act toward one another, communicate with one another, and how they behave in the group.
• The counselor and group members offer individuals feedback about their behavior. In individual counseling patients simply disagree with their counselor. In group counseling the counselor's feedback is combined with positive peer feedback from the group members. This makes messages more powerful.
• The group provides a place for the counselor to help individuals practice new skills such as problem solving, communication, and managing stress.
In group counseling, the counselor uses a peer group to influence individual patients and change behavior in a positive way.
Group Counseling Theory
Stages of Group Development
When a group first begins, counselors and group members alike will feel very uncomfortable. The members may not know the counselor or one another. As people become familiar with the group, feelings and behavior begin to change. These changes follow predictable patterns. In fact, groups have a clear developmental life cycle, that is, a group goes through different stages. As the group leader gains experience, he or she learns to anticipate these changes and work with them.
There are many models for the stages of group development. The following is a composite of several models:
• Stage 1—Preaffiliation
• Stage 2—Power and control
• Stage 3—Intimacy
• Stage 4—Differentiation
• Stage 5—Separation.
In the preaffiliation stage, members feel uncomfortable, anxious, or fearful with the newness of the experience. In this stage, members look to the leader for direction. Initially, the group should be leader-focused, with the leader helping members adjust to the new experience.
Once group members are more comfortable, it is predictable that they will challenge the authority of the leader and will pursue power and control. It is important for the leader to remember that this is a normal style in the group's development, not unlike the challenges that face the parents of an adolescent. This phase may be uncomfortable, with group members expressing anger and frustration. The leader should be careful not to personalize these challenges to authority. The leader should be consistent, avoid fighting with the group, and allow the group to become more autonomous without sacrificing his or her position of authority.
In the next stage, some degree of intimacy is established. It is very important for the leader to move members to a common level of intimacy before allowing too much self-disclosure by the group members. The setting and type of the group will determine the overall level of intimacy. As members feel safer in the group, they can better engage in activities and take risks necessary for change. At this stage, the leader can give less direction, allowing the members to work together more spontaneously and more independently.
Differentiation is the stage at which members have a strong sense of identification with the group and feel trusting. This is the most productive stage of group development.
Finally, at the point of termination or separation, members experience a range of feelings and display a range of behaviors in anticipation of leaving the group. It is important to remember that chemically dependent people typically have experienced a lot of loss over their lifetimes. Many have lost family members and friends to violence and illness. They do not handle the ending of relationships well. Termination of the group or loss of a group member presents an important opportunity to deal with this problem. The leader should begin to prepare the group for ending well in advance and do so gradually. The leader can expect members to use denial or to regress. It is important to predict these behaviors and to identify them as they occur.
These stages of group development are very predictable. Virtually all groups go through them. However, depending upon the circumstances a group may regress to an earlier stage at any time. For example, if a group adds new members, the level of intimacy will decrease. The group may return to a stage of preaffiliation. It is hard to predict how long a group will stay in a particular stage of development. The type of group (i.e., mandatory or voluntary), the setting (i.e. institution or community), and other factors can all influence the process. With experience, the group leader develops the skills to promote the group developmental process or alter.
Communication in Groups: Content and Interactive Process
The terms "content" and "interactive process" refer to the patterns of communication among group members. "Content" refers to the substance of a communication. The content is the subject matter, including issues, questions, or problems on which the group is focused. "Interactive process" refers to how members communicate and act with one another. The process includes not only the spoken words, but also the nonverbal messages expressed by tone of voice, posture, and facial expression. Process provides the "present focus" or "here and now" raw material for group treatment.
The content of a group meeting sometimes symbolizes the group process. In the same way a client might talk about "a friend who has a problem," group members may talk about prior events and issues that reflect current experiences. Often as group leaders, we get caught up in the content. We are very interested in the what, when, where, who, how, and why. In group counseling, this content has relevance in a way that can be different from its relevance in individual counseling.
The Counselor as Group Leader
Many techniques used in group counseling are similar to those used in individual counseling. The general approach of the group leader, however, must work to create a group culture that focuses on the Ahere and now" behavior. An active and dynamic approach along with an empathic style are needed to do this.
The group leader's focus should:
• encourage group and individual recovery
• teach members about chemical dependency, recovery, and relapse prevention
• build members' self-esteem.
The group leader's approach should:
• be empathic
• instill hope
• model desired behaviors
• treat all members consistently, equally, and fairly
• be active and directive
• use appropriate interventions to keep the group moving.
The group leader should:
• maintain control in a nonauthoritative way
• be firm but not punitive
• be assertive in setting limits
• provide appropriate rewards (activities, trips, etc.) to the group.
Planning for Group Work
Logistics
All logistical arrangements should be planned well in advance of beginning the group. In order for the preplanning to go smoothly, group counselors should seek the support of appropriate administrative and support staff. Establish the following before getting started.
Group Size
Groups typically range in size from 6 to 12 people. The size should be determined by such factors as the type of group and the capacity of the patients. "Capacity" refers to the level of individual functioning. Can the patient concentrate, focus, and pay attention? Some substance abusers, particularly those in the early stages of recovery, cannot make use of all their mental functions. Others may have mental/emotional problems that interfere with these abilities. Low-functioning individuals will need a smaller group. Educational groups can handle more members, whereas process oriented-groups should be smaller.
Time
Time is an important boundary. The length of group sessions should be preplanned if the group is to be time limited. A schedule of sessions should be established that considers holidays and other commitments.
Sessions should be of equal length. The ideal length depends on the capacity of the patients, the setting, and the type of group. More functional patients can handle longer sessions than less functional or younger patients. The materials presented in this manual are intended for two-hour group sessions.
Once the time boundaries have been established, it is very important to begin and end group sessions on time.
Space
The space chosen for group meetings will make a statement about the importance given to this activity. The space should be psychologically positive and provide a safe environment for the emotional risks that go with treatment. The space should be well lighted, well ventilated, and an appropriate size for the size of the group. A private location that is accessible, free from interruptions, and physically safe should be chosen.
Types of Groups
Different types of groups serve different purposes. The following is a review of some options to help you decide what type of group is most practical and useful for the setting.
Mandatory or Voluntary Group?
You might assume that voluntary groups are best, but research and practice indicate that both voluntary and mandatory groups have their advantages and disadvantages.
Mandatory groups ensure that members will attend. With regular attendance the group process can develop with little disruption. Unfortunately, mandatory requirements often increase hostility and resistance and intensify denial. No one likes to be told they must go to a counseling group, and few counselors like being confronted with such hostility, particularly by a group of eight or more people.
When the counselor is well prepared, the situation can be managed. Patients will attempt to engage you in battle. The best tactic is to avoid these battles. One way to do so is to join with the group by saying something like, "You have to be here and I have to be here. I understand and appreciate your anger but it is not my fault. How can we both make the best of things?" Offering concrete rewards for cooperation may also help. Setting rules for attendance can eliminate overt resistance but seldom reduces passive resistance.
The disadvantages of the mandatory group become the advantages of the voluntary group. Members of voluntary groups identify with one another, denial is less potent, there is less hostility, and one can move on more quickly to group goals. However, the voluntary group does not have some major disadvantages. When participation is voluntary, members often find excuses to be absent when there is pressure on them to face problems. Without a "captive" audience, leaders find that it is hard to ensure member attendance and that it is difficult for the group process to evolve with absent members.
Which type of group is best? Research indicates that mandatory treatment works as well as voluntary treatment with substance abusers. In a criminal justice setting, required attendance can be useful for all.
Open or Closed Group Membership?
One issue to be decided in advance is whether or not to add members after the group has started. The terms Aopen membership" and "closed membership" are used to describe the two options.
Open membership can reach more clients and is easier to keep going over time because lost members can be replaced. However, adding new members can cause a loss of group intimacy and cohesiveness. Development may regress. Although this may not be ideal, depending on the goals of group, adaptations can be made. Closed membership allows for greater individual progress but is impractical in some settings.
Time-Limited or Open-Ended Group?
It may be practical to place a time limit on a group depending on the patients' stage of recovery. This way patients graduate together to another group with another specified goal. If the setting allows, an open-ended, closed membership group can be ideal. Such a group can achieve high levels of intimacy and differentiation that allow for greater risk taking. The goals can advance while the membership remains the same.
Educational Groups?
For patients to succeed in recovery, they must learn certain things about chemical dependency. This information helps them to cope with the challenges of recovery and avoid relapse. Educational groups also help engage the client in treatment and recovery. The overt or covert expectation of individual or group therapy is "change." People find this threatening. An educational group is much less threatening because it is easier to Alearn" than to Achange."
Educational sessions can be offered in 60- to 90-minute blocks. The educational sessions should offer basic information on
• Chemical dependency as a bio/psycho/social disease
• The recovery process
• Symptoms that appear after beginning abstinence
• Relapse warning signs
• Recovery planning.
These sessions should consist of a lecture and an exercise, presented with media supplements. Some programs have an educational curriculum available, and such programs may be available through your State Alcohol and Drug Abuse Agency. One prepackaged educational program that can be ordered is the Staying Sober Educational Modules (see the bibliography).
Group Goals and Principles
It is important for the group leader to be clear about what is to be accomplished in the group. It is best to have a written goal with a step-by-step plan for reaching the goal. Having both a written goal and a plan will help to keep the group on track.
The goals of group treatment with addicted patients should be:
Self-assessment. The patients should be able to talk about and understand the meaning of different exercises to their recovery.
Communication training. The group leader should teach patients basic techniques for talking about their thoughts, feelings, and reports of life events. This training should focus on teaching patients how to reveal things about themselves and how to give and receive feedback.
Cognitive restructuring. Patients should relearn how to think so that they can accurately examine and report information and understand how it pertains to their recovery.
Effective counseling. Group treatment should teach patients how to identify, express and self-regulate their emotions and moods.
Memory retraining. Treatment should help patients restore short-term and long-term memory.
Treatment monitoring. Group sessions should provide a vehicle for monitoring and holding the patient accountable for progress and problems encountered when pursuing treatment goals.
Support. The group leader should provide peer and professional support throughout the recovery process.
Opportunity for dialogue. Group sessions should give the patient a chance to talk about recovery issues in a supportive environment where feedback from and discussion with people both more and less advanced in the recovery are available.
Involvement of others in problem solving. The group process should involve the patient in problem solving with other recovering people. The group leader can tell patients that others can and will help in problem solving if they are allowed to, that they too are capable of helping others, and that they can help themselves by helping others.
The principles of group counseling for patients recovering from addictions should be:
Addiction groups. In order to be successful, groups must consist of only recovering alcoholics and drug addicts.
Group treatment goals with addicted patients. The addicted patient is suffering from chemical dependency. This is an illness causing specific physical, mental and social impairments. Group treatment must be directed at helping the patient with these impairments.
Structured and directive group process. The group process should be structured rather than free-floating. Patients must focus on concrete, specific problem solving relating to accepting their addiction and achieving a comfortable recovery. Feelings should be dealt with in the context of these concrete problems. All problems dealt with in the group must be related to recovery from chemical dependency.
The role of the group counselor. The group counselor should be directive, yet permissive and supportive. The counselor is responsible for establishing and maintaining direction for each patient and for the group as a whole. The group counselor gives direction and supervision to the group. He or she must provide a consistent group format; set the pace of the group and see that it is maintained; assign, follow, and review assignments; and manage group problems as they develop.
The abstinence goal. The first focus of group treatment should be for each patient to establish and maintain abstinence from alcohol and mood-altering drugs. This goal of recovery involves the identification of concrete problems and situations that could jeopardize abstinence, the development of specific plans for managing these problems, and the completion of skills training and assignments designed to develop skills in coping with these problems and situations.
Reliance on group support. Patients need to develop a strong substitute dependency to replace their old dependency on alcohol and drugs. Patients will tend to develop a strong dependency on the counselor as this substitute dependency. Group treatment should be used to transfer this dependency from the counselor to the group. Group counseling for addicted patients should be designed to support the patient's ongoing involvement in AA, NA, and other support groups. It should also focus on building strong, positive, supportive relationships among the group members.
Admission and discharge criteria. There should be specific admission criteria that describe the type of patient that is appropriate for treatment in group counseling. There should also be specific discharge criteria that describe when a patient is ready to responsibly Agraduate" from the group.
Issues that are inappropriate for group treatment. There are certain issues that are best dealt with individually. This is due to the need for extreme confidentiality or a patient's inability to deal with the issues in a group setting. Care needs to be taken, however, not to support a patient's continuing denial by allowing him or her to avoid talking about routine recovery issues in group sessions.
Role modeling by the counselor. The counselor should model the behaviors that he or she expects from the patients.
Supportive counseling. The early efforts of the group counselor should be directed toward allying himself or herself with the addicted patient's needs rather than with attacking defenses. Addicted patients need basic support, education, communication training, and direction in recovery. These should be provided with support rather than harsh confrontation.
Group involvement. Eighty percent of the benefits of group treatment comes from becoming actively involved in utilizing the group process to help other group members to recover. This involvement interrupts chemically dependent self-centered behavior and provides training in the processes of problem solving and recovery. Many patients will automatically identify and discover solutions to problems in their lives by helping other patients cope with similar problems. Only 20 percent of the benefits of group counseling comes from working on personal problems.
Note taking and tape recording in group. Addicted patients suffer from severe memory impairments. It is recommended that all patients take notes on important issues. Patients can also tape record portions of the group sessions where they work on an issue and receive feedback. Listening to these tapes later often speeds up the counseling process.
The intoxicated patient in group treatment. It is unproductive to allow a patient to attend group sessions while actively intoxicated with alcohol or drugs. The patient should be asked to leave the group and an individual appointment should be made to motivate the patient to enter appropriate detoxification treatment.
Rules and Contracting
Contracting is a tool that many groups use to help get members to attend meetings and follow rules. Because it is very important that all members agree to the requirements and rules of the group, a document can be written up and copied for each member and the group leader. Each member and the leader will sign this contract. The contract sets forth the day or dates of meetings, time, location and group rules.
Clearly stated and enforced rules are critical for a successful group. They can free members to deal with recovery issues. For example, when a rule of no violence is clearly stated and enforced, it allows the patient to feel and express anger, knowing that the group will not allow any one person to get out of control. Rules also offer limits to patients who have very few internal controls and who cannot set their own limits. Many substance abusers grew up in situations that did not teach them controls and limits. Establishing and enforcing group rules can help correct this.
Use the following guidelines in setting group rules.
• Do not make a rule that you or the agency cannot enforce.
• All rules must be enforced fairly and anytime they are violated.
• Rules should be clear and understood by all.
• Many substance abusers have memory problems; therefore, rules should be restated periodically and whenever a new members joins the group.
Group Rules
The following rules are designed to be used as part of the problem-solving group process.
• You can say anything you want, any time you want to say it. Silence is not a virtue in this group and can be harmful to your recovery.
• You can refuse to answer any question or participate in any activity except the basic group responsibilities. The group cannot force you to participate, but group members do have the right to express how they feel about your silence or your choice not to get involved.
• What happens in the group stays among the members with one exception: Counselors may consult with other counselors in order to provide more effective treatment.
• No swearing, putting down, physical violence, or threat of violence.
• No dating, romantic involvement, or sexual involvement among the members of the group. Such activities can sabotage the treatment of those involved and others. If such involvements develop, members should bring it to the attention of the group or individual counselor at once.
• Anyone who decides to leave group treatment must tell the group in person prior to termination.
• Group sessions are 2 hours in duration. Patients should be on time and plan on not leaving the session before it is over. Smoking, eating, and drinking are not allowed in group sessions.
Responsibilities of patients in the group include the following:
• Listen to other group members' problems.
• Ask questions to help clarify problems or proposed solutions.
• Give feedback about what you think and feel about a problem and the personal strengths you see in the person that will help him or her solve the problem. Also give feedback about the weaknesses you see that may set the person up to fail to solve the problem.
• Share personal experiences with similar problems when appropriate. Self-disclosure must be carefully managed to keep the primary focus on the patient who is working on the issue.
Problem-Solving Group Counseling Format
The Preparation Session
Before the group session begins, the counselors must prepare. Counselors meet as a group. A brief written description of each patient (a Athumbnail" sketch) is presented, and the patient's progress is reviewed. An attempt is made to predict the assignments and problems that patients will present.
The Opening Procedure (5 Minutes)
During the opening procedure, the counselor sets the climate for the group, establishes leadership, and helps patients warm up to the group process.
• The counselor enters the group room. He or she makes sure that the room is set up with a circle of upright chairs arranged close enough for the members to touch each other. The counselor greets each member informally by talking to them before the group starts.
• The counselor asks the members to touch the person on either side and while doing this make eye contact with each person in the group. He asks them to make sure the other person sees them by nodding or giving another response.
• The counselor completes a centering technique (see Counseling Techniques). This is designed to get the patient in touch with himself or herself and leave nonrelated problems outside the group room.
• The counselor then takes attendance. During the attendance procedure, the counselor makes eye contact with each patient, engages in a brief social greeting, and tries to get an idea of each patient's attitude and mood before going on.
Reactions to Last Session (15 Minutes)
A reaction is a brief description of (1) what each group member thought during the last group session, (2) how the group member felt during the last group session, and (3) identification of the three persons who stood out from the last session and why they were remembered.
All group members are required to give a reaction to the last session. This accomplishes a variety of goals:
• It forces each patient to talk in the first phase of the group session.
• It breaks the tendency toward isolation and self-centeredness by forcing the patient to notice and comment on at least three other group members. This reaction forces group involvement.
• It provides training in basic communication and on how to give feedback.
• It provides feedback to other group members about who stood out from the last session and why.
• It puts pressure on group members to recall important events from previous group sessions. As a result, it serves as a memory training device.
• It tests a group member's motivation. Members who refuse to give reactions or repeat what others say generally have problems cooperating with other aspects of treatment.
• It provides an opportunity for the counselor to reflect on the last group and compare his or her personal memory with the group members' memories.
It is important to remember that a reaction is a one-way communication. Other group members are not permitted to comment on the reactions. If someone is upset by what another group member says, it is that person's responsibility to volunteer to work on the issue when the agenda is set.
A reaction is also a no-fault communication. There are no right or wrong reactions. The only feedback the counselor and other group members generally give is on the format and completeness of the reaction. In other words, the group member is reporting on his or her thoughts, feelings, and at least three persons who stood out to them in the last session.
A typical reaction should have three parts:
• What I thought about during the last group session.
• How I felt during the last group session.
• Three people that stood out to me in the last group session.
A counselor must help patients by coaching their responses.
Typical problems that patients will have are
• They will say what they thought about or felt about the last session, instead of what they thought or felt during the last session.
Example:
Patient—I thought last week's session was good. (Incorrect)
Counselor—You misunderstand. What I would like you to do is tell what conversations or pictures went on in your head.
Patient—What I thought about during last week's session was how my drinking and drug use has affected my life. (Correct)
• They will confuse thoughts and feelings.
Example:
Patient—I think I was angry. (Incorrect)
Counselor—You felt angry? (Explain the difference between a thought and a feeling.)
Patient—I felt angry. I was thinking about going to jail. (Correct)
• They will talk about a group member instead of to them.
Example:
Patient—Joe stood out because his life history was a lot like mine. (Incorrect)
Counselor—Please say this again and this time speak directly to Joe. Look at him and say, "Joe, you stood out because . . ."
Patient—Joe, you stood out because your life history was a lot like mine. (Correct)
Examples of Good Responses. A typical reaction made by a group member to the last group might be as follows:
• I thought a lot about how I deal with anger and frustration. There was a lot of good feedback when I talked about my problem.
• I had a feeling of accomplishment as I worked on my problems. I was surprised. I got excited instead of depressed for the first time in a long time.
• Joe, you stood out to me because you understood what I was talking about.
• Mary, you stood out to me because you told me you cared. I'm not sure if I believe you. A part of me thought you were telling the truth and I felt good. Another part of me said, "Why should she care—no one else does."
• Pete, you stood out because you did not seem to pay attention to me when I was talking.
Learning To Give Good Reactions
It takes time for the average person to learn how to give good reactions in group session. This learning takes place as a result of instruction and imitation. The counselor and other group members should explain the components of a good reaction to each new group member. A written handout should be provided that describes the components of a reaction and gives examples.
The group member will also learn by observing and imitating the reactions of other group members. Counselors can speed up this progress by acknowledging good reactions. This is done by saying, "Good" or another positive response to encourage and reward the person. The counselor gives positive feedback for doing the reaction correctly, not based on agreement with the content of what the person says.
Report on Assignments (10 minutes)
Assignments are exercises that patients are working on in their workbook or in addition to their workbook. Additional assignments are often given to help a group member solve a problem that is being worked on in the group. Some of these assignments will be completed in group, and others will need to be completed in between group sessions. Immediately following reactions, the counselor will ask all group members who have received assignments to briefly answer six questions.
• What was the assignment and why was it assigned?
• Was the assignment completed? If not, what happened when you tried to do it?
• What was learned from the completion of the assignment?
• What feelings and emotions did you experience while completing the assignment?
• Did any issues surface that require additional work in group?
• Is there anything else that you want to work on in group today?
Patients should be asked to rate how important their assignment or problems are in the group session by labeling them with a number from 1 to 10, with 1 being not very important and 10 being extremely important.
Setting the Agenda (3 Minutes)
After all assignments have been reported on, the group counselor will identify all persons who want to work, and announce who will work and in what order. Group members who do not have time to present their work in this group session will be first on the agenda in the following group session. It is best to not plan on over three patients working in any group session.
The Problem-Solving Group Process (70 Minutes)
The problem solving group process is designed to allow patients to present issues to the group, clarify these issues through group questioning, receive feedback from the group, receive feedback from the counselor (if appropriate), and develop assignments for continued progress.
The problem solving process is guided in two ways. A series of exercises are assigned and then processed in group. Special problems that come up are discussed by the group. One goal of group counseling is to teach problem solving skills that will enable the recovering patient to handle difficult situations when they arise.
When dealing with problems that are not assignments, a standard problem solving process is recommended. This process consists of the following steps:
Step 1: Problem Identification.
First, have the members ask questions to identify what is causing difficulty. What is the problem?
Step 2: Problem Clarification.
Encourage them to be specific and complete. Is this the real problem or is there a more fundamental problem?
Step 3: Identification of Alternatives.
What are some options for dealing with the problem? Ask the patient to list them on paper so they can readily see them. Try to have the group come up with a list of at least five possible solutions. This will give them more of a chance of choosing the best solution and give them some alternatives if their first choice doesn't work.
Step 4: Projected Consequences of Each Alternative.
What are the probable outcomes of each option? Have the group ask the person the following questions:
• What is the best possible thing that could happen if you choose this alternative?
• What is the worst possible thing that could happen?
• What is the most likely thing that will happen?
• What is your reaction (thoughts, feelings, memories, and future projections) when you think about implementing that alternative?
Step 5: Decision.
Have the group ask the person which option offers the best outcomes and seems to have the best chance for success. Ask them to make a decision based upon the alternatives they have.
Step 6: Action.
Once they have decided on a solution to the problem, they need to plan how they will carry it out. Making a plan answers the question, "What are you going to do about it?" A plan is a road map to achieve a goal. There are long range goals and short range goals. Long range goals are achieved along with short range goals. One step at a time.
Step 7: Followup.
Ask the person to carry out his or her plan and report on how it is working.
Most problems will not be solved by presenting them one time in group session. Personal problem solving is a process that requires time. It may require three to six presentations of a problem, accompanied by specific assignments completed between group sessions to bring a problem to full resolution. Patients should be given a limited time to present a problem or the summary of an assignment. As a general rule, patients should not work in group for more than 20 minutes.
Not every person will work on a problem during each session. There is an 80/20 rule for group treatment. Eighty percent of the benefit of group treatment occurs from learning how to become responsibly involved in helping others to solve their problems. Only 20 percent of the benefit is derived from working on personal problem issues.
Feedback
When you reach a point where part of the problem solving process is completed or an assignment is presented, group members and the counselor should give feedback. The counselor should go last. Feedback should be given by having the members complete the following:
• My gut level reactions is . . . (A feeling, thought, or how members can identify with the patient who presented)
• I think that how this affects your recovery is . . .
• What I think of you as a person is . . . .
The purpose of this feedback exercise is to practice communication skills, learn to give and take feedback, and use the group for problem solving. The counselor may give an assignment to the patient if it would be helpful to continue to learn more about how to solve this issue.
The Closure Exercise (15 minutes)
When there is approximately 15 minutes left in the group session, the counselor will ask the members the following:
• What is the most important thing you learned in group this evening? It is important to write this down in your notebook.
• What are you going to change about your behavior? Write this down in your notebook.
• Share with the group what you learned and what changes you are willing to make.
Each participant will then briefly review his or her answers to those questions with the group. The counselor then adjourns the group.
The Debriefing Session
The debriefing session is designed to review the patient's problems and progress, prevent counselor burnout, and improve the group skills of the counselor. If this can be done with other counselors running similar groups, it is especially helpful. A brief review of each patient is completed, outstanding group members and events are identified, progress and problems are discussed, and the personal feelings and reactions of the counselor are reviewed.
Outline for Group Counseling Sessions
Opening Procedure—Format (5 minutes)
• Form a tight circle.
• Do physical and eye contact exercises.
• Do centering (breathing) exercise.
• Take attendance to identify moods.
Opening Procedure—Purpose
• Establish control.
• Get group members in contact with one another.
• Get group focused.
• Check members' attitude and mood.
Reactions to Last Sessions—Format (15 minutes)
• Ask what patients thought about during last session.
• Ask how they feel during last session.
• Ask which three people stood out from last session and why.
Reactions to Last Session—Purpose
• Communication training.
• Memory training.
• Tie together group experience.
• Force interest in other group members.
• Initiate high quality group interaction.
• Test motivation.
• Create opportunity for "no fault" communication.
Report on Assignments—Format (10 minutes)
• Find out who had an assignment.
• Ask whether they completed it.
• If yes, ask what they learned.
• If no, ask what happened when they tried to complete it.
• Ask how important is it for them to present this in group tonight. (Rate 1-10.)
• Discuss any other problems that need to be worked on in group. (Rate 1-10.)
Report on Assignments—Purpose
• Accountability (getting only what you expect and inspect).
• Continuity (ensuring that all assignments are completed).
Setting the Agenda—Format (3 minutes)
• DECIDE and announce: The order of presentation by the group members.
Setting the Agenda—Purpose
• To identify the members who need to work in group.
• To review a brief description of the issue the member wants to work on.
• To establish priorities based on:
• Problem severity
• History of participation
Problem Solving Process—Format (70 minutes)
• Problem presentation.
• Questioning by the group.
• Feedback from group members.
• Feedback from the group counselor, if appropriate.
• Closure by the therapist.
Problem Solving Process—Purpose
• To present issues.
• To clarify the issue through questioning by the group.
• To receive feedback from group members.
• To develop assignments for continued progress.
Presenting a Problem in Group
• "The problem I want to work on is . . ."
• "This first became a problem when . . ."
• "The relationship of this problem to my addiction is . . ."
• "I have tried to solve this problem in the past by . . ."
Goals of Group Questioning
• To establish rapport by active listening.
• To encourage group members to know and understand the member who is working on a problem.
• To convey the message, "You are listened to, understood, taken seriously, and affirmed as a person."
Types of Questions
• Open—Cannot be answered with a "yes" or "no."
• Focus—Forces a choice between limited options.
• Closed—Forces a "yes" or" no" answer.
• Leading—Forces consideration of a new point of view.
The "EIAG" Method.of Questioning
• E—EXPERIENCE: "What exactly did you experience and why is it a problem?"
• I—IDENTIFICATION: "Can you identify what the important parts, elements, or outcomes of the experience were for you?"
• A—ANALYZE: "Why was this experience important? What is its meaning or significance?
• G—GENERALIZE: "What did you learn from this experience and how will you apply what you learned to other experiences?"
Addiction-Focused Questions
• How did this problem or experience contribute to the development of your addiction?
• How did this problem or experience affect your willingness or ability to recognize or seek treatment for your addiction?
• How did this problem or experience affect your willingness or ability to stay sober or maintain your recovery program?
• How did this problem or experience set you up to relapse in the future?
Giving Feedback in Group
• "My gut level reaction to your problem or assignment is . . ."
• "I believe your problem is . . ."
• "How I feel about you as a person is . . ."
The Timing of Change
• No problem is ever solved in one group presentation.
• To solve a single problem requires three to six group presentations.
• Each problem will need to be broken down into pieces that can be worked on in 20- to 30-minute sessions.
• Limit each presentation to 20–30 minutes.
• Allow time for two to four patients to work in each group.
The Problem Solving Process
• Problem identification
• Problem clarification
• Identification of alternatives
• Projecting the consequences of each alternative (best, worst, most likely)
• Decision
• Action
• Followup
The Closure Exercise—Format (15 minutes)
• Write down the most important thing you learned in group today.
• Write down what you will do differently as a result of what you learned.
• Explain to the group the most important thing you learned in group and what you will do differently as a result.
The Closure Exercise—Purpose
• To ensure that each group member understands and integrates the group experience.
• To assist in documenting the group process.
Adjournment
• Ask group members to report if they are not going to be in the next group session.
• Confirm the day, date, and time of the next group.
• The group is officially ended.
The Debriefing Session—Format
• Patient review: Review the progress and problems of each patient.
• Outstanding group members: Think about and record which group members stood out the most in today's group and why.
• Outstanding events: Think about and record any outstanding positive or negative events in the group.
• Problems—Progress: Think about and record any problems or progress observed in the overall management of the group.
• Personal feelings and reactions: Think about and record any personal feelings and reactions about the group.
The Debriefing Session—Purpose
• To review patient progress and problems.
• To prevent counselor burnout.
• To train and develop the skills of the counselor team.
• Debriefing is critical to long-term group success.
Contributors and Attributions
Source: http://store.samhsa.gov/shin/content/SMA06-4217/19c.htm , Chapter 6
4.03: Resource Videos
TIP41 Group Therapy for Counseling Training and CEUs for LPC and Addiction Counselors. Dr. Dawn-Elise Snipes PhD, LMHC, CRC.
A demonstration of interpersonal group therapy for clients in recovery from addiction. Powerful drama combined with expert commentary to show how this model of relapse prevention can be effective in the field of addiction. | textbooks/socialsci/Social_Work_and_Human_Services/Book%3A_Treatment_of_Addictions_Individual_and_Group/04%3A_Group_Counseling-_Theories_Modalities_and_Skills/4.01%3A_TIP_41-_Substance_Abuse_Treatment__Group_Therapy.txt |
TAP-21.pdf
5.02: Counselors Manual for Relapse Prevention with Chemically
Basic Counseling Skills
Although the workbook is intended to be used in a group counseling session, occasionally you will need to do individual counseling. This chapter discusses some basic counseling skills that can be used in individual and group counseling. It also explains some of the concepts and terms used in relapse prevention counseling that you will need to help patients with the workbook.
Helping Traits
People who are effective at counseling have developed eight behaviors that they use during counseling sessions. It is important to develop these traits if you are to improve your ability to help others. The counselor is a role model (someone whom patients tend to imitate). Therefore, you want to model behaviors that will be helpful to patients' recovery. The following are some of these traits.
Empathy. Empathy is the ability to understand how another person sees and interprets an experience. It is different from sympathy (feeling sorry for someone). When you are empathetic, you can look at and understand a situation from another person's perspective. It does not mean you have to agree with that person.
Genuineness. Genuineness is the ability to be fully yourself and express yourself to others. It is the lack of phoniness, faking, and defensiveness. When you are genuine, the way you act on the outside matches your thoughts and feelings on the inside.
Respect. Respect is the ability to let another person know, through your words and actions, that you believe that he or she has the ability to make it in life, the right to make his or her own decisions, and the ability to learn from the outcome of those decisions.
Self-Disclosure. Self-disclosure is the ability to disclose information about yourselfCthe ways you think and feel, the things you believeCin order to help other people.
Warmth. Warmth is the ability to show another person you care about him or her. Behaviors that show warmth include touching someone, making eye contact, smiling, and having a caring, sincere tone of voice.
Immediacy. Immediacy is the ability to focus on the "here and now" relationship with another person. You can express immediacy by saying things like: "Right now I am feeling ________." "When you said that, I began to think _________." "As you were speaking, I sensed that you felt __________."
Concreteness. Concreteness is the ability to identify specific problems and the steps necessary to correct them. When a problem, situation, behavior, or set of actions is defined in concrete terms, you could draw a picture or make a movie about it if you were able.
Confrontation. Confrontation is the act of honestly telling another person your perception of what is going on without putting them down. Confronting someone can include:
• Giving an honest evaluation of the person's strengths and weaknesses
• Saying what you believe the person is thinking and feeling
• Stating how you see the person acting
• Telling the person what you believe will happen because of their actions.
Active Listening
When a patient is talking about a problem or presenting an assignment, it is important to listen actively. Active listening is a basic counseling skill that helps you clarify for yourself and the patient what is really going on. Patients in recovery are not always clear in their thinking. This lack of clarity can confuse them and those around them. Active listening will help them clarify their thinking.
Active thinking consists of several skills. These include the following:
Clear listening. When you are listening to a patient, it is important to just listen. The most common problem for new counselors is that they think while they listen. If you are thinking about what you are going to say, you will not accurately hear what the person is saying. It is important that you listen without judging what the patient is saying and without immediately trying to correct his or her thoughts.
Reflecting. When someone talks to you, reflecting is summarizing and repeating that person's thoughts andfeelings in a simple, clear manner. Reflecting helps clarify the issues for both of you. If you misunderstand the patient, he or she can correct you. When you repeat thoughts and feelings back to the patient, use statements instead of questions.
Example: Patient—"I try and try to stay straight but everything goes wrong and I end up using again."
Counselor-"You seem to feel hopeless about recovering." Reflecting gives a patient the sense that you are really listening. He or she will tend to open up more and talk about problems he or she hasn't talked about before.
Asking-open ended questions. Do not ask questions that can be answered with a "yes" or a "no." Instead, ask questions that require patients to explore the reasons they think, feel, and act the way they do.
Example: "What happens when you try to recover?" "What do you do when you feel hopeless?"
Not asking "Why?". Most new counselors make the mistake of asking "Why?" The patient does not know why, or else he or she would have changed. If you ask "Why?" the patient will give you an excuse. By asking "What?" you are getting the patient to focus on what he or she has done that can be changed.
Using effective body language. How you physically position yourself tells a patient a lot about how you feel about him or her. When you are working with patients, it is best to sit with your legs and arms uncrossed, to lean forward and to make eye contact. This body position shows that you are interested in what the patient has to say and that you are paying attention.
Watching for nonverbal cues. When you are working with a patient, listen and watch carefully. Does the person tense up, tap his or her foot, shift around, etc.? When you see these cues, make the patient aware of them and let him or her know what this might mean the patient is feeling.
Basic Relapse Prevention Techniques
There are a number of techniques that are used when doing relapse prevention counseling.
Centering
When you begin a group or an individual session or when you want a patient to calm down and get in touch with thoughts and feelings, you can use a technique called centering. This is basically a relaxation technique. Instruct the patient to do the following:
• Put both feet on the floor, sit up straight and close your eyes.
• Breathe in through your nose and out through your mouth.
• Breathe in deeply, hold it for a second, then breathe out.
• Do this again and feel your lungs fill with air, then empty.
• Slow your breathing to a steady rhythm.
• See if any thoughts are entering your mind.
• Ask yourself if you are feeling any body tensions.
• Open your eyes when you are ready.
Speak slowly as you give the instructions. This will help the patient calm down.
Sentence completion
Sentence completion is a technique used to help patients identify thoughts that they have that may not be true. These thoughts are called mistaken beliefs. Many times when a patient is acting in a self-defeating way, it is a result of mistaken beliefs he or she has about the world and himself or herself. When a patient is behaving in a way that hurts himself or herself and others, it is because the patient believes that this is the only choice he or she has. Sentence completion is a way to help a patient identify and correct mistaken beliefs. You do this by doing the following.
• Have the patient form a sentence stem: A sentence stem is the beginning of a sentence that has meaning for the patient. You can form these stems based on topics the patient is talking about. Examples are:
"I know my recovery is in trouble when . . ."
"When I think about drugs, I . . ."
"Right now, I am feeling . . ."
• Have the patient write down the sentence stem.
• Have the patient repeat it out loud and end it differently six to eight times or until he or she cannot think of new endings.
• Have the other group members write down the endings. If you are in an individual session, do this yourself.
• Have the group members read the endings back to the patient as they write them down. Have them use the following form: A(patient's name), I heard you say (sentence stem)(first ending)." Repeat the exercise until all the endings have been read.
• Look for a common theme in the endings. You may form a new sentence stem from the common theme and repeat the exercise, or stop here if the mistaken belief is identified.
• Have the patient identify the mistaken belief if he or she can and write it down.
Sentence repetition
Sentence repetition is a way for a patient to become conscious of mistaken beliefs and the thoughts, feelings, and actions they cause. Identify the mistaken belief and ask the patient to write it down.
• Ask the patient to repeat it out loud, slowly.
• After each repetition, ask the patient to take a deep breath, let it out, and report any thoughts, feelings, or urges that surfaced.
• Have the patient write down these thoughts, feelings, and urges.
• Ask the patient if he or she can remember who caused this mistaken belief or where it came from.
• Ask the patient if the person could have been wrong.
• Ask the patient if there are other ways to believe that could be true. You may have to ask the group to help.
• Ask the patient to complete the following sentences:
"If I continue to believe this, the best that can happen is . . ."
"The worst that can happen is . . ."
"The most likely to happen is . . ."
"If I change what I believe, the best that can happen is . . ."
"The worst that can happen is . . ."
"The most likely to happen is . . ."
• The probable outcomes can be discussed and a course of action decided by the group. The most important decision is to identify a rational thought that the patient can substitute when the mistaken belief occurs. Example are as follows.
Mistaken belief—I can't tell others what I feel or they will look down on me.
Contributors and Attributions
Source: store.samhsa.gov/shin/content/SMA06-4217/19c.htm | textbooks/socialsci/Social_Work_and_Human_Services/Book%3A_Treatment_of_Addictions_Individual_and_Group/05%3A_Addiction_Counseling_Practices_Skills_and_Treatment_Modalities/5.01%3A_TAP_21.txt |
A-Cognitive-Behavioral-Approach-Treating-Cocaine-Addiction-NIDA.pdf
5.04: An Individual Drug Counseling Approach
The Role of the Addiction Counselor
Patient-Counselor Relationship
The role of the counselor in addiction treatment is to provide support, education, and nonjudgmental confrontation. The counselor must establish good rapport with the patient. The patient recovering from chemical addiction deserves to feel understood and that he or she has an ally. The counselor wants to convey to the patient that he or she appreciates the difficulty of this struggle and the need for support through the recovery process.
The metaphor of the hiker and the guide is useful for conceptualizing the counselor-patient relationship. The counselor guides the patient through at least the early stages of recovery, but the recovery process ultimately belongs to the patient. It is the patient alone who is responsible and accountable for his or her recovery. The counselor must emphasize this point to facilitate personal responsibility. Confronting the patient may be useful to emphasize personal responsibility. However, when confrontation is necessary, the counselor should convey a supportive rather than a punitive attitude.
The counselor must find a balance between being directive and allowing the patient to be self directed. This process is facilitated if the counselor imposes a structure on the session that includes giving the patient feedback about the most recent urine drug screens and about the patient's progress in recovery and evaluatively processing any episodes of use or near use. The counselor identifies the relevant topic for discussion, based on what the patient seems to need, and introduces that topic. At times, the counselor may directly pressure the patient to change certain behaviors, perhaps, as an example, to start attending 12-step meetings.
However, the patient also is encouraged to be self-directed. For example, within the framework of a particular topic, perhaps coping with "social pressure to use," the patient may explore how to manage this problem best, and the counselor will respond to the patient's direction. If the patient seems unable to change some aspect of addictive behavior - for example, being around dangerous situations - the counselor should accept where the patient is and assist the patient to explore those perceptions or situations in a way that might allow himself or herself to do it differently, i.e., in a better way, the next time. However, the counselor should discourage regressive or other movements that lead back toward addiction. A balance needs to be struck so there is respect for the patient and acceptance of where he or she is and continual, ongoing pressure in the direction of abstinence and recovery.
Therapeutic Alliance
The counselor should create a sense of participating in a collaboration and partnership. This goal is best accomplished through three main avenues of approach. First, the counselor should possess a thorough knowledge of addiction and the lifestyles of addicts. Second, no matter how expert the counselor is, he or she must acknowledge that the patient is the true expert in discussing his or her own life. The counselor must listen accurately, empathize effectively, and avoid passing judgment. Third, the counselor should convey to the patient that he or she has an ally in the difficult progress toward recovery. Each of these approaches should help strengthen the therapeutic alliance and make the relationship a collaborative one.
Generally, the interventions that are most helpful in fostering a strong therapeutic alliance are those that involve the counselor's active listening and those that emphasize collaboration (Luborsky et al. 1997). For example, after the patient reports a relapse, the counselor might say, "Let us examine what happened and together develop a plan to help you avoid using next time." Such language highlights the combined effort in the relationship.
If the therapeutic relationship initially seems weak, the counselor might use the following simple strategy to address the problem: Ask the patient what is not working in the relationship or what the patient thinks is causing it not to work. Often the patient knows full well what might improve the therapeutic relationship but, for whatever reason, does not feel comfortable enough to mention it until the counselor initiates the topic. For improvement to occur, the counselor should be willing to accept feedback from the patient and possibly change the approach. However, in responding to a patient's request to change, the counselor should not feel pressured to change, or in any way compromise, his or her philosophy of addiction treatment. Rather, the counselor may adjust his or her interpersonal style to improve the working alliance.
Behaviors That Should Not Be Done
The counselor should not be harshly judgmental of the patient's addictive behaviors. After all, if the patient did not suffer from addiction, he or she would not need drug counseling, so blaming the patient for exhibiting these symptoms is useless. Also, patients often feel a great deal of shame associated with their addictive behaviors. In order to help resolve those feelings of shame and guilt, the counselor should encourage the patient to speak honestly about drug use and other addictive behaviors and be accepting of what is said. The counselor should be respectful of the patient.
The counselor should always be professional, including not being late for appointments and never treating or talking to the patient in a derogatory or disrespectful manner. Moreover, the counselor should avoid too much self-disclosure. While occasional appropriate self-disclosure can help the patient to open up or motivate the patient by providing a role model, too much self-disclosure removes the focus from the patient's own recovery. A good rule for when to self-disclose, if the counselor is indeed so inclined, is for the counselor first to have a clear purpose or goal for the intervention and then to analyze why he or she is choosing to self-disclose at this particular time. If any doubt results from this analysis, it probably should lead to a more conservative, nondisclosure position.
Lastly, counselors need to be aware of when their own issues are stimulated by a patient's problems and refrain from responding from the context of their own personal issues. For example, consider the case where a counselor in recovery feels that it was extremely important for him or her to break ties with addicted peers. Now this counselor is working with a particular patient who has an addicted spouse or partner and does not want to break these relationship ties. It is imperative that the counselor be flexible and respond creatively to the patient's own perception of the problem. In this case, the counselor must not rigidly adhere to the notion of insisting that breaking ties with all addicts is the only acceptable path to recovery. In general, the reflexive, noncritical projection of the counselor's own needs or experiences onto that of the patient's situation can be damaging or, at least, counterproductive.
Contributors and Attributions
• The National Institute on Drug Abuse (NIDA) is part of the National Institutes of Health (NIH) , a component of the U.S. Department of Health and Human Services. Questions? See our Contact Information.
• An Individual Drug Counseling Approach to Treat Cocaine Addiction Chapter 5 | textbooks/socialsci/Social_Work_and_Human_Services/Book%3A_Treatment_of_Addictions_Individual_and_Group/05%3A_Addiction_Counseling_Practices_Skills_and_Treatment_Modalities/5.03%3A_A_Cognitive_Behavioral_Approach_Treating_Cocaine_Addicti.txt |
Coordinating Care for Better Mental, Substance-Use, and General Health.pdf
6.02: Example DAP Note
Case Note Format - DAP Charting
"D" - Subjective and objective data about the client
Subjective - what client can say or feel
Objective - observable, behavioral by therapist
Standard I ' sentence, progress on presenting problem, review of HW
Description of both the content and process of the session
"A" - Intervention, assessment -what's going on?
Working hypotheses, gut hunches
"Depression appears improved this week"
"more resistant ... less involved... "
"P" - Response or revision
What you're going to do about it
Next session date-"couple will call in four weeks"
Any topics to be covered in next session(s), and HW given
1/27/97 (D)Met with Sally and Joe for one hour, 4' session, V. Thomas supervised. Joe reported that he was sleeping less and able to concentrate more at work, but does not think it is due to starting Prozac two weeks ago. Both Sally and Joe report and increase in the frequency and effectiveness of their communication due to their "speaker-listener" HW. Sally stated that "Joe still doesn't seem to open up that much." Joe disagrees with Sally's assessment and feels that he is really "spilling his guts." The rest of the session focused on their differing views of openness and possible relationship to family-of-origiri issues (note: you may want to list these). During this discussion Sally interrupted Joe four times to add to his statement; after the fourth time Joe sat quietly and stated Sally could finish for him. Sally shouted at Joe that he was a quitter and after a few moments apologized. (A) Joe's symptoms of depression appear to be lessening. Couple has improved their communication style, but have not rebuilt their trust and safety. Sally continues to view Joe as not trying and thus not caring. (P) Next session scheduled for 2/3 at 6pm. Continue work on building safety for communication. HW: What did you learn about being a husband/wife from your parents?
2/3/97 (D)Met with Sally and Joe for one hour, 5' session, V.Thomas supervised. Joe started the session enthusiastically reporting that they had a "GREAT week." Joe noted that they did not talk for three days after the last session, but each had done their HW. On Friday night they each started to talk about feeling hurt and not cared for which resulted in crying and "snuggling all night long." Joe continued to report that the last few days was just like when they first met. Sally stated she had enjoyed their time together, but was afraid it was "just a phase" and that it would go away. Focus of the rest of the session was on how they created this special time, and how it could be maintained
(note.-you want to list their ideas), (A) Joe is no longer reporting any symptoms of depression, but still does not think the Prozac is helping. Sally seems reserved, and appears to be reacting to Joe's euphoric state about the relationship. (P) Next session scheduled for 2/10 at 6pm, May need to prepare Sally and Joe for when the euphoria
goes away. Continue towork on safety, get back to last HW on FOO issues. HW:Continue with the List HW of what did you learn from your parents about being a husband/wife.
Writing Behavioral Goals
Lends itself to any 2 people agreeing the goal is met
Subject + verb -Client will/will not
Action -Be able to sleep
Frequency -At least five nights per week
Duration -For three consecutive weeks
Monitor -As observed by husband
Goals:
• Measurable
• Observable
• Time-limited
• Target-dated
• Realistic (achievable)
• Relevant (to the problem)
• Appropriate
• Consistent with the client's values
• Should be able to describe what the client should be able to do to demonstrate improvement/symptom relief
Everything You Ever Wanted To Know About Case Notes
• Think about what you are going to write and formulate before you begin
• Be sure you have the right chart!
• Date and sign every entry
• Proofread
• Record as "late entry" anytime it doesn't fall in chronological order; be timely
• Think about how the client comes through on paper
• Watch abbreviations-use only those approved
• Errors should have a line through incorrect information. Write error,intital and date
• Write neatly and legibly; print if handwriting is difficult to read
• Use proper spelling, grammar and sentence structure
• Don't leave blank spaces between entries; can imply vital information left out
• Put client name/case number on each page
• Avoid slang,curse words
• Another provider should be able to continue quality care
• Use quotes from client that are clinically pertinent Use descriptive terms
• Describe what you observed, not just your opinion of what you observed
• Reference identified problems from the treatment plan
• Reference diagnostic criteria from DSM-lV
• Use power quotes:
• "Client remains at risk for _____________ as evidenced by ___________”
• "The current symptoms include _____________”
• "Limited progress in ___________”
• "Continues to be depressed as evidenced by ____________”
• "Client continues to have suicidal ideation as evidenced by the following comment made to this writer: ____________”
Who Relies On Your Documentation?
Clients’ Families
Rely on your documentation to advocate for the most appropriate and effective care
Physicians, Mental Health Professionals, Referral Sources
Rely on the medical record as an official and practical means of communicating with each other Rely on your documentation to help them provide a unified treatment approach consistent with your work with the client Rely on your documentation to provide continuity of care from one treatment setting to another
Employers, Other Payors, Managed Care Companies
Rely on your documentation to justify need for continued treatment, need for admission, demonstrate appropriateness and cost-effectiveness of care, demonstrate all billable services were provided
Licensing and Accreditation Agencies
Rely on your documentation to verify your practice's quality of care and approve your license to operate
6.03: Integrated Interdisciplinary Models of Care
Integrated, Interdisciplinary Models of Care.pdf
6.04: Ten Principles of Good Interdisciplinary Teamwork
Ten Principles of Good Interdisciplinary Team.pdf | textbooks/socialsci/Social_Work_and_Human_Services/Book%3A_Treatment_of_Addictions_Individual_and_Group/06%3A_Documentation_Referral_and_Coordination_of_Care/6.01%3A_Coordinating_Care_for_Better_Mental_Substance-Use_and_General_Health.txt |
What Is Relapse Prevention Treatment?
Relapse prevention is a systematic method of teaching recovering patients to recognize and manage relapse warning signs. Relapse prevention becomes the primary focus for patients who are unable to maintain abstinence from alcohol or drugs despite primary treatment.
Recovery is defined as abstinence plus a full return to bio/psycho/social functioning. As previously noted, relapse is defined as the process of becoming dysfunctional in recovery, which leads to a return to chemical use, physical or emotional collapse, or suicide. Relapse episodes are usually preceded by a series of observable warning signs. Typically, relapse progresses from bio/psycho/social stability through a period of progressively increasing distress that leads to physical or emotional collapse. The symptoms intensify unless the individual turns to the use of alcohol or drugs for relief.
To understand the progression of warning signs, it is important to look at the dynamic interaction between the recovery and relapse processes. Recovery and relapse can be described as related processes that unfold in six stages:
• Abstaining from alcohol and other drugs
• Separating from people, places, and things that promote the use of alcohol or drugs, and establishing a social network that supports recovery
• Stopping self-defeating behaviors that prevent awareness of painful feelings and irrational thoughts
• Learning how to manage feelings and emotions responsibly without resorting to compulsive behavior or the use of alcohol or drugs
• Learning to change addictive thinking patterns that create painful feelings and self-defeating behaviors
• Identifying and changing the mistaken core beliefs about oneself, others, and the world that promote irrational thinking.
When people who have had a stable recovery and have done well begin to relapse, they simply reverse this process. In other words, they
• Have a mistaken belief that causes irrational thoughts
• Begin to return to addictive thinking patterns that cause painful feelings
• Engage in compulsive, self-defeating behaviors as a way to avoid the feelings
• Seek out situations involving people who use alcohol and drugs
• Find themselves in more pain, thinking less rationally, and behaving less responsibly
• Find themselves in a situation in which drug or alcohol use seems like a logical escape from their pain, and they use alcohol or drugs.
A number of basic principles and procedures underlie the CENAPS Model of Relapse Prevention Therapy. Each principle forms the basis of specific relapse prevention therapy procedures. Counselors can use the following principles and procedures to develop appropriate treatment plans for relapse-prone patients. Following a description of each principle is the relapse prevention procedure for that principle.
Principle 1: Self-Regulation
The risk of relapse will decrease as a patient's capacity to self-regulate thinking, feeling, memory, judgment, and behavior increases.
Relapse Prevention Procedure 1: Stabilization
An initial treatment plan is established that allows relapse-prone individuals to stabilize physically, psychologically, and socially. The level of stabilization is measured by the ability to perform the basic activities of daily living. Because the symptoms of withdrawal are stress-sensitive, it is important to evaluate the patient's level of stability under both high and low stress. Many people who appear stable in a low-stress environment become unstable when placed in a more stressful environment.
The stabilization process often includes
• Detoxification from alcohol and other drugs
• Solving the immediate crises that threaten sobriety
• Learning skills to identify and manage Post Acute Withdrawal and Addictive Preoccupation
• Establishing a daily structure that includes proper diet, exercise, stress management, and regular contact with treatment personnel and self-help groups.
Because the risk of using alcohol or drugs is highest during the stabilization period, steps must be taken to prevent use during this time. The patient needs to be in a drug-free environment. Any irrational thoughts (thoughts that don't make sense to a healthy person) that are creating immediate justification for relapse need to be identified and discussed. The patient should then be helped to remember the consequences of past chemical use and to develop new coping strategies.
An early relapse intervention plan can be developed by the counselor and patient to decide what action to take if the patient begins to use alcohol or drugs. This early intervention plan motivates the patient to stay sober and provides a safety net should chemical use occur.
Principle 2: Integration
The risk of relapse will decrease as the level of conscious understanding and acceptance of situations and events that have led to past relapses increases.
Relapse Prevention Procedure 2: Self-Assessment
Self-assessment first involves a detailed reconstruction of the presenting problems (problems that caused the patient to seek treatment) and the alcohol and drug use history. A careful exploration of the presenting problems identifies critical issues that can trigger relapse. This allows the counselor to design intervention plans that help to solve crises that can be used for relapse justification in the early treatment stages. The next step is a reconstruction of the recovery and relapse history. This helps identify past causes of relapse.
In reconstructing the recovery/relapse history, it is important to identify the recovery tasks that were completed or ignored, and to find the sequence of warning signs that led back to drug or alcohol use. The assessment is most effective if the counselor reconstructs the relapse history using exercises (done as homework assignments), such as making a list of all relapse episodes and identifying the problems that led to relapse. These assignments should be reviewed in group and individual sessions.
Principle 3: Understanding
The risk of relapse will decrease as the understanding of the general factors that cause relapse increases.
Relapse Prevention Procedure 3: Relapse Education
Relapsers need accurate information about what causes relapse and what can be done to prevent it. This is typically provided in structured relapse education sessions and reading assignments, which provide specific information about recovery, relapse, and relapse prevention planning methods. This information should include, but not be limited to
• A bio/psycho/social model of addictive disease
• A DMR
• Common Astuck points" in recovery
• Complicating factors in relapse
• Warning sign identification
• Relapse warning sign management strategies
• Effective recovery planning.
The recommended format for a relapse education session is as follows:
• Introduction and pretest (15 minutes)
• Educational presentationClecture, film, or videotape (30 minutes)
• Educational exercise conducted in dyads or small groups (15 minutes)
• Large group discussion (15 minutes)
• Post-test session and review of correct answers (15 minutes).
It is important to test patients to determine their retention and understanding of the material. Many relapsers have severe memory problems associated with Post Acute Withdrawal that prevent them from comprehending or remembering educational information.
Principle 4: Self-Knowledge
The risk of relapse will decrease as the patient's ability to recognize personal relapse warning signs increases.
Relapse Prevention Procedure 4: Warning Sign Identification
Warning sign identification is the process of teaching patients to identify the sequence of problems that has led from stable recovery to alcohol and drug use in the past and then recognizing how those steps could cause relapse in the future. The process of developing a personal relapse warning sign list is (1) reviewing warning signs, (2) making an initial warning sign list, (3) analyzing warning signs, and (4) making a final warning sign list.
The patient develops his or her own individualized warning sign list by thinking of irrational thoughts, unmanageable feelings, and self-defeating behaviors. Most final warning sign lists identify two different types of warning signs: those related to core psychological issues (problems from childhood) and those related to core addictive issues (problems from the addiction). Warning signs related to core psychological issues create pain and dysfunction, but they do not directly cause a person to relapse into chemical use. When patterns of addictive thinking that justify relapse are reactivated, a return to using alcohol and drugs occurs.
Principle 5: Coping Skills
The risk of relapse will decrease as the ability to manage relapse warning signs increases.
Relapse Prevention Procedure 5: Warning Sign Management
This involves teaching relapse-prone patients how to manage or cope with their warning signs as they occur. The better they are at coping with warning signs, the better their ability will be to stay in recovery.
Warning sign management should focus on three distinct levels. The first is the situational-behavioral level, where patients are taught to avoid situations that trigger warning signs. At this level, they are taught to modify their behavioral responses should these situations arise. The second level is the cognitiveBaffective (thoughts and feelings) level, where patients are taught to challenge their irrational thoughts and deal with their unmanageable feelings that emerge when a warning sign is activated. The third level is the core issue level, where patients are taught to identify the core addictive and psychological issues that initially create the warning signs.
Principle 6: Change
The risk of relapse will decrease as the relationship between relapse warning signs and recovery program recommendations increases.
Relapse Prevention Procedure 6: Recovery Planning
Recovery planning involves the development of a schedule of recovery activities that will help patients recognize and manage warning signs as they develop in sobriety. This is done by reviewing each warning sign on the final warning sign list and ensuring that there is a scheduled recovery activity focused on each sign. Each critical warning sign needs to be linked to a specific recovery activity.
Principle 7: Awareness
The risk of relapse will decrease as the use of daily inventory techniques designed to identify relapse warning signs increases.
Relapse Prevention Procedure 7: Inventory Training
Inventory training involves teaching relapse-prone patients to complete daily inventories. These inventories monitor compliance with the recovery program and check for the emergence of relapse warning signs. A daily recovery plan sheet is used to plan the day, and an evening inventory sheet is used to review progress and problems that occurred during that day.
A typical morning inventory asks the patient to identify three primary goals for that day, create a to-do list, then schedule time for completion of each task on the to-do list on a daily calendar. During the evening review inventory, the patient should review his or her warning sign list and recovery plan to determine whether he or she completed the required activities and experienced any relapse warning signs.
Whenever possible, these inventories should be reviewed by someone who knows the patient and who can assist him or her in looking for emerging patterns of problems that could cause relapse.
Principle 8: Significant Others
The risk of relapse will decrease as the responsible involvement of significant others in recovery and in relapse prevention planning increases.
Relapse Prevention Procedure 8: Involvement of Others
Relapse-prone individuals cannot recover alone. They need the help of others. Family members, 12-step program sponsors, counselors, and peers are just a few of the many recovery resources available. A counselor should ensure that others are involved in the recovery process whenever possible. The more psychologically and emotionally healthy the significant others are, the more likely they are to help the relapse-prone patient remain abstinent. The more directly the significant others are involved in the relapse prevention planning process, the more likely they are to become productively involved in supporting positive efforts at recovery and intervening on relapse warning signs or initial chemical use.
Principle 9: Maintenance
The risk of relapse decreases if the relapse prevention plan is regularlyupdated during the first 3 years of sobriety.
Relapse Prevention Procedure 9: Relapse Prevention Plan Updating
The patient's relapse prevention plan needs to be updated on a monthly basis for the first 3 months, quarterly for the remainder of the first year, and twice a year for the next 2 years. Once a person has maintained 3 years of uninterrupted sobriety, the relapse prevention plan should be updated on a yearly basis.
Nearly two thirds of all relapses occur during the first 6 months of recovery. Less than one quarter of the variables that actually cause relapse can be predicted during the initial treatment phase. As a result, ongoing outpatient treatment is necessary for effective relapse prevention. Even the most effective short-term inpatient or primary outpatient programs will fail to interrupt long-term relapse cycles without the ongoing reinforcement of some type of outpatient therapy.
A relapse prevention plan update session involves the following:
• A review of the original assessment, warning sign list, management strategies, and recovery plan.
• An update of the assessment by adding documents that are significant to progress or problems since the previous update.
• A revision of the relapse warning sign list to incorporate new warning signs that have developed since the previous update.
• The development of management strategies for the newly identified warning signs.
• A revision of the recovery program to add recovery activities to address the new warning signs and to eliminate activities that are no longer needed.
Contributors and Attributions
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Substance Abuse and Mental Health Services Administration Source: store.samhsa.gov/shin/content/SMA06-4217/19c.htm
7.02: Action Planning for Prevention and Recovery
Action Planning for Prevention and Recovery.pdf
8.01: TIP 42 Substance Abuse Treatment For Persons with Co-Occurring Disorders
TIP 42.pdf
9.01: TIP 35- Enhancing Motivation for Change in Substance Abuse Treatment
TIP 35.pdf
10.01: TIP 27- Comprehensive Case Management for Substance Abuse Treatment
TIP 27.pdf | textbooks/socialsci/Social_Work_and_Human_Services/Book%3A_Treatment_of_Addictions_Individual_and_Group/07%3A_Relapse_Prevention_and_Treatment/7.01%3A_Counselors_Manual_for_Relapse_Prevention_with_Chemically_Dependent_Criminal_Offenders_.txt |
Part One: The Three C’s
For thousands of years, human cultures have used psychoactive substances for various purposes, including religious ceremonies, medicinal healing, to experience altered mind states, and for the pure pleasure it can produce.
In popular American culture, drug use is often glamorized – or even dramatized – as a way of providing maximum effect in television shows, films, and books. These stories shape our expectancies about what drugs will do to us (or for us) and how we understand the issue of addiction. Unfortunately, these portrayals do little to clarify the confusion about addiction, and they may worsen the stigma.
Going into this book, we ask you to keep an open mind. It is tempting to see addiction through the lens of our own experiences, and that is natural to do. However, many voices contribute to the concept of addiction, and they deserve to be heard as well. Because addiction is a complicated process, our understanding of it often requires us to challenge our existing views.
Below are some questions people often ask about addiction, which can aid your exploration of the topics in this book and help us seek answers:
Common Questions About Addiction
How do you distinguish between addiction and other types of drug use?
Why can’t an addicted person just stop using?
Can a person be addicted to anything?
Is everyone addicted to something?
Is addiction always a bad thing / Can you have a good addiction?
Can addiction be successfully treated?
While discussions about addiction have changed and will continue to evolve, one thing we know is that the core of addiction is the brain. Stated simply, “anyone with a brain can become an addict” (Kuhn, Swartzwelder, & Wilson, 2019). Certain people are more likely to develop an addiction, and people who are not necessarily addicted can still have significant problems with drugs of abuse. And relatively speaking, our understanding of the brain is in its infancy, particularly when it comes to mental health, compulsive behavior, and addiction.
Let’s start by looking at drug use on a continuum. On one end, we have abstinence or no use. Next to that we have use, followed by abuse, and finally addictive use.
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Abstinence Use Abuse Addictive Use
A person who is not using a certain drug will not have problems with it; that’s fairly simple to understand. This may include someone who never wanted to try a certain drug, who does not have access to it, or who previously used it but no longer does.
From there, we can look at use. This involves trying any particular drug, such as marijuana, alcohol, or cocaine. Notably, this can also include prescribed medication. Drug use can become habitual and problematic, but it does not always. Some people experiment with a drug and never use it again, or they use it infrequently and moderately enough that it does not interfere with their life. However, we should note that some users do not perceive the damage that has been caused by their drug use and fail to identify the consequences.
A more serious step would be drug abuse, and at this stage, the user has experienced problems related to their use. They are using more of the drug than intended or have engaged in problematic behavior while using or getting the drug. This could occur after just a single use of a drug, particularly if someone is unfamiliar with the effects of the drug. Think of a young person taking several shots of alcohol for the first time in their life and then trying to drive afterward. This could lead to catastrophic consequences.
Chronic use of a drug may also fall under the category of abuse, provided that it doesn’t meet the definition of addictive use. Note that there is no longer a diagnostic category called “abuse” in the newest version of the Diagnostic and Statistical Manual (DSM). Instead, there is simply the term Substance Use Disorder, and qualifiers to define the level of severity: Mild, Moderate, or Severe.
Finally, we have addictive use. An easy way to identify addictive use is by remembering the three Cs: Compulsion, Loss of Control, & Consequences. When a person’s use has all of these characteristics, it is an addiction. This also fits well with the definition written by the American Society of Addiction Medicine (ASAM), which can be found later in this chapter.
Let’s explain each of the three Cs a bit further:
Compulsion – this is an overwhelming urge to use the drug; an obsession is a repetitive and disruptive thought, and compulsion represents the behavior to act on the thought (as in obsessive-compulsive disorder)
Loss of Control – occurs when the person can no longer predict how much they will use and what will happen when they do use
Consequences – characterized by a person continuing to use despite consequences related to their use, such as financial, legal, social, interpersonal, emotional and spiritual (what we call the six “ALs”)
Examples of the Three Cs
Compulsion: A woman experiences intense urges to use cocaine while at work and leaves her desk to get high in the bathroom.
Loss of Control: A college student intends to have one drink with a friend before going back to his room to study. He ends up having eight drinks throughout the night and staying until the bar closes.
Consequences: A woman has been arrested and convicted three times for driving under the influence, yet she continues to drink and drive while denying that she has a problem.
There is a significant discussion around the role of choice in addiction. One way to think of it is that addiction involves choices, but addiction itself is not a choice. As with other diseases and disorders, individual choice plays a role, as do genetics, home environment, and cultural norms. Addiction is a complex disorder because it involves perhaps the most complex entity in the universe, namely the human brain.
Some people are uncomfortable with the disease concept of addiction because they believe it removes responsibility from the using person. However, addictions specialists use the disease concept to remove the burden and guilt associated with the consequences of addictive use, while empowering the individual to take healthy steps toward recovery. While other models may emerge in the future to describe addictive use, the brain disease model holds several advantages.
For one, it is destigmatizing and takes away blame. It also suggests an important role for treatment, whether that be through the use of medications, formal therapy, support groups, or other positive lifestyle changes. And finally, the disease concept opens up the need for further research to better understand the illness and develop improved ways of recovering from it.
It is crucial that a person identifies a problem and takes responsibility for their recovery. However, no benefit has been found from forcing people to accept a certain label, like the terms “addict” and “alcoholic.” Because of the long-standing stigma in the fields of addiction and mental health, people struggling with these issues often minimize or hide their problems and refuse to seek help. Therefore, it is vital to make treatment and recovery accessible to all without putting unnecessary barriers in the way.
As you explore this chapter, you will learn to define addiction, recognize its impact on society, compare United States drug-using norms to those of other countries, and identify addiction as a dysfunctional relationship between user and substance.
References
American Society of Addiction Medicine. (2011). ASAM releases new definition of addiction. ASAM News, 26:3, 1.
Kinney, J. (2014) Loosening the grip (11th edition). New York: McGraw-Hill.
Kuhn, C., Swartwelder, S., & Wilson, W. (2019) Buzzed (5th edition). New York: Norton.
Rosenthal, R.J., & Faris, S.B. (2019). The etymology and early history of ‘addiction’. Addiction Research & Theory, 27:5, 437-449, DOI: 10.1080/16066359.2018.1543412
Video
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Article: ASAM Definition of Addiction Offers Support for Long Term Treatment and Recovery Approaches
by David Kerr
The American Society of Addiction Medicine (ASAM) has recently created a definition of addiction. The essential long-term treatment and recovery needs of the addict are supported by this recent ASAM definition.
The definition of addiction offered by ASAM is as follows:
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, and craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.
This definition describes physical attributes that appear to relate to the very wiring of the human brain. After reading both the short and long term definitions recently published by ASAM, it is clear to me why addicts have such a difficult time stopping their drug and/or alcohol use. It is equally clear why relapse may be frequent. The brain of a substance abuser is hard-wired for addiction and if changes are to occur to reverse this, the re-wiring will likely take a long time. Knowing this, it is easy to see why long term treatment and recovery approaches appear to be more durable than the short-term acute care approaches.
A logical assumption can be made that it took years to wire the addictive brain chemistry and any approach to restore normalcy in this chemistry or to re-wire the brain will also probably take years. This is why the Alcoholics Anonymous (AA) approach has had success and is why long-term treatment, recovery, and supportive care are likely to be more durable.
How Addiction Hijacks the Brain
Published by Harvard Health Publishing, Harvard Medical School
Image courtesy Pixabay
Desire initiates the process, but learning sustains it.
The word “addiction” is derived from a Latin term for “enslaved by” or “bound to.” Anyone who has struggled to overcome an addiction — or has tried to help someone else to do so — understands why.
Addiction exerts a long and powerful influence on the brain that manifests in three distinct ways: craving for the object of addiction, loss of control over its use, and continuing involvement with it despite adverse consequences. While overcoming addiction is possible, the process is often long, slow, and complicated. It took years for researchers and policymakers to arrive at this understanding.
In the 1930s, when researchers first began to investigate what caused addictive behavior, they believed that people who developed addictions were somehow morally flawed or lacking in willpower. Overcoming addiction, they thought, involved punishing miscreants or, alternately, encouraging them to muster the will to break a habit.
The scientific consensus has changed since then. Today we recognize addiction as a chronic disease that changes both brain structure and function. Just as cardiovascular disease damages the heart and diabetes impairs the pancreas, addiction hijacks the brain. Recovery from addiction involves willpower, certainly, but it is not enough to “just say no” — as the 1980s slogan suggested. Instead, people typically use multiple strategies — including psychotherapy, medication, and self-care — as they try to break the grip of an addiction.
Another shift in thinking about addiction has occurred as well. For many years, experts believed that only alcohol and powerful drugs could cause addiction. Neuroimaging technologies and more recent research, however, have shown that certain pleasurable activities, such as gambling, shopping, and sex, can also co-opt the brain. Although the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) describes multiple addictions, each tied to a specific substance or activity, consensus is emerging that these may represent multiple expressions of a common underlying brain process.
From liking to wanting
Nobody starts out intending to develop an addiction, but many people get caught in its snare. According to the latest government statistics, nearly 23 million Americans — almost one in 10 — are addicted to alcohol or other drugs. More than two-thirds of people with addiction abuse alcohol. The top three drugs causing addiction are marijuana, opioid (narcotic) pain relievers, and cocaine.
Genetic vulnerability contributes to the risk of developing an addiction. Twin and adoption studies show that about 40% to 60% of susceptibility to addiction is hereditary. But behavior plays a key role, especially when it comes to reinforcing a habit.
Pleasure principle. The brain registers all pleasures in the same way, whether they originate with a psychoactive drug, a monetary reward, a sexual encounter, or a satisfying meal. In the brain, pleasure has a distinct signature: the release of the neurotransmitter dopamine in the nucleus accumbens, a cluster of nerve cells lying underneath the cerebral cortex (see illustration). Dopamine release in the nucleus accumbens is so consistently tied with pleasure that neuroscientists refer to the region as the brain’s pleasure center.
The brain’s reward center
Addictive drugs provide a shortcut to the brain’s reward system by flooding the nucleus accumbens with dopamine. The hippocampus lays down memories of this rapid sense of satisfaction, and the amygdala creates a conditioned response to certain stimuli.
All drugs of abuse, from nicotine to heroin, cause a particularly powerful surge of dopamine in the nucleus accumbens. The likelihood that the use of a drug or participation in a rewarding activity will lead to addiction is directly linked to the speed with which it promotes dopamine release, the intensity of that release, and the reliability of that release. Even taking the same drug through different methods of administration can influence how likely it is to lead to addiction. Smoking a drug or injecting it intravenously, as opposed to swallowing it as a pill, for example, generally produces a faster, stronger dopamine signal and is more likely to lead to drug misuse.
Learning process. Scientists once believed that the experience of pleasure alone was enough to prompt people to continue seeking an addictive substance or activity. But more recent research suggests that the situation is more complicated. Dopamine not only contributes to the experience of pleasure, but also plays a role in learning and memory — two key elements in the transition from liking something to becoming addicted to it.
According to the current theory about addiction, dopamine interacts with another neurotransmitter, glutamate, to take over the brain’s system of reward-related learning. This system has an important role in sustaining life because it links activities needed for human survival (such as eating and sex) with pleasure and reward. The reward circuit in the brain includes areas involved with motivation and memory as well as with pleasure. Addictive substances and behaviors stimulate the same circuit — and then overload it.
Repeated exposure to an addictive substance or behavior causes nerve cells in the nucleus accumbens and the prefrontal cortex (the area of the brain involved in planning and executing tasks) to communicate in a way that couples liking something with wanting it, in turn driving us to go after it. That is, this process motivates us to take action to seek out the source of pleasure.
Tolerance and compulsion. Over time, the brain adapts in a way that actually makes the sought-after substance or activity less pleasurable.
In nature, rewards usually come only with time and effort. Addictive drugs and behaviors provide a shortcut, flooding the brain with dopamine and other neurotransmitters. Our brains do not have an easy way to withstand the onslaught.
Addictive drugs, for example, can release two to 10 times the amount of dopamine that natural rewards do, and they do it more quickly and more reliably. In a person who becomes addicted, brain receptors become overwhelmed. The brain responds by producing less dopamine or eliminating dopamine receptors — an adaptation similar to turning the volume down on a loudspeaker when noise becomes too loud.
As a result of these adaptations, dopamine has less impact on the brain’s reward center. People who develop an addiction typically find that, in time, the desired substance no longer gives them as much pleasure. They have to take more of it to obtain the same dopamine “high” because their brains have adapted — an effect known as tolerance.
At this point, compulsion takes over. The pleasure associated with an addictive drug or behavior subsides — and yet the memory of the desired effect and the need to recreate it (the wanting) persists. It’s as though the normal machinery of motivation is no longer functioning.
The learning process mentioned earlier also comes into play. The hippocampus and the amygdala store information about environmental cues associated with the desired substance, so that it can be located again. These memories help create a conditioned response — intense craving — whenever the person encounters those environmental cues.
Cravings contribute not only to addiction but to relapse after a hard-won sobriety. A person addicted to heroin may be in danger of relapse when he sees a hypodermic needle, for example, while another person might start to drink again after seeing a bottle of whiskey. Conditioned learning helps explain why people who develop an addiction risk relapse even after years of abstinence.
The long road to recovery
Because addiction is learned and stored in the brain as memory, recovery is a slow and hesitant process in which the influence of those memories diminishes.
About 40% to 60% of people with a drug addiction experience at least one relapse after an initial recovery. While this may seem discouraging, the relapse rate is similar to that in other chronic diseases, such as high blood pressure and asthma, where 50% to 70% of people each year experience a recurrence of symptoms significant enough to require medical intervention.
Key Takeaway
Relapse rates from drug addiction are comparable to many other chronic illnesses, such as hypertension and asthma.
Fortunately, a number of effective treatments exist for addiction, usually combining self-help strategies, psychotherapy, and rehabilitation. For some types of addictions, medication may also help.
The precise plan varies based on the nature of the addiction, but all treatments are aimed at helping people to unlearn their addictions while adopting healthier coping strategies — truly a brain-based recovery program.
References
Benowitz NL. “Nicotine Addiction,” The New England Journal of Medicine (June 17, 2010): Vol. 362, No. 24, pp. 2295–303.
Brady KT, et al., eds. Women and Addiction: A Comprehensive Handbook (The Guilford Press, 2009).
Chandler RK, et al. “Treating Drug Abuse and Addiction in the Criminal Justice System: Improving Public Health and Safety,” Journal of the American Medical Association (Jan. 14, 2009): Vol. 301, No. 2, pp. 183–90.
Greenfield SF, et al. “Substance Abuse Treatment Entry, Retention, and Outcome in Women: A Review of the Literature,” Drug and Alcohol Dependence (Jan. 5, 2007): Vol. 86, No. 1, pp. 1–21.
Koob GF, et al. “Neurocircuitry of Addiction,” Neuropsychopharmacology (Jan. 2010): Vol. 35, No. 1, pp. 217–38.
McLellan AT, et al. “Drug Dependence, A Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation,” Journal of the American Medical Association (Oct. 4, 2000): Vol. 284, No. 13, pp. 1689–95.
National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction(National Institutes of Health, Aug. 2010).
Polosa R, et al. “Treatment of Nicotine Addiction: Present Therapeutic Options and Pipeline Developments,” Trends in Pharmacological Sciences (Jan. 20, 2011): E-publication.
Potenza MN, et al. “Neuroscience of Behavioral and Pharmacological Treatments for Addictions,” Neuron (Feb. 24, 2011): Vol. 69, No. 4, pp. 695–712.
Shaffer HJ, et al. “Toward a Syndrome Model of Addiction: Multiple Expressions, Common Etiology,” Harvard Review of Psychiatry (Nov.–Dec. 2004): Vol. 12, No. 6, pp. 367–74. *
Stead LF, et al. “Nicotine Replacement Therapy for Smoking Cessation,” Cochrane Database of Systematic Reviews (Jan. 23, 2008): Doc. No. CD000146.
Substance Abuse and Mental Health Services Administration. National Survey on Drug Use & Health, 2009.
Activities
1. List the three Cs of addiction and give an example of each one.
2. Complete the Brief Substance Abuse Attitude Survey.
3. Visit the following link to learn more about addiction basics: Addiction Policy Forum
Let’s Talk About It…
How do you understand addiction? What characteristics of addiction make it similar to other diseases?
Chapter One, Part One Quiz
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Part Two: The Costs of Addiction
Next, we will explore the costs of addiction to American society, while also turning an eye toward the cultural norms around drug use. In this section, keep in mind the ways that your culture influences certain behaviors, including whether you try a certain drug and which drugs are more acceptable than others.
This section includes a video from the former head of the Office of National Drug Control Policy, Michael Botinelli, as well as an excellent article from the National Institute on Drug Abuse that describes the science of addiction. There is also a slideshow that explores the societal costs of addiction and concludes by telling the Tale of 10 Beers, a metaphorical party that represents alcohol consumption among Americans.
Video
In this TED Talk, Michael Botticelli, the former Director of the Office of National Drug Control Policy, discusses why we should treat addiction as a disease.
Reading
This pamphlet, produced by the National Institute on Drug Abuse, explains the effects of addiction on the brain and why it changes people’s behavior.
Slides
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Activity
Visit the website Our World in Data to compare drinking in the United States to other countries. How does consumption in the U.S. compare to other countries? Which regions of the world have the highest rates, and which have the lowest rates? What might explain these variations?
Let’s Talk About It…
• How do social norms influence the use of drugs? What do you think are the social norms in the United States when it comes to alcohol? In other words, what are the messages about whether you should drink, at what age you can and cannot drink, how many drinks is a good limit, etc.?
Part Two Quiz
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Part Three: Our Relationship with Drugs of Abuse
In the final part of Chapter 1, we examine how each person has an individual relationship with drugs of abuse. These relationships are influenced by our genetics, our environment, and our life decisions. Pay particular attention to how Gabor Mate describes addiction in his captivating video, “The Power of Addiction.”
After that, there is an article and a slideshow that both describe the ways in which addiction can be viewed through the lens of relationships. Although dysfunctional, the relationship with addiction can become just as important as any other meaningful connection. The process of coming back from the relationship of addiction requires a grieving process and new, healthy relationships.
Finally, notice how addiction subtly hijacks the brain over time by overloading our primitive “go” system and impairing our rational “stop” system to create the central struggle of addictive behavior.
Video
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Article
Addiction, Heartbreak, and the Healing Power of Relationships
Relationships take on a multitude of forms, from friends united by common interests and shared experiences, to family members bound by genetics and loyalty. Our relationships are built around intimacy, connection, spirituality, and emotion. Some relationships last a lifetime, while others carry us through a particularly difficult stage of life. When they end, most relationships leave an individual in some manner of pain and grieving. Often, people do not want the relationship to end when it does. In this sense, perhaps no relationship is more powerful or hard to part with than the relationship of addiction.
For over half a century, the addictions field has worked to erase the stigma of addiction by reframing the problem not as one of morality or inadequate willpower, but rather as a complex illness marked by specific characteristics (DuPont, 2000; Kinney, 2012). Research now strongly supports the notion of addiction as a brain disease involving physiological changes in two key regions: the reward circuit in the limbic system, and the prefrontal cortex (National Institute on Drug Abuse, 2010; Inaba & Cohen, 2011). In the simplest terms, the human brain can be broken into two parts. The first is the “old brain,” responsible for our physical drives, raw emotions, and survival and pleasure instincts. The second is the “new brain” where higher-order planning, rational thinking, and judgment happen (Inaba & Cohen, 2011). The process of addiction hijacks both regions.
A cascade of neurotransmitters activated by substance use initiates the relationship between user and substance. The drug plays the role of activating the old brain’s reward system, which happens each time the user engages in the behavior (Kuhn, Swartzwelder, & Wilson, 2008; Inaba & Cohen, 2011). This relationship is unique because it is more reliable and predictable than most human relationships. Drugs are so effective at delivering their promised high that the individual comes to count on the pleasurable feeling with near 100% certainty. Future events, from celebrations to loss of a loved one, cue the brain to seek more of the drug.
According to the National Institute on Drug Abuse, the old brain becomes altered in such a way that it interprets the need for a drug as being equally or even more important than the need for food and sex (2010). Further exacerbating the problem is a change happening in the new brain, where the brakes should be applied to this runaway train. However, the prefrontal cortex also adapts to the drug and begins taking a backseat to the old brain’s drives. The ability to make sound, rational decisions is significantly impaired (National Institute on Drug Abuse, 2010). Thus, the brain is in a state of having a brick on the gas pedal and a malfunctioning brake line.
Understanding addiction as an intimate bond between an individual and a behavior helps counselors to conceptualize exactly what happens when a person cannot simply choose to change. As dysfunctional as the relationship becomes, the way out seems nearly impossible to the person suffering from addiction. A search for a logical explanation to this phenomenon yields confusion for friends, family, and for the user. The question of why certain people become addicted is as complicated as the brain itself, and there is no simple or complete answer. Genetics clearly play a central role, but environment, culture, access to substances, and personal choices are important as well (Kinney, 2012).
While some clients and counselors may find it important to flesh out the exact underpinnings of one’s addiction, more critical in the short term is finding ways to terminate the old relationship and begin the path toward change. Thus, the treatment for the relationship of addiction is new, healthy connections. These may come in the form of a positive client-counselor relationship, a sponsor, sober peers, healthy family members, a higher power, or a change in environment.
With abstinence, the brain begins to re-wire over time, although drug cravings are inevitable and notoriously difficult to fend off (Marlatt & Donovan, 2007; Kuhn, Swartzwelder, & Wilson, 2008). This is one area where counselors can make an important impact, helping clients to anticipate and avoid high-risk situations, or practice new coping skills. Clients who relapse and use the drug again have not committed a shameful act. Marlatt and Donovan (2007) warn that clients who view relapse as a failure will be more likely to repeat the unhealthy behavior and ultimately renew the harmful relationship. Instead, counselors and clients alike can use the experience as a learning tool.
While many factors co-occur with substance use, including trauma, mental illness, and medical concerns, counselors need to remember to treat addiction as a primary disorder (National Institute on Drug Abuse, 2010; Kinney, 2012). Addiction should not be viewed simply as the symptom of an underlying mental health issue. Treatment needs to center on the addiction. In many cases, especially with long-term use of alcohol, benzodiazepines, or opiates, a period of detoxification is necessary. Following that, a referral to a level of treatment appropriate to the client’s situation should be made, which may include meeting with a licensed counselor. If a client’s substance use disorder is beyond the scope of your training, make sure to provide ample resources. Referrals to treatment programs that accept various forms of payment should be made available. One good resource is SAMHSA’s free online treatment finder. Counselors can also provide information on local mutual help meetings, such as 12-Step groups and SMART Recovery.
When working with clients with addictions, remember that there is a physiological change that has taken place. Healing can and will happen, but expect it to take time and be patient with the process. Focus on ways to end the unhealthy, life-draining relationship of addiction, no matter how heartbreaking the loss may be. Shift the client into healthy, life-giving relationships that invoke passion, which is the opposite of addiction.
Key Takeaways
• Addiction involves physiological changes.
• Healing can happen, but it takes time.
• Helping professionals can make a difference by teaching coping skills and providing referrals to self-help meetings.
Written by Jason Florin and originally published in the Illinois Counseling Association’s newsletter, Contact.
References
DuPont, R. (2000). The selfish brain: Learning from addiction. Center City, MN: Hazelden.
Inaba, D. S., & Cohen. W.E. (2011). Uppers, downers, all arounders: Physical and mental effects of psychoactive drugs (7th ed.). Manassas Park, VA: Impact Publications.
Kinney, J. (2012). Loosening the grip: A handbook of alcohol information (10th ed.). New York, NY: McGraw-Hill.
Kuhn, C., Swartzwelder, S., & Wilson, W. (2008). Buzzed: The straight factsabout the most used and abused drugs from alcohol to ecstasy (3rd ed.). New York, NY: Norton.
Marlatt, G.A., & Donovan, D.M. (2007). Relapse prevention: Maintenance strategies in the treatment of addictive behavior (2nd ed.). New York, NY: Guilford.
National Institute on Drug Abuse. (2010). Drugs, brains, and behavior: The science of addiction (rev.). National Institutes of Health Publication No. 10-5605.
Resources
Treatment Finder
Alcoholics Anonymous
Slides
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Activities
1. Identify the primary functions of our old brain and our new brain. Label which one is responsible for our STOP system, and which is responsible for our GO system.
2. What are three traits that can be found in both relationships and addictive processes?
Let’s Talk About It…
• Gabor Mate describes addiction as “being in the realm of hungry ghosts,” a Buddhist expression for a creature who has an unending appetite that cannot be fulfilled. Think of another metaphor that would help someone visualize what addiction means.
Part Three Quiz
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Want to keep exploring? Try this free online course, Addiction 101. | textbooks/socialsci/Social_Work_and_Human_Services/Foundations_of_Addiction_Studies_(Florin_and_Trytek)/1.01%3A_What_is_Addiction.txt |
A common question that arises when talking about addiction is why? Why do people use? Why do some people become addicted while others don’t? Why can’t people who are addicted just stop?
These questions are understandable especially when individuals dealing with addiction have suffered catastrophic consequences as a result of their use. Yet the answers to these queries are complex, and there isn’t a one-size-fits-all answer. In this chapter we will look to answer these common inquiries to gain a better understanding of addiction.
Nature or nurture? Yes!
Is the cause of addiction related to nature or nurture? Often a combination of factors contribute to the development of an addiction. Various theories of addiction seek to explain these factors. To better understand addiction, it is important to explore these theories and look at the risk factors.
Theories of Addiction
Morals and Personal Responsibility
A widely held societal belief is that addiction is simply a lack of willpower or moral compass. After all, it’s hard to imagine why someone would continue a particular behavior despite having catastrophic consequences related to it. Many people assume that addiction is a matter of choice, and if the addicted person simply had willpower and would adhere to appropriate morals, they would be able to stop. This is not the case with addiction. Once the brain has been hijacked, the power of choice is removed even for the most righteous.
Chew on this: In a three-year longitudinal study done by Snoke, Levey, and Kennett (2016), researchers found no correlation between willpower and recovery success.
The Agent
With an agent model of addiction, the focus is on the drug, or the agent, and its powerful effects. Drugs affect the central nervous system, including the brain. The most significant area of the brain that is impacted by drugs is the nucleus accumbens, often referred to as the “pleasure center.” Because of the drugs’ ability to tantalize this pleasure center in profound ways, drugs are seen as the reason people use and become addicted. Not sure if this model of addiction is widely accepted? Simply look at “the war on drugs” which emphasizes the notion that if we simply get rid of the drugs, we’ll get rid of the drug problem and thus addiction.
Genetics
Much research has been done to determine whether or not there is a genetic component related to addiction. Just as people may be genetically predisposed to certain diseases such as cancer or diabetes, so too may be the case with addiction. Given the findings from various studies, genetics does appear to play a role in the development of addiction. However, it’s important to remember that individuals are complex beings with complex and unique experiences. Simply because a person is predisposed does not guarantee they will develop an addiction. However, they will be more at risk to develop one. More research into epigenetics, the study of the interaction between the environment and genetic make-up, is being conducted.
Learned Behavior
Social learning models of addiction focus on combinations of factors. One is that alcohol and drug use are behaviors that are influenced or learned from others (family and peers) who model that behavior. Another factor in social learning models is the importance of classical and operant conditioning. When drugs or alcohol are ingested into the body, involuntary reactions occur such as neurotransmitters being released (classical conditioning). The consequence of ingesting, often a pleasurable feeling, draws an individual back to use (operant conditioning). The expectations that person has as to what drugs or alcohol will do (the cognitive process and belief) are the final factor that comprise social learning models. Let’s be honest . . . drug and alcohol use have some benefits; otherwise, people wouldn’t use them. Of course there are negative consequences associated with using, such as hangovers, but those who are addicted overlook these disadvantages and focus on the pleasurable effects.
Sociocultural Influences
Sociocultural models take into account the societal environment in which people live and how that environment may influence use. The idea is that environments with higher levels of use, combined with easily accessible drugs and alcohol, place individuals at a higher risk for consumption. Furthermore, drugs and alcohol are often portrayed in advertising and media in positive ways. One area of particular concern is disadvantaged communities. Look in any socioeconomically deprived area, and you are likey to find an abundance of liquor stores.
Public Health
The public health model is the most comprehensive model of addiction. It takes various factors into consideration when identifying the causes of addiction. These factors are broken into three categories: the agent (the drug), the host (the individual), and the environment (those factors outside of the individual). Addiction is viewed as the result of a complex relationship between biological, psychological, and social factors (Kinney, 2014). Because of the intricacy of this model, we feel it is the most comprehensive and best for guiding treatment.
Risk and Protective Factors
Risk factors can be internal (within the individual) or external (outside the individual). No single risk factor or combination of risk factors determines whether a person will develop an addiction. Instead, having one or more risk factors increases the chances that an individual who uses alcohol or other drugs will develop an addiction.
These risk factors include (in no particular order of importance):
• Having a mental health disorder
• Lack of family involvement
• Lower socioeconomic status
• Peer pressure
• Using drugs at an early age
• Chaotic home environment
• Poor social skills
• Drug availability
• Low self-esteem
• Poor academic performance or other school related problems
• Using drugs that have a higher likelihood of physical or psychological dependence (opiates, cocaine, etc.)
• Route of administration (such as smoking or injection)
The good news is, just as there are risk factors that can contribute to developing an addiction, so too are there protective factors that can help prevent addiction. Like risk factors, protective factors can be internal or external. Also, just as having one or more risk factors does not make addiction inevitable, having one or more protective factors is not a guarantee that an addiction will not develop.
These protective factors include (in no particular order of importance):
• Having a network of support
• Parental/family involvement
• Academic competence
• Having healthy coping strategies
• Sense of psychological and physical safety
• High self-esteem
• Ability to emotionally self-regulate
• Resiliency
• Social competence
Quiz
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Transtheoretical Model of Change
Professionals in the field of addiction often refer to the transtheoretical model of change created by James Prochaska and Carlo DiClemente to help people who do not have an addiction understand why people continue to use and why they might relapse/lapse. While studying behavior change, Prochaska and DiClemente identified six distinct stages that people tend to move through when making behavior changes. We will discuss those in just a moment.
For now, think of your own examples of behavior change. Perhaps you’ve tried to quit smoking. Maybe you have tried to implement a healthy eating plan or an exercise routine. Other examples of behavior change include stopping cussing, listening and communicating more effectively, avoiding procrastination, being more punctual, etc., etc. The list is truly endless. Chances are you have tried to make some type of behavior change in your life. Most of us have. Chances are, you were challenged with sticking to the new behavior. Most of us do experience a return to the old behavior, even if briefly. Hats off to those who set out to make a behavior change and stick to it without ever taking a backward step. They are often exceptions to the rule. If you are one of those people, kudos to you. Now let’s look at the stages identified by Prochaska and DiClemente and see if you can relate those to your own behavior change process while we examine how it might look for the addicted individual.
The first stage they identified is what they termed precontemplation. In this stage, the individual doesn’t realize there is a problem with their behavior. They may say something along the lines of, “Problem? What problem? I don’t have a problem. I like to drink a little bit. So what? I work hard and I deserve to have a couple of drinks at the end of a long week.”
The next stage is contemplation. During this stage, the individual starts to contemplate change, realizing that perhaps something needs to be different. This stage is also marked with ambivalence: sometimes the person thinks change is necessary; at other times, the status quo feels perfectly fine.
Following contemplation is preparation, where an individual begins to take steps to prepare for change. Those with a substance use disorder may make calls to treatment centers to gather information, or make inquiries about community-based support groups. No matter what the actions, the person is taking steps in the direction of change. However, it’s important to note that an individual in this stage hasn’t fully implemented the desired behavior change.
Next up is action. Just as the name suggests, individuals in this stage are engaging in the new behavior and have taken action. They are doing it! In the case of substance use disorders, the individual has stopped using (unless a harm reduction approach is being used). They have committed to the new behavior. Prochaska and DiClemente felt it important to make a distinction between this stage and the next. They suggested the action stage lasts from a period of 0 to 6 months.
Should the new behavior continue past 6 months, the individual then enters the maintenance phase. In this stage, the individual is maintaining their new behavior. Those in recovery from addiction have an abundance of pathways for maintaining the new behavior. From community-based support groups such as Alcoholics Anonymous and SMART Recovery, to avoiding people, places, and things associated with use, to taking up new interests and hobbies . . . the list could go on ad infinitum.
One of the defining features of addiction is the tendency toward relapse, the return to the old behavior. Relapse is the last stage of change identified by Prochaska and DiClemente. Most individuals who attempt to change a behavior experience a lapse or relapse (a lapse is temporary—a bump in the road—and a relapse is a prolonged return to the old behavior). In a study conducted by Kelly et al (2019), the researchers found that the average number of times an individual attempts recovery from addiction is 5.35. If lapses and relapses are typical with any behavior change, why would we expect recovery from addiction to be any different?
It is important to recognize that a lapse or relapse isn’t a sign of complete failure. Rather, it is a time to reflect on what went wrong and what was missing from the behavior change plan. It is a time to build upon skills that were already learned and implemented as well as looking for new possibilities.
Quiz
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Summary
As we can see from this chapter, there isn’t a simple answer as to one specific cause of addiction. Rather, there are many possible contributing factors. The more contributing factors (also known as risk factors) a person has, the more at risk they are of developing an addiction. The good news is there are also protective factors that can ward off risk factors and help prevent addiction from occurring. Our hope is that all who read this have a better understanding as to not only how addiction develops, but also why the simple suggestion, “Just stop!” isn’t so simple.
References
Harvard Mental Health Letter., (n.d.). Understanding addiction: New insights into the causes of addiction. Help Guide. https://www.helpguide.org/harvard/how-addiction-hijacks-the-brain.htm#:~:text=Pleasure%20principle&text=Dopamine%20release%20in%20the%20nucleus,dopamine%20in%20the%20nucleus%20accumbens
Kelly, J.F., Greene, M.C., Bergman, B.G., White, W.L. and Hoeppner, B.B. (2019), How many recovery attempts does it take to successfully resolve an alcohol or drug problem? Estimates and correlates from a national study of recovering U.S. adults. Alcoholism & Clinical Experimental Research, 43: 1533-1544. doi.org/10.1111/acer.14067
Kinney, J. (2019). Loosening the Grip: A Handbook of Alcohol Information. Outskirts Press.
Mayo Clinic. (n.d.) Drug addiction (substance use disorder). Retrieved January 11, 2021, from https://www.mayoclinic.org/diseases-conditions/ drug-addiction/symptoms-causes/syc-20365112
NIDA. (2002, February 1). Risk and Protective Factors in Drug Abuse Prevention. Retrieved from https://archives.drugabuse.gov/news-...use-prevention on 2021, January 11
NIDA. 2020, May 25. What are risk factors and protective factors?. Retrieved from https://www.drugabuse.gov/publicatio...e-risk-factors on 2021, January 11
Snoek, A., Levy, N., & Kennett, J. (2016). Strong-willed but not successful: The importance of strategies in recovery from addiction, Addictive Behaviors Reports, Volume 4, 102-107. https://doi.org/10.1016/j.abrep.2016.09.002.
Van Womer, K., Davis, D. (2017). Addiction Treatment: A Strengths Perspective. Cengage Learning. | textbooks/socialsci/Social_Work_and_Human_Services/Foundations_of_Addiction_Studies_(Florin_and_Trytek)/1.02%3A_Why_Do_People_Use.txt |
Having a working knowledge of the various psychoactive substances that are commonly used for recreational and medicinal purposes is important. It would be nearly impossible to maintain a list of all such substances because there are always new drugs being made, often in an attempt to avoid the legal restrictions placed on known drugs. However, a relatively small number of drugs actually create enough of an effect for people to repeatedly seek them out for their high. In this chapter, we highlight some of the primary drugs – and categories of drugs – that fall under this description.
Most people will recognize the names of many of these drugs in the table below. Alcohol, marijuana, heroin, cocaine, nicotine, ecstasy, and methamphetamine are well-known substances that can lead to the three Cs of addiction: compulsion, loss of control, and consequences.
This chapter begins with a video on psychoactive drugs to offer a context for the general categories of addictive drugs. There is also an interactive data chart created by the Substance Abuse and Mental Health Services Administration (SAMHSA) that allows you to compare drug use trends over time.
After that, you can view a chart highlighting the prevalence of several drugs of abuse, followed by a table listing of the most common drugs of abuse along with their uses, signs of intoxication, physiological effects, routes of administration, and withdrawal symptoms.
Next is a presentation on blood-alcohol concentration (BAC) that describes alcohol metabolism, factors that influence BAC, and drinking and driving laws.
The chapter concludes with The Celebrated Drugs, a look at three drugs that are widely recognized and promoted in modern U.S. culture. These drugs are alcohol, caffeine, and marijuana. That last one might surprise some people, especially if you grew up in a time when marijuana was considered just as dangerous as drugs like cocaine and heroin. However, marijuana has gained significant acceptance, along with innumerable references in music, movies, and media.
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Many drugs can alter a person’s thinking and judgment and can lead to health risks, including addiction, drugged driving, infectious disease, and adverse effects on pregnancy. Information on commonly used drugs with the potential for misuse or addiction can be found here: Commonly Used Drugs: Developed by the National Institute on Drug Abuse.
Use the chart of Commonly Used Drugs to answer the following questions:
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Activity
Using the interactive Substance Abuse and Mental Health Data Archive, find the following information:
1. For 2017-2018, what was the prevalence of marijuana use among people 12 and older in the past month?
1. How does past-month alcohol use compare in 2017-2018 to 10 years earlier: higher, lower, or the same (within 1%)?
1. Which region had the lowest rate of past-month alcohol use by people age 18 and over: Midwest, New England, West Coast, or South?
1. Choose the description that best matches the trends in marijuana and cigarette use since 2010:
• Both cigarette and marijuana use are increasing
• Cigarette use is increasing and marijuana use is decreasing
• Cigarette use is decreasing and marijuana use is increasing
• Both cigarette and marijuana use are decreasing
1. The prevalence of pain reliever misuse among adults 18 and over is approximately what percentage: 2%, 4%, 6%, or 8%?
National Survey of Drug Use and Health: Trends in Prevalence of Various Drugs
National Survey on Drug Use and Health: Trends in Prevalence of Various Drugs for Ages 12 or Older, Ages 12 to 17, Ages 18 to 25, and Ages 26 or Older; 2016 - 2018 (in percent)*
Drug Time Period Ages 12 or Older Ages 12 to 17 Ages 18 to 25 Ages 26 or Older
2016 2017 2018 2016 2017 2018 2016 2017 2018 2016 2017 2018
Alcohol Lifetime 80.2 80.9 80.8 27 27.1 26.3 81.3 81.1 79.9 86.4 87.1 87.3
Past Year 64.8 65.7 65.5 21.6 21.9 20.8 74.4 74 73.1 68.4 69.5 69.5
Past Month 50.7 51.7 51.1 9.2 9.9 9 57.1 56.3 55.1 54.6 55.8 55.3
Cigarettes (any use) Lifetime 57.4 57.1 55.7 11.6 10.8 9.6 50.5 49.5 45.9 64 63.8 62.6
Past Year 22.7 21.5 21 7.2 6.3 5.5 31.7 31 27.9 23.1 21.7 21.7
Past Month 19.1 17.9 17.2 3.4 3.2 2.7 23.5 22.3 19.1 20.2 18.9 18.5
Smokeless Tobacco Lifetime 16.1 16.1 15.6 4.7 5 4.4 18.2 18 16.7 17.1 17.1 16.7
Past Year 4.4 4.3 4 3 3 2.5 8 7.7 7.1 4 3.9 3.7
Past Month 3.3 3.2 2.9 1.4 1.3 1.1 5.2 4.8 4.4 3.1 3.1 2.9
Illicit Drugs Lifetime 48.5 49.5 49.2 23 23.9 23.9 56.3 57 55.6 50.2 51.3 51.2
Past Year 18 19 19.4 15.8 16.3 16.7 37.7 39.4 38.7 15 16.1 16.7
Past Month 10.6 11.2 11.7 7.9 7.9 8 23.2 24.2 23.9 8.9 9.5 10.1
Cocaine Lifetime 14.4 14.9 14.7 0.9 0.7 0.7 11.3 12 11.4 16.6 17 16.8
Past Year 1.9 2.2 2 0.5 0.5 0.4 5.6 6.2 5.8 1.4 1.7 1.6
Past Month 0.7 0.8 0.7 0.1 0.1 0 1.6 1.9 1.5 0.6 0.7 0.7
Crack Cocaine Lifetime 3.3 3.5 3.4 0.1 0.1 0.1 1.1 1.3 1 4 4.3 4.1
Past Year 0.3 0.3 0.3 0 0.1 0 0.3 0.3 0.3 0.4 0.4 0.3
Past Month 0.2 0.2 0.2 0 0 0 0 0.1 0.1 0.2 0.2 0.2
Hallucinogens Lifetime 15.4 15.5 15.8 2.7 2.8 2.3 17.2 17.1 16.4 16.6 16.7 17.3
Past Year 1.8 1.9 2 1.8 2.1 1.5 6.9 7 6.9 1 1 1.3
Past Month 0.5 0.5 0.6 0.5 0.6 0.6 1.9 1.7 1.7 0.3 0.3 0.4
Heroin Lifetime 1.8 1.9 1.9 0.1 0.1 0.1 1.6 1.8 1.3 2.1 2.2 2.2
Past Year 0.4 0.3 0.3 0.1 0.1 0 0.7 0.6 0.5 0.3 0.3 0.3
Past Month 0.2 0.2 0.1 0 0 0 0.3 0.3 0.2 0.2 0.2 0.1
Inhalants Lifetime 9.1 9.3 9.1 8.3 8.6 8.5 9.8 9.5 9 9 9.3 9.1
Past Year 0.6 0.6 0.7 2.2 2.3 2.7 1.4 1.6 1.5 0.3 0.3 0.4
Past Month 0.2 0.2 0.2 0.6 0.6 0.7 0.4 0.5 0.4 0.2 0.1 0.1
LSD Lifetime 9.6 9.6 10 1.2 1.5 1.3 8.3 9.1 9.8 10.8 10.6 11
Past Year 0.7 0.8 0.8 0.8 1 0.8 3.4 3.8 3.5 0.3 0.3 0.4
Past Month 0.1 0.2 0.2 0.2 0.2 0.2 0.6 0.8 0.7 0.1 0.1 0.1
Marijuana/ Hashish Lifetime 44 45.2 45.3 14.8 15.3 15.4 51.8 52.7 51.5 46.2 47.5 47.8
Past Year 13.9 15 15.9 12 12.4 12.5 33 34.9 34.8 11 12.2 13.3
Past Month 8.9 9.6 10.1 6.5 6.5 6.7 20.8 22.1 22.1 7.2 7.9 8.6
MDMA Lifetime 6.9 7 7.3 1.2 1 0.8 11.6 12 10.5 6.7 7 7.5
Past Year 0.9 0.9 0.9 0.7 0.7 0.5 3.5 3.5 3.1 0.5 0.5 0.6
Past Month 0.2 0.2 0.3 0.1 0.2 0.2 0.9 0.7 0.7 0.1 0.1 0.2
Methamphetamine Lifetime 5.4 5.4 5.4 0.3 0.3 0.3 2.4 3 2.5 6.5 6.4 6.5
Past Year 0.5 0.6 0.7 0.1 0.2 0.2 0.8 1.1 0.8 0.5 0.6 0.7
Past Month 0.2 0.3 0.4 0 0.1 0.1 0.2 0.4 0.3 0.3 0.3 0.4
PCP Lifetime 2.4 2.2 2.2 0.2 0.2 0.1 0.7 0.8 0.6 2.9 2.7 2.7
Past Year 0 0 0 0.1 0.1 0.1 0 0.1 0 0 0 0
Past Month 0 0 0 0 0 0 0 0 0 0 0 0
Tranquilizers Lifetime 0 0 - 0 0 - 0 0 - 0 0 -
Past Year 2.2 2.2 2.1 1.7 1.8 1.7 5.3 5.5 4.6 1.8 1.7 1.7
Past Month 0.7 0.6 0.6 0.5 0.5 0.3 1.5 1.6 1.2 0.6 0.5 0.5
Psychotherapeutics (Nonmedical Use) Lifetime 0 0 - 0 0 - 0 0 - 0 0 -
Past Year 6.9 6.6 6.2 5.3 4.9 4.8 14.5 14.4 12.3 5.9 5.6 5.3
Past Month 2.3 2.2 2 1.6 1.5 1.3 4.6 4.5 3.7 2 1.9 1.8
Pain Relievers Lifetime 0 0 - 0 0 - 0 0 - 0 0 -
Past Year 4.3 4.1 3.6 3.5 3.1 2.8 7.1 7.2 5.5 3.9 3.7 3.4
Past Month 1.2 1.2 1 1 0.9 0.6 1.8 1.8 1.4 1.2 1.1 1
Sedatives Lifetime 0 0 - 0 0 - 0 0 - 0 0 -
Past Year 0.6 0.5 0.4 0.4 0.3 0.3 0.7 0.6 0.6 0.6 0.5 0.4
Past Month 0.2 0.1 0.1 0.1 0.1 0 0.1 0.2 0.1 0.2 0.1 0.1
Stimulants Lifetime 0 0 - 0 0 - 0 0 - 0 0 -
Past Year 2.1 2.1 1.9 1.7 1.8 1.5 7.5 7.4 6.5 1.3 1.3 1.2
Past Month 0.6 0.7 0.6 0.4 0.5 0.5 2.2 2.1 1.7 0.4 0.5 0.4
The table below highlights the major categories of drugs of abuse. Each category includes examples, uses, routes of administration, signs of intoxication, effects, and withdrawal symptoms. Note that alcohol and benzodiazepines are chemically similar, and both can lead to severe and potentially deadly withdrawal. For this reason, chronic users of these drugs should receive medical supervision during withdrawal.
SEDATIVES / DEPRESSANTS NICOTINE OPIOIDS STIMULANTS
EXAMPLES Alcohol
Barbiturates
Seconal, Phenobarbitol
Cigarettes
Cigars
Pipes
Chewing tobacco
Heroin
Morphine
Codeine
Vicodin
Oxycontin
Dilaudid
Fentanyl
Cocaine
Caffeine
Amphetamine
Methamphetamine
Ritalin, Adderall
USES Recreational; alcohol withdrawal; treat anxiety; anti-convulsant Recreational; smoking cessation Pain relievers Recreational; ADHD treatment; surgical anesthetic
ROUTES OF ADMINISTRATION Oral (pills and liquid); crushed & snorted Smoked; oral absorption Oral, snorted, IV, smoked Oral, snorted, IV, smoked
SIGNS OF INTOXICATION Slurred speech; loss of coordination; sleepiness; impaired judgment; benzos can cause amnesia N/A (Nicotine is poisonous but leaves the body rapidly after ingestion) Nodding; depressed respiration rate; severe drowsiness; decreased motor activity; incoherent Hyper-arousal; increased heart rate and breathing; rapid speech; paranoia
PHYSIOLOGICAL EFFECTS Altered brain function; cognitive impairment; Lowered heart rate, respiration, and BP Initially increases, then decreases respiration and heart rate; rapidly acts in the lungs and moves to the brain; related to many types of cancer, brain damage, COPD Decreased respiration; used to alleviate or prevent pain; intense high when misused; overdoses are usually associated with adulterants Increased respiration, heart rate, and BP; impairment in motor function; cognitive deficits
WITHDRAWAL SYMPTOMS Increased heart rate and BP; Delerium Tremens; anxiety; sweating, fever; dizziness; personality changes Intense craving for more of the drug; irritability Diarrhea; profuse sweating; shaking; fever; nausea; sleeplessness; “flu-like symptoms” Depressed mood; irritability; headaches; possible psychosis; anxiety; sleep disturbances; anhedonia
HALLUCINOGENS INHALANTS MARIJUANA DISSOCIATIVES
EXAMPLES Psilocybin
Flowers, edibles, oils
PCP
Ketamine
Dextromethorphan
Salvia divinorum
Nitrous oxide
USES Recreational; couples therapy (MDMA) Recreational; no medical benefit Recreational; pain management; appetite stimulant Recreational; surgery; depression treatment
SIGNS OF
INTOXICATION
Nonsensical thoughts and speech; visual & auditory hallucinations (tactile hallucinations also possible) Visible red marks around the lips and nose; incoherent speech; uncoordinated movement Bloodshot eyes; possible hallucinations; decreased motor coordination Hallucinations; feelings of detachment
PHYSIOLOGICAL EFFECTS Acute or chronic psychotic episodes; flashbacks Irregular heartbeat (possible death); Significant damage to brain cells, causing irreversible damage; psychiatric and neurological problems; headaches; sensitivity to light Difficulty forming short-term memories; increased onset of mental illness; orthostatic hypotension; peripheral neuropathy; increased risk of lung damage and cancer Memory loss; changes in blood pressure; slowed heart rate and respiration; feelings of extreme panic; aggression; respiratory arrest
WITHDRAWAL SYMPTOMS Cravings; irritability Anxiety, depression, irritability; aggressive behavior; hallucinations Insomnia; disturbances in sleeping and dreaming; anxiety; change of appetite; weight loss; irritability Cravings; headaches; sweating; depression; social withdrawal
*Ecstasy, or MDMA, has several effects and is technically an entactogen. It has properties of stimulants and hallucinogens.
Activity
Click the following link to view an activity developed by the University of Utah that highlights brain changes related to methamphetamine use: METH MOUSE
Activity
Use the flashcards below to test yourself on several drug definitions.
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Click through the presentation below to explore information on blood-alcohol concentration.
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A YouTube element has been excluded from this version of the text. You can view it online here: https://cod.pressbooks.pub/addiction/?p=92 | textbooks/socialsci/Social_Work_and_Human_Services/Foundations_of_Addiction_Studies_(Florin_and_Trytek)/1.03%3A_An_Overview_of_Pharmacology.txt |
Now that you have a sense of how to define addiction, along with a grasp of the role that drugs play in our society, it is time to turn our attention to additional issues. We call these special considerations because they are important to think about in the context of how addiction develops.
Addiction knows no boundaries. It doesn’t care about your gender, race, ethnicity, age, socioeconomic status, religion, or occupation. It can affect anyone at any point along the lifespan. However, a few populations have a special connection to or relationship with addiction.
This chapter examines drug use among older adults, as well as information on conditions that impact the development of addiction, such as co-occurring disorders, trauma, and chronic pain. The chapter concludes by discussing how behavioral addictions like compulsive gambling, shopping, or internet use fit into our definition.
Substance Use in Older Adults
Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.
Updated 2020
The scope of substance use in older adults
While illicit drug use typically declines after young adulthood, nearly 1 million adults aged 65 and older live with a substance use disorder (SUD), as reported in 2018 data.1 While the total number of SUD admissions to treatment facilities between 2000 and 2012 differed slightly, the proportion of admissions of older adults increased from 3.4% to 7.0% during this time.2
Are older adults impacted differently by alcohol and drugs?
Aging could possibly lead to social and physical changes that may increase vulnerability to substance misuse. Little is known about the effects of drugs and alcohol on the aging brain. However, older adults typically metabolize substances more slowly, and their brains can be more sensitive to drugs.3 One study suggests that people addicted to cocaine in their youth may have an accelerated age-related decline in temporal lobe gray matter and a smaller temporal lobe compared to control groups who do not use cocaine. This could make them more vulnerable to adverse consequences of cocaine use as they age.19
Older adults may be more likely to experience mood disorders, lung and heart problems, or memory issues. Drugs can worsen these conditions, exacerbating the negative health consequences of substance use. Additionally, the effects of some drugs—like impaired judgment, coordination, or reaction time—can result in accidents, such as falls and motor vehicle crashes. These sorts of injuries can pose a greater risk to health than in younger adults and coincide with a possible longer recovery time.
Prescription Medicines
Chronic health conditions tend to develop as part of aging, and older adults are often prescribed more medicines than other age groups, leading to a higher rate of exposure to potentially addictive medications. One study of 3,000 adults aged 57-85 showed common mixing of prescription medicines, nonprescription drugs, and dietary supplements. More than 80% of participants used at least one prescription medication daily, with nearly half using more than five medications or supplements,5 putting at least 1 in 25 people in this age group at risk for a major drug-drug interaction.5
Other risks could include accidental misuse of prescription drugs and possible worsening of existing mental health issues. For example, a 2019 study of patients over the age of 50 noted that more than 25% who misuse prescription opioids or benzodiazepines expressed suicidal ideation, compared to 2% who do not use them, underscoring the need for careful screening before prescribing these medications.6
Opioid Pain Medicines
Persistent pain may be more complicated in older adults experiencing other health conditions. Up to 80% of patients with advanced cancer report pain, as well as 77% of heart disease patients, and up to 40% of outpatients 65 and older. Between 4-9% of adults age 65 or older use prescription opioid medications for pain relief.7 From 1995 to 2010, opioids prescribed for older adults during regular office visits increased by a factor of nine.7
The U.S. population of adults 55 and older increased by about 6% between 2013-2015, yet the proportion of people in that age group seeking treatment for opioid use disorder increased nearly 54%.4 The proportion of older adults using heroin—an illicit opioid—more than doubled between 2013-2015,4 in part because some people misusing prescription opioids switch to this cheaper drug.4
Marijuana
Nine percent of adults aged 50-64 reported past year marijuana use in 2015-2016, compared to 7.1% in 2012-2013.10 The use of cannabis in the past year by adults 65 years and older increased sharply from 0.4% in 2006 and 2007 to 2.9% in 2015 and 2016.22
Medical Marijuana
One U.S. study suggests that close to a quarter of marijuana users age 65 or older report that a doctor had recommended marijuana in the past year.10 Research suggests medical marijuana may relieve symptoms related to chronic pain, sleep hygiene, malnutrition, depression, or to help with side effects from cancer treatment.11 It is important to note that the marijuana plant has not been approved by the Food and Drug Administration (FDA) as a medicine. Therefore, the potential benefits of medical marijuana must be weighed against its risks, particularly for individuals who have other health conditions or take prescribed medications.11
Risks of Marijuana Use
Regular marijuana use for medical or other reasons at any age has been linked to chronic respiratory conditions, depression, impaired memory, adverse cardiovascular functions, and altered judgment and motor skills.12 Marijuana can interact with a number of prescription drugs and complicate already existing health issues and common physiological changes in older adults.
Nicotine
The Centers for Disease Control and Prevention (CDC) reports that in 2017, about 8 of every 100 adults aged 65 and older smoked cigarettes, increasing their risk for heart disease and cancer.20 While this rate is lower than that for younger adults, research suggests that older people who smoke have increased risk of becoming frail, though smokers who have quit do not appear to be at higher risk.14 Although about 300,000 smoking-related deaths occur each year among people who are age 65 and older, the risk diminishes in older adults who quit smoking.13 A typical smoker who quits after age 65 could add two to three years to their life expectancy. Within a year of quitting, most former smokers reduce their risk of coronary heart disease by half.13
Nicotine Vaping
There has been little research on the effects of vaping nicotine (e-cigarettes) among older adults; however, certain risks exist in all age groups. Some research suggests that e-cigarettes might be less harmful than cigarettes when people who regularly smoke switch to vaping as a complete replacement. However, research on this is mixed, and the FDA has not approved e-cigarettes as a smoking cessation aid. There is also evidence that many people continue to use both delivery systems to inhale nicotine, which is a highly addictive drug.
Alcohol
Alcohol is the most used drug among older adults, with about 65% of people 65 and older reporting high-risk drinking, defined as exceeding daily guidelines at least weekly in the past year.16 Of particular concern, more than a tenth of adults age 65 and older currently binge drink,18 which is defined as drinking five or more drinks on the same occasion for men, and four or more drinks on the same occasion for women. In addition, research published in 2020 shows that increases in alcohol consumption in recent years have been greater for people aged 50 and older relative to younger age‐groups.21
Alcohol Use Disorder: Most admissions to substance use treatment centers in this age group relate to alcohol.2 One study documented a 107% increase in alcohol use disorder among adults aged 65 years and older from 2001 to 2013.16 Alcohol use disorder can put older people at greater risk for a range of health problems, including diabetes, high blood pressure, congestive heart failure, liver and bone problems, memory issues and mood disorders.16
Risk Factors for Substance Use Disorders in Older Adults
Physical risk factors for substance use disorders in older adults can include: chronic pain; physical disabilities or reduced mobility; transitions in living or care situations; loss of loved ones; forced retirement or change in income; poor health status; chronic illness; and taking a lot of medicines and supplements. Psychiatric risk factors include: avoidance coping style; history of substance use disorders; previous or current mental illness; and feeling socially isolated.19
How are substance use disorders treated in older adults?
Many behavioral therapies and medications have been successful in treating substance use disorders in older adults. Little is known about the best models of care, but research shows that older patients have better results with longer durations of care.7 Ideal models include diagnosis and management of other chronic conditions, re-building support networks, improving access to medical services, improved case management, and staff training in evidence-based strategies for this age group.7
Providers may confuse SUD symptoms with those of other chronic health conditions or with natural, age-related changes. Research is needed to develop targeted SUD screening methods for older adults. Integrated models of care for those with coexisting medical and psychiatric conditions are also needed.2 It is important to note that once in treatment, people can respond well to care.2
Key Takeaways
• While use of illicit drugs in older adults is much lower than among other adults, it is currently increasing.
• Older adults are often more susceptible to the effects of drugs, because as the body ages, it often cannot absorb and break down drugs and alcohol as easily as it once did.
• Older adults are more likely to unintentionally misuse medicines by forgetting to take their medicine, taking it too often, or taking the wrong amount.
• Some older adults may take substances to cope with big life changes such as retirement, grief and loss, declining health, or a change in living situation.
• Most admissions to substance use treatment centers in this age group are for alcohol.
• Many behavioral therapies and medications have been successful in treating substance use disorders, although medications are underutilized.
• It is never too late to quit using substances—quitting can improve quality of life and future health.
• More science is needed on the effects of substance use on the aging brain, as well as into effective models of care for older adults with substance use disorders.
• Providers may confuse symptoms of substance use with other symptoms of aging, which could include chronic health conditions or reactions to stressful, life-changing events. References:
1. Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed tables. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
2. Chatre S, Cook R, Mallik E et al. Trends in substance use admissions among older adults. BMC Health Services Research. 2017; 584(17). doi: https://doi.org/10.1186/s12913-017-2538-z
3. Colliver JD, Compton WM, Gfroerer JC, Condon T. Projecting drug use among aging baby boomers in 2020. Annals of Epidemiology. 2006; 16(4): 257–265.
4. Huhn AS, Strain EC, Tompkins DA, Dunn KE. A hidden aspect of the U.S. opioid crisis: Rise in first-time treatment admissions for older adults with opioid use disorder. Drug Alcohol Depend. 2018 Dec 1; 193: 142-147. doi: 10.1016/j.drugalcdep.2018
5. Qato DM, Alexander GC, Conti RM, Johnson M, Schumm P, Lindau ST. Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States. JAMA. 2008 Dec 24; 300(24): 2867-2878. doi: 10.1001/jama.2008.892
6. Schepis TS, Simoni-Wastila L, McCabe SE. Prescription opioid and benzodiazepine misuse is associated with suicidal ideation in older adults. Int J Geriatr Psychiatry. 2019; 34(1): 122-129. doi: 10.1002/gps.4999
7. Lehmann S, Fingerhood M. Substance-use disorders in later life, N Engl J Med. 2018 December 13; 379(24): 2351-2360. doi: 10.1056/NEJMra1805981
8. Galicia-Castillo, M. Opioids for persistent pain in older adults. Cleveland Clinic Journal of Medicine. 2016 June 6; 83(6). Retrieved from: mdedge-files-live.s3.us-east...lderAdults.pdf
9. Wu LT, Blazer DG. Illicit and nonmedical drug use among older adults: A review. Journal of Aging and Health. 2011; 23(3): 481–504. doi:10.1177/0898264310386224
10. Han BH, Palamar JJ. Marijuana use by middle-aged and older adults in the United States, 2015-2016. Drug Alcohol Depend. 2018; 191: 374-381. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/30197051
11. Abuhasira R, Ron A, Sikorin I, Noack V. Medical cannabis for older patients—Treatment protocol and initial results. Journal of Clinical Medicine. 2019; 8(11): 1819. https://doi.org/10.3390/jcm8111819
12. Volkow N, Baler R, Compton W, Weiss S. Adverse health effects of marijuana use. N Engl J Med. 2014 June 5; 370(23): 2219-2227. doi: 10.1056/NEJMra1402309
13. Centers for Disease Control and Prevention. Smoking and Older Adults. November 2008. https://www2c.cdc.gov/podcasts/media...ingSmoking.pdf. Accessed March 12, 2020.
14. Kojima G, Iliffe S, Jivraj S, Liljas A, Walters K. Does current smoking predict future frailty? The English longitudinal study of ageing. Age and Ageing. 2018 January; 47(1): 126-131. https://doi.org/10.1093/ageing/afx136
15. Older adults fact sheet. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/alcohol-he...s/older-adults
16. Grant BF, Chou SP, Saha TD, et al. Prevalence of 12‐month alcohol use, high‐risk drinking, and DSM‐IV alcohol use disorder in the United States, 2001‐2002 to 2012‐2013: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. JAMA Psychiat. 2017; 74(9): 911‐923.
17. Kuerbis et al. Substance abuse among older adults. Clin Geriatr Med. 2014 Aug; 30(3): 629–654. doi:10.1016/j.cger.2014.04.008
Substance Use in Older Adults • July 2020 • Page 8
18. Han B, Moore A, Ferris R, Palamar J. Binge drinking among older adults in the United States, 2015-2017. Journal of the American Geriatrics Society. 2019 July 31; 67(10). doi.org/10.1111/jgs.16071
19. Bartzokis et al. Magnetic resonance imaging evidence of “silent” cerebrovascular toxicity in cocaine dependence. Biol Psychiatry. 1999; 45: 1203-1211.
20. Current cigarette smoking among adults in the United States fact sheet. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/data_sta...king/index.htm
21. White A, Castle I, Hingson R, Powell P. Using death certificates to explore changes in alcohol‐related mortality in the United States, 1999 to 2017. Alcoholism Clinical and Experimental Research. 2020 January 7; 44(1): 178-187. doi.org/10.1111/acer.14239
22. Han BH, Sherman S, Mauro PM, Martins SS, Rotenberg J, Palamar JJ.
Demographic trends among older cannabis users in the United States, 2006-2013.
Addiction. 2017; 112(3): 516-525. doi:10.1111/add.13670
Part Two: Conditions that Impact the Development of Addiction
In 21st-century treatment centers, few clients are treated solely for a substance use disorder. In most cases, clients present with an extensive history that might involve mental health issues, trauma, attempts to manage chronic pain, or all of the above. It is critical for helping professionals, along with family members and friends, to understand the complex interaction of these problems.
We mentioned in Chapter 1 that addiction is a primary disorder, meaning that it requires its own treatment and is not simply a symptom of another problem. That said, addiction is rarely the only issue that someone is struggling with. Anxiety, depression, bipolar disorder, unresolved trauma, and severe pain are all commonly seen by helping professionals while treating addictive disorders.
The following interactive video explains the importance of treating co-occurring disorders in an integrated manner:
A link to an interactive elements can be found at the bottom of this page.
SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach
The convergence of the trauma survivor’s perspective with research and clinical work has underscored the central role of traumatic experiences in the lives of people with mental and substance use conditions. The connection between trauma and these conditions offers a potential explanatory model for what has happened to individuals, both children and adults, who come to the attention of the behavioral health and other service systems.
People with traumatic experiences, however, do not show up only in behavioral health systems. Responses to these experiences often manifest in behaviors or conditions that result in involvement with the child welfare and the criminal and juvenile justice system or in difficulties in the education, employment, or primary care system. Recently, there has also been a focus on individuals in the military and increasing rates of post-traumatic stress disorder.
SAMHSA’s Definition of Trauma
Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.
The six key principles fundamental to a trauma-informed approach include:
1. Safety
Throughout the organization, staff and the people they serve, whether children or adults, feel physically and psychologically safe; the physical setting is safe and interpersonal interactions promote a sense of safety. Understanding safety as defined by those served is a high priority.
2. Trustworthiness and Transparency
Organizational operations and decisions are conducted with transparency with the goal of building and maintaining trust with clients and family members, among staff, and others involved in the organization.
3. Peer Support
Peer support and mutual self-help are key vehicles for establishing safety and hope, building trust, enhancing collaboration, and utilizing stories and lived experiences to promote recovery and healing. The term peers refers to individuals with lived experiences of trauma. In the case of children, these may be members of their family who have experienced traumatic events and are key caregivers in their recovery. Peers have also been referred to as trauma survivors.
4. Collaboration and Mutuality
Importance is placed on partnering and the leveling of power differences between staff and clients and among organizational staff from clerical and housekeeping personnel, to professional staff to administrators, demonstrating that healing happens in relationships and in the meaningful sharing of power and decision-making. The organization recognizes that everyone has a role to play in a trauma-informed approach. As one expert stated, “one does not have to be a therapist to be therapeutic.”
5. Empowerment, Voice and Choice
Throughout the organization and among the clients served, individuals’ strengths and experiences are recognized and built upon. The organization fosters a belief in the primacy of the people served; in resilience; and in the ability of individuals, organizations, and communities to heal and promote recovery from trauma. The organization understands that the experience of trauma may be a unifying aspect in the lives of those who run the organization, who provide the services, and/ or who come to the organization for assistance and support. As such, operations, workforce development, and services are organized to foster empowerment for staff and clients alike. Organizations understand the importance of power differentials and ways in which clients, historically, have been diminished in voice and choice and are often recipients of coercive treatment. Clients are supported in shared decision-making, choice, and goal setting to determine the plan of action they need to heal and move forward. They are supported in cultivating self-advocacy skills. Staff are facilitators of recovery rather than controllers of recovery. Staff are empowered to do their work as well as possible by adequate organizational support. This is a parallel process as staff need to feel safe, as much as people receiving services.
6. Cultural, Historical, and Gender Issues
The organization actively moves past cultural stereotypes and biases (based on race, ethnicity, sexual orientation, age, religion, gender-identity, geography, etc.); offers access to gender-responsive services; leverages the healing value of traditional cultural connections; incorporates policies, protocols, and processes that are responsive to the racial, ethnic and cultural needs of individuals served; and recognizes and addresses historical trauma.
The Trauma-Addiction Connection
When a person fears for his/her safety, experiences intense pain, or witnesses a tragic or violent act, that person can be described as having experienced trauma. Levels of resiliency vary from person to person, so reactions to traumatic events are similarly varied. Although frightening experiences impact people at any age, adults will generally be more likely to manage through trauma than children will be. Further, some trauma is repeated or ongoing, such as that of child abuse or military combat. Other examples of traumatic events include car accidents, repeated bullying, street violence, sexual assault, domestic violence, growing up in an unstable home, natural disasters, or battling a life-threatening condition.
If trauma and the feelings associated with it are not resolved, serious long-term issues can develop. Post-traumatic stress disorder (PTSD) disrupts the lives of people who have experienced unresolved trauma by negatively impacting their relationships, emotions, physical body, thinking and behavior. PTSD sufferers may experience sleep disturbances, nightmares, anxiety and depression, flashbacks, dissociative episodes in which they feel disconnected from reality, excessive fears, self-injurious behaviors, impulsivity and addictive traits.
Researchers have been studying the connection between trauma and addiction in order to understand why so many drug and alcohol abusers have histories of traumatic experiences. Data from over 17,000 patients in Kaiser Permanente’s Adverse Childhood Experiences study indicate that a child who experiences four or more traumatic events is five times more likely to become an alcoholic, 60% more likely to become obese, and up to 46 times more likely to become an injection-drug user than the general population. Other studies have found similar connections between childhood trauma and addiction, and studies by the Veterans Administration have led to estimates that between 35-75% of veterans with PTSD abuse drugs and alcohol.
The reasons behind this common co-occurrence of addiction and trauma are complex. For one thing, some people struggling to manage the effects of trauma in their lives may turn to drugs and alcohol to self-medicate. Post-traumatic stress disorder symptoms like agitation, hypersensitivity to loud noises or sudden movements, depression, social withdrawal and insomnia may seem more manageable through the use of sedating or stimulating drugs depending on the symptom. However, addiction soon becomes yet another problem in the trauma survivor’s life. Before long, the “cure” no longer works, and it causes far more pain to an already suffering person.
Other possible reasons addiction and trauma are often found together include the theory that a substance abuser’s lifestyle puts him/her in harm’s way more often than that of a non-addicted person. Unsavory acquaintances, dangerous neighborhoods, impaired driving, and other aspects commonly associated with drug and alcohol abuse may indeed predispose substance abusers to being traumatized by crime, accidents, violence and abuse. There may also be a genetic component linking people prone toward PTSD and those with addictive tendencies, although no definitive conclusion has been made by research so far.
First Things First
Sometimes, years of self-medicating through drugs and alcohol have effectively dulled the memory of trauma, so the only problem seems to be substance abuse and addiction. A person who has suppressed or ignored traumatic experiences may work very hard to get and stay sober, only to find other addictive behaviors eventually replacing the drugs and alcohol. These might include compulsive overeating, gambling, sexual promiscuity or any other compulsion-driven behavior. Unfortunately, continuing to avoid resolution of trauma will almost guarantee ongoing suffering.
However, dealing with traumatic experiences is challenging work. Under the influence of drugs and alcohol, it is a nearly impossible task. That is why therapists always recommend working first on recovery from drug addiction and alcoholism. Then, when the trauma survivor is stronger and more clear-minded, s/he can begin working with a therapist in individual or group counseling to address the underlying problem of unresolved trauma. Specific treatment modalities have been developed for people suffering long-term effects after traumatic experiences, including trauma-focused therapies, PTSD Intervention, Body Psychotherapy which targets the physiological response to trauma, and medications for depression and anxiety.
Considering the frequent link between trauma and addiction, anyone working on recovery from substance abuse and addiction could benefit from an assessment by a skilled therapist, to determine if there are underlying issues that should be addressed and to devise an appropriate treatment plan. The best approach is always to work first on living a sober life, then on resolving past trauma and learning positive coping skills, thereby breaking the trauma-addiction connection and finding a better life all around.
Hackensack Meridian Carrier Clinic. (2019). Trauma and addiction. Retrieved from https://carrierclinic.org/2019/08/06...and-addiction/
For more information, visit carrierclinic.org
The following video, produced by the Carrier Clinic, highlights the significant link between post-traumatic stress disorder and addiction.
A YouTube element has been excluded from this version of the text. You can view it online here: https://cod.pressbooks.pub/addiction/?p=44
The following video examines the ways trauma and addiction are linked. The issue of trauma has become one of the most important concepts in the treatment of addiction.
A YouTube element has been excluded from this version of the text. You can view it online here: https://cod.pressbooks.pub/addiction/?p=44
NAMI Guide to Dual Diagnosis
Dual Diagnosis
Dual diagnosis (also referred to as co-occurring disorders) is a term for when someone experiences a mental illness and a substance use disorder simultaneously. Either disorder—substance use or mental illness—can develop first. People experiencing a mental health condition may turn to alcohol or other drugs as a form of self-medication to improve the mental health symptoms they experience. However, research shows that alcohol and other drugs worsen the symptoms of mental illnesses. The professional fields of mental health and substance use recovery have different cultures, so finding integrated care can challenging.
How Common Is Dual Diagnosis?
According to a 2014 National Survey on Drug Use and Health, 7.9 million people in the U.S. experience both a mental disorder and substance use disorder simultaneously. More than half of those people—4.1 million to be exact—are men.
Symptoms
Because many combinations of dual diagnosis can occur, the symptoms vary widely. Mental health clinics are starting to use alcohol and drug screening tools to help identify people at risk for drug and alcohol abuse. Symptoms of substance use disorder may include:
• Withdrawal from friends and family
• Sudden changes in behavior
• Using substances under dangerous conditions
• Engaging in risky behaviors
• Loss of control over use of substances
• Developing a high tolerance and withdrawal symptoms
• Feeling like you need a drug to be able to function
Symptoms of a mental health condition can also vary greatly. Warning signs, such as extreme mood changes, confused thinking or problems concentrating, avoiding friends and social activities and thoughts of suicide, may be reason to seek help.
How Is Dual Diagnosis Treated?
The best treatment for dual diagnosis is integrated intervention, when a person receives care for both their diagnosed mental illness and substance abuse. The idea that “I cannot treat your depression because you are also drinking” is outdated—current thinking requires both issues be addressed.
You and your treatment provider should understand the ways each condition affects the other and how your treatment can be most effective. Treatment planning will not be the same for everyone, but here are the common methods used as part of the treatment plan:
Detoxification. The first major hurdle that people with dual diagnosis will have to pass is detoxification. Inpatient detoxification is generally more effective than outpatient for initial sobriety and safety. During inpatient detoxification, trained medical staff monitor a person 24/7 for up to seven days. The staff may administer tapering amounts of the substance or its medical alternative to wean a person off and lessen the effects of withdrawal.
Inpatient Rehabilitation. A person experiencing a mental illness and dangerous/dependent patterns of substance use may benefit from an inpatient rehabilitation center where they can receive medical and mental health care 24/7. These treatment centers provide therapy, support, medication and health services to treat the substance use disorder and its underlying causes.
Supportive Housing, like group homes or sober houses, are residential treatment centers that may help people who are newly sober or trying to avoid relapse. These centers provide some support and independence. Sober homes have been criticized for offering varying levels of quality care because licensed professionals do not typically run them. Do your research when selecting a treatment setting.
Psychotherapy is usually a large part of an effective dual diagnosis treatment plan. In particular, cognitive-behavioral therapy (CBT) helps people with dual diagnosis learn how to cope and change ineffective patterns of thinking, which may increase the risk of substance use.
Medications are useful for treating mental illnesses. Certain medications can also help people experiencing substance use disorders ease withdrawal symptoms during the detoxification process and promote recovery.
Self-Help and Support Groups. Dealing with a dual diagnosis can feel challenging and isolating. Support groups allow members to share frustrations, celebrate successes, find referrals for specialists, find the best community resources and swap recovery tips. They also provide a space for forming healthy friendships filled with encouragement to stay clean. Here are some groups NAMI likes:
• Double Trouble in Recovery is a 12-step fellowship for people managing both a mental illness and substance abuse.
• Alcoholics Anonymous and Narcotics Anonymous are 12-step groups for people recovering from alcohol or drug addiction. Be sure to find a group that understands the role of mental health treatment in recovery.
• Smart Recovery is a sobriety support group for people with a variety of addictions that is not based in faith.
Chronic Pain Management
Excerpted from SAMHSA TIP 54: Managing Chronic Pain in Adults With or in Recovery From Substance Use Disorders
Chronic non-cancer pain (CNCP) is a major challenge for clinicians as well as for the patients who suffer from it. The complete elimination of pain is rarely obtainable for any substantial period. Therefore, patients and clinicians should discuss treatment goals that include reducing pain, maximizing function, and improving quality of life. The best outcomes can be achieved when chronic pain management addresses co-occurring mental disorders (e.g., depression, anxiety) and when it incorporates suitable nonpharmacologic and complementary therapies for symptom management.
Treatment recommendations:
• Treat chronic pain with non-opioid pain relievers as determined by pathophysiology
• Recommend or prescribe nonpharmacological therapies (e.g., cognitive–behavioral therapy, exercises to decrease pain and improve function)
• Treat comorbidities
• Assess treatment outcomes
• Initiate opioid therapy only if the potential benefits outweigh risk and only for as long as it is unequivocally beneficial to the patient
• Therapeutic exercise
• Physical therapy
• Cognitive–behavioral therapy
• Complementary and alternative medicine (CAM; e.g., chiropractic therapy, massage therapy, acupuncture, mind-body therapies, relaxation strategies)
Part Three: Behavioral Addictions
As you may know, the Diagnostic and Statistical Manual (DSM) is the source of psychiatric diagnoses in the United States. Its updated publications are eagerly anticipated and scrutinized throughout the field of mental health because it holds such significant influence. The language we use to discuss mental health issues, whether or not an insurance company will pay for a certain treatment, and whether a condition is even considered a disorder, are all part of the impact felt by this book. While the diagnostic manual has been criticized (Dr. William Glasser, founder of Reality Therapy, once called it “the most destructive book to human relationships ever written”), it maintains its prominent role in modern American psychology.
Currently, the DSM recognizes only one other addiction besides substance use disorder, and that is gambling disorder. The characteristics of compulsive gambling are quite similar to those found in substance use disorder.
Although other behaviors have yet to receive the same recognition, it is clear that the negative patterns associated with them match our present understanding of addiction. These can include shopping, spending, sex, internet gaming, relationships, eating, and other related behaviors.
As you will see in this section’s video, Dr. Robert Lefever has identified three clusters of addictive behaviors, which he labels as follows:
The Hedonistic Cluster:
• Psychoactive substances such as alcohol, marijuana, heroin, cocaine, prescription pills, and methamphetamine
• Caffeine
• Nicotine
• Gambling
• Sex without regard for the other person
The Nurturement of Self Cluster:
• Food, especially those containing sugar and refined flour
• Bingeing/starving/purging/vomiting
• Shopping and spending
• Work
• Internet and computer use
• Exercise
The Relationship Cluster
• Use of other people (intimate partner or co-workers)
• Compulsive helping
Lefever notes that the outlets within each cluster are related in a way that makes it more likely that a person in recovery will relapse if he or she engages in any of the others in the same cluster. He also notes that people may have addictions in more than one cluster. This concept provides an excellent way of understanding the many faces of addiction. It also points toward the necessity of avoiding other behaviors within the same cluster.
A YouTube element has been excluded from this version of the text. You can view it online here: https://cod.pressbooks.pub/addiction/?p=44
References
Hoffman, J. & Froemke, S. (Producers). (2007). Addiction (DVD).
Kuerbis, A., Sacco, P., Blazer, D. G., & Moore, A. A. (2014). Substance abuse among older adults. Clinics in geriatric medicine, 30(3), 629–654. https://doi.org/10.1016/j.cger.2014.04.008
National Alliance on Mental Illness. (2015). Dual Diagnosis.
NIDA. 2020, June 2. Principles of Adolescent Substance Use Disorder Treatment. Retrieved from https://www.drugabuse.gov/publicatio...rder-treatment on 2020, September 20.
Chapter Quiz
A link to an interactive elements can be found at the bottom of this page. | textbooks/socialsci/Social_Work_and_Human_Services/Foundations_of_Addiction_Studies_(Florin_and_Trytek)/1.04%3A_Special_Considerations.txt |
Drug Use Among Adolescents
Dr. Mark Willenbring of the National Institute of Alcohol Abuse and Alcoholism describes addiction as “a disorder of young people” (2007). He believes that approximately 75% of addiction develops by the age of 25, which roughly corresponds to the age when the pre-frontal cortex in a person’s brain finishes forming.
If addiction begins in adolescence, we must question, why that is the case? The answer is that this is the age when our brains are most vulnerable to the effects of drugs, while we are also our most curious and risk-taking selves. The perceived danger of trying drugs is lowest among high school students, and their desire to try novel things is at its peak.
Adolescence is the psychosocial life stage that Erik Erikson defined as Identity vs. Role Confusion, a time when we struggle to determine who we are and what we value. Drug experimentation is often part of this quest. In essence, our individual relationship with various drugs of abuse is first being developed during this window of time, and that relationship frequently carries into adulthood and the rest of our life.
Adolescents may be the group most vulnerable to the impact of drugs, but people of all ages can be affected. As we age, we experience significant physical, emotional, and spiritual changes in our lives that can lead to increased drug use and even addiction in our older adult years. In this section, we also examine the impact of drug use by older adults.
Exercise
Before reading the next section, think about your own experience with adolescence and how it helped shape your identity. In particular, consider how the following might have affected you while growing up:
• Relationships with family and friends
• Intimate relationships
• Physical changes
• School experiences
• Loss of a loved one
• Living environment
• Involvement in activities such as sports, band, theater, etc.
• Having friends or loved ones who used drugs
• Experiencing any major illnesses or injuries
• Significant social and political events
• Religious involvement
• Inspirational experiences (e.g., a memorable trip, a book, a movie, or a song that inspired you)
Did any of these influences lead you to engage in high-risk behaviors, whether related to drug use or not?
Treatment for Adolescents
The following section is from the National Institute on Drug Abuse. You can find the original online at the following link: Principles of Adolescent Substance Use Disorder Treatment.
Adolescents experiment with drugs or continue taking them for several reasons, including:
• To fit in: Many teens use drugs “because others are doing it”—or they think others are doing it—and they fear not being accepted in a social circle that includes drug-using peers.
• To feel good: Abused drugs interact with the neurochemistry of the brain to produce feelings of pleasure. The intensity of this euphoria differs by the type of drug and how it is used.
• To feel better: Some adolescents suffer from depression, social anxiety, stress-related disorders, and physical pain. Using drugs may be an attempt to lessen these feelings of distress. Stress especially plays a significant role in starting and continuing drug use as well as returning to drug use (relapsing) for those recovering from an addiction.
• To do better: Ours is a very competitive society, in which the pressure to perform athletically and academically can be intense. Some adolescents may turn to certain drugs like illegal or prescription stimulants because they think those substances will enhance or improve their performance.
• To experiment: Adolescents are often motivated to seek new experiences, particularly those they perceive as thrilling or daring.
Addiction occurs when repeated use of drugs changes how a person’s brain functions over time. The transition from voluntary to compulsive drug use reflects changes in the brain’s natural inhibition and reward centers that keep a person from exerting control over the impulse to use drugs even when there are negative consequences—the defining characteristic of addiction.
Some people are more vulnerable to this process than others, due to a range of possible risk factors. Stressful early life experiences such as being abused or suffering other forms of trauma are one important risk factor. Adolescents with a history of physical and/or sexual abuse are more likely to be diagnosed with substance use disorders.30 Many other risk factors, including genetic vulnerability, prenatal exposure to alcohol or other drugs, lack of parental supervision or monitoring, and association with drug-using peers also play an important role.31
At the same time, a wide range of genetic and environmental influences that promote strong psychosocial development and resilience may work to balance or counteract risk factors, making it ultimately hard to predict which individuals will develop substance use disorders and which won’t.
Drug use in adolescents frequently overlaps with other mental health problems. For example, a teen with a substance use disorder is more likely to have a mood, anxiety, learning, or behavioral disorder too. Sometimes drugs can make accurately diagnosing these other problems complicated. Adolescents may begin taking drugs to deal with depression or anxiety, for example; on the other hand, frequent drug use may also cause or precipitate those disorders. Adolescents entering drug abuse treatment should be given a comprehensive mental health screening to determine if other disorders are present. Effectively treating a substance use disorder requires addressing drug abuse and other mental health problems simultaneously.
If an adolescent starts behaving differently for no apparent reason—such as acting withdrawn, frequently tired or depressed, or hostile—it could be a sign he or she is developing a drug-related problem. Parents and others may overlook such signs, believing them to be a normal part of puberty.
Other signs include:
• a change in peer group
• carelessness with grooming
• decline in academic performance
• missing classes or skipping school
• loss of interest in favorite activities
• changes in eating or sleeping habits
• deteriorating relationships with family members and friends
Parents tend to underestimate the risks or seriousness of drug use. The symptoms listed here suggest a problem that may already have become serious and should be evaluated to determine the underlying cause—which could be a substance abuse problem or another mental health or medical disorder. Parents who are unsure whether their child is abusing drugs can enlist the help of a primary care physician, school guidance counselor, or drug abuse treatment provider.
Adolescent girls and boys may have different developmental and social issues that may call for different treatment strategies or emphases. For example, girls with substance use disorders may be more likely to also have mood disorders such as depression or to have experienced physical or sexual abuse. Boys with substance use disorders are more likely to also have conduct, behavioral, and learning problems, which may be very disruptive to their school, family, or community. Treatments should take into account the higher rate of internalizing and stress disorders among adolescent girls, the higher rate of externalizing disruptive disorders and juvenile justice problems among adolescent boys, and other gender differences that may play into adolescent substance use disorders.
Treatment providers are urged to consider the unique social and environmental characteristics that may influence drug abuse and treatment for racial/ethnic minority adolescents, such as stigma, discrimination, and sparse community resources. With the growing number of immigrant children living in the United States, issues of culture of origin, language, and acculturation are important considerations for treatment. The demand for bilingual treatment providers to work with adolescents and their families will also be increasing as the diversity of the U.S. population increases.
Below are the 13 principles that NIDA recommends for dealing with adolescent substance use:
1. Adolescent substance use needs to be identified and addressed as soon as possible. Drugs can have long-lasting effects on the developing brain and may interfere with family, positive peer relationships, and school performance. Most adults who develop a substance use disorder report having started drug use in adolescence or young adulthood, so it is important to identify and intervene in drug use early.
2. Adolescents can benefit from a drug abuse intervention even if they are not addicted to a drug.18 Substance use disorders range from problematic use to addiction and can be treated successfully at any stage, and at any age. For young people, any drug use (even if it seems like only “experimentation”), is cause for concern, as it exposes them to dangers from the drug and associated risky behaviors and may lead to more drug use in the future. Parents and other adults should monitor young people and not underestimate the significance of what may appear as isolated instances of drug-taking.
3. Routine annual medical visits are an opportunity to ask adolescents about drug use. Standardized screening tools are available to help pediatricians, dentists, emergency room doctors, psychiatrists, and other clinicians determine an adolescent’s level of involvement (if any) in tobacco, alcohol, and illicit and nonmedical prescription drug use.19 When an adolescent reports substance use, the health care provider can assess its severity and either provide an onsite brief intervention or refer the teen to a substance abuse treatment program.20, 21
4. Legal interventions and sanctions or family pressure may play an important role in getting adolescents to enter, stay in, and complete treatment. Adolescents with substance use disorders rarely feel they need treatment and almost never seek it on their own. Research shows that treatment can work even if it is mandated or entered into unwillingly.22
5. Substance use disorder treatment should be tailored to the unique needs of the adolescent. Treatment planning begins with a comprehensive assessment to identify the person’s strengths and weaknesses to be addressed. Appropriate treatment considers an adolescent’s level of psychological development, gender, relations with family and peers, how well he or she is doing in school, the larger community, cultural and ethnic factors, and any special physical or behavioral issues.
6. Treatment should address the needs of the whole person, rather than just focusing on his or her drug use. The best approach to treatment includes supporting the adolescent’s larger life needs, such as those related to medical, psychological, and social well-being, as well as housing, school, transportation, and legal services. Failing to address such needs simultaneously could sabotage the adolescent’s treatment success.
7. Behavioral therapies are effective in addressing adolescent drug use. Behavioral therapies, delivered by trained clinicians, help an adolescent stay off drugs by strengthening his or her motivation to change. This can be done by providing incentives for abstinence, building skills to resist and refuse substances and deal with triggers or craving, replacing drug use with constructive and rewarding activities, improving problem-solving skills, and facilitating better interpersonal relationships.
8. Families and the community are important aspects of treatment. The support of family members is important for an adolescent’s recovery. Several evidence-based interventions for adolescent drug abuse seek to strengthen family relationships by improving communication and improving family members’ ability to support abstinence from drugs. In addition, members of the community (such as school counselors, parents, peers, and mentors) can encourage young people who need help to get into treatment—and support them along the way.
9. Effectively treating substance use disorders in adolescents requires also identifying and treating any other mental health conditions they may have. Adolescents who abuse drugs frequently also suffer from other conditions including depression, anxiety disorders, attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct problems.23 Adolescents who abuse drugs, particularly those involved in the juvenile justice system, should be screened for other psychiatric disorders. Treatment for these problems should be integrated with the treatment for a substance use disorder.
10. Sensitive issues such as violence and child abuse or risk of suicide should be identified and addressed. Many adolescents who abuse drugs have a history of physical, emotional, and/or sexual abuse or other trauma.24 If abuse is suspected, referrals should be made to social and protective services, following local regulations and reporting requirements.
11. It is important to monitor drug use during treatment. Adolescents recovering from substance use disorders may experience relapse, or a return to drug use. Triggers associated with relapse vary and can include mental stress and social situations linked with prior drug use. It is important to identify a return to drug use early before an undetected relapse progresses to more serious consequences. A relapse signals the need for more treatment or a need to adjust the individual’s current treatment plan to better meet his or her needs.
12. Staying in treatment for an adequate period of time and continuity of care afterward are important. The minimal length of drug treatment depends on the type and extent of the adolescent’s problems, but studies show outcomes are better when a person stays in treatment for 3 months or more.25 Because relapses often occur, more than one episode of treatment may be necessary. Many adolescents also benefit from continuing care following treatment,26 including drug use monitoring, follow-up visits at home,27 and linking the family to other needed services.
13. Testing adolescents for sexually transmitted diseases like HIV, as well as hepatitis B and C, is an important part of drug treatment. Adolescents who use drugs—whether injecting or non-injecting—are at an increased risk for diseases that are transmitted sexually as well as through the blood, including HIV and hepatitis B and C. All drugs of abuse alter judgment and decision making, increasing the likelihood that an adolescent will engage in unprotected sex and other high-risk behaviors including sharing contaminated drug injection equipment and unsafe tattooing and body piercing practices—potential routes of virus transmission. Substance use treatment can reduce this risk both by reducing adolescents’ drug use (and thus keeping them out of situations in which they are not thinking clearly) and by providing risk-reduction counseling to help them modify or change their high-risk behaviors.28,29
Let’s Talk About It… If you were to develop either a prevention program or a treatment program specifically for adolescents, what approach would you use? What kinds of tools or information would you want to be part of the program?
Understanding Adolescent Drug Use
Addiction has been referred to as a disease of youth. For most who develop a substance use disorder, their use started as a teen or young adult. Rarely do we see a person whose addiction began during later years in life. Simply look at the statistics and we can see why this is thought to be true. According to the National Center for Drug Abuse Statistics (n.d.), 86% of teens report knowing someone who smokes, drinks, or uses drugs during the school day, 50% report having misused a drug at least once in their lifetime, and 43% of college students report using illicit drugs.
In adolescence, young people experience profound changes, both physically and emotionally. Adolescence bridges the gap between childhood and adulthood. Young people attempt to gain independence while still being dependent on caregivers. Despite their desire for independence and autonomy, they feel a competing need to conform to their peers. It is a time of self-discovery and trying to answer the question, “Who am I?” in relation to their families, their peers, and society as a whole.
Have you ever known a teen (or had one of your own) who made a decision or engaged in a behavior that led you to question, What were theythinking?! The answer is quite simple. Teens don’t think. They feel. What do you mean, you may ask? This is because teens process information with the amygdala, an area of the brain tied to the ability to experience emotions. Research has shown that the prefrontal cortex, the area of the brain that is involved in executive functions including reasoning, judgment, and decision-making, develops during adolescence but doesn’t fully mature until the age of 25 years. Thus, as the brain of an adolescent is processing incoming stimuli with the amygdala, it doesn’t have the ability to use executive functions. Add the use of alcohol and drugs to the developing brain and the result is changes in neuropsychological functioning. To the lay person this includes such things as lower educational achievement, changes in cognitive functioning, and poorer verbal and visual learning and memory.
Alcohol and drug use are often considered rites of passage for adolescents and experimentation is common. We by no means want to give the impression that the use of drugs and alcohol by teens isn’t something to be concerned about. Of course it is. However, just because teens may experiment with drugs and/or alcohol doesn’t mean they will develop an addiction. Also, a relatively large percentage of adolescents don’t drink or use, a fact that is often overlooked.
Current Trends
Given the amount of information we are bombarded with regarding drug and alcohol use via various forms of media, you might think adolescent use is at an all time high. Our answer would be to say that it depends. It depends on such things as risk and protective factors for each individual and it also depends on the type of drug. According the National Institute on Drug Abuse’s (NIH) annual survey of 8th, 10th, and 12th graders for 2019, use of cannabis remains steady, but use of illicit substances other than cannabis has declined steadily since 1997. The use of prescription opiates has declined for all three age groups. Abuse of medications used to treat ADHD has declined over the last 5 years for 10th and 12th graders, but has increased for 8th graders. Both cigarette smoking and use of alcohol has also decreased. One area that has increased exponentially from 2018 to 2019 for all three age groups is vaping, including both nicotine and cannabis.
A YouTube element has been excluded from this version of the text. You can view it online here: https://cod.pressbooks.pub/addiction/?p=46
Maturation of the adolescent brain
Abstract
Adolescence is the developmental epoch during which children become adults – intellectually, physically, hormonally, and socially. Adolescence is a tumultuous time, full of changes and transformations. The pubertal transition to adulthood involves both gonadal and behavioral maturation. Magnetic resonance imaging studies have discovered that myelinogenesis, required for proper insulation and efficient neurocybernetics, continues from childhood and the brain’s region-specific neurocircuitry remains structurally and functionally vulnerable to impulsive sex, food, and sleep habits. The maturation of the adolescent brain is also influenced by heredity, environment, and sex hormones (estrogen, progesterone, and testosterone), which play a crucial role in myelination. Furthermore, glutamatergic neurotransmission predominates, whereas gamma-aminobutyric acid neurotransmission remains under construction, and this might be responsible for immature and impulsive behavior and neurobehavioral excitement during adolescent life. The adolescent population is highly vulnerable to driving under the influence of alcohol and social maladjustments due to an immature limbic system and prefrontal cortex. Synaptic plasticity and the release of neurotransmitters may also be influenced by environmental neurotoxins and drugs of abuse including cigarettes, caffeine, and alcohol during adolescence. Adolescents may become involved with offensive crimes, irresponsible behavior, unprotected sex, juvenile courts, or even prison. According to a report by the Centers for Disease Control and Prevention, the major cause of death among the teenage population is due to injury and violence related to sex and substance abuse. Prenatal neglect, cigarette smoking, and alcohol consumption may also significantly impact maturation of the adolescent brain. Pharmacological interventions to regulate adolescent behavior have been attempted with limited success. Since several factors, including age, sex, disease, nutritional status, and substance abuse have a significant impact on the maturation of the adolescent brain, we have highlighted the influence of these clinically significant and socially important aspects in this report.
Keywords: myelinogenesis, neurocircuitry, molecular imaging, drug addiction, behavior, social adjustment
Introduction
Significant progress has been made over the last 25 years in understanding the brain’s regional morphology and function during adolescence. It is now realized that several major morphological and functional changes occur in the human brain during adolescence.1 Molecular imaging and functional genomics studies have indicated that the brain remains in an active state of development during adolescence.1 In particular, magnetic resonance imaging (MRI) studies have discovered that myelinogenesis continues and the neurocircuitry remains structurally and functionally vulnerable to significant increases in sex hormones (estrogen, progesterone, and testosterone) during puberty which, along with environmental input, influences sex, eating, and sleeping habits. Particularly significant changes occur in the limbic system, which may impact self-control, decision making, emotions, and risk-taking behaviors. The brain also experiences a surge of myelin synthesis in the frontal lobe, which is implicated in cognitive processes during adolescence.1
Brain maturation during adolescence (ages 10–24 years) could be governed by several factors, as illustrated in Figure 1. It may be influenced by heredity and environment, prenatal and postnatal insult, nutritional status, sleep patterns, pharmacotherapy, and surgical interventions during early childhood. Furthermore, physical, mental, economical, and psychological stress; drug abuse (caffeine, nicotine, and alcohol); and sex hormones including estrogen, progesterone, and testosterone can influence the development and maturation of the adolescent brain. MRI studies have suggested that neurocircuitry and myelinogenesis remain under construction during adolescence because these events in the central nervous system (CNS) are transcriptionally regulated by sex hormones that are specifically increased during puberty.
Neurobehavioral, morphological, neurochemical, and pharmacological evidence suggests that the brain remains under construction during adolescence,1,2,3,7,12,21,22,23,27,49 as illustrated in Figure 2. Thus, the consolidation of neurocybernetics occurs during adolescence by the maturation of neurocircuitry and myelination. Although tubulinogenesis, axonogenesis, and synaptogenesis may be accomplished during prenatal and immediate postnatal life, myelinogenesis remains active during adolescent life. Neurochemical evidence suggests that glutamatergic neurotransmission is accomplished during prenatal and immediate postnatal life while gamma-aminobutyric acid (GABA)ergic neurotransmission, particularly in the prefrontal cortex, remains under construction during adolescence.2 Hence, delayed development of GABAergic neurotransmission is held responsible for neurobehavioral excitement including euphoria and risk-taking behavior, whereas dopaminergic (DA)ergic neurotransmission, particularly in the prefrontal area, is developmentally regulated by sex hormones and is implicated in drug-seeking behavior during adolescence;3 thus, brain development in critical areas is an ongoing process during adolescence. Indeed, adolescents are risk-taking and novelty-seeking individuals and they are more likely to weigh positive experiences more heavily and negative experiences less so than adults. This behavioral bias can lead to engagement in risky activities like reckless driving, unprotected sex, and drug abuse.13 In fact, most drug addictions initiate during adolescence, and early drug abuse is usually associated with an increased incidence of physical tolerance and dependence. The hormonal changes in puberty contribute to physical, emotional, intellectual, and social changes during adolescence. These changes do not just induce maturation of reproductive function and the emergence of secondary sex characteristics, but they also contribute to the appearance of sex differences in nonreproductive behaviors. Physical changes, including accelerated body growth, sexual maturation, and development of secondary sexual characteristics occur simultaneously along with social, emotional, and cognitive development during adolescence. Furthermore, the adolescent brain evolves its capability to organize, regulate impulses, and weigh risks and rewards; however, these changes can make adolescents highly vulnerable to risk-taking behavior. Thus, brain maturation is an extremely important aspect of overall adolescent development, and a basic understanding of the process might aid in the understanding of adolescent sexual behavior, pregnancy, and intellectual performance issues.
A diagram illustrating various stages of human brain development.
Notes: Several neurobehavioral, morphological, neurochemical, and pharmacological evidences suggest that the brain remains under construction during adolescence.1,2,3,7,12,21,22,23,25,42 Tubulinogenesis, axonogenesis, and synaptogenesis may be accomplished during prenatal and immediate postnatal life, yet myelinogenesis remains active during adolescent life. Furthermore, glutamatergic neurotransmission is accomplished during prenatal and immediate postnatal life, while GABAergic neurotransmission in the prefrontal cortex remains under construction. Delayed development of GABAergic neurotransmission among adolescents is implicated in neurobehavioral excitement and risk-taking behavior.
Abbreviations: CT, computed tomography; GABAergic, gamma amino butyric acid ergic; MRI, magnetic resonance imaging.
There are several other crucial developmental aspects of adolescence that are associated with changes in physical, cognitive, and psychosocial characteristics, as well as with attitudes toward intimacy and independence, and these may also influence brain maturation; these will also be discussed in the present report. Furthermore, we emphasize the deleterious effects of drug abuse and the clinical significance of nutrition from fish oils and fatty acids in adolescent brain maturation.
Neuronal plasticity and neurocircuitry
The term “plasticity” refers to the possible significant neuronal changes that occur in the acquisition of new skills.13 These skills initiate the process of elaboration and stabilization of synaptic circuitry as part of the learning process. Plasticity permits adolescents to learn and adapt in order to acquire independence; however, plasticity also increases an individual’s vulnerability toward making improper decisions because the brain’s region-specific neurocircuitry remains under construction, thus making it difficult to think critically and rationally before making complex decisions. Moreover, the neurocircuitry may be forged, refined or weakened, and damaged during plasticity. Thus, neuronal proliferation, rewiring, dendritic pruning, and environmental exposure are important components of brain plasticity during adolescence. A significant portion of brain growth and development occurring in adolescence is the construction and strengthening of regional neurocircuitry and pathways; in particular, the brain stem, cerebellum, occipital lobe, parietal lobe, frontal lobe, and temporal lobe actively mature during adolescence. The frontal lobes are involved in movement control, problem solving, spontaneity, memory, language, initiation, judgment, impulse control, and social and sexual behavior. Furthermore, the prefrontal cortex, which is implicated in drug-seeking behavior, remains in a process of continuous reconstruction, consolidation, and maturation during adolescence.
The adolescent brain
It is well established that various morphological and physiological changes occur in the human brain during adolescence. The term “adolescence” is generally used to describe a transition stage between childhood and adulthood. “Adolescence” also denotes both teenage years and puberty, as these terms are not mutually exclusive. The second surge of synaptogenesis occurs in the brain during the adolescent years. Hence, adolescence is one of the most dynamic events of human growth and development, second only to infancy in terms of the rate of developmental changes that can occur within the brain. Although there is no single definition of adolescence or a set age boundary, Kaplan4 has pointed out that puberty refers to the hormonal changes that occur in early youth, and adolescence may extend well beyond the teenage years. In fact, there are characteristic developmental changes that almost all adolescents experience during their transition from childhood to adulthood. It is well established that the brain undergoes a “rewiring” process that is not complete until approximately 25 years of age.5 This discovery has enhanced our basic understanding regarding adolescent brain maturation and it has provided support for behaviors experienced in late adolescence and early adulthood. Several investigators consider the age span 10–24 years as adolescence, which can be further divided into substages specific to physical, cognitive, and social–emotional development.5,6 Hence, understanding neurological development in conjunction with physical, cognitive, and social–emotional adolescent development may facilitate the better understanding of adolescent brain maturation, which can subsequently inform proper guidance to adolescents.7
Longitudinal MRI studies have confirmed that a second surge of neuronal growth occurs just before puberty.1,7 This surge is similar to that noticed during infancy and consists of a thickening of the grey matter. Following neuronal proliferation, the brain rewires itself from the onset of puberty up until 24 years old, especially in the prefrontal cortex. The rewiring is accomplished by dendritic pruning and myelination. Dendritic pruning eradicates unused synapses and is generally considered a beneficial process, whereas myelination increases the speed of impulse conduction across the brain’s region-specific neurocircuitry. The myelination also optimizes the communication of information throughout the CNS and augments the speed of information processing. Thus, dendritic pruning and myelination are functionally very important for accomplishing efficient neurocybernetics in the adolescent brain.
During adolescence, the neurocircuitry strengthens and allows for multitasking, enhanced ability to solve problems, and the capability to process complex information. Furthermore, adolescent brain plasticity provides an opportunity to develop talents and lifelong interests; however, neurotoxic insult, trauma, chronic stress, drug abuse, and sedentary lifestyles may have a negative impact during this sensitive period of brain maturation.8,9
Out of several neurotransmitters in the CNS, three play a significant role in the maturation of adolescent behavior: dopamine, serotonin, and melatonin.3,8,9 Dopamine influences brain events that control movement, emotional response, and the ability to experience pleasure and pain. Its levels decrease during adolescence, resulting in mood swings and difficulties regulating emotions. Serotonin plays a significant role in mood alterations, anxiety, impulse control, and arousal. Its levels also decrease during adolescence, and this is associated with decreased impulse control. Lastly, melatonin regulates circadian rhythms and the sleep–wake cycle. The body’s daily production of melatonin increases the requirement for sleep during adolescence.8,9
Behavioral problems and puberty
It is now known that hormones are not the only explanation for erratic adolescent behavior; hence, investigators are now trying to establish the exact nature of the interrelationship between pubertal processes and adolescent brain maturation. Dahl has explained three main categories of brain changes related to puberty: (1) changes that precede puberty; (2) changes that are the consequence of puberty; and (3) changes that occur after puberty is over.9 The timing of these changes may underlie many aspects of risk-taking behavior. These changes, which are the consequence of puberty, occur primarily in the brain regions closely linked to emotions, arousal, motivation, as well as to appetite and sleep patterns. Brain changes independent of puberty are those related to the development of advanced cognitive functioning.
Animal studies have shown that sex hormones (estrogen, progesterone, and testosterone) are critically involved in myelination.12 These studies have provided a relationship between sex hormones, white matter, and functional connectivity in the human brain, measured using neuroimaging. The results suggest that sex hormones organize structural connections and activate the brain areas they connect. These processes could underlie a better integration of structural and functional communication between brain regions with age. Specifically, ovarian hormones (estradiol and progesterone) may enhance both corticocortical and subcorticocortical functional connectivity, whereas androgens (testosterone) may decrease subcorticocortical functional connectivity but increase the functional connectivity between subcortical brain areas. Therefore, when examining brain development and aging, or when investigating the possible biological mechanisms of neurological diseases, the contribution of sex hormones should not be ignored.10
A recent study has described how the social brain develops during adolescence.10 Adolescence is a time characterized by change – hormonally, physically, psychologically, and socially. Functional MRI studies have demonstrated the developmental changes that occur during adolescence among white matter and grey matter volumes in regions within the “social brain.”1,7,12 Activity in the mesolimbic brain regions also showed changes between adolescence and adulthood during social cognition tasks. A developmental clock – along with the signals that provide information on somatic growth, energy balance, and season of the year – times the awakening of gonadotropin-releasing hormone (GnRH) neurons at the onset of puberty. High-frequency GnRH release results in the disinhibition and activation of GnRH neurons at the onset of puberty, leading to gametogenesis and an increase in sex hormone secretion. Sex hormones and adrenocorticotropic hormones both remodel and activate neurocircuits during adolescent brain development, leading to the development of sexual salience of sensory stimuli, sexual motivation, and expression of copulatory behavior. These influences of hormones on reproductive behavior depend on changes in the adolescent brain that occur independently of gonadal maturation. Reproductive maturity is therefore the product of developmentally timed, brain-driven, and recurrent interactions between steroid hormones and the adolescent nervous system.11,12
Limbic system
The limbic system is a group of structures located deep within the cerebrum. It is composed of the amygdala, the hippocampus, and the hypothalamus. These brain regions are involved in the expression of emotions and motivation, which are related to survival. The emotions include fear, anger, and the fight or fight response. The limbic system is also involved in feelings of pleasure that reward behaviors related to species survival, such as eating and sex. In addition, the limbic system regulates functions related to memory storage and retrieval of events that invoke a strong emotional response. Neuroimaging studies have revealed that when interacting with others and making decisions, adolescents are more likely than adults to be swayed by their emotions.1216 In addition, adolescents often read others’ emotions incorrectly. These studies involved comparing a teen brain to an adult brain determined that adolescents’ prefrontal cortices are used less often during interpersonal interactions and decision making than their adult counterparts. In fact, adolescents relied more on the emotional region of their brains when reading others’ emotions, which is more impulsive when compared to a logical or measured interpretation. Thus, an understanding of how the limbic system and the prefrontal cortex are used has provided a partial explanation for certain characteristics of adolescents and adolescent behaviors, such as quickness to anger, intense mood swings, and making decisions on the basis of “gut” feelings. Because adolescents rely heavily on the emotional regions of their brains, it can be challenging to make what adults consider logical and appropriate decisions, as illustrated in Figure 3.
A diagram illustrating the developmental regulation of executive functions by the prefrontal cortex, which remains under construction during adolescence.
Notes: Several executive brain functions are governed by the prefrontal cortex, which remains in a state of active maturation during adolescence. These complex brain functions are regulated by the prefrontal cortex as illustrated in this figure (based on the original discoveries by Gedd and Steinberg).1,2123,25 Due to immature functional areas in the prefrontal cortex, adolescent teens may take part in risk seeking behavior including unprotected sex, impaired driving, and drug addiction.
Prefrontal cortex
Recently, investigators have studied various aspects of the maturation process of the prefrontal cortex of adolescents.17,18 The prefrontal cortex offers an individual the capacity to exercise good judgment when presented with difficult life situations. The prefrontal cortex, the part of the frontal lobes lying just behind the forehead, is responsible for cognitive analysis, abstract thought, and the moderation of correct behavior in social situations. The prefrontal cortex acquires information from all of the senses and orchestrates thoughts and actions in order to achieve specific goals.
The prefrontal cortex is one of the last regions of the brain to reach maturation, which explains why some adolescents exhibit behavioral immaturity. There are several executive functions of the human prefrontal cortex that remain under construction during adolescence, as illustrated in Figures 3 and and4.4. The fact that brain development is not complete until near the age of 25 years refers specifically to the development of the prefrontal cortex.19
MRI studies have discovered that developmental processes tend to occur in the brain in a back-to-front pattern, explaining why the prefrontal cortex develops last. These studies have also shown that teens have less white matter (myelin) in the frontal lobes compared to adults, and that myelin in the frontal lobes increases throughout adolescence.1,7,21 With more myelin comes the growth of important neurocircuitry, allowing for better flow of information between brain regions.20,21 These findings have led to the concept of frontalization, whereby the prefrontal cortex develops in order to regulate the behavioral responses initiated by the limbic structures. During adolescence, white matter increases in the corpus callosum, the bundle of nerve fibers connecting the right and left hemispheres of the brain, which allows for efficient communication between the hemispheres and enables an individual to access a full array of analytical and creative strategies to respond to complex dilemmas that may arise in adolescent life. Hence, the role of experience is critical in developing the neurocircuitry that allows for increased cognitive control of the emotions and impulses of adolescence. Adolescents, who tend to engage in risky behaviors in relatively safe environments, utilize this circuitry and develop the skills to tackle more dangerous situations; however, with an immature prefrontal cortex, even if adolescents understand that something is dangerous, they may still engage in such risky behavior.21
Risk-taking behavior
The exact biological basis of risk-taking behavior in adolescents remains enigmatic. Adolescents are at their peak of physical strength, resilience, and immune function, yet mortality rates among 15–24 year-olds are more than triple the mortality rates of middle school children. The Centers for Disease Control and Prevention has identified the leading causes of death and illness among adolescents,22,23,59 as illustrated in Figure 5. It is generally held that adolescents take risks to test and define themselves, as risk-taking can be both beneficial and harmful. It can lead to situations where new skills are learned and new experiences can prepare them for future challenges in their lives. Risk-taking serves as a means of discovery about oneself, others, and the world at large. The proclivity for risk-taking behavior plays a significant role in adolescent development, rendering this a period of time for both accomplishing their full potential and vulnerability. Hence, acquiring knowledge regarding adolescent brain maturation can help understand why teens take risks, while keeping in mind that risk-taking behavior is a normal and necessary component of adolescence. This knowledge may help in developing physiologically and pharmacologically effective interventions that focus on reducing the negative consequences associated with risk-taking behavior among the adolescent population.22
Risk perception
It has been established that, around the age of 12 years, adolescents decrease their reliance on concrete thinking and begin to show the capacity for abstract thinking, visualization of potential outcomes, and a logical understanding of cause and effect.23 Teens begin looking at situations and deciding whether they are safe, risky, or dangerous. These aspects of development correlate with the maturation of the frontal lobe, and is marked by a shift from the development of additional neural connections to synaptic pruning, as well as by an increase in the release of hormones, all of which drive an adolescent’s mood and impulsive behavior.
By the age of 15 years, there is little difference in adolescents’ and adults’ decision-making patterns pertaining to hypothetical situations. Teens were found to be capable of reasoning about the possible harm or benefits of different courses of action; however, in the real world, teens still engaged in dangerous behaviors, despite understanding the risks involved.22,23,59 Hence, both the role of emotions and the connection between feeling and thinking need to be considered while studying the way teens make decisions.
Investigators have differentiated between “hot” cognition and “cold” cognition.24 Hot cognition is described as thinking under conditions of high arousal and intense emotion. Under these conditions, teens tend to make poorer decisions. The opposite of hot cognition is cold cognition, which is critical and over-analyzing.25 In cold cognition, circumstances are less intense and teens tend to make better decisions. Then, with the addition of complex feelings – such as fear of rejection, wanting to look cool, the excitement of risk, or anxiety of being caught – it is more difficult for teens to think through potential outcomes, understand the consequences of their decisions, or even use common sense.26 The apparent immaturity of the connections between the limbic system, prefrontal cortex, and the amygdala provides further support for this concept.
Sensation seeking
The nucleus accumbens, a part of the brain’s reward system located within the limbic system, is the area that processes information related to motivation and reward. Brain imaging has shown that the nucleus accumbens is highly sensitive in adolescents, sending out impulses to act when faced with the opportunity to obtain something desirable.27 For instance, adolescents are more vulnerable to nicotine, alcohol, and other drug addictions because the limbic brain regions that govern impulse and motivation are not yet fully developed.28 During puberty, the increases in estrogen and testosterone bind receptors in the limbic system, which not only stimulates sex drive, but also increases adolescents’ emotional volatility and impulsivity. Changes in the brain’s reward sensitivity that occur during puberty have also been explored. These changes are related to decreases in DA, a neurotransmitter that produces feelings of pleasure.29 Due to these changes, adolescents may require higher levels of DAergic stimulation to achieve the same levels of pleasure/reward, driving them to make riskier decisions.
Self-regulation
Self-regulation has been broadly classified as the management of emotions and motivation.30 It also involves directing and controlling behavior in order to meet the challenges of the environment and to work toward a conscious purpose. Self-regulation also entails controlling the expression of intense emotions, impulse control, and delayed gratification. As adolescents progress toward adulthood with a body that is almost mature, the self-regulatory parts of their brains are still maturing. An earlier onset of puberty increases the window of vulnerability for teens, making them more susceptible to taking risks that affect their health and development over a prolonged period.31
Behavioral control requires a great involvement of cognitive and executive functions. These functions are localized in the prefrontal cortex, which matures independent of puberty and continues to evolve up until 24 years of age. It has been suggested that, during this period, adolescents should not be overprotected, but be allowed to make mistakes, learn from their own experiences, and practice self-regulation. Parents and teachers can help adolescents through this period by listening and offering support and guidance.
Recently, Steinberg studied risk-taking behavior in teens and how this was influenced by their peers.32 He used a driving simulation game in which he studied teens deciding on whether or not to run a yellow light, and found that when teens were playing alone they made safer decisions, but in the presence of friends they made riskier decisions. When teens find themselves in emotionally arousing situations, with their immature prefrontal cortices, hot cognitive thinking comes into play, and these adolescents are more likely to take riskier actions and make impulsive decisions.
Societal influences
Mass media, community, and adult role models can also influence adolescent risk-taking behaviors. Teens are constantly exposed to emotionally arousing stimuli through multimedia, which encourages unprotected sex, substance abuse, alcohol abuse, and life-threatening activities.32,33 Even neighborhoods, friends, and communities provide teens with opportunities to engage in risky behaviors, although local law enforcement authorities regulate the purchase of cigarettes, access to and acceptability of guns, and the ability to drive cars. Even adults can have trouble resisting engaging in some of these risky behaviors; however, the temptation must be much harder for teens, whose judgment and decision-making skills are still developing.34
Recent functional MRI studies have demonstrated the extent of development during adolescence in the white matter and grey matter regions within the social brain. Activity in some of these regions showed changes between adolescence and adulthood during social cognition tasks. These studies have provided evidence that the concept of mind usage remains developing late in adolescence.1,21,33
Substance abuse
The mechanisms underlying the long-term effects of prenatal substance abuse and its consequent elevated impulsivity during adolescence are poorly understood. Liu and Lester34 have reported on developmentally-programmed neural maturation and highlighted adolescence as a critical period of brain maturation. These investigators have studied impairments in the DAergic system, the hypothalamic–pituitary–adrenal axis, and the pathological interactions between these two systems that originate from previous fetal programming in order to explain insufficient behavioral inhibition in affected adolescents. In addition, Burke35 has examined the development of brain functions and the cognitive capabilities of teenagers. Specifically, these two sets of investigators have explored the effect of alcohol abuse on brain development, and the fundamental cognitive differences between adolescents and adults, and have suggested that the adultification of youth is harsh for those whose brains have not fully matured.
Cannabis
Cannabis is the most commonly consumed drug among adolescents, and its chronic use may affect maturational refinement by disrupting the regulatory role of the endocannabinoid system.36 Adolescence represents a critical period for brain development and the endocannabinoid system plays a critical role in the regulation of neuronal refinement during this period. In animals, adolescent cannabinoid exposure caused long-term impairment in specific components of learning and memory, and differentially affected emotional reactivity with milder effects on anxiety behavior and more pronounced effects on depressive behavior.37 Epidemiological studies have suggested that adolescent cannabis abuse may increase their risk of developing cognitive abnormalities, psychotic illness, mood disorders, and other illicit substance abuse later in life.36,3840 Cannabis abuse in adolescence could increase the risk of developing psychiatric disorders, especially in people who are vulnerable to developing psychiatric syndromes. So far, only a few studies have investigated the neurobiological substrates of this vulnerability;56 hence, further investigation is required to clarify the molecular mechanisms underlying the effect of cannabis on the adolescent brain.
Nicotine
Recent studies have provided a neural framework to explain the developmental differences that occur within the mesolimbic pathway based on the established role of DA in addiction.41,42 During adolescence, excitatory glutamatergic systems that facilitate DAergic neurotransmisson are overdeveloped, whereas inhibitory GABAergic systems remain underdeveloped. DAergic pathways originate in the ventral tegmental area and terminate in the nucleus accumbens, where dopamine is increased by nicotine, but decreased during withdrawal. Thus, it has been hypothesized that adolescents display enhanced nicotine reward and reduced withdrawal via enhanced excitation and reduced inhibition of ventral tegmental area cell bodies that release DA in the nucleus accumbens.44,45 Although this framework focuses on both adolescents and adults, it may also apply to the enhanced vulnerability to nicotine in adults that were previously exposed to nicotine during adolescence, suggesting that the diagnostic criteria developed for nicotine dependence in adults (based primarily on withdrawal) may be inappropriate during adolescence, when nicotine withdrawal does not appear to play a major role in nicotine use.39 Furthermore, treatment strategies involving nicotine replacement may be harmful for adolescents because it may cause enhanced vulnerability to nicotine dependence later in adulthood. Adolescents that initiate tobacco abuse are more vulnerable to long-term nicotine dependence. A unifying hypothesis has been proposed based on animal studies, and it suggests that adolescents (as compared to adults) experience enhanced short-term positive effects and reduced adverse effects toward nicotine, and they also experience fewer negative effects during nicotine withdrawal.39 Thus, during adolescence, the strong positive effects associated with nicotine are inadequately balanced by the negative effects that contribute to nicotine dependence in adults.
Alcohol
Recently, the development of brain functions, the cognitive capabilities of adolescents, and the effect of alcohol abuse on brain maturation have been examined.49,50 Cognitive differences between adolescents and adults suggest that the adultification of youths is deleterious for youths whose brains have not fully matured. Adolescence is the time during which most individuals first experience alcohol exposure, and binge drinking is very common during this period.29,50,43 There is increasing evidence for long-lasting neurophysiological changes that may occur following exposure to ethanol during adolescence in animal models.50 If alcohol exposure is neurotoxic to the developing brain during adolescence, then understanding how ethanol affects the developing adolescent brain becomes a major public health issue. Adolescence is a critical time period when cognitive, emotional, and social maturation occurs and it is likely that ethanol exposure may affect these complex processes. During a period that corresponds to adolescence in rats, the relatively brief exposure to high levels of alcohol via ethanol vapors caused long-lasting changes in functional brain activity.51 The following observations were recorded: disturbances in waking electroencephalography; a reduction in the P3 wave (P3a and P3b) component of event-related potential measurements; reductions in the mean duration of slow-wave sleep; and the total amount of time spent in slow-wave sleep – findings that are consistent with the premature sleep patterns observed during aging.50
Sex differences
Sex differences in many behaviors, including drug abuse, have been attributed to social and cultural factors.43,46 A narrowing gap in drug abuse between adolescent boys and girls supports this hypothesis;52 however, some sex differences in addiction vulnerability refect biologic differences in the neurocircuits involved in addiction. A male predominance in overall drug abuse appears by the end of adolescence, while girls develop a rapid progression from the time of the first abuse to dependence, and this represents female-based vulnerability. Recent studies have emphasized the contribution of sex differences in the function of the ascending DAergic systems, which are critical in reinforcement.3,43 These studies highlight the behavioral, neurochemical, and anatomical changes that occur in the DAergic functions that are related to the addictions that occur during adolescence. In addition, these studies have presented novel findings about the emergence of sex differences in DAergic function during adolescence.43,4648 Sex differences in drinking patterns and the rates of alcohol abuse and dependence begin to emerge during the transition from late puberty to young adulthood. Increases in pubertal hormones, including gonadal and stress hormones, are a prominent developmental feature of adolescence and could contribute to the progression of sex differences in alcohol drinking behavior during puberty. Witt46 reviewed experimental and correlational studies of gonadal and stress-related hormone changes, as well as their effects on alcohol consumption and the associated neurobehavioral actions of alcohol on the mesolimbic dopaminergic system. Mechanisms have been suggested by which reproductive and stress-related hormones may modulate neural circuits within the brain reward system, and these hormones may produce sex differences in terms of alcohol consumption patterns and adolescents’ vulnerability to alcohol abuse and dependence, which become apparent during the late pubertal period.
Chemotherapy
Recently, Vázquez et al53 emphasized the need for the early and accurate diagnosis of CNS complications during and after pediatric cancer treatment because of the improvement in overall survival rates related to innovative and aggressive oncologic therapies. A major concern in this issue is recognizing the radiologic features of these CNS complications. Radiologists are supposed to be familiar with the early and late effects of cancer therapy in the pediatric CNS (toxic effects, infection, endocrine or sensory dysfunction, neuropsychological impairment, and secondary malignancies) in order to provide an accurate diagnosis and to minimize morbidity. The acquisition of further knowledge about these complications will enable the development of more appropriate therapeutic decisions, effective patient surveillance, and an improved quality of life by decreasing the long-term consequences in survivors. Certain chemotherapeutic compounds and environmental agents, such as anesthetics, antiepileptics, sleep-inducing and anxiolytic compounds, nicotine, alcohol, and stress, as well as agents of infection have also been investigated quite extensively and have been shown to contribute to the etiopathogenesis of serious neuropsychiatric disorders.54 All of these agents have a deleterious influence on developmental processes during the time when the brain experiences major changes in early childhood and during adulthood. Several of these agents have contributed to the structural and functional brain abnormalities that have been observed in the biomarker profiles of schizophrenia and fetal alcohol syndrome. The effects of these agents are generally permanent and irreversible.54
Nutrition
The rapid expansion of knowledge in this field, from basic science to clinical and community-based research, is expected to lead to urgently needed research in support of effective, evidence-based medicine and treatment strategies for undernutrition, overnutrition, and eating disorders in early childhood. Eating is necessary for survival and provides a sense of pleasure, but may be perturbed, leading to undernutrition, overnutrition, and eating disorders. The development of feeding in humans relies on the complex interplay between homeostatic mechanisms; neural reward systems; and adolescents’ motor, sensory, and emotional capabilities. Furthermore, parenting, social factors, and food influence the development of eating behavior.
Recently, the neural development of eating behavior in children has been investigated.55 Furthermore, developmentally programmed neural maturation has been discussed in order to highlight adolescence as the second most critical period of brain maturation.56 These studies used impairments of the DAergic system, the hypothalamic–pituitary–adrenal axis, and pathological interactions between these two systems originating from fetal programming in a dual-system model to explain insufficient behavioral inhibition in affected adolescents.
The range of exogenous agents, such as alcohol and cocaine, which are generally likely to detrimentally affect the development of the brain and CNS defies estimation, although the accumulated evidence is substantial.5760 Pubertal age affects the fundamental property of nervous tissue excitability; excessive excitatory drive is seen in early puberty and a deficiency is seen in late puberty. It has been postulated that, with adequate fish oils and fatty acids, the risk of psychopathology can be minimized, whereas a deficiency could lead to subcortical dysfunction in early puberty, and a breakdown of cortical circuitry and cognitive dysfunctions in late puberty.61 Thus, postpubertal psychoses, schizophrenia, and manic–depressive psychosis during the pubertal age, along with excitability, may be the result of continuous dietary deficiency, which may inhibit the expression of the oligodendrocyte-related genes responsible for myelinogenesis. The beneficial effect of fish oils and fatty acids in schizophrenia, fetal alcohol syndrome, developmental dyslexia, attention deficit hyperactivity disorder, and in other CNS disorders supports the hypothesis that the typical diet might be persistently deficient in the affected individuals, as illustrated in Figure 6. However, the amount of fish oils and fatty acids needed to secure normal brain development and function is not known. It seems conjectural to postulate that a dietary deficiency in fish oils and fatty acids is causing brain dysfunction and death; however, all of these observations tend to suggest that a diet focusing on mainly protein is deficient, and the deficiency is most pronounced in maternal nutrition and in infancy, which might have a deleterious impact on the maturation of the adolescent brain.
Effect of seafood on the maturation of the adolescent brain.
Notes: MRI studies have provided evidence that in addition to the prefrontal cortex and limbic system, myelinogenesis and neurocircuitry remains under construction during adolescence.1,7,19,21 Myelinogenesis requires precursors such as polyunsaturated fatty acids, of which many seafoods are a rich source. Hence, consuming seafood may accelerate brain maturation in adolescents. However, malnutrition and substance abuse may inhibit maturation of the adolescent brain. (+) induction; (−) inhibition.
Conclusion
Neuromorphological, neurochemical, neurophysiological, neurobehavioral, and neuropharmacological evidence suggests that the brain remains in its active state of maturation during adolescence.1,7,19,21 Such evidence supports the hypothesis that the adolescent brain is structurally and functionally vulnerable to environmental stress, risky behavior, drug addiction, impaired driving, and unprotected sex. Computed tomography and MRI studies also provide evidence in support of this hypothesis.19
Brain maturation occurs during adolescence due to a surge in the synthesis of sex hormones implicated in puberty including estrogen, progesterone, and testosterone. These sex hormones augment myelinogenesis and the development of the neurocircuitry involved in efficient neurocybernetics. Although tubulinogenesis, axonogenesis, and synaptogenesis can occur during the prenatal and early postnatal periods, myelinogenesis involved in the insulation of axons remains under construction in adolescence. Sex hormones also significantly influence food intake and sleep requirements during puberty. In addition to dramatic changes in secondary sex characteristics, sex hormones may also influence the learning, intelligence, memory, and behavior of adolescents.
Furthermore, it can be observed that the development of excitatory glutamatergic neurotransmission occurs earlier in the developing brain as compared to GABAergic neurotransmission, which makes the pediatric population susceptible to seizures.
The development and maturation of the prefrontal cortex occurs primarily during adolescence and is fully accomplished at the age of 25 years. The development of the prefrontal cortex is very important for complex behavioral performance, as this region of the brain helps accomplish executive brain functions.
A detailed study is required in order to determine the exact biomarkers involved, as well as the intricate influence of diet, drugs, sex, and sleep on the maturation of the adolescent brain as discussed briefly in this report.
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A YouTube element has been excluded from this version of the text. You can view it online here: https://cod.pressbooks.pub/addiction/?p=46 | textbooks/socialsci/Social_Work_and_Human_Services/Foundations_of_Addiction_Studies_(Florin_and_Trytek)/1.05%3A_Adolescents_and_Addiction.txt |
In a 2017 Pew Research survey, 46% of American adults said they have a family member or close friend who is addicted to drugs. Furthermore, data collected on household drug use from 2009-2014 indicated that 1 in 8 children age 17 and younger were growing up with at least one parent who had a substance use disorder (Lipari & Van Horn, 2017).
As much as the person suffering from a substance use disorder struggles, their friends, family, and loved ones also face tremendous challenges. Family members are impacted directly by the addiction. Their physical health, mental well-being, social lives, and family roles are all upended. In this chapter, we examine some of these impacts and look at ways for family members to find balance as they navigate a path toward their own recovery.
Below, you will hear one story of the impact of growing up in an addicted family:
A YouTube element has been excluded from this version of the text. You can view it online here: https://cod.pressbooks.pub/addiction/?p=381
The following article is from the Substance Abuse and Mental Health Service Administration’s Treatment Improvement Protocol series (TIP 39: Substance Abuse Treatment and Family Therapy).
Impact of Substance Abuse on Families
Family structures in America have become more complex—growing from the traditional nuclear family to single‐parent families, stepfamilies, foster families, and multigenerational families. Therefore, when a family member abuses substances, the effect on the family may differ according to family structure. This chapter discusses treatment issues likely to arise in different family structures that include a person abusing substances. For example, the non–substance‐abusing parent may act as a “superhero” or may become very bonded with the children and too focused on ensuring their comfort. Treatment issues such as the economic consequences of substance abuse will be examined as will distinct psychological consequences that spouses, parents, and children experience. This chapter concludes with a description of social issues that coexist with substance abuse in families and recommends ways to address these issues in therapy.
Introduction
A growing body of literature suggests that substance abuse has distinct effects on different family structures. For example, the parent of small children may attempt to compensate for deficiencies that his or her substance‐abusing spouse has developed as a consequence of that substance abuse (Brown and Lewis 1999). Frequently, children may act as surrogate spouses for the parent who abuses substances. For example, children may develop elaborate systems of denial to protect themselves against the reality of the parent’s addiction. Because that option does not exist in a single‐parent household with a parent who abuses substances, children are likely to behave in a manner that is not age‐appropriate to compensate for the parental deficiency (for more information, see Substance Abuse Treatment: Addressing the Specific Needs of Women [Center for Substance Abuse Treatment (CSAT) in development e] and TIP 32, Treatment of Adolescents With Substance Use Disorders [CSAT 1999e]). Alternately, the aging parents of adults with substance use disorders may maintain inappropriately dependent relationships with their grown offspring, missing the necessary “launching phase” in their relationship, so vital to the maturational processes of all family members involved.
The effects of substance abuse frequently extend beyond the nuclear family. Extended family members may experience feelings of abandonment, anxiety, fear, anger, concern, embarrassment, or guilt; they may wish to ignore or cut ties with the person abusing substances. Some family members even may feel the need for legal protection from the person abusing substances. Moreover, the effects on families may continue for generations. Intergenerational effects of substance abuse can have a negative impact on role modeling, trust, and concepts of normative behavior, which can damage the relationships between generations. For example, a child with a parent who abuses substances may grow up to be an overprotective and controlling parent who does not allow his or her children sufficient autonomy.
Neighbors, friends, and coworkers also experience the effects of substance abuse because a person who abuses substances often is unreliable. Friends may be asked to help financially or in other ways. Coworkers may be forced to compensate for decreased productivity or carry a disproportionate share of the workload. As a consequence, they may resent the person abusing substances.
People who abuse substances are likely to find themselves increasingly isolated from their families. Often they prefer associating with others who abuse substances or participate in some other form of antisocial activity. These associates support and reinforce each other’s behavior.
Different treatment issues emerge based on the age and role of the person who uses substances in the family and on whether small children or adolescents are present. In some cases, a family might present a healthy face to the community while substance abuse issues lie just below the surface.
Reilly (1992) describes several characteristic patterns of interaction, one or more of which are likely to be present in a family that includes parents or children abusing alcohol or illicit drugs:
1. Negativism. Any communication that occurs among family members is negative, taking the form of complaints, criticism, and other expressions of displeasure. The overall mood of the household is decidedly downbeat, and positive behavior is ignored. In such families, the only way to get attention or enliven the situation is to create a crisis. This negativity may serve to reinforce the substance abuse.
• Parental inconsistency. Rule setting is erratic, enforcement is inconsistent, and family structure is inadequate. Children are confused because they cannot figure out the boundaries of right and wrong. As a result, they may behave badly in the hope of getting their parents to set clearly defined boundaries. Without known limits, children cannot predict parental responses and adjust their behavior accordingly. These inconsistencies tend to be present regardless of whether the person abusing substances is a parent or child and they create a sense of confusion—a key factor—in the children. | textbooks/socialsci/Social_Work_and_Human_Services/Foundations_of_Addiction_Studies_(Florin_and_Trytek)/1.06%3A_Addiction_and_the_Family.txt |
One of the most significant contributions to the assessment and treatment of addictions is the bio-psycho-social (BPS) model. This holistic concept allows us to consider a range of factors that influence the development and maintenance of addictive behavior.
Further, using a BPS approach to substance use disorders allows us to identify the context in which problematic drug use occurs (Buchmann, Skinner, & Illies, 2011). Although substance use disorder is a primary diagnosis, it does not occur in isolation. By recognizing individuals as whole people – with a rich history that involves friends, family, jobs, living environments, religious beliefs, personal values, and life experiences – we can better understand how harmful substance use emerged and what might help to change their unhealthy using patterns. A BPS model provides a foundation for understanding both the causes of addictive disorders and the best treatments for them.
The BPS model also fits well with the definition of addiction developed by the American Society of Addiction Medicine (ASAM), which incorporates physiology, psychology, and environment. ASAM utilizes an assessment format with six dimensions on which client concerns are evaluated prior to entering treatment. Those six ASAM dimensions include:
1. Risk of intoxication and withdrawal
2. Biomedical complications
3. Cognitive, emotional, and behavioral issues
4. Readiness to change
5. Relapse/continued use risk
6. Recovery environment
These dimensions can be broken down to match the three parts of the BPS framework. Dimensions one and two refer to biological concerns; dimensions three and four refer to psychological concerns; dimensions five and six refer to social concerns. The video below provides an overview of how the ASAM dimensions are applied by professional addictions counselors.
A YouTube element has been excluded from this version of the text. You can view it online here: https://cod.pressbooks.pub/addiction/?p=48
Check your understanding of the ASAM assessment dimensions using the flashcards below:
A link to an interactive elements can be found at the bottom of this page.
Each of the six dimensions holds a key to the disease of addiction. The first two dimensions, the biological categories, uncover how physiology influences drug use. This might include pain management, physical disabilities, use of medications, or using to avoid withdrawal. Dimensions three and four describe individual characteristics such as emotional needs, behavioral concerns, and motivation. Earlier in the book, we discussed the role of trauma and co-occurring disorders in the development of substance use disorder. Unresolved trauma and mental health problems belong to this psychological aspect of the BPS assessment. Having a working knowledge of these concerns provides insight into how addiction emerges, as well as what needs to be included in a comprehensive plan of treatment. Importantly, it also points to addiction as a chronic illness, one which requires ongoing maintenance to manage successfully. The final two dimensions, five and six, incorporate social and environmental influences on the individual. Here we evaluate whether the people, places, and things in the person’s life are supportive of sobriety or detrimental to the recovery process. One of the great struggles of the addictions field is that we are excellent at getting people sober, but we are poor at keeping them sober. The risk of relapse increases when “clients . . . do not live in environments that support recovery” (Polcin, Korcha, Bond, & Galloway, 2010). Thus, beyond managing withdrawal and promoting abstinence, treatment programs must emphasize the need for sober housing, stable employment, and a network of supportive contacts that nurture the recovering person’s long-term sobriety.
Key Takeaways
• Addiction is a multi-dimensional problem.
• Recovery requires long-term solutions that address medical, psychological, and social concerns.
Ref erences
Buchman, D. Z., Skinner, W., & Illes, J. (2010). Negotiating the Relationship Between Addiction, Ethics, and Brain Science. AJOB Neuroscience, 1(1), 36–45. https://doi.org/10.1080/21507740903508609
Hunt, A. (2014) Expanding the biopsychosocial model: The active reinforcement model of addiction. Graduate Student Journal of Psychology, 15, 57-69.
Polcin, D. L., Korcha, R., Bond, J., & Galloway, G. (2010). Eighteen Month Outcomes for Clients Receiving Combined Outpatient Treatment and Sober Living Houses. Journal of substance use, 15(5), 352–366. https://doi.org/10.3109/14659890903531279
Poudel, An., Sharma, C, Gautam S., & Poudel Am. (2016). Psychosocial problems among individuals with substance use disorders in drug rehabilitation centers. Substance Abuse Treatment, Prevention, and Policy11(28), 1-10. https://doi.org/10.1186/s13011-016-0072-3
Biology of Addiction
(Excerpted from the National Institutes of Health)
People with addiction lose control over their actions. They crave and seek out drugs, alcohol, or other substances no matter what the cost—even at the risk of damaging friendships, hurting family, or losing jobs. What is it about addiction that makes people behave in such destructive ways? And why is it so hard to quit?
NIH-funded scientists are working to learn more about the biology of addiction. They’ve shown that addiction is a long-lasting and complex brain disease, and that current treatments can help people control their addictions. But even for those who’ve successfully quit, there’s always a risk of the addiction returning, which is called relapse.
The biological basis of addiction helps to explain why people need much more than good intentions or willpower to break their addictions.
“A common misperception is that addiction is a choice or moral problem, and all you have to do is stop. But nothing could be further from the truth,” says Dr. George Koob, director of NIH’s National Institute on Alcohol Abuse and Alcoholism. “The brain actually changes with addiction, and it takes a good deal of work to get it back to its normal state. The more drugs or alcohol you’ve taken, the more disruptive it is to the brain.”
Researchers have found that much of addiction’s power lies in its ability to hijack and even destroy key brain regions that are meant to help us survive.
A healthy brain rewards healthy behaviors—like exercising, eating, or bonding with loved ones. It does this by switching on brain circuits that make you feel wonderful, which then motivates you to repeat those behaviors. In contrast, when you’re in danger, a healthy brain pushes your body to react quickly with fear or alarm, so you’ll get out of harm’s way. If you’re tempted by something questionable—like eating ice cream before dinner or buying things you can’t afford—the front regions of your brain can help you decide if the consequences are worth the actions.
But when you’re becoming addicted to a substance, that normal hardwiring of helpful brain processes can begin to work against you. Drugs or alcohol can hijack the pleasure/reward circuits in your brain and hook you into wanting more and more. Addiction can also send your emotional danger-sensing circuits into overdrive, making you feel anxious and stressed when you’re not using drugs or alcohol. At this stage, people often use drugs or alcohol to keep from feeling bad rather than for their pleasurable effects.
To add to that, repeated use of drugs can damage the essential decision-making center at the front of the brain. This area, known as the prefrontal cortex, is the very region that should help you recognize the harms of using addictive substances.
“Brain imaging studies of people addicted to drugs or alcohol show decreased activity in this frontal cortex,” says Dr. Nora Volkow, director of NIH’s National Institute on Drug Abuse. “When the frontal cortex isn’t working properly, people can’t make the decision to stop taking the drug—even if they realize the price of taking that drug may be extremely high, and they might lose custody of their children or end up in jail. Nonetheless, they take it.”
Scientists don’t yet understand why some people become addicted while others don’t. Addiction tends to run in families, and certain types of genes have been linked to different forms of addiction. But not all members of an affected family are necessarily prone to addiction. “As with heart disease or diabetes, there’s no one gene that makes you vulnerable,” Koob says.
Other factors can also raise your chances of addiction. “Growing up with an alcoholic; being abused as a child; being exposed to extraordinary stress—all of these social factors can contribute to the risk for alcohol addiction or drug abuse,” Koob says. “And with drugs or underage drinking, the earlier you start, the greater the likelihood of having alcohol use disorder or addiction later in life.”
Teens are especially vulnerable to possible addiction because their brains are not yet fully developed—particularly the frontal regions that help with impulse control and assessing risk. Pleasure circuits in adolescent brains also operate in overdrive, making drug and alcohol use even more rewarding and enticing.
Although there’s much still to learn, we do know that prevention is critical to reducing the harms of addiction. “Childhood and adolescence are times when parents can get involved and teach their kids about a healthy lifestyle and activities that can protect against the use of drugs,” Volkow says. “Physical activity is important, as well as getting engaged in work, science projects, art, or social networks that do not promote use of drugs.”
Source: National Institutes of Health. 2015. Biology of addiction: Drugs and alcohol can hijack your brain. News in Health Newsletter (October 2015). https://newsinhealth.nih.gov/2015/10...logy-addiction
Drug Cultures, Recovery Cultures
A significant factor in the development and maintenance of addictive behavior is the context in which the behavior occurs. Drug-using rituals are often an ingrained part of life for people with substance use disorders. These deep-seated habits support ongoing use of the mind-altering substance.
Substance users, loved ones, and treatment providers need to realize that significant lifestyle changes are frequently required to replace the culture of addiction with a culture of recovery. In the following passage, the Substance Abuse and Mental Health Services Administration (SAMHSA) shares its insights into the role of drug cultures.
From SAMHSA Treatment Improvement Protocol (TIP) 59: Improving Cultural Competence
This chapter aims to explain that people who use drugs participate in a drug culture, and further, that they value this participation. However, not all people who abuse substances are part of a drug culture. White (1996) draws attention to a set of individuals whom he calls “acultural addicts.” These people initiate and sustain their substance use in relative isolation from other people who use drugs. Examples of acultural addicts include the medical professional who does not have to use illegal drug networks to abuse prescription medication, or the older, middle-class individual who “pill shops” from multiple doctors and procures drugs for misuse from pharmacies. Although drug cultures typically play a greater role in the lives of people who use illicit drugs, people who use legal substances—such as alcohol—are also likely to participate in such a culture (Gordon et al. 2012). Drinking cultures can develop among heavy drinkers at a bar or a college fraternity or sorority house that works to encourage new people to use, supports high levels of continued or binge use, reinforces denial, and develops rituals and customary behaviors surrounding drinking. In this chapter, drug culture refers to cultures that evolve from drug and alcohol use.
The Relationship Between Drug Cultures and Mainstream Culture
To some extent, subcultures define themselves in opposition to the mainstream culture. Subcultures may reject some, if not all, of the values and beliefs of the mainstream culture in favor of their own, and they will often adapt some elements of that culture in ways quite different from those originally intended (Hebdige 1991; Issitt 2009;). Individuals often identify with subcultures—such as drug cultures—because they feel excluded from or unable to participate in mainstream society. The subculture provides an alternative source of social support and cultural activities, but those activities can run counter to the best interests of the individual. Many subcultures are neither harmful nor antisocial, but their focus is on the substance(s) of abuse, not on the people who participate in the culture or their well-being.
Mainstream culture in the United States has historically frowned on most substance use and certainly substance abuse (Corrigan et al. 2009; White 1979, 1998). This can extend to legal substances such as alcohol or tobacco (including, in recent years, the increased prohibition against cigarette smoking in public spaces and its growing social unacceptability in private spaces). As a result, mainstream culture does not—for the most part—have an accepted role for most types of substance use, unlike many older cultures, which may accept use, for example, as part of specific religious rituals. Thus, people who experiment with drugs in the United States usually do so in highly marginalized social settings, which can contribute to the development of substance use disorders (Wilcox 1998). Individuals who are curious about substance use, particularly young people, are therefore more likely to become involved in a drug culture that encourages excessive use and experimentation with other, often stronger, substances (for a review of intervention strategies to reduce discrimination related to substance use disorders, see Livingston et al. 2012).
When people who abuse substances are marginalized, they tend not to seek access to mainstream institutions that typically provide sociocultural support (Myers et al. 2009). This can result in even stronger bonding with the drug culture. A marginalized person’s behavior is seen as abnormal even if he or she attempts to act differently, thus further reducing the chances of any attempt to change behavior (Cohen 1992). The drug culture enables its members to view substance use disorders as normal or even as status symbols. The disorder becomes a source of pride, and people may celebrate their drug-related identity with other members of the culture (Pearson and Bourgois 1995; White 1996). Social stigma also aids in the formation of oppositional values and beliefs that can promote unity among members of the drug culture.
When people with substance use disorders experience discrimination, they are likely to delay entering treatment and can have less positive treatment outcomes (Fortney et al. 2004; Link et al. 1997; Semple et al. 2005). Discrimination can also increase denial and step up the individual’s attempts to hide substance use (Mateu-Gelabert et al. 2005). The immorality that mainstream society attaches to substance use and abuse can unintentionally serve to strengthen individuals’ ties with the drug culture and decrease the likelihood that they will seek treatment.
The relationship between the drug and mainstream cultures is not unidirectional. Since the beginning of a definable drug culture, that culture has had an effect on mainstream cultural institutions, particularly through music, art, and literature. These connections can add significantly to the attraction a drug culture holds for some individuals (especially the young and those who pride themselves on being nonconformists) and create a greater risk for substance use escalating to abuse and relapse.
Understanding Why People Are Attracted to Drug Cultures
To understand what an individual gains from participating in a drug culture, it is important first to examine some of the factors involved in substance use and the development of substance use disorders. Despite having differing theories about the root causes of substance use disorders, most researchers would agree that substance abuse is, to some extent, a learned behavior. Beginning with Becker’s (1953) seminal work, research has shown that many commonly abused substances are not automatically experienced as pleasurable by people who use them for the first time (Fekjaer 1994). For instance, many people find the taste of alcoholic beverages disagreeable during their first experience with them, and they only learn to experience these effects as pleasurable over time. Expectations can also be important among people who use drugs; those who have greater expectancies of pleasure typically have a more intense and pleasurable experience. These expectancies may play a part in the development of substance use disorders (Fekjaer 1994; Leventhal and Schmitz 2006).
Key Takeaways
• Expectancies, or anticipated effects, develop based on the information we gather from parents, peers, and media.
• These anticipated effects then play in part in how we experience drug use.
• When we anticipate a drug to have a certain effect, it tends to influence how we feel when we use the drug (similar to a placebo effect).
• Studies have even shown that people drinking a non-alcoholic placebo acted similarly to people who were consuming alcohol. (Bodnár, V., Nagy, K., Ciboly, Á. C., & Bárdos, G. (2018). The placebo effect and the alcohol. Journal of Mental Health and Psychosomatics, 19(1), 1–12.)
Additionally, drug-seeking and other behaviors associated with substance use have a reinforcing effect beyond that of the actual drugs. Activities such as rituals of use, which make up part of the drug culture, provide a focus for those who use drugs when the drugs themselves are unavailable and help them shift attention away from problems they might otherwise need to face (Lende 2005).
Drug cultures serve as an initiating force as well as a sustaining force for substance use and abuse (White 1996). As an initiating force, the culture provides a way for people new to drug use to learn what to expect and how to appreciate the experience of getting high. As White (1996) notes, the drug culture teaches the new user “how to recognize and enjoy drug effects” (p. 46). There are also practical matters involved in using substances (e.g., how much to take, how to ingest the substance for strongest effect) that people new to drug use may not know when they first begin to experiment with drugs. The skills needed to use some drugs can be quite complicated.
The drug culture has an appeal all its own that promotes initiation into drug use. Stephens (1991) uses examples from a number of ethnographic studies to show how people can be as taken by the excitement of the drug culture as they are by the drug itself. Media portrayals, along with singer or music group autobiographies, that glamorize the drug lifestyle may increase its lure (Manning 2007; Oksanen 2012). In buying (and perhaps selling) drugs, individuals can find excitement that is missing in their lives. They can likewise find a sense of purpose they otherwise lack in the daily need to seek out and acquire drugs. In successfully navigating the difficulties of living as a person who uses drugs, they can gain approval from peers who use drugs and a feeling that they are successful at something.
Marginalized adolescents and young adults find drug cultures particularly appealing. Many individual, family, and social risk factors associated with adolescent substance abuse are also risk factors for youth involvement with a drug culture. Individual factors—such as feelings of alienation from society and a strong rejection of authority—can cause youth to look outside the traditional cultural institutions available to them (family, church, school, etc.) and instead seek acceptance in a subculture, such as a drug culture (Hebdige 1991; Moshier et al. 2012). Individual traits like sensation-seeking and poor impulse control, which can interfere with functioning in mainstream society, are often tolerated or can be freely expressed in a drug culture. Family involvement with drugs is a significant risk factor due to additional exposure to the drug lifestyle, as well as early learning of the values and behaviors (e.g., lying to cover for parents’ illicit activities) associated with it (Haight et al. 2005). Social risk factors (e.g., rejection by peers, poverty, failure in school) can also increase young people’s alienation from traditional cultural institutions. The need for social acceptance is a major reason many young people begin to use drugs, as social acceptance can be found with less effort within the drug culture.
In addition to helping initiate drug use, drug cultures serve as sustaining forces. They support continued use and reinforce denial that a problem with alcohol or drugs exists. The importance of the drug culture to the person using drugs often increases with time as the person’s association with it deepens (Moshier et al. 2012). White (1996) notes that as a person progresses from experimentation to abuse and/or dependence, he or she develops a more intense need to “seek for supports to sustain the drug relationship” (p. 9). In addition to gaining social sanction for their substance use, participants in the drug culture learn many skills that can help them avoid the pitfalls of the substance-abusing lifestyle and thus continue their use. They learn how to avoid arrest, how to get money to support their habit, and how to find a new supplier when necessary.
The more an individual’s needs are met within a drug culture, the harder it will be to leave that culture behind. White (1996) gives an example of a person who was initially attracted in youth to a drug culture because of a desire for social acceptance and then grew up within that culture. Through involvement in the drug culture, he was able to gain a measure of self-esteem, change his family dynamic, explore his sexuality, develop lasting friendships, and find a career path (albeit a criminal one). For this individual, who had so much of his life invested in the drug culture, it was as difficult to conceive of leaving that culture as it was to conceive of stopping his substance use.
Finding Alternatives to Drug Cultures
A client can meet the psychosocial needs previously satisfied by the drug culture in a number of ways. Strengthening cultural identity can be a positive action for the client; in some cases, the client’s family or cultural peers can serve as a replacement for involvement in the drug culture. This option is particularly helpful when the client’s connection to a drug culture is relatively weak and his or her traditional culture is relatively strong. However, when this option is unavailable or insufficient, clinicians must focus on replacing the client’s ties with the drug culture (or the culture of addiction) with new ties to a culture of recovery.
To help clients break ties with drug cultures, programs need to challenge clients’ continued involvement with elements of those cultures (e.g., style of dress, music, language, or communication patterns). This can occur through two basic processes: replacing the element with something new that is positively associated with a culture of recovery (e.g., replacing a marijuana leaf keychain with an NA keychain), and reframing something so that it is no longer associated with drug use or the drug culture (e.g., listening to music that was associated with the drug culture at a sober dance with others in recovery; White 1996). The process will depend on the nature of the cultural element.
Developing a Culture of Recovery
Just as people who are actively using or abusing substances bond over that common experience to create a drug culture that supports their continued substance use, people in recovery can participate in activities with others who are having similar experiences to build a culture of recovery. There is no single drug culture; likewise, there is no single culture of recovery. However, large international mutual-help organizations like Alcoholics Anonymous (AA) do represent the culture of recovery for many individuals. Even within such organizations, though, there is some cultural diversity; regional differences exist, for example, in meeting-related rituals or attitudes toward certain issues (e.g., use of prescribed psychotropic medication, approaches to spirituality).
Treatment programs need to have a plan for creating a culture of recovery.
Programs that do not have a plan for creating a culture of recovery among clients risk their clients returning to the drug culture or holding on to elements of that culture because it meets their basic and social needs. In the worst case scenario, clients will recreate a drug culture among themselves within the program. In the best case, staff members will have a plan for creating a culture of recovery within their treatment population. | textbooks/socialsci/Social_Work_and_Human_Services/Foundations_of_Addiction_Studies_(Florin_and_Trytek)/1.07%3A_Bio-Psycho-Social_Issues.txt |
Before someone receives substance use disorder treatment, he or she must be both screened and assessed to determine whether services are needed and what type of treatment best matches the situation. The screening process is generally brief and provides feedback suggesting that someone does or does not have a problem requiring treatment. Some screening tools can even be self-administered. Among the most-used screening instruments are the short four-question CAGE survey and the Alcohol Use Disorder Identification Test, or AUDIT. These tools provide insight into the presence of a problem and set up the next step of looking for helpful programs or interventions to address the problem.
In contrast to the screening process, assessment is a longer and more formal process conducted by a trained professional. The assessment helps to clarify the specific problem areas to address in treatment and at what level of intensity the person should be treated. At the end of this chapter is a chart created by the National Institute on Drug Abuse that highlights several available screening and assessment tools.
Once a substance use problem has been identified and a recommendation for treatment has been made, a person can begin receiving services. There are numerous options when it comes to treating substance use disorder. In the next chapter, we discuss the importance of having several options available and utilizing multiple pathways to recovery. Here we look at the tools of the treatment provider and what a course of treatment might look like.
To start, let’s look at the story of someone who may need treatment services:
Sample Client
Jessica is a 26-year-old woman who recently received her second driving-under-the-influence (DUI) ticket and has been charged with a misdemeanor crime. She got her first DUI at age 21 and lost her license for one year. During that time, she completed a basic risk education DUI course and paid several thousand dollars in fines and attorney’s fees.
Jessica drinks with her friends on weekends, usually having five or six drinks per night. One of Jessica’s best friends growing up (Kaitlin) has started distancing herself from Jessica because she does not like how much their other friends are drinking. Kaitlin still occasionally invites Jessica to hang out, but Jessica refuses because there is no drinking involved.
In addition to alcohol, Jessica has started taking Xanax, a benzodiazepine. Although she has a prescription from her doctor to take Xanax to help treat her anxiety disorder, Jessica often takes more than prescribed, sometimes even mixing the pills with her alcohol consumption.
Jessica works a full-time job as a graphic designer and does most of her work from home. She says that she has little time to socialize during the week, so she looks forward to the weekend when she can see her friends and relax.
Now that she has a second DUI, Jessica has lost her license again, although she is not overly concerned because she can continue working from home and can walk or order a ride wherever she needs to go.
The court has ordered Jessica to have an evaluation done and to complete any treatment recommendations.
Although this is an imaginary client, the story probably applies to many of the clients who seek treatment. A screening of Jessica would reveal that she likely meets the criteria for a substance use disorder and should receive a full assessment. (Note that a screening tool alone never diagnoses a substance use disorder.)
The exercise below gives you the opportunity to apply the knowledge you have learned in this book to her case.
Exercise
Consider the story of Jessica in the example above:
• What stands out about her story?
• Identify the drug or drugs that might be a problem for Jessica.
• If you were evaluating Jessica, what are some of the questions you would ask her?
• List at least three issues that might be addressed in a treatment plan for Jessica.
• How many of the DSM-5 criteria for Substance Use Disorder can you identify from the brief description above?
• How do her legal issues impact treatment?
Treatment services can be performed at several levels of care. These levels are defined by the American Society of Addiction Medicine (ASAM).
ASAM Levels of Care
Level 0.5: Risk Education
Level I: Outpatient
Level II.1: Intensive Outpatient
Level II.5: Partial Hospitalization
Level III.1: Residential Recovery Homes
Level III.5: High-Intensity Residential
Level IV: Medically Managed Inpatient (Hospitalization)
A critical part of the assessment is recommending the appropriate level of care based on the client’s bio-psycho-social needs. The higher the level, the more intense the treatment. Other issues to consider are the client’s level of motivation, payment source, transportation, and child care. If a client requires medical detoxification, that should be completed prior to beginning treatment.
It is also a good idea to involve a client’s physician when possible. With the case of Jessica, she would benefit from an evaluation to determine if she can safely withdraw from two potentially life-threatening drugs, alcohol and Xanax.
Flip through the cards below to review the levels of treatment care.
An interactive or media element has been excluded from this version of the text. You can view it online here:
https://cod.pressbooks.pub/addiction/?p=50
Principles of Drug Addiction Treatment: A Research-Based Guide (NIDA, 2018)
Preface
Drug addiction is a complex illness.
It is characterized by intense and, at times, uncontrollable drug craving, along with compulsive drug seeking and use that persist even in the face of devastating consequences. This update of the National Institute on Drug Abuse’s Principles of Drug Addiction Treatment is intended to address addiction to a wide variety of drugs, including nicotine, alcohol, and illicit and prescription drugs. It is designed to serve as a resource for healthcare providers, family members, and other stakeholders trying to address the myriad problems faced by patients in need of treatment for drug abuse or addiction.
Addiction affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behavior. That is why addiction is a brain disease. Some individuals are more vulnerable than others to becoming addicted, depending on the interplay between genetic makeup, age of exposure to drugs, and other environmental influences. While a person initially chooses to take drugs, over time the effects of prolonged exposure on brain functioning compromise that ability to choose, and seeking and consuming the drug become compulsive, often eluding a person’s self-control or willpower.
But addiction is more than just compulsive drug taking—it can also produce far-reaching health and social consequences. For example, drug abuse and addiction increase a person’s risk for a variety of other mental and physical illnesses related to a drug-abusing lifestyle or the toxic effects of the drugs themselves. Additionally, the dysfunctional behaviors that result from drug abuse can interfere with a person’s normal functioning in the family, the workplace, and the broader community.
Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual’s life, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Addiction treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society. Because addiction is a disease, most people cannot simply stop using drugs for a few days and be cured. Patients typically require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives. Indeed, scientific research and clinical practice demonstrate the value of continuing care in treating addiction, with a variety of approaches having been tested and integrated in residential and community settings.
As we look toward the future, we will harness new research results on the influence of genetics and environment on gene function and expression (i.e., epigenetics), which are heralding the development of personalized treatment interventions. These findings will be integrated with current evidence supporting the most effective drug abuse and addiction treatments and their implementation, which are reflected in this guide.
Principles of Effective Treatment: Dr. Nora Volkow, Director of the National Institute on Drug Abuse 1. Addiction is a complex but treatable disease that affects brain function and behavior. Drugs of abuse alter the brain’s structure and function, resulting in changes that persist long after drug use has ceased. This may explain why drug abusers are at risk for relapse even after long periods of abstinence and despite the potentially devastating consequences. 2. No single treatment is appropriate for everyone. Treatment varies depending on the type of drug and the characteristics of the patients. Matching treatment settings, interventions, and services to an individual’s particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society. 3. Treatment needs to be readily available. Because drug-addicted individuals may be uncertain about entering treatment, taking advantage of available services the moment people are ready for treatment is critical. Potential patients can be lost if treatment is not immediately available or readily accessible. As with other chronic diseases, the earlier treatment is offered in the disease process, the greater the likelihood of positive outcomes. 4. Effective treatment attends to multiple needs of the individual, not just his or her drug abuse. To be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems. It is also important that treatment be appropriate to the individual’s age, gender, ethnicity, and culture. 5. Remaining in treatment for an adequate period of time is critical. The appropriate duration for an individual depends on the type and degree of the patient’s problems and needs. Research indicates that most addicted individuals need at least 3 months in treatment to significantly reduce or stop their drug use and that the best outcomes occur with longer durations of treatment. Recovery from drug addiction is a long-term process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapses to drug abuse can occur and should signal a need for treatment to be reinstated or adjusted. Because individuals often leave treatment prematurely, programs should include strategies to engage and keep patients in treatment. 6. Behavioral therapies—including individual, family, or group counseling—are the most commonly used forms of drug abuse treatment. Behavioral therapies vary in their focus and may involve addressing a patient’s motivation to change, providing incentives for abstinence, building skills to resist drug use, replacing drug-using activities with constructive and rewarding activities, improving problem-solving skills, and facilitating better interpersonal relationships. Also, participation in group therapy and other peer support programs during and following treatment can help maintain abstinence. 7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. For example, methadone, buprenorphine, and naltrexone (including a new long-acting formulation) are effective in helping individuals addicted to heroin or other opioids stabilize their lives and reduce their illicit drug use. Acamprosate, disulfiram, and naltrexone are medications approved for treating alcohol dependence. For persons addicted to nicotine, a nicotine replacement product (available as patches, gum, lozenges, or nasal spray) or an oral medication (such as bupropion or varenicline) can be an effective component of treatment when part of a comprehensive behavioral treatment program. 8. An individual’s treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs. A patient may require varying combinations of services and treatment components during the course of treatment and recovery. In addition to counseling or psychotherapy, a patient may require medication, medical services, family therapy, parenting instruction, vocational rehabilitation, and/or social and legal services. For many patients, a continuing care approach provides the best results, with the treatment intensity varying according to a person’s changing needs. 9. Many drug-addicted individuals also have other mental disorders. Because drug abuse and addiction—both of which are mental disorders—often co-occur with other mental illnesses, patients presenting with one condition should be assessed for the other(s). And when these problems co- occur, treatment should address both (or all), including the use of medications as appropriate. 10. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse. Although medically assisted detoxification can safely manage the acute physical symptoms of withdrawal and can, for some, pave the way for effective long-term addiction treatment, detoxification alone is rarely sufficient to help addicted individuals achieve long-term abstinence. Thus, patients should be encouraged to continue drug treatment following detoxification. Motivational enhancement and incentive strategies, begun at initial patient intake, can improve treatment engagement. 11. Treatment does not need to be voluntary to be effective. Sanctions or enticements from family, employment settings, and/or the criminal justice system can significantly increase treatment entry, retention rates, and the ultimate success of drug treatment interventions. 12. Drug use during treatment must be monitored continuously, as lapses during treatment do occur. Knowing their drug use is being monitored can be a powerful incentive for patients and can help them withstand urges to use drugs. Monitoring also provides an early indication of a return to drug use, signaling a possible need to adjust an individual’s treatment plan to better meet his or her needs. 13. Treatment programs should test patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counseling, linking patients to treatment if necessary. Typically, drug abuse treatment addresses some of the drug-related behaviors that put people at risk of infectious diseases. Targeted counseling focused on reducing infectious disease risk can help patients further reduce or avoid substance-related and other high-risk behaviors. Counseling can also help those who are already infected to manage their illness. Moreover, engaging in substance abuse treatment can facilitate adherence to other medical treatments. Substance abuse treatment facilities should provide onsite, rapid HIV testing rather than referrals to offsite testing—research shows that doing so increases the likelihood that patients will be tested and receive their test results. Treatment providers should also inform patients that highly active antiretroviral therapy (HAART) has proven effective in combating HIV, including among drug-abusing populations, and help link them to HIV treatment if they test positive. Frequently Asked QuestionsWhy do drug-addicted persons keep using drugs? Nearly all addicted individuals believe at the outset that they can stop using drugs on their own, and most try to stop without treatment. Although some people are successful, many attempts result in failure to achieve long-term abstinence. Research has shown that long-term drug abuse results in changes in the brain that persist long after a person stops using drugs. These drug-induced changes in brain function can have many behavioral consequences, including an inability to exert control over the impulse to use drugs despite adverse consequences—the defining characteristic of addiction. Understanding that addiction has such a fundamental biological component may help explain the difficulty of achieving and maintaining abstinence without treatment. Psychological stress from work, family problems, psychiatric illness, pain associated with medical problems, social cues (such as meeting individuals from one’s drug-using past), or environmental cues (such as encountering streets, objects, or even smells associated with drug abuse) can trigger intense cravings without the individual even being consciously aware of the triggering event. Any one of these factors can hinder attainment of sustained abstinence and make relapse more likely. Nevertheless, research indicates that active participation in treatment is an essential component for good outcomes and can benefit even the most severely addicted individuals. What is drug addiction treatment?
Drug treatment is intended to help addicted individuals stop compulsive drug seeking and use. Treatment can occur in a variety of settings, take many different forms, and last for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a long-term process that involves multiple interventions and regular monitoring.There are a variety of evidence-based approaches to treating addiction. Drug treatment can include behavioral therapy (such as cognitive-behavioral therapy or contingency management), medications, or their combination. The specific type of treatment or combination of treatments will vary depending on the patient’s individual needs and, often, on the types of drugs they use.
Treatment medications, such as methadone, buprenorphine, and naltrexone (including a new long-acting formulation), are available for individuals addicted to opioids, while nicotine preparations (patches, gum, lozenges, and nasal spray) and the medications varenicline and bupropion are available for individuals addicted to tobacco. Disulfiram, acamprosate, and naltrexone are medications available for treating alcohol dependence, which commonly co-occurs with other drug addictions, including addiction to prescription medications.
Key Takeaways
Drug addiction treatment can include medications, behavioral therapies, or their combination.
Treatments for prescription drug abuse tend to be similar to those for illicit drugs that affect the same brain systems. For example, buprenorphine, used to treat heroin addiction, can also be used to treat addiction to opioid pain medications. Addiction to prescription stimulants, which affect the same brain systems as illicit stimulants like cocaine, can be treated with behavioral therapies, as there are not yet medications for treating addiction to these types of drugs.
Behavioral therapies can help motivate people to participate in drug treatment, offer strategies for coping with drug cravings, teach ways to avoid drugs and prevent relapse, and help individuals deal with relapse if it occurs. Behavioral therapies can also help people improve communication, relationship, and parenting skills, as well as family dynamics.
Many treatment programs employ both individual and group therapies. Group therapy can provide social reinforcement and help enforce behavioral contingencies that promote abstinence and a non- drug-using lifestyle. Some of the more established behavioral treatments, such as contingency management and cognitive-behavioral therapy, are also being adapted for group settings to improve efficiency and cost-effectiveness. However, particularly in adolescents, there can also be a danger of unintended harmful (or iatrogenic) effects of group treatment—sometimes group members (especially groups of highly delinquent youth) can reinforce drug use and thereby derail the purpose of the therapy. Thus, trained counselors should be aware of and monitor for such effects.
Because they work on different aspects of addiction, combinations of behavioral therapies and medications (when available) generally appear to be more effective than either approach used alone. Finally, people who are addicted to drugs often suffer from other health (e.g., depression, HIV), occupational, legal, familial, and social problems that should be addressed concurrently. The best programs provide a combination of therapies and other services to meet an individual patient’s needs. Psychoactive medications, such as antidepressants, anti-anxiety agents, mood stabilizers, and antipsychotic medications, may be critical for treatment success when patients have co-occurring mental disorders such as depression, anxiety disorders (including post-traumatic stress disorder), bipolar disorder, or schizophrenia. In addition, most people with severe addiction abuse multiple drugs and require treatment for all substances abused.
Treatment for drug abuse and addiction is delivered in many different settings, using a variety of behavioral and pharmacological approaches.
How effective is drug addiction treatment?
In addition to stopping drug abuse, the goal of treatment is to return people to productive functioning in the family, workplace, and community. According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning. For example, methadone treatment has been shown to increase participation in behavioral therapy and decrease both drug use and criminal behavior. However, individual treatment outcomes depend on the extent and nature of the patient’s problems, the appropriateness of treatment and related services used to address those problems, and the quality of interaction between the patient and his or her treatment providers.
Like other chronic diseases, addiction can be managed successfully. Treatment enables people to counteract addiction’s powerful disruptive effects on the brain and behavior and to regain control of their lives. The chronic nature of the disease means that relapsing to drug abuse is not only possible but also likely, with symptom recurrence rates similar to those for other well-characterized chronic medical illnesses—such as diabetes, hypertension, and asthma (see figure, “Comparison of Relapse Rates Between Drug Addiction and Other Chronic Illnesses”)—that also have both physiological and behavioral components.
Unfortunately, when relapse occurs many deem treatment a failure. This is not the case: Successful treatment for addiction typically requires continual evaluation and modification as appropriate, similar to the approach taken for other chronic diseases. For example, when a patient is receiving active treatment for hypertension and symptoms decrease, treatment is deemed successful, even though symptoms may recur when treatment is discontinued. For the addicted individual, lapses to drug abuse do not indicate failure—rather, they signify that treatment needs to be reinstated or adjusted, or that alternate treatment is needed (see figure, “Why is Addiction Treatment Evaluated Differently?”).
Is drug addiction treatment worth its cost?
Substance abuse costs our nation over \$600 billion annually and treatment can help reduce these costs. Drug addiction treatment has been shown to reduce associated health and social costs by far more than the cost of the treatment itself. Treatment is also much less expensive than its alternatives, such as incarcerating addicted persons. For example, the average cost for 1 full year of methadone maintenance treatment is approximately \$4,700 per patient, whereas 1 full year of imprisonment costs approximately \$24,000 per person.
According to several conservative estimates, every dollar invested in addiction treatment programs yields a return of between \$4 and \$7 in reduced drug-related crime, criminal justice costs, and theft. When savings related to healthcare are included, total savings can exceed costs by a ratio of 12 to 1. Major savings to the individual and to society also stem from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths.
How long does drug addiction treatment usually last?
Individuals progress through drug addiction treatment at various rates, so there is no predetermined length of treatment. However, research has shown unequivocally that good outcomes are contingent on adequate treatment length. Generally, for residential or outpatient treatment, participation for less than 90 days is of limited effectiveness, and treatment lasting significantly longer is recommended for maintaining positive outcomes. For methadone maintenance, 12 months is considered the minimum, and some opioid-addicted individuals continue to benefit from methadone maintenance for many years.
Treatment dropout is one of the major problems encountered by treatment programs; therefore, motivational techniques that can keep patients engaged will also improve outcomes. By viewing addiction as a chronic disease and offering continuing care and monitoring, programs can succeed, but this will often require multiple episodes of treatment and readily readmitting patients that have relapsed.
What helps people stay in treatment?
Because successful outcomes often depend on a person’s staying in treatment long enough to reap its full benefits, strategies for keeping people in treatment are critical. Whether a patient stays in treatment depends on factors associated with both the individual and the program. Individual factors related to engagement and retention typically include motivation to change drug-using behavior; degree of support from family and friends; and, frequently, pressure from the criminal justice system, child protection services, employers, or family. Within a treatment program, successful clinicians can establish a positive, therapeutic relationship with their patients. The clinician should ensure that a treatment plan is developed cooperatively with the person seeking treatment, that the plan is followed, and that treatment expectations are clearly understood. Medical, psychiatric, and social services should also be available.
Key Takeaways
Whether a patient stays in treatment depends on factors associated with both the individual and the program.
Because some problems (such as serious medical or mental illness or criminal involvement) increase the likelihood of patients dropping out of treatment, intensive interventions may be required to retain them. After a course of intensive treatment, the provider should ensure a transition to less intensive continuing care to support and monitor individuals in their ongoing recovery.
How do we get more substance-abusing people into treatment?
It has been known for many years that the “treatment gap” is massive—that is, among those who need treatment for a substance use disorder, few receive it. In 2011, 21.6 million persons aged 12 or older needed treatment for an illicit drug or alcohol use problem, but only 2.3 million received treatment at a specialty substance abuse facility.
Reducing this gap requires a multipronged approach. Strategies include increasing access to effective treatment, achieving insurance parity (now in its earliest phase of implementation), reducing stigma, and raising awareness among both patients and healthcare professionals of the value of addiction treatment. To assist physicians in identifying treatment need in their patients and making appropriate referrals, NIDA is encouraging widespread use of screening, brief intervention, and referral to treatment (SBIRT) tools for use in primary care settings through its NIDAMED initiative. SBIRT, which evidence shows to be effective against tobacco and alcohol use—and, increasingly, against abuse of illicit and prescription drugs—has the potential not only to catch people before serious drug problems develop, but also to identify people in need of treatment and connect them with appropriate treatment providers.
How can family and friends make a difference in the life of someone needing treatment?
Family and friends can play critical roles in motivating individuals with drug problems to enter and stay in treatment. Family therapy can also be important, especially for adolescents. Involvement of a family member or significant other in an individual’s treatment program can strengthen and extend treatment benefits.
How can the workplace play a role in substance abuse treatment?
Many workplaces sponsor Employee Assistance Programs (EAPs) that offer short-term counseling and/or assistance in linking employees with drug or alcohol problems to local treatment resources, including peer support/recovery groups. In addition, therapeutic work environments that provide employment for drug-abusing individuals who can demonstrate abstinence have been shown not only to promote a continued drug-free lifestyle but also to improve job skills, punctuality, and other behaviors necessary for active employment throughout life. Urine testing facilities, trained personnel, and workplace monitors are needed to implement this type of treatment.
What role can the criminal justice system play in addressing drug addiction?
It is estimated that about one-half of State and Federal prisoners abuse or are addicted to drugs, but relatively few receive treatment while incarcerated. Initiating drug abuse treatment in prison and continuing it upon release is vital to both individual recovery and to public health and safety. Various studies have shown that combining prison- and community-based treatment for addicted offenders reduces the risk of both recidivism to drug-related criminal behavior and relapse to drug use—which, in turn, nets huge savings in societal costs. A 2009 study in Baltimore, Maryland, for example, found that opioid-addicted prisoners who started methadone treatment (along with counseling) in prison and then continued it after release had better outcomes (reduced drug use and criminal activity) than those who only received counseling while in prison or those who only started methadone treatment after their release.
Key Takeaways
Individuals who enter treatment under legal pressure have outcomes as favorable as those who enter treatment voluntarily.
The majority of offenders involved with the criminal justice system are not in prison but are under community supervision. For those with known drug problems, drug addiction treatment may be recommended or mandated as a condition of probation. Research has demonstrated that individuals who enter treatment under legal pressure have outcomes as favorable as those who enter treatment voluntarily.
The criminal justice system refers drug offenders into treatment through a variety of mechanisms, such as diverting nonviolent offenders to treatment; stipulating treatment as a condition of incarceration, probation, or pretrial release; and convening specialized courts, or drug courts, that handle drug offense cases. These courts mandate and arrange for treatment as an alternative to incarceration, actively monitor progress in treatment, and arrange for other services for drug-involved offenders.
The most effective models integrate criminal justice and drug treatment systems and services. Treatment and criminal justice personnel work together on treatment planning—including implementation of screening, placement, testing, monitoring, and supervision—as well as on the systematic use of sanctions and rewards. Treatment for incarcerated drug abusers should include continuing care, monitoring, and supervision after incarceration and during parole. Methods to achieve better coordination between parole/probation officers and health providers are being studied to improve offender outcomes.
What are the unique needs of women with substance use disorders?
Gender-related drug abuse treatment should attend not only to biological differences but also to social and environmental factors, all of which can influence the motivations for drug use, the reasons for seeking treatment, the types of environments where treatment is obtained, the treatments that are most effective, and the consequences of not receiving treatment. Many life circumstances predominate in women as a group, which may require a specialized treatment approach. For example, research has shown that physical and sexual trauma followed by post-traumatic stress disorder (PTSD) is more common in drug-abusing women than in men seeking treatment. Other factors unique to women that can influence the treatment process include issues around how they come into treatment (as women are more likely than men to seek the assistance of a general or mental health practitioner), financial independence, and pregnancy and child care.
What are the unique needs of pregnant women with substance use disorders?
Using drugs, alcohol, or tobacco during pregnancy exposes not just the woman but also her developing fetus to the substance and can have potentially deleterious and even long-term effects on exposed children. Smoking during pregnancy can increase risk of stillbirth, infant mortality, sudden infant death syndrome, preterm birth, respiratory problems, slowed fetal growth, and low birth weight. Drinking during pregnancy can lead to the child developing fetal alcohol spectrum disorders, characterized by low birth weight and enduring cognitive and behavioral problems.
Prenatal use of some drugs, including opioids, may cause a withdrawal syndrome in newborns called neonatal abstinence syndrome (NAS). Babies with NAS are at greater risk of seizures, respiratory problems, feeding difficulties, low birth weight, and even death.
Research has established the value of evidence-based treatments for pregnant women (and their babies), including medications. For example, although no medications have been FDA-approved to treat opioid dependence in pregnant women, methadone maintenance combined with prenatal care and a comprehensive drug treatment program can improve many of the detrimental outcomes associated with untreated heroin abuse. However, newborns exposed to methadone during pregnancy still require treatment for withdrawal symptoms. Recently, another medication option for opioid dependence, buprenorphine, has been shown to produce fewer NAS symptoms in babies than methadone, resulting in shorter infant hospital stays. In general, it is important to closely monitor women who are trying to quit drug use during pregnancy and to provide treatment as needed.
What are the unique needs of adolescents with substance use disorders?
Adolescent drug abusers have unique needs stemming from their immature neurocognitive and psychosocial stage of development. Research has demonstrated that the brain undergoes a prolonged process of development and refinement from birth through early adulthood. Over the course of this developmental period, a young person’s actions go from being more impulsive to being more reasoned and reflective. In fact, the brain areas most closely associated with aspects of behavior such as decision-making, judgment, planning, and self-control undergo a period of rapid development during adolescence and young adulthood.
Adolescent drug abuse is also often associated with other co-occurring mental health problems. These include attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct problems, as well as depressive and anxiety disorders.
Adolescents are also especially sensitive to social cues, with peer groups and families being highly influential during this time. Therefore, treatments that facilitate positive parental involvement, integrate other systems in which the adolescent participates (such as school and athletics), and recognize the importance of prosocial peer relationships are among the most effective. Access to comprehensive assessment, treatment, case management, and family-support services that are developmentally, culturally, and gender-appropriate is also integral when addressing adolescent addiction.
Medications for substance abuse among adolescents may in certain cases be helpful. Currently, the only addiction medications approved by FDA for people under 18 are over-the-counter transdermal nicotine skin patches, chewing gum, and lozenges (physician advice should be sought first).
Buprenorphine, a medication for treating opioid addiction that must be prescribed by specially trained physicians, has not been approved for adolescents, but recent research suggests it could be effective for those as young as 16. Studies are underway to determine the safety and efficacy of this and other medications for opioid-, nicotine-, and alcohol-dependent adolescents and for adolescents with co-occurring disorders.
Are there specific drug addiction treatments for older adults?
With the aging of the baby boomer generation, the composition of the general population is changing dramatically with respect to the number of older adults. Such a change, coupled with a greater history of lifetime drug use (than previous older generations), different cultural norms and general attitudes about drug use, and increases in the availability of psychotherapeutic medications, is already leading to greater drug use by older adults and may increase substance use problems in this population.
While substance abuse in older adults often goes unrecognized and therefore untreated, research indicates that currently available addiction treatment programs can be as effective for them as for younger adults.
Can a person become addicted to medications prescribed by a doctor?
Yes. People who abuse prescription drugs—that is, taking them in a manner or a dose other than prescribed, or taking medications prescribed for another person—risk addiction and other serious health consequences. Such drugs include opioid pain relievers, stimulants used to treat ADHD, and benzodiazepines to treat anxiety or sleep disorders. Indeed, in 2010, an estimated 2.4 million people 12 or older met criteria for abuse of or dependence on prescription drugs, the second most common illicit drug use after marijuana. To minimize these risks, a physician (or other prescribing health provider) should screen patients for prior or current substance abuse problems and assess their family history of substance abuse or addiction before prescribing a psychoactive medication and monitor patients who are prescribed such drugs. Physicians also need to educate patients about the potential risks so that they will follow their physician’s instructions faithfully, safeguard their medications, and dispose of them appropriately.
Is there a difference between physical dependence and addiction?
Yes. Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal. The latter reflect physical dependence in which the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). Physical dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed. Thus, physical dependence in and of itself does not constitute addiction, but it often accompanies addiction. This distinction can be difficult to discern, particularly with prescribed pain medications, for which the need for increasing dosages can represent tolerance or a worsening underlying problem, as opposed to the beginning of abuse or addiction.
How do other mental disorders coexisting with drug addiction affect drug addiction treatment?
Drug addiction is a disease of the brain that frequently occurs with other mental disorders. In fact, as many as 6 in 10 people with an illicit substance use disorder also suffer from another mental illness; and rates are similar for users of licit drugs—i.e., tobacco and alcohol. For these individuals, one condition becomes more difficult to treat successfully as an additional condition is intertwined. Thus, people entering treatment either for a substance use disorder or for another mental disorder should be assessed for the co-occurrence of the other condition. Research indicates that treating both (or multiple) illnesses simultaneously in an integrated fashion is generally the best treatment approach for these patients.
Is the use of medications like methadone and buprenorphine simply replacing one addiction with another?
No. Buprenorphine and methadone are prescribed or administered under monitored, controlled conditions and are safe and effective for treating opioid addiction when used as directed. They are administered orally or sublingually (i.e., under the tongue) in specified doses, and their effects differ from those of heroin and other abused opioids.
Heroin, for example, is often injected, snorted, or smoked, causing an almost immediate “rush,” or brief period of intense euphoria, that wears off quickly and ends in a “crash.” The individual then experiences an intense craving to use the drug again to stop the crash and reinstate the euphoria.
The cycle of euphoria, crash, and craving—sometimes repeated several times a day—is a hallmark of addiction and results in severe behavioral disruption. These characteristics result from heroin’s rapid onset and short duration of action in the brain.
In contrast, methadone and buprenorphine have gradual onsets of action and produce stable levels of the drug in the brain. As a result, patients maintained on these medications do not experience a rush, while they also markedly reduce their desire to use opioids.
If an individual treated with these medications tries to take an opioid such as heroin, the euphoric effects are usually dampened or suppressed. Patients undergoing maintenance treatment do not experience the physiological or behavioral abnormalities from rapid fluctuations in drug levels associated with heroin use. Maintenance treatments save lives—they help to stabilize individuals, allowing treatment of their medical, psychological, and other problems so they can contribute effectively as members of families and of society.
Where do 12-step or self-help programs fit into drug addiction treatment?
Self-help groups can complement and extend the effects of professional treatment. The most prominent self-help groups are those affiliated with Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Cocaine Anonymous (CA), all of which are based on the 12-step model. Most drug addiction treatment programs encourage patients to participate in self-help group therapy during and after formal treatment. These groups can be particularly helpful during recovery, offering an added layer of community-level social support to help people achieve and maintain abstinence and other healthy lifestyle behaviors over the course of a lifetime.
Can exercise play a role in the treatment process?
Yes. Exercise is increasingly becoming a component of many treatment programs and has proven effective, when combined with cognitive-behavioral therapy, at helping people quit smoking. Exercise may exert beneficial effects by addressing psychosocial and physiological needs that nicotine replacement alone does not, by reducing negative feelings and stress, and by helping prevent weight gain following cessation. Research to determine if and how exercise programs can play a similar role in the treatment of other forms of drug abuse is under way.
How does drug addiction treatment help reduce the spread of HIV/AIDS, Hepatitis C (HCV), and other infectious diseases?
Drug-abusing individuals, including injecting and non-injecting drug users, are at increased risk of human immunodeficiency virus (HIV), hepatitis C virus (HCV), and other infectious diseases. These diseases are transmitted by sharing contaminated drug injection equipment and by engaging in risky sexual behavior sometimes associated with drug use. Effective drug abuse treatment is HIV/HCV prevention because it reduces activities that can spread disease, such as sharing injection equipment and engaging in unprotected sexual activity. Counseling that targets a range of HIV/HCV risk behaviors provides an added level of disease prevention.
Drug abuse treatment is HIV and HCV prevention.
Injection drug users who do not enter treatment are up to six times more likely to become infected with HIV than those who enter and remain in treatment. Participation in treatment also presents opportunities for HIV screening and referral to early HIV treatment. In fact, recent research from NIDA’s National Drug Abuse Treatment Clinical Trials Network showed that providing rapid onsite HIV testing in substance abuse treatment facilities increased patients’ likelihood of being tested and of receiving their test results. HIV counseling and testing are key aspects of superior drug abuse treatment programs and should be offered to all individuals entering treatment. Greater availability of inexpensive and unobtrusive rapid HIV tests should increase access to these important aspects of HIV prevention and treatment.
Drug addiction is a complex disorder that can involve virtually every aspect of an individual’s functioning—in the family, at work and school, and in the community.
Because of addiction’s complexity and pervasive consequences, drug addiction treatment typically must involve many components. Some of those components focus directly on the individual’s drug use; others, like employment training, focus on restoring the addicted individual to productive membership in the family and society (See diagram “Components of Comprehensive Drug AbuseTreatment“), enabling him or her to experience the rewards associated with abstinence.
Treatment for drug abuse and addiction is delivered in many different settings using a variety of behavioral and pharmacological approaches. In the United States, more than 14,500 specialized drug treatment facilities provide counseling, behavioral therapy, medication, case management, and other types of services to persons with substance use disorders.
Along with specialized drug treatment facilities, drug abuse and addiction are treated in physicians’ offices and mental health clinics by a variety of providers, including counselors, physicians, psychiatrists, psychologists, nurses, and social workers. Treatment is delivered in outpatient, inpatient, and residential settings. Although specific treatment approaches often are associated with particular treatment settings, a variety of therapeutic interventions or services can be included in any given setting.
Because drug abuse and addiction are major public health problems, a large portion of drug treatment is funded by local, State, and Federal governments. Private and employer-subsidized health plans also may provide coverage for treatment of addiction and its medical consequences. Unfortunately, managed care has resulted in shorter average stays, while a historical lack of or insufficient coverage for substance abuse treatment has curtailed the number of operational programs. The recent passage of parity for insurance coverage of mental health and substance abuse problems will hopefully improve this state of affairs. Health Care Reform (i.e., the Patient Protection and Affordable Care Act of 2010, “ACA”) also stands to increase the demand for drug abuse treatment services and presents an opportunity to study how innovations in service delivery, organization, and financing can improve access to and use of them.
Types of Treatment Programs
Research studies on addiction treatment typically have classified programs into several general types or modalities. Treatment approaches and individual programs continue to evolve and diversify, and many programs today do not fit neatly into traditional drug addiction treatment classifications.
Most, however, start with detoxification and medically managed withdrawal, often considered the first stage of treatment. Detoxification, the process by which the body clears itself of drugs, is designed to manage the acute and potentially dangerous physiological effects of stopping drug use. As stated previously, detoxification alone does not address the psychological, social, and behavioral problems associated with addiction and therefore does not typically produce lasting behavioral changes necessary for recovery. Detoxification should thus be followed by a formal assessment and referral to drug addiction treatment.
Because it is often accompanied by unpleasant and potentially fatal side effects stemming from withdrawal, detoxification is often managed with medications administered by a physician in an inpatient or outpatient setting; therefore, it is referred to as “medically managed withdrawal.” Medications are available to assist in the withdrawal from opioids, benzodiazepines, alcohol, nicotine, barbiturates, and other sedatives.
Long-Term Residential Treatment
Long-term residential treatment provides care 24 hours a day, generally in non-hospital settings. The best-known residential treatment model is the therapeutic community (TC), with planned lengths of stay of between 6 and 12 months. TCs focus on the “resocialization” of the individual and use the program’s entire community—including other residents, staff, and the social context—as active components of treatment. Addiction is viewed in the context of an individual’s social and psychological deficits, and treatment focuses on developing personal accountability and responsibility as well as socially productive lives. Treatment is highly structured and can be confrontational at times, with activities designed to help residents examine damaging beliefs, self-concepts, and destructive patterns of behavior and adopt new, more harmonious and constructive ways to interact with others.
Many TCs offer comprehensive services, which can include employment training and other support services, onsite. Research shows that TCs can be modified to treat individuals with special needs, including adolescents, women, homeless individuals, people with severe mental disorders, and individuals in the criminal justice system.
Short-Term Residential Treatment
Short-term residential programs provide intensive but relatively brief treatment based on a modified 12-step approach. These programs were originally designed to treat alcohol problems, but during the cocaine epidemic of the mid-1980s, many began to treat other types of substance use disorders. The original residential treatment model consisted of a 3- to 6-week hospital-based inpatient treatment phase followed by extended outpatient therapy and participation in a self-help group, such as AA. Following stays in residential treatment programs, it is important for individuals to remain engaged in outpatient treatment programs and/or aftercare programs. These programs help to reduce the risk of relapse once a patient leaves the residential setting.
Outpatient Treatment Programs
Outpatient treatment varies in the types and intensity of services offered. Such treatment costs less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social supports. It should be noted, however, that low-intensity programs may offer little more than drug education. Other outpatient models, such as intensive day treatment, can be comparable to residential programs in services and effectiveness, depending on the individual patient’s characteristics and needs. In many outpatient programs, group counseling can be a major component. Some outpatient programs are also designed to treat patients with medical or other mental health problems in addition to their drug disorders.
Individualized Drug Counseling
Individualized drug counseling not only focuses on reducing or stopping illicit drug or alcohol use; it also addresses related areas of impaired functioning—such as employment status, illegal activity, and family/social relations—as well as the content and structure of the patient’s recovery program.
Through its emphasis on short-term behavioral goals, individualized counseling helps the patient develop coping strategies and tools to abstain from drug use and maintain abstinence. The addiction counselor encourages 12-step participation (at least one or two times per week) and makes referrals for needed supplemental medical, psychiatric, employment, and other services.
Group Counseling
Many therapeutic settings use group therapy to capitalize on the social reinforcement offered by peer discussion and to help promote drug-free lifestyles. Research has shown that when group therapy either is offered in conjunction with individualized drug counseling or is formatted to reflect the principles of cognitive-behavioral therapy or contingency management, positive outcomes are achieved. Currently, researchers are testing conditions in which group therapy can be standardized and made more community-friendly.
Treating Criminal Justice-Involved Drug Abusers and Addicted Individuals
Often, drug abusers come into contact with the criminal justice system earlier than other health or social systems, presenting opportunities for intervention and treatment prior to, during, after, or in lieu of incarceration. Research has shown that combining criminal justice sanctions with drug treatment can be effective in decreasing drug abuse and related crime. Individuals under legal coercion tend to stay in treatment longer and do as well as or better than those not under legal pressure. Studies show that for incarcerated individuals with drug problems, starting drug abuse treatment in prison and continuing the same treatment upon release—in other words, a seamless continuum of services—results in better outcomes: less drug use and less criminal behavior. More information on how the criminal justice system can address the problem of drug addiction can be found in Principles of Drug Abuse Treatment for Criminal Justice Populations: A Research-Based Guide (National Institute on Drug Abuse, revised 2012).
Key Takeaways
• Drug addiction can be treated, but it’s not simple. Addiction treatment must help the person do the following:
• stop using drugs
• stay drug-free
• be productive in the family, at work, and in society
• Successful treatment has several steps:
• detoxification
• behavioral counseling
• medication (for opioid, tobacco, or alcohol addiction)
• evaluation and treatment for co-occurring mental health issues such as depression and anxiety
• long-term follow-up to prevent relapse
• Medications and devices can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.
• Behavioral therapies help patients
• modify their attitudes and behaviors related to drug use
• increase healthy life skills
• persist with other forms of treatment, such as medication
• People within the criminal justice system may need additional treatment services to treat drug use disorders effectively. However, many offenders don’t have access to the types of services they need.
SAMHSA Guide to MAT Medications, Counseling, and Related Conditions
Medication-Assisted Treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies , to provide a “whole-patient” approach to the treatment of substance use disorders. It is also important to address other health conditions during treatment.
MAT Medications
The Food and Drug Administration (FDA) has approved several different medications to treat alcohol and opioid use disorders MAT medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. Medications used for MAT are evidence-based treatment options and do not just substitute one drug for another.
Methadone used to treat those with a confirmed diagnosis of Opioid Use Disorder can only be dispensed through a SAMHSA certified OTP. Some of the medications used in MAT are controlled substances due to their potential for misuse. Drugs, substances, and certain chemicals used to make drugs are classified by the Drug Enforcement Administration (DEA) into five distinct categories, or schedules, depending upon a drug’s acceptable medical use and potential for misuse. Learn more about DEA drug schedules.
Alcohol Use Disorder Medications – Acamprosate, disulfiram, and naltrexone are the most common drugs used to treat alcohol use disorder. They do not provide a cure for the disorder but are most effective in people who participate in a MAT program.
• Acamprosate – is for people in recovery, who are no longer drinking alcohol and want to avoid drinking. It works to prevent people from drinking alcohol, but it does not prevent withdrawal symptoms after people drink alcohol. It has not been shown to work in people who continue drinking alcohol, consume illicit drugs, and/or engage in prescription drug misuse and abuse. The use of acamprosate typically begins on the fifth day of abstinence, reaching full effectiveness in five to eight days. It is offered in tablet form and taken three times a day, preferably at the same time every day. The medication’s side effects may include diarrhea, upset stomach, appetite loss, anxiety, dizziness, and difficulty sleeping.
• Disulfiram – treats chronic alcoholism and is most effective in people who have already gone through detoxification or are in the initial stage of abstinence. Offered in a tablet form and taken once a day, disulfiram should never be taken while intoxicated and it should not be taken for at least 12 hours after drinking alcohol. Unpleasant side effects (nausea, headache, vomiting, chest pains, difficulty breathing) can occur as soon as ten minutes after drinking even a small amount of alcohol and can last for an hour or more.
• Naltrexone – blocks the euphoric effects and feelings of intoxication and allows people with alcohol use disorders to reduce alcohol use and to remain motivated to continue to take the medication, stay in treatment, and avoid relapses.
To learn more about MAT for alcohol use disorders view Medication for the Treatment of Alcohol Use Disorder: A Brief Guide – 2015 and TIP 49: Incorporating Alcohol Pharmacotherapies Into Medical Practice.
Opioid Dependency Medications – Buprenorphine, methadone, and naltrexone are used to treat opioid use disorders to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. These MAT medications are safe to use for months, years, or even a lifetime. As with any medication, consult your doctor before discontinuing use.
• Buprenorphine – suppresses and reduces cravings for opioids. Learn more about buprenorphine.
• Methadone – reduces opioid cravings and withdrawal and blunts or blocks the effects of opioids. Learn more about methadone.
• Naltrexone – blocks the euphoric and sedative effects of opioids and prevents feelings of euphoria. Learn more about naltrexone.
Opioid Overdose Prevention Medication – Naloxone saves lives by reversing the toxic effects of overdose. According to the World Health Organization (WHO), naloxone is one of a number of medications considered essential to a functioning health care system.
• Naloxone – used to prevent opioid overdose, naloxone reverses the toxic effects of the overdose. Learn more about Naloxone.
Counseling and Behavioral Therapies
Under federal law 42.CFR 8.12, MAT patients receiving treatment in OTPs must receive counseling, which may include different forms of behavioral therapy. These services are required along with medical, vocational, educational, and other assessment and treatment services. Learn more about these treatments for substance use disorders.
Regardless of what setting MAT is provided in, it is more effective when counseling and other behavioral health therapies are included to provide patients with a whole-person approach.
Co-Occurring Disorders and Other Health Conditions
The coexistence of both a substance use disorder and a mental illness, known as a co-occurring disorder, is common among people in MAT. In addition, individuals may have other health-related conditions such as hepatitis, HIV and AIDS. Learn more about co-occurring disorders and other health conditions.
Case Management in Addiction
Case management is a coordinated, intentional approach to delivering quality services (SAMHSA, 2015). It requires cooperation among multiple agencies and professionals, awareness of the multifaceted needs of clients, and purposeful collaboration between counselor and client.
In many ways, all addiction professionals take on the role of case manager. This includes doctors, nurses, social workers, licensed counselors, and certified addictions counselors. The reason for this distinction is because of the range of “whole-person” issues discussed throughout this book. Substance use disorder is a primary diagnosis, but it is not an isolated one.
SAMHSA developed a series of treatment improvement protocol manuals (TIPs) designed to provide professionals with expert guidance, and they devoted an entire manual to the importance of case management services (TIP 27). Included in the manual is an overview of the skills that case managers in substance abuse treatment settings need to have:
• Understanding various models and theories of addiction and other problems related to substance abuse
• Ability to describe the philosophies, practices, policies, and outcomes of the most generally accepted and scientifically supported models of treatment, recovery, relapse prevention, and continuing care for addiction and other substance-related problems
• Ability to recognize the importance of family, social networks, community systems, and self-help groups in the treatment and recovery process
• Understanding the variety of insurance and health maintenance options available and the importance of helping clients access those benefits
• Understanding diverse cultures and incorporating the relevant needs of culturally diverse groups, as well as people with disabilities, into clinical practice
• Understanding the value of an interdisciplinary approach to addiction treatment
Chapter Quiz
An interactive or media element has been excluded from this version of the text. You can view it online here:
https://cod.pressbooks.pub/addiction/?p=50
Screening and Assessment Tools Chart
Tool Substance type Patient age How tool is administered
Alcohol Drugs Adults Adolescents Self-
administered
Clinician-
administered
Screens
Screening to Brief Intervention (S2BI) X X X X X
Brief Screener for Alcohol, Tobacco, and other Drugs (BSTAD) X X X X X
Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) X X X X X
NIDA Drug Use Screening Tool: Quick Screen (NMASSIST) X X X X
Alcohol Use Disorders Identification Test-C (AUDIT-C (PDF, 41KB)) X X X X
Alcohol Use Disorders Identification Test (AUDIT (PDF, 233KB)) X X X
Opioid Risk Tool (PDF, 168KB) X X X
CAGE-AID (PDF, 30KB) X X X X
CAGE (PDF, 14KB)(link is external) X X X
Helping Patients Who Drink Too Much: A Clinician’s Guide (NIAAA) X X X
Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide (NIAAA) X X X
Assessments
Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) X X X X X
CRAFFT(link is external) X X X X X
Drug Abuse Screen Test (DAST-10)*
For use of this tool – please contact Dr. Harvey Skinner(link sends email)
X X X X
Drug Abuse Screen Test (DAST-20: Adolescent version)*
For use of this tool – please contact Dr. Harvey Skinner(link sends email)
X X X X
NIDA Drug Use Screening Tool (NMASSIST) X X X X
Helping Patients Who Drink Too Much: A Clinician’s Guide (NIAAA) X X X
Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide (NIAAA) X X X
DSM-5 Criteria for Substance Use Disorder
1. The substance is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful effort to cut down or control use of the substance.
3. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
4. Craving, or a strong desire or urge to use the substance, occurs.
5. Recurrent use of the substance results in a failure to fulfill major role obligations at work, school, or home.
6. Use of the substance continues despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use.
7. Important social, occupational, or recreational activities are given up or reduced because of use of the substance.
8. Use of the substance is recurrent in situations in which it is physically hazardous.
9. Use of the substance is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
10. Tolerance, as defined by either of the following:
1. A need for markedly increased amounts of the substance to achieve intoxication or desired effect
2. A markedly diminished effect with continued use of the same amount of the substance.
11. Withdrawal, as manifested by either of the following:
1. The characteristic withdrawal syndrome for that substance (as specified in the DSM-5 for each substance).
2. The use of a substance (or a closely related substance) to relieve or avoid withdrawal symptoms.
The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations
Sean M. Robinson and Bryon Adinoff
Behav. Sci. 2016, 6, 18; doi:10.3390/bs6030018
Published August 2016
Abstract: This article provides an overview of the history of substance use and misuse and chronicles the long shared history humans have had with psychoactive substances, including alcohol. The practical and personal functions of substances and the prevailing views of society towards substance users are described for selected historical periods and within certain cultural contexts. This article portrays how the changing historical and cultural milieu influences the prevailing medical, moral, and legal conceptualizations of substance use as reflected both in popular opinion and the consensus of the scientific community and represented by the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM). Finally, this article discusses the efforts to classify substance use disorders (SUDs) and associated psychopathology in the APA compendium. Controversies both lingering and resolved in the field are discussed, and implications for the future of SUD diagnoses are identified.
1. Introduction
Today, the Diagnostic and Statistical Manual of Mental Disorders (DSM) is regarded as the defining standard for mental health diagnoses (including substance use disorders (SUDs)) in America and increasingly abroad. While the fact that the DSM identifies SUDs as primary mental health disorders may be taken for granted today, it is noteworthy that SUDs were, prior to the third publication of the DSM (1980), largely conceptualized as manifestations of underlying primary psychopathology [1]. Thus, a large paradigm shift in SUD nosology is apparent in less than half a century’s time. Taking an even longer perspective reveals that, although psychoactive substances (including alcohol) have been around for nearly as long as recorded history, the scientific classification of SUDs only began in the early 19th century. Taken together, these observations suggest that the complex relationships human societies have had with substances over time may provide a rich and valuable backdrop of contextual and conceptual considerations for the eventual rise of nosological science. While it is beyond the scope of this article to provide a well-rounded historical account of the complex history of substance use in its entirety, the general purpose is to provide a historical framework by which the reader can contextualize and therefore better understand those influences which have shaped development of the DSM nosology of SUDs. Because the development of the DSM is singularly tied to cultural and historical developments in both Europe and the United States of America (i.e., “US”, “American”), this review takes a decidedly Western-oriented outlook on modern nosology and focuses almost exclusively on the American classification system (i.e., that which is associated with the American Psychiatric Association [APA]). Also of note: consistent with the most recent DSM, this manuscript generally uses the terminology “substance use disorder(s)” to refer to a superordinate category which is comprised of a number of singular disorders (e.g., alcohol use disorder (AUD), cannabis use disorder, etc.). In order to most effectively contrast this modern diagnostic label with earlier conceptualizations, this term is often used alongside and in comparison to earlier terms and labels.
First, a relatively brief historical overview of the long and complicated relationships humans have had with substances is provided, including the historical context of both medical and non-medical use preceding the advent of the modern diagnostic system. In order to provide a detailed yet bounded overview, this review focuses on a number of substances (including their pharmacological progenitors and/or descendants), which have, arguably, played more prominent historical roles (i.e., opium, cannabis, alcohol, cocaine). Second, this article provides demonstrative historical examples of the top-down impact that societal factors have had on substance use and substance use conceptualization and also discusses a number of influences (i.e., cultural, industrial, socio-political) which have impacted the development of the APA compendium. Third, the impact of substance use on society today is discussed in terms of substance use-related costs. Finally, following an account of the development of each version of the DSM, a few of the lingering controversies in the field are identified, and future considerations are discussed for SUD diagnoses specifically and for the addiction field as a whole.
2. Historical Considerations: A Long History of Psychoactive Substances
2.1. Opioids
The history of psychoactive drugs is closely entwined with the lives and histories of the humans that cultivated and used them. Likely one of the first drugs known to humans, opium and its derivatives, have been associated with its human cultivators for millennia (for an in-depth review of the history of opium/narcotics, the reader is referred to Davenport-Hines [2] and Booth [3]). Opium itself (which contains the active opioid alkaloids morphine and codeine) is derived from a species of poppy flower, Papaver somniferum (Latin for “sleep inducing poppy”). Knowledge of the effects of opium in the ancient world most likely originated in Egypt, the Balkans, or the Black Sea, and the substance was obtained through relatively simple harvesting and preparation methods. The promulgation of opium throughout Persia, India, China, North Africa, and Spain by Arab traders allowed for the quick spread of the drug throughout the ancient world, leaving behind well-known written records of is properties and uses. One written account believed to reference an opium concoction, known as nepenthe, takes place in Homer’s The Odyssey, where he gives an account of “a drug that had the power of robbing grief and anger of their sting and banishing all painful memories.” This mixture may refer to opium and alcohol, a mixture later known as laudanum. Figure 1 provides additional points of historical reference. Advancing to more recent times, it was in the 19th century that experimentation with morphine for non-nonmedicinal purposes by Europeans increased while physicians concurrently came to recognize the negative effects of the drug—especially with regards to prolonged medical use.
2.2. Cannabis
Evidence of cannabis (a.k.a. marijuana, hemp) use dates back tens of thousands of years in both Europe and Taiwan. For detailed reviews on the history of cannabis, the reader is referred to Abel [24], Earleywine [5], Grinspoon and Bakalar [7], and Lee [9]. Although cannabis originated in Afghanistan, it was cultivated in in Europe, Arabia, France, Asia, and North and South Africa, and its use was common in the cultures comprising the modern day nations of China, Japan, India, and others. The widespread cultivation of the plant was largely due to its ability to make rope and textiles and its fibers, and was purportedly used in the creation of paper in China and Japan in the 2nd and 5th centuries A.D., respectively [25,26]. The popularity of the plant was also due to its use as a medicine; its pain-relieving properties were well known in ancient China and recorded in pharmacopeias dating back to the 1st century A.D. The historical use of cannabis in the treatment of medical illness has also been documented by the ancient people of India, who used cannabis preparations to treat headaches, dysentery, and venereal disease [2]. In ancient China cannabis was used to ease the pain associated with surgery, in Japan it was used to drive away the evil spirits believed to be the cause of illness, and among the ancient Greeks it was believed to be a cure for earaches and to reduce sexual desires [24]. In 17th and 18th century Europe the use of cannabis for its purported antibiotic and analgesic effects became common and it was recognized as a sedative/hallucinogen. In India, cannabis preparations in a variety of forms were used recreationally, including bhang, ganja, and charas (i.e., hashish). As seen in Figure 1, the use of cannabis continued over time, partly as a folk remedy for a number of ailments. While its use as a recreational drug eventually became more widespread, it was not until the mid-19th century that interest in the medicinal properties of the drug once again became popular. In the US around this time, exposure to recreational use of the drug was limited to a relatively small number of individuals [5].
2.3. Cocaine
Although the history of cocaine itself is relatively short compared to the coca plant from which it is derived, both substances have a longstanding place in history (for reviews on the topic, the reader is referred to Davenport-Hines [2] and Karch [27]). Cocaine is one of the alkaloids contained in the leaves of the coca plant (Erythroxylum coca), which has grown wild for thousands of years in what currently comprises the countries Colombia and Bolivia. The alkaloids were used by native peoples in modern-day Peru for thousands of years to reduce hunger and thirst and to increase energy through the chewing of coca leaves. In addition to the functional utility of the leaves, they were also considered sacred by the Peruvian Incas and were used ritualistically in worship of the divine. Because the plant is cultivated under hot and humid tropical climates, it was not grown in Europe until the 1700’s, when heated greenhouses became available. In the mid-19th century, cocaine was isolated as the active ingredient in the coca leaf in Europe and cocaine was extolled by both American pharmaceutical companies as well as some notable figures in the medical community for its non-addictive qualities and its potential usefulness in weaning people off the dangerous “morphine habit” (see Figure 1 for additional selected historical events). Although cocaine is famously known for being included in popular beverages in the late 19th century, the idea of cocaine as a non-addictive panacea-like wonder-drug was short-lived and since then cocaine has been employed with increasing rarity in medicine. Today, it is most commonly used by otolaryngologists as a local anesthetic with vasoconstrictive properties [28,29].
2.4. Alcohol
Alcohol, along with opium, is probably one of the first psychoactive substances used by man and remains one of the most widely used recreational substances. Today, the non-pathological use of alcohol today is typically associated with festivity, leisure, and recreational activities, and history is replete with examples of practical and functional uses of alcohol dating back to antiquity (for detailed explications of this history see Sournia [6], Davenport-Hines [2], and White [8]). Beer and wine, for example, are believed to have been important resources for the Ancient Egyptians, with pictographs from around 4000 BCE depicting Egyptians using the substance for medicine and nutrition as well as for religious and other cultural practices. Consumption of alcohol was also pervasive throughout all segments of ancient Chinese society and its sale also provided major sources of revenue for the empire. The use of alcohol became widespread in a number of religious and cultural practices such that an imperial edict was issued stating that “moderate consumption was a religious obligation” [4]. The word alcohol (from the Arabic word al-kuhl) came to mean an essential property or spirit of something, and the mysterious properties of the substance became associated with transcendental and therefore religious experiences in a number of cultures [6,8]. The association of alcohol with religion and the divine was also common among the ancient Babylonians and the area that is now Greece. With the exception of all but a few Native American and Australian native tribes (for whom alcohol was largely non-existent prior to the arrival of Europeans), alcohol was continually consumed in large quantities throughout much of the known world. In 13th century England, as knowledge of the brewing process spread, ale became both a dietary staple for children and adults alike as well as a commodity for commerce. Alcohol use was also prominent during the renaissance and in beer was a staple of the early economy in America [2].
Along with its functional uses, alcohol was used in the ancient world, as it is today, as an intoxicant. One early account of excessive alcohol intoxication is found in the cult of Dionysus, a religious sect, which held to the idea that intoxication brought worshippers closer to their god. Indeed, consumption of alcohol, particularly wine, was so central to Greek culture that abstinence was frowned upon and wine consumption was considered a civic duty in Athens [2]. Despite the central role of alcohol in Greek society, Greeks promoted moderate drinking and reproached intoxication, with some exceptions. Similar to the Greeks, the Romans also considered wine to be central to their society and placed a high value on moderation. The decline of moderation and the rise of excessive consumption, however, began after the third century BCE, as the Roman Empire continued to spread and eventually began its period of decline [2]. As the influence of the Romans declined, so did the influence of the Christian religion rise. The growing power of the Church would exert an influence over attitudes towards drinking and intoxication for nearly two thousand years. See Figure 1 for additional selected historical events involving alcohol.
3. Cultural and Contextual Considerations
3.1. Societal Influences on Attitudes and Perceptions of Substance Use
Over time, a number of influences (i.e., religious, cultural, industrial, and sociopolitical) can be seen to impact attitudes and perceptions of substance use among both professionals and the laity alike. These attitudes and perceptions, enmeshed with the prevailing cultural zeitgeist of the time, have considerable impact across a number of domains, including interest in and funding towards treatment, the legal status/criminalization of substance users, substance use itself, as well as professional conceptualization and psychiatric nosology. A selected few of these influences are described below.
3.1.1. Religious Influences
Historically speaking, the beliefs and practices of the Christian religion, for one, provided both support for the consumption of wine and also warned against excessive use [4]. Indeed, while the church held largely favorable views regarding the consumption of alcohol in moderation, it also considered over-indulgence to be a sin. According to Hanson [4],
Paul the apostle considered wine to be a creation of God and therefore inherently good and recommended its use for medicinal purposes but condemned intoxication and recommended abstinence for those who could not control their drinking [4] (p. 3).
The Bible itself contains nearly two thousand references to vineyards and wine, and numerous references to drinking that both condemn its use in excess and extoll its virtues in moderation [ 6 ]. As alcohol consumption remained high in colonial America, the abuse of alcohol came to be considered a sin by the church and was increasingly condemned by society [ 8 ]. The temperance movement of the late 19th century, which [ 30 ] describes as one of evangelical “moral absolutes”, left little room for consideration of moderation [ 30 ]. The movement sought to cement its cause in morality and set forth a number of arguments designed to reconcile the absolutist beliefs of the temperance movement with a number of positive references to wine in the bible (e.g., wine’s association with Jesus at the Marriage at Cana, the transfiguration of wine at communion). Although prohibition was enacted and eventually repealed, the characterological and moral problems believed to be associated with the sinful vice of excessive alcohol consumption remained. One sign, perhaps, of the perseverance of such beliefs was the groundswell of the post-prohibition grass-roots self-help group, Alcoholics Anonymous, founded in 1935 on the belief that alcoholism represented a medical disease worthy of professional attention and not societal enmity. The group simultaneously upheld the beliefs that alcoholism was both (a) a medical disease; and (b) that treatment for this disease was best accomplished through a “ moral inventory, confession of personality defects, restitution of those harmed, and the necessity of belief in and dependence upon God ” [ 31 , 32 ]. Today, the organization boasts more than 2 million members worldwide [ 33 ].
3.1.2. Cultural Influences
As the field of mental health has come to recognize that the process of human development is inexorably linked to and fundamentally shaped by the environment in which we are enmeshed, so, too, is the ever-unfolding process of conceptualizing substance use shaped by the habits, beliefs, and traditions of the larger society. Top-down cultural influences can be seen to exert notable effects on substance use and perceptions of substance use, particularly in the 19th century. The culturally bound perception of morphine addiction of the Victorian age, for example, was enmeshed with the highly restrictive sexual attitudes towards women characteristic of the era (the same era in which psychoanalysis rose to prominence). Due to the drugs well-known effect on decreasing libido, for example, opium was often prescribed to women for the treatment of neuroses, hysteria, and hypochondriacal disorders; all of which were linked to sexual desires and frustrations among women [34,35]. Thus, the integration of societal standards regarding female sexuality into the mental health profession and diagnostic nomenclature is representative of the way in which the cultural zeitgeist at any given time can influence, if not directly promote, the misuse of substances. With the decline of the Victorian-era, cultural norms shifted, psychiatric diagnoses were re-conceptualized, and female sexuality became less restrained/is no longer treated in a ubiquitously pathological manner.
3.1.3. Industrialization
The influence of industrialization upon the attitudes and perceptions of substance users is readily apparent as America progressed into the industrial revolution. The rapid change from an agricultural to an industrial economy during this time was largely a result from the establishment of the factory system, where labor was carried out by individuals in a centralized location on a large scale [36]. The already negative view of excessive consumption became magnified as society came to rely heavily upon individual personal characteristics incompatible with intoxication—namely productivity, reliability, and punctuality [4]. This was coupled with a shift in the national zeitgeist towards values consistent with the engine of the new economy, including the accumulation of materials and personal wealth. The growing antipathy surrounding the use of alcohol and substances fueled the conceptualization of the “addict” as an unproductive social outcast. Such views were only strengthened by the concomitant rise of problems typically associated with industrialization and urbanization such as increased crime, poverty, and infant mortality rates [2,4]. Furthermore, the already negative perception of “addicts” became enmeshed with moral judgment; “Addicts were represented as self-tormenting devils lost in eternal damnation . . . plagued by a ‘diseased soul’” [2] (p. 63). The near inexorable link between criminal behavior and substance use had thus been influenced by the economic concerns and industrial needs of the world’s largest burgeoning economy.
The effects of industrialization on substance use were not limited solely to alcohol, wherein excessive consumption was antagonistic to the zeitgeist of the times. Harkening back to the provision of coca leaves by the Spanish Conquistadors to the Peruvian slaves in order to increase mining of silver, the modern day equivalent of the coca leaf, cocaine, was supplied by American industrialists and plantation owners to black construction and plantation workers to increase productivity (see Figure 1). Nonetheless, the association of the drug with racial minorities resulted in racialized, zealous accounts of minorities (i.e., “negro cocaine fiends”) driven mad by the drug, whose use resulted in acts of murder and/or sexual depravity; not surprisingly, public disapproval of the drugs soon followed [2,37]. The propagation of such attitudes of disapproval across various strata of society would play a principal role in criminalization of substance use (including, most notably, the Temperance Movement and Prohibition). The socio-political American Temperance Movement (1817) coincided with the increasing religious and moral condemnation of alcohol use as detrimental to religious ideals and values related to family and society [4].
4. Legality and MoralityRecreational drug use began to be stigmatized as “socially offensive” with records referencing opium as “the pernicious drug” around 1814, and drug users were depicted in medical case studies and referenced as being “incapable of self-control” from a “self-inflicted, self-purchased curse” with “no happy earthly end” [2] (p. 62). Due to the widespread use of narcotic medications to treat wartime injuries, societies around the world found a rise in the number of addicted individuals following the American Civil War (1861–1865), the Austro-Prussian War (1866), and the Franco-Prussian War (1870–1871). Despite the growing moral intolerance of substance users, with the exception of a few US cities in the 1870’s, the possession of drugs for non-medicinal use was not a criminal offense until the early 20th century [5]. Like cocaine, cannabis became highly stigmatized in America due to its association with racial minorities and impoverished workers and, by the mid 1890’s these substances became relegated to the category of “vice” associated with criminals and the lower class. A series of laws were enacted starting in the early 20th century which criminalized the distribution of cocaine [27]. As motor vehicles became increasingly common in American early 20th century, research into the metabolic effects of alcohol on driving impairments increased, and the newfound dangers posed by alcohol intoxication took on additional costs to society [15]. As the temperance movement drew strength in industrialized America, so too did it influence attitudes abroad, with prohibition enacted in Russia (1916–1917), Hungary (1919), Norway (1919–1927), Finland (1919–1932) and the United States (1920–1933), among others [4]. Attitudes towards drug use and the increasing costs to a newly industrialized society resulted in widespread legislation designed to restrict their possession and distribution which in turn resulted in the criminalization of substance use and the entrenched association of addiction with crime, an association which has persisted (even within the mental health field). For over 30 years until its most recent iteration, the DSM has included references to legal problems as part of the criteria for SUDs (see Section 7.2).
5. Modern Developments
5.1. Opioids
In the last several decades, substantial advances in pharmacology have led to the identification of endogenous G-protein coupled opioid receptors and the use of synthetic opioids (e.g., methadone, fentanyl) and opiates (e.g., heroin, oxycodone) has proliferated, greatly increasing the amount of drugs manufactured and distributed in the United States and also abroad [38,39]. Due to their potent analgesic effect, opiate drugs have been increasingly used over the past 20 years by physicians in the treatment of chronic pain. There is a growing acceptance, however, that the long term benefits of opiates for the treatment of chronic pain are limited by analgesic tolerance, worsening of pain, the development of an opioid use disorder in those in whom the opiates were initially prescribed for chronic pain. Additionally, the diversion of prescription opioid medication is believed to have resulted in increased illicit use stemming from the subjective reduction in anxiety, mild sedation, and sense of well-being or euphoria induced by consumption of these drugs [38,39]. In 2010, about 12 million Americans (age 12 or older) reported nonmedical use of prescription painkillers during the past year, with nearly a million emergency department visits associated with prescription painkillers with an associated cost to health insurers of 72.5 billion dollars a year [40]. In 2014, over 18,000 deaths have been attributed to overdose from prescription opioid pain relievers, in addition to those associated with their illicit counterpart, heroin [41]. Today, there is increasing recognition on a national level in the U.S. of the problems associated with overuse of opioids.
5.2. Cannabis
Relatively recent advances in our understanding of the pharmacology of cannabis has led to the identification of its active ingredient, chemicals collectively termed cannabinoids, including tetrahydrocannabinol (THC), the chemical most associated with psychotropic effects [42]. Federal Drug Administration (FDA) approved synthetic cannabinoids are now available for the treatment of nausea/vomiting associated with chemotherapy and weight loss/loss of appetite associated with cancer and HIV/AIDS. The last several decades have also seen an unprecedented rise in physician approved marijuana use for the treatment of medical conditions in a growing number of American states [42]. Despite these advances, in 2014, it is estimated that 22.2 million Americans aged 12 or over were current users of marijuana, with 4.2 million meeting criteria for a marijuana use disorder [43].
5.3. Cocaine
The pharmacological properties of cocaine and related drugs are now well known and its effects on behavior are primarily attributable its effect on the neurotransmitter dopamine [28,44]. Cocaine, coca leaves, and ecgonine are presently listed as Schedule II substances by the Drug Enforcement Administration [45]. In 2014, it is estimated that 1.5 million Americans age 12 or older were current uses of cocaine (including crack cocaine), with 913,000 meeting criteria for a cocaine use disorder [43].
5.4. Alcohol
Alcohol is now largely used as a ritualistic and recreational intoxicant. In contrast to most illicit psychoactive substances, the health consequences of alcohol use are recognized as occurring on a continuum in which the level of potential harm is relative to the amount and pattern of an individual’s consumption. For example, while excessive use of alcohol remains the third preventable leading cause of death in the United States and contributes to over 200 diseases and health related conditions, there is also a growing recognition of the potential benefits of moderate drinking, including decreased risk of diabetes, ischemic stroke, risk heart disease and related mortality [21,46]. In 2014, slightly more than half (52.7 percent) of Americans reported current use of alcohol, with 6.4 percent of people age 12 or older having a past-year AUD [43].
6. Modern Classification of Substance Use Disorders: The DSM
6.1. DSM-I: 1952
After World War II, following the decline of German influence on psychiatric nosology, the center of psychiatry shifted to the United States and the APA commissioned its constituents to create its own psychiatric nosology [11,47]. In 1952 the first DSM (DSM-I) [14] was based upon an expanded nosology used by the United States Army created by psychoanalyst William Menninger (brother to Karl Menninger) [47,48]. Evidence of the influence of psychoanalysis and the psychosocial model in the DSM-I are evident with its observable emphasis on psychoneurosis and functional reactions to environmental stressors [11,47]. The first DSM conceptualized substance use disorder (i.e., “drug addiction” and “alcoholism”) as most commonly arising from a primary personality disorder (see Table 1) [14]. Although DSM-I conceptualized the etiology of substance use disorder as a symptom of a broader underlying disturbance, it did leave some room for exceptions—at least in coding. For example, in the case of alcoholism, the DSM did allow for a primary diagnosis of SUD when “there is a well-established addiction to alcohol without recognizable underlying disorder” [14]. Similarly, for drug addiction, the diagnostic label could be given “while the individual is actually addicted” with the “proper personality classification to be given as an additional diagnosis” [14]. That these exceptions were noteworthy exemptions, and not the rule, however, speaks to the strength of the etiological conceptualization of SUD as being secondary to, or arising from a primary personality disorder.
6.2. DSM-II: 1968
In 1959, only seven years after the publication of DSM-I, major advances in the treatment of mental disorders (i.e., the introduction of effective pharmacologic treatments) occurred in the field and, following the lead of the World Health Organization (1951), the American Medical Association (1965) recognized the severity of alcoholism and declared it to be a medical disorder. This further emphasized the need for a classification system based on the medical model [11,47,49]. The publication of the DSM-II [16] however, did little to change the influence of psychoanalysis and its characteristic descriptions of disorders described in the DSM-I. Interestingly, while the DSM-I and DSM-II did not employ diagnostic criteria as we understand them today, the DSM-II did encourage separate diagnoses for alcoholism and drug addiction “even when it begins as a symptomatic expression of another disorder” [40]. As seen in Table 1, three recognized types of alcoholism were recognized in DSM-II: (a) episodic excessive drinking (intoxication four times per year); (b) habitual excessive drinking (given to alcoholic persons who become intoxicated more than 12 times a year or are recognizably under the influence of alcohol more than once a week, even though not intoxicated); and (c) alcohol addiction (defined in terms of dependency, suggested by withdrawal which may be evidenced by inability to abstain for one day or heavy drinking for three months or more) [16]. Although withdrawal was emphasized for Drug Addiction, it was also recognized that dependence could occur without withdrawal (a point of semantic confusion which would follow the DSM until its most recent publication). Medically prescribed drugs were excluded in that they were taken in proportion “to the medical need” [16].
6.3. DSM-III: 1980
In keeping with the growing need for a valid and reliable diagnostic compendium for clinicians and researchers alike, the third edition of the DSM (DSM-III) [1] broke with psychoanalytic tradition and instituted consensus based diagnoses and diagnostic criteria [47]. These criteria, including those for SUDs, were based on the Research Diagnostic Criteria (1978) which were, in turn, influenced by the Feighner criteria (1972) [50] and earlier diagnostic attempts by Jellinek [15] to classify alcoholism. The DSM-III also saw the addition of new diagnoses (e.g., Post-traumatic Stress Disorder, Attention Deficit Disorder) and the use of consensus-based diagnoses and diagnostic criteria which, although unremarkable today, were novel concepts at the time [51]. The DSM-III is thus considered a major milestone in the field, reflecting a reemergence of the medical model and the rise of research investigators as the most prominent voices within the field [35,36].
In terms of SUDs, it is notable that the new iteration appeared devoid of the term “alcoholic” and continued the trend of separately diagnosing SUDs by now setting them apart from other mental health conditions (see Table 1). While, for the first time, this version of the DSM explicitly acknowledged differences in cultural perspectives on the acceptability of substance use, it also attempted to anchor the diagnostic criteria in terms of behavioral changes “almost all subcultures would view as extremely undesirable” [1]. Starting in DSM-III, the categories of Substance Abuse and Substance Dependence were adopted, and, although little explicit explanation is offered within the manual as to the basis for adopting this distinction, it seems that the former was equated with pathological use (e.g., social or occupational consequences, including legal problems which may arise from car accidents due to intoxication) and the later with physiological dependence (i.e., tolerance or withdrawal) [51]. While the rationale behind the DSM-III’s creation of these two categories was not described in the manual, there are a number of criticisms of this paradigm by individuals ultimately tasked with subsequent DSM revisions. Among other things, they stated that the distinction between “abuse” and “dependence” is made entirely on the basis of evidence for the presence of physiological tolerance or withdrawal . . . [which leaves the current system] vulnerable to powerful, swiftly changing social forces such as the tightening of laws restricting alcohol use while driving. Thus, for example, actions of a legislature in a particular state can determine the number of residents who met DSM-III criteria for a mental disorder (i.e., alcohol abuse) [52].
Such criticisms would form the basis for recommendations to alter these categories in the next iteration. Interestingly, some notable irregularities existed within the DSM-III. For example, the manual made the explicit additional requirements of a pathological use criterion for Alcohol and Cannabis Dependence diagnoses in addition to the main physiological criterion; the manual also stated that data was lacking in support of the main physiological criterion necessary for a Cannabis Dependence diagnosis, i.e., “the existence and significance of tolerance with regular heavy use of cannabis are controversial” [ 1 ] (p. 176). Furthermore, while Cocaine Abuse was a recognized diagnosis, Cocaine Dependence was not included “ since only transitory withdrawal symptoms occur after cessation of or reduction in prolonged use ” [ 1 ] (p. 173).
6.4. DSM-III-R (1987)
While the third edition of the DSM reflected, up to this point, the most profound changes in conceptualization of psychiatric nosology since its inception, its successor, the DSM-III-R also evidenced important changes. One such change was DSM-III-R’s inclusion of criterion items formerly associated with Abuse (i.e., aspects of pathological use) in the Dependence category. By grouping (pathological) behavioral dysfunctions with physiological processes in a polythetic diagnostic set, the conceptualization of the new Dependence category stood in contrast to earlier view that physiological symptoms were both necessary and sufficient for a dependence diagnosis. The DSM-III-R goes even further in separating physiological dependence from the diagnosis of Dependence, explicitly stating that “surgical patients [who] develop a tolerance to prescribed opioids and experience withdrawal symptoms without showing any signs of impaired control over their use of opioids” are not considered to fall in the category of Substance Dependence [17,53].
In examining the question of how such a change came about, the reader is referred back to the conceptual validity critiques of the Abuse/Dependence diagnostic sets described in the previous section. In light of these and other conceptual validity problems, recommended revisions to the DSM-III-R included elimination of the Abuse category and incorporation of elements into a newly expanded Dependence category [52]. Such a large conceptual change, they argued, would be consistent with the influential model of a dependence syndrome set forth in 1976 by Edwards and Gross which described a clinical syndrome of alcohol dependence that was comprised of physiological dependence on one axis and pathological use/behavioral consequences on the other axis of a singular disorder [54]. The recommendation to expand the Dependence criteria while removing the Abuse category offers some justification for the integration of the pathological use criterion into the Dependence category and the reversal of the DSM-III stance that physiological use was, in most cases, the hallmark of the disorder. As the DSM-III-R ultimately retained the Abuse category, this re-conceptualization of the mental health disorder never fully took shape. One admitted disadvantage to the re-conceptualized single disorder model was the potential for diagnostic abandonment of individuals with lower level problems who did not meet the criterion for the would-be expanded Dependence category [52]. Although possible coding schemes were set forth to circumvent this potential problem with the removal of the Abuse diagnosis [52], some suspect the pragmatic fears of diagnostic abandonment superseded validity concerns and ultimately left the Abuse category intact while at the same time advancing the dependence syndrome’s biaxial concept . . . albeit solely within the Dependence diagnosis [55].
6.5. DSM-IV (1994), DSM-IV-TR (2000)
As the science of mental health continued to progress, the Abuse and Dependence categories were shown to have significant limitations, including: differences in reliability and external validity, incorrect assumptions about the relationship between abuse and dependence, and the problem of “diagnostic orphans” (individuals with symptoms for whom neither diagnosis was met) [56]. The DSM-IV attempted to clarify earlier inconsistencies regarding the distinction between physiological dependence and Substance Dependence by specifying that “Neither tolerance or withdrawal is necessary or sufficient for a diagnosis of Substance Dependence” and added specifiers “With” and “Without Physiological Dependence” [19]. The DSM-IV-TR makes a number of other relatively minor revisions to the Substance Use Disorders and highlights that, compared to Substance Dependence, “the criteria for Substance Abuse do not include tolerance, withdrawal, or a pattern of compulsive use and instead only the harmful consequences of repeated use” [20].
6.6. DSM-5: 2013 (See Also Section 7 )
The fifth and most recent iteration of DSM (DSM-5) [22] represented the most dramatic modifications since DSM-III with the removal of the Abuse-Dependence paradigm and important revisions to the diagnostic criteria themselves. Most notably, DSM-5 combines Abuse and Dependence into a single unified category and measures severity on a continuous scale from mild (2–3 symptoms endorsed), moderate (4–5 symptoms endorsed) and severe (6 or more symptoms endorsed) out of 11 total symptoms (versus the previous 7) (see Table 1). The shift to a unified category measured along a dimension of severity represents a notable change from the post-hoc categorical severity specifiers in the previous version and also further cements the difference between the now defunct DSM diagnosis of Dependence and the medical concept of physiological dependence, a distinction which had been increasingly emphasized over time. As reported in Hasin, et al. [57], a number of empirical considerations supported this change, including psychometric studies reporting the uni-dimensionality of the biaxial abuse/dependence paradigm across a number of populations. These empirical findings suggests that, contrary to the categorization of abuse and dependence as more-or-less distinct entities with different severity levels, the criterion items actuality represent a single continuum-of-severity construct. The integration of dimensional elements of classification seen here in SUD also mirrors the call for such an approach among a number of other categorical diagnostic classifications [5860].
Other noteworthy changes in the DSM-5 were the addition of the craving criterion, the removal of the legal problems criterion, and the title of the chapter, which now reads “Substance-Related and Addictive Disorders” (despite the use of the term addiction in the title, the text reveals that “ . . . the word [addiction] is omitted from the official DSM-5 substance use disorder diagnostic terminology because of its uncertain definition and its potentially negative connotation” [22]). The chapter also, for the first time, includes a behavioral addiction (i.e., Gambling Disorder), suggesting that a behavioral addiction has a shared underlying neurological reward systems and a compatible symptom set with SUDs [22]. These changes (i.e., craving criterion addition, legal problems criterion elimination, and the introduction of behavioral addictions) are further discussed in the section below.
7. Discussion
7.1. Potential Practical Implications of Atheoretical Nosology
While the departure from psychoanalytic etiology and adoption of atheoretical consensus based diagnostic entities in the DSM-III is regarded as one of the greatest advances in the field over the last century, the fact that the definitive manual for the diagnosis of mental disorders provides no known etiology or pathophysiology and relies, instead, on defining a disorder by its symptoms may pose a challenge not only for the field in general but for the treatment of SUDs more specifically. One way in which atheoretical classification may prove problematic is the actual clinical usage of the diagnostic criteria themselves. While in vivo studies of clinician usage of DSM-5 for substance use disorder have yet to be carried out beyond the routine clinical practice field trials, past research comparing clinical psychiatric diagnosis versus vs. structured clinical interviews revealed significant disparities in diagnoses among providers for the same patient [61]. According to a review by First et al. [61] these and other results suggest that clinicians “were most likely making DSM diagnoses using a method other than by evaluating each of the diagnostic criteria in sequence” [61] (p. 842). This observation raises several points of consideration. First, while there are substantial benefits in utilizing consensus-driven standardized diagnostic criteria (e.g., increased reliability and validity of diagnoses, communication between providers) these benefits are significantly curtailed if clinicians do not actually adequately employ the criteria as intended. Second, while more research is needed in order to determine precisely how clinicians are arriving at diagnoses if not utilizing full diagnostic criteria, cognitive research into the clinical reasoning of clinical psychologists suggests that experienced practitioners still rely on their own particular causal theoretical conceptualizations despite the atheoretical diagnostic criteria that have been in place for well over thirty years [62]. Thus, the same lack of universally recognized etiology that was the impetus to move beyond the early psychoanalytic influence and advance to a more valid and reliable model may run contrary to innate mechanisms for conceptualizing diagnostic entities among individual providers.
Given the necessity of the diagnostic agnosticism of the DSM and the substantial benefits this model provides to both clinicians and researchers when used correctly, the question arises as to what contributions does the particular state of psychiatric nosology today have on the field as a whole and for SUD specifically? The adoption of a consensus-based symptomological approach might represent the lack of a shared etiology among professionals. Indeed, some of the major controversies (e.g., natural recovery and the disease model, abstinence and moderation/harm reduction approaches) in the field of substance use over the last several decades have inspired protracted debate [6365] and may very well epitomize this lack of etiological consensus. Today, while the DSM continues to retain its etiological neutrality, the field of substance use has undoubtedly moved in the direction of explicitly emphasizing biological and disease model conceptualizations of addictive behaviors. While advocates of a strict disease model of pathology underlying SUDs point out important achievements including improved recognition of the neurobiological process involved in addiction as well as new pharmacotherapies for treating addiction [66], this conceptualization is still, today, not without its detractors [67,68].
One potential manifestation of this lack of unified etiology or conceptually-driven nosology is the “scientist-practitioner gap”, noted in the field as a whole [6972] and in the treatment of SUDs. Within SUD treatment, this gap is exemplified in the hesitancy among some practitioners and training programs to readily adopt and promote Evidence-Based Practices (EBPs) in favor of empirically unsupported alternative approaches. Differences in support for and knowledge of the effectiveness of EBPs has been shown to be related to provider level of education, institutional culture, provider type, training, academic affiliation [7376] and, despite the effectiveness of both psychosocial and pharmacological EBPs, research has shown that their widespread adoption has remained challenging, if not controversial, in some arenas [61]. Specifically, despite increasing availability of effective pharmacologic agents and reductions in cost associated with prescription medication for SUDs, adoption of these practices are slow [77], with considerable variation in adoption across publicly funded non-profit, government-owned, privately funded non-profit, and for-profit treatment centers[78] (p. 164). In addition to such macro-influences, individual provider attitudes and beliefs may be another link between conceptualization of SUDs and use of EBPs, with providers with higher responsibility-focused conceptualizations of addiction holding more negative views of the use of naltrexone in the treatment of AUD [79]. Interestingly, the use of pharmacotherapies is particularly low for SUDs (i.e., AUDs) when compared to substantially higher rates of prescribing for other comorbid mental health conditions (e.g., schizophrenia, bipolar, post-traumatic stress disorder) [80], a phenomenon which might suggest larger conceptual differences among SUD providers when compared to other mental health conditions.
7.2. Removal of Legal Problems Criterion
One of the significant DSM-5 changes identified above (Section 6.6) is the removal of the legal problems criterion for Substance Use Disorders. The removal of the legal problems criterion was reported to reflect the low prevalence for endorsement of this item in the general population, as well as poor fit with other criteria, and little added information based on item response theory (IRT) and differential item functioning analyses [8183]. In contrast to simple summations of items endorsed by an individual in determining an outcome (i.e., level of severity), IRT is used to estimate the level of information provided by a particular item and its utility in predicting that outcome [84]. The data gathered from these models suggests that legal problems were the least associated with the overarching construct when compared to the other items and model fit was actually improved when the legal problems criterion was omitted [82]. Thus, while the removal of this criterion was accomplished through the impartiality of advanced empirical models, as described above, the significance of the departure of the tradition of using the legal problems criterion as a diagnostic criterion reveals the ways in which even a purportedly atheoretical nosology can be influenced by specific contexts and cultural changes. This point becomes particularly salient when we consider the original contextual factors (e.g., racism, industrialization) which came together in the 19th century to make the use of certain substances illegal, thereby forming the nearly inexorable link between criminality and substance use which has persisted over time despite its questionable utility in describing SUD. The historical example of the use of opium-based drugs on women from the not-so-distant Victorian age past illustrates the powerful enmeshment of legality, medical acceptance, and cultural norms that remain so saturated in the culture of the time that they remain effectively invisible. Only with the benefit of time do these cultural factors reveal themselves, and, while the example of the influence of Victorian-era cultural factors on the diagnosis and treatment of mental health in women may seem part of psychiatry’s remote past, the influence of culture on nosology can be readily witnessed even in modern times.
Although not substance-related, perhaps the most salient example of social norms affecting diagnosis in recent history is the diagnostic evolution of homosexuality in the DSM which was, much like early conceptualization of SUD, considered a symptom of a real psychological illness (i.e., sociopathic personality disturbance) [85,86]. Following the advent of the LGBT rights movement in the 1960s and subsequent research into the condition, the APA eventually reversed its stance on the issue and today it is recognized that the pathology of sexual behavior (which was, in part, justified by the subjective level of disturbance it caused) is related not to an underlying pathology but rather to socially accepted norms and stigmatization. Consequently, homosexuality is no longer considered a disease or a representation of underlying personality disturbance and is conceptualized from a non-pathological viewpoint (and indeed labeled differently in order to avoid the long-held stigma associated with the term homosexual [87]. Thus, history provides clear examples of how even an atheoretical psychiatric nosology such as the DSM is vulnerable to pathologizing behavior based on socially accepted norms- norms which only come to be revealed as reflecting large scale societal biases as they change over time though shifts in generational perspectives.
In terms of legality of substance use today, we are, perhaps, in the midst of another cultural shift; along with the government’s acknowledgment of disparate racial sentencing in drug crimes, there is an increased recognition today among professionals of the dissociation between legal status of drugs with their relative dangerousness to individuals and society as well as the calls for a scientifically informed drug policy [8892]. Cannabis and its derivations, for example, hold the distinction of being classified as both a Schedule I (no currently accepted medical use and lack of safety) and its active ingredient, THC, in pill-form, as Schedule II (accepted medical use and high potential for abuse) [45]. Disparities can also be seen in the legal status of alcohol use which, despite its non-illicit standing, has been recognized to provide a relatively greater level of harm to individuals and society compared to illicit drugs (i.e., heroin, crack cocaine) [90]. The removal of the legal problems criterion may be reflective of a larger cultural change of increased recognition of the somewhat arbitrary division between legal status and levels of harm of substances. The removal of the legal problems criterion underscores the larger philosophical issue of relying on a fluctuating socially-constructed criterion with arguable racial and socio-economic disparity in defining an ostensibly biological disorder in an atheoretical symptom- based diagnostic manual.
7.3. Removal of the Abuse/Dependence Paradigm
Another significant change to the latest iteration of the DSM identified above (Section 6.4) is the removal of the Abuse/Dependence paradigm for Substance Use Disorders, a paradigm that has been present since the adoption of the DSM-III (1980). Within this paradigm Substance Abuse has been considered a “milder” form of Substance Dependence and often construed as a prodrome. Thus, while the two categories were intended to be diagnostically distinct, they were often interpreted as being related- a conceptualization which was argued in the 1970s and resurrected, albeit in a different form, in the new millennium. In making the case for the changes to the DSM-5, empirical findings derived from modern statistical models of the dimensionality of these categories was used, which found that the criteria aligned themselves on a single dimension, a single underlying construct [83,84,9395]. Thus, the issue of validity was again brought into the spotlight. Similar to the socially constructed legal criterion described in the previous section, research into the validity of the Abuse category revealed a disproportionate number of cases of Abuse being diagnosed by a criterion item (i.e., hazardous drinking) which was, itself, socially biased and mediated by political factors. One study, for example, reported that out of 1385 individuals diagnosed with current alcohol abuse, 83.6% met the criteria based solely on hazardous use, with the majority (69.3%) meeting criteria through drinking and driving alone [96]. The same study found a positive relationship between socio-economic status and DSM-IV Alcohol Abuse diagnosis, which may be explained by higher-income drinkers having greater access to vehicles which, in turn, may lead to higher rates of hazardous drinking and, subsequently, Alcohol Abuse [9698]. Such findings recall the recommendations described earlier [52] warning of the socially constructed and therefore problematic nature of the Abuse diagnosis.
Such findings resulted in the shift to the continuum model espoused in the DSM-5, a trend which was evident in the severity specifiers of previous versions (in fact, the DSM-IV and IV-TR contain a disclaimer, titled “Issues in the Use of DSM-IV: Limitations of the Categorical Approach” [19]; [20] (pp. xxii, xxxi). Although the DSM-5 has been criticized by some for retooling the longstanding dichotomy, this change may be viewed, in a larger sense, as finally addressing the conceptual validity problems underlying this distinction. For example, if Abuse was best conceptualized not a standalone mental disorder but rather as one dimension of the larger construct of the dependence syndrome as described by Edwards and Gross (1976) [54], then the amalgamation of the two diagnostic entities in the DSM-5 has increased not only the empirical but the conceptual validity of this underlying construct.
While the categorical classification of substance users in the DSM was done from an etiologically agnostic standpoint, is it plausible that, because the format is consensus (vs. theoretically) driven, and because individuals are pre-disposed to cause and effect thinking [62], the DSM will always retain elements of theory (albeit indirectly) and these will likely change as culture and thinking shift over time. As once (in) famously pointed out, symptoms of mental illness are directly tied to the social and ethical culture in which they take place [99]. While the advancement of empirical inductive reasoning which prompted the shift to the current model is a step forward in the science of classification, it is not without its limitations; some disagreements exist about relying on mathematical models to disprove clinically entrenched concepts [55] while others have raised concerns about the validity of diagnostic thresholds (i.e., mild, moderate, severe) and the arbitrariness of diagnostic cut-offs among SUD and other diagnoses [100102]. Looking forward, it remains to be seen what effect this continuum of severity conceptualization has on clinical work and reliability and validity of diagnoses.
7.4. Addition of Craving Criterion
Another significant change in the DSM-5 identified above (Section 6.5) is the addition of the craving criterion. While craving has been noted in previous versions as a feature of the disorder, DSM-5 marks the first use of the symptom as an actual criterion item. According to Hasin, Fenton, Beseler, Park and Wall [57], the inclusion of craving was supported on several fronts, including its theoretical centrality in accurately describing a clinical feature of SUD, its association with cued self-administration and relapse, its well-studied role in human and animal models of substance use, its inclusion in the ICD-10, as well as the potential for pharmacotherapeutic intervention for craving and its neural substrates. Indeed, craving is often associated with increased likelihood of relapse to alcohol use, and therefore it is thought that managing craving may improve treatment outcomes. As such, a number of pharmacologic interventions have been investigated in the last several decades which target craving reduction as a mechanism to reduce substance use including acamprosate, naltrexone, disulfiram, varenicline, lamotrigine and others [103]. To date, the results of clinical studies on reducing craving have been promising although somewhat inconsistent and await future developments (e.g., the elucidation of underlying neurobiological circuits). Current hypotheses on the neurobiology of craving (i.e., Incentive-Sensitization Theory) posit that long term substance use leads to neuroadaptations which increase the incentive salience around stimuli associated with that substance which may occur independently of the changes that mediate the subjective euphoric effects as well as withdrawal, thereby resulting in subjective experience of craving even in circumstances which highly disincentivize substance use (i.e., social, occupational, recreational impairment) [104]. As craving is then, perhaps, the only criterion which may persist following protracted abstinence, future questions may arise about how to treat and code for craving and what role craving plays in identifying remission.
7.5. Inclusion of “Behavioral Addictions”
Since the DSM-III-R, the field has defined addictive behaviors as relating to compulsive substance use despite adverse consequences with physiological changes often present. The inclusion of behavioral addictions as psychiatric disorders likely marks the next large paradigm shift in the field of addictions and, not surprisingly, has already garnered some debate. Although the future of behavioral addictions may lack certitude as of yet, what does seem clear, from a nosological standpoint, is the eventual expansion of the conceptualization of the broader category of addictions. This is evidenced by the chapter title “Substance-Related and Addictive Disorders” and the inclusion of a behavioral addiction in the form of Gambling Disorder and discussion of Internet Gaming Disorder as an area of future research. Gambling Disorder had previously been included in Impulse Disorders Not Elsewhere Classified since the DSM-III (originally “Pathological Gambling”). That routine ingestion of a psychopharmacologic substance is not needed in conceptualizing addictive pathology may point to the growing conceptualization of addiction as the sum of a host of neuroadaptations related to dysregulation of endogenous neurotransmitters (as well as behavioral, genetic, and pyscho-social factors) of which exogenous chemicals play a historically important but potentially diminishing part as the field progresses. Indeed, the rationale presented in the DSM-5 (i.e., that Gambling Disorder has a shared underlying neurological reward systems and some “behavioral symptoms that appear comparable to those produced by the substance use disorders” [22] appears to clearly lay the groundwork for the inclusion of other behavioral addictions. In fact, the text reports that other “excessive behavioral patterns” (i.e., internet gaming, “sex addiction”, “exercise addiction”, “shopping addiction”) are not yet included with the rationale cited that there has not been enough peer reviewed evidence to support diagnostic criteria “needed to identify these behaviors as mental disorders” [22]. While concern has been expressed about over-pathologizing human behavior, decreasing individual responsibility, and allowing for a deluge of un- or under-supported diagnoses to saturate and hence weaken the credibility of the field [105107], future research into the neurobiological substrates of impulse-related disorders and addictions may lay a more solid framework for the behavioral addictions. Epidemiological and cultural factors of behavioral addictions will likely be an area of future research, as well as identifying behavioral and pharmacological treatment targets, creating validated and reliable measures, and measuring treatment outcomes.
8. Conclusions
The history of psychoactive substance use is remarkably long, dating as far back, in some cases, as the recorded history of human civilization allows. Compared to the length and complexity of human interactions with psychoactive substances over millennia, the involvement of mental health in regulating the extremes associated with over-use of psychoactive substances is a relatively recent phenomenon. The official nosology of the American mental health system, the DSM, was itself a significant advancement to the field, which lacked a unified classification system. Through its early iterations, the DSM continued to mature and shed its psychoanalytic roots in the name of the development of a unified nosology. By moving to atheoretical, consensus-based diagnostic entities, the DSM-III made a much needed and significant advancements in diagnostic reliability and validity, which supported the scientific development of the field of mental health. The observation that, despite the DSM’s agnostic approach, most providers today do not conceptualize from a strictly atheoretical standpoint suggests the possibility that the greatest advancement in psychiatric in the last century may have the unintended effect of allowing room for unscientific, idiosyncratic, or disparate etiological interpretations in a field already beleaguered by lack of consensus. Despite the atheoretical nature of the DSM clinicians retain their own conceptualizations of causal etiologies of SUDs and such lack of consensus may hinder the adoption of EBPs as the field progresses.
One of the most recent developments in the DSM-5 is the removal of the legal problems criterion, a change, which may be not only driven by empirical findings but may also represent a cultural shift away from criminalizing substance users. Philosophically, such changes may signify a coming-to-terms with the socially constructed and therefore variable nature of criminal behavior, which has long been regarded as one of the characteristic descriptors of an ostensibly biological disorder. Such a change speaks to the observation that, contrary to the popular assumption that the path of social sciences is entirely objective and linear, the iterations of the DSM reveal, in fact, a progression that is susceptible to political and social influences [11]. As Kawa and Giordano [108] state,
The evolution of the DSM illustrates that what is considered to be “medical” and “scientific” is often not an immutable standard, but rather, may be variable across time and culture, and in this way contingent upon changes in dominant schools of thought [108] (p. 7).
While mental health disorders have characteristically lacked clearly demarcated boundaries and have so far largely defied attempts to elucidate and categorize their exclusive etiologies, an increasing number of individuals have, over time, connected such concerns to the descriptive vs. etiological nature of psychiatric nosology and the limitations inherent in maintaining such a model [107,108].
Today, the mental health field continues to defy its atheoretical nosology by developing, for example, concrete guidelines and research funding priorities to promote cross-diagnostic advancements in the etiology of mental health disorders based on translational neuroscience. This endeavor, known as Research Domain Criteria Initiative (RDoC), is bold in its unambiguously transdiagnostic approach and was developed by the National Institute of Mental Health as a direct challenge to the diagnostically agnostic categorizational approach of the DSM [109]. While RDoC has, of yet, failed to gain significant traction in the area of SUD research, it has the potential to impact the identity of the field of mental health, including the future of diagnostic classification, research priorities, and practitioner training [110]. If more readily adopted in SUD research, RDoC may be useful in expanding existing pre-clinical, and human translational approaches and could, potentially, impact the development of a new generation of SUD pharmacotherapies [111]. While such innovations might lend much needed support to a causation-based nosological system, other advancements (e.g., in statistical modeling and classification, including latent class analysis, latent profile analysis, etc.) may provide meaningful ways of understanding and classifying groups of individuals with SUDs without the need to forgo the descriptive approach. As such advances continue to develop, questions of epidemiology and, indeed, epistemology will no doubt continue to challenge the increasingly inter-connected fields of psychology, psychiatry, and neurology. In the meantime, the continued examination and quantification of objective characterological traits (e.g., impulsivity, affect dysregulation) and their neurobiological underpinnings [112114] as well as the expanding field of epigenetics [115] may continue to deconstruct the historical debate of monism vs. dualism (i.e., “the mind-body problem”) which has long beleaguered epidemiology (and therefore nosology) in mental health.
Despite, then, the growing promise and increasing allure of a truly causation-based nosology in SUD/mental health, the realization of such an undertaking may yet prove elusive for decades to come. For now, little choice remains but to continue to refine the current classification strategy in a stepwise fashion while continuously promoting a deeper understanding and appreciation of its origins and influences.
© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
Acknowledgments: This material is based upon work supported by the Office of Academic Affiliations, Department of Veterans Affairs and resources and the use of facilities at the North Texas Veteran’s Affairs Healthcare System, Dallas, Texas. The views expressed in this article do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government.
Author Contributions: Sean M. Robinson developed most of the original content for this manuscript with guidance, direction, and content editing provided by Bryon Adinoff.
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• Timetable of Drug Addiction | textbooks/socialsci/Social_Work_and_Human_Services/Foundations_of_Addiction_Studies_(Florin_and_Trytek)/1.08%3A_Assessment_and_Treatment_of_Substance_Use_Disorders.txt |
The overarching message of this chapter is that there is no single right way to recover from the disease of addiction. Research and experience have demonstrated that recovery has many paths, and treatment providers, family members, and recovering persons should be open to using the methods that work best for the individual struggling with addiction. In short, although we might assume there is a single best way to do things, often many roads arrive at the same destination. This idea is critical to how we approach healing from addiction.
Recovery from addiction can include formal treatment, medication, dietary changes, increased exercise, meditation, mutual help groups, faith-based engagement, work with a counselor or therapist, and more. As the U. S. Surgeon General’s Report from 2016 acknowledges: There are many paths to recovery. People will choose their pathway based on their cultural values, their socioeconomic status, their psychological and behavioral needs, and the nature of their substance use disorder.
At the same time, we do not need to have limitless choices. Successful outcomes can be grouped into clusters that represent a relatively brief menu of effective options for recovery. In this chapter, we emphasize principles of addiction treatment, evidence-based approaches, medication-assisted treatment, mutual help groups including Alcoholics Anonymous, and holistic approaches that incorporate diet, exercise, and spiritual practices.
Evidence-Based Approaches to Drug Addiction Treatment
This section presents examples of treatment approaches and components that have an evidence base supporting their use. Each approach is designed to address certain aspects of drug addiction and its consequences for the individual, family, and society. Some of the approaches are intended to supplement or enhance existing treatment programs, and others are fairly comprehensive in and of themselves.
The following section is broken down into Pharmacotherapies, Behavioral Therapies, and Behavioral Therapies Primarily for Adolescents. They are further subdivided according to particular substance use disorders. This list is not exhaustive, and new treatments are continually under development.
Pharmacotherapies
Opioid Addiction Methadone
Methadone is a long-acting synthetic opioid agonist medication that can prevent withdrawal symptoms and reduce craving in opioid-addicted individuals. It can also block the effects of illicit opioids. It has a long history of use in treatment of opioid dependence in adults and is taken orally. Methadone maintenance treatment is available in all but three States through specially licensed opioid treatment programs or methadone maintenance programs.
Combined with behavioral treatment: Research has shown that methadone maintenance is more effective when it includes individual and/or group counseling, with even better outcomes when patients are provided with, or referred to, other needed medical/psychiatric, psychological, and social services (e.g., employment or family services).
Buprenorphine
Buprenorphine is a synthetic opioid medication that acts as a partial agonist at opioid receptors—it does not produce the euphoria and sedation caused by heroin or other opioids but is able to reduce or eliminate withdrawal symptoms associated with opioid dependence and carries a low risk of overdose.
Buprenorphine is currently available in two formulations that are taken sublingually: (1) a pure form of the drug and (2) a more commonly prescribed formulation called Suboxone, which combines buprenorphine with the drug naloxone, an antagonist (or blocker) at opioid receptors. Naloxone has no effect when Suboxone is taken as prescribed, but if an addicted individual attempts to inject Suboxone, the naloxone will produce severe withdrawal symptoms. Thus, this formulation lessens the likelihood that the drug will be abused or diverted to others.
Buprenorphine treatment for detoxification and/or maintenance can be provided in office-based settings by qualified physicians who have received a waiver from the Drug Enforcement Administration (DEA), allowing them to prescribe it. The availability of office-based treatment for opioid addiction is a cost-effective approach that increases the reach of treatment and the options available to patients.
Buprenorphine is also available as in an implant and injection. The U.S. Food and Drug Administration (FDA) approved a 6-month subdermal buprenorphine implant in May 2016 and a once-monthly buprenorphine injection in November 2017.
Naltrexone
Naltrexone is a synthetic opioid antagonist—it blocks opioids from binding to their receptors and thereby prevents their euphoric and other effects. It has been used for many years to reverse opioid overdose and is also approved for treating opioid addiction. The theory behind this treatment is that the repeated absence of the desired effects and the perceived futility of abusing opioids will gradually diminish craving and addiction. Naltrexone itself has no subjective effects following detoxification (that is, a person does not perceive any particular drug effect), it has no potential for abuse, and it is not addictive.
Naltrexone as a treatment for opioid addiction is usually prescribed in outpatient medical settings, although the treatment should begin after medical detoxification in a residential setting in order to prevent withdrawal symptoms.
Naltrexone must be taken orally—either daily or three times a week—but noncompliance with treatment is a common problem. Many experienced clinicians have found naltrexone best suited for highly motivated, recently detoxified patients who desire total abstinence because of external circumstances—for instance, professionals or parolees. Recently, a long-acting injectable version of naltrexone, called Vivitrol, was approved to treat opioid addiction. Because it only needs to be delivered once a month, this version of the drug can facilitate compliance and offers an alternative for those who do not wish to be placed on agonist/partial agonist medications.
Comparing Buprenorphine and Naltrexone
A NIDA study comparing the effectiveness of a buprenorphine/naloxone combination and an extended release naltrexone formulation on treating opioid use disorder has found that both medications are similarly effective in treating opioid use disorder once treatment is initiated. Because naltrexone requires full detoxification, initiating treatment among active opioid users was more difficult with this medication. However, once detoxification was complete, the naltrexone formulation had a similar effectiveness as the buprenorphine/naloxone combination.
Tobacco Addiction Nicotine Replacement Therapy (NRT)
A variety of formulations of nicotine replacement therapies (NRTs) now exist, including the transdermal nicotine patch, nicotine spray, nicotine gum, and nicotine lozenges. Because nicotine is the main addictive ingredient in tobacco, the rationale for NRT is that stable low levels of nicotine will prevent withdrawal symptoms—which often drive continued tobacco use—and help keep people motivated to quit. Research shows that combining the patch with another replacement therapy is more effective than a single therapy alone.
Bupropion (Zyban®)
Bupropion was originally marketed as an antidepressant (Wellbutrin). It produces mild stimulant effects by blocking the reuptake of certain neurotransmitters, especially norepinephrine and dopamine. A serendipitous observation among depressed patients was that the medication was also effective in suppressing tobacco craving, helping them quit smoking without also gaining weight. Although bupropion’s exact mechanisms of action in facilitating smoking cessation are unclear, it has FDA approval as a smoking cessation treatment.
Varenicline (Chantix®)
Varenicline is the most recently FDA-approved medication for smoking cessation. It acts on a subset of nicotinic receptors in the brain thought to be involved in the rewarding effects of nicotine. Varenicline acts as a partial agonist/antagonist at these receptors—this means that it midly stimulates the nicotine receptor but not sufficiently to trigger the release of dopamine, which is important for the rewarding effects of nicotine. As an antagonist, varenicline also blocks the ability of nicotine to activate dopamine, interfering with the reinforcing effects of smoking, thereby reducing cravings and supporting abstinence from smoking.
Combined With Behavioral Treatment
Each of the above pharmacotherapies is recommended for use in combination with behavioral interventions, including group and individual therapies, as well as telephone quitlines. Behavioral approaches complement most tobacco addiction treatment programs. They can amplify the effects of medications by teaching people how to manage stress, recognize and avoid high-risk situations for smoking relapse, and develop alternative coping strategies (e.g., cigarette refusal skills, assertiveness, and time management skills) that they can practice in treatment, social, and work settings. Combined treatment is urged because behavioral and pharmacological treatments are thought to operate by different yet complementary mechanisms that can have additive effects.
Alcohol Addiction
Naltrexone
Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and the craving for alcohol. It has been shown to reduce relapse to problem drinking in some patients. An extended release version, Vivitrol—administered once a month by injection—is also FDA-approved for treating alcoholism, and may offer benefits regarding compliance.
Acamprosate
Acamprosate (Campral®) acts on the gamma-aminobutyric acid (GABA) and glutamate neurotransmitter systems and is thought to reduce symptoms of protracted withdrawal, such as insomnia, anxiety, restlessness, and dysphoria. Acamprosate has been shown to help dependent drinkers maintain abstinence for several weeks to months, and it may be more effective in patients with severe dependence.
Disulfiram
Disulfiram (Antabuse®) interferes with degradation of alcohol, resulting in the accumulation of acetaldehyde, which, in turn, produces a very unpleasant reaction that includes flushing, nausea, and plapitations if a person drinks alcohol. The utility and effectiveness of disulfiram are considered limited because compliance is generally poor. However, among patients who are highly motivated, disulfiram can be effective, and some patients use it episodically for high-risk situations, such as social occasions where alcohol is present. It can also be administered in a monitored fashion, such as in a clinic or by a spouse, improving its efficacy.
Topiramate
Topiramate is thought to work by increasing inhibitory (GABA) neurotransmission and reducing stimulatory (glutamate) neurotransmission, although its precise mechanism of action is not known. Although topiramate has not yet received FDA approval for treating alcohol addiction, it is sometimes used off-label for this purpose. Topiramate has been shown in studies to significantly improve multiple drinking outcomes, compared with a placebo.
Combined With Behavioral Treatment
While a number of behavioral treatments have been shown to be effective in the treatment of alcohol addiction, it does not appear that an additive effect exists between behavioral treatments and pharmacotherapy. Studies have shown that just getting help is one of the most important factors in treating alcohol addiction; the precise type of treatment received is not as important.
Behavioral Therapies
Behavioral approaches help engage people in drug abuse treatment, provide incentives for them to remain abstinent, modify their attitudes and behaviors related to drug abuse, and increase their life skills to handle stressful circumstances and environmental cues that may trigger intense craving for drugs and prompt another cycle of compulsive abuse. Below are a number of behavioral therapies shown to be effective in addressing substance abuse (effectiveness with particular drugs of abuse is denoted in parentheses).
Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine)
Cognitive-Behavioral Therapy (CBT) was developed as a method to prevent relapse when treating problem drinking, and later it was adapted for cocaine-addicted individuals. Cognitive-behavioral strategies are based on the theory that in the development of maladaptive behavioral patterns like substance abuse, learning processes play a critical role. Individuals in CBT learn to identify and correct problematic behaviors by applying a range of different skills that can be used to stop drug abuse and to address a range of other problems that often co-occur with it.
A central element of CBT is anticipating likely problems and enhancing patients’ self-control by helping them develop effective coping strategies. Specific techniques include exploring the positive and negative consequences of continued drug use, self-monitoring to recognize cravings early and identify situations that might put one at risk for use, and developing strategies for coping with cravings and avoiding those high-risk situations.
Research indicates that the skills individuals learn through cognitive-behavioral approaches remain after the completion of treatment. Current research focuses on how to produce even more powerful effects by combining CBT with medications for drug abuse and with other types of behavioral therapies. A computer-based CBT system has also been developed and has been shown to be effective in helping reduce drug use following standard drug abuse treatment.
Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine)
Research has demonstrated the effectiveness of treatment approaches using contingency management (CM) principles, which involve giving patients tangible rewards to reinforce positive behaviors such as abstinence. Studies conducted in both methadone programs and psychosocial counseling treatment programs demonstrate that incentive-based interventions are highly effective in increasing treatment retention and promoting abstinence from drugs.
Voucher-Based Reinforcement (VBR) augments other community-based treatments for adults who primarily abuse opioids (especially heroin) or stimulants (especially cocaine) or both. In VBR, the patient receives a voucher for every drug-free urine sample provided. The voucher has monetary value that can be exchanged for food items, movie passes, or other goods or services that are consistent with a drug-free lifestyle. The voucher values are low at first, but increase as the number of consecutive drug-free urine samples increases; positive urine samples reset the value of the vouchers to the initial low value. VBR has been shown to be effective in promoting abstinence from opioids and cocaine in patients undergoing methadone detoxification.
Prize Incentives CM applies similar principles as VBR but uses chances to win cash prizes instead of vouchers. Over the course of the program (at least 3 months, one or more times weekly), participants supplying drug-negative urine or breath tests draw from a bowl for the chance to win a prize worth between \$1 and \$100. Participants may also receive draws for attending counseling sessions and completing weekly goal-related activities. The number of draws starts at one and increases with consecutive negative drug tests and/or counseling sessions attended but resets to one with any drug-positive sample or unexcused absence. The practitioner community has raised concerns that this intervention could promote gambling—as it contains an element of chance—and that pathological gambling and substance use disorders can be comorbid. However, studies examining this concern found that Prize Incentives CM did not promote gambling behavior.
Community Reinforcement Approach Plus Vouchers (Alcohol, Cocaine, Opioids)
Community Reinforcement Approach (CRA) Plus Vouchers is an intensive 24-week outpatient therapy for treating people addicted to cocaine and alcohol. It uses a range of recreational, familial, social, and vocational reinforcers, along with material incentives, to make a non-drug-using lifestyle more rewarding than substance use. The treatment goals are twofold:
To maintain abstinence long enough for patients to learn new life skills to help sustain it; and To reduce alcohol consumption for patients whose drinking is associated with cocaine use
Patients attend one or two individual counseling sessions each week, where they focus on improving family relations, learn a variety of skills to minimize drug use, receive vocational counseling, and develop new recreational activities and social networks. Those who also abuse alcohol receive clinic- monitored disulfiram (Antabuse) therapy. Patients submit urine samples two or three times each week and receive vouchers for cocaine-negative samples. As in VBR, the value of the vouchers increases with consecutive clean samples, and the vouchers may be exchanged for retail goods that are consistent with a drug-free lifestyle. Studies in both urban and rural areas have found that this approach facilitates patients’ engagement in treatment and successfully aids them in gaining substantial periods of cocaine abstinence.
A computer-based version of CRA Plus Vouchers called the Therapeutic Education System (TES) was found to be nearly as effective as treatment administered by a therapist in promoting abstinence from opioids and cocaine among opioid-dependent individuals in outpatient treatment. A version of CRA for adolescents addresses problem-solving, coping, and communication skills and encourages active participation in positive social and recreational activities.
Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine)
Motivational Enhancement Therapy (MET) is a counseling approach that helps individuals resolve their ambivalence about engaging in treatment and stopping their drug use. This approach aims to evoke rapid and internally motivated change, rather than guide the patient stepwise through the recovery process. This therapy consists of an initial assessment battery session, followed by two to four individual treatment sessions with a therapist. In the first treatment session, the therapist provides feedback to the initial assessment, stimulating discussion about personal substance use and eliciting self-motivational statements. Motivational interviewing principles are used to strengthen motivation and build a plan for change. Coping strategies for high-risk situations are suggested and discussed with the patient. In subsequent sessions, the therapist monitors change, reviews cessation strategies being used, and continues to encourage commitment to change or sustained abstinence. Patients sometimes are encouraged to bring a significant other to sessions.
Research on MET suggests that its effects depend on the type of drug used by participants and on the goal of the intervention. This approach has been used successfully with people addicted to alcohol to both improve their engagement in treatment and reduce their problem drinking. MET has also been used successfully with marijuana-dependent adults when combined with cognitive- behavioral therapy, constituting a more comprehensive treatment approach. The results of MET are mixed for people abusing other drugs (e.g., heroin, cocaine, nicotine) and for adolescents who tend to use multiple drugs. In general, MET seems to be more effective for engaging drug abusers in treatment than for producing changes in drug use.
The Matrix Model (Stimulants)
The Matrix Model provides a framework for engaging stimulant (e.g., methamphetamine and cocaine) abusers in treatment and helping them achieve abstinence. Patients learn about issues critical to addiction and relapse, receive direction and support from a trained therapist, and become familiar with self-help programs. Patients are monitored for drug use through urine testing.
The therapist functions simultaneously as teacher and coach, fostering a positive, encouraging relationship with the patient and using that relationship to reinforce positive behavior change. The interaction between the therapist and the patient is authentic and direct but not confrontational or parental. Therapists are trained to conduct treatment sessions in a way that promotes the patient’s self-esteem, dignity, and self-worth. A positive relationship between patient and therapist is critical to patient retention.
Treatment materials draw heavily on other tested treatment approaches and, thus, include elements of relapse prevention, family and group therapies, drug education, and self-help participation. Detailed treatment manuals contain worksheets for individual sessions; other components include family education groups, early recovery skills groups, relapse prevention groups, combined sessions, urine tests, 12-step programs, relapse analysis, and social support groups.
A number of studies have demonstrated that participants treated using the Matrix Model show statistically significant reductions in drug and alcohol use, improvements in psychological indicators, and reduced risky sexual behaviors associated with HIV transmission.
12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates)
Twelve-step facilitation therapy is an active engagement strategy designed to increase the likelihood of a substance abuser becoming affiliated with and actively involved in 12-step self-help groups, thereby promoting abstinence. Three key ideas predominate: (1) acceptance, which includes the realization that drug addiction is a chronic, progressive disease over which one has no control, that life has become unmanageable because of drugs, that willpower alone is insufficient to overcome the problem, and that abstinence is the only alternative; (2) surrender, which involves giving oneself over to a higher power, accepting the fellowship and support structure of other recovering addicted individuals, and following the recovery activities laid out by the 12-step program; and (3) active involvement in 12-step meetings and related activities. While the efficacy of 12-step programs (and 12- step facilitation) in treating alcohol dependence has been established, the research on its usefulness for other forms of substance abuse is more preliminary, but the treatment appears promising for helping drug abusers sustain recovery.
Family Behavior Therapy
Family Behavior Therapy (FBT), which has demonstrated positive results in both adults and adolescents, is aimed at addressing not only substance use problems but other co-occurring problems as well, such as conduct disorders, child mistreatment, depression, family conflict, and unemployment. FBT combines behavioral contracting with contingency management.
FBT involves the patient along with at least one significant other such as a cohabiting partner or a parent (in the case of adolescents). Therapists seek to engage families in applying the behavioral strategies taught in sessions and in acquiring new skills to improve the home environment. Patients are encouraged to develop behavioral goals for preventing substance use and HIV infection, which are anchored to a contingency management system. Substance-abusing parents are prompted to set goals related to effective parenting behaviors. During each session, the behavioral goals are reviewed, with rewards provided by significant others when goals are accomplished. Patients participate in treatment planning, choosing specific interventions from a menu of evidence-based treatment options. In a series of comparisons involving adolescents with and without conduct disorder, FBT was found to be more effective than supportive counseling.
Behavioral Therapies Primarily for Adolescents
Drug-abusing and addicted adolescents have unique treatment needs. Research has shown that treatments designed for and tested in adult populations often need to be modified to be effective in adolescents. Family involvement is a particularly important component for interventions targeting youth. Below are examples of behavioral interventions that employ these principles and have shown efficacy for treating addiction in youth.
Multisystemic Therapy
Multisystemic Therapy (MST) addresses the factors associated with serious antisocial behavior in children and adolescents who abuse alcohol and other drugs. These factors include characteristics of the child or adolescent (e.g., favorable attitudes toward drug use), the family (poor discipline, family conflict, parental drug abuse), peers (positive attitudes toward drug use), school (dropout, poor performance), and neighborhood (criminal subculture). By participating in intensive treatment in natural environments (homes, schools, and neighborhood settings), most youths and families complete a full course of treatment. MST significantly reduces adolescent drug use during treatment and for at least 6 months after treatment. Fewer incarcerations and out-of-home juvenile placements offset the cost of providing this intensive service and maintaining the clinicians’ low caseloads.
Multidimensional Family Therapy
Multidimensional Family Therapy (MDFT) for adolescents is an outpatient, family-based treatment for teenagers who abuse alcohol or other drugs. MDFT views adolescent drug use in terms of a network of influences (individual, family, peer, community) and suggests that reducing unwanted behavior and increasing desirable behavior occur in multiple ways in different settings. Treatment includes individual and family sessions held in the clinic, in the home, or with family members at the family court, school, or other community locations.
During individual sessions, the therapist and adolescent work on important developmental tasks, such as developing decision-making, negotiation, and problem-solving skills. Teenagers acquire vocational skills and skills in communicating their thoughts and feelings to deal better with life stressors. Parallel sessions are held with family members. Parents examine their particular parenting styles, learning to distinguish influence from control and to have a positive and developmentally appropriate influence on their children.
Brief Strategic Family Therapy
Brief Strategic Family Therapy (BSFT) targets family interactions that are thought to maintain or exacerbate adolescent drug abuse and other co-occurring problem behaviors. Such problem behaviors include conduct problems at home and at school, oppositional behavior, delinquency, associating with antisocial peers, aggressive and violent behavior, and risky sexual behavior. BSFT is based on a family systems approach to treatment, in which family members’ behaviors are assumed to be interdependent such that the symptoms of one member (the drug-abusing adolescent, for example) are indicative, at least in part, of what else is occurring in the family system. The role of the BSFT counselor is to identify the patterns of family interaction that are associated with the adolescent’s behavior problems and to assist in changing those problem-maintaining family patterns. BSFT is meant to be a flexible approach that can be adapted to a broad range of family situations in various settings (mental health clinics, drug abuse treatment programs, other social service settings, and families’ homes) and in various treatment modalities (as a primary outpatient intervention, in combination with residential or day treatment, and as an aftercare/continuing-care service following residential treatment).
Functional Family Therapy
Functional Family Therapy (FFT) is another treatment based on a family systems approach, in which an adolescent’s behavior problems are seen as being created or maintained by a family’s dysfunctional interaction patterns. FFT aims to reduce problem behaviors by improving communication, problem-solving, conflict resolution, and parenting skills. The intervention always includes the adolescent and at least one family member in each session. Principal treatment tactics include (1) engaging families in the treatment process and enhancing their motivation for change and (2) bringing about changes in family members’ behavior using contingency management techniques, communication and problem-solving, behavioral contracts, and other behavioral interventions.
Adolescent Community Reinforcement Approach and Assertive Continuing Care
The Adolescent Community Reinforcement Approach (A-CRA) is another comprehensive substance abuse treatment intervention that involves the adolescent and his or her family. It seeks to support the individual’s recovery by increasing family, social, and educational/vocational reinforcers. After assessing the adolescent’s needs and levels of functioning, the therapist chooses from among 17 A- CRA procedures to address problem-solving, coping, and communication skills and to encourage active participation in positive social and recreational activities. A-CRA skills training involves role-playing and behavioral rehearsal.
Assertive Continuing Care (ACC) is a home-based continuing-care approach to preventing relapse. Weekly home visits take place over a 12- to 14-week period after an adolescent is discharged from residential, intensive outpatient, or regular outpatient treatment. Using positive and negative reinforcement to shape behaviors, along with training in problem-solving and communication skills, ACC combines A-CRA and assertive case management services (e.g., use of a multidisciplinary team of professionals, round-the-clock coverage, assertive outreach) to help adolescents and their caregivers acquire the skills to engage in positive social activities.
Mutual Help Groups
12-Step Groups
To describe the impact and evolution of 12-step groups, let’s begin here:
It’s a warm spring afternoon in 1935, and Bill Wilson is out of town on a business trip. He paces impatiently in the lobby of his hotel in Akron, Ohio, hundreds of miles from his home in New York. He has concluded a series of unsuccessful meetings and feels frustrated and alone.
Wilson has struggled with his sobriety since returning as an officer in the Great War (World War I) in 1919. He has been in and out of hospitals and psychiatric wards, repeatedly finding his way back to alcohol. Following a spiritual awakening, he now has several months sober, but he realizes he desperately needs to talk to someone else.
And not just any someone, but in particular, someone who can understand what he is going through. He needs someone who can listen to him without judgment, who won’t continuously interrupt to have him explain his experiences and feelings. Someone who will just KNOW what Wilson is going through as he feels the pangs of longing for just one sip of a drink.
There’s a well-stocked bar a few steps away. From inside, Wilson hears the friendly chatter of hotel guests enjoying a carefree afternoon. He sees rows of attractive bottles lining the walls as the bartender pours a crisp, refreshing beer into a cold glass for one of the patrons. Wilson begins to sweat, and his brain can only think about the pure delight of that first sip of alcohol touching his lips. Yet he resists the urge momentarily and has another idea.
Wilson begins pouring nickel after nickel into the payphone in the hotel’s lobby, looking to connect with a local who might guide him to another person who has experienced the struggle of sobriety. He eventually gets in touch with a pastor who gives him the name of Henrietta Seiberling, a local Oxford Group leader. Seiberling invites Wilson to meet with a nearby physician and known alcoholic, Dr. Bob Smith.
Wilson drives to Dr. Smith’s residence and approaches him tentatively. Wilson begins describing his desire to speak with someone about his drinking. At first, Smith mistakenly assumes Wilson has come to convince him of the need to seek help for Smith’s drinking problem, but the opposite is true. Wilson wants to be able to share openly about his own experiences and feelings, with Smith serving as audience and de facto therapist.
By the end of the afternoon, neither has taken a drink. A fast friendship develops, along with a growing desire to reach out to others by sharing their stories. Their collaboration leads to the emergence of the first meetings of a group called Alcoholics Anonymous (AA). The group eventually spreads to every state and nearly every country in the world, and it has spawned over 200 other groups that utilize the same 12 steps of AA, touching millions of lives along the way.[1]
AA was not the first group to try and support people who wanted to quit drinking, but it was the most successful, and its staying power is a testament to the model. Before AA, organizations that tried to help people stay sober were primarily religious in nature. Just before AA’s founding, Bill Wilson attended the Oxford Group, which emphasized evangelical Christian principles along with meetings where members confessed their struggles with alcoholism while seeking guidance from senior group members.
The roots of AA are clear to see in the tenets of the Oxford Group. In an essay he wrote in 1960, Bill Wilson acknowledged that most of the steps of AA “stem directly” from the Oxford Group’s principles. However, Wilson and Smith realized that a strict emphasis on religion would ultimately turn people away and fracture the group, so they developed an approach that mirrors many traditional Judeo-Christian teachings but invites people of all backgrounds to participate. The rapid spread of AA meetings, followed by the publication of the group’s official text (often referred to as ‘The Big Book‘) in 1939, laid the groundwork for what would become modern addiction treatment in America. Bill Wilson was actively involved in helping several treatment centers establish their programs, notably the flagship location of Hazelden in Center City, Minnesota.
In addition to 12-step groups, several other groups have emerged to support various types of recovery. These include Rational Recovery/SMART Recovery, Celebrate Recovery, Women for Sobriety, and Refuge Recovery. Interestingly, some of these groups vehemently eschew the role of spirituality in recovery (e.g. Rational Recovery), while others use it as their primary focus (e.g., Celebrate Recovery).
A brief list of examples of 12-step organizations:
Alcoholics Anonymous – founded in 1935, the original 12-step group focuses on helping its members to quit drinking and to spread their message to others
Al-Anon Family Groups – founded in 1951 as a group to support family members and loved ones of alcoholics
Narcotics Anonymous – founded in 1953 to help people quit using drugs other than alcohol
Gamblers Anonymous – founded in 1957 to help compulsive gamblers
Overeaters Anonymous – founded in 1960 to help people who have lost control over their eating
Emotions Anonymous – founded in 1971 for people who are working on emotional stability
In addition to the groups listed above, dozens of other problems have been targeted by 12-step fellowships. Each group applies the same steps to a particular issue that people are struggling with. This is consistent with the 12 traditions of AA, which include a narrow focus on helping others who have a problem with alcohol (tradition five) and avoidance of views on all outside issues (tradition ten).
Recovery Support Groups Not Based on the 12 Steps
While millions of people credit 12-step involvement for their sobriety, many have been unsuccessful in Alcoholics Anonymous or have sought other alternatives. Some of these groups are discussed below.
Women for Sobriety
Often cited as the first secular alternative to Alcoholics Anonymous, Women for Sobriety was established in the 1970s by sociologist Jean Kirkpatrick as a group seeking to create a program more friendly to women. The group developed their own steps called the New Life program that alter the language of AA’s 12 steps, notably removing the word “powerless” from the first step.
Rational Recovery
As an alternative to traditional Alcoholics Anonymous groups, Rational Recovery was founded in 1986 by Jack Trimpey based on self-help rather than mutual help. The model of Rational Recovery does away with all mentions of spirituality and does not hold meetings. Instead, Rational Recovery emphasizes identifying and labeling one’s addictive voice that perpetuates the using behavior. According to the program, once a person learns the foundational cognitive skills of the approach, he or she simply needs to apply them on a regular basis, thus the removal of spirituality and fellowship from the program.
SMART Recovery
SMART stands for self-management and recovery training. This group emerged in the 1990s as some members of Rational Recovery found they wanted to hold in-person meetings to discuss their recovery. They utilize cognitive-behavioral techniques to help members practice improved coping skills and resist urges to use. Their in-person and online meetings are run by a certified SMART trainer.
Celebrate Recovery
Founded in 1991, Celebrate Recovery is a dedicated Christian organization. Whereas the 12 steps make general reference to a higher power but do not promote any particular religious beliefs, Celebrate Recovery promotes a path to healing that incorporates teachings from the Bible. As their website explains, they are a “Christ-centered 12-step program.” There are other significant differences from 12-step groups that distinguish Celebrate Recovery. First, the group does not focus on a single issue; they allow people with all addictions to participate. Members struggle with a range of problems the group describes as “hurts, hang-ups, and habits.” Second, there is an emphasis on naming your higher power as Jesus and an unapologetic push to make Christ the focal point of recovery.
Refuge Recovery
Like Celebrate Recovery, Refuge Recovery uses spiritual practices as a foundation for recovery. In this group, Buddhist beliefs and practices are used in a non-theistic way to support sobriety. The group’s principles are based in part on those of Alcoholics Anonymous. Practices include meditation and mindfulness training, along with the “Four Truths of Refuge Recovery”:
• Addiction creates suffering
• The cause of addiction is repetitive craving
• Recovery is possible
• The path to recovery is available
Substance Abuse and Mental Health Services Administration (US); Office of the Surgeon General (US). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. Washington (DC): US Department of Health and Human Services; 2016 Nov. CHAPTER 5, RECOVERY: THE MANY PATHS TO WELLNESS. Available from: www.ncbi.nlm.nih.gov/books/NBK424846/
Holistic Approaches
In keeping with the concept of offering a menu of options to people in recovery, we close this chapter with a look at additional practices that may be beneficial. This includes such tools as dietary changes, exercise, and spiritual involvement.
Substance Use Recovery and Diet Courtesy of MedlinePlus from the National Library of Medicine
Substance use harms the body in two ways:
• The substance itself affects the body.
• It causes negative lifestyle changes, such as irregular eating and poor diet.
Proper nutrition can help the healing process. Nutrients supply the body with energy. They provide substances to build and maintain healthy organs and fight off infection.
Recovery from substance use also affects the body in different ways, including metabolism (processing energy), organ function, and mental well-being.
The impact of different drugs on nutrition is described below.
OPIATES
Opiates (including codeine, oxycodone, heroin, and morphine) affect the gastrointestinal system. Constipation is a very common symptom of substance use. Symptoms that are common during withdrawal include:
• Diarrhea
• Nausea and vomiting
These symptoms may lead to a lack of enough nutrients and an imbalance of electrolytes (such as sodium, potassium, and chloride).
Eating balanced meals may make these symptoms less severe (however, eating can be difficult, due to nausea). A high-fiber diet with plenty of complex carbohydrates (such as whole grains, vegetables, peas, and beans) is recommended.
ALCOHOL
Alcohol use is one of the major causes of nutritional deficiency in the United States. The most common deficiencies are of the B vitamins (B1, B6, and folic acid). A lack of these nutrients causes anemia and nervous system (neurologic) problems. For example, a disease called Wernicke-Korsakoff syndrome (“wet brain”) occurs when heavy alcohol use causes a lack of vitamin B1.
Alcohol use also damages two major organs involved in metabolism and nutrition: the liver and the pancreas. The liver removes toxins from harmful substances. The pancreas regulates blood sugar and the absorption of fat. Damage to these two organs results in an imbalance of fluids, calories, protein, and electrolytes.
Other complications include:
A woman’s poor diet when pregnant, especially if she drinks alcohol, can harm the baby’s growth and development in the womb. Infants who were exposed to alcohol while in the womb often have physical and mental problems. The alcohol affects the growing baby by crossing the placenta. After birth, the baby may have withdrawal symptoms.
Laboratory tests for protein, iron, and electrolytes may be needed to determine if there is liver disease in addition to the alcohol problem. Women who drink heavily are at high risk of osteoporosis and may need to take calcium supplements.
STIMULANTS
Stimulant use (such as crack, cocaine, and methamphetamine) reduces appetite, and leads to weight loss and poor nutrition. Users of these drugs may stay up for days at a time. They may be dehydrated and have electrolyte imbalances during these episodes. Returning to a normal diet can be hard if a person has lost a lot of weight.
Memory problems, which may be permanent, are a complication of long-term stimulant use.
MARIJUANA
Marijuana can increase appetite. Some long-term users may be overweight and need to cut back on fat, sugar, and total calories.
NUTRITION AND PSYCHOLOGICAL ASPECTS OF SUBSTANCE USE
When a person feels better, they are less likely to start using alcohol and drugs again. Because balanced nutrition helps improve mood and health, it is important to encourage a healthy diet in a person recovering from alcohol and other drug problems.
But someone who has just given up an important source of pleasure may not be ready to make other drastic lifestyle changes. So, it is more important that the person avoid returning to substance use than sticking with a strict diet.
GUIDELINES
• Stick to regular mealtimes.
• Eat foods that are low in fat.
• Get more protein, complex carbohydrates, and dietary fiber.
• Vitamin and mineral supplements may be helpful during recovery (this may include B-complex, zinc, and vitamins A and C).
A person with substance use is more likely to relapse when they have poor eating habits. This is why regular meals are important. Drug and alcohol addiction causes a person to forget what it is like to be hungry, and instead think of this feeling as a drug craving. The person should be encouraged to think that they may be hungry when cravings become strong.
During recovery from substance use, dehydration is common. It is important to get enough fluids during and in between meals. Appetite usually returns during recovery. A person in recovery is often more likely to overeat, particularly if they were taking stimulants. It is important to eat healthy meals and snacks and avoid high-calorie foods with low nutrition, such as sweets.
The following tips can help improve the odds of a lasting and healthy recovery:
• Eat nutritious meals and snacks.
• Get physical activity and enough rest.
• Reduce caffeine and stop smoking, if possible.
• Seek help from counselors or support groups on a regular basis.
• Take vitamin and mineral supplements if recommended by the health care provider.
Roessler, K.K. Exercise treatment for drug abuse–a Danish pilot study. Scand J Public Health. 2010 Aug;38(6):664-9. doi: 10.1177/1403494810371249. Epub 2010 Jun 7. PMID: 20529968.
Chapter Quiz
A link to an interactive elements can be found at the bottom of this page.
1. This story is based on the book My Name is Bill by Susan Cheever. ↵ | textbooks/socialsci/Social_Work_and_Human_Services/Foundations_of_Addiction_Studies_(Florin_and_Trytek)/1.09%3A_Pathways_to_Recovery.txt |
Relatively speaking, the field of addiction studies is a new one. Before the mid-1900s, addiction treatment and addiction professionals did not exist. The lack of research and the stigma around addiction meant that those struggling with addiction had few options at the time.
Over the past several decades, our understanding of this illness has increased significantly, and we expect that it will grow tremendously in the coming years. We may well look back in just a couple of decades at how limited our knowledge is today, and that would be a wonderful thing!
We wanted to close this book by discussing a few of the significant issues we see facing the field of addictions in the coming years. These topics are food for thought for anyone currently in the field or considering a career that deals with addictions.
1. One of the trends we have noticed in recent years is an increased emphasis on the use of medications to treat addiction. The gold standard of opioid treatment is now rooted in medication-assisted therapy such as Suboxone or methadone. We believe that this trend will continue as further research uncovers medications that help support recovery from drugs such as cocaine and marijuana, which currently have no such options.
2. Other developments may arise through new ways to treat chronic pain. The opioid epidemics of the early 21st century have created concern among elected officials and the general public about the overuse of prescription pain medicines. Scientists are now attempting to find ways of managing pain that do not have the same risk of abuse and addiction that come with traditional opioid medications. Such a breakthrough could be a major public health milestone, as opioid overdose has become one of the leading causes of death in the United States.
3. In terms of treatment approaches, we also see creative methods being used to offer improved services, such as case management and coaching models. Managed care remains a struggle for treatment providers, with an emphasis on evidenced-based, well-documented treatment. Agencies have also begun emphasizing case management approaches that connect clients with a myriad of community resources to support the recovery process.
4. Recovery coaching is a new model that utilizes a paraprofessional who can guide someone in recovery. Such an individual would have some training but would not serve in the role of a clinical staff member. In many ways, this harkens back to the roots of the field, when most counselors were themselves in recovery and often newly-minted graduates of the very treatment program where they worked. Addictions treatment has become more medically-based and now requires higher levels of education, which are positive developments. At the same time, the importance of peer support cannot be underestimated. After all, it is one of the foundations of 12-step recovery, which has a longer history of success than any other approach. A recovery coach might fill this need while supporting the work of treatment professionals.
5. One last issue we wanted to raise here is that the cultural norms around drug use are shifting. As mentioned in the presentation on “the celebrated drugs,” the role of marijuana in American culture has changed as medicinal and even recreational use become the norm. Meanwhile, traditional tobacco products such as cigarettes are on the decline, even though e-cigarettes may be quickly taking their place. As we learn more about the dangers of alcohol, will its prominent place in society remain unchanged, or will it experience the same fate as cigarettes? These issues may have different answers from one year to the next, and even from one part of the country to the next.
We hope you have enjoyed this book and expanded your knowledge about the field of addiction studies. At the same time, we realize the contents here only scratch the surface when it comes to the ocean of information about addiction. Whether you are considering a career in addictions or another mental health profession, or you are the friend or loved one of someone suffering from addiction, or you find yourself wondering about your own drug use, please keep learning and searching for answers. | textbooks/socialsci/Social_Work_and_Human_Services/Foundations_of_Addiction_Studies_(Florin_and_Trytek)/1.10%3A_Epilogue-_Future_Directions.txt |
Learning Objectives
• Explain the basic idea of reflexivity in human selfhood—how the “I” encounters and makes sense of itself (the “Me”).
• Describe fundamental distinctions between three different perspectives on the self: the self as actor, agent, and author.
• Describe how a sense of self as a social actor emerges around the age of 2 years and how it develops going forward.
• Describe the development of the self’s sense of motivated agency from the emergence of the child’s theory of mind to the articulation of life goals and values in adolescence and beyond.
• Define the term narrative identity, and explain what psychological and cultural functions narrative identity serves.
For human beings, the self is what happens when “I” encounters “Me.” The central psychological question of selfhood, then, is this: How does a person apprehend and understand who he or she is? Over the past 100 years, psychologists have approached the study of self (and the related concept of identity) in many different ways, but three central metaphors for the self repeatedly emerge. First, the self may be seen as a social actor, who enacts roles and displays traits by performing behaviors in the presence of others. Second, the self is a motivated agent, who acts upon inner desires and formulates goals, values, and plans to guide behavior in the future. Third, the self eventually becomes an autobiographical author, too, who takes stock of life — past, present, and future — to create a story about who I am, how I came to be, and where my life may be going. This module briefly reviews central ideas and research findings on the self as an actor, an agent, and an author, with an emphasis on how these features of selfhood develop over the human life course.
1.1 Introduction
In the Temple of Apollo at Delphi, the ancient Greeks inscribed the words: “Know thyself.” For at least 2,500 years, and probably longer, human beings have pondered the meaning of the ancient aphorism. Over the past century, psychological scientists have joined the effort. They have formulated many theories and tested countless hypotheses that speak to the central question of human selfhood: How does a person know who he or she is?
The ancient Greeks seemed to realize that the self is inherently reflexive—it reflects back on itself. In the disarmingly simple idea made famous by the great psychologist William James (1892/1963), the self is what happens when “I” reflects back upon “Me.” The self is both the I and the Me—it is the knower, and it is what the knower knows when the knower reflects upon itself. When you look back at yourself, what do you see? When you look inside, what do you find? Moreover, when you try to change your self in some way, what is it that you are trying to change? The philosopher Charles Taylor (1989) describes the self as a reflexive project. In modern life, Taylor argues that, we often try to manage, discipline, refine, improve, or develop the self. We work on our selves, as we might work on any other interesting project. But what exactly is it that we work on?
Imagine for a moment that you have decided to improve yourself. You might say, go on a diet to improve your appearance. Or you might decide to be nicer to your mother, in order to improve that important social role. Or maybe the problem is at work—you need to find a better job or go back to school to prepare for a different career. Perhaps you just need to work harder. Or get organized. Or recommit yourself to religion. Or maybe the key is to begin thinking about your whole life story in a completely different way, in a way that you hope will bring you more happiness, fulfillment, peace, or excitement.
Although there are many different ways you might reflect upon and try to improve the self, it turns out that many, if not most, of them fall roughly into three broad psychological categories (McAdams & Cox, 2010). The I may encounter the Me as (a) a social actor, (b) a motivated agent, or (c) an autobiographical author.
1.2 The Social Actor
Shakespeare tapped into a deep truth about human nature when he famously wrote, “All the world’s a stage, and all the men and women merely players.” He was wrong about the “merely,” however, for there is nothing more important for human adaptation than the manner in which we perform our roles as actors in the everyday theatre of social life. What Shakespeare may have sensed but could not have fully understood is that human beings evolved to live in social groups. Beginning with Darwin (1872/1965) and running through contemporary conceptions of human evolution, scientists have portrayed human nature as profoundly social (Wilson, 2012). For a few million years, Homo sapiens and their evolutionary forerunners have survived and flourished by virtue of their ability to live and work together in complex social groups, cooperating with each other to solve problems and overcome threats and competing with each other in the face of limited resources. As social animals, human beings strive to get along and get ahead in the presence of each other (Hogan, 1982). Evolution has prepared us to care deeply about social acceptance and social status, for those unfortunate individuals who do not get along well in social groups or who fail to attain a requisite status among their peers have typically been severely compromised when it comes to survival and reproduction. It makes consummate evolutionary sense, therefore, that the human “I” should apprehend the “Me” first and foremost as a social actor.
For human beings, the sense of the self as a social actor begins to emerge around the age of 18 months. Numerous studies have shown that by the time they reach their second birthday most toddlers recognize themselves in mirrors and other reflecting devices (Lewis,M Brooks-Gunn, 1979Lewis & Brooks-Gunn, 1979; Rochat, 2003). What they see is an embodied actor who moves through space and time. Many children begin to use words such as “me” and “mine” in the second year of life, suggesting that the I now has linguistic labels that can be applied reflexively to itself: I call myself “me.” Around the same time, children also begin to express social emotions such as embarrassment, shame, guilt, and pride (Tangney, Stuewig, & Mashek, 2007). These emotions tell the social actor how well he or she is performing in the group. When I do things that win the approval of others, I feel proud of myself. When I fail in the presence of others, I may feel embarrassment or shame. When I violate a social rule, I may experience guilt, which may motivate me to make amends.
Many of the classic psychological theories of human selfhood point to the second year of life as a key developmental period. For example, Freud (1923/1961) and his followers in the psychoanalytic tradition traced the emergence of an autonomous ego back to the second year. Freud used the term “ego” (in German das Ich, which also translates into “the I”) to refer to an executive self in the personality. Erikson (1963) argued that experiences of trust and interpersonal attachment in the first year of life help to consolidate the autonomy of the ego in the second. Coming from a more sociological perspective, Mead (1934) suggested that the I comes to know the Me through reflection, which may begin quite literally with mirrors but later involves the reflected appraisals of others. I come to know who I am as a social actor, Mead argued, by noting how other people in my social world react to my performances. In the development of the self as a social actor, other people function like mirrors—they reflect who I am back to me.
Research has shown that when young children begin to make attributions about themselves, they start simple (Harter, 2006). At age 4, Jessica knows that she has dark hair, knows that she lives in a white house, and describes herself to others in terms of simple behavioral traits. She may say that she is “nice,” or “helpful,” or that she is “a good girl most of the time.” By the time, she hits fifth grade (age 10), Jessica sees herself in more complex ways, attributing traits to the self such as “honest,” “moody,” “outgoing,” “shy,” “hard-working,” “smart,” “good at math but not gym class,” or “nice except when I am around my annoying brother.” By late childhood and early adolescence, the personality traits that people attribute to themselves, as well as those attributed to them by others, tend to correlate with each other in ways that conform to a well-established taxonomy of five broad trait domains, repeatedly derived in studies of adult personality and often called the Big Five: (1) extraversion, (2) neuroticism, (3) agreeableness, (4) conscientiousness, and (5) openness to experience (Roberts, Wood, & Caspi, 2008). By late childhood, moreover, self-conceptions will likely also include important social roles: “I am a good student,” “I am the oldest daughter,” or “I am a good friend to Sarah.”
Traits and roles, and variations on these notions, are the main currency of the self as social actor (McAdams & Cox, 2010). Trait terms capture perceived consistencies in social performance. They convey what I reflexively perceive to be my overall acting style, based in part on how I think others see me as an actor in many different social situations. Roles capture the quality, as I perceive it, of important structured relationships in my life. Taken together, traits and roles make up the main features of my social reputation, as I apprehend it in my own mind (Hogan, 1982).
If you have ever tried hard to change yourself, you may have taken aim at your social reputation, targeting your central traits or your social roles. Maybe you woke up one day and decided that you must become a more optimistic and emotionally upbeat person. Taking into consideration the reflected appraisals of others, you realized that even your friends seem to avoid you because you bring them down. In addition, it feels bad to feel so bad all the time: Wouldn’t it be better to feel good, to have more energy and hope? In the language of traits, you have decided to “work on” your “neuroticism.” Or maybe instead, your problem is the trait of “conscientiousness”: You are undisciplined and don’t work hard enough, so you resolve to make changes in that area. Self-improvement efforts such as these—aimed at changing one’s traits to become a more effective social actor—are sometimes successful, but they are very hard—kind of like dieting. Research suggests that broad traits tend to be stubborn, resistant to change, even with the aid of psychotherapy. However, people often have more success working directly on their social roles. To become a more effective social actor, you may want to take aim at the important roles you play in life. What can I do to become a better son or daughter? How can I find new and meaningful roles to perform at work, or in my family, or among my friends, or in my church and community? By doing concrete things that enrich your performances in important social roles, you may begin to see yourself in a new light, and others will notice the change, too. Social actors hold the potential to transform their performances across the human life course. Each time you walk out on stage, you have a chance to start anew.
1.3 The Motivated Agent
Whether we are talking literally about the theatrical stage or more figuratively, as I do in this module, about the everyday social environment for human behavior, observers can never fully know what is in the actor’s head, no matter how closely they watch. We can see actors act, but we cannot know for sure what they want or what they value, unless they tell us straightaway. As a social actor, a person may come across as friendly and compassionate, or cynical and mean-spirited, but in neither case can we infer their motivations from their traits or their roles. What does the friendly person want? What is the cynical father trying to achieve? Many broad psychological theories of the self prioritize the motivational qualities of human behavior—the inner needs, wants, desires, goals, values, plans, programs, fears, and aversions that seem to give behavior its direction and purpose (Bandura, 1989; Deci & Ryan, 1991; Markus & Nurius, 1986). These kinds of theories explicitly conceive of the self as a motivated agent.
To be an agent is to act with direction and purpose, to move forward into the future in pursuit of self-chosen and valued goals. In a sense, human beings are agents even as infants, for babies can surely act in goal-directed ways. By age 1 year, moreover, infants show a strong preference for observing and imitating the goal-directed, intentional behavior of others, rather than random behaviors (Woodward, 2009). Still, it is one thing to act in goal-directed ways; it is quite another for the I to know itself (the Me) as an intentional and purposeful force who moves forward in life in pursuit of self-chosen goals, values, and other desired end states. In order to do so, the person must first realize that people indeed have desires and goals in their minds and that these inner desires and goals motivate (initiate, energize, put into motion) their behavior. According to a strong line of research in developmental psychology, attaining this kind of understanding means acquiring a theory of mind (Wellman, 1993), which occurs for most children by the age of 4. Once a child understands that other people’s behavior is often motivated by inner desires and goals, it is a small step to apprehend the self in similar terms.
Building on theory of mind and other cognitive and social developments, children begin to construct the self as a motivated agent in the elementary school years, layered over their still-developing sense of themselves as social actors. Theory and research on what developmental psychologists call the age 5-to-7 shift converge to suggest that children become more planful, intentional, and systematic in their pursuit of valued goals during this time (Sameroff & Haith, 1996). Schooling reinforces the shift in that teachers and curricula place increasing demands on students to work hard, adhere to schedules, focus on goals, and achieve success in particular, well-defined task domains. Their relative success in achieving their most cherished goals, furthermore, goes a long way in determining children’s self-esteem (Robins, Tracy, & Trzesniewski, 2008). Motivated agents feel good about themselves to the extent they believe that they are making good progress in achieving their goals and advancing their most important values.
Goals and values become even more important for the self in adolescence, as teenagers begin to confront what Erikson (1963) famously termed the developmental challenge of identity. For adolescents and young adults, establishing a psychologically efficacious identity involves exploring different options with respect to life goals, values, vocations, and intimate relationships and eventually committing to a motivational and ideological agenda for adult life—an integrated and realistic sense of what I want and value in life and how I plan to achieve it (Kroger & Marcia, 2011). Committing oneself to an integrated suite of life goals and values is perhaps the greatest achievement for the self as motivated agent. Establishing an adult identity has implications, as well, for how a person moves through life as a social actor, entailing new role commitments and, perhaps, a changing understanding of one’s basic dispositional traits. According to Erikson, however, identity achievement is always provisional, for adults continue to work on their identities as they move into midlife and beyond, often relinquishing old goals in favor of new ones, investing themselves in new projects and making new plans, exploring new relationships, and shifting their priorities in response to changing life circumstances (Freund & Riediger, 2006; Josselson, 1996).
There is a sense whereby any time you try to change yourself, you are assuming the role of a motivated agent. After all, to strive to change something is inherently what an agent does. However, what particular feature of selfhood you try to change may correspond to your self as actor, agent, or author, or some combination. When you try to change your traits or roles, you take aim at the social actor. By contrast, when you try to change your values or life goals, you are focusing on yourself as a motivated agent. Adolescence and young adulthood are periods in the human life course when many of us focus attention on our values and life goals. Perhaps you grew up as a traditional Catholic, but now in college you believe that the values inculcated in your childhood no longer function so well for you. You no longer believe in the central tenets of the Catholic Church, say, and are now working to replace your old values with new ones. Or maybe you still want to be Catholic, but you feel that your new take on faith requires a different kind of personal ideology. In the realm of the motivated agent, moreover, changing values can influence life goals. If your new value system prioritizes alleviating the suffering of others, you may decide to pursue a degree in social work, or to become a public interest lawyer, or to live a simpler life that prioritizes people over material wealth. A great deal of the identity work we do in adolescence and young adulthood is about values and goals, as we strive to articulate a personal vision or dream for what we hope to accomplish in the future.
1.4 The Autobiographical Author
Even as the “I”continues to develop a sense of the “Me” as both a social actor and a motivated agent, a third standpoint for selfhood gradually emerges in the adolescent and early-adult years. The third perspective is a response to Erikson’s (1963) challenge of identity. According to Erikson, developing an identity involves more than the exploration of and commitment to life goals and values (the self as motivated agent), and more than committing to new roles and re-evaluating old traits (the self as social actor). It also involves achieving a sense of temporal continuity in life—a reflexive understanding of how I have come to be the person I am becoming, or put differently, how my past self has developed into my present self, and how my present self will, in turn, develop into an envisioned future self. In his analysis of identity formation in the life of the 15th-century Protestant reformer Martin Luther, Erikson (1958) describes the culmination of a young adult’s search for identity in this way:
“To be adult means among other things to see one’s own life in continuous perspective, both in retrospect and prospect. By accepting some definition of who he is, usually on the basis of a function in an economy, a place in the sequence of generations, and a status in the structure of society, the adult is able to selectively reconstruct his past in such a way that, step for step, it seems to have planned him, or better, he seems to have planned it. In this sense, psychologically we do choose our parents, our family history, and the history of our kings, heroes, and gods. By making them our own, we maneuver ourselves into the inner position of proprietors, of creators.”(Erikson, 1958, pp. 111–112; emphasis added).
In this rich passage, Erikson intimates that the development of a mature identity in young adulthood involves the I’s ability to construct a retrospective and prospective story about the Me (McAdams, 1985). In their efforts to find a meaningful identity for life, young men and women begin “to selectively reconstruct” their past, as Erikson wrote, and imagine their future to create an integrative life story, or what psychologists today often call a narrative identity. A narrative identity is an internalized and evolving story of the self that reconstructs the past and anticipates the future in such a way as to provide a personarrative identityn’s life with some degree of unity, meaning, and purpose over time (McAdams, 2008; McLean, Pasupathi, & Pals, 2007). The self typically becomes an autobiographical author in the early-adult years, a way of being that is layered over the motivated agent, which is layered over the social actor. In order to provide life with the sense of temporal continuity and deep meaning that Erikson believed identity should confer, we must author a personalized life story that integrates our understanding of who we once were, who we are today, and who we may become in the future. The story helps to explain, for the author and for the author’s world, why the social actor does what it does and why the motivated agent wants what it wants, and how the person as a whole has developed over time, from the past’s reconstructed beginning to the future’s imagined ending.
By the time they are 5 or 6 years of age, children can tell well-formed stories about personal events in their lives (Fivush, 2011). By the end of childhood, they usually have a good sense of what a typical biography contains and how it is sequenced, from birth to death (Thomsen & Bernsten, 2008). But it is not until adolescence, research shows, that human beings express advanced storytelling skills and what psychologists call autobiographical reasoning (Habermas & Bluck, 2000; McLean & Fournier, 2008). In autobiographical reasoning, a narrator is able to derive substantive conclusions about the self from analyzing his or her own personal experiences. Adolescents may develop the ability to string together events into causal chains and inductively derive general themes about life from a sequence of chapters and scenes (Habermas & de Silveira, 2008). For example, a 16-year-old may be able to explain to herself and to others how childhood experiences in her family have shaped her vocation in life. Her parents were divorced when she was 5 years old, the teenager recalls, and this caused a great deal of stress in her family. Her mother often seemed anxious and depressed, but she (the now-teenager when she was a little girl—the story’s protagoniHabermas & de Silveira, 2008st) often tried to cheer her mother up, and her efforts seemed to work. In more recent years, the teenager notes that her friends often come to her with their boyfriend problems. She seems to be very adept at giving advice about love and relationships, which stems, the teenager now believes, from her early experiences with her mother. Carrying this causal narrative forward, the teenager now thinks that she would like to be a marriage counselor when she grows up.
Unlike children, then, adolescents can tell a full and convincing story about an entire human life, or at least a prominent line of causation within a full life, explaining continuity and change in the story’s protagonist over time. Once the cognitive skills are in place, young people seek interpersonal opportunities to share and refine their developing sense of themselves as storytellers (the I) who tell stories about themselves (the Me). Adolescents and young adults author a narrative sense of the self by telling stories about their experiences to other people, monitoring the feedback they receive from the tellings, editing their stories in light of the feedback, gaining new experiences and telling stories about those, and on and on, as selves create stories that, in turn, create new selves (McLean et al., 2007). Gradually, in fits and starts, through conversation and introspection, the I develops a convincing and coherent narrative about the Me.
Contemporary research on the self as autobiographical author emphasizes the strong effect of culture on narrative identity (Hammack, 2008). Culture provides a menu of favored plot lines, themes, and character types for the construction of self-defining life stories. Autobiographical authors sample selectively from the cultural menu, appropriating ideas that seem to resonate well with their own life experiences. As such, life stories reflect the culture, wherein they are situated as much as they reflect the authorial efforts of the autobiographical I.
As one example of the tight link between culture and narrative identity, McAdams (2013) and others (e.g., Kleinfeld, 2012) have highlighted the prominence of redemptive narratives in American culture. Epitomized in such iconic cultural ideals as the American dream, Horatio Alger stories, and narratives of Christian atonement, redemptive stories track the move from suffering to an enhanced status or state, while scripting the development of a chosen protagonist who journeys forth into a dangerous and unredeemed world (McAdams, 2013). Hollywood movies often celebrate redemptive quests. Americans are exposed to similar narrative messages in self-help books, 12-step programs, Sunday sermons, and in the rhetoric of political campaigns. Over the past two decades, the world’s most influential spokesperson for the power of redemption in human lives may be Oprah Winfrey, who tells her own story of overcoming childhood adversity while encouraging others, through her media outlets and philanthropy, to tell similar kinds of stories for their own lives (McAdams, 2013). Research has demonstrated that American adults who enjoy high levels of mental health and civic engagement tend to construct their lives as narratives of redemption, tracking the move from sin to salvation, rags to riches, oppression to liberation, or sickness/abuse to health/recovery (McAdams, Diamond, de St. Aubin, & Mansfield, 1997; McAdams, Reynolds, Lewis, Patten, & Bowman, 2001; Walker & Frimer, 2007). In American society, these kinds of stories are often seen to be inspirational.
At the same time, McAdams (2011, 2013) has pointed to shortcomings and limitations in the redemptive stories that many Americans tell, which mirror cultural biases and stereotypes in American culture and heritage. McAdams has argued that redemptive stories support happiness and societal engagement for some Americans, but the same stories can encourage moral righteousness and a naïve expectation that suffering will always be redeemed. For better and sometimes for worse, Americans seem to love stories of personal redemption and often aim to assimilate their autobiographical memories and aspirations to a redemptive form. Nonetheless, these same stories may not work so well in cultures that espouse different values and narrative ideals (Hammack, 2008). It is important to remember that every culture offers its own storehouse of favored narrative forms. It is also essential to know that no single narrative form captures all that is good (or bad) about a culture. In American society, the redemptive narrative is but one of many different kinds of stories that people commonly employ to make sense of their lives.
What is your story? What kind of a narrative are you working on? As you look to the past and imagine the future, what threads of continuity, change, and meaning do you discern? For many people, the most dramatic and fulfilling efforts to change the self happen when the I works hard, as an autobiographical author, to construct and, ultimately, to tell a new story about the Me. Storytelling may be the most powerful form of self-transformation that human beings have ever invented. Changing one’s life story is at the heart of many forms of psychotherapy and counseling, as well as religious conversions, vocational epiphanies, and other dramatic transformations of the self that people often celebrate as turning points in their lives (Adler, 2012). Storytelling is often at the heart of the little changes, too, minor edits in the self that we make as we move through daily life, as we live and experience life, and as we later tell it to ourselves and to others.
1.5 End-of-Chapter Summary
For human beings, selves begin as social actors, but they eventually become motivated agents and autobiographical authors, too. The I first sees itself as an embodied actor in social space; with development, however, it comes to appreciate itself also as a forward-looking source of self-determined goals and values, and later yet, as a storyteller of personal experience, oriented to the reconstructed past and the imagined future. To “know thyself” in mature adulthood, then, is to do three things: (a) to apprehend and to perform with social approval my self-ascribed traits and roles, (b) to pursue with vigor and (ideally) success my most valued goals and plans, and (c) to construct a story about life that conveys, with vividness and cultural resonance, how I became the person I am becoming, integrating my past as I remember it, my present as I am experiencing it, and my future as I hope it to be.
1.6 Additional Resources
The website for the Foley Center for the Study of Lives, at Northwestern University. The site contains research materials, interview protocols, and coding manuals for conducting studies of narrative identity.
1.7 Discussion Questions
1. Back in the 1950s, Erik Erikson argued that many adolescents and young adults experience a tumultuous identity crisis. Do you think this is true today? What might an identity crisis look and feel like? And, how might it be resolved?
2. Many people believe that they have a true self buried inside of them. From this perspective, the development of self is about discovering a psychological truth deep inside. Do you believe this to be true? How does thinking about the self as an actor, agent, and author bear on this question?
3. Psychological research shows that when people are placed in front of mirrors they often behave in a more moral and conscientious manner, even though they sometimes experience this procedure as unpleasant. From the standpoint of the self as a social actor, how might we explain this phenomenon?
4. By the time they reach adulthood, does everybody have a narrative identity? Do some people simply never develop a story for their life?
5. What happens when the three perspectives on self—the self as actor, agent, and author—conflict with each other? Is it necessary for people’s self-ascribed traits and roles to line up well with their goals and their stories?
6. William James wrote that the self includes all things that the person considers to be “mine.” If we take James literally, a person’s self might extend to include his or her material possessions, pets, and friends and family. Does this make sense?
7. To what extent can we control the self? Are some features of selfhood easier to control than others?
8. What cultural differences may be observed in the construction of the self? How might gender, ethnicity, and class impact the development of the self as actor, as agent, and as author?
Attribution
Adapted from Self and Identity by Dan P. McAdams under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/01%3A_Traditional_Paradigms_and_Dominant_Perspectives_on_Individuals/01%3A_Self_and_Identity.txt |
Learning Objectives
• Explain the relationship between culture and the social world
• Understand the role and impact of culture on society
• Describe concepts central to cultural sociology
• Summarize and apply the theoretical perspectives on the study of culture
2.1 Introduction
Culture is an expression of our lives. It molds our identity and connection to the social world. Whether it is our values, beliefs, norms, language, or everyday artifacts each element of culture reflects who we are and influences our position in society.
If you think about how we live, communicate, think and act, these parts of our existence develop from the values, beliefs, and norms we learn from others, the language and symbols we understand, and the artifacts or materials we use. Culture is embedded into everyday life and is the attribute in which others view and understand us.
2.2 Link between Culture and Society
Culture is both expressive and social. Neither culture nor society exist in the real world rather it is the thoughts and behaviors of people that constructs a society, its culture, and meanings (Griswold 2013). People build the world we live in including the cultural attributes we choose to obtain, exhibit, and follow. Societies communicate and teach culture as part of the human experience.
Ballet_Swan Lake CCO. Image by Niki Dinov from Pixabay
Historically, culture referred to characteristics and qualities of the fine arts, performing arts, and literature connecting culture to social status. This perspective emphasized a subculture shared by the social elite or upper class and has been historically characterized as civilized culture. This perspective within the humanities studied the “ideal type” or “high culture” of affluent social groups depicting whom was “cultured” or rather was wealthy and educated in society lending itself to a ranking of cultures in its study.
In the 19th century, anthropologist Edward B. Tyler (1871) introduced culture as a complex social structure encompassing “. . . knowledge, belief, art, morals, law, customs, and other capabilities and habits acquired by man as a member of society.” This definition focused on culture as a social attribute of humanity. Social scientists adopted this perspective expanding the study of culture beyond the ethnocentric elitism of “high culture.” With emphasis on human social life as a reflection of culture, social scientists sought to understand not only how culture reflects society but also how society reflects culture. These new insights inspired social scientists to examine the practices of people lending itself to a sociological perspective on culture.
2.3 Defining Culture
Culture is universal. Every society has culture. Culture touches every “aspect of who and what we are” and becomes a lens of how we see and evaluate the world around us (Henslin 2011:36). Culture molds human nature and people learn to express nature in cultural ways. The sociological perspective acknowledges that all people are cultured.
Each generation transmits culture to the next providing us a roadmap and instruction on how to live our lives. Cultural transmission occurs through the learning and expression of traditions and customs. Learning your own group’s culture is enculturation. Adults are agents of enculturation responsible for passing on culture to each generation.
Through learning, people develop individual cultural characteristics that are part of a social pattern and integrated set of traits expressing a group’s core values (Kottak and Kozitis 2012). Thus, cultures are integrated and patterned systems serving a variety of social functions within groups. Enculturation gives members of a group a process to think symbolically, use language and tools, share common experiences and knowledge, and learn by observation, experience, as well as unconsciously from each other (Kottak and Kozitis 2003). The commonalities we share
through culture establish familiarity and comfort among members of our own group.
Non-Material vs. Material Culture
Culture is either non-material or material. Non-material culture includes psychological and spiritual elements influencing the way individuals think and act. Material culture refers to physical artifacts people use and consume.
Immaterial aspects of culture reflect social values, beliefs, norms, expressive symbols, and practices. Though these cultural elements are intangible, they often take on a physical form in our minds. Non-material culture becomes real in our perceptions and we begin to view them as objects as in the belief of God or other deity. Though we cannot physically see, hear, or touch a God belief makes them real and imaginable to us.
Values or ideals define what is desirable in life and guides our preferences and choices. Changes in core values may seem threatening to some individuals or societies as “a threat to a way of life” (Henslin 2011). A strong bind to core values can also blind individuals to reality or objectivity reinforcing fallacies and stereotypes. Throughout history, there have always been differences between what people value (their ideal or public culture) and how they actually live their lives (their real or personal culture).
Beliefs sometimes mirror values. One’s belief system may align or determine their values influencing thoughts and actions. Beliefs are not always spiritual or supernatural. For example, the belief in love or feelings of affection are internal emotions or physical reactions that exhibit physiological changes in human chemistry. Some beliefs are true representations of metaphysical or abstract thinking which transcend the laws of nature such as faith or superstitions.
Cultural Inventory
• What is your personal cultural inventory? Describe your values and beliefs, the social norms in which you conform, the expressive symbols (including language) you understand and use regularly, your daily practices, and the artifacts you use frequently and those you treasure.
• How did you learn culture? Explain the socializing agents responsible for teaching you the traditions, customs, and rituals you live by and follow.
• What impact does culture have on your identity? Discuss how your culture influences your self-image,
views, and role in society.
• How does culture influence your thinking and behavior towards others? Explain how your culture impacts the image or understanding you have about others including assumptions, stereotypes, and prejudices.
Norms or rules develop out of a group’s values and beliefs. When people defy the rules, they receive social reactions resulting in a sanction. Sanctions are a form of social control (Griffiths et al, 2015). When people follow the rules, they receive a positive sanction or reward, and when they break the rules, they receive a negative one or punishment that may include social isolation.
Symbols help people understand the world (Griffiths et al. 2015). Symbols include gestures, signs, signals, objects, and words. Language is the symbolic system people use to communicate both verbally and in writing (Griffiths et al. 2015). Language constantly evolves and provides the basis for sharing cultural experiences and ideas.
The Sapir-Worf Hypothesis suggests people experience the world through symbolic language that derives from culture itself (Griffiths et al. 2015). If you see, hear, or think of a word, it creates a mental image in your head helping you understand and interpret meaning. If you are not familiar with a word or its language, you are unable to comprehend meaning creating a cultural gap or boundary between you and the cultural world around you. Language makes symbolic thought possible.
Practices or the behaviors we carry out develop from or in response to our thoughts. We fulfill rituals, traditions, or customs based on our values, beliefs, norms, and expressive symbols. Culture dictates and influences how people live their lives. Cultural practices become habitual from frequent repetition (Henslin 2011). Habitualization leads to institutionalization by consensus of a social group. This results in cultural patterns and systems becoming logical and
the viewed as the norm.
Material culture is inherently unnatural, such as buildings, machines, electronic devices, clothing, hairstyles, etc. (Henslin 2011). Dialogue about culture often ignores its close tie to material realities in society. The cultural explanations we receive from family, friends, school, work, and media justify cultural realities and utilities of the artifacts we use and consume. Human behavior is purposeful and material culture in our lives derives from the interests of our socializing agents in our environment.
2.4 Cultural Sociology
There is division among sociologists who study culture. Those who study the sociology of culture have limitations on the categorizations of cultural topics and objects restricting the view of culture as a social product or consequence. The theoretical works of Emile Durkheim, Karl Marx, and Max Weber and the field of anthropology, shaped the sociology of culture. Durkheim found culture and society are interrelated. He explained social structures or institutions serve a functions society. As a collective group, society’s culture including its social, political and economic values are essentially part of and reflected in all structures or institutions (Durkheim 1965). Marx believed social power influences culture. He suggested cultural products depend on economics and people who have power are able to produce and distribute culture (Marx 1977). Weber in alignment with the traditional humanities viewpoint emphasized the ability of culture to influence human behavior. His perspective argued some cultures and cultural works are ideal types that could be lost if they were not preserved or archived (Weber 1946). Until the late twentieth century, anthropologists emphasized the importance of art and culture to educate, instill morality, critique society to inspire change (Best 2007). Initial thoughts on culture focused on how culture makes a person. These works accentuated the idea that certain cultural elements (i.e., elite or high culture) make a person cultured.
In contrast, the study of cultural sociology suggests social phenomena is inherently cultural (Alexander 2003). Cultural sociology investigates culture as an explanation of social phenomena. During the cultural turn movement of the 1970s, cultural sociology emerged as a field of study among anthropologists and social scientists evaluating the role of culture in society. Academics expanded their research to the social process in which people communicate meaning, understand the world, construct identity, and express values and beliefs (Best 2007). This new approach incorporates analyzing culture using data from interviews, discussions, and observations of people to understand the social, historical structures and ideological forces that produce and confine culture.
Cultural sociology examines the social meanings and expressions associated with culture. Cultural sociologists study representations of culture including elitist definitions and understanding such as art, literature, and classical music, but also investigate the broad range of culture in everyday social life (Back et al). Noting the significance of culture in human social life, sociologists empirically study culture, the impact of culture on social order, the link between culture and society, and the persistence and durability of culture over time (Griswold 2013). Cultural sociology incorporates an interdisciplinary approach drawing on different disciplines because of the broad scope and social influences culture has on people. Culture is inseparable from the acts and influence of cultural practices embedded within social categories (i.e., gender, ethnicity, and social class) and social institutions (i.e., family, school, and work) that construct identities and lifestyle practices of individuals (Giddens 1991; Chaney 1996). In the effort to understand the relationship between culture and society, sociologists study cultural practices, institutions, and systems including the forms of power exhibited among social groups related to age, body and mind, ethnicity, gender, geography, race, religion and belief systems, sex, sexuality, and social class.
Cultural Identity in Art
Ethnographers and Native Anthropologists
In the study of cultural sociology, many practitioners examine both quantitative and qualitative data to develop an understanding of cultural experiences. Quantitative or numeric data provides a framework for understanding observable patterns or trends while qualitative or categorical data presents the reasoning behind thoughts and actions associated with patterns or trends.
The collection of qualitative data incorporates scientific methodological approaches including participant observation (observing people as a member of the group), interviews (face-to-face meetings), focus groups (group discussions), or images (pictures or video). Each method focuses on collecting specific types of information to develop a deep understanding about a particular culture and the experiences associated with being a member of that culture.
Ethnographers study people and cultures by using qualitative methods. Ethnography or ethnographic research is the firsthand, field-based study of a particular culture by spending at least one year living with people and learning their customs and practices (Kottak and Kozaitis 2012). In the field, ethnographers are participant observers and a participant of the group or society of study. Participant observers face challenges in remaining objective, non-bias, and ensuring their participation does not lead or influence others of the group in a specific direction (Kennedy, Norwood, and Jendian 2017). This research approach expects ethnographers to eliminate the risk of contaminating data with interference or bias interpretations as much as humanly possible.
Some researchers choose to study their own culture. These practitioners refer to themselves as native anthropologists. Many native anthropologists have experience studying other cultures prior to researching their own (Kottak and Kozaitis 2012). The practice of learning how to study other cultures gives practitioners the skills and knowledge they need to study their own culture more objectively. In addition, by studying other cultures then one’s own, native anthropologists are able to compare and analyze similarities and differences in cultural perceptions and practices.
2.5 Theoretical Perspectives on Culture
The social structure plays an integral role in the social location (i.e., place or position) people occupy in society. Your social location is a result of cultural values and norms from the time period and place in which you live. Culture affects personal and social development including the way people will think or behave. Cultural characteristics pertaining to age, gender, race, education, income, and other social factors influence the location people occupy at any given time.
Furthermore, social location influences how people perceive and understand the world in which we live. People have a difficult time being objective in all contexts because of their social location within cultural controls and standards derived from values and norms. Objective conditions exist without bias because they are measurable and quantifiable (Carl 2013). Subjective concerns rely on judgments rather than external facts. Personal feelings and opinions from a person’s social location drive subjective concerns. The sociological imagination is a tool to help people step outside subjective or personal biography, and look at objective facts and the historical background of a situation, issue, society, or person (Carl 2013).
Perceptions of Reality
The time period we live (history) and our personal life experiences (biography) influence our perspectives and understanding about others and the world. Our history and biography guide our perceptions of reality reinforcing our personal bias and subjectivity. Relying on subjective viewpoints and perspectives leads to diffusion of misinformation and fake news that can be detrimental to our physical and socio-cultural environment and negatively impact our interactions with others. We must seek out facts and develop knowledge to enhance our objective eye. By using valid, reliable, proven facts, data, and information, we establish credibility and make better decisions for the world and ourselves.
• Consider a socio-cultural issue you are passionate about and want to change or improve.
• What is your position on the issue? What ideological or value-laden reasons or beliefs support your
position? What facts or empirical data support your position?
• What portion of your viewpoint or perspective on the issue relies on personal values, opinions, or beliefs in comparison to facts?
• Why is it important to identity and use empirical data or facts in our lives rather than relying on ideological reasoning and false or fake information?
According to C. Wright Mills (1959), the sociological imagination requires individuals to “think themselves away” in examining personal and social influences on people’s life choices and outcomes. Large-scale or macrosociological influences help create understanding about the effect of the social structure and history on people’s lives. Whereas, small-scale or microsociological influences focus on interpreting personal viewpoints from an individual’s biography. Using only a microsociological perspective leads to an unclear understanding of the world from biased perceptions and assumptions about people, social groups, and society (Carl 2013).
Sociologists use theories to study the people. “The theoretical paradigms provide different lenses into the social constructions of life and the relationships of people” (Kennedy, Norwood, and Jendian 2017:22). The theoretical paradigms in sociology help us examine and understand cultural reflections including the social structure and social value culture creates and sustains to fulfill human needs as mediated by society itself. Each paradigm provides an objective framework of analysis and evaluation for understanding the social structure including the construction of the cultural values and norms and their influence on thinking and behavior.
The Theoretical Paradigms
Macrosociology studies large-scale social arrangements or constructs in the social world. The macro perspective examines how groups, organizations, networks, processes, and systems influences thoughts and actions of individuals and groups (Kennedy et al. 2017). Functionalism, Conflict Theory, Feminism, and Environmental Theory are macrosociological perspectives.
Microsociology studies the social interactions of individuals and groups. The micro perspective observes how thinking and behavior influences the social world such as groups, organizations, networks, processes, and systems (Kennedy et al. 2017). Symbolic Interactionism and Exchange Theory are microsociological perspectives.
Functionalism is a macrosociological perspective examining the purpose or contributions of interrelated parts within the social structure. Functionalists examine how parts of society contribute to the whole. Everything in society has a purpose or function. Even a negative contribution helps society discern its function. For example, driving under the influence of alcohol or drugs inspired society to define the behavior as undesirable, develop laws, and consequences for people committing such an act. A manifest function in society results in expected outcomes (i.e., using a pencil to develop written communication). Whereas, a latent function has an unexpected result (i.e., using a pencil to stab someone). When a function creates unexpected results that cause hardships, problems, or negative consequences the result is a latent dysfunction.
Conflict Theory is a macrosociological perspective exploring the fight among social groups over resources in society. Groups compete for status, power, control, money, territory, and other resources for economic or other social gain. Conflict Theory explores the struggle between those in power and those who are not in power within the context of the struggle. Cultural wars are common in society, whether controversy over a deity and way of life or ownership and rights over Holy Land.
Symbolic Interactionism is a microsociological perspective observing the influence of interactions on thinking and behavior. Interactionists consider how people interpret meaning and symbols to understand and navigate the social world. Individuals create social reality through verbal and non-verbal interactions. These interactions form thoughts and behaviors in response to others influencing motivation and decision-making. Hearing or reading a word in a language one understands develop a mental image and comprehension about information shared or communicated (i.e., the English word “bread” is most commonly visualized as a slice or loaf and considered a food item).
There are three modern approaches to sociological theory (Carl 2013).
Feminism, a macrosociological perspective, studies the experiences of women and minorities in the social world including the outcomes of inequality and oppression for these groups. One major focus of the feminist theoretical approach is to understand how age, ethnicity, race, sexuality, and social class interact with gender to determine outcomes for people (Carl 2013).
Exchange Theory examines decision-making of individuals in society. This microsociological perspective focuses on understanding how people consider a cost versus benefit analysis accentuating their self-interest to make decisions. Environmental Theory explores how people adjust to ecological (environmental and social) changes over time (Carl 2013). The focal point of this macrosociological perspective is to figure out how people adapt or evolve over time and share the same ecological space.
Applying Theories
Functionalists view how people work together to create society as a whole. From this perspective, societies needs culture to exist (Griffiths et al). For example, cultural norms or rules function to support the social structure of society, and cultural values guide people in their thoughts and actions. Consider how education is an important concept in the United States because it is valued. The culture of education including the norms surrounding registration, attendance, grades, graduation, and material culture (i.e., classrooms, textbooks, libraries) all support the emphasis placed on the value of education in the United States. Just as members of a society work together to fulfill the needs of society, culture exists to meet the basic needs of its members.
Conflict theorists understand the social structure as inherently unequal resulting from the differences in power based on age, class, education, gender, income, race, sexuality, and other social factors. For a conflict theorist, culture reinforces issues of “privilege” groups and their status in social categories (Griffiths et al. 2015). Inequalities exist in every cultural system. Therefore, cultural norms benefit people with status and power while harming others and at the expense of others. For example, although cultural diversity is valued in the United States, some people and states prohibit interracial marriages, same-sex marriages, and polygamy (Griffiths et al. 2015).
Symbolic interactionists see culture as created and maintained by the interactions and interpretations of each other’s actions. These theorists conceptualize human interactions as a continuous process of deriving meaning from the physical and social environment. “Every object and action has a symbolic meaning, and language serves as a means for people to represent and communicate their interpretations of these meanings to others” (Griffiths et al. 2015:72). Interactionists evaluate how culture depends on the interpretation of meaning and how individuals interact when exchanging comprehension and meaning. For instance, derogatory terms such as the “N” word might be acceptable among people of the same cultural group but viewed as offensive and antagonistic when used by someone outside of the group.
Feminists explore the cultural experiences of women and minorities. For example, women in Lebanon do not have the right to dissolve a marriage without her husband’s consent even in cases of spousal abuse (Human Rights Watch 2015). Feminism explicitly examines oppression structures within culture systems and the inequity some groups confront in relation to their age, gender, race, social class, sexuality, or other social category.
Exchange theorists observe how culture influences decision-making. Cultural values and beliefs often influence people’s choices about premarital sex and cohabitation before marriage. If you evaluate your decisions on a daily basis, you might see elements of culture behind the motivation driving your choices.
Environmental theorists assess how culture, as part of the social and physical environment, adapts and changes over time. If you contemplate any rule of law, you can see how culture has altered because of shifts in social ideas or ecological fluctuations. Consider the anti-tobacco laws in the United States making it illegal to smoke in public areas as an example of social shifts towards health and wellness or water meters to control and regulate residential water usage and waste as an example of ecological drought and prolonged water shortages in the United States.
Theoretical Application
Popular culture reflects prominent values, beliefs, norms, symbolic expressions, and practices while reinforcing American ideologies and myths. Develop a written response exploring the depiction of contemporary American culture in an episode of a contemporary television show drama (i.e., NCIS, Game of Thrones, Agents of S.H.I.E.L.D., Breaking Bad, etc.)
Attribution
Adapted from Modules 1 through 5, pages 1 through 77 from “Beyond Race: Cultural Influences on Human Social Life” by Vera Kennedy under the license CC BY-NC-SA 4.0. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/01%3A_Traditional_Paradigms_and_Dominant_Perspectives_on_Individuals/02%3A_Culture_and_Meaning.txt |
Learning Objectives
• Illustrate how culture is constructed and received.
• Describe the influence of context on cultural creation and acceptance.
• Explain the significance of collective culture on group solidarity and cohesion.
• Discuss and assess the impact of cultural change on the social structure.
3.1 Social Production of Culture
How does culture affect your thinking and behavior? How are you able to communicate the influence of culture on your life to others? How do you justify your culture as true, real, or tangible?
Because culture is a socially meaningful expression that can be articulated and shared it often takes a physical form in our minds. A spiritual or philosophical expression that is not physical in nature becomes tangible in our minds and is equivalent to an “object” (Griswold 2013). The cultural expression is so real that people perceive it as something achievable or concrete (even if only in psychological form). The mental picture is the object and the meaning associated with the object is the expression when we are speaking about non-material culture. When people discuss love, they imagine it in their minds and feel it in their hearts even though no one can truly touch love in a physical form. We associate love to a variety of mental and physical interactions, but love itself is not tangible or concrete. Whereas, material culture is associated with physical artifacts projecting a clear understanding of its nature because it is visible, audible, and can be touched. We buy and give gifts to express our love. The material artifact we give to someone is a tangible expression of love. In this example, the expression of non-material culture is evident in material culture (love = gift) and material culture represents non-material culture (gift = love) making both forms cultural “objects.”
Cultural objects become representations of many things and can have many meanings based on the history and biography of an individual, group, or society. Think about the mantra, “Follow your dreams.” The expression is often used in the United States when discussing educational and career motivation and planning. For many U.S. citizens, this statement creates an open space for academic or professional choices and opportunities. However, the “object” is
limited to the culture of the individual. In other words, your “dream” is limited to the cultural environment and social location you occupy. For example, if you are in a family where men and women fill different roles in work and family then your educational and career choices or pathways are limited to the options within the context of your culture (i.e., values, beliefs, and norms). Afghan culture does not value or permit the education of girls. In Afghanistan, one third of girls marry before 18, and once married they are compelled to drop out of school (Human Rights Watch 2017). The educational and career choices of Afghan girls is limited to the culture of their country and the social location of their gender. This means to “follow your dreams” in Afghanistan is confined to what a dream as an object can represent based on the gender of the person.
How does culture become an “object” or solidified, socially accepted, and followed? According to Griswold (2013) people create, articulate, and communicate culture. However, this does not mean every cultural idea or creation is accepted by society. Though people create culture, other people must receive or accept culture to become tangible, real, or recognized as an object including artifacts. The creation of cultural ideas and concepts must have an audience to receive it and articulate its meaning in order for culture to be established and accepted. The context of the social world including time, place, conditions, and social forces influence whether an audience accepts or rejects a cultural object. Consider the many social media applications available to us today. With so many social media outlets and options available, which are the most recognized and used? Which social media apps have become part of our everyday lives, and which do we expect people to use and be familiar with as a norm? When Jack Dorsey, Noah Glass, Biz Stone, and Evan Williams created Twitter, they introduced a cultural idea to society. As word spread about the application and people began to use it, communication about its relevance and usefulness grew. As the network of users grew more and more people were intrigued to discover the application and make it part of their lives leading to Twitter becoming a cultural object. Not only did Twitter need to demonstrate relevance to reach potential users, but it also had to be timely and applicable in context or to the needs of modern society.
Since the development of the Internet, many people and organizations have developed a variety of social media applications, but only a few apps have transcended time to become part of our culture because they were able to develop an audience or significant number of cultural receivers to legitimize them. Other than Twitter, what social media applications have become part of our culture? Research and describe the demographics of the audience or receivers for each application identified and discuss the context or environment that made the app relevant for its time and users.
Dissecting Cultural Construction
Consider the social issue of cyberbullying
• Describe the social context or environment that has led to the development and growth of this issue.
• What cultural elements do we associate with cyberbullying? What are the values, beliefs, norms, symbolic expressions, and artifacts or materials used by perpetrators to create a culture of cyberbullying?
• How do victims, observers, and the public receive this culture? What meanings do people associate by the expressions used by perpetrators that make the issue “real”?
• Reflecting on your responses to Questions 1-3, explain how social context, cultural creation, and cultural acceptance work to make the issue of cyberbullying a cultural object.
3.2 Collective Culture
Among humans, there are universal cultural patterns or elements across groups and societies. Cultural universals are common to all humans throughout the globe. Some cultural universals include cooking, dancing, ethics, greetings, personal names, and taboos to name a few. Can you identify at least five other cultural universals shared by all humans?
In thinking about cultural universals, you may have noted the variations or differences in the practice of these cultural patterns or elements. Even though humans share several cultural universals, the practice of culture expresses itself in a variety of ways across different social groups and institutions. When different groups identify shared culture, we often are speaking from generalizations or general characteristics and principles shared by humans. The description of cultural universals speak to the generalization of culture such as in the practice of marriage. Different social groups share the institution of marriage but the process, ceremony, and legal commitments are different depending on the culture of the group or society.
Cultural generalities help us understand the similarities and connections all humans have in the way we understand and live even though we may have particular ways of applying them. Some cultural characteristics are unique to a single place, culture, group, or society. These particularities may develop or adapt from social and physical responses to time, geography, ecological changes, group member traits, and composition including power structures or other phenomena.
Cultural and Social Bonds
By living together in society, people “learn specific ways of looking at life” (Henslin 2011:104). Through daily interactions, people construct reality. The construction of reality provides a forum for interpreting experiences in life expressed through culture. Emile Durkheim ([1893] 1933) believed social bonds hold people together. When people live in small, integrated communities that share common values and beliefs, they develop a shared or collective consciousness. Durkheim referred to this type of social integration as mechanical solidarity meaning members of the community are all working parts of the group or work in unity creating a sense of togetherness forming a collective identity. In this example, members of the community think and act alike because they have a shared culture and shared experiences from living in remote, close-knit areas.
As society evolves and communities grow, people become more specialized in the work they do. This specialization leads individuals to work independently in order to contribute to a segment or part of a larger society (Henslin 2011). Durkheim referred to this type of social unity as organic solidarity meaning each member of the community has a specific task or place in the group in which they contribute to the overall function of the community that is spatial and culturally diverse. In this example, community members do not necessarily think or act alike but participate by fulfilling their role or tasks as part of the larger group. If members fulfill their parts, then everyone is contributing and exchanging labor or production for the community to function as a whole.
Both mechanical and organic solidarity explain how people cooperate to create and sustain social bonds relative to group size and membership. Each form of solidarity develops its own culture to hold society together and function. However, when society transitions from mechanical to organic solidarity, there is chaos or normlessness. Durkheim referred to this transition as social anomie meaning “without law” resulting from a lack of a firm collective consciousness. As people transition from social dependence (mechanical solidarity) to interdependence (organic solidarity), they become isolated and alienated from one another until a redeveloped set of shared norms arise. We see examples of this transition when there are changes in social institutions such as governments, industry, and religion. Transitions to democracy across the continent of Africa have shown countries contending with poverty, illiteracy, militarization, underdevelopment, and monopolization of power, all forms of anomie, as they move from social dependence to interdependence (The National Academic Press 1992).
People develop an understanding about their culture specifically their role and place in society through social interactions. Charles Horton Cooley ([1902] 1964) suggested people develop self and identity through interpersonal interactions such as perceptions, expectations, and judgement of others. Cooley referred to this practice as the looking glass self. We imagine how others observe us and we develop ourselves in response to their observations. The concept develops over three phases of interactions. First, we imagine another’s response to our behavior or appearance, then we envision their judgment, and lastly we have an emotional response to their judgement influencing our self-image or identity (Griswold 2013). Interpersonal interactions play a significant role in helping us create social bonds and understand our place in society.
Group and Organizational Culture
The term group refers to any collection of at least two people who interact frequently and share identity traits aligned with the group (Griffiths et al. 2015). Groups play different roles in our lives. Primary groups are usually small groups characterized by face-to-face interaction, intimacy, and a strong sense of commitment. Primary groups remain “inside” us throughout our lifetime (Henslin 2011). Secondary groups are large and impersonal groups that form from sharing a common interest. Different types of groups influence our interactions, identity, and social status. George Herbert Mead (1934) called individuals affecting a person’s life as significant others, and he conceptualized “generalized others” as the organized and generalized attitude of a social group.
Different types of groups influence our interactions, identity, and social status. An in-group is a group toward which one feels particular loyalty and respect. The traits of in-groups are virtues, whereas traits of out-groups are vices (Henslin 2011). An out-group is a group toward which one feels antagonism and contempt. Consider fans at a sporting event, people cheering on our supporting the same team will develop an in-group admiration and acceptance while viewing fans of the opposing team as members of their out-group.
Reference groups are also influential groups in someone’s life. A reference group provides a standard for judging one’s own attitudes or behaviors within a social setting or context (Henslin 2011). People use reference groups as a method for self-evaluation and social location. People commonly use reference groups in the workplace by watching and emulating the interactions and practices of others so they fit in and garner acceptance by the group.
Group dynamics focus on how groups influence individuals and how individuals affect groups. The social dynamics between individuals plays a significant role in forming group solidarity. Social unity reinforces a collective identity and shared thinking among group members thereby constructing a common culture (Griswold 2013). Commonalities of group membership are important for mobilizing individual members. When people attempt to create social change or establish a social movement group, solidarity helps facilitate motivation of individuals and framing of their actions. The sense of belonging and trust among the group makes it easier for members to align and recognize the problem, accept a possible solution, take certain actions that are congruent and complementary to the collective identity of the group (Griswold 2013). People accept the group’s approach based on solidarity and cohesiveness that overall amplifies personal mobilization and commitment to the group and its goals.
Collective Identity and Social Movement
Research TED Talks videos on social movements and social change such as the following:
1. What lessons can you learn about collective identity from the stories presented?
2. How does group culture make it possible to construct a social movement? Explain how micro-sociological acts (social interactions) lead to macro-sociological changes (systems, organizations, and processes) in society.
3. What impact does intrinsic or internal motivation and framing of the issue have on organizing a social movement?
An organization refers to a group of people with a collective goal or purpose linked to bureaucratic tendencies including a hierarchy of authority, clear division of labor, explicit rules, and impersonal (Giddens, Duneier, Applebaum, and Carr 2013). Organizations function within existing cultures and produce their own. Formal organizations fall into three categories including normative, coercive, and utilitarian (Etzioni 1975). People join normative or voluntary organizations based on shared interests (e.g., club or cause). Coercive organizations are groups that people are coerced or forced to join (e.g., addiction rehabilitation program or jail). People join utilitarian organizations to obtain a specific material reward (e.g., private school or college).
When we work or live in organizations, there are multiple levels of interaction that effect social unity and operations. On an individual level, people must learn and assimilate into the culture of the organization. All organizations face the problem of motivating its members to work together to achieve common goals (Griswold 2013). Generally, in organizations, small group subcultures develop with their own meaning and practices to help facilitate and safeguard members within the organizational structure. Group members will exercise force (peer pressure and incentives), actively socialize (guide feelings and actions with normative controls), and model behavior (exemplary actors and stories) to build cohesiveness (Griswold 2013). Small groups play an integral role in managing individual members to maintain the function of the organization. Think about the school or college you attend. There are many subcultures within any educational setting and each group establishes the norms and behaviors members must follow for social acceptance. Can you identify at least two subcultures on your school campus and speculate how members of the group pressure each other to fit in?
On a group level, symbolic power matters in recruiting members and sustaining the culture of a
group within the larger social culture (Hallet 2003). Symbolic power is the power of constructing reality to guide people in understanding their place in the organizational hierarchy (Bourdieu 1991). This power occurs in everyday interactions through unconscious cultural and social domination. The dominant group of an organization influences the prevailing culture and provides its function in communications forcing all groups or subcultures to define themselves by their distance from the dominant culture (Bourdieu 1991). The instrument of symbolic power is the instrument of domination in the organization by creating the ideological systems of its goals, purpose, and operations. Symbolic power not only governs culture of the organization but also manages solidarity and division between groups. We see examples of symbolic power in the military. Each branch of the military has a hierarchy of authority where generals serve as the dominant group and are responsible for the prevailing culture. Each rank socializes members according to their position within the organization in relation to the hierarchy and fulfills their role to achieve collective goals and maintain functions.
Cultural Solidarity
Describe the culture of an organization where you have worked, volunteered, or attended school.
There are external factors that influence organizational culture. The context and atmosphere of a nation shapes an organization. When an organization’s culture aligns with national ideology, they can receive special attention or privileges in the way of financial incentives or policy changes (Griswold 2013). In contrast, organizations opposing national culture may face suppression, marginalization, or be denied government and economic. Organizations must also operate across a multiplicity of cultures (Griswold 2013). Cultural differences between organizations may affect their operations and achievement of goals. To be successful, organizations must be able to operate in a variety of contexts and cultures. Griswold (2013) suggested one way to work across cultural contexts is to maintain an overarching organizational mission but be willing to adapt on insignificant or minor issues. Financial and banking institutions use this approach. Depending on the region, banks offer different cultural incentives for opening an account or obtaining a loan. In California, homeowners may obtain low-interest loans for ecological improvements including installation of solar panels, weatherproof windows, or drought resistance landscaping. In the state of Michigan, affluent homeowners may acquire a low-interest property improvement loan, and very low-income homeowners may receive grants for repairing, improving, or modernizing their homes to remove health and safety hazards.
Working across organizational cultures also requires some dimension of trust. Organizational leaders must model forms and symbols of trust between organizations, groups, and individuals (Mizrachi, Drori, and Anspach 2007). This means authority figures must draw on the organization’s internal and external diversity of cultures to show its ability to adapt and work in a variety of cultural and political settings and climates. Organizations often focus on internal allegiance forgetting that shared meaning across the marketplace, sector, or industry is what moves understanding of the overall system and each organization’s place in it (Griswold 2013). The lack of cultural coordination and understanding undermines many organizations and has significant consequences for accomplishing its goals and ability to sustain itself.
Organizational Culture
Consider the culture of an organization where you have worked, volunteered, or attended school. Describe a time when you witnessed someone receive a nonverbal, negative sanction (e.g., a look of disgust, a shake of the head, or some other nonverbal sign of disapproval).
Level of Culture
There are three recognized levels of culture in society (Kottak and Kozaitis 2012). Each level of culture signifies particular cultural traits and patterns within groups. International culture is one level referring to culture that transcends national boundaries. These cultural traits and patterns spread through migration, colonization, and the expansion of multinational organizations (Kottak and Kozaitis 2012). Some illustrations are evident in the adoption and use of technology and social media across continents. For example, computers and mobile devices allow people to live and operate across national boundaries enabling them to create and sustain an international culture around a common interest or purpose (i.e., Olympics, United Nations, etc.).
In contrast, cultural traits and patterns shared within a country is national culture. National culture is most easily recognizable in the form of symbols such as flags, logos, and colors as well as sound including national anthems and musical styles. Think about American culture, which values, beliefs, norms, and symbols are common only among people living in the United States? How about those living in China and Brazil?
Subcultures, another level of culture, are subgroups of people within the same country (e.g., doctors, lawyers, teachers, athletes, etc.). Subcultures have shared experiences and common cultural distinctions, but they blend into the larger society or cultural system. Subcultures have their own set of symbols, meanings, and behavioral norms, which develop by interacting with one another. Subcultures develop their own self-culture or idioculture that has significant meaning to members of the group and creates social boundaries for membership and social acceptance (Griswold 2013). Think about social cliques whether they be categorized as jocks, nerds, hipsters, punks, or stoners. Each group has a particular subculture from the artifacts they wear to the values and beliefs they exhibit. All groups form a subculture resulting in-group cohesion and shared consciousness among its members.
Sport as a Subculture
Research the sport, quadriplegic rugby. Examine the rules of the game, search for information or testimonials about any of the athletes, and watch videos of game highlights and athlete stories or interviews available online.
Doing Culture
All people are cultured. Social scientists argue all people have a culture represented in values,
beliefs, norms, expressive symbols, practices, and artifacts. This viewpoint transcends the humanities perspective that suggests one must project refined tastes, manners, and have a good education as exhibited by the elite class to have culture. The perspective of social scientists reinforce the ideology that cultures are integrated and patterned systems not simply desired characteristics that distinguish the ruling class.
Cultural patterns are a set of integrated traits transmitted by communication or social interactions (Kottak and Kozaitis 2012). Consider the cultural patterns associated with housing. Each cultural group or society maintains a housing system comprised of particular cultural traits including kitchen, sofa, bed, toilet, etc. The cultural traits or each individual cultural item is part of the home or accepted cultural pattern for housing.
Not only do people share cultural traits, but they may also share personality traits. These traits
are actions, attitudes, and behaviors (e.g., honesty, loyalty, courage, etc.). Shared personality traits develop through social interactions from core values within groups and societies (Kottak and Kozaitis 2012). Core values are formally (legally or recognized) and informally (unofficial) emphasized to develop a shared meaning and social expectations. The use of positive (reward) and negative (punishment) sanctions help in controlling desired and undesired personality traits. For example, if we want to instill courage, we might highlight people and moments depicting bravery with verbal praise or accepting awards. To prevent cowardness, we show a deserter or run-away to depict weakness and social isolation.
Doing culture is not always an expression of ideal culture. People’s practices and behaviors do
not always abide or fit into the ideal ethos we intend or expect. The Christmas holiday is one example where ideal culture does not match the real culture people live and convey. Christmas traditionally represents an annual celebration of the birth of Jesus Christ; however, many individuals and families do not worship Christ or attend church on Christmas day but instead exchange gifts and eat meals together. The ideal or public definition of Christmas does not match the real or individual practices people express on the holiday. Throughout history, there have always been differences between what people value (ideal culture) and how they actually live their lives (real culture).
3.3 Cultural Change
People biologically and culturally adapt. Cultural change or evolution is influenced directly (e.g.,
intentionally), indirectly (e.g., inadvertently), or by force. These changes are a response to fluctuations in the physical or social environment (Kottak and Kozaitis 2012). Social movements often start in response to shifting circumstances such as an event or issue in an effort to evoke cultural change. People will voluntarily join for collective action to either preserve or alter a cultural base or foundation. The fight over control of a cultural base has been the central conflict among many civil and human rights movements. On a deeper level, many of these movements are about cultural rights and control over what will be the prevailing or dominant culture.
Changes in cultural traits are either adaptive (better suited for the environment) or maladaptive (inadequate or inappropriate for the environment). During times of natural disasters, people must make cultural changes to daily norms and practices such as donating time and money to help relief efforts (adaptive) while also rebuilding homes and businesses. However, not all relief efforts direct money, energy, or time into long-term contributions of modifying physical infrastructures including roads, bridges, dams, etc. or helping people relocate away from high disaster areas (maladaptive). People adjust and learn to cope with cultural changes whether adaptive or maladaptive in an effort to soothe psychological or emotional needs.
Though technology continues to impact changes in society, culture does not always change at the same pace. There is a lag in how rapidly cultural changes occur. Generally, material culture changes before non-material culture. Contact between groups diffuses cultural change among groups, and people are usually open to adapt or try new artifacts or material possessions before modifying their values, beliefs, norms, expressive symbols (i.e., verbal and non-verbal language), or practices. Influencing fashion trends is easier than altering people’s religious beliefs.
Through travel and technological communications, people are sharing cultural elements worldwide. With the ability to travel and communicate across continents, time and space link the exchange of culture. Modern society is operating on a global scale (known as globalization) and people are now interlinked and mutually dependent. Acculturation or the merging of cultures is growing. Groups are adopting the cultural traits and social patterns of other groups leading to the blending of cultures. Cultural leveling is the process where cultures are becoming similar to one another because of globalization.
Attribution
Adapted from Modules 1 through 5, pages 1 through 77 from “Beyond Race: Cultural Influences on Human Social Life” by Vera Kennedy under the license CC BY-NC-SA 4.0. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/01%3A_Traditional_Paradigms_and_Dominant_Perspectives_on_Individuals/03%3A_Culture_as_a_Social_Construct.txt |
Learning Objectives
• Explain the implications of culture on social status and stratification
• Summarize the mechanisms used by dominant groups to develop and sustain cultural power
• Understand cultural hegemony
• Describe the consequences of social conflicts over cultural power
• Identify and evaluate cultural prejudice and discrimination
4.1 Cultural Hierarchies
All humans are comprised of the same biological structure and matter. The unique distinctions among us stem from our culture (Kottak and Kozaitis 2012). The differences in our values, beliefs, norms, expressive language, practices, and artifacts is which stands us apart from each other. Being culturally unique projects exclusivity that draws attention to our variations and differences. People find cultural fit or acceptance from those who share uniqueness or the same cultural characteristics. Consequently, people may find or experience intolerance or rejection from those with different cultural traits.
Cultural distinctions make groups unique, but they also provide a social structure for creating and ranking cultures based on similarities or differences. A cultural group’s size and strength influences their power over a region, area, or other groups. Cultural power lends itself to social power that influences people’s lives by controlling the prevailing norms or rules and making individuals adhere to the dominant culture voluntarily or involuntarily.
Culture is not a direct reflection of the social world (Griswold 2013). Humans mediate culture to define meaning and interpret the social world around them. As a result, dominant groups able to manipulate, reproduce, and influence culture among the masses. Common culture found in society is actually the selective transmission of elite-dominated values (Parenti 2006). This practice known as cultural hegemony suggests, culture is not autonomous, it is conditional dictated, regulated, and controlled by dominant groups. The major forces shaping culture are in the power of elite-dominated interests who make limited and marginal adjustments to appear culture is changing in alignment with evolving social values (Parenti 2006). The culturally dominating group often sets the standard for living and governs the distribution of resources.
Social and Culture Capital
Social and cultural relationships have productive benefits in society. Research defines social capital as a form of economic (e.g., money and property) and cultural (e.g., norms, fellowship, trust) assets central to a social network (Putnam 2000). The social networks people create and maintain with each other enable society to function. However, the work of Pierre Bourdieu (1972) found social capital produces and reproduces inequality when examining how people gain powerful positions through direct and indirect social connections. Social capital or a social network can help or hinder someone personally and socially. For example, strong and supportive social connections can facilitate job opportunities and promotions that are beneficial to the individual and social network. Weak and unsupportive social ties can jeopardize employment or advancement that are harmful to the individual and social group as well. People make cultural objects meaningful (Griswold 2013). Interactions and reasoning develop cultural perspectives and understanding. The “social mind” of groups process incoming signals influencing culture within the social structure including the social attributes and status of members in a society (Zerubavel 1999). Language and symbols express a person’s position in society and the expectations associated with their status. For example, the clothes people wear or car they drive represents style, fashion, and wealth. Owning designer clothing or a high-performance sports car depicts a person’s access to financial resources and worth. The use of formal language and titles also represent social status such as salutations including your majesty, your highness, president, director, chief executive officer, and doctor.
People may occupy multiple statuses in a society. At birth, people are ascribed social status in alignment to their physical and mental features, gender, and race. In some cases, societies differentiate status according to physical or mental disability as well as if a child is female or male, or a racial minority. According to Dr. Jody Heymann, Dean of the World Policy Analysis Center at the UCLA Fielding School of Public Health, “Persons with disabilities are one of the last groups whose equal rights have been recognized” around the world (Brink 2016). A report by the World Policy Analysis Center (2016) shows only 28% of 193 countries participating in the global survey guarantee a right to quality education for people with disabilities and only 18% guarantee a right to work.
In some societies, people may earn or achieve status from their talents, efforts, or accomplishments (Griffiths et al. 2015). Obtaining higher education or being an artistic prodigy often correspond to high status. For example, a college degree awarded from an “Ivy League” university social weighs higher status than a degree from a public state college. Just as talented artists, musicians, and athletes receive honors, privileges, and celebrity status.
Additionally, the social, political hierarchy of a society or region designates social status. Consider the social labels within class, race, ethnicity, gender, education, profession, age, and family. Labels defining a person’s characteristics serve as their position within the larger group. People in a majority or dominant group have higher status (e.g., rich, white, male, physician, etc.) than those of the minority or subordinate group (e.g., poor, black, female, housekeeper,
etc.). Overall, the location of a person on the social strata influences their social power and participation (Griswold 2013). Individuals with inferior power have limitations to social and physical resources including lack of authority, influence over others, formidable networks, capital, and money.
Social status serves as a method for building and maintaining boundaries among and between people and groups. Status dictates social inclusion or exclusion resulting in cultural stratification or hierarchy whereby a person’s position in society regulates their cultural participation by others. Cultural attributes within social networks build community, group loyalty, and personal and social identity.
People sometimes engage in status shifting to garner acceptance or avoid attention. DuBois (1903) described the act of people looking through the eyes of others to measure social place or position as double consciousness. His research explored the history and cultural experiences of American slavery and the plight of black folk in translating thinking and behavior between racial contexts. DuBois’ research helped sociologists understand how and why people display one identity in certain settings and another in different ones. People must negotiate a social situation to decide how to project their social identity and assign a label that fits (Kottak and Kozaitis 2012). Status shifting is evident when people move from informal to formal contexts. Our cultural identity and practices are very different at home than at school, work, or church. Each setting demands different aspects of who we are and our place in the social setting.
The significance of cultural capital
This short video summarizes Pierre Bourdieu’s (1930-2002) theory of cultural capital or “the cultural knowledge that serves as currency that helps us navigate culture and alters our experiences and the opportunities available to us.” The video discusses three different forms of cultural capital: embodied state, objectified state, and institutionalized state with examples of each type that students can apply to their own lives. At the end of the video, discussion questions are included to assist students in applying the concept of cultural capital to what is happening in the world today. Prepare a written response addressing the four discussion questions presented in the video to share with the class.
Sociologists find cultural capital or the social assets of person (including intellect, education, speech pattern, mannerisms, and dress) promote social mobility (Harper-Scott and Samson 2009). People who accumulate and display the cultural knowledge of a society or group may earn social acceptance, status, and power. Bourdieau (1991) explained the accumulation and transmission of culture is a social investment from socializing agents including family, peers, and community. People learn culture and cultural characteristics and traits from one another; however, social status effects whether people share, spread, or communicate cultural knowledge to each other. A person’s social status in a group or society influences their ability to access and develop cultural capital.
Cultural capital provides people access to cultural connections such as institutions, individuals, materials, and economic resources (Kennedy 2012). Status guides people in choosing who and when culture or cultural capital is transferable. Bourdieu (1991) believed cultural inheritance and personal biography attributes to individual success more than intelligence or talent. With status comes access to social and cultural capital that generates access to privileges and power among and between groups. Individuals with cultural capital deficits face social inequalities (Reay 2004). If someone does not have the cultural knowledge and skills to maneuver the social world she or he occupies, then she or he will not find acceptance within a group or society and access to support and resources.
College Success and Cultural Capital
Cultural capital evaluates the validity of culture (i.e., language, values, norms, and access to material
resources) on success and achievement. You can measure your cultural capital by examining the cultural traits
and patterns of your life. The following questions examine student values and beliefs, parental and family
support, residency status, language, childhood experiences focusing on access to cultural resources (e.g.,
books) and neighborhood vitality (e.g., employment opportunities), educational and professional influences,
and barriers affecting college success (Kennedy 2012).
1. What are the most important values or beliefs influencing your life?
2. What kind of support have you received from your parents or family regarding school and your education?
3. How many generations has your family lived in the United States?
4. What do you consider your primary language? Did you have any difficulty learning to read or write the English language?
5. Did your family have more than fifty books in the house when you were growing up? What type of reading materials were in your house when you were growing up?
6. Did your family ever go to art galleries, museums, or plays when you were a child? What types of activities did your family do with their time other than work and school?
7. How would you describe the neighborhood where you grew up?
8. What illegal activities, if any, were present in the neighborhood where you grew up?
9. What employment opportunities were available to your parents or family in the neighborhood where you grew up?
10. Do you have immediate family members who are doctors, lawyers, or other professionals? What types of jobs have your family members had throughout their lives?
11. Why did you decide to go to college? What has influenced you to continue or complete your college education?
12. Did anyone ever discourage or prevent you from pursuing academics or a professional career?
13. Do you consider school easy or difficult for you?
14. What has been the biggest obstacle for you in obtaining a college education?
15. What has been the greatest opportunity for you in obtaining a college education?
16. How did you learn to navigate educational environments? Who taught you the “ins” and “outs” of college or school?
4.2 Cultural Hegemony
The very nature of cultural creation and production requires an audience to receive a cultural idea or product. Without people willing to receive culture, it cannot be sustainable or become an object (Griswold 2013). Power and influence play an integral part in cultural creation and marketing. The ruling class has the ability to establish cultural norms and manipulate society while turning a profit. Culture is a commodity and those in a position of power to create, produce, and distribute culture gain further social and economic power.
Culture producing organizations such as multinational corporations and media industries are in the business of producing mass culture products for profit. These organizations have the power to influence people throughout the world. Paul Hirsch (1972) referred to this enterprise as the culture industry system or the “market.” In the culture industry system, multinational corporations and media industries (i.e., cultural creators) produce an excess supply of cultural objects to draw in public attention with the goal of flooding the market to ensure receipt and acceptance of at least one cultural idea or artifact by the people for monetary gain.
The culture industry system produces mass culture products to generate a culture of consumption (Grazian 2010). The production of mass culture thrives on the notion that culture influences people. In line with the humanities’ perspective on culture, multinational corporations and media industries, believe they have the ability to control and manipulate culture by creating objects or products that people want and desire. This viewpoint suggests cultural receivers or the people are weak, apathetic, and consume culture for recognition and social status (Griswold 2013). If you consider the cultural object of buying and owning a home, the concept of owning a home represents attaining the “American dream.” Even though not all Americans are able to buy and own a home, the cultural industry system has embedded homeownership as a requisite to success and achievement in America.
In contrast, popular culture implies people influence culture. This perspective indicates people are active makers in the creation and acceptance of cultural objects (Griswold 2013). Take into account one of the most popular musical genres today, rap music. The creative use of language and rhetorical styles and strategies of rap music gained local popularity in New York during the 1970s and entered mainstream acceptance in mid-1980s to early ‘90s (Caramanica 2005). The early developments of rap music by the masses led to the genre becoming a cultural object.
Is brown the new green?
Latinos are the largest and fastest-growing ethnic group in the United States. The culture industry system is
seeking ways to profit from this group. As multinational corporations and media industries produce cultural
objects or products geared toward this population, their cultural identity is transformed into a new subculture
blending American and Latino values, beliefs, norms, and practices. Phillip Rodriguez is a documentary filmmaker on Latino culture, history, and identity. He and many other race and diversity experts are exploring the influence of consumption on American Latino culture.
1. Research the products and advertisements targeting Latinos in the United States. Describe the cultural objects and messaging encouraging a culture of consumption among this group.
2. What type of values, beliefs, norms, and practices are reinforced in the cultural objects or projects created by the culture industry system?
3. How might the purchase or consumption of the cultural objects or products you researched influence the self-image, identity, and social status of Latinos?
4. What new subculture arises by the blending of American and Latino culture? Describe the impact of uniting or combining these cultures on Latinos and Americans.
Today, rap music like other forms of music is being created and produced by major music labels and related media industries. The culture industry system uses media gatekeepers to regulate information including culture (Grazian 2010). Even with the ability of the people to create popular culture, multinational corporations and media industries maintain power to spread awareness, control access and messaging. This power to influence the masses also gives the hegemonic ruling class known as the culture industry system the ability to reinforce stereotypes, close minds, and promote fear to encourage acceptance or rejection of certain cultural ideas and artifacts.
4.3 Prejudice and Discrimination
Cultural intolerance may arise when individuals or groups confront new or differing values, beliefs, norms, expressive symbols, practices, or artifacts. Think about a time when you came across someone who did not fit the cultural “norm” either expressively or behaviorally. How did the person’s presence make you feel? What type of thoughts ran through your head? Were you compelled to understand the differences between you and the other person or were you eager to dismiss, confront, or ignore the other person?
Living in a culturally diverse society requires us to tackle our anxiety of the unknown or unfamiliar. The discomfort or cognitive dissonance we feel when we are around others who live and think differently than ourselves makes us alter our thoughts and behaviors towards acceptance or rejection of the “different” person in order to restore cognitive balance (Festinger 1957). When people undergo culture shock or surprise from experiencing new culture, their minds undergo dissonance. Similar to a fight or flight response, we choose to learn and understand cultural differences or mock and run away from them.
People have a tendency to judge and evaluate each other on a daily basis. Assessing other people and our surroundings is necessary for interpreting and interacting in the social world. Problems arise when we judge others using our own cultural standards. We call the practice of judging others through our own cultural lens, ethnocentrism. This practice is a cultural universal. People everywhere think their culture is true, moral, proper, and right (Kottak and Kozaitis 2012). By its very definition, ethnocentrism creates division and conflict between social groups whereby mediating differences is challenging when everyone believes they are culturally superior and their culture should be the standard for living.
In contrast, cultural relativism insinuates judging a culture by the standards of another is objectionable. It seems reasonable to evaluate a person’s values, beliefs, and practices from their own cultural standards rather than judged against the criteria of another (Kottak and Kozaitis 2012). Learning to receive cultural differences from a place of empathy and understanding serves as a foundation for living together despite variances. Like many aspects of human civilization, culture is not absolute but relative suggesting values, beliefs, and practices are only standards of living as long as people accept and live by them (Boas 1887). Developing knowledge about cultures and cultural groups different from our own allows us to view and evaluate others from their cultural lens.
Sometimes people act on ethnocentric thinking and feel justified disregarding cultural relativism. Overcoming negative attitudes about people who are culturally different from us is challenging when we believe our culture and thinking are justified. Consider the social issue of infanticide or the killing of unwanted children after birth. The historical practice occurred in times of famine or hardship when resources were scarce to keep non-productive humans alive. Many people find infanticide a human rights violation regardless of a person’s cultural traditions and beliefs and think the practice should stop. People often feel justified condemning the practice of infanticide and the people who believe and practice the tradition.
Stereotypes are oversimplified ideas about groups of people (Griffitsh et al. 2015). Prejudiceis an attitude of thoughts and feelings directed at someone from prejudging or making negative assumptions. Negative attitudes about another’s culture is a form of prejudice or bias. Prejudice is a learned behavior. Prejudicial attitudes can lead to discriminatory acts and behaviors. Discriminationis an action of unfair treatment against someone based on characteristics such as age, gender, race, religion, etc.
Privilege and Life Changes
Research You-Tube user-created videos on privilege and life chances such as the following:
Complete the Test Your Life Chances exercise and type a written response addressing the following questions:
1. What life barriers or issues are you able to identify about yourself after completing the exercise?
2. What life advantages or opportunities are you able to distinguish about yourself after completing the exercise?
3. Were there any statements you found more difficult or easier to answer? Explain.
4. Were there any life challenges or obstacles that you have faced missing in the exercise? If so, explain.
5. Were there any life privileges you have experienced missing in the exercise? If so, explain.
6. Did you ever answer untruthfully on any of the statements? If you are comfortable sharing, explain which one(s)? Why did you not answer truthfully?
7. How do life’s barriers and opportunities influence people’s lives? What connections do you see among upward mobility and life chances in regards to: disability, racial-ethnic identity, gender identity, language, sexuality, and social class?
Thinking the practice of infanticide should stop and those who practice it malevolent is prejudicial. Trying to stop the practice with force is discriminatory. There are times in the case of human rights issues like this where the fine line between criticizing with action (ethnocentrism) and understanding with empathy (cultural relativism) are clear. However, knowing the appropriate context when to judge or be open-minded is not always evident. Do we allow men to treat women as subordinates if their religion or faith justifies it? Do we allow people to eat sea turtles or live octopus if it is a delicacy? Do we stop children who do not receive vaccinations from attending school? All of these issues stem from cultural differences and distinguishing the appropriate response is not always easy to identify.
When social groups have or are in power, they have the ability to discriminate on a large scale. A dominant group or the ruling class impart their culture in society by passing laws and informally using the culture industry system or “market” to spread it. Access to these methods allows hegemonic groups to institutionalize discrimination. This results in unjust and unequal treatment of people by society and its institutions. Those who culturally align to the ruling class fare better than those who are different.
Visual Ethnography
Part 1
Visual ethnography is a qualitative research method of photographic images with socio-cultural representations. The experience of producing and discussing visual images or texts develops ethnographic knowledge and provides sociological insight into how people live. In your home or the place you live, take one photo of the following:
• Part 2
1. Watch the video by Anna Rosling Ronnlund entitled See How the Rest of the World Lives, Organized by
Income.
2. Next visit the website Dollar Street.
3. Once you have accessed the Dollar Street website, take the Quick Tour for a tutorial on how to use the site. If the Quick Tour does not appear when you click the site link, click the menu on the right-hand top corner and select Quick Guide, which will open the Quick Tour window.
4. After completing the Quick Tour, access your visual ethnography photos and compare your photographs with other people throughout the world.
5. For your analysis, incomplete sentences explain the differences and similarities based on income and country. Specifically, describe what the poorest conditions are for each item as well as the richest conditions and what cultural similarities and/or differences exist in comparison to your items.
Attribution
Adapted from Modules 1 through 5, pages 1 through 77 from “Beyond Race: Cultural Influences on Human Social Life” by Vera Kennedy under the license CC BY-NC-SA 4.0. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/01%3A_Traditional_Paradigms_and_Dominant_Perspectives_on_Individuals/04%3A_Cultural_Power.txt |
Learning Objectives
• Explain the influence of culture on social and self-identity
• Discuss how personal, cultural, and universal identities shape perceptions
• Illustrate the relationship between self and social labels on status
• Assess the impact of technological advances and innovation on identity
5.1 Identity Formation
Trying to figure out who you are, what you value and believe, and why you think the way you do is a lifelong process. In the first chapter of Thinking Well, Stewart E. Kelly suggests, “we all have lenses through which we view reality, and we need to know what our individual lens is composed of and how it influences our perception of reality.” Take a moment to reflect and hypothetically paint a picture of yourself with words. Try to capture the core of your being by describing who you are. Once you have formulated a description of yourself, evaluate what you wrote. Does your description focus on your personal characteristics or your cultural characteristics you learned from other people in your life (i.e., family, friends, congregation, teachers, community, etc.)?
Cultural identity, like culture itself, is a social construct. The values, beliefs, norms, expressive symbols, practices, and artifacts we hold develop from the social relationships we experience throughout our lives. Not only does cultural identity make us aware of who we are, but it also defines what we stand for in comparison to others. Cultural identity is relational between individuals, groups, and society meaning through culture people are able to form social connections or refrain from them. It is real to each of us with real social consequences.
As defined in Module 1, we learn culture through the process of enculturation. Socializing agents including family, peers, school, work, and the media transmit traditions, customs, language, tools, and common experiences and knowledge. The passage of culture from one generation to the next ensures sustainability of that culture by instilling specific traits and characteristics of a group or society that become part of each group member’s identity.
Identity Labels and Categories
Identity shapes our perceptions and the way we categorize people. Our individual and collective views influence our thinking. Regardless of personal, cultural, or universal identity people naturally focus on traits, values, behaviors, and practices or behaviors they identify with and have a tendency to dismiss those they do not.
Age Cohorts
Our numeric ranking of age is associated with particular cultural traits. Even the social categories we assign to age express cultural characteristics of that age group or cohort. Age signifies one’s cultural identity and social status (Kottak and Kozaitis 2012). Many of the most common labels we use in society signify age categories and attributes. For example, the terms “newborns and infants “generally refer to children from birth to age four, whereas “school-age
children” signifies youngsters old enough to attend primary school.
Each age range has social and cultural expectations placed upon by others (Kottak and Kozaitis 2012). We have limited social expectations of newborns, but we expect infants to develop some language skills and behaviors like “potty training” or the practice of controlling bowel movements. Even though cultural expectations by age vary across other social categories (e.g., gender, geography, ethnicity, etc.), there are universal stages and understanding of intellectual, personal, and social development associated with each age range or cohort.
Throughout a person’s life course, they will experience and transition across different cultural phases and stages. Life course is the period from one’s birth to death (Griffiths et al. 2015). Each stage in the life course aligns with age-appropriate values, beliefs, norms, expressive language, practices, and artifacts. Like other social categories, age can be a basis of social ranking (Kottak and Kozaitis 2012). Society finds it perfectly acceptable for a baby or infant to wear a diaper but considers it a taboo or fetish among an adult 30 years old. However, diaper wearing becomes socially acceptable again as people age into senior years of life when biological functions become harder to control. This is also an illustration of how people will experience more than one age-based status during their lifetime.
Aging is a human universal (Kottak and Kozaitis 2012). Maneuvering life’s course is sometimes challenging. Cultural socialization occurs throughout the life course. Learning the cultural traits and characteristics needed at certain stages of life is important for developing self-identity and group acceptance. People engage in anticipatory socialization to prepare for future life roles or expectations (Griffiths et al. 2015). By engaging in social interactions with other people, we learn the cultural traits, characteristics, and expectations in preparation for the next phase or stage of life. Thinking back to “potty training” infants, parents and caregivers teach young children to control bowel movements so they are able to urinate and defecate in socially appropriate settings (i.e., restroom or outhouse) and times.
Generations have collective identity or shared experiences based on the time-period the group lived. Consider the popular culture of the 1980s to today. In the 1980s, people used a landline or fixed line phone rather than a cellular phone to communicate and went to a movie theater to see a film rather than downloaded a video to a mobile device. Therefore, someone who spent his or her youth and most of their adulthood without or with limited technology may not deem it necessary to have or operate it in daily life. Whereas, someone born in the 1990s or later will only know life with technology and find it a necessary part of human existence.
Each generation develops a perspective and cultural identify from the time and events surrounding their life. Generations experience life differently resulting from cultural and social shifts over time. The difference in life experience alters perspectives towards values, beliefs, norms, expressive symbols, practices, and artifacts. Political and social events often mark an era and influence generations. The ideology of white supremacy reinforced by events of Nazi Germany and World War II during the 1930s and 1940s instilled racist beliefs in society. Many adults living at this time believed the essays of Arthur Gobineau (1853-1855) regarding the existence of biologically differences between racial groups (Biddis 1970). It was not until the 1960s and 1970s when philosophers and critical theorists studied the underlying structures in cultural products and used analytical concepts from linguistics, anthropology, psychology, and sociology to interpret race discovering no biological or phenological variances between human groups and finding race is a social construct (Black and Solomos 2000). Scientists found cultural likeness did not equate to biological likeness. Nonetheless, many adults living in the 1930s and 1940s held racial beliefs of white supremacy throughout their lives because of the ideologies spread and shared during their lifetime. Whereas, modern science verifies the DNA of all people living today is 99.9% alike and a new generation of people are learning that there is only one human race despite the physical variations in size, shape, skin tone, and eye color (Smithsonian 2018).
Because there are diverse cultural expectations based on age, there can be conflict between age cohorts and generations. Age stratification theorists suggest that members of society are classified and have social status associated to their age (Riley, Johnson, and Foner 1972). Conflict often develops from age associated cultural differences influencing social and economic power of age groups. For example, the economic power of working adults conflicts with the political and voting power of the retired or elderly.
Age and generational conflicts are also highly influenced by government or state-sponsored milestones. In the United States, there are several age-related markers including the legal age of driving (16 years old), use of tobacco products (21 years old), consumption of alcohol ( 21 years old), and age of retirement (65-70 years old). Regardless of knowledge, skill, or condition, people must abide by formal rules with the expectations assigned to the each age group within the law. Because age serves as a basis of social control and reinforced by the state, different age groups have varying access to political and economic power and resources (Griffiths et al. 2015). For example, the United States is the only industrialized nation that does not respect the abilities of the elderly by assigning a marker of 65-70 years old as the indicator for someone to become a dependent of the state and an economically unproductive member of society.
5.2 Sex and Gender
Each of us is born with physical characteristics that represent and socially assign our sex and gender. Sex refers to our biological differences and gender the cultural traits assigned to females and males (Kottak and Kozaitis 2012). Our physical make-up distinguishes our sex as either female or male implicating the gender socialization process we will experience throughout our life associated with becoming a woman or man.
Gender identity is an individual’s self-concept of being female or male and their association with feminine and masculine qualities. People teach gender traits based on sex or biological composition (Kottak and Kozaitis 2012). Our sex signifies the gender roles (i.e., psychological, social, and cultural) we will learn and experience as a member of society. Children learn gender roles and acts of sexism in society through socialization (Griffiths et al. 2015). Girls learn feminine qualities and characteristics and boys masculine ones forming gender identity. Children become aware of gender roles between the ages of two and three and by four to five years old, they are fulfilling gender roles based on their sex (Griffiths et al. 2015). Nonetheless, gender-based characteristics do not always match one’s self or cultural identity as people grow and develop.
Gender Labels
1. Why do people need and use gender labels?
2. Why do people create gender roles or expectations?
3. Do gender labels and roles influence limitations on individuals or the social world? Explain.
Gender stratification focuses on the unequal access females have to socially valued resources, power, prestige, and personal freedom as compared to men based on differing positions within the socio-cultural hierarchy (Light, Keller, and Calhoun 1997). Traditionally, society treats women as second-class citizens in society. The design of dominant gender ideologies and inequality maintains the prevailing social structure, presenting male privilege as part of the natural order (Parenti 2006). Theorists suggests society is a male dominated patriarchy where men think of themselves as inherently superior to women resulting in unequal distribution of rewards between men and women (Henslin 2011).
Media portrays women and men in stereotypical ways that reflect and sustain socially endorsed views of gender (Wood 1994). Media affects the perception of social norms including gender. People think and act according to stereotypes associated with one’s gender broadcast by media (Goodall 2016). Media stereotypes reinforce gender inequality of girls and women. According to Wood (1994), the underrepresentation women in media implies that men are the cultural standard and women are unimportant or invisible. Stereotypes of men in media display them as independent, driven, skillful, and heroic lending them to higher-level positions and power in society.
In countries throughout the world, including the United States, women face discrimination in wages, occupational training, and job promotion (Parenti 2006). As a result, society tracks girls and women into career pathways that align with gender roles and match gender-linked aspirations such as teaching, nursing, and human services (Henslin 2011). Society views men’s work as having higher value than that of women. Even if women have the same job as men, they make 77 cents per every dollar in comparison (Griffiths et al. 2015). Inequality in career pathways, job placement, and promotion or advancement result in an income gap between genders effecting the buying power and economic vitality of women in comparison to men.
The United Nations found prejudice and violence against women are firmly rooted in cultures around the world (Parenti 2006). Gender inequality has allowed men to harness and abuse their social power. The leading cause of injury among women of reproductive age is domestic violence, and rape is an everyday occurrence and seen as a male prerogative throughout many parts of the world (Parenti 2006). Depictions in the media emphasize male dominant roles and normalize violence against women (Wood 1994). Culture plays an integral role in establishing and maintaining male dominance in society ascribing men the power and privilege that reinforces subordination and oppression of women.
Cross-cultural research shows gender stratification decreases when women and men make equal contributions to human subsistence or survival (Sanday 1974). Since the industrial revolution, attitudes about gender and work have been evolving with the need for women and men to contribute to the labor force and economy. Gendered work, attitudes, and beliefs have transformed in responses to American economic needs (Margolis 1984, 2000). Today’s society is encouraging gender flexibility resulting from cultural shifts among women seeking college degrees, prioritizing career, and delaying marriage and childbirth.
Self-role Inventory Traits
Your task is to find the ten words on the sex-role inventory trait list below that are most often culturally
associated with each of the following labels and categories: femininity, masculinity, wealth, poverty, President,
teacher, mother, father, minister, or athlete. Write down the label or category and ten terms to compare your
lists with other students.
1. self-reliant
2. yielding
3. helpful
4. defends own beliefs
5. cheerful
6. moody
7. independent
8. shy
9. conscientious
10. athletic
11. affectionate
12. theatrical
13. assertive
14. flatterable
15. happy
16. strong personality
17. loyal
18. unpredictable
19. forceful
20. feminine
21. reliable
22. analytical
23. sympathetic
24. jealous
25. leadership ability
26. sensitive to other’s needs
27. truthful
28. willing to take risks
29. understanding
30. secretive
31. makes decisions easily
32. compassionate
33. sincere
34. self-sufficient
35. eager to soothe hurt feelings
36. conceited
37. dominant
38. soft-spoken
39. likable
40. masculine
41. warm
42. solemn
43. willing to take a stand
44. tender
45. friendly
46. aggressive
47. gullible
48. inefficient
49. act as leader
50. childlike
51. adaptable
52. individualistic
53. does not use harsh
language
54. unsystematic
55. competitive
56. loves children
57. tactful
58. ambitious
59. gentle
60. conventional
Compare your results with other students in the class and answer the following questions:
1. What are the trait similarities and commonalities between femininity, masculinity, wealth, poverty, President, teacher, mother, father, minister, and athlete?
2. How are masculinity and femininity used as measures of conditions and vocations?
5.3 Sexuality and Sexual Orientation
Sexuality is an inborn person’s capacity for sexual feelings (Griffiths et al. 2015). Normative standards about sexuality are different throughout the world. Cultural codes prescribe sexual behaviors as legal, normal, deviant, or pathological (Kottak and Kozaitis 2012). In the United States, people have restrictive attitudes about premarital sex, extramarital sex, and homosexuality compared to other industrialized nations (Griffiths et al. 2015). The debate on sex education in U.S. schools focuses on abstinence and contraceptive curricula. In addition, people in the U.S. have restrictive attitudes about women and sex, believing men have more urges and therefore it is more acceptable for them to have multiple sexual partners than women setting a double standard.
Sexual orientation is a biological expression of sexual desire or attraction (Kottak and Kozaitis 2012). Culture sets the parameters for sexual norms and habits. Enculturation dictates and controls social acceptance of sexual expression and activity. Eroticism like all human activities and preferences is learned and malleable (Kottak and Kozaitis 2012). Sexual orientation labels categorize personal views and representations of sexual desire and activities. Most people ascribe and conform to the sexual labels constructed and assigned by society (i.e., heterosexual or desire for the opposite sex, homosexual or attraction to the same sex, bisexual or appeal to both sexes, and asexual or lack of sexual attraction and indifference).
The projection of one’s sexual personality is often through gender identity. Most people align their sexual disposition with what is socially or publically appropriate (Kottak and Kozaitis 2012). Because sexual desire or attraction is inborn, people within the socio-sexual dominant group (i.e., heterosexual) often believe their sexual preference is “normal.” However, heterosexual fit or type is not normal. History has documented diversity in sexual preference and behavior since the dawn of human existence (Kottak and Kozaitis 2012). There is diversity and variance in people’s libido and psychosocial relationship needs. Additionally, sexual activity or fantasy does not always align to sexual orientation (Kottak and Kozaitis 2012). Sexual pleasure from use of sexual toys, homoerotic images, or kinky fetishes do not necessarily correspond to a specific orientation, sexual label, or mean someone’s desire will alter or convert to another type because of the activity. Regardless, society uses sexual identity as an indicator of status dismissing the fact that sexuality is a learned behavior, flexible, and contextual (Kottak and Kozaitis 2012). People feel and display sexual variety, erotic impulses, and sensual expressions throughout their lives.
Individuals develop sexual understanding around middle childhood and adolescence (APA 2008). There is no genetic, biological, developmental, social, or cultural evidence linked to homosexual behavior. The difference is in society’s discriminatory response to homosexuality. Alfred Kinsley was the first to identify sexuality is a continuum rather than a dichotomy of gay or straight (Griffiths et al. 2015). His research showed people do not necessarily fall into the sexual categories, behaviors, and orientations constructed by society. Eve Kosofky Sedgwick (1990) expanded on Kinsley’s research to find women are more likely to express homosocial relationships such as hugging, handholding, and physical closeness. Whereas, men often face negative sanctions for displaying homosocial behavior.
Society ascribes meaning to sexual activities (Kottak and Kozaitis 2012). Variance reflects the cultural norms and sociopolitical conditions of a time and place. Since the 1970s, organized efforts by LGBTQ (Lesbian, Gay, Bisexual, Transgender, and Questioning) activists have helped establish a gay culture and civil rights (Herdt 1992). Gay culture provides social acceptance for persons rejected, marginalized, and punished by others because of sexual orientation and expression. Queer theorists are reclaiming the derogatory label to help in broadening the understanding of sexuality as flexible and fluid (Griffiths et al. 2015). Sexual culture is not necessarily subject to sexual desire and activity, but rather dominant affinity groups linked by common interests or purpose to restrict and control sexual behavior.
Geographic Region
The place people live or occupy renders a lifestyle and cultural identity. People identify with the geographic location they live in as a part of who they are and what they believe (Kottak and Kozaitis 2012). Places have subcultures specific to their geographic location, environmental surroundings, and population.
As one of the largest cities in the United States, New York City is home to 21 million together speaking over 200 languages (U.S. News and World Report 2017). The city itself is fast-paced and its large population supports the need for around the clock services as the “city that never sleeps.” With so many people living in the metropolis, it is a diverse melting pot of racial, ethnic, and socio-economic backgrounds though each neighborhood is its own enclave with its own identity. This large, heterogeneous population effects the impersonal, sometimes characterized as “dismissive and arrogant” attitudes of its residents. By the very nature and size of the city, people are able to maintain anonymity but cannot develop or sustain intimacy with the entire community or its residents. With millions of diverse people living, working, and playing in 304 square miles, it is understandable why tourists or newcomers feel that residents are in a rush, rude, and unfriendly.
On the opposite side of the nation in the Central Valley of California, many residents live in rural communities. The Central Valley is home to 6.5 million people across 18,000 square miles (American Museum of Natural History 2018). Though there is a large, metropolitan hub of Fresno, surrounding communities identify themselves as small, agricultural with a country lifestyle. Here residents seek face-to-face interactions and communities operate as kin or families.
Like other social categories or labels, people use location to denote status or lifestyle. Consider people in the U.S. who “live in Beverly Hills” or “work on Wall Street.” These locations imply socio-economic status and privilege. Values of a dominant regional culture marginalize those who do not possess or have the cultural characteristics of that geographic location (Kottak and Kozaitis 2012). People who do not culturally fit in a place face social stigma and rejection.
People move to explore new areas, experience new cultures, or change status. Changing where we live means changing our social and cultural surroundings including the family, friends, acquaintances, etc. The most desirable spaces are distributed inequitably (Kottak and Kozaitis 2012). Wealth and privilege provide access to desirable locations and living conditions. The poor, immigrants, and ethnic minorities are most likely to be concentrated in poor communities with less than optimal living standards (Kottak and Kozaitis 2012). Impoverished groups are the most likely to be exposed to environmental hazards and dangerous living conditions. The disproportionate impact of ecological hazards on people of color has led to the development of the environmental justice movement to abolish environmental racism and harm (Energy Justice Network 2018).
Geographic places also convey or signify stereotypes. People living in or being from an area inherent the region’s stereotypes whether they are accurate or not. Think about the previous U.S. examples of “living in Beverly Hills” or “working on Wall Street.” Stereotypes associated with these labels imply wealth and status. However, approximately 10% of people living in Beverly Hills are living below the poverty rate and most people employed on Wall Street do not work for financial institutions instead are police, sanitation workers, street vendors, and public employees to name a few (Data USA 2018).
Your Regional Culture
The place someone lives influences his or her value system and life. Describe the geographic location you live and the culture of your community. What values and beliefs do the social norms and practices of your neighborhood instill or project among residents? What type of artifacts or possessions (i.e., truck, luxury car, recreational vehicle, fenced yard, swimming pool, etc.) do people living in your community seek out, dismiss, or condone? Do you conform to the cultural standards where you live or deviate from them? Explain how the place you live influences your perceptions, choices, and life.
5.4 Body and Mind
Like other human characteristics, society constructs meaning and defines normality to physical and mental ability and appearance (Kottak and Kozaitis 2012). Behavior categorized as “normal” is the standard for determining appropriate thinking and behavior from an illness or disorder. An example of this construct is the criteria for determining mental illness that involves examining a person’s functionality around accepted norms, roles, status, and behavior appropriate for social situations and settings (Cockerham 2014). The difficulty in defining mental disorders, similar to defining other illness or deformities, is the ever-changing perspectives of society. For example, “homosexuality was considered a mental disorder by American psychiatrists until the early 1970s” (Cockerham, 2014:3). Other terms and classifications have either been eliminated or evolved over time including Melancholia (now Depression), Amentia (once referred to Mental Retardation is no longer used), and Neurosis
(which is now classified into subtypes).
Primitive society believed mental illness derived from supernatural phenomena (Cockerham 2014). Because mental disorders were not always observable, people thought supernatural powers were the cause of illness. These preliterate cultures assumed people became sick because they lost their soul, invaded by an evil spirit, violated a taboo, or were victims of witchcraft (Cockerham 2014). Witch doctors or shamans used folk medicine and religious beliefs to produce cures. Many of these healers older in age, had high intellect, were sometimes sexual deviants, orphans, disabled, or mentally ill themselves (Cockerham 2014). Nonetheless, healers helped reduce anxiety and reinforce faith in social norms and customs.
Both physical and mental health conditions become part of a person’s identity. Medical professionals, as was the case with witch doctors and shamans, play a role in labeling illness or defect internalizing a person’s condition as part of one’s identity (Kottak and Kozaitis 2012). As a result, the culture free, scientific objectivity of medicine has come into question. For centuries in western society, science sought to validate religious ideologies and text including the
natural inferiority of women and the mental and moral deficiencies of people of color and the poor (Parenti 2006). Many scientific opinions about the body and mind of minority groups have been disproven and found to be embellished beliefs posing as objective findings. Medicine and psychiatry like other aspects of social life have entrenched interests and do not always come from a place of bias-free science.
People adopt behaviors to minimize the impact of their illness or ailment on others. A sick person assumes a sick role when ill and not held responsible for their poor health or disorder, the sick individual is entitled release from normal responsibilities and must take steps to regain his or her health under care of a physician or medical expert (Parsons 1951). Because society views illness as a dysfunction or abnormality, people who are ill or have a condition learn the sick role or social expectations to demonstrate their willingness to cooperate with society though they are unable to perform or maintain standard responsibilities (i.e., attend school, work, participate in physical activity, etc.).
Social attributes around an ideal body and mind center on youthfulness and wellness without deformity or defect. Though a person’s physical and mental health ultimately affects them intrinsically, society influences the social or extrinsic experience related to one’s body and mind attributes. People face social stigma when they suffer from an illness or condition. Erving Goffman (1963) defined stigma as an unwanted characteristic that is devalued by society.
Society labels health conditions or defects (e.g., cancer, diabetes, mental illness, disability, etc.) as abnormal and undesirable creating a negative social environment for people with physical or mental differences.
Individuals with health issues or disparities face suspicion, hostility, or discrimination (Giddens, Duneier, Applebaum, and Carr 2013). Social stigma accentuates one’s illness or disorder marginalizing and alienating persons with physical or cognitive limitations. During the Middle Ages, the mentally ill were categorized as fools and village idiots. Some people were tolerated for amusement, others lived with family, and some were placed on ships for placement at a distant place (Cockerham 2014). People often blame the victim suggesting one’s illness or disability resulted from personal choice or behavior, and it is their responsibility to resolve, cope, and adapt. Blaming the victim ignores the reality that an illness or defect is always be preventable, people cannot always afford health care or purchase the medications to prevent or alleviate conditions, and care or treatment is not always available.
Social stigma often results in individuals avoiding treatment for fear of social labeling, rejection, and isolation. One in four persons worldwide will suffer a mental disorder in their lifetime (Cockerham 2014). In a recent study of California residents, data showed approximately 77% of the population with mental health needs received no or inadequate treatment (Tran and Ponce 2017). Children, older adults, men, Latinos, and Asians, people with low education, the uninsured, and limited English speakers were most likely to have an unmet need of treatment. Respondents in the study reported the cost of treatment and social stigma were the contributing factors to not receiving treatment. Untreated mental disorders have high economic and social costs including alcoholism, drug abuse, divorce, domestic violence, suicide, and unemployment (Cockerham 2014). The lack of treatment have devastating effects on those in need, their families, and society.
Society promotes health and wellness as the norm and ideal life experience. Media upholds these ideals by portraying the body as a commodity and the value of being young, fit, and strong (Kottak and Kozaitis 2012). This fitness-minded culture projects individuals who are healthy and well with greater social status than those inflicted with illness or body and mind differences. In today’s society, there is low tolerance for unproductive citizens characterized by the inability to work and contribute to the economy. Darwinian (1859) ideology embedded in modern day principles promote a culture of strength, endurance, and self-reliance under the guise of survival of the fittest. This culture reinforces the modern-day values of productivity associated to one being healthy and well in order to compete, conquer, and be successful in work and life.
There are body and mind differences associated with age, gender, and race. Ideal, actual, and normal body characteristics vary from culture to culture and even within one culture over time (Kottak and Kozaitis 2012). Nonetheless, cultures throughout the world are obsessed with youth and beauty. We see examples of this in media and fashion where actors and models are fit to match regional stereotypes of the young and beautiful. In the United States, most Hollywood movies portray heroines and heroes who are fit without ailment or defect, under the age of 30, and reinforce beauty labels of hyper-femininity (i.e., thin, busty, sexy, cooperative, etc.) and hyper-masculinity (i.e., built, strong, aggressive, tough, etc.). The fashion industry also emphasizes this body by depicting unrealistic ideals of beauty for people to compare themselves while nonetheless achievable by buying the clothes and products models sell.
Body and mind depictions in the media and fashion create appearance stereotypes that imply status and class. If one contains the resources to purchase high-end brands or expense apparel, she or he are able to project status through wealth. If one is attractive, she or he are able to project status through beauty. Research shows stereotypes influence the way people speak to each other. People respond warm and friendly to attractive people and cold, reserved, and humorless to unattractive (Snyder 1993). Additionally, attractive people earn 10-15% more than ordinary or unattractive people (Judge et al. 2009; Hamermesh 2011). We most also note, if one is able to achieve beauty through plastic surgery or exercise and have no health conditions or deformities, they are also more likely to be socially accepted and obtain status.
People with disabilities have worked to dispel misconceptions, promote nondiscrimination, and fair representation (Kottak and Kozaitis 2012). Individuals with body and mind illnesses and differences form support groups and establish membership or affinity based on their condition to organize politically. By acknowledging differences and demanding civil rights, people with illnesses and disabilities are able to receive equal treatment and protection under the law eliminating the stigma and discriminatory labels society has long placed on them. Political organization for social change has given people with body and mind differences the ability to redefine culture and insist on social inclusion and participation of all people regardless of physical or mental differences, challenges, or limitations.
An illustration of civil rights changes occurred in the 20th century with a paradigm shift and growth of professionals, paraprofessionals, and laypeople in mental health (Cockerham 2014). Treatment altered to focus on psychoanalysis and psychoactive drugs rather than institutionalization. With this new approach, hospital discharges increased and hospitalization stays decreased (Cockerham 2014). The most recent revolution in mental health treatment was the development of the community mental health model. The model emphasizes local community support as a method of treatment where relationships are the focus of care. This therapeutic approach uses mental health workers who live in the community to fill the service gaps between the patient and professionals stressing a social rather than medical model (Cockerham 2014). The community mental health model extends civil rights putting consent to treatment and service approach in the hands of patients.
5.5 Race and Ethnicity
There are two myths or ideas about race. The first suggests people inherit physical characteristics distinguishing race. Second, the idea that one race is superior to others or that one “pure” race exists. In actuality, scientific research mapping of the human genome system found that humans are homogenous (Henslin 2011). Race is truly an arbitrary label that has become part of society’s culture with no justifiable evidence to support differences in physical appearance substantiate the idea that there are a variety of human species. Traditionally, racial terms classify and stratify people by appearance and inherently assign racial groups as inferior or superior in society (Kottak and Kozaitis 2012). Scientific data finds only one human species making up only one human race. Evidence shows physical differences in human appearance including skin color are a result of human migration patterns and adaptions to the environment (Jablonski 2012). Nonetheless, people use physical characteristics to identify, relate, and interact with one another.
Ethnicity refers to the cultural characteristics related to ancestry and heritage. Ethnicity describes shared culture such as group practices, values, and beliefs (Griffiths et al. 2015). People who identify with an ethnic group share common cultural characteristics (i.e., nationality, history, language, religion, etc.). Ethnic groups select rituals, customs, ceremonies, and other traditions to help preserve shared heritage (Kottak and Kozaitis 2012). Lifestyle requirements and other identity characteristics such as geography and region influence how we adapt our ethnic behaviors to fit the context or setting in which we live. Culture is also key in determining how human bodies grow and develop such as food preferences and diet and cultural traditions promote certain activities and abilities including physical well-being and sport (Kottak and Kozaitis 2012). Someone of Mexican decent living in Central California who is a college professor will project different ethnic behaviors than someone of the same ethnic culture who is a housekeeper in Las Vegas, Nevada. Differences in profession, social class, and region will influence each person’s lifestyle, physical composition, and health though both may identify and affiliate themselves as Mexican.
Not all people see themselves as belonging to an ethnic group or view ethnic heritage as important to their identity. People who do not identify with an ethnic identity either have no distinct cultural background because their ancestors come from a variety of cultural groups and offspring have not maintained a specific culture, instead have a blended culture, or they lack awareness about their ethnic heritage (Kottak and Kozaitis 2012). It may be difficult for some people to feel a sense of solidarity or association with any specific ethnic group because they do not know where their cultural practices originated and how their cultural behaviors adapted over time. What is your ethnicity? Is your ethnic heritage very important, somewhat important, or not important in defining who you are? Why?
Race and ethnic identity like other cultural characteristics influence social status or position in society. Minority groups are people who receive unequal treatment and discrimination based on social categories such as age, gender, sexuality, race and ethnicity, religious beliefs, or socio-economic class. Minority groups are not necessarily numerical minorities (Griffith et al. 2015). For example, a large group of people may be a minority group because they lack social power. The physical and cultural traits of minority groups “are held in low esteem by the dominant or majority group which treats them unfairly” (Henslin 2011:217). The dominant group has higher power and status in society and receives greater privileges. As a result, the dominant group uses its position to discriminate against those that are different. The dominant group in the United States is represented by white, middle-class, Protestant people of northern European descent (Doane 2005). Minority groups can garner power by expanding political boundaries or through expanded migration though both of these efforts do not occur with ease and require societal support from minority and dominant group members. The loss of power among dominant groups threatens not only their authority over other groups but also the privileges and way of life established by the majority.
There are seven patterns of intergroup relations between dominant and minority groups influencing not only the racial and ethnic identity of people but also the opportunities and barriers each will experience through social interactions. Maladaptive contacts and exchanges include genocide, population transfer, internal colonialism, and segregation. Genocide attempts to destroy a group of people because of their race or ethnicity. “Labeling the targeted group as inferior or even less than fully human facilitates genocide” (Henslin 2011:225). Population transfer moves or expels a minority group through direct or indirect transfer. Indirect transfer forces people to leave by making living conditions unbearable, whereas, direct transfer literally expels minorities by force.
Another form of rejection by the dominant group is a type of colonialism. Internal colonialism refers to a country’s dominant group exploiting the minority group for economic advantage. Internal colonialism generally accompanies segregation (Henslin 2011). In segregation, minority groups live physically separate from the dominant group by law.
Three adaptive intergroup relations include assimilation, multiculturalism, and pluralism. The pattern of assimilation is the process by which a minority group assumes the attitudes and language of the dominant or mainstream culture. An individual or group gives up its identity by taking on the characteristics of the dominant culture (Griffiths et al. 2015). When minorities assimilate by force to dominant ideologies and practices, they can no longer practice their own religion, speak their own language, or follow their own customs. In permissible assimilation, minority groups adopt the dominant culture in their own way and at their own speed (Henslin 2011).
Multiculturalism is the most accepting intergroup relationship between dominant and minority groups. Multiculturalism or pluralism encourages variation and diversity. Multiculturalism promotes affirmation and practice of ethnic traditions while socializing individuals into the dominant culture (Kottak and Kozaitis 2012). This model works well in diverse societies comprised of a variety of cultural groups and a political system supporting freedom of
expression. Pluralism is a mixture of cultures where each retains its own identity (Griffiths et al. 2015). Under pluralism, groups exist separately and equally while working together such as through economic interdependence where each group fills a different societal niche then exchanges activities or services for the sustainability and survival of all. Both the multicultural and pluralism models stress interactions and contributions to their society by all ethnic groups.
Reducing Ethnic Conflict
Research three online sources on methods and approaches to reducing ethnic conflict such as the following:
1. What is your reaction or feelings about the suggestions or ideas for ending ethnic conflicts presented in the sources you identified?
2. Why does type of leadership, approaches to diplomacy, and collective or organizational design matter in reducing ethnic conflicts?
3. What is the most important idea from the sources you identified as they relate to peacekeeping and multiculturalism?
Race reflects a social stigma or marker of superiority (Kottak and Kozaitis 2012). When discrimination centers on race, it is racism. There are two types of racial discrimination: individual and institutional. Individual discrimination is “unfair treatment directed against someone” (Henslin 2011:218). Whereas, institutional discrimination is negative systematic treatment of individuals by society through education, government, economy, health care, etc. According to Perry (2000), when people focus on racial-ethnic differences, they engage in the process of identity formation through structural and institutional norms. As a result, racial-ethnic identity conforms to normative perceptions people have of race and ethnicity reinforcing the structural order without challenging the socio-cultural arrangement of society. Maintaining racial-ethnic norms reinforces differences, creates tension, and disputes between racial-ethnic groups sustaining the status quo and reasserting the dominant groups’ position and hierarchy in society.
Upon the establishment of the United States, white legislators and leaders limited the roles of racial minorities and made them subordinate to those of white Europeans (Konradi and Schmidt 2004). This structure systematically created governmental and social disadvantages for minority groups and people of color. Today, toxic waste dumps continue to be disproportionately located in areas with nonwhite populations (Kottak and Kozaitis 2012). It has taken over 200 years to ensure civil rights and equal treatment of all people in the United States; however, discriminatory practices continue because of policies, precedents, and practices historically embedded in U.S. institutions and individuals behaving from ideas of racial stereotypes. Think about the differences people have in employment qualifications, compensation, obtaining home loans, or getting into college. What racial and ethnic stereotypes persist about different racial and ethnic groups in these areas of life?
Whites in the United States infrequently experience racial discrimination making them unaware of the importance of race in their own and others’ thinking in comparison to people of color or ethnic minorities (Konradi and Schmidt 2004). Many argue racial discrimination is outdated and uncomfortable with the blame, guilt, and accountability of individual acts and institutional discrimination. By paying no attention to race, people think racial equality is an act of color blindness and it will eliminate racist atmospheres (Konradi and Schmidt 2004). They do not realize the experience of not “seeing” race itself is racial privilege. Research shows the distribution of resources and opportunities are not equal among racial and ethnic categories, and White groups do better than other groups, and Blacks are predominantly among the underclass (Konradi and Schmidt 2004). Regardless of social perception, in reality, there are institutional and cultural differences in government, education, criminal justice, and media and racial-ethnic minorities received subordinate roles and treatment in society.
5.6 Religion and Belief Systems
The concept of a higher power or spiritual truth is a cultural universal. Like ethnicity, religion is the basis of identity and solidarity (Kottak and Kozaitis 2012). People’s beliefs and faith support their values, norms, and practices. Individual faith influences one’s extrinsic motivation and behaviors including treatment of others. Religion is malleable and adaptive for it changes and adapts within cultural and social contexts. Human groups have diverse beliefs and different functions of their faith and religion. Historically, religion has driven both social union and division (Kottak and Kozaitis 2012). When religious groups unite, they can be a strong mobilizing force; however, when they divide, they can work to destroy each other.
Religion is malleable and adaptive for it changes and adapts within cultural and social contexts. Human groups have diverse beliefs and different functions of their faith and religion. Historically, religion has driven both social union and division (Kottak and Kozaitis 2012). When religious groups unite, they can be a strong mobilizing force; however, when they divide, they can work to destroy each other.
Religion may be formal or informal (Kottak and Kozaitis 2012). Someone who is a member of an organized religious group, attends religious services, and practices rituals is a participant in formal or institutional religion. Whereas, someone participating in informal religion may or may not be a member of an organized religious group and experiencing a communal spirit, solidarity, and togetherness through shared experience. Informal religion may occur when we participate as a member of a team or during a group excursion such as camp.
Religion is a vehicle for guiding values, beliefs, norms, and practices. People learn religion through socialization. The meaning and structure of religion controls lives through sanctions or rewards and punishments. Religion prescribes to a code of ethics to guide behavior (Kottak and Kozaitis 2012). One who abides by religious teachings receives rewards such as afterlife and one who contradicts its instruction accepts punishment including damnation. People engage in religion and religious practices because they think it works (Kottak and Kozaitis 2012). The connection between religious faith and emotion sustains belief playing a strong role on personal and social identity. What formal or informal religious experiences have you encountered during your life? How does your faith and spirituality conform or deviate from your family of origin and friends?
Social Class
A person’s socio-economic status influences her or his personal and social identity. In society, we rank individuals on their wealth, power, and prestige (Weber [1968] 1978). The calculation of wealth is the addition of one’s income and assets minus their debts. The net worth of a person is wealth whereas income from work and investments is the resources a person has available to access. Power is the ability to influence others directly or indirectly and prestige is
the esteem or respect associated with social status (Carl 2013). This social stratification system or ranking creates inequality in society and determines one’s social position in areas such as income, education, and occupation.
Multiple factors influence social standing, however, people often assume hard work and effort leads to a high status and wealth. Socialization reinforces the ideology that social stratification is a result of personal effort or merit (Carl 2013). The concept of meritocracy is a social ideal or value, but no society exists where the determination of social rank is purely on merit. Inheritance alone shows social standing is not always individually earned. Some people have to put little to no effort to inherit social status and wealth. Additionally, societies operating under a caste system where birth determines lifelong status undermines meritocracy. Caste systems function on the structure that someone born into a low-status group remains low status regardless of their accomplishments, and those born into high-status groups stay high status (Henslin 2011). The caste system reinforces ascribed status rather than achieved to ensure sustainment of multiple roles and occupations in society.
In modern societies, there is evidence of merit-based standing in academics and job performance but other factors such as age, disability, gender, race, and region influence life’s opportunities and challenges for obtaining social standing. A major flaw of meritocracy is how society measures social contributions. Janitorial and custodial work is necessary in society to reduce illness and manage waste just as much as surgery is to keep people healthy and alive, but surgeons receive greater rewards than janitors do for their contributions.
Marx and Engels (1967) suggested there is a social class division between the capitalists who control the means of production and the workers. In 1985, Erik Wright interjected that people can occupy contradictory class positions throughout their lifetime. People who have occupied various class positions (e.g., bookkeeper to manager to chief operating officer) relate to the experiences of others in those positions, and as a result, may feel internal conflict in handling situations between positions or favoring one over another. Late in the twentieth century, Joseph Kahl and Dennis Gilbert (1992) updated the theoretical perspective of Max Weber by developing a six-tier model portraying the United States class structure including underclass, working-poor, working, lower-middle, upper-middle, and capitalists. The social class model depicts the distribution of property, prestige, and power among society based on income and education.
Each class lifestyle requires a certain level of wealth in order to acquire the material necessities and comforts of life (Henslin 2011). The correlation between the standard of living and quality of life or life chances (i.e., opportunities and barriers) influences one’s ability to afford food, shelter, clothing, healthcare, other basic needs, and luxury items. A person’s standards of living including income, employment, class, and housing effects their cultural identity.
Social class serves as a marker or indication of resources. These markers are noticeable in the behaviors, customs, and norms of each stratified group (Carl 2013). People living in impoverished communities have different cultural norms and practices compared to those with middle incomes or families of wealth. For example, the urban poor often sleep on cardboard boxes on the ground or on sidewalks and feed themselves by begging, scavenging, and raiding garbage (Kottak and Kozaitis 2012). Middle income and wealth families tend to sleep in housing structures and nourish themselves with food from supermarkets or restaurants.
Language and fashion also vary among these classes because of educational attainment, employment, and income. People will use language like “white trash” or “welfare mom” to marginalize people in the lower class and use distinguished labels to identify the upper class such as “noble” and “elite.” Sometimes people often engage in conspicuous consumption or purchase and use certain products (e.g., buy a luxury car or jewelry) to make a social statement about their status (Henslin 2011). Nonetheless, the experience of poor people is very different in comparison to others in the upper and middle classes and the lives of people within each social class may vary based on their position within other social categories including age, disability, gender, race, region, and religion.
Similar to people, nations are also stratified. The most extreme social class differences are between the wealthiest in industrialized countries and the poorest in the least developed nations (Kottak and Kozaitis 2012). The most industrialized or modern countries have the greatest property and wealth. Most industrialized nations are leaders in technology and progress allowing them to dominant, control, and access global resources. Industrializing nations have much lower incomes and standards of living than those living in most industrialized nations (Henslin 2011). The least industrialized nations are not modern, and people living in these nations tend to be impoverished and live on farms and in villages.
Hidden Rules of Class
Could you survive in poverty, middle class, or wealth? In her book A Framework for Understanding Poverty
(2005), Dr. Ruby K Payne presents lists of survival skills needed by different societal classes. Test your skills by
answering the following questions:
Could you survive in . . . (mark all that apply)
POVERTY
____ find the best rummage sales.
____ locate grocery stores’ garbage bins that have thrown away food.
____ bail someone out of jail.
____ get a gun, even if I have a police record.
____ keep my clothes from being stolen at the laundromat.
____ sniff out problems in a used car.
____ live without a checking account.
____ manage without electricity and a phone.
____ entertain friends with just my personality and stories.
____ get by when I don’t have money to pay the bills.
____ move in half a day.
____ get and use food stamps.
____ find free medical clinics.
____ get around without a car.
____ use a knife as scissors.
MIDDLE CLASS know how to….
____ get my children into Little League, piano lessons, and soccer.
____ set a table properly.
____ find stores that sell the clothing brands my family wears.
____ use a credit card, checking and /or savings account.
____ evaluate insurance: life, disability, 20/80 medical, homeowners, and personal property.
____ talk to my children about going to college.
____ get the best interest rate on my car loan.
____ help my children with homework and don’t hesitate to make a call if I need more information.
WEALTH, check if you….
____ can read a menu in French, English, and another language.
____ have favorite restaurants in different countries around the world.
____ know how to hire a professional decorator to help decorate your home during the holidays.
____ can name your preferred financial advisor, lawyer, designer, hairdresser, or domestic-employment service.
____ have at least two homes that are staffed and maintained.
____ know how to ensure confidentiality and loyalty with domestic staff.
____ use two or three “screens” that keep people whom you don’t wish to see away from you
____ fly in your own plane, the company plane, or the Concorde.
____ know how to enroll your children in the preferred private schools.
____ are on the boards of at least two charities.
____ know the hidden rules of the Junior League.
____ know how to read a corporate balance sheet and analyze your own financial statements.
____ support or buy the work of a particular artist.
5.7 Identity Today
All forms of media and technology teach culture including values, norms, language, and behaviors by providing information about activities and events of social significance (Griffiths et al. 2015). Media and technology socialize us to think and act within socio-cultural appropriate norms and accepted practices. Watching and listening to people act and behave through media and technology shows the influence this social institution has like family, peers, school, and work on teaching social norms, values, and beliefs.
Technological innovations and advancements have influenced social interactions and communication patterns in the twenty-first century creating new social constructions of reality. These changes, particularly in information technology, have led to further segmentation of society based on user-participant affinity groups (Kottak and Kozaitis 2012). The internet and web-based applications link people together transecting local, state, and national boundaries centered on common interests. People who share interests, ideas, values, beliefs, and practices are able to connect to one another through web-based and virtual worlds. These shared interests create solidarity among user-participants while disengaging them from others with differing or opposing interests. Cybersocial interactions have reinforced affinity groups creating attitudes and behaviors that strongly encourage tribalism or loyalty to the social group and
indifference to others.
Even though there are so many media, news, and information outlets available online, they are homogenous and tell the same stories using the same sources delivering the same message (McManus 1995). Regardless of the news or information outlets one accesses, the coverage of events is predominantly the same with differences focusing on commentary, perspective, and analysis. Shoemaker and Vos (2009) found this practice allow outlets to serve as gatekeepers by shaping stories and messages into mass media-appropriate forms and reducing them to a manageable amount for the audience. Fragmentation of stories and messages occurs solely on ideology related to events rather than actual coverage of accounts, reports, or news.
Technology like other resources in society creates inequality among social groups (Griffiths et al. 2015). People with greater access to resources have the ability to purchase and use online services and applications. Privilege access to technological innovations and advancements depend on one’s age, family, education, ethnicity, gender, profession, race, and social class (Kottak and Kozaitis 2012). Signs of technological stratification are visible in the increasing knowledge gap for those with less access to information technology. People with exposure to technology gain further proficiency that makes them more marketable and employable in modern society (Griffiths et al. 2015). Inflation of the knowledge gap results from the lack of technological infrastructure among races, classes, geographic areas creating a digital divide between those who have internet access and those that do not.
Native Anthropologist
Native anthropologists study their own culture. For this project, you will explore your own culture by
answering the questions below. Your response to each question must be a minimum of one paragraph
consisting of 3-5 sentences, typed, and in ASA format (i.e., paragraphs indented and double-spaced). You must
include parenthetical citations if you ask or interview someone in your family or kin group to help you
understand and answer any one of the questions. Here is a helpful link with information on citing interviews in
ASA format:
libguides.tru.ca/c.php?g=194012&p=1277266.
PART 1
1. In examining your background and heritage, what traditions or rituals do you practice regularly? To what extent are traditional cultural group beliefs still held by individuals within the community? To what extent and in what areas have your ethnic or traditional culture changed in comparison to your ancestors?
2. What major stereotypes do you have about other cultural groups based on age, gender, sex, sexuality, race, ethnicity, region, and social class?
3. Reflecting on your cultural background, how do you define family?
4. What is the hierarchy of authority in your family?
5. What do you think are the functions and obligations of the family as a large social unit to individual family members? To school? To work? To social events?
6. What do you think are the rights and responsibilities of each family member? For example, do children have an obligation to work and help the family?
7. In your culture, what stage of life is most valued?
8. What behaviors are appropriate or unacceptable for children of various ages? How might these conflict with behaviors taught or encouraged in the school, work, or by other social groups?
9. How does your cultural group compute age? What commemoration is recognized or celebrated, if any
(i.e., birthdays, anniversaries, etc.)?
PART 2
1. Considering your cultural heritage, what roles within a group are available to whom and how are they acquired?
2. Are there class or status differences in the expectations of roles within your culture?
3. Do particular roles have positive or malevolent characteristics?
4. Is language competence a requirement or qualification for family or cultural group membership?
5. How do people greet each other?
6. How is deference or respect shown?
7. How are insults expressed?
8. Who may disagree with whom in the cultural group? Under what circumstances? Are mitigating forms used?
9. Which cultural traditions or rituals are written and how widespread is cultural knowledge found in written forms?
10. What roles, attitudes, or personality traits are associated with particular ways of speaking among the cultural group?
11. What is the appropriate decorum or manners among your cultural group?
12. What counts as discipline in terms of your culture, and what doesn’t? What is its importance and value?
13. Who is responsible and how is blame ascribed if a child misbehaves?
14. Do means of social control vary with recognized stages in the life cycle, membership in various social categories (i.e., gender, region, class, etc.), or according to setting or offense?
15. What is the role of language in social control? What is the significance of using the first vs. the second language?
PART 3
1. What is considered sacred (religious) and what secular (non-religious)?
2. What religious roles and authority are recognized in the community?
3. What should an outsider not know, or not acknowledge knowing about your religion or culture?
4. Are there any external signs of participation in religious rituals (e.g., ashes, dress, marking)?
5. Are dietary restrictions to be observed including fasting on particular occasions?
6. Are there any prescribed religious procedures or forms of participation if there is a death in the family?
7. What taboos are associated with death and the dead?
8. Who or what is believed to cause illness or death (e.g., biological vs. supernatural or other causes)?
9. Who or what is responsible for treating or curing illness?
10. Reflecting on your culture, what foods are typical or favorites? What are taboo?
11. What rules are observed during meals regarding age and sex roles within the family, the order of serving, seating, utensils used, and appropriate verbal formulas (e.g., how, and if, one may request, refuse, or thank)?
12. What social obligations are there with regard to food giving, preparation, reciprocity, and honoring
people?
13. What relation does food have to health? What medicinal uses are made of food, or categories of food?
14. What are the taboos or prescriptions associated with the handling, offering, or discarding of food?
15. What clothing is common or typical among your cultural group? What is worn for special occasions?
16. What significance does dress have for group identity?
17. How does dress differ for age, sex, and social class? What restrictions are imposed for modesty (e.g., can girls wear pants, wear shorts, or shower in the gym)?
18. What is the concept of beauty, or attractiveness in the culture? What characteristics are most valued?
19. What constitutes a compliment of beauty or attractiveness in your culture (e.g., in traditional Latin American culture, telling a woman she is getting fat is a compliment)?
20. Does the color of dress have symbolic significance (e.g., black or white for mourning, celebrations, etc.)?
PART 4
1. In your culture, what individuals and events in history are a source of pride for the group?
2. How is knowledge of the group’s history preserved? How and in what ways is it passed on to new
generations (e.g., writings, aphorisms or opinions, proverbs or sayings)?
3. Do any ceremonies or festive activities re-enact historical events?
4. Among your cultural group, what holidays and celebrations are observed? What is their purpose? What
cultural values do they intend to inculcate?
5. What aspects of socialization/enculturation do holidays and celebrations observed further?
6. In your culture, what is the purpose of education?
7. What methods for teaching and learning are used at home (e.g., modeling and imitation, didactic stories
and proverbs, direct verbal instruction)?
8. What is the role of language in learning and teaching?
9. How many years is it considered ‘normal’ for children to go to school?
10. Are there different expectations with respect to different groups (e.g., boys vs. girls)? In different subjects?
11. Considering your culture, what kinds of work are prestigious and why?
12. Why is work valued (e.g., financial gain, group welfare, individual satisfaction, promotes group cohesiveness, fulfillment or creation of obligations, position in the community, etc.)?
PART 5
1. How and to what extent may approval or disapproval be expressed in you culture?
2. What defines the concepts of successful among your cultural group?
3. To what extent is it possible or proper for an individual to express personal vs. group goals?
4. What beliefs are held regarding luck and fate?
5. What significance does adherence to traditional culture have for individual success or achievement?
6. What are the perceptions on the acquisition of dominant group culture have on success or achievement?
7. Do parents expect and desire assimilation of children to the dominant culture as a result of education and the acquisition of language?
8. Are the attitudes of the cultural community the same as or different from those of cultural leaders?
9. Among your cultural group, what beliefs or values are associated with concepts of time? How important is punctuality, speed, patience, etc.?
10. Are particular behavioral prescriptions or taboos associated with the seasons?
11. Is there a seasonal organization of work or other activities?
12. How do individuals organize themselves spatially in groups during cultural events, activities, or gatherings
(e.g., in rows, circles, around tables, on the floor, in the middle of the room, etc.)?
13. What is the spatial organization of the home in your culture (e.g., particular activities in various areas of the home, areas allotted to children, or open to children,)?
14. What geo-spatial concepts, understandings, and beliefs (e.g., cardinal directions, heaven, hell, sun, moon, stars, natural phenomena, etc.) exist among the cultural group or are known to individuals?
15. Are particular behavioral prescriptions or taboos associated with geo-spatial concepts, understandings, and beliefs? What sanctions are there against individuals violating restrictions or prescriptions?
16. Which animals are valued in your culture, and for what reasons?
17. Which animals are considered appropriate as pets and which are inappropriate? Why?
18. Are particular behavioral prescriptions or taboos associated with particular animals?
19. Are any animals of religious significance? Of historical importance?
20. What forms of art and music are most highly valued?
21. What art medium and musical instruments are traditionally used?
22. Are there any behavioral prescriptions or taboos related to art and music (e.g., both sexes sing, play a
particular instrument, paint or photograph nude images, etc.)?
Attribution
Adapted from Modules 1 through 5, pages 1 through 77 from “Beyond Race: Cultural Influences on Human Social Life” by Vera Kennedy under the license CC BY-NC-SA 4.0. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/01%3A_Traditional_Paradigms_and_Dominant_Perspectives_on_Individuals/05%3A_Cultural_Identity.txt |
Learning Objectives
6.1 Globalization and Identity
Everyday production of culture centers on local and global influences (Giddens 1991). With the advancements in technology and communications, people are experiencing greater social forces in the construction of their cultural reality and identity. The boundaries of locality have expanded to global and virtual contexts that create complexities in understanding the creation, socialization, adaptation, and sustainability of culture.
Globalization is typically associated to the creation of world-spanning free market and global reach of capitalist systems resulting from technological advances (Back, Bennett, Edles, Gibson, Inglis, Jacobs, and Woodward 2012). However, globalization has the unintended consequences of connecting every person in the world to each other. In this era, everyone’s life is connected to everyone else’s life in obvious and hidden ways (Albrow 1996). A food production shortage in the United States affects the overall economic and physical well-being and livelihoods of people throughout the world in an obvious way. Our hidden connections stem from the individuals who grow, produce, and transport the food people eat. It is easier for people to recognize the big picture or macro-sociological influences we have on each other, but sometimes harder to recognize the role individuals have on each other across the globe.
Globalization also influences our cultural identity and affinity groups. Technology allows us to eliminate communication boundaries and interact with each other on a global scale. Globalization lends itself to cultural homogenization that is the world becoming culturally similar (Back et al. 2012). However, the cultural similarities we now share center on capitalist enterprises including fashion and fast food. Globalization has resulted in the worldwide spread of capitalism (Back et al. 201). Transnational corporations or companies with locations throughout the world like McDonald’s, Coca-Cola, and Nike dominate the global market with goods and services spreading and embedding their cultural artifacts on a global scale. These corporations increase the influence of global practices on people’s lives that sometimes result in economic and social consequences including closing factories in one country and moving to another where costs and regulations are lower.
Along with people throughout the world becoming culturally similar, sociologists also recognize patterns of cultural heterogenization where aspects of our lives are becoming more complex and differentiated resulting from globalization. Our social relationships and interactions have become unconstrained by geography (Back et al.). People are no longer restricted to spatial locales and are able to interact beyond time and space with those sharing common culture, language, or religion (Giddens 1990; Kottak and Kozaitis 2012). People can travel across the globe within hours, but also connect with others by phone or the Internet within seconds. These advancements in technology and communications alters what people perceive as close and far away (Back et al. 2012). Our social and cultural arrangements in an era of globalization are adapting and changing the way we think and act.
Today people are able to form and live across national borders. Advances in transportation and communications give people the opportunity to affiliate with multiple countries as transnationals. At different times of their lives or different times of the year, people may live in two or more countries.
We are moving beyond local, state, and national identities to broader identities developing from our global interactions forming transnational communities. A key cultural development has been the construction of globality or thinking of the whole earth as one place (Beck 2000). Social events like Earth Day and the World Cup of soccer are examples of globality. People associate and connect with each other in which they identify. Today people frame their thinking about who they are within global lenses of reference (Back et al. 2012). Even in our global and virtual interactions, people align themselves with the affinity groups relative to where they think they belong and will find acceptance. Think about your global and virtual friend and peer groups. How did you meet or connect? Why do you continue to interact? What value do you have in each other’s lives even though you do not physically interact?
Our online future
Research three online sources on how online interactions and social media influence human social life such as the following:
1. What is the relationship between inputting information online and privacy?
2. Do you think the web re-enforces narcissism? How does narcissistic behavior influence our connections to the social world and other people?
3. Even if we choose NOT to participate or be part of the online universe, how does the behavior of other people online affect what the world knows about us?
4. Should everything we do online be open and available to the public? Who should be able to view your browsing patterns, profile, photos, etc.?
5. What rights do you think people should have in controlling their privacy online?
Culture Today
With the world in flux from globalization and technological advances, people are developing multiple identities apparent in their local and global linkages. Cultural identity is becoming increasingly contextual in the postmodern world where people transform and adapt depending on time and place (Kottak and Kozaitis 2012). Social and cultural changes now adapt in response to single events or issues. The instant response and connections to others beyond time and place immediately impact our lives, and we have the technology to react quickly with our thoughts and actions.
Approximately two-thirds of American adults are online connecting with others, working, studying, or learning (Griswold 2013). The increasing use of the Internet makes virtual worlds and cybersocial interactions powerful in constructing new social realities. Having a networked society allows anyone to be a cultural creator and develop an audience by sharing their thoughts, ideas, and work online. Amateurs are now cultural creators and have the ability to control dissemination of their creations (Griswold 2013). Individuals now have the freedom to restrict or share cultural meaning and systems.
Postmodern culture and the new borderless world fragments traditional social connections into new cultural elements beyond place, time, and diversity without norms. People can now live within global electronic cultural communities and reject cultural meta-narratives (Griswold 2013). Postmodern culture also blurs history by rearranging and juxtaposing unconnected signs to produce new meanings. We find references to actual events in fictional culture and fictional events in non-fictional culture (Barker and Jane 2016). Many U.S. television dramas refer to 9/11 in episodes focusing on terrorists or terrorist activities. Additionally, U.S. social activities and fundraising events will highlight historical figures or icons. The blurring of non-fiction and fiction creates a new narrative or historical reality people begin to associate with and recognize as actual or fact.
Cultural Transformation
1. How has globalization and technology changed culture and cultural tastes?
2. How have people harnessed these changes into cultural objects or real culture?
3. How do you envision the growth or transformation of receivers or the audience as participants in cultural production?
4. What cultural objects are threatened in the age of postmodern culture?
6.2 Building Cultural Intelligence
In a cultural diverse society, it is becoming increasingly important to be able to interact effectively with others. Our ability to communicate and interact with each other plays an integral role in the successful development of our relationships for personal and social prosperity. Building cultural intelligence requires active awareness of self, others, and context (Bucher 2008). Self-awareness requires an understanding of our cultural identity including intrinsic or extrinsic bias we have about others and social categories of people. Cultural background greatly influences perception and understanding, and how we identify ourselves reflects on how we communicate and get along with others. It is easier to adjust and change our interactions if we are able to recognize our own uniqueness, broaden our percepts, and respect others (Bucher 2008). We must be aware of our cultural identity including any multiple or changing identities we take on in different contexts as well as those we keep hidden or hide to avoid marginalization or recognition.
Active awareness of others requires us to use new cultural lenses. We must learn to recognize and appreciate commonalities in our culture, not just differences. This practice develops understanding of each other’s divergent needs, values, behaviors, interactions, and approach to teamwork (Bucher 2008). Understanding others involves evaluating assumptions and cultural truths. Cultural lens filter perceptions of others and conditions us to view the world and others in one way blinding us from what we have to offer or complement each other (Bucher 2008). Active awareness of others broadens one’s sociological imagination to see the world and others through a different lens and understand diverse perspectives that ultimately helps us interact and work together effectively.
Today’s workplace requires us to have a global consciousness that encompasses awareness, understanding, and skills to work with people of diverse cultures (Bucher 2008). Working with diverse groups involves us learning about other cultures to manage complex and uncertain social situations and contexts. What may be culturally appropriate or specific in one setting may not apply in another. This means we must develop a cultural understanding of not only differences and similarities, but those of cultural significance as well to identify which interactions fit certain situations or settings.
Cultural Intelligence Resources
1. How do you develop collaboration among people with different backgrounds and experiences?
2. What role does power play in our ability to collaborate with others and develop deep levels of understanding?
3. How might power structures be created when one group tries to provide aid to another?
4. Research the Cultural Intelligence Center and online videos on the topic of building cultural intelligence such as Cultural Intelligence: A New Way of Thinking by Jeff Thomas. Describe what information and free services are available online to help people improve their knowledge and communication skills with people of different cultural backgrounds and experiences.
5. Provide examples of how you will apply the following skills to develop global consciousness:
• Minimize culture shock
• Recognize ethnocentrism
• Practice cultural relativism
• Develop multiple consciousness
• Step outside your comfort zone
As we come into contact with diverse people, one of our greatest challenges will be managing cross-cultural conflict. When people have opposing cultural values, beliefs, norms, or practices, they tend to create a mindset of division or the “us vs. them” perspective. This act of loyalty to one side or another displays tribalism and creates an ethnocentric and scapegoating environment where people judge and blame each other for any issues or problems. Everyone attaches some importance to what one values and beliefs. As a result, people from different cultures might attach greater or lesser importance to family and work. If people are arguing over the roles and commitment of women and men in the family and workplace, their personal values and beliefs are likely to influence their willingness to compromise or listen to one another. Learning to manage conflict among people from different cultural backgrounds increases our ability to build trust, respect all parties, deal with people’s behaviors, and assess success (Bucher 2008). How we deal with conflict influences productive or destructive results for others and ourselves.
Self-assessment is key to managing cross-cultural conflicts. Having everyone involved in the conflict assess herself or himself first and recognize their cultural realities (i.e., history and biography) will help individuals see where they may clash or conflict with others. If someone comes from the perspective of men should lead, their interactions with others will display women in low regard or subordinate positions to men. Recognizing our cultural reality will help us identify how we might be stereotyping and treating others and give us cause to adapt and avoid conflict with those with differing realities.
Some form of cultural bias is evident in everyone (Bucher 2008). Whether you have preferences based on gender, sexuality disability, region, social class or all social categories, they affect your thoughts and interactions with others. Many people believe women are nurturers and responsible for child-rearing, so they do not believe men should get custody of the children when a family gets a divorce. Bias serves as the foundation for stereotyping and prejudice (Bucher 2008). Many of the ideas we have about others are ingrained, and we have to unlearn what we know to reduce or manage bias. Removing bias perspectives requires resocialization through an ongoing conscious effort in recognizing our bias then making a diligent effort to learn about others to dispel fiction from fact. Dealing with bias commands personal growth and the biggest obstacles are our fears and complacency to change.
Additionally, power structures and stratification emerge in cross-cultural conflicts. The dynamics of power impact each of us (Bucher 2008). Our assumptions and interactions with each other is a result of our position and power in a particular context or setting. The social roles and categories we each fall into effect on how and when we respond to each other. A Hispanic, female, college professor has the position and authority to speak and control conflict of people in her classroom but may have to show deference and humility when conflict arises at the Catholic Church she attends. The professor’s position in society is contextual and in some situations, she has the privileges of power, but in
others, she may be marginalized or disregarded.
Power effects how others view, relate, and interact with us (Bucher 2008). Power comes with the ability to change, and when you have power, you are able to invoke change. For example, the racial majority in the United States holds more economic, political, and social power than other groups in the nation. The dominant group’s power in the United States allows the group to define social and cultural norms as well as condemn or contest opposing views and perspectives. This group has consistently argued the reality of “reverse racism” even though racism is the practice of the dominant race benefitting off the oppression of others. Because the dominant group has felt prejudice and discrimination by others, they want to control the narrative and use their power to create a reality that further benefits their race by calling thoughts and actions against the group as “reverse racism.”
However, when you are powerless, you may not have or be given the opportunity to participate or have a voice. Think about when you are communicating with someone who has more power than you. What do your tone, word choice, and body language project? So now imagine you are the person in a position of power because of your age, gender, race, or other social category what privilege does your position give you? Power implies authority, respect, significance, and value so those of us who do not have a social position of power in a time of conflict may feel and receive treatment that reinforces our lack of authority, disrespect, insignificance, and devalued. Therefore, power reinforces social exclusion of some inflating cross-cultural conflict (Ryle 2008). We must assess our cultural and social power as well as those of others we interact with to develop an inclusive environment that builds on respect and understanding to deal with conflicts more effectively.
Communication is essential when confronted with cross-cultural conflict (Bucher 2008). Conflicts escalate from our inability to express our cultural realities or interact appropriately in diverse settings. In order to relate to each other with empathy and understanding, we must learn to employ use of positive words, phrases, and body language. Rather than engaging in negative words to take sides (e.g., “Tell your side of the problem” or “How did that affect you?”), use positive words that describe an experience or feeling. Use open-ended questions that focus on the situation or concern (e.g., “Could you explain to be sure everyone understands?” or “Explain how this is important and what needs to be different”) in your communications with others (Ryle 2008). In addition, our body language expresses our emotions and feelings to others. People are able to recognize sadness, fear, and disgust through the expressions and movements we make. It is important to project expressions, postures, and positions that are open and inviting even when we feel difference or uncomfortable around others. Remember, words and body language have meaning and set the tone or atmosphere in our interactions with others. The words and physical expressions we choose either inflate or deescalate cross-cultural conflicts.
The act of reframing or rephrasing communications is also helpful in managing conflicts between diverse people. Reframing requires active listening skills and patience to translate negative and value-laden statements into neutral statements that focus on the actual issue or concern. This form of transformative mediation integrates neutral language that focuses on changing the message delivery, syntax or working, meaning, and context or situation to resolve destructive conflict. For example, reframe “That’s a stupid idea” to “I hear you would like to consider all possible options.” Conversely, reframe a direct verbal attack, “She lied! Why do you want to be friends with her?” to “I’m hearing that confidentiality and trust are important to you.” There are four steps to reframing: 1) actively listen to the statement; 2) identify the feelings, message, and interests in communications; 3) remove toxic language; and 4) re-state the issue or concern (Ryle 2008). These tips for resolving conflict helps people hear the underlying interests and cultural realities.
Ethnography
PART 1
1. Interview another student in class. Record the student’s responses to the following:
CULTURAL EXPRESSIONS
• What are typical foods served in the culture?
• Are there any typical styles of dress?
• What do people do for recreation?
• How is space used (e.g., How close should two people who are social acquaintances stand next to one another when they are having a conversation?)
• How is public space used? For example, do people tend to “hang out” on the street, or are they in public because they are going from one place to the next?
STANDARD BEHAVIORS
• How do people greet one another?
• Describe how a significant holiday is celebrated.
• How would a visitor be welcomed into a family member’s home?
• What are the norms around weddings? Births? Deaths?
SPECIFIC BELIEFS
• How important is hierarchy or social status?
• How are gender roles perceived?
• How do people view obligations toward one another?
• What personal activities are seen as public? What activities are seen as private?
• What are the cultural attitudes toward aging and the elderly?
ENTRENCHED IDEOLOGIES
• How important is the individual in the culture? How important is the group?
• How is time understood and measured? (e.g., How late can you be to class, work, family event, or appointment before you are considered rude?)
• Is change considered positive or negative?
• What are the criteria for individual success?
• What is the relationship between humans and nature? (e.g., Do humans dominate nature? does nature dominate humans? Do the two live in harmony?)
• What is considered humorous or funny?
• How do individuals “know” things? (e.g., Are people encouraged to question things? Are they encouraged to master accepted wisdom?)
• Are people encouraged to be more action-oriented (i.e., doers) or to be contemplative (i.e., thinkers)
• What is the role of luck in people’s lives?
• How is divine power or spirituality viewed?
PART 2
1. Exchange the photos each of you took in the exercise.
2. Next visit the website Dollar Street.
3. Compare the visual ethnography photos with other people throughout the world.
4. In complete sentences, explain the differences and similarities based on income and country. Specifically, describe what the poorest conditions are for each item as well as the richest conditions and what similarities and/or differences exist in comparison to the student photos.
PART 3
Write a paper summarizing the ethnographic data you collected and examined. Your paper must include a description and analysis of the following:
• Thesis statement and introductory paragraph (3-5 sentences) about the student you studied and learned about for this project and methods used to gather data.
• A summary of the ethnography interview containing a minimum of five paragraphs (3-5 sentences each) with first-level headings entitled cultural expressions, standard behaviors, specific beliefs, and
entrenched ideologies.
• A comparison of visual ethnography photos with other people throughout the world using the Dollar Street website. Write a minimum of 10 paragraphs
(3-5 sentences each) discussing the poorest and richest conditions of the archived photos on the
website, and explain the similarities and/or differences to the 22 photos shared by your study
subject.
• Concluding paragraph (3-5 sentences) telling what you learned by completing an ethnography project and the significance to understanding cultural sociology.
Type and double-space project papers with paragraphs comprised of three to five sentences in length and first-level headers (left-justified, all caps) as appropriate. Do not write your paper in one block paragraph. Include parenthetical and complete reference citations in ASA format as appropriate.
Attribution
Adapted from Modules 1 through 5, pages 1 through 77 from “Beyond Race: Cultural Influences on Human Social Life” by Vera Kennedy under the license CC BY-NC-SA 4.0. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/01%3A_Traditional_Paradigms_and_Dominant_Perspectives_on_Individuals/06%3A_The_Multicultural_World.txt |
Learning Objectives
• Outline the characteristics of perceivers and of cultures that influence their causal attributions.
• Explain the ways that our attributions can influence our mental health and the ways that our mental health affects our attributions.
7.1 Introduction
To this point, we have focused on how the appearance, behaviors, and traits of the people we encounter influence our understanding of them. It makes sense that this would be our focus because of the emphasis within social psychology on the social situation—in this case, the people we are judging. But the person is also important, so let’s consider some of the person variables that influence how we judge other people.
7.2 Perceiver Characteristics
1. So far, we have assumed that different perceivers will all form pretty much the same impression of the same person. For instance, if you and I are both thinking about our friend Janetta, or describing her to someone else, we should each think about or describe her in pretty much the same way—after all, Janetta is Janetta, and she should have a personality that you and I can both see. But this is not always the case—you and I may form different impressions of Janetta, and for a variety of reasons. For one, my experiences with Janetta are somewhat different than yours. I see her in different places and talk to her about different things than you do, and thus I will have a different sample of behavior on which to base my impressions.
But you and I might even form different impressions of Janetta if we see her performing exactly the same behavior. To every experience, each of us brings our own schemas, attitudes, and expectations. In fact, the process of interpretation guarantees that we will not all form exactly the same impression of the people that we see. This, of course, reflects a basic principle that we have discussed throughout this book—our prior experiences color our current perceptions.
One perceiver factor that influences how we perceive others is the current cognitive accessibility of a given person characteristic—that is, the extent to which a person characteristic quickly and easily comes to mind for the perceiver. Differences in accessibility will lead different people to attend to different aspects of the other person. Some people first notice how attractive someone is because they care a lot about physical appearance—for them, appearance is a highly accessible characteristic. Others pay more attention to a person’s race or religion, and still others attend to a person’s height or weight. If you are interested in style and fashion, you would probably first notice a person’s clothes, whereas another person might be more likely to notice one’s athletic skills.
You can see that these differences in accessibility will influence the kinds of impressions that we form about others because they influence what we focus on and how we think about them. In fact, when people are asked to describe others, there is often more overlap in the descriptions provided by the same perceiver about different people than there is in those provided by different perceivers about the same target person (Dornbusch, Hastorf, Richardson, Muzzy, & Vreeland, 1965; Park, 1986). If you care a lot about fashion, you will describe all your friends on that dimension, whereas if I care about athletic skills, I will tend to describe all my friends on the basis of their athletic qualities. These differences reflect the differing emphasis that we as observers place on the characteristics of others rather than the real differences between those people.
People also differ in terms of how carefully they process information about others. Some people have a strong need to think about and understand others. I’m sure you know people like this—they want to know why something went wrong or right, or just to know more about anyone with whom they interact. Need for cognition refers to the tendency to think carefully and fully about social situations (Cacioppo & Petty, 1982). People with a strong need for cognition tend to process information more thoughtfully and therefore may make more causal attributions overall. In contrast, people without a strong need for cognition tend to be more impulsive and impatient and may make attributions more quickly and spontaneously (Sargent, 2004). Although the need for cognition refers to a tendency to think carefully and fully about any topic, there are also individual differences in the tendency to be interested in people more specifically. For instance, Fletcher, Danilovics, Fernandez, Peterson, and Reeder (1986) found that psychology majors were more curious about people than were natural science majors.
Individual differences exist not only in the depth of our attributions but also in the types of attributions we tend to make about both ourselves and others (Plaks, Levy, & Dweck, 2009). Some people tend to believe that people’s traits are fundamentally stable and incapable of change. We call these people entity theorists. Entity theorists tend to focus on the traits of other people and tend to make a lot of personal attributions. On the other hand, incremental theorists are those who believe that personalities change a lot over time and who therefore are more likely to make situational attributions for events. Incremental theorists are more focused on the dynamic psychological processes that arise from individuals’ changing mental states in different situations.
In one relevant study, Molden, Plaks, and Dweck (2006) found that when forced to make judgments quickly, people who had been classified as entity theorists were nevertheless still able to make personal attributions about others but were not able to easily encode the situational causes of behavior. On the other hand, when forced to make judgments quickly, the people who were classified as incremental theorists were better able to make use of the situational aspects of the scene than the personalities of the actors.
Individual differences in attributional styles can also influence our own behavior. Entity theorists are more likely to have difficulty when they move on to new tasks because they don’t think that they will be able to adapt to the new challenges. Incremental theorists, on the other hand, are more optimistic and do better in such challenging environments because they believe that their personality can adapt to the new situation. You can see that these differences in how people make attributions can help us understand both how we think about ourselves and others and how we respond to our own social contexts (Malle, Knobe, O’Laughlin, Pearce, & Nelson, 2000).
Research Focus:
How Our Attributions Can Influence Our School Performance
Carol Dweck and her colleagues (Blackwell, Trzesniewski, & Dweck, 2007) tested whether the type of attributions students make about their own characteristics might influence their school performance. They assessed the attributional tendencies and the math performance of 373 junior high school students at a public school in New York City. When they first entered seventh grade, the students all completed a measure of attributional styles. Those who tended to agree with statements such as “You have a certain amount of intelligence, and you really can’t do much to change it” were classified as entity theorists, whereas those who agreed more with statements such as “You can always greatly change how intelligent you are” were classified as incremental theorists. Then the researchers measured the students’ math grades at the end of the fall and spring terms in seventh and eighth grades.
2. >As you can see in int the following figure, the researchers found that the students who were classified as incremental theorists improved their math scores significantly more than did the entity students. It seems that the incremental theorists really believed that they could improve their skills and were then actually able to do it. These findings confirm that how we think about traits can have a substantial impact on our own behavior.
Figure 6.6
3. >Students who believed that their intelligence was more malleable (incremental styles) were more likely to improve their math skills than were students who believed that intelligence was difficult to change (entity styles). Data are from Blackwell et al. (2007).
4. 7.3 Cultural Differences in Person Perception
As we have seen in many places in this book, the culture that we live in has a significant impact on the way we think about and perceive the world. And thus it is not surprising that people in different cultures would tend to think about people at least somewhat differently. One difference is between people from Western cultures (e.g., the United States, Canada, and Australia) and people from East Asian cultures (e.g., Japan, China, Taiwan, Korea, and India). People from Western cultures tend to be primarily oriented toward individualism, tending to think about themselves as different from (and often better than) the other people in their environment and believing that other people make their own decisions and are responsible for their own actions. In contrast, people in many East Asian cultures take a more collectivistic view of people that emphasizes not so much the individual but rather the relationship between individuals and the other people and things that surround them. The outcome of these differences is that on average, people from individualistic cultures tend to focus more on the individual person, whereas, again on average, people from collectivistic cultures tend to focus more on the situation (Ji, Peng, & Nisbett, 2000; Lewis, Goto, & Kong, 2008; Maddux & Yuki, 2006).
In one study demonstrating this difference, Miller (1984) asked children and adults in both India (a collectivist culture) and the United States (an individualist culture) to indicate the causes of negative actions by other people. Although the youngest children (ages 8 and 11) did not differ, the older children (age 15) and the adults did—Americans made more personal attributions, whereas Indians made more situational attributions for the same behavior.
Masuda and Nisbett (2001) asked American and Japanese students to describe what they saw in images like the one shown in Figure 6.7 “Cultural Differences in Perception”. They found that while both groups talked about the most salient objects (the fish, which were brightly colored and swimming around), the Japanese students also tended to talk and remember more about the images in the background—they remembered the frog and the plants as well as the fish.
Figure 6.7 Cultural Differences in Perception
Michael Morris and his colleagues (Hong, Morris, Chiu, & Benet-Martínez, 2000) investigated the role of culture on person perception in a different way, by focusing on people who are bicultural (i.e., who have knowledge about two different cultures). In their research, they used high school students living in Hong Kong. Although traditional Chinese values are emphasized in Hong Kong, because Hong Kong was a British-administrated territory for more than a century, the students there are also acculturated with Western social beliefs and values.
Morris and his colleagues first randomly assigned the students to one of three priming conditions. Participants in the American culture priming condition saw pictures of American icons (such as the U.S. Capitol building and the American flag) and then wrote 10 sentences about American culture. Participants in the Chinese culture priming condition saw eight Chinese icons (such as a Chinese dragon and the Great Wall of China) and then wrote 10 sentences about Chinese culture. Finally, participants in the control condition saw pictures of natural landscapes and wrote 10 sentences about the landscapes.
Then participants in all conditions read a story about an overweight boy who was advised by a physician not to eat food with high sugar content. One day, he and his friends went to a buffet dinner where a delicious-looking cake was offered. Despite its high sugar content, he ate it. After reading the story, the participants were asked to indicate the extent to which the boy’s weight problem was caused by his personality (personal attribution) or by the situation (situational attribution). The students who had been primed with symbols about American culture gave relatively less weight to situational (rather than personal) factors in comparison with students who had been primed with symbols of Chinese culture.
In still another test of cultural differences in person perception, Kim and Markus (1999) analyzed the statements made by athletes and by the news media regarding the winners of medals in the 2000 and 2002 Olympic Games. They found that athletes in China described themselves more in terms of the situation (they talked about the importance of their coaches, their managers, and the spectators in helping them to do well), whereas American athletes (can you guess?) focused on themselves, emphasizing their own strength, determination, and focus.
Taken together then, we can see that cultural and individual differences play a similar role in person perception as they do in other social psychological areas. Although most people tend to use the same basic person-perception processes, and although we can understand these processes by observing the communalities among people, the outcomes of person perception will also be determined—at least in part—by the characteristics of the person himself or herself. And these differences are often created by the culture in which the person lives.
7.4 Attribution Styles and Mental Health
5. As we have seen in this chapter, how we make attributions about other people has a big influence on our reactions to them. But we also make attributions for our own behaviors. Social psychologists have discovered that there are important individual differences in the attributions that people make to the negative events that they experience and that these attributions can have a big influence on how they respond to them. The same negative event can create anxiety and depression in one individual but have virtually no effect on someone else. And still another person may see the negative event as a challenge to try even harder to overcome the difficulty (Blascovich & Mendes, 2000).
A major determinant of how we react to perceived threats is the attributions that we make to them. Attributional style refers to the type of attributions that we tend to make for the events that occur to us. These attributions can be to our own characteristics (internal) or to the situation (external), but attributions can also be made on other dimensions, including stable versus unstable, and global versus specific. Stable attributions are those that we think will be relatively permanent, whereas unstable attributions are expected to change over time. Global attributions are those that we feel apply broadly, whereas specific attributions are those causes that we see as more unique to specific events.
You may know some people who tend to make negative or pessimistic attributions to negative events that they experience—we say that these people have a negative attributional style. These people explain negative events by referring to their own internal, stable, and global qualities. People with negative attributional styles say things such as the following:
• “I failed because I am no good” (an internal attribution).
• “I always fail” (a stable attribution).
• “I fail in everything” (a global attribution).
You might well imagine that the result of these negative attributional styles is a sense of hopelessness and despair (Metalsky, Joiner, Hardin, & Abramson, 1993). Indeed, Alloy, Abramson, and Francis (1999) found that college students who indicated that they had negative attributional styles when they first came to college were more likely than those who had a more positive style to experience an episode of depression within the next few months.
People who have extremely negative attributional styles, in which they continually make external, stable, and global attributions for their behavior, are said to be experiencing learned helplessness (Abramson, Seligman, & Teasdale, 1978; Seligman, 1975). Learned helplessness was first demonstrated in research that found that some dogs that were strapped into a harness and exposed to painful electric shocks became passive and gave up trying to escape from the shock, even in new situations in which the harness had been removed and escape was therefore possible. Similarly, some people who were exposed to bursts of noise later failed to stop the noise when they were actually able to do so. In short, learned helplessness is the tendency to make external, rather than internal, attributions for our behaviors. Those who experience learned helplessness do not feel that they have any control over their own outcomes and are more likely to have a variety of negative health outcomes (Henry, 2005; Peterson & Seligman, 1984).
Another type of attributional technique that people sometimes use to help them feel better about themselves is known as self-handicapping.Self-handicappingoccurs when we make statements or engage in behaviors that help us create a convenient external attribution for potential failure. For instance, in research by Berglas and Jones (1978), participants first performed an intelligence test on which they did very well. It was then explained to them that the researchers were testing the effects of different drugs on performance and that they would be asked to take a similar but potentially more difficult intelligence test while they were under the influence of one of two different drugs.
The participants were then given a choice—they could take a pill that was supposed to facilitate performance on the intelligence task (making it easier for them to perform) or a pill that was supposed to inhibit performance on the intelligence task, thereby making the task harder to perform (no drugs were actually administered). Berglas found that men—but not women—engaged in self-handicapping: They preferred to take the performance-inhibiting rather than the performance-enhancing drug, choosing the drug that provided a convenient external attribution for potential failure.
Although women may also self-handicap, particularly by indicating that they are unable to perform well due to stress or time constraints (Hirt, Deppe, & Gordon, 1991), men seem to do it more frequently. This is consistent with the general gender differences we have talked about in many places in this book—on average, men are more concerned about maintaining their self-esteem and social status in the eyes of themselves and others than are women.
You can see that there are some benefits (but also, of course, some costs) of self-handicapping. If we fail after we self-handicap, we simply blame the failure on the external factor. But if we succeed despite the handicap that we have created for ourselves, we can make clear internal attributions for our success. But engaging in behaviors that create self-handicapping can be costly because they make it harder for us to succeed. In fact, research has found that people who report that they self-handicap regularly show lower life satisfaction, less competence, poorer moods, less interest in their jobs, and even more substance abuse (Zuckerman & Tsai, 2005). Although self-handicapping would seem to be useful for insulating our feelings from failure, it is not a good tack to take in the long run.
Fortunately, not all people have such negative attributional styles. In fact, most people tend to have more positive ones—styles that are related to high positive self-esteem and a tendency to explain the negative events they experience by referring to external, unstable, and specific qualities. Thus people with positive attributional styles are likely to say things such as the following:
• “I failed because the task is very difficult” (an external attribution).
• “I will do better next time” (an unstable attribution).
• “I failed in this domain, but I’m good in other things” (a specific attribution).
In sum, we can say that people who make more positive attributions toward the negative events that they experience will persist longer at tasks and that this persistence can help them. But there are limits to the effectiveness of these strategies. We cannot control everything, and trying to do so can be stressful. We can change some things but not others; thus sometimes the important thing is to know when it’s better to give up, stop worrying, and just let things happen. Having a positive outlook is healthy, but we cannot be unrealistic about what we can and cannot do. Unrealistic optimism is the tendency to be overly positive about the likelihood that negative things will occur to us and that we will be able to effectively cope with them if they do. When we are too optimistic, we may set ourselves up for failure and depression when things do not work out as we had hoped (Weinstein & Klein, 1996). We may think that we are immune to the potential negative outcomes of driving while intoxicated or practicing unsafe sex, but these optimistic beliefs are not healthy. Fortunately, most people have a reasonable balance between optimism and realism (Taylor & Armor, 1996). They tend to set goals that they believe they can attain, and they regularly make some progress toward reaching them. Research has found that setting reasonable goals and feeling that we are moving toward them makes us happy, even if we may not, in fact, attain the goals themselves (Lawrence, Carver, & Scheier, 2002).
7.5 End-of-Chapter Summary
6. Key Takeaways
• Because we each use our own expectations in judgment, people may form different impressions of the same person performing the same behavior.
• Individual differences in the cognitive accessibility of a given personal characteristic may lead to more overlap in the descriptions provided by the same perceiver about different people than there is in those provided by different perceivers about the same target person.
• People with a strong need for cognition make more causal attributions overall. Entity theorists tend to focus on the traits of other people and tend to make a lot of personal attributions, whereas incremental theorists tend to believe that personalities change a lot over time and therefore are more likely to make situational attributions for events.
• People from Western cultures tend to make more personal attributions, whereas people from collectivistic cultures tend to focus more on the situational explanations of behavior. Individual differences in attributional styles can influence how we respond to the negative events that we experience.
• People who have extremely negative attributional styles, in which they continually make external, stable, and global attributions for their behavior, are said to be experiencing learned helplessness.
• Self-handicapping is an attributional technique that prevents us from making ability attributions for our own failures.
• Having a positive outlook is healthy, but it must be tempered. We cannot be unrealistic about what we can and cannot do.
Exercises & Critical Thinking
1. Can you think of a time when your own expectations influenced your attributions about another person?
2. Which constructs are more cognitively accessible for you? Do these constructs influence how you judge other people?
3. Consider a time when you or someone you knew engaged in self-handicapping. What was the outcome of doing so?
4. Do you think that you have a more positive or a more negative attributional style? How do you think this style influences your judgments about your own successes and failures?
Attribution
Adapted from Chapter 6.3 from Principles of Social Psychology by the University of Minnesota under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/02%3A_Alternative_Perspectives_on_Individuals/07%3A_Individual_and_Cultural_Differences_in_Person_Perception.txt |
Learning Objectives
• Describe how a person’s environment and culture helps to shape their development.
• Explain how poverty and food insecurity can impact multiple factors of a person’s life.
8.1 Introduction
“Survey: More US Kids Go to School Hungry,” the headline said. As the US economy continued to struggle, a nationwide survey of 638 public school teachers in grades K–8 conducted for Share Our Strength, a nonprofit organization working to end childhood hunger, found alarming evidence of children coming to school with empty stomachs. More than two-thirds of the teachers said they had students who “regularly come to school too hungry to learn—some having had no dinner the night before,” according to the news article. More than 60 percent of the teachers said the problem had worsened during the past year, and more than 40 percent called it a “serious” problem. Many of the teachers said they spent their own money to buy food for their students. As an elementary school teacher explained, “I’ve had lots of students come to school—not just one or two—who put their heads down and cry because they haven’t eaten since lunch yesterday” (United Press International, 2011).
The United States is one of the richest nations in the world. Many Americans live in luxury or at least are comfortably well-off. Yet, as this poignant news story of childhood hunger reminds us, many Americans also live in poverty or near poverty. This chapter explains why poverty exists and why the US poverty rate is so high, and it discusses the devastating consequences of poverty for the millions of Americans who live in or near poverty. It also examines poverty in the poorest nations of the world and outlines efforts for reducing poverty in the United States and these nations.
Although this chapter will paint a disturbing picture of poverty, there is still cause for hope. As we shall see, the “war on poverty” that began in the United States during the 1960s dramatically reduced poverty. Inspired by books with titles like The Other America: Poverty in the United States (Harrington, 1962) and In the Midst of Plenty: The Poor in America (Bagdikian, 1964) that described the plight of the poor in heartbreaking detail, the federal government established various funding programs and other policies that greatly lowered the poverty rate in less than a decade (Schwartz, 1984). Since the 1960s and 1970s, however, the United States has cut back on these programs, and the poor are no longer on the national agenda. Other wealthy democracies provide much more funding and many more services for their poor than does the United States, and their poverty rates are much lower than ours.
Still, the history of the war on poverty and the experience of these other nations both demonstrate that US poverty can be reduced with appropriate policies and programs. If the United States were to go back to the future by remembering its earlier war on poverty and by learning from other Western democracies, it could again lower poverty and help millions of Americans lead better, healthier, and more productive lives.
But why should we care about poverty in the first place? As this chapter discusses, many politicians and much of the public blame the poor for being poor, and they oppose increasing federal spending to help the poor and even want to reduce such spending. As poverty expert Mark R. Rank (Rank, 2011) summarizes this way of thinking, “All too often we view poverty as someone else’s problem.” Rank says this unsympathetic view is shortsighted because, as he puts it, “poverty affects us all” (Rank, 2011). This is true, he explains, for at least two reasons.
First, the United States spends much more money than it needs to because of the consequences of poverty. Poor people experience worse health, family problems, higher crime rates, and many other problems, all of which our nation spends billions of dollars annually to address. In fact, childhood poverty has been estimated to cost the US economy an estimated \$500 billion annually because of the problems it leads to, including unemployment, low-paid employment, higher crime rates, and physical and mental health problems (Eckholm, 2007). If the US poverty rate were no higher than that of other democracies, billions of tax dollars and other resources would be saved.
Second, the majority of Americans can actually expect to be poor or near poor at some point in their lives, with about 75 percent of Americans in the 20–75 age range living in poverty or near poverty for at least one year in their lives. As Rank (Rank, 2011) observes, most Americans “will find ourselves below the poverty line and using a social safety net program at some point.” Because poverty costs the United States so much money and because so many people experience poverty, says Rank, everyone should want the United States to do everything possible to reduce poverty.
Sociologist John Iceland (Iceland, 2006) adds two additional reasons for why everyone should care about poverty and want it reduced. First, a high rate of poverty impairs our nation’s economic progress: When a large number of people cannot afford to purchase goods and services, economic growth is more difficult to achieve. Second, poverty produces crime and other social problems that affect people across the socioeconomic ladder. Reductions in poverty would help not only the poor but also people who are not poor.
We begin our examination of poverty by discussing how poverty is measured and how much poverty exists.
8.2 The Measurement & Extent of Poverty
Learning Objectives
• Understand how official poverty in the United States is measured.
• Describe problems in the measurement of official poverty.
• Describe the extent of official poverty.
When US officials became concerned about poverty during the 1960s, they quickly realized they needed to find out how much poverty we had. To do so, a measure of official poverty, or a poverty line, was needed. A government economist, Mollie Orshanky, first calculated this line in 1963 by multiplying the cost of a very minimal diet by three, as a 1955 government study had determined that the typical American family spent one-third of its income on food. Thus a family whose cash income is lower than three times the cost of a very minimal diet is considered officially poor.
This way of calculating the official poverty line has not changed since 1963. It is thus out of date for many reasons. For example, many expenses, such as heat and electricity, child care, transportation, and health care, now occupy a greater percentage of the typical family’s budget than was true in 1963. In addition, this official measure ignores a family’s noncash income from benefits such as food stamps and tax credits. As a national measure, the poverty line also fails to take into account regional differences in the cost of living. All these problems make the official measurement of poverty highly suspect. As one poverty expert observes, “The official measure no longer corresponds to reality. It doesn’t get either side of the equation right—how much the poor have or how much they need. No one really trusts the data” (DeParle, et. al., 2011). We’ll return to this issue shortly.
The measure of official poverty began in 1963 and stipulates that a family whose income is lower than three times the cost of a minimal diet is considered officially poor. This measure has not changed since 1963 even though family expenses have risen greatly in many areas. Wikimedia Commons – public domain.
The poverty line is adjusted annually for inflation and takes into account the number of people in a family: The larger the family size, the higher the poverty line. In 2010, the poverty line for a nonfarm family of four (two adults, two children) was \$22,213. A four-person family earning even one more dollar than \$22,213 in 2010 was not officially poor, even though its “extra” income hardly lifted it out of dire economic straits. Poverty experts have calculated a no-frills budget that enables a family to meet its basic needs in food, clothing, shelter, and so forth; this budget is about twice the poverty line. Families with incomes between the poverty line and twice the poverty line (or twice poverty) are barely making ends meet, but they are not considered officially poor. When we talk here about the poverty level, then, keep in mind that we are talking only about official poverty and that there are many families and individuals living in near poverty who have trouble meeting their basic needs, especially when they face unusually high medical expenses, motor vehicle expenses, or the like. For this reason, many analysts think families need incomes twice as high as the federal poverty level just to get by (Wright, et. al., 2011). They thus use twice-poverty data (i.e., family incomes below twice the poverty line) to provide a more accurate understanding of how many Americans face serious financial difficulties, even if they are not living in official poverty.
• The Extent of Poverty
With this caveat in mind, how many Americans are poor? The US Census Bureau gives us some answers that use the traditional, official measure of poverty developed in 1963. In 2010, 15.1 percent of the US population, or 46.2 million Americans, lived in official poverty (DeNavas-Walt, et. al., 2011). This percentage represented a decline from the early 1990s but was higher than 2000 and even higher than the rate in the late 1960s (see Figure 2.1 “US Poverty, 1959–2010”). If we were winning the war on poverty in the 1960s (notice the sharp drop in the 1960s in Figure 2.1 “US Poverty, 1959–2010”), since then poverty has fought us to a standstill.
Figure 2.1 US Poverty, 1959–2010
Source: Data from US Census Bureau. (2011). Historical poverty tables: People. Retrieved from www.census.gov/hhes/www/pover...al/people.html
Another way of understanding the extent of poverty is to consider episodic poverty, defined by the Census Bureau as being poor for at least two consecutive months in some time period. From 2004 to 2007, the last years for which data are available, almost one-third of the US public, equal to about 95 million people, were poor for at least two consecutive months, although only 2.2 percent were poor for all three years (DeNavas-Walt, et al., 2010). As these figures indicate, people go into and out of poverty, but even those who go out of it do not usually move very far from it. And as we have seen, the majority of Americans can expect to experience poverty or near poverty at some point in their lives.
The problems in the official poverty measure that were noted earlier have led the Census Bureau to develop a Supplemental Poverty Measure. This measure takes into account the many family expenses in addition to food; it also takes into account geographic differences in the cost of living, taxes paid and tax credits received, and the provision of food stamps, Medicaid, and certain other kinds of government aid. This new measure yields an estimate of poverty that is higher than the rather simplistic official poverty measure that, as noted earlier, is based solely on the size of a family and the cost of food and the amount of a family’s cash income. According to this new measure, the 2010 poverty rate was 16.0 percent, equal to 49.1 million Americans (Short, 2011). Because the official poverty measure identified 46.2 million people as poor, the new, more accurate measure increased the number of poor people in the United States by almost 3 million. Without the help of Social Security, food stamps, and other federal programs, at least 25 million additional people would be classified as poor (Sherman, 2011). These programs thus are essential in keeping many people above the poverty level, even if they still have trouble making ends meet and even though the poverty rate remains unacceptably high.
A final figure is worth noting. Recall that many poverty experts think that twice-poverty data—the percentage and number of people living in families with incomes below twice the official poverty level—are a better gauge than the official poverty level of the actual extent of poverty, broadly defined, in the United States. Using the twice-poverty threshold, about one-third of the US population, or more than 100 million Americans, live in poverty or near poverty (Pereyra, 2011). Those in near poverty are just one crisis—losing a job or sustaining a serious illness or injury—away from poverty. Twice-poverty data paint a very discouraging picture.
Key Takeaways
• The official poverty rate is based on the size of a family and a minimal food budget; this measure underestimates the true extent of poverty.
• The official poverty rate in 2010 was 15.1 percent, equal to more than 46 million Americans.
• About one-third of the US population, or more than 100 million Americans, have incomes no higher than twice the poverty line.
For Your Review
1. Write a short essay that summarizes the problems by which the official poverty rate is determined.
2. Sit down with some classmates and estimate what a family of four (two parents, two young children) in your area would have to pay annually for food, clothing, shelter, energy, and other necessities of life. What figure do you end up with? How does this sum of money compare with the official poverty line of \$22,213 in 2010 for a family of four?
8.3 Who the Poor Are: Social Patterns of Poverty
Learning Objectives
• Describe racial/ethnic differences in the poverty rate.
• Discuss how family structure is related to the poverty rate.
• Explain what poverty and labor force participation data imply about the belief that many poor people lack the motivation to work.
Who are the poor? Although the official poverty rate in 2010 was 15.1 percent, this rate differs by the important sociodemographic characteristics of race/ethnicity, gender, and age, and it also differs by region of the nation and by family structure. The poverty rate differences based on these variables are critical to understanding the nature and social patterning of poverty in the United States. We look at each of these variables in turn with 2010 census data (DeNavas-Walt, et, al., 2011).
• Race/Ethnicity
Here is a quick quiz; please circle the correct answer.
• Most poor people in the United States are
1. Black/African American
2. Latino
3. Native American
4. Asian
5. White
What did you circle? If you are like the majority of people who answer a similar question in public opinion surveys, you would have circled a. Black/African American. When Americans think about poor people, they tend to picture African Americans (White, 2007). This popular image is thought to reduce the public’s sympathy for poor people and to lead them to oppose increased government aid for the poor. The public’s views on these matters are, in turn, thought to play a key role in government poverty policy. It is thus essential for the public to have an accurate understanding of the racial/ethnic patterning of poverty.
The most typical poor people in the United States are non-Latino whites. These individuals comprise 42.4 percent of all poor Americans. Franco Folini – Homeless guys with dogs – CC BY-SA 2.0.
Unfortunately, the public’s racial image of poor people is mistaken, as census data reveal that the most typical poor person is white (non-Latino). To be more precise, 42.4 percent of poor people are white (non-Latino), 28.7 percent are Latino, 23.1 percent are black, and 3.7 percent are Asian (see Figure 2.2 “Racial and Ethnic Composition of the Poor, 2010 (Percentage of Poor Persons Who Belong to Each Group)”). As these figures show, non-Latino whites certainly comprise the greatest number of the American poor. Turning these percentages into numbers, they account for 19.6 million of the 46.2 million poor Americans.
It is also true, though, that race and ethnicity affect the chances of being poor. While only 9.9 percent of non-Latino whites are poor, 27.4 percent of African Americans, 12.1 percent of Asians, and 26.6 percent of Latinos (who may be of any race) are poor (see Figure 2.3 “Race, Ethnicity, and Poverty, 2010 (Percentage of Each Group That Is Poor)”). Thus African Americans and Latinos are almost three times as likely as non-Latino whites to be poor. (Because there are so many non-Latino whites in the United States, the greatest number of poor people are non-Latino white, even if the percentage of whites who are poor is relatively low.) The higher poverty rates of people of color are so striking and important that they have been termed the “colors of poverty” (Lin & Harris, 2008).
Figure 2.2 Racial and Ethnic Composition of the Poor, 2010 (Percentage of Poor Persons Who Belong to Each Group)
Figure 2.3 Race, Ethnicity, and Poverty, 2010 (Percentage of Each Group That Is Poor)
• Gender
One thing that many women know all too well is that women are more likely than men to be poor. According to the census, 16.2 percent of all females live in poverty, compared to only 14.0 percent of all males. These figures translate to a large gender gap in the actual number of poor people, as 25.2 million women and girls live in poverty, compared to only 21.0 million men and boys, for a difference of 4.2 million people. The high rate of female poverty is called the feminization of poverty (Iceland, 2006). We will see additional evidence of this pattern when we look at the section on family structure that follows.
• Age
Turning to age, at any one time 22 percent of children under age 18 are poor (amounting to 16.4 million children), a figure that rises to about 39 percent of African American children and 35 percent of Latino children. About 37 percent of all children live in poverty for at least one year before turning 18 (Ratcliffe & McKernan, 2010). The poverty rate for US children is the highest of all wealthy democracies and in fact is 1.5 to 9 times greater than the corresponding rates in Canada and Western Europe (Mishel, et. al., 2009). As high as the US childhood poverty rate is, twice-poverty data again paint an even more discouraging picture. Children living in families with incomes below twice the official poverty level are called low-income children, and their families are called low-income families. Almost 44 percent of American children, or some 32.5 million kids, live in such families (Addy & Wright, 2012). Almost two-thirds of African American children and Latino children live in low-income families.
The poverty rate for US children is the highest in the Western world. Wikimedia Commons – CC BY-SA 3.0.
At the other end of the age distribution, 9 percent of people aged 65 or older are poor (amounting to about 3.5 million seniors). Turning around these age figures, almost 36 percent of all poor people in the United States are children, and almost 8 percent of the poor are 65 or older. Thus more than 43.4 percent of Americans living in poverty are children or the elderly.
• Region
Poverty rates differ around the country. Some states have higher poverty rates than other states, and some counties within a state are poorer than other counties within that state. A basic way of understanding geographical differences in poverty is to examine the poverty rates of the four major regions of the nation. When we do this, the South is the poorest region, with a poverty rate of 16.9 percent. The West is next (15.3 percent), followed by the Midwest (13.9 percent) and then the Northeast (12.8 percent). The South’s high poverty rate is thought to be an important reason for the high rate of illnesses and other health problems it experiences compared to the other regions (Ramshaw, 2011).
• Family Structure
There are many types of family structures, including a married couple living with their children; an unmarried couple living with one or more children; a household with children headed by only one parent, usually a woman; a household with two adults and no children; and a household with only one adult living alone. Across the nation, poverty rates differ from one type of family structure to another.
Not surprisingly, poverty rates are higher in families with one adult than in those with two adults (because they often are bringing in two incomes), and, in one-adult families, they are higher in families headed by a woman than in those headed by a man (because women generally have lower incomes than men). Of all families headed by just a woman, 31.6 percent live in poverty, compared to only 15.8 percent of families headed by just a man. In contrast, only 6.2 percent of families headed by a married couple live in poverty (see Figure 2.4 “Family Structure and Poverty Rate (Percentage of Each Type of Structure That Lives in Poverty)”). The figure for female-headed families provides additional evidence for the feminization of poverty concept introduced earlier.
Figure 2.4 Family Structure and Poverty Rate (Percentage of Each Type of Structure That Lives in Poverty)
We saw earlier that 22 percent of American children are poor. This figure varies according to the type of family structure in which the children live. Whereas only 11.6 percent of children residing with married parents live in poverty, 46.9 percent of those living with only their mother live in poverty. This latter figure rises to 53.3 percent for African American children and 57.0 percent for Latino children (US Census Bureau, 2012). Yet regardless of their race or ethnicity, children living just with their mothers are at particularly great risk of living in poverty.
• Labor Force Status
As this chapter discusses later, many Americans think the poor are lazy and lack the motivation to work and, as is often said, “really could work if they wanted to.” However, government data on the poor show that most poor people are, in fact, either working, unemployed but looking for work, or unable to work because of their age or health. Table 2.1 “Poverty and Labor Force Participation, 2010” shows the relevant data. We discuss these numbers in some detail because of their importance, so please follow along carefully.
Table 2.1 Poverty and Labor Force Participation, 2010
Total number of poor people 46,180,000
Number of poor people under age 18 16,401,000
Number of poor people ages 65 and older 3,521,000
Number of poor people ages 18–64 26,258,000
Number of poor people ages 18–64 who were:
Working full- or part-time 9,053,000
Unemployed but looking for work 3,616,000
Disabled 4,247,000
In the armed forces 77,000
Able-bodied but not in the labor force 9,254,000
Let’s examine this table to see the story it tells. Of the roughly 46.2 million poor people, almost 20 million were either under age 18 or at least 65. Because of their ages, we would not expect them to be working. Of the remaining 26.3 million poor adults ages 18–64, almost 17 million, or about two-thirds, fell into one of these categories: (a) they worked full-time or part-time, (b) they were unemployed but looking for work during a year of very high unemployment due to the nation’s faltering economy, (c) they did not work because of a disability, or (d) they were in the armed forces. Subtracting all these adults leaves about 9.3 million able-bodied people ages 18–64.
Doing some arithmetic, we thus see that almost 37 million of the 46.2 million poor people we started with, or 80 percent, with were either working or unemployed but looking for work, too young or too old to work, disabled, or in the armed forces. It would thus be inaccurate to describe the vast majority of the poor as lazy and lacking the motivation to work.
What about the 9.3 million able-bodied poor people who are ages 18–64 but not in the labor force, who compose only 20 percent of the poor to begin with? Most of them were either taking care of small children or elderly parents or other relatives, retired for health reasons, or in school (US Census Bureau, 2012); some also left the labor force out of frustration and did not look for work (and thus were not counted officially as unemployed). Taking all these numbers and categories into account, it turns out that the percentage of poor people who “really could work if they wanted to” is rather minuscule, and the common belief that they “really could work if they wanted to” is nothing more than a myth.
People Making a Difference
Feeding “Motel Kids” Near Disneyland
• >Just blocks from Disneyland in Anaheim, California, more than 1,000 families live in cheap motels frequently used by drug dealers and prostitutes. Because they cannot afford the deposit for an apartment, the motels are their only alternative to homelessness. As Bruno Serato, a local Italian restaurant owner, observed, “Some people are stuck, they have no money. They need to live in that room. They’ve lost everything they have. They have no other choice. No choice.”
• >Serato learned about these families back in 2005, when he saw a boy at the local Boys & Girls Club eating a bag of potato chips as his only food for dinner. He was told that the boy lived with his family in a motel and that the Boys & Girls Club had a “motel kids” program that drove children in vans after school to their motels. Although the children got free breakfast and lunch at school, they often went hungry at night. Serato soon began serving pasta dinners to some seventy children at the club every evening, a number that had grown by spring 2011 to almost three hundred children nightly. Serato also pays to have the children transported to the club for their dinners, and he estimates that the food and transportation cost him about \$2,000 monthly. His program had served more than 300,000 pasta dinners to motel kids by 2011.
• >Two of the children who eat Serato’s pasta are Carlos and Anthony Gomez, 12, who live in a motel room with the other members of their family. Their father was grateful for the pasta: “I no longer worry as much, about them [coming home] and there being no food. I know that they eat over there at [the] Boys & Girls Club.”
• >Bruno Serato is merely happy to be helping out. “They’re customers,” he explains. “My favorite customers” (Toner, 2011).
• >For more information about Bruno Serato’s efforts, visit his charity site at www.thecaterinasclub.org.
• Key Takeaways
• Although people of color have higher poverty rates than non-Latino whites, the most typical poor person in the United States is non-Latino white.
• The US childhood poverty rate is the highest of all Western democracies.
• Labor force participation data indicate that the belief that poor people lack motivation to work is, in fact, a myth.
For Your Review
1. Why do you think the majority of Americans assume poor people lack the motivation to work?
2. Explain to a friend how labor force participation data indicate that it is inaccurate to think that poor people lack the motivation to work.
8.4 Explaining Poverty
Learning Objectives
• Describe the assumptions of the functionalist and conflict views of stratification and of poverty.
• Explain the focus of symbolic interactionist work on poverty.
• Understand the difference between the individualist and structural explanations of poverty.
Why does poverty exist, and why and how do poor people end up being poor? The sociological perspectives introduced in “Understanding Social Problems” provide some possible answers to these questions through their attempt to explain why American society is stratified—that is, why it has a range of wealth ranging from the extremely wealthy to the extremely poor. We review what these perspectives say generally about social stratification (rankings of people based on wealth and other resources a society values) before turning to explanations focusing specifically on poverty.
In general, the functionalist perspective and conflict perspective both try to explain why social stratification exists and endures, while the symbolic interactionist perspective discusses the differences that stratification produces for everyday interaction. Table 2.2 “Theory Snapshot” summarizes these three approaches.
Table 2.2 Theory Snapshot
Theoretical perspective Major assumptions
Functionalism Stratification is necessary to induce people with special intelligence, knowledge, and skills to enter the most important occupations. For this reason, stratification is necessary and inevitable.
Conflict theory Stratification results from lack of opportunity and from discrimination and prejudice against the poor, women, and people of color. It is neither necessary nor inevitable.
Symbolic interactionism Stratification affects people’s beliefs, lifestyles, daily interactions, and conceptions of themselves.
• The Functionalist View
As discussed in “Understanding Social Problems”, functionalist theory assumes that society’s structures and processes exist because they serve important functions for society’s stability and continuity. In line with this view, functionalist theorists in sociology assume that stratification exists because it also serves important functions for society. This explanation was developed more than sixty years ago by Kingsley Davis and Wilbert Moore (Davis & Moore, 1945) in the form of several logical assumptions that imply stratification is both necessary and inevitable. When applied to American society, their assumptions would be as follows:
1. Some jobs are more important than other jobs. For example, the job of a brain surgeon is more important than the job of shoe shining.
2. Some jobs require more skills and knowledge than other jobs. To stay with our example, it takes more skills and knowledge to perform brain surgery than to shine shoes.
3. Relatively few people have the ability to acquire the skills and knowledge that are needed to do these important, highly skilled jobs. Most of us would be able to do a decent job of shining shoes, but very few of us would be able to become brain surgeons.
4. To encourage people with the skills and knowledge to do the important, highly skilled jobs, society must promise them higher incomes or other rewards. If this is true, some people automatically end up higher in society’s ranking system than others, and stratification is thus necessary and inevitable.
To illustrate their assumptions, say we have a society where shining shoes and doing brain surgery both give us incomes of \$150,000 per year. (This example is very hypothetical, but please keep reading.) If you decide to shine shoes, you can begin making this money at age 16, but if you decide to become a brain surgeon, you will not start making this same amount until about age 35, as you must first go to college and medical school and then acquire several more years of medical training. While you have spent nineteen additional years beyond age 16 getting this education and training and taking out tens of thousands of dollars in student loans, you could have spent those years shining shoes and making \$150,000 a year, or \$2.85 million overall. Which job would you choose?
Functional theory argues that the promise of very high incomes is necessary to encourage talented people to pursue important careers such as surgery. If physicians and shoe shiners made the same high income, would enough people decide to become physicians? Public Domain Images – CC0 public domain.
As this example suggests, many people might not choose to become brain surgeons unless considerable financial and other rewards awaited them. By extension, we might not have enough people filling society’s important jobs unless they know they will be similarly rewarded. If this is true, we must have stratification. And if we must have stratification, then that means some people will have much less money than other people. If stratification is inevitable, then, poverty is also inevitable. The functionalist view further implies that if people are poor, it is because they do not have the ability to acquire the skills and knowledge necessary for the important, high-paying jobs.
The functionalist view sounds very logical, but a few years after Davis and Moore published their theory, other sociologists pointed out some serious problems in their argument (Tumin, 1953; Wrong, 1959).
First, it is difficult to compare the importance of many types of jobs. For example, which is more important, doing brain surgery or mining coal? Although you might be tempted to answer with brain surgery if no coal were mined then much of our society could not function. In another example, which job is more important, attorney or professor? (Be careful how you answer this one!)
Second, the functionalist explanation implies that the most important jobs have the highest incomes and the least important jobs the lowest incomes, but many examples, including the ones just mentioned, counter this view. Coal miners make much less money than physicians, and professors, for better or worse, earn much less on the average than lawyers. A professional athlete making millions of dollars a year earns many times the income of the president of the United States, but who is more important to the nation? Elementary school teachers do a very important job in our society, but their salaries are much lower than those of sports agents, advertising executives, and many other people whose jobs are far less essential.
Third, the functionalist view assumes that people move up the economic ladder based on their abilities, skills, knowledge, and, more generally, their merit. This implies that if they do not move up the ladder, they lack the necessary merit. However, this view ignores the fact that much of our stratification stems from lack of equal opportunity. As later chapters in this book discuss, because of their race, ethnicity, gender, and class standing at birth, some people have less opportunity than others to acquire the skills and training they need to fill the types of jobs addressed by the functionalist approach.
Finally, the functionalist explanation might make sense up to a point, but it does not justify the extremes of wealth and poverty found in the United States and other nations. Even if we do have to promise higher incomes to get enough people to become physicians, does that mean we also need the amount of poverty we have? Do CEOs of corporations really need to make millions of dollars per year to get enough qualified people to become CEOs? Do people take on a position as CEO or other high-paying jobs at least partly because of the challenge, working conditions, and other positive aspects they offer? The functionalist view does not answer these questions adequately.
One other line of functionalist thinking focuses more directly on poverty than generally on stratification. This particular functionalist view provocatively argues that poverty exists because it serves certain positive functions for our society. These functions include the following: (1) poor people do the work that other people do not want to do; (2) the programs that help poor people provide a lot of jobs for the people employed by the programs; (3) the poor purchase goods, such as day-old bread and used clothing, that other people do not wish to purchase, and thus extend the economic value of these goods; and (4) the poor provide jobs for doctors, lawyers, teachers, and other professionals who may not be competent enough to be employed in positions catering to wealthier patients, clients, students, and so forth (Gans, 1972). Because poverty serves all these functions and more, according to this argument, the middle and upper classes have a vested interested in neglecting poverty to help ensure its continued existence.
• The Conflict View
Because he was born in a log cabin and later became president, Abraham Lincoln’s life epitomizes the American Dream, which is the belief that people born into poverty can become successful through hard work. The popularity of this belief leads many Americans to blame poor people for their poverty. US Library of Congress – public domain.
Conflict theory’s explanation of stratification draws on Karl Marx’s view of class societies and incorporates the critique of the functionalist view just discussed. Many different explanations grounded in conflict theory exist, but they all assume that stratification stems from a fundamental conflict between the needs and interests of the powerful, or “haves,” in society and those of the weak, or “have-nots” (Kerbo, 2012). The former takes advantage of their position at the top of society to stay at the top, even if it means oppressing those at the bottom. At a minimum, they can heavily influence the law, the media, and other institutions in a way that maintains society’s class structure.
In general, conflict theory attributes stratification and thus poverty to lack of opportunity from discrimination and prejudice against the poor, women, and people of color. In this regard, it reflects one of the early critiques of the functionalist view that the previous section outlined. To reiterate an earlier point, several of the remaining chapters of this book discuss the various obstacles that make it difficult for the poor, women, and people of color in the United States to move up the socioeconomic ladder and to otherwise enjoy healthy and productive lives.
• Symbolic Interactionism
Consistent with its micro orientation, symbolic interactionism tries to understand stratification and thus poverty by looking at people’s interactions and understandings in their daily lives. Unlike the functionalist and conflict views, it does not try to explain why we have stratification in the first place. Rather, it examines the differences that stratification makes for people’s lifestyles and their interaction with other people.
Many detailed, insightful sociological books on the lives of the urban and rural poor reflect the symbolic interactionist perspective (Anderson, 1999; C. M. Duncan, 2000; Liebow, 1993; Rank, 1994). These books focus on different people in different places, but they all make very clear that the poor often lead lives of quiet desperation and must find ways of coping with the fact of being poor. In these books, the consequences of poverty discussed later in this chapter acquire a human face, and readers learn in great detail what it is like to live in poverty on a daily basis.
Some classic journalistic accounts by authors not trained in the social sciences also present eloquent descriptions of poor people’s lives (Bagdikian, 1964; Harrington, 1962). Writing in this tradition, a newspaper columnist who grew up in poverty recently recalled, “I know the feel of thick calluses on the bottom of shoeless feet. I know the bite of the cold breeze that slithers through a drafty house. I know the weight of constant worry over not having enough to fill a belly or fight an illness…Poverty is brutal, consuming, and unforgiving. It strikes at the soul” (Blow, 2011).
Sociological accounts of the poor provide a vivid portrait of what it is like to live in poverty on a daily basis. Pixabay – CC0 public domain.
On a more lighthearted note, examples of the symbolic interactionist framework are also seen in the many literary works and films that portray the difficulties that the rich and poor have in interacting on the relatively few occasions when they do interact. For example, in the film Pretty Woman, Richard Gere plays a rich businessman who hires a prostitute, played by Julia Roberts, to accompany him to swank parties and other affairs. Roberts has to buy a new wardrobe and learn how to dine and behave in these social settings, and much of the film’s humor and poignancy come from her awkwardness in learning the lifestyle of the rich.
• Specific Explanations of Poverty
The functionalist and conflict views focus broadly on social stratification but only indirectly on poverty. When poverty finally attracted national attention during the 1960s, scholars began to try specifically to understand why poor people become poor and remain poor. Two competing explanations developed, with the basic debate turning on whether poverty arises from problems either within the poor themselves or in the society in which they live (Rank, 2011). The first type of explanation follows logically from the functional theory of stratification and may be considered an individualistic explanation. The second type of explanation follows from conflict theory and is a structural explanation that focuses on problems in American society that produce poverty. Table 2.3 “Explanations of Poverty” summarizes these explanations.
Table 2.3 Explanations of Poverty
Explanation Major assumptions
Individualistic Poverty results from the fact that poor people lack the motivation to work and have certain beliefs and values that contribute to their poverty.
Structural Poverty results from problems in society that lead to a lack of opportunity and a lack of jobs.
It is critical to determine which explanation makes more sense because, as sociologist Theresa C. Davidson (Davidson, 2009) observes, “beliefs about the causes of poverty shape attitudes toward the poor.” To be more precise, the particular explanation that people favor affects their view of government efforts to help the poor. Those who attribute poverty to problems in the larger society are much more likely than those who attribute it to deficiencies among the poor to believe that the government should do more to help the poor (Bradley & Cole, 2002). The explanation for poverty we favor presumably affects the amount of sympathy we have for the poor, and our sympathy, or lack of sympathy, in turn, affects our views about the government’s role in helping the poor. With this backdrop in mind, what do the individualistic and structural explanations of poverty say?
• Individualistic Explanation
According to the individualistic explanation, the poor have personal problems and deficiencies that are responsible for their poverty. In the past, the poor were thought to be biologically inferior, a view that has not entirely faded, but today the much more common belief is that they lack the ambition and motivation to work hard and to achieve success. According to survey evidence, the majority of Americans share this belief (Davidson, 2009). A more sophisticated version of this type of explanation is called the culture of poverty theory (Banfield, 1974; Lewis, 1966; Murray, 2012). According to this theory, the poor generally have beliefs and values that differ from those of the nonpoor and that doom them to continued poverty. For example, they are said to be impulsive and to live for the present rather than the future.
Regardless of which version one might hold, the individualistic explanation is a blaming-the-victim approach (see “Understanding Social Problems”). Critics say this explanation ignores discrimination and other problems in American society and exaggerates the degree to which the poor and nonpoor do in fact hold different values (Ehrenreich, 2012; Holland, 2011; Schmidt, 2012). Regarding the latter point, they note that poor employed adults work more hours per week than wealthier adults and that poor parents interviewed in surveys value education for their children at least as much as wealthier parents. These and other similarities in values and beliefs lead critics of the individualistic explanation to conclude that poor people’s poverty cannot reasonably be said to result from a culture of poverty.
• Structural Explanation
According to the second, structural explanation, which is a blaming-the-system approach, US poverty stems from problems in American society that lead to a lack of equal opportunity and a lack of jobs. These problems include (a) racial, ethnic, gender, and age discrimination; (b) lack of good schooling and adequate health care; and (c) structural changes in the American economic system, such as the departure of manufacturing companies from American cities in the 1980s and 1990s that led to the loss of thousands of jobs. These problems help create a vicious cycle of poverty in which children of the poor are often fated to end up in poverty or near poverty themselves as adults.
As Rank (Rank, 2011) summarizes this view, “American poverty is largely the result of failings at the economic and political levels, rather than at the individual level…In contrast to [the individualistic] perspective, the basic problem lies in a shortage of viable opportunities for all Americans.” Rank points out that the US economy during the past few decades has created more low-paying and part-time jobs and jobs without benefits, meaning that Americans increasingly find themselves in jobs that barely lift them out of poverty, if at all. Sociologist Fred Block and colleagues share this critique of the individualistic perspective: “Most of our policies incorrectly assume that people can avoid or overcome poverty through hard work alone. Yet this assumption ignores the realities of our failing urban schools, increasing employment insecurities, and the lack of affordable housing, health care, and child care. It ignores the fact that the American Dream is rapidly becoming unattainable for an increasing number of Americans, whether employed or not” (Block, et. al., 2006).
Most sociologists favor the structural explanation. As later chapters in this book document, racial and ethnic discrimination, lack of adequate schooling and health care, and other problems make it difficult to rise out of poverty. On the other hand, some ethnographic research supports the individualistic explanation by showing that the poor do have certain values and follow certain practices that augment their plight (Small, et. al., 2010). For example, the poor have higher rates of cigarette smoking (34 percent of people with annual incomes between \$6,000 and \$11,999 smoke, compared to only 13 percent of those with incomes \$90,000 or greater [Goszkowski, 2008]), which helps cause them to have more serious health problems.
Adopting an integrated perspective, some researchers say these values and practices are ultimately the result of poverty itself (Small et, al., 2010). These scholars concede a culture of poverty does exist, but they also say it exists because it helps the poor cope daily with the structural effects of being poor. If these effects lead to a culture of poverty, they add, poverty then becomes self-perpetuating. If poverty is both cultural and structural in origin, these scholars say, efforts to improve the lives of people in the “other America” must involve increased structural opportunities for the poor and changes in some of their values and practices.
Key Takeaways
• According to the functionalist view, stratification is a necessary and inevitable consequence of the need to use the promise of financial reward to encourage talented people to pursue important jobs and careers.
• According to conflict theory, stratification results from lack of opportunity and discrimination against the poor and people of color.
• According to symbolic interactionism, social class affects how people interact in everyday life and how they view certain aspects of the social world.
• The individualistic view attributes poverty to individual failings of poor people themselves, while the structural view attributes poverty to problems in the larger society.
For Your Review
1. In explaining poverty in the United States, which view, individualist or structural, makes more sense to you? Why?
2. Suppose you could wave a magic wand and invent a society where everyone had about the same income no matter which job he or she performed. Do you think it would be difficult to persuade enough people to become physicians or to pursue other important careers? Explain your answer.
8.5 The Consequences of Poverty
Learning Objectives
• Describe the family and housing problems associated with poverty.
• Explain how poverty affects health and educational attainment.
Regardless of its causes, poverty has devastating consequences for the people who live in it. Much research conducted and/or analyzed by scholars, government agencies, and nonprofit organizations has documented the effects of poverty (and near poverty) on the lives of the poor (Lindsey, 2009; Moore, et. al., 2009; Ratcliffe & McKernan, 2010; Sanders, 2011). Many of these studies focus on childhood poverty, and these studies make it very clear that childhood poverty has lifelong consequences. In general, poor children are more likely to be poor as adults, more likely to drop out of high school, more likely to become a teenaged parent, and more likely to have employment problems. Although only 1 percent of children who are never poor end up being poor as young adults, 32 percent of poor children become poor as young adults (Ratcliffe & McKernan, 2010).
Poor children are more likely to have inadequate nutrition and to experience health, behavioral, and cognitive problems. Kelly Short – Poverty: “Damaged Child,” Oklahoma City, OK, USA, 1936. (Colorized).– CC BY-SA 2.0.
A recent study used government data to follow children born between 1968 and 1975 until they were ages 30 to 37 (Duncan & Magnuson, 2011). The researchers compared individuals who lived in poverty in early childhood to those whose families had incomes at least twice the poverty line in early childhood. Compared to the latter group, adults who were poor in early childhood
• had completed two fewer years of schooling on the average;
• had incomes that were less than half of those earned by adults who had wealthier childhoods;
• received \$826 more annually in food stamps on the average;
• were almost three times more likely to report being in poor health;
• were twice as likely to have been arrested (males only); and
• were five times as likely to have borne a child (females only).
We discuss some of the major specific consequences of poverty here and will return to them in later chapters.
• Family Problems
The poor are at greater risk for family problems, including divorce and domestic violence. As “Sexual Behavior” explains, a major reason for many of the problems families experience is stress. Even in families that are not poor, running a household can cause stress, children can cause stress, and paying the bills can cause stress. Families that are poor have more stress because of their poverty, and the ordinary stresses of family life become even more intense in poor families. The various kinds of family problems thus happen more commonly in poor families than in wealthier families. Compounding this situation, when these problems occur, poor families have fewer resources than wealthier families to deal with these problems.
Children and Our Future
Getting under Children’s Skin: The Biological Effects of Childhood Poverty
• >As the text discusses, childhood poverty often has lifelong consequences. Poor children are more likely to be poor when they become adults, and they are at greater risk for antisocial behavior when young, and for unemployment, criminal behavior, and other problems when they reach adolescence and young adulthood.
• >According to growing evidence, one reason poverty has these consequences is that it has certain neural effects on poor children that impair their cognitive abilities and thus their behavior and learning potential. As Greg J. Duncan and Katherine Magnuson (Duncan & Magnuson, 2011, p. 23) observe, “Emerging research in neuroscience and developmental psychology suggests that poverty early in a child’s life may be particularly harmful because the astonishingly rapid development of young children’s brains leaves them sensitive (and vulnerable) to environmental conditions.”
• >In short, poverty can change the way the brain develops in young children. The major reason for this effect is stress. Children growing up in poverty experience multiple stressful events: neighborhood crime and drug use; divorce, parental conflict, and other family problems, including abuse and neglect by their parents; parental financial problems and unemployment; physical and mental health problems of one or more family members; and so forth. Their great levels of stress, in turn, affect their bodies in certain harmful ways. As two poverty scholars note, “It’s not just that poverty-induced stress is mentally taxing. If it’s experienced early enough in childhood, it can, in fact, get ‘under the skin’ and change the way in which the body copes with the environment and the way in which the brain develops. These deep, enduring, and sometimes irreversible physiological changes are the very human price of running a high-poverty society” (Grusky & Wimer, 2011, p. 2).
• >One way poverty gets “under children’s skin” is as follows (Evans, et. al., 2011). Poor children’s high levels of stress produce unusually high levels of stress hormones such as cortisol and higher levels of blood pressure. Because these high levels impair their neural development, their memory and language development skills suffer. This result, in turn, affects their behavior and learning potential. For other physiological reasons, high levels of stress also affect the immune system, so that poor children are more likely to develop various illnesses during childhood and to have high blood pressure and other health problems when they grow older, and cause other biological changes that make poor children more likely to end up being obese and to have drug and alcohol problems.
• >The policy implications of the scientific research on childhood poverty are clear. As public health scholar, Jack P. Shonkoff (Shonkoff, 2011) explains, “Viewing this scientific evidence within a biodevelopmental framework points to the particular importance of addressing the needs of our most disadvantaged children at the earliest ages.” Duncan and Magnuson (Duncan & Magnuson, 2011) agree that “greater policy attention should be given to remediating situations involving deep and persistent poverty occurring early in childhood.” To reduce poverty’s harmful physiological effects on children, Skonkoff advocates efforts to promote strong, stable relationships among all members of poor families; to improve the quality of the home and neighborhood physical environments in which poor children grow, and to improve the nutrition of poor children. Duncan and Magnuson call for more generous income transfers to poor families with young children and note that many European democracies provide many kinds of support to such families. The recent scientific evidence on early childhood poverty underscores the importance of doing everything possible to reduce the harmful effects of poverty during the first few years of life.
• Health, Illness, and Medical Care
The poor are also more likely to have many kinds of health problems, including infant mortality, earlier adulthood mortality, and mental illness, and they are also more likely to receive inadequate medical care. Poor children are more likely to have inadequate nutrition and, partly, for this reason, to suffer health, behavioral, and cognitive problems. These problems, in turn, impair their ability to do well in school and land stable employment as adults, helping to ensure that poverty will persist across generations. Many poor people are uninsured or underinsured, at least until the US health-care reform legislation of 2010 takes full effect a few years from now, and many have to visit health clinics that are overcrowded and understaffed.
As “Work and the Economy” discusses, it is unclear how much of poor people’s worse health stems from their lack of money and lack of good health care versus their own behavior such as smoking and eating unhealthy diets. Regardless of the exact reasons, however, the fact remains that poor health is a major consequence of poverty. According to recent research, this fact means that poverty is responsible for almost 150,000 deaths annually, a figure about equal to the number of deaths from lung cancer (Bakalar, 2011).
• Education
Poor children typically go to rundown schools with inadequate facilities where they receive inadequate schooling. They are much less likely than wealthier children to graduate from high school or to go to college. Their lack of education, in turn, restricts them and their own children to poverty, once again helping to ensure a vicious cycle of continuing poverty across generations. As “The Changing Family” explains, scholars debate whether the poor school performance of poor children stems more from the inadequacy of their schools and schooling versus their own poverty. Regardless of exactly why poor children are more likely to do poorly in school and to have low educational attainment, these educational problems are another major consequence of poverty.
• Housing and Homelessness
The poor are, not surprisingly, more likely to be homeless than the nonpoor but also more likely to live in dilapidated housing and unable to buy their own homes. Many poor families spend more than half their income on rent, and they tend to live in poor neighborhoods that lack job opportunities, good schools, and other features of modern life that wealthier people take for granted. The lack of adequate housing for the poor remains a major national problem. Even worse is outright homelessness. An estimated 1.6 million people, including more than 300,000 children, are homeless at least part of the year (Lee, et. al., 2010).
• Crime and Victimization
As “Alcohol and Other Drugs” discusses, poor (and near-poor) people account for the bulk of our street crime (homicide, robbery, burglary, etc.), and they also account for the bulk of victims of street crime. That chapter will outline several reasons for this dual connection between poverty and street crime, but they include the deep frustration and stress of living in poverty and the fact that many poor people live in high-crime neighborhoods. In such neighborhoods, children are more likely to grow up under the influence of older peers who are already in gangs or otherwise committing crime, and people of any age are more likely to become crime victims. Moreover, because poor and near-poor people are more likely to commit street crime, they also comprise most of the people arrested for street crimes, convicted of street crime, and imprisoned for street crime. Most of the more than 2 million people now in the nation’s prisons and jails come from poor or near-poor backgrounds. Criminal behavior and criminal victimization, then, are other major consequences of poverty.
Lessons from Other Societies
Poverty and Poverty Policy in Other Western Democracies
• >To compare international poverty rates, scholars commonly use a measure of the percentage of households in a nation that receives less than half of the nation’s median household income after taxes and cash transfers from the government. In data from the late 2000s, 17.3 percent of US households lived in poverty as defined by this measure. By comparison, other Western democracies had the rates depicted in the figure that follows. The average poverty rate of the nations in the figure excluding the United States is 9.5 percent. The US rate is thus almost twice as high as the average for all the other democracies.
• >This graph illustrates the poverty rates in western democracies (i.e., the percentage of persons living with less than half of the median household income) as of the late 2000s
• >Why is there so much more poverty in the United States than in its Western counterparts? Several differences between the United States and the other nations stand out (Brady, 2009; Russell, 2011). First, other Western nations have higher minimum wages and stronger labor unions than the United States has, and these lead to incomes that help push people above poverty. Second, these other nations spend a much greater proportion of their gross domestic product on social expenditures (income support and social services such as child-care subsidies and housing allowances) than does the United States. As sociologist John Iceland (Iceland, 2006) notes, “Such countries often invest heavily in both universal benefits, such as maternity leave, child care, and medical care, and in promoting work among [poor] families…The United States, in comparison with other advanced nations, lacks national health insurance, provides less publicly supported housing, and spends less on job training and job creation.” Block and colleagues agree: “These other countries all take a more comprehensive government approach to combating poverty, and they assume that it is caused by economic and structural factors rather than bad behavior” (Block et, al., 2006).
• >The experience of the United Kingdom provides a striking contrast between the effectiveness of the expansive approach used in other wealthy democracies and the inadequacy of the American approach. In 1994, about 30 percent of British children lived in poverty; by 2009, that figure had fallen by more than half to 12 percent. Meanwhile, the US 2009 child poverty rate, was almost 21 percent.
• >Britain used three strategies to reduce its child poverty rate and to help poor children and their families in other ways. First, it induced more poor parents to work through a series of new measures, including a national minimum wage higher than its US counterpart and various tax savings for low-income workers. Because of these measures, the percentage of single parents who worked rose from 45 percent in 1997 to 57 percent in 2008. Second, Britain increased child welfare benefits regardless of whether a parent worked. Third, it increased paid maternity leave from four months to nine months, implemented two weeks of paid paternity leave, established universal preschool (which both helps children’s cognitive abilities and makes it easier for parents to afford to work), increased child-care aid, and made it possible for parents of young children to adjust their working hours to their parental responsibilities (Waldfogel, 2010). While the British child poverty rate fell dramatically because of these strategies, the US child poverty rate stagnated.
• >In short, the United States has so much more poverty than other democracies in part because it spends so much less than they do on helping the poor. The United States certainly has the wealth to follow their example, but it has chosen not to do so, and a high poverty rate is the unfortunate result. As the Nobel laureate economist Paul Krugman (2006, p. A25) summarizes this lesson, “Government truly can be a force for good. Decades of propaganda have conditioned many Americans to assume that government is always incompetent…But the [British experience has] shown that a government that seriously tries to reduce poverty can achieve a lot.”
• Key Takeaways
• Poor people are more likely to have several kinds of family problems, including divorce and family conflict.
• Poor people are more likely to have several kinds of health problems.
• Children growing up in poverty are less likely to graduate high school or go to college, and they are more likely to commit street crime.
For Your Review
1. Write a brief essay that summarizes the consequences of poverty.
2. Why do you think poor children are more likely to develop health problems?
8.6 Global Poverty
Learning Objectives
• Describe where poor nations tend to be located.
• Explain the difference between the modernization and dependency theories of poverty.
• List some of the consequences of global poverty.
As serious as poverty is in the United States, poverty in much of the rest of the world is beyond comprehension to the average American. Many of the world’s poor live in such desperate circumstances that they would envy the lives of poor Americans. Without at all meaning to minimize the plight of the American poor, this section provides a brief look at the world’s poor and at the dimensions of global poverty
• Global Inequality
The world has a few very rich nations and many very poor nations, and there is an enormous gulf between these two extremes. If the world were one nation, its median annual income (at which half of the world’s population is below this income and half is above it) would be only \$1,700 (Dikhanov, 2005). The richest fifth of the world’s population would have three-fourths of the world’s entire income, while the poorest fifth of the world’s population would have only 1.5 percent of the world’s income, and the poorest two-fifths would have only 5.0 percent of the world’s income (Dikhanov, 2005). Reflecting this latter fact, these poorest two-fifths, or about 2 billion people, live on less than \$2 per day (United Nations Development Programme, 2009). As Figure 2.5 “Global Income Distribution (Percentage of World Income Held by Each Fifth of World Population)” illustrates, this distribution of income resembles a champagne glass.
Figure 2.5 Global Income Distribution (Percentage of World Income Held by Each Fifth of World Population)
To understand global inequality, it is helpful to classify nations into a small number of categories based on their degree of wealth or poverty, their level of industrialization and economic development, and related factors. Over the decades, scholars and international organizations such as the United Nations and the World Bank have used various classification systems or typologies. A popular typology today simply ranks nations into groups called wealthy (or high-income) nations, middle-income nations, and poor (or low-income) nations, based on measures such as gross domestic product (GDP) per capita (the total value of a nation’s goods and services divided by its population). This typology has the advantage of emphasizing the most important variable in global stratification: how much wealth a nation has. At the risk of being somewhat simplistic, the other important differences among the world’s nations all stem from their degree of wealth or poverty. Figure 2.6 “Global Stratification Map” depicts these three categories of nations (with the middle category divided into upper-middle and lower-middle). As should be clear, whether a nation is wealthy, middle income, or poor is heavily related to the continent on which it is found.
Figure 2.6 Global Stratification Map
• Measuring Global Poverty
The World Bank has begun to emphasize vulnerability to poverty. Many people who are not officially poor have a good chance of becoming poor within a year. Strategies to prevent this from happening are a major focus of the World Bank. Wikimedia Commons– CC BY-SA 2.0.
How do we know which nations are poor? A very common measure of global poverty was developed by the World Bank, an international institution funded by wealthy nations that provides loans, grants, and other aid to help poor and middle-income nations. Each year the World Bank publishes its World Development Report, which provides statistics and other information on the economic and social well-being of the globe’s almost two hundred nations. The World Bank puts the official global poverty line (which is considered a measure of extreme poverty) at income under \$1.25 per person per day, which amounts to about \$456 yearly per person or \$1,825 for a family of four. According to this measure, 1.4 billion people, making up more than one-fifth of the world’s population and more than one-fourth of the population of developing (poor and middle-income) nations, are poor. This level of poverty rises to 40 percent of South Asia and 51 percent of sub-Saharan Africa (Haughton & Khandker, 2009).
In a new development, the World Bank has begun emphasizing the concept of vulnerability to poverty, which refers to a significant probability that people who are not officially poor will become poor within the next year. Determining vulnerability to poverty is important because it enables antipoverty strategies to be aimed at those most at risk for sliding into poverty, with the hope of preventing them from doing so.
Vulnerability to poverty appears widespread; in several developing nations, about one-fourth of the population is always poor, while almost one-third is vulnerable to poverty or is slipping into and out of poverty. In these nations, more than half the population is always or sometimes poor. (Haughton & Khandker, 2009) summarize this situation: “As typically defined, vulnerability to poverty is more widespread than poverty itself. A wide swathe of society risks poverty at some point of time; put another way, in most societies, only a relatively modest portion of society may be considered as economically secure.”
• Explaining Global Poverty
Explanations of global poverty parallel those of US poverty in their focus on individualistic versus structural problems. One type of explanation takes an individualistic approach by, in effect, blaming the people in the poorest nations for their own poverty, while a second explanation takes a structural approach in blaming the plight of poor nations on their treatment by the richest ones. Table 2.4 “Theory Snapshot” summarizes the two sets of explanations.
Table 2.4 Theory Snapshot
Theory Major assumptions
Modernization theory Wealthy nations became wealthy because early on they were able to develop the necessary beliefs, values, and practices for trade, industrialization, and rapid economic growth to occur. Poor nations remained poor because they failed to develop these beliefs, values, and practices; instead, they continued to follow traditional beliefs and practices that stymied industrial development and modernization.
Dependency theory The poverty of poor nations stems from their colonization by European nations, which exploited the poor nations’ resources and either enslaved their populations or used them as cheap labor. The colonized nations were thus unable to develop a professional and business class that would have enabled them to enter the industrial age and to otherwise develop their economies.
• Modernization Theory
The individualistic explanation is called modernization theory (Rostow, 1990). According to this theory, rich nations became wealthy because early on they were able to develop the “correct” beliefs, values, and practices—in short, the correct culture—for trade, industrialization, and rapid economic growth to occur. These cultural traits include a willingness to work hard, to abandon tradition in favor of new ways of thinking and doing things, and to adopt a future orientation rather than one focused on maintaining present conditions. Thus Western European nations began to emerge several centuries ago as economic powers because their populations adopted the kinds of values and practices just listed. In contrast, nations in other parts of the world never became wealthy and remain poor today because they never developed the appropriate values and practices. Instead, they continued to follow traditional beliefs and practices that stymied industrial development and modernization.
According to modernization theory, poor nations are poor because their people never developed values such as an emphasis on hard work. United Nations Photo – OLS Brings Support to Strained Medical Services– CC BY-NC-ND 2.0.
Modernization theory has much in common with the culture of poverty theory discussed earlier. It attributes the poverty of poor nations to their failure to develop the “proper” beliefs, values, and practices necessary for economic success both at the beginning of industrialization during the nineteenth century and in the two centuries that have since transpired. Because modernization theory implies that people in poor nations do not have the talent and ability to improve their lot, it may be considered a functionalist explanation of global inequality.
• Dependency Theory
The structural explanation for global stratification is called dependency theory, which may be considered a conflict explanation of global inequality. Not surprisingly, this theory’s views sharply challenge modernization theory’s assumptions (Packenham, 1992). Whereas modernization theory attributes global stratification to the “wrong” cultural values and practices in poor nations, dependency theory blames global stratification on the exploitation of these nations by wealthy nations. According to this view, poor nations never got the chance to pursue economic growth because early on they were conquered and colonized by European ones. The European nations stole the poor nations’ resources and either enslaved their populations or used them as cheap labor. They installed their own governments and often prevented the local populace from getting a good education. As a result, the colonized nations were unable to develop a professional and business class that would have enabled them to enter the industrial age and to otherwise develop their economies. Along the way, wealthy nations sold their own goods to colonized nations and forced them to run up enormous debt that continues to amount today.
In today’s world, huge multinational corporations continue to exploit the labor and resources of the poorest nations, say dependency theorists. These corporations run sweatshops in many nations, in which workers toil in inhumane conditions at extremely low wages (Sluiter, 2009). Often the corporations work hand-in-hand with corrupt officials in the poor nations to strengthen their economic stake in the countries.
• Comparing the Theories
Which makes more sense, modernization theory or dependency theory? As with many theories, both make sense to some degree, but both have their faults. Modernization theory places too much blame on poor nations for their own poverty and ignores the long history of exploitation of poor nations by rich nations and multinational corporations alike. For its part, dependency theory cannot explain why some of the poorest countries are poor even though they were never European colonies; neither can it explain why some former colonies such as Hong Kong have been able to attain enough economic growth to leave the rank of the poorest nations. Together, both theories help us understand the reasons for global stratification, but most sociologists would probably favor dependency theory because of its emphasis on structural factors in the world’s historic and current economy.
• The Lives of the World’s Poor
Poor nations are the least industrialized and most agricultural of all the world’s countries. They consist primarily of nations in Africa and parts of Asia and constitute roughly half of the world’s population. Many of these nations rely heavily on one or two crops, and if weather conditions render a crop unproductive in a particular season, the nations’ hungry become even hungrier. By the same token, if economic conditions reduce the price of a crop or other natural resource, the income from exports of these commodities plummets, and these already poor nations become even poorer.
People in poor nations live in the most miserable conditions possible. United Nations Photo – Maslakh Camp for Displaced, Afghanistan– CC BY-NC-ND 2.0.
By any standard, the more than 1.4 billion people in poor nations live a desperate existence in the most miserable conditions possible. They suffer from AIDS and other deadly diseases, live on the edge of starvation, and lack indoor plumbing, electricity, and other modern conveniences that most Americans take for granted. Most of us have seen unforgettable photos or video footage of African children with stick-thin limbs and distended stomachs reflecting severe malnutrition.
It would be nice if these images were merely fiction, but unfortunately, they are far too real. AIDS, malaria, starvation, and other deadly diseases are common. Many children die before reaching adolescence, and many adults die before reaching what in the richest nations would be considered middle age. Many people in the poorest nations are illiterate, and a college education remains as foreign to them as their way of life would be to us. The images of the world’s poor that we see in television news reports or in film documentaries fade quickly from our minds. Meanwhile, millions of people on our planet die every year because they do not have enough to eat because they lack access to clean water or adequate sanitation, or because they lack access to medicine that is found in every CVS, Rite Aid, and Walgreens in the United States. We now examine some specific dimensions and consequences of global poverty.
• Life Expectancy
When we look around the world, we see that global poverty is literally a matter of life and death. The clearest evidence of this fact comes from data on life expectancy, or the average number of years that a nation’s citizens can be expected to live. Life expectancy certainly differs within each nation, with some people dying younger and others dying older, but poverty and related conditions affect a nation’s overall life expectancy to a startling degree.
Figure 2.7 Average Life Expectancy across the Globe (Years)
A map of global life expectancy appears in Figure 2.7 “Average Life Expectancy across the Globe (Years)”. Life expectancy is highest in North America, Western Europe, and certain other regions of the world and lowest in Africa and South Asia, where life expectancy in many nations is some 30 years shorter than in other regions. Another way of visualizing the relationship between global poverty and life expectancy appears in Figure 2.8 “Global Poverty and Life Expectancy, 2006”, which depicts average life expectancy for wealthy nations, upper-middle-income nations, lower-middle-income nations, and poor nations. Men in wealthy nations can expect to live 76 years on average, compared to only 56 in poor nations; women in wealthy nations can expect to live 82 years, compared to only 58 in poor nations. Life expectancy in poor nations is thus 20 and 24 years lower, respectively, for the two sexes.
Figure 2.8 Global Poverty and Life Expectancy, 2006
• Child Mortality
A key contributor to life expectancy and also a significant consequence of global poverty in its own right is child mortality, the number of children who die before age 5 per 1,000 children. As Figure 2.9 “Global Poverty and Child Mortality, 2006” shows, the rate of child mortality in poor nations is 135 per 1,000 children, meaning that 13.5 percent of all children in these nations die before age 5. In a few African nations, child mortality exceeds 200 per 1,000. In contrast, the rate in wealthy nations is only 7 per 1,000. Children in poor nations are thus about 19 times (13.5 ÷ 0.7) more likely to die before age 5 than children in wealthy nations.
Figure 2.9 Global Poverty and Child Mortality, 2006
• Sanitation and Clean Water
Two other important indicators of a nation’s health are access to adequate sanitation (disposal of human waste) and access to clean water. When people lack adequate sanitation and clean water, they are at much greater risk for life-threatening diarrhea, serious infectious diseases such as cholera and typhoid, and parasitic diseases such as schistosomiasis (World Health Organization, 2010). About 2.4 billion people around the world, almost all of them in poor and middle-income nations, do not have adequate sanitation, and more than 2 million, most of them children, die annually from diarrhea. More than 40 million people worldwide, almost all of them again in poor and middle-income nations, suffer from a parasitic infection caused by flatworms.
As Figure 2.10 “Global Stratification and Access to Adequate Sanitation, 2006” and Figure 2.11 “Global Stratification and Access to Clean Water, 2006” show, access to adequate sanitation and clean water is strongly related to national wealth. Poor nations are much less likely than wealthier nations to have adequate access to both sanitation and clean water. Adequate sanitation is virtually universal in wealthy nations but is available to only 38 percent of people in poor nations. Clean water is also nearly universal in wealthy nations but is available to only 67 percent of people in poor nations.
Figure 2.10 Global Stratification and Access to Adequate Sanitation, 2006
Figure 2.11 Global Stratification and Access to Clean Water, 2006
• Malnutrition
About one-fifth of the population of poor nations, about 800 million individuals, are malnourished. Dr. Lyle Conrad at the Centers for Disease Control and Prevention- ID# 6874– public domain.
Another health indicator is malnutrition. This problem is caused by a lack of good food combined with infections and diseases such as diarrhea that sap the body of essential nutrients. About one-fifth of the population of poor nations, or about 800 million individuals, are malnourished; looking just at children, in developing nations more than one-fourth of children under age 5, or about 150 million altogether, are underweight. Half of all these children live in only three nations: Bangladesh, India, and Pakistan; almost half the children in these and other South Asian nations are underweight. Children who are malnourished are at much greater risk for fat and muscle loss, brain damage, blindness, and death; perhaps you have seen video footage of children in Africa or South Asia who are so starved that they look like skeletons. Not surprisingly, child malnutrition contributes heavily to the extremely high rates of child mortality that we just examined and is estimated to be responsible for more than 5 million deaths of children annually (United Nations Children’s Fund [UNICEF], 2006; World Health Organization, 2010).
• Adult Literacy
Moving from the area of health, a final indicator of human development is adult literacy, the percentage of people 15 and older who can read and write a simple sentence. Once again we see that people in poor and middle-income nations are far worse off (see Figure 2.12 “Global Poverty and Adult Literacy, 2008”). In poor nations, only about 69 percent of adults 15 and older can read and write a simple sentence. The high rate of illiteracy in poor nations not only reflects their poverty but also contributes to it, as people who cannot read and write are obviously at a huge disadvantage in the labor market.
Figure 2.12 Global Poverty and Adult Literacy, 2008
Applying Social Research
Unintended Consequences of Welfare Reform
• >Aid to Families with Dependent Children (AFDC) was a major government program to help the poor from the 1930s to the 1960s. Under this program, states allocated federal money to provide cash payments to poor families with children. Although the program was heavily criticized for allegedly providing an incentive to poor mothers both to have more children and to not join the workforce, research studies found little or no basis for this criticism. Still, many politicians and much of the public accepted the criticism as true, and AFDC became so unpopular that it was replaced in 1997 by a new program, Temporary Assistance for Needy Families (TANF), which is still a major program today.
• >TANF is more restrictive in many respects than AFDC was. In particular, it limits the amount of time a poor family can receive federal funds to five years and allows states to impose a shorter duration for funding, which many have done. In addition, it requires single parents in families receiving TANF funds to work at least thirty hours a week (or twenty hours a week if they have a child under the age of 6) and two parents to work at least thirty-five hours per week combined. In most states, going to school to obtain a degree does not count as the equivalent of working and thus does not make a parent eligible for TANF payments. Only short-term programs or workshops to develop job skills qualify.
• >Did welfare reform involving TANF work? Many adults formerly on AFDC found jobs, TANF payments nationwide have been much lower than AFDC payments, and many fewer families receive TANF payments than used to receive AFDC payments. All these facts lead many observers to hail TANF as a successful program. However, sociologists and other scholars who study TANF families say the numbers are misleading because poor families have in effect been excluded from TANF funding because of its strict requirements. The reduced payments and lower number of funded families indicate the failure of TANF, they say, not its success.
• >Several problems explain why TANF has had these unintended consequences. First, many families are poor for many more than five years, and the five-year time limit under TANF means that they receive financial help for only some of the years they live in poverty. Second, because the federal and state governments provide relatively little financial aid for child care, many parents simply cannot afford to work, and if they don’t work, they lose their TANF payments. Third, jobs are certainly difficult to find, especially if, as is typical, a poor parent has relatively little education and few job skills, and if parents cannot find a job, they again lose their TANF payments. Fourth, many parents cannot work because they have physical or mental health problems or because they are taking care of a family member or friend with a health problem; these parents, too, become ineligible for TANF payments.
• >Sociologist Lorna Rivera put a human face to these problems in a study of fifty poor women in Boston, Massachusetts. She lived among them, interviewed them individually, and conducted focus groups. She found that TANF worsened the situation of these women for the reasons just stated, and concluded that welfare reform left these and other poor women “uneducated, underemployed, underpaid, and unable to effectively move themselves and their families forward.”
• >Ironically, some studies suggest that welfare reform impaired the health of black women for several reasons. Many ended up with jobs with long bus commutes and odd hours, leading to sleep deprivation and less time for medical visits. Many of these new workers also suddenly had to struggle to find affordable daycare for their children. These problems are thought to have increased their stress levels and, in turn, harmed their health.
• >The research by social scientists on the effects of TANF reveals that the United States took a large step backward when it passed welfare reform in the 1990s. Far from reducing poverty, welfare reform only worsened it. This research underscores the need for the United States to develop better strategies for reducing poverty similar to those used by other Western democracies, as discussed in the Note 2.19 “Lessons from Other Societies” box in this chapter.
• >Sources: (Blitstein, 2009; Mink, 2008; Parrott & Sherman, 2008; Rivera, 2008)
• Key Takeaways
• People in poor nations live in the worst conditions possible. Deadly diseases are common, and many children die before reaching adolescence.
• According to the modernization theory, rich nations became rich because their peoples possessed certain values, beliefs, and practices that helped them become wealthy. Conversely, poor nations remained poor because their peoples did not possess these values, beliefs, and practices.
• According to the dependency theory, poor nations have remained poor because they have been exploited by rich nations and by multinational corporations.
For Your Review
1. Considering all the ways in which poor nations fare much worse than wealthy nations, which one seems to you to be the most important problem that poor nations experience? Explain your answer.
2. Which theory of global poverty, modernization or dependency, makes more sense to you? Why?
8.7 Reducing Poverty
Learning Objectives
• Explain why the United States neglects its poor.
• List any three potentially promising strategies to reduce US poverty.
• Describe how to reduce global poverty from a sociological perspective.
As this chapter noted at the outset, the United States greatly reduced poverty during the 1960s through a series of programs and policies that composed the so-called war on poverty. You saw evidence of the success of the war on poverty in Figure 2.1 “US Poverty, 1959–2010”, which showed that the poverty rate declined from 22.2 percent in 1960 to a low of 11.1 percent in 1973 before fluctuating from year to year and then rising since 2000. The Note 2.19 “Lessons from Other Societies” box showed that other democracies have much lower poverty rates than the United States because, as many scholars believe, they have better funded and more extensive programs to help their poor (Brady, 2009; Russell, 2011).
The lessons from the 1960s’ war on poverty and the experience of other democracies are clear: It is very possible to reduce poverty if, and only if, a nation is willing to fund and implement appropriate programs and policies that address the causes of poverty and that help the poor deal with the immediate and ongoing difficulties they experience.
A major reason that the US poverty rate reached its low in 1973 and never went lower during the past four decades is that the United States retreated from its war on poverty by cutting back on the programs and services it had provided during that good war (Soss, et. al., 2007). Another major reason is that changes in the national economy during the past few decades have meant that well-paying manufacturing jobs have been replaced by low-paying service jobs with fewer benefits (Wilson, 2010). Yet this has also happened in other democracies, and their poverty rates remain lower than the US rate because, unlike the United States, they have continued to try to help their poor rather than neglect them.
Why does the United States neglect its poor? Many scholars attribute this neglect to the fact that many citizens and politicians think the poor are poor because of their own failings. As summarized by sociologist Mark R. Rank (Rank, 2011), these failings include “not working hard enough, failure to acquire sufficient skills, or just making bad decisions.” By thus blaming the poor for their fate, citizens and politicians think the poor do not deserve to have the US government help them, and so the government does not help, or at least not nearly as much as other democracies do. We have seen that the facts do not support the myth that the poor lack motivation to work, but that does not lessen the blame given the poor for being poor.
To renew the US effort to help the poor, it is essential that the actual facts about poverty become better known so that a fundamental shift in thinking about poverty and the poor can occur. Rank (Rank, 2011) says that one aspect of this shift must include the recognition, as noted at the beginning of this chapter, that “poverty affects us all” because it costs so many tax dollars to help the poor and because a majority of the public can expect to be poor or near poor at some point in their lives. A second aspect of this shift in thinking, adds Rank, is the recognition (following a blaming-the-system approach) that poverty stems much more from the lack of opportunity, lack of jobs, declining government help for the poor, and other structural failings of American society than from individual failings of the poor themselves. A third aspect of this shift in thinking, he concludes, is that poverty must become seen as a “moral problem” and as “an injustice of a substantial magnitude” (Rank, 2011). As he forcefully argues, “Something is seriously wrong when we find that, in a country with the most abundant resources in the world, there are children without enough to eat, families who cannot afford health care, and people sleeping on the streets for lack of shelter” (Rank, 2011). This situation, he says, must become seen as a “moral outrage” (Rank, 2011).
Sociologist Joe Soss (Soss, 2011) argues that a change in thinking is not enough for a renewed antipoverty effort to occur. What is needed, he says, is political protest and other political activity by the poor and on behalf of the poor. Soss notes that “political conflict and mass mobilization played key roles” in providing the impetus for social-welfare programs in the 1930s and 1960s in the United States, and he adds that the lower poverty rates of Western European democracies “are products of labor movements, unions, and parties that mobilized workers to demand more adequate social supports.” These twin histories lead Soss to conclude that the United States will not increase its antipoverty efforts unless a new wave of political activity by and on behalf of the poor arises. As he argues, “History suggests that major antipoverty victories can be achieved. But they won’t be achieved by good will and smart ideas alone. They’ll be won politically, when people—in poor communities, in advocacy groups, in government, in the academy, and elsewhere—mobilize to advance antipoverty agendas in ways that make politics as usual untenable.”
• Antipoverty Programs and Policies
To help reduce poverty, it is essential to help poor parents pay for child care.
If a renewed antipoverty effort does occur for whatever reason, what types of programs and policies show promise for effectively reducing poverty? Here a sociological vision is essential. It is easy to understand why the hungry schoolchildren described in the news story that began this chapter might be going without food during a very faltering national economy. Yet a sociological understanding of poverty emphasizes its structural basis in bad times and good times alike. Poverty is rooted in social and economic problems of the larger society rather than in the lack of willpower, laziness, or other moral failings of poor individuals themselves. Individuals born into poverty suffer from a lack of opportunity from their first months up through adulthood, and poverty becomes a self-perpetuating, vicious cycle. To the extent a culture of poverty might exist, it is best seen as a logical and perhaps even inevitable outcome of, and adaptation to, the problem of being poor and not the primary force driving poverty itself.
This sort of understanding suggests that efforts to reduce poverty must address first and foremost the structural basis for poverty while not ignoring certain beliefs and practices of the poor that also make a difference. An extensive literature on poverty policy outlines many types of policies and programs that follow this dual approach (Cancian & Danziger, 2009; Greenberg, et. al., 2007; Iceland, 2006; Lindsey, 2009; Moore et al., 2009; Rank, 2004). If these were fully adopted, funded, and implemented, as they are in many other democracies, they would offer great promise for reducing poverty. As two poverty experts recently wrote, “We are optimistic that poverty can be reduced significantly in the long term if the public and policymakers can muster the political will to pursue a range of promising antipoverty policies” (M. Cancian & S. Danziger, 2009, p. 32).Cancian, M., & Danziger, S. H. (2009). Changing poverty, changing policies. New York, NY: Russell Sage Foundation. Although a full discussion of these policies is beyond the scope of this chapter, the following measures are commonly cited as holding strong potential for reducing poverty, and they are found in varying degrees in other Western democracies:
1. Adopt a national “full employment” policy for the poor, involving federally funded job training and public works programs, and increase the minimum wage so that individuals working full-time will earn enough to lift their families out of poverty.
2. Increase federal aid for the working poor, including higher earned income credits and child-care subsidies for those with children.
3. Establish well-funded early childhood intervention programs, including home visitations by trained professionals, for poor families.
4. Provide poor families with enough income to enable them to pay for food and housing.
5. Increase the supply of affordable housing.
6. Improve the schools that poor children attend and the schooling they receive and expand early childhood education programs for poor children.
7. Provide better nutrition and health services for poor families with young children.
8. Establish universal health insurance.
9. Increase Pell Grants and other financial aid for higher education.
• Global Poverty
Years of international aid to poor nations have helped them somewhat, but, as this chapter has shown, their situation remains dire. International aid experts acknowledge that efforts to achieve economic growth in poor nations have largely failed, but they disagree why this is so and what alternative strategies may prove more successful (Cohen & Easterly, 2009).Cohen, J., & Easterly, W. (Eds.). (2009). What works in development? Thinking big and thinking small. Washington, DC: Brookings Institution Press. One very promising trend has been a switch from macro efforts focusing on infrastructure problems and on social institutions, such as the schools, to micro efforts, such as providing cash payments or small loans directly to poor people in poor nations (a practice called microfinancing) and giving them bed nets to prevent mosquito bites (Banerjee & Duflo, 2011; Hanlon, Barrientos, & Hulme, 2010; Karlan & Appel, 2011).Banerjee, A. V., & Duflo, E. (2011). Poor economics: A radical rethinking of the way to fight global poverty. New York, NY: PublicAffairs; Hanlon, J., Barrientos, A., & Hulme, D. (2010). Just give money to the poor: The development revolution from the global south. Sterling, VA: Kumarian Press; Karlan, D., & Appel, J. (2011). More than good intentions: How a new economics is helping to solve global poverty. New York, NY: Dutton. However, the evidence on the success of these efforts is mixed (Bennett, 2009; The Economist, 2010).Bennett, D. (2009, September 20). Small change. The Boston Globe. Retrieved from http://www.boston.com/bostonglobe/ideas/articles/2009/09/20/small_change_does_microlending_actually_fight_poverty/; The Economist. (2010). A better mattress. The Economist, 394(8673), 75–76. Much more to help the world’s poor certainly needs to be done.
In this regard, sociology’s structural approach is in line with dependency theory and suggests that global stratification results from the history of colonialism and from continuing exploitation today of poor nations’ resources by wealthy nations and multinational corporations. To the extent such exploitation exists, global poverty will lessen if and only if this exploitation lessens. A sociological approach also emphasizes the role that class, gender, and ethnic inequality play in perpetuating global poverty. For global poverty to be reduced, gender and ethnic inequality must be reduced.
Writers Nicholas D. Kristof and Sheryl WuDunn (2010)Kristoff, N. D., & WuDunn, S. (2010). Half the sky: Turning oppression into opportunity for women worldwide. New York, NY: Vintage Books. emphasize the need to focus efforts to reduce global poverty of women. We have already seen one reason this emphasis makes sense: women are much worse off than men in poor nations in many ways, so helping them is crucial for both economic and humanitarian reasons. An additional reason is especially illuminating: When women in poor nations acquire extra money, they typically spend it on food, clothing, and medicine, essentials for their families. However, when men in poor nations acquire extra money, they often spend it on alcohol, tobacco, and gambling. This gender difference might sound like a stereotype, but it does indicate that aid to women will help in many ways, while aid to men might be less effective and often even wasted.
Key Takeaways
• According to some sociologists, a change in thinking about poverty and the poor and political action by and on behalf of the poor are necessary for a renewed effort to help poor Americans.
• Potentially successful antipoverty programs and policies to help the US poor include expanding their employment opportunities and providing them much greater amounts of financial and other aid.
• To help people in poor nations, gender and ethnic inequality must be addressed.
For Your Review
1. Write a brief essay summarizing the changes in thinking that some sociologists argue must occur before a renewed effort to reduce poverty can take place.
2. Write a brief essay summarizing any four policies or programs that could potentially lower US poverty.
8.8 End-of-Chapter Summary
Summary
1. Poverty statistics are misleading in at least two ways. First, the way that poverty is measured is inadequate for several reasons, and more accurate measures of poverty that have recently been developed suggest that poverty is higher than the official poverty measure indicates. Second, even if people live slightly above the poverty line, they are still living in very difficult circumstances and are having trouble making ends meet.
2. Children, people of color, the South, and single-parent families headed by women have especially high poverty rates. Despite what many Americans think, the most typical poor person is white, and most poor people who are able to work outside the home in fact do work.
3. To explain social stratification and thus poverty, functionalist theory says that stratification is necessary and inevitable because of the need to encourage people with the needed knowledge and skills to decide to pursue the careers that are most important to society. Conflict theory says stratification exists because of discrimination against, and blocked opportunities for, the have-nots of society. Symbolic interactionist theory does not try to explain why stratification and poverty exist, but it does attempt to understand the experience of being poor.
4. The individualistic explanation attributes poverty to individual failings of poor people themselves, while the structuralist explanation attributes poverty to lack of jobs and lack of opportunity in the larger society.
5. Poverty has serious consequences in many respects. Among other problems, poor children are more likely to grow up to be poor, to have health problems, to commit street crime, and to have lower levels of formal education.
6. The nations of the world differ dramatically in wealth and other resources, with the poorest nations being found in Africa and parts of Asia.
7. Global poverty has a devastating impact on the lives of hundreds of millions of people throughout the world. Poor nations have much higher rates of mortality and disease and lower rates of literacy.
8. Modernization theory attributes global poverty to the failure of poor nations to develop the necessary beliefs, values, and practices to achieve economic growth, while dependency theory attributes global poverty to the colonization and exploitation by European nations of nations in other parts of the world.
9. A sociological perspective suggests that poverty reduction in the United States and around the world can occur if the structural causes of poverty are successfully addressed.
Using What You Know
It is December 20, and you have just finished final exams. In two days, you will go home for winter break and are looking forward to a couple weeks of eating, sleeping, and seeing your high school friends. Your smartphone signals that someone has texted you. When you read the message, you see that a friend is asking you to join her in serving a holiday supper on December 23 at a food pantry just a few miles from your campus. If you do that, you will not be able to get home until two days after you had been planning to arrive, and you will miss a big high school “reunion” party set for the night of the twenty-third. What do you decide to do? Why?
What You Can Do
To help fight poverty and the effects of poverty, you may wish to do any of the following:
1. Contribute money to a local, state, or national organization that provides various kinds of aid to the poor.
2. Volunteer at a local food pantry or homeless shelter.
3. Start a canned food or used clothing drive on your campus.
4. Write letters or send e-mails to local, state, and federal officials that encourage them to expand anti-poverty programs.
Attribution
Adapted from Chapter 2 from Social Problems by the University of Minnesota under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/02%3A_Alternative_Perspectives_on_Individuals/08%3A_Poverty.txt |
Learning Objectives
• Distinguish prejudice, stereotypes, and discrimination.
• Distinguish old-fashioned, blatant biases from contemporary, subtle biases.
• Understand old-fashioned biases such as social dominance orientation and right-wing authoritarianism.
• Understand subtle, unexamined biases that are automatic, ambiguous, and ambivalent.
• Understand 21st-century biases that may break down as identities get more complicated.
9.1 Introduction to Prejudice, Discrimination, and Stereotyping
People are often biased against others outside of their own social group, showing prejudice (emotional bias), stereotypes (cognitive bias), and discrimination (behavioral bias). In the past, people used to be more explicit with their biases, but during the 20th century, when it became less socially acceptable to exhibit bias, such things like prejudice, stereotypes, and discrimination became more subtle (automatic, ambiguous, and ambivalent). In the 21st century, however, with social group categories even more complex, biases may be transforming once again.
You are an individual, full of beliefs, identities, and more that help makes you unique. You don’t want to be labeled just by your gender or race or religion. But as complex, as we perceive ourselves to be, we often define others merely by their most distinct social group.
Even in one’s own family, everyone wants to be seen for who they are, not as “just another typical X.” But still, people put other people into groups, using that label to inform their evaluation of the person as a whole—a process that can result in serious consequences. This module focuses on biases against social groups, which social psychologists sort into emotional prejudices , mental stereotypes , and behavioral discrimination . These three aspects of bias are related, but they each can occur separately from the others ( Dovidio & Gaertner, 2010 Fiske, 1998 ). For example, sometimes people have a negative, emotional reaction to a social group (prejudice) without knowing even the most superficial reasons to dislike them (stereotypes).
This module shows that today’s biases are not yesterday’s biases in many ways, but at the same time, they are troublingly similar. First, we’ll discuss old-fashioned biases that might have belonged to our grandparents and great-grandparents—or even the people nowadays who have yet to leave those wrongful times. Next, we will discuss late 20th century biases that affected our parents and still linger today. Finally, we will talk about today’s 21st-century biases that challenge fairness and respect for all.
Old-fashioned Biases: Almost Gone
You would be hard-pressed to find someone today who openly admits they don’t believe inequality. Regardless of one’s demographics, most people believe everyone is entitled to the same, natural rights. However, as much as we now collectively believe this, not too far back in our history, this idea of equality was an unpracticed sentiment. Of all the countries in the world, only a few have equality in their constitution and those who do originally defined it for a select group of people.
At the time, old-fashioned biases were simple: people openly put down those not from their own group. For example, just 80 years ago, American college students unabashedly thought Turkish people were “cruel, very religious, and treacherous” (Katz & Braly, 1933). So where did they get those ideas, assuming that most of them had never met anyone from Turkey? Old-fashioned stereotypes were overt, unapologetic, and expected to be shared by others—what we now call “blatant biases.”
Blatant biases are conscious beliefs, feelings, and behavior that people are perfectly willing to admit, which mostly express hostility toward other groups (outgroups) while unduly favoring one’s own group (in-group). For example, organizations that preach contempt for other races (and praise for their own) is an example of blatant bias. And scarily, these blatant biases tend to run in packs: People who openly hate one outgroup also hate many others. To illustrate this pattern, we turn to two personality scales next.
Social Dominance Orientation
People with a social dominance orientation are more likely to be attracted to certain types of careers, such as law enforcement, that maintain group hierarchies. [Image: Thomas Hawk, https://goo.gl/qWQ7jE, CC BY-NC 2.0, https://goo.gl/VnKlK8]
Social dominance orientation (SDO) describes a belief that group hierarchies are inevitable in all societies and are even a good idea to maintain order and stability (Sidanius & Pratto, 1999). Those who score high on SDO believe that some groups are inherently better than others, and because of this, there is no such thing as group “equality.” At the same time, though, SDO is not just about being personally dominant and controlling of others; SDO describes a preferred arrangement of groups with some on top (preferably one’s own group) and some on the bottom. For example, someone high in SDO would likely be upset if someone from an outgroup moved into his or her neighborhood. It’s not that the person high in SDO wants to “control” what this outgroup member does; it’s that moving into this “nice neighborhood” disrupts the social hierarchy the person high in SDO believes in (i.e. living in a nice neighborhood denotes one’s place in the social hierarchy—a place reserved for one’s in-group members).
Although research has shown that people higher in SDO are more likely to be politically conservative, there are other traits that more strongly predict one’s SDO. For example, researchers have found that those who score higher on SDO are usually lower than average on tolerance, empathy, altruism, and community orientation. In general, those high in SDO have a strong belief in work ethic—that hard work always pays off and leisure is a waste of time. People higher on SDO tend to choose and thrive in occupations that maintain existing group hierarchies (police, prosecutors, business), compared to those lower in SDO, who tend to pick more equalizing occupations (social work, public defense, psychology).
The point is that SDO—a preference for inequality as normal and natural—also predicts endorsing the superiority of certain groups: men, native-born residents, heterosexuals, and believers in the dominant religion. This means seeing women, minorities, homosexuals, and non-believers as inferior. Understandably, the first list of groups tend to score higher on SDO, while the second group tends to score lower. For example, the SDO gender difference (men higher, women lower) appears all over the world.
At its heart, SDO rests on a fundamental belief that the world is tough and competitive with only a limited number of resources. Thus, those high in SDO see groups as battling each other for these resources, with winners at the top of the social hierarchy and losers at the bottom (see Table 1).
Table 1.
Right-wing Authoritarianism
Right-wing authoritarianism (RWA) focuses on value conflicts, whereas SDO focuses on the economic ones. That is, RWA endorses respect for obedience and authority in the service of group conformity (Altemeyer, 1988). Returning to an example from earlier, the homeowner who’s high in SDO may dislike the outgroup member moving into his or her neighborhood because it “threatens” one’s economic resources (e.g. lowering the value of one’s house; fewer openings in the school; etc.). Those high in RWA may equally dislike the outgroup member moving into the neighborhood but for different reasons. Here, it’s because this outgroup member brings in values or beliefs that the person high in RWA disagrees with, thus “threatening” the collective values of his or her group. RWA respects group unity over individual preferences, wanting to maintain group values in the face of differing opinions. Despite its name, though, RWA is not necessarily limited to people on the right (conservatives). Like SDO, there does appear to be an association between this personality scale (i.e. the preference for order, clarity, and conventional values) and conservative beliefs. However, regardless of political ideology, RWA focuses on groups’ competing frameworks of values. Extreme scores on RWA predict biases against outgroups while demanding in-group loyalty and conformity Notably, the combination of high RWA and high SDO predicts joining hate groups that openly endorse aggression against minority groups, immigrants, homosexuals, and believers in non-dominant religions (Altemeyer, 2004).
20th Century Biases: Subtle but Significant
Fortunately, old-fashioned biases have diminished over the 20th century and into the 21st century. Openly expressing prejudice is like blowing second-hand cigarette smoke in someone’s face: It’s just not done any more in most circles, and if it is, people are readily criticized for their behavior. Still, these biases exist in people; they’re just less in view than before. These subtle biases are unexamined and sometimes unconscious but real in their consequences. They are automatic, ambiguous, and ambivalent, but nonetheless biased, unfair, and disrespectful to the belief in equality.
Automatic Biases
An actual screenshot from an IAT (Implicit Association Test) that is designed to test a person’s reaction time (measured in milliseconds) to an array of stimuli that are presented on the screen. This particular item is testing an individual’s unconscious reaction towards members of various ethnic groups. [Image: Courtesy of Anthony Greenwald from Project Implicit]
Most people like themselves well enough, and most people identify themselves as members of certain groups but not others. Logic suggests, then, that because we like ourselves, we therefore like the groups we associate with more, whether those groups are our hometown, school, religion, gender, or ethnicity. Liking yourself and your groups is human nature. The larger issue, however, is that own-group preference often results in liking other groups less. And whether you recognize this “favoritism” as wrong, this trade-off is relatively automatic, that is, unintended, immediate, and irresistible.
Social psychologists have developed several ways to measure this relatively automatic own-group preference, the most famous being the Implicit Association Test (IAT; Greenwald, Banaji, Rudman, Farnham, Nosek, & Mellott, 2002Greenwald, McGhee, & Schwartz, 1998). The test itself is rather simple and you can experience it yourself if you Google “implicit” or go to understandingprejudice.org. Essentially, the IAT is done on the computer and measures how quickly you can sort words or pictures into different categories. For example, if you were asked to categorize “ice cream” as good or bad, you would quickly categorize it as good. However, imagine if every time you ate ice cream, you got a brain freeze. When it comes time to categorize ice cream as good or bad, you may still categorize it as “good,” but you will likely be a little slower in doing so compared to someone who has nothing but positive thoughts about ice cream. Related to group biases, people may explicitly claim they don’t discriminate against outgroups—and this is very likely true. However, when they’re given this computer task to categorize people from these outgroups, that automatic or unconscious hesitation (a result of having mixed evaluations about the outgroup) will show up in the test. And as countless studies have revealed, people are mostly faster at pairing their own group with good categories, compared to pairing others’ groups. In fact, this finding generally holds regardless if one’s group is measured according to race, age, religion, nationality, and even temporary, insignificant memberships.
This all-too-human tendency would remain a mere interesting discovery except that people’s reaction time on the IAT predicts actual feelings about individuals from other groups, decisions about them, and behavior toward them, especially nonverbal behavior (Greenwald, Poehlman, Uhlmann, & Banaji, 2009). For example, although a job interviewer may not be “blatantly biased,” his or her “automatic or implicit biases” may result in unconsciously acting distant and indifferent, which can have devastating effects on the hopeful interviewee’s ability to perform well (Word, Zanna, & Cooper, 1973). Although this is unfair, sometimes the automatic associations—often driven by society’s stereotypes—trump our own, explicit values (Devine, 1989). And sadly, this can result in consequential discrimination, such as allocating fewer resources to disliked outgroups (Rudman & Ashmore, 2009). See Table 2 for a summary of this section and the next two sections on subtle biases.
Table 2: Subtle Biases
Ambiguous Biases
Whether we are aware of it or not (and usually we’re not), we sort the world into “us” and “them” categories. We are more likely to treat with bias or discrimination anyone we feel is outside our own group. [Image: Keira McPhee, https://goo.gl/gkaKBe, CC BY 2.0, https://goo.gl/BRvSA7]
As the IAT indicates, people’s biases often stem from the spontaneous tendency to favor their own, at the expense of the other. Social identity theory (Tajfel, Billig, Bundy, & Flament, 1971) describes this tendency to favor one’s own in-group over another’s outgroup. And as a result, outgroup disliking stems from this in-group liking (Brewer & Brown, 1998). For example, if two classes of children want to play on the same soccer field, the classes will come to dislike each other not because of any real, objectionable traits about the other group. The dislike originates from each class’s favoritism toward itself and the fact that only one group can play on the soccer field at a time. With this preferential perspective for one’s own group, people are not punishing the other one so much as neglecting it in favor of their own. However, to justify this preferential treatment, people will often exaggerate the differences between their in-group and the outgroup. In turn, people see the outgroup as more similar in personality than they are. This results in the perception that “they” really differ from us, and “they” are all alike. Spontaneously, people categorize people into groups just as we categorize furniture or food into one type or another. The difference is that we people inhabit categories ourselves, as self-categorization theory points out (Turner, 1975). Because the attributes of group categories can be either good or bad, we tend to favor the groups with people like us and incidentally disfavor the others. In-group favoritism is an ambiguous form of bias because it disfavors the outgroup by exclusion. For example, if a politician has to decide between funding one program or another, s/he may be more likely to give resources to the group that more closely represents his in-group. And this life-changing decision stems from the simple, natural human tendency to be more comfortable with people like yourself.
A specific case of comfort with the ingroup is called aversive racism, so-called because people do not like to admit their own racial biases to themselves or others (Dovidio & Gaertner, 2010). Tensions between, say, a White person’s own good intentions and discomfort with the perhaps novel situation of interacting closely with a Black person may cause the White person to feel uneasy, behave stiffly, or be distracted. As a result, the White person may give a good excuse to avoid the situation altogether and prevent any awkwardness that could have come from it. However, such a reaction will be ambiguous to both parties and hard to interpret. That is, was the White person right to avoid the situation so that neither person would feel uncomfortable? Indicators of aversive racism correlate with discriminatory behavior, despite being the ambiguous result of good intentions gone bad.
Bias Can Be Complicated – Ambivalent Biases
Not all stereotypes of outgroups are all bad. For example, ethnic Asians living in the United States are commonly referred to as the “model minority” because of their perceived success in areas such as education, income, and social stability. Another example includes people who feel benevolent toward traditional women but hostile toward nontraditional women. Or even ageist people who feel respect toward older adults but, at the same time, worry about the burden they place on public welfare programs. A simple way to understand these mixed feelings, across a variety of groups, results from the Stereotype Content Model (Fiske, Cuddy, & Glick, 2007).
When people learn about a new group, they first want to know if its intentions of the people in this group are for good or ill. Like the guard at night: “Who goes there, friend or foe?” If the other group has good, cooperative intentions, we view them as warm and trustworthy and often consider them part of “our side.” However, if the other group is cold and competitive or full of exploiters, we often view them as a threat and treat them accordingly. After learning the group’s intentions, though, we also want to know whether they are competent enough to act on them (if they are incompetent, or unable, their intentions matter less). These two simple dimensions—warmth and competence—together map how groups relate to each other in society.
Figure 1: Stereotype Content Model – 4 kinds of stereotypes that form from perceptions of competence and warmth
There are common stereotypes of people from all sorts of categories and occupations that lead them to be classified along these two dimensions. For example, a stereotypical “housewife” would be seen as high in warmth but lower in competence. This is not to suggest that actual housewives are not competent, of course, but that they are not widely admired for their competence in the same way as scientific pioneers, trendsetters, or captains of industry. At another end of the spectrum are homeless people and drug addicts, stereotyped as not having good intentions (perhaps exploitative for not trying to play by the rules), and likewise being incompetent (unable) to do anything useful. These groups reportedly make society more disgusted than any other groups do.
Some group stereotypes are mixed, high on one dimension and low on the other. Groups stereotyped as competent but not warm, for example, include rich people and outsiders good at business. These groups that are seen as “competent but cold” make people feel some envy, admitting that these others may have some talent but resenting them for not being “people like us.” The “model minority” stereotype mentioned earlier includes people with this excessive competence but deficient sociability.
The other mixed combination is high warmth but low competence. Groups who fit this combination include older people and disabled people. Others report pitying them, but only so long as they stay in their place. In an effort to combat this negative stereotype, disability- and elderly-rights activists try to eliminate that pity, hopefully gaining respect in the process.
Altogether, these four kinds of stereotypes and their associated emotional prejudices (pride, disgust, envy, pity) occur all over the world for each of society’s own groups. These maps of the group terrain predict specific types of discrimination for specific kinds of groups, underlining how bias is not exactly equal opportunity.
Figure 2: Combinations of perceived warmth and confidence and the associated behaviors/emotional prejudices.
End-of-Chapter Summary: 21st Century Prejudices
As the world becomes more interconnected—more collaborations between countries, more intermarrying between different groups—more and more people are encountering greater diversity of others in everyday life. Just ask yourself if you’ve ever been asked, “What are you?” Such a question would be preposterous if you were only surrounded by members of your own group. Categories, then, are becoming more and more uncertain, unclear, volatile, and complex (Bodenhausen & Peery, 2009). People’s identities are multifaceted, intersecting across gender, race, class, age, region, and more. Identities are not so simple, but maybe as the 21st century unfurls, we will recognize each other by the content of our character instead of the cover on our outside.
Attribution
Adapted from Prejudice, Discrimination, and Stereotyping by Susan T. Fiske under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
9.2 Dimension of Racial and Ethnic Equality
Learning Objectives
1. Describe any two manifestations of racial and ethnic inequality in the United States.
2. Explain how and why racial inequality takes a hidden toll on people of color.
3. Provide two examples of white privilege.
Racial and ethnic inequality manifests itself in all walks of life. The individual and institutional discrimination just discussed is one manifestation of this inequality. We can also see stark evidence of racial and ethnic inequality in various government statistics. Sometimes statistics lie, and sometimes they provide all too true a picture; statistics on racial and ethnic inequality fall into the latter category. Table 3.2 “Selected Indicators of Racial and Ethnic Inequality in the United States” presents data on racial and ethnic differences in income, education, and health.
Table 3.2 Selected Indicators of Racial and Ethnic Inequality in the United States
White African American Latino Asian Native American
Median family income, 2010 (\$) 68,818 39,900 41,102 76,736 39,664
Persons who are college-educated, 2010 (%) 30.3 19.8 13.9 52.4 14.9 (2008)
Persons in poverty, 2010 (%) 9.9 (non-Latino) 27.4 26.6 12.1 28.4
Infant mortality (number of infant deaths per 1,000 births), 2006 5.6 12.9 5.4 4.6 8.3
Asian Americans have higher family incomes than whites on average. Although Asian Americans are often viewed as a “model minority,” some Asians have been less able than others to achieve economic success, and stereotypes of Asians and discrimination against them remain serious problems. LindaDee2006 – CC BY-NC-ND 2.0.
The picture presented by Table 3.2 “Selected Indicators of Racial and Ethnic Inequality in the United States” is clear: US racial and ethnic groups differ dramatically in their life chances. Compared to whites, for example, African Americans, Latinos, and Native Americans have much lower family incomes and much higher rates of poverty; they are also much less likely to have college degrees. In addition, African Americans and Native Americans have much higher infant mortality rates than whites: Black infants, for example, are more than twice as likely as white infants to die. Later chapters in this book will continue to highlight various dimensions of racial and ethnic inequality.
Although Table 3.2 “Selected Indicators of Racial and Ethnic Inequality in the United States” shows that African Americans, Latinos, and Native Americans fare much worse than whites, it presents a more complex pattern for Asian Americans. Compared to whites, Asian Americans have higher family incomes and are more likely to hold college degrees, but they also have a higher poverty rate. Thus many Asian Americans do relatively well, while others fare relatively worse, as just noted. Although Asian Americans are often viewed as a “model minority,” meaning that they have achieved economic success despite not being white, some Asians have been less able than others to climb the economic ladder. Moreover, stereotypes of Asian Americans and discrimination against them remain serious problems (Chou & Feagin, 2008). Even the overall success rate of Asian Americans obscures the fact that their occupations and incomes are often lower than would be expected from their educational attainment. They thus have to work harder for their success than whites do (Hurh & Kim, 1999).
The Increasing Racial/Ethnic Wealth Gap
At the beginning of this chapter, we noted that racial and ethnic inequality has existed since the beginning of the United States. We also noted that social scientists have warned that certain conditions have actually worsened for people of color since the 1960s (Hacker, 2003; Massey & Sampson, 2009).
Recent evidence of this worsening appeared in a report by the Pew Research Center (2011). The report focused on racial disparities in wealth, which includes a family’s total assets (income, savings, and investments, home equity, etc.) and debts (mortgage, credit cards, etc.). The report found that the wealth gap between white households on the one hand and African American and Latino households, on the other hand, was much wider than just a few years earlier, thanks to the faltering US economy since 2008 that affected blacks more severely than whites.
According to the report, whites’ median wealth was ten times greater than blacks’ median wealth in 2007, a discouraging disparity for anyone who believes in racial equality. By 2009, however, whites’ median wealth had jumped to twenty times greater than blacks’ median wealth and eighteen times greater than Latinos’ median wealth. White households had a median net worth of about \$113,000, while black and Latino households had a median net worth of only \$5,700 and \$6,300, respectively (see Figure 3.5 “The Racial/Ethnic Wealth Gap (Median Net Worth of Households in 2009)”). This racial and ethnic difference is the largest since the government began tracking wealth more than a quarter-century ago.
Figure 3.5 The Racial/Ethnic Wealth Gap (Median Net Worth of Households in 2009)
A large racial/ethnic gap also existed in the percentage of families with negative net worth—that is, those whose debts exceed their assets. One-third of black and Latino households had negative net worth, compared to only 15 percent of white households. Black and Latino households were thus more than twice as likely as white households to be in debt.
The Hidden Toll of Racial and Ethnic Inequality
An increasing amount of evidence suggests that being black in a society filled with racial prejudice, discrimination, and inequality takes what has been called a “hidden toll” on the lives of African Americans (Blitstein, 2009). As we shall see in later chapters, African Americans on the average have worse health than whites and die at younger ages. In fact, every year there are an additional 100,000 African American deaths than would be expected if they lived as long as whites do. Although many reasons probably explain all these disparities, scholars are increasingly concluding that the stress of being black is a major factor (Geronimus et al., 2010).
In this way of thinking, African Americans are much more likely than whites to be poor, to live in high-crime neighborhoods, and to live in crowded conditions, among many other problems. As this chapter discussed earlier, they are also more likely, whether or not they are poor, to experience racial slights, refusals to be interviewed for jobs, and other forms of discrimination in their everyday lives. All these problems mean that African Americans from their earliest ages grow up with a great deal of stress, far more than what most whites experience. This stress, in turn, has certain neural and physiological effects, including hypertension (high blood pressure), that impair African Americans’ short-term and long-term health and that ultimately shorten their lives. These effects accumulate over time: black and white hypertension rates are equal for people in their twenties, but the black rate becomes much higher by the time people reach their forties and fifties. As a recent news article on evidence of this “hidden toll” summarized this process, “The long-term stress of living in a white-dominated society ‘weathers’ blacks, making them age faster than their white counterparts” (Blitstein, 2009, p. 48).
Although there is less research on other people of color, many Latinos and Native Americans also experience the various sources of stress that African Americans experience. To the extent this is true, racial and ethnic inequality also takes a hidden toll on members of these two groups. They, too, experience racial slights, live under disadvantaged conditions, and face other problems that result in high levels of stress and shorten their life spans.
White Privilege: The Benefits of Being White
American whites enjoy certain privileges merely because they are white. For example, they usually do not have to fear that a police officer will stop them simply because they are white, and they also generally do not have to worry about being mistaken for a bellhop, parking valet, or maid. Loren Kerns – Day 73 – CC BY 2.0.
Before we leave this section, it is important to discuss the advantages that US whites enjoy in their daily lives simply because they are white. Social scientists term these advantages white privilege and say that whites benefit from being white whether or not they are aware of their advantages (McIntosh, 2007).
This chapter’s discussion of the problems facing people of color points to some of these advantages. For example, whites can usually drive a car at night or walk down a street without having to fear that a police officer will stop them simply because they are white. Recalling the Trayvon Martin tragedy, they can also walk down a street without having to fear they will be confronted and possibly killed by a neighborhood watch volunteer. In addition, whites can count on being able to move into any neighborhood they desire to as long as they can afford the rent or mortgage. They generally do not have to fear being passed up for promotion simply because of their race. White students can live in college dorms without having to worry that racial slurs will be directed their way. White people, in general, do not have to worry about being the victims of hate crimes based on their race. They can be seated in a restaurant without having to worry that they will be served more slowly or not at all because of their skin color. If they are in a hotel, they do not have to think that someone will mistake them for a bellhop, parking valet, or maid. If they are trying to hail a taxi, they do not have to worry about the taxi driver ignoring them because the driver fears he or she will be robbed.
Social scientist Robert W. Terry (1981, p. 120) once summarized white privilege as follows: “To be white in America is not to have to think about it. Except for hard-core racial supremacists, the meaning of being white is having the choice of attending to or ignoring one’s own whiteness” (emphasis in original). For people of color in the United States, it is not an exaggeration to say that race and ethnicity is a daily fact of their existence. Yet whites do not generally have to think about being white. As all of us go about our daily lives, this basic difference is one of the most important manifestations of racial and ethnic inequality in the United States.
Perhaps because whites do not have to think about being white, many studies find they tend to underestimate the degree of racial inequality in the United States by assuming that African Americans and Latinos are much better off than they really are. As one report summarized these studies’ overall conclusion, “Whites tend to have a relatively rosy impression of what it means to be a black person in America. Whites are more than twice as likely as blacks to believe that the position of African Americans has improved a great deal” (Vedantam, 2008, p. A3). Because whites think African Americans and Latinos fare much better than they really do, that perception probably reduces whites’ sympathy for programs designed to reduce racial and ethnic inequality.
Key Takeaways
• Compared to non-Latino whites, people of color have lower incomes, lower educational attainment, higher poverty rates, and worse health.
• Racial and ethnic inequality takes a hidden toll on people of color, as the stress they experience impairs their health and ability to achieve.
• Whites benefit from being white, whether or not they realize it. This benefit is called white privilege.
For Your Review
1. Write a brief essay that describes important dimensions of racial and ethnic inequality in the United States.
2. If you are white, describe a time when you benefited from white privilege, whether or not you realized it at the time. If you are a person of color, describe an experience when you would have benefited if you had been white.
Attribution
Adapted from Chapter 3.2, Social Problems by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.
9.3 Feminism and Sexism
Learning Objectives
1. Define feminism, sexism, and patriarchy.
2. Discuss evidence for a decline in sexism.
In the national General Social Survey (GSS), slightly more than one-third of the public agrees with this statement: “It is much better for everyone involved if the man is the achiever outside the home and the woman takes care of the home and family.” Do you agree or disagree with this statement? If you are like the majority of college students, you disagree.
Today a lot of women, and some men, will say, “I’m not a feminist, but…,” and then go on to add that they hold certain beliefs about women’s equality and traditional gender roles that actually fall into a feminist framework. Their reluctance to self-identify as feminists underscores the negative image that feminists and feminism have but also suggests that the actual meaning of feminism may be unclear.
Feminism and sexism are generally two sides of the same coin. Feminism refers to the belief that women and men should have equal opportunities in economic, political, and social life, while sexism refers to a belief in traditional gender role stereotypes and in the inherent inequality between men and women. Sexism thus parallels the concept of racial and ethnic prejudice discussed in Chapter 3 “Racial and Ethnic Inequality”. Women and people of color are both said, for biological and/or cultural reasons, to lack certain qualities for success in today’s world.
Feminism as a social movement began in the United States during the abolitionist period before the Civil War. Elizabeth Cady Stanton (left) and Lucretia Mott (right) were outspoken abolitionists who made connections between slavery and the oppression of women.
Two feminist movements in US history have greatly advanced the cause of women’s equality and changed views about gender. The first began during the abolitionist period, when abolitionists such as Susan B. Anthony, Lucretia Mott, and Elizabeth Cady Stanton began to see similarities between slavery and the oppression of women. This new women’s movement focused on many issues but especially the right to vote, which women won in 1920. The second major feminist movement began in the late 1960s, as women active in the Southern civil rights movement turned their attention to women’s rights, and it is still active today. This movement has profoundly changed public thinking and social and economic institutions, but, as we will soon see, much gender inequality remains.
Several varieties of feminism exist. Although they all share the basic idea that women and men should be equal in their opportunities in all spheres of life, they differ in other ways (Hannam, 2012). Liberal feminism believes that the equality of women can be achieved within our existing society by passing laws and reforming social, economic, and political institutions. In contrast, socialist feminism blames capitalism for women’s inequality and says that true gender equality can result only if fundamental changes in social institutions, and even a socialist revolution, are achieved. Radical feminism, on the other hand, says that patriarchy (male domination) lies at the root of women’s oppression and that women are oppressed even in noncapitalist societies. Patriarchy itself must be abolished, they say, if women are to become equal to men. Finally, multicultural feminism emphasizes that women of color are oppressed not only because of their gender but also because of their race and class. They thus face a triple burden that goes beyond their gender. By focusing their attention on women of color in the United States and other nations, multicultural feminists remind us that the lives of these women differ in many ways from those of the middle-class women who historically have led US feminist movements.
The Growth of Feminism and the Decline of Sexism
What evidence is there for the impact of the contemporary women’s movement on public thinking? The GSS, the Gallup poll, and other national surveys show that the public has moved away from traditional views of gender toward more modern ones. Another way of saying this is that the public has moved from sexism toward feminism.
To illustrate this, let’s return to the GSS statement that it is much better for the man to achieve outside the home and for the woman to take care of home and family. Figure 4.2 “Change in Acceptance of Traditional Gender Roles in the Family, 1977–2010” shows that agreement with this statement dropped sharply during the 1970s and 1980s before leveling off afterward to slightly more than one-third of the public.
Figure 4.2 Change in Acceptance of Traditional Gender Roles in the Family, 1977–2010
Percentage agreeing that “it is much better for everyone involved if the man is the achiever outside the home and the woman takes care of the home and family.”
Another GSS question over the years has asked whether respondents would be willing to vote for a qualified woman for president of the United States. As Figure 4.3 “Change in Willingness to Vote for a Qualified Woman for President” illustrates, this percentage rose from 74 percent in the early 1970s to a high of 96.2 percent in 2010. Although we have not yet had a woman president, despite Hillary Rodham Clinton’s historic presidential primary campaign in 2007 and 2008 and Sarah Palin’s presence on the Republican ticket in 2008, the survey evidence indicates the public is willing to vote for one. As demonstrated by the responses to the survey questions on women’s home roles and on a woman president, traditional gender views have indeed declined.
Figure 4.3 Change in Willingness to Vote for a Qualified Woman for President
Key Takeaways
• Feminism refers to the belief that women and men should have equal opportunities in economic, political, and social life, while sexism refers to a belief in traditional gender role stereotypes and in the inherent inequality between men and women.
• Sexist beliefs have declined in the United States since the early 1970s.
For Your Review
1. Do you consider yourself a feminist? Why or why not?
2. Think about one of your parents or of another adult much older than you. Does this person hold more traditional views about gender than you do? Explain your answer.
Attribution
Adapted from Chapter 4.2, Social Problems by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.
9.4 Reducing Gender Inequality
Learning Objectives
1. Describe any three policies or programs that should help reduce gender inequality.
2. Discuss possible ways of reducing rape and sexual assault.
Gender inequality is found in varying degrees in most societies around the world, and the United States is no exception. Just as racial/ethnic stereotyping and prejudice underlie racial/ethnic inequality (see Chapter 3 “Racial and Ethnic Inequality”), so do stereotypes and false beliefs underlie gender inequality. Although these stereotypes and beliefs have weakened considerably since the 1970s thanks in large part to the contemporary women’s movement, they obviously persist and hamper efforts to achieve full gender equality.
A sociological perspective reminds us that gender inequality stems from a complex mixture of cultural and structural factors that must be addressed if gender inequality is to be reduced further than it already has been since the 1970s. Despite changes during this period, children are still socialized from birth into traditional notions of femininity and masculinity, and gender-based stereotyping incorporating these notions still continues. Although people should certainly be free to pursue whatever family and career responsibilities they desire, socialization and stereotyping still combine to limit the ability of girls and boys and women and men alike to imagine less traditional possibilities. Meanwhile, structural obstacles in the workplace and elsewhere continue to keep women in a subordinate social and economic status relative to men.
To reduce gender inequality, then, a sociological perspective suggests various policies and measures to address the cultural and structural factors that help produce gender inequality. These steps might include, but are not limited to, the following:
1. Reduce socialization by parents and other adults of girls and boys into traditional gender roles.
2. Confront gender stereotyping by the popular and news media.
3. Increase public consciousness of the reasons for, extent of, and consequences of rape and sexual assault, sexual harassment, and pornography.
4. Increase enforcement of existing laws against gender-based employment discrimination and against sexual harassment.
5. Increase funding of rape-crisis centers and other services for girls and women who have been raped and/or sexually assaulted.
6. Increase government funding of high-quality day-care options to enable parents, and especially mothers, to work outside the home if they so desire, and to do so without fear that their finances or their children’s well-being will be compromised.
7. Increase mentorship and other efforts to boost the number of women in traditionally male occupations and in positions of political leadership.
As we consider how best to reduce gender inequality, the impact of the contemporary women’s movement must be neither forgotten nor underestimated. Since it began in the late 1960s, the women’s movement has generated important advances for women in almost every sphere of life. Brave women (and some men) challenged the status quo by calling attention to gender inequality in the workplace, education, and elsewhere, and they brought rape and sexual assault, sexual harassment, and domestic violence into the national consciousness. For gender inequality to continue to be reduced, it is essential that a strong women’s movement continue to remind us of the sexism that still persists in American society and the rest of the world.
Reducing Rape and Sexual Assault
As we have seen, gender inequality also manifests itself in the form of violence against women. A sociological perspective tells us that cultural myths and economic and gender inequality help lead to rape, and that the rape problem goes far beyond a few psychopathic men who rape women. A sociological perspective thus tells us that our society cannot just stop at doing something about these men. Instead it must make more far-reaching changes by changing people’s beliefs about rape and by making every effort to reduce poverty and to empower women. This last task is especially important, for, as Randall and Haskell (1995, p. 22) observed, a sociological perspective on rape “means calling into question the organization of sexual inequality in our society.”
Aside from this fundamental change, other remedies, such as additional and better funded rape-crisis centers, would help women who experience rape and sexual assault. Yet even here women of color face an additional barrier. Because the antirape movement was begun by white, middle-class feminists, the rape-crisis centers they founded tended to be near where they live, such as college campuses, and not in the areas where women of color live, such as inner cities and Native American reservations. This meant that women of color who experienced sexual violence lacked the kinds of help available to their white, middle-class counterparts (Matthews, 1989), and despite some progress, this is still true today.
Key Takeaways
• Certain government efforts, including increased financial support for child care, should help reduce gender inequality.
• If gender inequality lessens, rape and sexual assault should decrease as well.
For Your Review
1. To reduce gender inequality, do you think efforts should focus more on changing socialization practices or on changing policies in the workplace and schools? Explain your answer.
2. How hopeful are you that rape and sexual assault will decrease significantly in your lifetime?
Attribution
Adapted from Chapter 4.6, Social Problems by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.
9.5 The Benefits and Costs of Being Male
Learning Objectives
1. List some of the benefits of being male.
2. List some of the costs of being male.
Most of the discussion so far has been about women, and with good reason: In a sexist society such as our own, women are the subordinate, unequal sex. But gender means more than female, and a few comments about men are in order.
Benefits
We have already discussed gender differences in occupations and incomes that favor men over women. In a patriarchal society, men have more wealth than women and more influence in the political and economic worlds more generally.
Men profit in other ways as well. In Chapter 3 “Racial and Ethnic Inequality”, we talked about white privilege, or the advantages that whites automatically have in a racist society whether or not they realize they have these advantages. Many scholars also talk about male privilege, or the advantages that males automatically have in a patriarchal society whether or not they realize they have these advantages (McIntosh, 2007).
A few examples illustrate male privilege. Men can usually walk anywhere they want or go into any bar they want without having to worry about being raped or sexually harassed. Susan Griffin was able to write “I have never been free of the fear of rape” because she was a woman; it is no exaggeration to say that few men could write the same thing and mean it. Although some men are sexually harassed, most men can work at any job they want without having to worry about sexual harassment. Men can walk down the street without having strangers make crude remarks about their looks, dress, and sexual behavior. Men can ride the subway system in large cities without having strangers grope them, flash them, or rub their bodies against them. Men can apply for most jobs without worrying about being rejected because of their gender, or, if hired, not being promoted because of their gender. We could go on with many other examples, but the fact remains that in a patriarchal society, men automatically have advantages just because they are men, even if race/ethnicity, social class, and sexual orientation affect the degree to which they are able to enjoy these advantages.
Costs
Yet it is also true that men pay a price for living in a patriarchy. Without trying to claim that men have it as bad as women, scholars are increasingly pointing to the problems men face in a society that promotes male domination and traditional standards of masculinity such as assertiveness, competitiveness, and toughness (Kimmel & Messner, 2010). Socialization into masculinity is thought to underlie many of the emotional problems men experience, which stem from a combination of their emotional inexpressiveness and reluctance to admit to, and seek help for, various personal problems (Wong & Rochlen, 2005). Sometimes these emotional problems build up and explode, as mass shootings by males at schools and elsewhere indicate, or express themselves in other ways. Compared to girls, for example, boys are much more likely to be diagnosed with emotional disorders, learning disabilities, and attention deficit disorder, and they are also more likely to commit suicide and to drop out of high school.
Men experience other problems that put themselves at a disadvantage compared to women. They commit much more violence than women do and, apart from rape and sexual assault, also suffer a much higher rate of violent victimization. They die earlier than women and are injured more often. Because men are less involved than women in child rearing, they also miss out on the joy of parenting that women are much more likely to experience.
Growing recognition of the problems males experience because of their socialization into masculinity has led to increased concern over what is happening to American boys. Citing the strong linkage between masculinity and violence, some writers urge parents to raise their sons differently in order to help our society reduce its violent behavior (Corbett, 2011). In all these respects, boys and men—and our nation as a whole—are paying a very real price for being male in a patriarchal society.
Key Takeaways
• In a patriarchal society, males automatically have certain advantages, including a general freedom from fear of being raped and sexually assaulted and from experiencing job discrimination on the basis of their gender.
• Men also suffer certain disadvantages from being male, including higher rates of injury, violence, and death and a lower likelihood of experiencing the joy that parenting often brings.
For Your Review
1. What do you think is the most important advantage, privilege, or benefit that men enjoy in the United States? Explain your answer.
2. What do you think is the most significant cost or disadvantage that men experience? Again, explain your answer.
Attribution
Adapted from Chapter 4.5, Social Problems by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.
9.6 Masculinities
Another concept that troubles the gender binary is the idea of multiple masculinities (Connell, 2005). Connell suggests that there is more than one kind of masculinity and what is considered “masculine” differs by race, class, ethnicity, sexuality, and gender. For example, being knowledgeable about computers might be understood as masculine because it can help a person accumulate income and wealth, and we consider wealth to be masculine. However, computer knowledge only translates into “masculinity” for certain men. While an Asian-American, middle-class man might get a boost in “masculinity points” (as it were) for his high-paying job with computers, the same might not be true for a working-class white man whose white-collar desk job may be seen as a weakness to his masculinity by other working-class men. Expectations for masculinity differ by age; what it means to be a man at 19 is very different than what it means to be a man at 70. Therefore, masculinity intersects with other identities and expectations change accordingly.
Judith (Jack) Halberstam used the concept of female masculinity to describe the ways female-assigned people may accomplish masculinity (2005). Halberstam defines masculinity as the connection between maleness and power, which female-assigned people access through drag-king performances, butch identity (where female-assigned people appear and act masculine and may or may not identify as women), or trans identity. Separating masculinity from male-assigned bodies illustrates how performative it is, such that masculinity is accomplished in interactions and not ordained by nature.
Attribution
Adapted from Unit II, Introduction to Women, Gender, Sexuality Studies by Miliann Kang, Donovan Lessard, Laura Heston, Sonny Nordmarken is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/02%3A_Alternative_Perspectives_on_Individuals/09%3A_People_of_Color_White_Identity_and_Women.txt |
Learning Objectives
10.1 Aging Social Problems in the News
“Still Working: Economy Forcing Retirees to Re-enter Workforce,” the headline said. The story featured four seniors, ranging in age from 66 to their eighties, in southern California who had retired several years ago but was now trying to get back into the labor force. Because of the faltering economy and rising costs, they were having trouble affording their retirement. They were also having trouble finding a job, in part because they lacked the computer skills that are virtually a necessity in today’s world to find and perform a job. One of the unemployed seniors was a retired warehouse worker who did not know how to fill out a job application online. He said, “To say I have computer skills—no, I don’t. But I can learn. I will do anything to get work.” An official in California’s Office on Aging indicated that employers who hire older people would be happy they did so: “You know the person’s going to come in and you know they’re going to accomplish something while they’re there. And, they are a wellspring of knowledge.” Source: Barkas, 2011
The number of older Americans is growing rapidly. As this news story suggests, they have much to contribute to our society. Yet they also encounter various problems because of their advanced age. We appreciate our elderly but also consider them something of a burden. We also hold unfortunate stereotypes of them and seemingly view old age as something to be shunned. Television commercials and other advertisements extol the virtues of staying young by “washing away the gray” and by removing all facial wrinkles. In our youth-obsessed culture, older people seem to be second-class citizens. This chapter discusses views about aging and the ways in which old age is a source of inequality.
Barkas, S. (2011, September 5). Still working: Economy forcing retirees to re-enter the workforce. The Desert Sun. Retrieved from http://www.mydesert.com.
Our numeric ranking of age is associated with particular cultural traits. Even the social categories we assign to age express cultural characteristics of that age group or cohort. Age signifies one’s cultural identity and social status (Kottak and Kozaitis 2012). Many of the most common labels we use in society signify age categories and attributes. For example, the terms “newborns and infants “generally refer to children from birth to age four, whereas “school-age children” signifies youngsters old enough to attend primary school. Each age range has social and cultural expectations placed upon by others (Kottak and Kozaitis 2012). We have limited social expectations of newborns, but we expect infants to develop some language skills and behaviors like “potty training” or the practice of controlling bowel movements. Even though cultural expectations by age vary across other social categories (e.g., gender, geography, ethnicity, etc.), there are universal stages and understanding of intellectual, personal, and social development associated with each age range or cohort. Throughout a person’s life course, they will experience and transition across different cultural phases and stages. Life-course is the period from one’s birth to death (Griffiths et al. 2015).
Each stage in the life course aligns with age-appropriate values, beliefs, norms, expressive language, practices, and artifacts. Like other social categories, age can be a basis of social ranking (Kottak and Kozaitis 2012). Society finds it perfectly acceptable for a baby or infant to wear a diaper but considers it a taboo or fetish among an adult 30 years old. However, diaper-wearing becomes socially acceptable again as people age into senior years of life when biological functions become harder to control. This is also an illustration of how people will experience more than one age-based status during their lifetime. Aging is a human universal (Kottak and Kozaitis 2012). Maneuvering life’s course is sometimes challenging. Cultural socialization occurs throughout the life course. Learning the cultural traits and characteristics needed at certain stages of life is important for developing self-identity and group acceptance. People engage in anticipatory socialization to prepare for future life roles or expectations (Griffiths et al. 2015). By engaging in social interactions with other people, we learn the cultural traits, characteristics, and expectations in preparation for the next phase or stage of life. Thinking back to “potty training” infants, parents and caregivers teach young children to control bowel movements so they are able to urinate and defecate in socially appropriate settings (i.e., restroom or outhouse) and times. Generations have a collective identity or shared experiences based on the time-period the group lived. Consider the popular culture of the 1980s to today. In the 1980s, people used a landline or fixed-line phone rather than a cellular phone to communicate and went to a movie theater to
see a film rather than downloaded a video to a mobile device. Therefore, someone who spent his or her youth and most of their adulthood without or with limited technology may not deem it necessary to have or operate it in daily life. Whereas, someone born in the 1990s or later will only know life with technology and find it a necessary part of human existence.
Each generation develops a perspective and cultural identity from the time and events surrounding their life. Generations experience life differently resulting from cultural and social shifts over time. The difference in life
experience alters perspectives towards values, beliefs, norms, expressive symbols, practices, and artifacts. Political and social events often mark an era and influenced generations. The ideology of white supremacy reinforced by events of Nazi Germany and World War II during the 1930s and 1940s instilled racist beliefs in society. Many adults living at this time believed the essays of Arthur Gobineau (1853-1855) regarding the existence of biological differences between racial groups (Biddis 1970). It was not until the 1960s and 1970s when philosophers and critical theorists studied the underlying structures in cultural products and used analytical concepts from linguistics, anthropology, psychology, and sociology to interpret race discovering no biological or phenological variances between human groups and finding race is a social construct (Black and Solomos 2000). Scientists found cultural likeness did not equate to biological likeness. Nonetheless, many adults living in the 1930s and 1940s held racial beliefs of white supremacy throughout their lives because of the ideologies spread and shared during their lifetime. Whereas, modern science verifies the DNA of all people living today is 99.9% alike and a new generation of people are learning that there is only one human race despite the physical variations in size, shape, skin tone, and eye color (Smithsonian 2018). Because there are diverse cultural expectations based on age, there can be a conflict between age cohorts and generations. Age stratification theorists suggest that members of society are classified and have a social status associated with their age (Riley, Johnson, and Foner 1972). Conflict often develops from age-associated cultural differences influencing the social and economic power of age groups. For example, the economic power of working adults conflicts with the political and voting power of the retired or elderly. Age and generational conflicts are also highly influenced by government or state-sponsored milestones. In the United States, there are several age-related markers including the legal age of driving (16 years old), use of tobacco products (21 years old), consumption of alcohol ( 21 years old), and age of retirement (65-70 years old). Regardless of knowledge, skill, or condition, people must abide by formal rules with the expectations assigned to each age group within the law. Because age serves as a basis of social control and reinforced by the state, different age groups have varying access to political and economic power and resources (Griffiths et al. 2015). For example, the United States is the only industrialized nation that does not respect the abilities of the elderly by assigning a marker of 65-70 years old as the indicator for someone to become a dependent of the state and an economically unproductive member of society.
Because we all want to live in old age, the study of age and aging helps us understand something about ourselves and a stage in the life course we all hope to reach.
Here is why you should want to know about aging and the problems older people face: You will be old someday. At least you will be old if you do not die prematurely from an accident, cancer, a heart attack, some other medical problem, murder, or suicide. Although we do not often think about aging when we are in our late teens and early twenties, one of our major goals in life is to become old. By studying age and aging and becoming familiar with some of the problems facing the elderly now and in the future, we are really studying something about ourselves and a stage in the life course we all hope to reach.
The study of aging is so important and popular that it has its own name, gerontology. Social gerontology is the study of the social aspects of aging (Novak, 2012). The scholars who study aging are called gerontologists. The people they study go by several names, most commonly “older people,” “elders,” and “the elderly.” The latter term is usually reserved for those 65 or older, while “older people” and “elders” often include people in their fifties as well as those 60 or older.
Age and aging have four dimensions. The dimension most of us think of is chronological age, defined as the number of years since someone was born. A second dimension is biological aging, which refers to the physical changes that “slow us down” as we get into our middle and older years. For example, our arteries might clog up, or problems with our lungs might make it more difficult for us to breathe. A third dimension, psychological aging, refers to the psychological changes, including those involving mental functioning and personality, that occur as we age. Gerontologists emphasize that chronological age is not always the same thing as biological or psychological age. Some people who are 65, for example, can look and act much younger than some who are 50.
The fourth dimension of aging is social. Social aging refers to changes in a person’s roles and relationships, both within their networks of relatives and friends and informal organizations such as the workplace and houses of worship. Although social aging can differ from one individual to another, it is also profoundly influenced by the perception of aging that is part of a society’s culture. If society views aging positively, the social aging experienced by individuals in that society will be more positive and enjoyable than in a society that views aging negatively. As we shall see, though, the perception of aging in the United States is not very positive, with important consequences for our older citizens.
Key Takeaways
• The study of the elderly and aging helps us understand problems in a state of the life course we all hope to reach.
• Biological aging refers to the physical changes that accompany the aging process, while psychological aging refers to the psychological changes that occur.
• Social aging refers to the changes in a person’s roles and relationships as the person ages.
Novak, M. (2012). Issues in aging (3rd ed.). Upper Saddle River, NJ: Pearson.
Recall that social aging refers to changes in people’s roles and relationships in society as they age. Social gerontologists have tried to explain how and why the aging process in the United States and other societies occurs. Their various explanations, summarized in Table 6.1 “Theory Snapshot”, help us understand patterns of social aging. They fall roughly into either the functionalist, social interactionist or conflict approaches discussed in Chapter 1 “Understanding Social Problems”.
Table 6.1 Theory Snapshot
Theoretical perspective Major assumptions
Disengagement theory To enable younger people to assume important roles, a society must encourage its older people to disengage from their previous roles and to take on roles more appropriate to their physical and mental decline. This theory is considered a functionalist explanation of the aging process.
Activity theory Older people benefit themselves and their society if they continue to be active. Their positive perceptions of the aging process are crucial to their ability to remain active. This theory is considered an interactionist explanation of the aging process.
Conflict theory Older people experience age-based prejudice and discrimination. Inequalities among the aged exist along the lines of gender, race/ethnicity, and social class. This theory falls into the more general conflict theory of society.
One of the first explanations was called disengagement theory (Cumming & Henry, 1961). This approach assumed that all societies must find ways for older people’s authority to give way to younger people. A society thus encourages its elderly to disengage from their previous roles and to take on roles more appropriate to their physical and mental decline. In this way, a society affects a smooth transition of its elderly into a new, more sedentary lifestyle and ensures that their previous roles will be undertaken by a younger generation that is presumably more able to carry out these roles. Because disengagement theory assumes that social aging preserves a society’s stability and that a society needs to ensure that disengagement occurs, it is often considered a functionalist explanation of the aging process.
A critical problem with this theory was that it assumes that older people are no longer capable of adequately performing their previous roles. However, older people in many societies continue to perform their previous roles quite well. In fact, society may suffer if its elderly do disengage, as it loses their insight and wisdom. It is also true that many elders cannot afford to disengage from their previous roles; if they leave their jobs, they are also leaving needed sources of income, as the opening news story discussed, and if they leave their jobs and other roles, they also reduce their social interaction and the benefits it brings.
Today most social gerontologists prefer activity theory, which assumes that older people benefit both themselves and their society if they remain active and try to continue to perform the roles they had before they aged (Choi & Kim, 2011). As they perform their roles, their perception of the situations they are in is crucial to their perception of their aging and thus to their self-esteem and other aspects of their psychological well-being. Because activity theory focuses on the individual and her or his perception of the aging process, it is often considered a social interactionist explanation of social aging.
One criticism of activity theory is that it overestimates the ability of the elderly to maintain their level of activity: Although some elders can remain active, others cannot. Another criticism is that activity theory is too much of an individualistic approach, as it overlooks the barriers many societies place to successful aging. Some elders are less able to remain active because of their poverty, gender, and social class, as these and other structural conditions may adversely affect their physical and mental health. The activity theory overlooks these conditions.
Explanations of aging grounded in conflict theory put these conditions at the forefront of their analyses. A conflict theory of aging, then, emphasizes the impact of ageism, or negative views about old age and prejudice and discrimination against the elderly (Novak, 2012). According to this view, older workers are devalued because they are no longer economically productive and because their higher salaries (because of their job seniority), health benefits, and other costs drive down capitalist profits. Conflict theory also emphasizes inequality among the aged along with gender, race/ethnicity, and social class lines. Reflecting on these inequalities in the larger society, some elders are quite wealthy, but others are very poor.
One criticism of conflict theory is that it blames ageism on modern, capitalist economies. However, negative views of the elderly also exist to some extent in modern, socialist societies and in preindustrial societies. Capitalism may make these views more negative, but such views can exist even in societies that are not capitalistic.
Key Takeaways
• Disengagement theory assumes that all societies must find ways for older people’s authority to give way to younger people. A society thus encourages its elderly to disengage from their previous roles and to take on roles more appropriate to their physical and mental decline.
• Activity theory assumes that older people will benefit both themselves and their society if they remain active and try to continue to perform the roles they had before they aged.
Choi, N. G., & Kim, J. (2011). The effect of time volunteering and charitable donations in later life on psychological wellbeing. Ageing & Society, 31(4), 590–610.
Cumming, E., & Henry, W. E. (1961). Growing old: The process of disengagement. New York, NY: Basic Books.
Novak, M. (2012). Issues in aging (3rd ed.). Upper Saddle River, NJ: Pearson.
10.5 Life Expectancy & the Graying of Society
When we look historically and cross-culturally, we see that old age is a relative term since few people in preindustrial times or in poor countries today reach the age range that most Americans would consider to be old, say 65 or older. When we compare contemporary societies, we find that life expectancy, or the average age to which people can be expected to live, varies dramatically across the world.
What accounts for these large disparities? The major factor is the wealth or poverty of a nation, as the wealthiest nations have much longer life expectancies than the poorest ones. They suffer from hunger, AIDS, and other diseases, and they lack indoor plumbing and other modern conveniences found in almost every home in the wealthiest nations. As a result, they have high rates of infant and childhood mortality, and many people who make it past childhood die prematurely from disease, starvation, and other problems.
These differences mean that few people in these societies reach the age of 65 that Western nations commonly mark as the beginning of old age. Not surprisingly, the nations of Africa have very low numbers of people 65 or older. In Uganda, for example, only 3 percent of the population is at least 65, compared to 13 percent of Americans and 20–21 percent of Germans and Italians.
Despite these international disparities, life expectancy overall has been increasing around the world. It was only 46 years worldwide in the early 1950s but was 69 in 2009 and is expected to reach about 75 by 2050 (Population Reference Bureau, 2011). This means that the number of people 65 or older is growing rapidly; they are expected to reach almost 1.5 billion worldwide by 2050, three times their number today and five times their number just twenty years ago (United Nations Population Division, 2011). Despite international differences in life expectancy and the elderly percentage of the population, the world as a whole is decidedly “graying,” with important implications for the cost and quality of eldercare and other issues.
Older people now constitute 15 percent of the combined population of wealthy nations, but they will account for 26 percent by 2050.
As life expectancy rises in poor nations, these nations will experience special problems (Hayutin, 2007). One problem will involve paying for the increased health care that older people in these nations will require. Because these nations are so poor, they will face even greater problems than the industrial world in paying for such care and for other programs and services their older citizens will need. Another problem stems from the fact that many poor nations are beginning or continuing to industrialize and urbanize. As they do so, traditional family patterns, including respect for the elderly and the continuation of their roles and influence, may weaken. One reason for this is that urban families have smaller dwelling units in which to accommodate their elderly relatives and lack any land on which they can build new housing. Families in poor nations will thus find it increasingly difficult to accommodate their elders.
Life expectancy has been increasing in the United States along with the rest of the world. It rose rapidly in the first half of the twentieth century and has increased steadily since then. From a low of 47.3 years in 1900, it rose to about 71 years in 1970 and 77 years in 2000 and to more than 78 years in 2010. Americans born in 2010 will thus be expected to live about 31 years longer than those born a century earlier.
During the next few decades, the numbers of the elderly will increase rapidly thanks to the large baby boom generation born after World War II (from 1946 to 1964) that is now entering its mid-sixties. Elders numbered about 3.1 million in 1900 (4.1 percent of the population), number about 40 million today, and are expected to reach 89 million by 2050 (20.2 percent of the population). The large increase in older Americans overall has been called the graying of America and will have important repercussions for elderly care and other aspects of old age in the United States, as we discuss later.
We have seen that inequality in life expectancy exists around the world, with life expectancy lower in poor nations than in wealthy nations. Inequality in life expectancy also exists within a given society along with gender, race/ethnicity, and social class lines.
For gender, inequality is in favor of women, who for both biological and social reasons outlive men across the globe. In the United States, for example, girls born in 2007 could expect to live 80.4 years on average, but boys only 75.4 years.
In most countries, race and ethnicity combine with the social class to produce longer life expectancies for the (wealthier) dominant race, which in the Western world is almost always white. The United States again reflects this international phenomenon: Whites born in 2007 could expect to live 78.4 years on the average, but African Americans only 73.6 years. In fact, gender and race combine in the United States to put African American males at a particular disadvantage, as they can expect to live only 70.0 years. The average African American male will die almost 11 years earlier than the average white woman.
Key Takeaways
• Life expectancy differs widely around the world and is much higher in wealthy nations than in poor nations.
• Life expectancy has also been increasing around the world, including in the United States, and the increasing number of older people in the decades ahead will pose several serious challenges.
• Inequality in life expectancy exists within a given society along gender, race/ethnicity, and social class lines.
Hayutin, A. M. (2007). Graying of the global population. Public Policy & Aging Report, 17(4), 12–17.
Population Reference Bureau. (2011). 2011 world population datasheet. Washington, DC: Author.
United Nations Population Division. (2011). World population prospects: The 2010 revision. New York, NY: Author.
Like many other societies, the United States has a mixed view of aging and older people. While we generally appreciate our elderly, we have a culture oriented toward youth, as evidenced by the abundance of television characters in their twenties and lack of those in their older years. As individuals, we do our best not to look old, as the many ads for wrinkle creams and products to darken gray hair attest. Moreover, when we think of the elderly, negative images often come to mind. We often think of someone who has been slowed by age both physically and mentally. She or he may have trouble walking up steps, picking up heavy grocery bags, standing up straight, or remembering recent events. The term senile often comes to mind, and phrases like “doddering old fool,” “geezer,” and other disparaging remarks sprinkle our language when we talk about them. Meanwhile, despite some improvement, the elderly are often portrayed in stereotypical ways on television and in movies (Lee, Carpenter, & Meyers, 2007).
How true is this negative image? What do we know of physical and psychological changes among the elderly? How much of what we think we know about aging and the elderly is a myth, and how much is reality? Gerontologists have paid special attention to answering these questions (Novak, 2012).
Biological changes certainly occur as we age. The first signs are probably in our appearance. Our hair begins to turn gray, our (male) hairlines recede, and a few wrinkles set in. The internal changes that often accompany aging are more consequential, among them being that (a) fat replaces lean body mass, and many people gain weight; (b) bone and muscle loss occur; (c) lungs lose their ability to take in air, and our respiratory efficiency declines; (d) the functions of the cardiovascular and renal (kidney) systems decline; (e) the number of brain cells declines, as does brain mass overall; and (f) vision and hearing decline. Cognitive and psychological changes also occur. Learning and memory begin declining after people reach their seventies; depression and other mental and/or emotional disorders can set in; and dementia, including Alzheimer’s disease, can occur. Because our society values youthfulness, many people try to do their best not to look old.
All these conditions yield statistics such as follows: about half of people 65 or older have arthritis or high blood pressure; almost one-fifth have coronary heart disease; more than one-fifth have diabetes; and about 60 percent of women in their seventies have osteoporosis (Centers for Disease Control and Prevention & The Merck Company Foundation, 2007; Crawthorne, 2008).
Still, the nature and extent of all these changes vary widely among older people. Some individuals are frail at 65, while others remain vigorous well into their seventies and beyond. People can be “old” at 60 or even 50, while others can be “young” at 80. Many elders are no longer able to work, but others remain in the labor force. All in all, then, most older people do not fit the doddering image myth and can still live a satisfying and productive life (Rowe et al., 2010).
To what extent are the effects of biological and psychological aging the inevitable results of chronological aging? Gerontologists are still trying to understand what causes these effects, and their explanations center on such things as a declining immune system, the slowing of cellular replication, and other processes that need not concern us here.
One thing is clear: We can all take several steps to help us age better because what we do as we enter our older years matters much more than genetics (Centers for Disease Control and Prevention & The Merck Company Foundation, 2007; Crawthorne, 2008). To the extent this is true, the effects of biological and psychological aging are not necessarily inevitable, and “successful aging” is possible. The steps highlighted in the gerontological literature are by now almost a cliché, but regular exercise, good nutrition, and stress reduction stand at the top of most gerontologists’ recommendations for continued vitality in later life. In fact, Americans live about ten years less than an average set of genes should let them live because they do not exercise enough and because they eat inadequate diets.
Research by social gerontologists suggests at least two additional steps older people can take if they want “successful aging.” The first is involved in informal, personal networks of friends, neighbors, and relatives. The importance of such networks is one of the most thoroughly documented in social gerontological literature (Binstock & George, 2006). Networks enhance successful aging for at least two reasons. First, they provide practical support, such as help buying groceries and visiting the doctor, to the elderly who need it. Second, they help older people maintain their self-esteem, meet their desire for friendships, and satisfy other emotional needs.
An increasing number of grandparents are raising their grandchildren. Almost 6 million children, or about 8 percent of all children, live in a household headed by a grandparent, up from 4.5 million in 2000. Grandparents are the sole caregiver for almost 3 million of these children because the child’s parents are absent for several reasons: The parents may have died, they may be in jail or prison or have been unable to deal with substance abuse, a child may have been removed from a parent because of parental abuse, or a child may have been abandoned.
In the remaining households where a parent is present, grandparents (usually the grandmother) are still the primary caregivers or at least play a major role in raising the child; the same is true of many grandparents who live near their grown child’s home. In today’s faltering economy, many grandparents are also helping their children out with the expenses of raising their grandchild and running a home. As a family expert with AARP explained, “Grandparents have become the family safety net, and I don’t see that changing any time soon. While they will continue to enjoy their traditional roles, including spending on gifts for grandchildren, I see them increasingly paying for the extras that parents are struggling to keep up with—sports, camps, tutoring or other educational needs, such as music lessons.”
Estella Hyde, 65, and her husband live near Erie, Pennsylvania. They began raising their granddaughter, who started college in fall 2011 when she was one-year-old after her mother said she did not want to raise her. Ms. Hyde called for more government assistance for people in her situation: “It never happens in a happy situation where a son or daughter comes and says, ‘I need you to raise a child for me.’ We were very lucky, we were able to financially take care of her and support her. But many grandparent caregivers need other sources of assistance.”
Many grandparents consider the caregiving and financial support they provide for a grandchild to be both a joy and a privilege. But as their numbers grow, many such grandparents are also finding their involvement to also be somewhat of a physical and/or financial burden. As their numbers continue to grow, it will be important for the federal and state governments to provide them the assistance that Estella Hyde advocated.
A second step for successful aging suggested by scholarly research is religious involvement (Moberg, 2008), which enhances psychological well-being for at least two reasons. As people worship in a congregation, they interact with other congregants and, as just noted, enhance their social support networks. Moreover, as they practice their religious faith, they reduce their stress and can cope better with personal troubles. For both these reasons, attendance at religious services and the practice of prayer are thought to enhance psychological well-being among older people. Some elders cannot attend religious services regularly because they have health problems or are no longer able to drive a car. But prayer and other private devotional activities remain significant for many of them. To the extent that religion makes a difference for elders’ well-being, health-care facilities and congregations should do what they can to enable older adults to attend religious services and to otherwise practice their religious faith.
As the text discusses, social networks improve the lives of older Americans by providing both practical and emotional support. Early research on social networks and aging focused more on relatives than on friends. Rebecca G. Adams, former president of the Southern Sociological Society, was one of the first sociologists to emphasize the role that friends can also play in the lives of the elderly. She interviewed seventy older women who lived in a Chicago suburb and asked them many questions about the extent and quality of their friendships.
In one of her most important findings, Adams discovered that the women reported receiving more help from friends than other researchers had assumed was the case. The women were somewhat reluctant to ask friends for help but did so when family members were not available and when they would not overly inconvenience the friends whom they asked for help. Adams also found that “secondary” friendships—those involving friends that a woman spent time with but with whom she was not especially close—were more likely than “primary” friendships (very close friendships) to contribute to her interviewees’ psychological well-being, as these friendships enabled the women to meet new people, to become involved in new activities, and thus to be engaged with the larger society. This finding led Adams to conclude that one should not underestimate how important friends are to older people, particularly to the elderly without family. Friends are an important source of companionship and possibly a more important source of service support than most of the current literature suggests.
Adams also asked the women about their friendships with men. The seventy women she interviewed reported 670 friendships, of which only 3.6 percent were with men. (About 91 percent were with other women, and 6 percent were with couples.) Although prior research had assumed that the number of these friendships is small because there are so few unmarried elderly men compared to the number of unmarried elderly women, Adams discovered from her interviews some additional reasons. Her respondents interpreted any friendship with a man as a courting or romantic friendship, which they thought would be viewed negatively by their children and by their peers. Adopting a traditional gender-role orientation, they also expected any man they might marry to be able to protect them physically and financially. Yet they also realized that any elderly man they might know would be very likely unable to do so. For all these reasons, they shied away from friendships with men.
Work by Adams and other social scientists on the friendships and other aspects of the social support systems for older Americans has contributed greatly to our understanding of the components of successful aging. Practically speaking, it points to the need for programs and other activities to make it easier for the elderly to develop and maintain friendships with both sexes to improve their ability to meet both their practical and emotional needs.
Key Takeaways
• Certain biological, cognitive, and psychological changes occur as people age. These changes reinforce the negative view of the elderly, but this view nonetheless reflects stereotypes and myths about aging and the elderly.
• Regular exercise, good nutrition, stress reduction, involvement in personal networks, and religious involvement all enhance successful aging.
Adams, R. G. (1985). People would talk: Normative barriers to cross-sex friendships for elderly women. The Gerontologist, 25, 605–611.
Adams, R. G. (1986). Secondary friendship networks and psychological well-being among elderly women. Activities, Adaptation, and Aging, 8, 59–72.
Binstock, R. H., & George, L. K. (Eds.). (2006). Handbook of aging and the social sciences (6th ed.). Boston: Academic Press.
Centers for Disease Control and Prevention & The Merck Company Foundation. (2007). The state of aging and health in America 2007. Whitehouse Station, NJ: Merck Company Foundation.
Crawthorne, A. (2008). Elderly poverty: The challenge before us. Washington, DC: Center for American Progress.
Lee, M. M., Carpenter, B., & Meyers, L. S. (2007). Representations of older adults in television advertisements. Journal of Aging Studies, 21(1), 23–30.
Moberg, D. O. (2008). Spirituality and aging: Research and implications. Journal of Religion, Spirituality & Aging, 20, 95–134.
Novak, M. (2012). Issues in aging (3rd ed.). Upper Saddle River, NJ: Pearson.
Roscow, I. (1967). Social integration of the aged. New York, NY: Free Press.
Rowe, J. W., Berkman, L. F., Binstock, R., Boersch-Supan, A., Cacioppo, J., Carsternsen, L., et al. (2010). Policies and politics for an aging America. Contexts, 9(1), 22–27.
Whitley, D. M., & Kelley, S. J. (2007). Grandparents raising grandchildren: A call to action. Washington, DC: Administration for Children and Families.
Yen, H. (2011, August 25). Grandparents play a bigger role in child-rearing. Associated Press. Retrieved from http://www.huffingtonpost.com/2011/08/26/grandparents-play-a-bigge_n_937945.html.
We now turn our attention to older people in the United States. We first sketch a demographic profile of our elderly and then examine some of the problems they face because of their age and because of ageism.
Slightly more than half the elderly are 65–74 years of age and about 57 percent are female, reflecting males’ shorter life spans as discussed earlier. About 80 percent of the elderly are non-Latino whites, compared to about 66 percent in the population as a whole; 8.6 percent are African American, compared to about 13 percent of the population; and 7.0 percent are Latino, compared to 15 percent of the population. The greater proportion of whites among the elderly and lower proportions of African Americans and Latinos reflects these groups’ life expectancy differences discussed earlier and also their differences in birth rates.
Table 6.2 Demographic Composition of the Elderly, 2010
Age
65–74 years 52.3%
75–84 years 33.4%
85 years and over 14.3%
Gender
Female 56.9%
Male 43.1%
Race and/or ethnicity*
White, non-Latino 80.1%
African American 8.6%
Latino 7.0%
Asian/Pacific Islander 3.5%
Amer. Ind., Esk., Aleut. 0.6%
Two or more races 0.7%
Living in poverty 9.0%
Marital status
Married 57.6%
Widowed 28.1%
Divorced 10.0%
Never married 4.3%
Years of school completed
0–8 years 10.2%
1–3 years of high school 10.3%
High school graduate 36.4%
1–3 years of college 20.6%
College graduate 22.5%
Labor force participation
Employed 16.2%
Unemployed 1.2%
Not in labor force 82.6%
Household income*
Under \$15,000 18.8%
\$15,000–\$24,999 20.7%
\$25,000–\$34,999 15.4%
\$35,000–49,999 15.1%
\$50,000–\$74,999 14.2%
\$75,000–\$99,999 6.5%
\$100,000 and over 9.4%
* 2009 data
Source: Data from the US Census Bureau. (2012). Statistical abstract of the United States: 2012. Washington, DC: US Government Printing Office. Retrieved from www.census.gov/compendia/statab.
The lower proportions of African Americans and Latinos among the elderly partly reflect these groups’ lower life expectancies.
The percentage of elders living in poverty is 9.0, compared to 15.1 percent of the entire population. Although most elders have fixed incomes, the fact that their family size is usually one or two means that they are less likely than younger people to live in poverty. In fact, today’s elderly are financially much better off than their grandparents were, thanks to Social Security, Medicare (the federal health insurance program for older Americans), pensions, and their own assets. We will revisit the health and financial security of elders a little later.
Turning to education, about 22 percent of the elderly are college graduates, compared to about 29 percent of the population as a whole. This difference reflects the fact that few people went to college when today’s elderly were in their late teens and early twenties. However, it is still true that today’s elders are better educated than any previous generation of elders. Future generations of the elderly will be even better educated than those now.
While most elders are retired and no longer in the labor force, about 16 percent do continue to work (see Table 6.2 “Demographic Composition of the Elderly, 2010”). These seniors tend to be in good health and to find their jobs psychologically satisfying. Compared to younger workers, they miss fewer days of work for health or other reasons and are less likely to quit their jobs for other opportunities (Sears, 2009).
Although we emphasized earlier that many older Americans do not fit the negative image with which they are portrayed, it is still true that they face special problems because of their age and life circumstances and because of ageism. We discuss some of these here.
Perhaps the problem that comes most readily to mind is health, or, to be more precise, poor health. It is true that many older people remain in good health and are fully able to function mentally and physically (Rowe et al., 2010). Still, the biological and psychological effects of aging do lead to greater physical and mental health problems among the elderly than in younger age groups, as we briefly discussed earlier. These problems are reflected in responses to the General Social Survey (GSS) question, “Would you say your own health, in general, is excellent, good, fair, or poor?”
The elderly’s perception of their own health is supported by government estimates of chronic health conditions for older Americans. Of all people aged 65 or older not living in a nursing home or other institution, almost 50 percent have arthritis, 56 percent have high blood pressure, 32 percent have heart disease, 35 percent have hearing loss, 18 percent have vision problems, and 19 percent have diabetes (these numbers add up to more than 100 percent as people may have several health conditions) (Federal Interagency Forum on Aging-Related Statistics, 2010). These rates are much higher than those for younger age groups.
The elderly also suffer from dementia, including Alzheimer’s disease, which affects almost 13 percent of people 65 or older (Alzheimer’s Association, 2009). Another mental health problem is depression, which affects almost 15 percent of people 65 or older. Because of mental or physical disability, about two-thirds of all people 65 or older need help with at least one “daily living” activity, such as preparing a meal (Federal Interagency Forum on Aging-Related Statistics, 2010).
Older people visit the doctor and hospital more often than younger people. Partly for this reason, adequate health care for the elderly is of major importance.
If the elderly have more health problems, then adequate care for them is of major importance. They visit the doctor and hospital more often than their middle-aged counterparts. Medicare covers about one-half of their health-care costs; this is a substantial amount of coverage but still forces many seniors to pay thousands of dollars annually themselves. Some physicians and other health-care providers do not accept Medicare “assignment,” meaning that the patient must pay an even higher amount. Moreover, Medicare pays little or nothing for long-term care in nursing homes and other institutions and for mental health services. All these factors mean that older Americans can still face high medical expenses or at least pay high premiums for private health insurance.
In addition, Medicare costs have risen rapidly along with other health-care costs. Medicare expenditures soared from about \$37 billion in 1980 to more than \$500 billion today. As the population continues to age and as health-care costs continue to rise, Medicare expenses will continue to rise as well, making it increasingly difficult to find the money to finance Medicare.
While most older Americans live by themselves or with their families, a small minority live in group settings. A growing type of group setting is the continuous care retirement community, a set of private rooms, apartments, and/or condominiums that offers medical and practical care to those who need it. In some such communities, residents eat their meals together, while in others they cook for themselves. Usually, these communities offer above-average recreational facilities and can be very expensive, as some require a lifetime contract or at least monthly fees that can run into thousands of dollars.
Nursing homes are often understaffed to save costs and are also generally not subject to outside inspection. These conditions help contribute to the neglect of nursing home residents.
For elders who need high-level medical care or practical support, nursing homes are the primary option. About 16,100 nursing homes exist, and 3.9 percent of Americans 65 or older live in them (Federal Interagency Forum on Aging-Related Statistics, 2010). About three-fourths of all nursing home residents are women. Almost all residents receive assistance in bathing and showering, 80 percent receive help in using the bathroom, and one-third receive help in eating.
As noted earlier, Medicare does not pay for long-term institutional care for most older Americans. Because nursing home care costs at least \$70,000 yearly, residents can quickly use up all their assets and then, ironically, become eligible for payments from Medicaid, the federal insurance program for people with low incomes.
If one problem of nursing homes is their expense, another problem is the quality of care they provide. Because their residents are typically in poor physical and/or mental health, their care must be the best possible, as they can do little to help themselves if their care is substandard. As more people enter nursing homes in the years ahead, the quality of nursing home care will become even more important. Yet there is much evidence that nursing home care is often substandard and is replete with neglect and abuse (DeHart, Webb, & Cornman, 2009).
Earlier we noted that the elderly are less likely than younger age groups to live in poverty and that their financial status is much better than that of previous generations of older people. One reason for this is Social Security: If Social Security did not exist, the poverty rate of the elderly would be 45 percent, or five times higher than the actual rate (Kerby, 2012). Without Social Security, then, nearly half of all people 65 or older would be living in official poverty, and this rate would be even much higher for older women and older persons of color. However, this brief summary of their economic well-being obscures some underlying problems (Carr, 2010; Crawthorne, 2008).
First, recall the previous chapter that discussed episodic poverty, which refers to the drifting of many people into and out of poverty as their jobs and other circumstances change. Once they become poor, older people are more likely than younger ones to stay poor, as younger people have more jobs and other opportunities to move out of poverty. Recall also that the official poverty rate obscures the fact that many people live just above it and are “near poor.” This is especially true of the elderly, who, if hit by large medical bills or other expenses, can hardly afford to pay them.
Second, the extent of older Americans’ poverty varies by sociodemographic factors and is much worse for some groups than for others (Carr, 2010). Older women, for example, are more likely than older men to live in poverty for at least two reasons. Because women earn less than men and are more likely to take time off from work during their careers, they have lower monthly Social Security benefits than men and smaller pensions from their employers. As well, women outlive men and thus use up their savings. Racial and ethnic disparities also exist among the elderly, reflecting poverty disparities in the entire population, as older people of color are much more likely than older whites to live in poverty (Carr, 2010). Among women 65 and older, 9 percent of whites live in poverty, compared to 27 percent of African Americans, 12 percent of Asians, and 21 percent of Hispanics.
Older women are more likely than older men to live in poverty.
Third, monthly Social Security benefits are tied to people’s earnings before retirement; the higher the earnings, the higher the monthly benefit. Thus a paradox occurs: People who earn low wages will get lower Social Security benefits after they retire, even though they need higher benefits to make up for their lower earnings. In this manner, the income inequality that exists before retirement continues to exist after it.
This paradox reflects a wider problem involving Social Security. However helpful it might be in aiding older Americans, the aid it provides lags far behind comparable programs in other wealthy Western nations. Social Security payments are low enough that almost one-third of the elderly who receive no other income assistance live in official poverty. For all these reasons, Social Security is certainly beneficial for many older Americans, but it remains inadequate compared to what other nations provide.
A few years ago, AARP assessed quality-of-life issues for older people and the larger society in sixteen wealthy democracies (the nations of North America and Western Europe, along with Australia and Japan). Each nation was rated (on a scale of 1–5, with 5 being the highest score) on seventeen criteria, including life expectancy, health care for the elderly, pension coverage, and age-discrimination laws. Of the sixteen nations, the Netherlands ranked first, with a total score of 64, while Italy ranked last, with a score of 48; the United States was thirteenth, with a score of 50. Despite its immense wealth, then, the United States lagged behind most other democracies. Because a “perfect” score would have been 85 (17 × 5), even the Netherlands fell short of an ideal quality of life as measured by the AARP indicators.
Why did the United States not rank higher? The experience of the Netherlands and Sweden, both of which have longer life expectancies than the United States, points to some possible answers. In the Netherlands, everyone at age 65 receives a full pension that does not depend on how much money they earned while they were working, and everyone thus gets the same amount. This amount is larger than the average American gets, because Social Security does depend on earnings and many people earned fairly low amounts during their working years. As a result, Dutch elderly are much less likely than their American counterparts to be poor. The Dutch elderly (and also the nonelderly) have generous government insurance for medical problems and for nursing home care; this financial help is much higher than older Americans obtain through Medicare.
As one example, the AARP article mentioned an elderly Dutch woman who had cancer surgery and thirty-two chemotherapy treatments, for which she paid nothing. In the United States, the chemotherapy treatments would have cost at least \$30,000. Medicare would have covered only 80 percent of this amount, leaving a patient to pay \$6,000.
The Netherlands also helps its elderly in other ways. One example is that about one-fourth of that nation’s elderly receive regular government-subsidized home visits by health-care professionals and/or housekeepers; this practice enables the elderly to remain independent and avoid having to enter a nursing home. In another example, the elderly also receive seven days of free-riding on the nation’s rail system.
Sweden has a home-care visitation program that is similar to the Netherlands’ program. Many elderly are visited twice a day by a care assistant who helps them bathe and dress in the morning and go to bed at night. The care assistant also regularly cleans their residence and takes them out for exercise. The Swedish government pays about 80 percent of the costs of this assistance and subsidizes the remaining cost for the elderly who cannot afford it. Like the Netherlands’ program, Sweden’s program helps the elderly to remain independent and live at home rather than enter a nursing institution.
Compared to the United States, then, other democracies generally provide their elderly with less expensive or free health care, greater financial support during their retirement, and home visits by health-care professionals and other assistants. In these and other ways, these other governments encourage “active aging.” Adoption of similar policies in the United States would improve the lives of older Americans and perhaps prolong their life spans.
Older people who want to work may have trouble finding employment because of age discrimination and other factors.
Older Americans also face problems in employment. Recall that about 16 percent of seniors remain employed. Other elders may wish to work but are retired or unemployed because several obstacles make it difficult for them to find jobs. First, many workplaces do not permit the part-time working arrangements that many seniors favor. Second, and as the opening news story indicated, the rise in high-tech jobs means that older workers would need to be retrained for many of today’s jobs, and few retraining programs exist. Third, although federal law prohibits age discrimination in employment, it exists anyway, as employers do not think older people are “up to” the job, even though the evidence indicates they are good, productive workers (Berger, 2009; Roscigno, 2010). Finally, earnings above a certain level reduce Social Security benefits before full retirement age, leading some older people to avoid working at all or to at least limit their hours. All these obstacles lead seniors to drop out of the labor force or to remain unemployed (Gallo, Brand, Teng, Leo-Summers, & Byers, 2009).
Age discrimination in the workplace merits some further discussion. According to sociologist Vincent J. Roscigno (2010), survey evidence suggests that more than half of older workers have experienced or observed age discrimination in the workplace, and more than 80 percent of older workers have experienced or observed jokes, disrespect, or other prejudicial comments about old age. Roscigno notes that workplace ageism receives little news media attention and has also been neglected by social scientists. This is so despite the related facts that ageism in the workplace is common and that the older people who experience this discrimination suffer financial loss and emotional problems. Roscigno (2010, p. 17) interviewed several victims of age discrimination and later wrote, “Many conveyed fear of defaulting on mortgages or being unable to pay for their children’s college after being pushed out of their jobs. Others expressed anger and insecurity over the loss of affordable health insurance or pension benefits…Just as prevalent and somewhat surprising to me in these discussions were the less-tangible, yet deeper social-psychological and emotional costs that social science research has established for racial discrimination or sexual harassment, for instance, but are only now being considered in relation to older workers.”
One of the people Roscigno interviewed was a maintenance worker who was laid off after more than two decades of working for his employer. This worker was both hurt and angry. “They now don’t want to pay me my pension,” he said. “I was a good worker for them and always did everything they asked. I went out of my way to help train people and make everything run smoothly, so everybody was happy and it was a good place to work. And now this is what I get like I never really mattered to them. It’s just not right” (Roscigno, 2010, p. 17).
“We all need someone we can lean on,” as a famous Rolling Stones song goes. Most older Americans do have adequate social support networks, which, as we saw earlier, are important for their well-being. However, a significant minority of elders live alone and do not see friends and relatives as often as they wish. Bereavement takes a toll, as elders who might have been married for many years suddenly find themselves living alone. Here a gender difference again exists. Because women outlive men and are generally younger than their husbands, they are three times more likely than men (42 percent compared to 13 percent) to be widowed and thus much more likely to live alone (see Table 6.3 “Living Arrangements of Noninstitutionalized Older Americans, 2010”).
Table 6.3 Living Arrangements of Noninstitutionalized Older Americans, 2010
Men (%) Women (%)
Living alone 19 41
Living with spouse 70 37
Other arrangement 11 21
Source: Data from Administration on Aging. (2011). A profile of older Americans: 2011. Retrieved from www.aoa.gov/aoaroot/aging_statistics/Profile/2011/docs/2011profile.pdf.
Many elders have at least one adult child living within driving distance, and such children are an invaluable resource. At the same time, however, some elders have no children, because either they have outlived their children or they never had any. As baby boomers begin reaching their older years, more of them will have no children because they were more likely than previous generations to not marry and/or to not have children if they did marry. Baby boomers thus face a relative lack of children to help them when they enter their “old-old” years (Leland, 2010).
Bereavement is always a difficult experience, but because so many elders lose a spouse, it is a particular problem in their lives. The grief that usually follows bereavement can last several years and, if it becomes extreme, can involve anxiety, depression, guilt, loneliness, and other problems. Of all these problems, loneliness is perhaps the most common and the most difficult to overcome.
Some seniors fall prey to their own relatives who commit elder abuse against them. Such abuse involves one or more of the following: physical or sexual violence, psychological or emotional abuse, neglect of care, or financial exploitation (Novak, 2012). Accurate data are hard to come by since few elders report their abuse, but estimates say that at least 10 percent of older Americans have suffered at least one form of abuse, amounting to hundreds of thousands of cases annually. However, few of these cases come to the attention of the police or other authorities (National Center on Elder Abuse, 2010).
Although we may never know the actual extent of elder abuse, it poses a serious health problem for the elders who are physically, sexually, and/or psychologically abused or neglected, and it may even raise their chances of dying. One study of more than 2,800 elders found that those who were abused or neglected were three times more likely than those who were not mistreated to die during the next thirteen years. This difference was found even after injury and chronic illness were taken into account (Horn, 1998).
A major reason for elder abuse seems to be stress. The adult children and other relatives who care for elders often find it an exhausting, emotionally trying experience, especially if the person they are helping needs extensive help with daily activities. Faced with this stress, elders’ caregivers can easily snap and take out their frustrations with physical violence, emotional abuse, or neglect of care.
Senior Power: Older Americans as a Political Force
Older Americans often hold strong views on issues that affect them directly, such as Medicare and Social Security. In turn, politicians often work to win the older vote and shape their political stances accordingly.
During the past few decades, older people have become more active politically on their own behalf.
To help address all the problems discussed in the preceding pages, several organizations have been established since the 1980s to act as interest groups in the political arena on behalf of older Americans (Walker, 2006). One of the most influential groups is the American Association of Retired Persons (AARP), which is open to people 50 or older. AARP provides travel and other discounts to its members and lobbies Congress and other groups extensively on elderly issues. Its membership numbers about 40 million, or 40 percent of the over-50 population. Some critics say AARP focuses too much on its largely middle-class membership’s self-interests instead of working for more far-reaching economic changes that might benefit the older poor; others say its efforts on Medicare, Social Security, and other issues do benefit the elderly from all walks of life. This controversy aside, AARP is an influential force in the political arena because of its numbers and resources.
A very different type of political organization of the elderly was the Gray Panthers, founded by the late Maggie Kuhn in 1970 (Kuhn, Long, & Quinn, 1991). Although this group has been less newsworthy since Kuhn’s death in 1995, at its height it had some eighty-five local chapters across the nation and 70,000 members and supporters. A more activist organization than AARP and other lobbying groups for the elderly, the Gray Panthers took more liberal stances. For example, it urged the establishment of national health-care services and programs to increase affordable housing for the elderly.
As older Americans have engaged the political process on their own behalf, critics have charged that programs for the elderly are too costly to the nation, that the elderly are better off than groups like AARP claim, and that new programs for the elderly will take even more money from younger generations and leave them insufficient funds for their own retirement many years from now. Their criticism, which began during the 1980s, is termed the generational equity argument (Williamson, McNamara, & Howling, 2003).
Advocates for the elderly say the generational equity critics exaggerate the financial well-being of older Americans and neglect the fact that many older Americans, especially women and those of color, are poor or near-poor and thus need additional government aid. Anything we can do now to help the aged, they continue, will also help future generations of the elderly. As Lenard W. Kaye (1994, p. 346) observed in an early critique of the generational equity movement, “In the long run, all of us can expect to live into extended old age, barring an unexpected fatal illness or accident. To do injustice to our current generation of elders, by means of policy change, can only come back to haunt us as each and every one of us—children, young families, and working people—move toward the latter stages of the life course.”
After Hurricane Irene swept up the East Coast in August 2011, many towns and cities faced severe flooding. One of these towns was Cranford, New Jersey, just southwest of Newark. Streets and hundreds of homes flooded, and many residents’ belongings were ruined.
Union County College, which has campuses in Cranford and a few other towns, came to Cranford residents’ aid. As the college president explained in late August, “Many of the town’s residents are senior citizens. Even though the fall term won’t begin until Sept. 1, we’ve still got a number of strong men and women on campus to help residents clear out their basements and help move whatever people needed moved.”
Led by the dean of college life, a dozen or so students went house-to-house on a Cranford street that experienced the worst flooding to aid the town’s senior citizens and younger ones as well. The dean later recalled, “Everyone we met was just so happy to see us there helping out. Sometimes they had plenty of work for us. Other times, they just smiled and said they were glad to know we cared.”
A news report summarized the impact of the students’ assistance: “In the coming weeks and months, Cranford residents will be able to recover what their town lost to Irene. But they may never forget the damage Irene caused, nor are they likely to forget how Union County College’s students came to help them in their time of need.” At a time of crisis, the staff and students of Union County College in the small town of Cranford, New Jersey, made a big difference in the lives of Cranford’s senior citizens and younger residents alike.
Key Takeaways
• The US elderly experience several health problems, including arthritis, high blood pressure, heart disease, hearing loss, vision problems, diabetes, and dementia.
• Nursing home care in the United States is very expensive and often substandard; neglect and abuse of nursing home residents is fairly common.
• Despite help from Social Security, many older Americans face problems of financial security.
• It is difficult to determine the actual extent of elder abuse, but elder abuse often has serious consequences for the health and lives of older Americans.
• During the last few decades, older Americans have been active in the political process on their own behalf and today are an important political force in the United States.
Alzheimer’s Association. (2009). 2009 Alzheimer’s disease facts and figures. Chicago, IL: Author.
Berger, E. D. (2009). Managing age discrimination: An examination of the techniques used when seeking employment. The Gerontologist, 49(3), 317–332.
Carr, D. (2010). Golden years? Poverty among older Americans. Contexts, 9(1), 62–63.
Cranford Chronicle. (2011, August 31). County College students help Cranford residents cleanup. Cranford Chronicle. Retrieved from www.nj.com/cranford/index.ssf/2011/2008/county_college_students_help_c.html.
Crawthorne, A. (2008). Elderly poverty: The challenge before us. Washington, DC: Center for American Progress.
DeHart, D., Webb, J., & Cornman, C. (2009). Prevention of elder mistreatment in nursing homes: Competencies for direct-care staff. Journal of Elder Abuse & Neglect, 21(4), 360–378.
Edwards, M. (2007). As Good As It Gets: What Country Takes the Best Care of Its Older Citizens? In D. S. Eitzen (Ed.), Solutions to Social Problems: Lessons from Other Societies (4th ed., pp. 76–85). Boston, MA: Allyn & Bacon.
Federal Interagency Forum on Aging-Related Statistics. (2010). Older Americans 2010: Key indicators of well-being. Washington, DC: US Goverment Printing Office.
Gallo, W. T., Brand, J. E., Teng, H.-M., Leo-Summers, L., & Byers, A. L. (2009). Differential impact of involuntary job loss on physical disability among older workers: Does predisposition matter? Research on Aging, 31(3), 345–360.
Hartlapp, M., & Schmid, G. (2008). Labour market policy for “active ageing” in Europe: Expanding the options for retirement transitions. Journal of Social Policy, 37(3), 409–431.
Horn, D. (1998, August 17). Bad news on elder abuse. Time, p. 82.
Kaye, L. W. (1994). Generational equity: Pitting young against old. In J. Robert B. Enright (Ed.), Perspectives in social gerontology (pp. 343–347). Boston, MA: Allyn and Bacon.
Kerby, S. (2012). Debunking poverty myths and racial stereotypes. Washington, DC: Center for American Progress.
Kuhn, M., Long, C., & Quinn, L. (1991). No stone unturned: The life and times of Maggie Kuhn. New York, NY: Ballantine Books.
Leland, J. (2010, April 25). A graying population, a graying work force. New York Times, p. A14.
National Center on Elder Abuse. (2010). Why should I care about elder abuse? Washington, DC: Author.
Ney, S. (2005). Active aging policy in Europe: Between path dependency and path departure. Ageing International, 30, 325–342.
Novak, M. (2012). Issues in aging (3rd ed.). Upper Saddle River, NJ: Pearson.
Roscigno, V. J. (2010). Ageism in the American workplace. Contexts, 9(1), 16–21.
Rowe, J. W., Berkman, L. F., Binstock, R., Boersch-Supan, A., Cacioppo, J., Carsternsen, L., et al. (2010). Policies and politics for an aging America. Contexts, 9(1), 22–27.
Sears, D. (2009, September 6). Myths busted on older workers’ job performance. TheLadders. Retrieved from www.career-line.com/job-search-news/myths-busted-on-older-workers-job-performance/.
Walker, A. (2006). Aging and politics: An international perspective. In R. H. Binstock & L. K. George (Eds.), Handbook of aging and the social sciences (6th ed., pp. 338–358). New York, NY: Academic Press.
Williamson, J. B., McNamara, T. K., & Howling, S. A. (2003). Generational equity, generational interdependence, and the framing of the debate over social security reform. Journal of Sociology and Social Welfare, 30(3), 3–14.
We have seen some contradictory impulses that make it difficult to predict the status of older Americans in the decades ahead. On the one hand, the large number of baby boomers will combine with increasing longevity to swell the ranks of the elderly; this process has already begun and will accelerate during the coming years. The inevitable jump in the size of the aged population may strain Social Security, Medicare, and other programs for the aged. On the other hand, the baby boomer generation will reach its old age as a much better educated and more healthy and wealthy group than any previous generation. It will likely participate in the labor force, politics, and other arenas more than previous generations of elders and, as has been true for some time, exert a good deal of influence on national political and cultural affairs.
Although this sounds like a rosier picture, several concerns remain. Despite the relative affluence of the baby boomers, segments of the group, especially among women and people of color, remain mired in poverty, and these segments will continue to be once they reach their older years. Moreover, the relative health of the baby boomers means that they will outlive previous generations of the aged. Yet as more of them reach the ranks of the “old-old,” they will become frailer and require care from health-care professionals and organizations and from social support networks. As noted earlier, some may not have children and will be in even more need of help.
Although older Americans fare much better than their counterparts in poor nations, they fare not nearly as well as their counterparts in other wealthy democracies, which generally provide many more extensive and better-funded programs and services for their elderly. Older Americans also continue to confront stereotypes and prejudicial attitudes that add to the burden many of them already face from the biological process of aging.
A sociological understanding of aging and ageism reminds us that many of the problems that older Americans face are ultimately rooted not in their chronological age but rather in the stereotypes about them and in the lack of adequate social programs like those found throughout other Western nations. This understanding also reminds us that the older Americans who face the most severe problems of health, health care, and financial security are women and people of color and that their more severe problems reflect the many inequalities they have experienced throughout the life course, long before they reached their older years. These inequalities accumulate over the years to leave them especially vulnerable when they finally arrive into their sixties.
With this understanding, it becomes clear that efforts to improve the lives of older Americans must focus on providing them with more numerous and more extensive social services and programming of many kinds and on reducing the stereotypes and prejudicial attitudes that many Americans hold of older people. Possibilities involving improved social services and programming might be drawn from the example provided by other Western nations and include the following (Rowe et al., 2010; Uhlenberg, 2009):
1. An expansion of Social Security to provide a much more comfortable life for all older Americans, regardless of their earnings history, and thus regardless of their gender and race/ethnicity.
2. An expansion of Medicare and other health aid for older Americans to match the level of health-care assistance provided by many other Western nations. In one particular area that needs attention, Medicare pays for nursing home care only after nursing home patients use up most of their own assets, leaving a patient’s spouse with severe financial problems. Other Western nations pay for nursing home care from the outset, and the United States should adopt this practice.
3. The establishment of more flexible work hours, job-sharing arrangements, and other policies that would enhance the ability of older people to work part-time or full-time.
4. Increase paid and volunteer opportunities for older adults to help take care of young children and adolescents, especially those who are poor or otherwise disadvantaged, in schools and other settings, creating a win-win situation for both the older adults and the children.
5. As with stereotypical and prejudicial views based on gender and on race/ethnicity, greater educational efforts should be launched to reduce stereotyping and prejudicial attitudes based on aging. Like sexism and racism, ageism has no place in a nation like the United States, which has historically promised equality and equal opportunity for all.
Beyond all these measures, aging scholars emphasize the need to help future older populations by investing in younger people. As a group of several scholars has noted, “Many of the key determinants of successful aging are cumulative, occurring throughout the lifetime and, importantly, starting in early childhood. The people who will turn 65 between 2050 and 2070 have already been born. If we want to promote their health and well-being into old age, we need to begin now, when they are infants and children. Childhood and early adolescent experiences leave a footprint for many functions in older age. Failing to invest in education and health throughout childhood and young adulthood is short-sighted” (Rowe et al., 2010, p. 24).
Key Takeaways
• Although the number of older Americans will be increasing in the years ahead, the baby boomers who are now reaching old age will be better educated and wealthier than older Americans of past generations.
• Efforts to help older Americans would benefit from relying on the models practiced by other Western democracies.
Rowe, J. W., Berkman, L. F., Binstock, R., Boersch-Supan, A., Cacioppo, J., Carsternsen, L., et al. (2010). Policies and politics for an aging America. Contexts, 9(1), 22–27.
Uhlenberg, P. (2009). Children in an aging society. Journal of Gerontology Series B: Psychological Sciences and Social Sciences, 64B(4), 489–496.
1. Gerontology is the study of aging. Gerontologists study the biological, psychological, and social dimensions of aging. Social gerontologists focus on social aging and distinguish several dimensions of aging, which refers to changes in people’s roles and relationships as they age.
2. The perception and experience of aging vary from one society to another and within a given society over time.
3. Sociological explanations of aging include disengagement theory, activity theory, and conflict theory. Disengagement theory emphasizes the need of society to disengage its elders from their previous roles to pave the way for a younger and presumably more able generation to take over those roles. In contrast, activity theory assumes that elders need to remain active to enhance their physical and mental health. Conflict theory emphasizes ageism, or discrimination and prejudice against the elderly, and the structural barriers society poses to elders’ economic and other aspects of overall well-being.
4. Life expectancy differs dramatically around the world and within the United States, where it’s lower for men and lower for people of color. Because life expectancy has increased, people are living longer, resulting in a “graying of society.” In the United States, the imminent entrance of the baby boom generation into its older years will further fuel a large rise in the number of older Americans. This graying of society may strain traditional economic and medical programs for their care and affect views of aging and the elderly.
5. Although aging involves several physiological and psychological changes, negative stereotypes of aging and the elderly exaggerate the extent and impact of these changes. Proper exercise, nutrition, and stress reduction can minimize the effects of aging, as can religious involvement and informal social support networks.
6. As a diverse group, older Americans differ greatly in terms of wealth and poverty, education, health, and other dimensions. They face several problems because of their age, including illness and disability, financial security, employment obstacles, and elder abuse. For several reasons, older Americans generally hold more conservative views on social and moral issues. At the same time, groups working on behalf of older Americans in the political arena have succeeded in bringing elder issues to the attention of public officials and political parties.
7. As the ranks of older Americans swell in the years ahead, elders will be better educated and wealthier than their predecessors, but their sheer numbers may impose considerable strain on social institutions. Already there are signs of perceived conflict between the needs of the elderly and those of younger generations. However, advocates for older Americans believe that efforts to help elders now will in the long run help younger Americans when they finally reach their old age.
It is about twenty years from now, and a close friend of yours is facing a difficult decision. Her mother is in failing health and might have the onset of dementia. It has become increasingly apparent that she can no longer live alone, and your friend is trying to decide whether to have her mother come live with her, to arrange for in-home care for her, or to place her into residential care. What advice do you give to your friend?
To help reduce inequality based on aging and ageism and the problems facing older people, you may wish to do any of the following:
1. Volunteer at a senior citizens’ center, residential care facility, or nursing home.
2. Write a letter to the editor about media stereotypes about older people.
3. Start a group on your campus to educate students about the problems facing senior citizens.
Attributions
Adapted from Chapter 6 from Social Problems by the University of Minnesota under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.
Adapted from page 37 through 38, Self and Identity by Dan P. McAdams under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/02%3A_Alternative_Perspectives_on_Individuals/10%3A_Aging_and_Ableness.txt |
Learning Objectives
• Define terms related to sexuality and sexual expression.
• Discuss different theories and models for sexual orientation.
• Explain the impact of history on the LGBTQ population.
• Discuss current treatment concerns for the LGBTQ population.
• Explain the impact of socialization and culture on sexuality.
• Define the meaning of pornography.
• Explore the disconnect between the consumption of pornography in the U.S. and public attitudes about pornography in the U.S.
• Discuss the impact of pornography replacing comprehensive sex education.
11.1 What is Sex, Gender, Sexuality, & Sexual Orientation?
Sex and Gender
Each of us is born with physical characteristics that represent and socially assign our sex and gender. Sex refers to our biological differences and gender the cultural traits assigned to females and males (Kottak and Kozaitis 2012). Our physical make-up distinguishes our sex as either female or male implicating the gender socialization process we will experience throughout our life associated with becoming a woman or man.
Gender identity is an individual’s self-concept of being female or male and their association with feminine and masculine qualities. People teach gender traits based on sex or biological composition (Kottak and Kozaitis 2012). Our sex signifies the gender roles (i.e., psychological, social, and cultural) we will learn and experience as a member of society. Children learn gender roles and acts of sexism in society through socialization (Griffiths et al. 2015). Girls learn feminine qualities and characteristics and boys masculine ones forming gender identity. Children become aware of gender roles between the ages of two and three and by four to five years old, they are fulfilling gender roles based on their sex (Griffiths et al. 2015). Nonetheless, gender-based characteristics do not always match one’s self or cultural identity as people grow and develop.
Gender stratification focuses on the unequal access females have to socially valued resources, power, prestige, and personal freedom as compared to men based on different positions within the socio-cultural hierarchy (Light, Keller, and Calhoun 1997). Traditionally, society treats women as second-class citizens in society. The design of dominant gender ideologies and inequality maintains the prevailing social structure, presenting male privilege as part of the natural order (Parenti 2006). Theorists suggest society is male-dominated patriarchy where men think of themselves as inherently superior to women resulting in an unequal distribution of rewards between men and women (Henslin 2011).
Media portrays women and men in stereotypical ways that reflect and sustain socially endorsed views of gender (Wood 1994). Media affects the perception of social norms including gender. People think and act according to stereotypes associated with one’s gender broadcast by media (Goodall 2016). Media stereotypes reinforce the gender inequality of girls and women. According to Wood (1994), the underrepresentation of women in media implies that men are the cultural standard, and women are unimportant or invisible. Stereotypes of men in media display them as independent, driven, skillful, and heroic lending them to higher-level positions and power in society.
In countries throughout the world, including the United States, women face discrimination in wages, occupational training, and job promotion (Parenti 2006). As a result, society tracks girls and women into career pathways that align with gender roles and match gender-linked aspirations such as teaching, nursing, and human services (Henslin 2011). Society views men’s work as having a higher value than that of women. Even if women have the same job as men, they make 77 cents per every dollar in comparison (Griffiths et al. 2015). Inequality in career pathways, job placement, and promotion or advancement results in an income gap between genders affecting the buying power and economic vitality of women in comparison to men.
The United Nations found prejudice and violence against women are firmly rooted in cultures around the world (Parenti 2006). Gender inequality has allowed men to harness and abuse their social power. The leading cause of injury among women of reproductive age is domestic violence, and rape is an everyday occurrence and seen as a male prerogative throughout many parts of the world (Parenti 2006). Depictions in the media emphasize male-dominant roles and normalize violence against women (Wood 1994). Culture plays an integral role in establishing and maintaining male dominance in society ascribing men the power and privilege that reinforces subordination and oppression of women.
Cross-cultural research shows gender stratification decreases when women and men make equal contributions to human subsistence or survival (Sanday 1974). Since the industrial revolution, attitudes about gender and work have been evolving with the need for women and men to contribute to the labor force and economy. Gendered work, attitudes, and beliefs have transformed in responses to American economic needs (Margolis 1984, 2000). Today’s society is encouraging gender flexibility resulting from cultural shifts among women seeking college degrees, prioritizing career, and delaying marriage and childbirth.
Sexuality and Sexual Orientation
Sexuality is an inborn person’s capacity for sexual feelings (Griffiths et al. 2015). Normative standards about sexuality are different throughout the world. Cultural codes prescribe sexual behaviors as legal, normal, deviant, or pathological (Kottak and Kozaitis 2012). In the United States, people have restrictive attitudes about premarital sex, extramarital sex, and homosexuality compared to other industrialized nations (Griffiths et al. 2015). The debate on
sex education in U.S. schools focuses on abstinence and contraceptive curricula. In addition, people in the U.S. have restrictive attitudes about women and sex, believing men have more urges and therefore it is more acceptable for them to have multiple sexual partners than women setting a double standard.
Sexual orientation is a biological expression of sexual desire or attraction (Kottak and Kozaitis 2012). Culture sets the parameters for sexual norms and habits. Enculturation dictates and controls social acceptance of sexual expression and activity. Eroticism like all human activities and preferences is learned and malleable (Kottak and Kozaitis 2012). Sexual orientation labels categorize personal views and representations of sexual desire and activities. Most people ascribe and conform to the sexual labels constructed and assigned by society (i.e., heterosexual or desire for the opposite sex, homosexual or attraction to the same sex, bisexual or appeal to both sexes, and asexual or lack of sexual attraction and indifference). The projection of one’s sexual personality is often through gender identity. Most people align their sexual disposition with what is socially or publically appropriate (Kottak and Kozaitis 2012). Because sexual desire or attraction is inborn, people within the socio-sexual dominant group (i.e., heterosexual) often believe their sexual preference is “normal.” However, heterosexual fit or type is not normal. History has documented diversity in sexual preference and behavior since the dawn of human existence (Kottak and Kozaitis 2012). There are diversity and variance in people’s libido and psychosocial relationship needs. Additionally, sexual activity or fantasy does not always align with sexual orientation (Kottak and Kozaitis 2012). Sexual pleasure from the use of sexual toys, homoerotic images, or kinky fetishes does not necessarily correspond to a specific orientation, sexual label, or mean someone’s desire will alter or convert to another type because of the activity. Regardless, society uses sexual identity as an indicator of status dismissing the fact that sexuality is a learned behavior, flexible, and contextual (Kottak and Kozaitis 2012). People feel and display sexual variety, erotic impulses, and sensual expressions throughout their lives.
Individuals develop sexual understanding around middle childhood and adolescence (APA 2008). There is no genetic, biological, developmental, social, or cultural evidence linked to homosexual behavior. The difference is in society’s discriminatory response to homosexuality. Alfred Kinsley was the first to identify sexuality is a continuum rather than a dichotomy of gay or straight (Griffiths et al. 2015). His research showed people do not necessarily fall into the sexual categories, behaviors, and orientations constructed by society. Eve Kosofsky Sedgwick (1990) expanded on Kinsley’s research to find women are more likely to express homosocial relationships such as hugging, handholding, and physical closeness. Whereas, men often face negative sanctions for displaying homosocial behavior. Society ascribes meaning to sexual activities (Kottak and Kozaitis 2012). Variance reflects the cultural norms and sociopolitical conditions of a time and place. Since the 1970s, organized efforts by LGBTQ (Lesbian, Gay, Bisexual, Transgender, and Questioning) activists have helped establish a gay culture and civil rights (Herdt 1992). Gay culture provides social acceptance for persons rejected, marginalized, and punished by others because of sexual orientation and expression. Queer theorists are reclaiming the derogatory label to help in broadening the understanding of sexuality as flexible and fluid (Griffiths et al. 2015). Sexual culture is not necessarily subject to sexual desire and activity, but rather dominant affinity groups linked by common interests or purpose to restrict and control sexual behavior.
11.2 Sexual Orientation and Inequality
Social Problems in the News
“Miami Beach to Fire Two Officers in Gay Beating at Park,” the headline said. City officials in Miami Beach, Florida, announced that the city would fire two police officers accused of beating a gay man two years earlier and kicking and arresting a gay tourist who came to the man’s defense. The tourist said he called 911 when he saw two officers, who were working undercover, beating the man and kicking his head. According to his account, the officers then shouted antigay slurs at him, kicked him, and arrested him on false charges. The president of Miami Beach Gay Pride welcomed the news of the impending firing. “It sets a precedent that you can’t discriminate against anyone and get away with it,” he said. “[The two officers] tried to cover it up and arrested the guy. It’s an abuse of power. Kudos to the city. They’ve taken it seriously.”
Source: Smiley & Rothaus, 2011
From 1933 to 1945, Adolf Hitler’s Nazi regime exterminated 6 million Jews in the Holocaust, but it also persecuted millions of other people, including gay men. Nazi officials alleged that these men harbored what they termed a “degeneracy” that threatened Germany’s “disciplined masculinity.” Calling gay men “antisocial parasites” and “enemies of the state,” the Nazi government arrested more than 100,000 men for violating a law against homosexuality, although it did not arrest lesbians because it valued their child-bearing capacity. At least 5,000 gay men were imprisoned, and many more were put in mental institutions. Several hundred other gay men were castrated, and up to 15,000 were placed in concentration camps, where most died from disease, starvation, or murder. As the United States Holocaust Memorial Museum (2011) summarizes these events, “Nazi Germany did not seek to kill all homosexuals. Nevertheless, the Nazi state, through active persecution, attempted to terrorize German homosexuals into sexual and social conformity, leaving thousands dead and shattering the lives of many more.”
This terrible history reminds us that sexual orientation has often resulted in inequality of many kinds, and, in the extreme case of the Nazis, the inhumane treatment that included castration, imprisonment, and death. The news story that began this chapter makes clear that sexual orientation still results in violence, even if this violence falls short of what the Nazis did. Although the gay rights movement has achieved much success, sexual orientation continues to result in other types of inequality as well. This chapter examines the many forms of inequality linked to sexual orientation today. It begins with a conceptual discussion of sexual orientation before turning to its history, explanation, types of inequality, and other matters.
11.3 Understanding Sexual Orientation
Learning Objectives
• Define sexual orientation and gender identity.
• Describe what percentage of the U.S. population is estimated to be LGBT.
• Summarize the history of sexual orientation.
• Evaluate the possible reasons for sexual orientation.
Sexual orientation refers to a person’s preference for sexual relationships with individuals of the other sex (heterosexuality), one’s own sex (homosexuality), or both sexes (bisexuality). The term also increasingly refers to transgender (also transgendered) individuals, those whose behavior, appearance, and/or gender identity (the personal conception of oneself as female, male, both, or neither) departs from conventional norms. Transgendered individuals include transvestites (those who dress in the clothing of the opposite sex) and transsexuals (those whose gender identity differs from their physiological sex and who sometimes undergo a sex change). A transgender woman is a person who was born biologically as a male and becomes a woman, while a transgender man is a person who was born biologically as a woman and becomes a man. As you almost certainly know, gay is the common term now used for any homosexual individual; gay men or gays is the common term used for homosexual men, while lesbian is the common term used for homosexual women. All the types of social orientation just outlined are often collectively referred to by the shorthand LGBT (lesbian/gay/bisexual/transgender). As you almost certainly also know, the term straight is used today as a synonym for heterosexual.
Counting Sexual Orientation
We will probably never know precisely how many people are gay, lesbian, bisexual, or transgendered. One problem is conceptual. For example, what does it mean to be gay or lesbian? Does one need to actually have sexual relations with a same-sex partner to be considered gay? What if someone is attracted to same-sex partners but does not actually engage in sex with such persons? What if someone identifies as heterosexual but engages in homosexual sex for money (as in certain forms of prostitution) or for power and influence (as in much prison sex)? These conceptual problems make it difficult to determine the extent of homosexuality (Gates, 2011).
It is difficult for several reasons to know exactly how many people are LGBT. Photo Above: A gay couple watching a parade – CC BY-NC 2.0.
A second problem is empirical. Even if we can settle on a definition of homosexuality, how do we then determine how many people fit this definition? For better or worse, our best evidence of the number of gays and lesbians in the United States comes from surveys that ask random samples of Americans various questions about their sexuality. Although these are anonymous surveys, some individuals may be reluctant to disclose their sexual activity and thoughts to an interviewer. Still, scholars think that estimates from these surveys are fairly accurate but also that they probably underestimate by at least a small amount the number of gays and lesbians.
During the 1940s and 1950s, sex researcher Alfred C. Kinsey carried out the first notable attempt to estimate the number of gays and lesbians (Kinsey, Pomeroy, & Martin, 1948; Kinsey, Pomeroy, Martin, & Gebhard, 1953). His project interviewed more than 11,000 white women and men about their sexual experiences, thoughts, and attractions, with each subject answering hundreds of questions. While most individuals had experiences and feelings that were exclusively heterosexual, a significant number had experiences and feelings that were either exclusively homosexual or both heterosexual and homosexual in varying degrees. These findings led Kinsey to reject the popular idea back then that a person is necessarily either heterosexual or homosexual (or straight or gay, to use the common modern terms). As he wrote, “It is a characteristic of the human mind that tries to dichotomize in its classification of phenomena…Sexual behavior is either normal or abnormal, socially acceptable or unacceptable, heterosexual or homosexual; and many persons do not want to believe that there are gradations in these matters from one to the other extreme” (Kinsey et al., 1953, p. 469). Perhaps Kinsey’s most significant and controversial finding was that gradations did, in fact, exist between being exclusively heterosexual on the one hand and exclusively homosexual on the other hand. To reflect these gradations, he developed the well-known Kinsey Scale, which ranks individuals on a continuum ranging from 0 (exclusively heterosexual) to 6 (exclusively homosexual).
In terms of specific numbers, Kinsey found that (a) 37 percent of males and 13 percent of females had had at least one same-sex experience; (b) 10 percent of males had mostly homosexual experiences between the ages of 16 and 55, while up to 6 percent of females had mostly homosexual experiences between the ages of 20 and 35; (c) 4 percent of males were exclusively homosexual after adolescence began, compared to 1–3 percent of females; and (d) 46 percent of males either had engaged in both heterosexual and homosexual experiences or had been attracted to persons of both sexes, compared to 14 percent of females.
An estimated 3.8 percent of the US adult population identifies as LGBT. This figure amounts to about 9 million people. Photo above: Nathan Rupert – Crazy fun lesbian couple – CC BY-NC-ND 2.0.
More recent research updates Kinsey’s early findings and, more importantly, uses nationally representative samples of Americans (which Kinsey did not use). In general, this research suggests that Kinsey overstated the numbers of Americans who have had same-sex experiences and/or attractions. A widely cited survey carried out in the early 1990s by researchers at the University of Chicago found that 2.8 percent of men and 1.4 percent of women self-identified as gay/lesbian or bisexual, with greater percentages reporting having had sexual relations with same-sex partners or being attracted to same-sex persons (see Table 5.1 “Prevalence of Homosexuality in the United States”). In the 2010 General Social Survey (GSS), 1.8 percent of men and 3.3 percent of women self-identified as gay/lesbian or bisexual. In the 2006–2008 National Survey of Family Growth (NSFG) conducted by the federal government (Chandra, Mosher, Copen, & Sionean, 2011), 2.8 percent of men self-identified as gay or bisexual, compared to 4.6 percent of women (ages 18–44 for both sexes).
Table 5.1 Prevalence of Homosexuality in the United States
Activity, attraction, or identity Men (%) Women (%)
Find same-sex sexual relations appealing 4.5 5.6
Attracted to people of same-sex 6.2 4.4
Identify as gay or bisexual 2.8 1.4
At least one sex partner of same-sex during the past year among those sexually active 2.7 1.3
At least one sex partner of same-sex since turning 18 4.9 4.1
These are all a lot of numbers, but demographer Gary J. Gates (2011) drew on the most recent national survey evidence to come up with the following estimates for adults 18 and older:
• 3.5 percent of Americans identify as gay, lesbian, or bisexual, and 0.3 percent are transgender; these figures add up to 3.8 percent of Americans, or 9 million people, who are LGBT.
• 3.4 percent of women and 3.6 percent of men identify as LGB.
• 66.7 percent of LGB women identify as bisexual, and 33.3 percent identify as a lesbian; 33.3 percent of LGB men identify as bisexual, and 66.7 percent identify as gay. LGB women are thus twice as likely as LGB men to identify as bisexual.
• 8.2 percent of Americans, or 19 million people, have engaged in same-sex sexual behavior, with women twice as likely as men to have done so.
• 11 percent of Americans, or 25.6 million people, report having some same-sex sexual attraction, with women twice as likely as men to report such attraction.
The overall picture from these estimates is clear: Self-identified LGBT people comprise only a small percentage of the US population, but they amount to about 9 million adults and undoubtedly a significant number of adolescents. In addition, the total number of people who, regardless of their sexual orientation, have had a same-sex experience is probably at least 19 million, and the number who have had same-sex attraction is probably at least 25 million.
Sexual Orientation in Historical Perspective
Based on what is known about homosexuality in past societies, it should be no surprise that so many people in the United States identify as gay/lesbian or have had same-sex experiences. This historical record is clear: Homosexuality has existed since ancient times and in some societies has been rather common or at least fully accepted as a normal form of sexual expression.
In the great city of Athens in ancient Greece, male homosexuality (to be more precise, sexual relations between a man and a teenaged boy and, less often, between a man and a man) was not only approved but even encouraged. According to classical scholar K. J. Dover (1989, p. 12), Athenian society “certainly regarded strong homosexual desire and emotion as normal,” in part because it also generally “entertained a low opinion of the intellectual capacity and staying-power of women.” Louis Crompton (2003, p. 2), who wrote perhaps the definitive history of homosexuality, agrees that male homosexuality in ancient Greece was common and notes that “in Greek history and literature…the abundance of accounts of homosexual love overwhelms the investigator.” He adds,
“Greek lyric poets sing of male love from almost the earliest fragments down to the end of classical times…Vase-painters portray scores of homoerotic scenes, hundreds of inscriptions celebrate the love of boys, and such affairs enter into the lives of a long catalog of famous Greek statesmen, warriors, artists, and authors. Though it has often been assumed that the love of males was a fashion confined to a small intellectual elite during the age of Plato, in fact, it was pervasive throughout all levels of Greek society and held an honored place in Greek culture for more than a thousand years, that is, from before 600 B.C.E. to about 400 C.E.”
Male homosexuality in ancient Rome was also common and accepted as normal sexuality, but it took a different form from than in ancient Greece. Ancient Romans disapproved of sexual relations between a man and a freeborn male youth, but they approved of relations between a slave master and his youthful male slave. Sexual activity of this type was common. As Crompton (2003, p. 80) wryly notes, “Opportunities were ample for Roman masters” because slaves comprised about 40 percent of the population of ancient Rome. However, these “opportunities” are best regarded as violent domination by slave masters over their slaves.
By the time Rome fell in 476 CE, Europe had become a Christian continent. Influenced by several passages in the Bible that condemn homosexuality, Europeans considered homosexuality a sin, and their governments outlawed same-sex relations. If discovered, male homosexuals (or any men suspected of homosexuality) were vulnerable to execution for the next fourteen centuries, and many did lose their lives. During the Middle Ages, gay men and lesbians were stoned, burned at the stake, hanged, or beheaded, and otherwise abused and mistreated. Crompton (2003, p. 539) calls these atrocities a “routine of terror” and a “kaleidoscope of horrors.” Hitler’s persecution of gay men several centuries after the Middle Ages ended had ample precedent in European history.
In contrast to the European treatment of gay men and lesbians, China and Japan from ancient times onward viewed homosexuality much more positively in what Crompton (2003, p. 215) calls an “unselfconscious acceptance of same-sex relations.” He adds that male love in Japan during the 1500s was “a national tradition—one the Japanese thought natural and meritorious” (Crompton, 2003, p. 412) and very much part of the samurai (military nobility) culture of preindustrial Japan. In China, both male and female homosexuality was seen as normal and even healthy sexual outlets. Because Confucianism, the major Chinese religion when the Common Era began, considered women inferior, it considered male friendships very important and thus may have unwittingly promoted same-sex relations among men. Various artistic and written records indicate that male homosexuality was fairly common in China over the centuries, although the exact numbers can never be known. When China began trading and otherwise communicating with Europe during the Ming dynasty, its tolerance for homosexuality shocked and disgusted Catholic missionaries and other Europeans. Some European clergy and scientists even blamed earthquakes and other natural disasters in China on this tolerance.
In addition to this body of work by historians, anthropologists have also studied same-sex relations in small, traditional societies. In many of these societies, homosexuality is both common and accepted as normal sexual behavior. In one overview of seventy-six societies, the authors found that almost two-thirds regarded homosexuality as “normal and socially acceptable for certain members of the community” (Ford & Beach, 1951, p. 130). Among the Azande of East Africa, for example, young warriors live with each other and are not allowed to marry. During this time, they often have sex with younger boys. Among the Sambia of New Guinea, young males live separately from females and have same-sex relations for at least a decade. It is felt that the boys would be less masculine if they continued to live with their mothers and that the semen of older males helps young boys become strong and fierce (Edgerton, 1976).
This brief historical and anthropological overview provides ready evidence of what was said at its outset: Homosexuality has existed since ancient times and in some societies has been rather common or at least fully accepted as a normal form of sexual expression. Although Western society, influenced by the Judeo-Christian tradition, has largely condemned homosexuality since Western civilization began some 2,000 years ago, the great civilizations of ancient Greece and ancient China and Japan until the industrial age approved of homosexuality. In these civilizations, male homosexuality was fairly common, and female homosexuality was far from unknown. Same-sex relations are also fairly common in many of the societies that anthropologists have studied. Although Western societies have long considered homosexuality sinful and unnatural and more generally have viewed it very negatively, the historical and anthropological record demonstrates that same-sex relationships are far from rare. They thus must objectively be regarded as normal expressions of sexuality.
In fact, some of the most famous individuals in Western political, literary, and artistic history certainly or probably engaged in same-sex relations, either sometimes or exclusively: Alexander the Great, Hans Christian Andersen, Marie Antoinette, Aristotle, Sir Francis Bacon, James Baldwin, Leonard Bernstein, Lord Byron, Julius Caesar, Ralph Waldo Emerson, Frederick the Great, Leonardo de Vinci, Herman Melville, Michelangelo, Plato, Cole Porter, Richard the Lionhearted, Eleanor Roosevelt, Socrates, Gertrude Stein, Pyotr Tchaikovsky, Henry David Thoreau, Walt Whitman, Tennessee Williams, Oscar Wilde, and Virginia Woolf, to name just a few. Regardless or perhaps in some cases because of their sexuality, they all made great contributions to the societies in which they lived.
Explaining Sexual Orientation
We have seen that it is difficult to determine the number of people who are gay/lesbian or bisexual. It is even more difficult to determine why some people have these sexual orientations while most do not, and scholars disagree on the “causes” of sexual orientation (Engle, McFalls, Gallagher, & Curtis, 2006; Sheldon, Pfeffer, Jayaratne, Feldbaum, & Petty, 2007). Determining the origins of sexual orientation is not just an academic exercise. When people believe that the roots of homosexuality are biological or that gays otherwise do not choose to be gay, they are more likely to have positive or at least tolerant views of same-sex behavior. When they believe that homosexuality is instead merely a personal choice, they are more likely to disapprove of it (Sheldon et al., 2007). For this reason, if for no other, it is important to know why some people are gay or bisexual while most are not.
Studies of the origins of sexual orientation focus mostly on biological factors and on social and cultural factors, and a healthy scholarly debate exists on the relative importance of these two sets of factors.
Biological Factors
Research points to certain genetic and other biological roots of sexual orientation but is by no means conclusive. One line of research concerns genetics. Although no “gay gene” has been discovered, studies of identical twins find they are more likely to have the same sexual orientation (gay or straight) than would be expected from chance alone (Kendler, Thornton, Gilman, & Kessler, 2000; Santtila et al., 2008). Because identical twins have the same DNA, this similarity suggests but does not prove, a genetic basis for sexual orientation. Keep in mind, however, that any physical or behavioral trait that is totally due to genetics should show up in both twins or in neither twin. Because many identical twins do not have the same sexual orientation, this dissimilarity suggests that genetics are far from the only cause of sexual orientation, to the extent they cause it at all. Several methodological problems also cast doubt on findings from many of these twin studies. A recent review concluded that the case for a genetic cause of sexual orientation is far from proven: “Findings from genetic studies of homosexuality in humans have been confusing—contradictory at worst and tantalizing at best—with no clear, strong, compelling
Despite scholarly speculation, sexual orientation does not appear to be affected by the level of prenatal hormones. The photo above: il-young ko – pregnant – CC BY-NC-ND 2.0.
Another line of research concerns brain anatomy, as some studies find differences in the size and structure of the hypothalamus, which controls many bodily functions, in the brains of gays versus the brains of straights (Allen & Gorski, 1992). However, other studies find no such differences (Lasco, Jordan, Edgar, Petito, & Byne, 2002). Complicating matters further, because sexual behavior can affect the hypothalamus (Breedlove, 1997), it is difficult to determine whether any differences that might be found reflect the influence of the hypothalamus on sexual orientation, or instead of the influence of sexual orientation on the hypothalamus (Sheldon et al., 2007).
The third line of biological research concerns hormonal balance in the womb, with scientists speculating that the level of prenatal androgen effects in which sexual orientation develops. Because prenatal androgen levels cannot be measured, studies typically measure it only indirectly in the bodies of gays and straights by comparing the lengths of certain fingers and bones that are thought to be related to prenatal androgen. Some of these studies suggest that gay men had lower levels of prenatal androgen than straight men and that lesbians had higher levels of prenatal androgen than straight women, but other studies find no evidence of this connection (Martin & Nguyen, 2004; Mustanski, Chivers, & Bailey, 2002). A recent review concluded that the results of the hormone studies are “often inconsistent” and that “the notion that non-heterosexual preferences may reflect [deviations from normal prenatal hormonal levels] is not supported by the available data” (Rahman, 2005, p. 1057).
Social and Cultural Factors
Sociologists usually emphasize the importance of socialization over biology for the learning of many forms of human behavior. In this view, humans are born with “blank slates” and thereafter shaped by their society and culture, and children are shaped by their parents, teachers, peers, and other aspects of their immediate social environment while they are growing up.
Given this standard sociological position, one might think that sociologists generally believe that people are gay or straight not because of their biology but because they learn to be gay or straight from their society, culture, and immediate social environment. This, in fact, was a common belief of sociologists about a generation ago (Engle et al., 2006). In a 1988 review article, two sociologists concluded that “evidence that homosexuality is a social construction [learned from society and culture] is far more powerful than the evidence for a widespread organic [biological] predisposition toward homosexual desire” (Risman & Schwartz, 1988, p. 143). The most popular introductory sociology text of the era similarly declared, “Many people, including some homosexuals, believe that gays and lesbians are simply ‘born that way.’ But since we know that even heterosexuals are not ‘born that way,’ this explanation seems unlikely…Homosexuality, like any other sexual behavior ranging from oral sex to sadomasochism to the pursuit of brunettes, is learned” (Robertson, 1987, p. 243).
However, sociologists’ views of the origins of sexual orientation have apparently changed since these passages were written. In a recent national survey of a random sample of sociologists, 22 percent said male homosexuality results from biological factors, 38 percent said it results from both biological and environmental (learning) factors, and 39 percent said it results from environmental factors (Engle et al., 2006). Thus 60 percent (= 22 + 38) thought that biology totally or partly explains male homosexuality, almost certainly a much higher figure than would have been found a generation ago had a similar survey been done.
In this regard, it is important to note that 77 percent (= 38 + 39) of the sociologists still feel that environmental factors, or socialization, matter as well. Scholars who hold this view believe that sexual orientation is partly or totally learned from one’s society, culture, and immediate social environment. In this way of thinking, we learn “messages” from all these influences about whether it is OK or not OK to be sexually attracted to someone from our own sex and/or to someone from the opposite sex. If we grow up with positive messages about same-sex attraction, we are more likely to acquire this attraction. If we grow up with negative messages about same-sex attraction, we are less likely to acquire it and more likely to have a heterosexual desire.
It is difficult to do the necessary type of research to test whether socialization matters in this way, but the historical and cross-cultural evidence discussed earlier provides at least some support for this process. Homosexuality was generally accepted in ancient Greece, ancient China, and ancient Japan, and it also seemed rather common in those societies. The same connection holds true in many of the societies that anthropologists have studied. In contrast, homosexuality was condemned in Europe from the very early part of the first millennium CE, and it seems to have been rather rare (although it is very possible that many gays hid their sexual orientation for fear of persecution and death).
So where does this leave us? What are the origins of sexual orientation? The most honest answer is that we do not yet know its origins. As we have seen, many scholars attribute sexual orientation to still unknown biological factor(s) over which individuals have no control, just as individuals do not decide whether they are left-handed or right-handed. Supporting this view, many gays say they realized they were gay during adolescence, just as straights would say they realized they were straight during their own adolescence; moreover, evidence (from toy, play, and clothing preferences) of future sexual orientation even appears during childhood (Rieger, Linsenmeier, Bailey, & Gygax, 2008). Other scholars say that sexual orientation is at least partly influenced by cultural norms so that individuals are more likely to identify as gay or straight and be attracted to their same-sex or opposite-sex depending on the cultural views of sexual orientation into which they are socialized as they grow up. At best, perhaps all we can say is that sexual orientation stems from a complex mix of biological and cultural factors that remain to be determined.
The official stance of the American Psychological Association (APA) is in line with this view. According to the APA, “There is no consensus among scientists about the exact reasons that an individual develops a heterosexual, bisexual, gay, or lesbian orientation. Although much research has examined the possible genetic, hormonal, developmental, social, and cultural influences on sexual orientation, no findings have emerged that permit scientists to conclude that sexual orientation is determined by any particular factor or factors. Many think that nature and nurture both play complex roles; most people experience little or no sense of choice about their sexual orientation” (American Psychological Association, 2008, p. 2).
Although the exact origins of sexual orientation remain unknown, the APA’s last statement is perhaps the most important conclusion from research on this issue: Most people experience little or no sense of choice about their sexual orientation. Because, as mentioned earlier, people are more likely to approve of or tolerate homosexuality when they believe it is not a choice, efforts to educate the public about this research conclusion should help the public become more accepting of LGBT behavior and individuals.
Key Takeaways
• An estimated 3.8 percent, or 9 million, Americans identify as LGBT.
• Homosexuality seems to have been fairly common and very much accepted in some ancient societies as well as in many societies studied by anthropologists.
• Scholars continue to debate the extent to which sexual orientation stems more from biological factors or from social and cultural factors and the extent to which sexual orientation is a choice or not a choice.
For Your Review
1. Do you think sexual orientation is a choice, or not? Explain your answer.
2. Write an essay that describes how your middle school and high school friends talked about sexual orientation generally and homosexuality specifically.
11.4 Public Attitudes About Sexual Orientation
Learning Objectives
• Understand the extent and correlates of heterosexism.
• Understand the nature of public opinion on other issues related to sexual orientation.
• Describe how views about LGBT issues have changed since a few decades ago.
As noted earlier, views about gays and lesbians have certainly been very negative over the centuries in the areas of the world, such as Europe and the Americas, that mostly follow the Judeo-Christian tradition. There is no question that the Bible condemns homosexuality, with perhaps the most quoted Biblical passages in this regard found in Leviticus:
• “Do not lie with a man as one lies with a woman; that is detestable” (Leviticus 18:22).
• “If a man lies with a man as one lies with a woman, both of them have done what is detestable. They must be put to death; their blood will be on their own heads” (Leviticus 20:13).
The Bible contains several passages that appear to condemn homosexuality. Sean MacEntee – Bible – CC BY 2.0.
The important question, though, is to what extent these passages should be interpreted literally. Certainly very few people today believe that male homosexuals should be executed, despite what Leviticus 20:13 declares. Still, many people who condemn homosexuality cite passages like Leviticus 18:22 and Leviticus 20:13 as reasons for their negative views.
This is not a theology text, but it is appropriate to mention briefly two points that many religious scholars make about what the Bible says about homosexuality (Helminiak, 2000; Via & Gagnon, 2003). First, English translations of the Bible’s antigay passages may distort their original meanings, and various contextual studies of the Bible suggest that these passages did not, in fact, make blanket condemnations about homosexuality.
Second, and perhaps more important, most people “pick and choose” what they decide to believe from the Bible and what they decide not to believe. Although the Bible is a great source of inspiration for many people, most individuals are inconsistent when it comes to choosing which Biblical beliefs to believe and about which beliefs not to believe. For example, if someone chooses to disapprove of homosexuality because the Bible condemns it, why does this person not also choose to believe that gay men should be executed, which is precisely what Leviticus 20:13 dictates? Further, the Bible calls for many practices and specifies many penalties that even very devout people do not follow or believe. For example, most people except for devout Jews do not keep kosher, even though the Bible says that everyone should do this, and most people certainly do not believe people who commit adultery, engage in premarital sex or work on the Sabbath should be executed, even though the Bible says that such people should be executed. Citing the inconsistency with which most people follow Biblical commands, many religious scholars say it is inappropriate to base public views about homosexuality on what the Bible says about it.
We now turn our attention to social science evidence on views about LGBT behavior and individuals. We first look at negative attitudes and then discuss a few other views.
The Extent of Heterosexism in the United States
We saw in earlier chapters that racism refers to negative views about, and practices toward, people of color, and that sexism refers to negative views about, and practices toward, women. Heterosexism is the analogous term for negative views about, and discriminatory practices toward, LGBT individuals and their sexual behavior.
There are many types of negative views about LGBT and thus many ways to measure heterosexism. The General Social Survey (GSS), given regularly to a national sample of US residents, asks whether respondents think that “sexual relations between two adults of the same sex” are always wrong, almost always wrong, sometimes wrong, or not wrong at all. In 2010, almost 46 percent of respondents said same-sex relations are “always wrong,” and 43 percent responded they are “not wrong at all” (see Figure 5.1 “Opinion about “Sexual Relations between Two Adults of the Same Sex,” 2010”).
Figure 5.1 Opinion about “Sexual Relations between Two Adults of the Same Sex,” 2010
Source: Data from General Social Survey. (2010). Retrieved from http://sda.berkeley.edu/cgi-bin/hsda?harcsda+gss10.
As another way of measuring heterosexism, the Gallup poll asks whether “gay or lesbian relations” are “morally acceptable or morally wrong” (Gallup, 2011). In 2011, 56 percent of Gallup respondents answered “morally acceptable,” while 39 percent replied “morally wrong.”
Although Figure 5.1 “Opinion about “Sexual Relations between Two Adults of the Same Sex,” 2010” shows that 57.3 percent of Americans (= 45.7 + 3.7 + 7.9) think that same-sex relations are at least sometimes wrong, public views regarding LGBT have notably become more positive over the past few decades. We can see evidence of this trend in Figure 5.2 “Changes in Opinion about “Sexual Relations between Two Adults of the Same Sex,” 1973–2010”, which shows that the percentage of GSS respondents who say same-sex relations are “always wrong” has dropped considerably since the GSS first asked this question in 1973, while the percentage who respond “not wrong at all” has risen considerably, with both these changes occurring since the early 1990s.
Figure 5.2 Changes in Opinion about “Sexual Relations between Two Adults of the Same Sex,” 1973–2010
Source: Data from General Social Surveys. (1973–2010). Retrieved from http://sda.berkeley.edu/cgi-bin/hsda?harcsda+gss10.
Trends in Gallup data confirm that public views regarding homosexuality have become more positive in recent times. Recall that 56 percent of Gallup respondents in 2011 called same-sex relations “morally acceptable,” while 39 percent replied “morally wrong.” Ten years earlier, these percentages were 40 percent and 53 percent, respectively, representing a marked shift in public opinion in just a decade.
Correlates of Heterosexism
Scholars have investigated the sociodemographic factors that predict heterosexist attitudes. Reflecting on the sociological axiom that our social backgrounds influence our attitudes and behavior, several aspects of our social backgrounds influence views about gays and lesbians. Among the most influential of these factors are gender, age, education, the region of residence, and religion. We can illustrate each of these influences with the GSS question on whether same-sex relations are wrong, using the response “always wrong” as a measure of heterosexism.
• Gender. Men are somewhat more heterosexist than women (see part a of Figure 5.3 “Correlates of Heterosexism (Percentage Saying That Same-Sex Relations Are “Always Wrong”)”).
• Age. Older people are considerably more heterosexist than younger people (see part b of Figure 5.3 “Correlates of Heterosexism (Percentage Saying That Same-Sex Relations Are “Always Wrong”)”).
• Education. Less educated people are considerably more heterosexist than more educated people (see part c of Figure 5.3 “Correlates of Heterosexism (Percentage Saying That Same-Sex Relations Are “Always Wrong”)”).
• Region of residence. Southerners are more heterosexist than non-Southerners (see part d of Figure 5.3 “Correlates of Heterosexism (Percentage Saying That Same-Sex Relations Are “Always Wrong”)”).
• Religion. Religious people are considerably more heterosexist than less religious people (see part e of Figure 5.3 “Correlates of Heterosexism (Percentage Saying That Same-Sex Relations Are “Always Wrong”)”).
Figure 5.3 Correlates of Heterosexism (Percentage Saying That Same-Sex Relations Are “Always Wrong”)
Source: Data from General Social Survey. (2010). Retrieved from http://sda.berkeley.edu/cgi-bin/hsda?harcsda+gss10.
Because young people are especially likely to be accepting of homosexuality, attitudes about LGBT issues should continue to improve as the older population passes away. hepingting – CB106492 – CC BY-SA 2.0.
The age difference in heterosexism is perhaps particularly interesting. Many studies find that young people—those younger than 30—are especially accepting of homosexuality and of same-sex marriage. As older people, who have more negative views, pass away, it is likely that public opinion as a whole will become more accepting of homosexuality and issues related to it. Scholars think this trend will further the legalization of same-sex marriage and the establishment of other laws and policies that will reduce the discrimination and inequality that the LGBT community experiences (Gelman, Lax, & Phillips, 2010).
Opinion on the Origins of Sexual Orientation
Earlier we discussed scholarly research on the origins of sexual orientation. In this regard, it is interesting to note that the US public is rather split over the issue of whether sexual orientation is in-born instead the result of environmental factors, and also over the closely related issue of whether it is something people are able to choose. A 2011 Gallup poll asked, “In your view, is being gay or lesbian something a person is born with, or due to factors such as upbringing and environment?” (Jones, 2011). Forty percent of respondents replied that sexual orientation is in-born, while 42 percent said it stems from upbringing and/or environment. The 40 percent in-born figure represented a sharp increase from the 13 percent figure that Gallup obtained when it first asked this question in 1977. A 2010 CBS News poll, asked, “Do you think being homosexual is something people choose to be, or do you think it is something they cannot change?” (CBS News, 2010). About 36 percent of respondents replied that homosexuality is a choice, while 51 percent said it is something that cannot be changed, with the remainder saying they did not know or providing no answer. The 51 percent “cannot change” figure represented an increase from the 43 percent figure that CBS News obtained when it first asked this question in 1993.
Other Views
The next section discusses several issues that demonstrate inequality based on sexual orientation. Because these issues are so controversial, public opinion polls have included many questions about them. We examine public views on some of these issues in this section.
A first issue is same-sex marriage. The 2010 GSS asked whether respondents agree that “homosexual couples should have the right to marry one another”: 53.3 percent of respondents who expressed an opinion agreed with this statement, and 46.7 percent disagreed, indicating a slight majority in favor of legalizing same-sex marriage (SDA, 2010). In 2011, an ABC News/Washington Post poll asked about same-sex marriage in a slightly different way: “Do you think it should be legal or illegal for gay and lesbian couples to get married?” A majority, 51 percent, of respondents, replied “legal,” and 45 percent replied, “illegal” (Langer, 2011). Although only bare majorities now favor legalizing same-sex marriage, public views on this issue have become much more positive in recent years. We can see dramatic evidence of this trend in Figure 5.4 “Changes in Opinion about Same-Sex Marriage, 1988–2010 (Percentage Agreeing That Same-Sex Couples Should Have the Right to Marry; Those Expressing No Opinion Excluded from Analysis)”, which shows that the percentage agreeing with the GSS question on the right of same-sex couples to marry has risen considerably during the past quarter-century.
Figure 5.4 Changes in Opinion about Same-Sex Marriage, 1988–2010 (Percentage Agreeing That Same-Sex Couples Should Have the Right to Marry; Those Expressing No Opinion Excluded from Analysis)
Source: Data from General Social Surveys. (1988–2010). Retrieved from http://sda.berkeley.edu/cgi-bin/hsda?harcsda+gss10.
In a related topic, public opinion about same-sex couples as parents has also become more favorable in recent years. In 2007, 50 percent of the public said that the increasing number of same-sex couples raising children was “a bad thing” for society. By 2011, this figure had declined to 35 percent, a remarkable decrease in just four years (Pew Research Center, 2011).
A second LGBT issue that has aroused public debate involves the right of gays and lesbians to serve in the military, which we discuss further later in this chapter. A 2010 ABC News/Washington Post poll asked whether “gays and lesbians who do not publicly disclose their sexual orientation should be allowed to serve in the military” (Mokrzycki, 2010). About 83 percent of respondents replied they “should be allowed,” up considerably from the 63 percent figure that this poll obtained when it first asked this question in 1993 (Saad, 2008).
A third issue involves the right of gays and lesbians to be free from job discrimination based on their sexual orientation, as federal law does not prohibit such discrimination. A 2008 Gallup poll asked whether “homosexuals should or should not have equal rights in terms of job opportunities.” About 89 percent of respondents replied that there “should be” such rights, and only 8 percent said there “should not be” such rights. The 89 percent figure represented a large increase from the 56 percent figure that Gallup obtained in 1977 when Gallup first asked this question.
Two Brief Conclusions on Public Attitudes
We have had limited space to discuss public views on LGBT topics, but two brief conclusions are apparent from the discussion. First, although the public remains sharply divided on various LGBT issues and much of the public remains heterosexist, views about LGBT behavior and certain rights of the LGBT community have become markedly more positive in recent decades. This trend matches what we saw in earlier chapters regarding views concerning people of color and women. The United States has without question become less racist, less sexist, and less heterosexist since the 1970s.
Second, certain aspects of people’s sociodemographic backgrounds influence the extent to which they do, or do not, hold heterosexist attitudes. This conclusion is not surprising, as sociology has long since demonstrated that social backgrounds influence many types of attitudes and behaviors, but the influence we saw earlier of sociodemographic factors on heterosexism was striking nonetheless. These factors would no doubt also be relevant for understanding differences in views on other LGBT issues. As you think about your own views, perhaps you can recognize why you might hold these views based on your gender, age, education, and other aspects of your social background.
Key Takeaways
• Views about LGBT behavior have improved markedly since a generation ago. More than half the US public now supports same-sex marriage.
• Males, older people, the less educated, Southerners, and the more religious exhibit higher levels of heterosexism than their counterparts.
For Your Review
1. Reread this section and indicate how you would have responded to every survey question discussed in the section. Drawing on the discussion of correlates of heterosexism, explain how knowing about these correlates helps you understand why you hold your own views.
2. Why do you think public opinion about LGBT behavior and issues has become more positive during the past few decades?
11.5 Inequality Based on Sexual Orientation
Learning Objectives
• Understand the behavioral, psychological, and health effects of bullying and other mistreatment of the LGBT community.
• Evaluate the arguments for and against same-sex marriage.
• Provide three examples of heterosexual privilege.
Until just a decade ago, individuals who engaged in consensual same-sex relations could be arrested in many states for violating so-called sodomy laws. The US Supreme Court, which had upheld such laws in 1986, finally outlawed them in 2003 in Lawrence v. Texas, 539 US 558, by a 6–3 vote. The majority opinion of the court declared that individuals have a constitutional right under the Fourteenth Amendment to engage in consensual, private sexual activity.
Until the Supreme Court’s Lawrence v. Texas ruling just a decade ago, individuals who engaged in consensual same-sex relations could be arrested in many states. philippe leroyer – Kiss In (08) – CC BY-NC-ND 2.0.
Despite this landmark ruling, the LGBT community continues to experience many types of problems. In this regard, sexual orientation is a significant source of social inequality, just as race/ethnicity, gender, and social class are sources of social inequality. We examine manifestations of inequality based on sexual orientation in this section.
Bullying and Violence
The news story that began this chapter concerned the reported beatings of two gay men. Bullying and violence against adolescents and adults thought or known to be gay or lesbian constitute perhaps the most serious manifestation of inequality based on sexual orientation. According to the Federal Bureau of Investigation (2011), 1,277 hate crimes (violence and/or property destruction) against gays and lesbians occurred in 2010, although this number is very likely an underestimate because many hate crime victims do not report their victimization to the police. An estimated 25 percent of gay men have been physically or sexually assaulted because of their sexual orientation (Egan, 2010), and some have been murdered. Matthew Shepard was one of these victims. He was a student at the University of Wyoming in October 1998 when he was kidnapped by two young men who tortured him, tied him to a fence, and left him to die. When finding out almost a day later, he was in a coma, and he died a few days later. Shepard’s murder prompted headlines around the country and is credited with winning public sympathy for the problems experienced by the LGBT community (Loffreda, 2001).
Gay teenagers and straight teenagers thought to be gay are very often the targets of taunting, bullying, physical assault, and other abuse in schools and elsewhere (Denizet-Lewis, 2009). Survey evidence indicates that 85 percent of LGBT students report being verbally harassed at school, and 40 percent report being verbally harassed; 72 percent report hearing antigay slurs frequently or often at school; 61 percent feel unsafe at school, with 30 percent missing at least one day of school in the past month for fear of their safety; and 17 percent are physically assaulted to the point they need medical attention (Kosciw, Greytak, Diaz, & Bartkiewicz, 2010).
The bullying, violence, and other mistreatment experienced by gay teens have significant educational and mental health effects. The most serious consequence is a suicide, as a series of suicides by gay teens in fall 2010 reminded the nation. During that period, three male teenagers in California, Indiana, and Texas killed themselves after reportedly being victims of antigay bullying, and a male college student also killed himself after his roommate broadcast a live video of the student making out with another male (Talbot, 2010).
In other effects, LGBT teens are much more likely than their straight peers to skip school; to do poorly in their studies; to drop out of school; and to experience depression, anxiety, and low self-esteem (Mental Health America, 2011). These mental health problems tend to last at least into their twenties (Russell, Ryan, Toomey, Diaz, & Sanchez, 2011). According to a 2011 report by the Centers for Disease Control and Prevention (CDC), LGBT teens are also much more likely to engage in risky and/or unhealthy behaviors such as using tobacco, alcohol, and other drugs, having unprotected sex, and even not using a seatbelt (Kann et al., 2011). Commenting on the report, a CDC official said, “This report should be a wake-up call. We are very concerned that these students face such dramatic disparities for so many different health risks” (Melnick, 2011).
Ironically, despite the bullying and another mistreatment that LBGT teens receive at school, they are much more likely to be disciplined for misconduct than straight students accused of similar misconduct. This disparity is greater for girls than for boys. The reasons for the disparity remain unknown but may stem from unconscious bias against gays and lesbians by school officials. As a scholar in educational psychology observed, “To me, it is saying there is some kind of internal bias that adults are not aware of that is impacting the punishment of this group” (St. George, 2010).
This candlelight vigil honored the memory of Matthew Shepard, a gay college student, who was tortured, tied, to a fence, and left to die in Wyoming in 1998. He was in a coma when he was found and died a few days later. Elvert Barnes – 21.MatthewShepard.CandleVigil.WDC.14October1998 – CC BY 2.0.
Children and Our Future
The Homeless Status of LGBT Teens
Many LGBT teens are taunted, bullied, and otherwise mistreated at school. As the text discusses, this mistreatment affects their school performance and psychological well-being, and some even drop out of school as a result. We often think of the home as a haven from the realities of life, but the lives of many gay teens are often no better at home. If they come out (disclose their sexual orientation) to their parents, one or both parents often reject them. Sometimes they kick their teen out of the home, and sometimes the teen leaves because the home environment has become intolerable. Regardless of the reason, a large number of LGBT teens become homeless. They may be living in the streets, but they may also be living with a friend, at a homeless shelter, or at some other venue. But the bottom line is that they are not living at home with a parent.
The actual number of homeless LGBT teens will probably never be known, but a study in Massachusetts of more than 6,300 high school students was the first to estimate the prevalence of their homelessness using a representative sample. The study found that 25 percent of gay or lesbian teens and 15 percent of bisexual teens are homeless in the state, compared to only 3 percent of heterosexual teens. Fewer than 5 percent of the students in the study identified themselves as LGB, but they accounted for 19 percent of all the homeless students who were surveyed. Regardless of their sexual orientation, some homeless teens live with a parent or guardian, but the study found that homeless LGBT teens were more likely than their heterosexual counterparts to be living without a parent.
Being homeless adds to the problems that many LGBT teens already experience. Regardless of sexual orientation, homeless people of all ages are at greater risk for victimization by robbers and other offenders, hunger, substance abuse, and mental health problems.
The study noted that LGBT teen homelessness may be higher in other states because attitudes about LGBT status are more favorable in Massachusetts than in many other states. Because the study was administered to high school students, it may have undercounted LGBT teens, who are more likely to be absent from school.
These methodological limitations should not obscure the central message of the study as summarized by one of its authors: “The high risk of homelessness among sexual minority teens is a serious problem requiring immediate attention. These teens face enormous risks and all types of obstacles to succeeding in school and are in need of a great deal of assistance.”
Sources: Connolly, 2011; Corliss, Goodenow, Nichols, & Austin, 2011
Employment Discrimination
Federal law prohibits employment discrimination based on race, nationality, sex, or religion. Notice that this list does not include sexual orientation. It is entirely legal under federal law for employers to refuse to hire LGBT individuals or those perceived as LGBT, to fire an employee who is openly LGBT or perceived as LGBT, or to refuse to promote such an employee. Twenty-one states do prohibit employment discrimination based on sexual orientation, but that leaves twenty-nine states that do not prohibit such discrimination. Employers in these states are entirely free to refuse to hire, fire, or refuse to promote LGBT people (openly LGBT or perceived as LGBT) as they see fit. In addition, only fifteen states prohibit employment discrimination based on gender identity (transgender), which leaves thirty-five states in which employers may practice such discrimination (Human Rights Campaign, 2011).
The Employment Non-Discrimination Act (ENDA), which would prohibit job discrimination based on sexual orientation or gender identity, has been proposed in Congress but has not come close to passing. In response to the absence of legal protection for LGBT employees, many companies have instituted their own policies. As of March 2011, 87 percent of the Fortune 500 companies, the largest 500 corporations in the United States, had policies prohibiting sexual orientation discrimination, and 46 percent had policies prohibiting gender identity discrimination (Human Rights Campaign, 2011).
National survey evidence shows that many LGBT people have, in fact, experienced workplace discrimination (Sears & Mallory, 2011). In the 2008 GSS, 27.1 percent of LGB respondents said they had been verbally harassed at work during the past five years, and 7.1 percent said they had been either fired or not hired during the same period (SDA, 2008). In other surveys that are not based on nationally representative samples, the percentage of LGB respondents who report workplace harassment or discrimination exceeds the GSS’s figures. Not surprisingly, more than one-third of LGB employees say they conceal their sexual orientation in their workplace. Transgender people appear to experience more employment problems than LGB people, as 78 percent of transgender respondents in one study reported some form of workplace harassment or discrimination. Scholars have also conducted field experiments in which they send out resumes or job applicants to prospective employers. The resumes are identical except that some mention the applicant is LGB, while the others do not indicate sexual orientation. The job applicants similarly either say they are LGB or do not say this. The LGB resumes and applicants are less likely than their non-LGB counterparts to receive a positive response from prospective employers.
LGBT people who experience workplace harassment and discrimination suffer in other ways as well (Sears & Mallory, 2011). Compared to LGBT employees who do not experience these problems, they are more likely to have various mental health issues, to be less satisfied with their jobs, and to have more absences from work.
Applying Social Research
How Well Do the Children of Same-Sex Couples Fare?
Many opponents of same-sex marriage claim that children are better off if they are raised by both a mother and a father and that children of same-sex couples fare worse as a result. As the National Organization for Marriage (National Organization for Marriage, 2011) states, “Two men might each be a good father, but neither can be a mom. The ideal for children is the love of their own mom and dad. No same-sex couple can provide that.”
Addressing this contention, social scientists have studied the children of same-sex couples and compared them to the children of heterosexual parents. Although it is difficult to have random, representative samples of same-sex couples’ children, a growing number of studies find that these children fare at least as well psychologically and in other respects as heterosexual couples’ children.
Perhaps the most notable published paper in this area appeared in the American Sociological Review, the preeminent sociology journal, in 2001. The authors, Judith Stacey and Timothy J. Biblarz, reviewed almost two dozen studies that had been done of same-sex couples’ children. All these studies yielded the central conclusion that the psychological well-being of these children is no worse than that of heterosexual couples’ children. As the authors summarized this conclusion and its policy implications, “Because every relevant study to date shows that parental sexual orientation per se has no measurable effect on the quality of parent-child relationships or on children’s mental health or social adjustment, there is no evidentiary basis for considering parental sexual orientation in decisions about children’s ‘best interest.’”
Biblarz and Stacey returned to this issue in a 2010 article in the Journal of Marriage and the Family, the preeminent journal in its field. This time they reviewed almost three dozen studies published since 1990 that compared the children of same-sex couples (most of them lesbian parents) to those of heterosexual couples. They again found that the psychological well-being and social adjustment of same-sex couples’ children was at least as high as those of heterosexual couples’ children, and they even found some evidence that children of lesbian couples fare better in some respects than those of heterosexual couples. Although the authors acknowledged that two parents are generally better for children than one parent, they concluded that the sexual orientation of the parents makes no difference overall. As they summarized the body of research on this issue: “Research consistently has demonstrated that despite prejudice and discrimination children raised by lesbians develop as well as their peers. Across the standard panoply of measures, studies find far more similarities than differences among children with lesbian and heterosexual parents, and the rare differences mainly favor the former.”
This body of research, then, contributes in important ways to the national debate on same-sex marriage. If children of same-sex couples indeed farewell, as the available evidence indicates, concern about these children’s welfare should play no part in this debate.
Same-Sex Marriage
Same-sex marriage has been one of the most controversial social issues in recent years. Nearly 650,000 same-sex couples live together in the United States (Gates, 2012). Many of them would like to marry, but most are not permitted by law to marry. In May 2012, President Obama endorsed same-sex marriage.
The issue of same-sex marriage has aroused much controversy in recent years. As of June 2012, same-sex couples could marry in only seven states and the District of Columbia. Elvert Barnes – 70a Marriage Equality US Capitol – CC BY-SA 2.0.
We saw earlier that a narrow margin of Americans now favors the right of same-sex couples to marry, and that public opinion in favor of same-sex marriage has increased greatly in recent times. As of June 2012, same-sex marriage was legal in seven states (Connecticut, Iowa, Maryland, Massachusetts, New Hampshire, New York, Vermont, and Washington) and the District of Columbia. Nine other states permitted same-sex couples to form civil unions or domestic partnerships, which provide some or many of the various legal benefits that married spouses enjoy. In the remaining thirty-five states, same-sex couples may not legally marry or form civil unions or domestic partnerships. The federal Defense of Marriage Act (DOMA), passed in 1996 (and under legal dispute at the time of this writing), prohibits federal recognition of same-sex marriage. This means that even when same-sex couples legally marry because their state allows them to, they do not enjoy the various federal tax, inheritance, and other benefits that married couples enjoy. Most of the states that do not allow same-sex marriage also have laws that prohibit recognition of same-sex marriages performed in the states that allow them.
Arguments against same-sex marriage. Opponents of same-sex marriage make at least three central points (Emrich, 2009; National Organization for Marriage, 2011). First, and in no particular order, marriage is intended to procreate the species, and same-sex couples cannot reproduce. Second, the children that same-sex couples do have through adoption or artificial means experience various psychological problems because their parents are gay or lesbian and/or because they do not have both a father and a mother. Third, allowing gays and lesbians to marry would undermine the institution of marriage.
Arguments for same-sex marriage. In reply, proponents of same-sex marriage make their own points (Barkan, Marks, & Milardo, 2009; Human Rights Campaign, 2009). First, many heterosexual couples are allowed to marry even though they will not have children, either because they are not able to have them, because they do not wish to have them, or because they are beyond childbearing age. Second, studies show that children of same-sex couples are at least as psychologically healthy as the children of opposite-sex couples (see Note 5.12 “Children and Our Future”). Third, there is no evidence that legalizing same-sex marriage has weakened the institution of marriage in the few states and other nations that have legalized it (see Note 5.14 “Lessons from Other Societies”).
Lessons from Other Societies
Same-Sex Marriage in the Netherlands
At the time of this writing, same-sex marriage was legal in ten nations: Argentina, Belgium, Canada, Iceland, the Netherlands, Norway, Portugal, Spain, South Africa, and Sweden. All these nations have legalized it since 2001, when the Netherlands became the first country to do so. Because more than a decade has passed since this notable event, it is informative to examine how, if at all, legalization has affected the lives of gays and lesbians and the institution of marriage itself in the Netherlands.
One thing is clear: There is no evidence that the institution of marriage in the Netherlands has in any respect become weaker because same-sex couples have been allowed to marry since 2001. Heterosexual couples continue to marry, and the institution appears at least as strong as it was before 2001. It also seems clear that same-sex marriages are working and that same-sex married couples’ unions are accepted as normal features of contemporary Dutch life. As Vera Bergkamp, a gay rights leader in the Netherlands said, “Gay marriage is Holland’s best export because we have shown that it is possible.”
In an interesting development, same-sex couples have not exactly rushed to marry. There was an initial spurt in 2001, and many such couples have married since. However, the Dutch government estimates that only 20 percent of same-sex couples have married compared to 80 percent of heterosexual couples.
Three reasons may account for this disparity. First, there is less pressure from family and friends for same-sex couples to marry than for heterosexual couples to marry. As Bergkamp put it, “For heterosexuals, it’s normal when you’re in a steady relationship for more than a year, that a lot of people start asking, ‘well when are you getting married?’ With two women or two men you don’t get that yet.” Second, fewer same-sex couples than heterosexual couples decide to marry in order to have children. Third, gays and lesbians in the Netherlands are thought to be somewhat more individualistic than their heterosexual counterparts.
The same-sex couples who have married in the Netherlands seem happy to have done so, at least according to anecdotal evidence. As one same-sex spouse reflected on her marriage, “It was a huge step. For me it was incredible…I’d been to my brother’s wedding and my sister’s wedding and their spouses were welcomed into the family. Now finally I was able to have my family take my partner in. The moment we got married there was a switch, she was now one of us.”
The experience of the Netherlands is mirrored in the other nine nations that have legalized same-sex marriage. Legalization seems to be working from all accounts, and the institution of marriage seems to be thriving at least as well as in other nations. As the first openly gay member of the Dutch parliament who played a key role in legalization wryly described its outcome, “Heterosexual couples did not turn away from the institution of marriage, and nor did the world isolate my country. After the Netherlands acted, civilization as we know it didn’t end.” As the United States continues to debate same-sex marriage, it has much to learn from the Netherlands and the other nations that have legalized this form of marriage.
Sources: Ames, 2011; Badgett, 2009; Dittrich, 2011
Although the children of same-sex couples fare at least as well as those of heterosexual couples, it is still difficult in many states for same-sex couples to adopt a child. Two states at the time of this writing, Mississippi, and Utah, prohibit adoptions by same-sex couples, but half of the other states make it very difficult for these adoptions to occur (Tavernise, 2011). For example, in some states, social workers are required to prefer married heterosexual couples over same-sex couples in adoption decisions. Moreover, several states require that a couple must be married to be adopted; in these states, a single gay or lesbian may adopt, but not a same-sex couple. Still, adoptions by same-sex couples have become more numerous in recent years because of the number of children waiting for adoption and because public opinion about gays and lesbians has become more favorable.
Costs of the Illegality of Same-Sex Marriage
Marriage provides many legal rights, benefits, and responsibilities for the two spouses. Because same-sex couples are not allowed to marry in most states and, even if they do marry, are currently denied federal recognition of their marriage, they suffer materially in numerous ways. In fact, there are more than 1,000 federal rights that heterosexual married couples receive that no married same-sex couple is allowed to receive (Shell, 2011).
We have space here to list only a few of the many costs that the illegality of same-sex marriage imposes on same-sex couples who cannot marry and on the same-sex couples whose marriages are not federally recognized (Human Rights Campaign, 2009):
• Spouses have visitation rights if one of them is hospitalized as well as the right to make medical decisions if one spouse is unable to do so; same-sex couples do not have these visitation rights.
• Same-sex couples cannot file joint federal tax returns or joint state tax returns (in the states that do not recognize same-sex marriage), potentially costing each couple thousands of dollars every year in taxes they would not have to pay if they were able to file jointly.
• Spouses receive Social Security survivor benefits averaging more than \$5,500 annually when a spouse dies; same-sex couples do not receive these benefits.
• Many employers who provide health insurance coverage for the spouse of an employee do not provide this coverage for a same-sex partner; when they do provide this coverage, the employee must pay taxes on the value of the coverage.
• When a spouse dies, the surviving spouse inherits the deceased spouse’s property without paying estate taxes; the surviving partner of a same-sex couple must pay estate taxes.
Notice that many of these costs are economic. It is difficult to estimate the exact economic costs of the illegality of same-sex marriage, but one analysis estimated that these costs can range from \$41,000 to as much as \$467,000 over the lifetime of a same-sex couple, depending on their income, state of residence, and many other factors (Bernard & Leber, 2009).
Military Service
LGBT individuals traditionally were not permitted to serve in the US military. If they remained in the closet (hid evidence of their sexual orientation), of course, they could serve with impunity, but many gays and lesbians in the military were given dishonorable discharges when their sexual orientation was discovered. Those who successfully remained in the closet lived under continual fear that their sexual orientation would become known and they would be ousted from the military.
As a presidential candidate in 1992, Bill Clinton said he would end the ban on LGBT people in the military. After his election, his intention to do so was met with fierce opposition by military leaders, much of the Congress, and considerable public opinion. As a compromise, in 1993 the government established the so-called don’t-ask, don’t-tell (DADT) policy. DADT protected members of the military from being asked about their sexual orientation, but it also stipulated that they would be discharged from the military if they made statements or engaged in behavior that indicated an LGBT orientation. Because DADT continued the military ban on LGBT people, proponents of allowing them to serve in the military opposed the policy and continued to call for the elimination of any restrictions regarding sexual orientation for military service.
In response to a lawsuit, a federal judge in 2010 ruled that DADT was unconstitutional. Meanwhile, Barack Obama had also called for the repeal of DADT, both as a presidential candidate and then as president. In late 2010, Congress passed legislation repealing DADT, and President Obama signed the legislation, which took effect in September 2011. Official discrimination against gays and lesbians in the military has thus ended, and they may now serve openly in the nation’s armed forces. It remains to be seen, however, whether they will be able to serve without facing negative experiences such as verbal and physical abuse.
Physical and Mental Health
It is well known that HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) racked the LGBT community beginning in the 1980s. Many gays and lesbians eventually died from AIDS-related complications, and HIV and AIDS remain serious illnesses for gays and straights alike. An estimated 1.2 million Americans now have HIV, and about 35,000 have AIDS. Almost 50,000 Americans are diagnosed with HIV annually, and more than half of these new cases are men who have had sex with other men. Fortunately, HIV can now be controlled fairly well by appropriate medical treatment (Centers for Disease Control and Prevention, 2011).
It is less well known that LGBT adults have higher rates than straight adults of other physical health problems and also of mental health problems (Frost, Lehavot, & Meyer, 2011; Institute of Medicine, 2011). These problems are thought to stem from the stress that the LGBT community experiences from living in a society in which they frequently encounter verbal and physical harassment, job discrimination, a need for some to conceal their sexual identity, and lack of equal treatment arising from the illegality of same-sex marriage. We saw earlier that LGBT secondary school students experience various kinds of educational and mental health issues because of the mistreatment they encounter. By the time LGBT individuals reach their adult years, the various stressors they have experienced at least since adolescence has begun to take a toll on their physical and mental health.
The stress of being LGBT in a society that disapproves of this sexual orientation is thought to account for the greater likelihood of LGBT people to have physical and mental health problems. Patrik Nygren – LGBT rights – CC BY-SA 2.0.
Because stress is thought to compromise immune systems, LGBT individuals on the average have lower immune functioning and lower perceived physical health than straight individuals. Because stress impairs mental health, they are also more likely to have higher rates of depression, loneliness, low self-esteem, and other psychiatric and psychological problems, including a tendency to attempt suicide (Sears & Mallory, 2011). Among all LGBT individuals, those who have experienced greater levels of stress related to their sexual orientation have higher levels of physical and mental health problems than those who have experienced lower levels of stress. It is important to keep in mind that these various physical and mental health problems do not stem from an LGBT sexual orientation in and of itself, but rather from the experience of living as an LGBT individual in a homophobic (disliking LGBT behavior and individuals) society.
Despite the health problems that LGBT people experience, medical students do not learn very much about these problems. A recent survey of medical school deans found that one-third of medical schools provide no clinical training about these health issues and that students in the medical schools that do provide training still receive only an average of five hours of training (Obedin-Maliver et al., 2011). The senior author of the study commented on its findings, “It’s great that a lot of schools are starting to teach these topics. But the conversation needs to go deeper. We heard from the deans that a lot of these important LGBT health topics are completely off the radar screens of many medical schools” (White, 2011).
Heterosexual Privilege
In earlier chapters, we discussed the related concepts of white privilege and male privilege. To recall, simply because they are white, whites can go through their daily lives without worrying about or experiencing the many kinds of subtle and not-so-subtle negative events that people of color experience. Moreover, simply because they are male, men can go through their daily lives without worrying about or experiencing the many kinds of subtle and not-so-subtle negative events that women experience. Whether or not they are conscious of it, therefore, whites and men are automatically privileged compared to people of color and women, respectively.
An analogous concept exists in the study of sexual orientation and inequality. This concept is heterosexual privilege, which refers to the many advantages that heterosexuals (or people perceived as heterosexuals) enjoy simply because their sexual orientation is not LGBT. There are many such advantages, and we have space to list only a few:
• Heterosexuals can be out day or night or at school or workplaces without fearing that they will be verbally harassed or physically attacked because of their sexuality or that they will hear jokes about their sexuality.
• Heterosexuals do not have to worry about not being hired for a job, about being fired, or not being promoted because of their sexuality.
• Heterosexuals can legally marry everywhere in the United States and receive all the federal, state, and other benefits that married couples receive.
• Heterosexuals can express a reasonable amount of affection (holding hands, kissing, etc.) in public without fearing negative reactions from onlookers.
• Heterosexuals do not have to worry about being asked why they prefer opposite-sex relations, being criticized for choosing their sexual orientation or being urged to change their sexual orientation.
• Heterosexual parents do not have to worry about anyone questioning their fitness as parents because of their sexuality.
• Heterosexuals do not have to feel the need to conceal their sexual orientation.
• Heterosexuals do not have to worry about being accused of trying to “push” their sexuality onto other people.
People Making a Difference
Improving the Family Lives of LGBT Youth
Many organizations and agencies around the country aim to improve the lives of LGBT teens. One of them is the Family Acceptance Project (FAP) at San Francisco State University, which focuses on the family problems that LGBT teens often experience. According to its website, FAP is “the only community research, intervention, education, and policy initiative that works to decrease major health and related risks for [LGBT] youth, such as suicide, substance abuse, HIV and homelessness—in the context of their families. We use a research-based, culturally grounded approach to help ethnically, socially and religiously diverse families decrease rejection and increase support for their LGBT children.”
To accomplish its mission, FAP engages in two types of activities: research and family support services. In the research area, FAP has published some pioneering studies of the effects of school victimization and of family rejection and acceptance on the physical and mental health of LGBT teens during their adolescence and into their early adulthood. In the family support services area, FAP provides confidential advice, information, and counseling to families with one or more LGBT children or adolescents, and it also has produced various educational materials for these families and for professionals who deal with LGBT issues. At the time of this writing, FAP was producing several documentary videos featuring LGBT youth talking about their family situations and other aspects of their lives. Its support services and written materials are available in English, Spanish, and Cantonese.
Through its pioneering efforts, the Family Acceptance Project is one of many organizations making a difference in the lives of LGBT youth. For further information about FAP, visit http://familyproject.sfsu.edu.
Key Takeaways
• Bullying, taunting, and violence are significant problems for the LGBT community.
• LGBT people are at greater risk for behavioral and physical and mental health problems because of the many negative experiences they encounter.
• Federal law does not protect LGBT individuals from employment discrimination.
• The children of same-sex couples fare at least as well as children of heterosexual couples.
For Your Review
1. Do you know anyone who has ever been bullied and taunted for being LGBT or for being perceived as LGBT? If so, describe what happened.
2. Write a brief essay in which you summarize the debate over same-sex marriage, provide your own view, and justify your view.
11.6 Improving the Lives of the LGBT Community
Learning Objectives
• Understand which measures show promise of reducing inequality based on sexual orientation.
The inequality arising from sexual orientation stems from long-standing and deep-rooted prejudice against nonheterosexual attraction and behavior and against the many people whose sexual orientation is not heterosexual. We have seen in this chapter that attitudes about and related to same-sex sexuality has become markedly more positive since a generation ago. Reflecting this trend, the number of openly gay elected officials and candidates for office has increased greatly since a generation ago, and the sexual orientation of candidates appears to be a non-issue in many areas of the nation (Page, 2011). In a 2011 Gallup poll, two-thirds of Americans said they would vote for a gay candidate for president, up from only one-fourth of Americans in 1978 (Page, 2011). Also in 2011, the US Senate confirmed the nomination of the first openly gay man for a federal judgeship (Milbank, 2011). To paraphrase the slogan of a nationwide campaign aimed at helping gay teens deal with bullying and another mistreatment, it is getting better.
Much of this improvement must be credited to the gay rights movement that is popularly thought to have begun in June 1969 in New York City after police raided a gay bar called the Stonewall Inn and arrested several people inside. A crowd of several hundred people gathered and rioted in protest that night and the next night. The gay rights movement had begun.
Despite the advances, this movement has made and despite the improvement in public attitudes about LGBT issues, we have seen in this chapter that LGBT people continue to experience many types of inequality and other problems. As with inequality based on race and/or ethnicity, social class, and gender, there is much work still to be done to reduce inequality based on sexual orientation.
For such inequality to be reduced, it is certainly essential that heterosexuals do everything possible in their daily lives to avoid any form of mistreatment of LGBT individuals and to treat them as they would treat any heterosexual. Beyond this, certain other measures should help address LGBT inequality. These measures might include, but are not limited to, the following:
1. Parents should make clear to their children that all sexual orientations are equally valid. Parents whose child happens to be LGBT should love that child at least as much as they would love a heterosexual child.
2. School programs should continue and strengthen their efforts to provide students a positive environment in regard to sexual orientation and to educate them about LGBT issues. Bullying and other harassment of LGBT students must not be tolerated. In 2011, California became the first state to require the teaching of gay and lesbian history; other states should follow this example.
3. Federal law should prohibit employment discrimination against LGBT people, and same-sex marriages should become legal throughout the United States. In the meantime, new legislation should provide same-sex couples the same rights, responsibilities, and benefits that heterosexual married couples have.
4. Police should continue to educate themselves about LGBT issues and should strengthen their efforts to ensure that physical attacks on LGBT people are treated at least as seriously as attacks on heterosexual people are treated.
Key Takeaways
• Although the gay rights movement has made significant advances, many types of inequality based on sexual orientation continue to exist.
• Several measures should be begun or continued to reduce inequality based on sexual orientation.
For Your Review
1. Is there a gay rights advocacy group on your campus? If so, what is your opinion of it?
2. How do you think parents should react if their teenaged daughter or son comes out to them?
Explain your answer.
11.7 Sexual Orientation & Inequality Summary
Summary
1. Sexual orientation refers to a person’s preference for sexual relationships with individuals of the other sex, one’s own sex, or both sexes. The term also increasingly refers to transgender individuals, whose behavior, appearance, and/or gender identity departs from conventional norms.
2. According to national survey evidence, almost 4 percent of American adults identify as LGBT (lesbian/gay/bisexual/transgender), a figure equivalent to 9 million adults. Almost 20 million have engaged in same-sex relations.
3. Male homosexuality in ancient Greece and Rome seems to have been accepted and rather common, but Europe, the Americas, and other areas influenced by the Judeo-Christian tradition have long viewed homosexuality very negatively. In many societies studied by anthropologists, homosexuality is rather common and considered a normal form of sexuality.
4. Scholars continue to debate whether sexual orientation is more the result of biological factors or social and cultural factors. Related to this debate, the public is fairly split over the issue of whether sexual orientation is a choice or something over which people have no control.
5. Heterosexism in the United States is higher among men than among women, among older people than younger people, among the less educated than among the more highly educated, among Southerners than among non-Southerners, and among more religious people than among less religious people. Levels of heterosexism have declined markedly since a generation ago.
6. Sexual orientation is a significant source of inequality. LGBT individuals experience bullying, taunting, and violence; they may experience employment discrimination, and they are not allowed to marry in most states. Because of the stress of living as LGBT, they are at greater risk than heterosexuals for several types of physical and mental health problems.
Using What You Know
You’re working in a medium-sized office and generally like your coworkers. However, occasionally you hear them make jokes about gays and lesbians. You never laugh at these jokes, but neither have you ever said anything critical about them. Your conscience is bothering you, but you also know that if you tell your supervisor or coworkers that their joking makes you feel uncomfortable, they may get angry with you and even stop talking to you. What do you decide to do?
What You Can Do
To help reduce inequality based on sexual orientation, you may wish to do any of the following:
1. Start or join an LGBT advocacy group on your campus.
2. Write a letter to the editor in favor of same-sex marriage.
3. Urge your US Senators and Representative to pass legislation prohibiting employment discrimination on the basis of sexual orientation.
4. Work for a social service agency in your local community that focuses on the needs of LGBT teens.
11.8 Pornography
Pornography may be defined as printed or visual materials that are sexually explicit and that are intended to arouse sexual excitement rather than artistic appreciation. This definition is fine as far as it goes, but it does raise many questions that underscore the difficulty of dealing with prostitution. For example, how “explicit” must a printed or visual material be for it to be explicit? Is a picture of a woman in a skimpy negligee explicit, or must she be fully unclothed? If a woman in a photo is wearing an evening gown that is very low-cut, is that explicit? If a young male gets aroused by seeing her cleavage, does that make the photo of her pornographic? If two people on network television are obviously beginning to have consensual sex just before a commercial begins (this is network television, after all), is that explicit and arousing enough to constitute pornography? If you answered no to this last question, what if some viewers did find this short portrayal of consensual sex to be explicit and arousing? Is their reaction enough for us to have to conclude that the scene they saw was indeed pornographic? How many people in fact have to find a printed or visual material explicit and arousing for it to be considered pornographic?
These questions suggest that it is not very easy to define pornography after all. Back in the 1950s, young males in the United States would leaf through National Geographic magazine to peek at photos of native women who were partially nude. Those photos, of course, were not put there to excite boys across the country; instead, they were there simply to depict native people in their natural habitat. Another magazine began about the same time that also contained photos of nude women. Its name was Playboy, and its photos obviously had a much different purpose: to excite teenage boys and older men alike. Other, more graphic magazines grew in its wake, and today television shows and PG-13 and R-rated movies show more nudity and sex than were ever imaginable in the days when National Geographic was a boy’s secret pleasure. Beyond these movies and television shows, a powerful pornography industry now exists on the Internet, in porn stores, and elsewhere. Although Playboy quickly became very controversial, it is considered tame compared to what else is now available.
If things as different as National GeographicPlayboy, R-rated movies, and hard-core pornography show nudity and can be sexually arousing, what, then, should be considered pornography? Are at least some of the tamer pictures in Playboy really that different from the great paintings in art history that depict nude women? This question is not necessarily meant to defend Playboy; rather, it is meant to have you think about what exactly is and is not pornography and what, if anything, our society can and should do about it.
However we define pornography, sexually explicit materials, along with drugs, prostitution, and abortion, have been common since ancient times (Bullough & Bullough, 1977). Archeologists have uncovered sexually explicit drawings, pottery, and other artifacts from China, Greece, Japan, Persia, Peru, and other locations; these artifacts depict sexual organs and sexual behavior. Sexually explicit material appears in much writing left from ancient Greece and ancient Rome. “Vast quantities of material dealing with sex” (Bullough & Bullough, 1977, p. 161) remain from medieval Europe. The huge amount of pornography that exists today represents a centuries-old tradition.
Public Opinion about Pornography
Many people oppose pornography, but two very different groups have been especially outspoken over the years, as has been true about prostitution. One of these groups consists of religious organizations and individuals who condemn pornography as a violation of religious values and as an offense to society’s moral order. The other group consists of feminists who condemn pornography for its sexual objectification of women and especially condemn the hard-core pornography that glorifies horrible sexual violence against women. Many feminists also charge that pornography promotes rape by reinforcing the cultural myths discussed earlier. As one writer put it in a famous phrase some thirty years ago, “Pornography is the theory, and rape the practice” (Morgan, 1980, p. 139).
The GSS asks, “Which of these statements comes closest to your feelings about pornography laws: (1) There should be laws against the distribution of pornography whatever the age; (2) There should be laws against the distribution of pornography to persons under 18; or (3) There should be no laws forbidding the distribution of pornography.” In 2010, about 31 percent of the public thought that pornography should be illegal for everyone, and 65 percent thought it should be illegal for people under 18; only 4 percent thought there should be no laws against pornography. Adding the last two percentages together, though, 69 percent thought pornography should be legal for everyone 18 and older.
Certain aspects of our social backgrounds predict our views about pornography laws. Two of the strongest predictors are gender and religiosity. Focusing on the percentage who favor laws against pornography regardless of age, there is a strong gender difference in this view (see Figure 9.16 “Gender and Support for Laws against Pornography Regardless of Age (%)”), with women more than twice as likely than men to favor these laws. Religiosity also predicts support for pornography laws regardless of age: People who consider themselves very religious are five times more likely than those who consider themselves not religious to favor these laws (see Figure 9.17 “Self-Rated Religiosity and Support for Laws against Pornography Regardless of Age (%)”).
Figure 9.16 Gender and Support for Laws against Pornography Regardless of Age (%)
Figure 9.17 Self-Rated Religiosity and Support for Laws against Pornography Regardless of Age (%)
The Popularity of Pornography
Pornography is so widespread and easy to access on the Internet and elsewhere that many people must be viewing it, reading it, and in general “using” it. Various data and estimates for the United States support this assumption (Diamond, 2009; Family Safe Media, 2011). For example, pornography revenues amount to more than \$13 billion annually (from the sale and rental of adult DVDs, the viewing of pornographic Internet sites, the purchase of adult videos on cable and in hotel rooms, payments for phone sex, visits in exotic dance clubs, the purchase of sexually explicit novelties, and subscriptions to and the purchase of sexually explicit magazines). An estimated 12 percent of all websites are pornographic. In addition, about 40 percent of Americans visit pornographic sites on the Internet at least monthly, and, according to the GSS, one-fourth of Americans, or almost 60 million adults, have seen an X-rated movie in the past year.
We saw earlier that gender and religiosity predict views about pornography laws. As you might expect, they also predict X-rated movie viewing. Men are more than twice as likely as women to have seen an X-rated movie in the past year (see Figure 9.18 “Gender and Viewing of X-Rated Movie in Past Year (Percentage Seeing a Movie at Least Once)”), while very religious people are only about one-third as likely as those who are not religious to have seen an X-rated movie.
Figure 9.18 Gender and Viewing of X-Rated Movie in Past Year (Percentage Seeing a Movie at Least Once)
Figure 9.19 Self-Rated Religiosity and Viewing of X-Rated Movie in Past Year (Percentage Seeing a Movie at Least Once)
Effects of Pornography
Many feminists and other people oppose pornography because they believe it causes rape or other violence against women. This belief raises an important question: To what extent does pornography in fact cause such violence? The fairest answer might be that we do not really know. Many scholars believe pornography does cause violence against women, but other scholars conclude that pornography does not have this effect and may even help reduce sexual violence by providing a sexual outlet for men (Diamond, 2009; Weitzer, 2011).
These divergent views reflect the complexity of the evidence from studies of pornography. Many studies do conclude that pornography causes rape. For example, male students who watch violent pornography in experiments later exhibit more hostile attitudes toward women than those watching consensual sex or nonsexual interaction. However, it remains doubtful that viewing pornography in real life has a longer-term effect that lasts beyond the laboratory setting, and several experimental studies do not even find any short-term effects. In other types of research, rape rates have not risen in the US states that have made their pornography laws more lenient, and states’ rape rates are not related to their circulation rates of pornographic magazines. Further, rape rates have declined sharply since the early 1990s even though pornography is much more widely available now than back then thanks to the Internet and other technologies.
A recent review of the research on pornography and rape concluded that pornography does not increase rape (Ferguson & Hartley, 2009, p. 323):
Evidence for a causal relationship between exposure to pornography and sexual aggression is slim and may, at certain times, have been exaggerated by politicians, pressure groups and some social scientists. Some of the debate has focused on violent pornography, but evidence of any negative effects is inconsistent, and violent pornography is comparatively rare in the real world. Victimization rates for rape in the United States demonstrate an inverse relationship between pornography consumption and rape rates. Data from other nations have suggested similar relationships…It is concluded that it is time to discard the hypothesis that pornography contributes to increased sexual assault behavior.
Dealing with Pornography
Whatever pornography is or is not, many people find it disgusting, but many other people are more tolerant of it. In our discussion of prostitution, we examined the issue of whether it is proper for a democracy to ban a consensual behavior simply or mostly because many people consider it immoral. The same question may be asked about pornography (to be more precise, pornography that does not involve children), especially because it does not appear to cause violence against women. Even if it did cause such violence, efforts to stop it raise important issues of freedom of speech and censorship. In a free society, civil liberties advocates say, we must proceed very cautiously. Once we ban some forms of pornography, they ask, where do we stop (Strossen, 2000).
This issue aside, much of what we call pornography still degrades women by depicting them as objects that exist for men’s sexual pleasure and by portraying them as legitimate targets of men’s sexual violence. These images should be troubling for any society that values gender equality. The extent of pornography in the United States may, for better or worse, reflect our historical commitment to freedom of speech, but it may also reflect our lack of commitment to full equality between women and men. Even if, as we have seen, the survey evidence shows growing disapproval of traditional gender roles, the persistence of pornography shows that our society has a long way to go toward viewing women as equally human as men.
Key Takeaways
• Pornography is notoriously difficult to define. Just as beauty is in the eyes of the beholder, to quote the old saying, so is pornography.
• Pornography is a major industry in the United States and around the world and accounts for about \$13 billion in US revenues annually.
• A growing conclusion from the research evidence is that pornography does not lead to violence against women. In addition to this consideration, laws against pornography raise questions of freedom of speech.
For Your Review
1. Do you think all pornography should be legal for people age eighteen and older? Why or why not?
2. In your opinion, does pornography promote violence against women? Explain your answer.
Attributions
Adapted from Chapter 5 and Chapter 9.5 from Social Problems by University of Minnesota under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.
Adapted from pages 39 through 43 from “Beyond Race: Cultural Influences on Human Social Life” by Vera Kennedy under the license CC BY-NC-SA 4.0. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/02%3A_Alternative_Perspectives_on_Individuals/11%3A_Sexual_Orientation_Sexuality_and_Pornography.txt |
Learning Objectives
• Understand the various family forms.
• Describe attachment theory.
• Identify different parenting styles.
• Know the typical developmental trajectory of families.
• Understand cultural differences in dating, marriage, and divorce.
• Explain the influence of children and aging parents on families.
• Know concrete tips for increasing happiness within your family.
12.1 Introduction
Each and every one of us has a family. However, these families exist in many variations around the world. In this module, we discuss definitions of family, family forms, the developmental trajectory of families, and commonly used theories to understand families. We also cover factors that influence families such as culture and societal expectations while incorporating the latest family relevant statistics.
It is often said that humans are social creatures. We make friends, live in communities, and connect to acquaintances through shared interests. In recent times, social media has become a new way for people to connect with childhood peers, friends of friends, and even strangers. Perhaps nothing is more central to the social world than the concept of family. Our families represent our earliest relationships and—often—our most enduring ones. In this module, you will learn about the psychology of families. Our discussion will begin with a basic definition of family and how this has changed across time and place. Next, we move on to a discussion of family roles and how families evolve across the lifespan. Finally, we conclude with issues such as divorce and abuse that are important factors in the psychological health of families.
12.2 What is Family?
In J.K. Rowling’s famous Harry Potter novels, the boy magician lives in a cupboard under the stairs. His unfortunate situation is the result of his wizarding parents having been killed in a duel, causing the young Potter to be subsequently shipped off to live with his cruel aunt and uncle. Although the family may not be the central theme of these wand and sorcery novels, Harry’s example raises a compelling question: what, exactly, counts as family?
A traditional family has a somewhat narrow definition that includes only relationships of blood, marriage, and occasionally adoption. More recently, in many societies, the definition of family has expanded. A modern family may include less traditional variations based on strong commitment and emotional ties. [Image: 10070052 moodboard, http://goo.gl/2xAZGA, CC BY 2.0, goo.gl/v4Y0Zv]
The definition of family changes across time and across culture. The traditional family has been defined as two or more people who are related by blood, marriage, and—occasionally—adoption (Murdock, 1949). Historically, the most standard version of the traditional family has been the two-parent family. Are there people in your life you consider family who is not necessarily related to you in the traditional sense? Harry Potter would undoubtedly call his schoolmates Ron Weasley and Hermione Granger family, even though they do not fit the traditional definition. Likewise, Harry might consider Hedwig, his snowy owl, a family member, and he would not be alone in doing so. Research from the US (Harris, 2015) and Japan (Veldkamp, 2009) finds that many pet owners consider their pets to be members of the family. Another traditional form of family is the joint family, in which three or more generations of blood relatives live in a single household or compound. Joint families often include cousins, aunts, and uncles, and other relatives from the extended family. Versions of the joint family system exist around the globe including in South Asia, Southern Europe, the South Pacific, and other locations.
In more modern times, the traditional definition of family has been criticized as being too narrow. Modern families—especially those in industrialized societies—exist in many forms, including the single-parent family, foster families, same-sex couples, childfree families, and many other variations from traditional norms. Common to each of these family forms is a commitment, caring, and close emotional ties—which are increasingly the defining characteristics of family (Benokraitis, 2015). The changing definition of family has come about, in part, because of factors such as divorce and re-marriage. In many cases, people do not grow up with their family of orientation but become part of a stepfamily or blended family. Whether a single-parent, joint, or two-parent family, a person’s family of orientation or the family into which he or she is born, generally acts as the social context for young children learning about relationships.
According to Bowen (1978), each person has a role to play in his or her family, and each role comes with certain rules and expectations. This system of rules and roles is known as family systems theory. The goal for the family is stability: rules and expectations that work for all. When the role of one member of the family changes, so do the rules and expectations. Such changes ripple through the family and cause each member to adjust his or her own role and expectations to compensate for the change.
There are many variations of modern families, including blended or stepfamilies where two families combine. In a combined family the roles of individuals may be different than in their original family of orientation. [Image: Doc List, http://goo.gl/5FpSeU, CC BY-NC-SA 2.0, goo.gl/iF4hmM]
Take, for example, the classic story of Cinderella. Cinderella’s initial role is that of a child. Her parents’ expectations of her are what would be expected of a growing and developing child. But, by the time Cinderella reaches her teen years, her role has changed considerably. Both of her biological parents have died and she has ended up living with her stepmother and stepsisters. Cinderella’s role shifts from being an adored child to acting as the household servant. The stereotype of stepfamilies as being emotionally toxic is, of course, not true. You might even say there are often-overlooked instructive elements in the Cinderella story: Her role in the family has become not only that of a servant but also that of caretaker– the others expecting her to cook and clean while in return they treat her with spite and cruelty. When Cinderella finds her prince and leaves to start her own family—known as a family of procreation—it is safe to assume that the roles of her stepmother and stepsisters will change—suddenly having to cook and clean for themselves.
Gender has been one factor by which family roles have long been assigned. Traditional roles have historically placed housekeeping and childrearing squarely in the realm of women’s responsibilities. Men, by contrast, have been seen as protectors and as providers of resources including money. Increasingly, families are crossing these traditional roles with women working outside the home and men contributing more to domestic and childrearing responsibilities. Despite this shift toward more egalitarian roles, women still tend to do more housekeeping and childrearing tasks than their husbands (known as the second shift) (Hochschild & Machung, 2012).
Interestingly, parental roles have an impact on the ambitions of their children. Croft and her colleagues (2014) examined the beliefs of more than 300 children. The researchers discovered that when fathers endorsed more equal sharing of household duties and when mothers were more workplace oriented it influenced how their daughters thought. In both cases, daughters were more likely to have ambitions toward working outside the home and working in less gender-stereotyped professions.
12.3 How Families Develop
Our families are so familiar to us that we can sometimes take for granted the idea that families develop over time. Nuclear families, those core units of parents and children, do not simply pop into being. The parents meet one another, the court or date one another, and they make the decision to have children. Even then the family does not quit changing. Children grow up and leave home and the roles shift yet again.
Intimacy
According to Attachment Theory, the type of care that we receive as infants can have a significant influence on the intimate relationships that we have as adults. [Image: Muriel HEARD-COLLIER, http://goo.gl/BK7WUm, CC BY-NC-SA 2.0, goo.gl/iF4hmM]
In a psychological sense, families begin with intimacy. The need for intimacy, or close relationships with others, is universal. We seek out close and meaningful relationships over the course of our lives. What our adult intimate relationships look like actually stems from infancy and our relationship with our primary caregiver (historically our mother)—a process of development described by attachment theory. According to attachment theory, different styles of caregiving result in different relationship “attachments.” For example, responsive mothers—mothers who soothe their crying infants—produce infants who have secure attachments (Ainsworth, 1973; Bowlby, 1969). About 60% of all children are securely attached. As adults, secure individuals rely on their working models—concepts of how relationships operate—that were created in infancy, as a result of their interactions with their primary caregiver (mother), to foster happy and healthy adult intimate relationships. Securely attached adults feel comfortable being depended on and depending on others.
As you might imagine, inconsistent or dismissive parents also impact the attachment style of their infants (Ainsworth, 1973), but in a different direction. In early studies on attachment style, infants were observed interacting with their caregivers, followed by being separated from them, then finally reunited. About 20% of the observed children were “resistant,” meaning they were anxious even before, and especially during, the separation; and 20% were “avoidant,” meaning they actively avoided their caregiver after separation (i.e., ignoring the mother when they were reunited). These early attachment patterns can affect the way people relate to one another in adulthood. Anxious-resistant adults worry that others don’t love them, and they often become frustrated or angry when their needs go unmet. Anxious-avoidant adults will appear not to care much about their intimate relationships and are uncomfortable being depended on or depending on others themselves.
Table 1: Early attachment and adult intimacy
The good news is that our attachment can be changed. It isn’t easy, but it is possible for anyone to “recover” a secure attachment. The process often requires the help of a supportive and dependable other, and for the insecure person to achieve coherence—the realization that his or her upbringing is not a permanent reflection of character or a reflection of the world at large, nor does it bar him or her from being worthy of love or others of being trustworthy (Treboux, Crowell, & Waters, 2004).
12.4 Dating, Courtship, and Cohabitation
Over time, the process of finding a mate has changed dramatically. In Victorian England, for instance, young women in a high society trained for years in the arts—to sing, play music, dance, compose verse, etc. These skills were thought to be vital to the courtship ritual—a demonstration of feminine worthiness. Once a woman was of marriageable age, she would attend dances and other public events as a means of displaying her availability. A young couple interested in one another would find opportunities to spend time together, such as taking a walk. That era had very different dating practices from today, in which teenagers have more freedom, more privacy, and can date more people.
One major difference in the way people find a mate these days is the way we use technology to both expand and restrict the marriage market—the process by which potential mates compare assets and liabilities of available prospects and choose the best option (Benokraitis, 2015). Comparing marriage to a market might sound unromantic, but think of it as a way to illustrate how people seek out attractive qualities in a mate. Modern technology has allowed us to expand our “market” by allowing us to search for potential partners all over the world—as opposed to the days when people mostly relied on local dating pools. Technology also allows us to filter out undesirable (albeit available) prospects at the outset, based on factors such as shared interests, age, and other features.
The use of filters to find the most desirable partner is a common practice, resulting in people marrying others very similar to themselves—a concept called homogamy; the opposite is known as heterogamy (Burgess & Wallin, 1943). In his comparison of educational homogamy in 55 countries, Smits (2003) found strong support for higher-educated people marrying other highly educated people. As such, education appears to be a strong filter people use to help them select a mate. The most common filters we use—or, put another way, the characteristics we focus on most in potential mates—are age, race, social status, and religion (Regan, 2008). Other filters we use include compatibility, physical attractiveness (we tend to pick people who are as attractive as we are), and proximity (for practical reasons, we often pick people close to us) (Klenke-Hamel & Janda, 1980).
In many countries, technology is increasingly used to help single people find each other, and this may be especially true of older adults who are divorced or widowed, as there are few societally-structured activities for older singles. For example, younger people in school are usually surrounded by many potential dating partners of a similar age and background. As we get older, this is less true, as we focus on our careers and find ourselves surrounded by co-workers of various ages, marital statuses, and backgrounds.
In some countries, many people are coupled and committed to marriage through arrangements made by parents or professional marriage brokers. [Image: Ananabanana, http://goo.gl/gzCR0x, CC BY-NC-SA 2.0, goo.gl/iF4hmM]
In some cultures, however, it is not uncommon for the families of young people to do the work of finding a mate for them. For example, the Shanghai Marriage Market refers to the People’s Park in Shanghai, China—a place where parents of unmarried adults meet on weekends to trade information about their children in attempts to find suitable spouses for them (Bolsover, 2011). In India, the marriage market refers to the use of marriage brokers or marriage bureaus to pair eligible singles together (Trivedi, 2013). To many Westerners, the idea of arranged marriage can seem puzzling. It can appear to take the romance out of the equation and violate values about personal freedom. On the other hand, some people in favor of arranged marriage argue that parents are able to make more mature decisions than young people.
While such intrusions may seem inappropriate based on your upbringing, for many people of the world such help is expected, even appreciated. In India for example, “parental arranged marriages are largely preferred to other forms of marital choices” (Ramsheena & Gundemeda, 2015, p. 138). Of course, one’s religious and social caste plays a role in determining how involved family may be.
In terms of other notable shifts in attitude seen around the world, an increase in cohabitation has been documented. Cohabitation is defined as an arrangement in which two people who are romantically live together even though they are not married (Prinz, 1995). Cohabitation is common in many countries, with the Scandinavian nations of Iceland, Sweden, and Norway reporting the highest percentages, and more traditional countries like India, China, and Japan reporting low percentages (DeRose, 2011). In countries where cohabitation is increasingly common, there has been speculation as to whether or not cohabitation is now part of the natural developmental progression of romantic relationships: dating and courtship, then cohabitation, engagement, and finally marriage. Though, while many cohabitating arrangements ultimately lead to marriage, many do not.
Engagement and Marriage
While marriage is common across cultures, the details such as “How” and “When” are often quite different. Now the “Who” of marriage is experiencing an important change as laws are updated in a growing number of countries and states to give same-sex couples the same rights and benefits through marriage as heterosexual couples. [Image: Bart Vis, http://goo.gl/liSy9P, CC BY 2.0, goo.gl/T4qgSp]
Most people will marry in their lifetime. In the majority of countries, 80% of men and women have been married by the age of 49 (United Nations, 2013). Despite how common marriage remains, it has undergone some interesting shifts in recent times. Around the world, people are tending to get married later in life or, increasingly, not at all. People in more developed countries (e.g., Nordic and Western Europe), for instance, marry later in life—at an average age of 30 years. This is very different than, for example, the economically developing country of Afghanistan, which has one of the lowest average-age statistics for marriage—at 20.2 years (United Nations, 2013). Another shift seen around the world is a gender gap in terms of age when people get married. In every country, men marry later than women. Since the 1970s, the average age of marriage for women has increased from 21.8 to 24.7 years. Men have seen a similar increase in age at first marriage.
As illustrated, the courtship process can vary greatly around the world. So too can an engagement—a formal agreement to get married. Some of these differences are small, such as on which hand an engagement ring is worn. In many countries, it is worn on the left, but in Russia, Germany, Norway, and India, women wear their ring on their right. There are also more overt differences, such as who makes the proposal. In India and Pakistan, it is not uncommon for the family of the groom to propose to the family of the bride, with little to no involvement from the bride and groom themselves. In most Western industrialized countries, it is traditional for the male to propose to the female. What types of engagement traditions, practices, and rituals are common where you are from? How are they changing?
Children?
Do you want children? Do you already have children? Increasingly, families are postponing or not having children. Families that choose to forego having children are known as childfree families, while families that want but are unable to conceive are referred to as childless families. As more young people pursue their education and careers, age at first marriage has increased; similarly, so has the age at which people become parents. The average age for first-time mothers is 25 in the United States (up from 21 in 1970), 29.4 in Switzerland, and 29.2 in Japan (Matthews & Hamilton, 2014).
The decision to become a parent should not be taken lightly. There are positives and negatives associated with parenting that should be considered. Many parents report that having children increases their well-being (White & Dolan, 2009). Researchers have also found that parents, compared to their non-parent peers, are more positive about their lives (Nelson, Kushlev, English, Dunn, & Lyubomirsky, 2013). On the other hand, researchers have also found that parents, compared to non-parents, are more likely to be depressed, report lower levels of marital quality, and feel like their relationship with their partner is more businesslike than intimate (Walker, 2011).
If you do become a parent, your parenting style will impact your child’s future success in romantic and parenting relationships. Authoritative parenting, arguably the best parenting style, is both demanding and supportive of the child (Maccoby & Martin, 1983). Support refers to the amount of affection, acceptance, and warmth a parent provides. Demandingness refers to the degree a parent controls his/her child’s behavior. Children who have authoritative parents are generally happy, capable, and successful (Maccoby, 1992).
Table 2: Four parenting styles
Other, less advantageous parenting styles include authoritarian (in contrast to authoritative), permissive, and uninvolved (Tavassolie, Dudding, Madigan, Thorvardarson, & Winsler, 2016). Authoritarian parents are low in support and high in demandingness. Arguably, this is the parenting style used by Harry Potter’s harsh aunt and uncle, and Cinderella’s vindictive stepmother. Children who receive authoritarian parenting are more likely to be obedient and proficient but score lower in happiness, social competence, and self-esteem. Permissive parents are high in support and low in demandingness. Their children rank low in happiness and self-regulation and are more likely to have problems with authority. Uninvolved parents are low in both support and demandingness. Children of these parents tend to rank lowest across all life domains, lack self-control, have low self-esteem, and are less competent than their peers.
Support for the benefits of authoritative parenting has been found in countries as diverse as the Czech Republic (Dmitrieva, Chen, Greenberger, & Gil-Rivas, 2004), India (Carson, Chowdhurry, Perry, & Pati, 1999), China (Pilgrim, Luo, Urberg, & Fang, 1999), Israel (Mayseless, Scharf, & Sholt, 2003), and Palestine (Punamaki, Qouta, & Sarraj, 1997). In fact, authoritative parenting appears to be superior in Western, individualistic societies—so much so that some people have argued that there is no longer a need to study it (Steinberg, 2001). Other researchers are less certain about the superiority of authoritative parenting and point to differences in cultural values and beliefs. For example, while many European-American children do poorly with too much strictness (authoritarian parenting), Chinese children often do well, especially academically. The reason for this likely stems from Chinese culture viewing strictness in parenting as related to training, which is not central to American parenting (Chao, 1994).
Parenting in Later Life
Just because children grow up does not mean their family stops being a family. The concept of family persists across the entire lifespan, but the specific roles and expectations of its members change over time. One major change comes when a child reaches adulthood and moves away. When exactly children leave home varies greatly depending on societal norms and expectations, as well as on economic conditions such as employment opportunities and affordable housing options. Some parents may experience sadness when their adult children leave the home—a situation known as Empty Nest.
When one’s children reach adulthood it doesn’t mean that parenting stops. Boomerang kids and multigenerational households that include aging parents are increasingly common. [Image: davidmulder61, goo.gl/eGPT5i, CC BY-SA 2.0, goo.gl/S6i0RI]
Many parents are also finding that their grown children are struggling to launch into independence. It’s an increasingly common story: a child goes off to college and, upon graduation, is unable to find steady employment. In such instances, a frequent outcome is for the child to return home, becoming a “boomerang kid.” The boomerang generation, as the phenomenon has come to be known, refers to young adults, mostly between the ages of 25 and 34, who return home to live with their parents while they strive for stability in their lives—often in terms of finances, living arrangements, and sometimes romantic relationships. These boomerang kids can be both good and bad for families. Within American families, 48% of boomerang kids report having paid rent to their parents, and 89% say they help out with household expenses—a win for everyone (Parker, 2012). On the other hand, 24% of boomerang kids report that returning home hurts their relationship with their parents (Parker, 2012). For better or for worse, the number of children returning home has been increasing around the world.
In addition to middle-aged parents spending more time, money, and energy taking care of their adult children, they are also increasingly taking care of their own aging and ailing parents. Middle-aged people in this set of circumstances are commonly referred to as the sandwich generation (Dukhovnov & Zagheni, 2015). Of course, cultural norms and practices again come into play. In some Asian and Hispanic cultures, the expectation is that adult children are supposed to take care of aging parents and parents-in-law. In other Western cultures—cultures that emphasize individuality and self-sustainability—the expectation has historically been that elders either age in place, modifying their home and receiving services to allow them to continue to live independently or enter long-term care facilities. However, given financial constraints, many families find themselves taking in and caring for their aging parents, increasing the number of multigenerational homes around the world.
12.5 Family Issues and Considerations
Divorce
Divorce refers to the legal dissolution of a marriage. Depending on societal factors, divorce may be more or less of an option for married couples. Despite popular belief, divorce rates in the United States actually declined for many years during the 1980s and 1990s, and only just recently started to climb back up—landing at just below 50% of marriages ending in divorce today (Marriage & Divorce, 2016); however, it should be noted that divorce rates increase for each subsequent marriage, and there is considerable debate about the exact divorce rate. Are there specific factors that can predict divorce? Are certain types of people or certain types of relationships more or less at risk for breaking up? Indeed, there are several factors that appear to be either risk factors or protective factors.
Pursuing education decreases the risk of divorce. So too does waiting until we are older to marry. Likewise, if our parents are still married we are less likely to divorce. Factors that increase our risk of divorce include having a child before marriage and living with multiple partners before marriage, known as serial cohabitation (cohabitation with one’s expected martial partner does not appear to have the same effect). And, of course, societal and religious attitudes must also be taken into account. In societies that are more accepting of divorce, divorce rates tend to be higher. Likewise, in religions that are less accepting of divorce, divorce rates tend to be lower. See Lyngstad & Jalovaara (2010) for a more thorough discussion of divorce risk.
Table 3: Divorce Factors
If a couple does divorce, there are specific considerations they should take into account to help their children cope. Parents should reassure their children that both parents will continue to love them and that the divorce is in no way the children’s fault. Parents should also encourage open communication with their children and be careful not to bias them against their “ex” or use them as a means of hurting their “ex” (Denham, 2013; Harvey & Fine, 2004; Pescosoido, 2013).
Abuse
Abuse can occur in multiple forms and across all family relationships. Breiding, Basile, Smith, Black, & Mahendra (2015) define the forms of abuse as:
• Physical abuse, the use of intentional physical force to cause harm. Scratching, pushing, shoving, throwing, grabbing, biting, choking, shaking, slapping, punching, and hitting are common forms of physical abuse;
• Sexual abuse, the act of forcing someone to participate in a sex act against his or her will. Such abuse is often referred to as sexual assault or rape. A marital relationship does not grant anyone the right to demand sex or sexual activity from anyone, even a spouse;
• Psychological abuse, aggressive behavior that is intended to control someone else. Such abuse can include threats of physical or sexual abuse, manipulation, bullying, and stalking.
Abuse between partners is referred to as intimate partner violence; however, such abuse can also occur between a parent and child (child abuse), adult children and their aging parents (elder abuse), and even between siblings.
The most common form of abuse between parents and children is actually that of neglect. Neglect refers to a family’s failure to provide for a child’s basic physical, emotional, medical, or educational needs (DePanfilis, 2006). Harry Potter’s aunt and uncle, as well as Cinderella’s stepmother, could all be prosecuted for neglect in the real world.
Abuse is a complex issue, especially within families. There are many reasons people become abusers: poverty, stress, and substance abuse are common characteristics shared by abusers, although abuse can happen in any family. There are also many reasons adults stay in abusive relationships: (a) learned helplessness (the abused person believing he or she has no control over the situation); (b) the belief that the abuser can/will change; (c) shame, guilt, self-blame, and/or fear; and (d) economic dependence. All of these factors can play a role.
Children who experience abuse may “act out” or otherwise respond in a variety of unhealthful ways. These include acts of self-destruction, withdrawal, and aggression, as well as struggles with depression, anxiety, and academic performance. Researchers have found that abused children’s brains may produce higher levels of stress hormones. These hormones can lead to decreased brain development, lower stress thresholds, suppressed immune responses, and lifelong difficulties with learning and memory (Middlebrooks & Audage, 2008).
Adoption
Divorce and abuse are important concerns, but not all family hurdles are negative. One example of a positive family issue is adoption. Adoption has long historical roots (it is even mentioned in the Bible) and involves taking in and raising someone else’s child legally as one’s own. Becoming a parent is one of the most fulfilling things a person can do (Gallup & Newport, 1990), but even with modern reproductive technologies, not all couples who would like to have children (which is still most) are able to. For these families, adoption often allows them to feel whole—by completing their family.
In 2013, in the United States, there were over 100,000 children in foster care (where children go when their biological families are unable to adequately care for them) available for adoption (Soronen, 2013). In total, about 2% of the U.S. child population is adopted, either through foster care or through private domestic or international adoption (Adopted Children, 2012). Adopting a child from the foster care system is relatively inexpensive, costing \$0-\$2,500, with many families qualifying for state-subsidized support (Soronen, 2013).
Adoption is an important option for creating or expanding a family. Foster care adoptions and international adoptions are both common. Regardless of why a family chooses to adopt and from where, traits such as patience, flexibility and strong problem-solving skills are desirable for adoptive parents. [Image: Steven Depolo, https://goo.gl/ElGvwe, CC BY 2.0, goo.gl/BRvSA7]
For years, international adoptions have been popular. In the United States, between 1999 and 2014, 256,132 international adoptions occurred, with the largest number of children coming from China (73,672) and Russia (46,113) (Intercountry Adoption, 2016). People in the United States, Spain, France, Italy, and Canada adopt the largest numbers of children (Selman, 2009). More recently, however, international adoptions have begun to decrease. One significant complication is that each country has its own set of requirements for adoption, as does each country from which an adopted child originates. As such, the adoption process can vary greatly, especially in terms of cost, and countries are able to police who adopt their children. For example, single, obese, or over-50 individuals are not allowed to adopt a child from China (Bartholet, 2007).
Regardless of why a family chooses to adopt, traits such as flexibility, patience, strong problem-solving skills, and a willingness to identify local community resources are highly favorable for the prospective parents to possess. Additionally, it may be helpful for adoptive parents to recognize that they do not have to be “perfect” parents as long as they are loving and willing to meet the unique challenges their adopted child may pose.
12.6 Happy Healthy Families
Our families play a crucial role in our overall development and happiness. They can support and validate us, but they can also criticize and burden us. For better or worse, we all have a family. In closing, here are strategies you can use to increase the happiness of your family:
• Teach morality—fostering a sense of moral development in children can promote well-being (Damon, 2004).
• Savor the good—celebrate each other’s successes (Gable, Gonzaga & Strachman, 2006).
• Use the extended family network—family members of all ages, including older siblings and grandparents, who can act as caregivers can promote family well-being (Armstrong, Birnie-Lefcovitch & Ungar, 2005).
• Create family identity—share inside jokes, fond memories, and frame the story of the family (McAdams, 1993).
• Forgive—Don’t hold grudges against one another (McCullough, Worthington & Rachal, 1997).
12.7 Additional Resources
Article: Social Trends Institute: The Sustainable Demographic Dividend
Video: TED Talk: What Makes a Good Life? Lessons from the Longest Study on Happiness
Web: Pew Research Center_Family and Relationships
Web: PSYCHALIVE: Psychology for Everyday Life: Relationships
Web: United States Census Bureau: Families and Living Arrangements
References
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Bowlby, J. (1969). Attachment. Attachment and loss: Vol. 1. Loss. New York: Basic Books
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Burgess, E. W. & Locke, H. J. (1945). The family: From institution to companionship. New York: The American Book Co.
Burgess, E. W. & Wallin, P. (1943). Homogamy in social characteristics. American Journal of Sociology, 49, 109-124.
Carson, D., Chowdhurry, A., Perry, C., & Pati, C. (1999). Family characteristics and adolescent competence in India: Investigation of youth in southern Orissa. Journal of Youth and Adolescence, 28. 211-233.
Chao, R. K. (1994). Beyond parental control and authoritarian parenting style: Understanding Chinese parenting through the cultural notion of training. Child Development, 65, 1111-1119.
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Damon, W. (2004). What is positive youth development? Annals of the American Academy of Political and Social Science, 591, 13-24
DePanfilis, D. (2006). Child Neglect: A Guide for Prevention, Assessment, and Intervention. Child Abuse and Neglect User Manual Series. U.S. Department of Health and Human Services.
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Dmitrieva, J., Chen, C., Greenberger, E., & Gil-Rivas, V. (2004). Family relationships and adolescent psychosocial outcomes: Converging findings from Eastern and Western cultures. Journal of Research on Adolescence, 14, 425-447.
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Hochschild, A. & Machung, A. (2012). The second shift: Working families and the revolution at home. New York, NY: Penguin.
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Klenke, K. E. & Janda, L. H. (1980). Exploring Human Sexuality. Van Nostrand Reinhold Company.
Lyngstad, T. H. & Jalovaara, M. (2010). A review of the antecedents of union dissolution. Demographic Research, 23, 257-292.
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Ramsheena, C. A. & Gundemeda, N. (2015). Youth and marriage: A study of changing marital choices among the university students in India. Journal of Sociology and Social Anthropology, 6, 137-147.
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Smits, J. (2003). Social closure among the higher educated: trends in educational homogamy in 55 countries. Social Science Research, 32, 251-277.
Soronen, R. L. (2013). National Foster Care Adoption Attitudes Survey. Dave Thomas Foundation for Adoption conducted by Harris Interactive.
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Tavassolie, T., Dudding, S., Madigan, A. L., Thorvardarson, E., & Winsler, A. (2016). Differences in perceived parenting style between mothers and fathers: Implications for child outcomes and marital conflict. Journal of Child and Family Studies. doi: 10.1007/s10826-016-0376-y
Treboux, D., Crowell, J. A., & Waters, E. (2004). When “new” meets “old”: Configurations of adult attachment representations and their implications for marital functioning. Developmental Psychology, 40, 295-314.
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Learning Objectives
• Understand why relationships are key to happiness and health.
• Define and list different forms of relationships.
• List different aspects of well-being.
• Explain how relationships can enhance well-being.
• Explain how relationships might not enhance well-being.
13.1 Introduction
The relationships we cultivate in our lives are essential to our well-being—namely, happiness and health. Why is that so? We begin to answer this question by exploring the types of relationships—family, friends, colleagues, and lovers—we have in our lives and how they are measured. We also explore the different aspects of happiness and health and show how the quantity and quality of relationships can affect our happiness and health.
In Daniel Defoe’s classic novel Robinson Crusoe (1719), the main character is shipwrecked. For years he lives alone, creating a shelter for himself and marking the passage of time on a wooden calendar. It is a lonely existence, and Crusoe describes climbing a hilltop in the hopes of seeing a passing ship and possible rescue. He scans the horizon until, in his own words, he is “almost blind.” Then, without hope, he sits and weeps.
Although it is a work of fiction, Robinson Crusoe contains themes we can all relate to. One of these is the idea of loneliness. Humans are social animals and we prefer living together in groups. We cluster in families, in cities, and in groups of friends. In fact, most people spend relatively few of their waking hours alone. Even introverts report feeling happier when they are with others! Yes, being surrounded by people and feeling connected to others appears to be a natural impulse.
In this module, we will discuss relationships in the context of well-being. We will begin by defining well-being and then presenting research about different types of relationships. We will explore how both the quantity and quality of our relationships affect us, as well as take a look at a few popular conceptions (or misconceptions) about relationships and happiness.
13.2 The Importance of Relationships
If you were to reflect on the best moments of your life, chances are they involved other people. We feel good sharing our experiences with others, and our desire for high-quality relationships may be connected to a deep-seated psychological impulse: the need to belong (Baumeister & Leary, 1995). Aristotle commented that humans are fundamentally social in nature. Modern society is full of evidence that Aristotle was right. For instance, people often hold strong opinions about single child families—usually concerning what are often viewed as problematic “only child” characteristics—and most parents choose to have multiple kids. People join book clubs to make a solitary activity—reading—into a social activity. Prisons often punish offenders by putting them in solitary confinement, depriving them of the company of others. Perhaps the most obvious expression of the need to belong in contemporary life is the prevalence of social media. We live in an era when, for the first time in history, people effectively have two overlapping sets of social relationships: those in the real world and those in the virtual world. It may seem intuitive that our strong urge to connect with others has to do with the boost we receive to our own well-being from relationships. After all, we derive considerable meaning from our relational bonds—as seen in the joy a newborn brings to its parents, the happiness of a wedding, and the good feelings of having reliable, supportive friendships. In fact, this intuition is borne out by research suggesting that relationships can be sources of intimacy and closeness (Reis, Clark & Holmes, 2004), comfort and relief from stress (Collins & Feeney, 2000), and accountability—all of which help toward achieving better health outcomes (Tay, Tan, Diener, & Gonzalez, 2013; Taylor, 2010). Indeed, scholars have long considered social relationships to be fundamental to happiness and well-being (Argyle, 2001; Myers, 2000). If the people in our lives are as important to our happiness as the research suggests, it only makes sense to investigate how relationships affect us.
13.3 The Question of Measurement
Despite the intuitive appeal of the idea that good relationships translate to more happiness, researchers must collect and analyze data to arrive at reliable conclusions. This is particularly difficult with the concepts of relationships and happiness because both can be difficult to define. What counts as a relationship? A pet? An old friend from childhood you haven’t seen in ten years? Similarly, it is difficult to pinpoint exactly what qualifies as happiness. It is vital to define these terms because their definitions serve as the guidelines by which they can be measured, a process called operationalization. Scientifically speaking, the two major questions any researcher needs to answer before he or she can begin to understand how relationships and well-being interact are, “How do I best measure relationships?” and “How do I best measure well-being?”
Scientists are interested in objective measures such as the number of friends a person has and subjective measures such as feelings of social support. [Image: CC0 Public Domain, goo.gl/m25gce]
Let’s begin with relationships. There are both objective and subjective ways to measure social relationships. Objective social variables are factors that are based on evidence rather than opinions. They focus on the presence and frequency of different types of relationships, and the degree of contact and the number of shared activities between people. Examples of these measures include participants’ marital status, their number of friends and work colleagues, and the size of their social networks. Each of these variables is factually based (e.g., you have x number of coworkers, etc.). Another objective social variable is social integration or one’s degree of integration into social networks. This can be measured by looking at the frequency and amount of social activity or contact one has with others (see Okun, Stock, Haring, & Witter, 1984; Pinquart & Sorensen, 2000). The strength of objective measures is that they generally have a single correct answer. For example, a person is either married or not; there is no in-between.
Subjective social variables, as the name suggests, are those that focus on the subjective qualities of social relationships. These are the products of personal opinions and feelings rather than facts. A key subjective variable is social support—the extent to which individuals feel cared for can receive help from others, and are part of a supportive network. Measures of social support ask people to report on their perceived levels of support as well as their satisfaction with the support they receive (see Cohen, Underwood, & Gottlieb, 2000). Other subjective social variables assess the nature and quality of social relationships themselves—that is, what types of relationships people have, and whether these social relationships are good or bad. These can include measures that ask about the quality of a marriage (e.g., Dyadic Adjustment Scale; Spanier, 1976), the amount of conflict in a relationship (e.g., Conflict Tactics Scale; Straus, 1979), or the quality of each relationship in one’s social network (e.g., Network of Relationships Inventory (NRI); Furman & Buhrmester, 1985). The strength of subjective measures is that they provide insight into people’s personal experiences. A married person, for example, might love or hate his/her marriage; subjective measures tell us which of these is the case.
Objective and subjective measures are often administered in a way that asks individuals to make a global assessment of their relationships (i.e., “How much social support do you receive?”). However, scientists have more recently begun to study social relationships and activity using methods such as daily diary methodology (Bolger, Davis, & Rafaeli, 2003), whereby individuals report on their relationships on a regular basis (e.g., three times a day). This allows researchers to examine in-the-moment instances and/or day-to-day trends of how social relationships affect happiness and well-being compared to more global measures. Many researchers try to include multiple types of measurement—objective, subjective, and daily diaries—to overcome the weaknesses associated with anyone’s measurement technique.
Just as researchers must consider how to best measure relationships, they must also face the issue of measuring well-being. Well-being is a topic many people have an opinion about. If you and nine other people were to write down your own definitions of happiness, or of well-being, there’s a good chance you’d end up with ten unique answers. Some folks define happiness as a sense of peace, while others think of it as being healthy. Some people equate happiness with a sense of purpose, while others think of it as just another word for joy. Modern researchers have wrestled with this topic for decades. They acknowledge that both psychological and physical approaches are relevant to defining well-being and that many dimensions—satisfaction, joy, meaning—are all important.
One prominent psychological dimension of well-being is happiness. In psychology, the scientific term for happiness is subjective well-being, which is defined by three different components: high life satisfaction, which refers to positive evaluations of one’s life in general (e.g., “Overall, I am satisfied with my life”); positive feelings, which refers to the amount of positive emotions one experiences in life (e.g., peace, joy); and low negative feelings, which refers to the amount of negative emotions one experiences in life (e.g., sadness, anger) (Diener, 1984). These components are commonly measured using subjective self-report scales.
The Satisfaction with Life Scale is one of the most widely used measures of well-being in the world.
The physical dimension of well-being is best thought of as one’s health. Health is a broad concept and includes, at least in part, being free of illness or infirmity. There are several aspects of physical health that researchers commonly consider when thinking about well-being and relationships. For example, health can be defined in terms of (A) injury, (B) disease, and (C) mortality. Health can also include physiological indicators, such as blood pressure or the strength of a person’s immune system. Finally, there are health behaviors to be considered, such as dietary consumption, exercise, and smoking. Researchers often examine a variety of health variables in order to better understand the possible benefits of good relationships.
13.4 Presence and Quality of Relationships and Well-Being
If you wanted to investigate the connection between social relationships and well-being, where would you start? Would you focus on teenagers? Married couples? Would you interview religious people who have taken a vow of silence? These are the types of considerations well-being researchers face. It is impossible for a single study to look at all types of relationships across all age groups and cultures. Instead, researchers narrow their focus to specific variables. They tend to consider two major elements: the presence of relationships, and the quality of relationships.
Presence of Relationships
The first consideration when trying to understand how relationships influence well-being is the presence of relationships. Simply put, researchers need to know whether or not people have relationships. Are they married? Do they have many friends? Are they a member of a club? Finding this out can be accomplished by looking at objective social variables, such as the size of a person’s social network, or the number of friends they have. Researchers have discovered that the more social relationships people have, in general, the more positively their sense of well-being is impacted (Lucas, Dyrenforth, & Diener 2008). In one study of more than 200 undergraduate students, psychologists Ed Diener and Martin Seligman (2002) compared the happiest 10% to the unhappiest 10%. The researchers were curious to see what differentiated these two groups. Was it gender? Exercise habits? Religion? The answer turned out to be relationships! The happiest students were much more satisfied with their relationships, including close friends, family, and romantic partnerships than the unhappiest. They also spent less time alone.
Some people might be inclined to dismiss the research findings above because they focused primarily on college students. However, in a worldwide study of people of all ages from 123 nations, results showed that having even a few high-quality social relationships were consistently linked with subjective well-being (Tay & Diener, 2011). This is an important finding because it means that a person doesn’t have to be a social butterfly in order to be happy. Happiness doesn’t depend necessarily on having dozens of friends, but rather on having at least a few close connections.
Another way of gaining an understanding of the presence of relationships is by looking at the absence of relationships. A lack of social connections can lead to loneliness and depression. People lose well-being when social relationships are denied—as in cases of ostracism. In many societies, withholding social relationships is used as a form of punishment. For example, in some Western high schools, people form social groups known as “cliques,” in which people share interests and a sense of identity. Unlike clubs, cliques do not have explicit rules for membership but tend to form organically, as exclusive group friendships. When one member of a clique conflicts with the others, the offending member may be socially rejected.
Ostracism is a form of social rejection and isolation that has a negative impact on well-being. [Image: CC0 Public Domain, goo.gl/m25gce]
Similarly, some small societies practice shunning, a temporary period during which members withhold emotion, communication, and other forms of social contact as a form of punishment for wrongdoing. The Amish—a group of traditional Christian communities in North America who reject modern conveniences such as electricity—occasionally practice shunning (Hostetler, 1993). Members who break important social rules, for example, are made to eat alone rather than with their family. This typically lasts for one to two weeks. Individuals’ well-being has been shown to dramatically suffer when they are ostracized in such a way (Williams, 2009). Research has even shown that the areas of the brain that process physical pain when we are injured are the same areas that process emotional pain when we are ostracized (Eisenberger, Lieberman, & Williams, 2003).
Quality of Relationships
Simply having a relationship is not, in itself, sufficient to produce well-being. We’re all familiar with instances of awful relationships: Cinderella and her step-sisters, loveless marriages, friends who have frequent falling-outs (giving birth to the word “frenemy”). In order for a relationship to improve well-being, it has to be a good one. Researchers have found that higher friendship quality is associated with increased happiness (Demir & Weitekamp, 2007). Friendships aren’t the only relationships that help, though. Researchers have found that high-quality relationships between parents and children are associated with increased happiness, both for teenagers (Gohm, Oishi, Darlington, & Diener, 1998) and adults (Amato & Afifi, 2006).
Finally, an argument can be made for looking at relationships’ effects on each of the distinct components of subjective well-being. Walen and Luchman (2000) investigated a mix of relationships, including family, friends, and romantic partners. They found that social support and conflict were associated with all three aspects of subjective well-being (life satisfaction, positive affect, and negative affect). Similarly, in a cross-cultural study comparing college students in Iran, Jordan, and the United States, researchers found that social support was linked to higher life satisfaction, higher positive affect, and lower negative affect (Brannan, Biswas-Diener, Mohr, Mortazavi, & Stein, 2012).
It may seem like common sense that good relationships translate to more happiness. You may be surprised to learn, however, that good relationships also translate to better health. Interestingly, both the quality and quantity of social relationships can affect a person’s health (Cohen 1988; House, Landis, & Umberson, 1988). Research has shown that having a larger social network and high-quality relationships can be beneficial for health, whereas having a small social network and poor quality relationships can actually be detrimental to health (Uchino, 2006). Why might it be the case those good relationships are linked to health? One reason is that friends and romantic partners might share health behaviors, such as wearing seat belts, exercising, or abstaining from heavy alcohol consumption. Another reason is that people who experience social support might feel less stress. Stress, it turns out, is associated with a variety of health problems. Other discussions on social relationships and health can also be found in Noba (http://noba.to/4tm85z2x).
13.5 Types of Relationships
Intimate relationships
Intimate Relationships have been shown to have a strong positive impact on individuals’ well-being. [Image: CC0 Public Domain, goo.gl/m25gce]
It makes sense to consider the various types of relationships in our lives when trying to determine just how relationships impact our well-being. For example, would you expect a person to derive the exact same happiness from an ex-spouse as from a child or coworker? Among the most important relationships for most people is their long-time romantic partner. Most researchers begin their investigation of this topic by focusing on intimate relationships because they are the closest form of the social bond. Intimacy is more than just physical in nature; it also entails psychological closeness. Research findings suggest that having a single confidante—a person with whom you can be authentic and trust not to exploit your secrets and vulnerabilities—is more important to happiness than having a large social network (see Taylor, 2010 for a review).
Another important aspect of relationships is the distinction between formal and informal. Formal relationships are those that are bound by the rules of politeness. In most cultures, for instance, young people treat older people with formal respect, avoiding profanity and slang when interacting with them. Similarly, workplace relationships tend to be more formal, as do relationships with new acquaintances. Formal connections are generally less relaxed because they require a bit more work, demanding that we exert more self-control. Contrast these connections with informal relationships—friends, lovers, siblings, or others with whom you can relax. We can express our true feelings and opinions in these informal relationships, using the language that comes most naturally to us, and generally being more authentic. Because of this, it makes sense that more intimate relationships—those that are more comfortable and in which you can be more vulnerable—might be the most likely to translate to happiness.
The most common way researchers investigate intimacy is by examining marital status. Although marriage is just one type of intimate relationship, it is by far the most common type. In some research, the well-being of married people is compared to that of people who are single or have never been married, and in other research, married people are compared to people who are divorced or widowed (Lucas & Dyrenforth, 2005). Researchers have found that the transition from singlehood to marriage brings about an increase in subjective well-being (Haring-Hidore, Stock, Okun, & Witter, 1985; Lucas, 2005; Williams, 2003). Research has also shown that progress through the stages of relationship commitment (i.e., from singlehood to dating to marriage) is also associated with an increase in happiness (Dush & Amato, 2005). On the other hand, experiencing divorce, or the death of a spouse, leads to adverse effects on subjective well-being and happiness, and these effects are stronger than the positive effects of being married (Lucas, 2005).
Although research frequently points to marriage is associated with higher rates of happiness, this does not guarantee that getting married will make you happy! The quality of one’s marriage matters greatly. When a person remains in a problematic marriage, it takes an emotional toll. Indeed, a large body of research shows that people’s overall life satisfaction is affected by their satisfaction with their marriage (Carr, Freedman, Cornman, Schwarz, 2014; Dush, Taylor, & Kroeger, 2008; Karney, 2001; Luhmann, Hofmann, Eid, & Lucas, 2012; Proulx, Helms, & Buehler, 2007). The lower a person’s self-reported level of marital quality, the more likely he or she is to report depression (Bookwala, 2012). In fact, longitudinal studies—those that follow the same people over a period of time—show that as marital quality declines, depressive symptoms increase (Fincham, Beach, Harold, & Osborne, 1997; Karney, 2001). Proulx and colleagues (2007) arrived at this same conclusion after a systematic review of 66 cross-sectional and 27 longitudinal studies.
What is it about bad marriages or bad relationships in general, that takes such a toll on well-being? Research has pointed to the conflict between partners as a major factor leading to lower subjective well-being (Gere & Schimmack, 2011). This makes sense. Negative relationships are linked to ineffective social support (Reblin, Uchino, & Smith, 2010) and are a source of stress (Holt-Lunstad, Uchino, Smith, & Hicks, 2007). In more extreme cases, physical and psychological abuse can be detrimental to well-being (Follingstad, Rutledge, Berg, Hause, & Polek, 1990). Victims of abuse sometimes feel shame, lose their sense of self, and become less happy and prone to depression and anxiety (Arias & Pape, 1999). However, the unhappiness and dissatisfaction that occur in abusive relationships tend to dissipate once the relationships end. (Arriaga, Capezza, Goodfriend, Rayl & Sands, 2013).
Work Relationships and Well-Being
Since we spend so much of our time at work it’s essential to our well-being that we get along with our coworkers! [Image: Editor B, https://goo.gl/pnc4G6, CC BY 2.0, goo.gl/BRvSA7]
Working adults spend a large part of their waking hours in relationships with coworkers and supervisors. Because these relationships are forced upon us by work, researchers focus less on their presence or absence and instead focus on their quality. High quality work relationships can make jobs enjoyable and less stressful. This is because workers experience mutual trust and support in the workplace to overcome work challenges. Liking the people we work with can also translate to more humor and fun on the job. Research has shown that supervisors who are more supportive have employees who are more likely to thrive at work (Paterson, Luthans, & Jeung, 2014; Monnot & Beehr, 2014; Winkler, Busch, Clasen, & Vowinkel, 2015). On the other hand, poor quality work relationships can make a job feel like drudgery. Everyone knows that a horrible boss can make the workday unpleasant. Supervisors that are sources of stress have a negative impact on the subjective well-being of their employees (Monnot & Beehr, 2014). Specifically, research has shown that employees who rate their supervisors high on the so-called “dark triad”—psychopathy, narcissism, and Machiavellianism—reported greater psychological distress at work, as well as less job satisfaction (Mathieu, Neumann, Hare, & Babiak, 2014).
In addition to the direct benefits or costs of work relationships on our well-being, we should also consider how these relationships can impact our job performance. Research has shown that feeling engaged in our work and having a high job performance predicts better health and greater life satisfaction (Shimazu, Schaufeli, Kamiyama, & Kawakami, 2015). Given that so many of our waking hours are spent on the job—about ninety thousand hours across a lifetime—it makes sense that we should seek out and invest in positive relationships at work.
13.6 Fact or Myth: Are Social Relationships the Secret to Happiness?
If you read pop culture magazines or blogs, you’ve likely come across many supposed “secrets” to happiness. Some articles point to exercise as a sure route to happiness, while others point to gratitude as a crucial piece of the puzzle. Perhaps the most written about “secret” to happiness is having high-quality social relationships. Some researchers argue that social relationships are central to subjective well-being (Argyle, 2001), but others contend that social relationships’ effects on happiness have been exaggerated. This is because, when looking at the correlations—the size of the associations—between social relationships and well-being, they are typically small (Lucas & Dyrenforth, 2006; Lucas et al., 2008). Does this mean that social relationships are not actually important for well-being? It would be premature to draw such conclusions because even though the effects are small, they are robust and reliable across different studies, as well as other domains of well-being. There may be no single secret to happiness but there may be a recipe, and, if so, good social relationships would be one ingredient.
13.7 Additional Resources
Article: The New Yorker Magazine—“Hellhole” article on solitary confinement
http://www.newyorker.com/magazine/2009/03/30/hellhole
Blog: The Gottman Relationship Blog
Helen Fisher on Millennials’ Dating Trends
Web: Science of Relationship’s website on Social Relationships and Health
Web: Science of Relationship’s website on Social Relationships and Well-being
Attribution
Adapted from Relationships and Well-being by Kenneth Tan and Louis Tay is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/03%3A_Perspectives_on_Families/13%3A_Relationships_and_Well-Being.txt |
Learning Objectives
• Explain how epigenetics may impact child development and generational cycles of poverty and abuse.
• Discuss how stress programming can impact a child’s development and potentially influence the development of mental health diagnoses and/or substance use disorders.
• Discuss the ACE and how to offset abuse and trauma experienced in childhood.
14.1 Early childhood experience
The development of an individual is an active process of adaptation that occurs within a social and economic context. For example, the closeness or degree of positive attachment of the parent (typically the mother)–infant bond and parental investment (including nutrient supply provided by the parent) that define early childhood experience also program the development of individual differences in stress responses in the brain, which then affect memory, attention, and emotion. In terms of evolution, this process provides the offspring with the ability to physiologically adjust gene expression profiles contributing to the organization and function of neural circuits and molecular pathways that support (1) biological defensive systems for survival (e.g., stress resilience), (2) reproductive success to promote establishment and persistence in the present environment, and (3) adequate parenting in the next generation (Bradshaw, 1965).
14.2 Parental investment and programming of stress responses in the offspring
The most comprehensive study to date of variations in parental investment and epigenetic inheritance in mammals is that of the maternally transmitted responses to stress in rats. In rat pups, maternal nurturing (licking and grooming) during the first week of life is associated with long-term programming of individual differences in stress responsiveness, emotionality, cognitive performance, and reproductive behavior (Caldji et al., 1998; Francis, Diorio, Liu, & Meaney, 1999; Liu et al., 1997; Myers, Brunelli, Shair, Squire, & Hofer, 1989; Stern, 1997). In adulthood, the offspring of mothers that exhibit increased levels of pup licking and grooming over the first week of life show increased expression of the glucocorticoid receptor in the hippocampus (a brain structure associated with stress responsivity as well as learning and memory) and a lower hormonal response to stress compared with adult animals reared by low licking and grooming mothers (Francis et al., 1999; Liu et al., 1997). Moreover, rat pups that received low levels of maternal licking and grooming during the first week of life showed decreased histone acetylation and increased DNA methylation of a neuron-specific promoter of the glucocorticoid receptor gene (Weaver et al., 2004). The expression of this gene is then reduced, the number of glucocorticoid receptors in the brain is decreased, and the animals show a higher hormonal response to stress throughout their life. The effects of maternal care on stress hormone responses and behavior in the offspring can be eliminated in adulthood by pharmacological treatment (HDAC inhibitor trichostatin A, TSA) or dietary amino acid supplementation (methyl donor L-methionine), treatments that influence histone acetylation, DNA methylation, and expression of the glucocorticoid receptor gene (Weaver et al., 2004; Weaver et al., 2005). This series of experiments shows that histone acetylation and DNA methylation of the glucocorticoid receptor gene promoter is a necessary link in the process leading to the long-term physiological and behavioral sequelae of poor maternal care. This points to a possible molecular target for treatments that may reverse or ameliorate the traces of childhood maltreatment.
Several studies have attempted to determine to what extent the findings from model animals are transferable to humans. Examination of post-mortem brain tissue from healthy human subjects found that the human equivalent of the glucocorticoid receptor gene promoter (NR3C1 exon 1F promoter) is also unique to the individual (Turner, Pelascini, Macedo, & Muller, 2008). A similar study examining newborns showed that methylation of the glucocorticoid receptor gene promoter may be an early epigenetic marker of maternal mood and risk of increased hormonal responses to stress in infants 3 months of age (Oberlander et al., 2008). Although further studies are required to examine the functional consequence of this DNA methylation, these findings are consistent with our studies in the neonate and adult offspring of low licking and grooming mothers that show increased DNA methylation of the promoter of the glucocorticoid receptor gene, decreased glucocorticoid receptor gene expression, and increased hormonal responses to stress (Weaver et al., 2004). Examinations of brain tissue from suicide victims found that the human glucocorticoid receptor gene promoter is also more methylated in the brains of individuals who had experienced maltreatment during childhood (McGowan et al., 2009). This finding suggests that DNA methylation mediates the effects of early environment in both rodents and humans and points to the possibility of new therapeutic approaches stemming from translational epigenetic research. Indeed, similar processes at comparable epigenetic labile regions could explain why the adult offspring of high and low licking/grooming mothers exhibit widespread differences in hippocampal gene expression and cognitive function (Weaver, Meaney, & Szyf, 2006).
However, this type of research is limited by the inaccessibility of human brain samples. The translational potential of this finding would be greatly enhanced if the relevant epigenetic modification can be measured in an accessible tissue. Examination of blood samples from adult patients with bipolar disorder, who also retrospectively reported on their experiences of childhood abuse and neglect, found that the degree of DNA methylation of the human glucocorticoid receptor gene promoter was strongly positively related to the reported experience of childhood maltreatment decades earlier. For a relationship between a molecular measure and reported historical exposure, the size of the effect is extraordinarily large. This opens a range of new possibilities: given the large effect size and consistency of this association, measurement of the GR promoter methylation may effectively become a blood test measuring the physiological traces left on the genome by early experiences. Although this blood test cannot replace current methods of diagnosis, this unique and additional information adds to our knowledge of how the disease may arise and be manifested throughout life. Near-future research will examine whether this measure adds value over and above simple reporting of early adversities when it comes to predicting important outcomes, such as response to treatment or suicide.
14.3 Child nutrition and the epigenome
The old adage “you are what you eat” might be true on more than just a physical level: The food you choose (and even what your parents and grandparents chose) is reflected in your own personal development and risk for disease in adult life (Wells, 2003). Nutrients can reverse or change DNA methylation and histone modifications, thereby modifying the expression of critical genes associated with physiologic and pathologic processes, including embryonic development, aging, and carcinogenesis. It appears that nutrients can influence the epigenome either by directly inhibiting enzymes that catalyze DNA methylation or histone modifications or by altering the availability of substrates necessary for those enzymatic reactions. For example, rat mothers fed a diet low in methyl group donors during pregnancy produce offspring with reduced DNMT-1 expression, decreased DNA methylation, and increased histone acetylation at promoter regions of specific genes, including the glucocorticoid receptor, and increased gene expression in the liver of juvenile offspring (Lillycrop, Phillips, Jackson, Hanson, & Burdge, 2005) and adult offspring (Lillycrop et al., 2007). These data suggest that early life nutrition has the potential to influence epigenetic programming in the brain not only during early development but also in adult life, thereby modulating health throughout life. In this regard, nutritional epigenetics has been viewed as an attractive tool to prevent pediatric developmental diseases and cancer, as well as to delay aging-associated processes.
The best evidence relating to the impact of adverse environmental conditions development and health comes from studies of the children of women who were pregnant during two civilian famines of World War II: the Siege of Leningrad (1941–44) (Bateson, 2001) and the Dutch Hunger Winter (1944–1945) (Stanner et al., 1997). In the Netherlands famine, women who were previously well-nourished were subjected to low caloric intake and associated environmental stressors. Women who endured the famine in the late stages of pregnancy gave birth to smaller babies (Lumey & Stein, 1997) and these children had an increased risk of insulin resistance later in life (Painter, Roseboom, & Bleker, 2005). In addition, offspring who were starved prenatally later experienced impaired glucose tolerance in adulthood, even when food was more abundant (Stanner et al., 1997). Famine exposure at various stages of gestation was associated with a wide range of risks such as increased obesity, higher rates of coronary heart disease, and lower birth weight (Lumey & Stein, 1997). Interestingly, when examined 60 years later, people exposed to famine prenatally showed reduced DNA methylation compared with their unexposed same-sex siblings (Heijmans et al., 2008).
Attribution
Adapted from Epigenetics in Psychology by Ian Weaver under the CC BY-NC-SA: Attribution-NonCommercial-ShareAlike license. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/03%3A_Perspectives_on_Families/14%3A_Childhood_Experiences_and_Epigenetics.txt |
Learning Objectives
• Define the factors that create social groups.
• Define the concept of social identity, and explain how it applies to social groups.
• Review the stages of group development and dissolution.
• Describe the situations under which social facilitation and social inhibition might occur, and review the theories that have been used to explain these processes.
• Outline the effects of member characteristics, process gains, and process losses on group performance.
• Summarize how social psychologists classify the different types of tasks that groups are asked to perform.
• Explain the influence of each of these concepts on group performance: groupthink, information sharing, brainstorming, and group polarization.
• Review the ways that people can work to make group performance more effective.
15.1 Introduction
Groupthink and Presidential Decision Making
Wikimedia Commons – CC BY 2.0.
In 2003, President George Bush, in his State of the Union address, made specific claims about Iraq’s weapons of mass destruction. The president claimed that there was evidence for “500 tons of sarin, mustard, and VX nerve agent; mobile biological weapons labs” and “a design for a nuclear weapon.” But none of this was true, and in 2004, after the war was started, Bush himself called for an investigation of intelligence failures about such weapons preceding the invasion of Iraq. Many Americans were surprised at the vast failure of intelligence that led the United States into war. In fact, Bush’s decision to go to war based on erroneous facts is part of a long tradition of decision making in the White House. Psychologist Irving Janis popularized the term groupthink in the 1970s to describe the dynamic that afflicted the Kennedy administration when the president and a close-knit band of advisers authorized the ill-fated Bay of Pigs invasion in Cuba in 1961. The president’s view was that the Cuban people would greet the American backed invaders as liberators who would replace Castro’s dictatorship with democracy. In fact, no Cubans greeted the American-backed force as liberators, and Cuba rapidly defeated the invaders. The reasons for the erroneous consensus are easy to understand, at least in hindsight. Kennedy and his advisers largely relied on testimony from Cuban exiles, coupled with a selective reading of available intelligence. As is natural, the president and his advisers searched for information to support their point of view. Those supporting the group’s views were invited into the discussion. In contrast, dissenters were seen as not being team players and had difficulty in getting a hearing. Some dissenters feared to speak loudly, wanting to maintain political influence. As the top team became more selective in gathering information, the bias of information that reached the president became even more pronounced. A few years later, the administration of President Lyndon Johnson became mired in the Vietnam War. The historical record shows that once again, few voices at the very top levels of the administration gave the president the information he needed to make unbiased decisions. Johnson was frequently told that the United States was winning the hearts and minds of the Vietnamese but was rarely informed that most Vietnamese viewed the Americans as occupiers, not liberators. The result was another presidential example of groupthink, with the president repeatedly surprised by military failures. How could a president, a generation after the debacles at the Bay of Pigs and in Vietnam, once again fall prey to the well-documented problem of groupthink? The answer, in the language of former Treasury Secretary Paul O’Neill, is that Vice President Dick Cheney and his allies formed “a praetorian guard that encircled the president” to block out views they did not like. Unfortunately, filtering dissent is associated with more famous presidential failures than
spectacular successes.
Source: Levine, D. I. (2004, February 5). Groupthink and Iraq. San Francisco Chronicle.
Retrieved from http://www.sfgate.com/cgi-
bin/article.cgi?file=/chronicle/archive/2004/02/05/EDGV34OCEP1.DTL.
Although people and their worlds have changed dramatically over the course of our history, one
fundamental aspect of human existence remains essentially the same. Just as our primitive
ancestors lived together in small social groups of families, tribes, and clans, people today still
spend a great deal of time in social groups. We go to bars and restaurants, we study together in
groups, and we work together on production lines and in businesses. We form governments, play
together on sports teams, and use Internet chat rooms and user groups to communicate with
others. It seems that no matter how much our world changes, humans will always remain social
creatures. It is probably not incorrect to say that the human group is the very foundation of
human existence; without our interactions with each other, we would simply not be people, and
there would be no human culture.
We can define a social group as a set of individuals with a shared purpose and who normally
share a positive social identity. While social groups form the basis of human culture and
productivity, they also produce some of our most profound disappointments. Groups sometimes
create the very opposite of what we might hope for, such as when a group of highly intelligent
advisers lead their president to make a poor decision when a peaceful demonstration turns into a
violent riot, or when the members of a clique at a high school tease other students until they
become violent.
In this chapter, we will first consider how social psychologists define social groups. We will also see that effective group decision making is important in business, education, politics, law, and many
other areas (Kovera & Borgida, 2010; Straus, Parker, & Bruce, 2011). We will close the chapter
with a set of recommendations for improving group performance. Taking all the data together, one psychologist once went so far as to comment that “humans would do better without groups!” (Buys, 1978). What Buys probably meant by this comment, I think, was to acknowledge the enormous force of social groups and to point out the importance of being aware that these forces can have both positive and negative consequences (Allen & Hecht, 2004; Kozlowski & Ilgen, 2006; Larson, 2010; Levi, 2007; Nijstad, 2009). Keep this important idea in mind as you read this chapter.
15.2 Understanding Social Groups
We work together in social groups to help us perform tasks and make decisions. Susan Sermoneta – small group work at FIT – CC BY-NC-ND 2.0; Nic McPhee – Four heads are better than one – CC BY-SA 2.0; Hazel Owen – Group work – VPD Meeting – CC BY-NC-ND 2.0.
Although it might seem that we could easily recognize a social group when we come across one, it is actually not that easy to define what makes a group of people a social group. Imagine, for instance, a half dozen people waiting in a checkout line at a supermarket. You would probably agree that this set of individuals should not be considered a social group because the people are not meaningfully related to each other. And the individuals watching a movie at a theater or those attending a large lecture class might also be considered simply as individuals who are in the same place at the same time but who are not connected as a social group.
Of course, a group of individuals who are currently in the same place may nevertheless easily turn into a social group if something happens that brings them “together.” For instance, if a man in the checkout line of the supermarket suddenly collapsed on the floor, it is likely that the others around him would quickly begin to work together to help him. Someone would call an ambulance, another might give CPR, and another might attempt to contact his family. Similarly, if the movie theater were to catch on fire, a group would quickly form as the individuals attempted to leave the theater. And even the class of students might come to feel like a group if the instructor continually praised it for being the best (or the worst) class that she has ever had. It has been a challenge to characterize what the “something” is that makes a group a group, but one term that has been used is entitativity (Campbell, 1958; Lickel et al., 2000). Entitativity refers to something like “groupiness”—the perception, either by the group members themselves or by others, that the people together are a group.
Similarity
One determinant of entitativity is a cognitive one—the perception of similarity. A group can only be a group to the extent that its members have something in common; at minimum, they are similar because they all belong to the group. If a collection of people are interested in the same things, share the same opinions and beliefs, or work together on the same task, then it seems they should be considered—by both themselves and others—to be a group. However, if there are a lot of differences among the individuals, particularly in their values, beliefs, and behaviors, then they are not likely to be seen as a group.
People generally get together to form groups precisely because they are similar—they are all interested in playing poker, listening to rock and roll, or passing a chemistry test. And groups tend to fall apart because the group members become dissimilar and thus no longer have enough in common to keep them together (Crump, Hamilton, Sherman, Lickel, & Thakkar, 2010; Miles & Kivlighan, 2008).
Communication, Interdependence, and Group Structure
Although similarity is critical, it is not the only factor that creates a group. Groups have more entitativity when the group members have frequent interaction and communication with each other. Although communication can occur in groups that meet together in a single place, it can also occur among individuals who are at great distances from each other. The members of a research team who communicate regularly via Skype, for instance, might have frequent interactions and feel as if they are a group even though they never or rarely meet in person.
Interaction is particularly important when it is accompanied by interdependence—the extent to which the group members are mutually dependent upon each other to reach a goal. In some cases, and particularly in working groups, interdependence involves the need to work together to successfully accomplish a task. Individuals playing baseball are dependent upon each other to be able to play the game and also to play well. Each individual must do his or her job in order for the group to function. And we are also interdependent when we work together to write a research article or create a class project. When group members are interdependent, they report liking each other more, tend to cooperate and communicate with each other to a greater extent, and may be more productive (Deutsch, 1949).
Still another aspect of working groups whose members spend some time working together and that makes them seem “groupy” is that they develop group structure—the stable norms and roles that define the appropriate behaviors for the group as a whole and for each of the members. The relevant social norms for groups include customs, traditions, standards, and rules, as well as the general values of the group. These norms tell the group members what to do to be good group members and give the group more entitativity. Effective groups also develop and assign social roles (the expected behaviors) to group members. For instance, some groups may be structured such that they have a president, a secretary, and many different working committees.
Social Identity
Although cognitive factors such as perceived similarity, communication, interdependence, and structure are part of what we mean by being a group, they do not seem to be sufficient. Groups may be seen as groups even if they have little independence, communication, or structure. Partly because of this difficulty, an alternative approach to thinking about groups, and one that has been very important in social psychology, makes use of the affective feelings that we have toward the groups that we belong to. Social identity refers to the part of the self-concept that results from our membership in social groups (Hogg, 2003). Generally, because we prefer to remain in groups that we feel good about, the outcome of group membership is a positive social identity—our group memberships make us feel good about ourselves.
According to the social identity approach, a group is a group when the members experience social identity—when they define themselves in part by the group that they belong to and feel good about their group membership (Hogg, 2003, 2010). This identity might be seen as a tendency on the part of the individual to talk positively about the group to others, a general enjoyment of being part of the group, and a feeling of pride that comes from group membership. Because identity is such an important part of group membership, we may attempt to create it to make ourselves feel good, both about our group and about ourselves. Perhaps you know some people—maybe you are one—who wear the clothes of their crowd or school to highlight their identity with the group because they want to be part of and accepted by, the other group members.
The Stages of Group Development
Although many groups are basically static, performing the same types of tasks day in and day out, other groups are more dynamic. In fact, in almost all groups there is at least some change; members come and go, and the goals of the group may change. And even groups that have remained relatively stable for long periods of time may suddenly make dramatic changes, for instance, when they face a crisis, such as a change in task goals or the loss of a leader. Groups may also lose their meaning and identity as they successfully meet the goals they initially set out to accomplish.
One way to understand group development is to consider the potential stages that groups generally go through. As you can see in Figure 11.1 “Stages of Group Development”, the stages involve forming, storming, norming and performing, and adjourning. The group formation stage occurs when the members of the group come together and begin their existence as a group. In some cases, when a new group, such as a courtroom jury, forms to accomplish a goal, the formation stage occurs relatively quickly and is appropriately considered the group’s first stage. In other cases, however, the process of group formation occurs continually over a long period of time, such as when factory workers leave their jobs and are replaced by new employees, or when a fraternity or sorority recruits new members every year to replace the old ones who leave at the end of the school year.
Figure 11.1 Stages of Group Development
This figure represents a general model of the phases of group development, beginning with group formation and ending with adjournment. It should be kept in mind, however, that the stages are not necessarily sequential, nor do all groups necessarily pass through all stages.
The development stage is important for the new members as well as for the group itself. During this time, the group and the individual will exchange knowledge about appropriate norms, including the existing group structures, procedures, and routines. The individual will need to learn about the group and determine how he or she is going to fit in. And the group may be inspecting the individual’s characteristics and appropriateness as a group member. This initial investigation process may end up with the individual rejecting the group or the group rejecting the individual.
If the group formation stage can be compared to childhood, there is no doubt that the next stage—storming—can be compared to adolescence. As the group members begin to get to know each other, they may find that they don’t always agree on everything. In this stage, members may attempt to make their own views known, expressing their independence and attempting to persuade the group to accept their ideas. Storming may occur as the group first gets started, and it may recur at any point during the group’s development, particularly if the group experiences stress caused by a negative event, such as a setback in progress toward the group goal. In some cases, the conflict may be so strong that the group members decide that the group is not working at all and they disband. In fact, field studies of real working groups have shown that a large percentage of new groups never get past the forming and storming stages before breaking up (Kuypers, Davies, & Hazewinkel, 1986).
Although storming can be harmful to group functioning and thus groups must work to keep it from escalating, some conflict among group members may, in fact, be helpful to the group. Sometimes the most successful groups are those that have successfully passed through a storming stage, because conflict may increase the productivity of the group unless the conflict becomes so extreme that the group disbands prematurely (Rispens & Jehn, 2011). Groups that experience no conflict at all may be unproductive because the members are bored, uninvolved, and unmotivated, and because they do not think creatively or openly about the topics of relevance to them. In order to progress, the group needs to develop new ideas and approaches, and this requires that the members discuss their different opinions about the decisions that the group needs to make.
Assuming that the storming does not escalate too far, the group will move into a stage in which the appropriate norms and roles for the group are developed, allowing the group to establish a routine and effectively work together. At this stage—the norming and performing stage—the individual group members may report great satisfaction and identification with the group, as well as strong group identity. Groups that have effectively reached this stage have the ability to meet goals and survive challenges. And at this point, the group becomes well-tuned to its task and is able to perform the task efficiently.
In one interesting observational study of the group development process in real groups, Gersick (1988, 1989) observed a number of teams as they worked on different projects. The teams were selected such that they were all working within a specific time frame, but the time frame itself varied dramatically—from 8 to 25 meetings held over periods ranging from 11 days to 6 months. Despite this variability, Gersick found that each of the teams followed a very similar pattern of norming and performing. In each case, the team established well-defined norms regarding its method of attacking its task in its very first meeting. And each team stayed with this approach, with very little deviation, during the first half of the time it had been allotted. However, midway through the time, it had been given to complete the project (and regardless of whether that was after 4 meetings or after 12), the group suddenly had a meeting in which it decided to change its approach. Then, each of the groups used this new method of performing the task during the rest of its allotted time. It was as if a sort of alarm clock went off at the halfway point, which led each group to rethink its approach.
Most groups eventually come to an end—the adjournment stage. In some cases, this is because the task for which the group was formed has been completed, whereas in other cases, it occurs because the group members have developed new interests outside the group. In any case, because people who have worked in a group have likely developed a strong identification with the group and the other group members, the adjournment phase is frequently stressful, and participants may resist the breakup. Faced with these situations, individuals frequently plan to get together again in the future, exchanging addresses and phone numbers, even though they may well know that it is unlikely they will actually do so. Sometimes it is useful for the group to work ahead of time to prepare members for the breakup.
Key Takeaways
• Social groups form the foundation of human society—without groups, there would be no human culture. Working together in groups, however, may lead to a variety of negative outcomes as well.
• Similarity, communication, interdependence, and group structure are variables that make a collection of individuals seem more like a group—the perception of group entitativity.
• Most groups that we belong to provide us with a positive social identity—the part of the self-concept that results from our membership in social groups.
• One way to understand group development is to consider the potential stages that groups generally go through. The normal stages are forming, storming, norming and performing, and adjourning.
Exercises and Critical Thinking
1. Consider some of the social groups that you belong to. Which of the variables that we discussed in this section make them seem more like a group?
2. Consider groups that provide a particularly strong social identity for their members. Why do you think social identity is so strong in these groups, and how does the experience of identity influence the group members’ behavior?
15.3 Group Process: the Pluses & Minuses of Working Together
When important decisions need to be made, or when tasks need to be performed quickly or effectively, we frequently create groups to accomplish them. Many people believe that groups are effective for making decisions and performing other tasks (Nijstad, Stroebe, & Lodewijkx, 2006), and such a belief seems commonsensical. After all, because groups have many members, they will also have more resources and thus more ability to efficiently perform tasks and make good decisions. However, although groups sometimes do perform better than individuals, this outcome is not guaranteed. Let’s consider some of the many variables that can influence group performance.
Social Facilitation and Social Inhibition
In one of the earliest social psychological studies, Norman Triplett (1898) investigated how bicycle racers were influenced by the social situation in which they raced. Triplett found something very interesting—the racers who were competing with other bicyclers on the same track rode significantly faster than bicyclers who were racing alone, against the clock. This led Triplett to hypothesize that people perform tasks better when the social context includes other people than when they do the tasks alone. Subsequent findings validated Triplett’s results, and other experiments have shown that the presence of others can increase performance on many types of tasks, including jogging, shooting pool, lifting weights, and working on math and computer problems (Geen, 1989; Guerin, 1983; Robinson-Staveley & Cooper, 1990; Strube, Miles, & Finch, 1981). The tendency to perform tasks better or faster in the presence of others is known as social facilitation.
Although people sometimes perform better when they are in groups than they do alone, the situation is not that simple. Perhaps you can remember a time when you found that a task you could perform well alone (e.g., giving a public presentation, playing the piano, shooting basketball free throws) was not performed as well when you tried it with, or in front of, others. Thus it seems that the conclusion that being with others increases performance cannot be entirely true and that sometimes the presence of others can worsen our performance. The tendency to perform tasks more poorly or slower in the presence of others is known as social inhibition.
To study social facilitation and social inhibition, Hazel Markus (1978) gave research participants both an easy task (putting on and tying their shoes) and an unfamiliar and thus more difficult task (putting on and tying a lab coat that tied in the back). The research participants were asked to perform both tasks in one of three social situations—alone, with a confederate present who was watching them, or with a confederate present who sat in the corner of the room repairing a piece of equipment without watching. As you can see in Figure 11.2 “Group Task Performance”, Markus found first that the difficult task was performed more slowly overall. But she also found an interaction effect, such that the participants performed the easy task faster but the more difficult task slower when a confederate was present in the room. Furthermore, it did not matter whether the other person was paying attention to their performance or whether the other person just happened to be in the room working on another task—the mere presence of another person nearby influenced performance.
Figure 11.2 Group Task Performance
In this experiment, participants were asked to perform a well-learned task (tying their shoes) and a poorly learned task (putting on a lab coat that tied in the back). There is both a main effect of task difficulty and a task-difficulty-by-performance-condition interaction. Data are from Markus (1978).
These results convincingly demonstrated that working around others could either help or hinder performance. But why would this be? One explanation of the influence of others on task performance was proposed by Robert Zajonc (1965). As shown in Figure 11.3 “Explaining Social Facilitation and Social Inhibition”, Zajonc made use of the affective component of arousal in his explanation. Zajonc argued that when we are with others, we experience more arousal than we do when we are alone, and that this arousal increases the likelihood that we will perform the dominant responsethe action that we are most likely to emit in any given situation.
Figure 11.3 Explaining Social Facilitation and Social Inhibition
According to the social facilitation model of Robert Zajonc (1965), the mere presence of others produces arousal, which increases the probability that the dominant response will occur. If the dominant response is correct, the task is performed better, whereas if the dominant response is incorrect, the task is performed more poorly.
The important aspect of Zajonc’s theory was that the experience of arousal and the resulting increase in the performance of the dominant response could be used to predict whether the presence of others would produce social facilitation or social inhibition. Zajonc argued that if the task to be performed was relatively easy, or if the individual had learned to perform the task very well (a task such as pedaling a bicycle or tying one’s shoes), the dominant response was likely to be the correct response, and the increase in arousal caused by the presence of others would improve performance. On the other hand, if the task was difficult or not well learned (e.g., solving a complex problem, giving a speech in front of others, or tying a lab apron behind one’s back), the dominant response was likely to be the incorrect one; and because the increase in arousal would increase the occurrence of the (incorrect) dominant response, performance would be hindered.
Zajonc’s theory explained how the presence of others can increase or decrease performance, depending on the nature of the task, and a great deal of experimental research has now confirmed his predictions. In a meta-analysis, Bond and Titus (1983) looked at the results of over 200 studies using over 20,000 research participants and found that the presence of others did significantly increase the rate of performance on simple tasks and decrease both the rate and the quality of performance on complex tasks.
One interesting aspect of Zajonc’s theory is that because it only requires the concepts of arousal and dominant response to explain task performance, it predicts that the effects of others on performance will not necessarily be confined to humans. Zajonc reviewed evidence that dogs ran faster, chickens ate more feed, ants built bigger nests, and rats had more sex when other dogs, chickens, ants, and rats, respectively, were around (Zajonc, 1965). In fact, in one of the most unusual of all social psychology experiments, Zajonc, Heingartner, and Herman (1969) found that cockroaches ran faster on straight runways when other cockroaches were observing them (from behind a plastic window) but that they ran slower, in the presence of other roaches, on a maze that involved making a difficult turn, presumably because running straight was the dominant response, whereas turning was not.
Although the arousal model proposed by Zajonc is perhaps the most elegant, other explanations have also been proposed to account for social facilitation and social inhibition. One modification argues that we are particularly influenced by others when we perceive that the others are evaluating us or competing with us (Szymanski & Harkins, 1987). This makes sense because in these cases, another important motivator of human behavior—the desire to enhance the self—is involved in addition to arousal. In one study supporting this idea, Strube and his colleagues (Strube, Miles, & Finch, 1981) found that the presence of spectators increased the speed of joggers only when the spectators were facing the joggers and thus could see them and assess their performance.
The presence of others who expect us to do well and who are thus likely to be particularly distracting has been found to have important consequences in some real-world situations. For example, Baumeister and Steinhilber (1984) found that professional athletes frequently performed more poorly than would be expected in crucial games that were played in front of their own fans (such as the final baseball game of the World Series championship).
Process Losses and Process Gains
Working in groups has some benefits. Because groups consist of many members, group performance is almost always better than the performance of an individual acting alone, and group decisions are generally more accurate than the decisions of any one individual. Many heads are better than one in terms of knowledge, memory, physical strength, and other abilities. The group from the National Aeronautics and Space Administration that worked together to land a human on the moon, a rock band whose members are writing a new song together, or a surgical team in the middle of a complex operation may coordinate their efforts so well that is clear that the same outcome could never have occurred if the individuals had worked alone, or in another group of less well-suited individuals. In these cases, the knowledge and skills of the individuals seem to work together to be effective, and the outcome of the group appears to be enhanced. When groups work better than we would expect, given the individuals who form them, we call the outcome a process gain.
There are at least some data suggesting that groups may in some cases experience process gains. For instance, weber and Hertel (2007) found in a recent meta-analysis that individuals can in some cases exert higher motivation when working in a group compared with working individually, resulting in increased group performance. This is particularly true for less capable, inferior group members who seem to become inspired to work harder when they are part of a group. On the other hand, there are also costs to working in groups—for instance, the disastrous decision made by the team of advisors to President Kennedy that led to the unsuccessful invasion of Cuba in 1961, as well as countless other poor decisions. In these cases, the groups experience process losses. A process loss is an outcome in situations in which groups perform more poorly than we would expect, given the characteristics of the members of the group.
One way to think about the benefits of groups is to compare the potential productivity of the group—that is, what the group should be able to do, given its membership—with the actual productivity of the group. For example, on a rope-pulling task, the potential group productivity (the strength with which the group should pull when working together) would be calculated as the sum of all the individual inputs. The difference between the expected productivity of the group and the actual productivity of the group (i.e., the extent to which the group is more or less than the sum of its parts) is determined by the group process, defined as the events that occur while the group is working together on the task. When the outcome of the group performance is better than would be expected on the basis of the members’ characteristics (the group pulls harder than expected), there is a process gain; when the outcome of the group performance is worse than would be expected on the basis of the members’ characteristics, there is a process loss. Mathematically, we can write the following equation to express this relationship:
actual productivity = potential productivity − process loss + process gain.
As you can see, group performance is another example of a case in which person and situation variables work together because it depends on both the skills of the people in the group and the way these resources are combined as the group members work together.
People work together in a variety of ways for a variety of reasons. Groups are sometimes effective, but they are often less so than we might hope. toffehoff – Tug of War – CC BY-SA 2.0; Army Medicine – Surgery – CC BY 2.0; Ben Rodford – London 2012 Olympic Rowing – CC BY-NC 2.0.
Person Variables: Group Member Characteristics
No matter what type of group we are considering, the group will naturally attempt to recruit the best people they can find to help them meet their goals. Member characteristics are the relevant traits, skills, or abilities of the individual group members. On a rope-pulling task, for instance, the member characteristic is the ability of each of group member to pull hard on the rope on his or her own. In addition to having different skills, people differ in personality factors that relate to group performance. Some people are highly motivated to join groups and to make positive contributions to those groups, whereas others are more wary of group membership and prefer to meet their goals working alone. Furthermore, when they are in groups, people may be expected to respond somewhat differently in group interactions, because each is using the group to meet his or her own social and personal goals.
The extent to which member skill influences group performance varies across different group tasks. On an automobile assembly line, performing the task requires only relatively minimal skills, and there is not a lot of coordination among the individuals involved. In this case, it is primarily the number and skill of the individuals who are working on the task that influences the group outcome. In other cases, such as a surgical team or a work team within a corporation, the group includes individuals with a wide variety of different skills, each working at very different tasks. In cases such as these, communication and coordination among the group members is essential, and thus group process will be very important. As an example of variation in the importance of member skills, Jones (1974) found that the skill of individual baseball players accounted for 99% of the team performance on baseball teams (and thus group process accounted for only 1%) but that the skill of individual basketball players accounted for only 35% of the team performance on basketball teams (and thus group process accounted for 65%).
The Importance of the Social Situation: Task Characteristics
Although the characteristics of the group members themselves are critical, they represent only the person part of the equation. To fully understand group performance, we must also consider the particulars of the group’s situation—for instance, the task that the group needs to accomplish. Let’s now consider some of the different types of tasks that might be performed by groups and how they might influence performance (Hackman & Morris, 1975; Straus, 1999). These classifications are summarized as follows:
1. Task division
• Divisible. A task in which the work can be divided up among individuals.
• Unitary. A task in which the work cannot be divided up among individuals.
2. Task combination
• Additive. A task in which the inputs of each group member are added together to create the group performance.
• Compensatory or averaging. A task in which the group input is combined such that the performance of the individuals is averaged.
3. Group member performance
• Disjunctive. A task in which the group’s performance is determined by its best group member.
• Conjunctive. A task in which the group’s performance is determined by its worst member.
4. Task assessment
• Maximizing. A task that involves performance that is measured by how rapidly the group works or how much of a product they are able to make.
• Intellective. A task that involves the ability of the group to make a decision or a judgment.
5. Task clarity
• Criterion. A task in which there is a clearly correct answer to the problem that is being posed.
• Judgmental. A task in which there is no clearly correct answer to the problem that is being posed
One basic distinction concerns whether the task can be divided into smaller subtasks or has to be done as a whole. Building a car on an assembly line or painting a house is a divisible task, because each of the group members working on the job can do a separate part of the job at the same time. Groups are likely to be particularly productive on divisible tasks when the division of the work allows the group members to specialize in those tasks that they are best at performing. Writing a group term paper is facilitated if one group member is an expert typist, another is an expert at library research, and so forth. Climbing a mountain or moving a piano, on the other hand, is a unitary taskbecause it has to be done all at once and cannot be divided up. In this case, specialization among group members is less useful, because each group member has to work on the same task at the same time.
Another way of classifying tasks is by the way the contributions of the group members are combined. On an additive task, the inputs of each group member are added together to create the group performance, and the expected performance of the group is the sum of group members’ individual inputs. A tug of war is a good example of an additive task because the total performance of a team is expected to be the sum of all the team members’ individual efforts.
On a compensatory (averaging) task, however, the group input is combined such that the performance of the individuals is averaged rather than added. Imagine that you wanted to estimate the current temperature in your classroom, but you had no thermometer. One approach to getting an estimate would be to have each of the individuals in your class make his or her estimate of the temperature and then average the estimates together to create a group judgment. On decisions such as this, the average group judgment is likely to be more accurate than that made by most individuals (Armstrong, 2001; Surowiecki, 2004).
Another task classification involves comparing tasks in which the group performance is dependent upon the abilities of the best member or members of the group with tasks in which the group performance is dependent upon the abilities of the worst member or members of the group. When the group’s performance is determined by the best group member, we call it a disjunctive task. Consider what might happen when a group is given a complicated problem to solve, such as this horse-trading problem:
A man buys a horse for \$50. He later decides he wants to sell his horse and he gets \$60. He then decides to buy it back and pays \$70. However, he can no longer keep it, and he sells it for \$80. Did he make money, lose money, or break-even? Explain why.
The correct answer to the problem is not immediately apparent, and each group member will attempt to solve the problem. With some luck, one or more of the members will discover the correct solution, and when that happens, the other members will be able to see that it is indeed the correct answer. At this point, the group as a whole has correctly solved the problem, and the performance of the group is thus determined by the ability of the best member of the group.
In contrast, on a conjunctive taskthe group performance is determined by the ability of the group member who performs most poorly. Imagine an assembly line in which each individual working on the line has to insert one screw into the part being made and that the parts move down the line at a constant speed. If anyone individual is substantially slower than the others, the speed of the entire line will need to be slowed down to match the capability of that individual. As another example, hiking up a mountain in a group is also conjunctive because the group must wait for the slowest hiker to catch up.
Still another distinction among tasks concerns the specific product that the group is creating and how that group output is measured. An intellective task involves the ability of the group to make a decision or a judgment and is measured by studying either the processes that the group uses to make the decision (such as how a jury arrives at a verdict) or the quality of the decision (such as whether the group is able to solve a complicated problem). A maximizing task, on the other hand, is one that involves performance that is measured by how rapidly the group works or how much of a product they are able to make (e.g., how many computer chips are manufactured on an assembly line, how many creative ideas are generated by a brainstorming group, how fast a construction crew can build a house).
Finally, we can differentiate intellective task problems for which there is an objectively correct decision from those in which there is not a clear best decision. On a criterion taskthe group can see that there is a clearly correct answer to the problem that is being posed. Some examples would be finding solutions to mathematics or logic problems, such as the horse-trading problem.
On some criterion tasks, the correct answer is immediately seen as the correct one once it is found. For instance, what is the next letter in each of the following two patterns of letters?
J F M A M _
O T T F F _
In criterion problems such as this one, as soon as one of the group members finds the correct answer, the problem is solved because all the group members can see that it is correct. Criterion tasks in which the correct answer is obvious once it is found are known as “Eureka!” or “Aha!” tasks (Lorge, Fox, Davitz, & Brenner, 1958), named for the response that we have when we see the correct solution.
In other types of criterion-based tasks, there is an objectively correct answer, although that answer is not immediately obvious. For instance, consider again the horse-trading problem. In this case, there is a correct answer, but it may not be apparent to the group members even when it is proposed by one or more of them (for this reason, we might call this a “non-Eureka” task). In fact, in one study using the horse-trading problem, only 80% of the groups in which the correct answer was considered actually decided upon that answer as the correct one after the members had discussed it together.
In still other criterion-based tasks, experts must be used to assess the quality or creativity of the group’s performance. Einhorn, Hogarth, and Klempner (1977) asked groups of individuals to imagine themselves as a group of astronauts who are exploring the moon but who have become stranded from their base. The problem is to determine which of the available pieces of equipment (e.g., oxygen bottles, a rope, a knife) they should take with them as they attempt to reach the base. To assess group performance, experts on the difficulties of living in space made judgments about the quality of the group decisions. Non-Eureka tasks represent an interesting challenge for groups because even when they have found what they think is a good answer, they may still need to continue their discussion to convince themselves that their answer is the best they can do and that they can, therefore, stop their deliberation.
In contrast to a criterion task, in a judgmental task, there is no clearly correct answer to the problem. Judgmental tasks involve such decisions as determining the innocence or guilt of an accused person in a jury or making an appropriate business decision. Because there is no objectively correct answer on judgmental tasks, the research approach usually involves studying the processes that the group uses to make the decision rather than measuring the outcome of the decision itself. Thus the question of interest on judgmental tasks is not “Did the group get the right answer?” but rather “How did the group reach its decision?”
Process Losses Due to Difficulties in Coordination and Motivation
Process losses are caused by events that occur within the group that make it difficult for the group to live up to its full potential. In one study, Ringelmann (1913; reported in Kravitz & Martin, 1986) investigated the ability of individuals to reach their full potential when working together on tasks. Ringelmann had individual men and groups of various numbers of men pull as hard as they could on ropes while he measured the maximum amount that they were able to pull. Because rope pulling is an additive task, the total amount that could be pulled by the group should be the sum of the contributions of the individuals. However, as shown in Figure 11.4 “The Ringelmann Effect”, although Ringelmann did find that adding individuals to the group increased the overall amount of pulling on the rope (the groups were better than any one individual), he also found a substantial process loss. In fact, the loss was so large that groups of three men pulled at only 85% of their expected capability, whereas groups of eight pulled at only 37% of their expected capability.
Figure 11.4 The Ringelmann Effect
Ringelmann found that although more men pulled harder on a rope than fewer men did, there was a substantial process loss in comparison with what would have been expected on the basis of their individual performances.
This type of process loss, in which group productivity decreases as the size of the group increases, has been found to occur on a wide variety of tasks, including maximizing tasks such as clapping and cheering and swimming (Latané, Williams, & Harkins, 1979; Williams, Nida, Baca, & Latané, 1989), and judgmental tasks such as evaluating a poem (Petty, Harkins, Williams, & Latané, 1977). Furthermore, these process losses have been observed in different cultures, including India, Japan, and Taiwan (Gabrenya, Wang, & Latané, 1985; Karau & Williams, 1993).
Process losses in groups occur in part simply because it is difficult for people to work together. The maximum group performance can only occur if all the participants put forth their greatest effort at exactly the same time. Since, despite the best efforts of the group, it is difficult to perfectly coordinate the input of the group members, the likely result is a process loss such that the group performance is less than would be expected, as calculated as the sum of the individual inputs. Thus actual productivity in the group is reduced in part by coordination losses.
Coordination losses become more problematic as the size of the group increases because it becomes correspondingly more difficult to coordinate the group members. Kelley, Condry, Dahlke, and Hill (1965) put individuals into separate booths and threatened them with electrical shock. Each person could avoid the shock, however, by pressing a button in the booth for 3 seconds. But the situation was arranged such that only one person in the group could press the button at one time, and so the group members needed to coordinate their actions. Kelley et al. found that larger groups had significantly more difficulty coordinating their actions to escape the shocks than did smaller groups.
In addition to being influenced by the coordination of activities, group performance is influenced by self-concern on the part of the individual group members. Since each group member is motivated at least in part by individual self-concerns, each member may desire, at least in part, to gain from the group effort without having to contribute very much. You may have been in a work or study group that had this problem—each group member was interested in doing well but also was hoping that the other group members would do most of the work for them. A group process loss that occurs when people do not work as hard in a group as they do when they are alone is known as social loafing (Karau & Williams, 1993).
Research Focus
Differentiating Coordination Losses From Social Loafing
Latané, Williams, and Harkins (1979) conducted an experiment that allowed them to measure the extent to which process losses in groups were caused by coordination losses and by social loafing. Research participants were placed in a room with a microphone and were instructed to shout as loudly as they could when a signal was given. Furthermore, the participants were blindfolded and wore headsets that prevented them from either seeing or hearing the performance of the other group members. On some trials, the participants were told (via the headsets) that they would be shouting alone, and on other trials, they were told that they would be shouting with other participants. However, although the individuals sometimes did shout in groups, in other cases (although they still thought that they were shouting in groups) they actually shouted alone. Thus Latané and his colleagues were able to measure the contribution of the individuals, both when they thought they were shouting alone and when they thought they were shouting in a group.
Latané et al.’s results are presented in in the following figure, which shows the amount of sound produced per person. The top line represents the potential productivity of the group, which was calculated as the sum of the sound produced by the individuals as they performed alone. The middle line represents the performance of hypothetical groups, computed by summing the sound in the conditions in which the participants thought that they were shouting in a group of either two or six individuals, but where they were actually performing alone. Finally, the bottom line represents the performance of real two-person and six-person groups who were actually shouting together.
Figure 11.5 Coordination and Motivation Losses in Working Groups
Individuals who were asked to shout as loudly as they could shouted much less so when they were in larger groups, and this process loss was the result of both motivation and coordination losses. Data from Latané, Williams, and Harkins (1979).
The results of the study are very clear. First, as the number of people in the group increased (from one to two to six), each person’s individual input got smaller, demonstrating the process loss that the groups created. Furthermore, the decrease for real groups (the lower line) is greater than the decrease for the groups created by summing the contributions of the individuals. Because performance in the summed groups is a function of motivation but not coordination, and the performance in real groups is a function of both motivation and coordination, Latané and his colleagues effectively showed how much of the process loss was due to each.
Process Losses Due to Group Conformity Pressures: Groupthink
Even if groups are able to get beyond the process losses that result from coordination difficulties and social loafing, they can make effective decisions only when they are able to make use of the advantages that come with group membership. These advantages include the ability to pool the information that is known to each of the members and to test out contradictory ideas through group discussion. Group decisions can be better than individual decisions only when the group members act carefully and rationally—considering all the evidence and coming to an unbiased, fair, and open decision. However, these conditions are not always met in real groups.
As we saw in the chapter opener, one example of a group process that can lead to very poor group decisions is groupthinkGroupthink occurs when a group that is made up of members who may actually be very competent and thus quite capable of making excellent decisions nevertheless ends up making a poor one as a result of a flawed group process and strong conformity pressures (Baron, 2005; Janis, 2007). Groupthink is more likely to occur in groups in which the members are feeling strong social identity—for instance when there is a powerful and directive leader who creates a positive group feeling, and in times of stress and crisis when the group needs to rise to the occasion and make an important decision. The problem is that groups suffering from groupthink become unwilling to seek out or discuss discrepant or unsettling information about the topic at hand, and the group members do not express contradictory opinions. Because the group members are afraid to express ideas that contradict those of the leader or to bring in outsiders who have other information, the group is prevented from making a fully informed decision. Figure 11.6 “Antecedents and Outcomes of Groupthink” summarizes the basic causes and outcomes of groupthink.
Figure 11.6 Antecedents and Outcomes of Groupthink
Although at least some scholars are skeptical of the importance of groupthink in real group decisions (Kramer, 1998), many others have suggested that groupthink was involved in a number of well-known and important, but very poor, decisions made by government and business groups. Decisions analyzed in terms of groupthink include the decision to invade Iraq made by President George Bush and his advisers; the decision of President John Kennedy and his advisers to commit U.S. forces to help with an invasion of Cuba, with the goal of overthrowing Fidel Castro in 1962; and the lack of response to warnings on an attack on Pearl Harbor, Hawaii, in 1941.
Careful analyses of the decision-making process in these cases have documented the role of conformity pressures. In fact, the group process often seems to be arranged to maximize the amount of conformity rather than to foster free and open discussion. In the meetings of the Bay of Pigs advisory committee, for instance, President Kennedy sometimes demanded that the group members give a voice vote regarding their individual opinions before the group actually discussed the pros and cons of a new idea. The result of these conformity pressures is a general unwillingness to express ideas that do not match the group norm.
The pressures for conformity also lead to the situation in which only a few of the group members are actually involved in conversation, whereas the others do not express any opinions. Because little or no dissent is expressed in the group, the group members come to believe that they are in complete agreement. In some cases, the leader may even select individuals (known as mindguards) whose job it is to help quash dissent and to increase conformity to the leader’s opinions.
An outcome of the high levels of conformity found in these groups is that the group begins to see itself as extremely valuable and important, highly capable of making high-quality decisions, and invulnerable. In short, the group members develop extremely high levels of conformity and social identity. Although this social identity may have some positive outcomes in terms of a commitment to work toward group goals (and it certainly makes the group members feel good about themselves), it also tends to result in illusions of invulnerability, leading the group members to feel that they are superior and that they do not need to seek outside information. Such a situation is conducive to terrible decision making and resulting fiascos.
Cognitive Process Losses: Lack of Information Sharing
Although group discussion generally improves the quality of a group’s decisions, this will only be true if the group discusses the information that is most useful to the decision that needs to be made. One difficulty is that groups tend to discuss some types of information more than others. In addition to the pressures to focus on information that comes from leaders and that is consistent with group norms, discussion is influenced by the way the relevant information is originally shared among the group members. The problem is that group members tend to discuss information that they all have access to while ignoring equally important information that is available to only a few of the members (Faulmüller, Kerschreiter, Mojzisch, & Schulz-Hardt, 2010; Reimer, Reimer, & Czienskowski (2010).
Research Focus
Poor Information Sharing in Groups
In one demonstration of the tendency for groups to preferentially discuss information that all the group members know about, Stasser and Titus (1985) used an experimental design based on the hidden profile task, as shown in the following table. Students read descriptions of two candidates for a hypothetical student body presidential election and then met in groups to discuss and pick the best candidate. The information about the candidates was arranged such that one of the candidates (Candidate A) had more positive qualities overall in comparison with the other (Candidate B). Reflecting this superiority, in groups in which all the members were given all the information about both candidates, the members chose Candidate A 83% of the time after their discussion.
Table 11.1 Hidden Profiles
Group member Information favoring Candidate A Information favoring Candidate B
X a1, a2 b1, b2, b3
Y a1, a3 b1, b2, b3
Z a1, a4 b1, b2, b3
This is an example of the type of “hidden profile” that was used by Stasser and Titus (1985) to study information sharing in group discussion. (The researchers’ profiles were actually somewhat more complicated). The three pieces of favorable information about Candidate B (b1, b2, and b3) were seen by all of the group members, but the favorable information about Candidate A (a1, a2, a3, and a4) was not given to everyone. Because the group members did not share the information about Candidate A, Candidate B was erroneously seen as a better choice.
However, in some cases, the experimenters made the task more difficult by creating a “hidden profile,” in which each member of the group received only part of the information. In these cases, although all the information was potentially available to the group, it was necessary that it be properly shared to make the correct choice. Specifically, in this case, in which the information favoring Candidate B was shared, but the information favoring Candidate A was not, only 18% of the groups chose A, whereas the others chose the inferior candidate. This occurred because although the group members had access to all the positive information collectively, the information that was not originally shared among all the group members was never discussed. Furthermore, this bias occurred even in participants who were given explicit instructions to be sure to avoid expressing their initial preferences and to review all the available facts (Stasser, Taylor, & Hanna, 1989).
Although the tendency to share information poorly seems to occur quite frequently, at least in experimentally created groups, it does not occur equally under all conditions. For one, groups have been found to better share information when the group members believe that there is a correct answer that can be found if there is sufficient discussion (Stasser & Stewart, 1992), and groups also are more likely to share information if they are forced to continue their discussion even after they believe that they have discussed all the relevant information (Larson, Foster-Fishman, & Keys, 1994). These findings suggest that an important job of the group leader is to continue group discussion until he or she is convinced that all the relevant information has been addressed.
The structure of the group will also influence information sharing (Stasser & Taylor, 1991). Groups in which the members are more physically separated and thus have difficulty communicating with each other may find that they need to reorganize themselves to improve communication. And the status of the group members can also be important. Group members with lower status may have less confidence and thus be unlikely to express their opinions. Wittenbaum (1998) found that group members with higher status were more likely to share new information. However, those with higher status may sometimes dominate the discussion, even if the information that they have is not more valid or important (Hinsz, 1990). Groups are also likely to share unique information when the group members do not initially know the alternatives that need to be determined or the preferences of the other group members (Mojzisch & Schulz-Hardt, 2010; Reimer, Reimer, & Hinsz, 2010).
Findings showing that groups neither share nor discuss originally unshared information have very disconcerting implications for group decision making because they suggest that group discussion is likely to lead to very poor judgments. Not only is unshared information not brought to the table, but because the shared information is discussed repeatedly, it is likely to be seen as more valid and to have a greater influence on decisions as a result of its high cognitive accessibility. It is not uncommon that individuals within a working group come to the discussion with different types of information, and this unshared information needs to be presented. For instance, in a meeting of a design team for a new building, the architects, the engineers, and the customer representatives will have different and potentially incompatible information. Thus leaders of working groups must be aware of this problem and work hard to foster open climates that encourage information sharing and discussion.
Brainstorming: Is It Effective?
One technique that is frequently used to produce creative decisions in working groups is known as brainstorming. The technique was first developed by Osborn (1953) in an attempt to increase the effectiveness of group sessions at his advertising agency. Osborn had the idea that people might be able to effectively use their brains to “storm” a problem by sharing ideas with each other in groups. Osborn felt that creative solutions would be increased when the group members generated a lot of ideas and when judgments about the quality of those ideas were initially deferred and only later evaluated. Thus brainstorming was based on the following rules:
• Each group member was to create as many ideas as possible, no matter how silly, unimportant, or unworkable they were thought to be.
• As many ideas as possible were to be generated by the group.
• No one was allowed to offer opinions about the quality of an idea (even one’s own).
• The group members were encouraged and expected to modify and expand upon other’s ideas.
Researchers have devoted considerable effort to testing the effectiveness of brainstorming, and yet, despite the creativeness of the idea itself, there is very little evidence to suggest that it works (Diehl & Stroebe, 1987, 1991; Stroebe & Diehl, 1994). In fact, virtually all individual studies, as well as meta-analyses of those studies, find that regardless of the exact instructions given to a group, brainstorming groups do not generate as many ideas as one would expect, and the ideas that they do generate are usually of lesser quality than those generated by an equal number of individuals working alone who then share their results. Thus brainstorming represents still another example of a case in which, despite the expectation of a process gain by the group, a process loss is instead observed.
A number of explanations have been proposed for the failure of brainstorming to be effective, and many of these have been found to be important. One obvious problem is social loafing by the group members, and at least some research suggests that this does cause part of the problem. For instance, Paulus and Dzindolet (1993) found that social loafing in brainstorming groups occurred in part because individuals perceived that the other group members were not working very hard, and they matched their own behavior to this perceived norm. To test the role of social loafing more directly, Diehl and Stroebe (1987) compared face-to-face brainstorming groups with equal numbers of individuals who worked alone; they found that face-to-face brainstorming groups generated fewer and less creative solutions than did an equal number of equivalent individuals working by themselves. However, for some of the face-to-face groups, the researchers set up a television camera to record the contributions of each of the participants in order to make individual contributions to the discussion identifiable. Being identifiable reduced social loafing and increased the productivity of the individuals in the face-to-face groups; but the face-to-face groups still did not perform as well as the individuals.
Even though individuals in brainstorming groups are told that no evaluation of the quality of the ideas is to be made, and thus that all ideas are good ones, individuals might nevertheless be unwilling to state some of their ideas in brainstorming groups because they are afraid that they will be negatively evaluated by the other group members. When individuals are told that other group members are more knowledgeable than they are, they reduce their own contributions (Collaros & Anderson, 1969), and when they are convinced that they themselves are experts, their contributions increase (Diehl & Stroebe, 1987).
Although social loafing and evaluation apprehension seem to cause some of the problems, the most important difficulty that reduces the effectiveness of brainstorming in face-to-face groups is that being with others in a group hinders opportunities for idea production and expression. In a group, only one person can speak at a time, and this can cause people to forget their ideas because they are listening to others, or to miss what others are saying because they are thinking of their own ideas. This problem—which is caused entirely by the social situation in the group—is known as production blocking. Considered another way, production blocking occurs because although individuals working alone can spend the entire available time generating ideas, participants in face-to-face groups must perform other tasks as well, and this reduces their creativity.
Diehl and Stroebe (1987) demonstrated the importance of production blocking in another experiment that compared individuals with groups. In this experiment, rather than changing things in the real group, they created production blocking in the individual conditions through a turn-taking procedure, such that the individuals, who were working in individual cubicles, had to express their ideas verbally into a microphone, but they were only able to speak when none of the other individuals was speaking. Having to coordinate in this way decreased the performance of individuals such that they were no longer better than the face-to-face groups.
Follow-up research (Diehl & Stroebe, 1991) showed that the main factor responsible for productivity loss in face-to-face brainstorming groups is that the group members are not able to make good use of the time they are forced to spend waiting for others. While they are waiting, they tend to forget their ideas because they must concentrate on negotiating when it is going to be their turn to speak. In fact, even when the researchers gave the face-to-face groups extra time to perform the task (to make up for having to wait for others), they still did not reach the level of productivity of the individuals. Thus the necessity of monitoring the behavior of others and the delay that is involved in waiting to be able to express one’s ideas reduce the ability to think creatively (Gallupe, Cooper, Grise, & Bastianutti, 1994).
Although brainstorming is a classic example of a group process loss, there are ways to make it more effective. One variation on the brainstorming idea is known as the nominal group technique (Delbecq, Van de Ven, & Gustafson, 1975). The nominal group technique capitalizes on the use of individual sessions to generate initial ideas, followed by face-to-face group meetings to discuss and build on them. In this approach, participants first work alone to generate and write down their ideas before the group discussion starts, and the group then records the ideas that are generated. In addition, a round-robin procedure is used to make sure that each individual has a chance to communicate his or her ideas. Other similar approaches include the Delphi technique (Clayton, 1997; Hornsby, Smith, & Gupta, 1994) and Synectics (Stein, 1978).
Contemporary advances in technology have created the ability for individuals to work together on creativity tasks via computer. These computer systems, generally known as group support systems, are used in many businesses and other organizations. One use involves brainstorming on creativity tasks. Each individual in the group works at his or her own computer on the problem. As he or she writes suggestions or ideas, they are passed to the other group members via the computer network, so that each individual can see the suggestions of all the group members, including one’s own.
A number of research programs have found that electronic brainstorming is more effective than face-to-face brainstorming (Dennis & Valacich, 1993; Gallupe, Cooper, Grise, & Bastianutti, 1994; Siau, 1995), in large part because it reduces the production blocking that occurs in face-to-face groups. Groups that work together virtually rather than face-to-face have also been found to be more likely to share unique information (Mesmer-Magnus, DeChurch, Jimenez-Rodriguez, Wildman, & Schuffler, 2011).
Each individual has the comments of all the other group members handy and can read them when it is convenient. The individual can alternate between reading the comments of others and writing his or her own comments and therefore is not required to wait to express his or her ideas. In addition, electronic brainstorming can be effective because it reduces evaluation apprehension, particularly when the participants’ contributions are anonymous (Connolly, Routhieaux, & Schneider, 1993; Valacich, Jessup, Dennis, & Nunamaker, 1992).
In summary, the most important conclusion to be drawn from the literature that has studied brainstorming is that the technique is less effective than expected because group members are required to do other things in addition to being creative. However, this does not necessarily mean that brainstorming is not useful overall, and modifications of the original brainstorming procedures have been found to be quite effective in producing creative thinking in groups. Techniques that make use of initial individual thought, which is later followed by group discussion, represent the best approaches to brainstorming and group creativity. When you are in a group that needs to make a decision, you can make use of this knowledge. Ask the group members to spend some time thinking about and writing down their own ideas before the group begins its discussion.
Group Polarization
One common task of groups is to come to a consensus regarding a judgment or decision, such as where to hold a party, whether a defendant is innocent or guilty, or how much money a corporation should invest in a new product. Whenever a majority of members in the group favors a given opinion, even if that majority is very slim, the group is likely to end up adopting that majority opinion. Of course, such a result would be expected, since, as a result of conformity pressures, the group’s final judgment should reflect the average of group members’ initial opinions.
Although groups generally do show pressures toward conformity, the tendency to side with the majority after group discussion turns out to be even stronger than this. It is commonly found that groups make even more extreme decisions, in the direction of the existing norm, than we would predict they would, given the initial opinions of the group members. Group polarization is said to occur when, after discussion, the attitudes held by the individual group members become more extreme than they were before the group began discussing the topic (Brauer, Judd, & Gliner, 2006; Myers, 1982).
Group polarization was initially observed using problems in which the group members had to indicate how an individual should choose between a risky, but very positive, outcome and a certain, but less desirable, outcome (Stoner, 1968). Consider the following question:
Frederica has a secure job with a large bank. Her salary is adequate but unlikely to increase. However, Frederica has been offered a job with a relatively unknown startup company in which the likelihood of failure is high and in which the salary is dependent upon the success of the company. What is the minimum probability of the startup company’s success that you would find acceptable to make it worthwhile for Frederica to take the job? (choose one)
1 in 10, 3 in 10, 5 in 10, 7 in 10, 9 in 10
Research has found group polarization on these types of decisions, such that the group recommendation is riskier (in this case, requiring a lower probability of success of the new company) than the average of the individual group members’ initial opinions. In these cases, the polarization can be explained in terms of diffusion of responsibility (Kogan & Wallach, 1967). Because the group as a whole is taking responsibility for the decision, the individual may be willing to take a more extreme stand, since he or she can share the blame with other group members if the risky decision does not work out.
But group polarization is not limited to decisions that involve risk. For instance, in an experiment by Myers and Kaplan (1976), groups of students were asked to assess the guilt or innocence of defendants in traffic cases. The researchers also manipulated the strength of the evidence against the defendant, such that in some groups the evidence was strong and in other groups the evidence was weak. This resulted in two groups of juries—some in which the majority of the students initially favored conviction (on the basis of the strong evidence) and others in which a majority initially favored acquittal (on the basis of only weak evidence). The researchers asked the individuals to express their opinions about the guilt of the defendant both before and after the jury deliberated.
As you can see in Figure 11.7 “Group Polarization”, the opinions that the individuals held about the guilt or innocence of the defendants were found to be more extreme after discussion than they were, on average, before the discussion began. That is, members of juries in which the majority of the individuals initially favored conviction became more likely to believe the defendant was guilty after the discussion, and members of juries in which the majority of the individuals initially favored acquittal became more likely to believe the defendant was innocent after the discussion. Similarly, Myers and Bishop (1970) found that groups of college students who had initially racist attitudes became more racist after group discussion, whereas groups of college students who had initially antiracist attitudes became less racist after group discussion. Similar findings have been found for groups discussing a very wide variety of topics and across many different cultures.
Figure 11.7 Group Polarization
The juries in this research were given either strong or weak evidence about the guilt of a defendant and then were either allowed or not allowed to discuss the evidence before making a final decision. Demonstrating group polarization, the juries that discussed the case made significantly more extreme decisions than did the juries that did not discuss the case. Data are from Myers and Kaplan (1976).
Group polarization does not occur in all groups and in all settings but tends to happen when two conditions are present: First, the group members must have an initial leaning toward a given opinion or decision. If the group members generally support liberal policies, their opinions are likely to become even more liberal after discussion. But if the group is made up of both liberals and conservatives, group polarization would not be expected. Second, group polarization is strengthened by discussion of the topic. For instance, in the research by Myers and Kaplan (1976) just reported, in some experimental conditions the group members expressed their opinions but did not discuss the issue, and these groups showed less polarization than groups that discussed the issue.
Group polarization has also been observed in important real-world contexts, including financial decision-making in group and corporate boardrooms (Cheng & Chiou, 2008; Zhu, 2010), and it may also occur in other situations. It has been argued that the recent polarization in political attitudes in the United States (the “blue” Democratic states versus the “red” Republican states) is occurring in large part because each group spends time communicating with other like-minded group members, leading to more extreme opinions on each side. And it has been argued that terrorist groups develop their extreme positions and engage in violent behaviors as a result of the group polarization that occurs in their everyday interactions (Drummond, 2002; McCauley, 1989). As the group members, all of whom initially have some radical beliefs, meet and discuss their concerns and desires, their opinions polarize, allowing them to become progressively more extreme. Because they are also away from any other influences that might moderate their opinions, they may eventually become mass killers.
Group polarization is the result of both cognitive and affective factors. The general idea of the persuasive argument approach to explaining group polarization is cognitive in orientation. This approach assumes is that there is a set of potential arguments that support any given opinion and another set of potential arguments that refute that opinion. Furthermore, an individual’s current opinion about the topic is predicted to be based on the arguments that he or she is currently aware of. During group discussion, each member presents arguments supporting his or her individual opinions. And because the group members are initially leaning in one direction, it is expected that there will be many arguments generated that support the initial leaning of the group members. As a result, each member is exposed to new arguments supporting the initial leaning of the group, and this predominance of arguments leaning in one direction polarizes the opinions of the group members (Van Swol, 2009). Supporting the predictions of persuasive arguments theory, research has shown that the number of novel arguments mentioned in the discussion is related to the amount of polarization (Vinokur & Burnstein, 1978) and that there is likely to be little group polarization without discussion (Clark, Crockett, & Archer, 1971).
But group polarization is in part based on the affective responses of the individuals—and particularly the social identity they receive from being good group members (Hogg, Turner, & Davidson, 1990; Mackie, 1986; Mackie & Cooper, 1984). The idea here is that group members, in their desire to create positive social identity, attempt to differentiate their group from other implied or actual groups by adopting extreme beliefs. Thus the amount of group polarization observed is expected to be determined not only by the norms of the ingroup but also by a movement away from the norms of other relevant outgroups. In short, this explanation says that groups that have well-defined (extreme) beliefs are better able to produce social identity for their members than are groups that have more moderate (and potentially less clear) beliefs.
Group polarization effects are stronger when the group members have high social identity (Abrams, Wetherell, Cochrane, & Hogg, 1990; Hogg, Turner, & Davidson, 1990; Mackie, 1986). Diane Mackie (1986) had participants listen to three people discussing a topic, supposedly so that they could become familiar with the issue themselves to help them make their own decisions. However, the individuals that they listened to were said to be members of a group that they would be joining during the upcoming experimental session, members of a group that they were not expecting to join, or some individuals who were not a group at all. Mackie found that the perceived norms of the (future) ingroup were seen as more extreme than those of the other group or the individuals, and that the participants were more likely to agree with the arguments of the ingroup. This finding supports the idea that group norms are perceived as more extreme for groups that people identify with (in this case, because they were expecting to join it in the future). And another experiment by Mackie (1986) also supported the social identity prediction that the existence of a rival outgroup increases polarization as the group members attempt to differentiate themselves from the other group by adopting more extreme positions.
Taken together then, the research reveals that another potential problem with group decision making is that it can be polarized. These changes toward more extreme positions have a variety of causes and occur more under some conditions than others, but they must be kept in mind whenever groups come together to make important decisions.
Social Psychology in the Public Interest
Decision Making by a Jury
Although many other countries rely on the decisions of judges in civil and criminal trials, the jury is the foundation of the legal system in the United States. The notion of a trial by one’s peers is based on the assumption that average individuals can make informed and fair decisions when they work together in groups. But given all the problems facing groups, social psychologists and others frequently wonder whether juries are really the best way to make these important decisions and whether the particular composition of a jury influences the likely outcome of its deliberation (Lieberman, 2011).
As small working groups, juries have the potential to produce either good or poor decisions, depending on many of the factors that we have discussed in this chapter (Bornstein & Greene, 2011; Hastie, 1993; Winter & Robicheaux, 2011). And again, the ability of the jury to make a good decision is based on both personal characteristics and group process. In terms of person variables, there is at least some evidence that the jury member characteristics do matter. For one, individuals who have already served on juries are more likely to be seen as experts, are more likely to be chosen as jury foreperson, and give more input during the deliberation (Stasser, Kerr, & Bray, 1982). It has also been found that status matters—jury members with higher-status occupations and education, males rather than females, and those who talk first are more likely to be chosen as the foreperson, and these individuals also contribute more to the jury discussion (Stasser et al., 1982). And as in other small groups, a minority of the group members generally dominate the jury discussion (Hastie, Penrod, & Pennington, 1983), And there is frequently a tendency toward social loafing in the group (Najdowski, 2010). As a result, relevant information or opinions are likely to remain unshared because some individuals never or rarely participate in the discussion.
Perhaps the strongest evidence for the importance of member characteristics in the decision-making process concerns the selection of death-qualified juries in trials in which a potential sentence includes the death penalty. In order to be selected for such a jury, the potential members must indicate that they would, in principle, be willing to recommend the death penalty as a punishment. Potential jurors who indicate being opposed to the death penalty cannot serve on these juries. However, this selection process creates a potential bias because the individuals who say that they would not under any condition vote for the death penalty are also more likely to be rigid and punitive and thus more likely to find defendants guilty, a situation that increases the chances of a conviction for defendants (Ellsworth, 1993).
Although there are at least some member characteristics that have an influence upon jury decision making, group process, as in other working groups, plays a more important role in the outcome of jury decisions than do member characteristics. Like any group, juries develop their own individual norms, and these norms can have a profound impact on how they reach their decisions. Analysis of group process within juries shows that different juries take very different approaches to reaching a verdict. Some spend a lot of time in initial planning, whereas others immediately jump right into the deliberation. And some juries base their discussion around a review and reorganization of the evidence, waiting to take a vote until it has all been considered, whereas other juries first determine which decision is preferred in the group by taking a poll and then (if the first vote does not lead to a final verdict) organize their discussion around these opinions. These two approaches are used about equally often but may in some cases lead to different decisions (Hastie, 2008).
Perhaps most important, conformity pressures have a strong impact on jury decision making. As you can see in the following figure, when there are a greater number of jury members who hold the majority position, it becomes more and more certain that their opinion will prevail during the discussion. This is not to say that minorities cannot ever be persuasive, but it is very difficult for them. The strong influence of the majority is probably due to both informational conformity (i.e., that there are more arguments supporting the favored position) and normative conformity (people are less likely to want to be seen as disagreeing with the majority opinion).
Figure 11.8 Conformity in Juries
This figure shows the decisions of six-member mock juries that made “majority rules” decisions. When the majority of the six initially favored voting guilty, the jury almost always voted guilty, and when the majority of the six initially favored voting innocent, the jury almost always voted innocence. The juries were frequently hung (could not make a decision) when the initial split was three to three. Data are from Stasser, Kerr, and Bray (1982).
Research has also found that juries that are evenly split (three to three or six to six) tend to show a leniency bias by voting toward acquittal more often than they vote toward guilt, all other factors being equal (MacCoun & Kerr, 1988). This is in part because juries are usually instructed to assume innocence unless there is sufficient evidence to confirm guilt—they must apply a burden of proof of guilt “beyond a reasonable doubt.” The leniency bias in juries does not always occur, although it is more likely to occur when the potential penalty is more severe (Devine et al., 2004; Kerr, 1978).
Given what you now know about the potential difficulties that groups face in making good decisions, you might be worried that the verdicts rendered by juries may not be particularly effective, accurate, or fair. However, despite these concerns, the evidence suggests that juries may not do as badly as we would expect. The deliberation process seems to cancel out many individual juror biases, and the importance of the decision leads the jury members to carefully consider the evidence itself.
Key Takeaways
• Although groups may sometimes perform better than individuals, this will occur only when the people in the group expend effort to meet the group goals and when the group is able to efficiently coordinate the efforts of the group members.
• The benefits or costs of group performance can be computed by comparing the potential productivity of the group with the actual productivity of the group. The difference will be either a process loss or a process gain.
• Group member characteristics can have a strong effect on group outcomes, but to fully understand group performance, we must also consider the particulars of the group’s situation.
• Classifying group tasks can help us understand the situations in which groups are more or less likely to be successful.
• Some group process losses are due to difficulties in coordination and motivation (social loafing).
• Some group process losses are the result of groupthink—when a group, as result of a flawed group process and strong conformity pressures, makes a poor judgment.
• Process losses may result from the tendency for groups to discuss information that all members have access to while ignoring equally important information that is available to only a few of the members.
• Brainstorming is a technique designed to foster creativity in a group. Although brainstorming often leads to group process losses, alternative approaches, including the use of group support systems, may be more effective.
• Group decisions can also be influenced by group polarization—when the attitudes held by the individual group members become more extreme than they were before the group began discussing the topic.
• Understanding group processes can help us better understand the factors that lead juries to make better or worse decisions.
Exercises and Critical Thinking
1. Consider a time when a group that you belonged to experienced a process loss. Which of the factors discussed in this section do you think were important in creating the problem?
2. If you or someone you knew had a choice to be tried by either a judge or a jury, which would you choose, and why?
15.4 Improving Group Performance
As we have seen, it makes sense to use groups to make decisions because people can create outcomes working together that any one individual could not hope to accomplish alone. In addition, once a group makes a decision, the group will normally find it easier to get other people to implement it because many people feel that decisions made by groups are fairer than those made by individuals. And yet, as we have also seen, there are also many problems associated with groups that make it difficult for them to live up to their full potential. In this section, let’s consider this issue more fully: What approaches can we use to make best use of the groups that we belong to, helping them to achieve as best as is possible? Training groups to perform more effectively is possible if appropriate techniques are used (Salas et al., 2008).
Perhaps the first thing we need to do is to remind our group members that groups are not as effective as they sometimes seem. Group members often think that their group is being more productive than it really is and that their own groups are particularly productive. For instance, people who participate in brainstorming groups report that they have been more productive than those who work alone, even if the group has actually not done all that well (Paulus, Dzindolet, Poletes, & Camacho, 1993; Stroebe, Diehl, & Abakoumkin, 1992).
The tendency to overvalue the productivity of groups is known as the illusion of group effectivity, and it seems to occur for several reasons. For one, the productivity of the group as a whole is highly accessible, and this productivity generally seems quite good, at least in comparison with the contributions of single individuals. The group members hear many ideas expressed by themselves and the other group members, and this gives the impression that the group is doing very well, even if objectively it is not. And on the affective side, group members receive a lot of positive social identity from their group memberships. These positive feelings naturally lead them to believe that the group is strong and performing well. Thus the illusion of group effectivity poses a severe problem for group performance, and we must work to make sure that group members are aware of it. Just because we are working in groups does not mean that we are making good decisions or performing a task particularly well—group members, and particularly the group leader, must always monitor group performance and attempt to motivate the group to work harder.
Motivating Groups to Perform Better by Appealing to Self-Interest
In addition to helping group members understand the nature of group performance, we must be aware of their self-interest goals. Group members, like all other people, act at least in part for themselves. So anything we can do to reward them for their participation or to make them enjoy being in the group more will be helpful.
Perhaps the most straightforward approach to getting people to work harder in groups is to provide rewards for performance. Corporations reward their employees with raises and bonuses if they perform well, and players on sports teams are paid according to their successes on the playing field. However, although incentives may increase the effort of the individual group members and thus enhance group performance, they also have some potential disadvantages for group process.
One potential problem is that the group members will compare their own rewards with those of others. It might be hoped that individuals would use their coworkers as positive role models (upward social comparison), which would inspire them to work harder. For instance, when corporations set up “employee of the week” programs, which reward excellence on the part of individual group members, they are attempting to develop this type of positive comparison.
On the other hand, if group members believe that others are being rewarded more than they are for what they perceive as the same work (downward social comparison), they may change their behavior to attempt to restore equity. Perhaps they will attempt to work harder in order to receive greater rewards for themselves. But they may instead decide to reduce their effort to match what they perceive as a low level of reward (Platow, O’Connell, Shave, & Hanning, 1995). It has been found, for instance, that workers who perceive that their pay is lower than it should be are more likely to be absent from work (Baron & Pfefer, 1994; Geurts, Buunk, & Schaufeli, 1994). Taken together then, incentives can have some positive effects on group performance, but they may also create their own difficulties.
But incentives do not have to be so directly financial. People will also work harder in groups when they feel that they are contributing to the group and that their work is visible to and valued by the other group members (Karau & Williams, 1993; Kerr & Bruun, 1983). One study (Williams, Harkins, & Latané, 1981) found that when groups of individuals were asked to cheer as loudly as they could into a microphone placed in the center of the room, social loafing occurred. However, when each individual was given his or her own personal microphone and thus believed that his or her own input could be measured, social loafing was virtually eliminated. Thus when our contributions to the group are identifiable as our own, and particularly when we receive credit for those contributions, we feel that our performance counts, and we are less likely to loaf.
It turns out that the size of the group matters in this regard. Although larger groups are more able than smaller ones to diversify into specialized roles and activities, and this is likely to make them efficient in some ways (Bond & Keys, 1993; Miller & Davidson-Podgorny, 1987), larger groups are also more likely to suffer from coordination problems and social loafing. The problem is that individuals in larger groups are less likely to feel that their effort is going to make a difference to the output of the group as a whole or that their contribution will be noticed and appreciated by the other group members (Kerr & Bruun, 1981).
In the end, because of the difficulties that accompany large groups, the most effective working groups are of relatively small size—about four or five members. Research suggests that in addition to being more efficient, working in groups of about this size is also more enjoyable to the members, in comparison with being in larger groups (Mullen, Symons, Hu, & Salas, 1989). However, the optimal group size will be different for different types of tasks. Groups in which the members have high ability may benefit more from larger group size (Yetton & Bottger, 1983), and groups that have greater commitment or social identity may suffer less from motivational losses, even when they are large (Hardy & Latané, 1988).
Groups will also be more effective when they develop appropriate social norms. If the group develops a strong group identity and the group members care about the ability of the group to do a good job (e.g., a cohesive sports or military team), the amount of social loafing is reduced (Harkins & Petty, 1982; Latané, Williams, & Harkins, 1979). On the other hand, some groups develop norms that prohibit members from working up to their full potential and thus encourage loafing (Mullen & Baumeister, 1987). It is also important for the group to fully define the roles that each group member should play in the group and help the individuals accomplish these roles.
Cognitive Approaches: Improving Communication and Information Sharing
Even if we are successful in encouraging the group members to work hard toward the group goals, groups may fail anyway because they do not gather and share information openly. However, the likelihood of poor information search and information sharing, such as that which occurs in groupthink, can be reduced by creating situations that foster open and full discussion of the issues.
One important method of creating adequate information sharing is to ensure that the group has plenty of time to make its decision and that it is not rushed in doing so. Of course, such a luxury is not always possible, but better decisions are likely to be made when there is sufficient time. Having plenty of time prevents the group from coming to premature consensus and making an unwise choice. Time to consider the issues fully also allows the group to gain new knowledge by seeking information and analysis from outside experts.
One approach to increasing full discussion of the issues is to have the group break up into smaller subgroups for discussion. This technique increases the amount of discussion overall and allows more group members to air more ideas. In some decision-making groups, it is standard practice to set up several independent groups that consider the same questions, each carrying on its deliberations under a separate leader; the subgroups then meet together to make the final decision.
Within the group itself, conversation can be encouraged through the use of a devil’s advocate—an individual who is given the job of expressing conflicting opinions and forcing the group (in a noncombative way) to fully discuss all the alternatives. Because the opinions of the devil’s advocate challenge the group consensus and thus may hinder quick group decision making and group identity, the individual who takes the job may not be particularly popular in the group. For this reason, the group leader should formally assign the person to the role and make it clear that this role is an essential part of group functioning. The job can profitably be given to one of the most qualified group members and may sometimes rotate from person to person. In other cases, it may be useful to invite an expert or another qualified individual who is not a regular member of the group to the decision-making meetings to give his or her input. This person should be encouraged to challenge the views of the core group.
The group leader is extremely important in fostering norms of open discussion in decision-making groups. An effective leader makes sure that he or she does not state his or her opinions early but rather, allows the other group members to express their ideas first and encourages the presentation of contrasting positions. This allows a fuller discussion of pros and cons and prevents simple agreement by conformity. Leaders also have the ability to solicit unshared information from the group members, and they must be sure to do so, for instance, by making it clear that each member has important and unique information to share and that it is important to do so. Leaders may particularly need to solicit and support opinions from low-status or socially anxious group members. Some decision-making groups even have a “second-chance meeting” before a final decision is made. In this final meeting, the goal is to explicitly consider alternatives and allow any lingering doubts to be expressed by group members.
One difficulty with many working groups is that once they have developed a set of plans or strategies, these plans become established social norms, and it becomes very difficult for the group to later adopt new, alternative, and perhaps better, strategies. As a result, even when the group is having difficulty performing effectively, it may nevertheless stick with its original methods; developing or reformulating strategies is much less common. The development of specific strategies that allow groups to break out of their existing patterns may be useful in these cases. Hackman and Morris (1975) suggest that it can be helpful to have outside observers who are experts in group process provide feedback about relevant norms and encourage the groups to discuss them. In some cases, the consultation may involve restructuring the group by changing the status hierarchy, the social norms, or the group roles, for instance. These changes may help reduce conflict and increase effective communication and coordination.
Setting Appropriate Goals
One aspect of planning that has been found to be strongly related to positive group performance is the setting of goals that the group uses to guide its work (Latham & Locke, 1991; Weldon & Weingart, 1993). Groups that set specific, difficult, and yet attainable goals (e.g., “Improve sales by 10% over the next 6 months”) are much more effective than groups that are given goals that are not very clear (“Let’s sell as much as we can!”). In addition, groups that set clear goals produce better attendance. Goals have been found to be even more important in determining performance than are other incentives, including rewards such as praise and money.
Setting goals appears to be effective because it increases member effort and expectations of success, because it improves cooperation and communication among the members, and because it produces better planning and more accurate monitoring of the group’s work. Specific goals may also result in increased commitment to the group (Locke & Latham, 1990; Weldon, Jehn, & Pradhan, 1991), and when the goals are successfully attained, there is a resulting feeling of accomplishment, group identity and pride, a commitment to the task, and a motivation to set even higher goals. Moreover, there is at least some evidence that it is useful to let the group choose its own goals rather than assigning goals to the group (Haslam, Wegge, & Postmes, 2009). Groups tend to select more challenging goals, and because they have set them themselves, they do not need to be convinced to accept them as appropriate. However, even assigned goals are effective as long as they are seen as legitimate and attainable (Latham, Winters, & Locke, 1994).
One potential problem associated with setting goals is that the goals may turn out to be too difficult. If the goals that are set are too high to actually be reached, or if the group perceives that they are too high even if they are not, the group may become demoralized and reduce its effort (Hinsz, 1995). Groups that are characterized by a strong social identity and a sense of group efficacy—the belief that they can accomplish the tasks given to them—have been found to perform better (Little & Madigan, 1997; Silver & Bufanio, 1996, 1997). Fortunately, over time, groups frequently adjust their goals to be attainable.
Group Member Diversity: Costs and Benefits
As we have seen, most groups tend to be made up of individuals who are similar to each other. This isn’t particularly surprising because groups frequently come together as a result of common interests, values, and beliefs. Groups also tend to recruit new members who are similar to the current members, in the sense that they have personalities, beliefs, and goals that match those of the existing members (Graves & Powell, 1995).
There are some potential advantages for groups in which the members share personalities, beliefs, and values. Similarity among group members will likely help the group reach consensus on the best approaches to performing a task and may lead it to make decisions more quickly and effectively. Groups whose members are similar in terms of their personality characteristics work better and have less conflict, probably at least in part because the members are able to communicate well and to effectively coordinate their efforts (Bond & Shiu, 1997). In some cases, a group may even ostracize or expel members who are dissimilar, and this is particularly likely when it is important that the group make a decision or finish a task quickly and the dissimilarity prevents achieving these goals (Kruglanski & webster, 1991).
Although similarity among group members may be useful in some cases, groups that are characterized by diversity among members—for instance, in terms of personalities, experiences, and abilities—might have some potential advantages (Crisp & Turner, 2011; Jackson & Joshi, 2011; van Knippenberg & Schippers, 2007). For one, assuming that people are willing to express them, diverse interests, opinions, and goals among the group members may reduce tendencies toward conformity and groupthink. Diverse groups may also be able to take advantage of the wider range of resources, ideas, and viewpoints that diversity provides, perhaps by increasing discussion of the issues and therefore improving creative thinking. Bantel and Jackson (1989) appraised the diversity of top management teams in 199 banks and found that the greater the diversity of the team in terms of age, education, and length of time on the team, the greater the number of administrative innovations. Diversity has also been found to increase positive attitudes among the group members and may increase group performance and creativity (Gurin, Peng, Lopez, & Nagda, 1999; McLeod, Lobel, & Cox, 1996; Nemeth, Brown, & Rogers, 2001).
Extreme levels of diversity, however, may be problematic for group process. One difficulty is that it may be harder for diverse groups to get past the formation stage and begin to work on the task, and once they get started, it may take more time for them to make a decision. More diverse groups may also show more turnover over time (Wagner, Pfeffer, & O’Reilly, 1984), and group diversity may produce increased conflict within the group (Kim, 1988).
Diversity in gender and ethnic background in-group members may be either beneficial or harmful to a group. In terms of potential benefits, men and women bring different orientations to the group, as do members of different ethnic groups, and this diversity in background and skills may help group performance. In a meta-analysis of gender diversity, Wendy Wood (1987) found that there was at least some evidence that groups composed of both men and women tended to outperform same-sex groups (either all males or all females) at least in part because they brought different, complementary skills to the group. However, she also found that groups made up only of men performed well on tasks that involved task-oriented activities, whereas groups of women did better on tasks that involved social interaction. Thus, and again supporting the importance of the person-by-situation interaction, the congruency of members and tasks seems more important than either member characteristics or group characteristics alone.
However, although ethnic and gender diversity may have at least some benefits for groups, there are also some potential costs to diversity. Tsui, Egan, and O’Reilly (1992) found that highly diverse groups had lower cohesion and lower social identity in comparison with groups that were more homogeneous. Furthermore, if there are differences in status between the members of the different ethnic or gender groups (such as when men have higher status than women), members of the group with lower status may feel that they are being treated unfairly, particularly if they feel that they do not have equal opportunities for advancement, and this may produce intergroup conflict. And problems may also result if the number of individuals from one group is particularly small. When there are only a few (token) members of one group, these individuals may be seen and treated stereotypically by the members of the larger group (Kanter, 1977).
In sum, group diversity may produce either process losses or process gains, but it is difficult to predict which will occur in any given group. When the diversity experience is not too extreme, and when the group leaders and group members treat the diversity in a positive way, diversity may encourage greater tolerance and also have a variety of positive group functions for the group (Crisp & Turner, 2011; Nishii & Mayer, 2009).
Key Takeaways
• A variety of approaches may be taken to help groups avoid group process losses and to increase the likelihood of process gains.
• It is important to help group members avoid the illusion of group effectivity and to monitor group performance.
• Providing rewards for performance may increase the effort of the individual group members, but if the rewards are not perceived as equitable, they may also lead to upward social comparison and a reduction in effort by other members.
• People will work harder in groups when they feel that they are contributing to the group and that their work is visible to and valued by the other group members. This is particularly likely in smaller groups.
• Adequate information sharing is more likely when the group has plenty of time to make its decision and is not rushed in doing so. The group leader is extremely important in fostering norms of open discussion.
• Groups that set specific, difficult, and yet attainable goals have been found to be more effective than groups that are given goals that are not very clear.
• Group diversity may produce either process losses or process gains, but it is difficult to predict which will occur in any given group.
Exercises and Critical Thinking
1. Analyze each of the following in terms of the principles discussed in this chapter.
• In 1986, the scientists at NASA launched the space shuttle Challenger in weather that was too cold, which led to an explosion on liftoff and the death of the seven astronauts aboard. Although the scientists had debated whether or not to launch the shuttle, analyses of the decision-making process, in this case, found that rather than obtaining unbiased information from all the relevant individuals, many of those in the know were pressured to give a yes response for the launch. Furthermore, the decision to launch was made as the result of a yes vote from only four of the responsible decision-makers, while the opinions of the others were ignored. In January 2003, a very similar event occurred when the space shuttle Columbia burned and crashed on reentry into Earth’s atmosphere. Analysis of the decision making leading to this decision suggests that the NASA team members again acted in isolation, again without fully considering the knowledge and opinions of all the team members, and again with disastrous consequences.
• John, Sarah, Billy, and Warren were assigned to work on a group project for their psychology class. However, they never really made much progress on it. It seemed as if each of them was waiting for the other person to call a meeting. They finally met a couple of days before the paper was due, but nobody seemed to do much work on it. In the end, they didn’t get a very good grade. They realized that they might have done better if they had each worked alone on the project.
2. Imagine that you were working on a group project that did not seem to be going very well. What techniques might you use to motivate the group to do better?
3. Consider a time when you experienced a process gain in a group. Do you think the gain was real or was the group influenced by the illusion of group effectivity?
15.5 Thinking Like A Social Psychologist About Social Groups
This chapter has looked at the ways in which small working groups come together to perform tasks and make decisions. I hope you can see now, perhaps better than you were able to before, the advantages and disadvantages of using groups. Although groups can perform many tasks well, and although people like to use groups to make decisions, groups also come with their own problems.
Since you are likely to spend time working with others in small groups—almost everyone does—I hope that you can now see how groups can succeed and how they can fail. Will you use your new knowledge about social groups to help you be a more effective group member and to help the groups you work in become more effective?
Because you are thinking like a social psychologist, you will realize that groups are determined in part by their personalities—that is, the member characteristics of the group. But you also know that this is not enough and that group performance is also influenced by what happens in the group itself. Groups may become too sure of themselves, too full of social identity and with strong conformity pressures, making it difficult for them to succeed. Can you now see the many ways that you—either as a group member or as a group leader—can help prevent these negative outcomes?
Your value as a group member will increase when you make use of your knowledge about groups. You now have many ideas about how to recognize groupthink and group polarization when they occur and how to prevent them. And you can now see how important group discussion is. When you are in a group, you must work to get the group to talk about the topics fully, even if the group members feel that they have already done enough. Groups think that they are doing better than they really are, and you must work to help them overcome this overconfidence.
15.6 End-of-Chapter Summary
This chapter has focused on the decision making and performance of small working groups. Because groups consist of many members, group performance is almost always better, and group decisions generally more accurate, than that of any individual acting alone. On the other hand, there are also costs to working in groups—we call them process losses.
A variety of research has found that the presence of others can create social facilitation—an increase in task performance—on many types of tasks. However, the presence of others sometimes creates poorer individual performance—social inhibition. According to Robert Zajonc’s explanation for the difference, when we are with others, we experience more arousal than we do when we are alone, and this arousal increases the likelihood that we will perform the dominant response—the action that we are most likely to emit in any given situation. Although the arousal model proposed by Zajonc is perhaps the most elegant, other explanations have also been proposed to account for social facilitation and social inhibition.
One determinant of the perception of a group is a cognitive one—the perception of similarity. A group can only be a group to the extent that its members have something in common. A group also has more entitativity when the group members have frequent interaction and communication with each other. Interaction is particularly important when it is accompanied by interdependence—the extent to which the group members are mutually dependent upon each other to reach a goal. And a group that develops group structure is also more likely to be seen as a group. The affective feelings that we have toward the group we belong to—social identity—also help to create an experience of a group. Most groups pass through a series of stages—forming, storming, norming and performing, and adjourning—during their time together.
We can compare the potential productivity of the group—that is, what the group should be able to do, given its membership—with the actual productivity of the group by use of the following formula:
actual productivity = potential productivity − process loss + process gain.
The actual productivity of a group is based in part on the member characteristics of the group—the relevant traits, skills, or abilities of the individual group members. But group performance is also influenced by situational variables, such as the type of task needed to be performed. Tasks vary in terms of whether they can be divided into smaller subtasks or not, whether the group performance on the task is dependent on the abilities of the best or the worst member of the group, what specific product the group is creating, and whether there is an objectively correct decision for the task.
Process losses are caused by events that occur within the group that make it difficult for the group to live up to its full potential. They occur in part as a result of coordination losses that occur when people work together and in part because people do not work as hard in a group as they do when they are alone—social loafing.
An example of a group process that can lead to very poor group decisions is groupthink. Groupthink occurs when a group, which is made up of members who may actually be very competent and thus quite capable of making excellent decisions, nevertheless ends up making a poor decision as a result of a flawed group process and strong conformity pressures. And process losses occur because group members tend to discuss information that they all have access to while ignoring equally important information that is available to only a few of the members.
One technique that is frequently used to produce creative decisions in working groups is brainstorming. However, as a result of social loafing, evaluation apprehension, and production blocking, brainstorming also creates a process loss in groups. Approaches to brainstorming that reduce production blocking, such as group support systems, can be successful.
Group polarization occurs when the attitudes held by the individual group members become more extreme than they were before the group began discussing the topic. Group polarization is the result of both cognitive and affective factors.
Group members frequently overvalue the productivity of their group—the illusion of group effectivity. This occurs because the productivity of the group as a whole is highly accessible and because the group experiences high social identity. Thus groups must be motivated to work harder and to realize that their positive feelings may lead them to overestimate their worth.
Perhaps the most straightforward approach to getting people to work harder in groups is to provide rewards for performance. This approach is frequently, but not always, successful. People also work harder in groups when they feel that they are contributing to the group and that their work is visible to and valued by the other group members.
Groups are also more effective when they develop appropriate social norms—for instance, norms about sharing information. Information is more likely to be shared when the group has plenty of time to make its decision. The group leader is extremely important in fostering norms of open discussion.
One aspect of planning that has been found to be strongly related to positive group performance is the setting of goals that the group uses to guide its work. Groups that set specific, difficult and yet attainable goals perform better. In terms of group diversity, there are both pluses and minuses. Although diverse groups may have some advantages, the groups—and particularly the group leaders—must work to create a positive experience for the group members.
Your new knowledge about working groups can help you in your everyday life. When you find yourself in a working group, be sure to use this information to become a better group member and to make the groups you work in more productive.
Attribution
Adapted from Chapter 11 from Principles of Social Psychology by University of Minnesota under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/04%3A_Perspectives_on_Groups/15%3A_Working_Groups-_Performance_and_Decision_Making.txt |
Learning Objectives
16.1 Introduction to the Psychology of Groups
This module assumes that a thorough understanding of people requires a thorough understanding of groups. Each of us is an autonomous individual seeking our own objectives, yet we are also members of groups—groups that constrain us, guide us, and sustain us. Just as each of us influences the group and the people in the group, so, too, do groups change each one of us. Joining groups satisfies our need to belong, gain information and understanding through social comparison, define our sense of self and social identity, and achieve goals that might elude us if we worked alone. Groups are also practically significant, for much of the world’s work is done by groups rather than by individuals. Success sometimes eludes our groups, but when group members learn to work together as a cohesive team their success becomes more certain. People also turn to groups when important decisions must be made, and this choice is justified as long as groups avoid such problems as group polarization and groupthink.
How many groups are you a part of on a daily basis? Whether it’s family, class, work, social, sports, church or other areas, we typically spend a good deal of our time and attention each day interacting with others in groups. [Image: CC0 Public Domain, goo.gl/m25gce]
Psychologists study groups because nearly all human activities—working, learning, worshiping, relaxing, playing, and even sleeping—occur in groups. The lone individual who is cut off from all groups is a rarity. Most of us live out our lives in groups, and these groups have a profound impact on our thoughts, feelings, and actions. Many psychologists focus their attention on single individuals, but social psychologists expand their analysis to include groups, organizations, communities, and even cultures.
This module examines the psychology of groups and group membership. It begins with a basic question: What is the psychological significance of groups? People are, undeniably, more often in groups rather than alone. What accounts for this marked gregariousness and what does it say about our psychological makeup? The module then reviews some of the key findings from studies of groups. Researchers have asked many questions about people and groups: Do people work as hard as they can when they are in groups? Are groups more cautious than individuals? Do groups make wiser decisions than single individuals? In many cases the answers are not what common sense and folk wisdom might suggest.
16.2 The Psychological Significance of Groups
Many people loudly proclaim their autonomy and independence. Like Ralph Waldo Emerson, they avow, “I must be myself. I will not hide my tastes or aversions . . . . I will seek my own” (1903/2004, p. 127). Even though people are capable of living separate and apart from others, they join with others because groups meet their psychological and social needs.
The Need to Belong
The need to belong is a strong psychological motivation. [Image: CC0 Public Domain, goo.gl/m25gce]
Across individuals, societies, and even eras, humans consistently seek inclusion over exclusion, membership over isolation, and acceptance over rejection. As Roy Baumeister and Mark Leary conclude, humans have a need to belong: “a pervasive drive to form and maintain at least a minimum quantity of lasting, positive, and impactful interpersonal relationships” (1995, p. 497). And most of us satisfy this need by joining groups. When surveyed, 87.3% of Americans reported that they lived with other people, including family members, partners, and roommates (Davis & Smith, 2007). The majority, ranging from 50% to 80%, reported regularly doing things in groups, such as attending a sports event together, visiting one another for the evening, sharing a meal together, or going out as a group to see a movie (Putnam, 2000).
People respond negatively when their need to belong is unfulfilled. For example, college students often feel homesick and lonely when they first start college, but not if they belong to a cohesive, socially satisfying group (Buote et al., 2007). People who are accepted members of a group tend to feel happier and more satisfied. But should they be rejected by a group, they feel unhappy, helpless, and depressed. Studies of ostracism—the deliberate exclusion from groups—indicate this experience is highly stressful and can lead to depression, confused thinking, and even aggression (Williams, 2007). When researchers used a functional magnetic resonance imaging scanner to track neural responses to exclusion, they found that people who were left out of a group activity displayed heightened cortical activity in two specific areas of the brain—the dorsal anterior cingulate cortex and the anterior insula. These areas of the brain are associated with the experience of physical pain sensations (Eisenberger, Lieberman, & Williams, 2003). It hurts, quite literally, to be left out of a group.
Affiliation in Groups
Groups not only satisfy the need to belong, they also provide members with information, assistance, and social support. Leon Festinger’s theory of social comparison (1950, 1954) suggested that in many cases people join with others to evaluate the accuracy of their personal beliefs and attitudes. Stanley Schachter (1959) explored this process by putting individuals in ambiguous, stressful situations and asking them if they wished to wait alone or with others. He found that people affiliate in such situations—they seek the company of others.
Although any kind of companionship is appreciated, we prefer those who provide us with reassurance and support as well as accurate information. In some cases, we also prefer to join with others who are even worse off than we are. Imagine, for example, how you would respond when the teacher hands back the test and yours is marked 85%. Do you want to affiliate with a friend who got a 95% or a friend who got a 78%? To maintain a sense of self-worth, people seek out and compare themselves to the less fortunate. This process is known as downward social comparison.
Identity and Membership
Groups are not only founts of information during times of ambiguity, they also help us answer the existentially significant question, “Who am I?” Common sense tells us that our sense of self is our private definition of who we are, a kind of archival record of our experiences, qualities, and capabilities. Yet, the self also includes all those qualities that spring from memberships in groups. People are defined not only by their traits, preferences, interests, likes, and dislikes, but also by their friendships, social roles, family connections, and group memberships. The self is not just a “me,” but also a “we.”
Even demographic qualities such as sex or age can influence us if we categorize ourselves based on these qualities. Social identity theory, for example, assumes that we don’t just classify other people into such social categories as man, woman, Anglo, elderly, or college student, but we also categorize ourselves. Moreover, if we strongly identify with these categories, then we will ascribe the characteristics of the typical member of these groups to ourselves, and so stereotype ourselves. If, for example, we believe that college students are intellectual, then we will assume we, too, are intellectual if we identify with that group (Hogg, 2001).
Groups also provide a variety of means for maintaining and enhancing a sense of self-worth, as our assessment of the quality of groups we belong to influences our collective self-esteem (Crocker & Luhtanen, 1990). If our self-esteem is shaken by a personal setback, we can focus on our group’s success and prestige. In addition, by comparing our group to other groups, we frequently discover that we are members of the better group, and so can take pride in our superiority. By denigrating other groups, we elevate both our personal and our collective self-esteem (Crocker & Major, 1989).
Mark Leary’s sociometer model goes so far as to suggest that “self-esteem is part of a sociometer that monitors peoples’ relational value in other people’s eyes” (2007, p. 328). He maintains self-esteem is not just an index of one’s sense of personal value, but also an indicator of acceptance into groups. Like a gauge that indicates how much fuel is left in the tank, a dip in self-esteem indicates exclusion from our group is likely. Disquieting feelings of self-worth, then, prompt us to search for and correct characteristics and qualities that put us at risk of social exclusion. Self-esteem is not just high self-regard, but the self-approbation that we feel when included in groups (Leary & Baumeister, 2000).
Evolutionary Advantages of Group Living
Groups may be humans’ most useful invention, for they provide us with the means to reach goals that would elude us if we remained alone. Individuals in groups can secure advantages and avoid disadvantages that would plague the lone individuals. In his theory of social integration, Moreland concludes that groups tend to form whenever “people become dependent on one another for the satisfaction of their needs” (1987, p. 104). The advantages of group life may be so great that humans are biologically prepared to seek membership and avoid isolation. From an evolutionary psychology perspective, because groups have increased humans’ overall fitness for countless generations, individuals who carried genes that promoted solitude-seeking were less likely to survive and procreate compared to those with genes that prompted them to join groups (Darwin, 1859/1963). This process of natural selection culminated in the creation of a modern human who seeks out membership in groups instinctively, for most of us are descendants of “joiners” rather than “loners.”
16.3 Motivation and Performance
Groups usually exist for a reason. In groups, we solve problems, create products, create standards, communicate knowledge, have fun, perform arts, create institutions, and even ensure our safety from attacks by other groups. But do groups always outperform individuals?
Social Facilitation in Groups
Do people perform more effectively when alone or when part of a group? Norman Triplett (1898) examined this issue in one of the first empirical studies in psychology. While watching bicycle races, Triplett noticed that cyclists were faster when they competed against other racers than when they raced alone against the clock. To determine if the presence of others leads to the psychological stimulation that enhances performance, he arranged for 40 children to play a game that involved turning a small reel as quickly as possible (see Figure 1). When he measured how quickly they turned the reel, he confirmed that children performed slightly better when they played the game in pairs compared to when they played alone (see Stroebe, 2012; Strube, 2005).
Figure 1: The “competition machine” Triplett used to study the impact of competition on performance. Triplett’s study was one of the first laboratory studies conducted in the field of social psychology. Triplett, N. (1898)
Triplett succeeded in sparking interest in a phenomenon now known as social facilitation: the enhancement of an individual’s performance when that person works in the presence of other people. However, it remained for Robert Zajonc (1965) to specify when social facilitation does and does not occur. After reviewing prior research, Zajonc noted that the facilitating effects of an audience usually only occur when the task requires the person to perform dominant responses, i.e., ones that are well-learned or based on instinctive behaviors. If the task requires nondominant responses, i.e., novel, complicated, or untried behaviors that the organism has never performed before or has performed only infrequently, then the presence of others inhibits performance. Hence, students write poorer quality essays on complex philosophical questions when they labor in a group rather than alone (Allport, 1924), but they make fewer mistakes in solving simple, low-level multiplication problems with an audience or a coactor than when they work in isolation (Dashiell, 1930).
Social facilitation, then, depends on the task: other people facilitate performance when the task is so simple that it requires only dominant responses, but others interfere when the task requires nondominant responses. However, a number of psychological processes combine to influence when social facilitation, not social interference, occurs. Studies of the challenge-threat response and brain imaging, for example, confirm that we respond physiologically and neurologically to the presence of others (Blascovich, Mendes, Hunter, & Salomon, 1999). Other people also can trigger evaluation apprehension, particularly when we feel that our individual performance will be known to others, and those others might judge it negatively (Bond, Atoum, & VanLeeuwen, 1996). The presence of other people can also cause perturbations in our capacity to concentrate on and process information (Harkins, 2006). Distractions due to the presence of other people have been shown to improve performance on certain tasks, such as the Stroop task, but undermine performance on more cognitively demanding tasks(Huguet, Galvaing, Monteil, & Dumas, 1999).
Social Loafing
Groups usually outperform individuals. A single student, working alone on a paper, will get less done in an hour than will four students working on a group project. One person playing a tug-of-war game against a group will lose. A crew of movers can pack up and transport your household belongings faster than you can by yourself. As the saying goes, “Many hands make light the work” (Littlepage, 1991; Steiner, 1972).
Groups, though, tend to be underachievers. Studies of social facilitation confirmed the positive motivational benefits of working with other people on well-practiced tasks in which each member’s contribution to the collective enterprise can be identified and evaluated. But what happens when tasks require a truly collective effort? First, when people work together they must coordinate their individual activities and contributions to reach the maximum level of efficiency—but they rarely do (Diehl & Stroebe, 1987). Three people in a tug-of-war competition, for example, invariably pull and pause at slightly different times, so their efforts are uncoordinated. The result is coordination loss: the three-person group is stronger than a single person, but not three times as strong. Second, people just don’t exert as much effort when working on a collective endeavor, nor do they expend as much cognitive effort trying to solve problems, as they do when working alone. They display social loafing (Latané, 1981).
Bibb Latané, Kip Williams, and Stephen Harkins (1979) examined both coordination losses and social loafing by arranging for students to cheer or clap either alone or in groups of varying sizes. The students cheered alone or in 2- or 6-person groups, or they were lead to believe they were in 2- or 6-person groups (those in the “pseudo-groups” wore blindfolds and headsets that played masking sound). As Figure 2 indicates, groups generated more noise than solitary subjects, but the productivity dropped as the groups became larger in size. In dyads, each subject worked at only 66% of capacity, and in 6-person groups at 36%. Productivity also dropped when subjects merely believed they were in groups. If subjects thought that one other person was shouting with them, they shouted 82% as intensely, and if they thought five other people were shouting, they reached only 74% of their capacity. These loses in productivity were not due to coordination problems; this decline in production could be attributed only to a reduction in effort—to social loafing (Latané et al., 1979, Experiment 2).
Figure 2: Sound pressure per person as a function of group or pseudo group size. Latane, B. (1981)
Teamwork
Social loafing can be a problem. One way to overcome it is by recognizing that each group member has an important part to play in the success of the group. [Image: Marc Dalmulder, https://goo.gl/Xa5aiE, CC BY 2.0, goo.gl/BRvSA7]
Social loafing is no rare phenomenon. When sales personnel work in groups with shared goals, they tend to “take it easy” if another salesperson is nearby who can do their work (George, 1992). People who are trying to generate new, creative ideas in group brainstorming sessions usually put in less effort and are thus less productive than people who are generating new ideas individually (Paulus & Brown, 2007). Students assigned group projects often complain of inequity in the quality and quantity of each member’s contributions: Some people just don’t work as much as they should to help the group reach its learning goals (Neu, 2012). People carrying out all sorts of physical and mental tasks expend less effort when working in groups, and the larger the group, the more they loaf (Karau & Williams, 1993).
Groups can, however, overcome this impediment to performance through teamwork. A group may include many talented individuals, but they must learn how to pool their individual abilities and energies to maximize the team’s performance. Team goals must be set, work patterns structured, and a sense of group identity developed. Individual members must learn how to coordinate their actions, and any strains and stresses in interpersonal relations need to be identified and resolved (Salas, Rosen, Burke, & Goodwin, 2009).
Researchers have identified two key ingredients to effective teamwork: a shared mental representation of the task and group unity. Teams improve their performance over time as they develop a shared understanding of the team and the tasks they are attempting. Some semblance of this shared mental model is present nearly from its inception, but as the team practices, differences among the members in terms of their understanding of their situation and their team diminish as a consensus becomes implicitly accepted (Tindale, Stawiski, & Jacobs, 2008).
Effective teams are also, in most cases, cohesive groups (Dion, 2000). Group cohesion is the integrity, solidarity, social integration, or unity of a group. In most cases, members of cohesive groups like each other and the group and they also are united in their pursuit of collective, group-level goals. Members tend to enjoy their groups more when they are cohesive, and cohesive groups usually outperform ones that lack cohesion.
This cohesion-performance relationship, however, is a complex one. Meta-analytic studies suggest that cohesion improves teamwork among members, but that performance quality influences cohesion more than cohesion influences performance (Mullen & Copper, 1994; Mullen, Driskell, & Salas, 1998; see Figure 3). Cohesive groups also can be spectacularly unproductive if the group’s norms stress low productivity rather than high productivity (Seashore, 1954).
Figure 3: The relationship between group cohesion and performance over time. Groups that are cohesive do tend to perform well on tasks now (Time1) and in the future (Time 2). Notice, though, that the relationship between Performance at Time 1 and Cohesiveness at Time 2 is greater (r=.51) than the relationship between Cohesion at Time 1 and Performance at Time 2 (r=.25). These findings suggest that cohesion improves performance, but that a group that performs well is likely to also become more cohesive. Mullen, Driskell, & Salas (1998)
Group Development
In most cases, groups do not become smooth-functioning teams overnight. As Bruce Tuckman’s (1965) theory of group development suggests, groups usually pass through several stages of development as they change from a newly formed group into an effective team. As noted in Focus Topic 1, in the forming phase, the members become oriented toward one another. In the storming phase, the group members find themselves in conflict, and some solution is sought to improve the group environment. In the norming, phase standards for behavior and roles develop that regulate behavior. In the performing, phase the group has reached a point where it can work as a unit to achieve desired goals, and the adjourning phase ends the sequence of development; the group disbands. Throughout these stages, groups tend to oscillate between the task-oriented issues and the relationship issues, with members sometimes working hard but at other times strengthening their interpersonal bonds (Tuckman & Jensen, 1977).
Focus Topic 1: Group Development Stages and Characteristics
Stage 1 – “Forming”. Members expose information about themselves in polite but tentative interactions. They explore the purposes of the group and gather information about each other’s interests, skills, and personal tendencies.
Stage 2 – “Storming”. Disagreements about procedures and purposes surface, so criticism and conflict increase. Much of the conflict stems from challenges between members who are seeking to increase their status and control in the group.
Stage 3 – “Norming”. Once the group agrees on its goals, procedures, and leadership, norms, roles, and social relationships develop that increase the group’s stability and cohesiveness.
Stage 4 – “Performing”. The group focuses its energies and attention on its goals, displaying higher rates of task-orientation, decision-making, and problem-solving.
Stage 5 – “Adjourning”. The group prepares to disband by completing its tasks, reduces levels of dependency among members, and dealing with any unresolved issues.
Sources based on Tuckman (1965) and Tuckman & Jensen (1977)
We also experience change as we pass through a group, for we don’t become full-fledged members of a group in an instant. Instead, we gradually become a part of the group and remain in the group until we leave it. Richard Moreland and John Levine’s (1982) model of group socialization describes this process, beginning with initial entry into the group and ending when the member exits it. For example, when you are thinking of joining a new group—a social club, a professional society, a fraternity or sorority, or a sports team—you investigate what the group has to offer, but the group also investigates you. During this investigation stage you are still an outsider: interested in joining the group, but not yet committed to it in any way. But once the group accepts you and you accept the group, socialization begins: you learn the group’s norms and take on different responsibilities depending on your role. On a sports team, for example, you may initially hope to be a star who starts every game or plays a particular position, but the team may need something else from you. In time, though, the group will accept you as a full-fledged member and both sides in the process—you and the group itself—increase their commitment to one another. When that commitment wanes, however, your membership may come to an end as well.
16.4 Making Decisions in Groups
Groups are particularly useful when it comes to making a decision, for groups can draw on more resources than can a lone individual. A single individual may know a great deal about a problem and possible solutions, but his or her information is far surpassed by the combined knowledge of a group. Groups not only generate more ideas and possible solutions by discussing the problem, but they can also more objectively evaluate the options that they generate during discussion. Before accepting a solution, a group may require that a certain number of people favor it, or that it meets some other standard of acceptability. People generally feel that a group’s decision will be superior to an individual’s decision.
Groups, however, do not always make good decisions. Juries sometimes render verdicts that run counter to the evidence presented. Community groups take radical stances on issues before thinking through all the ramifications. Military strategists concoct plans that seem, in retrospect, ill-conceived and short-sighted. Why do groups sometimes make poor decisions?
Group Polarization
Let’s say you are part of a group assigned to make a presentation. One of the group members suggests showing a short video that, although amusing, includes some provocative images. Even though initially you think the clip is inappropriate, you begin to change your mind as the group discusses the idea. The group decides, eventually, to throw caution to the wind and show the clip—and your instructor is horrified by your choice.
This hypothetical example is consistent with studies of groups making decisions that involve risk. Common sense notions suggest that groups exert a moderating, subduing effect on their members. However, when researchers looked at groups closely, they discovered many groups shift toward more extreme decisions rather than less extreme decisions after group interaction. Discussion, it turns out, doesn’t moderate people’s judgments after all. Instead, it leads to group polarization: judgments made after group discussion will be more extreme in the same direction as the average of individual judgments made prior to discussion (Myers & Lamm, 1976). If a majority of members feel that taking risks is more acceptable than exercising caution, then the group will become riskier after a discussion. For example, in France, where people generally like their government but dislike Americans, group discussion improved their attitude toward their government but exacerbated their negative opinions of Americans (Moscovici & Zavalloni, 1969). Similarly, prejudiced people who discussed racial issues with other prejudiced individuals became even more negative, but those who were relatively unprejudiced exhibited even more acceptance of diversity when in groups (Myers & Bishop, 1970).
Common Knowledge Effect
One of the advantages of making decisions in groups is the group’s greater access to information. When seeking a solution to a problem, group members can put their ideas on the table and share their knowledge and judgments with each other through discussions. But all too often groups spend much of their discussion time examining common knowledge—information that two or more group members know in common—rather than unshared information. This common knowledge effect will result in a bad outcome if something known by only one or two group members is very important.
Researchers have studied this bias using the hidden profile task. On such tasks, information known to many of the group members suggests that one alternative, say Option A, is best. However, Option B is definitely the better choice, but all the facts that support Option B are only known to individual groups members—they are not common knowledge in the group. As a result, the group will likely spend most of its time reviewing the factors that favor Option A, and never discover any of its drawbacks. In consequence, groups often perform poorly when working on problems with nonobvious solutions that can only be identified by extensive information sharing (Stasser & Titus, 1987).
Groupthink
Groupthink helps us blend in and feel accepted and validated but it can also lead to problems. [Image: CC0 Public Domain, goo.gl/m25gce]
Groups sometimes make spectacularly bad decisions. In 1961, a special advisory committee to President John F. Kennedy planned and implemented a covert invasion of Cuba at the Bay of Pigs that ended in total disaster. In 1986, NASA carefully, and incorrectly, decided to launch the Challenger space shuttle in temperatures that were too cold.
Irving Janis (1982), intrigued by these kinds of blundering groups, carried out a number of case studies of such groups: the military experts that planned the defense of Pearl Harbor; Kennedy’s Bay of Pigs planning group; the presidential team that escalated the war in Vietnam. Each group, he concluded, fell prey to a distorted style of thinking that rendered the group members incapable of making a rational decision. Janis labeled this syndrome groupthink: “a mode of thinking that people engage in when they are deeply involved in a cohesive in-group, when the members’ strivings for unanimity override their motivation to realistically appraise alternative courses of action” (p. 9).
Janis identified both the telltale symptoms that signal the group is experiencing groupthink and the interpersonal factors that combine to cause groupthink. To Janis, groupthink is a disease that infects healthy groups, rendering them inefficient and unproductive. And like the physician who searches for symptoms that distinguish one disease from another, Janis identified a number of symptoms that should serve to warn members that they may be falling prey to groupthink. These symptoms include overestimating the group’s skills and wisdom, biased perceptions and evaluations of other groups and people who are outside of the group, strong conformity pressures within the group, and poor decision-making methods.
Janis also singled out four group-level factors that combine to cause groupthink: cohesion, isolation, biased leadership, and decisional stress.
• Cohesion: Groupthink only occurs in cohesive groups. Such groups have many advantages over groups that lack unity. People enjoy their membership much more in cohesive groups, they are less likely to abandon the group, and they work harder in pursuit of the group’s goals. But extreme cohesiveness can be dangerous. When cohesiveness intensifies, members become more likely to accept the goals, decisions, and norms of the group without reservation. Conformity pressures also rise as members become reluctant to say or do anything that goes against the grain of the group, and the number of internal disagreements—necessary for good decision making—decreases.
• Isolation. Groupthink groups too often work behind closed doors, keeping out of the limelight. They isolate themselves from outsiders and refuse to modify their beliefs to bring them into line with society’s beliefs. They avoid leaks by maintaining strict confidentiality and working only with people who are members of their group.
• Biased leadership. A biased leader who exerts too much authority over group members can increase conformity pressures and railroad decisions. In groupthink groups, the leader determines the agenda for each meeting, sets limits on discussion, and can even decide who will be heard.
• Decisional stress. Groupthink becomes more likely when the group is stressed, particularly by time pressures. When groups are stressed they minimize their discomfort by quickly choosing a plan of action with little argument or dissension. Then, through collective discussion, the group members can rationalize their choice by exaggerating the positive consequences, minimizing the possibility of negative outcomes, concentrating on minor details, and overlooking larger issues.
16.5 You and Your Groups
Even groups that like one another and work well together in most situations can be victims of groupthink or the common knowledge effect. But knowing that these pitfalls exist is the first step to overcoming them. [Image: CC0 Public Domain, goo.gl/m25gce]
Most of us belong to at least one group that must make decisions from time to time: a community group that needs to choose a fund-raising project; a union or employee group that must ratify a new contract; a family that must discuss your college plans; or the staff of a high school discussing ways to deal with the potential for violence during football games. Could these kinds of groups experience groupthink? Yes, they could, if the symptoms of groupthink discussed above are present, combined with other contributing causal factors, such as cohesiveness, isolation, biased leadership, and stress. To avoid polarization, the common knowledge effect, and groupthink, groups should strive to emphasize open inquiry of all sides of the issue while admitting the possibility of failure. The leaders of the group can also do much to limit groupthink by requiring full discussion of pros and cons, appointing devil’s advocates, and breaking the group up into small discussion groups.
If these precautions are taken, your group has a much greater chance of making an informed, rational decision. Furthermore, although your group should review its goals, teamwork, and decision-making strategies, the human side of groups—the strong friendships and bonds that make group activity so enjoyable—shouldn’t be overlooked. Groups have instrumental, practical value, but also emotional, psychological value. In groups, we find others who appreciate and value us. In groups, we gain the support we need in difficult times, but also have the opportunity to influence others. In groups, we find evidence of our self-worth, and secure ourselves from the threat of loneliness and despair. For most of us, groups are the secret source of well-being.
16.6 Outside Resources
Audio: This American Life. Episode 109 deals with the motivation and excitement of joining with others at summer camp.
Audio: This American Life. Episode 158 examines how people act when they are immersed in a large crowd.
Audio: This American Life. Episode 61 deals with fiascos, many of which are perpetrated by groups.
Audio: This American Life. Episode 74 examines how individuals act at conventions when they join with hundreds or thousands of other people who are similar in terms of their avocations or employment.
Forsyth, D. (2011). Group Dynamics. In R. Miller, E. Balcetis, S. Burns, D. Daniel, B. Saville, & W. Woody (Eds.), Promoting student engagement: Volume 2: Activities, exercises, and demonstrations for psychology courses. (pp. 28-32) Washington, DC: Society for the Teaching of Psychology, American Psychological Association.
Forsyth, D.R. (n.d.) Group Dynamics: Instructional Resources.
Journal Article: The Dynamogenic Factors in Pacemaking and Competition presents Norman Triplett’s original paper on what would eventually be known as social facilitation.
Resources for the Teaching of Social Psychology.
Social Psychology Network Student Activities
Society for Social and Personality Psychology
Tablante, C. B., & Fiske, S. T. (2015). Teaching social class. Teaching of Psychology, 42, 184-190. doi:10.1177/0098628315573148 The article abstract can be viewed online. Visit your campus library to access the full-text version.
Video: Flash mobs illustrate the capacity of groups to organize quickly and complete complex tasks. One well-known example of a pseudo-flash mob is the rendition of “Do Re Mi” from the Sound of Music in the Central Station of Antwerp in 2009.
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=89
Web: Group Development – This is a website developed by James Atherton that provides detailed information about group development, with application to the lifecycle of a typical college course.
Web: Group Dynamics– A general repository of links, short articles, and discussions examining groups and group processes, including such topics as crowd behavior, leadership, group structure, and influence.
Web: Stanford Crowd Project – This is a rich resource of information about all things related to crowds, with a particular emphasis on crowds and collective behavior in literature and the arts.
Working Paper: Law of Group Polarization, by Cass Sunstein, is a wide-ranging application of the concept of polarization to a variety of legal and political decisions.
16.7 References
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Blascovich, J., Mendes, W. B., Hunter, S. B., & Salomon, K. (1999). Social “facilitation” as challenge and threat. Journal of Personality and Social Psychology, 77, 68–77.
Bond, C. F., Atoum, A. O., & VanLeeuwen, M. D. (1996). Social impairment of complex learning in the wake of public embarrassment. Basic and Applied Social Psychology, 18, 31–44.
Buote, V. M., Pancer, S. M., Pratt, M. W., Adams, G., Birnie-Lefcovitch, S., Polivy, J., & Wintre, M. G. (2007). The importance of friends: Friendship and adjustment among 1st-year university students. Journal of Adolescent Research, 22(6), 665–689.
Crocker, J., & Luhtanen, R. (1990). Collective self-esteem and ingroup bias. Journal of Personality and Social Psychology, 58, 60–67.
Crocker, J., & Major, B. (1989). Social stigma and self-esteem: The self-protective properties of stigma. Psychological Review, 96, 608–630.
Darwin, C. (1859/1963). The origin of species. New York: Washington Square Press.
Dashiell, J. F. (1930). An experimental analysis of some group effects. Journal of Abnormal and Social Psychology, 25, 190–199.
Davis, J. A., & Smith, T. W. (2007). General social surveys (1972–2006). [machine-readable data file]. Chicago: National Opinion Research Center & Storrs, CT: The Roper Center for Public Opinion Research. Retrieved from http://www.norc.uchicago.edu
Diehl, M., & Stroebe, W. (1987). Productivity loss in brainstorming groups: Toward the solution of a riddle. Journal of Personality and Social Psychology, 53, 497–509.
Dion, K. L. (2000). Group cohesion: From “field of forces” to multidimensional construct. Group Dynamics: Theory, Research, and Practice, 4, 7–26.
Eisenberger, N. I., Lieberman, M. D., & Williams, K. D. (2003). Does rejection hurt? An fMRI study of social exclusion. Science, 302, 290–292.
Emerson, R. W. (2004). Essays and poems by Ralph Waldo Emerson. New York: Barnes & Noble. (originally published 1903).
Festinger, L. (1954). A theory of social comparison processes. Human Relations, 7, 117–140.
Festinger, L. (1950). Informal social communication. Psychological Review, 57, 271–282.
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Attribution
Adapted from The Psychology of Groups by Donelson R. Forsyth under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/04%3A_Perspectives_on_Groups/16%3A_The_Psychology_of_Groups.txt |
Learning Objectives
• Define groupthink.
• Define the four-level factors.
17.1 Overview of Groupthink
Groupthink helps us blend in and feel accepted and validated but it can also lead to problems. [Image: CC0 Public Domain, goo.gl/m25gce]
Groups sometimes make spectacularly bad decisions. In 1961, a special advisory committee to President John F. Kennedy planned and implemented a covert invasion of Cuba at the Bay of Pigs that ended in total disaster. In 1986, NASA carefully, and incorrectly, decided to launch the Challenger space shuttle in temperatures that were too cold.
Irving Janis (1982), intrigued by these kinds of blundering groups, carried out a number of case studies of such groups: the military experts that planned the defense of Pearl Harbor; Kennedy’s Bay of Pigs planning group; the presidential team that escalated the war in Vietnam. Each group, he concluded, fell prey to a distorted style of thinking that rendered the group members incapable of making a rational decision. Janis labeled this syndrome groupthink: “a mode of thinking that people engage in when they are deeply involved in a cohesive in-group when the members’ strivings for unanimity override their motivation to realistically appraise alternative courses of action” (p. 9).
Janis identified both the telltale symptoms that signal the group is experiencing groupthink and the interpersonal factors that combine to cause groupthink. To Janis, groupthink is a disease that infects healthy groups, rendering them inefficient and unproductive. And like the physician who searches for symptoms that distinguish one disease from another, Janis identified a number of symptoms that should serve to warn members that they may be falling prey to groupthink. These symptoms include overestimating the group’s skills and wisdom, biased perceptions and evaluations of other groups and people who are outside of the group, strong conformity pressures within the group, and poor decision-making methods.
Janis also singled out four group-level factors that combine to cause groupthink: cohesion, isolation, biased leadership, and decisional stress.
• Cohesion: Groupthink only occurs in cohesive groups. Such groups have many advantages over groups that lack unity. People enjoy their membership much more in cohesive groups, they are less likely to abandon the group, and they work harder in pursuit of the group’s goals. But extreme cohesiveness can be dangerous. When cohesiveness intensifies, members become more likely to accept the goals, decisions, and norms of the group without reservation. Conformity pressures also rise as members become reluctant to say or do anything that goes against the grain of the group, and the number of internal disagreements—necessary for good decision making—decreases.
• Isolation. Groupthink groups too often work behind closed doors, keeping out of the limelight. They isolate themselves from outsiders and refuse to modify their beliefs to bring them into line with society’s beliefs. They avoid leaks by maintaining strict confidentiality and working only with people who are members of their group.
• Biased leadership. A biased leader who exerts too much authority over group members can increase conformity pressures and railroad decisions. In groupthink groups, the leader determines the agenda for each meeting, sets limits on discussion, and can even decide who will be heard.
• Decisional stress. Groupthink becomes more likely when the group is stressed, particularly by time pressures. When groups are stressed they minimize their discomfort by quickly choosing a plan of action with little argument or dissension. Then, through collective discussion, the group members can rationalize their choice by exaggerating the positive consequences, minimizing the possibility of negative outcomes, concentrating on minor details, and overlooking larger issues.
17.2 Additional Resources
Check out this reading concerning groupthink during the Mount Everest disaster.
Burnette, J. L., Pollack, J. M., & Forsyth, D. R. (2011). Leadership in extreme contexts: A groupthink analysis of the May 1996 Mount Everest disaster. Journal of Leadership Studies, 4(4), 29-40. doi:10.1002/jls.20190
Attribution
Adapted from The Psychology of Groups by Donelson R. Forsyth under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/05%3A_Stages_of_Group_Development_and_Group_Think/17%3A_Groupthink.txt |
This module provides an introduction to industrial and organizational (I/O) psychology. I/O psychology is an area of psychology that specializes in the scientific study of behavior in organizational settings and the application of psychology to understand work behavior. The U.S. Department of Labor estimates that I/O psychology, as a field, will grow 26% by the year 2018. I/O psychologists typically have advanced degrees such as a Ph.D. or master’s degree and may work in academic, consulting, government, military, or private for-profit and not-for-profit organizational settings. Depending on the state in which they work, I/O psychologists may be licensed. They might ask and answer questions such as “What makes people happy at work?” “What motivates employees at work?” “What types of leadership styles result in better performance of employees?” “Who are the best applicants to hire for a job?” One hallmark of I/O psychology is its basis in data and evidence to answer such questions, and I/O psychology is based on the scientist-practitioner model. The key individuals and studies in the history of I/O psychology are addressed in this module. Further, professional I/O associations are discussed, as are the key areas of competence developed in I/O master’s programs.
19.1 What is Industrial and Organizational (I/O) Psychology?
The term Industrial Organizational psychology can be applied to businesses, schools, clubs, and even to sports teams. [Image: Kevin Dooley, https://goo.gl/b45OFM, CC BY 2.0, goo.gl/BRvSA7]
Psychology as a field is composed of many different areas. When thinking of psychology, the person on the street probably imagines the clinical psychologist who studies and treats dysfunctional behavior or maybe the criminal psychologist who has become familiar due to popular TV shows such as Law & Order. I/O psychology may be underrepresented on TV, but it is a fast-growing and influential branch of psychology.
What is I/O psychology? Briefly, it can be defined as the scientific study of behavior in organizational settings and the application of psychology to understand work behavior. In other words, while general psychology concerns itself with behavior of individuals in general, I/O psychology focuses on understanding employee behavior in work settings. For example, they ask questions such as: How can organizations recruit and select the people they need in order to remain productive? How can organizations assess and improve the performance of their employees? What work and non-work factors contribute to the happiness, effectiveness, and well-being of employees in the workplace? How does work influence non-work behavior and happiness? What motivates employees at work? All of these important queries fall within the domain of I/O psychology. Table 1 presents a list of tasks I/O psychologists may perform in their work. This is an extensive list, and one person will not be responsible for all these tasks. The I/O psychology field prepares and trains individuals to be more effective in performing the tasks listed in this table.
Table 1. Sample Tasks I/O Psychologists May Perform
At this point you may be asking yourself: Does psychology really need a special field to study work behaviors? In other words, wouldn’t the findings of general psychology be sufficient to understand how individuals behave at work? The answer is an underlined no. Employees behave differently at work compared with how they behave in general. While some fundamental principles of psychology definitely explain how employees behave at work (such as selective perception or the desire to relate to those who are similar to us), organizational settings are unique. To begin with, organizations have a hierarchy. They have job descriptions for employees. Individuals go to work not only to seek fulfillment and to remain active, but also to receive a paycheck and satisfy their financial needs. Even when they dislike their jobs, many stay and continue to work until a better alternative comes along. All these constraints suggest that how we behave at work may be somewhat different from how we would behave without these constraints. According to the U.S. Bureau of Labor Statistics, in 2011, more than 149 million individuals worked at least part time and spent many hours of the week working—see Figure 1 for a breakdown (U.S. Department of Labor, 2011). In other words, we spend a large portion of our waking hours at work. How happy we are with our jobs and our careers is a primary predictor of how happy and content we are with our lives in general (Erdogan, Bauer, Truxillo, & Mansfield, 2012). Therefore, the I/O psychology field has much to offer to individuals and organizations interested in increasing employee productivity, retention, and effectiveness while at the same time ensuring that employees are happy and healthy.
Figure 1. Average Hours Worked by Full Time and Part Time Workers
It seems that I/O psychology is useful for organizations, but how is it helpful to you? Findings of I/O psychology are useful and relevant to everyone who is planning to work in an organizational setting. Note that we are not necessarily taking about a business setting. Even if you are planning to form your own band, or write a novel, or work in a not-for-profit organization, you will likely be working in, or interacting with, organizations. Understanding why people behave the way they do will be useful to you by helping you motivate and influence your coworkers and managers, communicate your message more effectively, negotiate a contract, and manage your own work life and career in a way that fits your life and career goals.
19.2 What Does an I/O Psychologist Do?
I/O psychologists conduct studies that look at important questions such as “What makes people happy at work?” and “What types of leadership styles result in better performance of employees?”
I/O psychology is a scientific discipline. Similar to other scientific fields, it uses research methods and approaches, and tests hypotheses. However, I/O psychology is a social science. This means that its findings will always be less exact than in physical sciences. Physical sciences study natural matter in closed systems and in controlled conditions. Social sciences study human behavior in its natural setting, with multiple factors that can affect behavior, so their predictive ability will never be perfect. While we can expect that two hydrogen and one oxygen atom will always make water when combined, combining job satisfaction with fair treatment will not always result in high performance. There are many influences on employee behaviors at work, and how they behave depends on the person interacting with a given situation on a given day.
Despite the lack of precise results, I/O psychology uses scientific principles to study organizational phenomena. Many of those who conduct these studies are located at universities, in psychology or management departments, but there are also many who work in private, government, or military organizations who conduct studies about I/O-related topics. These scholars conduct studies to understand topics such as “What makes people happy at work?” “What motivates employees at work?” “What types of leadership styles result in better performance of employees?” I/O psychology researchers tend to have a Ph.D. degree, and they develop hypotheses, find ways of reasonably testing those hypotheses in organizational settings, and distribute their findings by publishing in academic journals.
I/O psychology is based on the scientist-practitioner model. In other words, while the science part deals with understanding how and why things happen at work, the practitioner side takes a data-driven approach to understand organizational problems and to apply these findings to solving these specific problems facing the organization. While practitioners may learn about the most recent research findings by reading the journals that publish these results, some conduct their own research in their own companies, and some companies employ many I/O psychologists. Google is one company that collects and analyzes data to deal with talent-related issues. Google uses an annual Googlegeist (roughly translating to the spirit of Google) survey to keep tabs on how happy employees are. When survey results as well as turnover data showed that new mothers were twice as likely to leave the company as the average employee, the company made changes in its maternity leave policy and mitigated the problem (Manjoo, 2013). In other words, I/O psychologists both contribute to the science of workplace behavior by generating knowledge and solve actual problems organizations face by designing the workplace recruitment, selection, and workforce management policies using this knowledge.
While the scientist-practitioner model is the hoped-for ideal, not everyone agrees that it captures the reality. Some argue that practitioners are not always up to date about what scientists know and, conversely, that scientists do not study what practitioners really care about often enough (Briner & Rousseau, 2011). At the same time, consumers of research should be wary, as there is some pseudo-science out there. The issues related to I/O psychology are important to organizations, which are sometimes willing to pay a lot of money for solutions to their problems, with some people trying to sell their most recent invention in employee testing, training, performance appraisal, and coaching to organizations. Many of these claims are not valid, and there is very little evidence that some of these products, in fact, improve the performance or retention of employees. Therefore, organizations and consumers of I/O-related knowledge and interventions need to be selective and ask to see such evidence (which is not the same as asking to see the list of other clients who purchased their products!).
19.3 Careers in I/O Psychology
I/O Psychologists work in a variety of settings that include, but are not limited to education, research and government organizations. [Image: WOCinTech Chat, https://goo.gl/RxTG7B, CC BY 2.0, goo.gl/BRvSA7]
The U.S. Department of Labor estimates that I/O psychology as a field is expected to grow 26% by the year 2018 (American Psychological Association, 2011) so the job outlook for I/O psychologists is good. Helping organizations understand and manage their workforce more effectively using science-based tools is important regardless of the shape of the economy, and I/O psychology as a field remains a desirable career option for those who have an interest in psychology in a work-related context coupled with an affinity for research methods and statistics.
If you would like to refer to yourself as a psychologist in the United States, then you would need to be licensed, and this requirement also applies to I/O psychologists. Licensing requirements vary by state (see www.siop.org for details). However, it is possible to pursue a career relating to I/O psychology without holding the title psychologist. Licensing requirements usually include a doctoral degree in psychology. That said, there are many job opportunities for those with a master’s degree in I/O psychology, or in related fields such as organizational behavior and human resource management.
Academics and practitioners who work in I/O psychology or related fields are often members of the Society for Industrial and Organizational Psychology (SIOP). Students with an interest in I/O psychology are eligible to become an affiliated member of this organization, even if they are not pursuing a degree related to I/O psychology. SIOP membership brings benefits including networking opportunities and subscriptions to an academic journal of I/O research and a newsletter detailing current issues in I/O. The organization supports its members by providing forums for information and idea exchange, as well as monitoring developments about the field for its membership. SIOP is an independent organization but also a subdivision of American Psychological Association (APA), which is the scientific organization that represents psychologists in the United States. Different regions of the world have their own associations for I/O psychologists. For example, the European Association for Work and Organizational Psychology (EAWOP) is the premiere organization for I/O psychologists in Europe, where I/O psychology is typically referred to as work and organizational psychology. A global federation of I/O psychology organizations, named the Alliance for Organizational Psychology, was recently established. It currently has three member organizations (SIOP, EAWOP, and the Organizational Psychology Division of the International Association for Applied Psychology, or Division 1), with plans to expand in the future. The Association for Psychological Science (APS) is another association to which many I/O psychologists belong.
Those who work in the I/O field may be based at a university, teaching and researching I/O-related topics. Some private organizations employing I/O psychologists include DDI, HUMRRO, Corporate Executive Board (CEB), and IBM Smarter Workforce. These organizations engage in services such as testing, performance management, and administering attitude surveys. Many organizations also hire in-house employees with expertise in I/O psychology–related fields to work in departments including human resource management or “people analytics.” According to a 2011 membership survey of SIOP, the largest percentage of members were employed in academic institutions, followed by those in consulting or independent practice, private sector organizations, and public sector organizations (Society for Industrial and Organizational Psychology, 2011). Moreover, the majority of respondents (86%) were not licensed.
19.4 History of I/O Psychology
The field of I/O psychology is almost as old as the field of psychology itself. In order to understand any field, it helps to understand how it started and evolved. Let’s look at the pioneers of I/O psychology and some defining studies and developments in the field (see Koppes, 1997; Landy, 1997).
The term “founding father” of I/O psychology is usually associated with Hugo Munsterberg of Harvard University. His 1913 book on Psychology and Industrial Efficiency, is considered to be the first textbook in I/O psychology. The book is the first to discuss topics such as how to find the best person for the job and how to design jobs to maintain efficiency by dealing with fatigue.
Hugo Munsterberg, the founding father of I/O psychology who in turn was influenced by the writings of Wilhelm Wundt, the founding father of experimental psychology. [Image: CC0 Public Domain, goo.gl/m25gce]
One of his contemporaries, Frederick Taylor, was not a psychologist and is considered to be a founding father not of I/O psychology but of scientific management. Despite his non-psychology background, his ideas were important to the development of the I/O psychology field, because they evolved at around the same time, and some of his innovations, such as job analysis, later became critically important aspects of I/O psychology. Taylor was an engineer and management consultant who pioneered time studies where management observed how work was being performed and how it could be performed better. For example, after analyzing how workers shoveled coal, he decided that the optimum weight of coal to be lifted was 21 pounds, and he designed a shovel to be distributed to workers for this purpose. He instituted mandatory breaks to prevent fatigue, which increased efficiency of workers. His book Principles of Scientific Management was highly influential in pointing out how management could play a role in increasing efficiency of human factors.
Lillian Gilbreth was an engineer and I/O psychologist, arguably completing the first Ph.D. in I/O psychology. She and her husband, Frank Gilbreth, developed Taylor’s ideas by conducting time and motion studies, but also bringing more humanism to these efforts. Gilbreth underlined the importance of how workers felt about their jobs, in addition to how they could perform their jobs more efficiently. She was also the first to bring attention to the value of observing job candidates while they performed their jobs, which is the foundation behind work sample tests. The Gilbreths ran a successful consulting business based on these ideas. Her advising of GE in kitchen redesign resulted in foot-pedal trash cans and shelves in refrigerator doors. Her life with her husband and 12 kids is detailed in a book later made into a 1950 movie, Cheaper by the Dozen, authored by two of her children.
World War I was a turning point for the field of I/O psychology, as it popularized the notion of testing for placement purposes. During and after the war, more than 1 million Americans were tested, which exposed a generation of men to the idea of using tests as part of selection and placement. Following the war, the idea of testing started to take root in the private industry. American Psychological Association President Robert Yerkes, as well as Walter Dill Scott and Walter Van Dyke Bingham from the Carnegie Institute of Technology (later Carnegie Mellon University) division of applied psychology department were influential in popularizing the idea of testing by offering their services to the U.S. Army.
Another major development in the field was the Hawthorne Studies, conducted under the leadership of Harvard University researchers Elton Mayo and Fritz Roethlisberger at the Western Electric Co. in the late 1920s. Originally planned as a study of the effects of lighting on productivity, this series of studies revealed unexpected and surprising findings. For example, one study showed that regardless of the level of change in lighting, productivity remained high and started worsening only when it was reduced to the level of moonlight. Further exploration resulted in the hypothesis that employees were responding to being paid attention to and being observed, rather than the level of lighting (called the “Hawthorne effect”). Another study revealed the phenomenon of group pressure on individuals to limit production to be below their capacity. These studies are considered to be classics in I/O psychology due to their underlining the importance of understanding employee psychology to make sense of employee behavior in the workplace.
Since then, thousands of articles have been published on topics relating to I/O psychology, and it is one of the influential subdimensions of psychology. I/O psychologists generate scholarly knowledge and have a role in recruitment, selection, assessment and development of talent, and design and improvement of the workplace. One of the major projects I/O psychologists contributed to is O*Net, a vast database of occupational information sponsored by the U.S. government, which contains information on hundreds of jobs, listing tasks, knowledge, skill, and ability requirements of jobs, work activities, contexts under which work is performed, as well as personality and values that are critical to effectiveness on those jobs. This database is free and a useful resource for students, job seekers, and HR professionals.
Findings of I/O psychology have the potential to contribute to the health and happiness of people around the world. When people are asked how happy they are with their lives, their feelings about the work domain are a big part of how they answer this question. I/O psychology research uncovers the secrets of a happy workplace (see Table 2). Organizations designed around these principles will see direct benefits, in the form of employee happiness, well-being, motivation, effectiveness, and retention.
Table 2. Designing Work for Happiness: Research Based Recommendations. Based on research summarized in Erdogan et al., 2012.
We have now reviewed what I/O psychology is, what I/O psychologists do, the history of I/O, associations related to I/O psychology, and accomplishments of I/O psychologists. Those interested in finding out more about I/O psychology are encouraged to visit the outside resources below to learn more.
19.5 Additional Resources
Careers: Occupational information via O*Net\’s database containing information on hundreds of standardized and occupation-specific descriptors
Organization: Society for Industrial/Organizational Psychology (SIOP)
Organization: Alliance for Organizational Psychology (AOP)
Organization: American Psychological Association (APA)
Organization: Association for Psychological Science (APS)
Organization: European Association of Work and Organizational Psychology (EAWOP)
Organization: International Association for Applied Psychology (IAAP)
Training: For more about graduate training programs in I/O psychology and related fields
Video: An introduction to I/O Psychology produced by the Society for Industrial and Organizational Psychology.
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=97
American Psychological Association. (2011). Psychology job forecast: Partly sunny. Retrieved on 1/25/2013 from http://www.apa.org/gradpsych/2011/03/cover-sunny.aspx
Briner, R. B., & Rousseau, D. M. (2011). Evidence-based I-O psychology: Not there yet. Industrial and Organizational Psychology, 4, 3–22.
Erdogan, B., Bauer, T. N., Truxillo, D. M., & Mansfield, L. R. (2012). Whistle while you work: A review of the life satisfaction literature. Journal of Management, 38, 1038–1083.
Koppes, L. L. (1997). American female pioneers of industrial and organizational psychology during the early years. Journal of Applied Psychology, 82, 500–515.
Landy, F. J. (1997). Early influences on the development of industrial and organizational psychology. Journal of Applied Psychology, 82, 467–477.
Manjoo, F. (2013). The happiness machine: How Google became such a great place to work. Retrieved on 2/1/2013 from http://www.slate.com/articles/techno...fic_human.html
Society for Industrial and Organizational Psychology. (2011). SIOP 2011 membership survey, employment setting report. Retrieved on 2/5/2013 from www.siop.org/userfiles/image/...ing_Report.pdf
U.S. Department of Labor, Bureau of Labor Statistics. (2011). Economic news release. Retrieved on 1/20/2013 from http://www.bls.gov/news.release/atus.t04.htm
Authors of Text:
Berrin Erdogan , Express Employment Professionals Professor of Management at Portland State University and visiting professor at Koc University (Istanbul, Turkey), studies manager-employee relationships as a predictor of retention, effectiveness, and well being. She serves on editorial boards of several journals, is an Associate Editor for European Journal of Work and Organizational Psychology, and is a fellow of SIOP.
Talya N. Bauer (Phd, Purdue University), Cameron Professor of Management at Portland State University studies relationships at work draws on fairness and relational theories and encompasses recruitment, selection, onboarding, and key organizational relationships such as those with leaders and coworkers. She was Editor of the Journal of Management and is a Fellow of SIOP and APS.
Erdogan, B. & Bauer, T. N. (2020). Industrial/organizational (i/o) psychology. In R. Biswas-Diener & E. Diener (Eds), Noba textbook series: Psychology. Champaign, IL: DEF publishers. Retrieved from http://noba.to/qe3m9485
Attribution
Adapted from Industrial/Organizational (I/O) Psychology by Berrin Erdogan and Talya N. Bauer under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/06%3A_Perspectives_on_Organizations/18%3A_Industrial_Organizational_Psychology.txt |
Learning Objectives
19.1 Competition and Cooperation in Our Social Worlds
Chesapeake Bay Watermen Question Limits on Crab Harvests
In 2001, the crabbing industry in the Chesapeake Bay was on the verge of collapse. As a result, officials from the states of Maryland and Virginia imposed new regulations on overfishing. The restrictions limited fishing to just 8 hours per day and ended the crab season a month earlier than in the past. The aim of the new regulations was to reduce the crab harvest by 15%, which, in turn, was an attempt to maintain the \$150-million-per-year industry.
• >But many crabbers did not agree that their fishing was responsible for this collapse. They felt that poor water quality had killed off underwater seagrasses that made the natural hiding places for small crabs, leaving them vulnerable to predatory fish. Fisherman Eddie Evans believes that the solution for reviving the crab population was to give out more fishing licenses.
• >“We’ve got millions and millions of fish in the bay,” Evans said. “If we could catch more fish it could help the crab population.”
• >Because the number of bay crabs was declining at a fast pace, though, government officials and conservation groups said there was a need for preventive measures. The U.S. Environmental Protection Agency confirmed the overexploitation of crab stocks and felt there was definite justification for the changes. Bill Goldsborough, a fishery scientist at the Chesapeake Bay Foundation, supports the curb on crab harvests.
• >“I would say most sincerely that what is being attempted here is a comprehensive effort, a bay-wide effort, that for over two years has utilized the best scientific information in an attempt to improve the fishery,” he said.
• >But many watermen felt their own needs were being overlooked. The new regulations, they said, would undoubtedly hurt the livelihood of many crabbers.
• >“The crabbers are going to be hurt and a lot of them will fall by the wayside,” said Larry Simns, president of the Maryland Watermen’s Association.
• >On Smith Island, a small fishing community that is fully dependent on blue crab harvests, waterman Roland Bradshaw says that local incomes could fall by 25 percent as a result of the new regulations.
• >“This is our livelihood, this is my living. You probably might lose your boat or your home—either one,” Bradshaw said. “They’re persecuting us. For the watermen, this is it.”
• One of the most important themes of this book has been the extent to which the two human motives of self-concern and other-concern guide our everyday behavior. We have seen that although these two underlying goals are in many ways in direct opposition to each other, they nevertheless work together to create successful human outcomes. Particularly important is the fact that we cannot protect and enhance ourselves and those we care about without the help of the people around us. We cannot live alone—we must cooperate, work with, trust, and even provide help to other people in order to survive. The self-concern motive frequently leads us to desire to not do these things because they sometimes come at a cost to the self. And yet in the end, we must create an appropriate balance between self and other.
In this chapter, we revisit this basic topic one more time by considering the roles of self-concern and other-concern in social relationships between people and the social groups they belong to, and among social groups themselves. We will see, perhaps to a greater extent than ever before, how important our relationships with others are, and how careful we must be to develop and use these connections. Most important, we will see again that helping others also helps us help ourselves.
Furthermore, in this chapter, we will investigate the broadest level of analysis that we have so far considered—focusing on the cultural and societal level of analysis. In so doing, we will consider how the goals of self-concern and other-concern apply even to large groups of individuals, such as nations, societies, and cultures, and influence how these large groups interact with each other.
Most generally, we can say that when individuals or groups interact they may take either cooperative or competitive positions (De Dreu, 2010; Komorita & Parks, 1994). When we cooperate, the parties involved act in ways that they perceive will benefit both themselves and others. Cooperation is behavior that occurs when we trust the people or groups with whom we are interacting and are willing to communicate and share with the others, expecting to profit ourselves through the increased benefits that can be provided through joint behavior. On the other hand, when we engage in competition we attempt to gain as many of the limited rewards as possible for ourselves, and at the same time, we may work to reduce the likelihood of success for the other parties. Although competition is not always harmful, in some cases one or more of the parties may feel that their self-interest has not been adequately met and may attribute the cause of this outcome to another party (Miller, 2001). In these cases of perceived inequity or unfairness, competition may lead to conflict, in which the parties involved engage in violence and hostility (De Dreu, 2010).
Although competition is normal and will always be a part of human existence, cooperation and sharing are too. Although they may generally look out for their own interests, individuals do realize that there are both costs and benefits to always making selfish choices (Kelley & Thibaut, 1978). Although we might prefer to use as much gasoline as we want or to buy a couple of new mp3s rather than contribute to the local food bank, at the same time we realize that doing so may have negative consequences for the group as a whole. People have simultaneous goals of cooperating and competing, and the individual must coordinate these goals in making a choice (De Dreu, 2010; Schelling, 1960/1980).
We will also see that human beings, as members of cultures and societies, internalize social norms that promote other-concern, in the form of morality and social fairness norms and that these norms guide the conduct that allows groups to effectively function and survive (Haidt & Kesebir, 2010). As human beings, we want to do the right thing, and this includes accepting, cooperating, and working with others. And we will do so when we can. However, as in so many other cases, we will also see that the social situation frequently creates a powerful force that makes it difficult to cooperate and easy to compete.
A social dilemma is a situation in which the goals of the individual conflict with the goals of the group (Penner, Dovidio, Piliavin, & Schroeder, 2005; Suleiman, Budescu, Fischer, & Messick, 2004; Van Lange, De Cremer, Van Dijk, & Van Vugt, 2007). Social dilemmas impact a variety of important social problems because the dilemma creates a type of trap: Even though an individual or group may want to be cooperative, the situation leads to competitive behavior. For instance, the watermen we considered in the chapter opener find themselves in a social dilemma—they want to continue to harvest as many crabs as they can, and yet if they all do so, the supply will continue to fall, making the situation worse for everyone.
Although social dilemmas create the potential for conflict and even hostility, those outcomes are not inevitable. People usually think that situations of potential conflict are fixed-sum outcomes, meaning that again for one side necessarily means a loss for the other side or sides (Halevy, Chou, & Murnighan, 2011). But this is not always true. In some cases, the outcomes are instead integrative outcomes, meaning that a solution can be found that benefits all the parties. In the last section of this chapter, we will consider the ways that we can work to increase cooperation and to reduce competition, discussing some of the contributions that social psychologists have made to help solve some important social dilemmas (Oskamp, 2000a, 2000b).
19.2 Conflict, Cooperation, Morality, and Fairness
Whether we cooperate or compete is determined, as are most human behaviors, in part by the characteristics of the individuals who are involved in the relationship and in part by the social situation that surrounds them. Let’s begin by considering first the situational determinants of competition and conflict.
• Competition and Conflict
Conflict between individuals, between groups, and even between individuals and the social groups they belong to is a common part of our social worlds. We compete with other students to get better grades, and nations fight wars to gain territory and advantage. Businesses engage in competitive practices, sometimes in a very assertive manner, to gain market share. The behaviors of the parties that are in conflict are not necessarily designed to harm the others but rather are the result of the goals of self-enhancement and self-preservation. We compete to gain rewards for ourselves and for those with whom we are connected, and doing so sometimes involves trying to prevent the other parties from being able to gain the limited rewards for themselves.
Successful businessmen help their corporations compete against other companies to gain market share. Wikimedia Commons – CC BY 2.0; Wikimedia Commons – CC BY 2.0.
Although competition does not necessarily create overt hostility, competition does sow the seeds for potential problems, and thus hostility may not be far off. One problem is that negative feelings tend to escalate when parties are in competition. In these cases, and particularly when the competition is intense, negative behavior on the part of one person or group may be responded to with even more hostile responses on the part of the competing person or group.
In his summer camp studies, Muzafer Sherif and his colleagues (Sherif, Harvey, White, Hood, & Sherif (1961) created intergroup competition between the boys in the Rattlers club and the boys in the Eagles club. When the Eagles began by stealing the flag from the Rattlers’ cabin, the Rattlers did not respond merely by stealing a flag in return but rather, replied with even more hostile and negative behaviors. It was as if “getting even” was not enough—an even greater retaliation was called for. Similar escalation happened during the Cold War, when the United States and the Soviet Union continued to increase their nuclear arsenals and engaging in more and more aggressive and provocative behaviors, each trying to outdo the other. The magnitude of negative behaviors between the parties has a tendency to increase over time. As the conflict continues, each group perceives the other group more negatively, and these perceptions make it more difficult for the escalating conflict to be reversed.
This escalation in negative perceptions between groups that are in conflict occurs in part because conflict leads the groups to develop increasingly strong social identities. These increases in identity are accompanied by the development of even more hostile group norms, which are supported by the group members and their leaders and which sanction or encourage even more negative behaviors toward the outgroup. Conflict also leads to negative stereotypes of the outgroup, increases perceptions of the other groups as homogenous, and potentially even produces deindividuation and dehumanization of the outgroup (Staub, 2011). The conflict also reduces the amount of interaction among members of the competing groups, which makes it more difficult to change the negative perceptions. The unfortunate outcome of such events is that initially small conflicts may become increasingly hostile until they get out of control. World wars have begun with relatively small encroachments, and duels to the death have been fought over small insults.
Conflict is sometimes realistic, in the sense that the goals of the interacting parties really are incompatible and fixed-sum. At a football game, for instance, only one team can win. And in a business world, there is a limited market share for a product. If one business does better by gaining more customers, then the other competing businesses may well do worse because there are fewer customers left for them. Realistic group conflict occurs when groups are in competition for objectively scarce resources, such as when two sports teams are vying for a league championship or when the members of different ethnic groups are attempting to find employment in the same factory in a city (Brewer & Campbell, 1976; Jackson, 1993). Conflict results in these conditions because it is easy (and accurate) to blame the difficulties of one’s own group on the competition produced by the other group or groups.
Although many situations do create real conflict, some conflicts are more perceived than realistic because (although they may have a core of realistic conflict) they are based on misperceptions of the intentions of others or the nature of the potential rewards. In some cases, although the situation is perceived as conflicting, the benefits gained for one party do not necessarily mean a loss for the other party (the outcomes are actually integrative). For instance, when different supply businesses are working together on a project, each may prefer to supply more, rather than less, of the needed materials. However, the project may be so large that none of the businesses can alone meet the demands. In a case such as this, a compromise is perhaps possible such that the businesses may be able to work together, with each company supplying the products on which it makes a larger profit, therefore satisfying the needs of all the businesses. In this case, the parties may be better off working together than working on their own.
Some conflict is realistic, in the sense that the parties are in dispute over limited resources such as land. But many conflicts may have an integrative solution, such that all parties can gain benefits through cooperation. Source: http://commons.wikimedia.org/wiki/File:Bill_Clinton,_Yitzhak_Rabin,_Yasser_Arafat_at_the_White_ House_1993-09-13.jpg
Although intergroup relationships that involve hostility or violence are obviously to be avoided, it must be remembered that competition or conflict is not always negative or problematic (Coser, 1956; Rispens & Jehn, 2011). The Darwinian idea of “survival of the fittest” proposes that evolutionary progress occurs precisely because of the continued conflict among individuals within species and between different species as competing social groups. Over time, this competition, rather than being entirely harmful, increases diversity and the ability to adapt to changing environments.
Competition between social groups may also provide social comparison information, which can lead both groups to set higher standards and motivate them to greater achievement. And conflict produces increased social identity within each of the competing groups. For instance, in the summer camp study, Sherif noted that the boys in the Rattlers and the Eagles developed greater liking for the other members of their own group as well as a greater group identity as the competition between the two groups increased. In situations in which one nation is facing the threat of war with another nation, the resulting identity can be useful in combating the threat, for instance, by mobilizing the citizens to work together effectively and to make sacrifices for the country.
• Cooperation: Social Norms That Lead Us to Be Good to Others
Although competition is always a possibility, our concern for others leads most relationships among individuals and among groups to be more benign and favorable. Most people get along with others and generally work together in ways that promote liking, sharing, and cooperation. In these situations, the interacting parties perceive that the gains made by others also improve their own chances of gaining rewards and that their goals are compatible. The parties perceive the situation as integrative and desire to cooperate. The players on a baseball team, for instance, may cooperate with each other—the better any one of them does, the better the team as a whole does. And in cooperative situations, it may in some cases even be beneficial to accept some personal costs (such as bunting a player on first base to second base, even though it means an out for the self) in order to further the goals of the group (by placing the other player in scoring position, thereby benefiting the team).
Because cooperation is evolutionarily useful for human beings, social norms that help us cooperate have become part of human nature. These norms include principles of morality and social fairness.
• Morality
As we have seen in many places in this book, helping others is part of our human nature. And cooperation and help are found in other animals as well as in humans. For instance, it has been observed that the highest-status chimpanzees in a group do not act selfishly all the time—rather, they typically share food with others and help those who seem to be in need (de Waal, 1996). As humans, our desires to cooperate are guided in part by a set of social norms about morality that forms a basic and important part of our culture. All cultures have morality beliefsthe set of social norms that describe the principles and ideals, as well as the duties and obligations, that we view as appropriate and that we use to judge the actions of others and to guide our own behavior (Darley & Shultz, 1990; Haidt & Kesebir, 2010).
Researchers have identified two fundamental types of morality—social conventional morality and harm-based morality (Turiel, Killen, & Helwig, 1987). Social conventional morality refers to norms that are seen as appropriate within a culture but that do not involve behaviors that relate to doing good or doing harm toward others. There is a great deal of cultural variation in social conventional morality, and these norms relate to a wide variety of behaviors. Some cultures approve of polygamy and homosexuality, whereas others do not. In some cultures, it is appropriate for men and women to be held to different standards, whereas in other cultures, this is seen as wrong. Even things that seem completely normal to us in the West, such as dancing, eating beef, and allowing men to cook meals for women, are seen in other cultures as immoral.
If these conventions, as well as the fact that they are part of the moral code in these cultures, seem strange to you, rest assured that some of your own conventional beliefs probably seem just as strange to other cultures. Social conventions are in large part arbitrary and are determined by cultures themselves. Furthermore, social conventions change over time. Not so long ago in the United States, it was wrong for Blacks and Whites to marry, and yet that convention has now changed for the better. And soon it seems as if many states will fully accept gay marriages, a policy that seemed unheard of even a few years ago.
On the other hand, some of the most important and fundamental moral principles seem to be universally held by all people in all cultures and do not change over time. It has been found that starting at about age 10, children in most cultures come to a belief about harm-based moralitythat harming others, either physically or by violating their rights, is wrong (Helwig & Turiel, 2002). These fundamental and universal principles of morality involve rights, freedom, equality, and cooperation, and virtually all cultures have a form of the golden rule, which prescribes how we should treat other people (as we would have them treat us).
Morals are held and agreed to by all members of the culture. In most cases, morals are upheld through rules, laws, and other types of sanctions for their transgression. We give rewards to people who express our preferred morality, for instance, in the form of prizes, honors, and awards, and we punish those who violate our moral standards.
Morality has both a cognitive and an emotional component. Some judgments just feel wrong, even if we cannot put our finger on exactly why that is. For instance, I think you’d probably agree that it is morally wrong to kiss your sister or brother on the lips, although, at a cognitive level, it’s difficult to say exactly why it’s wrong. Is it wrong to kill someone if doing so saves lives? Most people agree that they should flip the switch to kill the single individual in the following scenario:
A runaway trolley is headed for five people who will all be killed. The only way to save them is to hit a switch that will turn the trolley onto a different track where it will kill one person instead of five.
And yet even when morality seems cognitive, our emotions come into play. Although most people agree that the decision to kill the one person is rational, they would have a hard time actually doing it—harm-based morality tells us we should not kill.
• Social Fairness
An essential part of morality involves determining what is “right” or “fair” in social interaction. We want things to be fair, we try to be fair ourselves, and we react negatively when we see things that are unfair. And we determine what is or is not fair by relying on another set of social norms, appropriately called social fairness norms, which are beliefs about how people should be treated fairly (Tyler & Lind, 2001; Tyler & Smith, 1998).
The preference for fairness has been proposed to be a basic human impulse (Tyler & Blader, 2000), and when we perceive unfairness, we also experience negative emotional responses in brain regions associated with reward and punishment (Tabibnia, Satpute, & Lieberman, 2008). The experience of unfairness is associated with negative emotions, including anger and contempt, whereas fairness is associated with positive emotions.
One type of social fairness, known as distributive fairness, refers to our judgments about whether or not a party is receiving a fair share of the available rewards. Distributive fairness is based on our perceptions of equity—the belief that we should each receive for our work a share proportionate to our contributions. If you and I work equally hard on a project, we should get the same grade on it. But if I work harder than you do, then I should get a better grade. Things seem fair and just when we see that these balances are occurring, but they seem unfair and unjust when they do not seem to be.
A second type of fairness doesn’t involve the outcomes of the work itself but rather our perceptions of the methods used to assign those outcomes. Procedural fairness refers to beliefs about the fairness (or unfairness) of the procedures used to distribute available rewards among parties (Schroeder, Steele, Woodell, & Bernbenek, 2003). Procedural fairness is important because in some cases we may not know what the outcomes are, but we may nevertheless feel that things are fair because we believe that the process used to determine the outcomes is fair. For instance, we may not know how much tax other people are paying, but we feel that the system itself is fair, and thus most of us endorse the idea of paying taxes (indeed, almost everyone in the United States pays their taxes). We do so not only out of respect for the laws that require us to but also because the procedure seems right and proper, part of the social structure of our society.
People are happier at work, at school, and in other aspects of their everyday lives when they feel that they and others are treated fairly. Wikimedia Commons – CC BY 2.0.
We believe in the importance of fairness in part because if we did not, then we would be forced to accept the fact that life is unpredictable and that negative things can occur to us at any time. Believing in fairness allows us to feel better because we can believe that we get what we deserve and deserve what we get. These beliefs allow us to maintain control over our worlds. To believe that those who work hard are not rewarded and that accidents happen to good people forces us to concede that we too are vulnerable.
Because we believe so strongly in fairness, and yet the world is not always just, we may distort our perceptions of the world to allow us to see it as more fair than it really is. One way to create a “just world” is to reinterpret behaviors and outcomes so that the events seem to be fair. Indeed Melvin Lerner and his colleagues (Lerner, 1980) found one way that people do this is by blaming the victim: Interpreting the negative outcomes that occur to others internally so that it seems that they deserved them. When we see that bad things have happened to other people, we tend to blame the people for them, even if they are not at fault. Thus we may believe that poor people deserve to be poor because they are lazy, that crime victims deserve to be victims because they were careless and that people with AIDS deserve their illness. In fact, the more threatened we feel by an apparent unfairness, the greater is our need to protect ourselves from the dreadful implication that it could happen to us, and the more we disparage the victim.
• Reactions to Unfairness
Although everyone believes that things should be fair, doing so is a lot easier for those of us for whom things have worked out well. If we have high status, we will generally be content with our analysis of the situation because it indicates that we deserve what we got. We are likely to think, “I must have a good education, a good job, and plenty of money because I worked hard for it and deserve it.” In these cases, reality supports our desires for self-concern, and there is no psychological dilemma posed. On the other hand, people with low status must reconcile their low status with their perceptions of fairness.
Although they do not necessarily feel good about it, individuals who have low status may nevertheless accept the existing status hierarchy, deciding that they deserve what little they have. This is particularly likely if these low-status individuals accept the procedural fairness of the system. People who believe that the system is fair and that the members of higher-status groups are trustworthy and respectful frequently accept their position, even if it is one of low status (Tyler, Degoey, & Smith, 1996). In all societies, some individuals have lower status than others, and the members of low-status groups may perceive that these differences because they are an essential part of the society, are acceptable. The acceptance of one’s own low status as part of the proper and normal functioning of society is known as false consciousness (Jost & Banaji, 1994; Major, 1994). In fact, people who have lower social status and who thus should be most likely to reject the existing status hierarchy are often the most accepting of it (Jost, Pelham, Sheldon, & Sullivan, 2003).
But what about people who have not succeeded, who have low social status, and yet who also do not accept the procedural fairness of the system? How do they respond to the situation that seems so unfair? One approach is to try to gain status, for instance, by leaving the low-status group to which they currently belong. Individuals who attempt to improve their social status by moving to a new, higher-status group must give up their social identity with the original group and then increasingly direct their communication and behavior toward the higher-status groups in the hope of being able to join them.
Although it represents the most direct method of change, leaving one group for another is not always desirable for the individual or effective if it is attempted. For one, if individuals are already highly identified with the low-status group, they may not wish to leave it despite the fact that it is low status. Doing so would sacrifice an important social identity, and it may be difficult to generate a new one with the new group (Ellemers, Spears, & Doosje, 1997; Spears, Doosje, & Ellemers, 1997). In addition, an attempt to leave the group is a likely response to low status only if the person perceives that the change is possible. In some situations, group memberships are constrained by physical appearance (such as when the low status is a result of one’s race or ethnicity) or cultural norms (such as in a caste system in which change is not allowed by social custom). And there may also be individual constraints on the possibility of mobility—if the individual feels that he or she does not have the skills or ability to make the move, he or she may be unlikely to attempt doing so.
When it does not seem possible to leave one’s low-status group, the individual may decide instead to use a social creativity strategy. Social creativity refers to the use of strategies that allow members of low-status groups to perceive their group as better than other groups, at least on some dimensions, which allows them to gain some positive social identity (Derks, van Laar, & Ellemers, 2007). In the United States, for example, Blacks, who are frequently the target of negative stereotypes, prejudices, and discrimination, may react to these negative outcomes by focusing on more positive aspects of their group membership. The idea is that their cultural background becomes a positive, rather than a negative, aspect of their personality—“Black is Beautiful!” is one example.
Social creativity frequently takes the form of finding alternative characteristics that help the group excel. For example, the students at a college that does not have a particularly good academic standing may look to the superior performance of their sports teams as a way of creating positive self-perceptions and social identity. Although the sports team performance may be a less important dimension than academic performance overall, it does provide at least some positive feelings. Alternatively, the members of the low-status group might regain identity by perceiving their group as very cohesive or homogenous, emphasizing group strength as a positive characteristic.
When individual mobility is not possible, group members may consider mobilizing their group using collective action. Collective action refers to the attempts on the part of one group to change the social status hierarchy by improving the status of their own group relative to others. This might occur through peaceful methods, such as lobbying for new laws requiring more equal opportunity or for affirmative action programs, or it may involve resorts to violence, such as the 1960s race riots in the United States or the recent uprisings in Middle Eastern countries (Ellemers & Barreto, 2009; Leonard, Moons, Mackie, & Smith, 2011; Levine, Taylor, & Best, 2011).
Collective action is more likely to occur when there is a perception on the part of the group that their low status is undeserved and caused by the actions of the higher-status group when communication among the people in the low-status group allows them to coordinate their efforts, and when there is strong leadership to help define an ideology, organize the group, and formulate a program for action. Taking part in collective action—for instance, by joining feminist, or civil rights, or the “Occupy Wall Street” movements in the United States—is a method of maintaining and increasing one’s group identity and attempting to change the current social structure.
Social Psychology in the Public Interest
System Justification
• >We have argued throughout this book that people have a strong desire to feel good about themselves and the people they care about, and we have seen much evidence to support this idea. Most people believe that they and their own groups are important, valued, competent, and generally “better than average.” And most people endorse social policies that favor themselves and the groups to which they belong (Bobo, 1983; Sidanius & Pratto, 1999).
• >If this is the case, then why do people who are of lower socioeconomic status so often support political policies that tax the poor more highly than they tax the rich and that support unequal income distributions that do not favor them? In short, why do people engage in system justification, even when the current state of affairs does not benefit them personally? Social psychologists have provided a number of potential explanations for this puzzling phenomenon.
• >One factor is that our perceptions of fairness or unfairness are not based on our objective position within the society but rather are more based on our comparison of our own status relative to the other people around us. For instance, poor people in the United States may not perceive that they have lower status because they compare their current state of affairs not with rich people but with the people who they are most likely to see every day—other poor people.
• >This explanation is supported by the fact that factors that increase the likelihood that lower-status individuals will compare themselves with higher-status people tend to reduce system justification beliefs, decrease life satisfaction, and lead to collective action. For instance, the civil rights riots of the 1960s occurred after Blacks had made many gains in the United States. At this time, they may have tended to reject the existing status system because they began to compare themselves with higher-status Whites rather than with other low-status Blacks, and this upward comparison made their relatively lower status seem more illegitimate and unfair (Gurr, 1970).
• >A second explanation is based on the principles of procedural fairness. Our perceptions of fairness and our satisfaction with our own lives are determined in large part by the culture in which we live. In the United States, culture provides a strong belief in fairness. Most people believe in the procedural fairness of the system itself and thus are willing to believe that systems and authorities are correct and proper and that inequality among groups and individuals is legitimate and even necessary. Furthermore, because believing otherwise would be highly threatening to the self-concept, poor people may be even more likely to believe in the correctness of these inequalities than are those of higher status (Jost, 2011; van der Toorn, Tyler, & Jost, 2011).
• >To test this hypothesis, John Jost and his colleagues (Jost, Pelham, Sheldon, & Sullivan, 2003) asked over 2,500 U.S. citizens the following question:
Some people earn a lot of money while others do not earn very much at all. In order to get people to work hard, do you think large differences in pay are absolutely necessary, probably necessary, probably not necessary, definitely not necessary?
As predicted by the idea that to believe otherwise is to accept that the social situation is unfair, Jost et al. found that poorer people were significantly more likely to think that large differences in pay were necessary and proper (responding “absolutely necessary” or “probably necessary”) than did wealthier people (see the following figure). You can see that social psychological principles—in this case, the idea of system justification—can be used to explain what otherwise would seem to be quite unexpected phenomena.
Figure 13.1
• >Poorer respondents reported finding the income differential between rich and poor more acceptable than did richer participants. Data are from Jost, Pelham, Sheldon, and Sullivan (2003).
• Key Takeaways
• The individual goals of self-concern and other-concern help explain tendencies to cooperate or compete with others.
• Both competition and cooperation are common and useful reactions to social interaction dilemmas.
• The solutions to social dilemmas are more favorable when the outcomes are integrative rather than fixed-sum.
• Conflict is sometimes realistic, in the sense that the goals of the interacting parties really are incompatible. But in many cases, conflicts are more perceived than realistic.
• Our reactions to conflict are influenced by harm-based morality beliefs and social fairness norms.
• Individuals who have low status may nevertheless accept the existing status hierarchy, deciding that they deserve what little they have, a phenomenon known as false consciousness. Individuals with low status who do not accept the procedural fairness of the system may use social creativity strategies or they may resort to collective action.
Exercises and Critical Thinking
1. Consider a time when you were in a type of social dilemma, perhaps with friends or family. How did your self-concern and other-concern lead you to resolve the dilemma?
2. Do you think that you or people you know are victims of system justification? How would you know if you or they were?
3. Discuss an example of a person who is a member of a social group and who you believe has used social creativity strategies in an attempt to improve his or her self-image. What were the strategies, and were they successful?
19.3 How the Social Situation Creates Conflict: The Role of Social Dilemmas
If human beings are well-equipped to cooperate with each other, and if morality, social fairness, and other human features favor it, why are so many social relationships still competitive? If you guessed that the competition comes not so much from the people as it does from the nature of the social situation, then you would be correct. In short, competition is often caused by the social dilemma itself—the dilemma creates patterns whereby even when we want to be good, the situation nevertheless rewards us for being selfish. Ross and Ward (1995) found that participants played a game more competitively when it was described as a “Wall Street Broker Game” than when the same game was called a “Community Game.” And other studies have found that subliminal priming of money or business materials (e.g., boardroom tables and business suits) increases competition (Kay, Wheeler, Bargh, & Ross, 2004; Vohs, Meed, & Goode, 2006).
Social dilemmas occur when the members of a group, culture, or society are in potential conflict over the creation and use of shared public goods. Public goods are benefits that are shared by a community at large and that everyone in the group has access to, regardless of whether or not they have personally contributed to the creation of the goods (Abele, Stasser, & Chartier, 2010). In many cases, the public good involves the responsible use of a resource that if used wisely by the group as a whole will remain intact but if overused will be destroyed. Examples include the crabs in the Chesapeake Bay, water in local reservoirs, public beaches, and clean air. In other cases, the public good involves a service—such as public television or public radio—that is supported by the members of the community but that is used freely by everyone in the community.
Let’s consider first a case in which a social dilemma leads people to overuse an existing public good—a type of social dilemma called a harvesting dilemma. One example, called the commons dilemma, was proposed by Garrett Hardin (1968). Hardin noted that in many towns in Europe, there was at one time a centrally located pasture, known as the commons, which was shared by the inhabitants of the village to graze their livestock. But the commons was not always used wisely. The problem was that each individual who owned livestock wanted to be able to use the commons to graze his or her own animals. However, when each group member took advantage of the commons by grazing many animals, the commons became overgrazed, the pasture died, and the commons was destroyed.
Although Hardin focused on the particular example of the commons, he noted that the basic dilemma of individual needs and desires versus the benefit of the group as a whole could also be found in many contemporary public goods issues, including the use of limited natural resources and public land. In large cities, most people may prefer the convenience of driving their own car to work each day rather than taking public transportation. Yet this behavior uses up public goods (roads that are not clogged with traffic, and air that is free of pollution). People are lured into the dilemma by short-term self-interest, seemingly without considering the potential long-term costs of the behavior, such as air pollution and the necessity of building even more highways.
Social dilemmas such as the commons dilemma are arranged in a way that it is easy to be selfish because the personally beneficial choice (such as using water during a water shortage or driving to work alone in one’s own car) produces benefits for the individual, no matter what others do. Furthermore, social dilemmas tend to work on a type of “time delay.” Because the long-term negative outcome (the extinction of fish species or dramatic changes in the climate) is far away in the future, and yet the individual benefits are occurring right now, it is difficult to see how many costs there really are. The paradox, of course, is that if everyone takes the personally selfish choice in an attempt to maximize his or her own rewards, the long-term result is poorer outcomes for every individual in the group. Each individual prefers to make use of the public goods for himself or herself, whereas the best outcome for the group as a whole is to use the resources more slowly and wisely.
Another type of social dilemma—the contributions dilemma—occurs when the short-term costs of a behavior lead individuals to avoid performing it, and this may prevent the long-term benefits that would have occurred if the behaviors had been performed. An example of a contributions dilemma occurs when individuals have to determine whether or not to donate to the local public radio or television station. If most people do not contribute, the TV station may have lower quality programming, or even go off the air entirely, thus producing a negative outcome for the group as a whole. However, if enough people already contribute, then it is not in anyone’s own best interest to do so, because the others will pay for the programming for them. Contributions dilemmas thus encourage people to free ride, relying on other group members to contribute for them.
• The Prisoner’s Dilemma
One method of understanding how individuals and groups behave in social dilemmas is to create such situations in the laboratory and observe how people react to them. The best known of these laboratory simulations is called the prisoner’s dilemma game (Poundstone, 1992). The prisoner’s dilemma game is a laboratory simulation that models a social dilemma in which the goals of the individual compete with the goals of another individual (or sometimes with a group of other individuals). Like all social dilemmas, the prisoner’s dilemma makes use of the assumptions of social learning approaches to behavior that assume that individuals will try to maximize their own outcomes in their interactions with others.
In the prisoner’s dilemma, the participants are shown a payoff matrix in which numbers are used to express the potential outcomes for each of the players in the game, given the decisions made by each player. The payoffs are chosen beforehand by the experimenter to create a situation that models some real-world outcome. Furthermore, in the prisoner’s dilemma, the payoffs are normally arranged as they would be in a typical social dilemma, such that each individual is better off acting in his or her immediate self-interest, and yet if all individuals act according to their self-interest, then everyone will be worse off.
In its original form, the prisoner’s dilemma involves a situation in which two prisoners (we’ll call them Frank and Malik) have been accused of committing a crime. The police have determined that the two worked together on the crime, but they have only been able to gather enough evidence to convict each of them of a more minor offense. In an attempt to gain more evidence and thus to be able to convict the prisoners of the larger crime, each prisoner is interrogated individually, with the hope that he will confess to having been involved in the more major crime in return for a promise of a reduced sentence if he confesses first. Each prisoner can make either the cooperative choice (which is to not confess) or the competitive choice (which is to confess).
The incentives for either confessing or not confessing are expressed in a payoff matrix such as the one shown in Figure 13.2 “The Prisoner’s Dilemma”. The top of the matrix represents the two choices that Malik might make (either to confess that he did the crime or to not confess), and the side of the matrix represents the two choices that Frank might make (also to either confess or not confess). The payoffs that each prisoner receives, given the choices of each of the two prisoners, are shown in each of the four squares.
Figure 13.2 The Prisoner’s Dilemma
• >In the prisoner’s dilemma, two suspected criminals are interrogated separately. The payoff matrix indicates the outcomes for each prisoner, measured as the number of years each is sentenced to prison, as a result of each combination of cooperative (don’t confess) and competitive (confess) decisions. Outcomes for Malik are in the darker color, and outcomes for Frank are in lighter color.
• If both prisoners take the cooperative choice by not confessing (the situation represented in the upper left square of the matrix), there will be a trial, the limited available information will be used to convict each prisoner, and each will be sentenced to a short prison term of 3 years. However, if either of the prisoners confesses, turning “state’s evidence” against the other prisoner, then there will be enough information to convict the other prisoner of the larger crime, and that prisoner will receive a sentence of 30 years, whereas the prisoner who confesses will get off free. These outcomes are represented in the lower left and upper right squares of the matrix. Finally, it is possible that both players confess at the same time. In this case, there is no need for a trial, and in return, the prosecutors offer a somewhat reduced sentence (of 10 years) to each of the prisoners.
• Characteristics of the Prisoner’s Dilemma
The prisoner’s dilemma has two interesting characteristics that make it a useful model of a social dilemma. For one, the prisoner’s dilemma is arranged such that a positive outcome for one player does not necessarily mean a negative outcome for the other player (i.e., the prisoner’s dilemma is not a fixed-sum situation but an integrative one). If you consider again the matrix in Figure 13.2 “The Prisoner’s Dilemma”, you can see that if one player takes the cooperative choice (to not confess) and the other takes the competitive choice (to confess), then the prisoner who cooperates loses, whereas the other prisoner wins. However, if both prisoners make the cooperative choice, each remaining quiet, then neither gains more than the other, and both prisoners receive a relatively light sentence. In this sense, both players can win at the same time.
Second, the prisoner’s dilemma matrix is arranged such that each individual player is motivated to take the competitive choice because this choice leads to a higher payoff regardless of what the other player does. Imagine for a moment that you are Malik, and you are trying to decide whether to cooperate (don’t confess) or to compete (confess). And imagine that you are not really sure what Frank is going to do. Remember that the goal of the individual is to maximize rewards. The values in the matrix make it clear that if you think that Frank is going to confess, you should confess yourself (to get 10 rather than 30 years in prison). And it is also clear that if you think Frank is not going to confess, you should still confess (to get 0 rather than 3 years in prison). So the matrix is arranged such that the “best” alternative for each player, at least in the sense of pure self-interest, is to make the competitive choice, even though in the end both players would prefer the combination in which both players cooperate to the one in which they both compete.
Although initially specified in terms of the two prisoners, similar payoff matrices can be used to predict behavior in many different types of dilemmas involving two or more parties and including choices between helping and not helping, working and loafing, and paying and not paying debts (weber & Messick, 2004). For instance, we can use the prisoner’s dilemma to help us understand a contributions dilemma, such as why two roommates might not want to contribute to the housework. Each of them would be better off if they relied upon the other to clean the house. Yet if neither of them makes an effort to clean the house (the cooperative choice), the house becomes a mess and they will both be worse off.
• Variations on the Prisoner’s Dilemma
In many cases, the prisoner’s dilemma game is played over a series of trials, in which players can modify their responses based on those given by their partners on previous trials. For example, the arms race between the Soviet Union and the United States during the Cold War can be seen as a social dilemma that occurs over time. Over a period of years, each country chooses whether to compete (by building nuclear weapons) or to cooperate (by not building nuclear weapons). And in each case, both countries feel that it is in their best interest to compete rather than cooperate.
The prisoner’s dilemma can also be expanded to be played by more than two players. The behavior of individuals leaving a crowed parking lot, as an example, represents a type of prisoner’s dilemma in which it is to each person’s individual benefit to try to be the first to leave. However, if each person rushes to the exit without regard for others, a traffic jam is more likely to result, which slows down the process for everyone. If all individuals take the cooperative choice—waiting until their turn—everyone wins.
• Resource Dilemma Games
In addition to the prisoner’s dilemma, social dilemmas have been studied using games in which a group of individuals share a common pool of resources. In these resource dilemma games, the participants may extract or harvest resources from the pool, and it is to their individual advantage to do so. Furthermore, as the resources are used, the pool can replenish itself through a fixed schedule, which will allow the individuals to continue to harvest over long periods of time. Optimal use of the resource involves keeping the pool level up and harvesting only as much as will be replenished in the given time period. Overuse of the pool provides immediate gain for the individuals but has a long-term cost in the inability to make harvests at a later time.
In one version of a resource dilemma game (Edney, 1979), the participants sit around a bowl of metal nuts, and the goal is to get as many nuts as one can. The experimenter adds nuts to the bowl such that the number of nuts in the bowl doubles every 10 seconds. However, the individual players are also motivated to harvest nuts for themselves and are allowed to take out as many nuts as they like at any time. In Edney’s research, rather than cooperating and watching the pool grow, the participants almost immediately acted in their self-interest, grabbing the nuts from the bowl. In fact, Edney reported that 65% of the groups never got to the first 10-second replenishment!
Research Focus
The Trucking Game
• >Another example of a laboratory simulation that has been used to study conflict is the trucking game. In the original research (Deutsch & Krauss, 1960), pairs of women played the trucking game. Each woman was given \$4 to begin with and was asked to imagine herself as the owner of one of two trucking companies (Acme or Bolt) that carried merchandise over the roads shown in the figure called “The Road Map From the Trucking Game”. Each time either player’s truck reached the destination on the opposite side of the board, she earned 60 cents, minus operating costs (1 cent for each second taken by the trip). However, the game was also arranged to create the potential for conflict. Each participant wanted to travel on the main road in order to get to the destination faster, but this road was arranged to be so narrow that only one truck could pass at a time. Whenever the two trucks met each other on this narrow road, one of them was eventually forced to back up. Thus there are two choices to getting to the destination. The players had to either take the long, winding roads, thus eliminating their profits (each player would lose 10 cents on each trip if they were forced to take the long road) or figure out a way to share the use of the one-lane road.
Figure 13.3 The Road Map From the Trucking Game
• >From Deutsch (1973).
• Figure 13.4 Outcomes of a Trucking Game Study
• >Data are from Deutsch and Krauss (1960).
• >Deutsch and Krauss made the game even more interesting by creating experimental conditions in which either or both of the truck company owners had a gate that controlled access to the road. In the unilateral-threat condition, only Acme had a gate. Thus if Bolt attempted to use the main road, Acme could close the gate, forcing Bolt to back up and enabling Acme to reopen the gate and proceed quickly to the destination. In the bilateral-threat condition, both sides had gates, whereas in the no-threat condition, there were no gates.
• >As shown in the figure titled “Outcomes of a Trucking Game Study,” participants without gates soon learned to share the one-lane road, and, on average, each made a profit. However, threat in the form of a gate produced conflict and led to fewer profits, although in many cases the participants learned to deal with these problems over time and improved their payoffs as the game went on (Lawler, Ford, & Blegen, 1988; Shomer, Davis, & Kelley, 1966). Participants lost the most money in the bilateral-threat condition in which both sides were given gates that they could control. In this situation, conflict immediately developed, and there were standoffs on the middle road that wasted time and prevented either truck from moving.
• >Two results of this study are particularly surprising. First, in the unilateral threat condition, both players (including Acme, who had control of the gate) made less money than did those in the no-threat condition (although it is true that in this condition, Acme did lose less than Bolt). Thus being able to threaten the other was not successful for generating overall profits. Second, in the conditions in which both individuals had gates, both individuals actually did worse than they did when only one individual had a gate. Thus when an opponent is able to threaten you, it may be to your benefit to not return with a threat of your own—the ability to counteract the threats of your partner may not always help you but rather may produce even more conflict and losses for both parties.
• Who Cooperates and Who Competes?
Although we have to this point focused on how situational variables, such as the nature of the payoffs in the matrix, increase the likelihood that we will compete rather than cooperate, not everyone is influenced the same way by the situation—the personality characteristics of the individuals also matter. In general, people who are more self-oriented are more likely to compete, whereas people who are more other-oriented are more likely to cooperate (Balliet, Parks, & Joireman, 2009; Sagiv, Sverdlik, & Schwarz, 2011). For instance, Campbell, Bush, Brunell, and Shelton (2005) found that students who were highly narcissistic (i.e., very highly self-focused) competed more in a resource dilemma and took more of the shared resource for themselves than did the other people playing the game.
Research Focus
Self and Other Orientations in Social Dilemmas
• >Paul Van Lange and his colleagues (Van Lange, 1999; Van Lange & Kuhlman, 1994) have focused on the person determinants of cooperation by characterizing individuals as one of two types—those who are “pro-social,” meaning that they are high on other-concern and value cooperation, and those who are “pro-self” and thus tend to behave in a manner that enhances their own outcomes by trying to gain advantage over others by making competitive choices.
• >Sonja Utz (2004) tested how people who were primarily self-concerned would respond differently than those who were primarily other-concerned when the self-concept was activated. In her research, male and female college students first completed a measure designed to assess whether they were more pro-social or more pro-self in orientation. On this measure, the participants had to make choices about whether to give points to themselves or to another person on a series of tasks. The students who tended to favor themselves were classified as pro-self, whereas those tended to favor others were classified as pro-social.
• >Then all the students read a story describing a trip to a nearby city. However, while reading the story, half of the students (the self-priming condition) were asked to circle all the pronouns occurring in the story. These pronouns were arranged to be self-relevant and thus to activate the self-concept—“I,” “we,” “my,” and so forth. The students in the control condition, however, were instructed to circle the prepositions, which were not self-relevant (e.g., “of” and “after”).
• >Finally, the students participated in a series of games in which they had to make a choice between two alternative distributions of points between themselves and another person. As you can see in the following figure, the self-manipulation influenced the pro-self students (who were primarily self-oriented already) in a way that they became even less cooperative and more self-serving. However, the students who were initially pro-social became even more cooperative when the self-concept was activated.
Figure 13.5
• >Priming the self-concept increased cooperation for those who were other-concerned but increased competition for those who were self-concerned. Data are from Utz (2004).
• Although it is possible that people are either self-concerned or other-concerned, another possibility is that people vary on both of these dimensions simultaneously, such that some people may be high on both self-concern and other-concern. The dual-concern model of cooperation and competition (Pruitt & Rubin, 1986) is based on this approach, and the four resulting personality types are outlined in Figure 13.6 “The Dual-Concern Model”.
The dual-concern model suggests that individuals will relate to social dilemmas, or other forms of conflict, in different ways, depending on their underlying personal orientations or as influenced by the characteristics of the situation that orient them toward a given concern. Individuals who are focused primarily on their own outcomes but who do not care about the goals of others are considered to be contending in orientation. These individuals are expected to try to take advantage of the other party, for instance, by withholding their contributions in social dilemmas. Those who are focused primarily on the others’ outcomes, however, will be yielding and likely to make cooperative choices. Individuals who are not concerned about the interests of either the self or others are inactive and unlikely to care about the situation or to participate in solving it at all.
Figure 13.6 The Dual-Concern Model
The interesting prediction of the dual-concern model is that being concerned with one’s own outcomes is not necessarily harmful to the possibility of cooperation. The individuals who are focused on maximizing their own outcomes but who are also concerned with the needs of the others (the problem solvers) are expected to be as likely to cooperate as are those who are yielding. In fact, the dual-concern model suggests that these individuals may be the best negotiators of all because they are likely to go beyond the trap posed by the dilemma itself, searching for ways to produce new and creative solutions through creative thinking and compromise.
• Gender and Cultural Differences in Cooperation and Competition
You might be wondering whether men or women are more cooperative. Because women are on average more concerned about maintaining positive relationships with others, whereas men are on average more self-concerned, it might be expected that women might be more likely to cooperate than men. And some research has supported this idea. For instance, in terms of whether or not people accepted an initial offer that was made to them or demanded more, Babcock, Gelfand, Small, and Stayn (2006) found that about half of the men they sampled negotiated a salary when they took their first job offer, whereas only about one eighth of the women reported doing so. Not surprisingly, women received substantially lower average annual starting salaries than did the men, a fact that is likely to contribute to the wage gap between men and women. And Small, Gelfand, Babcock, and Gettman (2007) found that, overall, women were less likely than men to try to bargain for personal gain in an experimental task. Small and colleagues concluded that women felt that asking for things for themselves was socially inappropriate, perhaps because they perceive that they have less social power than do men.
Although at least some studies have found that there are gender differences, an interactionist approach to the situation is even more informative. It turns out that women compete less than men in some situations, but they compete about much as men do in other situations. For example, Bowles, Babcock, and McGinn (2005) showed that the roles that are activated at the negotiation table (i.e., whether one is negotiating for oneself or on behalf of others) are important triggers for gender differences. Women negotiated as well as men when they were negotiating for others, but they negotiated less strongly than men did for themselves. And Kray, Galinsky, and Thompson (2002) showed that gender differences in negotiation behavior are strongly affected by cognitive constructs that are accessible during negotiation. In general, gender differences in negotiation seem to occur in situations in which other-concern is highly accessible but are reduced or eliminated in situations in which other-concern is less accessible (Gelfand, Major, Raver, Nishii, & O’Brien, 2006). A recent meta-analysis of 272 research results (Baillet, Li, Macfarlan, & van Vugt, 2011) found that overall, men and women cooperated equally. But men cooperated more with other men than women cooperated with other women. In mixed-sex interactions, women were more cooperative than men.
And there are also cultural differences in cooperation, in a direction that would be expected. For instance, Gelfand et al. (2002) found that Japanese students—who are more interdependent and thus generally more other-concerned—were more likely to cooperate and achieved higher outcomes in a negotiation task than did students from the United States (who are more individualistic and self-oriented; Chen, Mannix, & Okumura, 2003).
19.4 Strategies for Producing Cooperation
When we are faced with situations in which conflict is occurring or has the potential to develop, it will be useful if we are aware of the techniques that will help us best deal with it. We may want to help two roommates realize that they will be better off taking the cooperative choice—by contributing to the household chores—and we may desire to try to convince people to take public transportation rather than their own car because doing so is better for the environment and in the end better for everyone. The problem, of course, is that although the parties involved may well realize the potential costs of continuing to behave selfishly or competitively, the social situation nevertheless provides a strong motivation to continue to take the selfish choice.
It is important to attempt to determine appropriate ways to encourage more responsible use of social resources because individualistic consumption of these supplies will make them disappear faster and may have overall negative effects on human beings (Oskamp & Schultz, 2006).
It should be kept in mind that although social dilemmas are arranged such that competition is a likely outcome, they do not always end in collective disaster. Historical evidence shows, for example, that most of the commons grounds in England and other countries were, in fact, managed very well by local communities and were usually not overgrazed. Many British commons exist to this day. And even the Cold War between the United States and the Soviet Union, which inspired so much research into social dilemmas, had a peaceful end. In addition, findings from experimental social dilemma research involving repeated interactions between strangers suggest that the vast majority of interactions result in mutual cooperation (De Cremer & Van Vugt, 1999).
Although the solutions are not simple, by examining the many studies that have focused on cooperation and conflict in the real world and in the lab, we can draw some conclusions about the specific characteristics that determine when and whether people cooperate or compete. These factors include the type of task, such as its rules and regulations; our perceptions about the task; the norms that are operating in the current situation; and the type and amount of communication among the parties. Furthermore, we can use approaches such as negotiation, arbitration, and mediation to help parties that are in competition come to agreement.
• Task Characteristics and Perceptions
One factor that determines whether individuals cooperate or compete is the nature of the situation itself. The characteristics of some social dilemmas lead them to produce a lot of competitive responses, whereas others are arranged to elicit more cooperation. Thus one way to reduce conflict, when the approach is possible, is to change the rules of the task to reinforce more cooperation (Samuelson, Messick, Rutte, & Wilke, 1984). A class in which the instructor has decided ahead of time that only 10% of the students can get As will be likely to produce a competitive orientation among the students. On the other hand, if the instructor says that he or she would be quite happy to assign each student an A (assuming each individual deserves one!), a more cooperative orientation is likely to ensue. In general, cooperation will increase when it is more rewarded, and competition will increase when it is rewarded (Komorita & Parks, 1994).
If societies really desire to maintain the public goods for their citizens, they will work to maintain them through incentives—for instance, by creating taxes such that each person is required to contribute his or her fair share to support them. A city or a state may add a carpool lane to the roadways, making it more desirable to commute with others and thereby help keep the freeways unclogged. Similarly, in terms of harvesting dilemmas, rules can be implemented that regulate the amount of the public good that can be taken by each individual member of the society. In a water crisis, rationing can be implemented in which individuals are allowed to use only a certain amount of water each month, thereby protecting the supply for all, or fishing limits can be imposed to maintain populations. People form governments in part to make sure that all individuals in the community contribute to public goods and obey the rules of cooperation. Leaders may also be elected by the group to help convince the members of the society that it is important just to follow the rules, thereby increasing cooperation (Tyler & Lind, 1992).
• Privatization
Another approach to increase the optimal use of resources is to privatize them—that is, to divide up the public good into smaller pieces so that each individual is responsible for a small share rather than trusting the good to the group as a whole. In a study by Messick and McClelland (1983) using a resource game, individuals who were given their own private pool of resources to manage maintained them for an average of 31 trials of the game before they ran out. But individuals who were managing pools in groups maintained their pools for only about 10 trials and therefore gained much lower outcomes. In other experimental games, the outcomes are arranged such that the participants are either working for themselves or working for the joint outcomes of the group (Deutsch, 1949). These studies have found that when individuals have control over their own outcomes rather than sharing the resources with others, they tend to use them more efficiently. In general, smaller groups are more cooperative than larger ones and also make better use of the resources that they have available to them (Gockel, Kerr, Seok, & Harris, 2008; Kerr & Bruun, 1983).
One explanation for the difficulties of larger groups is that as the number of group members increases, each person’s behavior becomes less identifiable, which is likely to increase free riding. When people are allowed to monitor their water or energy use, they will use less of the public good (Siero, Bakker, Dekker, & van den Burg, 1996). Furthermore, people feel that they can make less of a difference in the outcome of larger (versus smaller) groups, and so they are less likely to work toward the common group goals, even if their input is actually not less important or less likely to have an influence (Kerr, 1989). Larger groups also lead people to feel more deindividuated, which may prevent them from conforming to group norms of cooperation. And in large groups, there is likely to be more difficulty coordinating the efforts of the individuals, and this may reduce cooperation. In a study by Kelley, Condry, Dahlke, and Hill (1965) in which participants had to coordinate their efforts in a type of crisis situation in which only one person could “escape” from a situation at a time, larger groups had more difficulty coordinating their activities and tended to perform more poorly. Again, the moral is straightforward: If possible, work in smaller rather than larger groups.
Decisions about whether to cooperate or compete are also influenced by expectations about the likely behavior of others. One factor that tends to produce conflict is that, overall, individuals expect others to take competitive, rather than cooperative, orientations (Sattler & Kerr, 1991), and once they see the behavior of others, they are likely to interpret that behavior as being competitive, even if it is not. In a study by Maki, Thorngate, and McClintock (1979), individuals viewed the decisions that had supposedly been made by other people who had participated in a prisoner’s dilemma task. Their task was to predict the choice that the partner had supposedly made from the payoff matrix. However, the choices had actually been selected, on the basis of a computer program, to take either competitive or cooperative orientations. Overall, across all the decisions, the participants were more accurate at making their predictions for partners who made competitive choices than for those who made cooperative choices, indicating that they expected the partners to be competitive and as a result tended to interpret their behaviors as being competitive.
The tendency to think that others will act in a competitive manner is more likely to cause problems when we are not sure what others are going to do. When we have a good idea of what the others in the situation are doing, we will likely match our responses to those of others. So when we see that others are cooperating, we are likely to cooperate as well. In other cases, for instance, when the group is very large, it is more difficult to be aware of or keep track of the behavior of others, and because there is less certainty about the behavior of others, taking the defensive (competitive) choice is more likely.
Another determinant of cooperation or competition is the prior norms of the individuals in the group (Pruitt, 1998). If the norm in the situation favors cooperation, then cooperation is likely to ensue, but if the norm favors competition, then competition will probably result. The group or society may attempt to create or uphold social norms through appeals to appropriate social values. Sattler and Kerr (1991) found that getting messages from others stressing the importance of cooperation increased cooperative behavior, particularly for individuals who were already motivated to be cooperative and when the partner actually played cooperatively. Group members may sometimes ostracize others who do not follow appropriate norms of group cooperation (Ouwerkerk, Kerr, Gallucci, & Van Lange, 2005). And situations in which the parties in interaction are similar, friendly, or have a positive group identity have also been found to be more likely to cooperate (Brewer & Kramer, 1986; Karau & Williams, 1993). Thus we should try to encourage groups to work together to create positive feelings in order to increase cooperation.
• The Important Role of Communication
When communication between the parties involved in a conflict is nonexistent, or when it is hostile or negative in tone, disagreements frequently result in escalation of negative feelings and lead to conflict. In other cases, when communication is more open and positive, the parties in potential conflict are more likely to be able to deal with each other effectively, with a result that produces compromise and cooperation (Balliet, 2010).
Communication has a number of benefits, each of which improves the likelihood of cooperation. For one, communication allows individuals to tell others how they are planning to behave and what they are currently contributing to the group effort, which helps the group learn about the motives and behaviors of the others and helps the group develop norms for cooperation. Communication has a positive effect because it increases the expectation that the others will act cooperatively and also reduces the potential of being a “sucker” to the free riding of others. Thus communication allows the parties to develop a sense of trust (Messick & Brewer, 1983).
Once cooperative norms are in place, they can improve the possibilities for long-term cooperation because they produce a public commitment on the part of the parties to cooperate as well as an internalized obligation to honor those commitments (Kerr, Garst, Lewandowski, & Harris, 1997). In fact, Norbert Kerr and his colleagues (Kerr, Ganst, Lewandowski, & Harris, 1997; Kerr & Kaufman-Gilliland, 1994) have found that group discussion commits group members to act cooperatively to such an extent that it is not always necessary to monitor their behavior; once the group members have shared their intentions to cooperate, they will continue to do so because of a private, internalized commitment to it.
Communication can also allow the people working together to plan what they should do and therefore can help them better coordinate their efforts. For instance, in a resource dilemma game, discussion allows the group to monitor their withdrawals from the public good so that the pool is not depleted (Liebrand, 1984). And if only a certain number of individuals need to contribute in a contributions dilemma in order for the public good to be maintained, communication may allow the group members to set up a system that ensures that this many, but not more, contribute in any given session.
Finally, communication may also help people realize the advantages, over the long term, of cooperating. If, as a result of communication, the individuals learn that the others are actually behaving cooperatively (something that might not have been apparent given prior misperceptions that make us overestimate the extent to which others are competing), this might increase the motivation to cooperate oneself. Alternatively, learning that others are behaving competitively and thus threatening the resources may help make it clear to all the parties that increased cooperation is essential (Jorgenson & Papciak, 1981).
Perhaps the most important benefit of communication is the potential of learning that the goals of the parties involved in the conflict are not always incompatible (Thompson & Hrebec, 1996; Thompson, 1991). A major barrier to increasing cooperation is that individuals expect both that situations are arranged such that they are fixed-sum and that others will act competitively to attempt to gain a greater share of the outcomes. Neither of these assumptions is necessarily true, however, and thus one potential benefit of communication is that the parties come to see the situation more accurately.
One example of a situation in which communication was successful is the meeting held at Camp David, Maryland, in 1978 between the delegates of Egypt and Israel. Both sides sat down together with then–U.S. President Carter to attempt to reach an accord over the fate of the Sinai Peninsula, which Israel had occupied for many years. Initially, neither side would budge, and attempts to divide the land in half were opposed by both sides. It appeared that there was a fixed-sum situation in which land was the important factor, and neither wanted to give it up. Over the course of discussion, communication prevailed. It became clear that what Egypt really wanted out of the deal was sovereignty over lands that were perceived as historically part of Egypt. On the other hand, what Israel valued the most was security. The outcome of the discussion was that Israel eventually agreed to return the land to Egypt in exchange for a demilitarized zone and the establishment of new Israeli airbases. Despite the initial perceptions, the situation turned out to be integrative rather than fixed-sum, and both sides were able to get what they wanted.
Laboratory studies have also demonstrated the benefits of communication. Leigh Thompson (1991) found that groups in negotiation did not always effectively communicate, but those that did were more able to reach compromises that benefited both parties. Although the parties came to the situation expecting the game to be a fixed-sum situation, communication allowed them to learn that the situation was actually integrative—the parties had different needs that allowed them to achieve a mutually beneficial solution. Interestingly, Thompson found that it did not matter whether both parties involved in the dispute were instructed to communicate or if the communication came in the form of questions from only one of the two participants. In both cases, the parties who communicated viewed the other’s perspectives more accurately, and the result was better outcomes. Communication will not improve cooperation, however, if it is based on communicating hostility rather than working toward cooperation. In studies in which individuals played the trucking game, for instance, the communication was generally in the form of threats and did not reduce conflict (McClintock, Stech, & Keil, 1983).
• The Tit-for-Tat Strategy
In social dilemma games that are run over a number of trials, various strategies can be used by the parties involved. But which is the best strategy to use in order to promote cooperation? One simple strategy that has been found to be effective in such situations is known as tit-for-tat. The tit-for-tat strategy involves initially making a cooperative choice and then waiting to see what the other individuals do. If it turns out that they also make the cooperative choice (or if most of them do), then the individual again makes a cooperative choice. On the other hand, if the other group members compete, then the individual again matches this behavior by competing. This process continues such that the individual always does what the others have done on the trial before.
Computers have been used to simulate the behavior of individuals who use the tit-for-tat strategy over a series of interactions in comparison with other approaches for determining whether to cooperate or compete on each trial. The tit-for-tat strategy has been found to work better than straight cooperation or other types of strategies in producing cooperation from the parties (Axelrod, 2005; Fischer & Suleiman, 2004; Van Lange & Visser, 1999).
The tit-for-tat strategy seems to be so effective because, first, it is “nice” in the sense that the individual first cooperates and signals a willingness to cooperate. Second, the strategy seems to be successful because, since it is relatively simple and easy to understand, others can clearly see how the choices are being determined. Furthermore, the approach sends a clear message that competitive choices on the part of the other will not be tolerated and that cooperation will always be reciprocated. The other party cannot take advantage of a person who is using tit-for-tat on more than one trial because if they try to do so, the result will always be retaliation in the form of a competitive choice on the next trial. Indeed, it has been found that having people play against a partner who uses the tit-for-tat strategy can help them learn to be more cooperative, particularly once they become aware of what the strategy is and how it is being used (Sheldon, 1999). The tit-for-tat strategy seems particularly effective because it balances self-concerned and other-concerned responses in an easy-to-understand way.
Despite the fact that it generally works better than most other strategies, tit-for-tat is not perfect. One problem is that because people are more likely to behave competitively than cooperatively, tit-for-tat is more likely to lead opponents to match noncooperative responses than to follow cooperation with cooperation, and thus tit-for-tat may in some cases produce a spiral of conflict (Kelley & Stahelski, 1970). This is particularly likely if the opposing party never makes a cooperative choice, and thus the party using tit-for-tat never gets a chance to play cooperatively after the first round, or in cases in which there is some noise in the system and the responses given by the parties are not always perceived accurately. Variations of the tit-for-tat strategy in which the individual acts more cooperatively than demanded by the strategy (e.g., by giving some extra cooperative trials in the beginning or being extra cooperative on other trials) have been found to be helpful in this regard, although they do allow the opponent to exploit the side who is playing tit-for-tat.
• Formal Solutions to Conflict: Negotiation, Mediation, and Arbitration
In some cases, conflict becomes so extreme that the groups feel that they need to work together to reach a compromise. Several methods are used in these cases, including negotiation, mediation, and arbitration.
Negotiation is the process by which two or more parties formally work together to attempt to resolve a perceived divergence of interest in order to avoid or resolve social conflict (Thompson, Wang, & Gunia, 2010). The parties involved are often social groups, such as businesses or nations, although the groups may rely on one or a few representatives who actually do the negotiating. When negotiating, the parties who are in disagreement develop a set of communication structures in which they discuss their respective positions and attempt to develop a compromise agreement. To reach this agreement, each side makes a series of offers, followed by counteroffers from the other side, each time moving closer to a position that they can each agree on. Negotiation is successful if each of the parties finds that they have more to gain by remaining in the relationship or completing the transaction, even if they cannot get exactly what they want, than they would gain if they left the relationship entirely or continued the existing competitive state.
In some cases, negotiation is a type of fixed-sum process in which each individual wants to get as much as he or she can of the same good or commodity. For instance, in the sale of a property, if the seller wants the highest price possible, and the buyer wants the lowest price possible, the compromise will involve some sacrifice for each, or else it will not occur at all if the two parties cannot find a price on which they can agree. More often, the outcome of the negotiation is dependent upon the ability of the two parties to effectively communicate and to dispel negative misperceptions about the goals of the other party. When communication and trust are obtained in the situation, the parties may find that the situation is not completely fixed-sum but rather more integrative. The seller and buyer may be able to find an acceptable solution that is based on other aspects of the deal, such as the time that the deal is made or other costs and benefits involved. In fact, negotiators that maintain the assumption that the conflict is fixed-sum end up with lower individual and joint gain in comparison with negotiators who change their perceptions to be more integrative.
Negotiation works better when both sides have an open mind and do not commit themselves to positions. It has been argued that negotiation is most beneficial when you take a position and stick to it, no matter what, because if you begin to compromise at all, it will look like weakness or as if you do not really need all that you asked for. However, when negotiators do not allow any compromise, the negotiations are likely to break off without a solution.
Negotiation is often accompanied by conflict, including threats and harassment of the other party or parties. In general, individuals who are firm in their positions will achieve more positive outcomes as a result of negotiation, unless both sides are too firm and no compromise can be reached. However, positive and cooperative communication is an important factor in improving negotiation. Individuals who truthfully represent their needs and goals with the other party will produce better outcomes for both parties, in part because they become more aware of each other’s needs and are better able to empathize with them. Parties that are in negotiation should therefore be encouraged to communicate.
In some serious cases of disagreement, the parties involved in the negotiation decide that they must bring in outside help, in the form of a “third” party, to help them reach an equitable solution or to prevent further conflict. The third party may be called upon by the parties who are in disagreement, their use may be required by laws, or in some cases a third party may rather spontaneously appear (such as when a friend or coworker steps in to help solve a dispute). The goal of the third party is to help those who are in conflict to reach agreement without embarrassment to either party. In general, third-party intervention works better if it is implemented before the conflict is too great. If the level of conflict is already high, the attempts to help may increase hostility, and the disputants may not consent to third-party intervention.
Mediation involves helping to create compromise by using third-party negotiation (Wall & Lynn, 1993). A mediator is a third party who is knowledgeable about the dispute and skilled at resolving conflict. During the mediation, the conflicting parties usually state the facts from their own perspective, which allows the mediator to determine each party’s interests and positions.
Mediators have a number of potential tactics that they can use, and they choose which ones seem best depending on the current state of affairs. These tactics include attempting to help the parties have more trust in each other, conferring with each of the parties separately, and helping them to accept the necessity of compromise. Through these tactics, the mediator may be able to reduce overt hostility and increase concern with understanding the others’ positions, which may lead to more integrative solutions. If necessary, the mediator may attempt to force the parties to make concessions, especially if there is little common ground to begin with. Mediation works best when both parties believe that a compromise is possible and think that third-party intervention can help reach it. Mediators who have experience and training make better mediators (Deutsch, 1994).
Arbitration isa type of third-party intervention that avoids negotiation as well as the necessity of any meetings between the parties in conflict. In the most common type of arbitration—binding arbitration—both sides agree ahead of time to abide by the decision of the third party (the arbitrator). They then independently submit their offers or desires along with their basis for their claims, and the arbitrator chooses between them. Whichever offer is chosen becomes the outcome, and there is no negotiation (Farber, 2005; Wolkinson & Ormiston, 2006). Arbitration is particularly useful when there is a single decision to be made under time constraints, whereas negotiation may be better if the parties have a long-term possibility for conflict and future discussion is necessary.
Exercise and Critical Thinking
Choose a real-world dispute among individuals or groups and analyze it using the principles we have considered in this chapter.
19.5 Thinking Like a Social Psychologist About Cooperation and Competition
Now that you are familiar with the factors that lead us to cooperate or compete, I hope you will use this information to be more aware of and to guide, your own behaviors in situations of conflict. Are you now more aware of how easy it is to assume that others will compete rather than cooperate and of how events that seem to be fixed-sum may in fact be integrative? Can you see that at least some conflict is more perceived than realistic and that cooperation is frequently more advantageous to both the self and others than is competition? Does this knowledge make you think differently about how you will want to react to situations of potential conflict?
You may want to keep in mind that solutions to the conflict may frequently be integrative, allowing both you or your party and the other individuals involved in the conflict to come to a mutually beneficial solution. Taking a problem-solving approach in which you keep not only your needs but also the needs of others in mind will be helpful.
You may find that you are now better able to use your social psychological knowledge to help reduce potentially dangerous situations of conflict. Social norms about morality and fairness lead us frequently to cooperate with others, but these principles may be undermined in conflict situations. Perhaps you will use your new knowledge to advocate for more cooperative positions regarding important social dilemmas, such as global warming and natural resource use. You can use the many approaches that help people cooperate to help you in this endeavor.
19.6 End-of-Chapter Summary
This chapter has examined how goals of self-concern and other-concern relate to our tendencies to cooperate or compete with others and how these individual goals can help us understand the behavior of large groups of people, such as nations, societies, and cultures. Most generally, we can say that when individuals or groups interact, they can take either cooperative or competitive positions. Competition frequently leads to conflict, in which the parties involved engage in violence and hostility. Although competition is normal and will always be a part of human existence, cooperation is also built into the human repertoire.
One type of situation in which the goals of the individual conflict with the goals of the group is known as a social dilemma. Social dilemmas have an important impact on a variety of important social problems because the dilemma creates a type of trap in which even though the individual or group may want to be cooperative, the situation leads to competitive behaviors. Although social dilemmas create the potential for conflict and even hostility, such outcomes are not inevitable. The solutions to social dilemmas are more favorable when the outcomes are integrative rather than fixed-sum.
Conflict is sometimes realistic, in the sense that the goals of the interacting parties really are incompatible. However, although many situations do create real conflict, conflicts are often more perceived than realistic because they are based on misperceptions of the intentions of others or of the nature of the potential rewards.
As humans, our desires to cooperate are guided in part by a set of social norms about morality—the set of social norms that describe the principles and ideals, as well as the duties and obligations, that we view as appropriate and that we use to judge the actions of others and to guide our own behavior. Two types of morality are social conventional morality and harm-based morality.
An essential part of morality involves determining what is “right” or “fair” in social interaction. We determine what is or is not fair by relying on another set of social norms, called social fairness norms, which are beliefs about how people should be treated fairly. One type of social fairness, known as distributive fairness, refers to our judgments about whether or not we are receiving a fair share of the available rewards. Procedural fairness refers to beliefs about the fairness (or unfairness) of the procedures used to distribute available rewards among group members.
Individuals who have low status may nevertheless accept the existing status hierarchy, deciding that they deserve what little they have, a phenomenon known as false consciousness. Individuals with low status who do not accept the procedural fairness of the system may try to gain status, for instance, by leaving the low-status group to which they currently belong. Or they may use social creativity strategies that allow them to perceive their group as better than other groups, at least on some dimensions. Or they may resort to attempts at collective action to change the social status hierarchy by improving the status of their own group relative to others.
The behavior of individuals in conflict situations has frequently been studied using laboratory games in which conflict is simulated. In the prisoner’s dilemma game, the rewards to be gained for making a cooperative or a competitive choice are displayed in a payoff matrix. The matrix is arranged such that competition is most beneficial for each individual, and yet if the players each choose the cooperative choice, each of them will gain. Other types of laboratory games include resource dilemma games and the trucking game.
There are individual differences in cooperation and competition, such that those who are more self-oriented are more likely to compete, whereas those who are more other-oriented are more likely to cooperate. The dual-concern model suggests that individuals will relate to social dilemmas or other forms of conflict in different ways, depending on their underlying personal orientations. Although women do compete less than men in some situations, they compete about as much as men do in other situations. And there are also cultural differences in cooperation.
One factor that determines whether individuals cooperate or compete is the nature of the situation itself. If we can make the negative consequences of competition and the positive consequences of cooperation more salient, we will be likely to create more positive behaviors. Decisions about whether to cooperate or compete are also influenced by expectations about the likely behavior of others. Smaller groups are more cooperative than larger ones and also make better use of the resources that they have available to them. Communication has a number of benefits, each of which improves the likelihood of cooperation. In some cases, conflict can become so extreme that the groups feel that they need to work together to reach a compromise. Several methods are used in these cases, including negotiation, mediation, and arbitration.
Learning about the nature of cooperation and competition may help you think more creatively about how to respond to conflict in your everyday life, make you more aware of the benefits of cooperating, and lead you to actively try to promote cooperative behaviors in your community.
Attribution
Adapted from Chapter 13 from Principles of Social Psychology by University of Minnesota under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/06%3A_Perspectives_on_Organizations/19%3A_Competition_and_Cooperation_in_Our_Social_Worlds.txt |
Learning Objectives
• Discuss alternative approaches used within organizations.
• Discuss different types of management and leadership styles and how they can shape an organization’s climate and culture.
• Explain why organizations are important to our lives.
• Define terms related to organizations.
• Discuss traditional theories of organizational development.
20.1 Introduction
The term group refers to any collection of at least two people who interact frequently and share identity traits aligned with the group (Griffiths et al. 2015). Groups play different roles in our lives. Primary groups are usually small groups characterized by face-to-face interaction, intimacy, and a strong sense of commitment. Primary groups remain “inside” us throughout our lifetime (Henslin 2011). Secondary groups are large and impersonal groups that form from sharing a common interest. Different types of groups influence our interactions, identity, and social status. George Herbert Mead (1934) called individuals affecting a person’s life as significant others, and he conceptualized “generalized others” as the organized and generalized attitude of a social group.
Different types of groups influence our interactions, identity, and social status. An in-group is a group toward which one feels particular loyalty and respect. The traits of in- groups are virtues, whereas traits of out-groups are vices (Henslin 2011). An out-group is a group toward which one feels antagonism and contempt. Consider fans at a sporting event, people cheering on our supporting the same team will develop an in-group admiration and acceptance while viewing fans of the opposing team as members of their out-group.
Reference groups are also influential groups in someone’s life. A reference group provides a standard for judging one’s own attitudes or behaviors within a social setting or context (Henslin 2011). People use reference groups as a method for self-evaluation and social location. People commonly use reference groups in the workplace by watching and emulating the interactions and practices of others so they fit in and garner acceptance by the group.
20.2 Group Dynamics
Group dynamics focus on how groups influence individuals and how individuals affect groups. The social dynamics between individuals play a significant role in forming group solidarity. Social unity reinforces a collective identity and shared thinking among group members thereby constructing a common culture (Griswold 2013). Commonalities of group membership are important for mobilizing individual members. When people attempt to create social change or establish a social movement group, solidarity helps facilitate the motivation of individuals and the framing of their actions. The sense of belonging and trust among the group makes it easier for members to align and recognize the problem, accept a possible solution, take certain actions that are congruent and complementary to the collective identity of the group (Griswold 2013). People accept the group’s approach based on solidarity and cohesiveness that overall amplifies personal mobilization and commitment to the group and its goals.
COLLECTIVE IDENTITY AND SOCIAL MOVEMENTS:
Research TED Talks videos on social movements and social change such as the following: How to Start a Movement by Derek Sivers and Online Social Change by Zeynep Tufekci
1. What lessons can you learn about collective identity from the stories presented?
2. How does group culture make it possible to construct a social movement? Explain how micro-sociological
acts (social interactions) lead to macro-sociological changes (systems, organizations, and processes) in
society.
3. What impact does intrinsic or internal motivation and framing of the issue have on organizing a social
movement?
20.3 Organization
An organization refers to a group of people with a collective goal or purpose linked to bureaucratic tendencies including a hierarchy of authority, clear division of labor, explicit rules, and impersonal (Giddens, Duneier, Applebaum, and Carr 2013). Organizations function within existing cultures and produce their own. Formal organizations fall into three categories including normative, coercive, and utilitarian (Etzioni 1975). People join normative or voluntary organizations based on shared interests (e.g., club or cause). Coercive organizations are groups that people are coerced or forced to join (e.g., addiction rehabilitation program or jail). People join utilitarian organizations to obtain a specific material reward (e.g., private school or college). When we work or live in organizations, there are multiple levels of interaction that affect social unity and operations. On an individual level, people must learn and assimilate into the culture of the organization. All organizations face the problem of motivating its members to work together to achieve common goals (Griswold 2013). Generally, in organizations, small group subcultures develop with their own meaning and practices to help facilitate and safeguard members within the organizational structure. Group members will exercise force (peer pressure and incentives), actively socialize (guide feelings and actions with normative controls), and model behavior (exemplary actors and stories) to build cohesiveness (Griswold 2013). Small groups play an integral role in managing individual members to maintain the function of the organization. Think about the school or college you attend. There are many subcultures within any educational setting and each group establishes the norms and behaviors members must follow for social acceptance. Can you identify at least two subcultures on your school campus and speculate how members of the group pressure each other to fit in?
20.4 Symbolic Power
On a group level, symbolic power matters in recruiting members and sustaining the culture of a group within the larger social culture (Hallet 2003). Symbolic power is the power of constructing reality to guide people in understanding their place in the organizational hierarchy (Bourdieu 1991). This power occurs in everyday interactions through unconscious cultural and social domination. The dominant group of an organization influences the prevailing culture and provides its function in communications forcing all groups or subcultures to define themselves by their distance from the dominant culture (Bourdieu 1991). The instrument of symbolic power is the instrument of domination in the organization by creating the ideological systems of its goals, purpose, and operations. Symbolic power not only governs the culture of the organization but also manages solidarity and division between groups. We see examples of symbolic power in the military. Each branch of the military has a hierarchy of authority where generals serve as the dominant group and are responsible for the prevailing culture. Each rank socializes members according to their position within the organization in relation to the hierarchy and fulfills their role to achieve collective goals and maintain functions.
20.5 Organizational Culture
There are external factors that influence organizational culture. The context and atmosphere of a nation shape an organization. When an organization’s culture aligns with national ideology, they can receive special attention or privileges in the way of financial incentives or policy changes (Griswold 2013). In contrast, organizations opposing national culture may face suppression, marginalization, or be denied government and economic. Organizations must also operate across a multiplicity of cultures (Griswold 2013). Cultural differences between organizations may affect their operations and achievement of goals. To be successful, organizations must be able to operate in a variety of contexts and cultures. Griswold (2013) suggested one way to work across cultural contexts is to maintain an overarching organizational mission but be willing to adapt on insignificant or minor issues. Financial and banking institutions use this approach. Depending on the region, banks offer different cultural incentives for opening an account or obtaining a loan. In California, homeowners may obtain low-interest loans for ecological improvements including installation of solar panels, weatherproof windows, or drought resistance landscaping.
CULTURAL SOLIDARITY
Describe the culture of an organization where you have worked, volunteered, or attended school.
1. What are the stories and symbols that everyone who works, volunteers, or attends there knows?
2. What subculture groups exist within the organization, and what forms of conflict take place between units or classifications.
3. How do the heads of the organization use symbolic power to motivate people?
In the state of Michigan, affluent homeowners may acquire a low-interest property improvement loan, and very low-income homeowners may receive grants for repairing, improving, or modernizing their homes to remove health and safety hazards. Working across organizational cultures also requires some dimension of trust. Organizational leaders must model forms and symbols of trust between organizations, groups, and individuals (Mizrachi, Drori, and Anspach 2007). This means authority figures must draw on the organization’s internal and external diversity of cultures to show its ability to adapt and work in a variety of cultural and political settings and climates. Organizations often focus on internal allegiance forgetting that shared meaning across the marketplace, sector, or industry is what moves the understanding of the overall system and each organization’s place in it (Griswold 2013). The lack of cultural coordination and understanding undermines many organizations and has significant consequences for accomplishing its goals and ability to sustain itself.
ORGANIZATIONAL CULTURE
Consider the culture of an organization where you have worked, volunteered, or attended school. Describe a time when you witnessed someone receive a nonverbal, negative sanction (e.g., a look of disgust, a shake of the head, or some other nonverbal sign of disapproval).
1. What organizational norm was being broken (i.e., what was the act that led the person to give a nonverbal negative sanctioning)?
2. Was the norm broken considered a structural or cultural violation?
3. What was the reaction of the norm violator to the negative sanction?
4. Was the norm being enforced as a result of peer pressure, external forces, mimicking, or modeling?
Attribution
Adapted from pages 17 through 20 from “Beyond Race: Cultural Influences on Human Social Life” by Vera Kennedy under the license CC BY-NC-SA 4.0. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/06%3A_Perspectives_on_Organizations/20%3A_Group_and_Organizational_Culture.txt |
Learning Objectives
21.1 Communities Based Upon Geographical Region
The place people live or occupy renders a lifestyle and cultural identity. People identify with the geographic location they live in as a part of who they are and what they believe (Kottak and Kozaitis 2012). Places have subcultures specific to their geographic location, environmental surroundings, and population.
As one of the largest cities in the United States, New York City is home to 21 million together speaking over 200 languages (U.S. News and World Report 2017). The city itself is fast-paced and its large population supports the need for around the clock services as the “city that never sleeps.” With so many people living in the metropolis, it is a diverse melting pot of racial, ethnic, and socio-economic backgrounds through each neighborhood is its own enclave with its own identity. This large, heterogeneous population effects the impersonal, sometimes characterized as “dismissive and arrogant” attitudes of its residents. By the very nature and size of the city, people are able to maintain anonymity but cannot develop or sustain intimacy with the entire community or its residents. With millions of diverse people living, working, and playing in 304 square miles, it is understandable why tourists or newcomers feel that residents are in a rush, rude, and unfriendly.
On the opposite side of the nation in the Central Valley of California, many residents live in rural communities. The Central Valley is home to 6.5 million people across 18,000 square miles (American Museum of Natural History 2018). Though there is a large, metropolitan hub of Fresno, surrounding communities identify themselves as small, agricultural with a country lifestyle. Here residents seek face-to-face interactions and communities operate as kin or families. Like other social categories or labels, people use location to denote status or lifestyle. Consider people in the U.S. who “live in Beverly Hills” or “work on Wall Street.” These locations imply socio-economic status and privilege. Values of a dominant regional culture marginalize those who do not possess or have the cultural characteristics of that geographic location (Kottak and Kozaitis 2012). People who do not culturally fit in a place face social stigma and rejection. People move to explore new areas, experience new cultures, or change status. Changing where
we live means changing our social and cultural surroundings including family, friends, acquaintances, etc. The most desirable spaces are distributed inequitably (Kottak and Kozaitis 2012). Wealth and privilege provide access to desirable locations and living conditions. The poor, immigrants and ethnic minorities are most likely to be concentrated in poor communities with less than optimal living standards (Kottak and Kozaitis 2012). Impoverished groups are the most likely to be exposed to environmental hazards and dangerous living conditions. The disproportionate impact of environmental hazards on people of color has led to the development of the environmental justice movement to abolish environmental racism and harm (Energy Justice Network 2018).
Geographic places also convey and signify stereotypes. People living in or being from an area inherent the region’s stereotypes whether they are accurate or not. Think about the previous U.S. examples of “living in Beverly Hills” or “working on Wall Street.” Stereotypes associated with these labels imply wealth and status. However, approximately 10% of people living in Beverly Hills are living below the poverty rate and most people employed on Wall Street do not work for financial institutions instead are police, sanitation workers, street vendors, and public employees to name a few (Data USA 2018).
YOUR REGIONAL CULTURE
The place someone lives influences his or her value system and life. Describe the geographic location you live and the culture of your community. What values and beliefs do the social norms and practices of your neighborhood instill or project among residents? What type of artifacts or possessions (i.e., truck, luxury car, recreational vehicle, fenced yard, swimming pool, etc.) do people living in your community seek out, dismiss, or condone? Do you conform to the cultural standards where you live or deviate from them? Explain how the place you live influences your perceptions, choices, and life.
Attribution
Adapted from pages 43 through 44 from “Beyond Race: Cultural Influences on Human Social Life” by Vera Kennedy under the license CC BY-NC-SA 4.0. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/07%3A_Perspectives_on_Communities/21%3A_Geographic_Region.txt |
Learning Objectives
• Discuss why the community is often the cornerstone of our work as social workers.
• Define what a community is.
• Describe the different types of communities.
• Discuss alternative approaches to community building and development.
22.1 Introduction
Social Problems in the News
“India’s Air the World’s Unhealthiest,” the headline said. A study by researchers at Columbia and Yale Universities ranked India as having the worst air pollution on the planet. India’s levels of one component of air pollution, fine particulate matter, were almost five times higher than the safe level for humans. The head of an Indian environmental organization attributed her country’s air problem to its numbers of motor vehicles. Although India has fewer vehicles per capita than wealthy nations, its vehicles are very polluting, and it still has a very high number of vehicles because of its huge population. Adding that India has very weak emission standards, she called for stronger standards: “We need to take big steps or the problem will overwhelm us.”
Source: Timmons & Vyawahare, 2012
This news story reminds us that air pollution is a worldwide problem. The story also reminds us that a major reason for India’s air pollution problem is its sheer population size, as India ranks second in the world with 1.2 billion people, just behind China. As India’s example suggests, population and environmental problems are often intertwined.
This chapter examines problems such as food scarcity and climate change associated with population growth and the environment. We will see that these problems raise complex issues without easy solutions, but we will also see that these are urgent problems that must be addressed. Indeed, it is no exaggeration to say that the fate of the earth depends on adequate solutions to these problems.
22.2 Sociological Perspectives on Population & the Environment
As usual, the major sociological perspectives offer insights that help us understand issues relating to population growth and to the environment. Table 15.1 “Theory Snapshot” summarizes their assumptions.
Table 15.1 Theory Snapshot
Theoretical perspective Major assumptions
Functionalism Population and the environment affect each other. Normal population growth is essential for any society, but population growth that is too great or too little leads to various problems. Environmental problems are to be expected in an industrial society, but severe environmental problems are dysfunctional.
Conflict theory Population growth is not a serious problem because the world has sufficient food and other resources, all of which must be more equitably distributed. The practices of multinational corporations and weak regulation of these practices account for many environmental problems.
Symbolic interactionism People have certain perceptions and understandings of population and environmental issues. Their social backgrounds affect these perceptions, which are important to appreciate if population and environmental problems are to be addressed.
Functionalism
Functionalism considers population growth and its various components (birth, death, and migration) as normal and essential processes for any society. A society certainly cannot survive if it loses members, but it can thrive only if it grows so that it can meet future challenges. Functionalism also considers pollution and other environmental problems to be an inevitable consequence of today’s society, but it assumes that environmental problems that are too severe are certainly dysfunctional for society.
The reasons for the importance of population growth depend on the type of a society’s economy. For example, agricultural and other nonindustrial societies need high birth rates to counteract their high death rates. Industrial societies have lower death rates, but they still need to be able to hire younger workers as older workers retire, while new industries need to be able to count on hiring enough young workers with the skills and knowledge these industries require. However, population growth that is too rapid and severe can be dysfunctional for a society. Such growth creates crowding and can use up valuable resources such as food, and it can also harm the environment.
As this discussion suggests, functionalism emphasizes how the population and environment affect each other. Population growth leads to certain environmental problems, as we shall see, while environmental problems have important consequences for the populations for whole nations and even the world. At the same time, several industrial nations today actually do not have enough population growth to provide sufficient numbers of younger workers to replace retiring workers and to maintain their tax bases. While too much population growth causes many problems, then, too little population growth also causes problems.
Conflict Theory
Conflict theory blames many environmental problems on pollution by multinational corporations that occurs because of weak regulations and a failure to enforce the regulations that do exist.
Conflict theory does not consider population growth to be a serious problem. Instead, it assumes that the earth has enough food and other resources to meet the needs of its growing population. To the extent that food shortages and other problems meeting these needs exist, these problems reflect decisions by economic and political elites in poor nations to deprive their peoples of food and other resources; they also reflect operations by multinational corporations that deprive these nations of their natural resources. If population growth is a problem, then, it is a problem not because there is a lack of food and other resources, but rather because these resources are not distributed fairly. To the extent this is true, efforts to satisfy the world’s need for food and other resources should focus on distributing these resources more equitably rather than on limiting population growth.
At the same time, conflict theory recognizes that many poor nations still have population growth that is more than desirable. The theory blames this growth on the failure of these nations’ governments to make contraceptives readily available and to do everything possible to increase women’s education and independence (which both reduce their birth rates).
In regard to a particular population issue we will discuss (immigration), conflict theory emphasizes the role played by racial and ethnic prejudice in popular views on immigration. It generally favors loosening restrictions on immigration into the United States and making it possible for undocumented immigrants to become US citizens if they so desire.
Conflict theory also assumes that the world’s environmental problems are not inevitable and instead arise from two related sources. First, multinational corporations engage in practices that pollute the air, water, and ground. Second, the United States and other governments fail to have strong regulations to limit corporate pollution, and they fail to adequately enforce the regulations they do have.
Symbolic Interactionism
Symbolic interactionism offers four kinds of understandings of population and environmental problems. First, it seeks to understand why people engage or do not engage in activities related to population growth and other problems (e.g., the use of contraception) and to environmental problems (e.g., recycling). In order to address population growth and environmental problems, it is important to understand why people become involved, or fail to become involved, in various activities related to these problems.
Second, it emphasizes people’s perceptions of population and environmental problems. To the extent that public attitudes play a key role in the persistence of these problems, it is important to know the reasons for public views on these problems so that efforts to address the problems may be better focused.
Next, symbolic interactionism assumes that population and environmental problems are to some extent social constructions (see Chapter 1 “Understanding Social Problems”), as these problems do not come to be considered social problems unless sufficient numbers of people and/or influential organizations in the public and private sectors recognize them as problems. For example, lead was a serious health problem long before the US government banned it in paint in 1977 and in gasoline in 1990. As early as the first few years of the twentieth century, scientists were calling attention to the toxic properties of lead paint and more generally of lead itself. Still, lead was added to gasoline in 1922 to raise octane levels. Despite growing evidence over the next few decades of lead’s toxic qualities, various industries continued to say that lead was safe for the general public (Michaels, 2008). The banning of lead was ultimately due to the efforts of environmental groups and to the fact that the growing amount of scientific evidence of lead’s dangers became overwhelming
Finally, symbolic interactionism emphasizes that people from different social backgrounds and from different cultures may have different understandings of population issues and of environmental issues. For example, someone who grows up in a rural area may consider even a small city to be incredibly crowded, while someone who grows up in a large city may consider a small city to be too tiny and lacking in museums, restaurants, and other amenities that large cities offer.
Key Takeaways
• Functionalism recognizes the problems arising from population growth that is too rapid but disagrees on the extent to which overpopulation is a serious problem.
• Conflict theory attributes world hunger to inequalities in the distribution of food rather than overpopulation.
• Symbolic interactionism considers people’s perceptions and activities regarding population (e.g., contraception) and the environment.
For Your Review
1. Which of the three major perspectives—functionalism, conflict theory, or symbolic interactionism—seems to have the best approach in how it understands population and environmental issues? Explain your answer.
22.3 Population
Population change often has weighty consequences throughout a society. As we think about population change, we usually think about and worry about population growth, but population decline is also a concern. Consider the experience of Michigan (Dzwonkowski, 2010). Like several other northern states, Michigan has lost population during the past few decades. Its birth rate has declined by 21 percent from 1990, and elementary school populations dropped as a result. Several schools lost so many students that they had to close, and others are in danger of closing. In addition, many more people have been moving out of Michigan than moving in. Because many of those moving out are young, college-educated adults, they take with them hundreds of millions of dollars in paychecks away from Michigan’s economy and tax revenue base. They also leave behind empty houses and apartments that help depress the state’s real estate market. Because of the loss of younger residents from the declining birth rate and out-migration, Michigan’s population has become older on the average. This shift means that there is now a greater percentage of residents in their older years who need state services.
Among other consequences, then, Michigan’s population decline has affected its economy, educational system, and services for its older residents. While Michigan and other states are shrinking, states in the southern and western regions of the nation are growing, with their large cities becoming even larger. This population growth also has consequences. For example, schools become more crowded, pressuring communities to hire more teachers and either enlarge existing schools or build new ones. Population growth also strains hospitals, social services, and many other sectors of society.
This brief discussion of US cities underscores the various problems arising from population growth and decline. These are not just American problems, as they play out across the world. The remainder of this section introduces the study of population and then examines population problems in greater depth.
The Study of Population
We have commented that population change is an important source of other changes in society. The study of population is so significant that it occupies a special subfield within sociology called demography. To be more precise, demography is the study of changes in the size and composition of population. It encompasses several concepts: fertility and birth rates, mortality and death rates, and migration. Let’s look at each of these briefly.
Fertility and Birth Rates
Fertility refers to the number of live births. Demographers use several measures of fertility. One measure is the crude birth rate or the number of live births for every 1,000 people in a population in a given year. We call this a “crude” birth rate because the population component consists of the total population, not just the number of women or even the number of women of childbearing age (commonly considered 15–44 years).
A second measure is the general fertility rate (also just called the fertility rate or birth rate), or the number of live births per 1,000 women aged 15–44 (i.e., of childbearing age). The US general fertility rate for 2010 was about 64.7 (i.e., 64.7 births per 1,000 women aged 15–44) (Sutton & Hamilton, 2011).
A third measure is the total fertility rate or the number of children an average woman is expected to have in her lifetime (taking into account that some women have more children and some women have fewer or no children). This measure often appears in the news media and is more easily understood by the public than either of the first two measures. In 2010, the US total fertility rate was about 1.93 (or 1,930 births for every 1,000 women) (Hamilton, Martin, & Ventura, 2011).
Demographers use several measures of fertility. The general fertility rate refers to the number of live births per 1,000 women aged 15–44. The US general fertility rate is about 65.5. Daniel – Delivery – CC BY-NC-ND 2.0.
As Figure 15.1 “US General Fertility Rate, 1920–2010” indicates, the US general fertility rate has changed a lot since 1920, dropping from 101 (per 1,000 women aged 15–44) in 1920 to 70 in 1935, during the Great Depression, before rising afterward until 1955. (Note the very sharp increase from 1945 to 1955, as the post–World War II baby boom began.) The fertility rate then fell steadily after 1960 until the 1970s but has remained rather steady since then, fluctuating only slightly between 65 and 70 per 1,000 women aged 15–44.
Figure 15.1 US General Fertility Rate, 1920–2010
Fertility rates differ around the world and are especially high in poor nations (see Figure 15.2 “Crude Birth Rates around the World, 2008 (Number of Births per 1,000 Population)”). Demographers identify several reasons for these high rates (Weeks, 2012).
Figure 15.2 Crude Birth Rates around the World, 2008 (Number of Births per 1,000 Population)
First, poor nations are usually agricultural ones. In agricultural societies, children are an important economic resource, as a family will be more productive if it has more children. This means that families will ordinarily try to have as many children as possible. Second, infant and child mortality rates are high in these nations. Because parents realize that one or more of their children may die before adulthood, they have more children to make up for the anticipated deaths.
A third reason is that many parents in low-income nations prefer sons to daughters, and, if a daughter is born, they try again for a son. Fourth, traditional gender roles are often very strong in poor nations, and these roles include the belief that women should be wives and mothers above all. With this ideology in place, it is not surprising that women will have several children. Finally, contraception is uncommon in poor nations. Without contraception, many more pregnancies and births certainly occur. For all these reasons, then, fertility is much higher in poor nations than in rich nations.
Poor nations have higher birth rates for several reasons. One reason is the agricultural economies typical of these nations. In these economies, children are an important economic resource, and families will ordinarily try to have as many children as possible. Wikimedia Commons – public domain.
Mortality and Death Rates
Mortality is the flip side of fertility and refers to the number of deaths. Demographers measure it with the crude death rate, the number of deaths for every 1,000 people in a population in a given year. We call this a “crude” death rate because the population component consists of the total population and does not take its age distribution into account. All things equal, a society with a higher proportion of older people should have a higher crude death rate. Demographers often calculate age-adjusted death rates that adjust for a population’s age distribution.
Migration
Another important demographic concept is migration, the movement of people into and out of specific regions. Since the dawn of human history, people have migrated in search of a better life, and many have been forced to migrate by ethnic conflict or the slave trade.
Several classifications of migration exist. When people move into a region, we call it in-migration, or immigration; when they move out of a region, we call it out-migration, or emigration. The in-migration rate is the number of people moving into a region for every 1,000 people in the region, while the out-migration rate is the number of people moving from the region for every 1,000 people. The difference between the two is the net migration rate (in-migration minus out-migration). Recalling our earlier discussion. Michigan has had a net migration of less than zero, as its out-migration has exceeded its in-migration.
Migration can also be either domestic or international in scope. Domestic migration happens within a country’s national borders, as when retired people from the northeastern United States move to Florida or the Southwest. International migration happens across national borders. When international immigration is heavy, the effect on population growth and other aspects of national life can be significant, as can increased prejudice against the new immigrants. Domestic migration can also have a large impact. The great migration of African Americans from the South into northern cities during the first half of the twentieth century changed many aspects of those cities’ lives (Wilkerson, 2011). Meanwhile, the movement during the past few decades of northerners into the South and Southwest also had quite an impact: The housing market initially exploded, for example, and traffic increased.
Population Growth and Decline
Now that you are familiar with some basic demographic concepts, we can discuss population change in more detail. Three of the factors just discussed determine changes in population size: fertility (crude birth rate), mortality (crude death rate), and net migration. The natural growth rate is simply the difference between the crude birth rate and the crude death rate. The US natural growth rate is about 0.6 percent (or 6 per 1,000 people) per year. When immigration is also taken into account, the total population growth rate has been almost 1.0 percent per year (Rosenberg, 2012).
Figure 15.3 “International Annual Population Growth Rates (%), 2005–2010” depicts the annual population growth rate (including both natural growth and net migration) of all the nations in the world. Note that many African nations are growing by at least 3 percent per year or more, while most European nations are growing by much less than 1 percent or are even losing population, as discussed earlier. Overall, the world population is growing by about 80 million people annually (Population Reference Bureau, 2012).
Figure 15.3 International Annual Population Growth Rates (%), 2005–2010
To determine how long it takes for a nation to double its population size, divide the number 70 by its population growth rate. For example, if a nation has an annual growth rate of 3 percent, it takes about 23.3 years (70 ÷ 3) for that nation’s population size to double. As you can see from the map in Figure 15.3 “International Annual Population Growth Rates (%), 2005–2010”, several nations will see their population size double in this time span if their annual growth continues at its present rate. For these nations, population growth will be a serious problem if food and other resources are not adequately distributed.
Demographers use their knowledge of fertility, mortality, and migration trends to make projections about population growth and decline several decades into the future. Coupled with our knowledge of past population sizes, these projections allow us to understand population trends over many generations. One clear pattern emerges from the study of population growth. When a society is small, population growth is slow because there are relatively few adults to procreate. But as the number of people grows over time, so does the number of adults. More and more procreation thus occurs every single generation, and population growth then soars in a virtual explosion.
We saw evidence of this pattern when we looked at world population growth. When agricultural societies developed some 12,000 years ago, only about 8 million people occupied the planet. This number had reached about 300 million about 2,100 years ago, and by the fifteenth century, it was still only about 500 million. It finally reached 1 billion by about 1850; by 1950, only a century later, it had doubled to 2 billion. Just fifty years later, it tripled to more than 6.8 billion, and it is projected to reach more than 9 billion by 2050 (see Figure 15.4 “Total World Population, 1950–2050”) and 10 billion by 2100 (Gillis & Dugger, 2011).
Figure 15.4 Total World Population, 1950–2050
Eventually, however, population growth begins to level off after exploding, as explained by demographic transition theory, discussed later. We see this in the bottom half of Figure 15.4 “Total World Population, 1950–2050”, which shows the average annual growth rate for the world’s population. This rate has declined over the last few decades and is projected to further decline over the next four decades. This means that while the world’s population will continue to grow during the foreseeable future, it will grow by a smaller rate as time goes by. As Figure 15.3 “International Annual Population Growth Rates (%), 2005–2010” suggested, the growth that does occur will be concentrated in the poor nations in Africa and some other parts of the world. Still, even in these nations the average number of children a woman has in her lifetime dropped from six a generation ago to about three today.
Past and projected sizes of the US population appear in Figure 15.5 “Past and Projected Size of the US Population, 1950–2050 (in Millions)”. The US population is expected to number about 440 million people by 2050.
Figure 15.5 Past and Projected Size of the US Population, 1950–2050 (in Millions)
Views of Population Growth
Thomas Malthus, an English economist who lived about two hundred years ago, wrote that population increases geometrically while food production increases only arithmetically. These understandings led him to predict mass starvation. Wikimedia Commons – public domain.
The numbers just discussed show that the size of the United States and world populations has increased tremendously in just a few centuries. Not surprisingly, people during this time have worried about population growth and specifically overpopulation. One of the first to warn about population growth was Thomas Malthus (1766–1834), an English economist, who said that population increases geometrically (2, 4, 8, 16, 32, 64, 128, 256, 512, 1024…). If you expand this list of numbers, you will see that they soon become overwhelmingly large in just a few more “generations.” Malthus (1798/1926) said that food production increases only arithmetically (1, 2, 3, 4, 5, 6…) and thus could not hope to keep up with the population increase, and he predicted that mass starvation would be the dire result.
During the 1970s, population growth became a major issue in the United States and some other nations. Zero population growth, or ZPG, was a slogan often heard. There was much concern over the rapidly growing population in the United States and, especially, around the world, and there was fear that our “small planet” could not support massive increases in the number of people (Ehrlich, 1969). Some of the most dire predictions of the time warned of serious food shortages by the end of the century.
Fortunately, Malthus and ZPG advocates were wrong to some degree. Although population levels have certainly soared, the projections in Figure 15.4 “Total World Population, 1950–2050” show the rate of increase is slowing. Among other factors, the development of more effective contraception, especially the birth control pill, has limited population growth in the industrial world and, increasingly, in poorer nations. Food production has also increased by a much greater amount than Malthus and ZPG advocates predicted.
The Debate over Overpopulation
Many experts continue to be concerned about overpopulation, as they feel it is directly responsible for the hunger and malnutrition that plague hundreds of millions of people in poor nations (Gillis, 2011). One expert expressed this concern: “Every billion more people makes life more difficult for everybody—it’s as simple as that. Is it the end of the world? No. Can we feed 10 billion people? Probably. But we obviously would be better off with a smaller population” (Gillis & Dugger, 2011, p. A1). Recognizing this problem, India has begun giving cash bonuses to poor, rural married couples, who typically have high fertility rates, to wait to have children, and it has intensified its encouragement of contraception (Yardley, 2010).
Calls during the 1970s for zero population growth (ZPG) population control stemmed from concern that the planet was becoming overpopulated and that food and other resources would soon be too meager to support the world’s population. James Cridland – Crowd – CC BY 2.0.
However, other experts say the world’s resources remain sufficient and minimize the problem of overpopulation. They acknowledge that widespread hunger in Africa and other regions does exist. However, they attribute this problem not to overpopulation and lack of food but rather to problems in distributing the sufficient amount of food that does in fact exist. As an official for Oxfam International explained, “Today’s major problems in the food system are not fundamentally about supply keeping up with demand, but more about how food gets from fields and on to forks” (2011). The official added that enough grain (cereal and soy) exists to easily feed the world, but that one-third of cereal and 90 percent of soy feed livestock instead. Moving away from a meat-laden Western diet would thus make much more grain available for the world’s hungry poor.
Sociologists Stephen J. Scanlan and colleagues add that food scarcity results from inequalities in food distribution rather than from overpopulation: “[Food] scarcity is largely a myth. On a per-capita basis, food is more plentiful today than any other time in human history…Even in times of localized production shortfalls or regional famines, there has long been a global food surplus…A good deal of thinking and research in sociology…suggests that world hunger has less to do with the shortage of food than with a shortage of affordable or accessible food. Sociologists have found that social inequalities, distribution systems, and other economic and political factors create barriers to food access” (Scanlan, Jenkins, & Peterson, 2010, p. 35).
This sociological view has important implications for how the world should try to reduce global hunger. International organizations such as the World Bank and several United Nations agencies have long believed that hunger is due to food scarcity, and this belief underlies the typical approaches to reducing world hunger that focus on increasing food supplies with new technologies and developing more efficient methods of delivering food. But if food scarcity is not a problem, then other approaches are necessary. According to Scanlan et al., these approaches involve reducing the social inequalities that limit poor nations’ access to food.
As an example of one such inequality, Scanlan et al. point out that poor nations lack the funds to import the abundant food that does exist. These nations’ poverty, then, is one inequality that leads to world hunger, but gender and ethnic inequalities are also responsible. Nations with higher rates of gender inequality and ethnic inequality have higher rates of hunger. In view of this fact, the authors emphasize that improvements in gender and ethnic equality are necessary to reduce global hunger: “International attention to food security should, therefore, shift from increasing food supply to regulating armed conflict, improving human rights, and promoting gender equity throughout the world—factors that reduce barriers to access and empower populations throughout the world to benefit from their food entitlements” (Scanlan et al., 2010, p. 39).
Demographic Transition Theory
As we consider whether overpopulation is the threat that Malthus and contemporary concerned scientists have considered it to be, it is important to appreciate demographic transition theory, mentioned earlier. This theory links population growth to the level of technological development across three stages of social evolution and suggests that this growth slows considerably as nations become more industrialized.
In the first stage, coinciding with preindustrial societies, the birth rate and death rate are both high. The birth rate is high because of the lack of contraception and the several other reasons cited earlier for high fertility rates, and the death rate is high because of disease, poor nutrition, lack of modern medicine, and other problems. These two high rates cancel each other out, and little population growth occurs.
In the second stage, coinciding with the development of industrial societies, the birth rate remains fairly high, owing to the lack of contraception and a continuing belief in the value of large families, but the death rate drops because of several factors, including increased food production, better sanitation, and improved medicine. Because the birth rate remains high but the death rate drops, population growth takes off dramatically.
In the third stage, the death rate remains low, but the birth rate finally drops as families begin to realize that large numbers of children in an industrial economy are more of a burden than an asset. Another reason for the drop is the availability of effective contraception. As a result, population growth slows, and, as we saw earlier, it has become quite low or even gone into a decline in several industrial nations.
Demographic transition theory, then, gives us more reason to be cautiously optimistic regarding the threat of overpopulation: As poor nations continue to modernize—much as industrial nations did two hundred years ago—their population growth rates should start to decline.
Still, population growth rates in poor nations continue to be high, and, as already mentioned, gender and ethnic inequality helps allow rampant hunger to persist. Hundreds of thousands of women die in poor nations each year during pregnancy and childbirth. Reduced fertility would save their lives, in part because their bodies would be healthier if their pregnancies were spaced farther apart (Schultz, 2008). Although world population growth is slowing, then, it is still growing too rapidly in poor nations. To reduce it further, more extensive family planning programs are needed, as is economic development in general: Women who are better educated and have more money tend to have lower fertility.
Population Decline and Pronatalism
Spain is one of several European nations that have been experiencing a population decline because of lower birth rates. Like some other nations, Spain has adopted pronatalist policies to encourage people to have more children; it provides €2,500, about \$3,400, for each child. paul.hartrick – Spain-477 – CC BY-NC 2.0.
If population growth remains a problem in poor nations, population decline is a problem in some industrial nations. As noted earlier, some nations are even experiencing population declines, while several more are projected to have population declines by 2050 (Brooks, 2012). For a country to maintain its population, the average woman needs to have 2.1 children, the replacement level for population stability. But several industrial nations, not including the United States, are below this level. Increased birth control is one reason for their lower fertility rates but so are decisions by women to stay in school longer, to go to work right after their schooling ends, and to postpone having their first child.
Ironically, these nations’ population declines have begun to concern demographers and policymakers (Haartsen & Venhorst, 2010). Because people in many industrial nations are living longer while the birth rate drops, these nations are increasingly having a greater proportion of older people and a smaller proportion of younger people. In several European nations, there are more people 61 or older than 19 or younger. As this trend continues, it will become increasingly difficult to take care of the health and income needs of so many older persons, and there may be too few younger people to fill the many jobs and provide the many services that an industrial society demands. The smaller labor force may also mean that governments will have fewer income tax dollars to provide these services.
To deal with these problems, several governments have initiated pronatalist policies aimed at encouraging women to have more children. In particular, they provide generous child-care subsidies, tax incentives, and flexible work schedules designed to make it easier to bear and raise children, and some even provide couples outright cash payments when they have an additional child. Russia in some cases provides the equivalent of about \$9,000 for each child beyond the first, while Spain provides €2,500 (equivalent to about \$3,400) for each child (Haub, 2009).
Two Other Problems Related to Population Growth
As we saw, population experts debate the degree to which population growth contributes to global poverty and hunger. But there is little debate that population growth contributes to two other global problems.
Population growth causes many environmental problems, one of which is deforestation. crustmania – Deforestation – CC BY 2.0.
One of these problems concerns the environment. Population growth in both wealthy and poor nations has damaged the environment in many ways (Walsh, 2011). As the news story that opens, this chapter illustrated, countries with large numbers of people drive many motor vehicles that pollute the air, and these countries engage in many other practices of the industrial era that pollute the air, water, and ground. Further, as populations have expanded over the centuries, they have cut down many trees and deforested many regions across the globe. This deforestation ruins animal habitats and helps to contribute to global warming because trees help remove carbon dioxide from the atmosphere and release oxygen into the atmosphere.
Another problem is interpersonal conflict in general and armed conflict in particular. As populations grow, they need more and more food, water, and other resources. When these resources have become too scarce over the centuries, many societies have decided to take resources from other societies “by any means necessary,” as the old saying goes, meaning the use of force (Gleditsch & Theisen, 2010).
Population growth thus helps to create armed conflict between societies, but it also helps to generate conflict within a single society. As a society grows, people begin to compete for resources. This competition has often led to hostility of many types, including interpersonal violence. As we shall discuss shortly, the history of immigration in the United States illustrates this dynamic. As the number of immigrants grew rapidly in various historical eras, native-born whites perceived threats to their jobs, land, and other resources and responded with mob violence.
Immigration
Recall that migration generally and immigration specifically are central concepts in the study of population. As just indicated, immigration is also a source of great controversy in the United States and in many other countries. This controversy is perhaps almost inevitable, as increasing numbers of immigrants can affect many aspects of a society: crowding in its cities, increasing enrollments in its schools, having enough jobs for everyone who wants to work, and so forth. However, the fact that immigration can cause these complications does not begin to justify the prejudice and hostility that have routinely greeted immigrants into the United States and elsewhere.
The history of the United States is filled with prejudice and hostility of this type. Starting with the Pilgrims, this nation was settled by immigrants who came to these shores seeking political and religious freedom and economic opportunity. Despite these origins, when great waves of immigrants came to the United States beginning in the nineteenth century, they were hardly greeted with open arms (Roediger, 2006). During the first half of this century, some 3 million Irish immigrants, most of them Catholic, moved to the United States. Because these immigrants were not Anglo-Saxon Protestants, native-born whites (most of whom were Anglo-Saxon Protestants) deeply disliked them and even considered them to be a different race from white. During the 1850s, the so-called Know-Nothing Party, composed of native-born whites, was openly hostile to Irish immigrants and would engage in mob violence against them, with many murders occurring. Later waves of immigrants from Italian, Polish, and Jewish backgrounds also were not considered fully white and subject to employment discrimination and other ethnic prejudice and hostility.
Beginning with the California gold rush of 1849 and continuing after the Civil War, great numbers of Chinese immigrants came to the United States and helped to build the nation’s railroads and performed other important roles. They, too, were greeted hostilely by native-born whites who feared the Chinese were taking away their jobs (Pfaelzer, 2008). As the national economy worsened during the 1870s, riots against the Chinese occurred in western cities. In more than three hundred cities and towns, whites went into Chinese neighborhoods, burned them down, and murdered some Chinese residents while forcing the remainder to leave town. Congress finally outlawed Chinese immigration in 1882, with this ban lasting for almost a century.
During the 1930s, rising numbers of Mexican Americans in the western United States led to similar hostility (Daniels, 2002). The fact that this decade was the time of the Great Depression deepened whites’ concerns that Mexican immigrants were taking away their jobs. White-owned newspapers falsely claimed that these immigrants posed a violent threat to white Americans and that their supposed violence was made more likely by their use of marijuana. It is estimated that at least 500,000 Mexicans returned to their native country, either because they were forcibly deported or because they returned there themselves under great pressure.
Immigration Today
Immigration continues to be a major concern for many Americans today, whose concern centers mostly on Mexican immigrants even though they are less than a majority of all immigrants. According to political scientist Victoria M. DeFrancesco Soto (2012), this focus stems from racial prejudice: “Let’s call a spade a spade. Opposition to immigration is not a concern rooted in personal economic concerns. Neither is it a concern having to do with state’s rights. Anti-immigrant sentiment isn’t even about immigrants as a whole. As rigorous social scientific research shows, opposition to immigration is closely linked to the negative racial animus toward one very specific group, Latinos.”
As we try to make sense of immigration and of immigration policy, some basic facts are worth appreciating. The number of immigrants greatly increased two or three decades ago, but the number of illegal immigrants entering the United States now is very small compared to just a decade ago (Myers, 2012). Foreign-born residents composed 12.9 percent of the US population in 2010, or 40 million immigrants overall, compared to only 7.9 percent in 1990 (Immigration Policy Center, 2012). Almost one-third of immigrants are Mexican, while one-fourth are Asian. Most of the remainders come from the Caribbean, Central America, and South America. Slightly more than half of all foreign-born residents come from Mexico or one of the other Latin American nations. Almost 40 percent of Latinos and two-thirds of Asians in the United States are foreign-born.
Almost three-fourths of immigrants are naturalized US citizens, legal residents, or legal temporary migrants. Slightly more than one-fourth, 28 percent, or about 11 million people, are illegal residents. About 60 percent, or almost 7 million, of these residents are Mexican. Approximately 4.5 million children born in the United States, who are thus citizens, have at least one parent who is an unauthorized immigrant.
Unauthorized immigrants compose more than 5 percent of the US labor force, a number equivalent to 8 million workers. Households headed by unauthorized immigrants paid an estimated \$11.2 billion in state and federal taxes in 2010. According to the Immigration Policy Center (2012), if all unauthorized immigrants somehow left the United States, the US economy would suffer an annual loss of 2.8 million jobs, \$552 billion in economic activity, and \$245 billion in gross domestic product (GDP).
As these labor and economic figures make clear, illegal immigrants form an important component of the US economy. In another fact that may surprise immigration opponents, many studies also find that immigrants, both legal and illegal, have lower crime rates than nonimmigrants (Wadsworth, 2010). These low rates are thought to stem from immigrants’ stable families, strong churches, and high numbers of small businesses that make for stable neighborhoods. Ironically, as immigrants stay longer in the United States, the crime rates of their children, and then those of their children’s children, become higher. As immigrant families stay longer in the United States, then, their crime rates tend to rise, in part because they become “Americanized” (Sampson, 2008).
Efforts to Limit Immigration
Although immigrants strengthen the US economy and have low crime rates, much of the public is opposed to immigration. In the 2010 General Social Survey (GSS), half the respondents said that the number of immigrants to the United States should be reduced by “a little” or “a lot,” and only about 14 percent said this number should be increased. In a 2011 CNN poll, one-third of the public said it is “somewhat” or “very” unsympathetic toward illegal immigrants and their families. In the same poll, more than half the public favored building a seven-hundred-mile fence along the border with Mexico (PollingReport.com, 2012).
In recent years, many states enacted strict laws regarding immigrants, including the denial of schooling and various social services to unauthorized immigrant families. Arizona, Georgia, and Alabama enacted some of the most restrictive legislation.
Arizona is one of several states that have enacted very restrictive laws regarding immigration. Nevele Osteog – Immigration Reform Leaders Arrested in Washington DC – CC BY 2.0.
Arizona’s law, passed in 2010, made failing to carry immigration documents a crime and required the police to question and detain anyone they suspected of being an illegal immigrant. Previously, these restrictions had been the sole province of the federal government. Critics charged this new law would lead to ethnic and racial profiling, as only people who looked Mexican would be stopped by police for suspicion of being illegal (Archibold, 2010). They also noted that the new law caused an economic loss of \$250 million during the first year after its enactment from a loss in conference and convention business in Arizona (Brown, 2011).
Georgia’s law, enacted in 2011, allowed police to demand immigration documents from criminal suspects and to hold suspects who do not provide documentation for deportation by federal officials. The law also made it more difficult to hire workers without proper documentation, increased the penalties for businesses that hire these workers, and provided penalties for people who house or transport unauthorized immigrants. Georgia’s Chamber of Commerce worried about the law’s economic impact, and in particular, was concerned that the law would reduce tourism. Reports estimated that if the law forced all unauthorized workers to leave Georgia, the state’s agricultural industry would lose up to \$1 billion annually since unauthorized workers form the bulk of Georgia’s farm labor force (Berman, 2011).
Alabama’s law, enacted in 2011, also allowed police to detain people suspected of being unauthorized immigrants. In addition, it required schools to record the immigration status of all students and also required people seeking a driver’s license to prove that they were US citizens. The law led to very long lines to renew driver’s licenses, and, because immigrant migrant workers left the state, many crops went unharvested on the state’s farms. Business leaders feared the law would harm the state’s economy, a fear that was heightened when a German executive at Mercedes-Benz was detained by police (Ott, 2012).
Several months after the Alabama law took effect, a study by a University of Alabama economist concluded that it had forced at least 40,000 and perhaps as many as 80,000 unauthorized workers to leave the state (Lee, 2012). The exit of so many workers caused an estimated annual loss to Alabama’s GDP of at least \$2 billion, a loss in state and state revenue from income and sales taxes of at least \$57 million, and a loss in local sales tax revenue of at least \$20 million.
Self-Deportation
Many critics of immigration hope these and other laws and practices will make life so difficult for unauthorized immigrants that they engage in self-deportation by returning to Mexico or their other native countries. According to the Immigration Policy Center (2012), however, there is little evidence that self-deportation actually occurs. A major reason for this fact is that two-thirds of unauthorized adult immigrants have been in the United States for at least ten years, and almost half are parents of children born in the United States (who, as mentioned earlier, are thus US citizens). These adults and their children, therefore, have established roots in American soil and simply want to stay in the United States.
Detention
The federal government has the responsibility for detaining and deporting unauthorized immigrants. The number of immigrants detained every year exceeds 360,000, with an average detention length of almost three months; more than 1,000 individuals are detained for over a year. At a cost of more than \$60,000 per detainee, the annual cost of this detention system exceeds \$21 billion. Most detainees are in custody for technical violations of immigrant laws, such as overstaying a visa, rather than for serious criminal behavior. As such, they do not pose a public danger.
Debate continues over the extent to which the government should carry out deportation, but critics and even immigration judges decry the conditions under which illegal immigrants are detained (Semple, 2011). They say that detainees are denied basic due process rights, such as the right to have a court-appointed attorney. More than four-fifths have no legal representation at all, and those who do receive legal assistance often receive incompetent assistance.
Immigrants and Domestic Violence
Another immigration issue concerns battered women who are immigrants (Constable, 2012). When women are beaten or otherwise abused by their husbands or boyfriends, it is often difficult for them to leave their abusers (see “The Changing Family”). But abused immigrant women face a special problem in this regard. Because often they are allowed to live in the United States only because their husbands are legal residents or citizens, they fear deportation if they go to the police and their husband is deported. Other abused immigrant women who are in the United States illegally similarly fear they will be deported if they go to the police. Fortunately, federal law now allows abused immigrant women to apply for legal residency, but many women are not aware of this possibility.
Although our discussion of immigration has painted a critical portrait of many aspects of US immigration policy, the United States actually ranks fairly high among the world’s nations in how it treats its immigrants. The Note 15.17 “Lessons from Other Societies” box discusses this international comparison in greater detail.
Lessons from Other Societies
The Status of Legal Immigrants in Western Democracies
The Migrant Integration Policy Index (MIPEX) is an effort of the British Council and the Migration Policy Group, an international consortium. This index ranks the United States, Canada, and twenty-eight European nations on the extent to which legal immigrants are integrated into each nation’s political and economic life and on the path to full citizenship. It also ranks the extent to which each nation has antidiscrimination laws to protect immigrants. Overall, MIPEX consists of 148 policy indicators.
In the latest (2011) MIPEX report, the United States ranked ninth out of the thirty-one states on this index; Sweden ranked first, followed by Portugal and Canada. Summarizing one of the effort’s major findings, a news report observed that “strong U.S. antidiscrimination laws protect immigrants and guarantee them equal rights and opportunities, a model for immigration rules elsewhere.” MIPEX also ranked the United States highly on legal immigrants’ opportunities for employment, for education, and for reuniting with family members.
At the same time, the MIPEX report noted that the United States denies many immigrants several federal benefits and imposes large fees for certain immigration procedures. It also asserted that US immigration laws are unnecessarily complex and that visa availability is too limited. The relatively lower scores that the United States enjoyed in all these areas led it to lag behind the eight nations that scored higher on the index.
Reacting to the MIPEX report, the director of the Immigration Policy Center in Washington, DC, said the United States would benefit from improving its efforts to integrate immigrants, for example by better helping them learn English, and she warned that federal and state budget cuts threatened to lower the US ranking.
Although the United States, then, ranks fairly high among the world’s democracies in the status of its legal immigrants, the higher status enjoyed by immigrants in Canada and some other democracies points to directions the United States should follow to improve its ranking and create a better climate for its immigrants.
Sources: Huddleston & Niessen, 2011; Restrepo, 2011
Key Takeaways
• To understand changes in the size and composition of population, demographers use several concepts, including fertility and birth rates, mortality and death rates, and migration.
• Although overpopulation remains a serious concern, many experts say the world’s food supply is sufficient providing that it is distributed efficiently and equitably.
• Although illegal immigration to the United States has dwindled and immigrants are faring well overall, many Americans are concerned about immigration, and several states have passed very restrictive laws concerning immigration.
For Your Review
1. How concerned are you about population growth and overpopulation? Explain your answer in a brief essay.
2. Before you began reading this chapter, did you think that food scarcity was the major reason for world hunger today? Why do you think a belief in food scarcity is so common among Americans?
3. Do you think nations with low birth rates should provide incentives for women to have more babies? Why or why not?
4. If immigrants seem to be faring fairly well in the United States, as the text explains, why do you think so many Americans have negative attitudes about immigration and immigrants? Explain your answer.
23.4 The Environment
At first glance, the environment does not seem to be a sociological topic. The natural and physical environment is something that geologists, meteorologists, oceanographers, and other scientists should be studying, not sociologists. Yet we have just discussed how the environment is affected by population growth, and that certainly sounds like a sociological discussion. In fact, the environment is very much a sociological topic for several reasons.
First, our worst environmental problems are the result of human activity, and this activity, like many human behaviors, is a proper topic for sociological study. This textbook has discussed many behaviors: racist behavior, sexist behavior, criminal behavior, sexual behavior, and others. Just as these behaviors are worthy of sociological study, so are the behaviors that harm (or try to improve) the environment.
Second, environmental problems have a significant impact on people, as do the many other social problems that sociologists study. We see the clearest evidence of this impact when a major hurricane, an earthquake, or another natural disaster strikes. In January 2010, for example, a devastating earthquake struck Haiti and killed more than 250,000 people, or about 2.5 percent of that nation’s population. The effects of these natural disasters on the economy and society of Haiti will certainly also be felt for many years to come.
As is evident in this photo taken in the aftermath of the 2010 earthquake that devastated Haiti, changes in the natural environment can lead to profound changes in a society. Environmental changes are one of the many sources of social change. United Nations Development Programme – Haiti Earthquake – CC BY-NC-ND 2.0.
Slower changes in the environment can also have a large social impact. As noted earlier, industrialization and population growth have increased the pollution of our air, water, and ground. Climate change, a larger environmental problem, has also been relatively slow in arriving but threatens the whole planet in ways that climate change researchers have documented and will no doubt be examining for the rest of our lifetimes and beyond. We return to these two environmental problems shortly.
A third reason the environment is a sociological topic is a bit more complex: Solutions to our environmental problems require changes in economic and environmental policies, and the potential implementation and impact of these changes depend heavily on social and political factors. In the United States, for example, the two major political parties, corporate lobbyists, and environmental organizations regularly battle over attempts to strengthen environmental regulations.
A fourth reason is that many environmental problems reflect and illustrate social inequality based on social class and on race and ethnicity: As with many problems in our society, the poor and people of color often fare worse when it comes to the environment. We return to this theme later in our discussion of environmental racism.
Fifth, efforts to improve the environment, often called the environmental movement, constitute a social movement and, as such, are again worthy of sociological study. Sociologists and other social scientists have conducted many studies of why people join the environmental movement and of the impact of this movement.
Environmental Sociology
All these reasons suggest that the environment is quite fittingly a sociological topic, and one on which sociologists should have important insights. In fact, so many sociologists study the environment that their collective study makes up a subfield in sociology called environmental sociology, which refers simply to the sociological study of the environment. More specifically, environmental sociology is the study of the interaction between human behavior and the natural and physical environment. According to a report by the American Sociological Association, environmental sociology “has provided important insights” (Nagel, Dietz, & Broadbent, 2010, p. 13) into such areas as public opinion about the environment, the influence of values on people’s environmental behavior, and inequality in the impact of environmental problems on communities and individuals.
Environmental sociology assumes “that humans are part of the environment and that the environment and society can only be fully understood in relation to each other” (McCarthy & King, 2009, p. 1). Because humans are responsible for the world’s environmental problems, humans have both the ability and the responsibility to address these problems. As sociologists, Leslie King and Deborah McCarthy (2009, p. ix) assert, “We both strongly believe that humans have come to a turning point in terms of our destruction of ecological resources and endangerment of human health. A daily look at the major newspapers points, without fail, to worsening environmental problems…Humans created these problems and we have the power to resolve them. Naturally, the longer we wait, the more devastating the problems will become; and the more we ignore the sociological dimensions of environmental decline the more our proposed solutions will fail.”
Environmental sociologists emphasize two important dimensions of the relationship between society and the environment: (a) the impact of human activity and decision making and (b) the existence and consequences of environmental inequality and environmental racism. We now turn to these two dimensions.
Human Activity and Decision Making
Perhaps more than anything else, environmental sociologists emphasize that environmental problems are the result of human decisions and activities that harm the environment. Masses of individuals acting independently of each other make decisions and engage in activities that harm the environment, as when we leave lights on, keep our homes too warm in the winter or too cool in the summer, and drive motor vehicles that get low gas mileage. Corporations, government agencies, and other organizations also make decisions and engage in practices that greatly harm the environment. Sometimes individuals and organizations know full well that their activities are harming the environment, and sometimes they just act carelessly without much thought about the possible environmental harm of their actions. Still, the environment is harmed whether or not individuals, corporations, and governments intend to harm it.
A major example of the environmental harm caused by human activity was the British Petroleum (BP) oil spill that began in April 2010 when an oil rig leased by BP exploded in the Gulf of Mexico and eventually released almost 5 million barrels of oil (about 200 million gallons) into the ocean. Congressional investigators later concluded that BP had made a series of decisions that “increased the danger of a catastrophic well,” including a decision to save money by using an inferior casing for the well that made an explosion more likely. A news report paraphrased the investigators as concluding that “some of the decisions appeared to violate industry guidelines and were made despite warnings from BP’s own employees and outside contractors” (Fountain, 2010, p. A1).
Sociologists McCarthy and King (2009) cite several other environmental accidents that stemmed from reckless decision making and natural disasters in which human decisions accelerated the harm that occurred. One accident occurred in Bhopal, India, in 1984, when a Union Carbide pesticide plant leaked forty tons of deadly gas. Between 3,000 and 16,000 people died immediately and another half-million suffered permanent illnesses or injuries. A contributing factor for the leak was Union Carbide’s decision to save money by violating safety standards in the construction and management of the plant.
The April 2010 BP oil spill occurred after BP made several decisions that may have increased the possibility of a catastrophic explosion of the well. International Bird Rescue Research Center – Gulf Oiled Pelicans June 3, 2010 – CC BY 2.0.
A second preventable accident was the 1989 Exxon Valdez oil tanker disaster, in which the tanker hit ground off the coast of Alaska and released 11 million gallons of oil into Prince William Sound. Among other consequences, the spill killed hundreds of thousands of birds and marine animals and almost destroyed the local fishing and seafood industries. The immediate cause of the accident was that the ship’s captain was an alcoholic and left the bridge in the hands of an unlicensed third mate after drinking five double vodkas in the hours before the crash occurred. Exxon officials knew of his alcoholism but let him command the ship anyway. Also, if the ship had had a double hull (one hull inside the other), it might not have cracked on impact or at least would have released less oil, but Exxon and the rest of the oil industry had successfully lobbied Congress not to require stronger hulls.
Hurricane Katrina was a more recent environmental disaster in which human decision making resulted in a great deal of preventable damage. After Katrina hit the Gulf Coast and especially New Orleans in August 2005, the resulting wind and flooding killed more than 1,800 people and left more than 700,000 homeless. McCarthy and King (2009, p. 4) attribute much of this damage to human decision making: “While hurricanes are typically considered ‘natural disasters,’ Katrina’s extreme consequences must be considered the result of social and political failures.” Long before Katrina hit, it was well known that a major flood could easily breach New Orleans levees and have a devastating impact. Despite this knowledge, US, state, and local officials did nothing over the years to strengthen or rebuild the levees. In addition, coastal land that would have protected New Orleans had been lost over time to commercial and residential development. In short, the flooding after Katrina was a human disaster, not a natural disaster.
Environmental Inequality and Environmental Racism
A second emphasis of environmental sociology is environmental inequality and the related concept of environmental racismEnvironmental inequality (also called environmental injustice) refers to the fact that low-income people and people of color are disproportionately likely to experience various environmental problems, while environmental racism refers just to the greater likelihood of people of color to experience these problems (Walker, 2012). The term environmental justice refers to scholarship on environmental inequality and racism and to public policy efforts and activism aimed at reducing these forms of inequality and racism. The Note 15.25 “Applying Social Research” box discusses some very significant scholarship on environmental racism.
Applying Social Research
Environmental Racism in the Land of Cotton
During the 1970s, people began to voice concern about the environment in the United States and across the planet. As research on the environment grew by leaps and bounds, some scholars and activists began to focus on environmental inequality in general and on environmental racism in particular. During the 1980s and 1990s, their research and activism spawned the environmental justice movement that has since shed important light on environmental inequality and racism and helped reduce these problems.
Research by sociologists played a key role in the beginning of the environmental justice movement and continues to play a key role today. Robert D. Bullard of Clark Atlanta University stands out among these sociologists for the impact of his early work in the 1980s on environmental racism in the South and for his continuing scholarship since then. He has been called “the father of environmental justice” and was named by Newsweek as one of the thirteen most influential environmental leaders of the twentieth century, along with environmental writer Rachel Carson, former vice president Al Gore, and ten others.
Bullard’s first research project on environmental racism began in the late 1970s after his wife, an attorney, filed a lawsuit on behalf of black residents in Atlanta who were fighting the placement of a landfill in their neighborhood. To collect data for the lawsuit, Bullard studied the placement of landfills in other areas. He found that every city-owned landfill in Houston was in a black neighborhood, even though African Americans amounted to only one-fourth of Houston residents at the time. He also found that three out of four privately owned landfills were in black neighborhoods, as were six of the eight city-owned incinerators. He extended his research to other locations and later recalled what he discovered: “Without a doubt, it was a form of apartheid where whites were making decisions and black people and brown people and people of color, including Native Americans on reservations, had no seat at the table.”
In 1990, Bullard published his findings in his book Dumping in Dixie: Race, Class, and Environmental Quality. This book described the systematic placement in several Southern states of toxic waste sites, landfills, and chemical plants in communities largely populated by low-income residents and/or African Americans. Dumping in Dixie was the first book to examine environmental racism and is widely credited with helping advance the environmental justice movement. It received some notable awards, including the Conservation Achievement Award from the National Wildlife Federation.
More recently, Bullard, along with other sociologists and scholars from other disciplines, has documented the impact of race and poverty on the experience of New Orleans residents affected by the flooding after Hurricane Katrina. As in many other cities, African Americans and other low-income people largely resided in the lower elevations in New Orleans, and whites and higher-income people largely resided in the higher elevations. The flooding naturally had a much greater impact on the lower elevations and thus on African Americans and the poor. After the flood, African Americans seeking new housing in various real estate markets were more likely than whites to be told that no housing was available.
Bullard’s early work alerted the nation to environmental racism and helped motivate the Environmental Protection Agency in the 1990s to begin paying attention to it. His various research efforts are an outstanding example of how social research can increase understanding of a significant social problem.
Sources: Bullard, 1990; Bullard & Wright, 2009; Dicum, 2006
According to the American Sociological Association report mentioned earlier, the emphasis of environmental sociology on environmental inequality reflects the emphasis that the larger discipline of sociology places on social inequality: “A central finding of sociology is that unequal power dynamics shape patterns of social mobility and access to social, political, and economic resources” (Nagel et al., 2010, p. 17). The report adds that global climate change will have its greatest effects on the poorest nations: “Many of the countries least responsible for the rise in greenhouse gases will be most likely to feel its impacts in changes in weather, sea levels, health care costs, and economic hardships” (Nagel et al., 2010, p. 17).
Examples of environmental racism and inequality abound. Almost all the hazardous waste sites we discuss later in this chapter are located in or near neighborhoods and communities that are largely populated by low-income people and people of color. When factories dump dangerous chemicals into rivers and lakes, the people living nearby are very likely to be low-income and of color. Around the world, the people most affected by climate change and other environmental problems are those in poor nations and, even within those nations, those who are poorer rather than those who are wealthier.
Some evidence shows that although low-income people are especially likely to be exposed to environmental problems, this exposure is even more likely if they are people of color than if they are white. As a review of this evidence concluded, “It would be fair to summarize this body of work as showing that the poor and especially the nonwhite poor bear a disproportionate burden of exposure to suboptimal, unhealthy environmental conditions in the United States. Moreover, the more researchers scrutinize environmental exposure and health data for racial and income inequalities, the stronger the evidence becomes that grave and widespread environmental injustices have occurred throughout the United States” (Evans & Kantrowitz, 2002, p. 323).
As should be apparent from the discussion in this section, the existence of environmental inequality and environmental racism shows that social inequality in the larger society exposes some people much more than others to environmental dangers. This insight is one of the most important contributions of environmental sociology.
Global climate change is very likely to have its greatest impact on people in the poorest nations, even though these nations are the least responsible for greenhouse gases. Hamed Saber – The Nomad’s Simple Life – CC BY 2.0.
Environmental Problems
To say that the world is in peril environmentally might sound extreme, but the world is in fact in peril. An overview of environmental problems will indicate the extent and seriousness of this problem.
Air pollution probably kills thousands of Americans every year and 2 million people across the planet. Lei Han – Shanghai – CC BY-NC-ND 2.0.
Air Pollution
Estimates of the annual number of US deaths from air pollution range from a low of 10,000 to a high of 60,000 (Reiman & Leighton, 2010). The worldwide toll is much greater, and the World Health Organization (2011) estimates that 1.3 million people across the globe die every year from air pollution.
These deaths stem from the health conditions that air pollution causes, including heart disease, lung cancer, and respiratory disease such as asthma. Most air pollution stems from the burning of fossil fuels such as oil, gas, and coal. This problem occurs not only in the wealthy industrial nations but also in the nations of the developing world; countries such as China and India have some of the worst air pollution. In developing nations, mortality rates of people in cities with high levels of particulate matter (carbon, nitrates, sulfates, and other particles) are 15–50 percent higher than the mortality rates of those in cleaner cities. In European countries, air pollution is estimated to reduce average life expectancy by 8.6 months. The World Health Organization (2011) does not exaggerate when it declares that air pollution “is a major environmental health problem affecting everyone in developed and developing countries alike.”
Pollution of many types especially harms children’s health. The Note 15.26 “Children and Our Future” box discusses this harm in greater detail.
Children and Our Future
Children and Environmental Health Hazards
As we consider environmental problems, we must not forget the world’s children, who are at special risk for environmental health problems precisely because they are children. Their bodies and brains grow rapidly, and they breathe in more air per pound of body weight than adults do. They also absorb substances, including toxic substances from their gastrointestinal tract faster than adults do.
These and other physiological differences all put children at greater risk than adults for harm from environmental health hazards. Children’s behavior also puts them at greater risk. For example, no adult of normal intelligence would eat paint chips found on the floor, but a young child can easily do so. Children also play on lawns, playgrounds, and other areas in which pesticides are often used, and this type of activity again gives them greater exposure. Young children also put their hands in their mouths regularly, and any toxins on their hands are thereby ingested.
Poverty compounds all these problems. Poor children are more likely to live in houses with lead paint, in neighborhoods with higher levels of air pollution, and in neighborhoods near to hazardous waste sites. Poor children of color are especially at risk for these environmental problems.
Three of the greatest environmental health hazards for children are lead, pesticides, and air pollution. Lead can cause brain and nervous system damage, hearing problems, and delayed growth among other effects; pesticides can cause various problems in the immune, neurological, and respiratory systems; and air pollution can cause asthma and respiratory illnesses. All these health problems can have lifelong consequences.
Unfortunately, certain environmentally induced health problems for children are becoming more common. For example, US children’s asthma cases have increased by more than 40 percent since 1980, and more than four hundred American children now have asthma. Two types of childhood cancer thought to stem at least partly from environmental hazards have also increased during the past two decades: acute lymphocytic by 10 percent and brain tumors by 30 percent.
It should be evident from this overview that environmental health hazards pose a serious danger for children in the United States and the rest of the world. Because children are our future, this danger underscores the need to do everything possible to improve the environment.
Source: Children’s Environmental Health Network, 2009
Global Climate Change
The burning of fossil fuels also contributes to global climate change, often called global warming, thanks to the oft-discussed greenhouse effect caused by the trapping of gases in the atmosphere that is turning the earth warmer, with a rise of almost 1°C during the past century. In addition to affecting the ecology of the earth’s polar regions and ocean levels throughout the planet, climate change threatens to produce a host of other problems, including increased disease transmitted via food and water, malnutrition resulting from decreased agricultural production and drought, a higher incidence of hurricanes and other weather disasters, and extinction of several species (Gillis & Foster, 2012; Zimmer, 2011). All these problems have been producing, and will continue to produce, higher mortality rates across the planet. The World Health Organization (2010) estimates that climate change causes more than 140,000 excess deaths worldwide annually.
Climate change is causing many problems, including weather disasters such as the one depicted here. kakela – Hurricane Jeanne – CC BY-NC-ND 2.0.
Another problem caused by climate change may be interpersonal violence and armed conflict (Agnew, 2012; Fisman & Miguel, 2010; Kristof, 2008), already discussed as a consequence of population growth. Historically, when unusual weather events have caused drought, flooding, or other problems, violence, and armed conflict have resulted. For example, witch-burnings in medieval Europe accelerated when extremely cold weather ruined crops and witches were blamed for the problem. Economic problems from declining farm values are thought to have increased the lynchings of African Americans in the US South. As crops fail from global warming and reduced rainfall in the years ahead, African populations may plunge into civil war: According to an Oxford University economist, having a drought increases by 50 percent the chance that an African nation will have a civil war a year later (Kristof, 2008).
As we consider climate change, it is important to keep in mind certain inequalities mentioned earlier (McNall, 2011). First, the world’s richest nations contribute more than their fair share to climate change. The United States, Canada, France, Germany, and the United Kingdom compose 15 percent of the world’s population but are responsible for half of the planet’s carbon dioxide emissions. Second, the effects of climate change are more severe for poor nations than for rich nations. Africans, for example, are much less able than Americans to deal with the effects of drought, weather disasters, and the other problems caused by climate change.
Although almost all climate scientists believe that climate change is a serious problem and stems from human behavior, 28 percent of Americans in a November 2011 poll responded “no” when asked, “Is there solid evidence the earth is warming?” Another 18 percent said solid evidence does exist but that global warming is occurring because of “natural patterns” rather than “human activity.” Only 38 percent agreed with climate scientists’ belief that global warming exists and that it arises from human activity (Pew Research Center, 2011).
Overall, 63 percent of respondents agreed that solid evidence of global warming exists (leaving aside the question of why it is occurring). This figure differed sharply by political party preference, however: Whereas 77 percent of Democrats said solid evidence exists, only 43 percent of Republicans and 63 percent of Independents shared this opinion. Similarly, whereas 55 percent of Democrats said global warming is a “very serious” problem, only 14 percent of Republicans and 39 percent of Independents felt this way (Pew Research Center, 2011).
Water Pollution and Inadequate Sanitation
Water quality is also a serious problem. Drinking water is often unsafe because of poor sanitation procedures for human waste in poor nations and because of industrial discharge into lakes, rivers, and streams in wealthy nations. Inadequate sanitation and unsafe drinking water cause parasitic infections and diseases such as diarrhea, malaria, cholera, intestinal worms, typhoid, and hepatitis A. The World Health Organization estimates that unsafe drinking water and inadequate sanitation cause the following number of annual deaths worldwide: (a) 2.5 million deaths from diarrhea, including 1.4 million child deaths from diarrhea; (b) 500,000 deaths from malaria; and (c) 860,000 child deaths from malnutrition. At least 200 million more people annually suffer at least one of these serious diseases due to inadequate sanitation and unsafe drinking water (Cameron, Hunter, Jagals, & Pond, 2011; Prüss-Üstün, Bos, Gore, & Bartram, 2008).
Nuclear Power
Nuclear power has been an environmental controversy at least since the 1970s. Proponents of nuclear power say it is a cleaner energy than fossil fuels such as oil and coal and does not contribute to global warming. Opponents of nuclear power counter that nuclear waste is highly dangerous no matter how it is disposed of, and they fear meltdowns that can result if nuclear power plant cores overheat and release large amounts of radioactive gases into the atmosphere.
The most serious nuclear plant disaster involved the Chernobyl plant in Ukraine in 1986. Chernobyl’s core exploded and released radioactive gases into the atmosphere that eventually spread throughout Europe. The amount of radiation released was four hundred times greater than the amount released by the atomic bomb that devastated Hiroshima at the end of World War II. About five-dozen people (Chernobyl workers or nearby residents) soon died because of the disaster. Because radiation can cause cancer and other health problems that take years to develop, scientists have studied the health effects of the Chernobyl disaster for the last quarter-century. According to the United Nations Scientific Committee of the Effects of Atomic Radiation (UNSCEAR), an estimated 27,000 additional cancer deaths worldwide will eventually result from the Chernobyl disaster (Gronlund, 2011).
Seven years earlier in March 1979, a nuclear disaster almost occurred in the United States at the Three Mile Island plant in central Pennsylvania. A series of technological and human failures allowed the plant’s core to overheat to almost disastrous levels. The nation held its breath for several days while officials sought to bring the problem under control. During this time, some 140,000 people living within twenty miles of the plant were evacuated. The near-disaster severely weakened enthusiasm for nuclear power in the United States, and the number of new nuclear plants dropped sharply in the ensuing two decades (Fischer, 1997).
Japan was the site of the worst nuclear disaster since Chernobyl in March 2011, when an earthquake and tsunami seriously damaged a nuclear plant in the Fukushima region, 155 miles north of Tokyo. More than 80,000 residents had to be evacuated because of the massive release of radioactive gases and water, and they remained far from their homes a year later as high levels of radiation continued to be found in the evacuated area. A news report on the anniversary of the disaster described the desolation that remained: “What’s most striking about Japan’s nuclear exclusion zone is what you don’t see. There are no people, few cars, no sign of life, aside from the occasional livestock wandering empty roads. Areas once home to 80,000 people are now ghost towns, frozen in time. Homes ravaged from the powerful earthquake that shook this region nearly a year ago remain virtually untouched. Collapsed roofs still block narrow streets. Cracked roads make for a bumpy ride” (Fujita, 2012). It will take at least thirty years to fully decommission the damaged reactors at Fukushima. The news report said, “This nuclear wasteland may not be livable for decades” (Fujita, 2012).
In February 2012, the US Nuclear Regulatory Commission (NRC) issued a study that said the risk from nuclear power accidents in the United States was “very small.” If an accident should occur, the NRC concluded, plant operators would have time to cool down reactor cores and prevent or reduce the emission of radiation (DiSavino, 2012). However, the Union of Concerned Scientists (UCS) is more concerned about this risk (Union of Concerned Scientists, 2011). It says that several US reactors are of the same design as the Fukushima reactors and thus potentially at risk for a similar outcome if damaged by an earthquake. According to the UCS, “If [these reactors] were confronted with a similar challenge, it would be foolish to assume the outcome would not also be similar.” It adds that although earthquakes can cause fires at reactors, US plants routinely violate fire protection standards. A news report on the similarities between US nuclear power plants and the Fukushima plant reached a similar conclusion, noting that US nuclear power plants “share some or all of the risk factors that played a role at Fukushima” (Zeller, 2011).
Critics say many US nuclear plants lack adequate protection against several kinds of dangers. James Marvin Phelps – Nuclear Wetlands – CC BY-NC 2.0.
As this conclusion implies, nuclear power critics say NRC oversight of the nuclear industry is too lax. A 2011 investigation by the Associated Press (AP) yielded support for this criticism (Donn, 2011). The AP found that the NRC has been “working closely with the nuclear power industry to keep the nation’s aging reactors operating within safety standards by repeatedly weakening those standards or simply failing to enforce them.” The report continued, “Time after time, officials at the [NRC] have decided that original regulations were too strict, arguing that safety margins could be eased without peril.” For example, when certain valves at nuclear plants leaked, the NRC revised its regulations to permit more leakage. Also, when cracking of steam generator tubes allowed radiation to leak, standards on tubing strength were weakened. And when reactors began to violate temperature standards, the NRC almost doubled the permitted temperatures. The investigation found “thousands” of problems in aging reactors that it said the NRC has simply ignored, and it concluded that a “cozy relationship” exists between the NRC and the nuclear industry.
A retired NRC engineer interviewed by the AP agreed that his former employer too often accommodated the nuclear industry by concluding that existing regulations are overly stringent. “That’s what they say for everything, whether that’s the case or not,” the engineer said. “They say ‘We have all this built-in conservatism.’”
Ground Pollution and Hazardous Waste
Pollution of the air and water is an environmental danger, as we saw earlier, but so is pollution of the ground from hazardous waste. Hazardous wastes are unwanted materials or byproducts that are potentially toxic. If discarded improperly, they enter the ground and/or bodies of water and eventually make their way into the bodies of humans and other animals and/or harm natural vegetation.
Love Canal, an area in Niagara Falls, New York, was the site of chemical dumping that led to many birth defects and other health problems. Wikimedia Commons – public domain.
Two major sources of hazardous waste exist: (1) commercial products such as pesticides, cleaning fluids, and certain paints, batteries, and electronics and (2) byproducts of industrial operations such as solvents and wastewater. Hazardous waste enters the environment through the careless actions of homeowners and other consumers, and also through the careless actions of major manufacturing corporations. It can cause birth defects, various chronic illnesses and conditions, and eventual death.
Sometimes companies have dumped so much hazardous waste into a specific location that they create hazardous waste sites. These sites are defined as parcels of land and water that have been contaminated by the dumping of dangerous chemicals into the ground by factories and other industrial operations. The most famous (or rather, infamous) hazardous waste site in the United States is undoubtedly Love Canal, an area in a corner of Niagara Falls, New York. During the 1940s and 1950s, a chemical company dumped 20,000 tons of toxic chemicals into the canal and then filled it in with dirt and sold it for development to the local school board. A school and more than eight hundred homes, many of them low income, were later built just near the site. The chemicals eventually leached into the groundwater, yards, and basements of the homes, reportedly causing birth defects and other health problems. (See Note 15.27 “People Making a Difference”.)
People Making a Difference
In Praise of Two Heroic Women
In the annals of activism against hazardous waste dumping, two women stand out for their contributions.
One was Lois Gibbs, who led a movement of residents of Love Canal to call attention to the dumping of hazardous waste in their neighborhood, as just discussed in the text. Gibbs had never been politically active before 1978 when evidence of the dumping first came to light. After reading a newspaper article about the dumping, she began a petition to shut down a local school that was next to the dumpsite. Her efforts generated a good deal of publicity and prompted state officials to perform environmental tests in the homes near the site. Two years later the federal government authorized funding to relocate 660 families from the dangerous area. Gibbs later wrote, “It will take a massive effort to move society from corporate domination, in which industry’s rights to pollute and damage health and the environment supersede the public’s right to live, work, and play in safety. This is a political fight. The science is already there, showing that people’s health is at risk. To win, we will need to keep building the movement, networking with one another, planning, strategizing, and moving forward. Our children’s futures, and those of their unborn children, are at stake.”
The second woman was Erin Brockovich, the subject of a 2000 film of that name starring Julia Roberts. Brockovich also was not politically active before she discovered hazardous waste dumping while she was working as a legal assistant for a small California law firm. As part of her work on a real estate case, she uncovered evidence that Pacific Gas & Electric had been dumping a toxic industrial solvent for thirty years into the water supply of the small town of Hinkley. Her investigation led to a lawsuit that ended in 1996 with the awarding of \$333 million in damages to several hundred Hinkley residents.
Both Lois Gibbs and Erin Brockovich have remained active on behalf of environmental safety in the years since their celebrated initial efforts. They are two heroic women who have made a very significant difference.
Sources: Brockovich, 2010; Gibbs, 1998
The Superfund program of the US Environmental Protection Agency (EPA), began about thirty years ago, monitors, and cleans up hazardous waste sites throughout the country. Since its inception, the Superfund program has identified and taken steps to address more than 1,300 hazardous waste sites. About 11 million people live within one mile of one of these sites.
Oceans
The world’s oceans are at peril for several reasons, with “potentially dire impacts for hundreds of millions of people across the planet,” according to a news report (ScienceDaily, 2010). A major reason is that overfishing of fish and mammals has dramatically reduced the supply of certain ocean animals. This reduction certainly makes it difficult for people to eat certain fishes at restaurants or buy them at supermarkets, but a far more important problem concerns the ocean food chain (Weise, 2011). As the supply of various ocean animals has dwindled, the food supply for the larger ocean animals that eat these smaller animals has declined, putting the larger animals at risk. And as the number of these larger animals has declined, other animals that prey on these larger animals have had to turn to other food sources or not have enough to eat. This chain reaction in the ocean food chain has serious consequences for the ocean’s ecosystem.
One example of this chain reaction involves killer whales and sea otters in the ocean off of western Alaska (Weise, 2011). Killer whales eat many things, but sea lions and harbor seals form a key part of their diet. However, the supply of these ocean mammals in western Alaska and elsewhere has decreased because of human overfishing of their prey fish species. In response, killer whales have been eating more sea otters, causing a 90 percent decline in the number of sea otters in western Alaska. Because sea otters eat sea urchins, the loss of sea otters, in turn, has increased the number of sea urchins there. And because sea urchins consume kelp beds, kelp beds there are disappearing, removing a significant source of food for other ocean life (Estes et al., 2011).
Another example of the ocean chain reaction concerns whales themselves. The whaling industry that began about 1,000 years ago and then intensified during the eighteenth century severely reduced the number of whales and made right whales almost extinct. In southern oceans, whale feces are an important source of nutrients for very small animals and plankton. As the whale population in these oceans has declined over the centuries, these animals and plankton that are essential for the ocean’s ecosystem have suffered immeasurable losses (Weise, 2011).
Bycatch. In addition to overfishing, bycatch, or the unintentional catching and killing of fish, marine mammals, sea turtles, and seabirds while other fish are being caught, also endangers hundreds of ocean species and further contributes to the chain reaction we have described. The US National Oceanic and Atmospheric Administration (2012) says that bycatch “can have significant social, environmental, and economic impacts.” It costs the fishing industry much time and money, it threatens many ocean species, and it endangers the ocean’s ecosystem.
A familiar bycatch example to many Americans is the accidental catching and killing of dolphins when tuna are being caught by large fishing nets. A less familiar example involves sea turtles. These animals’ numbers have declined so steeply in recent decades that six of the seven species of sea turtles are in danger of extinction. The major reason for this danger is bycatch from shrimp trawl nets and other types of fishing. This bycatch has killed millions of sea turtles since 1990 (Viegas, 2010).
Climate change. Other ocean problems stem from climate change. The oceans’ coral reefs are among the most colorful and beautiful sights in the world. More important, they are an essential source of nutrients for the oceans’ ecosystem and a major source of protein for 500 million people. They help protect shorelines from natural disasters such as tsunamis, and they attract tens of billions of dollars in tourism.
The decline of the whale population due to the whaling industry threatens the world’s supply of plankton and other very small marine animals. Denis Hawkins – Whale breaching at Jervis Bay – CC BY-ND 2.0.
Despite all these benefits, coral reefs have long been endangered by overfishing, tourism, and coastal development, among other factors. Scientists have now found that climate change is also harming coral reefs (Rudolf, 2011). The global warming arising from climate change is overheating coral reefs throughout the world. This overheating in turn causes the reefs to expel the algae they consume for food; the algae are also responsible for the reefs’ bright colors. The reefs then turn pale and die, and their deaths add to the ocean’s food chain problem already discussed. Scientists estimate that three-fourths of the earth’s reefs are at risk from global warming, and that one-fifth of all reefs have already been destroyed. They further estimate that almost all reefs will be at risk by 2050.
Global warming will continue to be a main culprit in this regard, but so will increasing acidity, yet another problem arising from climate change. As carbon dioxide is released into the atmosphere, much of it falls into the ocean. This lowers the oceans’ pH level and turns the oceans more acidic. This increasing acidity destroys coral reefs and also poses a risk to commercial species such as clams, lobsters, and mussels.
An additional ocean problem stemming from climate change is rising sea levels (Daley, 2011). Global warming has caused polar ice caps to melt and the seas to rise. This problem means that storm surges during severe weather are becoming an ever-greater problem. Even without storm surges, much coastal land has already been lost to rising ocean levels. Despite these problems, many coastal communities have failed to build adequate barriers that would minimize damage from ocean flooding.
Food
This chapter discussed food shortages earlier as a population problem, but food can also be an environmental hazard. Simply put, food is often unsafe to eat. In 2011, at least 31 Europeans died from a rare strain of E. coli, a deadly bacterium, and more than 3,000 became very ill; the culprit was contaminated bean sprouts (CNN, 2011). According to the Centers for Disease Control and Prevention, 325,000 Americans are hospitalized annually because of illnesses contracted from contaminated food, and 5,000 Americans die each year from these illnesses (Kristof, 2011).
The deadly bacteria at fault often result from improper handling and other activities related to growing livestock and processing food. But they also result from the fact that livestock are routinely given antibiotics to keep them healthy despite the crowded and often dirty conditions in which they live. However, this wide use of antibiotics allows bacteria resistant to antibiotics to grow. When humans contract illnesses from these bacteria, antibiotics do not relieve the illnesses (Kristof, 2012).
One journalist pointed out the obvious problem: “We would never think of trying to keep our children healthy by adding antibiotics to school water fountains, because we know this would breed antibiotic-resistant bacteria. It’s unconscionable that Big Ag [Big Agriculture] does something similar for livestock” (Kristof, 2011, p. WK10). A member of the US House of Representatives who is also a microbiologist agreed: “These statistics tell the tale of an industry that is rampantly misusing antibiotics in an attempt to cover up filthy, unsanitary living conditions among animals. As they feed antibiotics to animals to keep them healthy, they are making our families sicker by spreading these deadly strains of bacteria” (Kristof, 2011, p. WK10).
Key Takeaways
• Environmental problems are largely the result of human behavior and human decision making. Changes in human activity and decision making are thus necessary to improve the environment.
• Environmental inequality and environmental racism are significant issues. Within the United States and around the world, environmental problems are more often found where poor people and people of color reside.
• Air pollution, global climate change, water pollution and inadequate sanitation, and hazardous waste are major environmental problems that threaten the planet.
For Your Review
1. Pretend you are on a debate team and that your team is asked to argue in favor of the following resolution: Be it resolved, that air and water pollution is primarily the result of reckless human behavior rather than natural environmental changes. Using evidence from the text, write a two-minute speech (about three hundred words) in favor of the resolution.
2. How much of the environmental racism that exists do you think is intentional? Explain your answer.
3. List one thing you did yesterday that was good for the environment and one thing that was bad for the environment.
22.5 Addressing Population Problems & Improving the Environment
The topics of population and the environment raise many issues within the United States and across the globe for which a sociological perspective is very relevant. We address a few of these issues here.
Population
We saw earlier that experts disagree over how concerned we should be generally about global population growth, and especially about the degree to which overpopulation is responsible for world hunger. Still, almost everyone would agree that world hunger is a matter of the most serious concern, even if they do not agree on why world hunger is so serious and so persistent. Both across the globe and within the United States, children and adults go hungry every day, and millions starve in the poorest nations in Africa and Asia.
As our earlier discussion indicated, many experts believe it is a mistake to blame world hunger on a scarcity of food. Instead, they attribute world hunger to various inequalities in access to, and in the distribution of, what is actually a sufficient amount of food to feed the world’s people. To effectively reduce world hunger, inequalities across the globe and within the United States based on income, ethnicity, and gender must be addressed; some ways of doing so have been offered in previous chapters.
Population growth in poor nations has slowed but remains a significant problem. Their poverty, low educational levels, and rural settings all contribute to high birth rates. More effective contraception is needed to reduce their population growth, and the United Nations and other international bodies must bolster their efforts, with the aid of increased funding from rich nations, to provide contraception to poor nations. But contraceptive efforts will not be sufficient by themselves. Rather, it is also necessary to raise these nations’ economic circumstances and educational levels, as birth rates are lower in nations that are wealthier and more educated. In particular, efforts that raise women’s educational levels are especially important if contraceptive use is to increase. In all these respects, we once again see the importance of a sociological perspective centering on the significance of socioeconomic inequality.
The Environment
Environmental problems cannot be fully understood without appreciating their social context. In this regard, we discussed two major emphases of environmental sociology. First, environmental problems are largely the result of human decision making and activity and thus preventable. Second, environmental problems disproportionately affect the poor and people of color.
These two insights have important implications for how to improve our environment. Simply put, we must change the behaviors and decisions of individuals, businesses, and other organizations that harm the environment, and we must do everything possible to lessen the extra environmental harm that the poor and people of color experience. Many environmental scholars and activists believe that these efforts need to focus on the corporations whose industrial activities are often so damaging to the air, water, and land.
Beyond these general approaches to improving the environment, there are many strategies and policies that the United States and other nations could and should undertake to help the environment. Although a full discussion of these lies beyond the scope of this chapter, environmental experts recommend a number of actions for the United States to undertake (Lever-Tracy, 2011; Madrid, 2010; McNall, 2011). These include the following:
1. Establish mandatory electricity and natural gas reduction targets for utilities.
2. Expand renewable energy (wind and sun) by setting a national standard of 25 percent of energy to come from renewable sources by 2025.
3. Reduce deforestation by increasing the use of sustainable building materials and passing legislation to protect forests.
4. Reduce the use of fossil fuels by several measures, including higher fuel economy standards for motor vehicles, closing down older coal-fired power plants, and establishing a cap-and-trade system involving large payments by companies for carbon emissions to encourage them to reduce these emissions.
5. In cities, increase mass transit and develop more bicycle lanes and develop more efficient ways of using electricity and water.
If the rooftops of houses were painted white or covered with light-colored shingles, atmospheric temperatures would reduce. Ben Zibble – Shingles upon shingles – CC BY-NC-ND 2.0.
Another strategy is perhaps delightfully simple: turn rooftops and paved surfaces white! In many US cities, roofs of houses, high-rises, and other buildings are covered with dark asphalt shingles. Dark surfaces trap heat from the sun and promote higher air temperatures. Painting roofs white or using white shingles to reflect the sun’s heat would reduce these temperatures and help offset the effects of global warming (Levinson et al., 2010; Lomborg, 2010). A similar offset would occur from changing the color of our streets. Many roads in cities and other areas are composed of dark asphalt; using a lighter material would also help reduce air temperature and counter global warming. If these measures reduced air temperature in warm cities, less air conditioning would be needed. In turn, electricity use and carbon dioxide emissions would also decline.
To repeat what was said at the outset of this chapter, it is no exaggeration to say that the fate of our planet depends on the successful implementation of these and other strategies and policies. Because, as sociology emphasizes, the environmental problems that confront the world are the result of human activity, changes in human activity are necessary to save the environment.
Key Takeaways
• Efforts to address population issues should focus on the various inequalities that lead to both overpopulation and food scarcity.
• Efforts to improve the environment should keep in mind the greater environmental harm that the poor and people of color suffer.
For Your Review
1. If you had a million dollars to spend to address one population problem, would you use it to provide contraception, or would you use it to improve the distribution of food? Explain your answer.
2. Which one of the environmental problems discussed in the text concerns you the most? Why?
22.6 End-of-Chapter Summary
Summary
1. Functionalism stresses the value of normal changes in population growth and the environment, but recognizes that certain population and environmental problems are dysfunctional. Conflict theory stresses that world hunger stems from lack of access to food, not from overpopulation, and it blames multinational corporations for environmental problems. Symbolic interactionism emphasizes people’s activities and perceptions in regard to population and the environment.
2. Demography is the study of population. It encompasses three central concepts—fertility, mortality, and migration—which together determine population growth.
3. The world’s population is growing by about 80 million people annually. Population growth is greatest in the low-income nations of Africa and other regions, while in several industrial nations it is declining.
4. Thomas Malthus predicted that the earth’s population would greatly exceed the world’s food supply. Although his prediction did not come true, hunger remains a serious problem around the world. Food supply is generally ample thanks to improved technology, but the distribution of food is inadequate in low-income nations.
5. Demographic transition theory helps explain why population growth did not continue to rise as much as Malthus predicted. As societies become more technologically advanced, first death rates and then birth rates decline, leading eventually to little population growth.
6. US history is filled with prejudice against immigrants. Immigrants today contribute in many ways to the American economy and have relatively low crime rates. Despite these facts, many people are opposed to immigration, and many states have passed laws to restrict benefits and movement for immigrants.
7. Environmental sociology is the sociological study of the environment. One major emphasis of environmental sociology is that environmental problems are largely the result of human activity and human decision making. A second major emphasis is that environmental problems disproportionately affect low-income people and people of color. These effects are called environmental inequality and environmental racism, respectively.
8. Environmental problems include climate change, air and water pollution, and hazardous waste. Children are particularly vulnerable to the health effects of environmental problems.
Using What You Know
You are in your second year in the accounting division of a large company that operates a factory on the main river in a small town. One day you notice some financial documents. These documents suggest to you that your company has been dumping a toxic solvent into the river rather than having it collected and taken to a safe site. Having had an environmental sociology course in college, you are very concerned about this possible problem, but you are not certain that the dumping is in fact occurring, and you also do not want to lose your job. Do you take any action related to your new suspicion of the possible dumping, or do you remain silent? Explain your answer.
What You Can Do
To help deal with the population and environmental problems discussed in this chapter, you may wish to do any of the following:
1. Contribute money to a national environmental organization or join a local environmental group in your activity.
2. Start an organization on your campus to deal with world hunger.
3. Organize speaker series on your campus to various environmental topics.
Attribution
Adapted from Chapter 15 from Social Problems by the University of Minnesota under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/07%3A_Perspectives_on_Communities/22%3A_Population_and_the_Environment.txt |
Learning Objectives
• Define Smart Growth and discuss how it impacts community development and renewal.
• Define New Urbanism and discuss how it impacts community development and renewal.
• Explain how identifying different forms of capital in a community is necessary for comprehensive community development and renewal.
23.1 Introduction
Social Problems in the News
“Downtown Decay Poses Problem for Community,” the headline said. The downtown district of Charleston, South Carolina, has some of the most beautiful older homes in the country, but it also has its share of dilapidated housing. According to the news article, “There are two distinct sides to downtown Charleston, the postcard-perfect homes and the crumbling, rundown houses. Dilapidated buildings near the crosstown aren’t just eyesores, they’re becoming safety hazards.” A neighborhood activist criticized city officials for ignoring the problem of rundown, dangerous houses. “It’s out of sight, out of mind,” he said. Ignoring this problem “wouldn’t happen in the tourist areas,” he added, “but why should it happen in the community where people live and work every day?”
Source: Davenport, 2012.
America’s cities are centers of culture, innovation, fine dining, world-class medical research, high finance, and so many other hallmarks. Yet, as this news story from Charleston reminds us, our cities also have dilapidated housing and many other problems. So do the nation’s rural areas. This chapter examines urban and rural problems in the United States.
We will see that many of these problems reflect those that earlier chapters discussed. But we will also see that some problems are worse in cities precisely because they are cities (and therefore are crowded with traffic and many buildings and people). And we’ll see that some problems are worse in rural areas precisely because they are rural (and therefore are isolated with long distances to travel). These defining features of cities and rural areas, respectively, should be kept in mind as we examine the problems occurring in these two important settings for American life.
23.2 A Brief History of Urbanization
One of the most significant changes over the centuries has been urbanization or the shift from rural areas to large cities. Urbanization has had important consequences for many aspects of social, political, and economic life (Kleniewski & Thomas, 2011).
The earliest cities developed in ancient times after the rise of horticultural and pastoral societies made it possible for people to stay in one place instead of having to move around to find food. Because ancient cities had no sanitation facilities, people typically left their garbage and human waste in the city streets or just outside the city wall (which most cities had for protection from possible enemies). This poor sanitation led to rampant disease and high death rates. Some cities eventually developed better sanitation procedures, including, in Rome, a sewer system. Still, the world remained largely rural until the industrialization of the nineteenth century. We return to industrialization shortly.
During the American colonial period, cities along the eastern seaboard were the centers of commerce and politics. Boston, New York, and Philadelphia were the three largest cities in population size. Yet they were tiny in comparison to their size today. In 1790, the year after George Washington became the first president of the new nation, New York’s population was only 33,131; Philadelphia’s was 28,522; and Boston’s was 18,230 (Gibson, 1998). Today, of course, cities of this size are called small towns. New York’s population is vastly higher, at about 8.2 million; Philadelphia’s is 1.5 million; and Boston’s is 618, 000.
US cities became more numerous and much larger during the nineteenth century because of two trends. The first was immigration, as waves of immigrants from Ireland and then Italy and other nations began coming to the United States during the 1820s. The second was industrialization, as people moved to live near factories and other sites of industrial production. These two trends were momentous: People crowded together as never before, and they crowded into living conditions that were often squalid. Lack of sanitation continued to cause rampant disease, and death rates from cholera, typhoid, and other illnesses were high.
Muckraker Lincoln Steffens wrote a classic work, The Shame of the Cities, that criticized the municipal corruption characterizing many US cities at the turn of the twentieth century. Wikimedia Commons – public domain.
Crime also became a significant problem, as did riots and other mob violence beginning in the 1830s. This type of mass violence was so common that the 1830s have been called the “turbulent era” (Feldberg, 1980). Most of this mass violence was committed by native-born whites against African Americans, Catholics, and immigrants. Native whites resented their presence and were deeply prejudiced against them. During the three decades beginning in 1830, almost three-fourths of US cities with populations above 20,000 had at least one riot. This wave of mass violence in the nation’s cities led Abraham Lincoln to lament, “Accounts of outrages committed by mobs form the everyday news of the times…Whatever their causes be, it is common to the whole country” (Barkan & Snowden, 2008, p. 34).
American cities grew even more rapidly after the Civil War as both industrialization and immigration continued. By the early years of the twentieth century, US cities on the East Coast were almost unimaginably crowded, and their living conditions continued to be wretched for many of their residents. Their city governments, police forces, and business worlds were also notoriously corrupt. In 1904, Lincoln Steffens, a renowned “muckraking” journalist, published his classic work, The Shame of the Cities (Steffens, 1904), which was a collection of six articles he had written for McClure’s Magazine. In this book, Steffens used biting prose to attack the municipal corruption of the times in Chicago, Philadelphia, St. Louis, and other cities. In the original articles that compose the book, he named names: He listed by name people who gave and received bribes and those who were corrupt in other ways. A decade earlier, another muckraker, Jacob Riis, had published How the Other Half Lives: Studies among the Tenements of New York (Riis, 1890), a book of searing photographs of poverty in the largest US city. The books by Steffens and Riis remain as vivid reminders of what cities were like a century ago and perhaps are still like today in some respects.
As Americans moved west after the Civil War and during the twentieth century, western cities appeared almost overnight and expanded the pace of urbanization. Continued industrialization, immigration, and general population growth further increased the number and size of US cities. Internal migration had a similar impact, as waves of African Americans moved from the South to Chicago and other northern cities.
Figure 14.1 Populations of Chicago, New York, and Los Angeles, 1790–2010
Note: New York annexed Brooklyn in 1898; therefore, New York’s population beginning in 1900 includes Brooklyn’s population. Sources: Gibson, C. (1998). Population of the 100 largest cities and other urban places in the United States: 1790–1990. Washington, DC: US Census Bureau; US Census Bureau. (2012). Statistical abstract of the United States: 2012. Washington, DC: US Government Printing Office. Retrieved from http://www.census.gov/compendia/statab.
Figure 14.1 “Populations of Chicago, New York, and Los Angeles, 1790–2010” depicts the growth of Chicago, New York, and Los Angeles from 1790 to 2010. Chicago and Los Angeles first appear in the graph when they began to rank in the largest one hundred cities.
Note that the populations of New York and Chicago show some decline after 1950. This decline reflects two other trends affecting cities in the past half-century: (1) the movement of people from cities to suburbs; and (2) the movement of Americans from northern cities to southern and southwestern cities. Reflecting this second trend, and also reflecting increases in immigration from Mexico and Asia, southern and southwestern cities have grown rapidly during the past few decades. For example, during the 1970–2010 period, the populations of Albuquerque, New Mexico, and Phoenix, Arizona, more than doubled, while the populations of Cleveland, Ohio, and Detroit, Michigan, both fell by about half (see Figure 14.2 “Population Change from 1970 to 2010 for Selected Cities”).
Figure 14.2 Population Change from 1970 to 2010 for Selected Cities
Source: US Census Bureau. (2012). Statistical abstract of the United States: 2012. Washington, DC: US Government Printing Office. Retrieved from http://www.census.gov/compendia/statab.
This trend in urbanization aside, the fact remains that the United States has become much more urbanized since its formation. Today, more than three-fourths of the US population lives in an urban area (defined generally as an incorporated territory with a population of at least 2,500), and less than one-fourth lives in a rural area. As Figure 14.3 “Urbanization in the United States (Percentage Living in Urban Areas)” shows, the degree of urbanization rose steadily through the nineteenth and twentieth centuries before slowing down by the end of the last century.
Figure 14.3 Urbanization in the United States (Percentage Living in Urban Areas)
Global Urbanization
If the United States has urbanized during the last two centuries, so has much of the rest of the world. Only 3 percent of the world’s population lived in urban areas in 1800. By a century later in 1900, 14 percent of the world’s population lived in urban areas, and twelve cities had populations over 1 million. Just a half-century later in 1950, the world’s urban population had doubled to 30 percent, and the number of cities over 1 million grew six times to eighty-three cities.
Today, more than half the world’s population lives in urban areas, and the number of cities over 1 million stands at more than four hundred. By 2030, almost two-thirds of the world’s population is projected to live in urban areas. The number of megacities—cities with populations over 10 million—rose from three in 1975 to sixteen in 2000, and is expected to reach twenty-seven by 2025 (Population Reference Bureau, 2012).
Despite all this growth, the degree of urbanization still varies around the world (see Figure 14.4 “Percentage of World Population Living in Urban Areas”). In general, wealthy nations are more urban than poor nations, thanks in large part to the latter’s rural economies. Still, urbanization in poor nations is proceeding rapidly. Most megacities are now in, and will continue to be in, nations that are relatively poor or desperately poor. The number of urban residents in these nations will increase greatly in the years ahead as people there move to urban areas and as their populations continue to grow through natural fertility. Fertility is a special problem in this regard for two reasons. First, women in poor nations have high fertility rates. Second, poor nations have very high proportions of young people, and these high rates mean that many births occur because of the large number of women in their childbearing years.
Figure 14.4 Percentage of World Population Living in Urban Areas
Rapid urbanization poses both opportunities and challenges for poor nations. The opportunities are many. Jobs are more plentiful in cities than in rural areas and incomes are higher, and services such as health care and schooling are easier to deliver because people are living more closely together. In another advantage, women in poor nations generally fare better in cities than in rural areas in terms of education and employment possibilities (United Nations Population Fund, 2011).
In large cities in poor nations, as this scene illustrates, many people live in deep poverty and lack clean water and sanitation. Wikimedia Commons – CC BY-SA 3.0.
But there are also many challenges. In the large cities of poor nations, homeless children live in the streets as beggars, and many people lack necessities and conveniences that urban dwellers in industrial nations take for granted. As the United Nations Population Fund (2007) warns, “One billion people live in urban slums, which are typically overcrowded, polluted and dangerous, and lack basic services such as clean water and sanitation.” The rapid urbanization of poor nations will compound the many problems these nations already have, just as the rapid urbanization in the industrial world more than a century ago led to the disease and other problems discussed earlier. As cities grow rapidly in poor nations, moreover, these nations’ poverty makes them ill-equipped to meet the challenges of urbanization. Helping these nations meet the needs of their cities remains a major challenge for the world community in the years ahead. In this regard, the United Nations Population Fund (2007) urges particular attention to housing: “Addressing the housing needs of the poor will be critical. A roof and an address in a habitable area are the first steps to a better life. Improving access to basic social and health services, including reproductive health care, for poor people in urban slums is also critical to breaking the cycle of poverty.”
Life in the megacity of Mumbai (formerly called Bombay) in India illustrates many of the problems facing large cities in poor nations. Mumbai’s population exceeds 12.4 million, with another 8 million living in the greater metropolitan area; this total of more than 20 million ranks Mumbai’s metropolitan population as the fourth highest in the world. An author who grew up in Mumbai calls his city an “urban catastrophe.” He continued, “Bombay is the future of urban civilization on the planet. God help us” (Kotkin, 2011). A recent news story illustrated his bleak assessment with this description of life in Mumbai: “The majority of Mumbai’s population now lives in slums, up from one-sixth in 1971—a statistic that reflects a lack of decent affordable housing, even for those gainfully employed. Congested, overcrowded, and polluted, Mumbai has become a difficult place to live. The life expectancy of a Mumbaikar is now seven years shorter than an average Indian’s, a remarkable statistic in a country still populated by poor villagers with little or no access to health care” (Kotkin, 2011).
Key Takeaways
• US cities grew rapidly during the nineteenth century because of industrialization and immigration.
• The United States is now a heavily urbanized society, whereas it was largely a rural society just a century ago.
• Urbanization poses special challenges for poor nations, which are ill-equipped to address the many problems associated with urbanization.
For Your Review
1. Write an essay in which you discuss the advantages and disadvantages of urbanization.
2. If you had your preference, would you want to live in a large city, small city or town, or rural area? Explain your answer.
23.3 Sociological Perspectives on Urbanization
Once again the three major sociological perspectives offer important but varying insights to help us understand urbanization. Table 14.1 “Theory Snapshot” summarizes their assumptions.
Table 14.1 Theory Snapshot
Theoretical perspective Major assumptions
Functionalism Cities serve many important functions for society but also have their dysfunctions. Functionalist theorists differ on the relative merits and disadvantages of urban life, and in particular on the degree to which a sense of community and social bonding exists within cities.
Conflict theory Cities are run by political and economic elites that use their resources to enrich their positions and to take resources from the poor and people of color. The diversity of social backgrounds found in cities contributes to conflict over norms and values.
Symbolic interactionism City residents differ in their types of interaction and perceptions of urban life. Cities are not chaotic places but rather locations in which strong norms and values exist.
Functionalism
A basic debate within the functionalist perspective centers on the relative merits of cities and urbanization: In what ways and to what extent are cities useful (functional) for society, and in what ways and to what extent are cities disadvantageous and even harmful (dysfunctional) for society? Put more simply, are cities good or bad?
In essence, there is no one answer to this question, because cities are too complex for a simple answer. Cities are both good and bad. They are sites of creativity, high culture, population diversity, and excitement, but they are also sites of crime, impersonality, and other problems.
Since sociologists began studying urbanization in the early years of the discipline, an important question has been the degree to which cities are impersonal and alienating for their residents. In 1887, German sociologist Ferdinand Tönnies (1887/1963) raised this question when he wrote about the changes that occurred as societies changed from small, rural, and traditional cultures to larger, urban, and industrial settings. He said that a sense of community, or Gemeinschaft, characterizes traditional societies. In these societies, family, kin, and community ties are quite strong, with people caring for each other and looking out for one another. As societies grew and industrialized and as people moved to cities, he wrote, social ties weakened and became more impersonal. Tönnies called this type of society a Gesellschaft, and he was quite critical of this development. He lamented the loss in urban societies of close social bonds and of a strong sense of community, and he feared that a sense of rootlessness in these societies begins to replace the feeling of stability and steadiness characteristic of small, rural societies.
One of the key founders of sociology, French scholar Émile Durkheim, was more positive than Tönnies about the nature of cities and urbanized societies. He certainly appreciated the social bonds and community feeling, which he called mechanical solidarity, characteristic of small, rural societies. However, he also thought that these societies stifled individual freedom and that social ties still exist in larger, urban societies. He called these latter ties organic solidarity, which he said stems from the division of labor. When there is a division of labor, he wrote, everyone has to depend on everyone else to perform their jobs. This interdependence of roles creates a solidarity that retains much of the bonding and sense of community found in small, rural societies (Durkheim, 1893/1933).
Contemporary research tends to emphasize that strong social bonds do exist in cities (Guest, Cover, Matsueda, & Kubrin, 2006). Although cities can be anonymous (think of the mass of people walking by each other on a busy street in the downtown area of a large city), many city residents live in neighborhoods where people do know each other, associate with each other, and look out for each other. In these neighborhoods, a sense of community and strong social bonds do, in fact, exist.
In many urban neighborhoods, people are friendly with each other and feel a strong sense of community. Wikimedia Commons – CC BY 3.0.
In 1938, the University of Chicago sociologist Louis Wirth wrote a very influential essay, “Urbanism as a Way of Life,” in which he took both a positive and a negative view of cities (Wirth, 1938). He agreed with Tönnies that cities have a weaker sense of community and weaker social bonds than do rural areas. But he also agreed with Durkheim that cities generate more creativity and greater tolerance for new ways of thinking. In particular, he said that urban residents are more tolerant than rural residents of nontraditional attitudes, behaviors, and lifestyles, in part because they are much more exposed than rural residents to these nontraditional ways. Supporting Wirth’s hypothesis, contemporary research finds that urban residents indeed hold more tolerant views on several kinds of issues (Moore & Ovadia, 2006).
An example of the greater tolerance of urban residents (and thus the lower tolerance of rural residents) appears in Figure 14.5 “Urban/Rural Residence and Belief That Premarital Sex Is “Always Wrong” (%)”, which depicts the percentage of Americans in the nation’s twelve largest metropolitan areas and in its rural areas who say that premarital sex is “always wrong.” Rural residents are twice as likely as urban residents to feel this way.
Figure 14.5 Urban/Rural Residence and Belief That Premarital Sex Is “Always Wrong” (%)
Source: Data from General Social Survey. (2010). Retrieved from http://sda.berkeley.edu/cgi-bin/hsda?harcsda+gss10.
Conflict Theory
We just saw that functionalism has mixed views about the benefits and disadvantages of cities and urban life and thus of urbanization. In contrast to this ambivalence, conflict theory’s views are uniformly critical. In this regard, recall from Chapter 1 “Understanding Social Problems” that conflict theory assumes a basic conflict between society’s “haves” and “have-nots,” or between the economic and political elites and the poor and people of color. This type of conflict, says conflict theory, manifests itself, especially in the nation’s cities, in which the “haves” and “have-nots” live very different lives. On the one hand, the rich in American cities live in luxurious apartments and work in high-rise corporate buildings, and they dine at the finest restaurants and shop at the most expensive stores. On the other hand, the poor and people of color live in dilapidated housing and can often barely make ends meet.
Beyond this basic disparity of city life, conflict theorists add that the diverse backgrounds and interests of city residents often lead to conflict because some residents’ beliefs and practices clash with those of other residents. In one of the earliest statements of this position, sociologist Thorsten Sellin (1938), who was writing during an era of mass immigration into American cities of people from other nations, said that crime is the result of “culture conflict.” In particular, he wrote that crime by immigrants often results from the clash of their traditional ways of thinking and acting with the norms of American society. As one example, he wrote that a father in New Jersey who had emigrated from Sicily killed a teenage boy who had slept with his daughter. The father was surprised when he was arrested by local police because in the traditional Sicilian culture a man was permitted and even expected to defend his family’s honor by acting as the father did!
More recent applications of conflict theory to urbanization emphasize the importance of political economy, or the interaction of political and economic institutions and processes. In this way of thinking, political and economic elites in a city (bankers, real estate investors, politicians, and others) collaborate to advance their respective interests. Thus urban development often takes the form of displacing poor urban residents from their homes so that condominiums, high-rise banks, and other corporate buildings, posh shopping malls, or other buildings favoring the rich can be built. More generally, these elites treat cities as settings for the growth of their wealth and power, rather than as settings where real people live, go to school, work at a job, and have friends and acquaintances. Sociologists John Logan and Harvey Molotch use the term growth machine ideology to characterize the view of the city that guides these elites’ policies and practices (Logan & Molotch, 2007).
Symbolic Interactionism
Consistent with the overall approach of symbolic interactionism, scholars of the city who take this approach focus on the nature of urban residents’ interaction with each other, the reasons for their patterns of interaction, and their perceptions of various aspects of urban life. Their work has yielded many rich, vivid descriptions of urban life. Many and probably most of these accounts have concerned the lives of the poor and of people of color. The late Elliott Liebow wrote two of the most famous accounts. The first of these two was his majestic Tally’s Corner (Liebow, 1967), which depicted the lives of African American men who “hung around” a particular street corner in a large city. His second account was Tell Them Who I Am: The Lives of Homeless Women (Liebow, 1993), which, as its title implies, depicted the lives of urban homeless women. Yet another classic account is William Foote Whyte’s (1943) Street Corner Society, which examined leadership in a street gang in Chicago, Illinois.
These and other accounts all depict cities as places where various norms and values prevail, in contrast to views of cities that depict them as wild, chaotic places. Building on these more positive accounts, recent work by sociologist Elijah Anderson emphasizes that most poor urban residents are “decent” (as they call themselves), law-abiding people who strongly disapprove of the crime and drug use in their neighborhoods (Anderson, 2000). He also emphasizes that cities are filled with parks and other public settings in which people from different racial and socioeconomic backgrounds gather every day and interact in various ways that help foster interracial understanding. Anderson calls these settings “cosmopolitan canopies,” and says they “offer a respite from the lingering tensions of urban life and an opportunity for diverse peoples to come together…Through personal observation, they may come casually to appreciate one another’s differences and empathize with the other in a spirit of humanity” (Anderson, 2011, pp. xiv-xv). In this manner, writes Anderson, people from different races can at least partly overcome the racial tensions that afflict many American cities.
Types of Urban Residents
Other work in the symbolic interactionist tradition seeks to understand the different lifestyles of city residents. Sociologist Herbert Gans (1982) authored a classic typology of urban residents based on their differing lifestyles and experiences. Gans identified five types of city residents.
Herbert Gans identified several types of city residents. One of these types is the cosmopolites, who include students, writers, musicians, and intellectuals, all of whom live in a city because of its cultural attractions and other amenities. Brian Evans – Street Musician – CC BY-ND 2.0.
The first type is cosmopolites. These are people who live in a city because of its cultural attractions, restaurants, and other features of the best that a city has to offer. Cosmopolites include students, writers, musicians, and intellectuals. Unmarried and childless individuals and couples are the second type; they live in a city to be near their jobs and to enjoy the various kinds of entertainment found in most cities. If and when they marry or have children, respectively, many migrate to the suburbs to raise their families. The third type is ethnic villagers, who are recent immigrants and members of various ethnic groups who live among each other in certain neighborhoods. These neighborhoods tend to have strong social bonds and more generally a strong sense of community. Gans wrote that all these three types generally find the city inviting rather than alienating and have positive experiences far more often than negative ones.
In contrast, two final types of residents find the city alienating and experience a low quality of life. The first of these two types, and the fourth overall, is the deprived. These are people with low levels of formal education who live in poverty or near poverty and are unemployed, are underemployed, or work at low wages. They live in neighborhoods filled with trash, broken windows, and other signs of disorder. They commit high rates of crime and also have high rates of victimization by crime. The final type is the trapped. These are residents who, as their name implies, might wish to leave their neighborhoods but are unable to do so for several reasons: they may be alcoholics or drug addicts, they may be elderly and disabled, or they may be jobless and cannot afford to move to a better area.
In thinking about this typology, it is important to keep in mind that city residents’ social backgrounds—their social class, race/ethnicity, gender, age, and sexual orientation—all influence the kind of lifestyle they tend to adopt and thus the type of resident they are according to the typology. As earlier chapters documented, these dimensions of our social backgrounds often yield many kinds of social inequalities, and the quality of life that city residents enjoy depends heavily on these dimensions. For example, residents who are white and wealthy have the money and access to enjoy the best that cities have to offer, while those who are poor and of color typically experience the worst aspects of city life. Because of fear of rape and sexual assault, women often feel more constrained than men from traveling freely throughout a city and being out late at night; older people also often feel more constrained because of physical limitations and fear of muggings, and gays and lesbians are still subject to physical assaults stemming from homophobia. The type of resident we are, then, in terms of our sociodemographic profile affects what we experience in the city and whether that experience is positive or negative.
Key Takeaways
• Functionalism offers both a positive and a negative view of urbanization. Functionalist sociologists differ on the degree of social solidarity that exists in cities.
• According to conflict theory, economic and political elites use their resources to develop cities in a way that benefits them. The diverse social backgrounds of urban residents also contribute to certain types of conflict.
• According to symbolic interactionism, social inequality based on social class, race/ethnicity, gender, age, and sexual orientation affects the quality of urban experiences. In addition to differences in their sociodemographic profiles, city residents differ in other ways. Herbert Gans identified several types of urban dwellers: cosmopolites, unmarried and childless, ethnic villagers, deprived and trapped.
For Your Review
1. Write an essay that summarizes the assumptions of any two of the major sociological perspectives on urbanization.
2. Which of the three perspectives makes the most sense to you? Why?
23.4 Problems of Urban Life
Life in US cities today is certainly complex. On the one hand, many US cities are vibrant places, filled with museums and other cultural attractions, nightclubs, theaters, and restaurants and populated by people from many walks of life and from varied racial and ethnic and national backgrounds. Many college graduates flock to cities, not only for their employment opportunities but also for their many activities and the sheer excitement of living in a metropolis.
On the other hand, many US cities are also filled with abject poverty, filthy and dilapidated housing, high crime rates, traffic gridlock, and dirty air. Many Americans would live nowhere but a city and many would live anywhere but a city. Cities arouse strong opinions, pro, and con because there are many things both to like and to dislike about cities.
By definition, cities consist of very large numbers of people living in a relatively small amount of space. Some of these people have a good deal of money, but many people, and in some cities most people, have very little money. Cities must provide many kinds of services for all their residents, and certain additional services for their poorer residents. These basic facts of city life make for common sets of problems affecting cities throughout the nation, albeit to varying degrees, with some cities less able than others to address these problems. This section examines several of these problems.
Fiscal Problems
One evident problem is fiscal: Cities typically have serious difficulties in paying for basic services such as policing, public education, trash removal, street maintenance, and snow removal (at least in cold climates), and in providing certain services for their residents who are poor or disabled or who have other conditions. The fiscal difficulties that cities routinely face became even more serious with the onset of the nation’s deep recession in late 2007, as the term fiscal crisis was used again and again to describe the harsh financial realities that cities continued to face even after the recession officially ended in mid-2009 (McNichol, 2009).
In early 2012, almost three years after the United States officially emerged from the recession, this fiscal crisis persisted. The mayor of Syracuse, New York, announced that her city faced a budget deficit of \$16 million and called its fiscal problems “staggering” (Knauss, 2012). Mayors in Rhode Island told their governor that their cities need fiscal aid from the state to prevent them from having to declare bankruptcy. One of the mayors said, “We all have the same issues. Something has to be done this year. We cannot have a study commission. We cannot say ‘we’ll wait until 2013 or 2014.’ This is do or die” (Klepper, 2012). Detroit, Michigan, was in danger of running out of money altogether and being taken over by its state government. The member of the US House of Representatives who represents Detroit said he was seeking aid from the federal government: “Bottom line, I’m asking for federal aid to avoid massive layoffs, especially for our public safety workers. That’s what we actually need to attract businesses here who create jobs. We need safe streets and we need good schools” (Oosting, 2012).
In response to financial problems in these and other cities across the nation, the US Conference of Mayors urged Congress in early 2012 to provide several kinds of aid to cities, including low-interest loans for local rail and road projects and funding for housing and job training for low-income residents (United States Conference of Mayors, 2012).
Applying Social Research
Urban Neighborhoods and Poor Health
Social scientists have long thought that poor urban neighborhoods pose, in and of themselves, significant health risks for their residents. These neighborhoods lack supermarkets with fresh fruits and vegetables, and they lack safe parks and other settings for exercise. They are also neighborhoods with high crime rates and thus much stress. For all these reasons, they should impair the physical health of their residents. Reflecting this argument, the residents of poor urban neighborhoods do, in fact, exhibit significant health problems compared to the residents of wealthier neighborhoods.
Although this argument might sound compelling, the residents of poor and wealthier neighborhoods might differ in other ways that affect their respective health. For example, people living in wealthier neighborhoods are generally more educated and more conscious of taking care of their health. If their health then is better than that of their counterparts in poor neighborhoods, it is difficult to know how much the neighborhood setting itself plays a role in the health of residents.
For this reason, a recent study of a real-life experiment provided compelling evidence of the importance of the quality of a neighborhood for one’s health. In the 1990s, the federal government conducted an experiment in which 1,800 poor urban women were randomly selected and, with their permission, assigned to move from their neighborhoods to wealthier neighborhoods. The women were studied a decade after they moved. In particular, they were weighed and had their blood checked for evidence of diabetes. Their results were then compared to women in their original neighborhoods who were not selected to move away. The women who did move away ended up with somewhat lower rates of diabetes and obesity than those who stayed behind.
The experimental design of this study allowed the researchers to conclude that the change in neighborhoods was the reason for their improvement in these two health measures. Reflecting this conclusion, the secretary of the US Department of Housing and Urban Development said, “This study proves that concentrated poverty is not only bad policy, it’s bad for your health.” A news report observed that the results of this study “offered some of the strongest support yet for the idea that where you live can significantly affect your overall health, especially if your home is in a low-income area.”
The results of this experimental study underscore the need to improve the living conditions of poor urban neighborhoods, as these conditions affect many life outcomes of the adults and children who live in them.
Sources: Ludwig et al., 2011; Stobbe, 2011
Crowding
Cities experience many kinds of problems, and crowding is one of them. People who live amid crowding are more likely to experience stress and depression and to engage in aggressive behavior or be victimized by it. Stròlic Furlàn – Davide Gambino – Lots of people – CC BY-ND 2.0.
Another problem is crowding. Cities are crowded in at least two ways. The first involves residential crowding: large numbers of people living in a small amount of space. City streets are filled with apartment buildings, condominiums, rowhouses, and other types of housing, and many people live on any one city block. Residential crowding is perhaps the defining feature of any large city. In this regard, let’s compare the Manhattan borough of New York City with the state of Idaho. Roughly 1.6 million people live in each location. However, in Manhattan, they are packed into only about 24 square miles, while in Idaho they live within 84,000 square miles. Manhattan’s population density, the number of people per square mile, is 68,000 people per square mile; Idaho’s population density is only about 19 people per square mile. Population density in Manhattan is thus 3,579 times (68,000 ÷ 19) greater than in Idaho.
New York is incredibly crowded, but other cities are also very crowded. Chicago’s population density, for example, exceeds 12,200 persons per square mile, while even a smaller city like Cincinnati (population 331,000) has a population density of 4,700 persons per square mile. Even a much smaller city like Ames, Iowa (population 51,000) has a population density of 2,360 persons per square mile. Population density in the small city of Ames is still 124 times greater than in the entire state of Idaho. Residential crowding is thus very high in almost any city in the United States compared to a rural area.
The second type of crowding is household crowding: Dwelling units in cities (apartments and houses) are typically small because of lack of space, and much smaller overall than houses in suburbs or rural areas. This forces many people to live in close quarters within a particular dwelling unit, especially if they are low-income individuals or families.
Some research finds that either type of crowding produces higher levels of stress, depression, aggression, and crime. Here an interesting gender difference may exist (Regoeczi, 2008): Household crowding may produce depression in women but not men, and aggression in men but not women.
Although crowding of both types is a problem, then, there is little that cities can do to reduce crowding. This fact underscores the need to undertake other efforts that might address the various consequences of residential and household crowding. In this regard, “Crime and Criminal Justice” outlines several efforts to help reduce crime and delinquency.
Housing
A third problem involves housing. Here there are several related issues. Much urban housing is substandard, as this chapter’s opening news story illustrated, and characterized by such problems as broken windows, malfunctioning heating systems, peeling lead paint, and insect infestation.
At the same time, adequate housing is not affordable for many city residents, as housing prices in cities can be very high, and usually higher than in rural areas, and the residents’ incomes are typically very low. Cities thus have a great need for adequate, affordable housing. According to the US Department of Housing and Urban Development (2012), housing is affordable when a household pays no more than 30 percent of its annual income on housing. Low-income households that must spend more than this benchmark may be unable to afford clothing, food, health care, and transportation. Yet 12 million US households pay more than half their annual incomes for housing.
Another housing issue concerns racial segregation. Although federal law prohibits segregated housing, cities across the country are nonetheless highly segregated by race, with many neighborhoods all or mostly African American. In a widely cited book, sociologists Douglas S. Massey and Nancy A. Denton (1993) termed this situation “American apartheid.” They said that these segregated neighborhoods result from a combination of several factors, including (a) “white flight” into suburbs, (b) informal—and often illegal—racially discriminatory actions that make it difficult for African Americans to move into white neighborhoods (such as real estate agents falsely telling black couples that no houses are available in a particular neighborhood), and (c) a general lack of income and other resources that makes it very difficult for African Americans to move from segregated neighborhoods.
Massey and Denton argued that residential segregation worsens the general circumstances in which many urban African Americans live. Several reasons account for this effect. As whites flee to the suburbs, the people left behind are much poorer. The tax base of cities suffers accordingly, and along with it the quality of city schools, human services, and other social functions. All these problems help keep the crime rate high and perhaps even raise it further. Because segregated neighborhoods are poor and crime-ridden, businesses do not want to invest in them, and employment opportunities are meager. This fact worsens conditions in segregated neighborhoods even further. Consequently, concluded Massey and Denton, racial segregation helps to keep very poor people living in deep poverty and decaying neighborhoods.
Other research supports this conclusion. As a review of the research evidence summarized this situation, “Whether voluntary or involuntary, living in racially segregated neighborhoods has serious implications for the present and future mobility opportunities of those who are excluded from desirable areas. Where we live affects our proximity to good job opportunities, educational quality, and safety from crime (both as victim and as perpetrator), as well as the quality of our social networks” (Charles, 2003, pp. 167–168).
Against this pessimistic backdrop, it is worth noting that neighborhood segregation in US cities is somewhat less extensive now than four decades ago, thanks in part to fair-housing legislation enacted during the 1960s (Roberts, 2012). Despite this bit of progress, racial discrimination in the housing market continues (see “Racial and Ethnic Inequality”), and most African Americans still live in neighborhoods that are heavily populated by African Americans and hence racially segregated (Logan & Stults, 2011). One demographer summarizes this “good news, bad news” situation as follows: “There is now very much more black-white neighborhood integration than 40 years ago. Those of us who worked on segregation in the 1960s never anticipated such declines. Nevertheless, blacks remain considerably more segregated from whites than do Hispanics or Asians” (Roberts, 2012, p. A13).
To improve the socioeconomic status and living circumstances of African Americans, then, it is critical that residential segregation be reduced. Although Latinos live in segregated neighborhoods to a smaller degree, reducing segregation would also help their circumstances.
Children and Our Future
The Plight of Homeless Children
The faltering economy and wave of home foreclosures of the past few years resulted in what has been called a “national surge” of homeless children. The number of children who are homeless at least part of the year now reaches more than 1.6 million annually, equal to more than 2 percent of all American children. Because of their circumstances, they are at greater risk than their housed peers for hunger, asthma, and other chronic health conditions, and stress and emotional problems.
They are at also greater risk for poor school performance. Amid the surge in children’s homelessness, the nation’s schools marshaled their resources to help their homeless children. An official with a private charity that helps poor families pointed out the obvious problem: “It’s hard enough going to school and growing up, but these kids also have to worry where they’ll be staying that night and whether they’ll eat. We see 8-year-olds telling Mom not to worry, don’t cry.”
School districts began sending special buses to homeless shelters, motels, and other settings for homeless children and their parents so that the children could continue attending their regular school. They also assigned social workers to help homeless families and other personnel to bring them school supplies, to drive them to look at shelters where they could live and to perform other tasks. Federal legislation in fact requires schools to take extra measures to help homeless children, but school superintendents say that the federal government has not provided them the necessary funds to carry out the intent of the legislation. This lack of funding adds to their school districts’ already dire financial situation.
Charity Crowell, age 9, was just one of the hundreds of thousands of homeless children the schools were trying to help. During the semester her family became homeless, her grades fell to C’s from her usual high standard. One reason was that she had trouble staying awake in class. She explained why: “I couldn’t go to sleep, I was worried about all the stuff.”
Another homeless student, Destiny Corfee, age 11, became homeless after her parents lost both their jobs and then their house and had to move into their van. The family then parked the van at a Wal-Mart so that their children could go into the store and clean themselves before they went to school. Recalling life in the van, Destiny said, “I was embarrassed that maybe one of my friends might see me. I don’t want anybody to know that I was actually in there.”
Sources: Bassuk, Murphy, Coupe, Kenney, & Beach, 2011; Eckholm, 2009; Pelley, 2011
Homelessness
A related problem to housing is homelessness. In cities throughout the United States, men, women, and children live in the streets, abandoned vehicles or houses, cheap motels, or trailers, or living in someone else’s home temporarily. In cities with cold climates, homelessness can be life-threatening during the winter. But regardless of climate, the homeless are in a dire situation. Some research finds that one-third of the homeless are victims of violence or theft during the year; this rate of victimization is four times higher than that in the general population (Wenzel, Leake, & Gelberg, 2001). Homeless shelters provide some relief against crime, hunger, and the many other problems arising from homelessness, but too few shelters exist to meet the demand, and those that do exist are underfunded.
Homelessness is a major problem in many cities. The federal government estimates that 650,000 Americans are homeless on any given night. Gilbert Mercier – Homeless in America Los Angeles 1989 – CC BY-NC-ND 2.0.
As should be clear, the problem of homelessness cannot be understood from the problem of poverty (see “Poverty”). Wealthy families that lose their homes, as after a fire, usually can expect to find suitable temporary lodging and have their homeowners’ insurance pay for a new home (Lee, Tyler, & Wright, 2010). Poor families who can no longer pay their rent or mortgage payments face eviction and homelessness from which they find it difficult to recover.
It is rather difficult to determine the actual number of homeless persons (Lee et al., 2010). For example, if a family is living literally in the streets, we would all agree they are homeless. But if they are living in an abandoned building or in a cheap motel, should they be considered homeless? Even with an adequate definition of homelessness, it is difficult to actually count the number of homeless persons because it is very difficult to find them all. For example, if researchers count all the homeless people who use all the shelters in a city within a given time period, they still fail to count the homeless people who do not come to a shelter.
Keeping these definitions and measurement problems in mind, it is nonetheless worth noting that the federal government estimates 650,000 Americans to be homeless on any given night, and 1.6 million to use a shelter or other transitional housing annually (Lee et al., 2010). Because people move in and out of homelessness, the number of people who are homeless at least part of the year is undoubtedly much higher. National survey evidence suggests that 14 percent of Americans have been homeless at least once in their lives, a figure much higher than that in most European nations (Lee et al., 2010).
The US Conference of Mayors (2011) compiled information on homelessness in twenty-nine cities across the country. This large study yielded the following profile of homeless adults:
• 26% with severe mental illness
• 16% physically disabled
• 15% employed
• 13% victims of domestic violence
• 13% military veterans
• 4% HIV positive
As this profile suggests, the homeless population is at much greater risk for a variety of physical and mental health problems and other difficulties (Lee et al., 2010). In particular, they are much more likely than housed Americans to experience hunger and food insecurity, and they are up to twenty times more likely to suffer from chronic illnesses such as hepatitis, high blood pressure, tuberculosis, and vascular disease. On average, homeless adults die by their mid-fifties, about twenty years shorter than the average life span of housed adults.
Traffic and Transportation
A fifth problem of city life is traffic and transportation. For better or worse, a fact of city life that arises from the defining feature of cities—many people living in a relatively small area—is that many people need to travel to get to work or school and to visit stores, museums, and any number of other leisure-time settings. Someone living in a rural area is probably able to drive ten miles to work in no longer than twenty minutes, but someone living in an urban area may easily take an hour or longer to travel the same distance after crawling along in traffic and stopping at light after light, or sitting and crawling along in long miles of traffic on an urban highway.
Traffic is a major problem in cities. The great number of motor vehicles in a relatively small space often leads to gridlock and contributes greatly to air pollution. joiseyshowaa – World Class Traffic Jam 2 – CC BY-SA 2.0.
One manifestation of the traffic problem in cities is traffic gridlock when traffic in all directions is barely moving or not moving at all. Gridlock occurs in urban areas, not rural ones, because of the sheer volume of traffic and the sheer number of intersections controlled by traffic lights or stop signs. Some cities have better public transportation than others, but congested traffic and time-consuming commuting are problems that urban residents experience every day (see “Lessons from Other Societies”).
Lessons from Other Societies
Making Drivers Miserable to Reduce Traffic Congestion
One of the costs of urbanization and modern life is traffic. Urban streets and highways are clogged with motor vehicles, and two major consequences of so much traffic are air pollution and tens of thousands of deaths and injuries from vehicular accidents. To reduce city traffic, many European cities are trying to make driving so burdensome that commuters and other drivers will seek other forms of transportation. As a recent news story summarized this trend, these cities are “creating environments openly hostile to cars. The methods vary, but the mission is clear: to make car use expensive and just plain miserable enough to tilt drivers toward more environmentally friendly modes of transportation.”
For example, Copenhagen, Munich, and Vienna have banned cars on many streets. Barcelona and Paris have replaced car lanes with bicycle lanes. London and Stockholm now require drivers entering their downtowns to pay a heavy toll charge. Many German cities restrict parts of their downtowns to cars that meet certain limits on carbon dioxide emissions. Other European cities have sharply limited the number of parking spaces at shopping malls and other areas, and they have also eliminated on-street parking.
This European strategy to relieve traffic congestion differs greatly from the strategy the United States uses. As a European environmental official explained this difference, “In the United States, there has been much more of a tendency to adapt cities to accommodate driving. Here there has been more movement to make cities more livable for people, to get cities relatively free of cars.”
Zurich, the largest city in Switzerland, has made special efforts to “torment drivers,” said the news story, in the hope that drivers will seek other modes of transportation. For example, it added more traffic lights to cause more traffic delays, and it shortened the length of green lights and lengthened red lights. It also banned cars in one of its busiest downtown areas and elsewhere imposed speed limits of just a few miles an hour so that pedestrians are free to cross the street whenever they want. Although store owners in Zurich worried that they would lose business after their streets were closed to traffic, that effect has not happened because pedestrian traffic increased.
Observing traffic inching through hundreds of pedestrians and bicyclists, a Zurich traffic official was happy. “Driving is a stop-and-go experience,” he said. “That’s what we like! Our goal is to reconquer public space for pedestrians, not to make it easy for drivers.”
In contrast, most American cities have tried to make it easier for drivers through such measures as synchronizing green lights and developing apps to help drivers find parking. However, these measures do not reduce the number of cars and do little to relieve traffic congestion. Instead, they tend to make it more likely that people will want to drive in downtown areas. In contrast, Europe has tried to relieve traffic congestion by reducing the number of cars. Its model offers more potential for reducing pollution and other problems caused by traffic, and it is one that the United States should adopt.
Source: Rosenthal, 2011
To help reduce traffic congestion, cities long ago developed various means of public transportation: buses, subways, and light rail. Some cities have better public transportation than other cities; Los Angeles has a notoriously bad reputation for the quality of its public transportation. Yet residents of cities with relatively good public transportation still experience severe traffic congestion, long commutes, and related problems: It is estimated that the average Chicago commuter spends seventy hours per year just sitting in traffic jams (Greenfield, 2011). Public transportation is sometimes faster than commuting by car or SUV but can still be very time-consuming. People who take a bus or other public transportation can easily spend an hour or more, depending on how far they have to travel and the quality of their city’s transportation system, traveling to a bus or train station, waiting for their transportation, making any necessary connections, and then traveling to their workplace.
One consequence of traffic congestion is stress. As one mental health expert observed, “Commuters can experience greater stress than fighter pilots in battle” (Greenfield, 2011). Another consequence is huge financial costs. Sitting in traffic wastes both time and fuel. The Texas Transportation Institute (TTI), perhaps the leading scholarly unit for the study of traffic problems, estimates that traffic congestion costs the nation \$115 billion annually in wasted time and fuel, or \$713 for every auto commuter. Traffic congestion wastes 4.8 billion hours and 1.9 billion gallons of gasoline annually, an amount that would fill more than 200,000 gasoline tank trucks (Schrank, Lomax, & Eisele, 2011). To relieve traffic congestion, TTI recommends significant investments of public funds in public transportation and more efficient designs in private and public transportation systems such as the greater use of electronic toll taking and better timing of traffic lights to increase traffic flow.
Air Pollution
Traffic congestion and the sheer amount of traffic in cities also contribute mightily to air pollution, which we consider here as a separate urban problem. Traffic creates pollution from motor vehicles’ exhaust systems, and some cities have factories and other enterprises that also pollute. As a result, air quality in cities is substandard.
This poor air quality has significant health consequences, as it produces higher rates of respiratory and heart disease and higher mortality rates in cities (Stylianou & Nicolich, 2009). Because even fairly low levels of air pollution can have these health effects (Brunekreef, 2011), cities are unhealthy places and even deadly places for many people.
Both to increase their “carbon footprint” and to get some exercise, many urban residents bicycle in traffic to and from work or bicycle during their leisure time. Ironically, doing so subjects them to air pollution from the traffic surrounding them. This pollution has been shown to impair their cardiovascular and respiratory functioning (Weichenthal et al., 2011).
Because people of color disproportionately live in cities, urban air pollution affects them more than it affects white people. As “Health and Health Care” noted, this disparity is part of the larger problem of environmental racism. Cities are bad in many ways for their residents, and the air pollution of cities is bad for the health of their residents, who are overwhelmingly people of color in many cities.
If urban residents, in general, suffer health consequences from air pollution, these consequences are particularly serious and more common among children. Air pollution increases their rates of asthma and other respiratory diseases (Patel et al., 2011). These health problems, in turn, affect their school performance and can have other lifelong consequences.
Mental Health Problems
Our earlier discussions of crowding and of traffic congestion indicated that stress is one of the most important consequences of these two urban problems. Stress, in turn, impairs the mental health of urban residents. Much research finds that urban residents have worse mental health than rural residents. In particular, they have much higher levels of mood and anxiety disorders and schizophrenia (Lederbogen et al., 2011).
Public Education
Yet another issue for cities is the state of their public education. As “Schools and Education” emphasized, many city schools are housed in old buildings that, like much city housing, are falling apart. City schools are notoriously underfunded and lack current textbooks, adequate science equipment, and other instructional materials.
People Making a Difference
Working to Achieve Social Justice
Nancy Radner has been a tireless advocate for the homeless and for social justice more generally. From 2006 to 2012, she served as the head of the Chicago Alliance to End Homelessness, which works with eighty-four homeless service agencies and manages more than \$50 million in state and federal funding for homeless services. The Alliance also gathers and distributes various kinds of information on homelessness and coordinates political, educational, and public relations events to increase understanding of homelessness.
Before joining the Chicago Alliance, Radner was a program officer at the Corporation for Supportive Housing, a national organization that engages in many kinds of efforts aimed at helping the homeless and other low-income individuals find affordable housing. She also served as a staff attorney at the Legal Assistance Foundation of Chicago, where she specialized in housing law.
In 2012, Radner left the Chicago Alliance for another social justice position when she joined the Ounce of Prevention Fund as director of Illinois policy. The Ounce, as this Illinois organization calls itself, advocates for early childhood education and other programs and policies aimed at helping low-income children.
Many people who receive a law degree from a top law school, as Radner did, take a job in a large law firm or with a large corporation and spend their careers helping the wealthy. Instead, Radner chose to use her legal knowledge to help achieve social justice for the poor. She once said of her efforts to end homelessness, “People call us starry-eyed dreamers. But I actually say we’re steely-eyed realists because ending homelessness is not hard. We know exactly how to do it. And what we’re trying to do is create the political will to get it fully done. We can’t prevent people from losing their housing. But what we can do is ensure that if that happens that there’s a system in place to get them out of homelessness really quickly.”
In working her entire career to help the poor and homeless, Nancy Radner has helped make a difference.
Sources: Kapos, 2012; Schorsch, 2010
Crime
When many people think about the disadvantages of city life, they probably think about crime, a problem mentioned several times already in this chapter. Their fears are well-grounded. Simply put, cities have much higher rates of violent and property crime than do small towns or rural areas (see Figure 14.6 “Crime Rates in Large Cities and Rural Counties, 2010 (Number of Crimes per 100,000 Residents)”). For example, the violent crime rate (number of crimes per 100,000 residents) in 2010 was almost four times higher in the nation’s largest cities than in its rural counties, while the property crime rate was more than twice as high.
Figure 14.6 Crime Rates in Large Cities and Rural Counties, 2010 (Number of Crimes per 100,000 Residents)
Source: Federal Bureau of Investigation. (2011). Crime in the United States, 2010. Washington, DC: Author.
Why are city crime rates much higher? Because crime rates take the number of people into account, the answer is not simply that cities have more people than rural areas. Nor is the answer simply that cities have higher poverty than rural areas, because rural areas in fact have higher poverty overall, as we discuss later in this chapter. Rather, an important answer is that cities have higher residential crowding (or higher population density) and also more household crowding, as we saw earlier.
Crime rates are higher in cities in part because the great numbers of urban residents provide many potential targets for criminals. James Marvin Phelps – Las Vegas Boulevard – CC BY-NC 2.0.
Several reasons explain why higher residential crowding produces higher crime rates. Consider violent crime. For a violent crime to occur, it takes two people to tangle, so to speak. Criminals cannot kill, rob, or assault someone unless there is a “someone” to assault. In a city, there are many potential targets of violence all crowded together into a relatively small space, and thus many potential targets for criminals. In a rural area, potential targets are spread across miles, and a robber can go a long time without ever seeing a potential victim. Many assaults are also committed not by hardened criminals but by people (usually men) who get angry because of some perceived insult. In a city, there is a much greater chance for interaction to occur where someone might feel insulted, simply because there are so many people living within a small space and bars and other venues for them to congregate. A thousand people living on one city block are more likely to encounter each other than a thousand people living across thirty square miles in a rural area. Because there is more opportunity in a city for insults and other problems to occur that lead to violence, more violence occurs.
Cities also have more crowded households than rural areas, as we saw earlier, and these also make a difference for at least two reasons (Stark, 1987). Crowded households are more stressful, and people who experience stress are more likely to be aggressive. Further, people (and perhaps especially young people) who live in crowded households often find they need to “get outside” to be away from the stress of the household and to have some “elbow room” and privacy. But once outside, they are that much more likely to interact with other people. Because, as we just noted, social interaction is a prerequisite for violence, household crowding indirectly contributes to violence for this reason.
Residential crowding and household crowding thus combine to produce higher crime rates in cities than in urban areas. City neighborhoods differ in their degree of both types of crowding, and those that have higher crowding rates should have higher crime rates, all else equal. In sociologist Rodney Stark’s (1987) term, these neighborhoods are deviant places because their structural features, such as crowding, almost automatically contribute to higher crime rates regardless of who is living in these neighborhoods.
Another structural feature of cities helps to explain why they have a higher property crime rate than rural areas. Burglars obviously cannot burglarize a home unless there is a nearby home to burglarize. In cities, there are many homes to serve as potential targets for burglars; in rural areas, these homes are far and few between. Similarly, if someone wants to shoplift in a store or break into a store overnight, they can more easily do so in an urban area, where there are many stores, than in a rural area, where the landscape is filled with trees or fields rather than Walmarts or Best Buys.
Although Stark (1987) coined the term deviant places to refer to urban neighborhoods that had certain features that contribute to high crime rates, his term can also refer to cities themselves. For the reasons just discussed, cities are inevitably much more likely than rural areas to be deviant places. The defining feature of a city—large numbers of people living in a small area—guarantees that cities will have higher crime rates than rural areas. Cities are deviant places precisely because they are cities.
Key Takeaways
• Major issues and problems confronting US cities today include those involving fiscal difficulties, crowding, housing, traffic, pollution, public education, and crime.
• Several of these problems stem directly from the fact that cities involve large numbers of people living in a relatively small amount of space.
For Your Review
1. If you were to work for a mayor of a large city to help address one specific problem in that city, which problem would you prefer to work on? Why?
2. Americans often seem to blame city residents for many of the problems affecting US cities today, including low academic achievement and rundown conditions in city schools and crime in the streets. Do you think it is fair to blame city residents for these problems, or are there other reasons for them? Explain your answer.
23.5 Problems of Rural Life
Rural areas can be beautiful and relaxing, but they also must confront important challenges. These problems include a lack of public transportation, human services, and medical professionals and facilities. Marina del Castell – Rural life – CC BY 2.0.
About one-fourth of the US population and more than 40 percent of the world population live in rural areas. As the previous section demonstrated, a dual view of cities exists: they have many advantages, but they also have many disadvantages. This dual view also applies to rural areas, but it does so in a sort of mirror image: The advantages of cities are often disadvantages for rural areas, and the disadvantages of cities are often advantages for rural areas.
On the positive side, and focusing on the United States, rural areas feature much more open space and less crowding. Their violent and property crime rates are much lower than those in large cities, as we have seen. The air is cleaner because there is less traffic and fewer factories and other facilities that emit pollution. Life in rural areas is thought to be slower-paced, resulting in lower levels of anxiety and a greater sense of relaxation. For these and other reasons, rural residents exhibit better mental health on the average than do urban residents.
On the negative side, rural areas are often poor and lack the services, employment opportunities, and leisure activities that cities have. Teens often complain of boredom, and drug and alcohol use can be high (Johnson et al., 2008). Public transportation is often lacking, making it difficult for people without motor vehicles, who tend to have low incomes, to get to workplaces, stores, and other venues (Brown, 2008). Rural residents with motor vehicles often must still travel long distances to shop, to visit a doctor, to go to work, and to do any number of other activities. Many rural areas in the United States lack high-speed broadband, a necessity in today’s economy. As a result, economic development is impaired (Whitacre, 2010). All these challenges contribute to special problems in rural areas. We now examine some of these problems.
Rural Health
As “Health and Health Care” noted, rural areas often lack sufficient numbers of health care professionals, hospitals, and medical clinics. The National Rural Health Association (2012) points out that although one-fourth of the US population is rural, only one-tenth of physicians practice in rural areas. Urban areas have 134 physician specialists for every 100,000 residents, but rural areas have less than one-third this number.
Compounding these shortages are other problems. The first is that the small hospitals typical of rural areas generally lack high-quality care and equipment. A patient who needs heart bypass surgery, brain surgery, or other types of complex medical care is likely to have traveled to an urban hospital far away.
The second problem is the long distances that ambulances and patients must travel. Because ambulances and other emergency vehicles must travel so far, rural residents with emergencies receive medical attention more slowly than their urban counterparts. The long distances that people must travel make it more difficult for patients with health problems to receive medical care. For example, a rural cancer patient who needs chemotherapy or radiation might have to travel two to three hours in each direction to receive treatment. Travel distances in rural areas also mean that rural residents are less likely than urban residents to receive preventive services such as physical examinations; screenings for breast cancer, cervical cancer, and colorectal cancer; and vaccinations for various illnesses and diseases.
In yet another problem, rural areas are also much more likely than urban areas to lack mental health care, drug abuse counseling and programs, and other services related to physical and mental health.
For all these reasons, rural residents are more at risk than urban residents for certain health problems, including mortality. For example, only one-third of all motor vehicle accidents happen in rural areas, but two-thirds of all deaths from such accidents occur in rural areas. These problems help explain why rural residents are more likely than urban residents to report being in only fair or poor health in government surveys (Bennett, Olatosi, & Probst, 2009).
An additional health problem in rural areas arises from the age profile of their populations. Compared to urban areas, rural areas have an “aging population,” or a greater percentage of adults aged 65 and older. This fact adds to the health-care problems that rural areas must address.
Rural Schools and Education
The discussion of education in “Schools and Education” focused mostly on urban schools. Many of the problems discussed there also apply to rural schools. However, rural schools often face hurdles that urban and suburban schools are much less likely to encounter (Center for Rural Policy and Development, 2009).
First, because rural areas have been losing population, they have been experiencing declining school enrollment and school closings. When a school does close, teachers and other school employees have lost their jobs, and students have to rather suddenly attend a new school that is usually farther from their home than their former school.
Second, rural populations are generally older than urban populations, as mentioned earlier, and have a greater percentage of retired adults. Therefore, rural areas’ per-capita income and sales tax revenue are lower than that for urban and suburban areas, and this lower revenue makes the funding of public schools more challenging.
Third, rural families live relatively far from the public schools, and the schools are relatively far from each other. As a result, rural school districts have considerable expenses for transporting children to and from school, after-school athletic events, and other activities.
Finally, it is often difficult to recruit and retain quality teachers in rural areas. This problem has forced some rural school districts to offer hiring bonuses or housing assistance to staff their schools.
Rural Poverty
Although many US cities have high poverty rates, the poverty rate is actually somewhat higher overall in rural areas than in urban areas. In 2010, 16.5 percent of rural residents were classified as officially poor, compared to 14.9 percent of urban residents. However, the poverty rate in the nation’s largest cities was higher yet at 19.7 percent. The number of poor rural residents was almost 8 million, while the number of poor urban residents (reflecting the fact that most Americans live in urban areas) was almost 36 million (DeNavas-Walt, Proctor, & Smith, 2011).
Rural poverty is thought to be more persistent than urban poverty because of the factors that contribute to its high rate. These factors include the out-migration of young, highly skilled workers; the lack of industrial jobs that typically have been higher paying than agricultural jobs; and limited opportunities for the high-paying jobs of the information age. Biotech companies, electronics companies, and other symbols of the information age are hardly ever found in the nation’s rural areas. Instead, they locate themselves in or near urban areas, in which are found the universities, masses of people, and other necessary aspects these companies need to succeed.
Compounding the general problem of poverty, rural areas are also more likely than nonrural areas to lack human services programs to help the poor, disabled, elderly, and other people in need of aid (National Advisory Committee on Rural Health and Human Services, 2011). Because rural towns are so small, they often cannot afford services such as soup kitchens, homeless shelters, and Meals on Wheels, and thus must rely on services located in other towns. Yet rural towns are often far from each other, making it difficult and expensive for rural residents to obtain the services they need. For example, a Meals on Wheels program in an urban area may travel just a few miles and serve dozens of people, while it may have to travel more than one hundred miles in a rural area and serve only a few people. Adding to this problem is the strong sense in many rural areas that individuals should be strong enough to fend for themselves and not accept government help. Even when services are available, some people who need them decline to take advantage of them because of pride and shame.
Domestic Violence
One of the sad facts of rural life is domestic violence. This form of violence is certainly common in urban areas, but the defining feature of rural areas—a relatively low number of people living in a relatively broad area—creates several problems for victims of domestic violence, most of them women (DeKeseredy & Schwartz, 2009).
For example, these women often find it difficult to get help and/or to leave their abusers wherever they live. However, it is often even more difficult for rural women to do so. Rural police may be unenlightened about domestic violence and may even know the abuser; for either reason, they may not consider his violence a crime, and abused women may be that much more reluctant to tell the police about their abuse.
Another problem concerns the availability of battered women’s shelters, which provide invaluable services for abused women and any children they might have. These shelters tend to be found in cities, which still do not have nearly enough shelters. Rural areas generally lack shelters, and any shelters that exist are often long distances from the homes of abused women. In rural areas, abused women are also more likely than their urban counterparts to lack neighbors and friends to whom they can turn for support, or at least to live farther from these individuals. For all these reasons, rural women who experience domestic violence face a problem that has been called “dangerous exits” (DeKeseredy & Schwartz, 2009).
Key Takeaways
• Like cities, rural areas also have their advantages and disadvantages. They can be beautiful, relaxing places in which to live, but they also lack many of the cultural advantages and other amenities that cities feature.
• Rural areas are characterized by sparse populations and long distances that people must travel. These conditions make it difficult to provide adequate public transportation and various kinds of human services. The poverty of many rural areas aggravates these problems.
For Your Review
1. If you had your choice, would you want to live in a large city, medium-sized city, small town, or rural area? Explain your answer.
2. Americans often seem to blame city residents for many of the problems affecting US cities today, including low academic achievement, rundown conditions in city schools, and crime in the streets. Do you think it is fair to blame city residents for these problems, or are there other reasons for them? Explain your answer.
23.6 Improving Urban & Rural Life
Many urban problems are not, strictly speaking, sociological, or other social science problems. For example, traffic congestion is arguably more of an engineering issue than a sociological issue, even if traffic congestion has many social consequences. Other urban problems are problems discussed in previous chapters that disproportionately affect urban areas. For example, crime is more common in urban areas than elsewhere, and racial and ethnic inequality is much more of an issue in urban areas than in rural areas because of the concentration of people of color in our cities. Previous chapters have discussed such problems in some detail, and the strategies suggested in those chapters need not be discussed again here.
Still, other urban issues exist that this chapter was the first to present. Two of these involve crowding and housing. Cities are certainly crowded, and some parts of cities are especially crowded. Housing is expensive, and many urban residents live in dilapidated, substandard housing. Here again, a sociological perspective offers some insight, as it reminds us that these problems are intimately related to inequalities of social class, race and ethnicity, and gender. Although it is critical to provide adequate, affordable housing to city residents, it is also important to remember that these various social inequalities affect who is in most need of such housing. Ultimately, strategies aimed at providing affordable housing will not succeed unless they recognize the importance of these social inequalities and unless other efforts reduce or eliminate these inequalities. Racial residential segregation also remains a serious problem in our nation’s urban centers, and sociologists have repeatedly shown that residential segregation contributes to many of the problems that urban African Americans experience. Reducing such segregation must be a fundamental goal of any strategy to help American cities.
Although traffic congestion is largely an engineering issue, engineers do not operate in a social vacuum. People will be more likely to drive in a city when it is easier for them to drive, and less likely to drive when it is more difficult for them to drive. As the Note 14.19 “Lessons from Other Societies” box illustrated, European cities have done much more than US cities to reduce traffic congestion and thus improve air quality in their cities. Americans may resist the measures the European nations have taken, but the success of these measures suggests that the United States should also use them to deal with the many problems associated with traffic congestion.
Certain problems discussed in previous chapters are also more urgent in rural areas. In particular, the isolation and long distances of rural areas pose special challenges for the provision of adequate health care and for addressing the needs of victims of domestic violence. Ironically, some of the very features that make rural areas so attractive to many people also make them difficult settings for other people. In view of this context, it is essential that public transportation in rural areas be expanded, and that the many types of medical care and social and legal services commonly found in urban areas also be expanded. Although rural residents undoubtedly do not expect to find the range of care and services available to their urban counterparts, they should not have to suffer from a lack of adequate care and services.
Key Takeaways
• Many of the problems of urban and rural life were addressed in earlier chapters. The strategies discussed in these chapters to address these problems thus also apply to the problems examined in this chapter.
• Many urban problems are associated with poverty and racial discrimination. Reducing these problems should help relieve urban problems.
• The characteristics of rural areas that often make them so appealing also lead to certain problems that are especially urgent in rural areas.
For Your Review
1. How do you think American cities should try, if at all, to reduce traffic congestion?
2. Are urban problems worse than rural problems, or are rural problems worse than urban problems? Explain your answer.
23.7 End-of-Chapter Summary
Summary
1. Urbanization is a consequence of population growth. Cities first developed in ancient times after the rise of horticultural and pastoral societies and “took off” during the Industrial Revolution as people moved to be near factories. Urbanization led to many social changes then and continues today to affect society.
2. Functionalism, conflict theory, and symbolic interactionism offer varied understandings of urbanization. Functionalists have a mixed view of urbanization, while conflict theorists hold a negative view.
3. Cities face many problems, several of which reflect the fact that cities feature large numbers of people living within a relatively small space. Among the most serious of these problems are residential crowding, substandard and racially segregated housing, heavy traffic and great amounts of air pollution, and high crime rates.
4. Rural areas face many challenges that result from their sparse populations and the great distances that people must often travel. Among other problems, rural areas have a lack of economic opportunities in today’s information age and a general lack of various kinds of human services.
Using What You Know
After graduating from college, you are now working as an entry-level assistant to the mayor of a medium-sized city. You are aware that many city residents are unhappy with the quality of housing in their neighborhoods. The mayor thinks the city has little, if any, money to help improve the city’s housing, and also thinks that the housing problem is not nearly as bad as the city’s residents seem to think. The mayor asks your opinion about this issue. Based on what you have learned in this chapter and perhaps in other coursework and reading, what do you tell the mayor?
What You Can Do
To help deal with the urban and rural problems discussed in this chapter, you may wish to do any of the following:
1. Volunteer at a social service agency in your community.
2. Start or join a Habitat for Humanity or other group that builds homes for low-income families.
3. Attend local city council meetings to learn about budgetary issues so that you will be in a more knowledgeable position to help your community.
Attribution
Adapted from Chapter 14 from Social Problems by the University of Minnesota under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/07%3A_Perspectives_on_Communities/23%3A_Urban_and_Rural_Problems.txt |
Learning Objectives
• Describe what is meant by the “working personality” of the police.
• Discuss the quality of legal representation of criminal defendants.
• Explain whether incarceration reduces crime in an effective and cost-efficient manner.
24.1 Introduction
The criminal justice system in a democracy like the United States faces two major tasks: (1) keeping the public safe by apprehending criminals and, ideally, reducing crime; and (2) doing so while protecting individual freedom from the abuse of power by law enforcement agents and other government officials. Having a criminal justice system that protects individual rights and liberties is a key feature that distinguishes a democracy from a dictatorship.
How well does the US criminal justice system work in both respects? How well does it control and reduce crime, and how well does it observe individual rights and not treat people differently based on their social class, race and ethnicity, gender, and other social characteristics? What are other problems in our criminal justice system? Once again, whole books have been written about these topics, and we have space here to discuss only some of this rich literature.
24.2 Police
The police are our first line of defense against crime and criminals and for that reason are often called “the thin blue line.” Police officers realize that their lives may be in danger at any time, and they also often interact with suspects and other citizens whose hostility toward the police is quite evident. For these reasons, officers typically develop a working personality that, in response to the danger and hostility police face, tends to be authoritarian and suspicious (Skolnick, 1994). Indeed, it is not too far-fetched to say that police-citizen relations are characterized by mutual hostility and suspicion (Dempsey & Forst, 2012).
Two aspects of police behavior are especially relevant for a textbook on social problems. The first is police corruption. No one knows for sure how much police corruption occurs, but low-level corruption (e.g., accepting small bribes and stealing things from stores while on patrol) is thought to be fairly common, while high-level corruption (e.g., accepting large bribes and confiscating and then selling illegal drugs) is thought to be far from rare. In one study involving trained researchers who rode around in police cars, more than one-fifth of the officers being observed committed some corruption (Reiss, 1980). Several notorious police scandals have called attention to rampant corruption amid some police forces. One scandal more than three decades ago involved New York City officer Frank Serpico, whose story was later documented in a best-selling book (Maas, 1973) and in a tension-filled film starring Al Pacino. After Serpico reported high-level corruption to his superiors, other officers plotted to have him murdered and almost succeeded. A more recent scandal involved the so-called Rampart Division in Los Angeles and involved dozens of officers who beat and shot suspects, stole drugs and money, and lied at the trials of the people they arrested (Glover & Lait, 2000).
The other relevant behavior is police brutality or, to use a less provocative term, the use of undue (also called unjustified or excessive) force by police. Police, of course, are permitted and even expected to use physical force when necessary to subdue suspects. Given the context of police work noted earlier (feelings of danger and suspicion) and the strong emotions at work in any encounter between police and suspects, it is inevitable that some police will go beyond the bounds of appropriate force and commit brutality. An important question is how much police brutality occurs. In a recent national survey, about 1 percent of US residents who had had an encounter with the police in 2008 believed that excessive force was used against them (Eith & Durose, 2011). This is a low figure in percentage terms, but still translates to 417,000 people who may have been victims of police brutality in one year.
How well do the police prevent crime? To answer this question, let us be clear what it is asking. The relevant question is not whether having the police we do have keeps us safer than having no police at all. Rather, the relevant question is whether hiring more police or making some specific change in police practice would lower the crime rate. The evidence on this issue is complex, but certain conclusions are in order.
In terms of crime reduction, the ways in which police are deployed matter more than the actual number of police. Joery Bruijntjes – Polizia Locale – CC BY-NC 2.0.
First, simply adding more officers to a city’s existing police force will probably not reduce crime, or will reduce it only to a very small degree and at great expense (Walker, 2011). Several reasons may explain why additional police produce small or no reductions in crime. Much violence takes place indoors or in other locations far from police purview, and practical increases in police numbers still would not yield numbers high enough to guarantee a police presence in every public location where crime might happen. Because criminals typically think they can commit a crime with impunity if no police are around, the hiring of additional police is not likely to deter them.
Additional police may not matter, but how police are deployed does matter. In this regard, a second conclusion from the policing and crime literature is that directed patrol involving the consistent deployment of large numbers of police in high-crime areas (“hot spots”) can reduce crime significantly (Mastrofski, Weisburd, & Braga, 2010). Crackdowns—in which the police flood a high crime and drug neighborhood, make a lot of arrests, and then leave—have at most a short-term effect, with crime and drug use eventually returning to their previous levels or simply becoming displaced to other neighborhoods.
24.3 Criminal Courts
In the US legal system, suspects and defendants enjoy certain rights and protections guaranteed by the Constitution and Bill of Rights and provided in various Supreme Court rulings since these documents were written some 220 years ago. Although these rights and protections do exist and again help distinguish our democratic government from authoritarian regimes, in reality the criminal courts often fail to achieve the high standards by which they should be judged. Justice Denied (Downie, 1972) and Injustice for All (Strick, 1978) were the titles of two popular critiques of the courts written about four decades ago, and these titles continue to apply to the criminal courts today.
A basic problem is the lack of adequate counsel for the poor. Wealthy defendants can afford the best attorneys and get what they pay for: excellent legal defense. An oft-cited example here is O. J. Simpson, the former football star and television and film celebrity who was arrested and tried during the mid-1990s for allegedly killing his ex-wife and one of her friends (Barkan, 1996). Simpson hired a “dream team” of nationally famous attorneys and other experts, including private investigators, to defend him at an eventual cost of some \$10 million. A jury acquitted him, but a poor defendant in similar circumstances almost undoubtedly would have been found guilty and perhaps received a death sentence.
Almost all criminal defendants are poor or near poor. Although they enjoy the right to free legal counsel, in practice they receive ineffective counsel or virtually no counsel at all. The poor are defended by public defenders or by court-appointed private counsel, and either type of attorney simply has far too many cases in any time period to handle adequately. Many poor defendants see their attorneys for the first time just moments before a hearing before the judge. Because of their heavy caseloads, the defense attorneys do not have the time to consider the complexities of any one case, and most defendants end up pleading guilty.
A 2006 report by a New York state judicial commission reflected these problems (Hakim, 2006, p. B1). The report concluded that “local governments were falling well short of constitutional requirements in providing legal representation to the poor,” according to a news story. Some New York attorneys, the report found, had an average yearly caseload of 1,000 misdemeanors and 175 felonies. The report also found that many poor defendants in 1,300 towns and villages throughout the state received no legal representation at all. The judge who headed the commission called the situation “a serious crisis.”
Another problem is plea bargaining, in which a defendant agrees to plead guilty, usually in return for a reduced sentence. Under our system of justice, criminal defendants are entitled to a trial by jury if they want one. In reality, however, most defendants plead guilty, and criminal trials are very rare: Fewer than 3 percent of felony cases go to trial. Prosecutors favor plea bargains because they help ensure convictions while saving the time and expense of jury trials, while defendants favor plea bargains because they help ensure a lower sentence than they might receive if they exercised their right to have a jury trial and then were found guilty. However, this practice in effect means that defendants are punished if they do exercise their right to have a trial. Critics of this aspect say that defendants are being coerced into pleading guilty even when they have a good chance of winning a not guilty verdict if their case went to trial (Oppel, 2011).
24.4 The Problem of Prisons
The United States now houses more than 1.5 million people in state and federal prisons and more than 750,000 in local jails. This total of about 2.3 million people behind bars is about double the 1990 number and yields an incarceration rate that is by far the highest rate of any Western democracy. This high rate is troubling, and so is the racial composition of American prisoners. More than 60 percent of all state and federal prisoners are African American or Latino, even though these two groups comprise only about 30 percent of the national population. As “Alcohol and Other Drugs” notes, African Americans and Latinos have been arrested and imprisoned for drug offenses far out of proportion to their actual use of illegal drugs. This racial/ethnic disparity has contributed to what law professor Michelle Alexander (2010) terms the “new Jim Crow” of mass incarceration. Reflecting her concern, about one of every three young African American males are under correctional supervision (in jail or prison or on probation or parole).
The corrections system costs the nation more than \$75 billion annually. What does the expenditure of this huge sum accomplish? It would be reassuring to know that the high US incarceration rate keeps the nation safe and even helps reduce the crime rate, and it is certainly true that the crime rate would be much higher if we had no prisons at all. However, many criminologists think the surge in imprisonment during the last few decades has not helped reduce the crime rate at all or at least in a cost-efficient manner (Durlauf & Nagin, 2011). Greater crime declines would be produced, many criminologists say, if equivalent funds were instead spent on crime prevention programs instead of on incarceration (Welsh & Farrington, 2007).
Criminologists also worry that prison may be a breeding ground for crime because rehabilitation programs such as vocational training and drug and alcohol counseling are lacking and because prison conditions are substandard. They note that more than 700,000 inmates are released from prison every year and come back into their communities ill-equipped to resume a normal life. There they face a lack of job opportunities (how many employers want to hire an ex-con?) and a lack of friendships with law-abiding individuals, as our earlier discussion of labeling theory indicated. Partly for these reasons, imprisonment ironically may increase the likelihood of future offending (Durlauf & Nagin, 2011).
Living conditions behind bars merit further discussion. A common belief of Americans is that many prisons and jails are like country clubs, with exercise rooms and expensive video and audio equipment abounding. However, this belief is a myth. Although some minimum-security federal prisons may have clean, adequate facilities, state prisons and local jails are typically squalid places. As one critique summarized the situation, “Behind the walls, prisoners are likely to find cramped living conditions, poor ventilation, poor plumbing, substandard heating and cooling, unsanitary conditions, limited private possessions, restricted visitation rights, constant noise, and a complete lack of privacy” (Kappeler & Potter, 2005, p. 293).
Some Americans probably feel that criminals deserve to live amid overcrowding and squalid living conditions, while many Americans are probably at least not very bothered by this situation. But this situation increases the odds that inmates will leave prison and jail as more of a threat to public safety than when they were first incarcerated. Treating inmates humanely would be an important step toward successful reentry into mainstream society.
People Making a Difference
Making a Difference in the Lives of Ex-Cons
• >The text notes that more than 600,000 inmates are released from prison every year. Many of them are burdened with drug, alcohol, and other problems and face bleak prospects for employment, friendships, and stable lives, in general. Since 1967, The Fortune Society has been making a difference in the lives of ex-convicts in and near New York City.
• >The Fortune Society’s website (http://www.fortunesociety.org) describes the group’s mission: “The Fortune Society is a nonprofit social service and advocacy, founded in 1967, whose mission is to support successful reentry from prison and promote alternatives to incarceration, thus strengthening the fabric of our communities.” About 70 percent of its more than 190 employees are ex-prisoners and/or have histories of substance abuse or homelessness. It is fair to say that The Fortune Society was working on prisoner reentry long before scholars discovered the problem in the late 1990s and early 2000s.
• >The group’s president, JoAnne Page, described its halfway house where inmates stay for up to two months after their release from prisons: “This is what we do. We bring people home safely. There’s a point when the crime happened. The sentence was served, and the rehabilitation must begin. We look at a human being as much more than the worst they ever did.” Recalling that many of her relatives died in the Holocaust, Page added, “What my family experience did was to make me want to be somebody who fights institutions that damage people and who makes the world a little safer. Prisons are savage institutions.”
• >In addition to its halfway house, the Fortune Society provides many other services for inmates, ex-inmates, and offenders who are put on probation in lieu of incarceration. It regularly offers drug and alcohol counseling, family services, adult education and career development programs, and classes in anger management, parenting skills, and health care. One of its most novel programs is Miss Betty’s Practical Cooking and Nutrition Class, an eight-week course for ex-inmates who are young fathers. While a first reaction might be to scoff at such a class, a Fortune counselor pointed to its benefits after conceding her own immediate reaction. “When I found out about the cooking classes, I thought, ‘So they’re going to learn to cook, so what?’ What’s that going to do? But it’s building self-esteem. For most of these guys, they’re in a city, they’ve grown up on Kool-Aid and a bag of chips. This is building structure. They’re at the point where they have really accomplished something…They’re learning manners. You really can change patterns.”
• >One ex-convict that Fortune helped was 22-year-old Candice Ellison, who spent more than two years in prison for assault. After not finding a job despite applying to several dozen jobs over a six-month span, she turned in desperation to The Fortune Society for help. Fortune bought her interview clothes and advised her on how to talk about her prison record with potential employers. Commending the help she received, she noted, “Some of my high school friends say it’s not that hard to get a job, but for people like me with a criminal background, it’s like 20 times harder.”
• >The Fortune Society has received national recognition for its efforts. Two federal agencies, the Department of Justice and the Department of Housing and Urban Development, have featured The Fortune Society as a model program for helping ex-inmates. The Urban Institute featured this model in a video it developed about prisoner reentry programs. And in 2005, the American Society of Criminology presented the Society its President’s Award for “Distinguished Contributions to the Cause of Justice.” These and other examples of the national recognition won by The Fortune Society indicate that for more than four decades it has indeed been making a difference.
• >Sources: Bellafante, 2005; Greenhouse, 2011; Richardson, 2004
• 24.5 Focus on the Death Penalty
The death penalty is perhaps the most controversial issue in the criminal justice system today. The United States is the only Western democracy that sentences common criminals to death, as other democracies decided decades ago that civilized nations should not execute anyone, even if the person took a human life. About two-thirds of Americans in national surveys favor the death penalty, with their reasons including the need for retribution (“an eye for an eye”), deterrence of potential murderers, and lower expenditure of public funds compared to a lifetime sentence. Social science evidence is irrelevant to the retribution argument, which is a matter for philosophy and theology, but it is relevant to many other aspects of the death debate. Taken together, the evidence on all these aspects yields a powerful case against the death penalty (Death Penalty Information Center, 2011).
First, capital punishment does not deter homicide: Almost all studies on this issue fail to find a deterrent effect. An important reason for this stems from the nature of homicide. As discussed earlier, it is a relatively spontaneous, emotional crime. Most people who murder do not sit down beforehand to calculate their chances of being arrested, convicted, and executed. Instead, they lash out. Premeditated murders do exist, but the people who commit them do not think they will get caught and so, once again, are not deterred by the potential for execution.
Second, the death penalty is racially discriminatory. While some studies find that African Americans are more likely than whites who commit similar homicides to receive the death penalty, the clearest evidence for racial discrimination involves the race of the victim: Homicides with white victims are more likely than those with African American victims to result in a death sentence (Paternoster & Brame, 2008). Although this difference is not intended, it suggests that the criminal justice system values white lives more than African American lives.
The death penalty is racially discriminatory and does not deter homicide. Thomas Hawk – Miami Police – CC BY-NC 2.0.
Third, many people have been mistakenly convicted of capital offenses, raising the possibility of wrongful executions. Sometimes defendants are convicted out of honest errors, and sometimes they are convicted because the police and/or prosecution fabricated evidence or engaged in other legal misconduct. Whatever their source, wrongful convictions of capital offenses raise the ugly possibility that a defendant will be executed even though he was actually innocent of any capital crime. During the past four decades, more than 130 people have been released from death row after DNA or other evidence cast serious doubt on their guilt. In March 2011, Illinois abolished capital punishment, partly because of concern over the possibility of wrongful executions. As the Illinois governor summarized his reasons for signing the legislative bill to abolish the death penalty, “Since our experience has shown that there is no way to design a perfect death penalty system, free from the numerous flaws that can lead to wrongful convictions or discriminatory treatment, I have concluded that the proper course of action is to abolish it” (Schwartz & Fitzsimmons, 2011:A18).
Fourth, executions are expensive. Keeping a murderer in prison for life costs about \$1 million in current dollars (say 40 years at \$25,000 per year), while the average death sentence costs the state about \$2 million to \$3 million in legal expenses.
This diverse body of evidence leads most criminologists to oppose the death penalty. In 1989, the American Society of Criminology adopted this official policy position on capital punishment: “Be it resolved that because social science research has demonstrated the death penalty to be racist in application and social science research has found no consistent evidence of crime deterrence through execution, The American Society of Criminology publicly condemns this form of punishment, and urges its members to use their professional skills in legislatures and courts to seek a speedy abolition of this form of punishment.”
Key Takeaways
• Partly because the police often fear for their lives, they tend to have a “working personality” that is authoritarian and suspicious. Police corruption and use of undue force remain significant problems in many police departments.
• Although criminal defendants have the right to counsel, the legal representation of such defendants, most of whom are poor or near poor, is very inadequate.
• Prisons are squalid places, and incarceration has not been shown to reduce crime in an effective or cost-efficient manner.
• Most criminologists agree that capital punishment does not deter homicide, and they worry about racial discrimination in the use of the death penalty and about the possibility of wrongful executions.
For Your Review
1. Have you ever had an encounter with a police officer? If so, how would you describe the officer’s personality? Was it similar to what is described in the text?
2. The text argues that improvement in prison conditions would help reduce the probability of reoffending after inmates leave prison. Do you agree or disagree with this statement? Explain your answer.
Attribution
Adapted from Chapter 8.5 from Social Problems by the University of Minnesota under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/08%3A_Communities_and_Police_Relations/24%3A_The_Criminal_Justice_System.txt |
Learning Objectives
• Learn from a national and global perspective on immigration and immigrant policy.
• Recognizing that the world is constantly and rapidly changing.
• Recognizing that Global/national/international events can have an impact on individuals, families, groups, organizations, and communities.
• Global implications dictate that we foster international relationships and opportunities to address international concerns, needs, problems, and actions to improve the well-being of not only U.S. citizens, but global citizens.
25.1 Introduction
For Jose and Ester, it was painful to try to raise their two sons in El Salvador. The money they raised in a day was not enough to buy food for one family meal, and gang violence was everywhere. Jose decided to move to the United States to provide for his family. After 7 years, he saved enough to bring his wife to the United States, and they both started working long hours to save the money to bring their sons. They paid a coyote (someone who smuggles people across borders) \$10,000, which covered 3 attempts to bring their sons to the United States. The first time, they were caught an hour after crossing into Mexico and sent home. The second time, they were caught by police in Mexico and held 3 days for ransom, and then continued north after the coyote paid. The boys were caught by immigration officials in Texas. They were held in detention for several days. With the help of an advocacy office, the boys flew to Baltimore to be reunited with their parents. (Story published by Public Radio International in 2014. Full story available from: http://www.pri.org/stories/2014-08-18/these-salvadorian-parents-detail-their-sons-harrowing-journey-meet-them-us).
Migration is most often motivated by a desire to improve life for families. The story of Jose and Ester has common elements with most stories of migration: families must make painful choices about whether moving to a new home and/or being separated from one another is necessary to provide for the family’s well-being. Families often feel “pushed” out of their home country by poor pay or job availability, political instability, or violence. They feel “pulled” to a new country by the promise of better pay to support their families, greater educational opportunities for their children, greater safety for their families, or the opportunity to be together again after a long absence.
Jose and Ester’s story has another common element with all stories of migration: their methods of migration and their opportunities to be reunited were influenced by immigration and immigrant policy. Immigration policy determines who enters the United States and in what numbers, while immigrant policy influences the integration of immigrants who are already in the United States (Fix & Passel, 1994). For Jose and Ester, their sons were not eligible to travel legally across the border due to current immigration policy restrictions and delays. Policy determines whether immigrants have access to employment, to health or educational resources, and to family reunification (Menjívar, 2012). It determines whether they or their family are within the law or outside it (Menjívar, 2012).
Immigration and immigrant policy has a rippling impact on all facets of society, and impacts both immigrants and those born in the United States. At the economic level, the job skills and education of incoming immigrants impact our labor market and shifts where job growth occurs in our economy. On a social level, we interact with immigrants as neighbors and friends, and as coworkers, employees, and supervisors.
There are many articles, books, and book chapters that discuss the intricacies of immigration and immigrant policy. The purpose of this chapter is to explore the impact of these policies on families.
We will describe the different groups invested in immigration and immigrant policy and the various viewpoints on what is most important to incorporate into policy. We will then describe the history of policy, and the current policies affecting families. We end by describing the current barriers and opportunities for families. Chapter 26 will address special policies and issues that apply to refugees specifically.
Immigrant Definitions
Immigrants are people who leave their country of origin to permanently settle in another country. They may enter the country legally and are therefore called documented immigrants or they may enter illegally and are referred to as undocumented immigrants.
Legal or documented immigrants. For the purposes of this chapter, legal immigrants are defined as individuals who were granted legal residence in the United States. This would include those from other countries who were granted asylum, admitted as refugees, admitted under a set of specific authorized temporary statuses for longer-term residence and work, or granted lawful permanent residence status or citizenship.
Illegal or undocumented immigrants. Illegal or undocumented immigrants are foreign-born non-citizens residing in the country who have not been granted a visa, or were not given access (i.e., inspected) by the Department of State upon entrance (US Visas, n.d.). They may have entered the country illegally (e.g., crossing the borders), or may have entered the country legally with a valid visa but have stayed beyond the visa’s expiration date. Other terms also used in immigration research include: unauthorized immigrants, undocumented immigrants, and illegal immigrants. However, in this chapter, “undocumented immigrant” will be used to reference illegal and unauthorized immigrants.
For the most up-to-date statistics on how many immigrants are coming to the United States and where they are coming from, see http://www.dhs.gov/immigration-statistics.
Jaime Ballard (Family Social Science, University of Minnesota), Damir Utržan (Family Social Science, University of Minnesota), Veronica Deenanath (Family Social Science, University of Minnesota), and Dung Mao (Family Social Science, University of Minnesota)
25.2 Immigration Policy
Purposes of Immigration Policy
There are five primary purposes of immigration policy (US English Foundation, 2016; Fix & Passel, 1994).
1. Social: Unify citizens and legal residents with their families.
2. Economic: Increase productivity and standard of living.
3. Cultural: Encourage diversity, increasing pluralism, and a variety of skills.
4. Moral: Promote and protect human rights, largely through protecting those feeling persecution.
5. Security: Control undocumented immigration and protect national security.
Tug-of-War in Immigration Policy
There are many ideological differences among the stakeholders in immigration policy, and many different priorities. In order to meet the purposes listed above, policy-makers must balance the following goals against one another.
Provide refuge to all versus recruit the best. Some stakeholders desire to provide refuge for the displaced (Permanently stamped on the Statue of Liberty are the words, “Give me your tired, your poor, your huddled masses yearning to breathe free”). These stakeholders seek to welcome all who are separated from their families or face economic, political, or safety concerns in their current locations. Others aim to recruit those best qualified to add to the economy.
Meet labor force needs versus protect current citizen employment. Immigrant workers are expected to make up 30-50% of the growth in the United States labor force in the coming decades (Lowell, Gelatt, & Batalova, 2006). In general, immigrants provide needed employment and do not impact the wages of the current workforce. However, there are situations (i.e., during economic downturns) where immigration can threaten the current work force’s conditions or wages.
Enforce policy versus minimize regulatory burden and intrusion on privacy. In order to enforce immigration policy away from the border, the government must access residents’ documents. However, this threatens citizens’ privacy. When employers are required to access these documents, it also increases regulatory burden for the employers.
BBC World Service – Border fence – CC BY-NC 2.0.
Key Stakeholders in Policy
There are many groups who are deeply invested in immigration and immigrant policy; their fortunes rise or fall with the policies set. These groups are called “stakeholders.” Key stakeholders in immigration and immigrant policy in the United States include the federal government, state governments, voluntary agencies, employers, families, current workers, local communities, states, and the nation as a whole.
Families. As we described in the introduction, one of the most common motivations for immigration is to provide a better quality of life for one’s family, either by sending money to family in another country or by bringing family to the United States (Solheim, Rojas-Garcia, Olson, & Zuiker, 2012). Immigration policy impacts these families’ abilities to migrate to access safer living conditions and seek economic stability. Further, immigration policy impacts a family’s opportunity for reunification. Reunification means that immigrants with legal status in the United States can apply for visas to bring family members to join them. Approximately two-thirds of the immigrants in the United States were sponsored by family members who migrated first and became permanent residents (Kandel, 2014).
“My goals are to offer my family a decent life and economic stability, to guarantee them a future without serious problems, with a house, a means of transport… things that sometimes you can’t achieve in Mexico. Our goal must be for our family’s welfare, as much for my family here as for my family back there” – Mexican Immigrant, Solheim et al., 2012 p. 247.
Federal government. The federal government is currently solely responsible for the creation of immigration policies (Weissbrodt & Danielson, 2004). In the past, each state determined its own immigration policy according to the Articles of Confederation because it was unclear whether the United States Constitution gave the federal government power to regulate immigration (Weissbrodt & Danielson, 2011). A series of Supreme Court cases beginning in the 1850s upheld the federal government’s right to create immigration policies, arguing that the federal government must have the power to exclude non-citizens to protect the national public interest (Weissbrodt & Danielson, 2004). The Supreme Court has determined that the power to admit and to remove immigrants to the United States belongs solely to the federal government (using as precedents the uniform rule of Naturalization, Article 1.8.4, and the commerce clause, Article 1.8.3). In fact, there is no area where the legislative power of Congress is more complete (Weissbrodt & Danielson, 2004).
Immigration responsibilities were originally housed in the Treasury Department and the Department of Labor, due to its connection to foreign commerce. In the 1940s, the immigration office (now called the “INS”) was moved to the United States Department of Justice due to its connection to protecting national public interest (USCIS, 2010). The federal departments and agencies that implement immigration laws and policies have changed significantly since the terrorist attacks of 2001. In 2001, the United States Commission on National Security created the Department of Homeland Security (DHS), which absorbed and assumed the duties of Immigration and Naturalization Services (INS).
Three key agencies within DHS enforce immigration and immigrant policy (see Figure 1):
• United States Citizenship and Immigration Services (USCIS): USCIS provides immigration services, including processing immigrant visa requests, naturalization petitions, and asylum/refugee requests. Its offices are divided into four national regions: (1) Burlington, Vermont (Northeast); (2) Dallas, Texas (Central); (3) Laguna Niguel, California (West); and (4) Orlando, Florida (Southeast). The director of USCIS reports directly to the Deputy Secretary of Homeland Security. It is important to note that immigration officers, who traditionally hold law degrees, have broad discretion in deciding whether an application is complete and accurate (Weissbrodt & Danielson, 2011).
• Immigration and Customs Enforcement (ICE): ICE is primarily tasked with enforcing immigration laws once immigrants are inside the United States’ ICE is responsible for identifying and fixing problems in the nation’s security. This is accomplished through five operational divisions: (1) immigration investigations; (2) detention and removal; (3) Federal Protective Service; (4) international affairs; and (5) intelligence.
• United States Customs and Border Protection (CBP): USCBP includes the Border Patrol, which is responsible for identifying and preventing undocumented aliens, terrorists, and weapons from entering the country. In addition to these responsibilities, USCBP is responsible for regulating customs and international trade to intercept drugs, illicit currency, fraudulent documents or products with intellectual property rights violations, and materials for quarantine.
Figure 1: Federal Immigration Organizations
State governments. Although states have no power to create immigration policy, the Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA, 1996) enabled the Secretary of Homeland Security to enter into agreements with states to implement the administration and enforcement of federal immigration laws. States are also responsible for policy regarding immigrant and refugee integration. There is wide variation in how states pursue integration. Not all policies are welcoming. For example, several have passed legislation that limits access of public services to undocumented immigrants (e.g., Alabama, Georgia, Indiana, South Carolina, and Utah). In contrast, states such as Minnesota, have sought to expand immigrant access to public services. These drastically different approaches have promoted consideration of this critical important task at the federal level. In late 2014, President Obama formed the “White House Task Force on New Americans” whose primary purpose is to “create welcoming communities and fully integrating immigrants and refugees” (White House, 2014). This is the first time in United States history that the executive branch of the government has undertaken such an effort.
Employers. Employers have high stakes in policy that impact immigration, particularly as it impacts their available labor force. United States employers who recruit highly skilled workers from abroad typically sponsor their employees for permanent residence. Other employers who need a large labor force, particularly for low-skill work, often look to immigrants to fill positions.
Employers are also impacted by requirements to monitor the immigrant status of employees. Following the Immigration Reform and Control Act (IRCA) of 1986, it became illegal to knowingly employ undocumented immigrants. Many employers are now required by state law or federal contract to use the e-verify program to confirm that prospective employees are not undocumented immigrants. Such requirements aim to reduce incentives for undocumented immigration, but also pose burdens of liability and reduced labor availability for employers. The National Council of Farmer Cooperatives (2015) and the American Farm Bureau Federation oppose measures that could constrict immigration such as the E-Verify program, stating that it could have a detrimental impact on the country’s agriculture.
Migrant worker. Bread for the World – Migrant Worker and Cucumbers, Blackwater, VA – CC BY-NC-ND 2.0.
Current workforce. Overall, research demonstrates that immigration increases wages for United States-born workers (Ottaviano & Peri, 2008; Ottaviano & Peri, 2012; Cortes, 2008; Peri, 2010). Estimated increases in wages from immigration range from .1 to .6% (Borjas & Katz, 2007; Ottaviano & Peri, 2008; Shierholz, 2010). However, these wage increases are not unilaterally and consistently distributed across time, skill, and education levels of workers. Some researchers have found that low-education workers have experienced wage decreases due to immigration, as large as 4.8% (Borjas & Katz, 2007). However, other researchers have found that among those without a high school diploma, wages decreased by approximately 1% in the short-run (Shierholz, 2010; Ottaviano & Peri, 2012) but were increased slightly in the long run (Ottaviano & Peri, 2012).
Immigration generally does not decrease job opportunities for United States-born workers, and may slightly increase them (Peri, 2010). However, during economic downturns when job growth is slowed, immigration may have short-term negative effects on job availability and wages for the current workforce (Peri, 2010). Immigrants create growth in community businesses (see Textbox 1, “Did you know”). It is nonetheless important to emphasize that the fear of non-citizens taking away employment opportunities from citizens is a primary driver for immigration laws (Weissbrodt & Danielson, 2011).
Communities. United States communities must provide education and health care regardless of immigration status (i.e., Plyer v. Doe, 1982). In areas with rapidly increasing numbers of immigrant workers and their families, this can tax local communities that are already overburdened (Meissner, Meyers, Papademetriou & Fix, 2006). The Congressional Budget Office found that most state and local governments provide services to unauthorized immigrants that cost more than those immigrants generate in taxes (2007). However, studies have found that immigrants may also infuse new growth in communities and sustain current levels of living for residents (Meissner, Meyers, Papademetriou & Fix, 2006).
Country. Immigrants provide many benefits at a national level. Overall, immigrants create more jobs than they fill, both through demand for goods and service and entrepreneurship. Foreign labor allows growth in the labor force and sustained standard of living (Meissner, Meyers, Papademetriou & Fix, 2006). Even though immigrants cost more in services than they provide in taxes at a state and local government level, immigrants pay far more in taxes than they cost in services at a national level. In particular, immigrants (both documented and undocumented) contribute billions more to Medicare through payroll taxes than they use in medical services (Zallman, Woolhandler, Himmelstein, Bor & McCormick, 2013). Additionally, many undocumented immigrants obtain social security cards that are not in their name and thereby contribute to social security, from which they will not be authorized to benefit. The Social security administration estimates that \$12 billion dollars were paid into social security in 2010 alone (Goss et al., 2013).
Did you know?
While immigrants make up 16% of the labor force, they make up 18% of the business owners
Between 2000 and 2013, immigrants accounted for nearly half of overall growth of business ownership in the United States (Fiscal Policy Insitute, 2015).
25.3 Current Immigration Policy
Although the decision to migrate is generally made and motivated by families, immigration policy generally focuses on the individual. For example, visas are granted to individuals, not families. In this section, we will describe the immigration policies that are most influential for today’s families. For an overview of all immigration policies and their historical context, please see The History of Documented Immigration Policy (1850s-1920s, 1920s-1950s, 1950s to Present, and the History of Undocumented Immigration Policy, respectively).
In the landmark decision of Arizona et al. v. United States (2012), Associate Justice Anthony Kennedy remarked that “The history of the United States is in part made of the stories, talents, and lasting contributions of those who crossed oceans and deserts to come here.”
1952 McCarran-Walter Act: This act and its amendments remain the basic body of immigration law. It opened immigration to all countries, establishing quotas for each (US English Foundation, 2016). This act instituted a priority system for admitting family members of current citizens. Admission preference was given to spouses, children, and parents of U.S. citizens, as well as to skilled workers (Immigration History, 2019). This meant that more families from more countries had the opportunity to reunite in the United States.
1965 Hart-Celler Immigration Act or Immigration and Nationality Act and 1978 Amendments. In this act, the national ethnicity quotas were repealed. Instead, a cap was set for each hemisphere. Once again, priority was given to family reunification and employment skills. This act also expanded the original four admission preferences to seven, adding: (5) siblings of United States citizens; (6) workers, skilled and unskilled, in occupations for which labor was in short supply in the United States; and (7) refugees from Communist-dominated countries or those affected by natural disasters. This expanded the opportunities for family members to reunite in the United States.
1990 Immigration Act. This act eased the limits on family-based immigration (US English Foundation, 2016). It ultimately led to a 40% increase in total admissions (Fix & Passel, 1994).
Deferred Action for Childhood Arrivals. The Dream Act, first introduced in 2001, would allow for conditional permanent residency to immigrants who arrived in the United States as minors and have long-standing United States residency. While this bill has not yet been signed into law, the Obama administration created renewable two-year work permits for those who meet these standards. This had the largest impact on undocumented families. Many children travel to the United States without documents to be with their families, and then spend most of their lives in the United States. If the bill passed, these children would have new opportunities to pursue higher education and jobs in the land they think of as home, without fear of deportation. In 2017, the Trump administration attempted to rescind the DACA memorandum, but federal judges blocked the termination. Individuals with DACA can continue to renew their benefits, but first-time applicants are no longer accepted (American Immigration Council, 2019).
2000 Life Act and Section 245(i). This allowed undocumented immigrants present in the United Sttes to adjust their status to permanent resident, if they had family or employers to sponsor them (US English Foundation, 2016).
2001 Patriot Act: The sociopolitical climate after the September 11, 2001 terrorist attacks drastically changed immigrant policies in the United States. This act created Immigration and Customs Enforcement (ICE) and Citizenship and Immigration Services (CIS), greatly enhancing immigration enforcement.
2005 Bill. The House of Representatives passed a bill that increased enforcement at the borders, focusing on national security rather than family or economic influences (Meissner, Meyers, Papademetriou & Fix, 2006).
2006 Bill. The Senate passed a bill that expanded legal immigration, in order to decrease undocumented immigration (Meissner, Meyers, Papademetriou & Fix, 2006).
As these policies indicate, it is currently very difficult to enter the United States without documentation. There are few supports available to those who do make it across the border (see Table 1). However, the 2000 Life Act and the Dream Act provide some provisions for families who live in the United States to obtain documentation to remain together, at least temporarily.
For families who want to immigrate with documentation, current policy prioritizes family reunification. Visas are available for family members of current permanent residents, and there are no quotas on family reunification visas (See “Process for Becoming a Citizen). Even when family members of a current permanent resident are granted a visa, they are a long way from residency. They must wait for their priority date and process extensive paperwork. If a family wants to immigrate to the United States but does not have a family member who is a current permanent resident or a sponsoring employer, options for documented immigration are very limited.
HomeTable 1
Supports available to documented and undocumented immigrants</strong
Taken from US Citizenship and Immigration Services, 2010
Textbox 2
Process of Becoming a Citizen, also called “Naturalization”
File a petition for an immigrant visa. The first step of documented immigration is obtaining an immigrant visa. There are a number of ways this can occur:
• For family members. A citizen or lawful permanent resident in the United States can file an immigrant visa petition for their immediate family members in other countries. In some cases, they can file a petition for a fiancé or adopted child.
• For sponsored employees. United States employers sometimes recruit skilled workers who will be hired for permanent jobs. These employers can file a visa petition for the workers.
• For immigrants from countries with low rates of immigration. The Diversity Visa Lottery program accepts applications from individuals in countries with low rates of immigration. These individuals can file an application, and visas are awarded based on random selection.
If prospective immigrants do not fall into one of these categories, their avenues for documented immigration are quite limited. For prospective immigrants who fall within one of these categories, their petition must be approved by USCIS and consular officers. However, they are still a long way from residency.
Wait for priority date. There is an annual limit to the number of available visas in most categories. Petitions are filed chronologically, and each prospective immigrant is given a “priority date.” The prospective immigrant must then wait until there is an available visa, based on their priority date.
Process paperwork. While waiting for the priority date, prospective immigrants can begin to process the paperwork. They must pay processing fees, submit a visa application form, and compile extensive additional documentation (such as evidence of income, proof of relationship, proof of United States status, birth certificates, military records, etc.) They must then complete an interview at the United States. Embassy or Consulate and complete a medical exam. Once all of these steps are complete, the prospective immigrant received an immigrant visa. They can travel to the United States with a green card and enter as a lawful permanent resident (US Visas, n.d.).
A lawful permanent resident is entitled to many of the supports of legal residents, including free public education, authorization to work in the United States, and travel documents to leave and return to the United States (Refugee Council USA, 2019). However, permanent resident aliens remain citizens of their home country, must maintain residence in the United States in order to maintain their status, must renew their status every 10 years, and cannot vote in federal elections (USCIS, 2015).
Apply for citizenship. Generally, immigrants are eligible to apply for citizenship when they have been a permanent resident for at least five years, or three years if they are married to a citizen. Prospective citizens must complete an application, be fingerprinted, and have a background check, complete an interview with a USCIS officer, and take an English and civics test. They must then take an Oath of Allegiance (USCIS, 2012).
25.4 Opportunities & Barriers for Immigrant Families
The United States gives priority to family reunification and has made great efforts to make the process of reunification accessible to immigrants. This provides new opportunities and security for immigrant families. However, there are still substantial challenges and barriers to families. In the sections below, we will describe the opportunities and barriers available to families in different configurations, including families seeking reunification, families living together in the United States without documentation, and couples in international marriages.
Reunification
As we outlined in the policy section, United States policy prioritizes family reunification, and immigrant and refugees’ spouses and children are eligible to immigrate without visa quotas. The majority of current immigrants are family members being reunited with United States citizens or permanent residents.
USCIS providing answers about citizenship and immigration for soldiers and families at Army Community Services in Seoul. US Army Garrison Red Cloud – U.S. Embassy answers immigration questions – CC BY-NC-ND 2.0.
In addition to these policies that promote family reunification, there are now more accepting policies to support reunification of gay citizens and their immigrant spouses. Historically, United States immigration policy has denied immigration to same-sex orientation applicants. Under the 1917 Immigration Act, homosexuality was grounds for exclusion from immigration. In 1965, Congress argued that gay immigrants were included in a ban on “sexual deviation” (Dunton, 2012). The ban against gay immigrants continued until 1990, when the Immigration and National Act was amended, removing the homosexual exclusion. Moreover, asylum has been granted for persecution due to sexual orientation (Dunton, 2012). Until 2013, immigrants and refugees could apply for residency or visas for their opposite-sex spouses. There was no provision made for same-sex partners. Following the overturn of the Defense of Marriage Act (DOMA), citizens and permanent residents can now sponsor their same-sex spouses for visas. United States citizens can also sponsor a same-sex fiancé for a visa (USCIS, 2014).
Despite these advances, there are two large challenges faced by immigrants seeking reunification. First, it requires substantial time and resources, including legal counsel, to navigate the visa system. Adults can petition for permanent resident visas for themselves and their minor children, but processing such applications can take years. Currently, children of permanent residents can face seven-year wait times to be accepted as legal immigrants (Meissner, Meyers, Papademetriou & Fix, 2006).
In some cases, children can age out of eligibility by the time the application is processed and the visa is granted. Such children then go to the end of the waiting list for adult visa processing (Brown, 2014). The 2002 Child Status Protection Act is designed to protect children against aging out of visa eligibility when the child is the primary applicant for a visa, but the act does not state if it applies if a parent was applying on behalf of their family (Brown, 2014). In the 2014 ruling to Cuellar de Osorio v. Mayorkas, the Supreme Court found that the child status protection act does not apply for children when a parent is applying on behalf of their family. Such young adults have already generally been separated from family for many years, and will now be separated for years or decades more.
Undocumented Families
For families who do not have a sponsoring family member, have a sponsoring employer, or originate from a country with few immigrants, the options for legal immigration to the United States are very limited. Those families who choose to travel to the United States face substantial barriers, including a perilous trip across the border, few resources, and the constant threat of deportation.
One of the most dangerous times for undocumented families is the risky trip across the border. In order to avoid border patrol, undocumented immigrants take very dangerous routes across the United States border. The vast majority of all apprehensions of undocumented immigrants are on the border (while the remainder is apprehended through interior enforcement). For example, in 2014 ICE conducted 315,943 removals, 67% of which were apprehended at the border (nearly always by the Border Patrol), and 33% of which were apprehended in the interior (ICE, 2019). The trip and efforts to avoid Border Patrol can be physically dangerous and in some cases, deadly. The acronym ICE symbolizes the fear that immigrants feel about capture and deportation. A deportee in Exile Nation: The Plastic People (2014), a documentary that follows United States deportees in Tijuana, Mexico, stated that ICE was chosen as the acronym for the Immigration and Customs Enforcement agency because it “freezes the blood of the most vulnerable.” The Trump administration instituted a policy of separating families apprehended at the border and of criminal prosecution for all apprehended crossing the border illegally, including those applying for asylum. More than 2,600 children were separated from their caregivers under this policy, which was later overturned.
Even after arrival at the interior of the United States, undocumented immigrants feel stress and anxiety relating to the fear of deportation by ICE (Chavez et al., 2012). This impacts their daily life activities. Undocumented parents sometimes fear interacting with school, health care systems, and police, for fear of revealing their own undocumented status (Chavez et al., 2012; Menjivar, 2012). They may also avoid driving, as they are not eligible for a driver’s license.
Since 2014, the Department of Homeland Security has placed a new emphasis on deporting undocumented immigrants. Department efforts generally prioritize apprehending convicted criminals and threats to public safety, but recent operations have taken a broader approach. In the opening weeks of 2016, ICE coordinated a nationwide operation to apprehend and deport undocumented adults who entered the country with their children, taking 121 people into custody in a single weekend. The majority of these individuals were families who applied for asylum, but whose cases were denied. Similar enforcement operations are planned (DHS press office, 2016). In many cases, the parents’ largest concern is that immigration enforcement will break up the family. Over 5,000 children have been turned over to the foster care system when parents were deported or detained. This can occur in three ways:
• when parents are taken into custody by ICE, the child welfare system can reassign custody rights for the child,
• when a parent is accused of child abuse or neglect and there are simultaneous custody and deportation proceedings, and
• when a parent who already has a case open in a child welfare system is detained or deported (Enriquez, 2015; Rogerson, 2012).
“One of my greatest fears right now is for anybody to take me away from my baby, and that I cannot provide for my baby. Growing up as a child without a father [as I did], it’s very painful… I felt like there was no male to protect them.” – Mexican Immigrant describing how his fear of deportation grew after his baby daughter was born (Enriquez, 2015, p. 944)
Although the perilous trip and threat of deportation are significant challenges for undocumented immigrant families, there are two recent policy changes that offer new opportunities and protections for undocumented families. First, some states have sought to expand the educational supports available to undocumented immigrants. The State of Minnesota, for example, enacted the “Dream Act” into law (2013). This unique act, which is also known as the “Minnesota Prosperity Act,” makes undocumented students eligible for State financial aid (State of Minnesota, 2014; Chapter 99, Article 4, Section 1).
Protesting for immigration reform. Peoplesworld – CC BY-NC 2.0.
Second, there are now greater protections for unaccompanied children. In some cases, children travel across the border alone, without their families. They may be travelling to join parents already in the United States, or their parents may send them ahead to try to obtain greater opportunities for them. As a result of human rights activism, unaccompanied and separated immigrant children are now placed in a child welfare framework by licensed facilities under the care of the Office of Refugee Replacement (Somers, 2011). They provide for education, health care, and psychological support until they can be released to family or a community (Somers, 2011). Each year, 8,000 unaccompanied immigrant children receive care from the ORR (Somers, 2011).
Mixed Status Families
Some members of the family may have documentation, while others do not. There may be cases where a United States citizen has applied for a visa for his family members, but they live without documentation while they wait for their priority date. Alternatively, there may be children who are born in the United States to undocumented parents. These children are entitled to benefits that their undocumented parents are not, such as welfare benefits (Peterson Institute for International Economics, 2005).
Children are subject to “multigenerational punishment,” where they are disadvantaged because of their parents’ undocumented status (Enriquez, 2015). As in undocumented families, parents fear interacting with school, health care, or police (Chavez et al., 2012; Menjivar, 2012). These children have limited opportunities to travel domestically (due to risks of driving without a license) or internationally (due to lack of travel papers) (Enriquez, 2015). When parents’ employment opportunities are limited due to their lack of documentation, the children share in the economic instability (Enriquez, 2015).
“I’m still [supposed to be] perceived as this male provider… [but] we lost our place [after my job found out about my status], and now I’m [living] with my in-laws, and it’s hard to find a great-paying job… It makes you feel like [people are saying]. ‘How dare you do that to a little child.’ It’s hard because you do feel guilty, you feel that you’re punishing someone that shouldn’t be punished.” –Mexican immigrant (Enriquez, 2015, p. 949)
International Marriages
Spouses of United States service members in Italy take the oath of allegiance to become United States citizens. felicito rustique, jr. – CC BY 2.0.
In our increasingly global world, more couples are meeting and courting across national borders. Many of these couples ultimately seek to live together in the same country. In some cases, an immigrant travels to the United States and obtains citizenship, but still hopes to marry someone from their home country and culture. Under current United States policy, there are visas available for fiancés to immigrate to the United States. However, these relationships are screened. There are strict requirements to prove that the marriage is “bonafide.” If a marriage is considered “fraudulent,” the immigrant spouse can be detained and the native spouse can be fined. There are also limits to how many fiancé visas can be filed within a certain time frame so that the same person cannot repeatedly apply for a fiancé visa with different partners (USCIS, 2005).
Regulations are in place to protect the non-citizen fiancés. In some cases, the United States citizen has much greater power than the non-citizen fiancé and may exploit their lack of knowledge of English, local customs, and culture. The United States Government is required to give non-citizen fiancés information about their rights and resources, in an effort to prevent or intervene in cases of intimate partner violence (USCIS, 2005). A citizen can use an international marriage broker (IMB) to connect with a partner from their home country or another desired country. The International Marriage Broker Regulation Act of 2005 (IMBRA) states that the government must conduct criminal background checks on prospective citizen clients, in order to protect the welfare of the fiancés who will enter the United States (USCIS, 2005).
Video
Ruben Parra-Cardona, Ph.D., LMFT discusses mixtures of hope and discrimination in the United States (10:48-11:53).
A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/humanbe/?p=117
25.5 Future Directions
There are two shifts in immigration policy that are critical for the well-being of families. First, policy should shift to accelerate family reunification for those families whose visas have been accepted. Families are currently separated from their children for years, caught in a holding pattern of waiting. This leads to stress, grief, and difficulty building relationships during key developmental times in a child’s life. Accelerating processing applications and shorter wait times would facilitate greater family well-being.
Second, policy could provide greater protection for vulnerable children in undocumented or mixed-status families. In cases where a parent is deported, the child’s welfare should be carefully considered in whether to leave the child in the care of a local caregiver or provide the option to send the child to the home country with their parent.
Recent Policy Changes and the Impact on Families
Malina Her
Since his presidential campaign, President Trump and his administration has placed immense attention on immigration policies. As a result, many recent policy changes and efforts related to immigration enforcement and refugee resettlement have greatly impacted immigrant and refugee families (Pierce, 2019). We highlight here two key policies, the lowering of the refugee admissions cap, and the introduction of new vetting requirements.
Lowering of the refugee admissions
Since the creation of the U.S. refugee resettlement program in 1980, the annual admission of refugees has hit an all-time low within the fiscal year of 2019 with a ceiling cap of 30,000 admissions. Yet the actual refugee admissions and arrivals are even lower, with only 12,154 actual admissions being granted within the first 6 months of the fiscal year (Meissner & Gelatt, 2019; Pierce, 2019). This policy change directly affects the possibility of family reunification, especially in families where partners are not legally married (Solis, 2019).
New vetting requirements
The Trump administration has introduced new vetting requirements for refugees, citing national security risk as a primary reason. This expansion of vetting has increased the amount of information needed for visa applications, such as providing prior years of travel or even usernames to social media accounts (Pierce, Bolter, & Selee, 2018). In addition, resettlement applications of refugees from 11 countries perceived as “high risk” to national security have been reduced on the priority list (Egypt, Iran, Iraq, Libya, Mali, North Korea, Somalia, South Sudan, Syria and Yemen). Yet reports by the National Counterterrorism Center in 2017 have shown that terrorists are unlikely to use resettlement programs as a means to enter the United States (Meissner & Gelatt, 2019; Pierce, 2019). A former director of the U.S. Citizenship and Immigration Services agrees that the increased vetting requirements of refugees appears unnecessary as the vetting procedures in place are already rigorous enough to identify any potentially problematic applicant (Rodriguez, 2017).
These policies have implications for both our communities and for individual refugee families. A draft report conducted by the Health and Human Services in the summer of 2017 found that between 2005 and 2014, refugees contributed an estimated amount of \$269.1 billion dollars in revenues to the U.S. government (Davis & Sengupta, 2017), income that may be stemmed by the low admissions ceiling and longer processing times due to increased vetting procedures. for refugee families, these new vetting procedures add to the long waiting times for family reunification as it backlogs cases. Family members have to wait longer as they undergo and complete additional requirements and it prolongs their cases such that delays can amount to decades. For some, reunification becomes nearly impossible (Hooper & Salant, 2018). Furthermore, applicants seeking refuge or asylum from countries on the high-risk list are turned away from immediate protection as their applications continue to float in the system for review of any potential security risk. Thus many may have to stay in a country where they continue to face violence and persecution as they wait.
25.6 End-of-Chapter Summary
Though there are substantial barriers to family reunification and well-being, there are also great opportunities. In recent decades, U.S. policy has been gradually changed to be more inclusive and aimed more intensely on family reunification. The case studies below outline different paths to immigration and family reunification. They demonstrate the opportunities and assistance which are available, as well as the challenges faced.
Case Study 1: Becoming a Citizen
Mr. and Mrs. Addisu, both in their early 70s, immigrated to the United States from Ethiopia nearly 15 years ago with sponsorship from their daughter and her United States-born husband. The couple was eager to learn English and embrace the different cultural values, which meant becoming citizens. They wanted to join the country that their child and grandchildren called home.
After filing the appropriate documentation, paying related fees, and waiting for several years, both Mr. and Mrs. Addisu were scheduled for their naturalization test. The Addisu’s daughter helped them study the material. They particularly hoped that their parents could obtain citizenship so that the Addisus could take a long trip home to see their friends in Ethiopia, which they had not been able to do since moving to the United States with strict residency requirements.
But it quickly became apparent that Mr. Addisu had trouble learning English, which was primarily age-related. With assistance from a local church, Mr. Addisu applied for an English Language Exemption. This enabled him to exempt from the English language requirement and take the civics test in Oromo with the assistance of an interpreter.
Case Study 2: Family Reunification
Matias, a United States citizen, filed a petition to request a green card for his daughter Victoria who still lived in Mexico. Victoria had a 15-year old son and a 14-year daughter, who were listed on the petition as “derivative beneficiaries”, eligible to receive a visa if their mother received one. Their petition was approved, and they waited for their priority date. Victoria and her son and daughter continued living in Mexico, they lived on a low income and in a violent neighborhood. They communicated regularly with Matias, and Victoria repeatedly expressed how excited she was to see her dad again, and to be able to provide a better life for her kids. She regularly checked on her application and the priority date, excited for its arrival.
The priority date arrived 7 years later. Victoria’s children were now 22 and 21, and so they were no longer eligible to be derivative beneficiaries on Victoria’s visa. When Victoria learned, she was distraught. She talked to every advocacy group she could find, but there were no options. There would have been services available to expedite their petition as the children approached adulthood, but she and Matias had been unaware.
Victoria talked with her children about the options; they could all remain together in Mexico, or she could travel to the United States and apply for them to join her. One of her children as now working, and the other was attending a technical school. They decided together that it would be best for Victoria to go on to the United States. Once she arrived and became a lawful permanent resident, she filed a petition for her kids to get a visa. It was approved. Once again, the family waited for their priority date. Now, Victoria was with her father, but separated from her kids. It was now her kids she was calling, saying, “I miss you, I am excited to see you, I hope we can be together soon, soon, soon.” After 8 years, the priority date arrived. Victoria’s children, now ages 29 and 30, joined their mother in the United States.
Discussion Questions
1. Think back on your own family history. If you had family immigrate to the United States, what policies were in place when they arrived?
2. What would motivate a family to immigrate without documentation? What might make them decide against it?
3. What challenges does a child face if their parents do not have documentation?
4. What are the arguments for making family reunification quicker and more accessible? What are the arguments against it?
5. What barriers did the families in the case studies have to reunification? What supports did they receive?
Helpful Links
Migration Policy Institute
• http://www.migrationpolicy.org/
• The Migration Policy Institute is “an independent, nonpartisan, nonprofit think tank in Washington, DC dedicated to analysis of the movement of people worldwide”. They have regular publications and press releases about trends in migration, both to the United States and internationally.
Statue of Liberty Oral History
27.7 Appendices
Appendix 1
History of Documented Immigration Policy: the Qualitative Restrictions Phase (1850s to 1920s)
In the mid-1800s, the United States began a phase of qualitative restrictions. There was a labor shortage during the 1840s, and many Chinese men and families had immigrated to fill this gap. During the recession that followed, stigma against the Chinese grew. Western states complained that wages were lowering due to Chinese immigration. Immigration policy during this time aimed to exclude “undesirable” immigrants based on country of origin (notably China), skills, and criminal background.
• 1868 14th Amendment: This amendment granted citizenship rights to all people born in the United States. Not all immigrants were considered equally eligible, however; aliens of African descent were eligible for naturalization, while Asians were not (US English Foundation, 2016).
• The Act of 1882: This act is considered the first federal immigration act, which barred (1) convicts; (2) prostitutes; (3) lunatics; (4) idiots; and (5) those likely to become public charges (dependent for support) from immigrating.
• 1882 Chinese Exclusion Act: Immigration of all Chinese laborers was banned. Current Chinese immigrants were denied naturalization, and undocumented immigrants could now be deported (Fix & Passel, 1994). The ban was not repealed until 1943 (US English Foundation, 2016).
• 1881: This Act added the (1) diseased; (2) paupers,” and “polygamists” to the list of people excluded from immigrating to the United States.
• 1903: And this act added (1) epileptics; (2) insane; (3) beggars; and (4) anarchists.
• 1906 Naturalization Act: Naturalization required the ability to speak and understand English (US English Foundation, 2016). This was implemented in an effort to discourage “inferior” immigrants from applying (Weissbrodt & Danielson, 2011).
• 1917 Immigration Act or Asiatic Barred Zone Act: Congress barred immigrants from most of Asia (US English Foundation, 2016). They also added a literacy test for naturalization and banned immigrants with “perceived mental inferiority”, which included homosexuality (Dunton, 2012).
Appendix 2
History of Documented Immigration Policy: the Quantitative Restrictions Phase (1920s to 1950s)
In the early 1900s, the United States began a phase of quantitative immigration restrictions. The United States was again in a recession, and citizens feared that immigrants could reduce employment opportunities. Immigration policy now instituted quotas to restrict immigration.
• 1921 Quota law: Each national origin was given a quota limit. For example, immigrants from each European country could not exceed 3% of the national census of people from that country currently living in the United States. Quotas favored western and northern Europeans, and most Asian countries continued to be excluded (US English Foundation, 2016).
• 1924 Immigration and Naturalization Act, also known as Johnson-Reed Act: This restricted the annual quota to 2% for each country, substantially reducing total immigration. The system favored Southern and Eastern European immigrants, and immigrants from most Asian countries were prohibited (US English Foundation, 2016).
• 1952 McCarran-Walter Act: This act, and the amendments below, remains the basic body of immigration law. It opened immigration for many countries, establishing quotas for all countries (US English Foundation, 2016). It also established a quota for immigrants whose skills were needed in the labor force (Fix & Passel, 1994). The act also implemented a four admission preferences: (1) unmarried adult sons and daughters of United States citizens; (2) spouses and unmarried sons and daughters of United States citizens; (3) professionals, scientists, and artists of exceptional ability; and (4) married adult sons and daughters of United States citizens.
Appendix 3
History of Documented Immigration Policy: the Inclusive Phase (1950s to Present)
President Kennedy denounced the national origins quota system (“Immigrant policy should be generous; it should be fair; it should be flexible. With such a policy we can turn the world, and our own past, with clean hands and a clear conscience.”). The civil rights movement gave further additional power to a more inclusionary policy system. Immigration policy began to eliminate racial, national, and ethnic biases (Fix & Passel, 1994).
• 1965 Hart-Celler Immigration Act or Immigration and Nationality Act and 1978 Amendments. In this act, the national ethnicity quotas were repealed. Instead, a cap was set for each hemisphere. Priority was given to family reunification and employment skills. This shifted away from a priority on European Immigration (Fix & Passel, 2004), and led to a substantial increase in documented immigration (Peterson Institute for International Economics, 2005). This act also expanded the original four admission preferences to seven, adding: (5) siblings of United States citizens; (6) workers, skilled and unskilled, in occupations for which labor was in short supply in the United States; and (7) refugees from Communist-dominated countries or those affected by natural disasters.
• 1990 Immigration Act: This act increased the ceiling for employment-based immigration and eased the limits on family-based immigration (US English Foundation, 2016). It was created as a compromise between exclusionary and inclusionary policies (see undocumented immigration section below), but ultimately led to a 40% increase in total admissions (Fix & Passel, 1994). It also created a Diversity Immigrant Visa Program, known as the “Green Card Lottery,” increasing the focus on diversity in admissions. Each year, the Attorney General issues visas through this program to regions that sent few immigrants to the United States.
• 2000 Legal Immigration Family Equity (LIFE) Act: This act temporarily revived a section of the Immigration Act, allowing qualified immigrants to obtain permanent residency, even if they entered without documents.
• 2001 Patriot Act: This act allowed for the indefinite detention of immigrants
• Deferred Action for Childhood Arrivals: The Dream Act, proposed in the Senate in 2001, would allow for conditional permanent residency to immigrants who arrived in the US as minors and have long-standing US residency. While this bill has not been signed into law, the Obama administration has created renewable two-year work permits for those who meet these standards.
Appendix 4
HomeHistory of Undocumented Immigration Policy
Before the mid-1900s, there were few policies that regulated the identification and deportation of undocumented immigrants. The Immigration Act of 1891 introduced undocumented immigration policy by establishing the Bureau of immigration, responsible for deportation of undocumented immigrants. In 1940, the Alien Registration Act allowed for all previously undocumented immigrants to obtain legal recognition. All residents who were not US citizens were required to register with the government. They were given a receipt card (AR-3) as proof of compliance. After World War II, this became part of the immigration procedure. Immigrants were now given a visitors form, temporary foreign laborer card, or a permanent resident card (“green card”; US English Foundation, 2016).
Policies became much more stringent beginning in the mid-1900s. Immigration rates dropped during the Great Depression resulting in a labor shortage. The government established the Bracero program in 1942 to actively recruit temporary agricultural laborers from Mexico. Over 4 million Mexican laborers were recruited over the next twenty years (Mandeel, 2014). Through this program, Mexican immigrants began to establish homes and social networks in the United States, and in turn, helped friends and family to come to the United States both legally and illegally.
There was controversy over the Bracero program. As a result, the INS implemented “Operation Wetback” that targeted and deported Mexican immigrants between 1954 and 1964. When the Bracero program ended in 1964, there was an influx in undocumented immigration (Mandeel, 2014; Nadadur, 2009). Legislation after this point has aimed to reduce undocumented immigration.
• 1986 Immigration Reform and Control Act: This act was implemented in response to criticism of the United States being unable to control the flow of undocumented immigrants. The act made it illegal to hire undocumented workers, and created sanctions. It required that states verify immigration status of applicants for welfare (Fix & Passel, 1994). It expanded border enforcement (Peterson Institute for International Economics, 2005; Fix & Passel, 1994). These provisions were meant to reduce enticements to immigrate without documentation and to enforce immigration policy. However, it also granted amnesty to all people living without documents prior to 1982, and to their immediate families in other countries (US English Foundation, 2016). This led to the legalization of more than one percent of the United States population (Fix & Passel, 1994). In order to reduce financial burdens of this declaration of amnesty, the act also provided funds for states to provide health care, public assistance, and English education (Meissner, Meyers, Papademetriou & Fix, 2006), but barred most previously undocumented immigrants from receiving federal public welfare assistance for five years (Weissbrodt & Danielson, 2011).
• 1996 Undocumented Immigration Reform and Immigrant Responsibility Act: This act aimed to reduce undocumented immigration. It reduced benefits for legal immigrants, such as food stamps and welfare. It increased border control and expedited deportation of undocumented immigrants and increased required documentation for employment (US English Foundation, 2016).
• 1996 Anti-Terrorism and Effective Death Penalty Act: This act expedited the removal of foreigners convicted of felonies, or who do not have proper documentation. The felony bar remains today and is an important determinant of immigrants being deported, even if they arrived in the United States legally.
• 2000 Life Act and Section 245(i): This allowed undocumented immigrants present in the United States to adjust their status to permanent resident, if they had family or employers to sponsor them (US English Foundation, 2016).
• 2001 Patriot Act: The sociopolitical climate post-September 11, 2001 drastically changed immigrant policies in the United States. The Department of Homeland Security (DHS) was formed in 2002 and absorbed Immigration and Naturalization Services (INS). This act created two other agencies: Immigration and Customs Enforcement (ICE) and Citizenship and Immigration Services (CIS). This act also enhanced immigration enforcement and barred immigrants with potential terrorist links (US English Foundation, 2016).
• 2005: The House of Representatives passed a bill that increased enforcement at the borders, focusing on national security rather than family or economic influences (Meissner, Meyers, Papademetriou & Fix, 2006).
• 2005 REAL ID Act: This act required that before states issue a driver’s license or identification care, they must verify the applicant’s legal status.
• 2006: The Senate passed a bill that expanded legal immigration, in order to decrease undocumented immigration (Meissner, Meyers, Papademetriou & Fix, 2006).
Attribution
Adapted from Chapters 1 through 9 from Immigrant and Refugee Families, 2nd Ed. by Jaime Ballard, Elizabeth Wieling, Catherine Solheim, and Lekie Dwanyen under the Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/09%3A_Global_Perspectives_and_Theories/25%3A_Immigration_and_Immigrant_Policy-_Barriers_and_Opportunities_for_Families.txt |
Learning Objectives
• Learn from the national and global perspectives of refugee families and their journey.
• Recognizing that the world is constantly and rapidly changing.
• Recognizing that Global/national/international events can have an impact on individuals, families, groups, organizations, and communities.
• Global implications dictate that we foster international relationships and opportunities to address international concerns, needs, problems, and actions to improve the well-being of not only U.S. citizens, but global citizens.
26.1 Introduction
“We mostly lived in the jungle, because it was not safe to stay in the village. I had four children, each a year apart, I think the oldest was four. Ever since the Hmong started to flee the villages, if the communists found people in the villages they would kill them, so we hid in jungles most of the time… I did not have time to be afraid. Of course, I was scared the communists might find us, but I thought to myself that it did not really matter if I was afraid or not. I left it up to fate what was to become of us. There was no one to help us, and no safe place we could run to where we knew there would be help if we arrived, so we just kept running and hiding, all the while trying to decide if we should flee to Thailand.”
-Mai Vang Thao, Hmong refugee
Hmong Women’s Action Team Oral History Project,
Minnesota Historical Society
Throughout history, families who are persecuted or fear persecution in their home countries have sought refuge in foreign countries. As Mai Vang Thao’s story demonstrates, these families face daily threats of violence and struggle to provide basic security or resources for their children. Families seek physical safety for themselves and their children by fleeing to a new country. The United States, which has been the final destination for many of these families who have been forced to flee, can offer them refugee or asylee status as a protection. Refugee or asylee families can live in the United States, with temporary assistance to get settled and to begin providing for themselves and their families.
A refugee is someone who was persecuted or fears persecution (on the basis of race, religion, nationality, membership in a particular social group, or political opinion), has fled to another country, and has not participated in persecuting others. There is a special subcategory of refugees called asylum seekers: refugees and asylum seekers are different only in the process of relocation. Refugees have applied for and been granted refugee status before they leave for the United States. Asylum seekers meet all the criteria for refugee status but have already reached the United States. Although the process of arrival is different, the term refugee will be used in this text to refer to refugees and asylees unless otherwise noted.
The purpose of this chapter is to identify the paths taken by refugee families from persecution to relative safety. We will continue to follow in Mai Vang Thao’s footsteps to see one story that demonstrates the steps of fleeing persecution, family separation, admittance to the United States, and becoming accustomed to the new home.
26.2 Fleeing Persecution and Separation from Family
During those times everyone was afraid, and we taught the children very young to be afraid, so at the age of one or two, they already learned to be afraid and did not cry either.
-Mai Vang Thao, Hmong refugee
Fleeing Persecution and Separation from Family
All refugees have experiences of loss and/or exposure to traumatic events, either personally or within their communities. Such experiences might include systematic discrimination and intimidation, civil war, ongoing military conflicts, forceful government expulsion from the country, ethnic cleansing, and even genocide. Families living in these contexts often experience violence, or they hear about it in their communities and have reason to fear it. Families’ top priority is to find safety. However, even after they relocate, some families will experience the long-term effects from the traumatic stress they have experienced.
Kosovar refugees fleeing their homeland. [Blace area, The former Yugoslav Republic of Macedonia] United Nations Photo – Kosovo refugees – CC BY-NC-ND 2.0.
“[The children’s father] was hardly with us. He went off with the men and left us hiding in the jungles. In fact he had prepared that in the event that we could no longer stay, he would leave to Thailand, and the children and I, if captured by the communists, would stay behind since the communist soldiers would not kill us because we are only women and children.”
-Mai Vang Thao, Hmong refugee
The conflicts and situations that cause people to flee their home countries often separate families. Families can become separated in the midst of a conflict or during the process of fleeing or migrating (families can also be separated during the resettlement process, see below). Even if parents and children are kept together through this arduous process, resettlement of an entire family unit (in many cultures, the family unit includes grandparents, aunts and uncles and their families) would rarely occur.
Separation from family members can be a source of guilt, loss, and added pressure. These losses of family ties and community support can often be characterized as ambiguous (Boss, 2006). When a family member dies, the loss is concrete, and the family can mourn. When family members are separated, there can be great ambiguity. Separated loved ones are physically absent but very present in the minds of their family members. Families have difficulty determining who is in the family, and what roles they play. This ambiguity can add to the stress of an already stressful migration. For example, youth separated from their parents during civil war wondered if their families had survived the fighting or had died. They described feelings of loneliness and intense depression. One child described, “The kids were most thinking – Are they alive or are they not alive?” (Luster, Qin, Bates, Johnson, & Rana, 2008, p. 449).
Wondering whether certain family members are alive or dead can cause individuals and families to become stuck with mixed feelings of hope, loss, guilt, and grief. These ambiguous losses compound the concrete losses of homes and family members. The impact of loss and traumatic events can be seen at both the individual and family level. In fact, one study found that the statistical relationships between traumatic events, grief, depression, and PTSD are stronger at the family level than they are at the individual level (Nickerson et al., 2011). Separated individuals must find ways to accept and live with the ambiguity. As one child said of his separation from his parents, “It happened. I did not have any control over it. I just think I wish it did not happen. But it did and I could not do anything about it” (Luster et al., 2008, p. 449).
When refugees are able to remain with close family members, it can ease the strains of relocation and coping with the traumas experienced in the home country. In a study of refugees in Norway, Lie, Lavik, and Laake (2001) found that the presence of close family in Norway had a positive impact on mental health symptoms, especially for those with higher exposure to traumatic events. McMichael, Gifford, and Correa-Velez (2011) similarly found that family connection is particularly important for youth early in the resettlement process.
26.3 Travel to Temporary Refuge
“When it became so unsafe we could not stay anymore. Some of the men who had returned [from Thailand] were my uncles, and they said that if we wanted to go with them to Thailand they would help us out, so that is why we decided to leave for Thailand… I still remember lots of things about living in camp, such as the sicknesses, not enough water to drink, the very hot weather, and not enough food…Everything about it was bad. We were living on the Thai people’s land, so they treated us any way they wanted. When the Hmong went to the flea market, they were beaten.”
-Mai Vang Thao, Hmong refugee
In order to be a refugee, families must have traveled to a new country in order to escape persecution. Families generally cross the border into another country where they have heard that some aid is available. Charity or government organizations will set up refugee camps, which provide some shelter, medical care, and food.
Refugee camps are set up in response to a sudden and great need. Consequently, there are rarely enough resources for all of the families. Women are particularly at risk after a disaster. They may struggle to compete with men for resources (Viswanath et al., 2013). Post-disaster resources tend to have little sensitivity to needs of women, such as sanitary towels, diapers, or privacy or protection near restroom facilities (Viswanath et al., 2013; Fisher, 2010). Women experience increased sexual violence and domestic abuse following a disaster (Luft, 2008; Neumayer & Plumper, 2007; Anastario, Larrance, & Lawry, 2008; Viswanath et al., 2013).
Families can sometimes be separated during this stage of relocation. For example, children are sometimes sent ahead to another camp that is thought to be safer, leading to separation from their parents (Luster, Qin, Bates, Johnson, & Rana, 2008). This can lead to both vulnerability and feelings of loss.
Figure 1. Camp for Pakistani Refugees. Al Jazeera English – Refugee camp – CC BY-SA 2.0.
26.4 Family Admittance to the United States
Once refugees have entered a new country, they can begin the road to refugee or asylee status in the United States. This process can be arduous and often takes over a year. The first step is a Refugee Status Determination or RSD. An authorized official from the United Nations High Commissioner for Refugees will determine if an individual is considered a refugee under international, regional, or national law. The official will then determine if the person should return to their home country, resettle in the neighboring country, or resettle in a third country (such as the United States). Less than 1% of refugees worldwide are ever resettled in a third country (UNHCR, 2015).
How do you define “refugee”?
UNHCR: The UNHCR held a Council in 1951 on the Status of Refugees, and they created a definition of refugee. Their definition is summarized in this chapter, but the full text is included on page 14 of the Council notes: http://www.unhcr.org/3b66c2aa10.html.
United States: The full definition of refugee adopted by the U.S. government comes from the UNHCR definition. You can see the U.S. definition in Section 101(a)(42) of the U.S. Immigration and Nationality Act.
United States Policies about Refugee Admittance
The UNHCR or an authorized NGO can refer a refugee for admission to the United States. Each year, the United States prioritizes particular groups to be eligible for refugee status. The current priorities are:
• Priority 1: Cases that are identified and referred to the program by the United Nations High Commissioner for Refugees (UNHCR), a United States Embassy, or a designated non-governmental organization (NGO).
• Priority 2: Groups of special humanitarian concern identified by the U.S. refugee program.
• Priority 3: Family reunification cases (spouses, unmarried children under 21, and parents of persons lawfully admitted to the United States as refugees or asylees or permanent residents (green card holders) or United States citizens who previously had refugee or asylum status; PRM, 2018).
The United States President sets a refugee ceiling each year that identifies the number of refugees who can be granted refuge in the country (see Refugee Policy: A Brief History for a brief history of United States Refugee policy). Limits for refugees allowed from particular world regions are also set. Asylees are not included in this number. These limits can be influenced by national security threats and political will. As an example, the number of admitted refugees across all refugee groups dropped from 68,925 to 26,788 following the terrorist attacks on September 11th, 2001 (Refugee Council, 2012). In the following years, the ceiling was consistently set between 70,000-85,000. The Trump Administration has cut the ceiling to 18,000, the lowest number since the creation of the refugee resettlement program. For the most up-to-date numbers of United States-admitted refugees and their countries of origin, see www.state.gov/j/prm/releases/statistics/
People who receive a referral for refugee status (not asylum seekers) work with a Resettlement Support Center to prepare their application. They then are interviewed by an officer from the United States Citizen and Immigration Services. Applying is free and applications can include a spouse, unmarried children, and occasionally other family members. All individuals approved as refugees are medically screened for infectious diseases, which could prevent entry to the United States. For a case example of this process, please see Ester’s Story.
In contrast, asylum seekers apply for asylum at a port of entry to the United States or apply within one year of arriving in the United States. There are two methods of seeking asylum: affirmative and defensive. In the affirmative asylum process, individuals file an application for asylum to the United States Citizenship and Immigration Services (USCIS). These individuals are free to live in the United States while their case is processed. In this past, a decision was required to be made within 180 days. However, processing time is currently estimated at 8 to 12 months (USCIS, 2019). During the application processing time or the first 180 days after filing the application (whichever is shorter), these individuals are not authorized to work. In the defensive asylum process, an immigrant who is in the process of being removed from the United States may request asylum as a form of relief. This process can happen when an immigrant 1) was apprehended in or entering the United States without documentation or 2) was denied asylum after applying to USCIS asylum officers. If an immigrant requests asylum as a defense against removal from the United States, they conduct removal proceedings in the immigrant court with the Executive Office for Immigration Review. An Immigration Judge hears these cases and makes a final decision about eligibility for asylum (American Immigration Council, 2018).
Many defensive asylum seekers are held in jails or detainment centers until they are paroled or a decision is made about asylum. They typically wear prison uniforms and are separated from opposite gendered family. This practice has been discouraged by the UNHCR and criticized by Human Rights First (Human Rights First, 2012). After an asylee declares a desire for asylum, he or she is interviewed to determine the credibility of the danger threat in their home country. If officials determine that there is a credible threat, there is still a process that must be followed before they are granted asylee status.
26.5 Entering the United States
Entering the United States
“In my opinion this country is even harder to adjust to, harder to live in because… because there are lots of rules and laws that bind us here. It is much harder to do things in this country. I came at an old age already, and learning English does not come easy. Everything is much harder for me.”
-Mai Vang Thao, Hmong refugee
Formal Supports
When refugees have been accepted for admittance to the United States, they are provided with a cultural orientation that can include information and education on basic English phrases, how to shake hands, interviewing for a job, using a western toilet, or the experience of flying on a plane. The International Organization for Migration provides a loan to refugees to cover their airplane ticket expenses from the United States government; they must repay this loan once they are resettled in the country.
Once they arrive, the Office of Refugee Resettlement assigns a voluntary agency (VOLAG) to offer them help (see “Key Organizations in Refugee Admissions and Integration” for a full description of agencies involved in refugee resettlement and policy). These VOLAGs often meet the refugee at the airport and arrange for housing and basic furnishings. They teach the refugees how to purchase groceries and use transportation, and connect them with resources for employment and education. These services are only available for 30-90 days. Across organizations and across states, there is no consistent process for these relocation/integration services, and availability of and applications for resources may vary. In some states, refugees are also eligible for cash assistance or medical assistance beyond this 90 day period (Refugee Council USA, 2019).
HomeKey Organizations in Refugee Admissions and Integration
The following organizations enforce refugee policy and/or help with refugee integration:
• Bureau of Population, Refugees, and Migration (PRM): PRM is a bureau under the U.S. Department of State, and it works internationally to develop human solutions to displacement. They provide funding to and work with international organizations such as the U.N. that operate refugee camps. The director of PRM also serves as the U.S. Coordinator for Refugee Affairs, and is responsible to the president to help develop policy relating to refugees, including admission ceilings and priorities.
• Office of Refugee Resettlement (ORR): ORR is an office within the Department of Health and Human Services. It works with state governments and provides funding for voluntary agencies to facilitate economic and social support to refugees.
• Resettlement Support Centers (RSC): These international organizations help prepare files and store data for those applying for refugee status.
• U.S. Citizenship and Immigration Services (USCIS) and Customs and Border Protection (CBP): USCIS evaluates applications for refugee status, and the CBP screens refugees when they arrive.
• Voluntary Agencies (VOLAGs). Voluntary agencies, such as Catholic Charities and Lutheran Immigration and Refugee Services, have agreements with the State Department to provide reception and placement services for refugees. These agencies are funded through the State Department’s Bureau of Population, Refugees, and Migration. VOLAGs often contract with the ORR to provide resettlement-related services.
The VOLAG works with sponsoring relatives when applicable, and will sometimes find an individual, church, or other private groups that can assist with sponsorship if there is no sponsoring relative (Refugee Council USA, 2019). Refugees are eligible for all welfare benefits offered to citizens, such as Temporary Assistance for Needy Families and Medicaid.
Congolese Family being met at the airport by their caseworker. World Relief Spokane – Welcome to Spokane – CC BY-NC-ND 2.0.
Video
True Thao, MSW, LICSW discusses economic challenges facing refugees and highlights observations in the Hmong community.
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=119
An Overwhelming Transition
Imagine waking up, and finding that everything in your life has changed. Your bed is a different size, shared with a different number of people, and in a different location. You wake up to a new sound, and it is a different temperature than you expect. You get up, and find that the only foods available are foreign to you. You try to go shopping, but you do not know how to navigate the transportation system. When you get there, the food all seem unfamiliar. You do not know how to pay for your food – the currency seems odd, and you also have a “money card” that you don’t understand how to use. You cannot talk to anyone well. You come home and someone has put a piece of paper on the door, which you cannot read and do not know how to have translated.
After relocation, families must navigate a new completely new culture. Everything is new. Often, a family faces changes in every aspect of life. Betancourt, Abdi, Ito, Lilienthal, Agalab, & Ellis (2014) documented major shifts in the experiences of Somali refugee families in Boston, including:
• These Somali families lost resources during the flight from their home country, and arrived to the United States in poverty regardless of their previous status.
• Parents lost employment status, as their previous employment credentials were not accepted in the United States.
• Children were exposed to drugs, violence, and gain activity in the neighborhoods in which they were located.
• Despite this strained economic standing, families felt responsible to send money back to extended family in Somalia.
• Parent-Child authority structures shifted. Children who were more fluent in English withheld information about their situations at school.
• Children faced discrimination based on their nationality. Families were separated from extended support (Betancourt et al., 2014).
These changes, combined with encountering a completely new culture, would shake any family’s coping skills. Unfortunately, the social supports available to refugees are difficult to access. Parents lack knowledge of how to navigate school systems and the health care system and are further isolated from services by lack of transportation and financial resources (Isik-Ercan, 2012; Navuluri et al., 2014). Mental health services are frequently not culturally sensitive or geared towards refugees (Shannon et al., 2014; Weine, 2011).
After arriving in the United States, many states require or recommend that refugees receive physical screening. In spite of the inherent exposure to potentially traumatic events, no states currently require mental health screenings. Some argue that screenings would be unethical without a referral infrastructure in place while others suggest that this is part of the process of addressing mental health concerns and working toward an infrastructure (for additional information about mental health among refugees, please see “Mental Health”). After conducting focus groups with refugees about mental health needs, Shannon and her colleagues argue that existing infrastructures could be trained to be responsive to refugee needs. “Health care providers might require more training about how to work collaboratively with new populations of refugees to assess the mental health effects of war” (2014, p. 13).
“Understanding and healing the symptoms of political oppression starts in the initial assessment with validating the ways that political trauma has rendered refugees ‘voiceless.’ Listening, documenting, and witnessing individual and community stories of exposure to human rights violations is credited as an essential component of restoring human dignity.”
-Shannon, Wieling, Simmelink, & Becher, 2014, p. 11.
Video
Paul Orieny, Sr. Clinical Advisor for Mental Health at the Center for Victims of Torture (CVT), discusses the immense change families encounter after arriving in the United States (0:00-1:23).
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=119
Applying for Citizenship
Refugee status is granted for one year. After that time, refugees are required to apply to become a permanent resident alien, which provides them with the commonly known ‘green card’ (Refugee Council, 2014). Asylees are also eligible to apply for permanent resident alien status, although it is not required. A permanent resident alien is entitled to many of the same supports as citizens, including free public education, authorization to work in the United States, and travel documents to leave and return to the United States (Refugee Council USA, 2019). However, permanent resident aliens remain citizens of their home country, must maintain residence in the United States in order to maintain their status, must renew their status every 10 years, and cannot vote in federal elections (USCIS, 2019). After being a permanent resident for five years, refugees and asylees can apply for citizenship (Congressional Research Service, 2018).
Family Reunification
Once resettled, refugees are able to apply to bring certain family members to join them in the United States if they were not able to come together. In order to bring additional family members to the United States, refugees must apply within two years of being granted refugee or asylee status. Refugees are able to apply to bring a spouse or children who are unmarried, under 21 years old, and conceived before leaving. Only anchor or “principal applicant” refugees are allowed to apply to bring family members. A principal applicant is generally the first refugee from a family to arrive in the United States. These principal applicants then apply to bring their immediate family members. However, the family members coming to join a principle refugee will not be able to apply to bring additional family members (Refugee Council USA, 2019). For example, a refugee could apply to bring his/her parents, his/her wife, and their children to the United States. After they arrive, the wife/husband is not eligible to apply to bring her/his parents. This means that some refugees will continue to feel separated and isolated from loved ones.
The process for family reunification is onerous. Refugees currently residing in their host country and their family members awaiting permission to join them must both work through cumbersome systems in their respective countries. The anchor or principal applicant in the United States must file an application with USCIS, and must provide proof of their relationship to the family members (through birth or marriage certificates, receipts of remittances sent home, photographs, etc.). The family members in the home country must then complete visa interviews, medical examinations, security background checks, and DNA testing (in the case of children).
At any stage along this process, the official can deny the application if they suspect fraud. If an adjudicator suspects fraud in the anchor refugee’s application, they can request stronger evidence of the relationship. If they remain unconvinced that the refugee is telling the truth, they can deny the application. If officers suspect fraud during the visa interview process, they will decline to issue the visa. They may also decline visas for health reasons or for past criminal behavior. There are waivers available, but not all potential refugees are aware of the waivers. Denials require a written rebuttal, the processing of which can take many months. If the rebuttal is approved, the family members in the home country must complete the interviews again. Many lack the education or the resources to tackle these processes. Refugees may not even be aware that they are eligible for reunification, as there is no systematic way of informing them. Currently, it is not clear how many family members eligible for reunification are able to complete the process and submit a full application (Haile, 2015).
There are supports available to help refugees through this process. The VOLAGs who assist with refugee resettlement generally have services available to assist in applications for family reunification. Local community organizations often also offer services to help prepare and complete applications. In Minnesota, for example, the Minnesota Council of Churches hosts weekly information sessions about family reunification eligibility and the application process.
Support from Afar
In cases where families cannot be or choose not to be reunited, refugees still find ways to provide support to one another. Refugees may support family and friends through remittances or may spend time and money trying to locate and bring family members to the United States. In other cases, some may forgo long terms gains, such as job training or college, to be able to immediately help others (Betancourt et al., 2014). While this may cause emotional distress for some, it can also be the source of motivation to make the most of their opportunities. Transnational family connections help refugees retain a sense of identity within their culture and family (Lim, 2009).
Resilience
Refugees are inherently survivors. They have experienced loss and traumatic events but have found ways to survive. For example, Somali refugee families in Boston used religious faith, healthy family communication, support networks, and peer talks to make new lives for themselves (Betancourt et al., 2014). Refugee youth take on new responsibilities after migration, including interpreting, providing financial support, and helping parents navigate services (Hynie, Guruge, & Shakya, 2012). The ways refugee individuals, families, and communities find and create support differ greatly. They draw on family and community resilience to find ways to continue to survive and, in many cases, thrive.
Refugee resilience is seen when they rebuild community networks in the cities to which they relocate. Others have formed organizations to protect and lobby for their communities, and others have been elected to public offices.
Keith Ellison – Congressman Ellison with Minnesota State Senator Mee Moua – CC BY 2.0.
Mee Moua: Senator Mee Moua is the first Hmong American woman to become a Minnesota State Senator. Moua came to the U.S. with her family in 1978 and has since worked her way up from the public housing projects of Appleton, Wisconsin to the State Capitol in St. Paul, Minnesota. Moua is also an accomplished attorney who lives with her mother, her husband, and their two children.
“The issue is not whether the Asian American politicians are ready, it’s really whether America is ready.”
For a complete interview about her path to the U.S., go to: https://www.mprnews.org/story/2010/06/29/moua.
26.6 Future Directions in Policy and Refugee Family Support
Future Directions in Policy and Refugee Family Support
There are great needs, both internationally and nationally, for integrated support for refugee families. One international concern is the lack of protection for internally displaced persons. Those seeking a referral for refugee status complete the process from within the country to which they have fled. Internally displaced persons are not eligible for refugee status unless specifically identified by the President to be approved for refugee status. Additional steps may be necessary to protect those who face persecution but cannot, for whatever reason, flee to another country. In the United States, there is no unified approach to relocating and supporting refugees. Procedures vary by state and by VOLAG. President Obama created the White House Task Force on New Americans specifically to create unified plans to “create welcoming communities and fully integrating immigrants and refugees” (White House, 2014), and more work can be done in this area. Particularly given the Trump administration’s drastic reduction in the number of refugee admissions and associated funding cuts, refugee resettlement programs must focus on providing support effectively and efficiently. The Migration Policy Institute has recommended development of two-generation approaches to support families (MPI, 2018).
Video
Paul Orieny, Sr. Clinical Advisor for Mental Health at the Center for Victims of Torture (CVT), discusses the importance of services when families arrive (6:40-10:23).
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=119
26.7 Conclusion
Refugee Stories: Policy in Practice
In this chapter, we have described the policies and processes that drive refugee resettlement. In order to have a complete picture, it is important to see how these policies and processes impact the real families who experience them. The case study highlighted throughout this chapter and the case study below provide examples of the opportunities and barriers they face during their transition.
Case Study
“Ester, a refugee from the Democratic Republic of the Congo, was forcibly separated from five of her children during civil conflict in the early 2000s. She spent years in a refugee camp and was eventually resettled to North Carolina without her children. Upon arrival in the United States, she petitioned the USCIS to bring her children here. USCIS required that Esther provide birth certificates to prove her relationship to her children, all minors, but these documents did not exist. Incurring months of extra delay, Esther contacted relatives in the Congo who procured retroactive documentation of the relationship. USCIS then approved the petition and transferred the file to the United States Embassy in Kinshasa, Congo’s capital. In order to continue processing, the children had to travel to Kinshasa for visa interviews. But the children lived on the other side of the country, hundreds of miles away, and the journey to Kinshasa was extremely dangerous. Esther had no choice, however, and raised money from her church to fly them to the capital in a small plane…. On the day of their interview, they were turned away from the embassy because they lacked the requisite paperwork, which was in the United States with Esther. Rescheduling the interview took months. During this time, the youngest child, Florence, went missing. She is presumed kidnapped or dead, and did not accompany her siblings to the United States to be reunited with their mother. When the remaining four children received a new interview…. Their visas were approved – nearly two years after Esther filed the petition.”
-“Esther’s Story” describes a true story presented in Haile, 2015.
Discussion Questions
1. Imagine you and your family were suddenly unsafe in the United States and feared for your life. What would you do? If you would leave the country, where would you go? How would you get there? How would you provide for your family in the meantime? How do you think you would be received there?
2. Why should a country receive refugee families?
3. What helps refugee families’ well-being during relocation?
4. Where did Ester run into problems with the resettlement process?
5. What examples of resilience to you see in Ester’s story? What is your reaction to the story’s ending?
6. How might this have been avoided during the process of family reunification?
7. Are there policy recommendations you can see?
Helpful Links
Stories of Recent Immigrants and Refugees
• http://education.mnhs.org/immigration/
• This website, created by the Minnesota Historical Society, is a database of oral histories of recent immigrants. They have stories from Asian Indian, Filipino, Hmong, Khmer, Latino, Somali and Tibetan refugees and immigrants.
UNHCR Website
• http://www.unhcr.org/
• This is the website of the UN Refugee Agency. It has up-to-date news on refugee crises, needs, and resources.
USCIS United States Refugee Admissions Program Consultation & Worldwide Processing Priorities
References
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Anastario, M. P., Larrance, R., & Lawry, L. (2008). Using mental health indicators to identify postdisaster gender-based violence among women displaced by Hurricane Katrina. Journal of Women’s Health, 17(9), 1437–1444.
Betancourt, T. S., Abdi, S., Ito, B. S., Lilienthal, G. M., & Agalab, N. (2014). We left one war and came to another: Resource loss, acculturative stress, and caregiver-child relationships in Somali refugee families. Cultural Diversity and Ethnic Minority Psychology, 21(1), 114-125. doi: 10.1037/a0037538
Bureau of Population, Refugees, and Migration (PRM). (2016). U.S. refugee admissions program FAQs. Retrieved from: https://2009-2017.state.gov/j/prm/releases/factsheets/2016/264449.htm
Bureau of Population, Refugees and Migration (PRM). (2018). Proposed refugee admissions for fiscal year 2019. Retrieved from: https://www.state.gov/remarks-and-releases-bureau-of-population-refugees-and-migration/proposed-refugee-admissions-for-fiscal-year-2019/
Boss, P. (2006). Loss, Trauma, and Resilience. New York: W.W. Norton.
Burt, L. & Batalova, J. (2014). Refugees and Asylees in the United States. Migration Policy Institute. Retrieved from: http://www.migrationpolicy.org/article/refugees-and-asylees-united-states
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Luster, t. Qin, D. B., Bates, L., Johnson, D. J., Rana, M. (2008). The lost boys of Sudan: Ambiguous loss,search for family, and reestablishing relationships with family members. Family Relations, 57, 444-456.
McMichael, C., Gifford, S, M., & Correa-Velez, I. (2011). Negotiating family, navigating resettlement: Family connectedness among resettled youth with refugee backgrounds living in Melbourne, Australia. Journal of Youth Studies, 14(2), 179-195. doi: 10.1080/13676261.2010.506529
Migration Policy Institute (2018). Report: Amid Extraordinary Pressure on Refugee Resettlement Program, Time Is Ripe to Rethink Ways to Improve Refugee Integration. Retrieved from: https://www.migrationpolicy.org/news/report-amid-extraordinary-pressure-refugee-resettlement-program-time-ripe-rethink-ways-improve
Minnesota Historical Society. (2001). Hmong Women’s Action Team Oral History Project: Interview with Mai V. Thao. Retrieved from: http://collections.mnhs.org/cms/largerimage.php?irn=10040206&catirn=10446858
Navuluri, N., Haring, A., Smithson-Riniker, K., Sosland, R., Vivanco, R., Berggren, R., & Rosenfeld, J. (2014). Assessing Barriers to Healthcare Access Among Refugees Living in San Antonio, Texas. Texas Public Health Journal, 66(3), 5-9.
Neumayer, E., & Plumper, T. (2007). The gendered nature of natural disasters: The impact of catastrophic events on the gender gap in life expectancy, 1981–2002. Annals of the Association of American Geographers, 97(3), 551–566.
Nickerson, A., Bryant, R., Brooks, R. T., Steel, Z., Silove, D., & Chen, J. (2011). The familial influence of loss and trauma on refugee mental health: A multilevel path analysis. Journal of Traumatic Stress, 24(1), 25-33. doi: 10.1002/jts.20608
Refugee Processing Center (2016). Admissions & Arrivals. Retrieved from http://www.wrapsnet.org/admissions-and-arrivals/
Change reference to:
Refugee Council USA. (2019). Services upon arrival. Retrieved from http://www.rcusa.org/integration-of-refugees
Shannon, P. J., Wieling, E., Simmelink, J., & Becher, E. (2014). Exploring the mental health effects of political trauma with newly arrived refugees. Qualitative Health Research, 1-15. Doi: 10.117/104973231454975
US English Foundation, Inc. (2016). American immigration – An overview. Retrieved from: https://usefoundation.org/research/issues/american-immigration-overview/
U.S. Citizenship and Immigration Services. (2019). Historical National Average Processing Time for All USCIS Offices. Retrieved from https://egov.uscis.gov/processing-times/historic-pt
United Nations Office of the High Commissioner on Refugees. (2014). Worldwide displacement hits all-time high as war and persecution increase. Retrieved from: http://www.unhcr.org/558193896.html
Viswanath, B., Maroky, A. S., Math, S. B., John, J. P., Cherian, A. V., Girimaji, S. C., & … Chaturvedi, S. K. (2013). Gender differences in the psychological impact of tsunami. International Journal of Social Psychiatry, 59(2), 130-136. doi:10.1177/0020764011423469
Weine, S. M. (2011). Developing preventive mental health interventions for refugee families in resettlement. Family Process, 50(3), 410-430. doi:10.1111/j.1545-5300.2011.01366.x
White House. (2014). Presidential memorandum: Creating welcoming communities and fully integrating immigrants and refugees. Retrieved from: https://www.whitehouse.gov/the-press-office/2014/11/21/presidential-memorandum-creating-welcoming-communities-and-fully-integra
26.8 Appendix
Refugee Policy: A Brief History
Until the mid-1900s, there was no separate policy for refugee admittance to the U.S. All immigrants admitted, including refugees, needed to fall within the established quotas. During World War II, the government began making shifts in order to provide haven for those in need (US English Foundation, 2016).
• 1948 Displaced Persons Act: This was the first U.S. policy for refugees. It allowed Europeans to enter the U.S., establishing a quota for the number of persons fleeing persecution after World War II who would be permitted to enter (US English Foundation, 2016).
• 1953 Refugee Relief Act: This act authorized admission of hundreds of thousands of refugees, escapees, or expellees from Europe and Communist-dominated countries, outside the limits of the established quota (US English Foundation, 2016).
• 1967 Protocol. In 1951, the Office of the United Nations High Commissioner for Refugees (UNHCR) held the Conventional Relating to the Status of Refugees, creating the definition of refugee in Textbox 1. It was amended later with the 1967 Protocol. The 1967 Protocol was ratified by the United States in 1968. This ratification began to move U.S. policy on refugees from individual legislative decisions about whether or not to provide refuge to a particular group, to developing a more comprehensive plan in line with the UNHCR (UNHCR, 2014).
• 1965 Hart-Celler Immigration Act and 1978 Immigration and Nationality Act Amendments. These acts repealed the exclusionary national ethnicity quotas. It introduced the current process of setting refugee admittance ceilings each year (Center for Immigration Studies, 1995).
• 1980 Refugee Act: This act defined refugee and asylee, attempting to follow the United Nations Criteria, and established a process for their admittance (Fix & Passel, 1994; US English Foundation, 2016). It also created the Office of Refugee Resettlement and established a process of resettlement, including providing economic, medical, and social support (Fix & Passel, 1994).
• 1990 Immigration Act: This act granted temporary protected status to refugees from war-torn countries (US English Foundation, 2016).
• 2001 Patriot Act: This act provided humanitarian assistance and special immigrant status for family members of those attacked in 9/11 (US English Foundation, 2016)
The American experience with refugees over the past seventy years has ranged from acceptance to rejection, from well-wrought program efforts to botched policy decisions, from humanitarian concerns to crass politics. The U.S. Department of State has been both the fabricator of paper walls to exclude refugees and the locus of intense efforts to move them quickly into the United States. Religious and secular voluntary agencies have been lauded for their efforts on behalf of refugees and chided for providing inconsistent services. Refugees themselves have been characterized as true American success stories and criticized as overly dependent on public welfare. The American people, in turn, have often been impressively generous in their welcome of refugees but at other times neglectful, disinterested, and sometimes hostile.
David Haines, in Safe Haven? A History of Refugees in America.
Attribution
Adapted from Chapters 1 through 9 from Immigrant and Refugee Families, 2nd Ed. by Jaime Ballard, Elizabeth Wieling, Catherine Solheim, and Lekie Dwanyen under the Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/09%3A_Global_Perspectives_and_Theories/26%3A_From_There_to_Here-_The_Journey_of_Refugee_Families_to_the_United_States.txt |
Learning Objectives
• Learn from the national and global perspectives on human rights for immigrants and refugees.
• Recognizing that the world is constantly and rapidly changing.
• Recognizing that Global/national/international events can have an impact on individuals, families, groups, organizations, and communities.
• Global implications dictate that we foster international relationships and opportunities to address international concerns, needs, problems, and actions to improve the well-being of not only U.S. citizens, but global citizens.
27.1 Introduction
Fatima and her three girls, ages 18 months, 4 and 8 years old, were exhausted by the time they reached the border between the United States and Canada. They had been on the bus from New York for two whole days: it had been very hard changing the baby’s diapers in the tiny bus bathroom that was their only option. Though Fatima had proper passports from the African nation they had fled, she told immigration officials that she was actually fleeing a neighboring country, since there was civil war raging and she thought they would be more likely to let her and her family into Canada. But since the passports did not match her story, United States officials confiscated all of their identity documents and sent her and the girls back to New York. Penniless and alone, the little family made their way to Chicago, where Fatima had heard they were more generous to refugees like herself. What was she fleeing with her three little girls? The prospect of their having to undergo the same female genital mutilation procedure that she had endured at the age of 9. Though their future was extremely unsure, Fatima knew that she had done the only thing she could to protect her girls. “In my country, they circumcise the boys in the hospital under anesthesia,” she told her therapist at the free clinic. “But the girls – no – the girls are circumcised in the bush with rusty razors and no anesthetic at all. This is what the girls get.” For Fatima, there was no other choice for her but to flee and take the girls with her. Even her husband agreed though he had stayed behind in their home country to try to keep sending them money and support. And so, Fatima was alone with her children in a foreign land, hoping for help and guidance with navigating the new language, customs, culture, and realities of the United States.
Background
There are currently an estimated 263,000 refugees and 84,300 asylum seekers residing in the United States (UNHCR; United Nations High Commissioner for Refugees, 2013). These estimates are staggering but will continue to increase in the subsequent years as a result of ongoing-armed conflict and political unrest around the world. If it were not for the significant and ongoing international human rights violations, the number of displaced families – both immigrants and refugees –would be considerably smaller. Families flee their home countries for a range of reasons; from escaping oppressive regimes, as is the case in Syria and Iraq, to attempting to better their economic situations, as is the case in Mexico and much of Latin America. The United States, amongst other Western countries, regularly sees influxes of immigrant and refugee families from around the world depending on the sociopolitical and historical context of the time. Some of these families are intact, but the vast majority are scattered and separated around the world.
According to the Migration Policy Institute (MPI, 2019), the top five countries of origin for resettlement in the United States are the Democratic Republic of Congo, Burma, Ukraine, Eritrea, and Afghanistan. President Trump’s announcement of additional screening for refugees from certain countries may shift these demographics somewhat (MPI, 2015). The controversy over admitting refugees into the United States from certain parts of the world, including Syria, continues to rage unabated in the mainstream press and online. For example, the fear following the Paris attacks of November 2015 prompted governors of 31 states to refuse to admit Syrian refugees; although they do not have the power to control nationality laws (Barajas & Frazee, 2015).
The purpose of this chapter is to provide a broad overview of human rights and lay out some of the essential concepts that are critical to understanding how this global issue affects immigrant and refugee families. We will present the history and general theories of human rights law, as well as explore how various issues pertaining to the current relationship between international human rights law and domestic sovereignty are being dealt with in the United States. Additionally, we will examine how specific human rights issues impact refugee and immigrant families in the United States. Implications for research, policy, and practice, questions for further discussion, and a case study can be found at the end of the chapter.
27.2 What are Human Rights?
António Guterres, the United Nations High Commissioner for Human Rights (UNHCR), wrote that the “…UNHCR has never had to address so much human misery in its 64-year history” (Project Syndicate, 2015). This maxim guides the importance of understanding and exploring the intricacies of human rights. The foundational definition of human rights, according to the UNHCR, encompasses “…inherent rights to all human beings, whatever the nationality, place of residence, sex, national or ethnic origin, color, religion, language, or any other status.” This definition is critical to understanding how and why the international community endeavors to define and protect these rights. A complete understanding of human rights includes moral values, ethical and philosophical norms such as autonomy, justice, beneficence, and non-maleficence. All of these characteristics factor into the creation of a particular paradigm of rights for human beings that has been specifically and gradually shaped into international law since the United Nations was founded in 1945.
While human rights are based on moral values, it is important to recognize that values are fundamentally different from rights. The concept of values addresses what is important whereas human rights address social practices that seek to empower human beings. A right is not merely a benefit since having a right also gives a person a significant legitimacy within the system of governmental authority. According to Donnelly (2003), “…a human rights conception of human dignity and political legitimacy rests on the fact that human beings have an essential, irreducible moral worth and dignity irrespective of the social groups to which they belong” (p. 27). This means that universal human rights, for the purpose of this discussion, are rights that have been codified (i.e., incorporated into a legal code) by the international community.
Early version of the Universal Declaration of Human Rights. United Nations Photo by Greg Kinch – public domain.
While human rights are based on an ideal, they also provide a social means of ensuring that nation-states grant to all human beings the opportunity to lead a life of human dignity; a life worthy for a human being. The specifics of exactly what human rights should entail have been enshrined in documents such as the Universal Declaration of Human Rights (UDHR, 1993), which conceptualizes the idea of human rights as a “self-fulfilling moral prophecy” (Donnelly, 2003, p 15). The UDHR has led to several international treaties, such as the International Covenant on Civil and Political Rights and the International Covenant on Economic Social, and Cultural Rights. These statutes and treaties are created by societies coming together in order to codify global requirements for the kind of human behavior that will support the thriving of all. Thus the notion of human rights as a social practice is integral to the process of understanding the impact on immigrant and refugee families.
27.3 The Universal Declaration of Human Rights
In response to the gross human rights violations following the Second World War, the UDHR was chartered by the United Nations in an attempt to prevent such atrocities from being committed again. The UDHR’s preamble states unequivocally “recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world” (OHCHR; Office of the High Commissioner for Human Rights, 1948). Following the preamble are 30 Articles, which lay out in detail the specific rights to which all human beings should be entitled. According to the UNHCR, there are 389 different translations of this document.
Poster depicting the Universal Declaration of Human Rights, English Version. United Nations Photo – public domain.
The UDHR encompasses both negative (i.e., the right to not be tortured, imprisoned without cause, or enslaved) as well as positive (i.e., the right to own property, the right to freedom of thought, and the right to marry) rights. It also enumerates, for the first time, the core principles of human rights, which are: universality, inter-dependence and indivisibility, equality, and non-discrimination. The UDHR states further that human rights are not merely an entitlement, they also include rights and obligations. In other words, having a right brings with it a particular obligation as well. If we are to enjoy our rights as humans, then we need to respect these same rights for others. These concepts have been reiterated in many subsequent international human rights treaties, declarations, and conventions. This document (UDHR), along with the International Covenant on Civil and Political Rights (ICCPR) and the International Covenant on Economic, Social, and Cultural Rights (ICESCR), are considered to be the foundational pillars of international human rights law and the legal basis for all subsequent human right norms, standards, and rules.
27.4 The Status of Human Rights in the United States
While human rights have in large part been internationalized, they have to be implemented at the domestic level. According to Donnelly (2003), this dichotomy permits countries to fulfill dual and seemingly incompatible roles: essential protector and principle violator. In the United States, this duality can be seen in the difference between the laws upon which the country was founded and the implementation of these laws in an equitable fashion.
The Bill of Rights, as codified in the United States Constitution, lays out specific human rights that parallel those to which the majority of international human rights regimes adhere. Thus, the founding myths of this country are grounded in the central place of human rights (Donnelly, 2003). In fact, many if not most liberal democracies share these constitutive principles. As Koopmans (2012) points out, “internal constitutive principles – such as the right to exercise one’s religion…imply that the granting of rights to individuals and groups will be more similar across democracies than it will be between them and non-democracies” (p 25). And yet, there remain significant areas where United States domestic policy can be seen to violate various rights of various portions of the population at any given time.
Original Bill of Rights, United States. Archives.org – public domain.
Political Issues
The most pressing human rights issues in the United States revolve around immigrant and refugee families. The strategic priorities outlined by the UNHCR include: (a) countering discrimination; (b) combating impunity and strengthening accountability; (c) pursuing economic, social and cultural rights and combating poverty; (d) protecting human rights in the context of migration; (e) protecting human rights during armed conflict, violence and insecurity; and (f) strengthening international human rights mechanisms and the progressive development of international human rights law. Priorities (a), (c) and (d) make up the elements most germane to the human rights situation in the United States today. The difficulties faced by immigrant and refugee families include classism, racism, sexism, and discrimination on the basis of religion as well as uncertain economic circumstances.
Secretary-General of the United Nations, Ban Ki-moon, meets President of the United States, Barack Obama. UN.org – public domain.
The United States voted in favor of the UDHR but it did not ratify (i.e., sign) the document. While various theories attempt to explain relevant reasons, numerous rights enshrined in the UDHR are in the Constitution and Bill of Rights (AHR; Advocates for Human Rights, n.d.) The United States’ apparent sense of exceptionalism to international standards and norms has been evidenced over time in two main ways: the ongoing torture of Guantanamo Bay detainees and the revelation that American social scientists were involved in reverse engineering torture techniques for the government. While the United States may at times act outside of the limitations established by the international community (and specifically the UDHR) this stance is not the focus of this chapter. As the UNCHR notes, “national and local politicians have sought to mobilize electoral support by promoting xenophobic sentiments, exaggerating the negative impact of hosting refugees while ignoring the fact that refugees can actually attract international assistance and investment to an area, creating new jobs and trading opportunities” (2006, p 32). In this way, the refugee situation has often been used as a political football in United States political culture.
Video
Ruben Parra-Cardona, Ph.D., LMFT discusses discrimination and systemic issues affecting Latino immigrants in the United States (6:30-9:19).
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=121
Legal Issues
The current legal climate in the United States is negatively skewed against international human rights, particularly as it pertains to the legal status of displaced persons (persons who are forced to leave their home country due to war, persecution or natural disasters). There are many reasons to be pessimistic about successfully using international human rights arguments as a way of advancing displaced person’s rights in the United States (Chilton, 2014; Cole, 2006; ICHR; International Council on Human Rights, 2008). According to Cole (2006), in spite of its history as a nation of immigrants, the United States remains deeply nationalist and quite parochial; the law reflects that parochialism. Furthermore, “International human rights arguments are often seen as the advocates’ last refuge pulled out only when there is no other authority to cite” (Cole, 2006, p. 628).
Poster entitled, “It is our right to seek and enjoy in other countries asylum from persecution.” UN Photo – public domain.
However, this trend seems to be moving the nation towards the transnational in terms of how human rights law is perceived and implemented in the legal system and culture of the United States. This means that increased globalization and interdependence has had the effect of strengthening the influence of international human rights standards in the United States. The hope is that these standards may “command greater respect from our own domestic institutions” (Cole, 2006, p 643). Cole further posits that the paradigm shift in the United States from national to transnational, merging the national and the international, parallels the shift in the United States from state to federal power that occurred with the advent of the New Deal in the 1930s. In other words, there is reason to hope that gradual change is coming within the legal system in the United States with regards to its acceptance of the international human rights regimes, norms, and standards.
Refugee families and asylum seekers. The terms of refugee and asylum seeker are often used interchangeably, but there are important legal differences between them. These differences not only determine which resources they are eligible for once arriving in the United States but also in which phase of the legal process they are currently.
Refugees and displaced persons in South-East Asia; Cambodia, Vietnam, and Laos. United Nations Photo – Coping with Disaster – CC BY-NC-ND 2.0.
Refugees. An estimated 51.2 million people were displaced since 2013 as a direct result of persecution, war, violence, and human rights atrocities (UNHCR, 2018). In 2017, USCIS received 139,801 affirmative asylum applications and the EOIR received 119,303 defensive asylum applications, but only 26,568 applications were approved (DHS, 2019). The remaining applications were abandoned (1,439), withdrawn (6,400), or simply unaccounted for (11,391). Being that the recent United States population estimate is 318 million people, refugees make up less than 1% of the population. The families seeking asylum from their home countries often have significant traumatic histories and thus can loom larger in the public sphere than other types of immigrants. Most of these families are fleeing extreme injustices in their home country, such as war, political instability, genocide, and severe oppression. Because of the uncertainty of their original situation, it remains quite difficult for the Department of Homeland Security (DHS) to determine who is legitimately eligible for asylum.
Asylum seekers. A further complication for government agencies lies in trying to determine when and how to return rejected asylum seekers to their home countries (Koser 2007). Within the domain of international migration studies, there has been traditionally a differentiation made between refugees (involuntary migration) and labor seekers (voluntary migration). While the former group represents the political outcome of global systems and interactions and the latter group represents the economic outcome, nonetheless, it is quite clear that people migrate for a whole complex series of reasons, including social ones (Koser, 2007). If an asylum seeker’s claim for asylum is denied, they are placed in deportation proceedings. During this process, an immigration judge (IJ) works with the asylum-seekers’ attorney to determine the removal process. It is important to note that displaced persons are rarely detained and/or immediately placed on the next flight to their country of origin.
Women and Children’s Rights
The UNHCR has, within the last decade, specifically recognized gender as a fundamental human rights issue. The policy on refugee women is based on the recognition that becoming a refugee affects men and women differently: “… even where there is no armed conflict, women and children continue to be subject to serious human rights violations resulting from discrimination and/or violence against them due to their gender…” (Zeiss Stange, Oyster, & Sloan, 2012). Many of the human rights issues that involve women and children obviously impact families in a very deep way. This category of violation stems from historical perceptions of women and children as property or “chattel.”
International Women’s Day March for Gender Equality and Women’s Rights. UN Photo – public domain.
Domestic violence. The issue of domestic violence, for example, is one that disproportionately affects women and children. In immigrant families from more patriarchal societies, the home is still considered the woman’s domain whereas earning is considered the man’s, even when both work for pay outside the home. This particular division of labor can increase the power imbalance in these relationships, which can create a setting within which domestic violence may be more likely to occur (Perilla, 1999). This imbalance can become particularly problematic when the power hierarchy between parents and children is inverted once they arrive in the United States. Since wage-earning immigrant women often gain autonomy and greater gender equity, while men tend to lose ground, this adds further threats to male self-esteem that is already being eroded by classism, racism, and legal status (Mahler & Pessar, 2006).
Children’s issues. Children are disproportionately impacted in other ways as well. Children of displaced families, asylum-seekers in particular, are more likely to be without health insurance and have less access to public programs across nationalities (Blewett, Johnson, & Mach, 2010). This is due to their legal designation of being persons who are ineligible for public services (i.e., health insurance). The literature suggests that traumatic events impact each family member regardless of whether they were directly or indirectly exposed. This is important because traumatic stress, loss, and grief extend beyond individual family members and influence the entire family (Nickerson, Bryant, Brooks, Silove, Steel, & Chen, 2011). Detention and deportation, in particular, pull families apart and make it much more difficult for parents and other caregivers to access necessary resources for their children. This is true for many immigrant families because there are many different legal statuses within families due to, for example, children being born to undocumented parents in the United States. Thus the tendency is for these families to be more careful and anxious about seeking out services that they might qualify for because of the fear of being reported to immigration authorities.
Female genital mutilation. Female genital mutilation (FGM), also known as female genital cutting, is a human rights issue of growing importance due to the increasing number of refugees arriving in the United States from East and West Africa. This practice, sometimes also known as female circumcision, is a long-standing cultural tradition in some communities. Although FGM is generally practiced in Muslim communities, there is no actual religious mandate for it (Cook, Dickens, & Fathalla, 2002). While the practice is deeply cultural, it is illegal in many African nations. However, regardless of legality, the practice is widespread. Fatima, for example, from the opening story, told the first author, “The president’s daughter has been circumcised – how will he enforce this law? Are they going to put him in jail? Hah!” (Personal communication, 2011).
Angélique Kidio and Concer Sponsors Brief on Efforts to End FGM. UN Photo – public domain.
According to Mather and Feldman-Jacobs (2015), over 500,000 girls and women have undergone genital mutilation in the United States. FGM is regarded as a human rights issue for women because it can cause severe health sequelae. Even though the family of the child may consent to the procedure, this does not make it a legal practice as consenting to physical mutilation can never be legal (Cook, et al., 2002) However, recommendations include more education and counseling of women as opposed to the firmer application of the law in cases like these. This practice remains illegal in the United States, which may have the effect of pushing those refugees wishing to practice this even further underground. In other words, shame and stigma often accompany FGM. And though it can be presented as a convincing claim for asylum in the United States, many women do not feel comfortable doing so and instead pursue other means (USCIS; United States Citizenship and Immigration Services, 2019).
In 2012, the United Nations issued an interagency resolution calling for the elimination of FGM worldwide. The resolution states unequivocally that “seen from a human rights perspective, the practice reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women” (WHO; World Health Organization, n.d.). The hope is that this ban will speed the process of eliminating this dangerous and painful practice worldwide.
Video
This video discusses the border crisis and children separated from their families (0:00-7:06).
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=121
Sex Trafficking and Human Trafficking
The United Nations Protocol to Prevent, Suppress, and Punish Trafficking in Persons, Especially Women and Children, defines trafficking as the “…recruitment, transfer, harboring or receipt of persons, by any means of threat or force…for the purpose of exploitation.” This crime is globally categorized as either sex trafficking or labor trafficking. According to the DOJ (2006), there have been an estimated 100,000 to 150,000 sex trafficking victims in the United States since 2001. Furthermore, estimates of persons currently in situations of forced labor or sexual servitude in the United States range from 40,000 to 50,000.
The leading countries of origin for foreign victims in fiscal year (FY) 2011 were Mexico, Philippines, Thailand, Guatemala, Honduras, and India (DOJ, 2012). In 2011, “notable prosecutions included those of sex and labor traffickers who used threats of deportation, violence, and sexual abuse to compel young, undocumented Central American women and girls into hostess jobs and forced prostitution in bars and nightclubs on Long Island, New York” (DOS, 2012). According to the International Labor Organization (ILO, 2019), globally an estimated 4.5 million women, men, and children are sexually exploited. While there is some legal benefit (a self-petitioned visa in the United States) in place for those who cooperate in prosecuting their traffickers; with this visa, victims can receive four years of legal status. Unfortunately, far fewer receive immigration aid than are identified as victims of sex trafficking, (DOS, 2012).
Human trafficking is another area where issues of physical safety and sexual exploitation of immigrant and refugee women and children come to the forefront as a human rights issue. Contrary to popular thought, sex trafficking is an ongoing and insidious activity that also includes young boys, and the prevalence of human and sex trafficking in the United States disproportionately affects the more vulnerable, under-resourced populations such as immigrant and refugee families (DOS, 2012).
Mixed Status (Deportation) and Separation of Families
One of the most pressing human rights issues for displaced persons in the United States today is the mixed-status families (i.e., documented and undocumented). These are families whose members hold different levels of legal status in the country. Some members of the family may be documented persons (such as asylum-seeker, permanent resident or citizen) while others have undocumented status. Though the children born to undocumented migrants typically receive citizenship by birth, this does not change their parents’ legal status. The exception, however, is when undocumented parents return to their country of origin and wait until that child is 18 years of age; at that point, the young adult child can sponsor them in becoming United States citizens. When families consist of members whose legal status is documented as well as undocumented, this uncertain distal context can set the stage for significant vulnerabilities within the family.
Brabeck and Xu (2010), who studied of the effects of detention and deportation on children of Latino/a immigrants, found that the legal vulnerability of Latino/a parents, as measured by immigration status and detention and deportation experience, predicted child well-being. In other words, the children suffer when they cannot be sure whether their parents will be able to stay and live with them in the United States on a day-to-day basis. Kanstroom (2010) writes that although “international law recognizes the power of the state to deport noncitizens, international human rights law has also long recognized the importance of procedural regularity, family unity, and proportionality. When such norms are violated the State may well be obligated to provide a remedy” (p. 222). Once again the paradox of international human rights norms conflicting with the actual social and political practices of the United States; as of this writing, the issue remains a political football in the United States.
Detention Without Trial
In 2011, the United States Congress passed the National Defense Authorization Act (NDAA) that codified, for the first time since the McCarthy era, indefinite detention without charge or trial. Subjecting refugees to detention induces unnecessary psychological fear and harm. Furthermore, it does not uphold the fundamental human rights principles set out in the ICCPR preamble (Prasow, 2012). The notion that people, whether citizens, documented or undocumented immigrants, could be held by the government indefinitely without access to the protections enshrined in the United States Constitution is a clear violation of international human rights law and anathema to human rights and civil liberties groups. As of late 2012, members of Congress proposed to have it repealed or amended. As noted by Senator Dianne Feinstein of California, “Just think of it. If someone is of the wrong race and they are in a place where there is a terrorist attack, they could be picked up, they could be held without charge or trial for month after month, year after year. That is wrong” (Prasow, 2012). The amendment that Senator Feinstein proposed, however, would protect only citizens and lawful residents; undocumented immigrants would still be subject to this odious practice.
27.5 Emerging Directions
While there is a lack of human rights literature that specifically deals with or involves the family unit, the United Nations recognizes that “…family is the basic unit of society” (UN, n.d.). As such, there is an undeniable connection between the status of immigrant and refugee families and how the United States deals with their human rights in a variety of ways. Issues such as FGM, the deportation of undocumented immigrants that splits the family between those with and without citizenship or documents, longtime detention of family members, sex trafficking, and other pressing human rights issues all have significant deleterious effects on families in this country. While much of the conversation revolves around rights and obligations for the individual as well as for the community, there is very little in the way of specific family references in the human rights literature.
Given that the UDHR focuses on individual and state actors, it is understandable that there is this gap in the research regarding how human rights issues specifically affect families. However, there needs to be a significantly deeper understanding of these issues if we are to be able to truly support immigrant and refugee families to thrive and flourish in the United States. Some questions that need to be answered are: How do families have a unique lens on their situations? Does the family structure provide a protective factor for its members? How do women’s and children’s issues play out in this arena? Perhaps the most pressing need for further research concerns the issue of how mixed-status immigrant families cope with the uncertainty regarding living with different levels of documentation and legal status within the same family.
Video
True Thao, MSW, LICSW discusses his perspectives on human rights and basic values such as respect and equality (1:45-3:44).
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=121
27.6 End-of-Chapter Summary
Case Study
Anna, a bright and extroverted 26-year-old from a Central American country, has just arrived at a counseling center presenting with severe depression and anxiety. Several years ago, three members of one of the most brutal guerrilla regimes in her home country held her hostage at gunpoint and sexually assaulted her for several hours. Her apparent crime was that some months before she had led a march for women’s rights at the college she attended. Members of the guerilla group broke up the march and then beat the young women and men, many of whom need hospitalization. Anna was among them and was hospitalized for five days of treatment. Several months later, three members of this group surprised Anna at home; they terrorized, raped, and threatened her numerous times with death before eventually leaving with further threats if she dared to protest publicly again for women.
After this last incident, Anna fled her home country and came to the United States through a circuitous route. She had no option but to use smugglers for much of the journey. She had had to leave so abruptly and had so few resources that she left her three-year-old son behind with her grandmother. Grandmother sends Anna pictures of her little boy regularly via text message, but Anna is devastated every time she thinks of him. In order to get through her day, she tries to put him out of her mind. It is clear that this effort and the loss that she feels for her son is serious. She is currently seeking asylum in this country and, because she needs to support herself though she has no documents yet, is working as a nightclub dancer. She does not feel hopeful about her asylum application because she is worried that no one will believe her story. Furthermore, she despairs over ever being able to bring her young son to the United States since she fears that they will jail him at the border.
Discussion Questions
1. What sort of information do you need that would help you understand Anna’s case better?
2. How might Anna be at continued risk for human rights violations?
3. What exposures to trauma-inducing experiences are affecting Anna? How might professionals working with immigrant and refugee populations emphasize positive adaptive skills/resilience that focus on individual and family strengths?
4. What other community resources might be helpful in Anna’s situation?
5. Discuss the importance of coordinating and integrating different community services for supporting immigrant and refugee resettlement.
Attribution
Adapted from Chapters 1 through 9 from Immigrant and Refugee Families, 2nd Ed. by Jaime Ballard, Elizabeth Wieling, Catherine Solheim, and Lekie Dwanyen under the Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/09%3A_Global_Perspectives_and_Theories/27%3A_Human_Rights.txt |
Learning Objectives
• Learn from the national and global perspectives of economic well-being, supports, and barriers among immigrants and refugees.
• Recognizing that the world is constantly and rapidly changing.
• Recognizing that Global/national/international events can have an impact on individuals, families, groups, organizations, and communities.
• Global implications dictate that we foster international relationships and opportunities to address international concerns, needs, problems, and actions to improve the well-being of not only U.S. citizens, but global citizens.
28.1 Introduction
The section was written by Veronica Deenanath (Family Social Science, University of Minnesota), Nancy Lo (Family Social Science, University of Minnesota), Dung Mao (Family Social Science, University of Minnesota), Jaime Ballard (Family Social Science, University of Minnesota), and Catherine Solheim (Family Social Science, University of Minnesota)
The United States is a nation of immigrants who often bring dreams of opportunities and economic prosperity and a goal to build a better life than the one left behind. Immigrant and refugee families are typically starting over economically; they arrive with few or no financial resources and are unfamiliar with the financial system in the host counties. As discussed in Chapter 1, some families immigrate because they were unable to financially support their families in their home country (Solheim, Rojas-Garcia, Olson, & Zuiker, 2012; Portes & Rumbaut, 2006). Others were able to support their families but had to leave everything behind to travel to safety after conflict or natural disasters. While there are some high-income immigrants who are recruited internationally by companies, this is a minority of immigration cases (U.S. Visas, 2013). The majority of immigrants come with hopes of economic change for their families.
Iraqi refugee children preparing for relocation. DFID – UK Department for International Development – Iraqi refugee children at Newroz camp – CC BY 2.0.
Although immigrants may arrive full of hope, their path to economic well-being can be long and challenging, making their dream seem far from reality. Economic systems differ between countries and cultures, and immigrants must learn new systems of payment and saving. They must also learn how to manage their finances in a virtual world of credit, debit, and online transactions – a far cry from mostly local cash-based markets in their home countries. Additionally, job skills and education do not always transfer across countries. Immigrants who were well-qualified for jobs in another country often find themselves under-qualified after resettlement. For example, an immigrant might have been a well-qualified teacher in their home country, but cannot teach in the United States without a teacher’s license, which takes time and money to obtain. Finally, many immigrants face discrimination as they apply for jobs and as they access services such as health care.
This chapter addresses immigrants’ and refugees’ road to achieving economic well-being. Only limited research has identified the challenges and supports available to immigrants on their economic journey; the majority of information is drawn from analysis of government reports of employment, income, housing, and healthcare usage. In this chapter, we use this research to highlight the key areas of economic well-being in immigrants and refugees, including employment, access to health care and housing, financial management skills, and access to financial products and services.
Economic Well-Being
Economic well-being is an individual’s ability to buy the necessities of life for themselves and their families, and have resources to pursue goals that improve their quality of life. (OECD, 2013).
28.2 Employment
The most critical step towards economic well-being is obtaining adequate employment. Immigrants account for more than 17% of the United States workforce, although they make up only 13% of the population (MPI, 2013). The unemployment rate for foreign-born persons is currently 5.6%, while it is 6.3% for native-born persons (Bureau of Labor Statistics, 2015). Although immigrants have relatively high rates of labor force participation, the opportunities and benefits that are available to them depend on the level of employment they can obtain. We will address each in turn.
Low-skill labor force. Immigrants make up half of the low-skill labor force in the United States (Bureau of Labor Statistics, 2011). In 2005, it was estimated that undocumented immigrants make up 23% of the low-skill labor force (Capps, Fortuny, & Fix, 2007). Low-skilled immigrant workers tend to be overrepresented in certain industries, particularly those with lower wages. Table 1 displays the foreign-born workforce by occupation.
Occupation Share of Foreign-Born Workers in Occupation (%) Share of Native-Born Workers in Occupation (%)
Management, professional, and related 29.8 37.7
Service 25.1 17
Sales and office 17.1 25.6
Production, transportation, and material moving 15.2 11.6
Natural resources, construction, and maintenance 12.9 8.1
Approximately 20% of immigrant workers are employed in construction, food service, and agriculture (Singer, 2012). More than half of all workers employed in private households are immigrants and immigrants also represent a third of the workers in the hospitality industry (Newbuger & Gryn, 2009). The majority of the positions in these industries are low-wage jobs.
South Central Farm in Los Angeles, one of the largest urban gardens in the United States. Wikimedia Commons – CC BY 2.5.
Middle- and high-skill labor force. More educated and skilled immigrant workers can obtain jobs that are high paying and offer job stability such as those in healthcare, high-technology manufacturing, information technology, and life sciences. Immigrant workers are keeping pace with the native-born workforce in these high skill industries (Singer, 2012). Immigrants hold bachelors and graduate degrees at similar rates to their native-born peers (30% and 11%, respectively; Singer, 2012).
Barriers to better employment. The largest barriers to higher-paying employment for immigrants are a lack of education and English-speaking ability. Approximately 29% of immigrant workers do not hold a high school diploma compared to only 7% of their native-born peers (Singer, 2012). Moreover, about 46% of immigrant workers would classify themselves as limited English proficient speakers (Capps, Fix, Passel, Ost, & Perez-Lopez, 2003). More than 62% of immigrant workers in low-wage jobs are limited English language speakers compared to only 2% of native-born workers in low-wage jobs (Capps, Fix, Passel, Ost, & Perez-Lopez, 2003). A study conducted by the Robert Wood Johnson Foundation (Garrett, 2006) found that it is extremely difficult for refugees to move from low-paying to better paying jobs after they have adjusted to living in the United States because many lack English language skills and education. It is difficult for immigrants to seek more education or training, due to the pressing need to work to provide for their families. Leaving the workforce to train may leave them financially vulnerable.
Immigrant workers who are middle-wage earners are still disadvantaged. In comparison to their native-born peers who earn a median income of \$820 weekly, a full-time salary immigrant worker earns \$664 weekly (Bureau of Labor Statistics, 2015). Moreover, these workers earn 12% less in hourly wage than their native-born counterparts; this wage gap is 26% in California, a state with the largest immigrant workforce (immigrants make up 37% of the workforce in California; Bohn & Schiff, 2011).
These wage disadvantages are partially due to employer discrimination. In 1996, the Illegal Immigration Reform and Immigrant Responsibility Act (IRCA) implemented additional restrictions on employment eligibility verification, including sanctions for employers who hired undocumented immigrants. Although it is illegal for an employer to discriminate based on national origin or citizenship status, many employers chose to avoid hiring individuals who appeared foreign, in order to avoid sanctions. A General Accounting Office survey found that 19% of employers (approximately 891,000 employers) admitted to discriminating against people based on language, accent, appearance, or citizenship status because of fear of violating IRCA.
Immigrant workers also face high rates of wage and workplace violations. A study looking at workplace violations in three large metropolitan cities in the United States (Chicago, Los Angeles, and New York City) found that immigrant workers were twice as likely to experience a minimum wage violation than their native-born peers (Bernhardt et al., 2008). Another study conducted by Orrenius and Zavodny (2009) also found that immigrants are more likely to be employed in dangerous industries than their native-born peers, and experience more workplace injuries and fatalities. In these injuries, limited English skills are a contributing factor. These workers may be afraid to speak for themselves with their livelihood at stake and are left at the mercy of others. Immigrant workers are in dire need of representation, but infrequently have access to it. Only 10% of the immigrant workforce is represented by unions in contrast to 14 percent of the native-born workforce (Batalova, 2011).
Supports for Employment: The Unique Case of Refugees
Refugees are a unique group of immigrants in that there are support systems in place to help with resettlement upon their arrival in the United States. Government agencies and voluntary agencies (VOLAGs) provide initial supports to help families resettle in their new home, including social services, food support, cash assistance, healthcare, and employment services. Great emphasis in the refugee resettlement process is placed on finding a job so that refugees can become financially self-sufficient without the support of the government. The Office of Refugee Resettlement (ORR) provides two programs to support VOLAGs in finding employment contracts for refugees:
• Early Employment Services: In this program, ORR provides funding for a staff member(s) to act as an employment specialist to prepare the refugees for work and for finding employment. VOLAGs are given anywhere from 18-24 months to help refugees secure jobs through the Early Employment Services program (Darrow, 2015); the time period varies by state.
• Voluntary Agency Matching Grant (VAMG): This is a selective and expedited employment program. The goal of this program is to help refugees attain economic self-sufficiency within the first four-six months upon arrival in the U.S. while declining public cash assistance (Office of Refugee Resettlement, 2016). Refugees selected for the VAMC program receive more intense job services and individual case management for six months and receive more generous cash and housing assistance for four months in comparison to those who are part of the Early Employment Services program. VAMC refugees are not eligible for any form of public assistance until one month after the program ends.
Short-Term Benefit, Long-Term Drain?
Problems in the VAMC program
The VAMC provides extra training and benefits for refugees, with the goal of economic self-sufficiency within the first few months of arrival. However, recent research suggests there are downsides. Funding for VOLAGs in the VAMC program in contingent upon meeting performance measures such as how many refugees entered employment and how many were self-sufficient at 120 and 180 days (Office of Refugee Resettlement, 2016).
Many of the jobs that are available quickly pay only \$8.25 hourly and require over an hour in travel time. Earlier employment means less time for job training and English language classes, which are factors that would impact the long-term economic well-being of refugees.
Videos
Ruben Parra-Cardona, Ph.D., LMFT discusses his frustration with historical amnesia surrounding the economic contributions of Latino immigrants in the United States (3:39-6:09).
Sunny Chanthanouvong, Executive Director, Lao Assistance Center of Minnesota, discusses financial challenges among elders in the Lao community (0:00-2:21).
A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/humanbe/?p=123
A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/humanbe/?p=123
28.3 Access to Necessities
Immigrants face barriers in their access to adequate income, particularly because they tend to be employed in low-skill jobs and face discrimination in their work environments. Poverty rates of children of immigrants are 50% higher than children of native-born citizens (Van Hook, 2003). This limits their access to adequate housing, food, and healthcare.
Housing and Food
Access to shelter and food are basic life necessities. Immigration has a positive impact on the rent and housing values for their communities, but immigrants themselves face barriers to accessing adequate housing. When immigrants enter a new area, rent and housing values in that area increase (Saiz, 2007). In metropolitan areas, immigrant inflow of 1% of the city’s population is tied to increases in housing values of 1% (Saiz, 2007). Despite this benefit to the community at large, immigrants are face barriers to achieving safe and affordable housing. They are less likely than native-born individuals to own a home and are more likely to live in overcrowded conditions (as measured by the number of people per room; Painter & Yu, 2010). Immigrant homeownership increases and overcrowding decreases the longer the immigrant lives in the United States. However, they still lag behind native-born citizens in homeownership and overcrowding even after living in the United States for 20 years (Painter & Yu, 2010).
Housing conditions are influenced by the immigrant’s documentation status and English language abilities. Immigrants who spent some time without documentation are less likely than documented immigrants to own a home, even if they now have documentation (McConnell & Akresh, 2008). Documentation likely influences access to high-paying jobs and to home loans. Similarly, English proficiency increases the chances of an individual becoming a home-owner, because English proficiency increases the ability to access labor and credit markets (Painter & Yu, 2010).
New York Tenement Museum
In the 19th and 20th centuries, a 350 square foot apartment here housed six recent immigrants. Michael Sean Gallagher – 94 Orchard Street, Lower East Side, New York – CC BY-SA 2.0.
Additionally, housing access is influenced by discriminatory practices. In the United States 42 cities and counties have passed anti-illegal immigration laws that prohibit landlords from allowing undocumented immigrants to use or rent their property (Oliveri, 2009).
Although the Federal Fair Housing Act prohibits discrimination on the basis of national origin (110. 42 U.S.C. §§ 3601-3619, 3631), it is easier for these landlords to discriminate against prospective tenants who appear foreign than to process the immigration status of every prospective tenant (Oliveri, 2009). Due to these discriminatory practices, immigrants’ housing options becomes even more limited.
Immigrant households are at a substantially higher risk of food insecurity, or a lack of adequate food for everyone in the household, than native-born households (Chilton, 2009). Newly arrived immigrants face the greatest risk (Chilton, 2009), perhaps due to a lack of English skills or education. This lack of access to adequate food has significant consequences: household food insecurity significantly increases the risk of children in the household having only fair or poor health (Chilton, 2009). It can be difficult for immigrant families to access food-related resources. Among families that have trouble paying for food, those headed by immigrants are less likely than families headed by native-born individuals to receive food stamps (Reardon-Anderson, Capps, & Fix, 2002). Those who do receive food assistance through food shelves may find that the food offered is unfamiliar.
Healthcare
Although immigrants have high rates of labor force participation, they are less likely than native-born peers to have health insurance (Derose, Bahney, Lurie, & Escarce, 2009). There are few services in the United States that are as crucial and complex as the healthcare system, which continues to be a major indicator of socio-economic success. A person’s inability to access and utilize healthcare services gives a strong indication of critical unmet needs and barriers that impede the ability of successful integration and participation in society. Immigrants face substantial barriers to healthcare access, including restricted access to government based healthcare services, language difficulties, and cultural differences.
Air Force doctor provides services through an interpreter. Wikimedia Commons – public domain.
Reduced Use of Healthcare. Total health care expenditures are lower for immigrant adults than for their native-born peers (Derose, Bahney, Lurie, & Escarce, 2009). Additionally, immigrants are less likely to report a regular source or provider for health care, and report lower health care use than native-born peers (Derose, Bahney, Lurie, & Escarce, 2009). This means that overall, immigrants have less access to healthcare and less healthcare use than do most native-born individuals.
Undocumented immigrants have particularly low rates of health insurance and health care use (Ortega et al., 2007). Undocumented Latinos/as have fewer physician visits annually than native born Latinos/as (Ortega et al., 2007). Undocumented immigrants are more likely than documented immigrants or native-born individuals to state that they have difficulty understanding their physicians or think they would get better care if they were a different race or ethnicity. Despite their low rates of use, immigrants are in need of healthcare. Children of immigrants are also more than twice as likely as children of natives to be in “fair” or “poor” health (Reardon-Anderson, Capps, & Fix, 2002).
Legal Status Restricts Healthcare Benefit Eligibility. Immigration status is an important legal criterion that may hinder access to healthcare benefits. The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), established in 1996, restricted Medicaid eligibility of immigrants. Immigrants cannot receive coverage, except in cases of medical emergencies, during their first five years in the country. States can choose to grant aid out of their own funds, but no federal welfare funds may be used for immigrant health care. The reform also stated that the eligibility of an immigrant for public services would be dependent on the income of the immigrant’s sponsor, who could be held financially liable for public benefits used by the immigrant. Finally, the Act required that states or local governments who fund benefits for undocumented immigrants take steps to identify their eligibility (Derose, Escarce, & Lurie, 2007). Hence, health benefits and insurance for most immigrants are highly dependent on eligibility through employment.
Immigrant Contributions to Medicare
Immigrants contribute substantial amounts to Medicare. In fact, immigrants contribute billions more to Medicare through payroll taxes than they use in medical services (Zallman, Woolhandler, Himmelstein, Bor & McCormick, 2013). Undocumented immigrants contribute more than 12 billion dollars annually to Social Security and Medicare through taxes under borrowed social security numbers, yet are ineligible for benefits through these systems (Goss et al., 2013).
The Affordable Care Act (ACA; Pub. Law No. 111-148 and 111-152), established in 2010, updated some of these policies. This act ensured that legal permanent residents with incomes up to 400 percent below the federal poverty level could qualify for subsidized health care coverage. Medicaid and other health benefits still require a 5-year waiting period, however, states have the option to remove the 5-year waiting period and cover lawfully residing children and/or pregnant women in Medicaid or Children’s Health Insurance Program (CHIP). Undocumented immigrants receive no federal support under the ACA. Under the ACA, refugees who are admitted to the United States and meet the immigration status eligibility have immediate access to Medicaid, CHIP and health coverage options.
Language Difficulties. Language difficulties, including limited English language proficiency and poor English literacy skills, are one of the most formidable barriers for immigrant access to healthcare. Language ability affects all levels of accessing the healthcare system, including making appointments, filling out of paperwork, the ability to locate healthcare facilities, direct communication with healthcare professionals, understanding written materials, filling out prescriptions, understanding of treatment options and general decision making. Among children, for example, those from non-English primary language households were four times as likely to lack health insurance and twice as likely to lack access to a medical home (Yu & Singh, 2009). Similarly, Spanish-speaking Latinos/as were twice as likely as English-speaking Latinos/as to be uninsured, and twice as likely to be without a personal doctor, and received less preventative care (DuBard & Gizlice, 2008).
These difficulties impede the facilitation of patient autonomy in making healthcare decisions. This is especially relevant in the transmission of complicated medical jargon and limits in-depth conversations about treatment options between the healthcare provider and immigrant patients. Patients with language-discordant providers receive less health education that patients with a provider or interpreter who speaks their language (Ngo-Metzger et al., 2007). Among Hispanics, for example, those who speak a language other than English at home are less likely to receive all the health care services for which they are eligible (Cheng, Chen, & Cunningham, 2007).
In some cases, miscommunication and misinterpretation can have significant consequences. At times, if an immigrant can communicate in English, providers may assume that the level of understanding of the immigrant patient is higher than what the immigrant patient can actually understand (Flores, 2006). This causes misinterpretations and miscommunications that leave immigrants feeling frustrated, which may result in the avoidance of healthcare use unless it is critical.
To overcome the language gap, immigrants often utilize friends and family members as interpreters in medical settings (Diamond, Wilson-Stronks, & Jacobs, 2010). Children in immigrant families often speak, read and understand English better than their parents do and, as such, are often burdened with the duty of being the family translator and interpreter when dealing with the healthcare system (Kim & Keefe, 2010). This role reversal may cause conflicts within the family, as the child must take on the responsibility of communicating complex and difficult information. Additionally, the utilization of family and friends as interpreters is often ineffective as family and friends may not be accurately able to translate complex medical information and ensure accurate understanding of complex medical language, treatments, interventions or outcomes that are necessary in healthcare decision making (Flores, 2006). The use of family members, friends or even community members as interpreters also has great concerns in the ensuring of confidentiality of sensitive health information of immigrant patients, as they are not trained in appropriate confidentiality procedures.
Health care centers that offer professional interpreters or who have multi-lingual medical providers can greatly alleviate these stressors. The Civil Rights Act of 1964 requires that medical providers receiving federal funds provide language services for clients with limited English, and many states have similar guidelines (Jacobs, Chen, Karliner, Agger-Gapta, & Mutha, 2006). However, resource allocation is a significant issue in the actual implementation of interpreter services in healthcare facilities. Many healthcare providers find it difficult to provide adequate language services, as they may be understaffed, underfunded, and often unable to provide service due to other demands of the job (Morris et al., 2009). For example, though hospitals inform clients of their right to receive language services, many do so only in English (Diamond, Wilson-Stronks, & Jacobs, 2010). The majority of hospitals report providing language assistance in a timely manner only in the most commonly requested language (the most commonly requested languages varied by hospital area, but most frequently included Spanish, American Sign Language, and Vietnamese) (Diamond, Wilson-Stronks, & Jacobs, 2010). There is also a lack of minority and multilingual health professionals in the field. Most immigrants will choose to use healthcare resources in their native language or providers who are representative of their native culture, even at the cost of quality (Morris et al., 2009). In order to provide immigrants with effective healthcare services, great consideration and support must be made to ensure the diversification of the healthcare workforce. This can be achieved through the provision of educational and vocational pathways for minority students to enter academic programs and health care careers (Fernandez-Pena, 2012). The efforts to improve linguistically relevant health services is important as it increases provider cultural competence, cultural humility and language access for immigrants.
Culture. Culture is an important aspect to consider in healthcare access for immigrants as it determines the perceptions and values placed on systems and providers, willingness to utilize these services and ability to successfully navigate the system.
• Culture influences our ideas of when healthcare is needed. For some immigrants, the idea of preventative care, such as annual medical, vision, and dental exams are not normative. This may be due to lack of economic circumstances in the country or origin where healthcare was inaccessible to the majority of the population or only utilized in times of extreme need such as serious health issues or emergencies. For example, Vietnamese generally do not recognize the concept of preventative medicine, and will not seek treatment unless symptoms are present and will sometimes discontinue medication when symptoms abate (CDC, 2008a).
• Culture influences our definitions of healthcare. Many immigrants may place a higher value in homeopathic treatment and spiritual healers. This was noted especially in Latino immigrants where a strong belief in faith-based and alternative healing practices lead the usage of religious organizations for help in mental disorders. For example, recent Latina immigrants reported using alternative or complementary medicine first and then sought medical help only if these methods were ineffective (Garces, Scarinci, & Harrison, 2006).
Koguis shaman in Colombia. Wikimedia Commons – CC BY-SA 3.0.
• The Hmong traditionally view illness as the result of a curse, violation of taboos, or a soul separating from its body, in addition to natural causes such as infectious disease (CDC, 2014). These values are contrary to Eurocentric models, which are predominant in the United States healthcare systems (Rastogi, Massey-Hastings, & Wieling, 2012).
• Culture influences our expectations of healthcare effectiveness. In some cultures, a healthcare professional is expected to cure the illness versus manage it. A strong expectation is then placed in immediate improvement of illness after meeting or seeing healthcare providers. This unmet expectation can cause a great sense of disappointment for immigrants and increase their reluctance in using healthcare services.
• Cultural norms restrict interactions between genders. In some cases cultural and religious values impose strict regulations on gender roles and expectations which affects with whom an immigrant can interact and under what circumstances. For example, Somali individuals following an Islamic tradition that men and women should not touch (CDC, 2008b), which may lead to strong preferences for female immigrants to see female practitioners and male immigrants to see male practitioners. This could limit access to care. It adds unique challenges for healthcare practitioners to communicate across genders effectively and provide comfortable and respectful services for their immigrant patients.
• Culture influences the stigma of health issues. Cultural values and beliefs have a strong impact on the perceptions of certain health issues or diseases. Among the Somali, for example, there is a strong stigma against those who have tuberculosis (CDC, 2008b). Individuals avoid talking about having tuberculosis or seeking treatment, in order to avoid stigma (CDC, 2008b). In other cultures, mental illness may suggest that an individual has a weak will or personality. Individuals feel shame and work to hide these issues rather than seeking help. There is a great need for more culturally and linguistically appropriate health services (Diamond, Wilson-Stronks, & Jacobs, 2010; Shannon, McCleary, Wieling, Im, Becher, & O’Fallon, 2015).
Access to Supports
The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) restricts access to food stamps, Medicaid, and housing assistance for most non-citizens with less than 5 years of United States residency (Van Hook & Balisteri, 2006). States, however, can decide to offer assistance for immigrants.
Many children of immigrants are native-born citizens, and consequently are eligible for public benefits including food stamps, housing assistance and health insurance. However, many immigrant parents fear that attempts to access these benefits may interfere with their process of becoming citizens or may result in deportation and separation of parents and other families’ members who are undocumented (Perreira et al., 2012).
Child welfare systems need to be prepared to respond to the numerous challenges of immigrant children and families who come to the attention of the system. Child welfare has largely been unaware of these challenges and response to cases with this particular group may be slow or impeded. This heralds the need for the development of tools, approaches, practices and policy improvements within the child welfare system to effectively address the needs of immigrant children and their families.
28.4 Financial Problems
When immigrants come to the United States, they frequently must learn how to navigate new financial systems. Some immigrants come from countries where banks are both trusted and common, some have only experienced weak or corrupt banks, and others have interacted primarily with cash-based markets. They must learn to navigate new financial institutions and products.
Immigrants face unique barriers to accessing financial institutions and products. First, immigrants whose native countries have weak or corrupt financial instructions may distrust banks. Immigrants from countries with weak financial institutions (those that do not effectively protect private property or offer incentives for investment) are less likely to participate in United States financial markets (Osili & Paulson, 2008). Additionally, immigrants may face language and cultural barriers in accessing financial products. Banks may not have employees who speak the immigrant’s native language or who are familiar with specific cultural customs surrounding finances.
Banking
One of the first steps to establishing financial security is the ability to utilize financial products and services available to both protect and increase one’s assets. The most important and basic of these financial tools are checking and savings accounts. Having checking and savings accounts allow individuals to keep their money safe, dramatically reduce the fees associated with financial transactions (e.g., cashing paychecks), efficiently and safely pay bills and other obligations, and establish creditworthiness (Rhine & Greene, 2006).
Immigrants are much more likely than native-born peers to be “unbanked,” or have no bank accounts of any kind. The incidence of being unbanked in immigrant communities is 13% higher than the native-born population (Bohn & Pearlman, 2013). Among immigrant communities in New York, as much as 57% of Mexican immigrants and 35% of Ecuadorian were unbanked (Department of Consumer Affairs, 2013). Immigrants who create bank accounts are able to access financial benefits. For example, immigrants with bank accounts in the United States are more likely to own than to rent or live for free, suggesting that this is an important correlate of homeownership (McConnell & Akresh, 2008).
Research investigating the differences between banked and unbanked immigrants found unbaked immigrants tended to live in enclaves (Bohn & Pearlman, 2013), arrived in the United States at a later age, and have less education, lower English proficiency, lower-income level, and larger families (Paulson, Singer, Newberger, & Smith, 2006; Rhine & Greene, 2006). Immigrants who are unsure about the length of stay in the United States also more likely to be unbanked (Department of Consumer Affairs, 2013). Furthermore, those who are unbanked, experience more structural barriers such as understanding the banking system, documents, and process. Having direct, physical control over cash rather than keeping it in a bank was found to deter Hispanic consumers from using financial products and services (Federal Reserve Bank of Kansas City, 2010).
Savings
Immigrants are less likely than native-born citizens to have a savings account, even after accounting for socioeconomic status (Paulson, Singer, Newberger, & Smith, 2006). However, many immigrants are saving money, using both savings accounts and less formal methods. In a study of Southeast Asian refugees in Canada, Johnson (1999) found that 80% of the participants were saving money. A study of later-age, low-income Asian immigrants in the United States found much lower rates; only 15% saved regularly (Nam, Lee, Huang, & Kim, 2015). The most common reasons quoted for saving money include emergencies (Johnson, 1999; Solheim & Yang, 2010), children’s education, and home purchases (Johnson, 1999).
Credit
Immigrants who are more acculturated tend to be more open to using credit cards. Likewise, individuals who are younger, employed, higher-income, and have greater English proficiency are more likely to use credit cards (Johnson, 2007; Solheim & Yang, 2010). The reasons for using credit cards range from everyday purchases (e.g. eating out, buying clothes, buying furniture or appliances, etc.) (Johnson, 2007), to emergencies (Johnson, 2007; Solheim & Yang, 2010), to building credit (Solheim & Yang, 2010). It is worthwhile to note that although individuals that are less acculturated (e.g. first-generation Hmong parents) tended to prefer to use cash for purchases rather than credit card, these individuals also recognized the importance of building credit. This recognition motivates older, less acculturated individuals to use credit cards (Solheim & Yang, 2010).
Remittances
Remittances are money sent by migrants to spouses, children, parents, or other relatives in their country of origin. These funds are typically sent through money transfer agencies (e.g. MoneyGram, Western Union) for a fee, through banks, or via friends or relatives visiting the country of origin. According to the World Bank, in 2013 international migrants sent \$404 billion in remittances to their counties of origin (Tuck-Primdahl & Chand, 2014). Approximately a quarter of these funds originated from the United States. The top four countries to receive funds were India (\$70 billion), China (\$60 billion), the Philippines (\$25 billion), and Mexico (\$22 billion).
Remittances have a significant impact on both individuals and families. Remittances make it possible to meet basic needs such as purchasing food and clothing and paying for rent and utilities. Furthermore, remittances allow families to pay down (or pay off) debt as well as provide family members access to healthcare (Solheim, Rojas-Garcia, Olson, & Zuiker, 2012).
For immigrants in the United States, the obligation to send money home can create stress and hardship. The urgent need for financial support adds pressure to gain employment. It can be difficult to make enough money to meet the individual’s personal financial obligations (e.g. pay for rent, food, utilities, etc.) and to send money home. In some cases, the need to take care of the financial obligations associated with the trip to the new country (e.g. paying back borrowed money needed to for shelter and food upon first arrival) drains the finance so much that it is difficult to send money home (Martone, Munoz, Lahey, Yonder, & Gurewitz, 2011). For many immigrants, the knowledge that one is contributing to the improved living standard of one’s family makes the hardship worthwhile.
Culturally Appropriate Services
In order to meet the financial needs of immigrants, some community-based organizations are offering financial services that are culturally tailored. In research among Asian Americans, receiving financial services from other Asian Americans led to better financial outcomes; the clients were more likely to obtain loans and to save more and longer (Zonta, 2004). This may be because there is greater trust and fewer language barriers (Zonta, 2004). Culturally competent financial service providers can frame their materials and products in appropriate ways. For example, one bank offered loan counseling tailored to Vietnamese clients. To deal with clients’ fears of losing face over taking out a loan, the loan counselors stressed that their information and application was confidential and would not be shared with anyone in the community. The counselors also explained why they needed information, saying that the institution needed to vouch for the client in front of their loan committee (Patraporn, Pfeiffer, & Ong, 2010). Such adaptations can increase accessibility and usability of financial services for immigrants.
Video
Sunny Chanthanouvong, Executive Director, Lao Assistance Center of Minnesota, discusses financial and economic issues in the Lao community.
A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/humanbe/?p=123
28.5 Future Directions
Immigrants face significant and complex challenges in achieving economic well-being. Legislation such as the PRWORA and IRCA currently limit immigrants’ access to employment, housing, and health services. The implementation of these restrictive policies is often fueled by misconceptions of the economic impact of immigrants in the greater society, especially the perception that undocumented immigrants place an economic burden on our health care system. Federal policies that facilitate more effective access to employment, housing, and healthcare and financial services are needed.
Healthcare and financial systems can improve the provision of culturally and linguistically appropriate services for immigrants. This can be supported by the diversification of professionals in these industries through the promotion of minority individuals in financial and medical careers, the promotion of interpretation services in healthcare facilities and financial institutions, and the recruitment and training of culturally sensitive staff.
Research is needed to more deeply understand the values, needs, and stressors in immigrant and refugee families as they transition to a new economic environment. Worry about supporting their families creates stress which can led to mental health issues. We need to understand the connections between financial worry and mental health in these families and find ways to support them.
Research has shown financial education and interventions that are timely and relevant are the most effective. For immigrant and refugee families, what does that support entail, and at what critical transition points is it best provided? For example, in refugee resettlement, the transition from reliance on initial government assistance to reliance on earned wages is a major shift. When would an intervention have the most impact and what support do they need at that time?
It is important to understand the strengths that immigrant and refugee families bring to these tasks, particularly the strategies they’ve learned over time that have helped them to survive in harsh living situations. We can build on those strengths and honor their root culture values from their root cultures as we create culturally-appropriate education and intervention programs.
28.6 End-of-Chapter Summary
Case Study
Seng Xiong grew up in Laos. Like many Hmong in Laos, his parents were nomadic farmers. Their only bills were to purchase food or clothing, and they paid for these goods with cash or traded goods for them. Seng watched his parents keep their money safe by storing it in silver bars under their mattress. They took this money out only to pay the bride price when he married Bao.
Seng and Bao expected to be farmers as well, but they became increasingly threatened by persecution from the Lao government. Their focus was on day-to-day survival, never on saving for the future. Ultimately, they decided to flee to a refugee camp in Thailand. While there, they were not allowed to hold formal employment, but they volunteered to work in exchange for food and small goods. Seng and Bao had three children while in the refugee camp, and they hoped for a better life for these children. They decided to move to the United States.
When they arrived in the United States, Seng and Bao had only limited English skills. Bao was able to get work as a personal care attendant, and Seng began working in a meatpacking factory. Each job paid very little. It was very important to Seng and Bao to save for their children’s future and also to send money to their brothers and sisters still in the refugee camps. Their sponsor found them a small, two-bedroom apartment, and they furnished it with used beds, two couches, a table, and a TV. Neither job provided any health care benefits. When anyone in the family was injured or sick, Seng and Bao would talk with the elders in their community and treat the illness as best they could on their own.
They purchased only necessities, and set aside all other money under their mattress or shipped it to their families in Laos. Neither Seng nor Bao had any experience tracking money or budgeting for things in the future; they simply spent little and tried to save or share the rest. They both distrusted banks, and preferred to use cash for all exchanges.
As their children got older, they wanted to buy more entertainment items. It was difficult for Seng and Bao to decide what items to purchase for their children, wanting them to have a good life, and which items to say no to. Their oldest daughter started talking to them about building credit, but this seemed like a very risky situation. Bao had a friend whose identity had been stolen when she started a bank account, and Bao and Seng knew that when you borrow money from the bank, you have to pay back some interest. They knew they could borrow money from another sibling in the United States if they needed to, and having any kind of credit card or loan seemed unnecessary.
Discussion Questions
1. Think back on your own family history. What did you learn from your parents about banking, saving, credit, and financial obligations to family? How might that have been influenced by your cultural background?
2. What barriers do immigrants frequently face to economic well-being?
3. How might not having healthcare impact the well-being of an immigrant family? What about healthcare in another language?
4. How might Seng and Bao’s financial background impact their children’s choices, particularly as their children become adults and consider college and other savings goals?
Helpful Links
The Culture of Money
• This report by the Annie E. Casey Foundation, titled “The Culture of Money: The Impact of Race, Ethnicity, and Color on the Implementation of Asset-Building Strategies” describes institutional barriers low-income families navigate to become financially stable and outlines financial education strategies to support low-income families.
• https://www.aecf.org/resources/the-culture-of-money/
The Consumer Financial Protection Board
Attribution
Adapted from Chapters 1 through 9 from Immigrant and Refugee Families, 2nd Ed. by Jaime Ballard, Elizabeth Wieling, Catherine Solheim, and Lekie Dwanyen under the Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/09%3A_Global_Perspectives_and_Theories/28%3A_Economic_Well-Being_Supports_and_Barriers.txt |
Learning Objectives
• Learn from the national and global perspectives of mental health among immigrants and refugees.
• Recognizing that the world is constantly and rapidly changing.
• Recognizing that Global/national/international events can have an impact on individuals, families, groups, organizations, and communities.
• Global implications dictate that we foster international relationships and opportunities to address international concerns, needs, problems, and actions to improve the well-being of not only U.S. citizens, but global citizens.
29.1 Introduction
“After all, when a stone is dropped into a pond, the water continues quivering even after the stone has sunk to the bottom.”
–Arthur Golden, Memoirs of a Geisha, 1999, p. 265.
Immigrant and refugee journeys are often idealized in literature, art, and historical accounts. Their experiences are repeatedly distilled into tales of extreme adventure where rugged courage and the intense desire for a better life overshadow all other experiences. Individuals and families become characters in larger than life stories, archetypes of human heroism and determination. As observers, we are often drawn in by the rich stories of survival, pain, and loss where people flee oppression and sacrifice to find unparalleled freedom and endless opportunity. These are the stories that incite respect, shock, and awe. However, immigrants and refugees are more than stories, more than the romanticized inspiring tales. They are real people who have suffered the loss of loved ones, homes, and communities. The multilayered impact of displacement is frequently manifest in one’s mental health and felt for multiple generations.
Leaving home, by choice or by force, is a disorienting experience. Through migration or via displacement and resettlement, immigrants and refugees are often confronted with a new world, new language, and new social norms. They face culture shock in everyday life events experienced as foreign. Immigrants and refugees experience disruption in their sense of self, often having to give up previous occupations, privilege, and social status. They lose community and established systems of social support. In addition to expected adjustment difficulties, immigrants and refugees may face additional challenges wrought by poor physical and mental health resulting from exposure to multiple traumatic events and extensive histories of loss. They may experience severe and long-lasting psychological struggles including depression, anxiety, posttraumatic stress symptoms, and adjustment problems. Compounding these difficulties can be logistical complexities such as a lack of jobs, affordable housing, culturally and linguistically appropriate health and mental health services, financial resources, and social support.
In spite of the myriad of obstacles, struggles, and daily stressors, most immigrants and refugees demonstrate tremendous resilience as they persist in finding ways to work around, cope with, or overcome displacement related challenges. Some, especially highly skilled immigrants with means, might not experience a great deal of negative stress. Unfortunately, this represents a small segment of the total immigrant population. Refugees and undocumented immigrants come with inherent risk factors and many other immigrants share experiences of loss and traumatic stress, including multiple exposures to traumatic events.
This chapter reviews some of the shared and unique experiences of immigrant and refugee populations with particular focus on mental health implications and relational risk factors associated with exposure to traumatic stress. Mental health treatments and emerging directions for future prevention and intervention research are also discussed.
29.2 Different Shared Experiences
“While every refugee’s story is different and their anguish personal, they all share a common thread of uncommon courage – the courage not only to survive, but to persevere and rebuild their shattered lives.”
–Antonio Guterres, UN High Commissioner for Refugees (UNHCR, 2005).
Families immigrate to the United States for various reasons. Some voluntary immigrants may choose to leave their country of origin in search of better opportunities, while others are forced to flee due to war, political oppression, or safety issues. Some families manage to stay together over the course of their journey, but many are divided or separated through the migration process. This is particularly true of refugee families whose migration is involuntary, hasty, and traumatic in nature (Rousseau, Mekki-Berrada, & Moreau, 2001). Refugees in particular may have survived traumatic events and violence including war, torture, multiple relocations, and temporary resettlements in refugee camps (Glick, 2010; Jamil, Hakim-Larson, Farrag, Kafaji, & Jamil, 2002; Keys & Kane, 2004; Steel et al., 2009). The destructive nature of war “involves an entire reorganization of family and society around a long-lasting traumatic situation” (Rousseau, Drapeau, & Platt, 1999, p. 1264) and individuals and families may continue to experience traumatic stress related to family left behind and stressful living conditions long after they have resettled.
When it comes to mental and physical health, refugees are a part of an especially vulnerable population. While some adjust to life in the United States without significant problems, studies have documented the negative impact of a trauma history on the psychological wellbeing of refugees (Keller et al., 2006; Birman & Tran, 2008). Pre-migration experiences may precipitate refugee mental health concerns, particularly in the early stages of resettlement (Beiser, 2006; Birman & Tran, 2008). These experiences may include witnessing and experiencing violence, fleeing from a family home located in a city or village that is being destroyed, and walking to find refuge and safety for days or weeks with limited food, water, and resources. Post-migration conditions, such as adapting to living in an overcrowded refugee camp or trying to rebuild life in a foreign country, as well as structural stressors, such as going through the legal process of obtaining asylum or legal documentation, may also precipitate a cascade of individual mental health and family relational issues. The pre- and post-migration experiences and stressors of refugees may compound and create a “cumulative effect on their ability to cope” (Lacroix & Sabbah, 2011). Spending weeks, months, or even years managing stressful and traumatic experiences may weaken an individual or family’s ability to cope with continued change and the multiple stressors of resettlement.
While it is reported that refugees are at risk for higher rates of psychiatric disorders such as posttraumatic stress disorder (PTSD), depression, anxiety, complicated grief, psychosis, and suicide (Akinsulure-Smith & O’Hara, 2012; Birman & Tran, 2008; Jamil et al., 2002; Jensen, 1996; Kandula, Kersey, & Lurie, 2004; Steel et al., 2009), immigrants are also at risk for these mental health complications, especially if they have been exposed to multiple traumatic events. However, when working with immigrants and refugees, it is important to remember that one cannot assume that all members of an affected population are psychologically traumatized and will have the same mental health symptoms (Shannon, Wieling, Simmelink, & Becher, 2014; Silove, 1999). Further, mental health symptomatology is expressed in a variety of culturally sanctioned ways. For example, somatic complaints such as headaches, dizziness, palpitations, and fatigue might be a way to avoid stigma and shame often associated admitting to mental health problems (Shannon, Wieling, Im, Becher, & Simmelink, 2014).
We know that the mental health of an individual does not exist in isolation; the experiences of one person in a family or community affect others. Unfortunately, the majority of the literature about immigrant and refugee mental health focuses on mental health as an individual process; the systemic ramifications are understudied and underrepresented in academic literature (Landau, Mittal, & Wieling, 2008; Nickerson et al., 2011).
29.3 Mental Health Challenges
“Just because you leave war, war does not leave you. And for me in America, it came back in my nightmares, it came back in the low kick of a car’s engine, it came back in the loud roar of a plane, it came back in a mother’s hum, in a father’s song.”
–Loung Ung, Cambodian American Author and Human-Rights Activist, full speech available at https://www.youtube.com/watch?v=6odKrFRfqkI&feature=youtu.be.
Much of the literature on immigrant and refugee mental health focuses on loss and trauma, as well as the depression and anxiety that frequently accompanies them. The interconnectedness of loss, trauma, depression, and anxiety can make it difficult to distinguish what is the presenting problem. When looking at one, others are likely to be present. Those who work with immigrants and refugees must be aware of how loss, trauma, depression, and anxiety may each affect an immigrant or refugee’s mental health as well as family health and functioning.
Loss
In every story of immigration or refugee resettlement, a common thread of loss is present. Some losses are obvious, like the loss of home and community or the severance from family and friends who have been left behind or killed. Loss does not end with resettlement; new losses are experienced and revealed over time, some of which can be obscure, like the loss of identity, social status, language, and cultural norms and values.
The grief response that comes with loss can manifest as physical, emotional, and psychological responses including crying, anger, numbness, confusion, anxiety, agitation, fatigue, and guilt. The loss of surroundings, possessions, ideas, and beliefs such as those experienced by immigrants and refugees can trigger a grief response similar to those experienced with the death of someone close (Casado, Hong, & Harrington, 2010).
Some losses and the accompanying grief are considered normative in United States culture. For instance, the death of a loved one or child is a recognized loss and the manifestations of grief associated with that type of loss are understood by most people. However, some losses and the accompanying grief are disenfranchised, meaning that grief occurs when a loss is experienced but is not recognized by others as loss. For example, Kurdish families who resettled in the United States while Saadam Hussein was president may have found that people in the United States did not understand why they would miss living in Iraq. Migratory grief is considered a disenfranchised grief (Casado et al., 2010) and is often dismissed in the immigrant and refugee adjustment experience. As a result, people with disenfranchised grief are unable to express feelings, and grief-related emotions are not recognized or accepted by others.
Another way to think about grief and loss experienced by immigrants and refugees is to understand the ambiguous nature of their loss experiences. There are two types of ambiguous loss (Boss, 2004). The first occurs when a loved one is physically absent but emotionally present because there is no proof of death. A kidnapped child, soldiers missing in action, family separation during war, deportation, and natural disasters can all result in this type of ambiguous loss. The second type of ambiguous loss occurs when a loved one is physically present but emotionally absent. Dementia, brain injuries, depression, PTSD, and homesickness can all result in individuals being physically present but emotionally or cognitively they have “gone to another place and time” (Boss, 2004, p 238). Family members who experience ambiguous loss describe physical and mental pain as a result (Robins, 2010). The lack of clarity associated with ambiguous loss can lead to boundary ambiguity expressed in conflict and ambivalence in the new roles family members take after resettlement. Ambiguous loss is also often characterized by frozen grief, represented by the immobilization of individuals and relational systems stuck between the old and new worlds (Boss, 2004). Although ambiguous loss is a common experience for immigrants and refugees, limited research has been conducted with this population (Rousseau, Rufagari, Bagilishya, & Measham, 2004).
Most people experience grief reactions to a mild or moderate degree and then return to pre-loss levels of functioning without the need for clinical intervention. However, some suffer a more complicated grief reaction (Bonanno et al., 2007). Complicated grief occurs when acute grief becomes a chronic debilitating condition (Shear et al., 2011). It may be incorrectly labeled as depression (Adams, Gardiner, & Assefi, 2004). However, research indicates that complicated grief is distinguishable from depression and other trauma-related psychological disorders. Intense longing for the object of loss, preoccupation with sorrow, extreme focus on the loss, and problems accepting the death or loss are all symptoms of complicated grief. Complicated grief can exacerbate psychiatric disorders and influence the relationship between loss, symptoms of posttraumatic stress and depression (Nickerson et al., 2011). In one study with Bosnian refugees, for example, complicated grief was a better predictor of refugee general mental health than was PTSD (Craig, Sossou, Schnak, & Essek, 2008).
Anxiety and Depression
The literature on immigrants’ and refugees’ experiences with anxiety and depression is often intermingled with that of loss and trauma. Comorbidity can make it difficult to measure and separate one symptom cluster from the other but the two comprise different psychological diagnoses. Anxiety is characterized as a normal human emotion that we all experience at one time or another. Symptoms include feelings of fear and panic, uncontrollable and obsessive thoughts, problems sleeping, shortness of breath, and an inability to be still and clam. Anxiety disorders are serious and sufferers are often burdened by constant fear and worry further exacerbating comorbidity of PTSD symptoms. The literature on anxiety prevalence of immigrant and refugee populations is limited but expected to be highly correlated with that of PTSD and depression. Depression, described as feelings of sadness, unhappiness, or feeling down, is a normative reaction and can be felt in varying degrees. However, clinical depression is a mood disorder in which the feelings of sadness interfere with everyday life for weeks or longer. Immigrants and refugees are at high risk for clinical depression due to their extensive histories of loss, potential trauma, and resettlement. Studies have also shown that depression among immigrants is related to the process of adapting to the host culture (Roosa et al., 2009). Depression is known to cause long-term psychosocial dysfunction in refugees who have experienced violence and loss (such as in Bosnian refugees resettled in Australia; Momartin et al, 2004). It should not be seen as a marginal issue when compared to PTSD and other trauma-related diagnoses (Weine, Henderson, & Kuc, 2005). Depression is a common clinical problem with successful available treatments. Weine et al. (2008) argue that it should be a target of intervention and focus of health education with immigrant and refugee populations.
Traumatic Stress
Many immigrants and most refugees have experienced or been exposed to traumatic events such as witnessing or experiencing violence, torture, loss, or separation. Psychological trauma is most often not limited to a single traumatic event but includes direct and indirect events over the course of a person’s life (Jamil et al., 2002). Traumatic stress affects how people see the world, how they find meaning in their lives, daily functioning and family relationships. Several studies have documented the effects of traumatic stress related to war violence on refugee health. Steel et al. (2009) conducted a meta-analysis with over 80,000 refugees and reported a weighted prevalence rate of PTSD ranging between 13% and 25%. In one critical review, torture and cumulative exposure to traumatic events were the strongest factors associated with PTSD, with some refugee communities experiencing PTSD prevalence rates as high as 86% (Hollifield et al., 2002). A study of symptom severity of PTSD and depression with 688 refugees in the Netherlands supported these findings, reporting that a lack of refugee status and accumulation of traumatic events were associated with PTSD and depression (Knipscheer, Sleijpen, Mooren, ter Heide, & van der Aa, 2015). Studies have also established the enduring effects of pre-migration traumatic stress even years after resettlement (Marshall, Schell, Elliott, Berthold, & Chun, 2005) as well as the long-term physical health effects of refugee trauma, including hypertension, vascular disease, coronary, metabolic syndrome, and diabetes (Crosby, 2013).
For immigrants and refugees, it is possible that entire families will have been exposed to similar traumatic events and losses that disrupt family and social networks (Nickerson et al., 2011). This is especially true for those who have experienced war or interpersonal violence. War is characterized as an attack on civilian populations where citizens are targeted, dislocated, and displaced (Lacroix & Sabbath, 2011). According to Sideris (2003), war unravels the social fabric of a community as the “social arrangements and relationships which provide people with inner security, a sense of stability, and human dignity are broken down” (p. 715). For instance, people may experience a sense of helplessness, damaged trust, shame, and/or humiliation associated with traumatic experiences such as rape, physical violence, witnessing death, being forced to violently turn on one another, and having to flee homes.
The harmful effects of traumatic stress on mental health and functioning have been well documented in refugee populations (de Jong et al., 2001; Hebebrand et al., 2016; Nickerson et al, 2011). Research in the United States shows that PTSD is higher for refugees who spent time in refugee camps affected by war and forced migration than for other resettled communities (LaCroix & Sabbath, 2011). Common trauma-related diagnoses are PTSD and Acute Stress Disorder (ASD). According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), PTSD and ASD correspond to a situation in which a person experiences or witnesses threatened or actual death, serious injury, or sexual violence and continues to bear the mark of the experience after the event has ceased. PTSD and ASD are characterized by a cluster of symptoms that cause symptom-related stress or functional impairment (e.g., difficulty in work or home life). Symptoms that are present between three days and one month after the traumatic event are classified as ASD, symptoms that last more than one month are classified as PTSD. Both adults and children can have PTSD and ASD. Symptoms fall into four categories: (a) persistently re-experiencing through intrusive thoughts or nightmares; (b) avoiding trauma-related reminders such as people, places, or situation; (c) negative alterations in mood or cognitions such as the inability to recall key features of the traumatic event, negative beliefs about and expectations about oneself and the world (e.g., “I am bad,” “the world is completely unsafe”), diminished interest in pre-traumatic activities, and persistent negative trauma-related emotions (e.g., fear, horror, anger, or shame); and (d) alterations in arousal and reactivity that worsen after the traumatic event such as increased irritable or aggressive behavior, self-destructive or reckless behavior, hypervigilance, exaggerated startle response, problems concentrating, and sleep disturbance.
Traumatic Stress and Family Relationships
Family consequences of exposure to traumatic stress include financial strain, abuse, neglect, poverty, chronic illness, and increased family stress (Weine et al., 2004), as well as a decreased ability to parent (Gewirtz, Forgatch, & Wieling, 2008). Individuals with PTSD, for example, are likely to be more reactive, more violent, and more withdrawn in relationships with a spouse or children (Gewirtz, Polusny, DeGarmo, Khaylis, & Erbes, 2010; Nickerson et al. 2011).
Floods in Sahrawi refugee camps in southwest Algeria. Wikimedia Commons – CC BY-SA 2.0.
The literature shows that family attachment and support can have a protective effect on those who have experienced traumatic stress, while separation from family can exacerbate symptoms (Rousseau et al., 2001). This makes family mental health and functioning particularly important when there has been loss and exposure to traumatic stress (Nickerson et al., 2011).
Research shows that parental PTSD can significantly affect the parent-child relationship. Parental PTSD is associated with an increase in self-reported aggressive parenting, indifference and neglect (Stover, Hall, McMahon, & Easton, 2012), lower parenting satisfaction (Samper, Taft, King, & King, 2004), an increase in family violence (Jordan et al., 1992), an increase in challenges with couple adjustment and parenting (Gewirtz et al., 2010), and lower perceived relationship quality with children (Lauterbach et al., 2007; Ruscio, Weathers, King, & King, 2002). Having a parent with PTSD has been linked to an increase in children’s behavior problems (Caselli & Motta, 1995; Jordan et al., 1992), trauma-related symptoms (Kilic, Kilic, & Aydin, 2011; Polusny et al., 2011), anxiety and stress (Brand, Schechter, Hammen, Brocque, & Brennan, 2011), and depression (Harpaz-Rotem, Rosenheck, & Desai, 2009). A recent study in Northern Uganda also found that exposure to trauma was associated with family violence (Saile, Neuner, Ertl, & Catani, 2013). In the same study, children reported that their worst traumatic experiences were related to family violence, not exposure to war violence. Similarly, Catani, Jacob, Schauer, Kohila, and Neuner (2008) found that following war and the tsunami in Sri Lanka, 14% of children reported an experience of family violence as the most distressing experience of their lives. A later study with by the same research group (Sriskandarajah, Neuner, & Catani, 2015) found that children listed their worst experiences of family violence immediately after war experiences, but reported that parental care significantly moderated the relationship between mass trauma and internalizing behavior problems. This literature documents the ubiquitous impact of traumatic stress on family relationships and underscores the need for prevention and intervention treatment modalities targeting individual and relational family systems for populations commonly exposed to multiple traumatic events (Catani, 2010).
Videos
Paul Orieny, Sr. Clinical Advisor for Mental Health at the Center for Victims of Torture (CVT), discusses post-traumatic stress and family adjustment issues (1:03-4:55).
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=125
Ruben Parra-Cardona, Ph.D., LMFT discusses intergenerational trauma and power in the context of parenting (12:00-13:40).
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=125
Child Mental Health
Children are not immune to the deleterious effects of the immigrant and refugee experience. Children who flee adversity to seek refuge in a foreign land often endure physical and mental challenges during a turbulent and uncertain journey (Fazel, Reed, Panter-Brick, & Stein, 2012). They may experience traumatic experiences in their homelands (war, torture, terrorism, natural disasters, famine), lose or become separated from family and caregivers, and endure traumatic journeys to a host country (crossing rivers and large bodies of water, experiencing hunger, lacking shelter; Pumariega, Rothe, & Pumariega, 2005). Children may feel relief once they resettle, but resettlement can bring additional challenges including financial stressors, difficulties finding adequate housing and employment, a lack of community support, new family roles and responsibilities that often transcend developmental age, acculturation stressors such as generational conflict between children and parents, and a struggle to form a cultural identity in the resettled country.
Abed (15) fled Syria to escape the war and was separated from his parents along the way. Trocaire – DSC_1009 – CC BY 2.0.
The cumulative effects of being exposed to traumatic events and/or stressors pre- and post-migration may overwhelm the coping ability and resilience of children, leading to an accumulation of stressors that may have profound and lasting effects on children’s ability to meet developmental milestones and optimally function on a day-to-day basis. This is especially true for children who experience post-migration detention or enter a host country unaccompanied (Hodes, Jagdev, Chandra, & Cunniff, 2008; Rijneveld, Boer, Bean, & Korfker, 2005). Immigrant and refugee children may continue to suffer from similar conditions as adults, such as anxiety disorders, depression, and PTSD (Fox, Burns, Popovich, Belknap, & Frank-Stromborg, 2004). Studies have shown that the prevalence of PTSD and depression among resettled refugee children in the United States is significantly higher than for children in the general population (Bronstein & Montgomery, 2011; Merikangas et al., 2010). A community-based participatory study conducted by Betancourt, Frounfelker, Mishra, Hussein, and Falzarano, (2015) with Somali Bantu and Bhutanese youth in the United States found that these communities also identified areas of distress corresponding to Western concepts of conduct disorders, depression, and anxiety.
Age Specific Effects of Trauma
See the National Child Traumatic Stress Network’s list of age-specific effects of trauma at: https://www.nctsn.org/resources/age-related-reactions-traumatic-event.
29.4 Mental Health Treatments
“We don’t heal in isolation, but in community.”
—S. Kelley Harrell, Gift of the Dreamtime: Awakening to the divinity of trauma, Reader’s Companion (2014).
Addressing the mental health needs of immigrants and refugees can be a complex challenge for providers. Research has shown that immigrants and refugees underutilize mental health services. This can be for a variety of reasons including the stigma associated with mental health in many cultures, the inability to properly diagnose because of cultural and linguistic barriers, less access to health insurance, lack of financial resources, and the propensity to seek help from traditional healers or providers before seeking Western mental health services (Betancourt et al., 2015; Kandula et al., 2004).
Treating immigrants and refugees within the United States offers unique opportunities and challenges. The refugee experience should be considered multidimensional and multifaceted, and the therapeutic perspective should be sensitive to each family member’s experience (Lacroix & Sabbath, 2011). However, many westernized treatments and interventions do not accommodate for such complexities. Using westernized treatments without proper cultural tailoring and testing may not be ideal or even ethical for those who come from other countries. Many immigrants and refugees come from collectivistic cultures that prioritize interpersonal relationships and social networks above the needs of the individual. The Western concept of psychotherapy as an individualized treatment modality that involves talking with a stranger might not fit with their more collectivist worldview. Many of the native cultures of immigrants and refugees take a holistic approach to mental health and are likely to seek assistance from religious leaders, community elders, or family members (Akinsulure-Smith, 2009; Bemak & Chung, 2008; Fabri, 2001). In a new country, they may be separated from family and indigenous leaders and may not know where to turn for help.
Another challenge is the inadequacy of Western psychiatric categories’ ability to describe refugees’ problems (Adams et al., 2004). Some critics question the validity of applying Western-based trauma models to diverse cultures and societies and believe that the PTSD diagnosis may not fully capture the complexities of the psychological responses that arise from individuals who have experienced human rights violations (Marsela, 2010; Silove, 1999).
Available treatments may also be limited in their abilities to treat immigrants and refugees. Many Western treatments are individually based, which may be appropriate for PTSD and other intrapsychic diagnoses but have not proven effective or sufficient to address the relational and systemic consequences of trauma and displacement-related stressors. In contrast, community connections offer protective factors that can buffer mental health and relational functioning of immigrants and refugees. Studies show that living in communities high in same-ethnic neighbors may contribute to lower levels of depression amongst immigrants and refugees (Ostir, Eshbach, Markides, & Goodwin, 2003). Practitioners can incorporate the positive influence of community support in treatment approaches. Traditional healers can be used to help immigrants and refugees in culturally relevant and acceptable ways, and family-level interventions can improve psychological symptoms and access to services (Weine et al., 2008; Nickerson et al., 2011). When possible, the incorporation of families in the treatment process is paramount. Families bring with them knowledge, competence, and values that can be used during the intervention process to facilitate healing and foster resilience (Lacroix & Sabbath, 2011).
In mental health treatment for children, it is particularly important to engage the child’s support system. Studies suggest that higher levels of family, community, and school support are related to fewer psychological symptoms among children who have experienced war (Betancourt & Khan, 2008). Family-based interventions may target improving the emotional functioning of the family, identifying family patterns of coping, and making meaning of the family’s experience. Schools offer a secure and predictable environment in which immigrant and refugee children struggling with anxiety, depression, and PTSD can be identified and receive supportive services.
Despite the protective factors associated with community and family connections, caution must be taken to acknowledge the potential complexities of a particular cultural community and to develop a deep understanding of contextual and relational dynamics of the group. Many refugee communities share a complex history involving conflict between groups from similar or same ethnic backgrounds that can problematize healing and community building.
PTSD Treatments
A variety of Western therapies have demonstrated efficacy and/or effectiveness for treating PTSD in children and adults. They commonly use various levels of exposure therapy to address one or more traumatic memories in an effort to reduce PTSD symptomatology. Evidence-based exposure therapies include Prolonged Exposure (PE), Trauma-Focused Cognitive Behavior Therapy (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR), and Narrative Exposure Therapy (NET; KIDNET for children). NET (Schauer, Neuner, & Elbert, 2011) is the only model specifically developed for treating immigrant and refugee populations in post-conflict, low-income contexts and has been extensively researched with refugee populations (Robjant & Fazel, 2010; Crumlish & O’Rourke, 2010). NET integrates elements of cognitive behavior therapy and testimony therapy and is specially targeted for individuals who have been exposed to multiple traumatic events in their lifetime (see Schauer, Neuner, & Elbert, 2011 for a full description of the treatment model). A recent study conducted by Slobodin and de Jong (2015a) reviewed the literature on the efficacy of treatments for asylum seekers and refugees, including trauma focused interventions, group therapies, multidisciplinary interventions and pharmacological treatments. They reported that the majority of studies had positive outcomes for reducing trauma-related symptoms. However, the evidence mostly supports NET and CBT as the recommended treatment modalities for refugees.
Parenting and Family Interventions for Trauma-Affected Immigrants and Refugees
The effects of traumatic stress related to war, violence, and subsequent displacement have far-reaching implications for parent-child relationships. There is a small but developing literature documenting the importance of parenting interventions for populations affected by traumatic stress, as parents are the most proximal resources to effectively intervene and affect child outcomes (Gewirtz et al., 2008; Siegel, 2013). Persistent intergenerational transmission of family violence accompanied by harsh parenting practices and low positive involvement between parents and children is one dimension of a complex set of consequences related to traumatic stress that affect family and community functioning. Although resilience is readily seen in displaced communities, the lasting negative effects of traumatic stress on individual and family health is ubiquitous across multiple generations. The sequelae of maladaptive coping that often includes mental health disturbances, substance abuse and intimate partner violence, are further exacerbated by poverty and social disparities that place these families on a delicate faultline. There are currently no evidence-based parent or family-level treatments for traumatic stress. A review of the literature on family-based interventions for traumatized immigrants and refugees conducted by Slobodin and de Jong (2015b) found only six experimental studies, four school-based and two multifamily support groups. They validated that the shortage of research in this area currently does not allow for effectiveness claims to be made about family-based interventions with these populations.
However, a small number of researchers worldwide have been advancing systemic treatments with promise. One such team is comprised of vivo International (vivo; www.vivo.org) researchers who have collaborated with post-conflict communities for over a decade, primarily providing treatment for PTSD. One of these communities is in Northern Uganda, the setting of a brutal civil war that lasted nearly two decades through 2006. Involvement in this community revealed a critical need for parent and family-level interventions in addition to PTSD treatment. Wieling and colleagues adapted an evidence-based intervention called Parent Management Training, Oregon model (PMTO; Patterson, 2005) which includes core components of encouragement, positive involvement, setting limits, monitoring, and problem-solving to the context of traumatic stress. Additional content areas included the individual and relational effects of traumatic stress, intergenerational transmission of violence, substance abuse, and other risk-taking behaviors. Multi-method data collection approaches and the parenting intervention were carefully tailored to fit the cultural characteristics of Northern Uganda and the models was successfully tested for feasibility of implementation in 2012 with much promise (see Wieling et al., 2015a; 2015b). The research team is currently adapting and testing a similar model with the Karen refugee community in the United States and hope to further test and implement it with other immigrant and refugee groups in the United States. Another approach that specifically targets the family and broader community level to rebuild societies after conflict or resettlement is called the Linking Human Systems or Link Approach (Landau, Mittal, & Wieling, 2008). Link is a specific method of engaging with individuals, families, and communities after trauma and disaster. It suggests that clinicians assess 1) individual, family, and community resources, 2) how resources balance against stressors, and 3) strengths and themes of resilience, including connection to stories of resilience within the family and community-facing past adversities. The Link approach identifies specific intervention strategies to target the individual, family, and community levels. At each level, service providers work collaboratively with the individual, family, or community to identify goals and mobilize resources. This approach demonstrates an ecologically based, culturally informed, and multilevel intervention that holds promise for immigrant and refugee groups affected by trauma and disaster.
Videos
Integrating Mental Health Therapy with Traditional Forms of Healing
Rebecca Ratcliff, MD introduces herself and background on the Peruvian and Mayan healing modalities (5:35-9:10).
Melissa Schebloom, MSW, LICSW discusses self-talk with clients with complex trauma (12:21-13:33).
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=125
29.5 Emerging Directions
The challenges of working with immigrant and refugee families are many and the need to improve our theoretical and methodological approaches is critical. First, there is a need for more in-depth and clinically-based research with families. While the body of knowledge about individuals is vast, family interventions remain understudied. There is also a need for more culturally sensitive research methods and interventions that go beyond typical Westernized ideas and methods and that move to incorporate indigenous strengths and cultural-specific practices. Third, we need trained, culturally sensitive practitioners who are willing to grapple with the complexities of working with immigrants and refugees to effectively intervene and achieve positive outcomes. Last, we need an appropriate resettlement infrastructure (e.g., school, medical, legal, economic, political) to support the healthy transition and integration of immigrant and refugee communities. As the number of refugees in the world continues to grow, we need stronger and proactive policies and programs to support their resettlement process. For example, a more comprehensive infrastructure for promoting successful refugee resettlement would involve screening and assessing for mental health, in addition to the required physical health examinations conducted within months of arrival, and building provider capacity across resettlement states for treating individual and relational levels of mental health functioning. At a broader level, a host of legal, human rights and policy level changes will need to be achieved nationally and globally to reduce the punitive stressors associated with undocumented immigrant status, which impact the daily lives of millions in this country.
29.6 End-of-Chapter Summary
Case Study
“Big trucks remind him of the tanks…they shot his friends.”
Ari was a bright-eyed, precocious child with big brown eyes. At the young age of 5 he was full of creative ideas and imaginative scenarios. “I’m stronger than Superman!” he said with unbending confidence while whizzing around the living room of his family’s first floor apartment.
“He is obsessed with superheroes,” His older brother Amed responded.
Ari climbed on the back of the couch, put his fisted hands on his hips, puffed out his chest and with a steely smile ripped open his buttoned shirt revealing a blue t-shirt with the iconic Superman S emblazoned across the chest. “I AM STRONGER THAN SUPERMAN!” he yelled as he threw one arm in the air and jumped off the couch. He continued to run around the room, making whooshing noises and stopping every few seconds to flex his tiny arm muscles.
“We didn’t have superheroes in Kurdistan,” Amed said. “At least I don’t remember them.”
“How old were you when you left Kurdistan?” I asked.
“I was 7, Ari was 3.”
“And how long have you been in the United States?” I asked.
“A little over a year,” he replied.
At that moment Ari and Amed’s mom entered the room with a large warm disk of flatbread wrapped in towel.
“For you,” she said, handing me the bread.
Ari rushed over to grab a piece but was swatted away by his mother’s hand. She began talking to him in Arabic.
“She is telling him to act like a good boy and to stop running around,” Ahmed translated.
Ahmed was 9. He was tall for his age, slender, and very soft spoken. He and his father were the only two in the house who spoke English fluently. This meant Ahmed was often tasked with translating for the family. Sometimes he appeared to enjoy this. At other times he looked burdened.
I smiled. “Little boys are full of energy,” I said while watching Ari flex his muscles at his mother.
At that moment the loud grumbling sound of the garbage truck came in through the open window. The heavy machine wheeled in front of the house, its hydraulics let out a violent gush of air as it thrust its iron teeth into the large dumpster. The dumpster was effortlessly thrown up in the air, its content dumping into the back of the truck. hen with a whoosh and a gush it was slammed back down to earth with a loud bang.
Ari froze. The rigidness in his body was instantaneous. All super hero powers melted away. His eyes grew large and glazed over. His face contorted into that of horror. He screamed uncontrollably. The gregarious little boy was gone, and in his place the embodiment of terror.
“What is wrong?” I asked.
His mother grabbed him. Ari flailed. She pulled his head into her chest and started singing.
“Big trucks remind him of the tanks,” Ahmed said nonchalantly.
“The tanks? I asked, “What tanks?”
“He was on the playground back home when the tanks came. The soldiers shot his friends.”
Unsure of how to respond, a quiet “oh” slipped from my lips.
“They shot his friends?” I asked.
“Yes, they shot everyone. They didn’t care. They killed children. I saw lots of kids die.” Ahmed spoke with authority but without emotion.
Ari continued screaming for several more minutes as his mother sang and rocked him. The garbage truck finished emptying the dumpsters and drove away. Its loud hum resonating throughout the complex as it left. After it was gone and the usual sounds of the apartment complex returned Ari slowly calmed down.
“Bread. Eat.” His mother smiled and motioned to me and the bread she had handed me minutes before.
“She wants you to eat the bread,” Ahmed said.
“Oh yes. The bread.” I looked down at my hands. “This is the best bread.” I said looking up, half smiling. My eyes moved to Ari. The boy stronger than Superman slowly crept back to life. His eyes unglazed. He yawned, and his mother kissed the top of his head. I pointed to the S on his t-shirt. He looked down at his chest and then instinctively flexed his tiny arm in a show of power before shyly burying his head in his mother’s arm.
Discussion Questions
1. What are some mental health challenges that may arise in this family? How might an educator, social worker, therapist, religious/spiritual leader, employer, etc. support them?
2. What types of treatments might be helpful for this family system?
3. What do you believe are the challenges and opportunities in helping this family successfully resettle in the United States?
4. What do you see as the role of United States’ communities in immigrant and refugee resettlement – whose responsibility is it to support these families?
Helpful Links
The National Child Traumatic Stress Network (NCTSN)
• http://www.nctsn.org/
• NCTSN’s mission is to raise the standard of care and improve access to services for traumatized children, their families and communities throughout the United States. Their website contains information for parents and caregivers, school personnel, and professionals.
The Center for Victims of Torture (CVT)
• CVT believes in the exchange of knowledge, ideas and creative strategies to heal torture survivors and inspire effective action to end torture worldwide.
Bridging Refugee Youth and Children’s Services (BRYCS)
• http://www.brycs.org
• BRYCS maintains the nation’s largest online collection of resources related to refugee immigrant children and families.
Vivo International
• (http://www.vivo.org/en/)
• vivo (victim’s voice) is an alliance of professionals experienced in the fields of psychotraumatology, international health, humanitarian aid, scientific laboratory and field research, sustainable development and human rights advocacy.
Attribution
Adapted from Chapters 1 through 9 from Immigrant and Refugee Families, 2nd Ed. by Jaime Ballard, Elizabeth Wieling, Catherine Solheim, and Lekie Dwanyen under the Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/09%3A_Global_Perspectives_and_Theories/29%3A_Mental_Health.txt |
Learning Objectives
• Learn from the national and global perspective of intimate partner violence among immigrants and refugees.
• Recognizing that the world is constantly and rapidly changing.
• Recognizing that Global/national/international events can have an impact on individuals, families, groups, organizations, and communities.
• Global implications dictate that we foster international relationships and opportunities to address international concerns, needs, problems, and actions to improve the well-being of not only U.S. citizens, but global citizens.
32.1 Introduction
Imagine that you, your partner, and your children are recently arrived in the United States. You do not speak the language well, and everything from the foods in grocery stores to the type of floor in your apartment feels new to you. While you and your family try to adjust to these changes, what kind of stresses would you be under? How would it affect your relationship with your partner?
Now imagine that in the midst of these stressors and changes, your partner periodically comes home and snaps. Your partner curses at you, grabs your shoulders, and throws you down on the ground. What do you do? Who in this new country can help you?
Approximately one out of every three women (36%) and one out of every four men (29%) in the United States report lifetime experiences of rape, physical violence, and/or stalking by an intimate partner (Black et al., 2011). Rates of intimate partner violence (IPV) are even higher among immigrants, ranging from 30% to 60% (Biafora & Warbeit, 2007; Erez, Adelman, & Gregory, 2009; Hazen & Soriano, 2005; Sabina, Cuevas, & Zadnik, 2014). There are likely additional incidents that go unreported when immigrant and refugee groups do not know how to access or navigate social and legal services in the United States, or when immigrants and refugees come from nations where violence against women is culturally accepted.
IPV has a significant impact on immigrant and refugee women and their families. Immigrant and refugee women who experience IPV are more likely to experience mental health issues and distress; for example, Latina immigrants who experience IPV are three times as likely to be diagnosed with posttraumatic stress disorder (PTSD) as Latina immigrants with no experiences of IPV (Fedovskiy, Higgins, & Paranjape, 2008). Also, children who witness IPV are more likely to experience anxiety, depression, PTSD, and aggression than children with no exposure to IPV (Kitzmann, Gaylord, Holt, & Kenny, 2003; Wolfe, Crooks, Lee, & McIntyre-Smith, 2003). IPV can also be fatal. Studies show that immigrant women are more likely than United States-born women to die from IPV (Frye, Hosein, Waltermaurer, Blaney, & Wilt, 2005). IPV is particularly threatening for undocumented immigrants as their access to police and social services is limited and accusations of abuse in the presence of a child can lead to both deportation and alternative custody arrangements (Rogerson, 2012).
The UN has a campaign to end violence against women across the globe. For 2 weeks in 2013, activists and celebrities wore orange to raise awareness of violence against women.
UN Women – Orange Your World in 16 days – CC BY-NC-ND 2.0.
The purpose of this chapter is to provide a broad overview of IPV and its unique characteristics among immigrants. We will explore IPV-related risk and protective factors, and also discuss how survivors cope with IPV. Finally, we will suggest how future research and interventions might address IPV among immigrants and refugees.
Which term to use?
There is controversy over whether to call people who have experience IPV “victims” or “survivors.” In this chapter we use the word “survivor,” but there are good reasons to use both terms. To read a brief description of the reasons for using each term, visit: https://www.rainn.org/articles/key-terms-and-phrases.
32.2 Defining IPV
It is impossible to form a universal definition of IPV that captures the sentiments of highly varied people groups. Immigrants, refugees, and United States-born citizens come from diverse cultures, ideologies, religions, and philosophies, each of which can impact perceptions of IPV. Even within the same culture or religion, family traditions and norms might greatly influence perceptions of IPV. Recognizing the different perspectives on IPV around the world will help to identify points of ideological tension in order to better understand the factors that initiate and sustain IPV in immigrant and refugee populations.
Cultural Variation in Perceptions of IPV
The World Health Organization (WHO), which is a United Nations recognized agency, defines IPV as “behavior by an intimate partner or ex-partner that causes physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse and controlling behaviors” (2017). While WHO provides us with a standard definition of IPV, past and present contexts of different countries inform their IPV-focused laws and also shape individuals’ and families’ thoughts, feelings, and behaviors regarding IPV. In each culture, different implicit and explicit messages are endorsed through social, political, religious, educational, and economic institutions. The following examples highlight the variance in IPV across countries. In each case, the legal definition of IPV is similar to the WHO definition (including physical, sexual, psychological abuse and controlling behaviors), but there is wide variation in the perceptions of IPV.
• In South Africa: Gender discrimination in a traditionally male-dominated society has promoted female objectification and discrimination. Women report not feeling permitted to stand up to or refuse male directives, which may reduce any attempts to interrupt violence or leave the relationship. This is further exacerbated by the fact that men typically hold financial control in the relationship. Approximately 50% of men physically abuse their partners (Jewkes, Levin, & Penn-Kekana, 2002).
• In Columbia: “Machismo” attitudes continue to exist. Patriarchal hegemony seems to reinforce tolerance for violent, neglectful actions of men, while more mild acts by women (i.e., not coming home on time) are considered abusive to men (Abramzon, 2004). A government survey found the majority (64%) of people reported that if they were faced with a case of IPV, they would encourage the partners to reconcile, and a large majority (81%) was unaware that there are laws against IPV (Segura, 2015).
• In Zimbabwe: The patriarchal framework of communities is linked to biblical texts that seem to support male oppressiveness. Zimbabwean women’s relationship behaviors are also shaped by their religious and cultural beliefs. A study by Makahamadze, Isacco, and Chireshe (2012) found that many women opposed legislation intended to reduce IPV because they believed it went against their religious teachings.
As seen in these examples, the cultural context informs how people and countries perceive and respond to IPV. It is important to be aware of the ways that national contexts and cultures can shape the interpretation and recognition of IPV.
Definition of IPV in the United States
The United States government promotes one understanding of IPV and expects those living within its borders to act in response to that understanding, albeit this view may not be shared by those from other countries-of-origin. There are four primary types of IPV as defined by the Centers for Disease Control (CDC; Breiding et al., 2015):
1. Physical violence. This is “the intentional use of physical force with the potential for causing death, disability, injury, or harm” (Breiding et al., 2015, p. 11), including a wide range of aggressive acts (i.e., pushing, hitting, biting, and punching).
2. Sexual violence. This includes both forcefully convincing a person into sexual acts against his/her wishes and any abusive sexual contact. Manipulating vulnerable individuals into sexual acts when they may lack the capacity to fully understand the nature of such acts is also termed sexual violence.
3. Stalking. This includes “a pattern of repeated, unwanted, attention and contact that causes fear or concern of one’s safety or the safety of someone else” (e.g., the safety of a family member or close friend) (Breiding et al., 2015, p. 14).
4. Psychological aggression. This includes the “use of verbal and non-verbal communication with the intent to a) harm another person mentally or emotionally; and/or b) exerting control over someone” (Brieiding et al., 2015, p. 14-15).
A single episode of violence can include one type or all four types; these categories are not mutually exclusive. IPV can occur in a range of relationships including current spouses, current non-marital partners, former marital partners, and former non-marital partners.
Are you experiencing partner violence?
Please, seek help. Everyone deserves to be physically safe and respected in their relationships. You can call the National Domestic Violence Hotline at 800-799-SAFE (7233) or 800-787-3224 (TDD) any time of night or day. Staff speak many languages, and they can give you the phone numbers of local shelters and other resources.
32.3 IPV Among Immigrants & Refugees
Current literature on IPV in immigrant and refugee populations is mostly organized by either country- or by continent- of- origin. There is merit to this practice. There is merit to this practice. It allows for the possible identification of similarities and differences among individuals, couples, and families from comparable regional, cultural, and ethnic backgrounds. Furthermore, there is ample evidence that perspectives of IPV are varied throughout the world (Malley-Morrison, 2004), and that separating the literature by these boundaries allows us to group people with potentially similar worldviews.
However, we will not be using geographical demarcations to organize our review of the literature. In our review, we will highlight shared experiences across groups of immigrants, and also note experiences that are markedly different. Both the shared and divergent experiences of individuals from similar and differing immigrant and refugee groups will be highlighted. We will pay close attention will be given to findings that expose atypical or unusual trends.
IPV has serious consequences for everyone; however, there are a few unique features of IPV among immigrants and refugees. Specifically, an abusive partner of an immigrant/refugee has additional methods of control compared to United States-born couples. The partner may limit contact with families in the country-of-origin or refuse to allow them to learn English (Raj & Silverman, 2002). Both of these methods cut off social support and access to tangible resources. Additionally, abusive partners may try to control undocumented partners by threats relating to their immigration status (Erez et al., 2009; Hass et al., 2000). They might threaten to report the partner or her children to immigration officials, refuse to file papers to obtain legal status, threaten to withdraw papers filed for legal status, or restrict access to documents needed to file for legal status.
32.4 Risk & Protective Factors
For immigrants/refugees and United States-born individuals alike, there are many factors that increase the risk of IPV. Individuals who have experienced abuse in childhood, either experiencing child abuse or witnessing IPV between parents, are more likely to experience IPV as adults (Simonelli, Mullis, Elliiot, & Pierce, 2002; Yoshioka et al., 2001). Experiencing trauma in adulthood increases risk of perpetration of IPV: men who have been exposed to political violence or imprisonment are twice as likely to perpetrate IPV as those who have not (Gupta, Acevedo-Garcia, & Hemenway, 2009; Shiu-Thornton, Senturia, & Sullivan, 2005). Additional risk factors for victimization and or perpetration include having high levels of stress, impulsivity, and alcohol or drug use by either partner (Brecklin, 2002; Dutton, Orloff, & Hass, 2000; Fife, Ebersole, Bigatti, Lane, & Huger, 2008; Hazen & Soriano, 2007; Kim-Goodwin, Maume, & Fox, 2014; Zarza, Ponsoda, & Carrillo, 2009). Social isolation, poverty, and neighborhood crime are also associated with increased risk (Koenig, Stephenson, Ahmen, Jejeeboy, & Campbell, 2006; Zarza et al., 2009).
In addition to these shared factors, there are many risk factors of experiencing IPV specific to immigrants, as well as a key protective factor. Each of these will be addressed in detail here.
Changes in Social Status During Resettlement
IPV is more likely to occur when an individual’s social status changes due to immigration (Lau, Takeuchi, & Alegria, 2006). During resettlement, many men lose previous occupational status and are no longer able to be the sole provider for their families. They may also experience a decrease in decision-making power relative to their partners. This kind of major change can lead to a loss of identity and purpose.
Shifts in social status are associated with greater risk of IPV. For example, in a study of Korean immigrant men, abuse toward wives was more common in families where the husband had greater difficulties adjusting to life in the United States (Rhee, 1997). In a study of Chinese immigrant men, those who felt they had lost power were more likely to have tolerant attitudes toward IPV (Jin & Keat, 2010).
Time in the United States and Acculturation
Greater time in the United States is associated with greater family conflict and IPV (Cook et al., 2009; Gupta, Acevedo-Garcia, Hemenway, Decker, Ray, & Silverman, 2010). Studies find that recent immigrants generally report lower IPV than individuals in the home country, United States-born citizens in the destination country, or immigrants who have been in the destination country for a long time (Hazen & Soriano, 2007; Gupta et al., 2010; Sabina et al., 2014). It may be that the process of immigration requires an intact family, and that families who can successfully migrate to the United States have strong coping and functionality skills (Sabina et al., 2014). However, over time, ongoing stresses contribute to an increase in IPV.
Studies have shown that when an individual has greater levels of acculturation to United States and greater experience of acculturation stress, they face greater conflict, IPV, and tolerance of IPV in their relationships (Caetano, Ramisetty-Mikler, Vaeth, & Harris, 2007; Garcia et al., 2005; Yoshihama, Blazevski, & Bybee, 2014). Acculturation is associated with less avoidance of conflict and more expression of feelings, which may partially explain why IPV would increase (Flores et al., 2004).
Although acculturation is associated with greater IPV, research has also demonstrated its protective effects. For example, one study found that women who are more acculturated practice more safety behaviors in the face of IPV (Nava, McFarlane, Gilroy, & Maddoux, 2014).
Norms from Country-of-Origin
Rigid, patriarchal gender roles learned in the country-of-origin are associated with increased tolerance for and experience of IPV (Morash, Bui, Zhang, & Holtfreter, 2007; Yoshioka, DiNoia, & Ullah, 2001). Arguments about fulfilling gender roles are also associated with greater IPV (Morash et al., 2007). For example, a study found that a quarter of their sample of Chinese, Korean, Vietnamese, and Cambodian immigrants believed that IPV was justified in certain role-specific situations, such as in cases of sexual infidelity or refusal to perform housekeeping duties (Yoshioka et al., 2001).
Social Support: A Protective Factor
There are many other protective factors that reduce risk of IPV in many populations including education, parental monitoring for adolescent relationships, and couple conflict resolution strategies and satisfaction in adult couples (Canaldi, Knoble, Shortt, & Kim, 2012). However, the limited research on immigrant and refugee communities has addressed only one protective factor: social support. Social support from family, friends, and community can protect against IPV in immigrants and refugees. For example, involvement in one’s own cultural community was associated with reduced IPV-supporting attitudes among East Asian immigrants (Yoshihama et al., 2014). However, there are exceptions. A study of 220 immigrant Southeast Asians found that those reporting more social support experienced more IPV than those reporting lower levels of social support (Wong, DiGangi, Young, Huang, Smith, & John, 2011). This may be due to social pressures within the community (see the “Barriers to Help Seeking” section).
32.5 Responses to IPV
Survivors of IPV are often not passive or helpless. They try a wide variety of tactics to try to prevent, minimize, or escape the violence, as well as to protect their families. Interviews conducted with women from Latina, Vietnamese, and South Asian backgrounds (Bhuyan, Mell, Senturia, Sullivan, & Shui-Thornton, 2005; Erez & Harley, 2003; Lee, Pomeroy, & Bohman, 2007; Takano, 2006; Yingling, Morash, & Song, 2015), immigrants from Africa (Ting, 2010), and immigrants from Mexico (Brabeck & Guzman, 2008) have helped identify the following ways of coping with IPV:
• Attempting to be unnoticeable. Survivors would attempt to be quiet, be still, and avoid arguments. One woman described “I don’t answer back, ignore, and just stand there and die inside of anger,” while another described “I keep quiet when he is angry and let him do whatever he wants” (Yingling et al., 2014, p. 12).
• Turning to family or friends. Survivors turned to family or friends for emotional help, resources, and help navigating social services. One woman described how she turned to co-workers, stating, “I told women at work. I couldn’t hide what was going on. It was too much to keep to myself”. Another described how turning to neighbors was helpful, reporting, “I talked to a neighbor. She’s the one who told me that you can call police; the police can help you and my husband would be arrested,” (Ting, 2010, p. 354-355).
• Relying on religion or religious leaders. Prayer is a common coping response. One woman reported that prayer “helps me forget the problem for a while, and I feel peace in my mind” (Yingling et al., 2014, p. 13).
• Trying to obey or calm the abuser. One woman described how she tried “staying to myself, doing things the way he wanted them to be done. I did that just to stay alive. It worked, and I stayed alive long enough to get away” (Brabeck, & Guzman, 2008, p. 1287). Another woman reported, “Even though I don’t agree, I end up agreeing with him to avoid more problems” (Ting, 2010).
• Ignoring, denying, or minimizing abuse. “Mainly, I would just try to ignore everything. If he hurt me, I tried to ignore it.” (Brabeck, & Guzman, 2008, p. 1289).
• Accepting fate. Some survivors believed in God’s will or accept karma. “I believe that God will take care for me, that God has a reason for having me suffer, and I believe that God is just, that God will punish my husband for what he did to me. Someday I will get justice and he [her husband] will get his punishment” (Ting, 2010, p. 352).
• Hoping for change in the future. Some women hoped for change in their relationship. One woman described, “I had hope he would change since in my family, my father had changed. [My grandparents] talked to my father, and he changed. He stopped, so I had hope my husband would too. Some men do. I believed it was possible” (Ting, 2010, p. 351). Other women looked forward to a future time when they would be able to leave: “I need him only for now, but when the children are older, and I can work, I will not need his money; I will not need him” (Ting, 2010, p. 351).
• Leaving the room or the home temporarily. Women locked themselves in a closet or left the home to avoid abuse. Women reported that these strategies could provide temporary safety although they were still at risk. For example, one woman who locked herself into a room described how “he’d just unscrew the bolts and open the door” (Brabeck & Guzman, 2008, p. 1288).
• Standing up to the partner by hitting back or talking back. One woman reported, “He would swear at me and put me down, watch me, order me around. I couldn’t stand it. I hit him and ran to the bedroom, locked the door, so he couldn’t come after me” (Yingling et al., 2014, p. 14).
• Seeking Formal Help. Survivors called the police. As one woman described, “I pressed charges and that was freeing. I didn’t want him to do this [abuse] to any other women. I said, this stops right here.” Survivors also accessed advocacy and shelter services. For example, one woman reported, “The shelter is very helpful because I can sleep at night finally, and my son can sleep at night” (Brabeck & Guzman, 2008, p. 1281).
• Leaving partners. When other coping strategies failed, survivors would leave their partners. This required advance planning, including efforts to move to an undisclosed location, disguise oneself, and/or save personal money (Brabeck & Guzman, 2008).A study found that survivors who used a greater variety of strategies were more likely to successfully separate from their abusive partners, and were also more likely to contact family or friends, an advocacy program, and the police (Yingling, et al., 2015). We note that not all survivors chose to leave their partners, and that there are many reasons for this choice. For more information, please see the callout: “Why don’t they just leave?”In one series of interviews about coping with IPV, survivors described how they would add new strategies over time. Survivors generally relied at first on internal resources do deal with IPV. They would begin by trying to tolerate abuse, become unnoticeable, or rely on faith. When this was unsuccessful, they would reach out to family, friends, and professionals for help (Yingling, et al., 2015). Survivors who continued to live with their abusive partners were most likely to use avoidance strategies, attempting to be unnoticeable (Yingling, et al., 2015).
A counselor talks with a woman who was a victim of partner abuse. Department of Foreign Affairs and Trade – Lola Koloa’Matangi – CC BY 2.0.
It is important to note that there are some marked differences in help-seeking behaviors that vary by immigrant/refugee background. For example, one study found that Muslim immigrants were less likely than non-Muslim immigrants to call the police, due to fear of spouses, fear of reprisal from family, and a desire to protect their spouses, but they are more likely to have the police become involved due to neighbors or others calling the police (Ammar, Couture-Carron, Alvi, & Antonio, 2013). Another study found that Asian immigrants access mental health services less frequently than immigrants from other areas (Cho & Kim, 2012). Japanese immigrants were less likely than United States-born women of Japanese descent to confront a partner, leave temporarily, or seek help (Yoshihama, 2002). Further, when Japanese immigrants used these strategies, they experienced higher psychological distress compared to Japanese immigrants who did not use them. It is likely that a cultural taboo against these strategies influences both the use of the strategies and feelings after using them (Yoshihama, 2002).
32.6 Barriers to Help Seeking
Support from family, friends, and formal social systems can promote coping after IPV (Coker et al., 2002). Immigrant/refugee women are not likely to seek formal assistance (such as from police or shelters; Ingram, 2007), and are more likely to seek assistance from family and friends (Brabeck & Guzman, 2008). Family and friends provide invaluable support to women who have experienced IPV, including emotional support, information about the system, and suggestions for getting help (Kyriakakis, 2014).
HomeWhy don’t they just leave?
Many people wonder why a survivor would choose to stay in a relationship with someone who hurts them. While some partners will choose to end a violent relationship, many will not. Their reasons could vary from ongoing love to pragmatic need to desperate fear, or even a combination of the above.
We describe many reasons why an immigrant/refugee survivor would not leave the relationship or even seek outside help in coping with the relation:
• Commitment to the relationship- Many survivors feel a bond of duty and love to their partner, even when they are sometimes treated poorly.
• Hope for change- Many survivors believe that the violence will go away or get better with time. They may believe that outside circumstances will become less stressful, that their partner will learn how to stop, or that they will be better able to control the situation in the future.
• Parenting Arrangements- A victim may stay in the relationship for the sake of their children, out of a desire for children to live with and be supported by both parents.
• Economic security- The abusive partner may control the finances, leaving the victim without access to resources to provide for self or children.
• Fear for safety- For many survivors, there are real physical threats to leaving the relationship. The abuser may threaten to hurt or even kill them or their children if they leave. When survivors do attempt to leave, many perpetrators will escalate threats and violence.
“For me also, my husband says if I dare put him in jail, when he gets out, he kills me. Then, I ask him to get divorced. He says before getting divorced plan to buy a coffin beforehand. He just says like that.” Khmer Immigrant, quoted in Bhuyan et al., p 912.
Survivors of all backgrounds face substantial barriers to seeking assistance, such as fear of the abuser and retaliation (Bhuyan et al., 2005). Immigrant/refugee survivors, however, face additional social, economic, and legal barriers to seeking informal and formal help for IPV. These challenges include country-of-origin norms, family taboos, distance from or unavailability of supports, fear of deportation or loss of custody, and a lack of culturally competent and language appropriate services.
Country-of-Origin and Family-related Norms
Norms from native countries may impact survivors’ willingness to seek help. In many countries, survivors and their families avoid outside intervention because it might bring shame or dishonor to the family or community (Dasgupta & Jain, 2007; Yoshihama, 2009). Latina and South Asian immigrants/refugees avoid seeking help due to the shame and stigmatization of divorce (Bauer, Rodriguez, Quiroga, & Flores-Ortiz, 2000), and because honorable marriage is one of few ways to maintain others’ respect (Fuchsel et al., 2012). For Vietnamese immigrants/refugees, traditional values, gender roles, and concern about discrimination decrease help seeking (Bui & Morash, 1999).
There may also be norms within the family that prevent help-seeking. Survivors sometimes do not seek help from parents because they do not want family to view their husband in a negative light. Also, they fear that their parents will be distressed and/ or feel shame about the violence (Bhuyan et al., 2005). Women report a taboo against sharing family problems with people outside the family. Also, they worry about gossip within the local immigrant community (Bhuyan et al., 2005; Kyriakakis, 2014).
Distance from or Unawareness of Supports
Families who are nearby can provide more support than families separated by great distances. For example, women living in Mexico often turn to their parents for tangible support such as safe refuge after violence (Kyriakakis, 2014). When these women immigrate to the United States, support from parents in Mexico is primarily emotional (Kyriakakis, 2014). Distance from family can also lead immigrants/refugees to be dependent on an abusive partner for emotional and social support, particularly when English language skills are lacking (Bhuyan et al., 2005; Denham et al., 2007).
Immigrants and refugees may be unaware of local services, such as social and legal service agencies (Bhuyan et al., 2005; Erez et al., 2009; Moya, Chavez-Baray, Martinez, 2014). Further, they might question access to or availability of social services based on prior experiences in their countries-of-origin. For example, in some countries, such as Mexico, the majority of the population do not have access to public social services, and Asian and Latina immigrants often do not believe that anyone is available to help them (Bauer et al., 2000; Bui, 2003; Esteinou, 2007). Even if they have knowledge of these services and how they work, linguistic and cultural barriers can deter seeking help or limit successful navigation of these resources (Bhuyan et al., 2005, Erez et al., 2009).
“In Cambodia, if the husband and wife fight we suffer the pain and only the parents can help resolve to get us back together. We live in America, there are centers to assist us. In Cambodia, there are no such centers to help us.”
-Khmer Immigrant
Quote taken from Bhuyan et al., p. 913
Lack of Language Appropriate and Culturally Competent Services
Language barriers pose a critical problem for community-based organizations and for systems like the police, to communicate with the survivors and their families and to help them effectively (Yingling, et al., 2015; Robert Wood Johnson Foundation, 2009). Further, services, particularly culturally competent services, are not always available to immigrant/refugee women (Morash & Bui, 2008). Community-based organizations and mainstream service providers such as the police need to be trained to understand the complexities of survivors’ lives and to assess common as well as the unique features of IPV experienced by immigrant/refugee women (Messing, Amanor-Boadu, Cavanaugh, Glass, & Campbell, 2013). Also, services providers for immigrant/refugee women must develop awareness about the socio-economic, cultural, and political contexts that these groups of women come from and use that information to develop programs and policies specific to them.
Fellows tour the Genesis Women’s Shelter in Dallas, TX before meeting with a panel of local stakeholders. The Bush Center – Genesis Women’s Shelter & Support – CC BY-NC-ND 2.0.
Video
True Thao, MSW, LICSW discusses the importance of rapport and relationship building when working with immigrant and refugee clients (3:48-8:02).
A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/humanbe/?p=127
Fear of Deportation or Loss of Custody
Undocumented immigrants are often afraid to report crimes to the police, including IPV, for fear of deportation or loss of custody (Adams & Campbell, 2012; Akinsulure-Smith et al., 2013). Such fears have likely escalated since the creation of “Secure Communities,” a government program which cross-checks police-recorded fingerprints to identify documentation status. If an undocumented immigrant is processed for a crime, including minor misdemeanors, it can be a first step towards deportation (Vishnuvajjala, 2012). Although many immigrants express fear of deportation if they report IPV, some research studies show that immigrant/refugee women are more likely to report IPV, particularly if they are on a spousal dependent visa and if their abusive partner threatens immigrant action (Raj, Silverman, & McCleary-Sills, 2005).
In some cases, the process of immigration leaves the immigrant spouse/partner dependent on their abusive partner. For example, when someone immigrates with an H1-B visa (targeting highly skilled professionals), their spouses are eligible for an H-4 visa. However, these spouses are not authorized to work, and they cannot file their own application for legal permanent residence status; the H1-B visa holder can choose whether or not to file for residence for his family (Balgamwalla, 2014). This leaves the spouse completely dependent on their partner for documentation for residency and for all economic benefits. Abusive partners can threaten immigration action to maintain control of a partner, by destroying immigration papers, not filing paperwork, or threatening to inform Immigration and Customs Enforcement (ICE; Balgamwalla, 2014; Erez et al., 2009).
Reporting IPV can also have implications for child custody. Undocumented immigrants can lose custody of their children if claims are brought against them. Also, if a parent accuses their spouse of IPV, the parent can be convicted for failing to protect their children from being exposed to IPV. In select cases, this can lead to deportation and reassignment of custody (Rogerson, 2012).
There are some legal resources for undocumented survivors of IPV. The Violence Against Women Act (VAWA) provides protections for survivors of IPV. If a non-citizen is married to a United States permanent resident, they can apply for a “U visa.” These visas give survivors of IPV temporary legal status and the ability to work. However, these are limited to 10,000 per year (Modi, Palmer, & Armstrong, 2014), and often fall short of meeting the needs of the total number of qualified partners (Levine & Peffer, 2012).
Economic Dependency
Immigrants/refugees who are unemployment depend on their partner to provide for themselves and their children and may avoid any reporting that could jeopardize the relationship (Bui & Morash, 2007). In some cases, gender norms may discourage pursuing education or employment, which facilitates dependency (Bhuyan et al., 2005). The majority of immigrant/refugee survivors have limited economic resources (Erez et al., 2009; Morash et al., 2007). When immigrant/refugee women have access to employment, it can lead to an increase in couple conflict due to extra responsibilities placed on both the partners, but it can also empower immigrant/refugee women to demand better treatment (Grzywacz, Rao, Gentry, Marin, & Arcury, 2009).
Ties that Bind
Even when IPV is present, most relationships also have positive components. Survivors often hope to remain in the relationship because of these components. For immigrants/refugees, the pull to stay with a violent partner may be even stronger. Two IPV advocates stated: “a battered immigrant woman who is in an intimidating and unfamiliar culture may find comfort and continuity with an abuser” (Sullivan & Orloff, 2013). Relationships are ties that bind, and partners cannot overlook their long history together, often beginning before immigration (Sullivan, Senturia, Negash, Shiu-Thornton, & Giday, 2005).
Throughout the experience of IPV, survivors must weigh the benefits and costs of remaining the relationship. They make changes to alleviate current pain and to prevent future incidents. Perpetrators make similar choices and changes. Some perpetrators are able to make choices that reduce or stop violence altogether. In order to have a stable family relationship, both partners must make decisions that protect the physical, emotional, financial, and social health of all members.
Impact on Children
Witnessing IPV is a harrowing experience for children. Children who witness IPV are more likely to experience mental health problems such as anxiety, depression, and PTSD, as well as internalizing and externalizing problems (Kitzmann et al., 2003; Wolfe et al., 2003). While very little research has assessed the experience of IPV or family violence (violence against the child themselves or witnessing violence towards another family member) among immigrant/refugee children specifically, we do know that they are heightened risk of witnessing IPV. Many refugees are at risk for IPV and family violence due to their experiences of conflict and violence in their countries-of-origin (Haj-Yahia & Abdo-Kaloti, 2003; Catani, Schauer, & Neuner, 2008).
Research with children living in conflict-affected areas underscores the negative impact of IPV on children. Research shows that family violence is an even stronger predictor of PTSD in children than war exposure (Catani et al., 2008). In a sample of children exposed to war, tsunami, and family violence, 14% identified family violence as the most distressing event of their lives (Catani et al., 2008). Immigrant/refugee children exposed to family violence face a unique set of stressors. They must cope with the experiences of family violence alongside the stressors of trauma and/or relocation.
Where’s Waldo?
There are several key people who are missing or hard to find in this chapter. Can you find them?
Where are the perpetrators?
You may have noticed that this chapter focuses on the survivors of IPV, and that the perpetrator’s perspective is rarely mentioned. Almost no research has been done with the perpetrators of IPV among immigrants/refugees.
Where are the men?
You can see that in all of the research we talk about, the survivor is a woman. We know that women are also perpetrators of IPV, and that men are also survivors of IPV (CDC, 2003). However, the vast majority of all research on survivors has studied women exclusively. This focus has likely arisen because women are more commonly injured by IPV (Whitaker, Haileyesus, Swahn, & Saltzman, 2007). It is nonetheless important to hear the stories of all people, regardless of gender.
Where are the children?
You might have noticed that in the introduction, we mentioned that children experience very negative effects from seeing IPV. But this section and the “Impact on Children” sections are the only time we mention them. Why? Once again, very little research has looked at the experience of IPV among immigrant/refugee children.
IPV is an issue that affects every member of the family – perpetrator, victim, and children. As you read the chapter, try to consider what the perspectives might be of the perpetrator and children in each story.
32.7 Future Decisions
What can be done to prevent and intervene with IPV among immigrants/refugees? We have several suggestions for research and practice to address this critical problem. First, researchers must evaluate if IPV in immigrant and refugee families has distinct etiologies, characteristics, and outcomes compared to non-immigrant and non-refugee families. As we discussed in the “Where’s Waldo” sidebar, very little research has captured IPV perpetrators’ perspectives. We urge researchers to particularly assess the features of IPV perpetration among immigrants/refugees. This research will guide prevention and intervention work among immigrants and refugees. Effective programs must: 1) be available in the immigrants’ language; 2) be adapted to be culturally appropriate for the immigrants’ background; 3) reframe cultural norms; and 4) encourage healthy relationships (Robert Wood Johnson Foundation, 2009). Perpetrators are also in need of culturally specific programs. Such programs could include psychoeducation about IPV and culturally specific practices that call for respecting women (Rana, 2012).
Immigrant/refugee survivors describe word-of-mouth as the most effective way to increase awareness of IPV and resources to address it. They propose a call to action to prevent and address IPV. Through conversation, we can help our community members know about available resources. Everyone is called to be a part of “increasing the visibility of people affected by IPV, working for equality, and raising awareness” (Moya et al., 2014).
32.8 Case Study
Sabeen and Alaa are a couple in their late 20’s from Syria, and they have a three-year-old daughter named Mais. For many years, Alaa worked as an office manager at a local hospital. However, when the increasing conflict led to deaths of many neighbors, the couple fled together to Jordan. In the refugee camp, the family lived alongside many other families in very cramped quarters. Alaa tried to get food and water for the family daily, but resources were limited and he often came home feeling both inadequate and frustrated. One night when he was especially hungry, Mais began acting defiant. Alaa turned to Sabeen and angrily asked why she couldn’t manage their daughter anymore, slapping her across the face. Sabeen was shocked – this had never happened before. Alaa looked sad, and they both got quiet for a minute. They each wished they could go somewhere to just think and be alone, but there was nowhere in the camp to go. They already knew their neighbors must have heard the fight.
As pressures in the camp mounted and resources became scarcer, Alaa more frequently hit Sabeen. They both talked about how they looked forward to when they could be relocated when life would be calmer, and their relationship would be better. When they were given refugee status and arrived in the United States, things were better – for a while. But after a few months, Sabeen had found work cleaning homes, but there was less work available for men. With nothing to do and few people to talk to, Alaa began to drink. As he became more and more aggressive, Sabeen became more and more depressed, not knowing how to respond. She once tried to call for help from a neighbor, but the neighbor either did not understand her English or did not respond. She decided it was better to try to manage the home well in order to try to avoid any outbursts, but her energy sagged lower and lower. In their small one-bedroom apartment, Mais would always manage to hide under blankets when her dad started yelling.
One day, Sabeen decided to talk to a fellow refugee about their family situation. It felt good to talk about it, and the friend said Sabeen could always come over to their apartment if she needed to get away for an evening. Sabeen started leaving the house with Mais right after an outburst started before things could escalate too far. Around this time, Alaa found a job. He started to become less violent, and the outbursts grew less and less frequent.
Context for case study taken from Leigh, 2014.
32.9 End-of-Chapter Summary
Discussion Questions
1. Think about your cultural background. What aspects of your background might increase tolerance of IPV? What aspects would reduce tolerance of IPV?
2. What pressures do immigrant/refugee families face, and how might that increase risk of IPV?
3. How might someone experience a feeling of loss of control, despite moving to a country with better safety and economic opportunities?
4. What are some possible consequences for children exposed to IPV?
Helpful Links
National Domestic Violence Hotline
• The Hotline maintains lists of resources for survivors, perpetrators, and friends. They have screening tests if you are worried you might be experiencing IPV, and tips for safety at every stage. They also maintain stories from survivors. They have a 24/7 chatline available for support.
• http://www.thehotline.org/
VAWnet (Online network provided by the National Resource Center on Domestic Violence)
Attribution
Adapted from Chapters 1 through 9 from Immigrant and Refugee Families, 2nd Ed. by Jaime Ballard, Elizabeth Wieling, Catherine Solheim, and Lekie Dwanyen under the Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/09%3A_Global_Perspectives_and_Theories/30%3A_Intimate_Partner_Violence_Among_Immigrants_and_Refugees.txt |
Learning Objectives
• Learn from the national and global perspectives of substance abuse among immigrants and refugees.
• Recognizing that the world is constantly and rapidly changing.
• Recognizing that Global/national/international events can have an impact on individuals, families, groups, organizations, and communities.
• Global implications dictate that we foster international relationships and opportunities to address international concerns, needs, problems, and actions to improve the well-being of not only U.S. citizens, but global citizens.
33.1 Introduction
“The area we are living [in] is very, very bad. . . . So the kids you cannot discipline them . . . they’re going to school, the kids are smoking weed, there are drug-addicted kids . . . But I don’t have a choice because that’s where I live and that’s where they go to school.”
– Somali Refugee mother (Betancourt et al., 2015, p. 117)
Substance abuse occurs among every community, regardless of race, ethnicity, culture, country of origin, and socioeconomic status. Immigrants and refugees living in the in the United States are no different. However, the resettlement process adds additional complexities to understanding how immigrant and refugee communities are impacted by substance abuse. Immigrants have acquired habits and customs of substance use from their home country, and they must navigate these customs and any clashes with local United States customs. Additionally, immigrants often face limited employment and housing options, which means they may be unable to leave neighborhoods with prevalent substance use (as in the example above). Immigrants frequently have stressors associated with scarce employment, the need to send money to family, past traumatic exposure, and separation from family. Some immigrant and refugee groups may be at greater risk for abusing substances as a means of coping with these stressors. However, immigrants also have significant protective factors, such as specific cultural norms and family support.
Upon entering the United States, immigrants are at lower risk of alcohol abuse than United States-born citizens, even in comparison to those with the same ethnic identity (Breslau & Chang, 2006; Escobar, Nervi, & Gara, 2000). Research has also found that for immigrants, there is a positive correlation between the length of stay in the United States and the increased risk of alcohol abuse (Szaflarski, Cubbins, & Ying, 2011). This may be due to protective factors shared by immigrants or to a lack of culturally validated assessments for substance use in immigrant communities. Understanding the influences of substance abuse within immigrant and refugee populations in the United States is incredibly complex due to two main considerations: (1) the breadth of substances that can be used and abused (e.g., alcohol, tobacco, illicit drugs, and non-prescribed prescription drugs) and (2) the diversity of peoples and cultures that are represented within the United States immigrant and refugee populations.
Definition of substance use disorders:
The American Psychological Association (APA) defines substance abuse disorders as recurrent use of alcohol or drugs that cause significant impairment. Individuals with substance abuse disorders have impaired control, social impairment, risky use, and/or meet pharmacological criteria (2013). There are separate diagnoses by each substance (alcohol, tobacco, cannabis, stimulant, hallucinogen, and opioid). Diagnoses are classified into five categories: use disorder, intoxication, withdrawal, other, substance-induced disorder, and substance-related disorder.
The purpose of this chapter is to more thoroughly explore some of these complexities by utilizing a systemic framework that places problems of substance abuse—within immigrant and refugee communities—within the broader context of families. We begin by reviewing the literature on prevalence and risk factors for substance use among immigrants, followed by an exploration of the specific role of the family. Next, we review the theoretical frameworks on substance abuse, policy, and prevention and intervention models. The scope of this chapter is not to provide a comprehensive review of the substance abuse literature for all immigrant and refugee groups but rather to introduce a general review of the existent research to promote dialogue of current and future research directed at strengthening immigrant and refugee communities within the United States.
33.2 Substance Abuse Prevalence
Substance abuse is problematic in every community across the United States, regardless of individual or socioeconomic characteristics. In its far-reaching effects, the estimated costs of substance abuse in the United States is \$700 billion annually, with much of the cost related to health care, crime, and loss of work productivity (CDC, 2015; NDIC, 2011; USHHS, 2014). Understanding substance abuse within immigrant populations is becoming increasingly important as the United States increases in cultural diversity (Szaflarski, Cubbins, & Ying, 2011).
In general, immigrants have lower rates of substance use disorders than do United States-born citizens. In a nationally representative sample of adults, prevalence of substance use disorders was substantially lower among first-generation immigrants than among United States-born, and slightly lower among second-generation immigrants than among United States-born (Salas-Wright, Vaughn, Clark, Terzis, & Cordova, 2014). United States-born persons were three to five times more likely to experience lifetime substance abuse or dependence disorders than first-generation immigrants. Specifically, 49% of the United States-born had a lifetime diagnosis of substance abuse or dependence, compared to 18% of first- immigrants.
Similarly, a study of immigrant adolescents in Massachusetts found they had a lower risk of alcohol, tobacco, and marijuana use than United States-born adolescents (Almeida, Johnson, Matsumoto, & Godette, 2012). According to the 1999-2001 National Survey on Drug Use and Health, the substance use rates across culture and substance can differ greatly across groups (Brown et al., 2005; see Table 1). These statistics show that understanding substance use and abuse is challenging and complex.
Table 1Estimated numbers and prevalence (with standard errors) of substance consumption in past month and past year among immigrants from selected countries
Prevalence among refugees
Little is known in terms of prevalence statistics of substance abuse in refugee communities in the United States, however in refugee camps, high rates of drug and alcohol use have been reported (Ezard et al., 2011; Luitel, Jordans, Murphy, Roberts, & McCambridge, 2013). In the refugee camps, common substances are alcohol, khat, and cannabis, some made for medicinal purposes and others for recreational use (Streel & Schilperoord, 2010).
Khat picnic in Yemen Wikimedia Commons – CC BY 2.0.
Despite these high rates of use in refugee camps, the few studies in the United States have found very low rates of alcohol use and disorders. In a study of substance use among all newly arriving adult refugees in a Texas city, reported rates of current smoking (38.5%) and alcohol use (23%) were very low (Barnes, Harrison, & Heneghan, 2004). The authors note that substance consumption may have been underreported, at least among some ethnicities. The study’s Bosnian interpreter and cultural consultant, for example, believed that the 20% alcohol use rate reported by Bosnians underrepresented use in that community.
Two studies have assessed substance use disorders among refugees. In a national study of refugee children and adolescents receiving treatment through the national child traumatic stress network, less than 4% had a substance use disorder (Betancourt et al., 2012). Similarly, a random sample of Cambodian refugees found that four percent had an alcohol use disorder (Marshall, Schell, Elliott, Berthold, & Chun, 2005).
For refugees, patterns of use differ significantly across the trajectory of displacement. These transitions can be demonstrated in the stories told by Karen refugees (McCleary, 2013; McCleary & Wieling, in press). When the Karen lived in Burma, their country of origin, there were cultural structures that protected most people from harmful alcohol use and consequent problems. However, once people fled to Thailand, alcohol use increased significantly and the problems resulting from harmful use increased. New problems such as violence between unrelated adult men, intimate partner violence, and suicide increased, and were all related to alcohol use. After resettlement, patterns of use changed again. For some people, rates of use increased due to resettlement stress and loss of roles. Alcohol-related problems were worse in the settlement location than in the camps because legal consequences such as DUIs, loss of licenses, fines and jail time were more significant. For other people, alcohol use dropped significantly because harmful alcohol use carried so much more risk (e.g., loss of job, loss of housing, loss of driving privileges). Additionally, in refugee camps, religious and community leaders acted as social supports for many refugees to address alcohol-related problems. However, in the United States, many religious and community leaders feel overwhelmed and unable to support their community members with substance use related concerns.
33.3 Risk Factors
Substances may be used as a means of coping with previous or ongoing trauma, stress, isolation, and uncertainty (Ezard, 2012; United Nations, 2014; Weaver & Roberts, 2010). Each of these phenomena can be a risk factor for substance use and related disorders in immigrant communities. Additionally, particular practices and cultural norms in the country of origin along with acculturation stressors related to local customs in the United States can put immigrants at an increased risk for substance use.
Exposure to traumatic stress and mental health. Many immigrants, particularly refugees, have been exposed to violence and traumatic events in their home countries and during resettlement (Porter & Haslam, 2005; United Nations, 2014). Trauma exposure increases the risk of mental health disorders (Porter & Haslam, 2005; Johnson & Thompson, 2008). Research indicates that some immigrants and refugees are at higher risk for posttraumatic stress disorder (PTSD), anxiety, depression, psychosis, complicated grief and suicide (Akinsulure-Smith & O’Hara, 2012; Birman, & Tran, 2008; Jamil, Hakim-Larson, Farrag, Kafaji, & Jamil, 2002; Jensen, 1996; Kandula Kersey, & Lurie, 2004). These mental health disorders in turn can increase the risk of substance abuse (Ezard, 2012; Weaver & Roberts, 2010). For more information about mental health among immigrants and refugees, see Chapter 5.
However, many immigrants and refugees avoid substance use even after traumatic exposure and distress. In a study of Cambodian refugees 20 years after arrival, alcohol use disorder was positively related to trauma exposure since arriving in the United States, but not to trauma exposure prior to arrival (Marshall, Schell, Elliott, Berthold, & Chun, 2005). A low rate (4%) of alcohol use disorder was found in spite of high rates of PTSD (62%) and major depression disorder (51%) in this community. Similarly, in focus groups conducted with Karen refugees, trauma was described as a much more influential factor in substance use in the refugee camps than in the United States.
Stresses after resettlement. Immigrants face significant stressors as they seek employment and a new life in the United States, particularly when they face discrimination along the way. These stressors are associated with increased substance use. For example, migrant workers report that three of their most common reasons for drinking are isolation from family, boredom, and stress, along with work constraints that lead to lack of dry recreation or opportunities for social connection (Organista, 2007). Furthermore, immigrants’ experiences of unfair treatment and perceived discrimination in finding work are associated with alcohol disorders, prescription drug abuse, and illicit drug use (Gee, Delva, & Takeuchi, 2007).
Immigrants also face stressors linked to the legal consequences of substance use. Within the United States, individuals who abuse alcohol and identify as being from racial minority backgrounds are seen as “doubly vulnerable” (Gwyn & Colin 2010, p. 38). The legal ramifications for racial minority communities are more severe than for majority communities, such as criminal charges (Iguchi, Bell, Ramchand & Fain, 2005) and increased involvement with social service related organizations (i.e., Child Protective Services, Department of Social Services; Roberts & Nuru-Jeter, 2012). Legal proceedings are often expensive and difficult to understand for those without a formal legal education. For people who have language and cultural barriers, this process may become additionally challenging. Immigrants and refugees often experience these additional challenges. Differences in culture, religion, acculturation process, gender roles, hierarchy, collectivism/individualism, and family structures and dynamics often exacerbate the amount of stressors these families face (Rastogi & Wadhwa, 2006). Each of these challenges requires consideration in research, policy, and intervention.
Norms in country of origin and acculturation to local customs. The norms from the country of origin frequently play a role in an immigrant’s substance use and abuse after arrival. For example, in a study of Asian American immigrants, the detrimental drinking pattern (or the “extent to which frequent heavy drinking, drunkenness, festive drinking at community celebrations, drinking with meals, and drinking in public places are common”) in the country of origin was significantly associated with the risk of frequent drunkenness and alcohol-abuse symptoms (Cook, Bond, Karriker-Jaffe, & Zemore, 2013, p. 533). Drinking prevalence (or the “extent to which alcohol consumption is integrated into society as an ordinary occurrence”) in the country of origin was associated with alcohol dependence symptoms (Cook et al., 2013, p. 533). Acculturation to the United States consumption behaviors can also increase the risk of substance abuse (Ezard, 2012; Bacio, Mays, & Lau, 2012; Kam, 2011; Prado et al., 2009). Pumariega, Millsaps, Rodriguez, Moser, & Pumariega (2007), for example, found that adolescents may be at an increased risk of substance abuse due to the challenges of acculturation and adopting ‘Americanized’ activities.
Brao woman making rice wine in a jarWikimedia Commons – CC BY-SA 3.0.
Knowing the various risk factors immigrants face, it is surprising that immigrants report less drug use (i.e., alcohol, cigarette, intravenous drugs, and other illegal drugs) than United States-born individuals (Hussey et al., 2007). This phenomenon of immigrants doing better than United States-born individuals has been termed the immigration paradox (for greater detail, see Chapter 8) because it contradicts assumptions that difficult transitions to a new country increase the likelihood of substance abuse. For example, one study found adolescents in neighborhoods of historical Mexican heritage (e.g., mostly non-immigrants) were at higher risk for alcohol and marijuana use; these neighborhoods tended to have higher rates of crime, poverty, and residential insecurity. However, youth living in neighborhoods that had higher numbers of immigrants reported lower use of alcohol, cigarettes, and marijuana. This suggests that there was something about neighborhoods with more of an immigrant presence that may act as a protective factor in adolescent substance use (Kulis et al., 2007). While this paradox does not hold true for all immigrant groups (Hernandez, Denton, MaCartney, & Blanchard, 2012), many researchers are puzzled at these findings. Recent literature suggests that family support may explain why this is the case.
Video
Sunny Chanthanouvong, Executive Director, Lao Assistance Center of Minnesota, discusses mental health as it relates to migration and resettlement (0:00-2:18).
A YouTube element has been excluded from this version of the text. You can view it online here: pb.libretexts.org/humanbe/?p=129
33.4 Family Influences on Substance Abuse
Family involvement and cohesion are key protective factors for substance abuse among immigrants (Bacio, Mays, & Lau, 2012; Kam, 2011; Prado et al., 2009; Pumariega, Millsaps, Rodriguez, Moser, & Pumariega, 2007). For example, the research team who conducted the neighborhood study addressed above hypothesized that the main protective characteristic against substance use and abuse was family involvement and cohesion. General family and ecological systems theories posit that family members influence each other as they interact on a regular basis. This might be especially true in the case of recently arrived immigrant families who are turn to each other for support.
Parenting style is one strong protective factor. For Latino/a adolescents, parenting style patterns were related to adolescent alcohol use or abstention (Driscoll, Russell, & Crockett, 2008). Driscoll et al. (2008) indicated that there was an increased amount of permissive parenting with successive generations of immigrants, and this parenting style was related to increased alcohol use among adolescents. Those that had authoritative parents did not have an increased risk of alcohol use (Driscoll et al., 2008). This suggests that parenting styles that are high on expectations and support (i.e., authoritative parenting; Baumrind, 1971) may serve as a protective factor against alcohol use for adolescents.
In addition to parenting being important, the general family environment can also influence substance use. For example, Schwartz, Mason, Pantin, & Szapocznik, (2008) indicated that family functioning influenced identity formation, and that adolescents in immigrant families with higher levels of identity confusion were more likely to initiate cigarette and alcohol use, in addition to initiating early sexual experiences. These findings indicate that family functioning can also serve as a protective factor in terms of initiating drug and alcohol behavior. It is important to put this into context as family cohesion pre-immigration has also been negatively correlated with drug use of young adults (Dillon, De La Rosa, Sanchez, & Schwartz, 2012).
The parent-child dyad seems to be of particular importance in the transmission of and uptake of substance abuse (Farrell & White, 1998). Farrel & White (1998) found that when mother-adolescent distress was high, risk of drug use increased among adolescents. In the context of displaced families, while high family cohesion is a protective factor, acculturated adolescents may see this cohesion as a challenge to their independence. If left unresolved, this can become a problem. Conflict between parents and children in immigrant Latinx families predicted lifetime use of alcohol and binge drinking behaviors (Marsiglia, Kulis, Parsai, Villar, & Garcia, 2009). It is important to note that not all families immigrate together and the experience of separation can also impact substance use. For example, when mother-child separates there is an increased risk in terms of drug and alcohol use for adolescents (Mena, Mitrani, Muir, & Santisteban 2008). A second kind of separation can also influence risk factors. Conceptually, this separation relates to ambiguous loss (Boss, 1991), in that they occur when the parent is unable to care for the child due to financial, health (both physical and mental), and substance abuse problems (Mena et al., 2008).
33.5 Theoretical Frameworks
Considering the theoretical background of research about substance abuse among immigrant and refugee populations within the United States is an important part of understanding the current literature; however, there are some difficulties in the conceptualization of theory for these populations within the context of substance abuse. In the existing literature, there are several theories that are used to frame substance abuse within immigrant communities, thus adding to the difficulties as well. It would be unreasonable to expect all authors to subscribe to only one theory, however, the variety of theories found increases the difficulty of a comprehensive discussion. It is beyond the scope of this chapter to mention all of the theories that have been identified to conceptualize this area of literature; instead, a few theoretical frameworks and societal factors that have been used repeatedly in relation to substance abuse and which might be useful in providing additional clarity to these extant complexities will be discussed.
Ecodevelopmental Theory
One approach that has been frequently utilized in the literature is ecodevelopmental theory (Szapocznik & Coatsworth, 1999). This theory takes tenets of ecological systems (Bronfenbrenner, 1977) and developmental theories such as stages highlighted in the expanded family life cycle model (Carter & McGoldrick, 2005) in an attempt to explain the complexities of substance abuse within immigrant and refugee populations. This enables a discussion of surrounding systems that influence the individual, while also taking into account the stages of life many individuals and families experience. For example, Bronfrenbrenner (1977) discussed development as a series of systems that mimicked concentric circles. The circle closest to the individual is the micro-system, which consists of people and environments that influence the individual on a regular basis (i.e., family members, friends, colleagues, work environment, etc.). Each of these micro-systems interacts with each other, and this interaction creates the meso-system. The next two systems are the exo- and macro-systems. The exo-system consists of the larger influences of economics, politics, education, government, and religion, while the macro-system consists of overarching values and beliefs that a person has. This whole system then moves through time and this element of time is termed the chronosystem. Immigrants and refugees may have similar types of micro-systems, however their interaction with their macro-system may be a bit different due to experiences during displacement or migration, language, culture, and law.
The second piece of ecodevelopmental theory is the Family Lifecycle Model. The Family Lifecycle Model describes the normative stages that a family goes through (i.e., initial coupling, marriage/commitment, transitioning to parenthood, etc.). Combining each of these concepts into one theory allows for an understanding of both external and internal influences. Ecological systems theory focuses more on the outside systems with which an individual interacts (i.e., peer and familial influence and work and/or school environment) and the family lifecycle provides an understanding of important internal influences such as stages of life (i.e., childhood, adolescents, coupling, etc.).
Assimilation (or Acculturation) Model
One model that focuses more on the population (i.e., immigrants and refugees) than on the problem (i.e., substance abuse) is the assimilation (or acculturation) model. This model describes newcomers (i.e., immigrants and refugees) as adopting the host country’s customs and patterns of substance use. This means that immigrants and refugees may likely adopt substance use habits that are more reflective of their current surroundings rather than their country of origin. This is not definitive, however, and the literature is mixed. Both D’Avanzo (1997) and Rebhun (1998) reported that people might simply continue the substance abuse patterns that they participated in while living in their country of origin. This may explain the immigrant paradox discussed previously; the longer that immigrants and refugees and their families stay in the United States, the higher their risk for substance abuse. This would make sense as first-generation migrant peoples would have a foreign country of origin, but second-generation would be living in their country of origin and thus only have their current location (with all of its influences, culture, etc.) as a frame of reference.
Biopsychosocial Theory
While the assimilation (or acculturation model) focuses more on the population rather than the problem, the biopsychosocial theory takes another angle. This theory integrates aspects of psychology and sociality to expand the explanation and understanding of biological factors (Engel, 1977), and in utilizing this theory, the problem (substance abuse) is placed as the primary focus. Marlatt (1992) first used this theory to describe substance abuse in an effort to explain the influence of substance abuse on the entirety of a person. According to Marlatt (1992) addictive behaviors are influenced by the combination of biological, psychological, and sociocultural factors. Biological determinants may include genetic predispositions to addiction (Palmer et al., 2015) and the way in which the substance physically affects the body. The biological portion of the experience of substance abuse greatly influences the psychological and social experiences (Marlatt, 1992). Psychological risk may include beliefs or values, mental health, exposure of psychological trauma, and expectations of substance effects. The sociocultural influences include both the influence received from and given to others. Each of these determinants interact with and influence each other, and provide a complex picture of how substance abuse might be experienced.
Health Disparity
Socially disadvantaged populations, such as racial or ethnic minorities, face health disparities. They are more likely to have health problems, less likely to have access to health care, and more likely to receive substandard care (Institute of Medicine, 2002). These disparities result partially from differences in socioeconomic status, education, employment and housing stability. In terms of substance abuse, ethnic minorities are less likely to use or to complete substance abuse treatment (Chartier & Caetano, 2011). This theory suggests that as a disadvantaged population, immigrants and refugees face disparities in access to and use of substance abuse treatment. Consequently, the outcomes of substance use in these populations would be more severe.
Historical Trauma
A historical trauma perspective reminds us that traumatic experiences can lead to wounds that extend across generations (Sotero, 2006). When a community experiences systematic trauma, such as genocide and forced removal from the community, the community as a whole suffers substantial loss and social disadvantages. For example, displacement can lead to reduced socioeconomic status as possessions are left behind and displaced persons must look for employment in a new location. For the individuals in the community, exposure to trauma often leads to psychological symptoms such as PTSD, depression, or anxiety. These trauma-impacted individuals must find a way to cope, and they are likely to turn to substance abuse or other self-destructive behaviors to numb pain. Their parenting and family functioning are likely to be negatively impacted, and their families are likely to be alienated from external supports. These effects will impact their children in turn. Among children of Holocaust survivors, for example, those children who perceived greater parental burden (i.e., the extent to which parents required care from their children due to the parent’s distress from traumatic exposure) had greater symptoms of PTSD (Letzter-Pouw, Shrira, Ben-Ezra, & Palgi, 2014). The children see the ongoing effects of the original trauma.
This framework can be very useful in understanding substance abuse in refugee and other trauma-impacted communities. A refugee community, for example, suffers substantial losses, which impact their ability to function as parents and family members and which increase their chances of turning to substance use to cope with ongoing losses. Children in these families may experience a powerful combination of ineffective parenting, family norms of substance use, socioeconomic disadvantages, and a sense of loss or disconnection related to the original traumatic events and stressors. These children are at risk to turn to substances.
Each of these theories could be helpful in explaining the immigrant or refugee experience of substance abuse. While it is not necessary for a professional to consider using all of these in guiding his/her work, examining each more closely would be beneficial. Each has something to add and to enable consideration of immigrants’ and refugees’ needs regarding substance abuse.
33.6 Policy on Legal Consequences on Substance Abuse
In addition to a host of complexities related to displacement, immigrants to the United States also potentially face additional legal challenges if their behavior is disclosed to the Immigration and Naturalization Service (INS). Substance use can lead to a rejection of an application for admission to the United States, or to deportation. Immigration laws classify three types of substance use: abusers, addicts, and persons convicted of drug-related offenses (Mautino, 2002). While the first two are difficult to determine, for immigrants convictions often result in the individual being deported. Additionally, Mautiono (2002) reports that individuals in any of these three categories may be deemed “inadmissible,” which means that they would not qualify to immigrate to the United States and cannot qualify for a nonimmigrant (temporary) visa (p.1). It is important to note, that if the INS determines an immigrant to be an “abuser” or “addict” the immigrant is deportable without a drug-related conviction (Mautino, 2002). An immigrant is typically labeled as an “abuser” if s/he admits to using at least one illegal substance on one occasion within the past three years (Mautino, 2002). Drug convictions are generally related to possession, transportation, and trafficking illegal substances, and can happen in or outside of the United States; such convictions need not happen within the United States and are cause for deportation or being considered inadmissible (Mautino, 2002).
33.7 Substance Abuse Prevention & Intervention
Substance abuse prevention and intervention programs within the United States are prevalent for both adolescents and adults. However, very few programs have been adapted for specific ethnic groups. There are no programs for refugees that incorporate the additional context of conflict-related displacement. In this section, we address the barriers to substance abuse treatment use among immigrants and refugees, suggestions for professionals providing substance abuse treatment for immigrants and refugees, and programs that have tried to address the barriers to treatment.
Barriers to treatment use and effective treatments. There are many barriers that prevent immigrant and refugee populations from receiving and/or seeking substance abuse treatment. There is common stigmatization of substance abuse, particularly given the potential legal consequences for immigrants determined to be drug abusers. When individuals choose to look into treatment options, they are likely to find a lack of culturally relevant evidence-based treatments and trained providers from various immigrant and refugee backgrounds (e.g., people who identify themselves as members within the community of interest; Amodeo et al., 2004). There may not be limited services available in the immigrant’s language. All of these factors can combine to prevent immigrants and refugees seeking treatment. For example, Arfken, Berry, and Owens (2009) conducted a study to investigate the barriers that prevent Arab Americans from beginning and remaining in substance abuse treatment programs. What they discovered is that the stigma of having a substance abuse problem and seeking treatment as well as language barriers prevented this group from receiving adequate treatment. In poor communities where there’s lack of information, immigrants can also opt not to seek treatment based on inadequate resources for their overall healthcare and their perception of how various laws and policies affect them (Moya & Shedlin, 2008).
In addition to a lack of culturally appropriate treatments and treatment providers, there are few to no culturally appropriate assessments for substance use. Most assessments for alcohol abuse, for example, ask about frequency of drink consumption. People from different countries tend to drink substances of different potencies and in different sizes. Effective measures must adapt the beverage referred to, the drink sizes assumed, and the amount of time asked about to be appropriate for the cultural background (WHO, 2000). For example, some assessments ask about drink usage in the past 7 days. These assessments would not be culturally appropriate for individuals from rural Mexico, who drink heavily only at seasonal fiestas (WHO, 2000).
Suggestions for professionals providing treatment for immigrants and refugees
Community professionals must be able to provide necessary services in as culturally responsible manner as possible. There are often limitations to providing such culturally tailored treatments (i.e., resources, training, money, etc.). When working with immigrants and refugees, it is important to focus on models that are inclusive of the family and systemic values (i.e., multiple causal factors, multidirectionality) because familial relationships promote protective factors for immigrants (Kim, Zane, & Hong, 2002). Different types of family-based treatments have been developed – some focusing on helping many families at one time, while others focus on individual families.
Group-based treatment. Group-based treatment can be helpful for immigrants because it provides a community context for healing. Social support is an essential part of behavior change (Mendenhall et al., 2012). Immigrants have often left behind important sources of social support (Pantin et al., 2003), which can be hard to duplicate in their new country. Effective treatments will rebuild some social support networks. Karen refugees, for example, report a direct connection between rebuilding communities and cultures that have been devastated by conflict, flight, displacement and resettlement and solving community-wide problems like substance use, intimate partner violence and stressed parent-child relationships. In focus groups, many Karen participants said that community rebuilding would be an essential part of recovery from harmful alcohol use (McCleary, 2013; McCleary & Wieling, in press).
Interventions that are group-based may involve the entire family or just specific members to experience the intervention. For example, an intervention may focus on the parents with the intent of participants implementing their new knowledge when they go back into their own family. Others may follow the protocols that include engaging the entire family in the intervention. Pantin et al. (2003) implemented a study to prevent substance use among immigrant adolescents which highlighted the needs of parents; the program included key variables of parenting, such as, communication, parenting behavioral problems, and parental involvement. These key variables seemed to be common in many interventions that focus on parents. For example, in a family treatment, Litrownik et al. (2000) focused on parent-child communication. Additional variables unique to this study included providing psychosocial information and social skills training. Marsiglia et al. (2010) similarly found familial communication to be helpful when working with adolescents of Mexican heritage. Adolescents were also taught decision making and risk assessment. Clearly adults and adolescents have some common needs (e.g., communication), but given their differing developmental levels (Carter & McGoldrick, 2005), it is appropriate that there be some differences in treatment also.
Family Therapy. Another route for intervention may be the treatment of the individual family. While this mode of treatment will be different depending on the provider and the family receiving services, there are some key components to keep in mind for treatment. Immigrant and refugee peoples may be in need of special consideration for potential differences in family structure and dynamics, religious considerations, language challenges, collectivism/individualism, hierarchy, gender roles, acculturation, and ethnic identity exploration (Rastogi & Wadhwa, 2006). Additionally, the provider must also focus on the identified problem the family wishes to address. Clearly this makes for complex needs and increases the need for clinicians to be culturally aware.
Culturally adapted programs
A small number of articles have described how they altered traditional substance abuse treatment programs to fit specific populations. Morelli, Fong, and Oliveira (2001) conducted a study on a residential, culturally competent substance abuse treatment for Asian/Pacific Islander mothers in Hawaii in which children could be with their mothers over the course of the program. The treatment program included traditional healing practices, infant healthcare services, and community elders lead the women in “infant-mother bonding” time. The women in the program found it especially helpful to, among other things, incorporate a blend of traditional healing practices along with conventional treatment methods, allowing mothers to be with their children in a nonjudgmental environment and working with “consistent and competent” staff members.
Another study illustrated how Alcoholics Anonymous (AA) was adapted to suit immigrants from Central America. Hoffman (1994) reported factors such as location of AA meetings, adapting treatment to fit subpopulations within the Latino/a community in Los Angeles and incorporating the traditional 12 steps with group-specific values. The location of these AA meetings was crucial in getting young Latinx males involved in the programs. Some meetings were held in churches, others in storefront buildings, and others in more traditional rental spaces. These decisions were carefully made to ensure the groups’ abilities to reach their targeted populations. Some groups utilized a theme of Machismo in Terapia Dura (Rough Therapy) to remind members of the negative impact alcohol can have on their lives. Some elements of Terapia Dura include aggressiveness and competitiveness. Groups varied in their use of Machismo based on levels of acculturation and group values. Though such groups were not culturally sensitive to women’s and homosexual members’ needs, they provided a way to treat a specific group of people who have previously been shown to do poorly in traditional AA groups.
An Alcoholics Anonymous group. Wikimedia Commons – CC BY-SA 3.0.
Amodeo, Peou, Grigg-Saito, Berke, Pin-Riebe, and Jones (2004) described a culturally specific treatment for Cambodian immigrants. The study implemented culturally significant techniques such as utilizing acupuncture, providing therapy in the participants’ native language, incorporating Buddhist believes, consulting with an advisory board of members of the Cambodian community, emphasizing relationships, cultural values, and coping mechanisms, as well as doing home visits and utilizing culturally relevant data gathering questionnaires. This treatment approach also took into consideration the location services would be provided. They chose a location that was respected and well known in the Cambodian community.
33.8 End-of-Chapter Summary
As previously stated, the topic of substance abuse prevalence and treatment within immigrant and refugee communities is complex as it involves many different types of populations representing different cultures, resources, traditions, and challenges. For some populations, family connection has been found to be a protective factor against substance abuse, but there is simply an overall dearth of research on the topic. It is clear that more research is needed across each of the areas discussed in this chapter specific to immigrant and refugee communities: theoretical, policy, familial, methodological and intervention-based. Additionally, it has been several years since the United States has published a comprehensive study on prevalence rates for substance abuse among immigrants and refugees (Brown et al., 2005). Given how much our country has changed politically, economically, and demographically in the past decade, it may be timely for the National Surveys on Drug Use and Health to publish the prevalence rates within the more recent 2013 survey and for other researchers to focus on substance use among immigrant and refugee populations.
Case Study
Jon is a 23-year-old first-generation Laotian man who has been using heroin for the past two years. Recently, he has been evaluated and recommended to attend drug treatment. Jon’s parents struggle to understand what addiction is. Historically, Jon’s father has struggled with alcohol abuse; his family reframes his drinking as normal behavior.
Prior to his heroin use, Jon used marijuana exclusively. Fifteen years ago, John came with his family (i.e., parents, younger brother, and older sister) from Vietnam as a refugee.
Jon states that he must return to work in order to help his family pay for living expenses (i.e., rent, food, transportation, medication). The family also supports extended family members back home in Vietnam; these family members are dependent on these financial remittances. Jon agrees that he needs to change, but struggles knowing how to make changes and with his motivation to change.
Jon appears to use the fact that he is proficient in English to his advantage. When communicating with employees at the treatment facility and with court representatives, he communicates different information to different staff members. He also continues this pattern with his family members. Jon does this by leaving out important details for his family and not translating his parents’ express wishes for his discharge. Jon states that his family does not understand addiction and therefore, do not need to be involved in his discharge recommendation planning.
• How might the living situation of newly immigrated refugees influence Jon’s substance use and treatment?
• Can you list 2-3 services in your community that would address Jon and his family needs on different subsystems? Would these resources be culturally sensitive and appropriate?
• What are some common intervention strategies that may encourage Jon’s family to engage in his treatment?
• How has traumatic stress potentially contributed to Jon’s substance abuse? How do you believe traumatic stress has impacted other generations of Jon’s family?
• What are some cultural barriers Jon faces in seeking treatment?
Helpful Links
Drug and Alcohol Use in Refugee Communities
• practicetransformation.umn.e...e-communities/
• This webinar by Dr. Simmelink McCleary describes how immigrants and refugees understand substance use and trauma, with guidelines for treatment providers.
Attribution
Adapted from Chapters 1 through 9 from Immigrant and Refugee Families, 2nd Ed. by Jaime Ballard, Elizabeth Wieling, Catherine Solheim, and Lekie Dwanyen under the Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/09%3A_Global_Perspectives_and_Theories/31%3A_Substance_Abuse.txt |
Learning Objectives
• Learn from the national and global perspectives of resilience in immigrant and refugee families.
• Recognizing that the world is constantly and rapidly changing.
• Recognizing that Global/national/international events can have an impact on individuals, families, groups, organizations, and communities.
• Global implications dictate that we foster international relationships and opportunities to address international concerns, needs, problems, and actions to improve the well-being of not only U.S. citizens, but global citizens.
34.1 Introduction
Ghetto Statistics
By Chay Douangphouxay We were 4th and Dupont
North side projects
Second-class refugee We were 1st of the month
Welfare checks
Food stamps
W.I.C.We were just kids
Community centers
Study groups
Basketball hoops They were broken school systems
Crooked cops
Drug dealers
Grave diggers I was supposed to be
Gang member
Prostitute
Dead before fifteen I proved them through
Church groups
Get out of the hood
College degree
The immigrant paradox has been highlighted in recent years as researchers have increasingly noted the resilience of immigrants in the face of challenges and adversity (Hernandez, Denton, Macartney, & Blanchard, 2012). Resilience refers to the process or outcomes of positive development in the context of adverse circumstances (Luthar & Cicchetti, 2000; Masten, Burt, & Coatsworth, 2006). Within families, Walsh (2006) views resilience as the capacity to rebound and grow from challenging experiences, building strength and resources. According to this perspective, essential elements to the process of resiliency are making meaning of adversity and supportive relationships. The challenges immigrants and refugees face are many, including loneliness and isolation in a new country (Campbell, 2008; Narchal, 2012), economic challenges (Fuligni, 2012; Parra-Cardona, Cordova, Holtrop, Villaruel, & Wieling, 2006), and poor educational opportunities (Crosnoe, 2012). Refugees often face further challenges of coping with multiple exposures to traumatic events that led them to flee their home countries along with displacement and resettlement stressors (Shannon, Wieling, Simmelink, & Becher, 2014; Weine et al., 2004). However, a resilience framework invites a consideration of the strengths and protective factors that allow immigrant families to overcome adversity.
The immigrant paradox is defined as the tendency for first and second-generation immigrants to do better in many areas than United States-born individuals (Hernandez et al., 2012). This trend has been observed in physical health, psychological health, and education. Fuligni (2012) outlines two considerations that increase immigrants’ abilities to thrive in the transition to a new culture and home, and then describes a third consideration that can pose barriers. First, immigrant families tend to be highly motivated and value work and education. Second, children of immigrants are protected by family connection and obligation. Finally, in spite of high educational aspirations, immigrant families have varied access to the resources and opportunities needed to achieve success. This review examines research on the strengths and the resilience of immigrant families in the United States in each of these three areas.
34.2 Family Motivation: Value of Work & Education
Consistent with a family resilience framework (Walsh, 2006), the value of family provides a powerful motivation among immigrants to work hard and gain an education. A sense of family identity can provide a sense of belonging and social identity (Fuligni, 2011). Furthermore, family identity promotes eudamonic well-being in minority populations, a sense of purpose, motivation, and meaning (Fuligni, 2011). For example, one young woman from a refugee family explains how her mother instilled the value of family identity to provide a compass for navigating her life:
The resounding words, “YOU ARE BETTER THAN THAT,” penned and embedded by my mother in the fiber of my being, echoed in the ear drums of my soul, brought me back to sanity. It was like the blinders were opened and the light of truth penetrated the darkness of my world. For the first time, I saw myself for who I really am and wanted to be. I was no longer ashamed of my uniqueness (Douangphouxay, 2012, p. 1).
Family often provides motivation to immigrate. In one study, Latino/a immigrants cited their desire to be reunited with families as a motivator for immigration (Campbell, 2008). Other reasons for leaving their home country have included dreams of an education and future for their children, a need to protect children from violence, and a desire to achieve financial stability in order to provide the family with basic necessities (Solheim, Rojas-García, Olson, & Zuiker, 2012). This section reviews immigrant and refugee families’ motivation to work hard and provide education for their children.
Value of Work
Across the literature, there is evidence that immigrant families emphasize the value of working hard to support their families. The opportunity to work hard in order to support the family has not only been cited as a reason for immigrating to the United States, but qualitative studies have also illustrated immigrants’ feelings of cultural pride in giving their best for their loved ones (Parra-Cardona, Bulock, Imiq, Villarruel, & Gold, 2006; Solheim et al., 2012). Immigrant families described enduring an anti-immigration environment in their country of destination because of economic opportunities and the possibility of upward social mobility for their loved ones (Valdez, Lewis Valentine, & Padilla, 2013). In another study of migrant workers, the demands of long hours and challenging schedules were noted, but the opportunity to work and be independent was highly valued (Parra-Cardona et al., 2006). In comparison to previous experiences in their home country, participants expressed satisfaction in having an income that was adequate for basic necessities. Imagining a better future was described as a coping strategy for immigrant participants (Parra-Cardona et al., 2008).
Mural to honor migrant workers at the Gundlach-Bundschu winery. Chris deRham – honoring the vineyard workers – CC BY-NC-ND 2.0.
Data from the Census Bureau’s American Community Survey suggest that work patterns among immigrant fathers differ by level of language fluency. Among immigrant fathers in English fluent families, 95% to 96% worked to support their families, a level comparable to United States-born families (Hernandez et al., 2012). Among those who were English language learners, more than 85% of fathers worked to support their families. Exceptions were found in Southeast Asian, Armenian, and Iraqi refugee families where rates were between 70-84%. This may be because refugee families from these conflict-ridden parts of the world are likely to have suffered more traumatic events and therefore may experience greater functioning and work-related barriers (See also Chapter 5).
Hernandez et al., (2012) found that the majority of immigrant families in their study also had a mother who contributed to the family finances. Campbell (2008) illustrated the pride that immigrant women took in their jobs, even if they were low paying. Several women demonstrated an entrepreneurial spirit, running businesses based on traditional roles of women (baking, sewing, etc.). The motivations for these efforts were often framed as dedication to the welfare of their families, and obstacles were seen as challenges to be overcome rather than insurmountable barriers. In another qualitative study, one woman shared her pride in balancing work and family as she obtained her GED, found a new job, built a new home with her spouse, and supported her children’s education (Parra-Cardona et al., 2006). Women also supported their spouses and took pride in their work ethic and sacrifices. One woman in Parra-Cardona et al.’s (2006) study noted that she was proud of her husband for getting a promotion in a factory for \$9/hour; she was proud that his 70 hour work weeks and sacrifices over the years were recognized (Parra-Cardona et al., 2006).
Children are a source of inspiration as immigrants work hard to face challenges and adversity (Ayón & Naddy, 2013; Valdez et al., 2013; Walsh, 2006). Qualitative research emphasized that well-being of children was a priority among immigrant workers, and being a good parent was their “central life commitment,” even a sacred responsibility (Parra-Cardona et al., 2008). These sentiments were illustrated when immigrant parents expressed desire to cover basic needs of their families without spending excessive time away from family. In another study, Southeast Asian adolescents, the majority of whom were children of immigrants, recognized that their parents shared affection by trying to provide for them (Xiong, Detzner, & Cleveland, 2004). They saw that their parents wanted them to do better than they had, sharing that their parents’ low paying jobs served as motivation to do better.
Videos
Ruben Parra-Cardona, Ph.D., LMFT discusses employment and parenting (14:13-14:52).
A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/humanbe/?p=131
Paul Orieny, Sr. Clinical Advisor for Mental Health, The Center for Victims of Torture (CVT), discusses the education and employment success of immigrants.
A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/humanbe/?p=131
Value of Education
Research has also emphasized how much immigrant parents value education for their children. In a qualitative study of Mexican American undocumented women in South Carolina, mothers were unanimous in their desire for children’s educational success (Campbell, 2008). As parents, they had given up life in Mexico for the sake of their children’s education. Many of these mothers invested in their own education to become better parents and to model the importance of education for their children (Campbell, 2008). In a longitudinal study, immigrant children of diverse backgrounds were found to have higher GPAs on average if their parents had listed education as a reason for immigrating, which suggests that parents’ motivations may have an impact on their children (Hagelskamp, Suarez-Orozco, & Hughes, 2010). Planning for children’s education was found to be a source of life satisfaction for immigrant migrant parents (Parra-Cardona et al., 2006).
In spite of early disadvantages, first-generation immigrant adolescents appear to have an advantage over second-generation or third-generation children of immigrants, an often-cited example of the immigrant paradox. Using data from the Educational Longitudinal Study, Pong and Zeiser (2012) found first-generation immigrant students in 10th grade had higher GPAs and more positive attitudes toward school than subsequent generations. These tendencies held true across race/ethnicity including White, Latino/a1, Black, and Asian immigrant children. Family influences may help account for these results as evidence connects immigrant and refugee parents’ aspirations to children’s academic outcomes. For example, Pong and Zeiser (2012) also found that parents’ expectations were related to 10th-grade math results. For Hmong men, having greater family conflict is linked to being more likely to complete the first year of college. In families like these, family conflict may reflect the parents’ investment in their child’s academic lives (Lee, Jung, Su, Tran, & Bahrassa, 2009). Portes and Fernandez-Kelly (2008) discussed the strict parenting practices in immigrant families that are often at odds with the parenting styles of the majority population. They concluded, “While such rearing practices will be surely frowned upon by many educational psychologists, they have the effect of protecting children from the perils of street life in their immediate surroundings and of keeping them in touch with their cultural roots” (p. 8).
Value of a Second Language
Although the challenge of learning English is great, studies have found that the ability to speak a second language represents advantages for many children in immigrant families. Children in families who promote learning in two languages benefit in academic achievements, cognitive gains, self-esteem, and family cohesion (Espinosa, 2008; Han, 2012). However, the importance of mastering English must be stressed. In a sample of Latino/a and Asian children, Han (2012) found that bilingual children dominant in the English language performed at an academic level similar to White monolingual children, controlling for other factors, while bilingual children who were not dominant in English or did not speak two languages performed at lower levels. In addition, first and second-generation bilingual children performed better than third-generation bilingual students providing further evidence for an immigrant paradox. Although it can be a stressful obligation, children of immigrants often express pride in their bi-lingual abilities and in being able to translate for their parents (Kasinitz, Mollenkopf, Waters, & Holdaway, 2008). In addition, speaking one’s native language allows children in immigrant and refugee families to connect with extended family members and ties them to their ethnic heritage (Costigan & Koryzma, 2011; Nesteruk & Marks, 2009). Espinosa (2008) advocated promoting rich language experiences in one’s native language during the first three years of life and then adding second language after the age of 3.
Home1The term Latino/a is used throughout this chapter, though some original studies used the term Hispanic.
34.3 Family Connectedness & Identity
Fuligni (2011) argued that because immigrant groups face barriers in their access to resources, family and ethnic identity is a salient protective factor in immigrant families. Family connection remains highest over time among the immigrant families facing the most stress, suggesting that families are a particularly important support for immigrants struggling in the new culture (Ibanez et al., 2015). The protection provided by family connectedness and identity may be one explanation for the immigrant paradox. In Latino/a families, the tradition of family connectedness and obligation is known as “familismo,” (Parra-Cardona et al., 2006). In a qualitative study to better understand parenting needs, Latina/o parents reported that “familismo” was a strong motivation to adopt more effective parenting practices (Parra-Cardona, Lappan, Escobar-Chew, & Whitehead, 2015). In Asian families, family cohesion stems from Confucian values (Walton & Takeuchi, 2010). Among Black Caribbean immigrants, gatherings of family and friends called “liming” sessions reinforce family and cultural identities through storytelling (Brooks, 2013).
Several aspects of family connectedness described in the following sections may serve as a source of resilience for both adults and children in immigrant families: family cohesion, a sense of family obligation, and an emphasis on ethnic heritage.
Family cohesion
Family cohesion is how emotionally close and supportive the members of a family are. An emphasis on family connection is reflected in the structure of immigrant families, which are more likely to include married couples and to be inclusive of extended family members. Immigrants, in general, are more likely than the United States-born to marry and less likely to divorce (Quian, 2013). According to the Census Bureau’s American Community Survey, 82% of children of immigrants live with two parents, whereas 71% of children in United States-born families are in living with two parents (Hernandez et al., 2012). This emphasis on cohesion reflected in the immediate and extended family structure could provide protective influences for both children and adults.
Immediate family. Family cohesion in immediate immigrant families is linked to positive outcomes for children and adolescents. In studies of Latinx immigrant families, family cohesion predicts child social skills and self-efficacy and protects against conduct problems and alcohol use (Leidy, Guerra, & Toro, 2012; Marsiglia, Parsai, & Kulis, 2009). Family cohesion may also help immigrants cope with the challenges of living in a new country and culture. For example, a study by Juang and Alvarez (2010) found that Chinese American youth who experienced discrimination felt loneliness and anxiety, but family cohesion buffered this negative effect. Family cohesion was particularly powerful for youth who experienced high levels of discrimination. Similarly, among adolescent refugees from Kmer who had been exposed to significant violence, family support protected against mental health and personal risk behavior problems (Berthold, 2000).
Immigrant Family in the Baggage Room of Ellis Island.
Wikimedia Commons – public domain.
Immediate families continue to provide needed support during the transition to adulthood and, later, to parenthood. A study by Kasinitz et al., (2008) found that in comparison to their United States-born peers, young adult children of immigrants were more likely to live at home, which enabled many to attend college without burdensome debt and save for a home. In several studies, immigrant adults relied on their parents when they themselves became parents. Even if new mothers had previously been critical of their own mothers, when second-generation women transitioned into parenting, they often relied heavily on their mothers for support and advice (Foner & Dreby, 2011; Ornelas et al., 2009). When their mothers remained in their home country, transnational phone calls were one important form of support (Ornelas et al., 2009).
Extended family. Another source of resilience for immigrant families is found in extended family cohesion. In several studies, extended family members were a crucial support during the transition time following migration, providing food, giving support, and helping pay bills until the recently arrived family could get established (Ayón & Naddy, 2013; DeJonckheere, Vaughn, & Jacquez, 2014; Parra-Cardona et al., 2006). For example, a Latino youth explained, “When we first came here my cousin and I told a lot of secrets, and he’s the one I trust” (p. 15). Campbell (2008) described how the undocumented women in the study depended on extended family members to help them navigate the system in order to buy a house, and how they relied on family members to look after their properties back home in Mexico. In a quantitative study of risk and resilience among immigrant Latina mothers, social capital, described as a network of family and friends, was related to life satisfaction and food security (Raffaelli, Tran, Wiley, Garlaza-Heras, & Lazarevic, 2012).
Extended family provided needed support in raising children. When immigrant new mothers were separated from their parents, they relied on other extended family members also living in the country of destination, especially in the time period immediately after giving birth (Ornelas et al., 2009). In a study of Eastern European immigrants, grandparents and other relatives played important roles in raising Unite States-born children (Nesteruk & Marks, 2009), often travelling to the United States for six months at a time to assist new parents after a child was born.
When children are older, relatives often provide child-rearing support for immigrant families. Xiong and colleagues (2004) reported that Hmong families living in the United States may send their children away to live with relatives to avoid the dangers of an unsafe neighborhood. Similar examples are found outside the United States. Vietnamese refugee parents in Norway depended on kin networks to provide support and protection to troubled youth (Tingvold, Hauff, Allen, & Middelthon, 2012). In order to maintain intergenerational ties, Eastern European immigrant families described making sacrifices to move closer to kin or send their children abroad to stay with grandparents in the summer (Nesteruk & Marks, 2009). Grandparents often played a key role in raising grandchildren in immigrant families, adding instrumental support especially in dual-career families (Treas & Mazumdar, 2004; Xie & Xia, 2011). Given the importance of many grandparents in immigrant families’ lives, Foner and colleagues (2011) suggest that intergenerational research among immigrant families with three generations in one household is needed.
Family Obligation
Family identity implies having a sense of obligation toward kin and striving to be valued, contributing members of one’s family (Fuligni, 2011). Even after controlling for socio-economic variables, immigrant adolescents and young adults from Filipino, Mexican, Latin American, and Central/South-American backgrounds were much more likely than European youth to report a sense of family obligation in the areas of assisting family, spending time with family, considering family members’ opinions and desires, and supporting family (Fuligni, 2011). Although foreign-born students had a higher level of obligation than United States-born students, second and third-generation youth from Asian and Latinx backgrounds were more likely to have a higher sense of obligation than those from European backgrounds. Ethnic differences in emotional closeness or conflict, however, were not found. Evidence suggests that these levels of obligation were connected to adolescents’ sense of ethnic identity, a topic explored later in this chapter.
Feelings of family obligation consistently predicted academic motivations in Latino/a and Asian immigrant children (Fuligni, 2011). Immigrant children with a strong sense of family obligation tended to believe that education was important and useful. This suggests that family obligation may help promote a higher level of engagement in school than socio-economic barriers and actual achievement levels would predict. However, no relationship between family obligation and achievement in terms of grades was found.
Parenting practices may contribute to a sense of family obligation. Xiong et al.’s (2004) study found that Southeast Asian adolescents perceived a parental emphasis on proper behaviors and academic success. One Cambodian participant in the study reported constant messages from parents to “stay in school, stay out of trouble, don’t go out with friends all the time to do bad things, be on time [when coming back home]” (p. 9). Adolescents also reported that parents often communicated the connection between education and opportunity. These findings imply that parents’ clear communication of family values contributes to the academic resilience of immigrant children, perhaps compensating for other challenges.
Family obligation appears to contribute to the mental health of immigrant children. One study of Latino families found that familism values contributed to lower rates of externalizing behavior (German, Gonzales, & Dumka, 2009). Also, family identity and obligation has been found to contribute to positive emotional well-being and personal self-efficacy in immigrant children (Fuligni, 2011; Kuperminc, Wilkins, Jurkovic, & Perilla, 2013). Feeling like a good family member has been found to mediate a relationship between helping at home and elevated levels of happiness in youth from Latino/a, Asian, and immigrant backgrounds, although increased helping is also related to feelings of burden (Telzer & Fuligni, 2009). A sense of fairness regarding family obligations was also an important predictor of declines in psychological distress among Latinx immigrant youth (Kuperminc et al., 2013). Most recently, engaging in family assistance has been found to be associated with ventral striatum activation in the brain, suggesting a neurological benefit associated with decreased risk-taking (Telzer, Fuligni, Lieberman, & Galván, 2013). Several studies have found that lower instances of risky behaviors such as early sex, violence, delinquency, and substance abuse have been reported in adolescent immigrant youth across race and ethnicity (Hernandez et al., 2012; Kao, Lupiya, & Clemen-Stone, 2014). While family obligations may be challenging at times, immigrant youth often benefit from these obligations.
Ethnic Heritage
A sense of ethnic identity developed through socialization in families and cultural communities may provide protective influence. For example, a strong ethnic identity was found to contribute to academic motivation in immigrant children (Fuligni, 2011). Turney and Kao (2012) found that immigrant parents were more likely to talk with their children about their racial and ethnic traditions than United States-born parents. Religiosity and spirituality, often integrated with one’s ethnic identity, rituals, and traditions, appear to play a significant role as a protective factor in the immigrant paradox among Latino/a and Somali youth (Areba, 2015; Ruiz & Steffen, 2011). Also, participation in a religious community was a key means of connecting children of Vietnam refugees with their ethnic heritage and building cultural capital (Tingvold et al., 2012). Among refugees, contact with those of the same ethnic background may be protective. Sudanese children living without any contact with other Sudanese were more likely to have PTSD than those who had fostered with Sudanese families (Geltman et al., 2005). In one study, ties to tradition and Somali culture were adaptive for Somali girls, but assimilation to the United States host country culture was adaptive for boys (Fazel, Reed, Panter-Brick, & Stein, 2012). Ethnic heritage appears to be a protective factor for many immigrants, although it is influenced by contextual factors such as gender.
34.4 Role of Resources in Achieving Aspirations
An ecological approach to resiliency invites us to consider the strengths of individuals and families as well as the ways that context contributes to the barriers and support of success (Parra-Cardona et al., 2008). Walsh (2006) cautions, “In advancing an understanding of personal or family resilience, we must be cautious not to blame those who succumb to adversity for lacking ‘the right stuff,’ especially when they are struggling with overwhelming conditions beyond their control” (p. 6). This section examines differences in families’ access to the resources that allow them to overcome adversity, specifically focusing on social stratification, contextual risk exposure, and acculturation.
Social Stratification
Kasinitz and colleagues (2009) point out that many groups of immigrants experience economic success. In New York, children of Chinese and Russian Jew immigrants have levels of income similar to United States-born White European Americans, children of West Indian immigrants have higher income levels than United States-born African Americans, and children of Dominican Republicans and South Americans have higher income levels than United States-born Puerto Ricans. However, Parra Cardona and colleagues (2006) paint a stark contrast to this picture of upward mobility for immigrants. Migrant workers earned lower levels of income than other groups in poverty (\$7,500/ year), with little opportunity for upward mobility despite their hard work (Parra-Cardona et al., 2006). These families were often required to move across the country without any advance notice; as they moved north to new work locations, schools were less likely to provide bilingual support.
Expectations of financial success in the United States often fall short of expectations. Families from Mexico reported that the cost of living in the United States was higher than expected, and the families could not save for goals as quickly as they had hoped (Solheim et al., 2012). A quantitative study of Latinx families unexpectedly found that human capital was associated with lower life satisfaction; this suggests a gap between reality and expectations based on the level of education and skill (Raffaelli et al., 2012). Although family influences can be protective, family needs and obligations may present a barrier for reaching goals among young adults. For example, one single young man had come to the United States to better his personal circumstances but supported his mother back in Mexico at the expense of his own education (Solheim et al., 2012). This is consistent with larger trends in research, where first-generation immigrant young adults were more likely than second or third-generation young adults to provide financial assistance to their families (Fuligni, 2011). Those immigrant youth who provided financial help to families were less likely to complete a 2 or 4-year degree. Similarly, in families whose primary motivation for immigrating was work prospects rather than educational prospects, children’s grades were more likely to decline over five years (Hagelskamp et al., 2010). This suggests that in families where family employment and work concerns are pressing, individual educational goals can suffer. These findings suggest that a hierarchy of needs may exist where basic needs are more important than education and limit upward mobility (Hagelskamp et al., 2010). Together, these studies suggest that high levels of family obligation may interfere with academic success.
Educational attainment. Some of the variations in achieving financial success may depend on the level of parents’ education upon arrival to the United States, which is a reminder that immigration is a selective process (Fuligni, 2012). Many immigrants are able to migrate because they have higher resources than their peers at home. In one study, Black immigrant heads of household had higher levels of education than Black United States-born heads of household (Thomas, 2011). Zhou (2008) found that many Chinese immigrant families had higher education than other immigrant groups and built a community of support for educational experiences, which benefited families with lower levels of SES as well. In another study, Chinese fathers were more educated that immigrant fathers from Central America, Dominican Republic, Mexico, or Haiti, and these Chinese families cited work prospects as motivation to migrate less often than those from other countries of origin (Hagelskamp et al., 2010). Children from Chinese families also tended to have higher grades. In contrast, those from Haiti and Central America were more likely to be fleeing political chaos and mentioned education less as a reason for migrating. In refugee samples outside the United States, parents’ education may be a long-term protective factor (Montgomery, 2010), but those who are educated may also be targeted in violent conflicts and suffer more as a result (Fazel et al., 2012).
Many of the examples of the immigrant paradox throughout the literature rely on data that controls for SES, but these may not have real world application if socioeconomic status is strongly related to outcomes. Crosnoe (2012) responded to this concern by examining educational outcomes over time for first- and second-generation immigrants as well as United States-born groups in two nationally representative samples, but without controlling for SES. The results showed that White European American children of third-generation-plus families scored well above all other groups. Among high school students, second-generation Latinx students outpaced third-generation Latinx students; first-generation were in-between, but not significantly different from either the second- or third-generation. Among elementary students, third-generation-plus Latinx students scored above first- and second-generation immigrants but this gap decreased as the children reached fifth grade. In a study of younger children, access to early education has been found to be limited for some groups of immigrants (Hernandez et al., 2012). Although some cited family and cultural barriers to obtaining early education, research shows the differences were largely accounted for by socioeconomic barriers for both immigrant and United States-born families from Central America and Southeast Asia (Hernandez et al., 2012). Thus, education barriers may vary across generations and across immigrant communities.
Contextual Risk Exposure
Contextual risk exposures can stem from numerous sources, but some of the most salient are local policies, neighborhoods, and discrimination. One study found that pro-immigrant local policies and integration among immigrants and other groups in 2000 was related to the availability of diverse job opportunities for immigrant families (Lester & Nguyen, 2015). In these contexts, immigrants were less likely to lose their jobs and had higher incomes in 2010, implying that they were more resilient to the economic stress of the Great Recession.
Immigrant families often settle in poor, high crime areas with lower quality schools and limited access to resources (Fuligni, 2011; Xiong et al., 2004). Ponger and Hao (2007) found that the schools Latinx immigrant children attended had a higher record of problem behaviors and poor learning climate compared to schools where Asian immigrant children attended. Portes and Raumbaut (2001) reported that immigrant children from Laos, Vietnam, or Cambodia were likely to attend unsafe schools. This research was substantiated by a large national study which found that schools immigrant children attended were more chaotic and had lower levels of academic expectations and challenges than schools that second- or third-generation students attended (Pong & Zeiser, 2012). Comparisons with children from non-immigrant families were not made, however, which may have shown an even greater difference. Furthermore, Southeast Asian adolescents of immigrant parents felt that their parents frequently lacked the resources to advocate for their children in a school environment because they were socially isolated (Xiong et al., 2004).
In addition to impoverished, low-resource communities, many immigrants face discrimination. Kasinitz and colleagues (2009) reported that children of immigrants from Indian or Latinx backgrounds faced more discrimination than other groups of immigrants in New York, which may have influenced their ability to access local resources. For example, criminal justice systems tend to give more lenient sentences to White adolescents than to Latino or Black adolescents for the same crimes, and these adolescents also have fewer economic and family resources to navigate their sentences. In a qualitative study, immigrants expressed more discrimination barriers than United States-born Latinxs; they felt a sense of isolation in communities where Latinxs were a minority and experienced discrimination rooted in language barriers (Parra-Cardona et al., 2006). In that same study, immigrant migrant workers experienced extreme discrimination, including from employers who reneged on the original agreement for compensation. Few employees received health care, and taking a day off for health or family reasons was punished by extra days of work. Parents felt that their children were disadvantaged in schools by being placed in a slow learning track and negatively labeled (Parra-Cardona et al., 2006). A study of Somali refugee children found those who perceived discrimination were more likely to report symptoms of depression and PTSD (Ellis et al., 2008). In contrast, those who felt safe at school or a sense of belonging were less likely to report depression or PTSD (Geltman et al., 2005). Even if discrimination is not obvious, social stereotypes created barriers to resources with long-term implications for mental and physical health (Fuligni et al., 2007). For example, East Asian immigrants tended to have higher incomes that allow high school students to enroll in higher-level courses and receive higher grades than peers from Latin American or Filipino backgrounds. In turn, these courses and grades predict college enrollment (Fulgini et al., 2007).
Acculturation Gap
Levels of acculturation may also affect access to resources. Adolescents and young adults who combine aspects of both their family of origin culture and the new culture and speak both languages tend to adjust better than those who either stay steeped in their root culture only or assimilate completely to their new culture (Kasinitz et al., 2008; Portes & Rumbaut, 2001).
In some cases, an acculturation gap between parents and their more quickly acculturated children leads to family conflict. As a result, family relationships become a risk factor rather than a protective factor (Lee et al., 2009; Xiong et al., 2004; Lazarevic, Wiley, & Pleck, 2012). When patterns of parent and child acculturation are similar to each other, parent-child relationships and youth well-being may benefit (Portes & Rubaut, 2001; Lazarevic et al., 2012). In a Canadian study, parenting efficacy mediated the relationship between acculturation into the new culture and psychological adjustment of both Chinese mothers and fathers (Costigan & Koryzma, 2011). A direct relationship between maintaining an orientation toward Chinese culture and positive psychological adjustment was found for women but not for men.
Research suggests that parents’ acculturation and adjustments in parenting that align with the demands of the new culture may have some protective factors for children in immigrant families. However, research also shows that subsequent generations do less well. It may be that over time as acculturation and opportunities increase, there is an erosion of a strong sense of family identity which diminishes the protection these connections provide.
Video
True Thao, MSW, LICSW discusses refugee resilience despite adjustment challenges and generational strains (0:00-1:43).
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34.5 Emerging Directions
Immigrant and refugee families may respond with resilience to challenging circumstances and adversity, particularly when policies and resources are in place to support them. Indeed, pro-immigrant policies have been shown to create economic opportunities for immigrant families (Lester & Nguyen, 2015) which allows them to provide for their family’s needs, raise healthy and successful children, and pursue their goals. Although barriers exist, as a whole, immigrants are highly motivated to invest in their families through hard work and education and often express a sense of pride in their independence. Another strength of immigrant communities is a sense of family identity and obligation that often serve as protective factors.
Scholars have pointed to several gaps in the literature on immigrant families. There is a lack of research regarding several specific subgroups in the United States, including Southeast Asian populations and immigrants from the Middle East (Xiong et al., 2004; Foner & Dreby, 2011). Also, research on refugee resilience is lacking in the United States. Research on couples in immigrant and refugee families is also needed (Helms et al., 2011). A focus on resilience offers a new lens that focuses on strengths and protective factors that provide an environment in which immigrant and refugee families can thrive and contribute to a continually changing and increasingly diverse United States society.
34.6 End-of-Chapter Summary
Case Study #1
Juan Morales stood at the grocery counter watching the clerk ring out each item while his mother looked through her purse to find her wallet. The clerk looked up and asked, “How are you folks doing?”
His mother answered with her thick accent, “Good, good.”
“That will be \$28.51, ma’am.” The clerk looked expectantly at Mrs. Morales, who turned to her son.
“Cuanto es, mi hijo?” she asked. He told his mother the amount in Spanish, and she reached into her purse to give him a ten and a twenty. When the clerk gave change of \$11.49, she refused the amount and told her eleven-year-old son to communicate the change was too much.
Juan turned bright red while the customers behind them formed a line. “You gave us too much change.” The clerk tried to explain that he was giving change for forty dollars, but Mrs. Morales insisted that she should get change for thirty dollars. In the end, the clerk thanked them for their honesty.
As Juan and his mother walked away, Mrs. Morales gave her son a quick hug. She told him how proud she was of him, studying so hard and speaking good English. “Por eso venimous aqui,” she said—that’s why we came here, so you could study hard and have a better life than we had in Colombia.
Case Study #2
Ayon ran down the sidewalk, dodging people walking briskly in the afternoon rush hour. She had to get to the Western Union before it closed. Slightly out of breath, she reached her destination and wired money back home to her grandmother in Somalia. Then she stopped by a store to grab a contribution to the family meal that night. Her cousins were coming over and her mom wanted to have a big meal. She was looking forward to a night with the family, even if it meant that she would be up late studying for exams that she had to take the next day.
When she got home, her family was gathered around her younger sister. She was crying because a girl at school had challenged her to take off her hijab, the headdress that the women in the family wore for modesty. Ayon smiled at her and said, “Don’t listen to them. They asked me the same thing.” Their cousin chimed in, and before long the girls were laughing and talking. Ayon smiled with a deep contented sigh.
Discussion Questions
1. What are some examples of the immigrant paradox in immigrant and refugee families?
2. How would you explain the attitude toward work and education of most immigrant and refugee families? What do you think is behind these attitudes?
3. Discuss the role families play in promoting resilience among immigrants and refugees? In what ways might family obligations be a barrier to resilience at times?
4. Why should a community worker or practitioner be careful to refrain from judging immigrant and refugee families negatively?
5. What is an acculturation gap? How could an acculturation gap affect resilience?
Attribution
Adapted from Chapters 1 through 9 from Immigrant and Refugee Families, 2nd Ed. by Jaime Ballard, Elizabeth Wieling, Catherine Solheim, and Lekie Dwanyen under the Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/09%3A_Global_Perspectives_and_Theories/32%3A_Resilience_in_Immigrant_and_Refugee_Families.txt |
Learning Objectives
• Learn from the national and global perspectives of immigrants and refugees resettling.
• Recognizing that the world is constantly and rapidly changing.
• Recognizing that Global/national/international events can have an impact on individuals, families, groups, organizations, and communities.
• Global implications dictate that we foster international relationships and opportunities to address international concerns, needs, problems, and actions to improve the well-being of not only U.S. citizens, but global citizens.
35.1 Introduction
The movement of people to the United States from all parts of the world has resulted in a very diverse and ever-evolving nation that can perhaps be described as a mosaic of cultures, races, and ethnicities. How does a nation achieve social cohesion in the midst of evolving diversity? How do individuals and families hold the complexities of honoring their home culture and reaching their goals in the new country and culture?
Because migration experiences are diverse, the process of resettlement is also varied and must be examined through lenses of race, ethnicity, nativity, gender, political orientation, religion, and sexuality, among others. In this chapter, we will conduct a historical review of the theories that have been used to assess the processes of resettlement. We begin by describing assimilation, acculturation, and multiculturalism – early theories that emphasized group processes. We will then describe the transition to intersectionality, and its focus on individual process. Finally, we will identify family theories and their potential role in the future of research on resettlement.
35.2 Assimilation
The Mortar of Assimilation and the One Element that Won’t Mix Cartoon from PUCK June 26, 1889 – public domain.
Classic assimilation theory or straight-line assimilation theory can be dated back to the 1920s originating from the Chicago School of Sociology (Park, Burgess, & McKenzie, 1925; Waters, Van, Kasinitz, & Mollenkopf, 2010). This early assimilation model set forth by Park (1928) described how immigrants followed a straight line of convergence in adopting “the culture of the native society” (Scholten, 2011). In many ways, assimilation was synonymous with ‘Americanization’ and interpreted as ‘becoming more American’ or conforming to norms of the dominant Euro-American culture (Kazal, 1995). Assimilation theory posited that immigrant assimilation was a necessary condition for preserving social cohesion and thus emphasized a one-sided, mono-directional process of immigrant enculturation leading to upward social mobility (Warner & Srole 1945). Assimilation ideas have been criticized for lacking the ability to differentiate the process of resettlement for diverse groups of immigrants; they fail to consider interacting contextual factors (van Tubergen, 2006).
Segmented assimilation theory emerged in the 1990s as an alternative to classical assimilation theories (Portes & Zhou, 1993; Waters et al., 2010). Segmented assimilation theory posits that depending on immigrants’ socioeconomic statuses, they may follow different trajectories. Trajectories could also vary based on other social factors such as human capital and family structure (Xie & Greenman, 2010). This new formulation accounted for starkly different trajectories of assimilation outcomes between generations and uniquely attended to familial effects on assimilation. The term often employed when one group is at a greater advantage and is able to make shifts more readily is segmented assimilation (Boyd, 2002).
Later, Alba and Nee (2003) formulated a new version of assimilation, borrowing from earlier understandings yet rejecting the prescriptive assertions that later generations must adopt Americanized norms (Waters et al., 2010). Within their conceptualization, assimilation is the natural but unanticipated consequence of people pursuing such practical goals of getting a good education, a good job, moving to a good neighborhood and acquiring good friends (Alba & Nee, 2003).
Numerous studies have utilized assimilation theories to guide their inquiry with diverse foci like adolescent educational outcomes, college enrollment, self-esteem, depression and psychological well-being, substance use, language fluency, parental involvement in school, and intermarriage among other things (Waters & Jimenez, 2005; Rumbaut, 1994). Despite such widespread use of assimilation, some scholars have noted that the theory may not adequately explain immigrants’ diverse and dynamic experiences (Glazer, 1993) and some note that other theories such as models of self-esteem or social identity may be added to assimilation to bolster its value (Bernal, 1993; Phinney, 1991).
A further critique is that a push for assimilation may mask an underlying sentiment that immigrants and refugees are unwelcome guests who have to compete for scarce resources (Danso, 1999; Danso & Grant, 2000). These sentiments can impact the reception and adaptation experiences of immigrant populations in the receiving country (Esses, Dovidio, Jackson, & Armstrong, 2001). Extreme nationalism and a sense of fear may encourage ideals of conformity that defines ‘successful integration’ or ‘successful resettlement’ as full adoption of the receiving country’s ways and beliefs while giving up old cultures and traditions. There is little or no support for the maintenance of cultural or linguistic differences, and groups’ rights may be violated. This belief can lead to misunderstandings when new United States residents speak, act, and believe differently than the dominant culture. It can result in an unwelcoming environment and prevent the development and offering of culturally and linguistically appropriate services for immigrant and refugee families, erecting barriers to their opportunity to adapt and thrive in their new homes. Assimilation may implicitly assume that some cultures and traits are inferior to the dominant White-European culture of the receiving nation and therefore should be abandoned for ways more sanctioned by that privileged group.
Acculturation and Adaptation
Later Milton Gordon’s newer multidimensional formulation of assimilation theory provided that ‘acculturation,’ which refers to one’s adoption of the majority’s cultural patterns, happens first and inevitably (1964). Contemporary acculturation models embrace some of the previous ideas of assimilation but can be less one-dimensional (Berry, 1990). At times, the terms assimilation and acculturation have been used interchangeably. John Berry employed the concept of acculturation and identified 4 modes: integration (where one accepts one’s old culture and accepts one’s new culture), assimilation (where one rejects one’s old culture and accepts one’s new culture), separation (where one accepts one’s old culture and rejects one’s new culture), and marginalization (where one rejects one’s old culture and also rejects one’s new culture) (Berry, 1990). This understanding of acculturation proposes that immigrants employ one of these four strategies by asking how it may benefit them to maintain their identity and/or maintain relationships with the dominant group, and does not assume that there is a typical one-dimensional trajectory they would follow.
While assimilation is applied to the post-migration experience generally, acculturation refers to the psychological or intrapersonal processes that immigrants experience (Berry, 1997). Hence, the concept of acculturative stress –linked to psychological models of stress (Lazarus & Folkman, 1984) arose to describe how incompatible behaviors, values, or patterns create difficulties for the acculturating individual (Berry, Kim, Minde, & Mok, 1987). Adaptation has been used in recent years to refer to internal and external psychological outcomes of acculturating individuals in their new context, such as a clear sense of personal identity, personal satisfaction in one’s cultural context, and an ability to cope with daily problems (Berry, 1997).
Much of the discourse concerning adaptation has focused on the socio-economic adaptation of immigrants as measured by English language proficiency, education, occupation, and income. When culture is included, the emphasis is typically on concepts of ethnic intermarriage and language proficiency (van Tubergen, 2006). Much less attention has been paid to how immigrants form attachments to their new society, subjective conceptions of ‘success’ in the new country, or to the factors that lead some immigrants to retain distinct characteristics and identities but adopt to new ways of being. Some have gone further to identify three types of adaptation: psychological, sociocultural, and economic (Berry, 1997).
Videos
Paul Orieny, Sr. Clinical Advisor for Mental Health, The Center for Victims of Torture (CVT), discusses the challenges of coping with the magnitude of change encountered during resettlement (0:00-4:28).
A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/humanbe/?p=133
True Thao, MSW, LICSW discusses cultural change and adaptations experienced by immigrants and refugees (1:43-2:40)
A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/humanbe/?p=133
Multiculturalism and Pluralism
Theories of assimilation, acculturation, and adaptation are all focused on the immigrant. This is not to say that these theories have not included the receiving society or the dominant group’s influence on the immigrant. However, a different way to conceptualize the post-migration experience may be by exploring how any society can support multicultural individuals both, United States-born and foreign-born, and how adjustments and accommodations are made by both the receiving culture and the immigrant culture to aid resettlement.
Critical Making Wikimedia Commons – CC BY-SA 4.0.
Multiculturalism and pluralism are often understood as the opposite of assimilation (Scholten, 2011), emphasizing a culturally open and neutral understanding of society. These ideas purport that diverse people need freedom to determine their method of resettlement and the degree to which they will integrate. A nation that embraces a multicultural view may promote the preservation of diverse ethnic identities, provide political representation, and protect rights of minority populations (Alba, 1999; Alexander, 2001). There are those, especially more liberally minded groups that support the idea that immigrant groups should not be judged according to their religion, skin color, ability or willingness to assimilate, language, or what is deemed culturally useful. Because multiculturalism acknowledges differences and responds to inequality in a society, critics charge that it is a form of ethnic or “racial particularism” that goes against the solidarity on which the United States democracy stands (Alexander, 2001, p. 238). Behind every policy are assumptions that implicitly or explicitly support a vast theoretical and ideological continuum. With the ebb and flow of immigration throughout the history of this country, some of these ideological positions have shifted, and also residuals of traditional nationalistic ideals remain.
Intersectionality Theory
The lessons learned from earlier conceptualizations of immigrant resettlement are 1) that an accurate understanding of resettlement is flexible, dynamic, and heterogeneous; 2) that resettlement itself is a synergistic process between the newcomer and the receiving society; and 3) that ultimately the knowledge of how resettlement is experienced is best understood from the standpoint of an immigrant. Thus in many ways, the discourse about immigrant experiences has shifted from an emphasis on group processes to individual processes. Contemporary scholars are beginning to explore the theory of intersectionality as a lens to understand immigrant identities and adaptation to receiving countries (Cole, 2009; Shields, 2008). Intersectionality theory allows for an understanding of the complex intersections of an individual’s identities shaped by the groups to which an individual belongs or to which s/he is perceived to belong, along with the interacting effects of an individual and the different contexts they are in. Intersectionality theory does not claim to be apolitical; it posits that an accurate understanding of the experiences of marginalization requires knowledge of broad historical, socio-political, cultural, and legal contexts. While theories of assimilation and acculturation tend to endorse integration – a stage in which an immigrant has successfully integrated their culture or origin and new culture (Sakamoto, 2007), intersectionality theory proposes that structural issues such as discrimination, migration policy, and disparity inaccessibility of resources based on language or nationality, affect an immigrant’s ability or desire to integrate.
Intersectionality is a feminist sociological theory developed by Kimberlé Crenshaw (1989), which posits that one, cannot truly arrive at an adequate understanding of a marginalized experience by merely adding the categories such as gender plus race, plus class, etc. Rather these identity categories must be examined as interdependent modes of oppression structures that are interactive and mutually reinforcing.
Intersectionality rests on three premises. First, it is believed that people live in a society that has multiple systems of social stratification. They are afforded resources and privileges depending on one’s location in this hierarchy (Berg, 2010). Social stratification can best be understood by accepting the premise that there are forms of social division in society that are based on identities or attributes, such as gender, race, nativity, class, etc. Within society, some of these social divisions are more valued than others, thus creating a hierarchy, or in cruder terms, a pecking order. These divisions and hierarchy are arbitrary in that they are socially constructed and have no essential meaning but have been established by those in power and maintained by society historically. Those deemed higher on the hierarchy and having more ‘status’ are provided with power and privileges and those deemed lower on the hierarchy are not (Anthias, 2001). Much research has been conducted on gender inequalities (Pollert 1996, Gottfried, 2000), ethnic inequalities (Modood et al., 1997) and class inequalities (Anthias & Yuval Davis, 2005; Bradley, 1996), providing evidence for the social constraints in the shape of sexism, racism, classism, etc.
The second premise on which intersectionality rests is that social stratification systems are interlocked. Every individual may hold different positions in different systems of stratification at the same time; there is not only variation among groups of people but within groups of people (Weber, 1998). The implications of this premise for immigrant populations are profound; individuals within immigrant communities may not have the same experiences adjusting to a new society given the varied positions they hold within different contexts based on their identities and attributes.
Within intersectionality theory, an individual has multiple intersecting identities. These identities are informed by group memberships such as gender, class, race, sexuality, ethnicity, ability, religion, nativity, gender identity, and more (Case, 2013). Intersecting identities place an individual at a particular social location. Individuals may have similar experiences with other individuals within one community, such as similar experiences to others of their nation of origin, but their experiences may also be quite different depending on other identities they hold.
For example, an immigrant is not only from Central American and female but is a Latina woman, two identities that when combined, create her unique experience.
There are pressures to conform to the expectations of each social group to which an individual belongs. Each cultural community has images, expectations, and norms associated with it. These ideas vary by culture and generation because they are constructed for that time, group, and purpose. Conformity to expectations of a social group has both tangible and intangible benefits (Cialdini, 2001), not the least of these is the benefit of affiliation (Cialdini & Trost 1998). There has been much research about conflict and dissonance that can arise from an individual’s pressure to identify with the larger social groups and contexts, and also reaffirm their identity within their family’s cultural group or the culture of their country of origin (Farver, Narang, & Bhadha, 2002; Phinney, Horenczyk, Liebkind, & Vedder, 2001; Rumbaut, 1994).
Adapted by Natalya D. From Morgan, K. P. (1996). Describing the Emporaro’s New Clothes: Three Myths of Education (In)Equality. In A. Diller (ed). The Gender Question in Education: Theory, Pedagogy & Politics. Boulder, CO: Westview. Image available at: sites.google.com/site/natalyadell/home/intersectionality.
The third premise of intersectionality is that where one is located within this complex social stratification system will consequently influence one’s worldview. This is logical given that each individual has different experiences depending on where they are located within the social stratification system (Demos & Lemelle, 2006). This speaks to one’s positionality – a person’s location across various axes of social group identities which are interrelated, interconnected, and intersecting. One’s position informs one’s unique standpoint. Furthermore, these identities may be external/visible, such as race and gender, or internal/invisible, such as sexuality or nativity, and carry privileges or limit choices depending upon one’s positionality. Thus one’s position and standpoint may be the most suitable way in which to frame and understand the discussion of immigrant resettlement. An example would be how research has indicated that skin color, often a physical feature that indicates identity, affects how immigrant experiences and adapts to their new society (Telzer & Garcia, 2009; Viruell-Fuentes, 2007).
The concept of intersectionality has been revolutionary in conceptualizing the lived experiences of people existing on the margins of society, a place where immigrants and refugees often find themselves existing. Specifically, intersectionality highlights ways in which “social divisions are constructed and intermeshed with one another in specific historical conditions to contribute to the oppression” of certain groups (Oleson, 2011, p. 134). Many hail the usefulness of intersectionality as a methodological tool that allows researchers to explore the interacting effects of multiple identities (Weldon, 2006). For example, research could examine ways that an immigrant may make decisions based on several important aspects of her/his identity such as race, gender, social class position, religion, and nationality.
This theory has been used to explore immigrants’ economic success, their experience of internalized classism, and their power and access to resources (Ali, Fall, & Hoffman, 2012; Cole, 2009). Intersectionality may be a unifying theory that illuminates the immigrant experience in a way that increases understanding of the role of the larger society, informs the efforts of each community, and provides a framework for policy.
David Fulmer – Picture this! Immigrant Children (at Ellis Island) – CC BY 2.0.
35.3 Family Theories: A New Direction for Research with Resettled Populations
The discourse about immigrant experiences has shifted over time from an emphasis on fairly simple group processes, such as a unidimensional model of assimilation from one culture to another, to complex individual processes, such as intersectionality. Processes that occur at the family level have been largely absent from this discussion.
As we have identified in this textbook, families play a key role in the goals, resources, coping processes, and choices of the resettlement process. Falicov (2005) described how family relationships and ethnic identity during resettlement are “not separate experiences, but they interact with and influence each other in adaptive or reactive ways” (p. 402). Parents, grandparents, siblings, and children all influence one another in their choices about what to retain from their original culture in individual and family life, as well as what to learn and adapt from the new culture. There are many theories within the family and social science fields that can address the complexities of immigrant families through the resettlement process. In this section, we identify several family theories and their application to immigrant families.
System Theory
General systems theory (Von Bertalanffy, 1950) assumes that a family must be understood as a whole. Each family is more than the sum of its parts; the family has characteristics, behavior patterns, and cycles beyond how individual family members might act on their own. Individual members and family subsystems are interdependent and have mutual influence. This theory assumes that studying one member is insufficient to understand the family system. In order to assess patterns of adjustment in immigrant families, we must look both at the structure of the family unit and the processes that occur within that family system. For example, one study collected data from both parents and children in Vietnamese and Cambodian immigrant families in order to assess the role of family processes in clashes over cultural values. The researchers found that cultural clashes were linked to parent-child conflict, which in turn was linked to reduced parent-child bonding, both of which increase adolescent behavioral problems (Choi, He, & Harachi, 2008). This demonstrates one family pattern related to resettlement that can only be understood at the family system level.
Previous frameworks (e.g., structural functionalism) assumed that families always sought to maintain homeostasis (or “stick to the status quo”). General systems theory was the first to address how change occurs within families by acknowledging that although families often seek to maintain homeostasis, they will also promote change away from homeostasis. Systems such as families also have tendencies towards change (morphogenesis) or stability (morphostasis) and for families resettling in a new country and making decisions on what to preserve and how to adapt, there is a balance of the two. Families are able to examine their own processes and to set deliberate goals. Change occurs as the family system acknowledges that a particular family pattern is dysfunctional and identifies new processes that support their goals. Resettlement is one example of a large change that a family system could choose or be forced to make.
Human Ecology Framework
The human ecology framework (Bronfenbrenner, 1979) assumes that families interact within multiple environments that mutually influence each other. These environments include the biophysical (personal variables), the microsystem (the systems in immediate surroundings, such as family, neighborhood, church, work, or school), the mesosystem (the ways these immediate systems connect, such as the relationships between family and work), the exosystem (the larger social system, such as the stress of another family member’s job), and the macrosystem (the cultural values and the larger social system, such as immigrant and immigration policy that influences admission and social system access). In the context of a refugee family, a family might be influenced by the biophysical (e.g., whether or not members were injured as they fled the persecution), their microsystem (e.g., parental conflict while fleeing), their mesosystem (e.g., teachers and school personnel who are struggling with their own trauma from fleeing conflict and thus their ability to provide robust services is impaired), the exosystem (e.g., local leaders who do not consult with women living in shelters regarding their resources needs and don’t provide feminine hygiene products or children’s toys), and countless other environments (examples adapted from Hoffman & Kruczek, 2011). The family may have access to and be able to directly influence the mesosystem and at the same time feel powerless to make changes in the exosystem. Each of these environments will contribute to their coping.
With its focus on interaction with multiple environments, s the human ecology framework is an incredibly useful lens to employ cross-cultural contexts such as when considering immigrant families. For example, a researcher could ask, “How do Hmong immigrant families manage financial resources in their new environment in the United States?” and “How did Hmong families manage their financial resources while still living in Laos?” The assumptions and central concepts of human ecology theory would apply equally in either culture. The needs, values, and environment would be sensitively identified within each culture (See Solheim & Yang, 2010).
Additionally, human ecology theory assumes that families are intentional in their decision-making, and that they work towards biological sustenance, economic maintenance, and psychosocial function. As patterns in the social environment are more and more threatening to the family’s quality of life in these three areas, the system will be more and more likely to seek change, possibly by a move to a new country. The family system has certain needs, including physical needs for resources and interpersonal needs for relationships. If their current situation is not meeting these needs, the family system will engage in management to meet these needs within their value system.
Fibonacci Blue – Minneapolis protest against Arizona immigrant law SB 1070. – CC BY 2.0.
Double ABC-X Stress Model
The double ABC-X model (McCubbin & Patterson, 1983) describes the impact of crises on a family. It states that the combination of stressors (A), the family’s resources (B), and the family’s definition of the event (C) will produce the family’s experience of a crisis (X). The family’s multiple environments inform each component of the model, consistent with the human ecology framework. The double ABC-X suggests that there are multiple paths of recovery following a crisis, and these paths will be determined by the family’s resources and coping processes, both personal and external.
This model is relevant to immigrant and refugee families, as all of these families go through a significant transition in the process of resettlement. Whether or not this transition, or the events that precipitate it, are interpreted as crises will depend on the family’s other stressors (such as employment, housing, and healthcare availability and family conflict), resources (such as socioeconomic resources, family support, and access to community resources), and family meaning making (such as cultural and family values surrounding the decision).
Resilience Framework
The family resilience framework (Walsh, 2003) highlights the ways families withstand and rebound from adversity. Families cope together through their shared belief systems (such as making meaning of their situation, promoting hope, and finding spiritual strength) and family organization (flexible structure, cohesion, and social and economic resources). This framework also draws from the Carter and McGoldrick (1999) family lifecycle model to describe how families transition through stages and major life events, with specific vulnerabilities and resilience factors at each stage. Research that uses the resilience framework with immigrant and refugee families can highlight families’ strengths and identify the ways they thrive through challenges. Chapter 8 is an excellent example of how this framework applies to immigrant and refugee families.
Ambiguous Loss Theory
The family theories listed above can apply broadly to immigrant and refugee families of all backgrounds. Many immigrant and refugee families have a shared background of loss and trauma, and there are family theories that specifically can address these contexts. Ambiguous loss theory (Boss, 2006) describes the ambiguity that immigrant families can feel when they are separated, when family members are physically absent but psychologically very present. This ambiguity and separation can lead to great distress (See Solheim, Zaid, & Ballard, 2015). For a greater description of this theory in immigrant and refugee families, please see Chapter 2 and Chapter 5.
Video
Sunny Chanthanouvong, Executive Director, Lao Assistance Center of Minnesota, discusses cultural differences and perspectives between Lao children and parents (0:00-2:28).
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35.4 Critical Theories
Critical theories offer an important contribution to the conceptualization of immigrant and refugee families. These theories assume that thought is mediated by power relationships, which are both socially and historically constructed (Kincheloe, McLaren, & Steinberg, 2011). They focus both on the individual’s experience and on how that experience developed through interactions with multiple environments (consistent with the human ecology framework; Chase, 2011; Olesen, 2011). Critical theories have emerged from a variety of disciplinary fields and with profound influence in the social sciences. Most prominently, feminist theory, queer theory, and critical race theory have challenged dominant discourses of social interactions. Researchers who operate from these critical approaches are committed to challenging constructed social divisions, and to acknowledging how structural mechanisms produce inequalities (Chase, 2011; McDowell & Shi Ruei, 2007; Olesen, 2011).
Critical theories are important lenses to employ in research with immigrant and refugee families specifically because they aim to amplify marginalized voices. Critical researchers actively look for the silent or subjugated voices, and seek to facilitate volume. Because immigrant and refugee groups are often marginalized within the new host culture, researchers can use critical research approaches to collaboratively advocate for these communities.
35.5 Cultural Values to Consider in Resettlement Research
Family theories hold promise for assessing the complex web of factors that influence family resettlement processes. As students, researchers, and/or clinicians, we must consider the values represented by the theories we choose to use. We offer several considerations as you evaluate potential theories.
In general, past and current ideas about the resettlement process place great responsibility for resettlement on the immigrants and their families. These ideas are grounded in the viewpoint that because these individuals and families choose to migrate, often to improve their life prospects, they should be held accountable for their success. However, underlying this viewpoint is a cultural bias towards personal responsibility and self-reliance. Although sometimes well-meaning, it can be at odds with different beliefs and practices held by immigrant communities. The bias towards personal responsibility and self-reliance is rooted in ideals of meritocracy that is widely accepted in the (commonly labeled) individualistic United States society. Meritocracy assumes that success and material possession results from an individual’s hard work and initiative within a fair and just society, and thus all privilege is attributed to one’s own hard work (Case, 2013). The argument against placing some responsibility on the larger society for the successful resettlement of immigrants emerges from the possible cultural incompatibility with this individualistic, capitalistic way of life. Most immigrant families arrive with hopes for achieving a better life and are prepared to continue to make sacrifices and work hard to do so. However, adapting to a new context with no frame of reference, little ability to communicate, and scarce resources may be a daunting task without external help.
Ludovic Bertron – Ellis Island – CC BY 2.0.
Immigrants have described their experiences of loss and disruption, which is magnified when they are visible minorities in their receiving country (Abbott, Wong, Williams, Au, & Young, 2005). In-depth studies with immigrant men and women reported that almost all initial interactions they had with members of the dominant group were experienced as condescending with messages of superiority and discrimination (Muwanguzi & Musambira, 2012). One very direct way that local community receptions and perceptions can negatively impact resettlement experiences for immigrants is parent-school involvement and immigrant children’s scholastic achievement. Studies have consistently shown that parent school involvement for immigrant families has been low (Kao, 1995, 2004; Nord & Griffin, 1999; Turney & Kao, 2009). Kwon (2006) found that Korean immigrant mothers felt disempowered in their role and involvement with the school system, specifically related to their identity, cultural differences, and English skills. Focusing solely on conventional ways of parental involvement can overlook and underestimate immigrant parent strengths and efforts to support their children academically (Tiwana, 2012). In sum, the assumptions and expectations from commonly held values, when not critically analyzed, can act as barriers to immigrant families’ abilities to thrive in a new society.
Videos
True Thao, MSW, LICSW describes best practices for working with immigrant and refugee families (0:00-1:44).
A YouTube element has been excluded from this version of the text. You can view it online here: http://pb.libretexts.org/humanbe/?p=133
True Thao discusses children’s and parents’ perspectives on migration and culture (0:00-2:42).
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35.6 Future Directions
It is crucial that researchers use a theoretical framework that appropriately positions immigrant individuals and families within a “historical, political and socioeconomic context that accounts for their experiences” when supporting these populations (Domenech-Rodriguez & Wieling, 2004, p. 8). Interventionists, policymakers, and researchers must adopt a multidimensional approach to understanding resettlement processes. There are contraindications for applying generalizations to diverse groups and research is limited when it focuses on outcomes that may be myopic. Exploring the multiple intersecting identities of each individual and the engendering experiences of oppression is one way to move beyond a one-dimensional understanding of an immigrant’s experience. Additionally, utilizing a family lens to assess the impact of family resettlement is another important step in developing a comprehensive understanding of immigrant and refugee communities. Moreover, prevention and intervention programs designed to address longstanding health, economic, and social disparities within these families cannot be effectively implemented without careful consideration of the family and the complexities of their resettlement experiences.
35.7 End-of-Chapter
Immigrant resettlement is a complex topic, requiring the consideration of historical perspectives of intergroup relations, the interactive and non-linear nature of acculturation, the contextual elements of a state’s and nation’s socio-eco-political situations, and a deep introspection of the philosophies guiding our stance. Research continues to lack a clear understanding of resettlement efforts, particularly the processes within families. Creativity and flexibility is needed to reach a level of sophistication in our research and intervention to meet the needs of the increasingly diverse population in the United States. Intersectionality and family theories offer useful lenses for studying and understanding complex immigrant experiences; they can also inform practical strategies and policies to support successful immigrant resettlement.
Case Study
Nadia moved to the United States to get her BA in Psychology 12 years ago. When she met her partner (Adbul) in college, it was an easy decision to get married and apply for her citizenship. She was raised in Indonesia, while her husband was a second-generation immigrant from Saudi Arabia and shared her religious faith as a Muslim. Despite their shared faith, her husband’s family had initially expressed concern, and some even overtly expressing displeasure of his choice to marry her. After they were married, she continued to feel the pressure to meet certain expectations from her new family, which felt incongruent with her own culture and self. The one thing that seemed particularly important to her parents-in-law was that she begin wearing the hijab (traditional Muslim head covering). She had never been opposed to the idea and thus chose to wear it. After starting to wear the hijab, she noticed a positive change in the way people in her and Abdul’s religious community treated her. She felt more accepted and respected. She often reflects on how different her parents had raised her from her husband’s parents; back in Indonesia, her parents were not particularly wealthy, she remembered growing up alongside peers from different ethnicities and religions, and they practiced their religion with less restriction from both outside their religious group and within. Abdul, while raised in the United States seemed to be less open to making connections and forging relationships with others outside of his parent’s religious community. He often asked how he could be more accepting when others were not accepting of him.
Within the academic setting, Nadia felt confident in how well she was able to ‘adapt’ to the learning community. She spoke English well as her second language and presented in a very professional way. She was told by her faculty advisor, after deciding to start wearing a hijab that she would ‘have it easier’ if she did not. She graduated with a masters in Nursing and began to apply for jobs. She was offered many jobs but chose to accept one in a hospital in Oklahoma because it was the only job in the specialization that she wanted to pursue and also was somewhat relieved to be able to build her life with her husband on their own. Abdul was not particularly happy to move away from his family especially when he heard one of his cousins comment about how ‘small’ of a man he was to follow his wife around while she worked on her career, but similarly, he felt that forging a life away from his family may have some value. Additionally, he worked in a large tech company with branches nationwide and could transfer to the office in Tulsa.
Nadia and Abdul moved into their lovely new home in a suburb. She had felt eyes on her as they were unloading the moving truck and decided to walk over to her new neighbors to introduce herself. She convinced Abdul that this would be a good idea. No one answered the first door she knocked even though she was sure she remembered seeing them come home. Her other neighbor was very pleasant however she noticed that she made efforts to avoid eye contact with her and her husband.
Nadia was shocked at one her first experiences while training at her new job when a patient exclaimed loudly to their family after she left their room that it was a shame that the hospital employed a person ‘like that’. Additionally, almost all of her coworkers didn’t ever seem to want to have lunch with her. Abdul also was taken aback when upon presenting for his first workday his immediate supervisor asked him to list out all his qualifications and training when this seemed strange for a job transfer. Nadia began to fear whether relocating was the right choice.
When asked about her resettlement as an immigrant, Nadia would explain it as a complex journey, where her identities as woman, person of color, and foreign-born individual, including her religious affiliation, were integral. How Nadia is perceived, and what expectations are placed on her within the different spheres of her life contributes to how she would continue to construct her own identity and then choose to interact with these external contexts. Her family’s values of openness and flexibility that have allowed her to interact successfully in her academic context may be at odds with her partner’s strong boundaries with others and her experiences in her new milieu. She may not talk about acculturating or it being a progression towards assimilation, and in various relationships and contexts in her life, she may not even have similar goals for integrating. It may make sense to her to think about intersections, both of her identities and how her identities intersect with her partners’ identities and the different contexts she is in. Getting the sense that her neighbor felt some discomfort interacting with her as an immigrant woman of color, with an accent, wearing a hijab, and in a marriage relationship with a Muslim man, (albeit based on possible erroneous assumptions) is Nadia’s unique experience because of the identities that she appears and/or does inhabit. Thus in discussing resettlement as a social, familial, and individual process, Nadia’s resettlement is informed by these complex experiences.
Discussion Questions
1. How have ideas about immigrant resettlement shifted through the years?
2. How could the use of a family theory in future research add to our understanding of resettlement?
3. Using the ABC-X model, identify the stressors, resources, and definition of the problem associated with Nadia and Abdul’s move to Oklahoma. Do you think they would consider it a crisis?
4. What about Nadia’s story would stand out to you if you looked at it from the systems lens? From an assimilation lens? From an intersectionality lens?
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Attribution
Adapted from Chapters 1 through 9 from Immigrant and Refugee Families, 2nd Ed. by Jaime Ballard, Elizabeth Wieling, Catherine Solheim, and Lekie Dwanyen under the Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted. | textbooks/socialsci/Social_Work_and_Human_Services/Human_Behavior_and_the_Social_Environment_II_(Payne)/09%3A_Global_Perspectives_and_Theories/33%3A_Embracing_a_New_Home-_Resettlement_Research_and_the_Family.txt |
The History of Social Work in the United States
The inception of the social work profession in the United States can be traced back to the late 1800’s beginning with charity work performed by local churches and communities seeing to meet the needs of the poor. Some of the earliest social work interventions were designed to meet basic human needs of populations and placed great value in providing support, assistance, and resources to families and communities in an attempt to alleviate suffering (Nsonwu, Casey, Cook & Armendariz, 2013). The profession now known as social work ultimately began as a result of a practice originally known as “helping” others to improve the well being of individuals, families, and communities. Throughout the years the social work profession played vital roles in the facilitation of social changes aimed at diminishing inequalities among various populations. Through the practice of “helping,” social workers were able to address many social problems that plagued vulnerable populations through facilitating, advocating, and influencing individuals, communities, politicians, and law makers (Langer & Leitz, 2014).
Video: Legacies of Social Change (https://vimeo.com/104132906).
Throughout the progressive movement era, many social workers emerged and were identified as key players known to have advanced the profession. These individuals came to be known as pioneers of the social work profession as their careers were devoted to improving the well being of individuals, families, and communities. In an effort to help conceptualize the social work profession, we will look closer at the origin of the social practice, as well as discuss a few pioneers and their contributions to the social work profession (Hansan, 2013).
In the early 20th century, Robert Hunter’s book Poverty was published. Hunter’s book placed a spotlight on America’s poor and challenged society’s long held belief that poverty signified moral failure (Hansan, 2013). Hunter’s book demonstrated a critical need to implement specific social measures in order to prevent the destruction of the working class population on the verge of poverty. Hunter additionally identified conditions known to breed poverty calling into question the need but also the tolerance for these unjust conditions particularly by a professed Christian population (Hunter, 1904).
Another known pioneer of the social work profession is Mary Richmond. Throughout her career, Richmond searched for answers surrounding the reasons and causes of poverty while also examining the interactions between individuals and their environments. Richmond believed that interventions and treatment approaches needed to be focused on the person within their environment. As a result of this belief, Richmond developed the circle diagram as a way to help her clients identify sources of power available to them within their own environment. One of Richmond’s biggest contributions to the social work profession was her book Social Diagnosis which was published in 1917. Richmond’s book focused on the practice of casework with individuals and was the first book to identify a systematic and methodological way to document and diagnose clients (Social Welfare History Project, 2011).
Jane Addams is another well-known pioneer to the social work profession. Addams, along with Ellen Gates Starr, founded Hull-House in 1889. Hull-House was a successful settlement house located in an area of Chicago that was largely populated by immigrants. Residents of Hull-House were provided with multiple services which included daycare and kindergarten facilities for the children of the residents. Throughout her career Addams’ continued to contribute to the social work profession by advocating for the rights and well-being of women and children on several important issues, one of those issues being the implementation of child labor laws (Hansan, 2010).
Jane Hoey’s career as a social worker began in 1916 when she was appointed as the Assistant Secretary of the Board of Child Welfare in New York City. Throughout the course of her career she would work in multiple social welfare agencies: serving as the Director of Field Service for the Atlanta Division of the American Red Cross, the Secretary of the Bronx Committee of the New York TB and Health Association, the Director of the Welfare Council of New York City, and ultimately as the Director of the Bureau of Public Assistance. Hoey is best known for her role in the enactment of the Social Security Public Assistance Act which became law in 1935. Following the law’s enactment, Hoey became the Director of the Bureau of Public Assistance within the Social Security Administration and was responsible for organizing and implementing the distribution of the public welfare provisions (Social Welfare History Project, 2011).
Additional Reading Material
Mary Richmond’s Social Diagnosis
https://archive.org/details/socialdiagnosis00richiala
Robert Hunter’s Poverty
https://archive.org/details/povertypoor00huntuoft
Social Work: What is it?
For over a century the answer to this question has been not only varied but also debated among members of the general public as well as in the professional social work community. The definition of “social work” may not be as clear as one may think when attempting to understand the meaning of social work. Embedded within these definitions of “social work” are common themes which can help to conceptualize social work. Although there are many varying definitions used to describe social work, what matters the most is the purpose of social work and what guides and directs social work practice. According to the Council on Social Work Education (CSWE), the purpose of the social work profession is to “promote human and community well-being”; which can be achieved through promoting social and economic justice and preventing conditions that limit human rights for all people.
Even after defining social work and identifying the purpose of the social work profession, there continues to be some misalignment among the profession with the overall mission of social work. This is not surprising considering the increasingly diverse populations being served by the profession. What is becoming increasing clear as the diversity of client systems continues to expand, is the critical importance of professional competence in order to meet the unique needs of individuals as well as emerging social issues. In an effort to better prepare new social workers to respond to these new challenges and social issues, the CSWE adopted a competency-based education framework, Educational Policy and Accreditation Standards, which gives students the opportunity to demonstrate and integrate social work knowledge and skills in various practice settings. More than ever social work requires a broad knowledge base in order to effectively meet the needs of others but also to help clients find hope in the process. Finding hope is essential to the social work practice as hope helps to empower diverse populations facing unique challenges (Clark & Hoffler, 2014).
The feelings associated with a sense of hope are considered to be fundamental to the social work practice. Hope is essential to social work as it allows those facing challenges to believe in a positive outcome and hope can play a major role in how the challenges/circumstances are viewed. A sense of hope is as essential to clients as it is for social workers who are helping clients. Social workers struggling to feel hope may communicate this verbally and non-verbally in their approach with their clients, ultimately impacting the effectiveness of the intervention. This is one of several reasons individuals wishing to pursue a career in social work should explore their personal values, overall worldview, beliefs, abilities, skills, and priorities as well as personal and career goals. This type of exploration is essential to determining whether or not a career in the social work field will be a good fit. In addition, individuals should also consider the demands, stressors, and challenges common to the social work practice giving serious consideration to whether helping the most vulnerable populations will negatively impact their own physical and/or mental health and overall quality of life (Sheafor, Horejsi, & Horejsi, 2000).
Additional Activities:
When in Doubt, Give Hope. (Speech starts at 2:20)
Allison Brunner a newly graduated MSW talks about her anxieties and doubts that recent graduates feel with their professional responsibility to hold hope for their clients. She describes her own doubts as a social worker, relates those to her personal moments of doubt and shares how she drew from those experiences to help her client. Using our experiences to benefit our clients rather than ourselves, is what we call “professional use of self.” And as Carl Rogers demonstrated many years ago, bringing our genuine self to the clinical relationship is one of the most important things we can do to help our clients.
Retrieved from: http://www.socialworkpodcast.com/GraduationSpeech2009.mp3
Bachelors of Social Work (BSW) versus Masters of Social Work (MSW)
According to the Bureau of Labor Statistics, the minimum pre-requisite needed to gain employment in the social work profession is a Bachelor’s Degree in Social Work (BSW). However, those with specific career goals may be required to obtain a higher level of education. Therefore, some may wish to pursue a Master’s Degree in Social Work (MSW).
Social workers may serve in all of these different roles in varying degrees at any time in their career.
There are some similarities between the two degrees which include the expectation that both BSW and MSW students complete supervised field placements within a social service type agency. The requirements related to the length of placement, expected tasks, and/or hours may vary based on degree. Common social service agency placements for both BSW and MSW students include places such as hospitals, schools, or mental health or substance abuse clinics. In addition to this requirement, both BSW and MSW graduates must be granted a license in the state they wish to practice. Licensure for an MSW requires a minimum of 2 years of supervised clinical experience following graduation and a passing score on the Association of Social Work Boards (ASWB) licensing examination.
There are several key differences between BSW and MSW degrees. One of the first differences is the pre-requisite for entrance into the programs. Typically the only requirement needed to enter into an accredited BSW program at a college or university is that the candidate has declared social work as their major. This differs from an MSW program as MSW candidates apply for entrance into the program after already having obtained a Bachelor’s Degree in which the graduate has likely earned credits in coursework areas related to psychology and sociology.
Another difference is the coursework required based on the desired degree. The Council on Social Work Education (CSWE), which accredits U.S. social work programs, designates BSW undergraduate programs teach students about diverse populations, human behavior, social welfare policy, and ethics in social work. Additionally, students are required to complete a supervised field placement at a social service agency. Baccalaureate social workers have the ability to obtain specialty certification in certain areas through their state chapter of the National Association of Social Workers (NASW), which offers specialty certification available in child, youth and family social work, gerontology, casework, and hospice, and palliative care. Master’s degree programs focus on developing clinical assessment and management skills and prepare students for work in a more targeted areas depending on the student’s interest.
The other important differences between the two degrees involves the type of employment each degree holder is eligible for and the earning potential based on the degree. MSW graduates typically earn a significantly higher salaries than BSW graduates. Individuals with a BSW degree tend to be employed in entry level jobs as caseworkers and are expected to provide direct services to clients through assessing, coordinating, and referring to area resources. The Michigan Board of Social Workers outlines the scope of practice/expected duties for social workers based on education and designated practice area (see chart below).
MSW graduates are often employed in clinical settings such as a hospital or a private practice setting and also in various administrative positions. MSW graduates can obtain either a Macro or Clinical license. The scope of practice differs depending on the type of MSW license. According to the National Association of Social Workers (NASW), a licensed Master Social Worker with macro designation can expect to be involved in administration, management, and supervision of human service organizations and perform functions that seek to improve the overall population’s quality of life through a policy/administrative perspective. These tasks range from collaboration, coordination, mediation, and consultation within organizations and/or communities, community organizing and development, research and evaluation, and advocacy/social justice work through involvement in the legislative process. A licensed Master Social Worker with a clinical designation (micro) typically work directly with individuals, families, and/or groups in an effort to improve the client’s overall quality of life. Social workers can expect to perform the following tasks/functions: advocating for care, protecting the vulnerable, providing psychotherapy as defined as “assessment, diagnosis, or treatment of mental, emotional, or behavioral disorders, conditions, addictions, or other biopsychosocial problems.”
Social Work Scope of Practice, created by the Michigan Department of Licensing and Regulatory Affairs (LARA). For a pdf of this chart, please see: www.michigan.gov/documents/mdch/mdch_sw_swgridforscopeofpractice_216194_7.pdf
What is a client? What’s in a name?
It is important that the social work profession accurately define and describe the relationship that exists between those who receive services and those who provide services (social workers). Over the years many terms have been used to describe the service-recipient relationship. Many of these terms have been scrutinized as failing to accurately describe the relationship that exists between the social worker and the service recipient. McLaughlin (2008) identified four terms commonly used to describe the social worker-service user relationship as patients, consumers, and service users. It is important to explore the language used to conceptualize this relationship because the social work profession seeks to empower the most disadvantaged and vulnerable of the population the language we use matters.
Client is the most widely used term used to describe the social work relationship.
The meaning and implications of the term “client” have been questioned as it gives the impression that the social worker is in a position of power over the client. In this instance a client would be viewed as someone who needs help but does not have the ability to help themselves, due to some deficiency either a lack of skills or ability, and therefore requires the knowledge of a social worker (McLaughlin, 2008).
The term “consumer” has been used to describe the relationship of those who use services the state offers. The meaning and implications of using the term “consumer” suggests that those receiving services has options and choices and the social worker is acting as a manager or a monitor of services and/or resources (McLaughlin, 2008).
The term “service user” has also been used in various social work settings. However “service user” may not be appropriate for use in all types of social work practice. For example social workers working in the arena of children’s protective services are mandated to respond to child abuse and neglect based on agency and state law. In this situation the service user would most likely object to the social worker’s response, therefore the service user would not be officially involved in the decision making process. Over the years social workers have been given a major role in the assessment of needs and risks over client groups and this role is often associated with a policing or surveillance role. In this way the relationship that exists between the client and social worker may get confusing and ambiguous (McLaughlin, 2008).
Common Roles of Social Workers
Over the course of their career, a social worker at any one time may perform multiple roles to varying degrees. The difficulty for many social workers is that over time the roles that involve direct case work have lessened; often social workers will find themselves in a position that involves little client involvement. One of the most difficult situations social workers will experience in their careers is the conflict they face while fulfilling some of the following roles often expected of a social worker at one time.
Broker
A social worker acting as a broker assists and links people with services or resources. In this role social workers assess the needs of the individual while also taking into account the client’s overall capacity and motivation to use available resources. Once the needs are assessed and potential services identified, the broker assists the client in choosing the most appropriate service option. The social worker as a broker role is also concerned with the quality, quantity, and accessibility of services. This role is expected to be up-to-date on current services and programs available, as well as familiar with the process for accessing those resources and programs (Zastrow, 2016).
Case Manager
A social worker acting as a case manager identifies the needs as well as the barriers of their clients. Occasionally case managers may also provide direct service to their clients. Case managers often engage with clients who require multiple services from a variety of agencies and work with the client to develop goals and implement interventions based on the identified goals. Social workers acting as case managers remain actively engaged with clients throughout the process by identifying and coordinating services, monitoring identified services and providing support when necessary, and finally providing follow-ups to ensure services are being utilized (Zastrow, 2016).
Advocate
A social worker as an advocate seeks to protect client’s rights and ensure access and utilization of services they are entitled to receive. Social workers may perform advocacy work by advocating for a single client or by representing groups of clients with a common problem or identified need. Social workers may advocate with other organizations/providers and encourage their clients to advocate for themselves in order to address a need or obtain a service. Advocacy is an integral and fundamental role in the social work profession as it is necessary to promote overall wellbeing. The National Association of Social Workers (NASW) (2015) “has specified social workers’ responsibility to the community and broader society since its adoption in 1960, and in 1996, strengthened its call to require all social workers to “engage in social and political action” to “expand choice and opportunity” and “equity and social justice for all people” (p. 27). Social workers acting in this capacity may advocate in varying capacities but often times may find themselves in a position of educating the public in order to garner support to seek changes in laws that are harming and impacting the wellbeing of clients. Social workers acting as advocates should always consider whether they are acting and advocating in a way that maximizes client self-determination (Zastrow, 2016).
Educator
Social workers acting as a teacher or educator often help in times of crisis for many clients. In this role social workers help clients develop insight into their behaviors through providing education aimed at helping clients learn skills to handle difficult situations and identify alternative life choices. In this role social workers aim to increase their client’s knowledge of various skills some of which include: budgeting, parenting, effective communication, and/or violence prevention (Zastrow, 2016).
Counselor
A social worker acting as a counselor helps clients express their needs, clarify their problems, explore resolution strategies, and applies intervention strategies to develop and expand the capacities of clients to deal with their problems more effectively. A key function of this role is to empower people by affirming their personal strengths and their capacities to deal with their problems more effectively (Zastrow, 2016).
Risk Assessor
Social workers acting as risk assessors have been given a major role in the assessment of needs and risks over a variety of client groups. Assessment is a primary role for social workers and often times is what dictates the services and resources identified as needs for clients. Often time’s social workers acting in this role find themselves in precarious situations as the relationship between the client and social worker may be conflicting, especially when working in the mental health field. While working as a risk assessor in the mental health field the social worker may experience conflict between encouraging client self-determination and addressing safety risks.
Mediator
It is common that social workers act as mediators and negotiators as conflict is the root of many areas of social work. Social workers acting in these roles are required to take a neutral stance in order to find compromises between divided parties. In this role social workers seek to empower the parties to arrive and their own solutions in order to reconcile differences and reach a mutually satisfying agreement (Stoesen, 2006).
R esearcher
A social worker in the role of researcher or program evaluator uses their practice experience to inform future research. The social worker is aware of current research and able to integrate their knowledge with the current research. Social workers acting in this capacity are able to utilize the knowledge they have obtained through gathering and examining the research to inform their practice interventions (Grinnell & Unrau, 2010).
Group Leader
Social workers who play the role of group leader or facilitator can do so with groups of people gathering for purposes including; task groups, psychoeducational groups, counseling groups, and psychotherapy groups. Task groups are like the name infers task oriented and social workers facilitate that process by understanding group dynamics. Psychoeducational groups are led by social workers who focus on developing members’ cognitive, affective, and behavioral skills in an area group members are deficient through integrating and providing factual information to participants. Social workers who facilitate counseling groups help participants resolve problems in various areas that can include: personal, social, educational, or career concerns. In psychotherapy groups social worker address psychological and interpersonal problems that are negatively impacting member’s lives (Corey, Corey, & Corey, 2014).
Additional Suggested Readings
Kerson, T. S., & McCoyd, J. (2013). In response to need: An analysis of social work roles over time. Social work, 58(4), 333-343. doi: 10.1093/sw/swt035
Gibelman, Margaret (1999). The search for identity: defining social work – past, present, future. Social Work, 44(4), 298-310. doi: 10.1093/sw/44.4.298
Characteristics and Skills of Effective Social Workers
Much like the definition of the term “social work,” the characteristics and skills required to become an effective social worker are also hard to define and require versatility in this complex and constantly changing environment. Competent and effective social workers are expected to have knowledge in varying intervention strategies and skills in order to enhance functioning and empower others. Effective social workers also must be willing to consider the needs of those being served when designing interventions seeking to enhance the wellbeing of others. In doing so many social workers may adopt specific roles or a combination of roles in order to effectively and efficiently meet the identified need(s). Some common elements and skills have been identified as effective across micro and macro practice settings. It is important to remember that when we are discussing effective social workers it is not just about what they do, it is also about how they do it (Sheafor, Horejsi & Horejsi, 2000).
Self-Awareness
One of the most important skills necessary for becoming a competent and effective social worker is self-awareness. Self-awareness starts with getting to know yourself and requires clarifying one’s own values and assumptions. Every day we are learning and changing as a result of our experiences, therefore self-awareness is a lifelong process that cannot be acquired through education and readings alone. This process requires understanding of past experiences and reflecting on the impacts of those experiences in relation to your world view and view of yourself. People who practice self-awareness can recognize, understand, and regulate their emotions. Self-awareness allows individuals to maximize their strengths by acknowledging their weaknesses. By recognizing areas of both strength and weakness, self-aware people can take proactive steps to manage their weakness and avoid setbacks (Sheafor, Horejsi & Horejsi, 2000).
Competence
Competence is essential in the social work world as there are numerous treatment approaches and intervention strategies available for clients. That being said, it is impossible for a social worker to be competent in every intervention strategy or treatment option. Social workers are expected to be knowledgeable in areas and intervention strategies they will be utilizing with their clients. According to Sheafor, Horejsi, and Horejsi (2000), generalist practice social workers need to be prepared to treat a diverse population of clients, which requires knowledge in a variety of assessment and intervention techniques.
Effective social workers can identify personal values, political beliefs and assumptions but also are willing to develop knowledge of other cultures through formal education and interaction. Professional development allows social workers to develop skills that will enable them to implement successful interventions. Cultural competence is also an area that should be considered when determining effectiveness. All social workers should continually seek cultural knowledge; through education and direct interaction. Culture is an area that is constantly changing and social workers should be prepared to engage in life-long learning in order to seek competence.
Empathy
One of the most critical elements is the relationship between the social worker and the client. Specifically whether or not the client feels the social worker is genuine, supportive and empathetic towards them. A sense of empathy from the social worker increases the chances of building a therapeutic relationship with the client. Because of this, ability to empathize is essential for social workers. Dr. Brown (2013) suggests that empathy is the best way to ease someone’s pain and suffering and is the skill that fuels connections. Empathy is a choice that requires individuals to acknowledge their own vulnerabilities which is often why the ability to empathize is considered a difficult skill to develop.
Critical thinking
The ability to critically think is crucial to the social work profession. Social workers use critical thinking skills on a daily basis to problem solve issues. Critical thinking skills include the ability to ask thoughtful and appropriate questions aimed at empowering others to find their own solutions. It is by applying critical thinking skills that social workers are able to make accurate observations, evaluate client abilities/limitation and/or agencies abilities/limitations. Critical thinking skills can also help social workers generate possible solutions and identify appropriate interventions to implement based of their critical evaluation of the issues and known barriers. Critical thinking skills also aid in the social worker’s ability to examine and evaluate the effectiveness of the interventions (Sheafor, Horejsi & Horejsi, 2000).
Communication skills
Communication in the social work profession encompasses a wide-range of activities beyond the ability to communicate effectively with their clients and other professionals. Determining the best approach to utilize when communicating with clients and other professionals will require the use of critical thinking skills. Many social workers are often working in the role of helping others who are seeking to make changes. Therefore, effective social workers will use a combination of different strategies to help move clients towards change. Social workers with effective communication skills avoid directly telling other’s what to do and rely heavily of their ability to communicate in order to empower clients to identify their own solutions. Developing and utilizing effective communication skills help clients establish trust and promotes rapport building between the social worker and the client which increases the chances of a successful intervention.
It is important to understand that effective communication skills go beyond one’s ability to communicate verbally and includes the ability to communicate through written reports as well as non-verbally while displaying active listening skills. Effective non-verbal communication requires the social worker to portray and display an empathetic, non-judgmental attitude when listening and engaging with clients. Effective written communication skills include the ability to communicate concisely, professionally, and honestly in various written formats as there are multiple mediums in which a social worker must be able to communicate. Because of this, competency in using word processors, email systems, spreadsheets, databases and knowledge of grammar and spelling are an important communication skill. These tasks may seem simple and appear obvious, however may prove challenging. Over time communication skills can be learned with practice, regular reflection, and self-assessment (Sheafor, Horejsi & Horejsi, 2000).
Additional readings
D’Aprix, A. S., Dunlap, K. M., Abel, E., & Edwards, R. L. (2004). Goodness of fit: Career goals of MSW students and the aims of the social work profession in the United States. Social Work Education, 23(3), 265-280. dx.doi.org/10.1080/0261547042000224029
S upplemental Activities
Brené Brown’s TED Talk: The Power of Vulnerability
https://www.ted.com/talks/brene_brown_on_vulnerability
Brené Brown on Empathy (2:53)
https://youtu.be/1Evwgu369Jw
Challenges Ahead
Rothman and Mizrahi (2014) identified a need to rectify an imbalance that exists between micro and macro social work practice to not only strengthen the profession, but to overcome the multitude of problems facing society. Historically the social work profession has addressed the needs of the population with a dual approach, encompasses both macro and micro practice social workers to achieve social progress. This approach requires involvement from social workers at every level of practice to bring about social reform as well as meet the needs of individuals and families.
Currently, the American Academy of Social Work and Social Welfare (AASWSW) is pioneering an innovative approach to achieving social progress powered by science called “The Grand Challenges of Social Work.” The AASWSW identifies 12 challenges and major social problems impacting today’s society. Today’s social workers will need to address and implement effective approaches known to improve individual and family wellbeing in order to begin strengthening the social fabric of America.
The 12 challenges are as follows:
The challenge to ensure healthy development for all youth: The AASWSW has identified the need to prevent behavioral health problems emerging in over six million young people yearly. Evidence has identified several effective prevention based approaches to address the severe mental, emotional, and behavior problems affecting today’s youth.
The challenge to close the health gap: More than 60 million Americans have inadequate access to basic health care. Even more disturbing – the majority of people with inadequate access also experience discrimination and poverty. There is an extreme need to develop new strategies targeted at improving the health of our society.
The challenge to stop family violence: Assaults by parents, partners, and adult children are common American tragedies that often result in serious injury, including death. This type of violence impacts society through various arenas. Effective intervention strategies have been identified and if implemented could help break the cycle of violence for many families.
The challenge to advance long and productive lives: Through identifying and engaging individuals with healthy and productive activities, overall health and well-being can be improved.
The challenge to eradicate social isolation: Social workers can help with this challenge by educating the public about the impacts of social isolation as well as, promote effective ways to make social connections.
The challenge to end homelessness: Over 1.5 million American’s experience homelessness at least one night a year. Homelessness affects health and well-being and often has lasting impacts on personal development. The challenge will be to implement and expand on proven approaches as well as, implement policies that promote affordable housing.
The challenge to create social responses to a changing environment: Climate change and urban development exacerbate the already existing social and environmental inequalities of marginalized communities. The challenge will be to develop improved social responses based on this knowledge as well as, helping those impacted by the changing environment through developing policies specific to helping those in need.
The challenge to harness technology for social good: A unique opportunity to access and target various populations and social problems exists because of advances to technology. The challenge will be for social workers to find ways to use technology to not only access knowledge, but to gain expertise for the advancement of the social work profession.
The challenge to promote “smart decarceration”: With the United States having the world’s largest percentage of its population behind bars this could prove to truly be a grand challenge. “Smart Decarceration” calls for a reduction in the number of people imprisoned, as well as the willingness of a nation to embrace a new and proactive way of addressing safety.
The challenge to reduce extreme inequality: One out of every five children live in poverty, while the top 1% owns almost half of the wealth in the U.S. Poor health outcomes and decreased overall well-being have been documented results of living in poverty. Inequality can be reduced through increased access to education, wages, tax benefits, and/or home ownership. Social workers should seek to adopt policies that promote equality.
The challenge to build financial capability for all: Nearly half of all American households are financially insecure, which means they do not have adequate savings to meet their basic living expense for three months. By adopting policies that support security in retirement accounts as well as, access to financial services that provide for financial literacy there can be a significant reduction in the economic hardships faced by families.
The challenge toachieve equal opportunity and justice: Historic and current prejudice and injustice in the United States impacts several groups of people by impeding and excluding access to education and employment. In order to overcome this challenge social workers must embrace and appreciate diversity and begin shedding light onto unfair practices.
Additional Reading/ Activities
Bent-Goodley, T.B. (2017). Readying the profession for changing times. Social Work, 62(2), 101-103. doi: 10.1093/sw/swx014
Singer, J. B. (Producer). (2016, March 28). #103 – The Grand Challenges for Social Work: Interview with Dr. Richard P. Barth [Audio Podcast]. Social Work Podcast. Retrieved from http://www.socialworkpodcast.com/2016/03/grand-challenges.html
Activities for Chapter One
Activity #1
25 questions to help you get to know yourself
http://www.mistysansom.com/know-who-you-are-with-these-25-questions
• What does your ideal day look like?
• What did you want to be when you were younger?
• Who are you most inspired by? Why?
• Who would you love to meet? What would you ask?
• What habit would you most like to break? What habit would you most like to start?
• Think of a person you truly admire. What qualities do you like about that person?
• How do you like to relax?
• When was the last time you did something you were afraid of?
• What are you most proud of?
• What are you most afraid of?
• If life stopped today, what would you regret not doing?
• Who would you like to connect (or reconnect) with? Why?
• What qualities do you admire in others?
• What practical skills do you wish you had?
• Imagine you’re in your 90s. What memories would you like to have? What stories do you want to tell?
• What is your favorite book/movie/song? Why?
• If you could make one change in the world, what would it be?
• What do you love to do for, or give to others (not an object – something from you personally)?
• What excites you?
• What do you wish you did more of?
• Pretend money is no object. What would you do?
• What area of your life, right now, makes you feel the best? Which area makes you feel the worst? Why?
• Let’s jump forward a year. What would you like to have achieved in the past year?
• What piece of advice would you give to five year old you? Sixteen year old you? Twenty-one year old you? Right now?
• How do you want to be remembered in life?
Activity #2:
The Five Minute Personality Test
http://www.sagestrategies.biz/documents/FiveMinutePersonalityTestforclass.pdf
Activity #3:
Character Strengths Survey
PODCASTS
Singer, J. B. (Producer). (2014, July 8). #87 – Beginnings, middles, and ends: Stories about social work from Ogden Rogers, Ph.D. [Audio Podcast]. Social Work Podcast. Retrieved from http://socialworkpodcast.blogspot.com/2014/07/ogden.html
Brunner, Allison (2009). When In doubt, give hope.” Social Work Podcast. Retrieved from http://www.socialworkpodcast.com/GraduationSpeech2009.mp3
Singer, J. B. (Producer). (2016, March 28). #103 – The Grand Challenges for Social Work: Interview with Dr. Richard P. Barth [Audio Podcast]. Social Work Podcast. Retrieved from http://www.socialworkpodcast.com/2016/03/grand-challenges.html | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.01%3A_Introduction_to_Social_Work.txt |
Social Work Mission: “To enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty” (Cournoyer, 2011, p. 160).
Ethics
NASW logo
Social work is considered a helping profession. Like many other helping professions such as nursing, counseling, teaching, and psychiatry, social work has ethical guidelines that help direct us in our work. Social workers are a vital membesr of the helping community and can be seen assisting many other helping professions (Cournoyer, 2011). Helping professions address a multitude of problems or dilemmas often involving a person’s physical, mental, social, intellectual, and spiritual well-being.
Therefore, as a social worker in the helping profession, you are responsible for many legal and important decisions. Often these decisions involve ethical choices in the best interest of clients’ lives. These decisions can be extremely difficult and emotionally charged and they may not always be the choices you are comfortable making.
The National Association of Social Work (NASW) Code of Ethics serves as guidelines for professional practice. It is relevant to all social workers, social work students, and social work educators regardless of their specific duties or settings. One should certainly use and become familiar with this website as a guide for learning about the Code of Ethics.
To be an ethical and professional social worker one must have a thorough understanding of the Code of Ethics and the legal obligations social workers are responsible for (Cournoyer, 2011). When encountering specific dilemmas, you as a social worker are responsible for knowing what ethical principle or value best applies to that situation. You must also be able to think critically to determine the best outcome for all parties involved (Woodcock, 2011).
The purpose of this chapter is to provide you with a brief understanding of the NASW Code of Ethics as you begin your journey through a social work program. This chapter is designed to help explore and provide a base understanding of these terms and overall principles. The goal is to prepare you for future courses and your future career so you are familiar with the general concepts. You will continue to explore the NASW Code of Ethics throughout your education, and will become much more applicable through continuing courses. (keywords: ethics, values, obligations and duties)
Establishment of the Code of Ethics
Social work is grounded on the concepts of social justice and fairness and the idea that all people should be treated equally. Clearly, when looking at the history of our nation, not all people have been treated equally. In the nineteenth century, social work became known as the calling that responded to the needs of vulnerable populations and those living in poverty. Through the rise of settlement houses and charity organization societies in the twentieth century and during the Great Depression, social workers promoted and provided new ways to address structural problems (Reamer, 2006)
As social work endeavored to gain recognition as a profession, the need arose for a formal code of ethics. While there were many social workers who helped pave the way, Mary Richmond is considered to be one of the most important. In 1920, Mary Richmond provided an experimental Code of Ethics which served as a base for many other social workers seeking social justice, equality, and fairness for vulnerable and oppressed populations (Reamer, 2006). Richmond’s Code of Ethics served as a guide to the first edition of the NASW Code of Ethics which was constructed in October of 1960. This document, developed by the NASW’s Delegate Assembly of the National Association of Social Workers, officially defined the duties and obligations for which a social worker is responsible. The 1960 edition defined fourteen responsibilities social workers were obligated to fulfill based on the mission of social work, and even included a discrimination clause. With the first revision in place the social work profession established a sense of professionalism.
Mary Richmond
Mary Richmond, a significant person in establishing social work as a profession.
For more information on Mary Richmond, see http://socialwelfare.library.vcu.edu/social-work/richmond-mary
The NASW Code of Ethics continues to be updated. Many significant revisions have been created as the needs of the increasingly diverse population social workers serve continue to change. Shortly after the publishing of the 1960 Code of Ethics, social workers became concerned with the Code’s suggestions for handling ethical dilemmas. In an effort to address these concerns, a task force was established to revise the original Code of Ethics (Reamer, 2006). In 1979, the NASW Delegate Assembly continued to work on the revisions as needed. It was not until the 1990’s when the NASW Code of Ethics was significantly modified again.
During the 1990’s the Code of Ethics had several impactful changes that were centered on the relationship between clients and social workers (Reamer, 2006). The profession began to stress the importance of maintaining professional boundaries with clients as social workers started to become more involved in clients’ lives. Five new principles were also included in the Code of Ethics that were centered on social work impairment and dual relationships. This lead to a major revision due to the profession’s developing understanding of ethical issues previously not addressed resulting in the public and media paying more attention to the NASW Code of Ethics.
In 2008, a major advancement occurred which incorporated the terms sexual orientation, gender identity, and immigration status into the non-discrimination standards in the Code of Ethics. This was a significant update because for a long period of time these groups of people have been heavily discriminated against in the United States and throughout the world.
Provided is a link with all updated changes: www.socialworkers.org/nasw/ethics/ethicshistory.asp
Overview of NASW Code of Ethics: Four Sections
Ethics highlighted
The NASW Code of Ethics consists of four sections:
• Preamble
• Purpose of the NASW Code of Ethics
• Ethical Principles
• Ethical Standards
(Woodcock, 2011).
The first section, the preamble, is intended to outline Social Work’s mission and core values while the second section provides a purpose and overview of the NASW Code of Ethics and how to handle or deal with ethical dilemmas (Woodcock, 2011). The third section, which is labeled Ethical Principles, helps define ethical principles based on Social Work’s six core values. Finally, the fourth section provides detailed ethical standards for which social workers are held accountable. It is important that as future social workers you are familiar with all four sections as they are intended to serve as guidelines for practice.
Preamble
Social Work’s mission is “to enhance human well-being and help meet the basic human needs of all people, with attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty” (Cournoyer, 2011, p. 160). With this mission, social workers should have a clear indication of what is expected when entering the field and practicing as a social worker. The six core values of Social Work are derived from the mission statement. These values will be further discussed in the chapter, but keep in mind the preamble section is rooted in these values.
Social workers should take pride in their work as they are seeking to improve the lives of others, and enhance the well-being of society. It is important to recognize social work’s primary mission, but as social workers you will also need to best represent the agency or organization you are working for. Every agency or organization will have their own guidelines or rules; it is then your responsibility to incorporate those guidelines along with the NASW Code of Ethics. Social workers have many different roles and can be found in many areas of work, but the primary goal is to endorse social justice (Woodcock, 2011).
Purpose of the NASW Code of Ethics
The purpose of the NASW Code of Ethics is to hold social workers to a high standard of professionalism.
The NASW Code of Ethics serves six purposes:
1. The Code identifies core values on which social work’s mission is based.
2. The Code summarizes broad ethical principles that reflect the profession’s core values and establishes a set of specific ethical standards that should be used to guide social work practice.
3. The Code is designed to help social workers identify relevant considerations when professional obligations conflict or ethical uncertainties arise.
4. The Code provides ethical standards to which the general public can hold the social work profession accountable.
5. The Code socializes practitioners new to the field to social work’s mission, values, ethical principles, and ethical standards.
6. The Code articulates standards that the social work profession itself can use to assess whether social workers have engaged in unethical conduct. NASW has formal procedures to adjudicate ethics complaints filed against its members.* In subscribing to this Code, social workers are required to cooperate in its implementation, participate in NASW adjudication proceedings, and abide by any NASW disciplinary rulings or sanctions based on it.
(NASW, 2008)
The NASW Code of Ethics cannot guarantee all ethical behavior, therefore it is up to you as a social worker to follow the Code of Ethics and best represent the profession. Become familiar with the Code of Ethics and continue to stay familiarized with them even beyond your education. There are going to be times when you as a social worker will not be sure what to do or what decision to make. This can be very frustrating. The Code of Ethics are intended to guide you through the process of difficult decision making so that you do come to the correct or best conclusion. Working closely with a supervisor will also be important.
When making ethical decisions where there is no clear answer on what to do, it becomes a difficult process. The simple answer is not always going to be present. Later in this chapter we will discuss ethical dilemmas, but remember to let the six core values, the NASW mission statement, and the Code of Ethics guide you in selecting the appropriate choice.
Ethical Principles
The ethical principles are based on the six core values of social work. These six values are important for all social workers to recognize and apply to their practice. They should help direct you in all ethical decisions or dilemmas you encounter. Social workers should also be conscientious of these values when working with clients, talking with co-workers, writing grants, or any other role a social worker performs, even if an ethical dilemma does not present itself. During your education, these six values will become much more significant than you may have imagined. You will learn true definitions of these terms and how to apply them to your practice.
How do you define value? What are important values in your life?
Today the term value is used in a variety of ways with many meanings. In the field of social work the six core values provide a framework for us that are connected in three important ways. First, the six core values have a direct relationship with clients, colleagues, and members of the broader society. Secondly, these six values derive from social works overall mission statement, and lastly, these six values relate to the resolution of ethical dilemmas and interventions that social workers use in their work (Reamer, 2006).
The six core values of social work are listed as:
• Service
• Social Justice
• Dignity and Worth of a Person
• Importance of Human Relationships
• Integrity
• Competence
Service
One of social work’s primary goals is to help people who are in need and to address social problems (Cournoyer, 2011). This value defines what social workers should be responsible for and the dedication to their job. As a social worker, you are encouraged to volunteer your time and professional skills with no expectation of significant financial return (Reamer, 2011). Social workers need to be dedicated to their delivery of services and be fully committed to assisting to a client’s needs.
Social Justice
Social Justice is a significant value for all social workers, as we seek to promote equality for all people. This is often done by advocating for fair laws or policies, on behalf of clients (Cournoyer, 2011). When promoting social justice, social workers have a specific focus on vulnerable and oppressed individuals or groups of people (Reamer, 2006).
Dignity and Worth of a Person
As a social worker, you must respect that individuals come from a variety of different backgrounds and cultures and that all people deserve to be treated with respect. Social workers should certainly support equality without assigning levels of worth to an individual or group and it is important to honor in the uniqueness of all individuals. Social workers should also be consistent with all values, ethical principles, and ethical standards of the profession when working with clients (Reamer, 2006). As social workers, one of your duties is to help others find their worth as a person.
Importance of Human Relationships
While recognizing the worth of all individuals, social workers should also respect the relationship of humans as they are important for change or working through dilemmas (Reamer, 2011). Social workers should work to strengthen relationships among people of all backgrounds. Relationships are a key in being successful in the field and promoting all ethics and values.
Integrity
Integrity is a significant value as it underlines the trustworthy manner all social workers should demonstrate. Social workers should be honest, responsible, and promote the ethical practices to the fullest (Reamer, 2006). You should also be aware of the profession’s mission, vision, values, and ethical standards and apply them in a consistent manner as well as promote all ethical practices for any agency they are affiliated with. Social workers should take pride in their work.
Competence
Social workers should frequently enhance their professional knowledge and skills. As a social worker, it is important to continue to strive to best serve clients and represent the profession. Social workers must be competent in their practice and also know when they do not have the knowledge base or skill set, and therefore must refer out for services.
Ethical Standards
The ethical standards of social work consist of six important criteria for which all social workers are held responsible. They are social workers’ ethical responsibilities:
• To clients
• To colleagues
• In practice settings
• As professionals
• To the social work profession
• To broader society
This link from the NASW website specifically lists all ethical standards under the six criteria: www.socialworkers.org/pubs/code/code.asp
Common ethical violations to be aware of consist of the following:
• Sexual activity with clients and colleagues
• Dual relationship
• Boundary violations
• Failure to seek supervision
• Failure to use practice skills
• Fraudulent behavior
• Premature termination
• Inadequate provisions for case transfer or referral
• Failure to discuss policies as part of informed consent with clients
(Cournoyer, 2011)
Summary
The NASW Code of Ethics is a living document and will continue to be adjusted as new developments and issues arise. Therefore, as a social worker, you are responsible to stay updated on all changes that are made and apply them to your practice. The Code of Ethics enforces the belief that the public will not be taken advantage of by the work of social workers for their own benefit and that clients will be treated fairly.
Legal Duties/Obligations
Another critical role of becoming a social worker is the legal obligations or duties you are responsible for. These duties are very serious and all social workers must abide by them. These duties or obligations consist of the:
• Duty to maintain confidentiality
• Duty to report
• Duty to inform
• Duty to respect privacy
• Duty to warn and protect
Duty to Maintain Confidentiality
Another important term in this chapter is the term confidentiality. Confidentiality, is extremely important for social workers as they have a duty to maintain confidentiality with all clients and the conversations they have with them. The term confidentiality indicates that any information shared by a client or pertaining to a client will not be shared with third parties (Cournoyer, 2011). It must remain between the social worker and the client. If confidentiality is broken, it can be a serious violation.
When meeting with clients for the first time it is mandatory to inform the client of their rights of confidentiality. No matter who is trying to seek information about a client you are working with, you must follow your duty to maintain confidentiality. Even if a client is deceased, you as the social worker are still obligated to protect the information you have obtained. Social workers should not only protect the information gained from clients, but they should also respect information shared by colleagues.
An important confidentiality law that you are likely to encounter as a social worker is the U.S. Health Insurance Portability and Accountability Act (HIPAA) which is commonly found in the health profession. HIPAA assures that client information will remain private and between them and the professional, and includes provisions for the protection of health information, records, or other information (Cournoyer, 2011). If a client wishes to give consent for their information to be shared, then they will be asked to sign a release form provided by the social worker giving permission to share that information.
Duty to Report
There are times when a social worker is required to break the confidentiality rule. These circumstances are the only time that a social worker is legally obligated to breach confidentiality agreements and must be taken very serious. This is known as duty to report. As a social worker, you are a mandated reporter and have a legal obligation to report to the designated authority if a client disclosed any of the following:
• they are going to harm or kill another person or indications of outrages against humanity
• abuse or neglect of a child, disabled person or senior citizen
• have a plan to commit suicide and admit to wanting to commit suicide
(Cournoyer, 2011)
For example, if a client discloses they have or plan to abuse a child or if a person’s life is at imminent risk, then you are required to act. These are the times when confidentiality agreements are broken and the social worker must report to a supervisor or the proper authority, so the authority can take further action. If not reported, the social worker can face serious legal offenses. Upon taking a job and throughout your education you will learn who the proper person or agency is that you should report to.
At times, it may be difficult to determine if you should report or not report. This can be known as an ethical dilemma. Throughout your education you will better learn about the times when you as a social worker will be required to breach confidentiality. For now it is extremely important to understand that as a social worker there are times when it is necessary to report.
Duty to Inform
Another important duty you will be obligated to abide by is duty to inform. As a social worker, you are required to educate clients concerning the scope of your services. This consists of informing the client about confidentiality, duty to report, but also the cost, length of treatment, risks, alternative services and anything else your agency requires (Cournoyer, 2011). When you are hired by an agency they will certainly walk you through the steps of your duty to inform and what they require, but it is your obligation as a social worker to best inform the client of your role. This is often completed early in the process when you are first meeting with a client.
If you are taking any actions regarding the care of client, it is your job to inform them and consult with the client first. It is best to inform the client in advance and have informed consent. Not informing a client of your role can be a form of malpractice.
Duty to Respect Privacy
When becoming a social worker, it is extremely important to follow your duty to respect the privacy of the people you serve and work with. As a social worker, you should protect all information obtained during services and respect the client’s right to privacy. Privacy differs from confidentiality because it refers to the client’s right to choose what to share and what to not share with a social worker. Social workers must respect that there may be things the client does not wish to disclose and we must not force them to do so.
Often social workers help or assist people during vulnerable times and become a part of many people’s lives. As a social worker, it is your duty to respect the relationship you have with clients and to not intrude on their lives outside of your sessions. For example, if you are working in a small town and run into a client you regularly meet with at the grocery store it is in your best interest as a social worker to respect the privacy of that individual and not approach them. Nor should you approach them and begin talking about what you previously talked about during one of your sessions together. You should discuss these possibilities with your client so they are aware of how you will react to them if you meet them in a public setting.
Duty to Warn and Protect.
Another duty social workers take on is the responsibility to warn potential victims a client may harm (Cournoyer, 2011). Along with many other helping professions a social worker is obligated to act to insure that anybody who may be in danger is aware of the possible danger. Therefore, as a social worker you must take serious action in deciding if a client is serious about harming another person. This is a great example of an ethical dilemma, deciding if the client is serious and has intent. If they do, then you are obligated to warn and protect. It is best to consult with a supervisor if there is any indication a client has stated he or she is going to act out and kill or harm another individual.
Case Study: Tarasoff v. Regents of the University of California
A case to be familiar with is the well-known Tarasoff v. Regents of the University of California case that helped ensure helping professions become obligated to act and protect the lives of third parties. Tatiana Tarasoff was a student studying at the University of California Berkley who met a fellow student named Prosenjit Poddar. The two briefly shared a romantic interaction, but Tarasoff decided to inform Poddar she wanted to date other men.
Afterward, Poddar became aggravated by this and he decided to see a psychologist by the name of Dr. Lawrence Moore. During sessions with Dr. Moore, Poddar mentioned that he intended to harm and kill Tatiana Tarasoff. After receiving a mental health diagnosis and held for a short time, Poddar was released and later killed Tatiana Tarasoff. At no point did Dr. Lawrence inform Tatiana or her parents of the possible danger Poddar had disclosed. After the murder of Tatiana Tarasoff, her parents brought the case against the Regents, in which the Supreme Court ruled that mental health professionals have a duty to protect individuals of a third party who may be threatened or at harm by a client, in which now is known as duty to warn and protect.
From (Dolgoff, Harrington, & Loewenberg, 2009).
Malpractice
Malpractice definition image
Another key term to be aware of related to the NASW Code of Ethics is malpractice. Malpractice can be defined as a form of negligence which occurs when a licensed social worker is not consistent with the professions’ Code of Ethics, standards of care, and is negligent to his or her legal duties and obligations (Reamer, 2006). Often this involves poor delivery of services or a social worker failing to meet the standard of care at his or her agency.
Malpractice is one reason why social workers need to be conscious of the Code of Ethics and make sure they are doing everything ethically correct. Malpractice lawsuits are common among many helping professions, not just social work, but due to the nature of and intimacy of social workers’ roles it is extremely important to best represent the NASW Code of Ethics. If not, serious consequences can follow.
Three common forms of malpractice include:
• Malfeasance: when the social worker intentionally engages in practice known to be harmful
• Misfeasance: when the social worker makes a mistake in the application of an acceptable practice
• Nonfeasance: when the social worker fails to apply standard and acceptable practice if the circumstances include such practice
(Cournoyer, 2011).
Clearly, malpractice can occur even if one intentionally or unintentionally is aware of the wrongdoing. For example, a genuine mistake social workers make is simply forgetting to obtain a client’s consent before sharing confidential records with third parties. This alone can lead to serious civil lawsuits and can jeopardize your social work license. When these mistakes occur, the social worker does not intend to provide harm, but due to the many responsibilities social workers have it is easy to forget and unintentionally make this mistake (Reamer, 2006).
Some common examples of malpractice include the following (Reamer, 2006; Cournoyer, 2011):
• Failure to report abuse of neglect of a child
• Failure to consult or refer other health professionals
• Failure to prevent a client from committing suicide
• Failure to warn or protect third parties of harm or abuse
• Failure to diagnose or incorrectly diagnosis for treatment
• Failure to provide treatment without consent
• Failure to renew their social work license
• Inappropriate or inaccurate billing of services
• Breach of confidentiality, even if the client is deceased
• Being sexually involved with a client
• Professional incompetence
It is your job as a social worker to know exactly what kinds of unethical behavior or misconduct result in malpractice. Simply acting inconsistent with the professions standard of care can place you in a civil lawsuit you may have never thought possible (Reamer, 2006). As a practicing social worker, it is important to have insurance coverage to protect you in case of a lawsuit. You will often be covered by your agency, and the NASW also provides legal coverage to social workers.
Ethical Dilemmas
Discussed earlier, as a social worker you are likely to face a situation where there is no clear answer or a time when you as a social worker are forced to choose between two or more decisions, but contradictory decisions with often undesirable outcomes for one or more persons (Dolgoff, Harrington, & Loewenberg, 2009). These are known as ethical dilemmas.
Dilemmas will occur often and you must be prepared to handle them. Whether you are working with individual clients, families, small groups, or community organizations in policy and planning, administration, or research and evaluation there will be ethical decisions/dilemmas along the way (Reamer, 2006).
Some social workers are uncomfortable with making difficult ethical decisions and ignore them while other social workers have no problem making a difficult decision (Dolgoff, Harrington, & Loewenberg, 2009). Ethical dilemmas are often known as the grey area of social work. Therefore, as a social worker, you must know yourself very well; be conscious of the Code of Ethics and let it guide you in making these decisions.
Some common ethical dilemmas include:
• Confidentiality and privacy issues
• Divided loyalties
• Professional boundaries with clients (this is a common and one of the most difficult dilemmas)
• Delivery of services
• When to terminate services
• Budget cuts (administration positions)
• Hiring and firing of staff members (administration positions)
• Conflicts of interest
• Relationship between professional and personal values
(Reamer, 2006)
Discussion Question: Why are professional boundaries so important?
There are many tips and suggestions for ethical problem solving, Dolgoff, Harrington, & Lowewenberg (2009) suggest considering the following when making ethical decisions:
• Who is my client?
• What obligations do I owe my client?
• Do I have professional obligations to people other than my clients? If so what are my obligations?
• What are my own personal values? Are these values compatible with the professions six core values?
• What are my ethical priorities when these value sets are not identical?
• What is the ethical way to respond when I have conflicting professional responsibilities to different people?
Often social workers are alone when they must make difficult choices and can’t always seek supervision right away. Therefore, you must be prepared to handle these situations on your own. After encountering an ethical decision alone, it is still a great idea to seek supervision afterward and talk the process over with a supervisor.
Social workers are encouraged to adopt this model; it is very helpful when struggling with ethical dilemmas, (Cournoyer, 2011; Congress, 2000, p. 10):
ETHIC Model of Decision Making
E—Examine relevant personal, societal, agency, client, and professional values
T—Think about what ethical standard of the NASW Code of Ethics applies, as well as relevant laws and case decisions
H—Hypothesize about possible consequences of different decisions
I—Identify who will benefit and who will be harmed
C—Consult with supervisor and colleagues about the most ethical choice
The following are great examples of ethical decisions you may encounter. Use these dilemmas as practice to work through a situation (Dolgoff, Harrington, & Loewenberg, 2009):
• A client tells you that he intends to embezzle funds from his employer. (What do you do?)
• A client who is HIV positive tells you that he has unprotected sex with his partners because he does not want his partners to know about his medical condition. (What do you do?)
• You discover that another social worker knows about a child abuse situation and has not yet reported the case to Child Protective Services (CPS), which is required by law. (What do you do?)
• You are a medical social worker and a surgeon at a children’s hospital strongly recommends that a child have surgery. The parents of the child refuse to consent with the surgery due to the complications and risks. The surgeon asks you to convince the parents to agree to let him operate regardless of the parents’ concerns. (What do you do?)
• A client has disclosed he is very angry with his cousin and wants to hurt him. (Do you breach confidentiality?)
• A previous client of mine has passed away, is it okay to talk about what that client has disclosed?
Summary
The NASW Code of Ethics does not list any value or ethic as more important than the next; you must consider all values and ethics as equal. To be a professional social worker you should be well acquainted with the Social Work Code of Ethics along with the six core values. Mentioned earlier, it is necessary to be familiar with the Code of Ethics to be an ethical social worker and to able to work with clients (Cournoyer, 2011). The NASW Code of Ethics is not something to take lightly and as you advance through your social work education these values and ethics will become much more ingrained. Having a copy of the NASW Code of Ethics with you or in your office is certainly a useful idea. Keep in mind that simply forgetting or unintentionally providing a standard of care can result in a malpractice lawsuit.
Ethical decision-making takes skill and practice, and is a never-ending process (Reamer, 2006). The more you prepare yourself, know yourself, and follow the Code of Ethics the greater skill you will obtain as a professional social worker (Cournoyer, 2011). There will always be ethical dilemmas during your career no matter the setting of your work. It is important to treat each dilemma as its own by using the suggested tips. Consulting with a supervisor before or after an ethical dilemma is a great suggestion. Supervisors are there to help and support you through difficult times.
Remember the Code of Ethics and values originated from the idea that all people are equal and deserving of the same entitlements. As a social worker, you are responsible for continuing and promoting social justice. In addition, you should always apply the ethical standards and legal duties to your work. | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.02%3A_NASW_Code_of_Ethics.txt |
"I believe that strong and vibrant cultures themselves nurture tolerance and justice. All cultures worth the name protect support and encourage diversity; and justice is the practical mechanism which enables them to do so.” —Dr. Nafis Sadik, former UNFPA Executive Director
Introduction
What is culture? Many individuals think of culture as something that is different from them. They may think of culture as something they desire to have; they mistakenly do not realize that everyone has culture. Culture is something that all of us have but because we live it, we do not realize that it is there. When we think of culture, we think of many different ways of life for others; we often neglect to understand that what we do in our everyday lives is different than others. We simply think of our lifestyles as “normal,” not cultured.
This chapter will explore various aspects of human diversity with a focus on the importance of understanding culture specifically for social workers to perform their ethical responsibility to be culturally competent. In this chapter we will clarify basic concepts, define key terms, discuss a variety of different cultures and begin to understand why this topic is of utmost importance to the social work profession. Let’s begin with defining culture.
Culture
Culture
Many different disciplines perceive culture and cultur al identity differently ; therefore we will begin with a general definition the n expand to a more specific definition as it relates to social work.
General Definition
Several general definitions of culture include:
1. A configuration of learned behaviors and results of behavior whose component elements are shared and transmitted by the members of a particular society (Linton, 1945)
2. The shared knowledge and schemes created by a set of people for perceiving, interpreting, expressing, and responding to the social realities around them (Lederach, 1995)
3. Learned and shared human patterns or models for living; day-to-day living patterns, these patterns and models pervade all aspects of human social interaction (Damen, 1987)
Culture has been defined in a number of ways, but most simply as the learned and shared behavior of a community of interacting human beings (Useem & Useem, 1963).
Social Work Definition
There is no standard popular definition or explanation of ‘culture’ in social work literature. Culture is often used synonymously and confusingly with the word ‘ethnicity’. From a social work perspective, culture has been defined well by Cindy Garthwait, MSW (2012) as: customs, beliefs, ideology, world-view, and values common to a group of people and which guide their individual and social behavior. More specifically, it is the product of the values, ideas, perceptions, and meanings which have evolved over time. These values, ideas, perceptions, and meanings constitute the individual’s knowledge and understanding of the world in which he or she lives.
They derive from:
• physical environment of birth and upbringing
• language
• institutions
• family and social relationships
• child rearing
• education
• systems of belief
• religion, mores and customs
• dress and diet
• particular uses of objects and material life
Culture embraces all of these, and the individual may regard each of them, or any number of them, as culturally significant. There is some consensus that culture is shared patterns of behavior and interactions, cognitive constructs and understanding that are learned by socialization. No matter the culture of an individual, one thing is for certain, it will change. Culture appears to have become key in our interconnected world which is made up of so many ethnically diverse societies, but also riddled by conflicts associated with religion, ethnicity, ethical beliefs, and the elements which make up culture. Culture is no longer fixed, if it ever was. It is essentially fluid and constantly in motion. This makes it difficult to define any culture in only one way.
Race and Ethnicity
Now that we have an understanding of the concept of culture, let’s discuss race and ethnicity. First, we need to have a basic understanding of ethnocentrism and how it affects our thinking and judgments. Ethnocentrism is a commonly used word in circles where ethnicity, inter-ethnic relations, and similar social issues are of concern. The usual definition of the term is “thinking one’s own group’s ways are superior to others” or “judging other groups as inferior to one’s own.” “Ethnic” refers to cultural heritage, and “centrism” refers to the central starting point… so “ethnocentrism” basically refers to judging other groups from our own cultural point of view. But even this does not address the underlying issue of why people misjudge others.
Most people, using a superficial definition, believe that they are not ethnocentric, but are rather “open minded” and “tolerant.” However, everyone is ethnocentric and there is no way not to be ethnocentric; it can neither be avoided because we only know what we have experienced in our own reality nor can it be willed away by a positive or well-meaning attitude. Yet this can have consequences within our own society and in international relations. We may be well meaning in inter-ethnic relations, for example, but can unintentionally offend others, generate ill feelings, and even set up situations that harm others. For example, it is easy not to see the life concerns of others (particularly minorities and the disadvantaged) or conversely to pity them for their inabilities to deal with life situations (like poverty or high crime rates). How do we feel when someone doesn’t recognize our concerns or feels sorry for us because we can’t “just let go” of a stressful situation?
A lack of understanding can also inhibit constructive resolutions when we face conflicts between social groups. It is easy to assume that others “should” have certain perspectives or values. How often are we prone to address conflicts when others tell us how we should think and feel? It can, however, be an opportunity to recognize and resolve our own biases and to learn more about potentials we all have for being human… a lifelong process of learning and growth.
What is the difference between race and ethnicity? Many people tend to think of race and ethnicity as one and the same. Often the words are used interchangeably. Looking up the definition in a dictionary doesn’t usually make it any clearer. However, these two words do have separate meanings. Understanding their distinctions is significant and increasingly important, particularly because diversity in the world is continuing to grow. This is especially important as social workers in terms of advocating and practicing non-discrimination.
What Is Race?
Race is a powerful social category forged historically through oppression, slavery, and conquest. Most geneticists agree that racial taxonomies at the DNA level are invalid. Genetic differences within any designated racial group are often greater than differences between racial groups. Most genetic markers do not differ sufficiently by race to be useful in medical research (Duster, 2009; Cosmides, 2003).
Stated simply, race is the word used to describe the physical characteristics of a person. These characteristics can include everything from skin color, eye color, facial structure, or hair color. This term is physiological in nature and refers to distinct populations within the larger species. Race was once a common scientific field of study. Today, however, most scientists agree that genetic differences among races do not exist which means we are all the same inside. Clearly, we all have the same make-up which consists of vitamins, minerals, water, and oxygen.
What Is Ethnicity?
Ethnicity denotes groups, such as Irish, Fijian, or Sioux, for example, that share a common identity-based ancestry, language, or culture. It is often based on religion, beliefs, and customs as well as memories of migration or colonization (Cornell & Hartmann, 2007). In scientific analysis, it can be important to distinguish between race and ethnicity. Biological anthropologist, Fatimah Jackson (2003), provides a pertinent example of cultural practices being misread as biological differences. Micro ethnic groups living in the Mississippi Delta, she writes, use sassafras in traditional cooking. Sassafras increases susceptibility to pancreatic cancer. Medical practitioners who do not carefully disaggregate cultural and biological traits might interpret a geographic cluster of pancreatic cancer as related to a genetic or racial trait when, in fact, the disease is produced by cultural practices—in this case, shared culinary habits.
Ethnicity, on the other hand, is the word used to describe the cultural identity of a person. These identities can include language, religion, nationality, ancestry, dress, and customs. The members of a particular ethnicity tend to identify with each other based on these shared cultural traits. This term is considered anthropological in nature because it is based on learned behaviors.
Difference betweenRace andEthnicity
One example of the difference between these two terms can be seen by examining people who share the same ethnicity. Two people can identify their ethnicity as American, yet their races may be black and white. Additionally, a person born of Asian descent that grew up in Germany may identify racially as Asian and ethnically as German. People who share the same race may also have distinct ethnicities. For example, people identifying as white may have German, Irish, or British ethnicity.
Socially Constructed Differences
Some researchers believe that the idea of race and ethnicity has been socially constructed. This is because their definitions change over time, based on widely accepted public opinion. Race was once believed to be due to genetic differences and biological morphologies. This belief gave way to racism, the idea of racial superiority and inferiority. For example, when Italian immigrants began arriving in the United States, they were not considered part of the “white race.” The same is true of Irish and Eastern European immigrants. The widely accepted view that these individuals were not white led to restrictions of immigration policies upon the arrival of “non-white” immigrants. In fact, during this time, people from these areas were considered of the “Alpine” or “Mediterranean” races. Today these race categories no longer exist. Instead, due to policy changes, people from these groups began to be accepted into the wider “white” race. They are now identified as individual ethnic groups. This shows that, like the idea of race, the idea of ethnicity also changes over time based on widely held public opinion.
Humans vary remarkably in wealth, exposure to environmental toxins, and access to medicine. These factors can create health disparities. Krieger (2000) describes disparities that result from racial discrimination as “biological expressions of race relations.” African Americans, for example, have higher rates of mortality than other racial groups for 8 of the top 10 causes of death in the U.S. (Race, Ethnicity, and Genetics Working Group, 2005). Although these disparities can be explained in part by social class, they are not reducible to class distinctions.
When we talk about power and privilege, we talk in terms of race, ethnicity, gender and class. And with good reason as these are some of the strongest cases of privilege in our culture. We also need to understand that one of the strongest aspects of power and privilege is that very often those who have it are not even aware of the extent of their privilege.
Racism and Prejudice
According to Gordon Allport, an American psychologist, Prejudice is an affective feeling toward a person or group member based solely on their group membership. The word is often used to refer to preconceived, usually unfavorable, feelings toward people or a person because of their beliefs, values, race/ethnicity, or other personal characteristics (Allport, 1979). In this case, it refers to a positive or negative evaluation of another person based on their perceived group membership.
If you open a dictionary, the definition that typically falls under “racism” is: a belief or doctrine that inherent differences among the various human racial groups determine cultural or individual achievement, usually involving the idea that one’s own race is superior and has the right to dominate others or that a particular racial group is inferior to the others.But racism is a lot more complicated than that. Racism is a “learned” form of hate that can be unlearned. It is systemic and institutional; basically it is prejudice plus power (influence, status and authority). Laws, restrictions and other norms in our society have been created by the majority in order to create these prejudices against another, differing group. For example, these things can include: slavery, wage gap, workplace and employment discrimination, police brutality, and so on.
There are many other definitions and concepts that make up this giant, tangled web. For example, with “white privilege,” people who are white benefit from societal structures simply by existing in them. Of course, some people do not consciously choose to benefit, but that doesn’t mean there isn’t a type of advantage for them. You may not hate someone for the color of his/her skin, but you may benefit from the systems that have been set up.
White privilege does not mean that white people have or grew up with everything handed to them. Being privileged does not mean someone had or has an easy life. The thing about privilege is that it can make people blind to struggles they are not aware of.
In 1989, Wellesley College professor Peggy McIntosh wrote an essay called “White Privilege: Unpacking the Invisible Knapsack.” McIntosh observes that people who are white, in the U.S. are “taught to see racism only in individual acts of meanness, not in invisible systems conferring dominance on my group.” To illustrate these invisible systems, McIntosh wrote a list of 26 invisible privileges whites benefit from.
For an interesting version of this look at http://privilegechecklist.com/ where you answer yes or no by pulling the image of the paper right(yes) or left (no)
McIntosh (1989) further describes white privilege as an “invisible package of unearned assets, which one can count on each day. White privilege is like an invisible weightless knapsack of special provisions, maps, passports, code books, visas, clothes, tools, and blank checks.”
Minority Groups
The term “minority” is applied to various groups who hold few or no positions of power in a given society. The term minority doesn’t necessarily refer to a numeric minority. Women, for example, make up roughly half the population but are often considered a minority group.
Minority does not just refer to a statistical measure and can instead refer to categories of persons who hold few or no positions of social power in a given society. For example: gender and sexuality minorities, religious minorities, and people with disabilities.
Gender and Sexuality Minorities
Gender Equality Symbol
Recognition of lesbian, gay, bisexual, and transgender people as a minority group or groups has gained prominence in Western culture since the nineteenth century. The abbreviation “LGBTQ” is currently used to group these identities together. The term queer is sometimes understood as an umbrella term for all non-normative sexualities and gender expressions but does not always signify a minority; rather, as with many gay rights activists of the 1960s and 1970s, it sometimes represents an attempt to highlight sexual diversity in everyone.
There is a growing realization that sexual and gender minorities face discrimination, violence, and criminalization. For example, nearly eighty countries criminalize homosexuality in some way (Park, 2016). Cultural stigma prohibits sexual and gender minorities from reaching their full potential. Stigma is an attribute, or mark on, another person. In the context of social interaction, it is a shared belief about someone’s characteristics and traits.
For example, the attribute might be wearing a turban. Many people might share a belief that a man wearing a turban is dangerous. Stigma assigns meaning to an otherwise meaningless attribute such as wearing a turban equates to certain political beliefs.
Gender minorities can be identified and grouped according to any one of the three different categories:
• People whose inter self-identity does not match gender assigned at birth
• People whose gender expression (or socially assigned gender) does not match gender assigned at birth
• People whose social expression does not conform to relevant cultural norms and expectations of gender.
Sexual minorities can be identified and grouped according to:
• People who describe themselves using sexual minority terminology
• People whose sexual partners are the same gender, or a minority gender
• People who experience attraction to individuals of the same or a minority gender
While in most societies the numbers of men and women are roughly equal, the status of women as an oppressed group has led some, such as feminists and other participants in women’s rights movements, to identify them as a minority group.
Religious Minorities
Symbols of many different religions
Persons belonging to religious minorities have a faith which is different from that held by the majority population or the population group that is in power. It is now accepted in many multicultural societies around the world that people should have the freedom to choose their own religion as well as including not having any religion (atheism or agnosticism), and including the right to convert from one religion to another. However, in some countries, this freedom is still either formally restricted or subject to cultural bias from the majority population.
For example, Burma’s population is 90 percent Theravada Buddhist, a faith the government embraces and promotes over Christianity, Islam and Hinduism. Minority populations that adhere to these and other faiths are denied building permits, banned from proselytizing and pressured to convert to the majority faith. Religious groups must register with the government, and Burmese citizens must list their faith on official documents. Burma’s constitution provides for limited religious freedom, but individual laws and government officials actively restrict it (U.S. Commission on International Religious Freedom, 2016).
People with Disabilities
Forms of disabilities
The disability rights movement has contributed to an understanding of people with disabilities as a minrity or a coalition of minorities who are disadvantaged by society, not just as people who are disadvantaged by their impairments. Advocates of disability rights emphasize differences in physical or psychological functioning rather than inferiority: for example, some people with autism argue for acceptance of neuro-diversity in the same way opponents of racism argue for acceptance of ethnic diversity. The deaf community is often regarded as a linguistic and cultural minority rather than a group with disabilities, and some deaf people do not see themselves as having a disability at all. Rather, they are disadvantaged by technologies and social institutions that are designed to cater to the dominant, hearing-unimpaired group.
Immigration
Immigration involves the permanent movement from one country to another. Social workers are often called upon to work with immigrants. Immigrants represent a significant portion of the U.S. population. In 2010, 40 million people (12.9%) of the total population were foreign-born (U.S. Census Bureau, 2010).
People with different national origins often find it difficult to integrate into mainstream culture, especially when language barriers exist or they experience immigration issues. Social workers play a crucial role in many immigration cases. A social worker is often the first person people talk to about their immigration struggles. Social workers often help clients gather key evidence, write detailed evaluations, assist with citizenship or change of legal status, or are the primary contact with police officers. There is a range of immigration status which immigrant children, youth and parents may hold. Immigrants may fall into one of the following categories:
• legal permanent residents
• naturalized citizens
• refugees
• undocumented persons
Each category or status can carry different legal rights and access to services.
Asylum
Provides specific protections to individuals who have reason (e.g. political, economic, etc.) to fear returning to their native country.
Deferred Action
Provides individuals who came to the US under the age of 16, protection from CHILDHOOD ARRIVALS deportation and an opportunity to receive employment authorization to two (DACA) 2 years. At the end of the two year period, individuals may apply for renewal.
Special Immigrant
Provides lawful permanent residence to immigrant children and youth who JUVENILE STATUS (SUS) are under the jurisdiction of the juvenile court and who have not been able to reunify with their families as a result of abuse, neglect or abandonment. Timing is critical; the SUS application must be processed while the child or youth is under the jurisdiction of the court.
T-VISA
Provides immigration relief to human trafficking victims who can demonstrate they have suffered tremendous hardships. Victims must have cooperated with reasonable requests during the investigation or in the prosecution of the accused.
U-VISA
Provides temporary visas to victims of crime. Victims must possess information related to the criminal activity and must cooperate with the criminal investigation and prosecution of the accused.
VIOLENCE AGAINST
Provides an abused victim an opportunity to seek permanent residency under WOMEN ACT (VAWA) the immigration provisions of the Violence Against Women Act (VAWA). The victim is eligible if he or she experiences abuse at the hands of a US citizen or permanent resident parent or stepparent.
Source: NASW Quick Resource Guide, 2013
A large number of immigrant households are comprised of mixed-status families (Capps & Passel, 2004; Torrico, 2010) which can mean that only some family members can access public funded services. For many immigration cases, it is important that a knowledgeable social worker be involved in the process.
Cultural Competency
It is important for social workers to have an understanding of the concept of culture in order to have cultural competence. This can be defined as a set of behaviors, attitudes, and policies that come together in a system, agency, or program. It can also be among individuals, enabling them to function effectively in diverse cultural interactions and similarities within, among, and between groups. Another way to describe cultural competence is a point on a continuum that represents the policies and practices of an organization, or the values and behavior of an individual which enable that organization or person to interact effectively in a culturally diverse environment. The competency of social workers is limited when they do not possess tools of acknowledgment that can affect them when working with diverse populations.
The social work profession is built upon culturally sensitive practices that advocate for social and economic justice for those who are disadvantaged, oppressed, and/or discriminated against. Standard 1.05(c) in the National Association of Social Workers’ (NASW) Code of Ethics (NASW, 2008), reminds social workers of their duty to be culturally competent and to purposefully “obtain education about and seek to understand the nature of social diversity and oppression.” NASW’s National Committee on Racial and Ethnic Diversity (NASW, 2001) highlights this necessity by identifying standards that make up culturally competent practices, including self-awareness, cross-cultural knowledge, skills, and leadership.
Although “diversity is taking on a broader meaning to include the sociocultural experiences of people of different genders, social classes, religious and spiritual beliefs, sexual orientations, ages, and physical and mental abilities” (p. 8), the historical impact of race on American society continues to play an integral part in the development and effectiveness of culturally competent practice. Having cross cultural sensitivity and cultural competence remains challenging as the concept of culture and how it relates to individuals continues to evolve.
Social workers must possess the skills to be able to understand a broad spectrum of varying cultures and have an understanding of important and influential beliefs related to that specific culture. An informed social worker will better understand how culture and diversity may impact how we present services and treatment and what interventions could produce better outcomes for those we serve. It would be useful for a social worker to be bilingual but not required as most agencies have access to interpreters.
Ethnic and Cultural Differences
We’ve established that understanding and appreciating diversity are essential for social workers to practice effectively with clients. The following section discusses some of the values, beliefs, and perspectives assumed by several cultural groups in our society: Hispanic, Native Americans, African Americans, Asian Americans, and Muslim Americans.
Celebration of Hispanic American Heritage
Hispanics
As we know, no one term is acceptable to all groups of people. Hispanic and Latino/Latina have generally been used to refer to people originating in countries in which Spanish is spoken. However, we have also established that the terms refer to people originating in a wide range of places. Others prefer to be addressed by their specific countries of origin. For example, people from Puerto Rico prefer to be addressed as Puerto Ricans. The three primary Hispanic groups in the United States in terms of size are Mexican Americans (over 66% of all Hispanics), Puerto Ricans (almost 9%), and Cuban Americans (almost 3.5%) (U.S. Census Bureau, 2010). Other groups include those from the Dominican Republic and from other countries in Central and South America (Santiag-Rivera, Arredondo, & Gallardo-Cooper, 2002). It’s important not to make stereotyped assumptions about such a diverse group.
Specific variations exist within the many sub-groups; we will discuss some cultural themes important to Hispanic families in general. Hispanic heritage is rich and diverse, but the groups tend to share similarities in terms of values, beliefs, attitudes, culture, and self-perception. These include the significance of a common language, the importance of family and other support systems, spirituality, and the traditional strictness of gender roles.
The first theme important in understanding the environment for children growing up in Hispanic families is the significance of a common language. According to the Pew Research Center, almost 60% of Latinos/Latinas indicate they speak English only or speak it fluently; however, almost 32% of Latinos/Latinas indicate they speak Spanish fluently. (Krogstad, Stepler, & Lopez, 2015).
A second theme reflecting a major strength in many Hispanic families is the significance placed on relationships with nuclear and extended family, including aunts, uncles, cousins, and grandparents, as well as close friends.
A third theme characterizing many Hispanic families is the importance of spirituality and religion. Catholicism is a defining role for family and gender roles for Latino or Hispanic people.
A fourth theme often characterizing Hispanic families is the strict gender roles. This is reflected in two major concepts: Machismo is the idea of male “superiority” that “defines the man as provider, protector, and head of the household”, marianismo, on the other hand, is the idea that, “after the Virgin Mary,” females are valued for their “female spiritual sensitivity and self-sacrifice for the good of husband and children”??? (Santiago-Rivera, Arredondo, and Gallardo-Cooper, 2002).
For more information on Hispanic Americans: www.dimensionsofculture.com/2011/03/cultural-values-of-latino-patients-and-families/
End of the Line
Native Americans
In the United States, there are about 700 native groups (Indian and Eskimo) that still exist. Of that number, about 556, including some 223 village groups in Alaska, are formally recognized. (For a listing of federally recognized groups, log on to www.doi.gov/bia/tribes/entry.html) (Sutton, 2004).
Each Native American group has always had a name for itself – a name that often translates to something like “The People.” However, groups have often been known to the outside world by other names (i.e. American Indian, Native American, and First Nation’s Peoples) (Weaver, 2008). Whenever possible, it’s best to identify the participants’ specific group. As part of their increasing pride and power, many groups are trying to revive their original names and asking that these be used instead of other names. For example, the Chippewa, Ottawa, and Potawatomi want to be called Anishinaabe (“The People from Above”).
Several themes characterize many Native American people. These include the importance of extended family and respect for older adults, noninterference, harmony with nature, the concept of time, and spirituality.
As with Hispanic people, family ties including those with extended family, are very important. The sense of self is secondary compared to that of the family and of the tribe. It is tradition to consult tribal leaders, elders, and spiritual leaders when conflicts emerge. It is also very common to have extended family members living together in one household.
Children receive supervision and instruction not only from their parents but also from relatives of several generations. In the Anishinaabe culture, it is the aunts and uncles who provide the discipline. The idea is that parents love their children and do not have the capability to see the “naughty” in their children. Aunts and uncles, who also love the children, have the ability to recognize when a child needs guidance and are obligated to provide it.
A second significant concept in Native American culture involves the emphasis on noninterference. The highest form of respect for another person is respecting their natural right to self-determination. For example, Native parents use noncoercive parenting styles that encourage the child’s self-determination. Unlike many other cultures, it is not uncommon to see children running around during religious ceremonies instead of sitting and paying attention. The hope is that the children will pick up on different things, said and done, and someday decide to participate.
A third theme that characterizes Native American culture is that of harmony with nature. Western culture generally tends to measure its advancement by the distance it places between itself and nature. In contrast, Native cultures tend to view greater closeness to the natural world and its cycles as a measure of significant achievement.
A fourth concept basic to Native people’s lives, and related to harmony with nature, is the concept of time, often termed “Indian Time”. Time is considered an aspect of nature which flows along with life. It is not something that should take precedence over relationships. It is more important to have human relationships rather than to be punctual. The idea is that it will happen when it is supposed to, not because of a certain time.
For more information on Native Americans: http://pluralism.org/religions/native-american-traditions/
The flag of the US and Ghana
African Americans
There are about 41.8 million African Americans in the United States (U.S. Census Bureau, 2010). African Americans, like other racial, cultural, and ethnic groups, reflect great diversity. Despite this diversity four general commonalities exist: importance of extended family, role flexibility, high respect for older adults, and strong religious beliefs and a close relationship with the church.
Like Hispanic and Native Americans, extended family ties are very important for African American families. Often children are raised not only by the nuclear family consisting of parents and children but also by extended family members (Martin, 1980). Children often receive nurture and support from multiple caring family members, who also provide each other with mutual aid.
A second theme characterizing African American families is role flexibility. Often time’s mothers play both roles of mother and father (Barbarin, 1983). Older children are also accustomed to being the parent figure so that the parents can work. Sometimes older African American children drop out of school so they can go to work and help their families financially.
A third theme common among African American families is respect for older adults. Older adults are held in high regard. It is a belief that older adults should be provided in home care by their children.
A fourth theme in African American life involves strong religious beliefs and a close relationship with the church. Many African American families consider the church to be a part of the extended family. Religion is considered to be what contributed to their resilience, their survival of slavery, and their ability to overcome struggles.
For more information on African Americans: African Americans in U.S. History in Context
Painted Indian Elephant Figurines
Asian Americans
In 2001, Asian Americans in the United States numbered more than 12.5 million and represented more than thirty different nationalities and ethnic groups, including Samoan, Tongan, Guamanian, and native Hawaiian from the Pacific Islands; Lao, Hmong, Mien, Vietnamese, Cambodian, Thai, Burmese, Malay, and Filipinos from Southeast Asia; Pakistani, Bangladeshi, Indian, and Sri Lankan from South Asia; Afghani and Iranian from Central Asia; and Korean, Japanese, and Chinese from East Asia. In 2000, the three largest Asian nationalities in the United States were Chinese, Filipinos, and Asian Indians. The diversity of Asian Americans, in terms of their various languages, cultures, and histories, is remarkable (Kiang, 2017). Obviously, there is a huge variation among these groups despite the fact that they are clustered under the same umbrella term Asian Americans.
All U.S. Asians –17,320,856
Chinese
4,010,114
Filipino
3,416,840
Indian
3,183,063
Vietnamese
1,737,433
Korean
1,706,822
Japanese
1,304,286
Pakistani
409,163
Cambodian
276,667
Hmong
260,073
Thai
237,583
Laotian
232,130
Bangladeshi
147,300
Burmese
100,200
Indonesian
95,270
Nepalese
59,490
Sri Lankan
45,381
Malaysian
26,179
Bhutanese
19,439
Mongolian
18,344
Okinawan
11,326
Source: The Asian Population: 2010, U.S. Census Bureau, Retrieved March 2012
Four themes tend to be similar throughout the diverse groups. These include family as the primary unit and individuality as secondary in importance, interdependence among family, filial piety, and their involvement in patriarchal hierarchy.
Like previous cultures discussed, Asian families stand out for their strong emphasis on family. More than half (54%) say that having a successful marriage is one of the most important things in life. Two-thirds of Asian-American adults (67%) say that being a good parent is one of the most important things in life (Pew Research Survey, 2012). Their living arrangements align with these values.
A second theme, related to the significance of the family, involves interdependence. For example, they are more likely than the general public to live in multi-generational family households. Some 28% live with at least two adult generations under the same roof. This is slightly more than the share of African-Americans and Hispanics who live in such households.
A third theme concerns a strong sense of filial piety—“a devotion to and compliance with parental and familial authority, to the point of sacrificing individual desires and ambitions.” About two-thirds say parents should have a lot or some influence in choosing one’s profession (66%) and spouse (61%) (Pew Research Survey, 2012).
A fourth theme characterizing many Asian American families involves the vertical family structure of patriarchal lineage and hierarchal relationships. This is common in traditional Asian-American families, but there is diversity in practice across cultures. Based on the teachings of Confucius, responsibility moves from father to son, elder brother to younger brother, and husband to wife. Women are expected to be passive, and nurture the well-being of the family. A mother forms a close bond with her children, favoring her eldest son over her husband.
For more information on Asian Americans: http://www.asian-nation.org
Muslim-American Flag
Muslim Americans
Since the U.S. Census Bureau does not ask questions about religion, there is no official government count of the U.S. Muslim population. It has been estimated, by Pew Research, in 2015 that there were 3.3 million Muslims of all ages in the United States. Islam is the second largest religion in the world and third largest in the United States (Lipka, 2017). As a social worker, it is likely that you will work with an individual who identifies as a Muslim.
It is important to understand that, unlike the previous cultures discussed, we are attempting to give a brief overview of the religion Islam and not the people. Like any religious group, religious beliefs and practices of Muslims vary depending on many factors including where they live. Each of these cultures practices Islam to a different degree just as many Christians practice their religion at different degrees. For example, a Muslim individual from Saudi Arabia may be very strict with the way that women should dress while an individual from Turkey may be more relaxed.
Social values are divided into three groups: necessities (dharuriyyat); convenience (hajiat); and refinements (kamaliat). Human basic values consist of life (al nafs), reason (al’aql), descent (nasab), property (al mal) and religion (al din) (Akunduz, 2002). Islam protects these primary human values and prohibits any violation of them.
Muslims around the world are almost universally united by a belief in one God and the Prophet Muhammad, and the practice of certain religious rituals.
For a brief introduction to Islam go to: http://www.islamicity.com/mosque/Intro_Islam.htm
Islam emphasizes practice as well as belief. Law rather than theology is the central religious discipline and locus for defining the path of Islam and preserving its way of life.
The essential duties of all Muslims, the Five Pillars (Bala, 2017), are:
• The Shahadah (Witness)
• The Salat (Prayer)
• The Zakat (Alms)
• The Sawm or Siyam (Fasting)
• The Hajj (Pilgrimage)
Islam law states there is no god but God and Muhammad is the messenger of God (Shahadah), worship or prayer should occur five times daily with community prayers at the mosque on Fridays (salat), charity (zakah), fasting during the month of Ramadan(siyam), and pilgrimage (hajj) to Mecca at least once in a lifetime. Jihad, or struggle in the way of God, is sometimes considered the sixth pillar. Jihad includes both internal spiritual struggles and external war waged in defense of the Muslim community (Bala, 2017).
Women are the dominant players in family and home. Men are considered to be the economic providers. Women are expected to cover their bodies, except their hands and faces, in front of men other than than their brothers, husbands, fathers and sons. This is an expression of modesty so as not to sexually provoke or invite unacceptable sexual behavior.
Of course, any discussion of these general cultural themes of values and behaviors is just that—general. Actual practices vary dramatically from one ethnic group to another and from one family to another. It’s important not to make assumptions about an individual’s values and expectations simply because that person belongs to a different group.
For more information on Muslim Americans: www.cfr.org/backgrounder/muslims-united-states
Case Study: Lia Lee
This true story involves the life of Lia Lee, a Hmong child who is epileptic, which was made famous by the author Anne Fadiman in her book “The Spirit Catches You and You Fall Down”. Lia began having epileptic seizures when she was about three months old. The Hmong regard this disease with ambivalence. They acknowledge that it is potentially dangerous and life threatening, but they also consider it to be an illness of some distinction, an illness in which a healing spirit enters the body. The Hmong saw it as divine, because many of their shamans (spiritual leaders) were afflicted with it.
Over the first few months of her life, Lia had over twenty seizures which made her parents (Foua-mother and Nao Kao-father) take her to the emergency room. There was obviously a great difference between American doctors and Hmong shamans. A shaman might spend eight hours in a Hmong home while an American doctor demanded the patient come to the hospital where the doctor might only see him for twenty minutes. Shamans could render an immediate diagnosis while the doctors had to run many tests and then sometimes didn’t know what was wrong anyway. Shamans never undressed their patients while doctors, on the other hand, put their hands and fingers into body orifices. Most significantly, shamans knew you had to treat the soul as well as the body unlike American doctors.
Besides the differences between doctors and shamans, there was a feeling among the Hmong that doctors’ procedures were actually more likely to threaten their health than to restore it. For example, the Hmong believe that there is only a finite amount of blood in the body, and doctors are continually taking it. Hmong people believe that when they are unconscious, their souls are at large, so anesthesia may lead to illness or death. Surgery is taboo and so are autopsies and embalming for the Hmong. The only form of medical treatment that was gratefully accepted by the Hmong was antibiotics. They had no fear of needles and frequently practiced dermal treatments like acupuncture, massage, pinching, scraping the skin, heating a cup to the skin or even burning the skin. The fact that epilepsy has a divine nature to them and the fact that the doctors see it only as a disease to be either cured or controlled foreshadows problems yet to come between the two cultures.
The greatest problem, for both the Lees and the hospital, was Lia’s medication. Most of the time, she was on a combination of several different medications. By the time she was four, she had changed prescriptions 23 times. Add to this the fact that Lia’s parents were illiterate in both English and Hmong; they often forgot what the doctors told them. The doctors never assumed anything other than that the Lees would give Lia her medicines properly, but time soon proved that Lia’s mother especially was either confused or lying about how she administered the medicines. This is where the hospital social worker (Jeanine Hilt) initially stepped in to help. Jeanine worked with the Lee family to simplify the medication regimen.
Later, the Lee’s had come to the conclusion that the medicines were causing the seizures and fever therefore, they refused the medications. The nurses soon come to the realization that the Lees were non-compliant. Due to the parent’s non-compliance, the doctor felt he had no choice but to refer Lia’s case to the health department and child protective services. He recommended she be placed in a foster home so that compliance of medications could be obtained. The Superior Court of the State of California immediately acted upon his request and declared that Lia should be removed from the custody of her parents.
Months later, with the efforts of social worker Jeanine, Lia is reunited with her family. The family is overjoyed to have her home again. However, the celebratory mood soon began to dissipate as the Lees realized that Lia had been returned to them in damaged condition. She didn’t know people she had known before, and she could speak very little. From their perspective, the courts and the foster care system had made her sicker, but of course, the doctors felt it was due to the damage done when the Lees failed to comply with their orders. As a result of Lia’s condition, the Lees stepped up her traditional medicine.
Lia’s family spent large amounts of their money on such things as amulets. They tried every known cure in their medical library even to the point of changing Lia’s name to Kou on the premise that the dab (spirit) that stole her soul would be tricked into thinking she was someone else, and the soul could return. They even took her to a shaman in Minnesota for help.
The doctors would have been surprised to learn that the Hmong actually took their children’s health seriously since they so readily spurned American care. At the hospital, Lia’s case metastasized into a mass of complaints that grew angrier with each passing year. Especially the nurses were angry that the Lees were so ungrateful for the \$250,000 worth of care they received for free. They were angry that the Lees had been noncompliant and believed that Lia did not need to be in the state she was in. They believed the Lees just hadn’t given her the medication.
Lia’s brain impairment is never resolved and she eventually becomes vegetative for the rest of her life. Lia is taken home by her parents to be loved and cared for by them. The doctors in Merced and other medical communities begin to realize that understanding the cultural differences of an immigrant must be considered when treating them as patients. However, in the end, the doctors still believe that the bottom line means save the patient’s life while the Hmong believed that it was the patient’ soul.
When the author of the book asked why the doctors never asked the Hmong how they treated their illnesses, he replied that because they dressed in American clothing, had American driver’s licenses and shopped in supermarkets, it never occurred to the medical staff that they might practice unconventional healing arts. Jeanine Hilt was the only one who ever asked the Lees how they were treating Lia’s developmental delays. She is the only person who fought against the medical establishment on Lia’s behalf. She had simplified Lia’ medication regimen, secured them their disability money and advocated to the courts for her return home and she never described them as closemouthed and dim.
Case study from: Fadiman, A. (1997). The Spirit Catches You and YouFall Down. New York: Farrar, Straus and Giroux
Summary
Being culturally competent and having cross-cultural awareness is an ongoing process. It is helpful in understanding the circumstances and social issues from a client’s perspective. Competency is also important as social workers must attend to their own perspectives about their own cultural identity and how the client may view us. The need to assess all aspects of a client’s belief system, values, and how they view themselves within their own culture is as important as assessing their whole bio-psychosocial history. By having some understanding of and sensitivity to other cultures means that we can also help others learn about different views and perspectives. Most importantly, we can dispel any generalizations or myths about a certain culture. With better insight we can appropriately match client’s needs in respect to resources and services.
A social worker’s aim is to advance social justice, equality and to end discrimination. In many ways, it has been observed, that a person’s or group’s culture has played a large part of many incidents of inequality and disenfranchisement in the past, both in our country’s history and across the globe. One of our most important goals is to be the voice of our client(s) whether it is for an individual, a group, a neighborhood, or organization, in order to make sure that their rights are not violated and they are treated with dignity and respect. Learning to deal with how and what types of social issues regarding injustices exist, will help when we are dealing with real life discrimination and inequality that occurs and may be affecting our clients. By understanding and identifying social injustice and inequality, we can offset mechanisms of oppression and how they work.
Having cross cultural sensitivity and cultural competence remains challenging as the concept of culture and how it relates to individuals continues to evolve. Social workers must possess the skills to be able to understand a broad spectrum of varying cultures and have an understanding of important and influential beliefs related to that specific culture. An informed social worker will better understand how culture and diversity may impact how we present services and treatment and what interventions could produce better outcomes for those we serve. | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.03%3A_Cultural_Competence.txt |
When looking at generalist practice primary theories, the first question that may come to mind is what is generalist practice? Generalist practice introduces students to the basic concepts in social work which includes promoting human well-being and applying preventative and intervention methods to social problems at individual (micro), group (mezzo), and community (macro) levels while following ethical principles and critical thinking (Inderbitzen, 2014).
Now that you have some insight on what generalist practice is, we should discuss what a social work generalist does. A social work generalist uses a wide range of prevention and intervention methods when working with families, groups, individuals, and communities to promote human and social well-being (Johnson & Yanca, 2010).
Being a social work generalist practitioner prepares you to enter nearly any profession within the social work field, depending on your population of interest (Inderbitzen, 2014).
Micro, Mezzo, Macro Levels of Social Work
Micro level social work is the most common practice scenario and happens directly with an individual client or family; in most cases this is considered to be case management and therapy service. Micro social work involves meeting with individuals, families or small groups to help identify, and manage emotional, social, financial, or mental challenges, such as helping individuals to find appropriate housing, health care, and social services. Micro-practice may even include military social work like helping military officials and families cope with military life and circumstances (see Chapter 14), school social work which could involve helping with school related resources, Individual education plans, and so on (see Chapter 11), or a mental health case manager to help individuals understand and cope with their mental illnesses (see Chapter 10).
The focus of micro level practice is to help individuals, families, and small groups by giving one on one support and provide skills to help manage challenges (Johnson & Yanca. 2010).
Mezzo level social work involves developing and implementing plans for communities such as neighborhoods, churches, and schools. Social workers on the mezzo level interact directly with people and agencies that share the same passion or interest. The big difference between micro and mezzo level social work is that instead of engaging in individual counseling and support, mezzo social workers administer help to groups of people. Examples of work and interest that mezzo social workers could be involved in include the establishment of a free food pantry within a local church to help with food resources for vulnerable populations, health clinics to provide services for the uninsured, or community budgeting/financial programs for low income families.
Many mezzo social work roles exist; however social workers generally engage in micro and mezzo practice simultaneously (Kirst-Ashman & Hull, 2015).
Macro level social work is very distinct from micro and mezzo level. The focus of macro level social work is to help vulnerable populations indirectly and on a larger scale. The responsibilities for social workers on a macro level typically are finding the root cause or the why and effects of citywide, state, and/or national social problems.
They are responsible for creation and implementation of human service programs to address large scale social problems. Macro level social workers often advocate to encourage state and federal governments to change policies to better serve vulnerable populations (Kirst-Ashman & Hull, 2015).
Social workers that work on the macro level are often employed at non-profit organizations, public defense law firms (working pro-bono cases), government departments, and human rights organizations.
While macro social workers typically do not provide therapy or other assistance (case management) to clients, they may interact directly with the individuals while conducting interviews during their research that pertains to the populations and social inequalities of their interest.
Although, social work is broad and allows practitioners to move within the micro, mezzo, and macro levels. All social workers begin at the micro level to understand the inequalities, disadvantages, and the needed advocacy for vulnerable populations.
Theories
Systems Theory
Systems Theory is an interdisciplinary study of complex systems. It focuses on the dynamics and interactions of people in their environments (Ashman, 2013). The Systems Theory is valuable to the social work profession because it assists social workers with identifying, defining, and addressing problems within social systems.
As social workers, we utilize the Systems Theory to help us understand the relationships between individuals, families, and organizations within our society. Systems theory allows social workers to identify how a system functions and how the negative impacts of a system can affect a person, family, organization, and society, by working together to cause a positive impact within that system (Flamand, 2017).
Ecological Systems Theory
The Ecological Systems Theory was created in the late 1970’s by Urie Bronfenbrenner. According to Oswalt (2015), Bronfenbrenner developed the Ecological Systems Theory to explain how a child’s environment affects their growth and development. The four levels that are described below are the different levels according to Bronfenbrenner that affect the different development stages of a child.
The main concept behind ecological approach is “person in environment” (P.I.E). The ecological approach implies that every person lives in an environment that can affect their outcome or circumstance. As social workers, our job is to improve a person’s environment by helping them identify what is negatively impacting their environment.
When discussing this theory, it is important to understand the four systems that make up the ecological systems: microsystem, mesosystem, exosystem, and macrosystem.
The microsystem is the smallest system, focusing on the relationship between a person and their direct environment. The mesosystem is a step above the microsystem. This system focuses on the relationship between groups and the effects that one social group may have on another social group. The exosystem is a more generalized system as it shows the effect that a group has on interactions among other groups. Lastly, the macrosystem focuses on the bigger issues such as culture, politics, government, and society (Allen-Meares & Lane, 1987).
When focusing on a client by providing case management or support to an individual that is facing hardships, we often look at a person’s microsystem. Looking at a person’s environment allows us as social workers to help identify problem areas or what is negatively impacting their lives.
This is usually done by making an eco-map to give the client a visual aide during the identifying process. An eco-map is a diagram that shows the social and personal relationships of an individual with his or her environment. Eco-maps were developed in 1975 by Dr. Ann Hartman, a social worker who is also credited for developing the genogram (Genachte, 2009).
Below is an example of what an eco-map would look like once it is completed with your client.
Eco-maps will vary in what they look like as each map will cater to the specific client/family, and will highlight the stressors (negatives), positives, and relationships.
Greg’s Eco-map
Example of an ecomap, http://www.genogramanalytics.com/
A genogram mimics a family tree. Normally when you look at a family tree you often find branches and each branch represent a family. A genogram digs deeper and identifies relationships, deaths, marriages, births, divorce, and adoptions just to name a few. When collecting information to complete a genogram it is useful to understand a family’s dynamics (Johnson & Yanca, 2010.)
Here is an example of a genogram; this genogram along with other samples and variations can be found on www.sampletemplates.com. Genograms can help clients identify their roots and culture. While completing genograms also be aware that while unraveling a client’s history, past trauma or closed wounds can be reopened. As a social worker you need to be prepared to discuss and address these issues to help your client address their past trauma.
Four Generation Family Genogram
Activity: In class or as homework complete and eco map and genogram of your own family. See how far you can go through family tree and connect your family, relationships, marriages, etc.
Strengths Approach
The development of the StrengthsApproach began and has been led by Dennis Saleeby and staff at the University of Kansas. The Strengths Approach is based off two very important principles:
• every person, group, family, and community has strengths
• every community or environment is full of resources (Johnson & Yanca, 2010)
In the Strengths Approach, it is the social worker’s job to help the client identify their strengths. Often clients with whom we work with are only able to identify the negative impacts of their lives and have a difficult time identifying the positive aspects of their lives and situations. When using the Strengths Approach not only is the social worker helping the client to identify their personal strengths, but the worker is also helping the client identify local resources to help the client needs.
This approach focuses on the strengths and resources that the client already has rather than building on new strengths and resources. The reasoning behind the strength approach is to help clients with immediate needs, and to help with finding solutions to immediate problems.
Planned Change Model
The planned change process was introduced to the social work profession in 1957 by Helen Harris Perlman. The Planned Change Model is the development and implementation of a plan or strategy to improve or alter a pattern of behaviors, a condition, or circumstance to improve a client’s well-being or situation (Kirst-Ashman, 2012).
The Planned Change Model consists of a seven-step process which includes:
• Engagement
• Assessment
• Planning
• Implementation
• Evaluation
• Termination
• Follow-up
The Engagement phase is the first interaction between the social worker and their client. The engagement stage does not have a predetermined time frame; it can last for a couple of minutes to a few hours depending on the client and the circumstances. It is very important during the engagement phase that the social worker displays active listening skills, eye contact, empathy and empathetic responses, can reflect to the client what has been said, and uses questioning skills (motivational interviewing). It is appropriate to take notes during the engagement phase for assessment purposes or for reflection. Remember, during the engagement phase, the social worker is building a level of rapport and trust with the client.
The Assessment phase is the process occurring between social worker and client in which information is gathered, analyzed and synthesized to provide a concise picture of the client and their needs and strengths. The assessment phase is very important as it is the foundation of the planning and action phases that follow.
During the assessment stages, there are five key points:
• identifying the need problem (concern)
• identify the nature of the problem
• identify strengths and resources
• collect information
• analyze the collected information
(Johnson & Yanca, 2010)
The Planning phase is when the client and social worker develop a plan with goals and objectives as to what needs to be done to address the problem. A plan is developed to help the client meet their need or address the problem (Johnson, & Yanca, 2010). The planning phase is a joint process where the worker and the client identify the strengths and resources gathered from the assessment phase. Once the strengths and resources are identified, the social worker and the client come up with a plan by outlining goals, objectives, and tasks to help meets the clients goal to address the need or problem. During the planning phase, keep in mind that the goals should be what the client is comfortable with and finds feasible to obtain. The social worker’s most important job during this phase is to help the client identify strengths and resources, not to come up with the client’s goals for them.
The Implementation/Actionphase is when the client and social worker execute a plan to address the areas of concern by completing the objectives to meet the client’s goals. The action phase is also considered a joint phase as the social worker and the client act! The worker and the client begin to work on the task that were identified in the planning phase (Johnson & Yanca, 2010). The worker and the client are responsible for taking on different parts of the identified task; for example, the social worker may find a local food pantry or help with food assistance program if the client needs food. The client may work on making a grocery list of foods that will make bigger portions for leftovers to make food last longer for the family. However, the worker and the client are jointly working together to obtain the goal of providing food for the client and their family.
The Evaluation Phase/Termination phase is a constant. The worker should always evaluate how the client is doing throughout the process of the working relationship (Johnson & Yanca, 2010). When the plan has been completed or the goals have been met, the client and social worker review the goals and objective and evaluate the change and/or the success. If change or progress has not been made the client and social worker will review the goals and objectives and make changes or modifications to meet the goal. Once the goals have been met, termination of services follows if there are no further need for services or other concerns to address. Sometimes termination happens before goal completion, due to hospitalizations, relocation, losing contact with a client, financial hardships , or the inability to engage the client.
The Follow Up phase is when the social worker reaches out to the client to make sure they are still following their goals, using their skills, and making sure the client is doing well. The follow up may not always be possible due to different situations such as death, relocation, and change in contact information, to name a few.
The diagram below shows the process of the Planned Change Model when working with clients.
Stages of Planned Change
Activity: Partner up with a classmate. Role play one person being the social worker and the other being the client. Come up with a problem or concern and try to go through the planned change process. I do not expect you to get through the whole process, but at least try to get through the first three stages. Remember to be creative and have fun while doing so!!
Evidence Based Practice (EBP)
According to David Sackett, evidence based practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of a client. When working with clients it is important to combine research and clinical expertise. In the field of social work there is constant research being conducted to assess various assessment and treatment modalities. The research that is conducted provides the evidence that we as social workers use to help our clients improve their living situations and concerns. Lastly, keep in mind that our clients are the experts on their own lives. We must keep in mind what their personal values are and what their preferences are for the outcome of their life situation. This is very important and often can become frustrating as a social worker as we think we know what is right for our client, but it may not be their personal preference.
When working with clients and evidence based practices it is important to know that research is constant surrounding evidence based practices, and as a practicing social worker it is very important to stay abreast of the constant change of new information and changes. It is important to do your own research, and most importantly always respect your clients’ personal values and preferences. | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.04%3A_Generalist_Practice.txt |
Social Work practice begins with the purpose of the social worker. Understanding of the social work profession starts with an intense appreciation of the person in which the social worker serves (Sheafor & Horejsi, 2008). The social worker understands that humans are social beings, these social creature’s growth and development need the guidance of nurturing and protection provided by others around them. It’s this inter-connectedness and interdependence of people in the social environment that is the foundation of practice in social work as a profession. The environment a person lives in has a lot to do with how a social worker may apply knowledge and guidance. There are two distinct types of social work practice that are used according to the type of setting.
Social work practice setting
Direct Practice
Direct practice is when the social worker works directly with an individual, family, or group of people. The first direct meeting can occur in a variety of ways such as a crisis, voluntary, or involuntary. The first meeting is a critical point in establishing a good helping relationship. A social worker should prepare for any type of first contact, so that they may set up the best relationship possible with the client (Sheafor & Horejsi, 2008).
Advocacy day
At the BSW level, direct practice is primarily done as a case worker. The case worker may met with the individual daily, weekly, or monthly depending on the type of work. For example, in short term crisis work, the person may have daily meetings. For adults with intellectual disabilities, a monthly check in may be more appropriate and required by the supervising agency. Direct practice is typically done as a worker at an agency, non- profit, or government setting. A direct case worker may be involved in many different areas of practice, including but not limited to working in adoption, Child Protective Services, in a group home for individuals with brain injuries, a shelter for abuse survivors, or with Community Mental Health. The caseworker may be involved in finding resources or providing support for the client. Meetings may take place at an agency or in the client’s home.
At the MSW level, direct practice is usually done in the role of the therapist or counselor. Therapists generally see their clients on a weekly basis, although this time frame may vary. Therapists often work at the same agencies as BSW level caseworkers, but in a different role. While the BSW worker is involved with taking care of the many logistical issues a client may have (housing, food, etc.), the MSW worker is usually assisting the client with skill building, learning coping strategies, and focusing on their overall mental health treatment. Sessions may take place at an agency or in the client’s home.
Indirect Practice
Indirect practice is generally when the social worker is involved in activities that consist with facilitating change through programs and policies. This type of practice is more of behind the scenes and is aimed to help prevent problems from developing. Also, the social worker may participate in this type of practice by advocating through agency administrators, legislators, or other powerful people to effect a change (Sheafor & Horejsi, 2008). You may also hear the term Macrosystem practice, which means systems larger than a small group or single person (Zastrow & Kirst-Ashman, 2010). Micro systems are continuously affected by the Macro systems. The two major Macro systems that impact individuals the most are communities and organizations.
Community is defined by Merriam-Webster a unified body of individuals: such as a state or common wealth; the people with common interests living in an area geographically. Community can also me the individuals are connected in other ways, such as an activity, job or an identifying ethnic trait (Zastrow & Kirst-Ashman, 2010). Community Theory, is a theoretical frame work adopted when working within a community. Community Theory consists of two components; the nature of the community such as perspectives which may include how it is defined. The second component is how social workers practice in the community (Zastrow & Kirst-Ashman, 2010).
An organization is defined by Merriam-Webster as an administrative and functional structure; this is a group of individuals that come together to work towards a common goal (as cited in Zastrow & Kirst-Ashman, 2010). Each of the individuals involved in the organization preform specific duties.
Collaboration with agencies are a vital part of indirect practice. The social (Zastrow & Kirst-Ashman, 2010) worker can help facilitate change by reaching out to other agencies that can assist in meeting other needs of the client.
According to an article written by Johnson (1999), Indirect social practice has often referred to environmental intervention in the client’s networks or social aspect. The belief was to help alleviate challenges in the client’s surroundings. There are two elements associated with indirect practice. The first one is called concrete assistance, this is resources available to the client to help with basic needs. For example, food assistance programs are the most common resource needed for clients. The second element to indirect social work practice is sociopsychological intervention. Which is the adjustment of attitude or behavior of significant people with in the client’s social environment (Johnson, 1999).
Human behavior occurs within a community, it is ever present and continuous. Individuals develop through the interactions with others. Behavior is ever dependent on others in the environment, as well as the individual client’s behavior affecting those they interact making behavior interdependent (Zastrow & Kirst-Ashman, 2010). The term community can mean so many various things. As a social worker, one must figure out in what context the clients community affects them. What makes up that person’s community? Do all the community members suffer the same common problems? Due to the broad nature of the meaning Community, we can break it down in three categories; A designated group of people; this group has something in common; and we know that because of a commonality the individuals in the community, they interact in some way or possibly will in the future (Zastrow & Kirst-Ashman, 2010).
Rural environment
Rural Communities
Agreement among scholars have lead the social work profession to use a more generalist approach in small towns. The generalist approach allows the social worker to gain skills for working with individuals, families, small groups, organizations and communities. The rationale for this type of practice is solely based on the structural normality’s in the majority of rural areas. These areas are usually characterized by a lack of formal resources which includes the services of private social entities. The Social workers that serve in these areas often work in the public service. They are asked to perform in a range of problems that are presented by those they serve.
There is no set-definition of what defines a rural community, but as such can be understood as those non-metropolitan areas, including surrounding towns with a reduced population that have limited to no access to social services (Lohmann, 2012). It is important to note that despite the stereotype that all rural areas are the same, the reality is that all rural areas differ from one to the next based on socioeconomics, climate, surrounding culture, present ethnicities, and religious structures to name just a few. With this in mind, the rural social worker must be able to work positively within this communities, and take into consideration the differences that exist within them. These areas are usually characterized by a lack of formal resources which includes the services of private social entities. The Social workers that serve in these areas often work in the public service.
Such limited resources in consideration include available locations, trained and licensed individuals, and monetary founds. Thus, as Lohmann (2011) describes, social workers must play multiple roles, from community organizers to caseworkers. As such, these roles are valued for their creativity in how treatment occurs, and how flexible the social worker is with switching between the individual and the community. Limited resources also mean that rural social workers often practice in isolation, without direct supervision and with difficulty accessing continuing educational materials. As such, it is important that these workers seek additional opportunities to expand their professional development and continue advocating for best practices.
Agreement among scholars have lead the social work profession to use a more generalist approach in small towns (Lohmann, 2012; Waltman, 2013). The generalist approach allows the social worker to gain skills for working with individuals, families, small groups, organizations, and communities. The rationale for generalist practice refers to the limited social resources available for rural communities that must be substituted by Social Workers. As such, the generalist approach is best used in rural settings, as it allows the social worker to take on multiple roles that the community needs.
One notable complication with rural communities is the potential of dual relationships between the Social Worker and their clientele. These relationships refer to the proximity of Social Workers living and working in the same environment, where clients may be neighbors or members of similar social groups. Pugh (2007) discusses that these situations present ethical problems, such as maintaining a professional appearance by avoiding invitations for conversations, but ultimately that the social workers role is defined by how they conduct themselves in the community. Additionally, Humble, Lewis, Scott, and Herzog (2013) describe the potential for professional fatigue when the social work is always “on duty”. Despite the additional transparency, rural social workers must balance their professional and private lives in order to work effectively in these areas.
Urban environment
Urban Communities
In contrast to rural communities, urban communities are those settings involving metropolitan areas with an increase in population density, a decrease in general size, and an increase in access to social services for its population. The rise of industrialization has led to a migration from rural communities to urban ones, resulting in a population shift between the two areas where urban areas hold the majority of the population. This, in term, leads to an increase in problems, such as differences in socioeconomic status, an increase in migrant and immigrant populations, higher crime rates, and differences in health outcomes of residents.
Social workers in urban environments will find considerable job opportunities in both the public and the private sectors. Publicly, Social Workers may find jobs with Community Mental Health programs, alliances that work with veteran or homeless populations, and with educational settings to name a few. Privately, Social Workers may find opportunities for clinical care roles and job specialties, such as working with victims of sexual assault. What urban environments offer is the ability for the social work individual to focus on what area, while allowing referrals to other qualified individuals.
Unlike rural environments, urban environments allow for a range of continual educational options, including seminars at meeting halls or college campuses, specialized opportunities for trainings in issues such as a trauma, and the ability for social workers to gather in conferences. This, in turn, allows social workers to have outside supervision, as well as an increase in communication across the profession.
Despite the advantages urban environments offer in terms of networking and job opportunities, it is important to remember that there are setbacks. As mentioned, with an increase in population comes a rise in disparities between socioeconomic status. One of the larger issues faced by clients is the level of healthcare coverage that they can afford. This often entails poor healthcare outcomes, and a decrease in mental health care. Social Workers in these environments will often work with the economically disadvantaged, and must understand the cultural variations that exist in the area they work. Additionally, it is imperative that Social Workers understand the local resources available to their clients, such as transportation and food services, and be able to help their clients with these issues.
Social Work Job Opportunities
BSW- Bachelors of Social Work: this is considered an Undergraduate degree and is an employable degree once you gain your Limited License. If you choose not to move on to a Graduate degree you will need to take the state licensing exam to practice a career in what you have learned. Your employment at the BSW level will generally be related to casework. Many individuals work with just their BSW for their entire lives. If you enjoy casework, it is not necessary to obtain your MSW degree. There are many positions available for BSW level workers.
MSW- Masters of Social Work: this is considered a graduate degree and is employable with a Limited License. If you choose to stay with your MSW you can take the licensing exam in the state you are choosing to practice in and follow your state’s guidelines for licensure and procure a clinical or macro licensure. After two years of practicing with your Limited License, you will be eligible for a full license. With this license you can practice independently without the supervision of a another fully licensed social worker.
Upon completion of your set professional education track, it is time to search for career opportunities. The search can be very overwhelming, even the thought of starting the process can be quite intimidating. Do not fear the search, with today’s technology there are many ways one can look for career starting jobs. One of the most common is to strike out on the internet. There are many sites to type in key words for the type of job you are looking for. For example, www.indeed.com and www.monster.com are amongst the most popular when aiming to post a resume for a position. Another great way to find an opportunity is to search the webpages of agencies around the community in which you are searching. Agencies typically have a section for employment opportunities they have available. If you are searching for a position in your home states public sector, you can go to the state website and find out how to apply for those. Volunteering at an agency where you may be interested in employment is also another opportunity to learn about future job possibilities.
When you locate a position, it is time to apply. The application usually has two parts: the cover letter and the professional resume. The cover letter is a letter that pertains to the reason why you are interested in that position. In the letter, you explain why you are qualified for the position. It should be no more than a page in length, and carefully written with no spelling, grammar or punctuation errors. The cover letter along with the resume should indicate the application for a position. The letter is not the place to discuss salary, or reasons for leaving a past job. The cover letter should be written in a positive and cheerful fashion.
See figure one below.
The second aspect to the application process is the professional resume. The resume is more nonspecific than the cover letter and can be applied to several positions with minor updates. The organization consists of a summary of your professional credentials. The purpose is to showcase the applicant’s abilities to the employer, in hope that he/she may consider the applicant for an interview. When creating a resume` there is no standard format, rather use a creative approach to gain the attention of the screening committee. Although you should avoid being adorable or cunning.
A resume should at least include the following information; other credentials may be added at the applicant’s discretion:
Personal data. Include your name, street address, email address and phone number where you can be easily reached so you can discuss interview details.
Education. List the name of your degree(s), your major, the name of the colleges or universities you have attended and the graduation dates. Also list all the schools that you have attended (list in reverse order). Also denote any special classes or projects you were included in such as honors or special training you may have had.
Experience. List employment starting with your most current employer and jobs previous. Give the job title, name of agency, dates of employment and job duties. It is also helpful to employers for you to add any volunteer experience that has contributed to your skill base.
Activities and interests. Denote your professional interests as well as those that go beyond social work. This may include memberships in professional organizations, your participation in clubs, offices or special interests.
References. If the job opening is asking specifically for references they should be listed on the cover letter or on a page after the resume`. The references you select to use, should be able to speak on your skills as they pertain to the position. Make sure to include the phone and email address of the people you have selected for references so that the employer can contact them.
Other information. You may want to add other information such as publications, travel experiences, and unique experiences that have impacted your skill level.
For examples of social work resumes, check out websites like https://www.luc.edu/media/lucedu/socialwork/pdfs/academicadvising/Resume Samples for Social Workers.pdf or Google “social work resume example”.
Upon a successful application process, you may hear back from the agency by receiving an invitation to interview. The interview typically will consist of a panel or committee of employees. The panel will ask you varied questions based on the type of position you are applying for, this may include scenarios of real possibilities on the field. To prepare for this interview, you will want to research the agency’s mission and vision statements, the type of population they serve. You can achieve this knowledge by going to the agency’s webpage, talking to employees, or stopping by the agency to pick up brochures on services. Finally, be prepared for inquiries about your personal and professional interests as well as your skills for specific job duties.
Licensure
Now that you are more familiar with the job processes let’s move on to a vital part of working in the field, licensure. It is important to keep in mind that all states and countries are different with regulations regarding licensure for practice. The same goes for BSW and MSW criteria for licensure. The examples I am going to use is for the state of Michigan; these are the regulations that I am more familiar with, please make sure to review the laws in your area for licensure to practice.
The Michigan Board of Social Workers was created under Article 16 of Public Act 299 of 1980, as amended, the Occupational Code, to register social workers in Michigan. Public Act 11 of 2000 transferred the Board of Social Work, and its authority, to the Public Health Code, Public Act 368 of 1978, as amended.
Social Work is defined as the professional application of social work values, principles, and techniques to counseling or to helping an individual, family, group, or community to enhance or restore the capacity for social functioning and/or provide, obtain, or improve tangible social and health services.
The Public Health Code mandates certain responsibilities and duties for a health professional licensing board. Underlying all duties is the responsibility of the board to promote and protect the public’s health, safety, and welfare. The Board implements this responsibility by ascertaining minimal entry level competency of health practitioners. The Board also has the obligation to take disciplinary action against licensees and registrants who have adversely affected the public’s health, safety, and welfare. Chapter One also includes information on obtaining your license for social work practice.
Figure 1
John Doe , MSW Graduate
Street address city, State zip Phone and email address
Date Written
Agency Name
Agency address
To Whom It May Concern:
I am extremely excited and interested in the Prevention Coordinator position for CMH. My experience working with clients as well as extended education has equipped me with a multitude of professional skills.
Throughout my career I have demonstrated excellent interpersonal skills such as compassion and understanding. When I saw that CMH was accepting resumes for a Prevention Coordinator, I immediately knew it would be a good fit for me. I am highly interested in helping individuals succeed. I am socially perceptive and able to demonstrate a caring and compassionate approach to people’s needs. I am also proficient at communicating with staff and clients, organizing and filing paper work as well as using multiple databases that will go along with the cases presented in this field. Not only do I have a great attitude, I am very detail orientated and I am also very motivated to do anything that is necessary to improve the clients’ well-being. I would prove to be an exceptional asset to your staff, and most importantly to the Team.
My interest has recently been in developing my knowledge in Mental Health and Trauma, in which I can assist those in need. I have a yearning to empower people so that they can lead better lives. Due to my knowledge and experience with serving clients, I know that I have the talent and knowledge necessary to succeed and enhance the staff in your agency. Thank you for considering me; I welcome the opportunity to introduce myself to your agency in person to discuss this collaboration.
Sincerely,
John Doe
What is it like to be a social worker?
Life as a social worker is never boring. One of the wonderful things about social work is that there is such a wide variety of employment possibilities. If you do not enjoy one area of social work, there is probably another area that you will enjoy. There are jobs in casework, therapy, administration, supervision, advocacy, community work, education, and other areas. Over time, many social workers move between these positions as their interests and skills levels change.
To read more about what it may be like to be a social worker, read the interview with Professor Gladden below.
Interview
Interviewer: How lead you to become a social worker?
Dr. Gladden: When I was in my undergraduate program, I worked at Degage Ministries in Grand Rapids with homeless individuals. I didn’t expect to love the work as much as I did! I decided social work wa the field I should be in and went straight into my MSW degree when I finished my BA.
I: What kinds of social work have you done?
Dr. G: I have done so many different kinds of work in the last 15 years! I started as a therapist for teens and adults who were survivors of domestic violence and sexual abuse. After that I worked with kids with autism, in therapeutic foster care, doing crisis work with adults and kids, and running a group home for adults with mental illness. One of my favorite positions was running and working on an Assertive Community Treatment (ACT) team. The ACT program works in depth with adults with severe mental illness diagnoses such as schizophrenia and Bipolar I disorders. There are therapists, caseworkers, nurses, and psychiatrists all working as a team to keep the adult safely in the community instead of in the hospital or an institution. I founded and ran a non- profit organization to support refugees in the Grand Rapids community. I have also been a social work professor for 10 years now, working to train new social workers!
I: What is a typical day for you as a social worker?
Dr. G: There is no such thing as a typical day, which is one of the things I love about social work! I’ve had positions where clients came to me in the office, so that was somewhat consistent, although there were always surprises such as a crisis client coming in. When running the crisis lines and working with the refugees, I would often spend part of the day in the office and part of the day driving out to see clients. Now I spend some days teaching classes, others seeing clients, and some doing paperwork for part of the day while doing all the other activities.
I: What is your favorite thing about social work?
Dr. G: I love the feeling of making a difference in someone’s life. There are many clients and students that you will work with that you have no idea what happened to them. Maybe they stopped coming in for therapy sessions without warning, or maybe the student graduates and you never even know if they are working in the social work field. But there are some that you do know about. I had a client who was a survivor of sexual abuse and sexual assault that I worked with for about a year and a half. At the end of our sessions, she wrote me a letter. In that letter, she said that I had saved her life. That may be overly dramatic, as I literally did not save her life, but that meant that to her, I made a difference. Those are the clients that keep you going.
I: What do you think makes social work unique?
Dr. G: I think social work’s perspective of the person in the environment is key. Many professions look at one part of the individual, but social work looks at everything. We look at the client’s mental status, where they live, where they work, what supports they have, what skills or strengths they have, and so much more! As social workers we need to know about more than just the person. We need to know community resources. We need to know about fields as varied as economics and neuroscience. And we need to have the ability to relate to the individual. Research has shown that it is not the method that we use that makes a difference, but the relationship. We need to be able to have those helping, supportive relationships with our clients. That is also what makes social work fun!
I: What advice would you give to new social workers or social work students?
Dr. G: Take care of yourself first. You need to know yourself, your beliefs, and what makes you feel safe and fuels your passions. Have outside interests and people to give you support. You can’t be there for your clients unless you take care of yourself first. | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.05%3A_Social_Work_Practice_Settings.txt |
“Poverty is hunger. Poverty is lack of shelter. Poverty is being sick and not being able to see a doctor. Poverty is not having access to school and not knowing how to read. Poverty is not having a job, is fear for the future, living one day at a time.
Poverty has many faces, changing from place to place and across time, and has been described in many ways . Most often, poverty is a situation people want to escape. So poverty is a call to action — for the poor and the wealthy alike — a call to change the world so that many more may have enough to eat, adequate shelter, access to education and health, protection from violence, and a voice in what happens in their communities.” – The World Bank Organization
Introduction to Poverty
Although poverty is one of the most familiar and enduring conditions known to humanity, it is a highly complicated concept to understand fully. Above is a definition of poverty given by The World Bank Organization. To date there is no one standard definition of poverty, but numerous definitions and descriptions. All current definitions and descriptions agree that poverty is a complex societal problem.
Regardless as to how poverty is defined, it can be agreed that it is a problem requiring everyone’s attention. It is important that all members of our society work together to provide opportunities for all members to reach their full potential. It helps all of us to help one another.
Povery wordart
Poverty looks different across the world. Commonly when we think of poverty, we relate it to the images we see on television of malnourished children living in developing countries. However, poverty is all around us. Even in the wealthiest of countries poverty still exists. Individuals who are living in poverty are made up of all races, ethnicities, ages, backgrounds, and geographic locations (Rodgers, 2015). For many individuals living in poverty, their lives are characterized by low wages, unemployment, underemployment, little property ownership, no savings, and lack of food reserves. The ability to meet even the most basic needs is in constant jeopardy. Feelings of helplessness, dependence, and inferiority develop easily under these circumstances (Sue, Rasheed, & Rasheed, 2012).
Absolute and Relative Poverty
When discussing poverty the terms absolute poverty and relative poverty are often used (Iceland, 2013). Absolute and relative are the two most common forms of poverty delineated in our society and around the world (Pierson & Thomas, 2010).
Absolute poverty
Absolute poverty refers to the amount of money necessary to meet basic needs such as food, clothing, and shelter. The concept of absolute poverty is not concerned with the broader quality of life issues or with the overall level of inequality in society but is based strictly on whether or not basic needs are being met (UNESCO, 2017). Examples of absolute poverty would include not knowing when or where your next meal will come from, not having access to clean drinking water, and not having an adequate place to sleep each night.
Relative poverty
Relative poverty refers to the lack of resources to obtain the types of diet, participate in the activities, and have the living conditions and amenities that are customary to maintain the average standard of living in society (Pierson, & Thomas, 2010; Poverty eradication, 2012). Relative poverty defines poverty in relation to the economic status of other members of the society, therefore determining if people are poor by gauging if they fall below normal standards of living in a given society (UNESCO, 2017). Examples of relative poverty would include not being able to have your children participate in after school activities, not being able to afford to dine out, or not being able to take vacations.
Three degrees of poverty
Evaluating poverty can be broken down into three different levels; the first and most severe is extreme poverty, the second is moderate poverty, and the third is relative poverty.
Extreme poverty
Extreme poverty is the most extensively discussed and researched degree of poverty due to its widespread effect around the world. Those living in extreme poverty are considered the poorest in the world (Harack, 2010). Individuals and families who live in extreme poverty cannot meet their basic needs for survival. These individuals frequently may not have access to food, safe drinking water, shelter, medical care, clothing, and educational opportunities, making everyday life a challenge (Poverty eradication, 2012, The World Bank, 2015).
Moderate poverty
Moderate poverty can be characterized when individuals and families can usually meet their basic needs but commonly face struggles in doing so (Poverty eradication, 2012). Individuals living in moderate poverty are in less danger than those living in extreme poverty. These individuals usually lack much, if any disposable income, but the majority, if not all of their basic needs are being met. Those living in moderate poverty may not be struggling to survive, but this type of poverty does make it difficult for individuals to progress in society and escape poverty completely (Harack, 2010).
Relative poverty: refer to the section above.
Measuring poverty in the United States
In the United States, there are two official poverty measures. Poverty thresholds are the primary version of the federal poverty measure and the second measure being poverty guidelines.
Poverty thresholds
Poverty thresholds were developed in the mid-1960s by Mollie Orshansky, a staff economist at the Social Security Administration. Orshansky created the poverty threshold by determining the cost of a minimum food diet and then multiplied the cost by three to account for other family expenses (United States Census Bureau, 2016). The U.S Census Bureau updates the threshold annually to account for inflation using the Consumer Price Index (Institute for Research on Poverty, 2016).
The U.S. Census Bureau determines poverty status by comparing pre-tax cash income against the threshold that has been set for that year (Institute for Research on Poverty, 2016). If the family’s total income is less than the family’s threshold, then that family and every individual in it is considered to be living in poverty (United States Census Bureau, 2016). According to the U.S Census Bureau in 2015, the most recent year for which data is available, the poverty threshold for a family of four was \$24,257, and the official poverty rate was 13.5 percent (Institute for Research on Poverty, 2016). Based on the poverty threshold data it was concluded there were 43.1 million people in the United States living in poverty in 2015 (Institute for Research on Poverty, 2016; Proctor, Semega, & Kollar, 2016).
Money income: Income used to compute poverty status
The poverty thresholds are primarily used for statistical purposes which include tracking poverty over time, poverty rates, and comparing poverty across different demographic groups. Furthermore, the data obtained from the poverty thresholds is used to create and develop annual poverty guidelines. (United States Census Bureau, 2016; Institute for Research on Poverty, 2016)
U.S. Census Bureau Poverty Thresholds, 2015, released September 2016
Poverty guidelines are the other official federal poverty measure used in the United States. The poverty guidelines are a simplification of the poverty thresholds utilized by the federal government to determine an individual’s eligibility for select federal programs (DHHS, 2017).
Updated poverty guidelines are issued every year by the U.S. Department of Health and Human Services (DHHS) (Institute for Research on Poverty, 2016). The 2017 poverty guidelines were determined using data taken from the 2015 poverty thresholds; the updated guidelines take economic changes taken into account.
Examples of federal programs that use poverty guidelines to determine eligibility include the following:
• Department of Health and Human Services: Community Services Block Grant, Head Start, Low-Income Home Energy Assistance
• Department of Agriculture: Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamp Program), National School Lunch Program, Child and Adult Care Food Program
• Department of Energy: Weatherization Assistance for Low-Income Persons
• Department of Labor: Job Corps, National Farmworker Jobs Program, Workforce Investment Act Youth Activities
(Institute for Research on Poverty, 2016)
2017 Povery Guidelines for the 48 Contiguous States and the District of Columbia
Even though the current official poverty measures have been used consistently since the 1960s, there are widespread concerns that the federal poverty measure is flawed. There is an overarching agreement that the Census Bureau does not identify all individuals living in poverty. The Census Bureau is unable to obtain exact numbers because many low-income individuals live with others or are frequently moving, and are in many cases homeless; furthermore, those residing in psychiatric hospitals, college dorms, nursing homes, serving in the military, and/or in jails or prisons are not counted. It is estimated that several million individuals who likely would fall below the poverty threshold and poverty guidelines are not counted each year (Rodgers, 2015).
For annual updates on poverty thresholds and poverty guidelines and further information on measuring poverty, please visit:
Measuring Global Poverty
International poverty line
Currently, global poverty is measured by the international poverty line. The international poverty line is a monetary threshold under which an individual is considered to be living in extreme poverty. It is calculated by taking the poverty threshold from each country, given the value of the goods needed to sustain one adult, and converting it to dollars (The World Bank, 2015).
The international poverty line was developed by The World Bank Organization and a team of independent researchers in order to gauge the number of individuals living in poverty around the world. The researchers examined national poverty lines from most impoverished countries around the world and converted the lines into a common currency by using purchasing power parity (PPP) exchange rates. The PPP exchange rates warrant that the same amount of goods or services are priced equivalently across the nation. Once converted into common currency, it was determined that the value of the national poverty line was \$1 per day per person in the 1990s (The World Bank, 2015).
Since the first national poverty line was developed, it has been revised twice, first in the mid-2000s when the line rose to \$1.25 per person per day after the collection of additional countries’ poverty lines and further data on internationally comparable prices were collected. The second and most recent revision was released in 2015 when the international poverty line rose again to \$1.90 per person per day (The World Bank, 2015). Unlike the United States, official poverty measures for the international poverty line does not have a set schedule as to when or how often the line is revised.
For further information on global poverty and how it is measured please visit: The World Bank http://www.worldbank.org/
Poverty in America
Poverty in America is much different than the poverty in third world countries. The standard of what constitutes poverty in the United States is much different than the global standard of poverty (Iceland, 2013). Even though the United States is one of the wealthiest countries in the world, the effects of poverty are crippling.
An example of what living in poverty looks like in America is a single parent who works full time, but still can’t afford to pay for food, rent, child care, medical bills, and the costs of transportation to work (Results, 2017).
Each year millions of Americans live in poverty. The United Sates Census Bureau reports that in 2015, there were 43.1 million people in poverty (Proctor, Semega, & Kollar, 2016). A wide array of Americans from all races, ethnicities, ages, backgrounds, and geographic locations make up the 43.1 million people currently living in poverty. Some groups are more vulnerable to poverty. The most vulnerable groups make up most of the impoverished population (Rodgers, 2015). The groups that are more susceptible to suffer poverty include single parent families (especially those headed by women), minorities, unemployed or under-employed adults, individuals with mental illness or disabilities, and the elderly (Rodgers, 2015).
Poverty is said to be America’s most serious and costly social problem (Rodgers, 2015). High levels of poverty result in many serious social and political consequences. Individuals living in poverty frequently feel alienated from a conventional society which can provoke social disorder. Individuals living in poverty also often feel overlooked in the political realm, further reducing the individual’s confidence in democratic institutions (Iceland, 2013).
Each year hundreds of billions of public and private dollars are spent on efforts to prevent poverty and assist those living in poverty (Rodgers, 2015). To many, it may seem that the efforts put forth to end poverty have not made an impact. However, the most up to date data attainable from the United States Census Bureau shows that there have been improvements. In 2015, for the first time in five years, the number of individuals living in poverty had decreased. The official poverty rate was down to 13.5%, 1.2% lower than in 2014, equaling 3.5 million fewer people living in poverty (Proctor, Semega, & Kollar, 2016). Although we may never see poverty completely eradicated in our lifetime, it is hopeful that poverty will continue to decrease in the coming years.
Find a Place to Live Simulation
Online poverty simulation game; click link to play: http://playspent.org/html/
Homelessness
Similar to the term poverty, there are numerous definitions for the term homeless or homelessness. We have chosen to use the definition of homeless used by the Department of Health and Human Services (DHHS) that was created by, and in conjunction with, the Health Resource and Service Administration (HRSA). It is as follows:
“A homeless individual is defined in section 330(h)(5)(A) as ‘an individual who lacks housing (without regard to whether the individual is a member of a family), including an individual whose primary residence during the night is a supervised public or private facility (e.g., shelters) that provides temporary living accommodations, and an individual who is a resident in transitional housing.” A homeless person is an individual without permanent housing who may live on the streets; stay in a shelter, mission, single room occupancy facilities, abandoned building or vehicle; or in any other unstable or non-permanent situation’ (National Health Care for Homeless Council, 2017, para. 2).
Who is experiencing homelessness?
The current 2016 statistics on homelessness in the United States are derived from The 2016 Annual Homeless Assessment Report (AHAR) to Congress.
• According to the AHAR the number of individuals experiencing homelessness on any given night in 2016 was 549,928.
• Among the 549,928 individuals who experience homelessness each night in the United States vary by age, race, sex, and other classifiable characteristics.
• According to AHAR, 69% of homeless individuals were over the age of 24, 22% were children and adolescents under the age of 18, and 9% were between the ages of 18 and 24.
• The AHAR reports that 60% of the individuals experiencing homelessness were men, 40% were women, and less than 1% were transgender.
• As for race, the AHAR reports that nearly half of all people experiencing homelessness were white totaling 48%, African Americans 39%, multiracial individuals 7%, and Native Americans, Asians, and Pacific Islanders made up the remaining 6%.
The data collected from the 2016 AHAR to Congress further concluded that homelessness and poverty affects all individuals regardless of age, sex, or race.
Picture of homelessness
Sheltering the Homeless
All information below is from The 2016 Annual Homeless Assessment Report (AHAR).
There are various resources for homeless individuals within the United States to gain safe shelter overnight or for temporary amounts of time. The following are some of the well-known homeless resources in the United States:
Emergency Shelter is a facility with the primary purpose of providing temporary shelter for homeless people
Rapid Rehousing is a housing model designed to provide temporary housing assistance to people experiencing homelessness, moving them quickly out of homelessness and into permanent housing.
Safe Havens are projects that provide private or semi-private long-term housing for people with severe mental illness and are limited to serving no more than 25 people within a facility.
Transitional Housing Programs provide people experiencing homelessness a place to stay combined with supportive services for up to 24 months.
Even with the implementation of the programs listed above, many homeless individuals remain unsheltered on any given night within the United States. Statistics show that 68% (373,571 people) were staying in emergency shelters, transitional housing programs, or safe havens, while 32% (176,357 people) were staying in unsheltered locations.
Rural vs Urban Homelessness
In our society, homelessness is often depicted as an urban problem. Urban areas are known to have a higher population of homeless individuals than in rural areas of the county. However, there is an increasing number of homeless individuals in rural America (National Alliance to End Homelessness, 2010). Geographical location makes a difference to the resources available for those experiencing homelessness, and sadly those living in rural America are often overlooked.
Rural areas face different barriers than urban areas when it comes to serving individuals experiencing homelessness. These barriers include lack of available, affordable housing, limited transportation methods and limited employment opportunities; federal grants and programs also tend to be dispersed in more urban areas (National Alliance to End Homelessness, 2010). The lack of federal funding in rural areas causes a problem when trying to house the homeless. Due to this lack of funding there typically are not homeless shelters in rural areas, causing individuals experiencing homelessness in these areas to sleep in cars, campers, tents because shelter is not available.
Affordable Housing:
There are countless reasons as to why or how an individual becomes homeless, but research shows the key reason as to why he or she cannot escape homelessness is because the individual cannot afford housing. The United States is currently experiencing an extreme shortage of affordable housing (National Alliance to End Homelessness, 2017). The two main types of affordable housing are Public Housing and the Housing Choice Voucher Program (HCVP) which was formerly known as Section 8. It is not uncommon for Public Housing programs and the HCVP to have wait lists that are several years out.
Housing Voucher Program: This program provides vouchers to low-income households to help them pay for housing in the private market and has been found to sharply reduce homelessness (National Alliance to End Homelessness, 2017).
Public Housing: Federally-funded housing that is rented at subsidized rates to eligible low-income families, the elderly, and persons with disabilities.
Federal Government Response to Poverty: Welfare
The United States laid its foundation for a national welfare system in response to the Great Depression that started in 1929 and went through most of the 1930s. The Social Security Act of 1935 was the first of many government policies and welfare programs created to combat poverty and economic hardships (Rodgers, 2015).
The welfare system in the United States consists of government programs which provide financial assistance to individuals and families who cannot support themselves. Welfare programs are funded by taxpayers and allow people to cope with financial stress during challenging periods of their lives. The goals of welfare include the attainment of work, education, and an overall better standard of living and decrease in economic hardship and poverty.
Welfare programs
Since the establishment of Social Security Act of 1935, the federal government has continued to develop numerous welfare programs to attempts to eradicate poverty and the economic hardships faced by millions of Americans.
Key programs to combat poverty include but are not limited to the following:
All information below is from the Center for Poverty Research
1935: The Social Security Act
Part of President Franklin Roosevelt’s New Deal legislation, the original act included grants to states for unemployment compensation, aid to dependent children and public health. Today, Social Security is the largest safety net program in the U.S.
1935: Unemployment Insurance
Unemployment insurance was a part of President Franklin Roosevelt’s 1935 Social Security Act. Today’s U.S. Department of Labor Unemployment Insurance (UI) programs provides benefits to eligible workers who become unemployed through no fault of their own and who meet certain requirements.
1964: Head Start
This pre-school education program was a part of the 1964 Economic Opportunity Act that was designed to reduce disparities among young children. The 1994 Head Start Act Amendments established the Early Head Start program, which expanded the benefits of early childhood development to low-income families with children under three years old.
1964: Supplemental Nutrition Assistance Program (SNAP)
The first Food Stamp program ran from 1939-43, but the program we know today was established with the 1964 Food Stamp Act. The program is now known as the Supplemental Nutrition Assistance Program.
1965: Medicare/Medicaid
These health programs were established with amendments to the Social Security Act in 1965. Today, Medicare provides health insurance for people over 65 years of age and some younger than that but who have certain disabilities or diseases. Medicaid is a Federal and state partnership that provides health coverage for people with low income.
1972: Supplemental Security Income Program (SSI)
SSI is a Federal program that provides income people 65 or older as well as to blind or disabled adults and children.
1972: Women, Infants, and Children (WIC)
WIC is a nutrition program that benefits pregnant women, new mothers and young children who live near poverty and who are at nutritional risk. WIC is not an entitlement program, so the number of people who receive the benefits depends on the amount Congress allots for the program from year to year.
1972: Federal Pell Grant Program
Pell Grants help pay for tuition and other expenses for low-income college students.
1975: The Earned Income Tax Credit (EITC)
The EITC is a tax credit that benefits working people who have low to moderate income, especially families.
1996: Temporary Assistance for Needy Families (TANF)
TANF issues federal grants to states for programs that provide temporary benefits to families with children when the income does not provide for the family’s basic needs. Programs include job preparation, family planning, and other benefits as well as cash assistance.
1997: Children’s Health Insurance Program (CHIP)
CHIP provides health coverage to nearly eight million children in families who cannot afford private health insurance but who have incomes that are too high to qualify for Medicaid.
According to the United States Census Bureau in 2012, there were approximately 52.2 million (or 21.3 %) people in the United States receiving some sort of assistance through government funded welfare programs (United States Census Bureau, 2016). To receive assistance from government funded programs individuals must meet a certain criteria to be eligible; each program has their own distinct criteria. To apply to these programs individuals must go through state Departments of Health and Human Services (DHHS).
For further information on government funded assistance programs please visit:
Poverty Stigmas and Stereotypes
Stigmas
In the United States individuals living in poverty are not only faced with their day to day hardships but also with the harsh stigmas that society has surrounding poverty. When evaluating stigmas surrounding poverty, they typically fall into three categories: institutional, social, and personal stigmas (Bell, 2012; Inglis, 2016):
Institutional Stigmas: institutional level stigma can be seen in laws, policies and institutional practices that discriminate against, or shame individuals living in poverty (Inglis, 2016). Institutional stigma is that which arises from the process of claiming benefits (Bell, 2012)
Social Stigmas: Social stigma includes public attitudes toward poverty and welfare, and are typically measured through national surveys (Inglis, 2016). Social stigma is the feeling that other people judge claiming benefits to be shameful (Bell, 2012)
Personal Stigmas: Personal stigma occurs when individuals internalize the various forms of stigma and discrimination that they experience or perceive from others (Inglis, 2016). Personal stigma is a person’s own feeling that claiming benefits is shameful (Bell, 2012).
Stereotypes
Furthermore, society holds many stereotypes about individuals living in poverty. A stereotype can be defined as an often unfair and untrue belief that many people have about all people with a specific characteristic (Stereotype, 2017). The stereotypes that society has labeled individuals living in poverty are usually false. Some of the most common stereotypes and misconceptions of individuals living in poverty include:
• Individuals living in poverty are lazy and have weak work ethics
In reality, there is no suggestion that individuals living in poverty are lazier or have weaker work ethics than individuals from other/higher socioeconomic groups. In fact, poor working adults work, on average, 2,500 hours per year, the rough equivalent of 1.2 full-time jobs often patching together several part-time jobs in order to support their families (Gorski, 2013)
• Individuals living in poverty have problems with substance use
In reality, research has shown that low-income individuals are less likely to use or abuse substances than their wealthier counterparts (Gorski, 2013).
Stigmatizing and stereotyping individuals living in poverty only further creates a divide between low-income people who are living in poverty and those who are not (Inglis, 2016). Society’s harsh views on poverty cause impoverished individuals to further feel socially excluded and ashamed of the situation they are in. Research has shown negative effects on an individual’s self-esteem, self-concept, and mental and physical health due to being stigmatized and stereotyped so severely by society (Inglis, 2016).
Theories and Explanations of Poverty
There are many theories that attempt to explain poverty and why it exists. A theory in simple terms can be defined as idea or a structure of ideas intended to explain something (Theory, 2017). You will learn more about theories in-depth in higher level social work courses.
The following are some of the most commonly used theories to explain the existence of poverty.
The Culture of Poverty
The culture of poverty theory was created by the anthropologist Oscar Lewis in 1959. The culture of poverty is the theory that certain groups and individuals persist in a state of poverty because they have distinct beliefs, values, behavior, and attitudes that are incompatible with economic success (Pierson, & Thomas, 2010). Therefore, the individuals are unable to get out of poverty.
The Cycle of Poverty
The cycle of poverty is also commonly known as the cycle of deprivation. The cycle of deprivation is a theoretical explanation for the persistence of poverty. The theory focuses on how attitudes, values, and behaviors are passed on from one generation to the next, further explaining the ongoing cycle of low educational attainment, unemployment, poor housing and so on within families and communities (Pierson & Thomas, 2010).
As discussed in the explanation of the cycle, poverty is passed down generationally, meaning that children and adolescents are targeted victims falling into the cycle of poverty and not getting out of it. There is much research that indicates that children and adolescents who grow up in poverty suffer significant disadvantages, not just as children but throughout their lifespan. Alarming statistics report that children who grow up in poverty are twice as likely to drop out of school and are one and half times more likely to be unemployed (Rodgers, 2015), further contributing to the ongoing cycle of poverty.
Structural/ Environmental Explanation:
Structural explanations propose that poverty is based on the social structure of society (Kirst-Ashman, 2013). To put it simply, the structural explanation suggests that poverty and its ongoing existence results from problems in society that lead to a lack of opportunity and a lack of jobs (University of Minnesota, 2010). Structural and environmental factors that play a role in this explanation include fluctuations in the economy, not having enough jobs in the job market, low paying jobs or jobs with no benefits, lack of affordable housing, and discrimination (Ritter, 2014). An example of this would be: poverty occurs when wages are too low and that there are not enough adequate paying jobs (Kirst-Ashman, 2013).
Individualistic Explanation:
Similar to the culture of poverty theory, the individualistic explanation of poverty suggests that poverty results from the fact that poor people lack the motivation to work and have certain beliefs and values that contribute to their poverty (University of Minnesota, 2010). Individual factors that contribute to a person living in poverty may include lack of job skills, educational deficits, mental illness, declining health or disabilities, substance use, single parenting, lack of childcare, and lack of reliable transportation (Ritter, 2014). An example of this would be: a person who lost their job due to being late so many days in a row and now he or she cannot afford rent and may be at risk of becoming homeless.
Poverty and Social Work
National Association of Social Work
As discussed in chapter two, social workers abide by the National Association of Social Work (NASW) Code of Ethics. One of the six values in the NASW code of ethics is social justice. The definition of the ethical principle from the NASW states, “Social workers’ social change efforts are focused primarily on issues of poverty, unemployment, discrimination, and other forms of social injustice,” (NASW, 2008). With the NASW Code of Ethics acting as the professions guiding light it is highly important for social workers to have knowledge and understanding of poverty and its severity within our society and around the world.
Social work’s role
The social work profession has an extensive history of working to assist poverty at the micro, mezzo, and macro levels (National Association of Social Workers, 2017). The following are examples of social work roles on each of the three levels.
Micro
Micro level practice works with an individual or a family on a one-on-one basis (Giffords, & Garber, 2014). Micro level social workers are the clinicians who often work most hands- on with individuals who are living in poverty. Micro practice, as it relates to poverty, may include linking a client to unemployment resources, housing resources, assisting individuals in applying for welfare programs, and helping the individual cope with the hardships of living in poverty.
Case Study: Micro Level Social Work
“A social worker has an intervention with a young woman living in a poor urban community. When she first appeared for social services, the young woman was pregnant, depressed and unable to pay her rent. However, she was determined to improve her life circumstances and those for her unborn child. She couldn’t save money because she had another child to support. Although he was emotionally supportive, her partner was unable to financially contribute to her support. During their work together, the social worker was able to develop a plan of action with her client. By following up on leads, the young woman was connected with several sources of tangible help in her community. Over the next few months, she was able to identify subsidized housing, obtain prenatal care, and receive treatment for her depression and to enroll in a part-time job training program. Her partner was also able to find employment through a community job bank. By the time her baby was born, the young woman’s outlook on life was brighter.” (NASW, 2017)
Mezzo
Intervening at the group level constitutes mezzo practice (Giffords, & Garber, 2014). Some focuses on mezzo level social work practice in regards to poverty include facilitating groups that focus on employment skills, working in schools to help low-income children learn to read and write better, and working with community organizations and agencies that assist with poverty and homelessness.
Macro
At the Macro level social workers focus on effecting systematic change that can benefit individuals at a societal level (MSW careers, 2017). In regards to poverty some of the ways macro level social workers can assist include advocating for laws that affect those living in poverty, developing programs to assist individuals and families living in poverty, and educating the community on the need for social change.
For further information on micro, mezzo, and macro social work please refer back to Chapter 4.
Summary
After reading this chapter it is my hope that you have expanded your knowledge and understanding of poverty and how it closely relates to the social work profession. As previously stated social works focus on poverty stems back the NASW Code of Ethics which acts as the professions guiding light.
Regardless as to what career path you take in the field of social work it is anticipated that you will serve individuals and families who fall below the poverty line and face financial hardships. Therefore, as future social workers it is important that you have an adequate understanding of what poverty is and the effects it has on individuals and society as a whole. | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.06%3A_Poverty.txt |
One hundred years from now it won’t matter what car I drove, what kind of house I lived in, how much I had in my bank account, nor what my clothes looked like. But, the world may be a little better because I was important in the life of a child. – Unknown
In this chapter, you will learn many of the basics of child welfare and foster care. In addition, you will learn about family, what the basic definition of family is, the various family functions, and how these play a role in the child welfare system. Family is the foundation of the child welfare system. The child welfare system is necessary to help keep children safe, including providing safe places to live through other family members or even foster care. Before the welfare system existed, the safety of children was left up to the parents. They were able to punish and raise their children however they felt was necessary.
You will learn through this chapter that the necessity of the child welfare system is important to help families keep children safe. Also, some myths about the child welfare system may be refuted as well to hopefully give you as the reader a better understanding of what the child welfare system is and what it is not.
To get a good overview/understanding of what a child may experience with their family, abuse, and in the Child Welfare System (CPS and Foster Care), please follow this link and watch the two videos provided. Warning, this video may evoke some heavy emotions of sadness, so prepare yourself to watch this video: Removed Film (https://www.removedfilm.com/pages/watch)
Family
Family Structure
Families are the foundation of society. Family is where children learn the basic skills necessary to succeed. Children learn how to interact with others, learn what love is, and more. There are numerous types of family structures, and each culture has its own family practice. A basic definition of family, according to the United States Census Bureau, is a group of people (two or more) that are related in various ways including birth, marriage, or adoption, and share residence with one another. This section will outline various family structures along with highlighting some families within different cultures.
The family structure is ever changing and can have various effects on the family as they move forward. A traditional family, also known as nuclear family, is defined by Edwards (2007) as a married couple and their biological children. This is one of the more reinforced family structures in the dominant society. It should be noted that a child starts out with their traditional family, and as they grow, becomes more involved in outside activities, or even move out to live with others. Thus, the family grows to beyond relatives and includes friends. Another thing to keep in mind is the idea that a child may start out in one type of family structure and then the structure or dynamic of that family may change due to divorce, death, parents marrying again, or even just an addition to the family through adoption, foster care and more.
Single-parent families are families with one parent and their child/children. The parent has sole responsibility for caring for their child. Though most think of it being single mothers, this includes fathers as well, and can happen in various other ways. The parents could separate and/or divorce/break-up and do what is known as co-parenting. Edwards (2009), coins the term as co-custody family. This is shared responsibility, in which both parents take care of the child at different points (i.e one parent may have them for a week and the other would have them on weekends or every other weekend). The co-parenting can be set up in various ways either through Friend of the Court, or just by mutual agreement. Single parent families can also occur by a spouse passing away. Grief counseling would then be a great tool for these families to utilize.
Key Term
Friend of the Court or FOC, is a section of the circuit court that investigates custody, parenting time, or even child support. They are directed by the judge, and is in a sense a third party to a lawsuit who is not the defendant or the plaintiff (the person who places the complaint in a lawsuit).
To learn more about what a FOC is and what their duties are, look at this FOC handbook provided by the Michigan Government. courts.mi.gov/administration/scao/resources/documents/publications/manuals/focb/focb_hbk.pdf
Often parents who are divorced or become a single parent by other means potentially remarry to others who may or may not have children of their own. This in turn creates what is known as step-family. Step-family refers to the dynamics of a re-married couple who have children but do not all share DNA. This means that the mother may have a child, but the child is only the fathers’ responsibility through marriage and not by any other means (same with the father having a child who does not share DNA with the mother). Another aspect to consider when step-families are created is that when they then have children together it creates a blended-family. Though the children may not be biologically related to both parents, they can still have a secure and strong bond/attachment with said parent. Some children may refer to their step-parent as their mother or father, and some may refer to them by first name. When working with the children within this family structure, validate them by addressing their caregivers the same way they do. This in turn will help build the rapport with the child needed to be able to help them to the best of our ability.
An extended family is a family that includes members outside of the nuclear family. This term encompasses the grandparents, aunts, uncles, cousins and more. In some cultures, the extended family members, more specifically grandparents, live with the nuclear family. Now, especially in American society, we see a lot of the elderly being placed in nursing homes. Even if they do stay home, usually they rely on home health practitioners for support. To learn more about the area of gerontology and the social workers role within that population refer to Chapter 8.
Keep in mind that these are only a handful of the various types of family. Other types may include transnational, LGBTQ (this population is especially vulnerable due to difficulty with civil rights), and more.
Family Function
One of the foundational functions of a family is to care for their children. Clinical Psychologist Diana Baumrind founded three models of parenting styles. These include authoritarian, permissive, and authoritative parents. Enrique et al. (2007) added uninvolved parenting as a style in child rearing.
Authoritarian parenting is defined by Baumrind (1966) as a parenting style that attempts to shape or control a child’s behavior with a set of absolute standards. They are typically the type of parents that lay out the rules with “no questions asked” mentality. Therefore, they expect their rules to be followed with no explanation at all.
Permissive parenting is known more as the responsive type rather than the demanding type. Characteristically, they are very “lenient, do not require mature behavior, and avoid confrontation” (Enrique et al., 2007). Baumrind (1966) describes permissive parenting as a style that does not expect or demand help around the house, orderly behavior and so on. However, she also describes them as parents who are more accepting of the child’s behavior.
Authoritative parenting is described by Baumrind (1966) as the parent attempting to “direct the child’s activities in a rational, issue oriented manner. Encourages verbal give and take,” and more (p. 891). Authoritative parenting is seen as more ideal and valued as this parenting style tends to encourage structure, and firmness with rules, but it does not restrict the child in any way.
Uninvolved parenting can take on many forms, but in every form the parents do not involve themselves in their child’s lives. Enrique et. al (2007), discuss that with uninvolved parenting parents are either too involved in other activities (work, friends, etc.) that they do not have the time or energy for their child(ren), or they may have even rejected their child.
It is important to consider that the parenting styles listed above only describe normative behaviors; meaning, they are not taking into consideration homes with abusive parents or other variations that could occur. A “crucial role for parents is to influence, teach, and control their children” (Enrique et. al, 2007). In other words, caregivers have a tremendous amount of impact on a child’s life. For example, a child who grew up in a household where the parents are accepting of everyone, non-judgmental, and respectful, may then portray the same behaviors in other environments. Thus, the four primary parenting styles simply describe some of the various ways in which parents attempt to interact and influence their children.
One of the foundational functions of a family is to care for their children.
Key Term
Antisocial Behavior: Antisocial Behavior is termed as Antisocial Personality Disorder in the DSM 5. This means that a person typically has no regard for others in the form of violence, and others, lack of remorse, no regard for safety, lack of empathy, and more.
To get more information refer to the DSM 5.
You can also follow the link provided to read more about it online: www.ncbi.nlm.nih.gov/books/NBK55333/ You can also learn more in Chapter 9: Mental Health and Substance Use.
Each parenting style has positive and negative aspects and having a balance is key. Baumrind (1966) discusses the various effects of different parenting styles and found that authoritative parenting tends to have a positive effect on children. She mentioned that having firm control was associated with conscious development and being too rigid could lead to hostility in children. Authoritative parenting, as mentioned above, is a mixture of give and take, and firm control. This typically allows the parents to have their children obey rules, and to discuss many variables as well to help the child understand the punishment.
Baumrind (1966) states that the key to avoiding negative outcomes when parenting children is to offer firmness and structure, but to not be repressive, hostile or restrictive. She goes on to mention that partaking in a more rigid and restrictive parenting style can lead to antisocial behavior, rebelliousness, and hostility. Authoritarian parenting, where the parents are more rigid – almost as if a drill sergeant – can have many negative effects, like hostility in children. Being more restrictive can lead to decreasing self-assertiveness in children, as well, according to Baumrind (1966).
Family Culture/Values
In the field of social work, it is highly important to remember that we are to validate the families we work with and not judge them. We must acknowledge the family’s culture by respecting their belief systems and values. For example, if a family comes to you and you notice that the female is looking down and not making eye contact, consider the fact that in their culture that may be how the female shows respect to her husband, and possibly other authoritative figures. Thus, interacting with the family in the way they feel comfortable (i.e talking to the husband first etc.) will help one build a solid rapport (close relationship) with the family group.
Enrique et al. (2007), provides the following ideas for working with families:
Working with Families
1. Avoid stereotyping
2. When introducing new ideas, materials, and more respect the family’s need for control
3. Recognize the parenting styles being utilized, and their boundaries
4. Recognize that everything may be a family affair with some families
5. Help families notice their strengths within each other
6. Ask for family’s input when coming up with solutions to conflict
7. Encourage families to plan ways to increase stability and security (i.e. bedtime rituals etc.)
8. Observe and engage with the family to learn the different dynamics (i.e. male head of the household, or is it the female?)
9. Provide opportunities for the family to discuss what their beliefs are about children (should they be seen not heard etc.)
10. Maintain an objective viewpoint when working with conflict within the family system
Child welfare wordcloud
Child Welfare
Brief History
Child welfare is necessary in our society to help maintain child safety and keep families working cohesively. The Child Welfare Information Gateway (CWIG) (www.childwelfare.gov) defines child welfare as a field of services that aims to protect children and ensure family have the tools to care for their children successfully. Many people see this happen through an agency like the Department of Health and Human Services (DHHS) which is present in every state. To ensure the safety of children, DHHS is responsible for performing various tasks. These tasks include things like coordinating services to help prevent abuse or neglect, and providing services to families who need help protecting and caring for children. They are also responsible for investigating reports of potential abuse and/or neglect, and then determining if alternative placement of children is necessary. They are also in charge of various other aspects including support services to children, achieving reunification, and more. Child protective service workers and foster care workers are the more specific workers in which these work functions are performed.
According to Myers (2008), the first organization that was solely focused on protection was known as the New York Society for the Prevention of Cruelty to Children. This agency was established in 1875, and prior to that many children in our society went without protection, although many people were still prosecuted by the criminal justice system. Organized protection services came about after the rescue of 11-year-old Mary Ellen Wilson who was continuously beaten and neglected in her home.
If you want to learn more about how her story inspired the creation of the New York Society for the Prevention of Cruelty to Children follow this link: http://www.facesofchildabuse.org/mary-ellen-wilson.html
The federal government did not become more involved in child welfare until approximately 1935 when they became more involved with the funding of the agencies. Thus, it was the Great Depression that sparked the start of the Child Welfare System. In 1975, Michigan passed the Child Protection Law available to view at the link provided below. This act defines various abuses, central registry and various other aspects that involve the child welfare system. The act provides guidelines for people to follow in regard to when to report (and what is grounds for a report, the court processes, and more).
https://www.michigan.gov/documents/DHS-PUB-0003_167609_7.pdf
Indian Child Welfare Act (ICWA)
ICWA is another segment of child welfare specifically for Native American families. “In 1958 until 1967 the Child Welfare League of America has contracted with the Bureau of Indian Affairs with the purpose of placing Native American children with white families in hopes of assimilating the children to mainstream culture.” (ICWA Law Center). This practice often left the children in boarding schools severing the relationship with the families. In response, the Indian Child Welfare Act was put into place in 1978. This act highlights the recognition of tribal sovereignty, preservation of Indian families, and tribal and family connectedness. To learn more about the ICWA visit the link provided.
http://www.icwlc.org/education-hub/understanding-the-icwa/
Child Protection Services
Child Protection Services, or CPS, is a segment within the Department of Health and Human Services. The role of CPS is filled by a variety of disciplines including but not limited to Social Work, Criminal Justice, and Psychology. According to the Michigan Department of Health and Human Services website CPS is “responsible investigating allegations of child abuse and neglect” (MDHHS, 2017c). There are many rules and regulations when it comes to the process of a CPS investigation and the removal of a child from the home. Keep in mind that though many think of CPS workers as being “kid snatchers” the intent of CPS is not to remove children just because they feel like it. Instead, their goal is to keep the family together if possible. They remove children if their safety is being threatened. The link provided outlines in more detail the grounds for a removal. If services alone cannot help provide protection and safety to children then a removal is necessary. dhhs.michigan.gov/OLMWEB/EX/PS/Public/PSM/715-2.pdf
The process of a CPS investigation starts out with a report called in of a suspected child abuse/neglect case. Chapter 2: Social Work Values and Ethics provides a definition of mandated reporting as well as the people who are mandated reporters. After a report has been made, CPS has 24 hours to begin the investigation, unless there are mitigating circumstances in which the investigation needs to be started sooner. There are different priority levels in which an investigation takes place. This is explained in the Child Protective Services Manual.
Priority one is when the child is in immediate danger, and thus CPS has 12 hours to begin the investigation and 24 hours to interview the victim. Priority two is when it is determined that the child is not in immediate danger/risk. The CPS worker then has 24 hours to begin the investigation, and 72 hours to initiate an interview with the child. After the investigation has begun, CPS then has 30 days to complete the investigation (unless there are circumstances that cause a need for an extension) and to determine whether or not the child needs to be removed, if further support services are needed, or if there is no need for an intervention.
According to the Michigan Government, the investigation typically includes face to face interviews with the alleged victims, caregivers, and the person who supposedly committed the act of abuse. They do a thorough search of the home making sure that there is food, running water, electricity, a bed to sleep in and that the house is well kept and clear of any safety hazards. The investigator then digs into previous reports, potential criminal history, and school and medical reports as well. They do a safety risk assessment, and analyze the child’s behavior and risk of future abuse/neglect, and then complete an assessment of the family’s needs and strengths as well.
The purpose of the assessments and interviews is to get a well-rounded understanding of what is going on. They are searching for things like alternative explanations of what was reported, if the child has any injuries, the condition of the home, adequate supervision, and do the best they can in finding out if the caretakers are abusing or neglecting the child in any way and more.
The next step is determination for removal (follow this link, Removal, to learn more about what the state finds as grounds for removal). There must be enough evidence to prove that the child was abused or neglected in some way.
MDHHS identifies five categories in which a case is placed depending on the evidence that was found during the investigation. They range from Category I to Category V.
• Category I: Department determines that there is enough evidence of abuse or neglect and court petition is needed and required.
• Category II: Department determines that there is enough evidence of abuse or neglect, and the risk assessments show high risks
• Category III: Department determines that there enough evidence of abuse and neglect, and the risk assessments show a low or moderate risk
• Category IV: Department did not find enough evidence of abuse and or neglect and the department must then assist the child’s family in participating in community based services.
• Category V: In this instance CPS was unable to locate the family, or there was no evidence of abuse or neglect. It is also possible that the courts may have declined to issue an order in which the family would be required to cooperate in the investigation.
These categories were listed at the Michigan government website (link below). In Category I and Category II cases, the person who committed the act of violence will be placed on the Child Abuse and Neglect Central Registry.
http://www.michigan.gov/mdhhs/0,5885,7-339-73971_7119_50648_7194-159484–,00.html
Though removals may be necessary, they are still traumatic for the child. The child has a bond with the caregiver, and that caregiver is all they know. If there is more than one child involved, CPS will try and keep the children together. A child who has been through any type of abuse in their home still has a strong emotional bond between all members of the family. That is why many people are confused as to why the victim may want to return to their families who harmed them. That is where their bond is, and it will take time for them to understand that what has happened is wrong and they deserve better.
CPS workers work in a high stress position. They often are entering into environments in which the safety of a child, and even their own safety, is of great concern. Vicarious Trauma (often known as secondary trauma) is another type of trauma in which CPS workers will need to be aware of. Vicarious trauma is defined by the National Children’s Traumatic Institute as the “experience of professionals who are exposed to others’ traumatic experiences and in turn develop their own traumatic systems and reactions” (NCTSN, 2012, p. 1).
Due to the high stress, and the emotional toll that this job can have on a person, self-care is highly important. Self-Care is in a sense something that a person does to help them cope with stress. This can be through meditation, doing an activity that they enjoy, going for a walk and more. YouTube, is a great resource to look up guided meditation videos. NCTSN (2012) discusses that without coping mechanisms, or even seeking out help for it, the reaction from one person can impact other workers until it spreads. The spreading is then as if the whole agency is one person who has experienced secondary trauma, thus burnout rates increase.
Key Term
Burnout: “prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by three dimensions of exhaustion, cynicism, and inefficacy” (Maslach, Schaufeli, Leiter, 2001, p. 397). In a sense, a person no longer has the passion or empathy they once had. The link below is an article that describes the signs of burnout, and what to do for prevention.
Prevention is the key to fighting against burnout. http://www.naswassurance.org/pdf/PP_Burnout_Final.pdf
Abused children often suffer from trauma throughout their adult lives. Patients that were exposed to trauma in early childhood can express their anxieties through drawings.
Types of Abuse/Trauma
Children involved in the Child Welfare System have often experienced trauma. Trauma is defined by the National Child Traumatic Stress Network as frightening events that are overwhelming to anyone who experiences them (NTCSN, 2017). Often a person feels that their safety is a concern and are on high alert to anticipate what may or may not happen next. There are three different types of trauma: acute, chronic and complex.
Before defining the different types of trauma, one must understand that all types of trauma impact the brain. The stress hormone cortisol is released, then creating the fight or flight mentality. These reactions can occur any time after a traumatic experience. The link provided is a video that explains the effects of trauma on the brain and provides many explanations of how one can help others’ who have experienced trauma: www.changingmindsnow.org.
Acute Trauma/Chronic Trauma
Acute Trauma is a single traumatic incident. An example would be a car accident or even a natural disaster. It may only be a single incident, but it can have lasting effects such as fear of being in a vehicle. Chronic Trauma is a traumatic experience that is repeated over a period of time. This type of trauma would include domestic violence, and war. Both have lasting effects on many people and the consequences can be hard to overcome.
Complex Trauma
Complex Trauma is a repeated traumatic experience that has been inflicted by a caregiver. This includes, but is not limited to, physical abuse, sexual abuse, and verbal/emotional abuse (also known as psychological abuse). Complex trauma leaves a child confused and conflicted. The person who inflicted harm was supposed to be the one protecting them and keeping them safe. When that does not happen the child is then in a predicament where they do not know who to trust. A main type of trauma that will be highlighted in this chapter is complex trauma. This type of trauma occurs in various forms of abuse which are defined below.
Abuse comes in many forms including physical, emotional/verbal, and sexual abuse. According to the National Child Traumatic Stress Network (NCTSN, 2017) physical abuse is defined as any act, completed or attempted, that physically hurts or injures a child. NCTSN also describes that acts of physical abuse include hitting, kicking, scratching, pulling hair, and more. Child Protection Services typically get reports of bruises, and other noticeable marks when investigating a report of physical abuse.
Emotional abuse is a nonphysical maltreatment of a child through verbal language. NSPCC (National Society for the Prevention of Cruelty to Children) states that emotional abuse includes “humiliation, threatening, ignoring, manipulating, and more.” (www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/emotional-abuse/what-is-emotional-abuse/) Emotional abuse can be combined with other forms of abuse like physical and sexual abuse. Most reports emotional abuse is harder to prove and thus physical or sexual abuse tends to be the main cause of removal in a home.
Statistics about Sexual Abuse
• In 2012 26% of sexually abused victims were ages of 12-14 years. 34% were ages 9 or younger. (U.S Department of Justice, NSOPW).
• Center for Disease Control found that 1 in 6 boys and 1 in 4 girls are sexually abused before they reach the age of 18.
The link provided is where these statistics were found, and more statistics are available: https://www.nsopw.gov/en/SafetyAndEducation/QuestionsAndAnswers#QuestionsAndAnswers
Sexual abuse has many facets when it comes to a specific definition. Overall, sexual abuse is a “type of maltreatment, violation, and exploitation that refers to the involvement of the child in sexual activity to provide sexual gratification or financial benefit to the perpetrator. It includes contact for sexual purposes, molestation, statutory rape, prostitution, pornography, exposure, incest, or other sexually exploitative activities.” (American Society for the Positive Care of Children, 2017). The person who inflicted harm will typically use force, threats, or coercion to those who cannot/do not give consent.
A grooming process typically takes place when it comes to sexual abuse. According to the National Center for Victims of Crime, there are seven grooming steps that tend to take place when sexual abuse may or already has occurred. They are good steps to watch for to potentially help prevent a potentially abusive situation from occurring. Most, if not all, sexual abuse is inflicted by someone the victim knows and usually trust. Thus, the grooming process can be very easy for the potential abuser to enact on the victim. However, this is not intending to say that all sexual abuse is inflicted by someone the victim knows; it can be inflicted by those the victim does not know, as well.
Grooming Steps
• Identify/Target Victim: anyone can be a victim pending the type of person the offender may be attracted to
• Gaining Trust/Access: the person intending to inflict harm may look for vulnerabilities
• Play a Role in Child’s Life: could be a mentor, may manipulate the relationship to make themselves appear to be the only one that knows the victim
• Isolating the Child: Offering rides away from current surroundings is an example.
• Creating Secrecy Around Relationship: reinforce the relationship through private communication. Coercion may be used like threatening harm to themselves, or others and more.
• Initiating Sexual Contact: At this point the offender has control of the relationship, may start as ‘friendly’ touching, but can lead to penetration or worse over time
• Controlling the Relationship: Secrecy is needed in order to keep the process going. Fear is usually the key factor as to why abuse is often not reported. Victim blaming (it’s your fault I am doing this, no one will believe you,) often happens at this point along with continued threat of potential harm to them or their families
Abuse does not always have to be physical, sexual, or verbal assault. It can also be neglect. According to the National Society for the Prevention of Cruelty to Children (NSPCC), neglect is the failure to meet the basic needs of a child. The NSPCC website states that neglect is the most common form of abuse. According to Crossen-Tower (2010) there are three categories of neglect: physical, medical, and emotional. NSPCC adds educational neglect to the list.
Things to Remember When Working with Trauma Victims
When working with children who have been abused, or a family who has experienced trauma, remember that building resiliency is a key factor. Resilience is defined by the American Psychological Association (APA) as having the ability to adapt when facing adversity including trauma (APA, 2017) This, in a sense, means that one is able to bounce back after facing trauma. However, this does not mean that there will not be any kind of consequences or negative impact as a result of trauma. A resilient individual will have the tools needed to move past the traumatic experience and potential future traumas.
To help children build resiliency, the APA suggests a variety of different techniques (APA, 2017). One is to help the client build connections. Finding a support person they can be close to and trust will help them have the ability to attach and bond appropriately. This, in turn, will also help them be able to work through the events that they have experienced. Another factor is to help them find a positive view of themselves. Trauma can often have a negative effect on the victims view of themselves. Building up their confidence will not only help them bounce back from present traumatic experiences, but give them the confidence to be able to move past future experiences as well.
Everyone deals with traumatic experiences differently. One child may be able to bounce back quickly after being abused or neglected, while another may be portraying heavy side effects such as resentment, anger, aggression, withdrawal and more. Here is a case example of how an adolescent has responded to a traumatic experience.
Case Study
** Disclaimer names have been changed to ensure confidentiality remained intact.
Jane Doe is a 16 -year- old white female living with her mother , Amy Doe. Jane has been exposed to sexual abuse. The abuse that she has been exp osed to has occurred since she was born. Jane Doe has negative behaviors as a result of the abuse that have taken place since the age of twelve. These behaviors include self-harm, and multiple suicide attempts. Other behaviors that can be linked to the trauma include hyperactivity, eating problems, excessive mood swings, chronic sadness, and presen ts herself with a flat affect. Jane Doe was referred to mental health services to receive counseling.
In the case of Jane Doe, what would you as a social worker do when working with this client? Why?
Childhood trauma is discussed heavily in this chapter as being some form of abuse or neglect, but that is not the only trauma to be aware of. The death of a loved one, car accidents, divorce, domestic violence, and negative experiences are equally as traumatic and age does not matter. There can also be medical trauma. Maybe you or someone you know has been diagnosed with an illness, or maybe you went in for a simple surgery and things did not go as planned so now there may be something else wrong. It is all trauma, and it is ALL IMPORTANT.
The intent of this chapter is to simply define the trauma that specifically relates to child welfare, not to minimize other traumatic events. Do not discredit yourself or others who may have been through a traumatic event that is not necessarily defined in this chapter. Go to www.nctsn.org to you will learn more about trauma, resiliency and more.
The National Child Traumatic Stress Network (NCTSN) uses a trauma screening checklist that lists various events that can be considered a traumatic event. This being said, we must take note that everyone has experienced some sort of trauma in their lives, and work in an empathetic way to help build resilience, and even just to educate them that what they have experienced was traumatic. The links provided below are checklists for different age groups – one is for ages 0-5 and the other for ages 6-18 – which provide the lists of traumas, and the emotional, and behavioral responses that may have occurred in response to the trauma. http://www.nctsn.org/sites/default/files/assets/pdfs/trauma_screening_checklist_0-18_final.pdf
Thus, when working with victims of trauma, regardless of the type, age, sex, and more, empathy (which is defined in Chapter 1) is an important tool to utilize. When working with a client avoid assuming that they are making anything up, or that their behavior that are being portrayed are intentional. As mentioned above, trauma has a huge impact on the brain. The primary areas of the brain in which are more heavily impacted is the hippocampus, medial prefrontal cortex, and the amygdala which is our alarm system (Bremmer, 2006). Work with the client and understand that they are protecting themselves the only way they know how.
Watch the video to gain more understanding of trauma on the brain, and what to do and what not to do when working with a victim of trauma. Working with Trauma Victims https://www.youtube.com/watch?v=4-tcKYx24aA
Circle of friends
Foster Care, Guardianships, and Adoption
Foster Care
The foster care system has been around for years. According to The National Foster Parent Association, the United States foster care system developed from the English Poor Law of 1562. This law stated that children from poor homes would enter into indentured services until they were at an age in which they could care for themselves. The first child in the US to enter into the foster care system was in 1636, and he went by the name Benjamin Eaton. Charles Loring Brace was the first to initiate a free foster home movement in 1853, more information about the history of foster care can be found at this link: nfpaonline.org/page-1105741.
Today foster care is known as a temporary placement in which children who have been removed from their families take up residence either with other family members (first choice, or non-relatives (alternative if no family is able or available to step in). Children who are in foster care were usually abused or neglected in some way and the risk of them being abused again is very high. Referring back to the categories of the different case levels in CPS, category I or II would typically encompass cases where the children were placed into foster care. Foster care can be done through the state at DHHS, and other agencies like the Big Rapids branch of Bethany Christian Services. To learn more about Bethany Christian Services refer to the link provided: https://www.bethany.org/
Foster care is usually the last result, and is also considered to be a short-term intervention. Thus, immediately after removal reunification is sought after to bring the child back to their family. Reunification, according to DHHS, is simply stated as returning to their homes. At this point, when reunification is mentioned many people are shocked and ask, “How is that possible? They hurt their kids!” Remember, as stated above, that the children still have a strong bond with their caregivers even though they have been abused. DHHS will NOT let a child back into their family’s home if it is deemed unsafe. For a parent to get their child back they have to prove to the courts through petitions that they are fit and can adequately care for their child. During this whole process foster care workers are looking out for the best interest of the child. If it is deemed that the parents have followed through with all of the recommendations made by CPS, foster care, and the courts, and that they have completed them successfully they have a chance to get their child back.
When a child is removed it does not necessarily mean that the parental rights are terminated. Foster care is intended to be short term, not a permanent solution. However, there are situations in which parental rights are terminated. Termination of parental rights ultimately means that they no longer have guardianship of their child. The Probate Code of 1939: Act 288 (legislature.mi.gov/doc.aspx?mcl-act-288-of-1939) outlines the protocols and reasons in which termination is permitted. An example that the act gives includes if the parent caused, or could have prevented, physical or sexual abuse and the courts deem that the abuse will most likely continue if they remain or return to their parents’ home. Once a parents’ rights are terminated they no longer have the ability to legally care for their child and may not have the opportunity to regain custody of their child. Thus, termination happens after sufficient evidence has been provided to the courts showing that the child would indeed be in imminent danger if returned to the parents.
Working with foster care is another high stress position as a child’s response to trauma varies and is uncertain. Having people willing to be foster parents is highly necessary and there are many websites and associations to go to in order to seek out help including the National Foster Parent Association: nfpaonline.org/
Steps to Become a Foster Parents
On the other end there are many steps to take to become a foster parent. The Michigan DHHS website lists five steps that have to be completed in order for anyone to become official foster parents. These steps are listed below:
• Call a Navigator: Foster Care Navigators are experienced foster parents who can answer questions and find an agency.
• Attend an Orientation: Review guidelines, illustrate what to expect, and has representatives to help answer questions.
• Complete Application: agency chosen provides a licensing application packet (one must be licensed in order to officially become a foster parent). Refer to link to learn more about the application process.
• Participate in a Home Evaluation: Have to pass an on-site home evaluation performed by licensing agent. Interviews and home visits will be done multiple times.
• Attend Free Training: Agency will schedule a PRIDE (Parent Resources for Information Development and Education) training with the prospective foster parent. Must complete 12 hours and once they are licensed they have 18 months to go through it again.
http://www.michigan.gov/mdhhs/0,5885,7-339-73971_7117—,00.html
Guardianships
With permanency being the goal, guardianship is one way to help provide permanency to children who may or may not be able to return home. This is an alternative to potentially avoid bouncing from one foster home to another. Guardianships, however, do not necessarily mean that the parental rights are terminated. This option provides permanency yet allows the parents to still have access to the child through visitation. For this process, there is a court hearing and the court decides if the potential guardians are deemed appropriate. They have to pass home visits and more, just like a foster parent. Anyone can be a guardian, but it is common for other family members to apply for guardianships to help avoid the child having to go to people who are not within the family system.
Key Terms
Permanency: is essentially finding or creating a permanent place for home, and care.
Guardianship: In lieu of terminating parental rights, a guardianship allows caregivers to legally make decisions on behalf of a child who has been removed from their home.
(MDHHS, 2014)
Adoption
If a child cannot be returned to the family, and the parental rights have been terminated, adoption is sought after. At this point, parental rights had already been terminated and thus can no longer go home to their birth family. The goal is to find permanency as quick as possible. According to MDHHS, nearly 3,000 foster children are up for adoption at any point in time, and of those 3,000 children, about 300 do not find homes for adoption (MDHHS, 2017).
Many youth in the foster care system age out. Aging out simply means that the youth turned 18 before finding a permanent home. According to the organization, Children’s Rights (www.childrensrights.org), more than 20,000 foster children aged out of the system in 2015. To top that off, they state that those who age out of the system are less likely to achieve a high school diploma. By the ages of about 26, 80% of youth who aged out of the foster care system were able to get a diploma or a GED in comparison with 94% of the general population. Michigan uses many private agencies in which their focus is finding parents to adopt children who cannot go back to their parents.
Social Work Roles in Foster Care and Adoption
Just like a CPS worker, a Foster Care worker can come from a variety of backgrounds including social work, criminal justice, and even psychology. Within the role of a Foster Care worker, their ultimate priority is to identify and place children who cannot remain with their parents due to safety concerns. MDHHS has protocols in place which outline the duties of a foster care worker. These include home visits and various other tasks such as interviews with biological parents and schools.
Before a child is placed with a foster family, or if the child is relocating to another foster home, there are protocols that a foster care worker follows. These protocols include providing Medicaid card/records, enrolling or insuring the children are attending school, and providing education records to the caregiver within five days of placement. If the child is attending the same school they previously attended then a transportation plan is to be discussed. One last example of what a Foster Care worker does is discussing any revision or plans for parents or siblings to be able to visit the child. Foster Care workers are responsible for visiting a child in the foster home. In a sense, they are searching for the same things a CPS worker would, mainly a safe place to live, ensuring that medical needs are taken care of and safe sleeping requirements are met, and then gathering information of how the child feels about being placed in that home. They meet with the caregivers as well to discuss various aspect of the child including medical (i.e doctor visits, dental visits etc.), education, and behaviors portrayed in the home.
There are also protocols set in place for human trafficking victims. Refer to Chapter 9 to learn more about human trafficking and what the definition of it is. In regard to foster care, there are seven behaviors or characteristics that a foster care worker must look for to determine whether or not the child indeed was a victim. The responses they gather will determine if further assessment and care is needed.
Foster Care and Human Trafficking Behaviors/Characteristics
• History of running away
• Withdrawal or lack of interest in previous activities
• Signs of current physical abuse, and/or sexually transmitted diseases
• Inexplicable appearance of expensive gifts, clothing, cell phones, tattoos, or other costly items
• Presence of an older boyfriend/girlfriend
• Drug addiction
• Gang Involvement
These behaviors may or may not indicate trafficking. However, more investigation should take place. If you, or anyone you know suspects that two or more of these items are happening call Centralized Intake at 1-855-444-3911. Foster Care workers are expected to call this number if the victim meets two or more of these assessment points. (MDHHS, 2015)
Summary
In this chapter, we have discussed family and what family is. We discussed various parenting styles and how they have an effect on children. There are many aspects that influence the family dynamics and how they function. We went on to discuss the history of child welfare, and discussed child protective services, trauma, and foster care, adoption, and guardianships. There is always more to learn about the child welfare system as it encompasses a wide range of services in our communities. Even the history of the system is a huge topic.
Key factors to remember are that a child has a right to be safe and cared for, and when the parents of the child fail to do just that, it is the duty of the state to step in and ensure that they are safe and can be kept safe. Regardless of rumors that people have heard (CPS workers being kid snatchers one of them), the state looks for the best interest of the child and that is the ultimate factor within this system. | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.07%3A_Child_Welfare_and_Foster_Care.txt |
Gerontology
One of the fastest growing populations that social workers provide services to is the elderly. For social workers, the elderly offer unique challenges that are not present in other populations. This section will discuss the various aspects and challenges that social workers will encounter when working with the aging population.
Key Terms
Gerontology: the scientific study of old age, the process of aging, and the particular problems of old people.
Dementia: a chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning.
Geriatric: relating to old people, especially regarding their health care.(Merriam-Webster’s collegiate dictionary, 1999)
The Aging Population
The biggest contributing factor to the fast-paced growth of the aging population, is the Baby Boomers. The Baby Boomers are the generation of individuals born in the years following WWII. What once was a large population of babies and children has now aged into a large population of aging and elderly individuals. With the advancement of modern medicine, people are now able to live longer than any other period in history. This aging population has posed many benefits and challenges to our society. Western culture has moved away from Eastern ideals of providing and caring for our elderly. Shifting cultural ideals has led to the rise of assisted living and nursing facilities in the United States and other parts of the world, which will be discussed later in this chapter. Social workers must be prepared to work with the ever-changing landscape of gerontology.
An aging population
Challenges of Aging
There are many challenges that the elderly face in our society which range from medical and mental health to financial concerns. Below are some common challenges that the elderly face in this country that social workers will have to be familiar with.
Dementia and Alzheimer’s Disease
Among the most common of challenges facing the elderly are medical conditions that attack cognition. Dementia and Alzheimer’s Disease are the most common medical conditions that the elderly suffer from; both directly impair cognition to various levels. Dementia is a general term for loss of memory and other mental abilities severe enough to interfere with daily life. It is caused by physical changes in the brain (Alzheimer’s Association, 2017). The rates of dementia are so high in the elderly that special facilities and whole units of nursing facilities are dedicated to working with those who suffer from it.
There are various forms of dementia ranging from Lewy Body Dementia to Frontotemporal Lobe Dementia. The most common form of Dementia is Alzheimer’s disease. It is estimated that 60-80% of dementia cases are Alzheimer’s disease (Alzheimer’s Association, 2017). Each form of dementia has different symptoms and physical impact on the brain. Social workers will need to be versed on the various types of dementia and the interventions available to best address their elderly clients need.
Health Complications
Along with medical conditions that impact cognition, there are also many illnesses and diseases that impact physical health. As we age, our body begins to break down over time. Our immune systems are no longer able to fight off infections and illnesses that it could earlier in the lifespan. There are multitude of illnesses and diseases that the elderly population are more susceptible to. These health complications range from simple infections such as urinary tract infections to major diseases such as Parkinson’s disease. The elderly are at a disadvantage when it comes to such diseases, as the older we get the less capable we are able to maintain health. All too often, physical health deterioration leads to elderly individuals to be placed in nursing facilities, as they can no longer care for themselves without medical professionals available around the clock.
Did You Know…
Urinary tract infections (UTIs) can cause unique symptoms in the elderly. With symptoms ranging from confusion, agitation, hallucinations, fallings, and delirium. It is due to these symptoms that some UTIs in elderly individuals are mistaken for earlier stages of dementia. (Solitto, 2016)
Mental Health
Not only are the elderly more prone to diseases that impact physical health and cognition, but the population has their own unique set of mental health concerns. There are many elderly individuals that have suffered from mental illness much of their lives. As we age, there are also mental health concerns that are a direct result of growing older. One of the most prevalent mental illnesses that the elderly face is depression. Depression is common among the elderly population due to a variety of reasons. Grief and loss are two contributing factors to elder depression. As we get older, we are subjected to a number of losses. There is the loss of loved ones through death, the loss of our physical capabilities and health, even the loss of financial independence. These series of losses can impact the mental health of the elderly.
Isolation is also a contributing factor for depression in the elderly. It does not matter if an elderly individual is living in the community, assisted living, or a nursing facility. Isolation rates for the elderly are high due to physical immobility and lack of transportation. Too often, our elderly are secluded from the rest of society, leading to feelings of loneliness and depression. Social workers working with this population must address grief, loss, and isolation with their clients to provide better mental health care.
The Cost of Aging
Another major challenge of aging is the simple cost to age. Most elderly are unemployed due to advanced age and physical health. Many live off Social Security and retirement benefits and many utilize Medicare and Medicaid for insurance. Those who live in assisted living communities or nursing facilities have a clear majority of their income allocated for their care. The cost of medications, general living expenses, and food often monopolize the fixed income of our elderly. With the constant political turmoil regarding nationwide health care, the elderly are not guaranteed health insurance in this country. These factors contribute to the rising cost of aging.
Remaining in the Community
One way to ease the growing cost of aging would be to implement support for elders so that they can stay in the community for as long as possible. Assisted living and nursing facilities are costly, even with health insurance and retirement benefits. The cost of being placed in a facility can absorb all an individual’s resources. Remaining in the community for as long as possible can save both the elderly and the taxpayers’ money in the long run.
However, there are potential dangers to the elderly who remain in the community. The risk of falls which can lead to life threatening complications is increased for those living in the community. According to the National Council on Aging, there are approximately 2.8 million falls a year. One fourth of elderly Americans over the age of 65 fall each year (2017). Isolation and depression rates can also increase for the elderly in the community, as lack of mobility and transportation can impede social interaction. While living in the community may seem like the most economically suited option, it can pose a risk to the elderly who need more medical assistance than the home can provide.
Caregivers
One way that the elderly can stay in the community longer is by having caregivers present in the home. Caregivers can be medical professionals, family members, or everyday individuals that provide care for the elderly in the home. Caregivers often come in the form of family such as adult children taking care of their elderly parents. Caregivers are a key role in enabling the elderly to remain in the community for as long as possible.
Caregiving is a demanding and strenuous role. Caregivers are often faced with the challenges of working outside the home while still trying to provide care. Caregivers also have to provide medical care that they may not be fully trained or competent in. Some caregivers are not suited to provide care and can pose a risk to the elderly individual. Unqualified caregivers can also be potentially dangerous, abusing their elderly charge in a variety of ways. Many caregivers do not have the proper physical, emotional, or mental support to deal with the stress that comes with the role. Lack of support can lead to feelings of burnout, resentment, and physical ailments for many providing care for the elderly.
Elder Abuse
For elders both inside facilities and outside facilities, there is a potential for abuse. While some abuse is unintentional, unfortunately there are multiple cases of elder abuse every year. Elder abuse can be committed by family members, medical staff, and anyone associating with the elderly on a regular basis.
Forms of elder abuse:
• Physical abuse. Use of physical force that may result in bodily injury, physical pain, or impairment.
• Sexual abuse. Non-consensual sexual contact of any kind with an elderly person.
• Emotional abuse. Infliction of anguish, pain, or distress through verbal or non-verbal acts.
• Financial/material exploitation. Illegal or improper use of an elder’s funds, property, or assets.
• Neglect. Refusal, or failure, to fulfill any part of a person’s obligations or duties to an elderly person.
• Abandonment. Desertion of an elderly person by an individual who has physical custody of the elder or by a person who has assumed responsibility for providing care to the elder.
• Self-neglect. Behaviors of an elderly person that threaten the elder’s health or safety.
(National Center on Elder Abuse, 2005)
Case Study: Gloria Fielding
Adult Protective Services (APS) received a report that Gloria Fielding, a very frail 88-year-old woman, needed care for all activities of daily living. Ms. Fielding was legally blind, extremely hard of hearing, unable to walk and suffered from dementia. She was confined to a hospital bed placed in the basement of her home by her caregiver. Ms. Fielding owned two houses. Her primary residence was so severely neglected as to be uninhabitable. The caregiver stated that the dilapidated condition of the house was the reason Ms. Fielding was moved into the basement, while the caregiver resided in Ms. Fielding’s other home.
When the APS worker investigated the report of abuse, she heard yelling coming from Ms. Fielding’s garage but could not gain access to the house. A neighbor offered to help the APS worker by calling the caregiver. The caregiver drove to Ms. Fielding’s house and upon arriving, opened the garage door and drove her car right into Ms. Fielding’s bed, knocking it with her bumper.
The basement had no furniture beside the hospital bed. The floor was littered with used hypodermic syringes. The caregiver stated that Ms. Fielding’s medical doctor pre-filled the syringes and instructed her to inject Ms. Fielding whenever she requested.
Upstairs, numerous photographs of Ms. Fielding’s physician were found throughout residence. The APS investigation discovered that the M.D. had received large monetary gifts from Ms. Fielding, had engaged in sexual relations with her and had recommended the caregiver to Ms. Fielding.
Despite Ms. Fielding’s frailties, when the APS worker interviewed Ms. Fielding, she reported that she was being abused by her doctor and caregiver.
(National Adult Protective Services Association, 2017)
What to do in the event of elder abuse.
• Contact your local Adult Protective Services
• For Michigan call 855-444-3911
• Contact your local police department
• Call 911
• Contact the local Long-Term Care Ombudsman for residents of assisted living, nursing homes, and adult foster care (AFC) care.
Assisted Living
As mentioned previously, one form of care for the elderly is assisted living facilities. Assisted living facilities are generally small communities or facilities that provide limited assistance for elderly individuals. Most often, elderly couples and individuals who are still in relative good health will reside in these forms of care. To the outside, assisted living facilities will often look like small apartment buildings with special features such as ramps and rails throughout the units. This forms of care often provides limited medical assistance such as having nurse aids employed to provide basic health care. Often, cleaning services and landscaping services will be provided as part of the fee.
Assisted living options offer more independence for those who reside in them, however there are other components to be considered. Some health insurance policies do not cover this form of assistance and even with health insurance, living in this form of community can be costly. Assisted living facilities are also not monitored by the State (which heavily monitor nursing facilities), thus leaving room for lack of quality and proper procedure. Assisted living facilities normally do not employ social services, for the elders who need these services they must be sought outside of assisted living services. Larger assisted living communities may contract with outside social service agencies to provide services, but rarely employ them on site.
Assisted living wordcloud
Nursing Facilities (Nursing Homes)
Nursing facilities have become a norm in our country for providing care for the elderly. They provide 24-hour medical care for those who can no longer remain in the community and need extra support than what assisted living facilities provide. Those who reside in these facilities are referred to as “residents” as most will remain in the facilities for the remainder of their lives. Many nursing facilities also provide rehabilitation services such as physical therapy, generally for those recovering from surgery or serious illness. These services are short-term and most of those who utilize them discharge back to the community.
Nursing facilities provide a wide range of services for residents. All meals and domestic services are covered by staff. There are a variety of medical professionals that are employed by these facilities such as certified nursing aids (CNAs), licensed practicing nurses (LPNs), and registered nurses (RNs). These professional provide medical care for the residents. For medical needs that are outside the scope of practice in nursing facilities, outside services are utilized. Most elderly living in nursing facilities have their expenses covered by health insurances such as Medicare and Medicaid. There are some who pay for their stay privately, but this is costly. U.S. News reported in 2013 that the general cost of living in a nursing facility \$222 dollars a day for a semi- private room, which is about \$81,000 per year (Mullin, 2013). The price of nursing home stays are on the rise and many cannot afford to stay in these facilities without health insurance.
Along with nursing staff, nursing facilities generally employ a large range of professions to best provide services. Social workers, dietitians, physical therapists, maintenance staff, and environmental services are just some professions outside of nursing that are employed in these types of facilities. Those professions that provide medical and mental health services work together as an Interdisciplinary Team (IDT). IDTs work collaboratively to provide the best care for each resident. The size and number of IDTs is determined by the size of the facility. One facility can have as many as five IDTs. Social workers in nursing facilities are tasked with the residents’ mental health and emotional well-being. The day to day tasks of social workers in these facilities can range depending on employment, but generally have common themes. Social workers in these facilities most commonly work with residents who are experiencing depression, anxiety, grief and loss, and dementia. MSWs will also oversee psychotropic monitoring (not prescribing) and will make medication recommendations. Social workers often play a major role in nursing facilities as they help with admissions, day-to-day activities, mental health and emotional well-being, and discharge planning.
Many residents, due to cognitive impairments and health complications, are no longer able to make decisions for themselves. Those who have been declared incompetent by two medical doctors, have in place a guardians’ or durable power of attorney (DPOAs). These individuals can be family, friends, or public guardian services. When one has a guardian or DPOA in place, they can no longer make medical or financial decisions for themselves. This process aims to protect residents from poor decision making.
Many interpret having a guardian or DPOA in place as having no rights of their own. This is not true. In the United States, every individual is guaranteed rights. Residents have a special Bill of Rights in place to insure they are being treated with respect and dignity. Residents who feel that their rights are being impeded upon can contact their local Ombudsman (information provided above).
Did You Know…
Nursing facilities that accept Medicaid and Medicare as funding must be certified and go through an annual State Survey as a requirement of federal law. Each state’s Health Department is in charge of the process. (Nursing Home Alert, 2017)
Summary
The aging face many unique challenges. Finances, health, mental health, and political considerations must all be considered when social workers provide services to the aging population. Growing older is inevitable, however social workers can make the process smoother from those who have entered the later stages of life.
Now let’s take a look at social work and people with disabilities.
People with Disabilities
There are many populations that social workers provide services for daily. One such population is People with Disabilities. Disabilities can take many forms, such as physical, cognitive, or mental illness (Centers for Disease Control and Prevention, 2016). The broad range of potential disabilities can pose many unique challenges for social workers. It is also important to note that while disabilities can be a singular occurrence for some individuals, often disabilities span across many population segments. It is common for people with disabilities to suffer from victimization, stigmatization, and segregation in our society. Therefore, all social workers no matter what area of social work they are in should knowledgeable on the types of disabilities and those who live their lives with them.
Forms of disabilities
Forms of Disabilities
There are various forms of disabilities that people can suffer from. The three major forms of disabilities are physical, cognitive, and mental illness, with most disabilities falling within these three categories. To better understand disabilities, let’s consider the three categories.
Key Terms
Physical Disability: a limitation on a person’s physical functioning, mobility, dexterity or stamina.
Cognitive Disability: a generalized disorder characterized by significantly impaired cognitive functioning and deficits in two or more adaptive behaviors that appears before adulthood.
Mental Illness: a wide range of mental health conditions — disorders that affect mood, thinking and behavior.(Merriam-Webster’s collegiate dictionary, 1999)
Physical Disabilities
Physical disabilities can take many forms and can occur at any time in an individual’s life. Many physical abnormalities can occur before a person is born, developing in utero. Known as congenital disorders and most commonly referred to as birth defects, these impairments can take many forms. Some can be a minor as a birth mark or as severe as a missing limb or internal abnormalities (Nemours, 2017). When a birth defect proves to be severe and long lasting, it has the potential to develop into a disability. Infants born with missing limbs or improperly developed physical traits will often grow to have a physical disability. Some physical birth defects can be corrected or improved with medical technology, such as surgeries to correct cleft palates; however there are many physical birth defects that cannot be corrected potentially leading to a physical disability.
There are also physical disabilities that occur after birth at any time in an individual’s life. Major accidents are the most common cause of physical disabilities after birth. Car accidents are a common accident that can cause physical disabilities at any time in life. Car accidents can lead to minor injuries, but in severe cases can cause lifelong physical disabilities such as severed limbs and brain injuries (Disabled World, 2015). Military personnel are also at high risk of procuring physical disabilities through outside means. War can lead to various physical disabilities due to military engagements. The most recent military conflicts have led to high numbers of physical disabilities resulting from IEDs (Intermittent Explosive Devices) which have caused loss of limbs and traumatic brain injuries.
Physical disabilities can impact individuals in a variety of ways. Depending on the nature of the physical impairment individuals may be limited on where they can travel, the type of employment they can procure, and even their personal relationships. Social workers must be prepared to not only address the physical limitations that a physical disability can pose, but also the emotional impact that one may have on a client. Working with clients who have a physical disability can be a unique and rewarding experience. Each client will require an individualized approach, as not everyone who has a physical disability will cope in a uniformed way.
Cognitive Disabilities
Cognitive disabilities, also known as intellectual disabilities, are other forms of disabilities that social workers will encounter in the field. There are many types of cognitive disabilities that can vary in severity.
Some common types of cognitive disabilities are:
• Autism
• Down Syndrome
• Traumatic Brain Injury (TBI)
• Dementia
• Dyslexia
• ADHD
• Learning Disabilities
Cognitive disabilities, like physical disabilities, can be present at birth. Cognitive disabilities at birth can be almost impossible to distinguish and usually begin to present in early childhood. Some indicators of cognitive disabilities can be present in infancy, such as the infant failing to meet certain milestones or presenting with unusual symptoms such as lack of sleep and inconsolable crying. While these indicators can be present, it is often difficult for medical professionals to diagnose cognitive disabilities in infants and toddlers.
Most cognitive disabilities are diagnosed in childhood and early adolescence. There are several assessments that can be conducted to determine the presence of a cognitive disability. While many medical professionals may suspect a cognitive disability, most often patients are referred out to have the appropriate assessments completed. Once a diagnosis is made there are several forms of therapy that can be performed depending on the type of cognitive disability.
Even with the advancements in medical technology, unfortunately there are no “cures” for cognitive disabilities. While various therapies and some medications can help improve cognition and stall deterioration in some, there is no way to fully heal the cognitive disability. Cognitive disabilities can impact individuals on many levels, from employment to personal relationships. Depending on the severity of the cognitive impairment, some individuals may never be able to live independently or function in mainstream society. Social workers working with this population must be prepared for the diversity within and the individual challenges faced by those with cognitive disabilities.
Mental Illness
While many may not consider mental illness to be a category of disability, there are several mental illnesses that impact an individual’s life in such a way that it can be classified as a disability. Mental illnesses such as Schizophrenia, Borderline Personality Disorder, and Bipolar Disorder can be so severe that an individual’s everyday life is impacted. When a mental illness impairs an individual’s ability to function, it can be considered a disability.
For some mental illnesses, medication can help alleviate symptoms. This is especially true regarding disorders such as Schizophrenia and Bipolar disorder. While there is no cure for these disorders, medication in combination with behavioral therapies can reduce the symptoms. However, there are some mental illnesses that even with medication and therapy can still make coping difficult. Agoraphobia is one disorder that can severely impact everyday functions, to the point where the individual may not even be able to leave their home due to anxiety.
Mental illnesses in themselves can be considered disabilities when they impact an individual’s life to the point of impairing functioning. Mental illnesses can also contribute to other health concerns and behavioral symptoms that greatly impact lives. For more information on mental illness please see Chapter 10: Mental Health and Substance Use.
Did You Know…
Agoraphobia consists of an individual experiencing marked anxiety in at least two of the following: using public transportation, being in open spaces, being in enclosed spaces, standing in line or being in a crowd, being outside of the home alone. (DSM-5, 2013, p. 217)
The Americans with Disability Act (ADA)
The Americans with Disability Act (ADA) was put into place in 1990. It guarantees equal rights for those with disabilities in the United States. It prohibits discrimination against those with disabilities “in all areas of public life, including jobs, schools, transportation, and all public and private places that are open to the general public” (ADA National Network, 2017). While this policy has created great advancements for those with disabilities, especially in education and employment, discrimination still takes place on a daily basis in our country.
ADA Compliance sign
Youth with Disabilities
As mentioned previously in this chapter, the age of diagnosis of disabilities can vary depending on the type of disability and potential origin. Most cognitive disabilities such as learning disabilities and autism are diagnosed in early childhood. Symptoms can vary in type and severity, the less severe generally being observed later. Children who are diagnosed with any type of disability face many challenges. Physical disabilities are often able to physically seen, therefore being diagnosed much sooner. Cognitive disabilities and mental illnesses do not manifest in a physical manner, therefore leading to later diagnosis. Parents, caregivers, and teachers are often the first to notice symptoms of a cognitive disability and/or mental illness. While cognitive disabilities have standard procedures for diagnosing, mental illnesses in children can often be difficult to diagnose. Many mental health professionals may be hesitant to make a mental illness diagnosis for a young child, as the brain is just beginning to develop and symptoms can vary.
The K-12 Education System
For cognitive disabilities and mental illnesses, the K-12 education system can pose particular challenges and resources for children. Depending on the geographic area, children with disabilities may find either a helpful system with resources or an overtaxed system with an inability to adequately help.
Higher Education System
The higher education system can also pose some unique challenges for people with disabilities. While many universities and community colleges have disability accommodations, the quality of these accommodations can vary depending on the institution. For many with physical disabilities, colleges and universities can be difficult places to maneuver – literally. There have been instances of universities failing in snow removal so that those who require mobility assistance such as wheelchairs are not able to traverse the campus. There have also been accounts of buildings being poorly designed so that doorways are not easily accessible for those who are not able to walk.
Accommodations for those with cognitive disabilities can also vary depending on the institution. Many higher education institutions have made efforts to be inclusive for those with cognitive disabilities, per ADA requirements. Most offer accommodations for those who qualify such as tutoring, alternate exam areas to allow for more time and individuals who are dedicated to helping those with cognitive disabilities succeed. People with cognitive disabilities in the higher education system most often have resources available to them provided by the institution, which is a change from the past, where even fifty years ago they would not have been accepted into the system.
The Workplace
For people with disabilities, the workplace can present certain difficulties. Discrimination in the work place for people with disabilities is unfortunately all too common. No matter what form of disability, employers can be quick to judge an individual’s abilities based solely on their disability. This is most common with physical and cognitive disabilities as they are more visible. Those with mental illness will also face discrimination in the work place as employers may see them as “too challenging” to employ. Some discrimination can be unintentional as well. Employers may make unnecessary accommodations for their employees with disabilities or may conduct themselves in a manner that is unintentionally condescending. Discrimination in the workplace can be both intentional and unintentional (Workplace Fairness, 2017).
While some employers can be hesitant or outright refuse to hire people with disabilities, others do not share such reservations. For employers who hire people with disabilities, accommodations must be made at times. The ADA requires that all public buildings be wheelchair accessible and many businesses have made great strides towards that goals. For those with cognitive disabilities and mental illnesses, accommodations can be made to make employment more inclusive such as training for other employees and trying to be educated on the topic.
Health insurance is a major factor for employers when hiring people with disabilities. Many employers may be hesitant to hire people with disabilities due to their health insurance provider. Some health insurance companies offer less coverage, some do not even offer mental health services in their packages. This could influence whether people with disabilities will be hired at certain workplaces, as the health insurance coverage may not be adequate to cover specialized medical care.
Aging with a Disability
As stated in the Gerontology portion of this chapter, aging with a disability can pose particular challenges. Often as those with disabilities begin to age, the familial caregivers become unable to provide care or pass away. This leads many with more severe disabilities to being placed in assisted living facilities, adult foster care, or nursing facilities. Nursing facilities provide around the clock medical care; however assisted living facilities and adult foster care homes do not.
Health insurance is also a major issue for those aging with a disability. For some, health insurance can be easily obtained. Medicaid and Medicare are the two main health insurances utilized by the aging. With the current political climate, it is unsure how available these resources will be for those with disabilities or what services they will provide. Social workers must be ready to contend with an ever changing political landscape of the country.
Elderly man sitting in a wheelchair
Abuse and Neglect
People with disabilities, like any other section of the population, are at risk for abuse and neglect. For children with disabilities, any suspected neglect or abuse should be reported to your local Child Protective Services. For adults with disabilities, any suspected abuse or neglect should be reported to your local Adult Protective Services.
Case Study: Carolyn Grant
Carolyn is 21-years-old, and autistic with moderate intellectual disabilities. She attends a special school program to assist with her disabilities. On a recent field trip, Carolyn’s teacher left her and two male students unsupervised in the school van for a brief period of time. While the teacher was gone, one of the young men took Carolyn’s shirt off, fondled her bare breasts, and took a picture of them. When the students returned to school, he showed the pictures to other students. Carolyn told her mother about what happened and her mother contacted APS for help.
(National Adult Protective Services Association, 2017)
What to do in the event of abuse/neglect for children with disabilities
What to do in the event of abuse/neglect for adults with disabilities
Summary
People with disabilities face challenges in modern society that other population segments do not experience. With the various and sometimes limited resources offered, social workers must know how to navigate a system to better provide for their clients. With the rising cost of health care and an ever changing political environment, social workers are tasked with advocating and serving those in the population who may not be able to do so themselves. Both people of advanced age and people with disabilities are valuable contributing members of our world and as social workers we must stand to make a better future for all. | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.08%3A_Gerontology_and_People_with_Disabilities.txt |
Medical social work is viewed as one of the most significant fields in practice . It has been acknowledged as the first subspecialty discipline to practice in hospital, public health, and clinical settings (Allen & Spitzer, 2016).
Medical Social Work
Medical social work can be defined as a specific form of specialized medical and public health care that focuses on the relationship between disease and human maladjustment (NASW, 2012; Gehlert, 2011).
In the 20th century, social service departments in hospitals were developed to address problems associated with the increase of immigration and poverty. The need for medical social work in the United States has intensified due to the substantial inequality of health care resources. Individuals and families that live in poverty or who are a part of certain ethnic communities are additionally at a disadvantage because they are more prone to experience higher rates of acute and or chronic illnesses. Therefore, the unequal distribution of healthcare insurance coverage in the United States hinders some people from seeking medical treatments due to their socioeconomic status. In 2013, more than 42 million people in the United States were uninsured. Today, the number has only increased (NASW, 2016).
Medical social workers practice in a variety of healthcare settings such as hospitals, community clinics, preventative public health programs, acute care, hospice, and out-patient medical centers that focus on specialized treatments or populations. These professionals help patients and their families through life changing and sometimes traumatic medical experiences. They often monitor and evaluate a patient’s mental and emotional health as they transition through a variety of medical treatments. Medical social workers also often find themselves helping the patient and family solve problems be that of financial difficulties or one-to-one counseling to help cope with new stressors (Mizrahi & Davis, 2008; NASW, 2016).
All medical social workers must familiarize themselves with cross-cultural knowledge in order to provide effective health care. They do this by familiarizing themselves with an array of different ethnicities, cultural beliefs, practices, and values that shape their family system. Medical social workers must have the ability to recognize how oppression can affect an individual’s bio-psycho-social-spiritual well-being. As future social workers, being able to understand and identify these issues will enhance your skills as a professional to provide excellent health care (Mizrahi & Davis, 2008; NASW, 2016).
For more information regarding cultural competency in social work, refer to Chapter 3.
Goals of Practice
The National Association of Social Workers (NASW) Standard for Social Work Practice in Health Care Setting (2016), describes eight standards of practice for health care social workers to follow. The eight goals were created as a guideline so that medical social workers would deliver excellent care.
Eight Standards of Practice for Health Care Social Workers
• All medical social workers in the healthcare arena must practice in accordance with the social work code of ethics.
• Advocate for client’s right to self-determination, confidentiality, access to supportive services and resources, and appropriate inclusion in decision making that affects their overall health and well-being.
• Encourage social work participation in the development, refinement, and integration of best practices in health care.
• Enhance the quality of social work services provided to clients and families in health care settings.
• Promote social work participation in system wide quality improvement and research efforts within health care settings.
• Provide a basis for the development of continuing education materials and programs related to social work in health care settings.
• Promote social work participation in the development and refinement of public policy at the local, state, federal, and tribal levels to support the well-being of clients, families, and communities served by the rapidly evolving U.S. health care system.
• Inform policymakers, employers, and the public about the essential role of social workers across the health care continuum.
The first and second standards of practice are extremely important to remember as you become professional social workers. All medical social workers must practice in accordance to the social work code of ethics. The social work code of ethics is rooted in a set of core values. Social work’s primary goal is to provide excellent service and to promote social justice for all patients, thereby ensuring that all medical and psychological services are met. Medical social workers must also embrace the importance of human relationships by building a positive and lasting rapport with clients. Always strive for professional competence by increasing the use of education and research and applying them to practice (NASW, 2016). For more information, please refer to Chapter 2 regarding the social work code of ethics.
Medical social workers advocate for the patient’s right to self-determination. Every patient is entitled to make their own decision based on treatment recommendations. The treatment team may desire and advocate for the best medical care for their patient; however, it is ultimately the patient’s decision to follow through with treatment. There are times when a patient may not be able to speak for themselves. You could encounter these situations when the patient is a child or if an adult has a cognitive impairment that enables them to make decisions for themselves. In these cases, the family has the authority to make the decision based on what they feel is the best course of action (NASW, 2016).
Case Study
In 1983, the University of Arizona was beginning to perform an experimental procedure on infants who were born with a congenital heart defect called Transposition of the Great Arteries (TGA). Katherine Frasier was born with this rare heart condition. Katherine’s parents realized that their options to save their daughter’s life were minimal because of the lack of research on TGA. The medical team insisted that they wait to do the procedure until Katherine has gone into congestive heart failure. The physicians at the hospital insisted the new experimental medical procedure would save their daughter’s life. The team of physicians, social workers and nurses corresponded with the University of Boston Children’s Hospital whom at the time was the only hospital who could successfully perform this operation.
At that time, Ms. Frasier’s family did not have the financial resources to travel to Boston as a family. Traveling also meant that Katherine’s father would not be able to attend because of his job in the military. The physicians repeatedly told her parents that this procedure was the only option and recommendation for treatment. However, they did not take into account that the procedure had never been done by the cardiologists at the University of Arizona. Katherine’s parents decided that it would be best if the physicians found another form of treatment.
The pediatric social worker stayed in contact with the family hourly and provided emotional support to Katherine’s family. She also insisted that the treatment team expand to other disciplines for more possible options.
Dr. Copeland, a world renowned heart transplant surgeon, was recommended to join the team. Dr. Copeland knew of another way to repair Katherine’s heart. Katherine’s parents agreed to allow him to operate that same day. Through the dedication of the social worker and treatment team that advocated for the Frasier’s right to self-determination, Katherine is still leading a productive and fulfilling life advocating for her pediatric patients the way her social worker did 30 years ago.
Team Work
The use of multidisciplinary team is an effective part of healthcare treatment. A multidisciplinary team is defined as a group of professionals that specialize in different disciplines that come together to deliver quality health care that addresses the patient’s well-being (Mitchell, Tieman & Shelby-James, 2008; Nancarrow et al., 2013; Allen & Spitzer, 2015). Using this approach allows the team to provide better-quality outcomes and to enhance client satisfactions.
There are also two other types of treatment teams in the healthcare setting:
1) An interdisciplinary team involves members from the same disciplinary background. An example would be: a team of medical social workers discuss possible treatment plans according to the results of a patient’s assessment. Working in a team allows for individual ideas to be heard and as a group develop a specific treatment plan.
2) An interdisciplinary team that includes individuals from different disciplines who collaborate to resolve a variety of issues. Medical social workers, physicians, nurses, and activity therapists experience different types of interactions with patients in which different behaviors are assessed. Together these disciplines paint an overall picture of how team work can increase a patient’s quality of life (Allen & Spitzer, 2015).
Biopsychosocial-Spiritual Assessments
The recommended health care approach to psychological evaluations is through the use of a biopsychosocial-spiritual assessment (NASW, 2016; Social Work Licensure Exam, 2008). This approach focuses on the individual as a whole and takes into account their biological, psychosocial, social, and spiritual sense of self. Together the interdisciplinary team can focus on the individual’s treatment from all professional perspectives. Using this approach allows for each practice the ability to provide optimal health care (Gehlert & Browne, 2011).
The term biopsychosocial assessment or biopsychosocial-spiritual assessment is an approach you will hear throughout school. This model examines not just the medical aspect of care whose primary focus is on the biological causes of a disease. Rather, the biopsychosocial-spiritual model examines a patient’s well-being through a holistic approach (Gehlert & Browne, 2011; McDaniel, Hepworth & Doherty, 2014; Allen & Spitzer, 2015).
Biopsychosocial Spiritual Assessment
The Biopsychosocial Spiritual (BPSS) Assessment offers a historical context for what the client presents with and assesses the client’s history, strengths, and resources.
How do these four areas contribute to the client’s current functioning?
• Biology: basic needs – the client’s access to food, shelter, etc.
• Psychosocial: history, personality, self-concept, medication, diagnosis and treatment history
• Social: support system (friends, family, social environment). Knowledge of life stages and development are essential
• Spiritual: sense of self, sense of meaning and purpose in life, religion and its context in client’s lif
ROPES method of identifying strengths: Resources, Options, Possibilities, Exceptions, and Solutions
(Social Work Licensure Exam, 2009)
Medical Social Work Job Descriptions
Overall Functions of a Medical Social Worker
According to TheSocialWorkers in Hospitals and Medical Centers Occupation Profile (2017), medical social workers employ a myriad of skills and approaches to ensure quality health care.
The following list is an example of tasks that most medical social workers use when providing services.
• Conducting initial psychosocial-spiritual assessments and screenings for patients and making referrals for individual, family and or group therapy if needed;
• Educating the patient and family members of the individual’s illness and treatment options as well as possible consequences of various treatments or refusal of treatment;
• Helping patient and their families adjust to the hospital dynamics and exploring emotional and social responses to the illness and treatment;
• Educating the patient and family on the roles of the healthcare team. Assisting patients and their families in communicating with one another and to the members of the multidisciplinary team;
• Facilitating decision making on behalf of patients and families.
• Educating hospital staff on patient’s psychosocial issues;
• Coordinating patient discharge with a safety plan and continued care planning by providing patient navigation services;
• Arranging resources/funds for finances, medications, medical equipment and other special needs services
(National Association of Social Workers, 2016)
Emergency Room Social Work er :
Emergency room social workers provide services to triage patients. One of their main functions is to diagnose and assess patients who show signs of mental illness. The medical social worker also performs discharge planning as a means of assurance that every patient will have a safety plan when discharged from the hospital (Fusenig, 2012).
The following is a list of tasks that emergency room social workers may perform:
• Performs mental health assessments and suicide evaluations;
• Conduct stress evaluations;
• Death notifications to family members;
• Counsels victims of violent crimes, domestic violence, substance abusers and families of deceased or terminally ill patients;
• Refers patients to community resources;
• Provides financial assistance;
• Conducts child and adult protective service reporting;
• Conducts domestic violence and sex trafficking screenings;
• Diagnoses and conducts mental health intake evaluations to establish proper psychiatric care;
• Conducts discharge planning; knowledge of community resources and services
(Fusenig, 2012)
Hospice or Palliative Care Social Workers:
Hospice social workers work in a variety of different medical settings. At times, there are hospice organizations that come into a hospital to provide assistance to those who are nearing the end of their life.
The following is a list of tasks that hospice and palliative care social workers perform:
• Ensuring that patients and family members have access to resources that will provide physical comfort;
• Providing emotional and or spiritual support to patients and their family members;
• Lead support groups for family members and in-service trainings to nurses, physicians, and other social workers who are involved in the treatment process;
• Ensure proper medical transitions from palliative care to hospice care if needed;
• Act as care coordinators; providing treatment planning with other members of the patient’s treatment team
(SocialWorkLicensure.Org, 2017)
Pediatric Cardiology Social Worker:
https://www.onlinemswprograms.com/in-focus/interview-with-andrea-kido-lcsw-on-clinical-social-work.html
The above link takes you to an interview with a pediatric and clinical social worker from Marin Community Clinics (MCC). She explains her role on the pediatric intensive care unit. She describes daily activities and the different types of challenges that one may experience working with children and their families (Louie, 2017).
Summary
Medical social workers play a very important role in the care and needs of all patients in the health care system. Above was brief introduction to the different types of medical social work job descriptions. Always keep in mind, as you pursue your education in social work, and possibly later in the health care field; the profession will always be centered on the code of ethics. Everything we do is focused on the rules and regulations of the social work code of ethics.
Recommended Readings and Videos
Video:
What does a medical social worker do? Kristin Scheeler, MSSW, CAPSW, OSW-C
Websites:
Interviews With Medical Social Workers
Books :
Allen, K. M., & Spitzer, W. J. (2015). Social work practice in healthcare: Advanced approaches and emerging trends. Los Angeles: SAGE.
Gehlert, S., & Browne, T. (Eds.). (2011). Handbook of healthsocial work. (2nd ed.). Hoboken, NJ: Wiley.
Public Health Social Work
Public health social work originated in the early 20th century to control communicable diseases, poverty, sanitation, and hygiene. It is defined as a collection of human service programs that has one common goal: identify, reduce and or eliminate the social stressors among the most vulnerable populations. A public health social worker’s main role is to establish preventative measures and to intervene in the health and social problems that affect communities and populations.
Epidemiological Approach
Public health social workers focus on the epidemiological approach to identify health related issues and diseases that affect certain populations. Epidemiology is a branch of medicine that researches the occurrence, delivery and possible control of diseases (CDC, 2017).
To better understand this approach, think of epidemiology as the basic science of public health. Epidemiology is a method that is used to develop and test a hypothesis (CDC, 2017).
Consider this: public health social workers and medical researchers are concerned with the occurrence and patterns of health events. In 2016, it was estimated that the population of Big Rapids, Michigan, is 10,475. Three-thousand students and faculty at Ferris State University in 2016 developed the same strain of bronchitis within a three-month period. The results allow public health workers to compare the same outbreak of bronchitis to other populations in the state of Michigan. A pattern has been established by the number of students and faculty at the university and in other cities that have the same strain of bronchitis. The occurrences also depend on the following variables: has the strain appeared in the same seasons? It is more prone to males or female? What is the average age of the individuals? Has it happened during the same weeks? Has it happened daily? The overall question is: what will public health social workers do about it?
Having the ability to compare the universities outbreak and the outbreaks throughout the state with the same symptomology will help to determine how the outbreak started and possibly the location where it began. In the end, findings will help provide evidence that will allow public health social workers to develop prevention and education interventions to help contain the outbreak.
Roles of a Public Health Social Worker:
• Find people who need help
• Assess the needs of your clients, their situations and support networks
• Come up with plans to improve their overall well-being
• Help clients to make adjustments to life challenges, including divorce, illness and unemployment
• Work with communities on public health efforts to prevent public health problems
• Assist clients in working with government agencies to receive benefits
• Respond to situations of crisis, including child abuse or natural disasters
• Follow up with clients to see if their personal situations have improved
(Allen & Spitzer, 2015)
Ethical Dilemma in Public Health
A good example of an ethical dilemma that most social workers would consider a concern is when public health clinics in hospitals call an individual who has contracted a sexually transmitted disease (STD). When women and men go into their family doctor for a yearly physical, they always check for STDs. If the results come back positive, the individual is notified by the doctor’s office to discuss an intervention. The next phone call is from a public health department either in a hospital or out-patient clinic.
In order for public health officials to gather information concerning STDs in the community, they have the right to gain certain information that will help to control the disease. For a clearer understanding, let’s refer to what is known as Health Insurance Portability and Accountably Act (HIPAA) (DHHS, 2003).
Whenever you go to the hospital you always sign a HIPAA disclosure form. By signing this form, you are allowing health care providers the means to share medical information without written consent. HIPAA also allows healthcare providers to share important information regarding an individual’s treatment plan, diagnosis and medications to another healthcare provider (DHHS, 2003).
For example: Jane Doe goes to see her primary health physician at Spectrums Family Health Center in Grand Rapids Michigan. Jane Doe is rushed to the emergency room the same day at Spectrums Children’s Hospital. The emergency room technicians will already have Jane Doe’s information because it has been documented and saved on Spectrums Health Care System Network.
Going back to the example of STDs, if a person is at risk of contracting or spreading a disease their healthcare provider has the right to disclose information. The information is revealed because it is a public health concern that effects the community. Health care providers release this information to help prevent and control another incident (DHHS, 2017).
Advocacy and Policy for Medical and Public Health Social Work
One of the most important roles of all social workers is to advocate for their clients. In the healthcare system, social workers do this by representing, promoting change, speaking on behalf of the client, assessing rights and benefits, and securing social justice. It is pertinent that all receive fair and equitable access to all medical services and benefits (NASW, 2012).
The healthcare system is driven by policies that outline the rules and regulations of the organization. Policies are developed based off the organizations ideas of acceptable and well-defined standards of healthcare practices. These policies are also implemented to reduce chaos, confusion, and legal issues that may arise due to unethical practice.
Some of these policies include:
• Patient care recipient rights.
• Abuse and neglect, investigation policies.
• Administrative policies
• Information management policies – HIPAA
• Accreditation Standards
• Medication Procedures
All physicians, nurses, social workers, administrative staff, and patient care workers must abide by all policies to produce effective outcomes for the organization.
Summary
Not all public health social workers will be found in the scenario above. One of the main roles of a public health social worker is to provide communities and vulnerable populations with the resources to help eliminate a social epidemic. This is usually done through community outreach programs and governmental agencies that focus on interventions and education to help improve community living.
Intimate Partner Violence
Intimate partner violence
“Violence sprouts in intimacy. Except for police and army, family is, probably, the most violent social group and a home is the most violent social space of our society. A person is most likely to be hit or killed in his/her own home by another member of the family than anywhere else or by anyone else” (Stark & Flitcraft, 1996)
Intimate partner violence has been recognized in the United States and other countries as a significant public health issue. This type of violence is universally condemned due to its heinous nature. The term, intimate partner violence (IPV) is defined as any incident or pattern of behaviors (physical, psychological, sexual or verbal) used by one partner to maintain power and control over the relationship. IPV is also considered to be an act of violence that takes place between intimate partners (heterosexual, cohabitating, married, same sex or dating (McGarry, Ali, & Hinchliff, 2016; Stark & Filtcraft, 1998).
Internationally the definition of intimate partner violence is “the use of power, threatened actions against oneself, another person, or a group or community, that either results in the likelihood of resulting in injury, death, psychological harm, mal-development or deprivation” (Haegerich & Dahlberg, 2011, p. 392-393). This definition is important because IPV also affects other cultures, ethnicities, sex, and races differently. In some countries, such as the Democratic Republic of Congo, intimate partner violence is not considered a crime. Spousal rape has been accepted as a marital tradition. Domestic and sexual violence against children and young women has been an acceptable practice by older males. In Egypt, domestic violence “is firmly entrenched in the country’s Muslim traditions” for example, Sharia Law (Achieng, 2017, p. 1).
Historically, in the United States, IPV has been considered an act of violence committed by men towards women. Although, this is still a societal belief, according to the National Intimate Partner and Sexual Violence Surveyof 2010– 2012, more than “1 in 4 men (28.5%) in the United States have experienced rape, physical violence and or stalking by an intimate partner in their lifetime and 1 in 7 men (13.8%) have experienced severe physical violence by an intimate partner (e.g., hit with a fist or something hard, beaten, slammed against something at some point in their lifetime” (Achieng, 2017, p.2).
Four Types of Violence
There are four different types of intimate partner violence. The most prevalent are defined in the text box below.
Physical Violence consists of touching or painful physical contacts that include intimidation of the victim through pushing, slapping, hair pulling, arm twisting, disfiguration, bruising, burning, beating, punching, and use of weapons.
Sexual Violence consists of making degrading comments, touching in unpleasant means of harm, addressing a partner in a degrading way during sexual intercourse which includes marital rape.
Psychological & Emotional Violence consists of threatening, intimidating, killing of pets, deprivation of fundamental needs (food, clothing, shelter, sleep), and distorting reality through control and manipulation.
Mandatory Reporting of IPV
In many intimate partner violence cases, victims have the tendency to not disclose to medical professionals or law enforcement due to possible repercussions from the offender. Many victims fear retaliation, family separations, violation of confidentiality and security. In these instances, a social worker could do more harm than possibly helping the situation.
As of 2002 only seven states have laws that make it mandatory to report actual or suspected victims of IPV (Hamberger, 2004). Most states have laws where reporting is an option, however conditions apply for protecting an individual’s identity. Social workers can be put into these challenging positions because of confidentiality and following an ethical obligation. Some argue if an individual is in a IPV situation it should be reported to the police because it is considered a punishable crime.
Potential positive outcomes and limitations from mandatory reporting by medical social workers include:
• Increase victim’s safety due to early detections and interventions;
• Improvement of patient care due to early identifications. This would allow
• physicians and social workers to preform rape kits, treatment of any diseases or injuries due to the assault;
• Allow social workers to immediately assess trauma and to advocate for resources as soon as the incident occurred;
• Could improve hospitals resources and outcomes by better documentation of DVA into medical records which will increase the availability of data to facilitate future research and;
• Mandatory reporting could undermine a key component of DV interventions of empowering the individual’s rights to self-disclosure
(Hamberger, 2004)
Prevention of IPV in Healthcare
There are four primary steps that medical and public health social workers take to insure a prevention plan. Public health and medical social workers focus primarily on the individual, family, and community to help reduce violence and its consequences. To reduce the occurrences of violence, social workers and community action agencies develop interventions to educate communities through public awareness using television commercials, billboards, radio broadcasts, DV trainings, self-defense classes, and DV screenings in hospitals (Haegerich & Dahlberg, 2011).
Four approaches to prevention of IPV include:
• Measure the incidence and burden over time through public health surveillance.
• Identify factors that place people at risk for, or protect people from, experiencing violence as the victim or perpetrator.
• Developing and testing strategies through rigorous evaluation that modify risk and protective factors to prevent violence from occurring.
• Facilitating the dissemination, adoption, and adaptations of effective strategies in communities to affect change
(Dahlberg & Haegerich, 2011)
Sex and Human Trafficking
Human trafficking isn’t talked about
Human trafficking is defined as the recruitment, transportation, and or harboring of a person by means of threat, force or another form of coercion, abduction, fraud, and deception. It is through the abuse of power over vulnerable individual’s that perpetrators are able to exploit them. It is often combined with extreme violence, torture and degrading treatment that leave psychological wounds for the rest of their lives. Human and sex trafficking is a violation of human rights. It is estimated to effect more than two million victims worldwide (Ahn, Albert & et.al, 2013; Gajic-Veljanoski & Stewart, 2007).
There are two different forms of human tracking: 1) forced labor and 2) sex trafficking. This section will focus on sex trafficking due to the increased prevalence in the United States. Additionally, this section will also focus on the roles that public and medical social workers take to identify victims and to provide proper medical care (Gajic-Veljanoski & Stewart, 2007).
Sex trafficking is defined as a commercial sex act which is conducted by force, fraud, coercion, or in which the child or adult is made to perform sexual acts for money. A majority of victims in the United States come from countries such as east and south Asia, Latin America, Russia, and Eastern European countries (Salett, 2006).
Medical social workers play a vital role in the identification of victims. Below is a list of clues that social workers and other medical professionals look for when assisting patients in hospitals. Victims have a tendency to not disclose their issues due to the fear of law enforcement, repercussions to family members and most are not aware of agencies that offer services specifically to the population.
Medical social workers can also help eliminate the potential of sex trafficking by:
• Identifying victims and assist them with the proper resources for medical, psychological and shelter;
• Serve on organizational committees or as board members who specifically focus on assisting sex trafficking victims and help to improve rehabilitation and reintegration into society and;
• Educate vulnerable populations such as children in schools or prostitutes that come through the emergency room on possible preventative measures and signs to look for when being encountered by certain populations
(Salett, 2006; Ahn, Albert & et.al, 2013)
What to Look For
• Multiple people in a cramped space
• People living with their employer
• Inability to speak to individuals alone
• Employers holding identity documentation
• Inability to move or leave current job
• Bruises or other signs of battery
• Submissive, fearful or depressed demeanor
• Little or no pay
• Recent arrivals from Asia, Latin America, Eastern European Countries, Canada, Africa or India
(Salett, 2006)
Facts and Statistics
The following facts and statistics were taken from the U.S. Department of State Trafficking in Persons Report (2017):
• Traffickers usually recruit victims from vulnerable populations such as: 1) young children who have run away from home. 2) adult females and males who have been involved in prostitution or escort services, 3) desire for a better future, 4) poor education, 5) history of abuse or violence, 6) single-parenting families, and 7) desperate socioeconomic status;
• Estimated global earnings of more than \$31 billion a year;
• Worldwide, between 4 – 27 million individuals have been or are victims of sex trafficking or forced labor;
• The majority of victims (80%) are women and girls;
• Over 70% of trafficked women with children are single mothers;
• During recruitment processes, some are promised substantial earnings and jobs as nannies, waitresses, and modeling;
• In 2016, the National Center for Missing & Exploited Children estimated that 1 in 6 endangered runaways reported to them were likely sex trafficking victims;
• In a 2014 report, the Urban Institute estimated that the underground sex economy ranged from \$39.9 million in Denver, Colorado, to \$290 million in Atlanta, Georgia and;
• In 2016, we learned of 8,042 cases of human trafficking.
Summary of Intimate Partner Violence and Sex Trafficking in the United States
In health care settings, medical social workers will encounter victims and survivors of domestic violence and sex trafficking often. Having the knowledge of the increased prevalence of these two societal epidemics will allow social workers to identify victims, promote educational resources and to prevent the increase of violence.
Summary
This chapter examined the roles of medical and public health social workers. Medical social work is a sophisticated and challenging practice that is conducted in multidisciplinary and fast-paced environments. Therefore, professional social workers in this field need to have a clear and concise understanding of the NASW code of ethics and how it relates to patient care. Medical social workers are in charge of advocating for diverse, sometimes vulnerable individuals and communities. Hospitals and insurance companies have become engrossed with enhancing the intake of profits. Because of that, it seems they lack the desire to enhance and develop a promising health care system that will support all populations.
As incoming first-year students, it is important to educate yourselves by researching and enhancing your knowledge of all social work arenas. Medical social work is so important because it embraces the importance of team work, advocacy, and a true commitment to the individual’s medical and personal health care.
Also remember, just because you may not hear about a societal epidemic (sex trafficking and domestic violence) does not mean it is not around you. Be a change agent who develops new therapeutic interventions that will enhance the quality of health care to the world.
Resources
• Achieng, V. (2017, May 26). 15 countries where domestic violence is legal. The Clever. Retrieved from http://www.theclever.com/15-countries-where-domestic-violence-is-legal/
• Ahn, R., Alpert, E. J., Purcell, G., Konstantopoulos, W. M., McGahan, A., Eckardt, M. . . . Burke, T. F. (2013). Human trafficking: Review of educational resources for health professionals. American Journal of Preventive Medicine, 44(3), 283-289. doi: 10.1016/j.amepre.2012.10.025.
• Allen, K. M., & Spitzer, W. J. (2016). Social work practice in healthcare: Advanced approachesand emerging trends. Los Angeles: SAGE.
• Fusenig, E. (2012, May). The role of emergency room social worker: An exploratory study. Master of Social Work Clinical Research Papers. Paper 26. Retrieved from sophia.stkate.edu/msw-papers/26
• Gajic-Veljanoski, O., & Stewart, D. E. (2007). Women trafficked into prostitution:Determinants, human rights and health needs. Transcultural Psychiatry, 44(3), 338-358.
• Gehlert, S., & Browne, T. (Eds.). (2011). Handbook of healthsocial work (2nd ed.). Hoboken, NJ: Wiley.
• Haegerich, T., & Dahlberg, L. (2011). Violence as a public health risk. American Journal of Lifestyle Medicine, 5(5), 392 -406.
• Hamberger, K. (2004). Domestic violence screening and intervention in medical and mentalhealth settings. New York: Springer.
• Keefe, R., & Jurkowski, E. T. (Eds.). (2012). Handbook for public health social work. New York: Springer.
• Louie, K. (2017). Interview with Andrea S. Kido, LCSW , on p edi atric and clinical social work. Online MSW Programs. Retrieved from https://www.onlinemswprograms.com/in-focus/interview-with-andrea-kido-lcsw-on-clinical-social-work.html
• McDaniel, S. H., Doherty, W. J., & Hepworth, J. (2014). Medical family therapy and integrated care. Washington, DC: American Psychological Association.
• McG arry, J., Ali, P., & Hinchliff, S. (2017). Older women, intimate partner violence and mental health: A consideration of the particular issues for health and healthcare practice. Journal of Clinical Nursing, 26 (15-16), 2177-2191. doi:// 10.1111/jocn.13490
• Mitchell, G., Tieman, J., & Shelby-James, T. (2008). Mult idisciplinary care planning and teamwork in primary care. Medical Journal of Australia, 188 (8 Suppl), S64-4. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18429739
• Mizrahi, T., & Davis, L. E. (2008). The encyclopedia of social work (20th ed.). New York: Oxford University Press.
• Nancarrow, S. A., Booth, A., Ariss, S., Smith, T., Enderby, P., & Roots, A. (2013). Ten principles of good interdisciplinary team work. Human Resources for Health, 11(19), 1-11. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662612/
• National Association of Social Workers (NASW). (2012). Social workers in hospital and medical center:Occupational profile. Washington, DC: NASW. Retrieved from workforce.socialworkers.org/studies/profiles/Hospitals.pdf
• National Association of Social Workers. (NASW). (2016). NASW standards for social work practice in health care settings. Washington, DC: NASW. Retrieved from www.socialworkers.org/practice/standards/NASWHealthCareStandards.pdf
• OnlineMPHdegree.net. (2017). Public health social work career, salary and job description in the field of public health. Retrieved from onlinemphdegree.net/public-health-socialworker/
• Salett, E. P. (2006, November). Human trafficking and modern day slavery. Human Rights and International Affairs Practice Update. Retrieved from www.socialworkers.org/diversity/affirmative_action/humanTraffic1206.pdf
• Smith, S. G., Chen, J., Basile, K. C., Gilbert, L. K., Merrick, M. T., Patel, N., . . . Jain, A. (2012). The national intimate partner and sexual violence survey (NISVS): 2010-2012. Atlanta, GA: National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention.
• Social Work Licensure.org. (2017). Palliative and hospice social workers and how to become one. Retrieved from http://www.socialworklicensure.org/types-of-social-workers/palliative-hospice-social-workers.html
• Stark, E., & Filtcraft, A. (1998). Women at risk: Domestic violence and women’s health. Criminal Behavior and Mental Health, 8(3), 232-234.
• United States Department of Health and Social Services (DHHS). (2003). Summary ofHIPAA privacy rule. Retrieved from https://www.hhs.gov/sites/default/files/privacysummary.pdf
• United States Department of Health and Social Services (DHHS). (2012, May). Principlesof epidemiology in public health practice (3rd ed.). (Self Study Course, SS1978). Retrieved from https://www.cdc.gov/ophss/csels/dsepd/ss1978/ss1978.pdf
• United States Department of State. (2017, June). Trafficking in persons report. Retrieved from www.state.gov/documents/organization/271339.pdf | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.09%3A_Social_Work_and_the_Health_Care_System.txt |
Introduction
Mental health and substance abuse are both multifaceted, challenging, and dynamic areas of the human service field. As professionals in this field, social workers help to make long lasting, life altering changes in people’s lives.
While numerous books have been written about mental disorders and substance use both broadly and specifically, this chapter will seek to introduce you to current information about mental disorders and substance use in the United States. This chapter will include, among other things, a brief history of both mental health and substance use, the current terminologies and definitions that professionals use in the field, some of the most commonly occurring disorders and/or substances that a social worker is likely to encounter in general practice, and briefly discuss the co-occurrence of mental disorders and substance use.
Van Gogh’s Man in a Straw Hat
Vincent Van Gogh (self-portrait: Above) may have suffered from numerous conditions including bipolar disorder or manic-depressive disorder (Wolf, 2001) . He is an example of how mental disorders and creativity can go hand in hand and how people living with a mental disorder can still be productive members of society.
Before We Get Started
Before we begin, it is important to understand some of the keywords, definitions, and sources that will be used. These are a small sample of the vast vocabulary that is used to identify and describe the mental disorders and substance use disorders that social workers may encounter in professional settings.
Key Terms
• Behavior – the response of an individual, group, or species to its environment
• Co-occurring – to appear together in sequence or simultaneously.
• Delusion – a false belief or opinion.
• Dual Diagnosis – when a person has two separate illnesses and each illness needs a treatment plan (DBSA, 2016).
• Hallucination – a sensory experience of something that does not exist outside the mind, caused by various physical and mental disorders, or by reaction to certain toxic substances, and usually manifested as visual or auditory images.
• Inpatient – a patient who stays in a hospital while receiving medical care or treatment.
• Mania – excessive excitement or enthusiasm; craze.
• Manic – pertaining to or affected by mania.
• Mental Disorder – any of the various forms of psychosis or severe neurosis.
• Outpatient – a patient who receives treatment at a hospital, as in an emergency room or clinic, but is not hospitalized.
• Prevalence – being widespread; of in wide extent or occurrence.
• Psychosis – a mental disorder characterized by symptoms, such as delusions or hallucinations, that indicate impaired contact with reality.
Definitions retrieved via Dictionary.com (2017), unless otherwise noted.
Mental Health
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (2013), also known as the DSM-5, is a living document created by social workers, psychologists, medical doctors and many other professions. The DSM-5 is the primary reference source social workers and other helping professions use to describe a mental disorder. In this text, just as in the DSM-5, “mental disorder” will be used as a broad term to describe several issues related to emotion, mental state, and behavior. However, this text is not enough to help people with a mental disorder. It takes a generalist approach from social workers, as well as other health professionals, to not just identify the disorder but then advocate on behalf of that person, provide supportive services, and work with the many challenges that accompany mental health disorders. Being a generalist means that the social worker employs various methods of treatment, expertise and skills to assist the client. Examples of methods used might be a strengthsbased approach where the client is encouraged to focus on and use their inherent strengths (not just physical ones) to improve other areas of their life. Social workers also focus on the person in environment. This means that social workers are aware of the impact the person has on their environment and how the environment impacts the person.
According to the National Alliance on Mental Illness (NAMI), approximately 1 in 5 adults in the United States experience some type of mental disorder in a given year. This means that, in a population of over 325 million people, over 43 million people will experience some form of mental health issue within a year. Among those that do experience a mental disorder, 9.8 million of those will experience a “severe” mental disorder meaning that it dramatically interferes or limits their ability to function in their everyday life. Of all the adults in the United States with a mental disorder, only 41% received mental health services in the past year. For those with a severe disorder, only 63% received any form of treatment or services (NAMI, 2017). Looking at those numbers it is clear to see that the need to identify, de-stigmatize and help individuals living with mental disorders, will impact millions of people.
There are six categories of mental disorders that this chapter will focus on as well as the variety of disorders found within those categories. These categories contain some of the most common disorders that a social worker will encounter in her or his career. This chapter also provides a brief description of the disorders as well as the estimated occurrence, or prevalence, of each one within the United States.
The selected categories are:
• Anxiety Disorders
• Psychotic Disorders
• Bipolar Disorders
• Depressive Disorders
• Trauma Disorders
• Personality Disorders.
History of Mental Health
Historically, people suffering from a mental disorder have also suffered abuse, experimentation, torture, and even death. As you go forth as a member of the social work profession, it is imperative that you understand how long of a road it has been and how much further the profession needs to go in the ethical treatment of people with a mental disorder. This link to a 27-minute video provides an example of where we were at just a few decades ago. The Willowbrook State School in New York City is one example of a tragic and possibly disturbing look the past treatment of those with a mental disorder and the developmentally disabled.
Willowbrook State Institution
As you can see from the video, the Willowbrook Institute lacked funding, professionals, and knowledge of what their patients needed to be able to live successfully. Unfortunately, the Willowbrook Institute was not an isolated incident, nor was it a new occurrence. Historically, those with a mental disorder have been looked down upon, shunned, stigmatized, vilified, criminalized or tortured. This kind of treatment has been documented as far back as the middle ages of Europe all the way to the mid 1900’s- United States where those with a mental disorder were placed in either hospitals or prisons.
This treatment continued up until 1963 when John F. Kennedy signed the Community Mental Health Act. President Kennedy described it as “a bold new approach”, and provided federal grants to states to construct community mental health centers (CMHC), to improve the delivery of mental health services, preventions, diagnosis, and treatment to individuals who reside in the community. To be able to supply federal funding for these statewide institutions, the Medicaid Act was passed in 1965. This Act allowed community-based care facilities to charge for reimbursement of funds while excluding payments to psychiatric institutions.
JFK signing The Community Mental Health Act
The Community Mental Health Act resulted in a mass “deinstitutionalization” across the country, and by 1980 nearly 75% of the psychiatric hospital population had declined. By 2009 less than 2% of those suffering from a mental health disorder remained in institutions. Unfortunately, this resulted in some unintended consequences. For example, community-based institutions could not keep up with the mass exodus of people from the psychiatric hospitals. This was the result of several factors such as a lack of space within the inpatient and outpatient settings, a lack of funding for proper care, and a lack of funding to improve care facilities. This lack of resources has negatively impacted the care and treatment of adults, children, families, and communities across the country.
Things to Be Aware Of
Having a mental disorder is often compared to having a physical illness (APA, 2015) and the comparison is one that professionals can often overlook. Just as there are varying degrees of physical illnesses, there are also varying degrees of mental disorders. The mental disorders can be managed in similar ways to physical ones. By maintaining medications, therapy, and problem-solving with the individual, social workers can help the person to not only stabilize, but excel in, their life. In fact, there are many successful individuals both in today’s world and throughout history, such as Vincent Van Gogh, who have found ways to cope with their mental disorders. Van Gogh most likely had one, maybe even two, mental disorders. Despite, or maybe because of, these challenges he was able to produce some of the most iconic and famous pieces of modern art to this date.
Being aware of the following mental disorders will allow you, as a social worker to better understand what the person is experiencing and how to help them meet their needs in the best possible way.
While every case is different, it is important to start thinking about some of the ways that mental disorders may present themselves. To assist you in this task some brief case studies have been provided throughout the chapter. These case studies are based on the experiences and case notes of real people and professionals.
All information and statistics following are from the DSM-5 unless otherwise indicated.
Anxiety Disorders:
Anxiety disorders are characterized by shared features like excessive fear (the emotional response to real or perceived imminent threat) and anxiety (anticipation of future threat) and other related behavioral disturbances.
• Social Anxiety Disorder or “Social Phobia” is an extreme fear of being judged by others in social situations. The fear is so intense that it will disrupt or impair the person’s ability to function in their everyday life. There is about a 7% prevalence in the United States for this disorder.
• Generalized Anxiety Disorder is an excessive, often unfounded, feeling of worry about the numerous everyday activities that a person could engage in. Approximately 2.9% of adults in the United States report symptoms or seek treatment for this disorder.
• Phobias are, simply put, an irrational fear of something. You may have heard of arachnophobia (fear of spiders) or acrophobia (fear of heights). In the United States, approximately 7%-9% of the population reports having a specific phobia and around 75% of this population will fear more than one object.
• Panic Disorder is defined as a debilitating fear or anxiety that occurs without any reasonable explanation. It is estimated that 2%-3% of the United States adult population will experience an episode of panic disorder in a year.
Case Sudy: Kristen
Kristen is a 38-year-old divorced mother of two teenagers. She has had a successful, well-paying career for the past several years in upper-level management. Even though she has worked for the same company for over 6 years, she’s found herself worrying constantly about losing her job and being unable to provide for her children. This worry has been troubling her for the past 8 months. Despite her best efforts, she hasn’t been able to shake the negative thoughts.
Kristen has found herself feeling restless, tired, and tense. She often paces in her office when alone. When she goes to bed at night, it’s as if her brain won’t shut off. She finds herself mentally rehearsing all the worse-case scenarios regarding losing her job, including ending up homeless (Case Studies, 2015).
What do you think Kristen might be diagnosed with?
Psychotic Disorders:
Psychotic disorders among the most serious and challenging disorders. This is because these disorders affect an individual’s interpretation of reality which then negatively impacts the person’s ability to function in their environments. Across the spectrum of psychotic disorders there are common symptoms such as hallucinations, delusions, or behaviors that are considered socially abnormal.
• Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves (NAMI, 2016). These disturbances may present as hallucinations or delusions. Adults in the United States report a lifetime prevalence of 0.3%-0.7%, with an age of onset often occurring in the early to mid-20s.
• Delusional Disorder is the presence of one or more delusions. These delusions must be present for at least one month to the DSM-5 definition for this disorder. The prevalence of this disorder occurs in 0.2% of adults in the United States.
• Schizoaffective Disorder is characterized by schizophrenic symptoms, such as delusions or hallucinations, but with an added component of a mood disorder like mania and depression. About 0.3% of the United States adult population with be diagnosed with schizoaffective disorder in a year (NAMI, n.d.).
Case Study: Martin
Martin is a 21-year-old business major at a large university. Over the past few weeks his family and friends have overheard him whispering in an agitated voice even though there is no one nearby. Lately, he has refused to answer or make calls on his cell phone, claiming that if he does it will activate a deadly chip that was implanted in his brain by evil aliens.
His parents have tried to get him to go to a psychiatrist for an evaluation, but he refuses. He has accused them of conspiring with the aliens to have him killed so they can remove his brain and put it inside one of their own. He has stopped attended classes altogether. He is now so far behind in his coursework that he will fail if something doesn’t change very soon (Case Studies, 2015).
What do you think Martin could be diagnosed with?
Bipolar Disorders:
A bipolar disorder can be defined as a variance in brain functioning that can cause unusual shifts in mood, energy, or activity levels. These shifts interfere with the person’s ability to carry out day-to-day tasks. These disorders can display a range of heightened emotions in the form of manic episodes (extreme ups) to depressive episodes (extreme downs) (NAMI, 2016).
• Bipolar Disorder I is a period of mania presented as persistently elevated, irritable mood, and persistently increased activity accompanied by feelings of euphoria (being excessively cheerful) or feeling “on top of the world.” The prevalence of adults in the United States with this disorder is 0.6%.
• Bipolar Disorder II is a milder form of mood elevation, involving mild episodes of mania, where one feels hyperactive and elated, that alternate with periods of severe depression, feeling down or sad for no obvious reason. Across a one-year span in the United States, about 0.8% of adults will meet criteria for this disorder.
Depressive Disorders:
Depression affects an estimated 300 million people globally and more than 15 million adults (6.7% of the population) in the United States. There are several levels of depression as well as minor levels that co-occur with other disorders or that are brought on by substance use/withdrawal.
• Major Depressive Disorder is a period of low mood for at least two weeks that is present most of the time in most situations. This may look like low self-esteem, low energy, or loss of enjoyment in pleasurable activities. Major depressive disorder will affect about 6.7% of the adult population in the United States (Facts and Statistics, 2016)
• Persistent Depressive Disorder, while lacking the severity of major depression, is a chronic, or ongoing, period of depression, usually for at least two years. Approximately 1.5% of the adult population of the United States will qualify under its criteria (ADAA, 2016)
Case Study: Jessica
Jessica is a 28-year-old married female. She has struggled with significant feelings of worthlessness and shame due to her inability to perform as well as she always has in the past . Jessica has found it increasingly difficult to concentrate at work . Jessica’s husband has noticed that she has called in sick on several occasions. On those days, she stays in bed all day, watching TV or sleeping . He’s overheard her having frequent tearful phone conversations with her closest friend which have him worried. When he tries to get her to open up about it, she pushes him away with an abrupt “everything’s fine.”
Although she hasn’t ever considered suicide, Jessica has found herself increasingly dissatisfied with her life. She’s been having frequent thoughts of wishing she was dead. She feels like she has every reason to be happy, yet can’t seem to shake the sense of doom and gloom that has been clouding each day as of late.
What do you think Jessica might be diagnosed with?
Trauma Disorders:
• Post-traumatic Stress Disorder (PTSD) can be brought on after experiencing, witnessing, or hearing about a traumatic event. This is most often associated with military personnel/veterans or victims of war. However, traumatic events can be shootings, physical assaults, or rape. After a month of being removed from the event a person may experience sleeplessness, increased heart rate, mood shifts, physically lashing out, or any combination of responses. These changes may be brought on by any stimulus in the environment that reminds the person of the terrifying event or from experiencing recurring thoughts about the event. In the United States, about 3.5% of adults will report experiencing some form of PTSD within a given year.
• Acute Stress Disorder can be described as the symptoms of post-traumatic stress disorder lasting for three days to one month. If it lasts for longer than one month, it than meets the criteria for PTSD. Acute Stress Disorder is reported in less than 20% of non-assault related events; it is reported in 20%-50% from related events like rape, assault, or witnessing a mass shooting.
Case Study: Josh
Josh is a 27-year-old male whose fiancée of four years was killed by a drunk driver 3 months ago. She died in his arms in the middle of the crosswalk. No matter how hard he tries to forget, he frequently finds himself reliving the entire incident.
He had to quit his job because his office was located in the building right next to the place of the incident. The few times that he attempted to return to work were unbearable for him. He has since avoided that entire area of town.
Normally an outgoing, fun-loving guy, Josh has become increasingly withdrawn, “jumpy”, and irritable. He’s stopped working out, playing his guitar, or playing basketball, all activities he once really enjoyed. His parents worry about how detached and emotionally flat he’s become.
(DeepDiveAdmin, 2015)
What do you think Josh might be diagnosed with?
Personality Disorders:
A personality disorder is a pattern of inner experiences and behavior that deviates from the expectations of the individual’s culture, is continuous, enduring and inflexible; it often has an onset in adolescence or early adulthood and leads to distress or impairment in the person’s life.
These types of personality disorders are often experienced by people seeking community mental health treatment and the homeless population, both areas social workers are employed. Some personality disorders that you might encounter include:
• Paranoid personality disorder which is a pattern of distrust and suspicion of others’ motives. These motives may be interpreted as malevolent or harmful to the person experiencing the paranoia. Paranoid personality disorder may be as prevalent as 4.4% among adults in the United States.
• Schizoid personality disorder is a pattern of detachment from social relationships and a restricted range of emotional expression. The prevalence of this disorder ranges from 3.1%-4.9% of the United States adult population.
• Antisocial personality disorder is a pattern of disregard for, and violation of, the rights of others. Those who display the symptoms of this disorder may habitually lie, commit aggressive or violent acts with little to no remorse, and violate social norms. The prevalence of this disorder ranges from 0.2%-3.3%.
• Borderline personality disorder is a pattern of instability in interpersonal relationships, self-image, and affect. People with borderline personality disorder may be overly impulsive or not understand social norms. It is estimated that 1.6% to as much as 5.9% of the United States adult population will be diagnosed with this disorder.
• Narcissistic personality disorder is a pattern of grandiosity, need for admiration, and lack of empathy. 6.2% of the adult population will report for this disorder within a year.
• ● Obsessive-compulsive personality disorder is a pattern of preoccupation with orderliness, perfectionism, and control. This preoccupation may impair their social lives, health, or ability to function in the outside environment. The prevalence for this disorder ranges from 2.7%-7.9% in a one-year period among the adult population in the United States.
Practice Settings
There are two main practice settings where you as the social worker are likely to encounter people with mental disorders: inpatient (hospitals, medical & psychiatric) and outpatient (mental health clinics). Though there are some similarities in goals and strategies, the differences are certainly worth noting.
Inpatient services in these settings are provided by social workers who work with individuals or groups to provide treatment in a variety of forms. The inpatient worker also works with friends, family, and employers to help the person return to their outside life. The social worker may advocate and work with other agencies to provide assistance or resources for individuals under their purview of care.
When a patient is ready to leave a psychiatric facility, the social worker may connect them to an outpatient clinic. In these settings, outpatient workers assist the individuals or groups in maintaining healthy functioning in their environment through therapy or clinical activities. The social worker in this setting will conduct therapy or planning sessions, contact outside agencies, and advocate for their client’s best interests.
Vulnerable Populations
While many people living with a mental disorder live fulfilling lives those who have a “severe” mental disorder are considered a vulnerable population. When we refer to people or a population as vulnerable this means it is “the degree to which a population, individual or organization is unable to anticipate, cope with, resist and recover from the impacts of disasters” (WHO, 2017). This vast population overlaps with several other populations that will/have been covered in this book:
• Veterans
• Children
• Poor/Disenfranchised
• LGBTQ+
• Minorities
• Homeless
• Prisoners
• Seniors
Things to Be Aware Of
The field of mental health is not perfect. Studies can only give us so much insight into the symptoms, behaviors, predictors, prevalence and other criteria used in identifying mental disorders. The DSM-5, while a useful tool, is still scrutinized for numerous reasons. For instance, this is the fifth edition of this text meaning that things have changed in definitions and classifications across the decades. The DSM-5, unlike its four previous versions, is being treated as a “living document” and will be amended more frequently in coming years than its previous versions. With this idea of a “living document” in mind, it is important to ask some questions. Is the DSM-5 a tool that attaches “labels” to people, thereby inhibiting the treatment that they seek? Is it a tool used only for insurance purposes? Does the collaboration between various backgrounds help or hurt the cause for proper mental health care? There are many more questions, critiques, and changes surrounding, not just the DSM-5, but therapy styles as well as our ever-improving understanding of the brain and we in the social work profession must be aware of them.
These changes have resulted in improvements to how we approach the concept of “mental disorders” as well as adhere more closely to the social worker core values and perspectives. For example, homosexuality used to be classified as a mental disorder but now we know that is simply not the case. Gender dysphoria is now more closely understood as the anxiety experienced due to the pressures of social norms rather than an internal struggle. There are many other changes, both big and small, between the DSM-IV and DSM-5 that are highlighted here.
But it’s not enough to just be aware of what we do in clinical settings. We also must be cognizant of our understanding of trauma (in its many forms), of a client’s resources and of society’s perception of what a mental disorder is. These things will continue to morph throughout time so it is important to remain vigilant and flexible regarding the many changes that occur in our field.
Current Issues
At the time of this book’s publication in late 2017, there are several pieces of legislation that could have important impacts on the services that social workers and other helping professionals offer. For example, the result of the debate over our national healthcare will have a profound impact on who receives Medicaid, how much the states will receive to supplement the costs of Medicaid funding, and what types of services will be covered. In the State of Michigan, for example, the legislators are looking to implement a bill that would take funding from direct providers like Community Mental Health and direct it towards private organizations. This link gives further description of this bill and will allow you, the reader, to form your own opinions http://www.michigan.gov/mdhhs/0,5885,7-339-71550_2941_76181—,00.html
Regardless of what your decisions or thoughts are on these issues are, the social work profession must always be vigilant to who/what/where/why/when of funding. We must also be aware politically of who’s in charge, what their agenda is, and if it impacts our profession, impacts the people we serve, and if it is in line with our professional ethics.
Substance Abuse/Use/Dependence
For decades, a war has raged across the globe. The financial costs have been high, the lives impacted even higher. During this time, we have been told to “Just Say No” and many have been arrested and imprisoned for participating in this war. The enemy in this war has taken many forms and continues to persist in modern times. It is not terror and it is not a tyrannical government. This is a war against drugs.
History of Substance Use
Discussing substance use/abuse would be incomplete without mentioning the “war on drugs” and the historical impact substances/drugs have had on our economy, population, education, law enforcement, and policy.
Made popular in 1971, President Richard Nixon declared drug abuse “public enemy number one.” This statement came along with a dedication of more federal resources towards “prevention of new addicts and the rehabilitation of those who are addicted.” This was not a new idea by any means. The drug war may have started as early as 1860 from certain laws at local levels. After that came the first federal law, the Harrison Narcotics Tax Act, which was signed into law in 1914. Then came Prohibition that, though ultimately unsuccessfully in its attempt to make alcohol illegal, was still an attempt at eliminating an object of public consumption (Thirty Years of America’s Drug War a Chronology, 2014).
This is just the tip of the iceberg as far as the historical legislation of the war on drugs. But the question we should ask is: Are these policies and means of “combating drugs” really working?
According to The National Center on Addiction and Substance Abuse (2017), over \$51 billion dollars is spent annually in the United States to combat illegal drugs and their use. For every dollar spent however, only two cents goes towards prevention and treatment of those seeking assistance from a substance use disorder. The rest of the money goes towards prosecution, imprisonment, and hospital costs.
These policies have also lead to an increase the incarceration of individuals, many of whom are in jail or prison for possession, not selling or distribution (Bureau of Justice Statistics, 2007).
Federal Prisoners by Offense, 2010
And yet it has not helped address number of deaths from drug use.
National Overdose Deaths, Number of Deaths from All Drugs, 2002 – 2015
To be clear, this is not to say that there should not be drug laws. Rather, the suggestion here is to consider that maybe these laws and investments are causing more harm to the victims of drug use. Perhaps these laws are not designed to prevent their use or help users to rehabilitate, as Nixon originally intended all those years ago?
The World Health Organization (WHO) states:
“Policies which influence the levels and patterns of substance use and related harm can significantly reduce the public health problems attributable to substance use, and interventions at the health care system level can work towards the restoration of health in affected individuals.” (WHO, 2017)
Things to Be Aware Of
It is important to note that the DSM-5 does not use the term “addiction” as a classification term. Some in the helping professions believe the term “addiction” can carry a negative connotation and is a very ambiguous definition. Therefore, the phrase “substance use disorder” is used as a more neutral term by these professionals for the purposes of describing the variety of ways that this disorder can be identified.
Key Terms
• Abstinence – the act or practice of restraining oneself from indulging in something.
• Depressant– a drug that reduces bodily functioning or instinct (ex. Tranquilizers, Klonopin, or Xanax.
• Hallucinations – perception like experiences that occur with an external stimulus; vivid/clear, involuntary, and can occur in all levels of sensation.
• Hallucinogen – a drug that causes hallucinations (ex. PCP, Ketamine and Peyote).Harm Reduction – a set of strategies aimed at reducing negative consequences from drug use. Also hold a belief in/respect for the rights of the people who use drugs.
• Inhalants – vapors introduced to the body by breathing it in (ex. Paint thinners and many household chemicals).
• Stimulant – a substance that increases attention, energy, heart rate, and respiration (ex. Cocaine and Ritalin).
• Opioids – a compound derived from the opium plant (ex. Morphine, methadone, and heroine).
Definitions retrieved via Dictionary.com (2017), unless otherwise noted
But, as you head into the social work profession you may find often times that the terms addiction, substance use, substance abuse, and dependency may be used interchangeably or be used to refer to the same thing. For example, the term “addiction” or “addict” can be seen on government websites whereas DSM-5 employs the term “substance use disorder”. These words are explaining the same events, symptoms, and treatments but from two different professional standpoints, the medical (government) person centered.
The goal of the DSM-5, as well as the social work profession, is to mitigate or prevent the self-imposed and social stigmas that can result from being labeled as “an addict.” By limiting harmful stereotypes and using person centered language (i.e. saying someone has a disorder rather than calling them an addict), the client may view the disorder as a manageable part of their life rather than being all of who they are. This is an important concept for social workers to be sensitive to and it is with that in mind that this chapter will use the term Substance Use/Substance Use Disorder.
Substance Use Disorder (SUD)
Substance use disorder (SUD) is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues using the substance despite significant substance related problems.
There are four key criteria that people must meet to be considered as having a Substance Use Disorder are impaired control, social impairment, risky use, and pharmacological criteria.
All information and statistics following are from the DSM-5 unless otherwise indicated.
SUDs include but are not limited to things such as:
• Alcohol Use Disorder is defined by a cluster of behavioral and physical symptoms, which can include withdrawal, tolerance, and craving. The prevalence of this disorder is very common in the United States with an 8.5% rate among those 18 years and older.
• Cannabis Use Disorder consist of behavioral and physiological symptoms that result from a long or heavy duration of cannabis use. This use disorder will often co-occur with other, more severe, substance use disorders like alcohol, stimulants or hallucinogens. While the full prevalence may be underreported, a study by Hasin et al. (2015) reveal that three out of ten (30%) marijuana users will qualify as having a use disorder.
• Hallucinogens are any drug that can produce alterations in perception and mood (See: Key Terms). Across a twelve-month span, it is estimated about 0.5% of the adult United States population will report symptoms of this disorder.
• Inhalants are classified as any substance that people only consume through inhaling. The result of this type of use is a mind-altering nature. Inhalants include things like gasoline, aerosol spray, or prescription medicines called nitrites (National Institute on Drug Abuse, 2017). This use disorder is most common in youth with about .4% of 12-17-year-olds reporting misuse although 10% of 13-year-olds do report using inhalants at least once.
• Opioids are a class of drugs that include the illegal drug heroin as well as legal drugs like morphine and codeine. These drugs deliver pain relief and euphoria when consumed. The consumption of prescribed opiates like morphine or OxyContin, becomes a substance use disorder when the opioids are consumed outside of a controlled environment or through self-administered dosages. In the United States, the prevalence of opioid use disorder is approximately 0.37% in adults.
• Stimulant use disorder is an abuse of substances like cocaine or methamphetamines. Symptoms of this disorder include cravings for stimulants, failure to control use when attempted, spending a great deal time obtaining and using stimulants, and withdrawal symptoms that occur after stopping or reducing use (SAMHSA, 2015)
• Tobacco use disorder occurs in people who use tobacco products in greater amounts or longer durations than originally intended. There is a strong desire to consume tobacco, increase intolerance to nicotine, and people may be unsuccessful at quitting tobacco products. The prevalence in the United States of tobacco use disorder is 13% (DSM-5, 2013) – a substantial number considering the estimated 66.9 million smokers of tobacco products (SAMHSA, 2015).
Substance Use Practice Settings
A social worker choosing the field of substance treatment will find themselves in two primary settings: inpatient and outpatient. Similar to the practice settings of mental disorders, substance use clinicians can work in inpatient clinics that house people trying to alleviate themselves of their substance use as well as enhance their health, an example of this can be seen in the film 28 Days starring Sandra Bullock. These types of facilities may have individual or group counseling sessions, provide drug screens, and provide time for the individual to reflect on their situation (Davis, 2013).
Outpatient clinics are another option for practice settings. These facilities offer potential clients scheduling flexibility and are not as intensive or hands on as inpatient facilities. These types of facilities allow clients to receive services like counseling, education, medication and support information at their own pace (AddictionCenter.com, 2017).
Current Issues
In 2017 there is a current drug use trend in the United States referred to as the Opioid epidemic. According to the Centers for Disease Control and Prevention (CDC) (2017), the majority of drug overdose deaths in the United States, six out of ten, in fact, involve some form of an opioid. This epidemic appears to be rooted in the use of prescription opiates. According to CDC statistics, nearly half of the opioid overdoses in the United States were linked to prescription pills like OxyContin, Methadone, and Vicodin (CDC, 2017).
But what happens when the person who has been using prescription opioids can no longer afford them? They turn to heroin. According to CNN reporter, Dr. Sanjay Gupta (2016), the price for heroin is almost one tenth the price per milligram than it is for a prescription. This may be one of the many reason we see such a rise in heroin use and, is often the case, death. They may also experiment with more dangerous drugs, such as fentanyl, as has been the case of the residents of Ohio (Opiate Action Team, 2017).
Chart showing that heroin use is part of a larger substance abuse problem
This increased trend in drug use has impacted a wide range of people and demographics, many of whom were never at “serious” risk for drug abuse before, like women, people with higher incomes, and the privately insured. Statistics show that 45% of people who used heroin were also addicted to some form of opiate painkiller (CDC, 2017).
The above links provide examples of the impacts and strategies that people and agencies dealing with the dramatic impact that opioids are currently having, not just on the country but all over the world. According to a White House press release titled President Trump’s First Budget Commits Significant Resources to Fight the Opioid Epidemic (2017), in the next year alone, the U.S. government will spend 12.1 billion dollars for treatment and prevention efforts. The U.S. will also provide 500 million dollars in grants so that states can work to reduce misuse, improve treatment, and increase access to treatment.
Social workers are at the forefront of combating this epidemic. Workers are meeting clients in hospitals as they recover from overdoses, counseling those seeking rehabilitation, work with insurance companies to distribute proper funds and ensure correct coverage, as well as educating youth on the dangers of opiates.
Philosophies of Treatment
As we can see, there is a large spectrum of substances that have different effects on the body and brain. If you choose to enter the field of substance treatment, you are bound to encounter different ways organizations or practitioners choose to treat their clients. Two main philosophies of substance treatment are Abstinence and Harm Reduction.
Some places may encourage the practice of abstinence. You may have heard this term regarding alcohol or sex because abstinence is defined as “the act or practice of restraining oneself from indulging in something” (Oxford Living Dictionaries, 2017). Some substance use treatment programs like Alcoholics Anonymous (AA) promote this type of behavior (DualDiagnosis.org, 2017).
According to Principles of Harm Reduction (2017), harm reduction, like many practices throughout social work, has the base philosophy of meeting people “where they are at” when it comes to their substance use. When working with a person who is suffering from a drug use problem (change the word problem) the social worker acknowledges that drugs are a part of part of this world, in both positive and negative terms (i.e. medications and illegal drugs). Rather than attacking or condemning the patient’s behavior, the clinician works with the person to minimize the use as well as the harmful effects of these substances thereby reducing the overall harm that is being done.
Both strategies have their limitations. For example, is it reasonable to ask someone to abstain without relapsing? How does a relapse impact the individual’s recovery? Will it be condemned or understood as part of healing? Can a person really get clean if they are still on a substance? Do we continually tolerate relapse or establish consequences for the undesired behavior? How much time is the counselor and client willing to take? Will the approach be safe for the client to participate in?
According to DualDiagnosis.org, 30% of people who participate in harm reduction or moderation type programs will end up in an abstinence-only program. However, according to a study conducted across a 33-month period, the success rate of abstinence only programs is very low – 5.9% for females and 9% for males (Recovery: Abstinence vs. Moderation, 2017). However, there is a current trend in this area of treatment moving more toward the use of interventions with evidence of effectiveness but information is currently limited.
Mental Disorder and Substance Abuse
Whether you are a social worker in mental health or substance treatment, inpatient or outpatient, there is an almost guarantee that you will encounter people who have both a mental disorder and substance use disorder in your career. This is referred to as a dual diagnosis where the presence of a mental disorder occurs along with the use of a substance.
According to the National Institute on Drug Abuse (2017), people who have a substance use disorder are nearly twice as likely to also be diagnosed with either a mood or anxiety disorder. However, a mental disorder can also lead to substance use in a sort of chicken vs. egg situation. For example, let’s say there is someone who has a diagnosis of depression who also uses a stimulant to try to alleviate it. Or perhaps someone has a diagnosis of alcohol use disorder and because of this use, they have developed depression. These are two potential examples of a dual diagnosis.
Case Study: Katie
Katie is a 26-year-old female. She has come into services due to a previous suicidal attempt. Her initial assessment gives her a diagnosis of Major Depressive Disorder and a secondary assessment of Alcohol Use Disorder. She remembers drinking since she was about 12 years old; she reports that she drinks to lessen the feelings of “sadness and feeling down.” She also reports that she feels “just as bad, if not worse” if she stops the drinking.Katie has attempted services in the past but discontinued them because she says, “I was fine after about 10 months of being with them so I stopped taking my medication and wanted to get on with my life.” Katie reports that she has a boyfriend who is very supportive and a mother in town. Her father is out of the picture but Katie reports he also had a history of substance use.
Consider how you would approach this case: What are some things you would want to know? What would you address first? Why? Feel free to discuss this in class.
As you can see, it takes a discerning professional to figure out the best path of treatment, plan for change with the individual, provide supports, assist in maintaining healthy coping, and a vast array of other tasks and responsibilities.
Things to Be Aware Of
Mental disorders and substance use are more common than people would like to admit. It adversely impacts many parts of people’s lives, whether directly or indirectly.
If you, or someone you know, is experiencing any signs or symptoms of a mental disorder or experiencing substance use please contact:
Mental Health Assistance 1
Mental Health Assistance 2
Substance Use Assistance
These websites are only an example of the many resources and supports available to people seeking help or assistance in navigating difficult life changes.
As a social worker in these fields, your role will be to help clients through these, potentially difficult, times. You will connect their clients to local resources, advocate for best practices to achieve client goals and outcomes, and offer non-judgmental supports to their clients. You yourself may even be that resource that people contact for individual therapy/counseling, or group therapy/counseling.
Techniques, Tools, and Strategies
Social workers can seek several avenues to assist their clients. As you may already be aware, social work strives to institute evidence based practice (EBP) when dealing directly with clients. These practices may include Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, or Motivational Interviewing.
Social workers must also be familiar with medications that have been prescribed for treatment and their potential benefits, drawbacks, or chance for abuse (i.e. opiates).
Social workers working in inpatient settings may also help guide their clients through the process of detox. This process can be a long, painful, arduous process for many people and the support that a caring social worker can provide is an invaluable resource.
Social workers may lead support groups. These are organizations, generally outpatient, where clients gather to share their stories, successes, setbacks, hopes, and needs as they recover or maintain their mental or physical health regarding their disorder or substance use.
Finally, it behooves the social worker to know the person they are assisting. Establishing rapport, trust, and familiarity with the client’s personality, lifestyle, family structure, culture, and environment are invaluable pieces of information. The impact that a mental disorder or substance use disorder can have on these different systems are not isolated to one; rather these systems impact each other.
For example, someone experiencing a substance use disorder may withdraw from work or family functions seeking out isolation. They may make friends with similar substance use disorders, thereby creating a new environment that encourages the behavior. The person then may not have the support to seek positive change when they decide to finally pursue help.
Similarly, someone who is diagnosed as paranoid schizophrenic may not be able to function in their working environment. This lack of employment may impact their social circles and places of enjoyment, even where they now shop. This change in lifestyle may, in turn, impact family dynamics. The family, once a great support, may now be uninformed, resentful, or frightened of the sudden change in their loved one. The rejection of family may then have an impact on the belief in oneself to recover, cope and maintain their mental health.
Career Outlook
The area of social work that specifically deals with mental disorders and/or substance use has been around for decades and shows no signs of slowing down. In 2014 the number of social workers employed in the mental health and substance use fields was 117,800. The field is projected to add 22,300 jobs over the next 10 years, resulting in 19% job growth (U.S. Department of Labor, 2017).
Unfortunately, the Bureau of Labor Statistics (2017) also indicates that the social workers in the mental health and substance use fields tend to make less than their peers. Workers in mental health and substance use can expect to make an average of \$42,700 compared to the top average pay of \$60,230 from fields like private clinical or veterans administration workers. (NOTE: Payment tends to be degree dependent; those with BSW degrees tend to make less than those with MSWs.)
Summary
Social workers have, and will continue to, advocate for the understanding of and pursuit of social justice for some of the most misunderstood and vulnerable among us. These workers will encounter a variety of individual and co-occurring disorders in their profession.
Social workers in the mental health and substance use fields continue to improve treatment outcomes with a better understanding of the brain, trauma, and evidence based practice (EBP) models to provide treatment and care. These treatments can be in a variety of settings from community mental health (CMH) facilities, to hospitals, to private clinics.
There are many challenges in the country, as well as the world, and social workers are well equipped to combat many of these challenges going forward. This field will continue to grow over the next decade although the funding and pay scale for services is currently in question. | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.10%3A_Mental_Health_and_Substance_Use.txt |
Introduction
As you have learned from previous chapters, a social worker can find themselves involved in numerous diverse systems depending on their client population and area of specialty. One of the most intimidating and controversial of these systems is the United States criminal justice system. Whether a social worker is tasked with working with inmates housed in jail/prison, rehabilitating individuals on probation/parole, investigating potential child abuse, or defending the rights of crime victims, the criminal justice system is sure to have an enormous impact on nearly every aspect of a client’s case and personal life. In order to best aid clients who have found themselves wrapped up in this complex system it is crucial that we as social workers have at least a basic knowledge of what the system is, how it works, basic terminology, and most importantly, the rights held by not only our clients but each person who is a citizen of this country.
What is Criminal Justice?
The United States Criminal Justice System
The United States criminal justice system is the set of agencies and processes established by the United States government to control crime and impose penalties on those who violate laws. It is directly involved in apprehending, prosecuting, defending, sentencing, and punishing those who are suspected of criminal offenses. Contrary to popular belief, there is no one system of justice within the United States, but rather a combination of multiple smaller jurisdictions which are determined by the individual’s area of residence, type of offense, and more. The most common of these include state (police) and federal (FBI) jurisdictions. The simplest way to compare these two is to think of an individual who commits multiple crimes in one state with an individual who commits one or multiple crimes in one state and then moves to another. Since the individual in the second scenario has moved, the two states involved would be competing for jurisdiction, making it necessary to involve the Federal Bureau of Investigations (FBI) as they have national jurisdiction. Other examples of jurisdictions include county, city, tribal government, or military installation (NCVC, 2008a).
Components of Criminal Justice
These descriptions are taken from NCVC’s The Criminal Justice System unless otherwise noted.
Most of these criminal justice systems consist of five components- law enforcement, prosecution, defense attorneys, courts, and corrections. Each of these play a unique but critical role in criminal justice proceedings.
Law enforcement officers are tasked with hearing and investigating reports for crimes which happen in their jurisdiction. These officers investigate crimes by gathering and protecting evidence, making arrests, providing testimony during court processes, and conducting follow-up investigations as needed.
After law enforcement officers investigate a criminal offense, it is up to the prosecution to represent the state or federal government throughout the court process. Prosecutors must review the evidence gathered by officers and determine whether to file formal charges against the suspect or to drop the case. They are also tasked with presenting the evidence in court, questioning witnesses, determining what charges a suspect will be charged with, and more.
While the prosecution represents the state or federal government, it is the job of defense attorneys to represent the individuals accused of a criminal offense. They can either be hired by the defendant themselves or assigned by the court since legal representation is a basic right outlined in the Constitution.
Both the prosecution and defense attorneys are involved in the courts which are run by judges. Their role is to ensure that the law is followed along with overseeing what happens in court. Judges are able to determine whether or not to release offenders before a trial, accept or reject plea agreements, oversee trials, and sentence individuals convicted of illegal acts. Judges are easily some of the most powerful individuals in the criminal justice system.
Finally, after an individual has been investigated, tried, convicted, and sentenced, they enter the last criminal justice component of corrections including jails and prisons. These terms are often used interchangeably, but in reality jails are used to house individuals sentenced to less than one year of incarceration as well as those awaiting trial, while prisons house individuals sentenced to be incarcerated for a year or more. Correction officers are tasked with supervising convicted individuals in jail or prison, and also include probation (jail) and parole (prison) officers who are responsible for monitoring these individuals either after they have completed their sentence or in some cases in lieu of incarceration. Corrections officers typically prepare pre-sentencing reports on the individual which are used to help judges decide on sentences as well as overseeing the day to day custody of incarcerated inmates (NCVC, 2008a).
*The image provided outlines the process from arrest to incarceration including the components discussed above. As a social worker within criminal justice settings it is often beneficial to be aware of the complexity of criminal justice proceedings as well as basic timelines in order support and advocate for clients. For more information and detailed descriptions of each step in the criminal justice system process, see The American Bar Association’s guide, How Courts Work.
What is the sequence of events in the criminal justice system? www.bjs.gov/content/justsys.cfm
The Courts
In order to understand the role of a social worker in court room proceedings, a basic understanding of the various types of courts and their roles are first required. Look to the next sections to learn a few of the most common types of courts that a social worker may find themselves involved in.
Courthouse in Washoe County, Nevada
The descriptions below were obtained from Michigan Courts, The Learning Center website .
United States Supreme Court
The Supreme Court of the United States is the “highest” court in the land. It has ultimate authority to hear appeals in nearly all cases decided in the federal court system. It can also hear appeals from state high appellate courts that involve a “federal question,” such as an issue involving a federal statute or arising under the Constitution of the United States. This essentially means that an individual who disagrees with a decision reached in a lower court has the right to apply for a second opinion from a higher court. They are able to practice this right by moving all the way from local courts to the top of the diagram, the US Supreme Court which can not be overruled. With that said, fewer than 100 cases are actually heard and decided by the Supreme Court each year.
There are currently nine justices on the Supreme Court: one chief justice and eight associate justices. These individuals can be thought of as a team of judges who are considered to be some of the most ethical individuals in the country nominated only by the President of the United States. The key to the number of justices is that it is an odd number when the decision on a case comes down to a vote. In order for a decision to be reached, a minimum of five justice votes are required either for or against the defendant. After each side’s argument has been presented the justices crafts a written explanation of their decision called an opinion. With that said, there can be more than one “opinion” since not all of the Justices need to agree in order for a decision to be reached. Most commonly opinions are either titled as “the majority opinion”, or “the minority opinion” and outline the details of the “winning” and “losing” arguments.
The main conditions for a Justice to hold office is found in Article III Section 1 of the Constitution, “[t]he Judges, both of the supreme and inferior Courts, shall hold their Offices during good Behavior, and shall, at stated Times, receive for their Services, a Compensation, which shall not be diminished during their Continuance in Office” (Constitution, 2017). Essentially this means that Justices serve for life, only being replaced due to death, retirement, or impeachment for unethical behavior. Since 2005, John G. Roberts Jr. has served as the Chief Justice and the oldest and longest serving justice is 80-year-old Anthony Kennedy appointed in 1988.
Supreme Court facts and landmark cases are available through the following links at ConstitutionFacts.com:
https://www.constitutionfacts.com/us-supreme-court/fascinating-facts/
https://www.constitutionfacts.com/us-supreme-court/landmark-cases/
Michigan Supreme Court
The State of Michigan Supreme Court is the highest court in the state and can be overruled only by the Supreme Court of the United States. The Michigan Supreme Court has seven justices, one of whom is elected to be the Chief Justice as in the US Supreme Court. Following the diagram provided below, the state and federal court systems can be thought of like a pyramid starting with local courts and working all the way to the US Supreme Court. At this level, if an individual is dissatisfied with a decision from the Michigan Court of Appeals they can complete a written “application for leave to appeal”. This essentially means that they would like to invoke their right to appeal a court decision which they believe is unjust. The Michigan Supreme Court receives approximately 2,000 applications each year and “grants leave” – meaning they will hear the case – in about 100 of these cases. Unlike the US Supreme Court however, in order for a decision/ majority opinion to be reached at this level, a minimum of four of the seven Justices must agree.
Michigan Court of Appeals
The Court of Appeals is a relatively new court that began in 1965. It is an “intermediate” court between the Circuit Court (where trials take place) and the State Supreme Court. Individuals who are dissatisfied by a Circuit Court decision go first to the Court of Appeals. In most cases, the person who loses in Circuit Court has the right to appeal to the Court of Appeals where the case will be argued before three judges who must reach a majority decision (2 out of 3) much like the higher courts described above. The Court of Appeals hears about 6,000 cases each year, and listens to arguments regularly in Detroit, Lansing, and Grand Rapids, and Northern Michigan.
Flowchart of the U.S. court system
Local Courts
Circuit Court
The Circuit Court is a general trial court. It has jurisdiction in all civil cases involving more than \$25,000, all felony cases, all serious misdemeanor criminal cases, and all family cases. The Family Division has jurisdiction over divorce, child custody, child support, paternity investigations, adoptions, name changes, juvenile proceedings, emancipation of minors, parental consent, and personal protection proceedings. The Family Division also houses the Friend of the Court, which handles cases involving child custody, parenting time, and support.
Probate Court
The Probate Court handles wills, administers estates and trusts, orders treatment for individuals who are developmentally disabled, and appoints guardians and conservators. In 2013, Probate Court handled 64,114 case filings.
District/Municipal Court
The District Court handles most traffic violation cases and hears both criminal and civil cases, including small claims and landlord-tenant disputes. All criminal cases for people 17 years old or older originate in district court. The defendant is told the charges, rights, and possible consequences. If the charge is a misdemeanor punishable by less than one year in jail, the District Court conducts the trial. For charges punishable by more than one year, the case goes to Circuit Court.
Small Claims Court
A division of the District Court, the Small Claims Court hears civil cases of \$5,500 or less. A case may be presented to a judge or an attorney magistrate. In 2013, 55,719 claims were filed here. A magistrate is a civil officer with the power to administer and enforce laws similar to a judge.
Court of Claims
The Court of Claims is part of the Court of Appeals. The court hears and determines all civil actions filed against the State of Michigan and its agencies. These cases include highway defect, medical malpractice against state-owned medical facilities and state-employed medical practitioners, contracts, constitutional claims, prisoner litigation, tax-related suits, and other claims for money damages.
Amendments of the Constitution
The criminal justice system is ultimately governed by the Constitution of the United States of America. The Constitution is responsible for outlining the basic, inalienable rights of each citizen of the United States. Obtaining an understanding of these rights is particularly relevant to social workers working with criminal justice populations in order to be able to determine if a client’s rights are being denied and what protections have been put in place to defend these rights.
Some examples most pertinent to criminal justice populations include Amendment 4 which protects individuals against unlawful search and seizure, and Amendment 8 which protects against cruel and unusual punishment.
To review these amendments as well as the entire Constitution, please follow this link: http://constitutionus.com/
The Constitution of the United States – Preamble
What is a Criminal Justice Social Worker?
Now that you have an idea of what the criminal justice system is and how it functions, how does social work come into play? With today’s increasingly controversial, challenging, and ever-changing legal system, criminal justice social work (also referred to as forensic justice social work) is rapidly rising as a vital public service for offering psychological and behavioral services in the criminal justice system (Coyle, 2017). Although the field of criminal justice social work is relatively new, the number of court cases and growing prison populations nationwide are creating a large demand for social workers with knowledge and/or experience within the criminal justice system.
While many mistakenly believe that criminal justice social work is limited to evaluating and treating criminal defendants in psychiatric hospitals, it is important to realize that the field is much broader and includes all social services within the civil and criminal justice systems on nearly every level. It is also important to note that, like many aspects of society, the media’s portrayal of criminal justice social work is highly inaccurate. For example, these workers are often depicted as performing and analyzing lab work which is rarely the case unless the workers specializes in research roles. It is also unlikely as a worker that you will run into the Jeffrey Dahmers of the world on a regular basis, rather you will be treating and advocating for individuals who often have significant histories of trauma and have simply made poor life decisions. So, if in reality this career is not what the media portrays it as, what exactly does a criminal justice social worker do? (Coyle, 2017).
A criminal justice social worker’s day-to-day activities largely include providing consultation to law enforcement personnel, law makers, attorneys, paralegals, community members, correctional officers, doctors, and psychiatrists on interdisciplinary teams (NCVC, 2017a). Criminal justicesocial workers often provide their clients with emotional support, guidance in navigating the court/legal systems, connections to relevant resources, housing application assistance, and individual and policy advocacy. Further, criminal justice social workers typically use their legal expertise to work within court systems in settings such as child and family agencies, hospitals, mental health agencies, substance abuse agencies, correctional facilities, prisons, and faith-based institutions.
Criminal justice social workers are also responsible for diagnosing criminal populations, making recommendations about mental status, serving as expert witnesses, training law enforcement personnel, referring defendants to community resources, and developing advocacy programs in the criminal justice system. These roles are more than likely where the inspirations for television and other media forms stem from. However, although diagnosing criminal populations is part of what criminal justice social workers do, this task realistically makes up very little of a worker’s activity and is not nearly as glamorous and intense as one might see in a movie. For example, while again it is accurate that a criminal justice social worker may work with criminal populations, other vulnerable populations served include but are not limited to:incarcerated youth and adults, recently released inmates, children who are victims of neglect, and victims of domestic or sexual abuse (MSW Guide, 2017).In order to better outline the types of populations criminal justice social workers commonly work with and what they do, please refer to the following case study:
Case Study
“Jonathan” is a 37-year-old , Caucasian male who identifies as heterosexual and non-religious. He is currently in prison for domestic assault against his wife of 11 years. Although he claims to love his wife, Jonathan states that he frequently struggles to control his anger , especially after a night of heavy drinking . After being interviewed by the prison social worker it was revealed that Jonathan was abused by his father while he was a child, and he also commonly saw them fight both verbally and physically. During the initial interview Jonathan struggled to make the connection between his own traumatic upbringing and his current beliefs and behaviors.
C ases such as these are incredibly common within the criminal justice system since, as outlined in previous chapters, unresolved traumas can so often be linked to negative behaviors as adults. For Jonathan’s case the main tasks of a criminal justice social worker would include assessing Jonathan’s risk to himself or others based on his past and current behaviors, developing a treatment plan to combat symptoms of anger and possible substance abuse, educating Jonathan on various coping skills to control his anger/ drinking, working to increase communication skills as an alternative to violence, meeting weekly or bi-weekly for individual therapy with subjects such as adjustment to prison and childhood trauma, detailed documentation of all activities, advocacy, testifying in court, and more. Although this case study does present a common issue that bridges social work and the criminal justice system it is just one of countless possibl e client populations.
For additional examples of specific career opportunities and client populations, refer to the next section.
Prisoners in a group therapy session
Specific Careers as a Criminal Justice Social Worker:
As a social worker in the criminal justice system there are a wide array of career options each with specific skill requirements, education requirements, salary ranges, and of course daily tasks. Although the previous sections discuss the most common tasks of a criminal justice social worker, each of the many career options listed below are equipped with their own unique challenges and rewards. This section will outline just a few of the countless job prospects for individuals with a mental health degree as well as a passion for helping those caught up in the criminal justice system.
If you are interested in learning more about any of the following career options including degree requirements, salary, job outlook, and more, please visit the website www.payscale.com.
CPS/APS Worker
CPS and APS are common acronyms that future social workers are sure to see in their careers. They stand for Children’s Protective Services (CPS) and Adult Protective Services (APS). These careers are easily some of the most controversial and emotionally taxing that a social worker can enter (Education Career Articles, 2012). The job titles can be broken down into Investigations and Ongoing services, which are tasked with determining whether or not an allegation of abuse on a child or adult is true (investigations), or are responsible for working directly with families who have been substantiated for some form of abuse or neglect (ongoing). Unlike the common misperception these workers are not solely responsible for the removal of children from their parents, although this is a necessary part of the job in the most severe of situations for the safety of the child.
However, these workers also rely heavily on providing parenting training and other necessary resources with the ultimate goal of keeping families together. Similar to CPS, APS investigations workers determine when a vulnerable adult (mentally ill, elderly, etc.) is being improperly taken care of or taken advantage of. A common example of this is elderly adults who are being physically or financially abused by family members or other care providers. Although these individuals are not “removed” in the same sense as a victimized child may be, it is the role of the APS worker to see that the abusive situation is terminated.
The most common social work skills utilized by CPS/ APS workers include case management, investigation, documentation, collaboration with other agencies and families, and quick decision-making. These careers also require frequent traveling within the worker’s county of employment in order to attend home visitations and/ or court. (Education Career Articles, 2012).
Youth Correctional Counselor
Counselors working with youth in the criminal justice system help rehabilitate young offenders (Study.com, 2017b). Counselors generally work in a juvenile correctional facility, such as a detention center or residential facilities that youth are referred to by the Department of Health and Human Services, Children’s Protective Services, or Foster Care. Here counselors are responsible for supervising the youth by enforcing discipline, making and maintaining records, and implementing constructive activity programs. Counselors may also be responsible for making recommendations such as the appropriate destination for a youth after they are released from placement. For example, a counselor who believes a youth is not capable of being unsupervised, may be unsuccessful, or simply has nowhere to go, may recommend an additional residential facility, foster care, or may even help the individual obtain independent housing in his or her community. In addition to working through various traumas with the incarcerated youth, juvenile justice counselors frequently work with youth and their families together in order to teach new skills designed to strengthen the support system of the youth, minimize conflict if/ when the youth is able to return home, or even provide specialized interventions including addiction recovery and anger management. (Study.com, 2017b).
Prison/jail social worker
Also commonly referred to as correctional social workers, prison social workers are trained mental health professionals with the purpose of reducing rates of recidivism (re-arrest) in the future. Prison social workers use their knowledge and skills to prevent recidivism by addressing psycho-social issues such as past trauma, providing education, and offering social service recommendations to successfully reintegrate offenders into the community upon release. A prison social worker’s responsibilities include performing psychological assessments to determine inmates’ level of mental health functioning, evaluating the presence of mental health or substance abuse disorders, providing individual or group counseling sessions, teaching inmates life skills in rehabilitation groups, and preparing inmates for their release. Along with the clinical duties prison social workers are responsible for a wide array of administrative tasks such as authoring treatment plans, documenting thorough notes/ files, and communicating with other professionals on inmates’ cases. (Social Work Degree Guide, 2017).
Probation and Parole Officer
Parole officers identify and supervise offenders who are eligible for conditional release from prison before they have completed their sentences (Roberts, 2017). In order to earn parole, prisoners must obey prison rules, perform prison jobs well, and show progress in rehabilitation and therapy programs.
In comparison, probation officers are responsible for monitoring those offenders who will be placed on probation as an alternative to jail time. The key difference between the two comes down to sentence length with prison almost always housing offenders with sentences of more than one year, while jails house both offenders awaiting sentencing and those whose sentences are less than one year. The tasks of probation and parole officers are essentially the same aside from the slight difference in the populations of offenders served (Roberts, 2017).
Some probation/ parole officers work inside correctional institutions, preparing reports for parole boards. They assess prisoners’ lives before and during incarceration; how prisoners’ families will affect their rehabilitation; and what job prospects prisoners might have if released. Based on the officers’ reports and interviews with the prisoners and their families, the boards choose certain prisoners for release. Field officers on the other hand work with parolees once they have returned to their communities. Their daily tasks include helping the offenders find jobs, schools, or therapy programs, meeting with them regularly, performing drug tests, and completing detailed paperwork including meeting notes, progress reports, and treatment recommendations. Some officers also supervise halfway houses in which small groups of offenders live together to share experiences and lend each other support. (Study.com, 2017a).
Sex offender clinician
Counseling individuals convicted of sexually motivated crimes is easily one of the most difficult and emotionally taxing career paths available to social workers within the criminal justice system. It is certainly not a job that is right for everyone, and requires a great deal of confidence as well as the ability to treat all people with dignity/ respect regardless of how you view their actions. On a daily basis, sex offender clinicians are responsible for psychological testing, counseling groups, conducting sex offender programming therapy sessions, interviewing inmates for psychosexual evaluation and recommendation purposes, emergency evaluations and management, diagnosing, case management, working with case managers and contracted professionals, psychological consultation to prisons, testifying in court, and more (Hubbard, 2014).
It is most common for this job to exist within a prison setting or in a support group that is required for sex offenders on parole within the community. This is one of the highest paid positions for therapists within the criminal justice system because of i ts intense nature and specialty; these positions are almost always reserved for the most experienced professionals within the field due to their difficult nature (Hubbard, 2014).
Victim advocate
If advocacy and helping those in crisis is your calling, a career as a victim advocate may be perfect. Rather than working with offending populations as is most common for a criminal justice social worker, victim advocates, as the name implies, are tasked with assisting victims of crimes on many different levels. Victim advocates are professionals trained in mental health or criminal justice related professions, but often require only a bachelor’s degree. These workers offer victims information about legal processes and their rights, emotional support after experiencing a traumatic crime, assistance finding resources and completing paperwork, and more. Victim advocates often support their clients by accompanying them to court and even offer clinical services when appropriately trained. Many advocates are employed by crisis hotlines or the courts themselves or as group counselors within the community. For this career path, the ability to speak a second language is particularly valuable. (NCVC, 2008b.).
Substance abuse counselor
A substance abuse counselor is another example of the specialized populations with which clinical social workers in the criminal justice system can work (Substance Abuse, 2017). These counselors work with individuals who use or abuse drugs and alcohol with the goal of overcoming addiction. As you may recall from previous chapters, substance abuse is a notoriously difficult mental disorder as it almost always involves relapse. Due to the difficult nature of this particular career, a substance abuse counselor must be patient, non-judgmental, and especially careful to treat clients with dignity and respect. Frequently done in group therapy sessions, a substance abuse counselor works with clients to overcome the both the motivations to use substances and the effects of their use on their personal and professional lives. These professionals also act as a key support system to aid individuals in making a plan to become substance free and maintain sobriety for years to come.
The main tasks of a substance abuse counselor include creating and monitoring a personalized recovery plan for each individual client on a case load. These plans help clients identify their motivations to use, behaviors which encourage use and/or sobriety, outline consequences of use, identify strategies to prevent relapse, and of course the creation of goals throughout the treatment process. As with most social work careers, a career as a substance abuse counselor involves a great deal of paperwork, case documentation, and collaboration with outside professionals including probation/ parole officers when applicable. (Psychology School Guide, 2017).
Mitigation Specialist
A mitigation specialist (mitigate=reduce severity) is a member of a defense attorney team that participates in courtroom proceedings (NLADA, 2016). These specialists possess clinical skills and must be extremely organized and detail oriented. The overall job function of a mitigation specialist is to reduce the potential punishment of his/ her client by identifying a factor that warrants a reduction in severity for sentencing. Social workers are often sought after for these positions due to their clinical skills and ability to extract sensitive information from clients in a positive and professional manner.
These specialists are responsible for compiling biopsychosocial assessments, analyzing the significance of the information obtained as it relates to personality/behavioral development, and determining the need for services such as counseling. One example of a typical case for a mitigation specialist may be to complete a psychosocial assessment (a type of life history interview) with a client and learning that although the individual may be responsible for their crime, their IQ is well below average. This information is then used in order to mitigate or “reduce the severity” of the individual’s sentence. As with victim advocacy, the ability to speak a second language is considered highly valued in this field. (NLADA, 2016).
Counselor W orking with Mandated Clients
Although this is not a specific job title, counseling individuals who are mandated to attend therapy poses its own unique set of challenges. Essentially the word “mandated” means that individuals are required to attend counseling and are often entering services unwillingly (Shallcross, 2010). These populations commonly include individuals caught up within the criminal justice system due to courts frequently referring individuals who are deemed to be a risk to themselves or others for counseling services. Some examples of these populations include some of those listed above such as: individuals who abuse substances, individuals who are violent (often discovered through violent crimes), those who are found to be responsible for the abuse/ neglect of a child or adult, people who commit sexual offenses, and more. Although it consists of many of the same therapeutic techniques as a general counselor, those who do not enter counseling willingly have the potential to be extremely difficult to work with. For example, while most individuals who voluntarily enter counseling are willing to openly discuss their reasons for seeking services, individuals such as those on probation/parole who have been referred to mandatory counseling are often unable to recognize why counseling is even necessary.
Counselors working with these populations have to be particularly skilled in communication as it is common for mandated clients to refuse to participate in counseling. This difficulty poses yet another problematic situation for workers as they are frequently required to report client progress to probation/ parole officers. Since social workers typically want to help their clients, the idea of reporting to court officials often creates ethical dilemmas about how much to share considering how the reports can impact their clients (Shallcross, 2010).
The following tips were obtained from Counseling Today and can be found by following the link provided: https://ct.counseling.org/2010/02/managing-resistant-clients/
• Avoid acting like an expert (focus on client goals)
• Empathize with clients
• Gently confront excuses
• Let the client set the pace
• Do not engage in power struggles
• Always treat clients with dignity and respect
*If you feel that your client is potentially dangerous, look to these additional tips:
• Inform coworkers that you will be in session with this client (develop a code word signifying that you need help)
• Ask your supervisor about installing panic buttons in therapy offices
• Avoid working alone/ at night with this client (or at all if possible)
• Do not allow the client to position themselves between you and your exit
• Make an excuse to leave if you feel uncomfortable
• Limit sharing personal information
• Know your agency’s emergency policies
Tips for Testifying in Court
Now you have a basic understanding of what the various court systems are and how they interact with each other, but where do social workers fit in? In short, as a citizen of the United States it is always helpful to have a fundamental understanding of the legal system which governs us. For social workers, however, this becomes even more critical as so many of the clients we work with become involved in the legal system in combination with our own services. Without holding at least a minimal understanding of what our clients are facing, it is almost certain that we would struggle to help them to the best of our ability by offering advocacy and comfort. With that said, a social worker should never offer legal advice to a client as it is not their area of expertise and, as you learned in the ethics chapter, could result in a breach of the NASW core value of competence.
While much of what a social worker does in relation to court is offering support to clients, it is not uncommon for their role to involve testifying in court which essentially involves providing spoken evidence to the court. This is especially true for professions including CPS/ foster care workers and probation/ parole officers. For even the most seasoned social workers the idea of testifying regarding a client’s case can stir up fear and dread. Having to speak in court is almost always a nerve racking experience in and of itself, but when social workers must also balance the legal requirement to tell the truth while on the stand with wanting to do what is right for their client, the situation becomes even more tricky and potentially ethically ambiguous.
The next section will offer a number of helpful tips to avoid being stumped on the stand by even the most talented attorney, and has been adapted for social workers based on the website listed here: https://www.justice.gov/usao-mdpa/victim-witness-assistance/tips-testifying-court
Refresh Your Memory
Before you testify in court perhaps the most crucial piece of advice that can be given is to review your notes and plan ahead. Since it is often part of a social worker’s job to provide the court with documentation it is not uncommon for court officials to provide you with these documents while you are on the stand. However, this should never be expected and a good social worker will always come prepared with their own case documents. Also, it is often helpful to highlight any particularly meaningful events, dates, or times in these notes for easy access. Never feel as if you cannot refer to your notes before answering a question; simply ask for a moment to review the facts to be sure. It is always better to take that time to check than to be wrong! Doing this will help you avoid suggestions by attorneys. Do not agree with their estimates or conclusions unless you arrive to the same one independently. Finally, it is important to note than any documents brought in by a worker can be seized as evidence by the judge. In order to avoid this, it is best to bring only documents already submitted to the court, and always analyze possible consequences for both the client and yourself if a document were to be seized as evidence.
Speak In Your Own Words
Don’t try to memorize what you are going to say. Doing so will make your testimony sound “pat” and unconvincing. Instead, be yourself, and prior to trial go over in your own mind the matter about which you will be questioned.
Appearance Is Important
A neat appearance and proper dress in court are important. An appearance that seems very casual or very dressy will distract the jury during the brief time you’re on the stand, and the jury may not pay attention to your testimony.
Speak Clearly
Present your testimony clearly, slowly, and loud enough so that the juror farthest away can easily hear and understand everything you say. Avoid distracting mannerisms such as chewing gum while testifying. Although you are responding to the questions of a lawyer, remember that the questions are really for the jury’s benefit.
Do Not Discuss the Case
Jurors who are or will be sitting on the case in which you are a witness may be present in the same public areas where you will be. For that reason, you MUST NOT discuss the case with anyone. Remember too, that jurors may have an opportunity to observe how you act outside of the courtroom.
Be Professional
When you are called into court for any reason, be serious, avoid laughing, and avoid saying anything about the case until you are actually on the witness stand.
Being Sworn In As A Witness
When you are called to testify, you will first be sworn in. When you take the oath, stand up straight, pay attention to the clerk, and say “I do” clearly.
Tell the Truth
Most important of all, you are sworn to TELL THE TRUTH. Tell it. Every true fact should be readily admitted. Do not stop to figure out whether your answer will help or hurt either side. Just answer the questions to the best of your memory.
Do Not Exaggerate
Don’t make overly broad statements that you may have to correct. Be particularly careful in responding to a question that begins, “Wouldn’t you agree that…?”. The explanation should be in your own words. Do not allow an attorney to put words in your mouth.
Listen Carefully
When a witness gives testimony, they are first asked some questions by the attorney who called them to the stand. For you, this is an Assistant United States Attorney (AUSA). The questions asked are for the purpose of “direct examination.” When you are questioned by the opposing attorney, it is called “cross examination.” This process is sometimes repeated several times in order to clearly address all aspects of the questions and answers. The basic purpose of direct examination is for you to tell the judge and jury what you know about the case. The basic purpose of cross examination is to raise doubts about the accuracy of your testimony. Don’t get mad if you feel you are being doubted during the cross examination. The defense attorney is just doing their job.
Do Not Lose Your Temper
A witness who is angry may exaggerate or appear to be less than objective, or emotionally unstable. Keep your temper. Always be courteous even if the attorney questioning you appears discourteous. Don’t appear to be a “wise guy” or you will lose the respect of the judge and jury.
Respond Orally To The Questions
Do not nod your head for a “yes” or “no” answer. Speak aloud so that the court reporter or recording device can hear and record your answer.
Think Before You Speak
Listen carefully to the questions you are asked. If you don’t understand the question, ask to have it repeated, then give a thoughtful, considered answer. NEVER give an answer without thinking about phrasing and potential consequences for both you and your client. While answers should not be rushed, pauses to simple questions are unnecessary and could imply a lack of knowledge or professionalism.
Explain Your Answer
Explain your answer if necessary. Give the answer in your own words, and if a question cannot be truthfully answered with a “yes” or “no”, it’s okay to explain your answer.
Correct Your Mistakes
If your answer was not correctly stated, correct it immediately. If your answer was not clear, clarify it immediately. It is better to correct a mistake yourself than to have the attorney discover an error in your testimony. If you realize you have answered incorrectly, say, “May I correct something I said earlier?” Sometimes witnesses give inconsistent testimony – something they said before doesn’t agree with something they said later. If this happens to you, don’t get flustered. Just explain honestly why you were mistaken. The jury, like the rest of us, understands that people make honest mistakes.
Do Not Volunteer Information
Answer ONLY the questions asked of you. Do not volunteer information that is not actually asked for. Additionally, the judge and the jury are interested in the facts that you have observed or personally know about. Therefore, don’t give your conclusions and opinions, and don’t state what someone else told you, unless you are specifically asked. Also, remember that as a social worker or even a non-professional witness, you can only provide your OPINION on a case or client. It is ok to specifically designate that a statement that you are about to make is your opinion as a professional.
Don’t Set Yourself Up For Error
Unless certain, avoid generalizing statements such as, “That was all of the conversation,” or “Nothing else happened.” Instead say, “That is all I recall” or “That is all I remember happening.” It may be that after more thought or another question, you will remember something important and by making generalized statements you could appear not knowledgeable, unprofessional, or in extreme cases could appear to be attempting to withhold information from the court.
Objections By Counsel
Stop speaking instantly when the judge interrupts you, or when an attorney objects to a question. Wait for the judge to tell you to continue before answering any further.
Only Testify To What You Know
Although you should be confident and definitive in your answers whenever possible, it is important to understand that, when testifying regarding client behavior, you can only discuss personal opinions based on your professional experience. When asked a question regarding client behaviors it is helpful to begin your answer with “In my professional opinion.” This is done in case any additional information or analyses change the worker’s clinical interpretation which can then be adjusted in court without appearing not knowledgeable.
*In addition to these tips, the NASW-Endorsed professional liability program which regularly assists NASW members in preparing to testify as a witness can serve as an excellent resource. For more information, follow this link:www.naswassurance.org/malpractice/malpractice-tips/witness/
Conclusion
Th e criminal justice system in the United States is immensely complicated and fascinating system which holds a great deal of power over the many lives it governs. Through reading this chapter you should now be able to identify various components of the criminal justice system including the courts, the process from arrest to incarceration, the Co nstitution of the United States, and more. In addition to these facts readers should be aware of the numerous ways in which the criminal justice system and the field of social work overlap. Combining these professional fields results in an incredibly interesting career path, as well as an extremely difficult one.
P ossessing a strong passion for advocacy is vital to success within this career path due to the highly contrasting viewpoints of mental health and criminal justice workers. Although it is sometimes easy to forget, the social work profession believe in the fact that each person, regardless of their offenses, is worthy of dignity and respect. This is not always a belief that is respected in society as a whole and particularly within a system which often promotes punishment in opposition to rehabilitation . This only makes it that more important that social workers become involved . Ultimately if you are passionate about advocating for vulnerable individuals, believe that each person has rights, can be unbiased and non- judgmental, and love the idea of working in a challenging, fast-paced, and rewarding field, this could be just the career path for you.
Legal Terminology for Social Workers
*All definitions were obtained from Michigan Criminal Law & Procedure, third edition (Beatty et al., 2014).
Abuse – The cruel or violent treatment of a human or animal.
Accessory – Someone who intentionally helps another person commit a felony (examples – giving advice before the crime, helping to conceal the evidence or the perpetrator). An accessory is usually not physically present during the crime.
Accomplice – Someone who helps another person (known as the principal) commit a crime. Unlike an accessory, an accomplice is usually present when the crime is committed. An accomplice is guilty of the same offense and usually receives the same sentence as the principal.
Accused – A person or persons formally charged but not yet tried for a crime.
Acquittal – A legal judgment, based on the decision to either a jury or a judge, that an accused is not guilty of the crime for which he or she has been charged or tried.
Actus Rea – The guilty act, otherwise states as a wrongful deed rendering the actor criminally liable.
Adjudication – The trial phase of a juvenile criminal proceeding.
Admissible Evidence – The evidence that a trial judge or jury may consider, because the rules of evidence deem it reliable.
Admission – Confession of a charge, an error, or a crime; acknowledgment.
Affidavit – A written statement made under oath, swearing to the truth of the contests of a document.
Allegation – A claim or statement of what a party intends to prove; the facts as one party claims they are.
Arraignment – The first appearance of the defendant before a judge or magistrate following his or her arrest in which the defendant is formally advised of charges, attorney may be appointed, and bail is set.
Arrest – The taking, seizing, or detaining of another person.
Assault — An attempt to commit a battery or an illegal act that caused the victim to reasonably fear a battery.
Bail/Bond – The money or property given to the court as security when an accused person is released before and during a trial with the agreement that the defendant will return to court when ordered to do so. Bail is forfeited if the defendant fails to return to court.
Battery — A forceful, violent, or offensive touching of the person or something closely connected with the victim.
Brief — A written argument by counsel arguing a case, which contains a summary of the facts of the case, pertinent laws, and an argument of how the law applies to the fact situation. Also called a memorandum of law.
Chain of Custody — The one who offers real evidence must account for the custody of the evidence from the moment it reaches his or her custody until the moment it is offered into evidence.
Custody — The person is under arrest or the person’s freedom has been deprived in any significant way.
Defense Attorney — An attorney who safeguards guaranteed rights of the accused.
Delinquent — A juvenile offender.
Deposition — An interview under oath.
Domestic Relationship — For purposes of the Domestic Violence Statute, a relationship that includes spouse or former spouse, resident or former resident of the same household, or persons who have a child in common.
Domestic Violence — An assault or assault and battery that occurs within a domestic relationship.
Due Process of Law — Procedures followed by law enforcement and courts to ensure the protection of an individual’s rights as assigned by the Constitution.
Entrapment— Occurs if (1) the police engage in impermissible conduct that would induce an otherwise law-abiding citizen to commit a crime in similar circumstances, or (2) the police engage in conduct so reprehensible that it cannot be tolerated by the court. 1
Felony — An offense for which the offender may be punished by death or imprisonment in state prison for more than one year.
Guardian Ad Litem — A guardian appointed by the court to represent the interests of infants, the unborn, or incompetent persons in legal actions.
Hearsay — A statement, other than the one made by the declarant while testifying at the trial or hearing, offered in evidence to prove the truth of the matter asserted.
Holding — A court’s determination of a matter of law, a specific legal principle contained in an opinion, or a court’s ruling concerning a specific question.
Indictment— A formal written accusation issued by a grand jury or similar entity charging one or more people with a crime.
Indigent — An individual who has been found by a court to be indigent (stricken by poverty) within the last 6 months, who qualifies for and receives assistance, or who demonstrates an annual income below the current federal poverty guidelines.
Interrogation — Questioning in a criminal investigation that may elicit a self-incriminating response from an individual.
Jail — A facility that is operated by a local unit of government for the detention of a persons charged with, or convicted of, criminal offenses. Houses those convicted of offenses with sentences less than one year as well as those awaiting trial.
Jurisdiction — The official power to make legal decisions and judgements.
Jury — A body of people (typically twelve in number) sworn to give a verdict in a legal case on the basis of evidence submitted to them in court.
Magistrate — Magistrates assist the district court judge and are responsible for hearing informal civil infraction hearings, issuing search and arrest warrants, and set bail/ accept bond.
Mens Rea — Guilty mind (motive).
Mentally Incapable — When a person suffers from a mental disease or defect which renders that person temporarily or permanently incapable of appraising the nature of his or her conduct. (Also referred to as NGRI-Not Guilty By Reason of Insanity).
Miranda Warning / Miranda Rights — By law (Miranda v. Arizona ruling by the United States Supreme Court) anyone being questioned by authorities must first receive a ‘Miranda Warning’. This requirement exists to prevent the police or other authorities from taking advantage of a person who does not know or fully understand their rights and thus speaks to the police and answers their questions without an attorney present. The Miranda Warning consists of the authorities explaining certain rights to a person before questioning them. These include: 1) You have the right to remain silent. 2) If you choose to speak, anything you say can be used against you in court. 3) If you decide to answer any questions, you may stop at any time and all questioning must cease. 4) You have a right to consult with your attorney before answering any questions. You have the right to have your attorney present if you decide to answer any questions, and if you cannot afford an attorney, one will be provided for you or appointed for you by the court without cost to you before any further questions may be asked.
Misdemeanor — A violation of a penal law of this state that is not a felony or a violation of an order, rule, or regulation of a state agency that is punishable by imprisonment or a fine that is not a civil fine.
Neglect — To fail to sufficiently and properly care for an individual or animal to the extent that the individual or animal’s health is jeopardized.
Notice to Appear — For minor offenses of 93-day misdemeanors or less, an appearance ticket may be issued in lieu of custodial arrest except in the cases of domestic violence and Personal Protection Order violations.
Perjury — Occurs when a person knowingly makes a false statement that is material to the case after taking a recognized oath.
Petition — A request for court action against a juvenile or removal for protective services.
Preliminary Breath Test (PBT) — A hand-held instrument utilized to determine presence or amount of alcohol in a person’s system.
Preliminary Examination — A hearing to determine if probable cause exists to believe a crime has been committed and to determine if probable cause exists that the defendant committed the offense.
Prison — A facility that houses prisoners committed to the jurisdiction of the department of corrections. Individuals housed here are must be sentenced to a minimum of one year.
Privilege — Certain confidential communications that cannot be used against a person (attorney/ client).
Probable Cause — Facts and circumstances sufficient to cause a person of reasonable caution to suspect the person to be arrested is committing or has committed a crime, or that the place to be searched contains the evidence sought.
Prosecuting Attorney — The chief law enforcement officer in a county, who authorizes complaints and represents state and county in all civil and criminal matters in county courts.
Protective Order — A personal protection order entered pursuant to law; conditions reasonably necessary for the protection of one or more named persons as part of an order for pretrial release, probation, removal from home, etc.
Reasonable Suspicion — An objective basis, supported by specific and articulable facts, for suspecting a person of committing a crime.
Ruling — The outcome of a court’s decision on a specific point or a case as a whole.
Search Warrant — A legal document authorizing a police officer or other official to enter and search premises.
Specific Intent — The prosecution must prove not only that the defendant did certain acts, but that he or she did the acts with the intent to cause a particular result.
Subpoena — A writ or order commanding a person to appear before a court or other tribunal, subject to a penalty for failing to appear.
Summons — A writing used to notify a person of an action that was commenced against him or her.
Testimony — The evidence given by a witness under oath. It does not include evidence from documents and other physical evidence.
Vulnerable Adult — An individual age 18 or over who, because of age, developmental disability,mental illness, or physical disability requires supervision or personal care or lacks the skills to live independently.
Warrant for Arrest (Bench Warrant) — Document issued by a judge if the information contained in the complaint establishes probable cause to substantiate the offense charged.
Write – A judicial order directing a person to do something | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.11%3A_Social_Work_in_Criminal_Justice_Settings.txt |
Introduction
You will likely find veterans in just about every facet of the social work profession. For example, veterans are young and old, and come from very diverse backgrounds. Veterans have families, spouses, and children. They struggle with poverty and experience homelessness. They seek aid from state and federal assistance programs, and struggle with mental and physical health disorders, both military-related and non. Veterans pursue employment, and often struggle to bridge the gap between military and civilian life, battle addictions, and are part of the criminal justice system. Though military core values stress excellence and a “never lose” mentality, veterans are no strangers to defeat. Regardless of whether you set out to work with veterans or not, it is very likely that you will interface with them at some point or another. Throughout this chapter, general background information on cultural aspects of veterans, as well as common benefits and services available to former members of the armed forces will be discussed. Specific to this section of the chapter, the question of “what is a veteran?” will be reviewed, and will include some key characteristics of military life, rank, and pay. Some insight on basic military organization and structure, core values and some common misconceptions, will also be addressed, along with the differences between Active Duty and Part-time components. Additionally, common military language and how it might impact services will also be provided. Hopefully better prepare you for the day a veteran knocks on your office door seeking aid.
With all that in mind, it’s important to stress that when talking about any cultural information, it is impossible to avoid generalizations. We, the authors, as veterans ourselves, feel safe talking for some, but not for all. This is basic information, after all. We have a chapter to define what could easily take volumes to adequately articulate. With that in mind, the views and opinions shared from this point forward are that of our own, and were peer-reviewed by members of academia and by those currently working in and/or are a part of the veteran community.
Section I. Components of the Military
Army
https://www.army.mil/
Seal – Department of the Army
The United States Army serves as the land-based branch of the U.S. Armed Forces. The U.S. Code of Military Justice (UCMJ) defines the Army in Section 3062 of Title 10, U.S. Code of Military Justice. It’s mission is to preserve the peace and security, provide a defense for the United States and the Commonwealths and possessions and any areas occupied by the United States. It supports the national policies implementing the national objectives overcoming any nations responsible for aggressive acts that imperil the peace and security of the United States.
Navy
http://www.navy.mil/
Seal – Department of the Navy
The mission of the United States Navy is to protect and defend the right of the United States and our allies to move freely on the oceans and to protect our country against her enemies. UCMJ defines the Navy in Section 3062 of Title 10, U.S. Code of Military Justice.
Marines
http://www.marines.com.mil/
Seal – United States Marine Corps
The United States Marine Corps (USMC) is a branch of the United States Armed Forces responsible for providing power projection, using the mobility of the US Navy to deliver rapidly, combined-arms task forces on land, at sea, and in the air.
Air Force
http://www.af.mil/
Seal – Department of the Air Force
According to the National Security Act of 1947 (61 Stat. 502), which created the USAF: §8062 of Title 10 US Code defines the purpose of the USAF to preserve the peace and security, and provide for the defense, of the United States, the Territories, Commonwealths, and possessions, and any areas occupied by the United States. The stated mission of the USAF today is to “fly, fight, and win in air, space, and cyberspace.”
U.S. Coast Guard
https://www.uscg.mil/
The Coast Guard is one of our nation’s five military services. It’s core values—honor, respect, and devotion to duty – are the guiding principles used to defend and preserve the United States of America. The Coast Guard protects the personal safety and security of our people; the marine transportation system and infrastructure; our natural and economic resources; and the territorial integrity of our nation–from both internal and external threats, natural and man-made. We protect these interests in U.S. ports, inland waterways, along the coasts, and on international waters.
Each branch of service has their own traditions, trademarks, flags, uniforms, requirements, boot camp, and way of training; however, combined they stand together for the protection of freedom, equality, and rights govern to us by us. The men and women who serve the United States are regular people but when they join the military service a higher standard of personal conduct, integrity, respect, honor, and sacrifice is expected.
Different branches of the military have different uniforms, histories, and tradiations
Section II. Military Culture
Military culture is comprised of the environment veterans have been a part of, and has had a major impact on the lives lead since exiting the military. It is important for those that have never served in the military to be familiar with some fundamentals of military service. Before moving on to specific information, there are a few key terms and characteristics that help describe some common threads that make up the backbone of military culture. These components include Camaraderie, Pride and Esprit de Corps, Tradition, and The Mission.
Camaraderie
The first term, camaraderie, is arguably the largest component of military culture. The relationship dynamics that arise out of a group of individuals whose success or failures dictates the groups’ fate is a hint of the camaraderie experienced in the military. The companionship that comes out of that type of environment is lifelong.
To further reinforce this point, refer to the following quote from an article from the newspaper that focuses and reports on matters concerning the armed forces, Stars and Stripes:
“It’s an unbreakable trust and kinship forged as men push their brains and bodies to the limits each day, together, in an environment that won’t forgive them should one man mess up. One guy keeps the next guy going, to keep all the brothers from falling.”
(Ziezulewicz, 2009)
This TED talk by Sebastian Junger entitled Why Veterans Miss War might help describe the strong sense of camaraderie a little better. https://www.youtube.com/watch?v=TGZMSmcuiXM
Pride and Esprit de Corps
Pride is undoubtedly a term you are familiar with. To a member of the military, pride (which could also be called Military Bearing) is a driving force behind much of our actions. The uniforms and the way they are worn, the walk, the talk: it is very explicit, strenuously orchestrated, and delivered with the highest possible standards of excellence. It’s meant to present an imposing force that inspires faith in our allies, and fear in our enemies. It stirs competition between service members, especially with those in different branches of the military (Sion, 2016). It boosts confidence to the point of thinking and feeling invincible. Pride is understandably a huge driving force in the actions of all those who don the uniform (Schumm, 2003, p.837). All of this is magnified by what the military refers to as esprit de corps.
Esprit de corps is essentially the glue that keeps a group of military men and women united; the common spirit that invokes enthusiasm, devotion, and pride in the unit a service member is part of. With hope and aspirations of being the best, they strive to bring honor to those serving with them and to those that served before them in the same unit. A phenomenal example of this can be found in the following video, Marine Corps Silent Drill Platoon Stun a Packed Arena. On the surface, this is a spectacle aimed to entertain. Under the surface, the preparation, precision, and delivery are all aspects of pride. Pride in themselves, pride in their brothers and sisters they serve with, pride in their unit (esprit de corps), and meant to invoke pride in the country’s military. The next component, tradition, has its roots in pride and esprit de corps.
Tradition
Four generations of a military family from Cumberland County, Tennessee
Any group of Soldiers, Marines, Airmen, or Seamen are organized into various-sized groups commonly referred to as units. (More on military organization will be detailed further in this chapter.) Each unit has its own traditions and each military member is part of those traditions, carrying on a tradition of honor, pride, ability, courage, and competence. The things service members do while assigned to that unit echo throughout time and bring honor or shame to those the individual is serving with, and those that served before him or her. In the HBO series Band of Brothers, the Army’s 82nd Airborne Division was glorified for their valor, courage, and bravery during various operations of World War II. Such a fine example can be tarnished and that reputation dwarfed by just a few poor decisions of an overzealous service member.
The Mission
The last term is potentially the most important one, and potentially the most ambiguous. The mission is any task that a service member or group is focused on at any given moment. And that task becomes the embodiment of their being until the task is completed. That task can be small or large and may require individual effort or a group approach. Furthermore, each specific unit within the military carries on its own specific mission, regardless of the size of the unit. Within the military, the Mission, especially when in combat, always comes first. It is placed in higher priority than hopes, dreams, health, and safety.
What is a Veteran?
So now that you have a basic understanding of what it is like to serve in the United States military, the next topic to be addressed is the term Veteran. What is a Veteran? This may seem a simple question at first, but in actuality it is a very murky subject. This is evident by conducting a quick online search for “what is a veteran.” Search results yield a new definition for practically every different site you go to. Quite frequently, the various sites contradict one another, as well. While most declare that anybody who has served in the military is a veteran, regardless of any other details, some sources include more specific categories, such as total time served in the military, if they served at times of conflict or war, or type of discharge character. To make matters worse, there is confusion among former service members as to what a veteran is, as well.
The safest answer can be gathered from the Department of Veterans Affairs (VA). The following exert helps to clear some of the fog: “Title 38 of the Code of Federal Regulations defines a veteran as a person who served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable (Veterans Authority, 2017).”
The different branches of the military, differences between Active Duty and the part-time components, as well as the different discharge characters will be detailed later in this chapter. For now, the above definition suggests that if they served at all in any branch of the military and were not dishonorably discharged, they are classified as a veteran. This same definition will be utilized for the purposes of this chapter. However, the initial question of what is a veteran is not entirely answered yet.
As a social worker, rarely will you yourself have to award veteran status to any individual. If and when you do, the program you are working with will have its own detailed and specific criteria to establish veteran status. For example, when this author (Brian) administered the Supportive Services for Veteran Families (SSVF) grant, a veterans-exclusive, VA-funded grant with aims of ending homelessness among veterans, the criteria stated that a veteran was an individual who had served at least one day on active duty outside of initial training, and also received any discharge character other than dishonorable (Department of Veterans, 2016).
Other veteran benefits awarded through the VA have their own eligibility criteria. This means a veteran may be eligible for some benefits, such as healthcare, and be ineligible for others, such as education benefits or small business loans. This may help in explaining why some veterans are not fans of the VA. Likely due to a lack of consistent definition, there are many former service members who do not view themselves as veterans. Some may even get defensive or react with guilt or shame when asked, “are you a veteran?” The most important take away from this portion of the text is that the term veteran is foggy at best. If you need to know if an individual was formerly affiliated with the military for whatever reason, you may find the best approach is to simply ask if they ever served in the military. This removes “veteran” from the equation entirely, and may assist in developing rapport with the individual as well (Conard, Allen, & Armstrong, 2015).
Rank Structure and Pay
All individuals affiliated with the military are given a rank in some form or another. Even civilian contractors that are affiliated with the military often have a rank structure that, according to some, has corresponding weight and gravitas as military rankings. Each different military branch has its own unique rank structure. Very specific information regarding the various rank structures can be found at Military.com via the following link: http://www.military.com/join-armed-forces/military-ranks-insignias.html)
To provide a very basic overview, each branch of the military has essentially two separate rank structures: enlisted and officers.
Enlisted: Enlisted service members are those who were recruited into the military via a recruiter and do not have a military commission. This category can be additionally separated into three categories: lower-enlisted, non-commissioned officers, and Senior non-commissioned officers.
Beginning with the lower-enlisted, these men and women are typically either new to the military, or as a result of disciplinary action have been demoted. In all branches of the military, ranks E-1 through E-4 would fit into this category. They are typically new, have little responsibility outside of taking care of themselves and their assigned equipment, and have the lowest level of pay.
Non-commissioned Officers (ranks E-5 through E-6), also referred to as NCOs, are enlisted personnel that have been awarded their rank through a designated promotion board, have a wide range of knowledge regarding their assigned specialty and of various military regulations and doctrine, and can also be found leading small- to medium-sized groups of service members.
Senior NCOs includes ranks E-7 through E-9, have an abundance of experience and training, having served in their respective branches for at least 15 years or more, are the highest trained enlisted service members. They typically have mastery over multiple specialties and can be found leading medium- to large-sized groups (Military.com, n.d.a).
Officers: Officers are traditionally the leaders within the military and are responsible for strategy. An officer might command what to do, and it typically falls to a lower-ranked officer or (more likely) an NCO to figure out how to do it. There are significantly fewer officers in the military than enlisted personnel, and all officers are higher ranked than any enlisted service member. In other words, an O1 brand new to the military technically outranks an E9 with 35 years of experience. A subsection of officers exists which are Warrant Officers. Warrant Officers do not have quite as much authority as standard officers, per se; however, Warrant Officers are often experts of their given specialty, and their knowledge and experience affords them just as much (though usually more) respect as their officer kin (Military.com, n.d.a).
As for pay, a chart of all paygrades, which are equivalent to the individual’s rank, can be found at the below link. It must be noted that this is a basic pay scale, and does not include information regarding the various additional funds an individual can receive, such as Basic Allowance for Housing (BAH), Basic Allowance for Sustenance (BAS), Hazardous Fire Pay, and Family Separation Pay. http://militarybenefits.info/2017-military-pay-charts/
General Organization
If you’ve ever heard such phrases as Platoon, Company, Battalion, Squadron, Wing, or Regiment, these are words that describe the size of the unit, which command the unit belongs to, and a general description of its capabilities and potential purpose. A ton of information is available about all the specific words, acronyms, and annotations, but the specifics are not necessarily important here. Suffice it to say, the military is organized in an incredibly intricate manner, and has accompanying policy that dictates precisely how much personnel and equipment it needs to accomplish its unique mission. Very basic information pertaining to military structure can be found here (Vetfriends.org, n.d.).
As a social worker, the takeaway from this section is this: the unit each individual veteran has served in is often at the core of the pride he or she has for his or her time in the military. These units are incredibly important to veterans. It may be greatly beneficial for you to look into some background history of your client’s unit, as nearly every unit within the military has its own website detailing its history and traditions. This could be a very quick and easy way to gain a lot of rapport with your client.
Active Duty and Part-Time Components
Each branch of the military is comprised of those on Active Duty, and those as part of either the Reserve or National Guard components. The differences between them are fairly obvious: Active duty is serving in the military full-time, while National Guard or Reservists typically serve in the military one weekend each month, with an additional two-week training event each year. It is important to note that while Active Duty and Reserve members are federally funded and monitored, National Guard members are state-funded and report to the Governor of whichever state they originate from. National Guard units are the modern equivalent of state militias (National Center for PTSD, 2012).
Beyond how often the various components don the uniform and serve, or who signs their paychecks, there is a very explicit difference in the benefits and prestige of each component as well. Refer back to the section where what a veteran is was discussed. As far as the majority of federal VA benefits are concerned, National Guard members or Reservists are not viewed as veterans unless they have served on Active Duty in support of either a local or state emergency or combat operation. For example, National Guard members and Reservists deployed to assist the areas struck by Hurricane Katrina were likely placed on Active Duty (effectively making them Active Duty members, albeit temporarily) and henceforth qualified for a variety of benefits they were otherwise ineligible for. Meanwhile, those that honorably completed their weekend duties and two-week training exercises per year with no other periods of service likely found themselves with little to show for it after their military contracts expire, aside from the memories and experiences, and a pension if they served long enough (Veterans Authority, 2017).
Core Values
Much as Social Workers follow the NASW Code of Ethics, each branch of the military has its own unique set of values that all members adhere to. Those values are as follows:
Army – Loyalty, Duty, Respect, Selfless Service, Honor, Integrity, Personal Courage
Navy, Marine Corps – Honor, Courage, Commitment
Air Force – Integrity first, Service before self, and excellence in all we do
Whilst serving in the military, the above core values become each individual’s creed while they serve, and each veteran likely still follows those values well after their terms of service ends. As some of you may have noticed, the one common value in all of them is honor. With that in mind, as you work with veterans in the future, if you establish yourself as an honorable person you will likely earn the respect and trust of your client. Adversely, if you do not display honorable qualities, you will lose that respect and trust and will likely not get it back. Consistency and honesty is the key. In our experience, veterans are typically apprehensive to work with civilians, and some may be actively looking for a reason not to trust you. Make it hard for them to not trust you. Earn respect, and you will likely be awarded with an intense loyalty (Department of Defense of Core Values, 2009).
Communication
Within the military, clear, concise communication is a requirement. Lives depend on it. The military often utilizes a phonetic alphabet to aid in this. This means that while civilians would say A, B, C, a veteran would likely say Alpha, Bravo, Charlie, etc. It isn’t necessarily to learn the phonetic alphabet (though it couldn’t hurt and might create some common ground with you and your client), but being clear on your communication is paramount. Veterans are trained to pay close attention to the words others say, and will likely let you know that your message was received and understood (Roger, Lima Charlie/Loud and Clear, Wilco/Will Comply, ring any bells?). Veterans will cling to the words you use, and will likely follow them like it’s their mission. Help them out and be very clear.
For example: I will see you next Thursday, June 15th, at 2:15 pm in my office. Bring documents 1, 2, and 3. You’ll need a pen and a pad of paper to write on. Not See you Thursday around 2 with the stuff we talked about. Talking in ambiguities will likely cause anxiety for a veteran, and could potentially impact your relationship. Furthermore, for those of you soft-spoken social workers out there: those veterans with hearing disturbances notwithstanding, speaking softly or quietly to the point you can barely be heard or understood is likely to frustrate the veteran, not to mention cause undue stress at not fully receiving or understanding your message.
Common Misconceptions
Before this section comes to a close a few common misconceptions exist, and might cloud perspective on veterans. Some of these are warranted. Others are not. For those that are not, it is necessary to shine some light on them and hopefully readjust potentially faulty thinking. It is hoped that clearing up some of these issues that may be skewing your understanding of service members may make it easier for you to work with veterans.
All-Volunteer Military: Though there is still the Selective Service, which actively identifies individuals for the Draft should the need arise, there are no “draftees” currently serving in the military. The Draft has been out of commission since 1973. All current US Military members enlisted at their own free will, conquering the arduous enlistment process and clearing all the rigorous specifications (USA.gov, 2017).
Political Mono-Partisan: It seems that many view members of the military as being a part of the conservative or Republican party. This is not necessarily true. Though research acknowledges that military members and veterans slightly favor conservative beliefs, there is still a large percentage of veterans that maintain progressive or liberal views, as well. Veterans belong to an incredibly diverse array of demographics and backgrounds, and have a variety of political affiliations (Newport, 2009).
Humans, not robots: Ingenuity, thinking out of the box, following instincts is highly encouraged within the military, and development of such skills begins during the initial training, and continues throughout the military experience. Veterans do not just blindly follow orders. Veterans prepare, coordinate, assess, complete, and when necessary, question. However, veterans also recognize a purpose greater than themselves, and will do whatever is necessary. And as always, the mission comes first.
Not stupid: The complex initial testing to enlist in the military aside, veterans strive to make themselves better and more capable. This is done for individual value and sense of worth, but also for the betterment of the unit and to increase its abilities to assist those we are fighting with (Military.com, 2014).
War is missed, but not enjoyed: War is part of the job. In fact, one could easily argue that it is the job. When service members are not in combat, they are preparing for it. Though combat can bring about thrills, adrenaline, and excitement unlike any other (potentially on a manic level), there isn’t a veteran out there who hasn’t experienced fear at the thought of going to war (Davis, 2012).
Veterans are not violent: They are capable and ready for violence, true. But that is not to say all veterans are prone to violence. For the most part, those in the military do not wish to harm others. War is hell, and can create extremely stressful and chaotic circumstances. The result is typical of the environment they are in. It is human nature to ensure one’s own continued survival. When in combat, situations might necessitate action. Those same actions are not glamorized or romanticized. Rather, they are typically the material that makes up the veteran’s nightmares and regrets and that is carried throughout the veteran’s life. Though it is easy to pass judgement, please remember that there is a world of difference between being there and watching it on television (Davis, 2012).
Section III. Uniform Code of Military Justice
Artist’s drawing inside a military courtroom
The Uniform Code of Military Justice (UCMJ), is the foundation of military law in the United States. It was established by the United States Congress in accordance with the authority given by the United States Constitution in Article I, Section 8, which provides that “The Congress shall have Power… To make Rules for the Government and Regulation of the land and naval forces (UCMJ, 2008).” www.au.af.mil/au/awc/awcgate/ucmj.htm
UCMJ exists separate from the Unites States (US) Constitution. Military members “rights” are not as extensive as civil rights because members of the armed services are bound by discipline and duty. UCMJ is the only form of “constitutional law” where individuals, whom serve in the armed forces, are subjected to “double” jeopardy which means individuals can be convicted by “civilian law” and “military law” for the same offense.
Discharges
Honorable disocharge papers
There are seven types of discharge and two categories of due process: administrative and punitive. Administrative covers such military discharge as honorable, general, other than honorable (OTH), and entry level separation (ELS). Punitive covers bad conduct (BCD), officer discharge (dismissal), and dishonorable discharge.
Honorable Discharge: When a military member receives good or excellent rating for their service time.
General Discharge: When a military member receives a satisfactory rating and does not meet all expectation of conduct.
Other than Honorable: The most severe type of administrative due process. Examples include: security violations, misuse of violence, conviction by a civilian court system, or being found guilty of adultery.
Entry Level Separation: If an individual leaves the military prior to completing 180 days of service. These individuals are not recognized by their state or federal government as “veterans.”
Bad Conduct Discharge: Only passed on to enlisted military member and is processed through court martial. This due process often comes with military prison time.
Officer Discharge: Because commissioned officers cannot receive a BCD or dishonorable discharge nor can they be reduced in rank, they receive a dismissal notice. This notice equates to a dishonorable.
Dishonorable Discharge: When a service member’s actions are considered reprehensible. Examples are murder, sexual assault (adult or minor), and child abuse or maltreatment. Individual’s whom receive such punitive action are not allowed under Federal law to own or possess a firearm and forfeit all military and veteran benefits.
The UCMJ was enacted by Congress in 1950. The purpose of the UCMJ was to establish a set of standards that outline procedure, substantive criminal law, and procedural safeguards. Prior to the UCMJ each system of military (Navy, Airforce, Army, and Marine Corps) established their own form of law known as Articles of War. The UCMJ united all systems of law developed by individual entities to ensure that military members accused of violating a “law” were subject to the same administrative or punitive charges and procedural rule(s) (UCMJ, 2008).
The UCMJ provides three levels of court systems known as court-martials (general, special, and summary). General court martial handles the more serious offenses and is similar to civilian trial courts. Special court martial handles intermediate level offenses. Special court martial impose such sentences like: six months of confinement (an individual is restricted to barracks, ship, or base movement only and for a certain amount of time allowed for personal reasons), forfeiture of pay, reduction in rank, and bad-conduct discharge. A summary court martial is issued by a commanding officer who handles minor offenses. The maximum penalties include confinement for one month, forfeiture of two-thirds of a month’s pay, and reduction in rank.
Court of Criminal Appeals (CCA) hear all cases involving death, punitive discharge (bad conduct, dismissal, or dishonorable), or imprisonment for a term of one year or more. Each branch of service has their own CCA judges and a CCA typically involves a panel review of three judges. The U.S. Court of Appeals for the Armed Forces (USCAAF) is the highest civilian court which is responsible for reviewing the decision of all military courts. Any case(s) where the death penalty is imposed are forwarded by the judge advocate to the USCAAF.
Additional information can be found at the below links.
Key Words
Uniform Code of Military Justice, court martial, court of appeals, dishonorable, honorable, other than honorable, entry level separation, bad conduct, general, officer discharge
Section IV: Family Life
Army Captains Ron and Rikki Opperman play with their children outside their home here. (U.S. Army photo by Capt. Antonia Greene/Released)
Throughout this chapter, the intricacies of military culture, the military’s own unique judicial system, and the differences between the various military branches has been discussed. A closer look at the day-to-day events and family life is appropriate. Though it may be hard to believe, day to day life within the military is not too different from civilian life. There’s a job to be done, a daily routine to follow, and outside responsibilities that need attention. Bills, expenses, debt, school, professional development, and goal-setting are part of the life as well. Service members have hopes, dreams, and desires much like anybody else. They also have families. This section will review some more specific information regarding the family life of service members and veterans.
Family life within the military can be successful and rewarding. Extra levels of support and protection are in place to ensure family life stays as consistent as possible and every opportunity of success is offered. Alternatively, it can also be a very precarious environment. We’ve been at war for a generation now; the young men and women currently fighting overseas could be as young as two or three years old when airplanes collided with the World Trade Center nearly 16 years ago. It’s understandably hard to maintain stability within a relationship when the knowledge that your wife or husband, the father or mother of your children, could be called upon to go overseas and potentially never come home. That knowledge is something that lingers overhead like the worst of storm clouds, and adds tension to relationships that already come with their own intrinsic difficulties. Relationships are tough. Even more so when added stressors are brought to the forefront by the daily challenges and risks that being part of the military can bring.
Military Spouses and Dependents
Spouses and Dependents of service members are an integral part of military life. It is certainly within the realm of possibility to have both service members with spouses and children, or with families with multiple service members. In fact, if you’d reviewed the pay scales previously noted in this chapter, you might have noticed that service members are awarded additions to their paycheck for each dependent they have. These funds are increased by a fair amount when on deployment in support of combat operations overseas (Military Benefits, 2017).
It’s important to remind you that the mission always comes first. Always. Men and women who wear the uniform are called upon to serve their country wherever necessary, and under any circumstances (within reason). When that call goes out, it’s answered. However, it’s important to note that the military is not in the habit of leaving dependents without their beneficiaries, at least without a plan. Each branch of the military has supportive elements in place for service members and their dependents. The military understands an individual cannot perform to their full potential whilst being concerned with what is happening with their wife, husband, or children at home. With that said, service members are required to have a plan in place for their dependents should that call be made. Who is going to take care of your dependents? For how long? How are the finances being taken care of? What happens when crises occur? These are just basic questions that need to be answered for the plan to be accepted. And once the plan is made, it can rarely be deviated from (Duttweiler, n.d.).
These plans are crucial. In fact, service members with dependents might be deemed as “non-deployable” without such plan in place, and may be blocked from participating in deployments. Though this may seem a quick and easy way to avoid heading to combat, it’s not quite that simple and could result in UCMJ disciplinary action up to and including discharge from the military. To conclude this matter, a service member cannot deploy with his brothers- and sisters-in-arms unless a plan is in place for his dependents, and to not be deployable is essentially a taboo within the military and can be punishable by discharge. This rule applies in households with one service member involved. In families when both spouses are service members, this rule applies doubly so: each service member must come up with a plan as mentioned earlier, and must also include the scenario of both service members being deployed at the same time. The mission does come first, but that does not mean the military is disinterested in the safety and well being of its members’ spouses and children (Duttweiler, n.d.).
Deployment Cycles
As already mentioned, the United States has been at war for quite some time. The military has adjusted its own tactics and most units within the military are on a specific deployment cycle. Before the specifics of such cycle is covered, it should be noted that there are several supportive-based units within the military that are not necessarily part of this cycle. Not all service members are responsible for conducting combat operations. Some, in fact, are exempt from these rotations, and are strictly devoted to other tasks.
A variety of units within each branch of the military are devoted to training; their overall mission is to train the next generation of soldiers, sailors, marines, or airmen. In a rotation that runs consistently throughout the year, new service members hoping to earn the right to serve in the military are cycled in and out, and either successfully join the ranks of their respective branches, or do not and either fail, quit, or are rejected.
Additionally, some units within the military are tasked with operating designated training zones and their mission is to prepare units by conducting combat-related training prior to deployment. Fort Polk, Louisiana’s Joint Readiness Training Center (JRTC), and Fort Irwin, California’s National Training Center (NTC) and a variety of others, for example, host year-round wargames (for lack of a better term) with a variety of different units from all branches of the military to ensure they are as ready as can be for any scenario they might face whilst in combat (U.S. Army, 2014).
Another example are the various support units that keep the military running. It takes a large host of men and women to keep these efforts in line and working smoothly. The military, believe it or not, is an incredibly well-oiled machine. This is not achieved by accident. Many service members and civilian contractors are in place to keep things running smoothly.
The rest of the men and women serving in the military who are not part of the above examples typically operate as part of a deployment cycle. These units train independently, with other units, at the training facilities such as NTC or JRTC mentioned above, and even with other militaries from allied nations. This occurs for a set amount of time, and concludes with a deployment in support of combat operations overseas. These deployment cycles vary in length between units and branches of the military. And while some units within the military have advanced training and can be deployed to combat zones in as little as 72 hours, such deployments are typically scheduled months or years in advance. This means that, for the most part, current deployments are usually not a surprise. They obviously are in the event a new conflict occurs. This is why readiness is such a crucial aspect of military life (Pincus, House, & Adler, n.d.).
Divorce Rates
There was a time when divorce rates were significantly higher in the military. A fairly large spike in divorce rates occurred in the early 2000’s shortly after the war on terrorism saw hundreds of thousands of service members deploy in support of combat operations overseas. A study posted in the Huffington Post found that of the 462,444 military marriages that occurred between 1999 and 2008, those that occurred prior to the attacks on September 11, 2001 “were 28 percent more likely to divorce within three years of marriage if one or both spouses experienced a deployment to Afghanistan or Iraq that lasted at least one year” (Military divorce risk, 2013, para. 2).
As mentioned earlier, it seems this would not remain consistent. The same article suggested that those who married after 9/11/2001 had a lower divorce rate, suggesting that perhaps they knew what they were getting into and expected frequent stints of being away from one another. This decline in divorce rates amongst service members continues according to this article on Military.com, and further suggests that not only have military families grown accustomed to frequent deployments and stints of separation, but have also weathered the storm, as deployments are not happening in quite as rapid succession. In fact, divorce rates have nearly returned to their pre-9/11 rates (Philpott, 2012).
Section V. Health Related Concerns
In 2008, The Department of Veterans Affairs (VA) introduced a new mental health handbook that provides guidelines for VA hospitals and clinics across the US. The new handbook specifies exactly what mental health services VA hospitals and clinics are required, by federal law, to offer all veterans and their families (Department of Veterans Affairs, 2014).
These guidelines include the following mental health requirements:
• Focus on Recovery: This approach requires the focus on individual strengths, a strength base approach.
• Coordinated Care for the Whole Person: VA workers collaborate to provide health care for each veteran to give safe and effective treatment.
• Mental Health Treatment in Primary Care: Each VA clinics uses Patient Aligned Care Teams (PACTs) manage the Veteran’s healthcare. A PACT is a medical team that includes mental health experts.
• Mental Health Treatment Coordinator: Mental Health Treatment Coordinator (MHTC) provide specialty mental health. The MHTC is goal oriented, providing individual or group care.
• Around-the-Clock Service: Mental health care is to provide seven days a week, 24 hours a day. If a VA facility does not offer such service, they are required to provide service through non- VA medical clinics.
• Care that is Sensitive to Gender & Cultural Issues: VA requires each PACT team to receive training regarding military culture, gender differences, and ethnicity.
• Care Close to Home: More VA clinics are opening in rural areas. Mobile clinics are becoming available. The VA is collaborating with community services to provide a larger scope of health services.
• Evidence-Based Treatment: Evidence-based treatments (EBT) are interventions backed by research to provide effective care for multiple health concerns. Each mental health team receives training on current EBT’s to ensure the best updated care is being offered.
• Family & Couple Services: In many cases veterans and their families/guardians also require treatment(s): family therapy, marriage counseling, grief counseling, drug addiction, anger management, etc.
Research provided by the VA (2014) suggests, the following mental health concerns rank the highest among veterans; posttraumatic stress disorder (PTSD), depression, substance abuse, traumatic brain injury (TBI), suicide, chronic pain, and sexual assault. Social workers that work with military members and/or families should be familiar with each issue listed.
The VA (2014) defines these mental health concerns as follows:
• PTSD occurs after an individual has experienced, witnessed, or viewed a traumatic event. Symptoms may include relieving the event, avoiding places or things associated with the event, an increase of negative thoughts and emotions, feeling numb, and/or tense (hyperarousal) (Litz, 2009).
• Depression disorder interferes with one’s personal life, daily routine, and normal functioning. These symptoms do not pass over a short period of time (Lapierre, 2007).
• Substance use disorder (SUD) is identified as the tolerance to drink greater amounts of alcohol over time, inability to stop drinking or use of drugs, and withdrawal (feeling sick when trying to stop drinking or using drugs) (Bennett, 2014).
• Traumatic Brain Injury occurs when a person experiences a blow to the head or a joggling of the brain. People who experience TBI often experience a change in consciousness, disorientation, loss of memory, and confusion. Most TBI’s occur during “combat” conditions (Hoge, McGurk, Thomas, et al., 2008).
• Suicide is behavior which actively seeks self-destruction. Such behaviors are often provoked by the feeling/emotion(s) of loss or hopelessness (Jakupcak, Cook, Imel, et al., 2009).
• Chronic pain is pain that last for six or more months and limits daily activities (work, depressed mood or increase anger, sleep disturbance, withdrawal from family or friends, or hard to participate in physical activities). Chronic pain is different from acute pain because it last beyond the healing of an injury (Brandt, Goulet, Haskell, et al., 2012).
• Sexual assault is intentional sexual contact utilizing force, physical threats, abuse of authority, acts of adultery, acts that violate the Uniform Code of Military Justice (UCMJ), or when a person is unable to consent to sexual activity (Burns, Grindlay, Grossman, et al., 2004).
Social workers who work within the VA follow a mission statement that maximizes health and well-being of all military members, families, and communities through the use of EBT. Their vision is leading by example, setting high standards, and establishing innovative psychosocial care and treatment.
“The values established by the VA and UCMJ suggest, that all social workers who serve military members, veterans, military communities, and their families must advocate for optimal health care by respecting the dignity and worth of the individual, understanding military socio-cultural environments, empower veteran’s as the primary member of their PACT, respect the individual role and expertise of the veteran, focus on the needs of at-risk-population within military communities/families, promote learning (fostering knowledge, enhances clinical social work practice, advances leadership, and focuses on administrative excellence), exemplifies and models professional and ethical practice, and promotes conscientious stewardship amongst organizational member(s) and within community services” (VA, 2014).
The Veterans Bureau General Order (1926) was the first to establish a social work program inside the VA. This program allowed 14 social workers who were predominately highered to work on psychiatric and tuberculosis victims. From 1926 to 1946, Irene Grant Dalymple, pioneered the social work medical environment into the current mental health settings seen in today’s VA. Her involvement set the stage for the current social work programs that were instrumental in establishing health care systems adapted by the VA after World War I. Prior to WWI, social work services were contracted outside the VA to non-military service type facilities. Due to her contributions, the VA now provides services of health care, mental health, group and family care plans, vocational and psychosocial rehabilitation, and programs to assist with adjustment/coping skills to be reunited back into civilian society.
Today, social workers working in the VA have evolved into a professional service responsible for the treatment of military members, military communities, and family members. These responsibilities include but are not limited to treatment approaches which address individual social problems, acute/chronic conditions, terminal patients, and bereavement. “VA social workers ensure continuity of care through the admission process, evaluation procedure, treatment, and follow-up treatment” (VA, 2017, July 24, para. 8). All continuity of care must include discharge planning and providing case management services.
Populations of veterans needing services are: homeless, the aged, HIV/AIDS patients, spinal cord injury, Ex-Prisoners Of War, Operation Enduring Freedom/Operation Iraqi Freedom veterans, Vietnam and Persian Gulf Veterans, WWI and WWII Veterans, Korean War Veterans, Active/Inactive/Reserve/National Guard members, and their families.
Social workers help coordinate program such as:
• Community Residential Care (CRC)
• Financial or housing assistance
• Getting help from such agencies as Meals on Wheels
• Applying for benefits (health care, vision, optical, mental health, dental, financial, educational, and more)
• Ensuring that members of the PACT know your concerns and decisions
• Arranging for respite care
• Marriage or family counseling
• Moving into an assisted living or nursing home
• Bereavement
• Substance Use Disorder prevention or treatment
• Abuse, mistreatment, being taken advantage of, maltreatment, or need of a guardianship
• Parents who feel overwhelmed with child care
• Parents or spouses dealing with failing health concerns
• Mental health or medical needs
• Need direction of services or other unspecified needs
How can Social Workers help Veterans with problems and concern?
VA social workers have experience in assessment, crisis intervention, high-risk screening, discharge planning, case management, advocacy, education, and psychotherapy. Social workers help with all types of services, plus many more. The VA social workers motto: “If you have a problem or a question, you can ask a social worker. We’re here to help you!” (U.S. Department of Veterans Affairs, 2017, July 24, para. 13).
Key Words
Uniform Code of Military Justice, Veteran Administration (VA), Evidence-based treatment (EBT), posttraumatic stress disorder (PTSD), traumatic brain disorder (TBI)
Section VI: Resources for Veterans
It could easily be argued that as long as our nation is involved in conflicts overseas, there will continue to be great efforts to ensure the men and women involved in those conflicts are well taken care of when they return home, and even more so when they retire their uniform and exit the military. There are many available services for veterans, yet access can be challenging. Veteran services are largely area-specific. Web links to state and federal programs will be included in each of the following subsections, but to learn about all the services available will require some searching on your part.
The Department of Veterans Affairs
This is the largest source of support for veterans. The Department of Veterans Affairs is a federal agency within the United States government whose purpose is to fulfill President Lincoln’s promise “[t]o care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s veterans” (United States Department of Veterans Affairs, (2015). When it comes to providing services to veterans, the race starts here. This agency has the incredible burden of assisting with millions of pensions, service-related disability claims, education benefits, life insurance claims, healthcare benefits, and much, much more. If you’ve been paying attention to the news over the past several years, it’s no surprise to hear they are struggling to meet the ever-growing needs of service members and veterans. Regardless, the VA is the primary service provider for veterans. For a generalized look at what this organization can provide, check out their website’s benefits section here. Additionally, for a look at state-funded veteran services, take a look here.
County VA offices and VSOs
Like the federal Department of Veterans Affairs, there are also County Veteran Affairs offices. While they are directly linked to the federal VA, they are funded by the local county and usually employ Veteran Service Officers (VSOs). These VSOs assist veterans in completing the rigorous paperwork involved in applying for benefits. And since they are typically locally funded, they likely have access or knowledge of local programs, grants, and services that are not directly administered by the VA. A listing of VSOs can be found here.
Mental Health
In addition to Department of VA offices and County VA offices, many larger cities often have Community-Based Outpatient Clinics (CBOCs). Though these CBOCs are often primarily utilized to provide veteran health care, they are typically staffed by one or more Licensed Masters level Social Worker (LMSW), Licensed Professional Counselor (LPC), or Psychologists. Vet Centers are also available in select cities. Vet Centers are connected with the VA, but typically operate independently with the sole purpose of providing individual- and group-therapy to veterans in their identified catchment area or area of responsibility. For smaller communities that may not have a CBOC or Vet Center, the VA likely has an agreement or contract setup with a local private agency, though this is not always the case. It’s a safe bet that the smaller the city, the more likely a veteran will have to travel to get access to veteran-specific services. Utilizing the Hospital Locator here is a quick and effective way at finding local VA mental health services. Take a look!
Veteran Suicide
One last section is necessary when talking about veterans and mental health struggles. Sadly, veteran suicide rates are high. According to a report posted in the Military Times, roughly twenty veterans commit suicide every day, and despite making up only 9% of the population, represent 18% of all American suicides.
The VA has a 24/7/365 Crisis hotline that can be reached via phone (800.273.8255), text (838255) or via online chat regardless if they are registered for any veteran services or not (Suicide Prevention).
References
Branches of Service:
United States Air Force. http://www.af.mil/
United States Army. https://www.army.mil/
United States Coast Guard. https://www.uscg.mil/
United States Marines. http://www.marines.mil/
United States Navy. http://www.navy.mil/ | textbooks/socialsci/Social_Work_and_Human_Services/Introduction_to_Social_Work_(Gladden_et_al.)/1.12%3A_Service_Members_and_Social_Work.txt |
Key Term Definition Source
Abuse Harm or threatened harm to an adult’s health or welfare caused by another person. Abuse may be physical, sexual or emotional. (State of Michigan, 2019)
Aging Shock The uncovered cost of prescriptions drugs, medical care not paid by Medicare or their private insurance and the actual cost of the private that is expected to pay the gaps that Medicare does not pay and the uncovered costs of long-term care. (Knickman & Snell, 2002)
Bereavement A form of depression with anxiety symptoms that is a common reaction to the loss of a loved one. It may be accompanied by insomnia, hyperactivity, and other effects. Although bereavement does not necessarily lead to depressive illness, it may be a triggering factor in a person who is otherwise vulnerable to depression. Bereavement (2001)
Burnout A process involving gradually increasing emotional exhaustion in workers, along with a negative attitude toward clients and reduced commitment to the profession (Maslach, 1993) (State of Michigan, 2019)
Compassion Fatigue Is the residue of emotional energy from the empathetic response to the client and is the on-going demand for action to relieve the suffering of a client. (State of Michigan, 2019)
Elderly Any person that is 65 years of age or older. (Niles-Yokum & Wagner,2015)
Empathetic Response Is the extent to which the psychotherapist makes an effort to reduce the suffering of the sufferer through empathetic understanding. (State of Michigan, 2019)
Exploitation Misuse of an adult’s funds, property, or personal dignity by another person. (State of Michigan, 2019)
Exposure to the Client Is experiencing the emotional energy of the suffering of clients through direct exposure. (State of Michigan, 2019)
Grief A nearly universal pattern of physical and emotional responses to bereavement, separation, or loss. It is time linked and must be differentiated from depression. The physical components are similar to those of fear, hunger, rage, and pain. The emotional components proceed in stages from alarm to disbelief and denial, to anger and guilt, to a search for a source of comfort, and, finally, to adjustment to the loss. Grief (2001)
Life Disruption Is the unexpected changes in schedule, routine, and managing life responsibilities that demand attention (e.g., illness, changes in life style, social status, or professional or personal responsibilities). (State of Michigan, 2019)
Material abuse Including theft, fraud, pressure in connection with wills, property or inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits. (O’Connor & Rowe, 2005, p. 48)
Neglect Including the failure of a designated care to meet the needs of a dependent old person, forced isolation from services or supportive networks, or failure to provide access to appropriate health or social care. (O’Connor & Rowe, 2005, p. 48)
Physical abuse Including physical harm or injury, physical coercion and physical restraint (O’Connor & Rowe, 2005, p. 48)
Prolonged Exposure Is the ongoing sense of responsibility for the care of the suffering, over a protracted period of time. (State of Michigan, 2019)
Psychological abuse Including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation and verbal abuse. (O’Connor & Rowe, 2005, p. 48)
Sexual Abuse Including rape, sexual assault or sexual acts to which the vulnerable older adult has not consented, could not consent, or was pressured into consenting. (O’Connor & Rowe, 2005, p. 48)
Stigma A mark of shame or disgrace. A strain. (Merriam-Webster, 2019)
Self-care Promote specific outcomes such as a “sense of subjective well-being”. (Lee & Miller, 2013, p. 97)
Senescence Refers to the aging process, including biological, emotional, intellectual, social, and spiritual changes. (Lee & Miller, 2013, p. 97)
Vulnerable A condition in which an adult is unable to protect himself or herself from abuse, neglect, or exploitation because of a mental or physical impairment or advanced age. (State of Michigan, 2019)
Statistics of Elderly Population: Prior to the 17th century, statistics show the elderly made up less than 2% of the population in the United States. A male’s life expectancy estimated 30 to 38 years of age due to lack of proper health care, farming accidents’, unhealthy working conditions, war fatalities and lack of proper nutrition. A women’s life expectancy was significantly decreased due to bearing many children and suffering poor medical services during childbirth (Egendorf, 2002). Following World War II, we experienced the fastest growth in population, this generation is known as the baby boomers. This population has now become our highest elderly population and with this significant increase, the influx poses both benefits and challenges to our society (Tice & Perkins, 1996).
Seventy-six million people were born between 1946 and 1964 making this the largest and longest-lived generation in the history of the United States. (Torres-Gil, 1992). This is identified as the baby boomer generation. As a result of the baby boomer generation, the number of Americans aged 65 or older is projected to more than double from 46 million today to over 98 million by 2060, increasing from 15% to 24% (Mather, 2016). As a result of improved healthcare, better working conditions and families choosing to have less children, the life expectancy for a man is now 74 years of age and women’s life expectancy is now 80 years of age (Merck Manual, 2004). This produces many new challenges to our current social structure. Social security and medical costs have increased, including the cost of uncovered expenses of medications and long term care.
Baby boomers have introduced a new lifestyle, building careers, having fewer children and waiting till later in life to have children. It is estimated since this population is not reproducing at a rate much less than historically, the population in the United States will decrease as a result (Colby, S., & Ortman, J., 2014 p.2). The decrease in population will help to stabilize the social structure and medical costs.
Diversity of Population
Populations representing about 16% of the elder population: 8% African American, 5.5% Hispanic, 2.1% Asian-Pacific Islander and less than 1% American Indian and native Alaskan. The majority elder population is comprised of whites, at a rate of 74%. (Older Americans, 2000, p.1). In order to understand the needs and circumstances of the diverse population in the United States, it is important to know the demographics of the clients we are serving. One plan does not fit all solutions. Some fail miserably. The various demographics we must know of the population we attempt to serve include: health, age, work, marital status, sex, sexual orientation, race and culture. Whether they have family support, access to transportation and disposable income. We must establish wants and needs before determining what services and products will be put into place. If we do not understand the needs of the population we are serving, we will likely fail when creating services to help. (ODPHD, 2013).
Stages of Development
“Growing older and dealing with long-term care includes help from many people, family members, friends, medical professionals and practitioners in the community. Sometimes aging is gradual and sometimes it’s abrupt with many bumps and emergencies. As people age, the majority develop at least one health problem resulting in functional decline” (Marak, C. 2016, p 1). Many seniors live healthy, independent lives, without experiencing the stages of decline.
Stage 1: Self Sufficiency. Seniors are more independent and able to manage their own health issues. They may begin to acknowledge what the community has to offer for seniors and determine if their homes may need safety features in the future. But for the present time, the elderly enjoys the sense of accomplishments their independence offers. Programs established to help seniors remain in their own homes are Area Agency on Aging, Senior SAFE Program and Life Alert, to name just a few.
Stage 2: Interdependence. Seniors may begin relying on others such as a partner, older children or friends for assistance. Many seniors view this stage as a time of decline because they are no longer able to accomplish the tasks they once could. This is the stage where help may be brought in to assist with minor tasks on a regular basis. It is also a time when safety and security should be addressed by installing safety bars in the bathtub and hallways, ramps for wheelchairs and walkers and obtaining life alert pendants in the case of a fall or emergency.
Stage 3: Dependency. As the aging process continues, the need for more assistance with activities of daily living (ADL’s) may increase. These activities include bathing, toileting, cooking, and shopping. There may also be a decline in memory or psychological functions. At this stage, the senior may experience more physical ailments and chronic pain. As these conditions advance, it may be necessary to move to a senior facility with the level of care necessary for the senior. More often, the needs can be provided by a caregiver for more advanced care and needs Other medical issues, including increased pain can be managed by the primary care physician. This option can become very costly and as additional care is needed, for the safety and care of the elderly, a move to a facility may be the best option.
Stage 4: Crisis Management. In the event of continued decline, the family may recognize they are unable to continue providing the level of care necessary to keep their loved one safe or manage their needs. In this case, family will make decisions regarding the best options for appropriate care such as seeking constant in-home care by a professional or moving the senior to a facility where the care needs can be met.
Stage 5: End of Life. If the senior is able to remain in the home with sufficient care and pain management, many are able to remain in the home until their demise. If hospice is involved, they assist to manage pain and help the family to deal with complex end-of-life decisions. Many professions such as home health aides, nursing home personnel, hospice providers and care physicians are involved at this stage. If the senior is in a facility or needs to be moved for care during the end of life stage, they will be cared for by professionals in a skilled nursing facility (Marak, C., 2016, p 1).
Elderly will progress through the stages of development differently. Some will live life without pain and suffering and pass easily, while others may suffer Alzheimer’s disease or symptoms of dementia and require the care offered by a memory care facility. As we are all very different and have been exposed to different lifestyles, we will move through these stages, each at our own pace and tolerances (Marak, C. 2016).
Physical Changes
According to Busse, (1989), there may be several meanings to the word “aging”. “As a biologic term, it is used to describe those inherent biologic changes that take place through time and ultimately end with death.” (Busse, 1989 pg. 3-4). This definition is at odds with the process of growth and development. Aging begins the moment a person is born. A baby develops into a child, teen and then an adult. But at some point, the aging process changes. The body begins to decline in function, ultimately leading to death. The term used to describe the beginning decline is called senescence. As aging occurs, the body’s cells age and the organs functioning declines.
• Change in vision is one of the most undeniable signs of aging.
• A seniors hearing may also decline, resulting in the need for hearing aids.
• The skin becomes thinner, less elastic, drier and finely wrinkled.
• A elder’s ability to taste and smell may also diminish as they age.
• Bones and joints become less dense and weaker due to the decrease in the body’s ability to absorb calcium. This causes high risk of falls and broken bones.
• The elder loses muscle tissue over time and muscle strength tends to decrease.
• The heart and blood vessels change. The walls of the heart become stiffer and the heart fills with blood more slowly.
• The artery walls become thicker and the blood flow changes.
• The aged lungs may weaken, and the kidneys and urinary tract are often affected by age.
• The most common reported chronic conditions among the elderly are arthritis, high blood pressure, heart disease, hearing loss, problems of bones and tendons, cataracts, chronic sinusitis, diabetes and vision loss. This is a condensed list (Merck Manual of Health and Aging, 2004, pp 7-16).
Mental/Emotional Changes
As with the body, the mind is also susceptible to illness. Among the most common challenges facing the elderly are medical conditions that attack the brain, specifically the memory. Alzheimer’s disease and dementia are the most common and both directly affect cognition at various levels. Dementia is a general term for loss of memory as well as other mental and physical abilities severe enough to interfere with daily activities. Dementia is not a disease, rather a multitude of symptoms that do not lead to a known disease and is caused by physical changes in the brain. Dementia is common among stroke victims (Mayo Clinic, 1998). There are 9 types of dementia. Alzheimer’s Disease comes in three known forms. Early onset which occurs in those under age 65, usually age 40 to 45, experiencing memory loss and difficulty with daily activities. Late onset occurs in those over 65 years of age and is the most common form of Alzheimer’s disease. The third and most rare form is called Familial Alzheimer’s Disease. It occurs in less than 1% of all cases of Alzheimer’s and is a gene known to exist in at least two generations of the family. (Alzheimer’s and Dementia, 2017). For those suffering Alzheimer’s Disease or dementia, it is not uncommon for them to experience a multitude of behaviors and symptoms. Along with memory loss, a senior suffering Alzheimer’s or dementia may incur loss of communication skills, loss of attention, perceptual problems, depression, agitation, suspiciousness, angry outburst, delusions and hallucinations.
Although depression is a common for those with Alzheimer’s disease and dementia, it is also very common among the elderly in general. Charles M. Schulz, Peanuts author and illustrator provided a scenario that perfectly depicts the emotional pain many feel as indicated by Charlie Brown.
“Charlie Brown was sitting at Lucy’s psychiatric booth. He asked, “Can you cure loneliness?” She replied, “For a nickel I can cure anything.” Charlie Brown then asked, “Can you cure deep down, black, bottom of the well, no hope end of the world, what’s the use loneliness?” Lucy protested, “For the same nickel?!” (Blazer, 1990, p.62-63).
Depression among elderly is a serious condition. Many become depressed due to the decline in their ability to function as they did in early years. Others are fearful of thoughts of end of life, while many suffer severe loneliness as the traditional family unit has changed so drastically over the years. Many lose their spouses and find it difficult to continue on while the severe loneliness and depression sets in. Many elderly men served in wars and suffer Post Traumatic Stress Syndrome.
Suicide is the 8th leading cause of death in the U.S. Persons 65 and older make up 12.5 of the total U.S. population and account for 20.9% of suicides annually. Suicide rates among the elderly increased significantly following the Great Depression, then declined until 1981 through 1987, again increasing from 17 to 20 per 100,000 persons. Among older men, suicide rates increase with age. Among women, the rates are lower at 6.6 per 100,000. Women are more likely to commit suicide at midlife. Although many factors can account for the reasons a senior may consider suicide, such as failing health, lack of independence, loss of spouse, it has been found a relationship between major depressive condition and death by suicide has been identified (Blazer, 1990)
Paranoia, suspiciousness and agitation are common behaviors among elderly. As the memory begins to fail, many elderly people become paranoid and suspicious about things they do not understand or cannot remember. The feeling of not knowing where they are or who the people are around them brings on much anxiety. If the anxiety increases, sudden outbursts often are the outcome of the paranoia or suspiciousness and agitation. When working with people who suffer these behaviors, it is necessary to make them feel safe and validate their thoughts but to also help them understand they do not need to feel fearful or frustrated. It is essential to help the senior feel safe when experiencing these episodes of paranoia, suspiciousness and agitation.
Additional emotional issues are often a result of alcohol abuse by elderly. Alcohol is a depressant and if used long term or abused can lead to more severe depression and many physical issues such as memory loss called alcohol amnesiac disorder which causes difficulty with both short- and long-term memory and an inability to learn new information. This is also identified as one of the 9 types of dementia. (Blazer, 2004).
Often seniors want to feel valued and listened to, especially as they evaluate their life. Oftentimes we deny them the privilege to share with us the knowledge and invaluable presence that we too could offer future generations. The history and knowledge of the elderly is priceless.
Social
The elderly struggle with a multitude of social issues. Some have been identified in other sections of this chapter but apply to their involvement in society as well. The most pertinent issues identified by both social workers and the elderly who were questioned provided the following list from (Aging Care, 2019):
• Loneliness from losing a spouse and friends
• Inability to independently manage regular activities of living
• Difficulty coping and accepting physical changes of aging
• Frustration with ongoing medical problems and increasing number of medications
• Social isolation as adult children are engaged in their own lives
• Feeling inadequate from the inability to continue to work
• Boredom from retirement and lack of routine activities
• Financial stresses from the loss of regular income
• STD’s are currently on the rise with the senior population
• Younger generation taking advantage of elderly’s vulnerability (Aging Care, 2019)
Spiritual
For most elderly, religion plays a major role in their life, with approximately half attending religious services weekly. “Older adults’ level of religious participation is greater than that in any other age group. For older people, the religious community is the largest source of social support outside of the family and involvement in religious organizations is the most comon type of voluntary social activity” (Kaplin & Berkman, 2019, p.1).
When caring for the elderly, religion and spiritual beliefs often play a significant part in the care provided for the seniors. As the elderly ages and necessary increased care is provided, the elderly may have special wishes in accordance with their religious beliefs or spiritual beliefs. It is essential to know if spirituality or religion are important to the elderly as the beliefs may offer assistance with the elderly coping skills acceptance of their declining health and decreased fear of their final demise (Erichsen & Bussing, 2013, p. 1).
Myths/Stigmas
There are many myths and stigmas that have been associated with elderly population. A myth as defined is, “a usually traditional story of ostensibly historical events that serves to unfold part of the world view of a people or explain a practice, belief, or natural phenomenon” (Merriam-Webster, 2019, p.1). Stigma is defined as, “a mark of shame or discredit” (Merriam-Webster, 2019 p. 1). The term stigmatization is evident in the prevailing of “if I can buy enough pills, cream, and hair, I can avoid becoming old” (Esposito, 1987). Seniors efforts to avoid the uncontrollable outcomes of old age reveal the stigma and negative attitudes associated with advanced age. “Ageism refers to the negative attitudes, stereotypes and behaviors directed toward older adults based solely on their perceived age” (Frankelstein, Burke & Raju, 1995, p.662-663).
Ideally ageism will be replaced by truths. For instance, mental health issues among the elderly can decline with mental health services. Further, older adults are not the victims of deterioration that comes with age but are the survivors of life and the strengths of the elderly must be recognized and celebrated and used as the cornerstone in intervention and prevention services (Zastrow, 1993). The way a senior ages depends on several factors including their lifestyle choices, culture they live in, as well as their supports (Thornton, 2002). This is a bulleted list as follows of different myths and stigmas that have been negatively associated with the elderly population.
The following is a list of negative stigmas and beliefs about seniors:
• All elderly people are ill or disabled (Thornton, 2002).
• Pain is a normal part of life and the aging process (Ellison, White, & Farrar, 2015).
• Elderly people live boring lives and do not have romantic and sexual relationships.
• Elderly are uneducated or even able to learn as the world is continuously changing around us (Thornton, 2002).
• The elderly people are mentally incompetent and are able to be educated and learn new tasks just as a younger person is able to.
• The elderly people are a financial drain on our medical institution (Zastrow, 1993).
• Barriers to delivering mental services to older people is ageism, the “negative image of and attitudes toward people simply because they are old. (Zastrow, 1993).
The invaluable presence of an elderly person is one that is too often overlooked. Positive attributes and beliefs about the elderly population:
• They provide the social and cultural continuity that holds our communities together.
• Wisdom comes with age and experience. The older generation is also a great storehouse of knowledge and history.
• Like a tree needs its roots for growth and nourishment, a society needs roots to keep it grounded in its traditional values and history.
• Grandparents are often available for babysitting and spending quality time with their grandchildren, teaching values and respect.
• Families who have active, healthy grandparents living nearby have the opportunity to develop strong relationships between the kids and their elderly relatives that can greatly enrich the lives of both generations. They can also provide positive role models for young children who probably have little contact with older adults and may regard aging as something negative and depressing.
• For many seniors, old age is a time to become deeply engaged in their churches, local politics, schools and cultural and community organizations.
• They know how to socialize and treat other people in face-to-face conversations without the need for modern technology.
• Many are more conscious of their diet and their health. They watch what they eat, and exercise in order to stay active.
• Seniors have time for themselves, to vacation, volunteer, take classes and garden, among many other activities they may not have had time to do when raising a family.
• Seniors become active in senior centers and organizations to meet other elderly people for social purposes such as dances, playing cards, bingo and dating (Pitlane Magazine, 2019).
Working with the Elderly
In the field of social work, it is important to be able to work with other disciplines of work including physicians, nurses, nurse assistants, chaplains, dietitians, volunteers, dentists, and other social workers at various agencies. There is a need to have client centered goals and plans of care from all disciplines that work with the client (Wright, Lockyer, Fidler, & Hofmeister, 2007).
Discipline Role Source
Social Worker
• Helps the client and family with funeral arrangements
• Provides financial assistance
• Provides resources
• Psychosocial support needs to the clients and their families
• Identifies and assists with environmental factors and barriers that arise
• Assessments for mental health concerns
(Csikai & Weisenfluh, 2013)
(Monroe & DeLoach, 2004)
(Reese & Raymer, 2004)
Physician
• Attend’s to client’s long-term care needs
• Leader of the team
• Collaboration
(Wright, Lockyer, Fidler, & Hofmeister, 2007)
Nurse
• Informs team of medical concerns
• Monitors client’s vitals and measurements
• Explains medications and health care needs
(Greene, 1984)
Nursing Assistant
• Help the client ’s with activities of daily living (ADLs) including feeding, bathing, and dressing.
• “Nurse aides’ duties include functional, psychosocial, and delegated care activities such as physical care and emotional support”
(Huey-Ming, 2004)
Chaplain
• Spiritual Care
• Provide education and support both with religion and non-religious support to clients and staff members.
• bereavement supports
• Help with funeral home decisions as well as help with leading a memorial service
(Williams, Wright, Cobb, & Shiels, 2004)
Dietitian
• Monitor for proper nutrition
• Monitor weight
• Assess for malnutrition
(Kang et al., 2018)
Volunteer Coordinator
• Completes volunteer requests/referrals
• Attends weekly meetings to discuss volunteers
(Claxton-Oldfield, & Jones, 2012)
Volunteers
• Make phone calls
• Provide emotional support as being a friendly visitor
• May aid with rides for various client needs
(Ghesquiere et al., 2015)
Elder Abuse and Neglect
Elder abuse and neglect are under reported in the United States for many reasons including fear and embarrassment by the elderly (O’Connor & Rowe, 2005). Elder victims of abuse risks that include; functional disability, lack of social supports, poor physical health, cognitive impairment, mental health issues, lower social economic status, gender, age, and financial dependence ( Pillemar , Burnes, Riffin , & Lachs , 2016). There is an Adult Protective Services ( APS) Hotline for reporting a suspected abuse or neglect situation referred to as centralized intake : 855-444-3911 (State of Michigan, 2019). It is important to understand that all social workers are mandated reporters of elder abuse and neglect (State of Michigan, 2019). There is not one specific cause for elderly abuse and neglect. There are many reasons including various dynamics, cultural norms, negligence and lack of education and support (Muehlbauer & Crane, 2006). Potential causes of abuse could be due to mental illness, substance abuse, and the need to abuse from the perpetrator ( Pillemar , Burnes, Riffin , & Lachs , 2016). There are several types of abuse defined as follows in Table 1: Kinds of Elder Abuse and their Definitions (Muehlbauer & Crane, 2006, p.44).
It is important as a social worker to be able to assess the signs and symptoms of elder abuse. It can be difficult to recognize the signs and symptoms of abuse as some elderly are nonverbal and unable to share what is occurring (Muehlbauer & Crane, 2006). T able 2 below lists common signs and symptoms of elder abuse (Muehlbauer & Crane, 2006, p.46).
Adult Protective Services (APS) Case Study:Janice
Janice, a 50 year old women is diagnosed with Schizophrenia and Bipolar Disorder. She was fired from her job as a professor from a University due to not taking her medications and making threats and allegations of a “witch hunt” for her. This client lives alone in a trailer in the middle of the woods. There is no heat or electricity in the home. Several medical professionals have called and reported that she is unable to take care of herself on her own. This client has not been deemed incompetent by two physicians. The APS worker attempts to visit the client and each time is asked to leave the premises. The APS worker noticed some bruises on Janice’s wrists and her arms. The APS worker attempts to address the bruises when Janice says, “Get off my property and never come back or I will call the police!” The APS worker has reported these allegations to her supervisor as well as to the police department. The client has been hospitalized for her medications, but once out of the hospital the client does not continue taking medications. The client is currently not able to pay her bills and the home is in the process of being foreclosed from the client. The bank has reported that there have been several cash withdrawals from the account from ATMs all over the state. The client has refused the APS worker to assist and will not leave the home. The APS worker is unaware of any family or friends of this client in the area. There are also no shelters in the area that will take a client that is non-compliant with taking medications.
• If you were the APS worker, what other resources could you reach out to?
• What would you do to help the client?
• As the APS worker, can you identify any ethical dilemmas, explain?
Medical Care and Insurance
Medicare
Medicare is a supplemental insurance that was created in the U.S. after the Social Security Amendment in 1965 ( Rajaram & Bilimoria, 2015 ) . People are eligible for Medicare if they are at least 65 years of age , have end stage renal disease or amyotrophic lateral sclerosis, or have another specific disability ( Rajaram & Bilimoria, 2015) . There are certain needs that Medicare does not cover including long term skilled nursing facility stays. There are four different sections of Medicare including Part A, Part B, Part C, and Part D ( Rajaram & Bilimoria, 2015). This link https://www.ssa.gov/benefits/medicare/ is where a senior can apply for Medicar e. Rajaram & Bilimoria (2015) explain the four parts of Medicare as:
Part A
• Inpatient hospitalizations
• Short term stays in skilled nursing facilities
• Home health care
• Hospice care
Part B
• Outpatient services
• Primary care appointments
• Medical equipment
• Lab tests
• Vaccinations
• Cancer screenings
Part C
• Have all benefits of Part A and B
• Private health plans
• Vision
• Dental
Part D Prescription drug coverage
Case Study: Jacob
You are working as the social worker for a Commission on Aging agency and one of your clients, Jacob walks into your office. Jacob is an 88-year-old Native American male. He is an U.S. Marine Corps Veteran. Medicare is Jacob’s only insurance. Jacob shares with you that he was unable to purchase his medications last week because the cost is too high with his fixed income of social security.
• What would you do as the social worker to help Jacob?
• What resources do you think could be available for Jacob?
Advanced Directives
As seniors, we have many choices regarding health care and end of life wishes. The Do-Not-Resuscitate orders and Comfort Care Only orders are important for family members who may not know the wishes regarding life sustaining practices. Therefore, if these decisions are made prior and family is made aware , the wishes of the loved one is often carried out with much less stress and ease to both the family and the senior making the decision. If the decision is not made prior to the time it becomes necessary, the loved one may not have the opportunity to have their wishes known. If the DNR or the Advance Directive is not in place, the doctor will make every effort to resuscitate a senior. The Advance Directive and DNR is done in the event an elder is incapacitated to guide decisions about medical treatment.
A Living Will is a document that directs the care in the event of an elderly’s mental incapacitation. A Durable Power of Attorney is a document in which a senior will appoint a person to make decisions in the event they are incapacitated and unable to make the decisions themselves. A Living Will is a document or type of Advance Directive in which a person gives specific directions about treatments that should be following in the event of his or her incapacitation, and usually addresses life-sustaining medical treatment such as removal from life supports, providing food and drink (Pietsch ad Braun, p. 41). Understanding rights as an elderly regarding your wishes for health care is essential as it alleviates much stress for those who would otherwise need to make these decisions. Most seniors have decided under which circumstances they would wish to be resuscitated. It is imperative that each senior make family members or their physician aware of their decisions. Most hospitals will allow these documents to be signed and notarized and filed at the hospital in the event of crisis. It is very important to have documents signed and available for use In the event of an emergency. (Pietsch and Braun, 2000, p. 41).
Placement
In many cases elderly people find they are unable to manage their own care in their homes without some assistance and modifications to their homes for safety purposes. Seniors can make their homes safe by installing ramps, safety bars in bathing areas and widen doorways for walkers and wheel chairs. Oftentimes, the first step taken to keep the elderly in their own home or a family members home, is to hire a caregiver to aid with activities of daily living, medication management and meal preparation. The caregiver will often provide transportation to doctor and dental appointments, errands and any other travel.
Independent Living Facilities
Many elderly people find that it is either too costly to safely update their own homes or may live in a property with many stairs that are difficult to climb. In the event they need a safer environment, many will seek out independent living facilities where they live in a community of other elderly people where the apartments or homes are built with safety features already I place within the units and where there are many activities and social events specifically designed to help the resident avoid isolation and make new friends. Independent living is typically for those who do not have healthcare needs, but some may need a caregiver to come in and assist with bathing, household chores or to run errands. Many Independent living facilities have a dining room for meals and transportation available for medical appointments and weekly trips to run errands and outing for the residents (National Institute on Aging, 2019).
Assisted Living Facilities
Once care levels increase and the resident is unable to manage their own care without the assistance of daily caregivers, the resident may be encouraged to move to an assisted living facility. Many independent living facilities offer assisted living units on the same property, so the move is minimal. An assisted living level of care, depending on the needs of the senior are often set up to allow one to two to a room, where they may set up their own living areas and meals are often taken in the dining room. The seniors may need assistance ambulating to the dining room resulting in a staff member to assist them with a walker or in a wheel chair. In assisted living facilities, the seniors are usually able to move about the facility without much help, but staff and medical care is available 24/7. There are activities provided for the seniors to encourage them to leave their rooms and engage in social events. Many seniors who move to assisted living facilities state they wish they had moved much sooner as the facilities offers the seniors the opportunity to socialize with others their age and offer a plethora of activities and day trips that seniors who remain in their own homes may have been missing out on. It is not uncommon for family members to take their loved ones out for outside medical appointments, such as dental, medical tests not performed on site and family time. Some seniors are able to be checked out for a night or two in order to spend time with family. For those families who wish to take their loved one out of town, they may make arrangements with another facility in the town they are visiting to place their loved one in an assisted living facility, so as not to interrupt their care, but to allow the senior to continue to be part of the family actives. This is all coordinated with both assisted living facilities prior to travel (Caregivers Library).
Adult Group Homes
Another option for the elderly who are unable to socialize and ambulate, but do not need the level of care of skilled nursing, a group home might be an option for them. The social activities are limited, and the level of care is more individualized with 24/7 care and generally only 10 to 20 seniors living in the home at any given time. All transportation is generally offered, and meals are served family style with all seniors eating together. Many of the seniors in elderly group homes are unable to participate in social activates or engage in extensive conversation. This option is generally utilized once they are unable to manage to ambulate in the assisted living facility and has deteriorated to a high level of care but are not yet bed bound . Many senior can remain in the group home until end of life with hospice care. Some group homes offer “field trips” such as color tours and outings to see the holiday lights. These trips are short, and the seniors generally do not leave the bus (National Institute on Aging, 2019).
Skilled Nursing Facilities
Skilled nursing facilities, often referred to as nursing homes are designed for those who need constant care and are unable to ambulate or perform any of their own ADL’s. This is often the final placement prior to their death. Many suffer significant illness or have been deemed unsafe and unable to be provided the level of care in any offer type of facility. Meals are provided to the residents in their rooms where they do not need to leave their beds. For those who can ambulate but need extensive medical care, there is often limited social activities for them. They may meet in common areas to socialize but rarely do they leave the facility unless a family member checks them out for the day (Caregivers Library).
Memory care facilities are also essential for the elderly who suffer Alzheimer’s disease or dementia. These are often locked wings of assisted living facilities or locked group homes. The care is specialized and considered high level of care as the senior often cannot remember how to toilet themselves, dress, eat by themselves or shower. They need 24/7 care and are a risk for wandering which is the purpose of a locked facility (National Institute on Aging, 2019).
Elderly and the Community
As has been indicated in the above portion of this chapter, the elderly struggle with a variety of issues. But in accordance with their integration and acceptance in the community, various conditions of each community may make a difference in the severity of struggles they endure. Some communities are much more understanding of the needs of their elderly residents and provide social outlets for them. They also redesign their public areas with the elder’s needs in mind and utilize the experiences and intelligence of this population. This is often found in smaller upscale towns where the elderly population is high, and their needs are heard.
For those living in low income or medium income areas in their own homes, many live in areas where the lifestyle is fast paced, transportation is limited to local buses or trains and businesses do not cater to the elderly. Many times, the elderly become victims due to their vulnerability and inability to keep up. Society as a whole tends to have little patience for the aged. They are concerned for their own time and space; they often miss the opportunities they could take to assist someone in need. Understanding that we will all be old one day and know how it feels to be left behind (Merck Manual of Health and Aging, 2004), should keep us all humble and aware of the needs of the older population.
There are many organizations available for elders in need of services. Both public and private social service agencies can either provide services or will have social workers to help locate the appropriate resources for the elderly.
Some agencies included, but are not limited to:
• American Association of Retired Persons
• Area on Aging
• Rotary Club
• Veterans organizations
• Masonic Orders
• United Way
• AARP
• Salvation Army
These are only a few and many more may be available to those living in larger cities (Phillips and Roman, 1984, p. 105-108).
Video shows people laughing (Closed Caption)
Hospice Care
The original concept of hospice care comes from England and has become more popular in the United States ( Holden, 1980). There are over three thousand hospices within the United States (Monroe & DeLoach, 2004 ). Hospice has continued to evolve and develop and ha s been integrated into the health care system (Monroe & DeLoach, 2004). The concept of hospice started when physician, Dame Saunders, worked with dying clients in 1948 . Saunder’s work inspired the creation of St Christopher’s Hospice in 1967 (National Hospice and Palliative Care Organization, 2016). Hospice was established in the United States in 1974 in Connecticut (National Hospice and Palliative Care Organization, 2016). It took a while to progress with hospice and achieve the hospice benefit through Medicaid in Tax Equity and Fiscal Responsibility Act of 1982. Then in 1984, “JCAHO initiated hospice accreditation” (National Hospice and Palliative Care Organization, 2016) Once the Medicare Hospice Benefit (MHB) was created in 1982, hospice care began to become more popular in the United States. Specifically, in 2005 when hospice care clients reached 1.2 million people. (Connor, 2008) As displayed in the chart below by Connor (2008):
Hospice patients served 1985-2005.
As found by National Hospice and Palliative Care Organization (2015) there needs to be two physicians that give a senior a life limiting diagnosis of 6 months or less. Clients can be on hospice at any place that they are comfortable being. The National Hospice and Palliative Care Organization (2018) asserted:
Hospice services can be provided to a terminally ill person wherever they live. This means a client living in a nursing facility or long-term care facility can receive specialized visits from hospice nurses, home health aides, chaplains, social workers, and volunteers, in addition to other care and services provided by the nursing facility. The hospice and the nursing home will have a written agreement in place in order for the hospice to serve residents of the facility (p.1).
There are for-profit, and non-profit hospices (Hospice Analytics, 2018). Hospice care has turned into a competition among hospices to give the best quality of care to the clients. There is a great benefit to having many different options for hospice care. It allows the client to have more control over their end of life decisions. There are more than 5,000 hospices in the United states. The hospices participate in the Medicare program, the first program began in 1974 and has expanded significantly since then across the United States (Fine, 2018). Hospice is growing as the baby boomer generation is aging, in 2020 it is predicted that 20 percent of the population will be elderly in the United States (Niles-Yokum & Wagner,2015).
What Hospice Care Offers
Hospice allows clients to be in the comfort of their homes and not be in a hospital environment. As stated by Holden (1980), “High person, low technology” is a good phrase to explain the idea of getting rid of all the hospital equipment and make the client more comfortable (Holden, 1980). Hospice care is not about dying; it is about living and having a good quality of life with celebration. Having an interdisciplinary team implies that all the needs are being met for the client both spiritually, emotionally, and physically (McPhee, Arcand, & MacDonald, 1979). An interdisciplinary team is a group made up of the “physicians, nurses, social workers, chaplains, physiotherapists, dietitians, and volunteers” (McPhee, Arcand, MacDonald, 1979, p.1).
Hospice care is a valuable resource for those near the end of life. It can be a great resource for clients regardless of where their home is. It is beneficial for the clients in nursing homes because they get more professional care experts to a client (Amar, 1994).
National Hospice and Palliative Care Organization (2018) states the following:
Hospice care is available ‘on-call’ after the administrative office has closed, seven days a week, 24 hours a day. Most hospices have nurses available to respond to a call for help within minutes, if necessary. Some hospice programs have chaplains and social workers on call as well (p.1). Both the social worker and nurse are suggested to be present for family at the time of death to offer support to family members and answer questions (Donovan, 1984).
Differences between Palliative Care and Hospice Care
Palliative Care
• Comfort care that allows for aggressive treatment (U.S. National Library of Medicine, 2018).
• Can be used from start of diagnosis until death (American College of Physicians, 2018).
• Serves hospital bound clients (American College of Physicians, 2018).
Hospice Care
• Does not serve clients that are in the hospital’s care unless that is the only way to control the severity of the pain symptoms (American College of Physicians, 2018).
• Care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness.
• Most often offered only when the person is expected to live 6 months or less (The U.S. National Library of Medicine, 2018, p.1).
Both
• Offered to any person regardless of demographics, including: race, gender, religion, ethnicity, social economic status, and age (National Hospice and Palliative Care Organization, 2009).
• Provide comfort (The U.S. National Library of Medicine, 2018)
Barriers to Hospice Care
Hospice can be a very difficult discussion and it can be challenging to bring this up to loved ones or a professional hospice staff member. This can be prevented by having the discussion earlier on before the last stages of life (National Hospice and Palliative Care Organization, 2018). Most people have little education on what hospice can offer and what the mission, values, and goals are (Cagle et al., 2015).
Many hospice clients have a great deal of pain. One of the barriers of hospice care is the controversial topic of opioid usage for pain particularly in older adults (Spitz, Moore, Papaleontiou, Granieri, Turner, & Reid, 2011). There are drugs that cause sedation to help with restlessness and pain. However, the ethical issue becomes whether it is better to allow the client to be in pain and able to communicate and eat on their own (Dean, Miller, & Woodwark, 2014). There are barriers to finding appropriate medications for pain management (Cagle et al.,2015). There is a concern about addiction, dependence, and abuse of the medications (Spitz et al., 2011). A fear that the opioids may not reach the client due to unethical doing by a caregiver is another reason to refuse opioid distribution (Spitz et al., 2011). Many physicians are hesitant to distribute opioids and look for alternatives to pain management for clients such as massage therapy (Spitz et al., 2011).
There are negative stigmas that have been associated with hospice and the end of life process. An idea to have a longer stay on hospice by using hospice to treat conditions that could not be stabilized while being at home (McPhee, Arcand, MacDonald, 1979). There is the stigma attached with hospice that is a form of giving up. There are false perceptions that taking medications makes a senior a drug addict or weak for needing pain management control (Cagle et al., 2015).
Hospice clients may feel suicidal and depressed due to the fact they are near the end stages of life (Fine, 2001). Some agencies may monitor the length of visits, which can cause clients not to get the best care or feel as though they were engaged in an appropriate amount of time needed for a life review intervention (Csikai & Weisenfluh, 2013).
It could be very difficult knowing that your lifespan has 6 months or less to be lived. Some clients feel they have unfinished business to attend to. There is a primal fear of death. It may or may not been an unexpected diagnosis (Kumar, D’Souza, & Sisodia, 2013). Some elderly may be living a normal life and suddenly have pain. Once going to a doctor for a checkup, a client may be given an untreatable life-threatening diagnosis. However, some clients may be sick for a long time and not be afraid of dying and be completely at peace with the dying process. Suicidal ideation is common among hospice clients and it is important address why a client is having suicidal feelings.
Barriers are specifically formed when members of the interdisciplinary team do not collaborate appropriately prior to client care (Donovan, 1984). This causes a ripple effect for the client ’s care. There are barriers with the services and resources available to the care team depending on the area. There may be resources available for client benefit in rural compared to urban areas.
Barriers can be very challenging to work through. It is critical to work with the team, which includes: a social worker, nurses, nurse aides, medical director, volunteer coordinator, music therapists, chaplains, and volunteers to brainstorm solutions to these barriers. Education is a good way to help people understand various aspects of social work that many have been mis conceptualized.
Ethical Considerations in Hospice Care
There are ethical dilemmas in all aspects of social work. Csikai (2004) asserted, “During this process hospital social workers may encounter ethical dilemmas regarding quality-of-life, privacy, and confidentiality, interpersonal conflicts, disclosure and truth telling, value conflicts, rationing of health care, and treatment options” (Csikai, 2004, p.1). Euthanasia and assisted suicide are also ethical dilemmas that comes up in conversations with clients on occasion (Csikai, 2004). People have seen this as a legal option in some states and staff struggle with this because it is not legal in all states to practice even when that is the client ’s wish (Csikai, 2004).
Ethical Dilemmas in End of Life Care
It is important to talk about ethical dilemmas when needed and many refer to ethical committees or to their interdisciplinary teams (Csikai, 2004). In the National Association of Social Work (NASW) C ode of E thics to empower a client and give them control . It is mentioned in the NASW Code of Ethics the importance for social workers to promote self-determination under the value of dignity and worth of a person. However, the social work field is not black and white; t his causes a struggle when a clinician has to decide if a client is competent to make a decision ( Ganzini , Harvath, Jackson, Goy, Miller, & Delorit , 2002). Many ethical dilemmas occur daily and hospice staff must address concerns with their supervisors or managers as needed to give the client the best outcome (Fine, 2001, p.131).Here are some examples of ethical dillemmas as follows in chart below.
• There is worry that the motives for suicide may not just be about the quality of life, but related to finances, feeling like a bother, and other ethical issues (Ganzini et al., 2002).
• There are concerns with the opioid epidemic and risks for abuse and addiction of drugs (Csikai, 2004).
• Is the client is safe in their own home? A client may be at risk of falling while alone, but if they are competent, they can choose to live alone in unsafe environments (Wilson, Gott, & Ingleton, 2011).
• Clinicians should assess for the risk of suicide in all client s who are depressed (Fine, 2001, p.131).
Death and Dying
There are several signs and symptoms that are common during the last few months of a client ’s life. Some of the symptoms include respiratory issues, skin irritations, weakness, swelling, restlessness, confusion, and fatigue (Kehl & Kowalkowski, 2012). There is always a chance that a client may not experience these symptoms at all during the last few days of a client’s life (Kehl & Kowalkowski, 2012). During the last few weeks hospice staff may refer to the client as “transitioning” meaning they are nearing the end of life (Kehl & Kowalkowski, 2012). Donovan (1984) explained, the social worker has a vital role within the hospice team. The social worker helps the client and family with funeral arrangements, financial assistance, resources, and support. Life review is one intervention that does reduce physical pain and depressive symptoms, improving the client’s quality of life (Csikai & Weisenfluh, 2013).
The social worker and the nurse work hand and hand with the client. Both the social worker and nurse are suggested to be present for family at the time of death to offer support to family members and answer questions (Donovan, 1984). The social worker should be present throughout the client’s journey through hospice to help with any issues that may arise (Reese & Raymer, 2004). Monroe & DeLoach explained, “The hospice social worker also makes clinical assessments, provides referrals, facilitates discharge planning, ensures continuity of care, serves as an advocate, offers crisis intervention, and serves as a counselor” (Monroe & DeLoach, 2004).
Grief and Loss
Every person will experience grief differently and will have various bereavement risk levels depending on the person and situation. As the social worker you will complete a bereavement risk assessment based on a specific scale. Most people will be able to function and return to their daily life activities following acute grief process. However, some may develop a mental health diagnosis because the grief may influence a person’s ability to function in their daily lives (Ghesquiere, Aldridge, Johnson-Hürzeler, Kaplan, Bruce, & Bradley, 2015). If grief becomes severe and is left untreated or assessed it may lead to thoughts of suicide or even suicide (Ghesquiere et al., 2015). The social worker should do a bereavement assessment and this information should be distributed to the entire hospice care team especially the Bereavement Coordinator (Ghesquiere et al., 2015). There are different types of grief such as normal grief, anticipatory grief, and complicated grief.
Normal Grief
• An individual’s behavior is acceptable for the circumstances and requires normal bereavement follow up (Egan & Arnold, 2003).
Anticipatory Grief
• “occurs before a death, usually at the time of diagnosis. A client may anticipate loss of good health (and in some cases a body part), independence, financial stability, cognitive ability, autonomy, and life itself” (Egan & Arnold, 2003, p.44)
Complicated Grief
• When a death is unexpected, the death is prolonged and even painful, or the relationships are complex and have past tension, and little support or resources (Egan & Arnold, 2003).
• Symptoms of reactive distress to the death (e.g., disbelief or bitterness) and disruption in social relationships or identity” (Ghesquiere et al., 2015, p.1).
Self Care and Social Work
There is a need to practice self-care as it has shown to be beneficial to an elder’s health and resilience (Lee & Miller, 2013). There has been a link between effective self-care and being able to cope with stress and traumatic situations. Self-care can help a social worker become a better advocate and have a life long career in social work (Lee & Miller, 2013). Social work leaders recognize the seriousness of the consequences of work-related fatigue, stress and compassion fatigue. “Figley (1995) coined the term Psychological symptoms of this type of secondary traumatic stress include depression, anxiety, fear, rage, shame, emotional numbing, cynicism, suspiciousness, poor self-esteem, and intrusive thoughts or avoidance of reminders about client trauma”. Physiological symptoms include hypertension, sleep disturbances, serious illness and a relatively high mortality rate in helping professionals (Beaton & Murphy, 1995).
Burnout has been an ongoing issue with workers in the human service field. It is a gradual emotional exhaustion that may lead to a negative attitude toward clients and reduced commitment to the profession (Maslach, 1993). When the work demand are high with limited rewards and appreciation, burnout occurs at a significantly high rate.
A YouTube element has been excluded from this version of the text.
Some effect means of self-care include:
• Start a “positivity” file.
• Get up and move.
• Shake up your routine
• Write it down (and throw it away).
• Activate your self-soothing system
• Take time out for yourself
• Work should be left at the office or job site.
Strengths and Challenges (Both)
There are benefits and barriers to the aging process and the transition into an elder. One challenge is that a selective few are forced to move from their home they have lived in their entire life into some type of facility due to not having caregivers or being able to care for themselves (Ellison, White, Farrar, 2015). Many elderly people also have experienced a significant amount of losses in their life including family, friends, a spouse, partners, and even children as they have aged (Ellison, White, Farrar, 2015).
During the aging process doctor visits may multiply, medical costs are rising, which can impact one’s retirement budget. Challenges also include the declining of health that threatens a senior’s day to day activities. Although it is inevitable health issues progress with age, it is important to prepare mentally prior to the occurrence by learning more about coping skills related to health issues. Challenges also include completing simple tasks once easily accomplished but escalating in difficulty as the body ages and weakens. It may become necessary to have a home care provider to assist with daily tasks. The elderly often worry about financial security. Most live on fixed incomes and are unable to afford the comforts of life they used to enjoy. Loneliness is a major concern of the elderly. They are unable to move about as they once did and find socialization difficult due to lack of mobility. Financial predators are those unscrupulous people looking to prey on the vulnerability of senior citizens by trying scare tactics to get them to provide banking information to them or to sell them unnecessary services or goods (Best for Seniors Online, 2019). Other challenges experienced by seniors are abuse and neglect in the nursing homes and assisted living facilities due to under-staffing issues, leading to discontented staff. Transportation and lack of mobility are also challenges of the elderly. They often must rely on others for help getting to doctors’ appointments, grocery shopping or other necessary errands. Likely the hardest hurdle for seniors to manage is the continuous changes in technology that hinders those who are not familiar with current technology (Agency for Health Care Administration, 2013).
Although challenges are experienced by the elderly, many seniors experience positive and healthy benefits as they age. Seniors who believe in themselves and their capabilities, remain active and stay engaged intellectually have a higher probability of a less challenging experience as they age. Also, those who have strong spiritual beliefs often handle adversity due to their resiliency and faith. Focusing on the strengths and encouraging active and healthy lifestyles can make significant improvements in an elder’s health of their body and mind (Merck Manual of Health and Aging, 2004). Seniors have a lifetime of valuable information to pass on to their family and friends. Many still believe a handshake is all that is needed to make an agreement. The elderly tend to hold to their values and beliefs of hard work and honesty. ” By not listening, society is allowing parents, grandparents, and great grandparents to slip away without allowing them the opportunity to teach. As they leave us, we are refusing them the privilege to share with us the knowledge and invaluable presence that we too could one day offer our own children.
The presence of the elderly is worth more than silver and gold, their presence is priceless” (Debate. org, 20)
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Have you been thinking about doing research? Presumably, you are feeling a mix of excitement and apprehension. Indeed, doing research and arriving at answers to complex social questions is an exciting endeavour. At the same time, research entails many uncertainties that might make you apprehensive e.g., will the data you get be sufficient to answer your question? Will you be able to recruit the sample that you want? Whatever your thoughts are about this process, they are valid; experiencing mixed emotions are part of the research process. The purpose of this manual is to help you think about your research idea and design your study in the best possible way to obtain evidence to answer the question. We hope to help you become more confident about all phases of the research process, from conceiving your question, developing your literature review and methodology, conducting analyses, to contributing your conclusions and findings with various audiences.
Before You Rush Ahead
Before you begin your research, please read this chapter carefully. A common mistake among young researchers is the tendency to rush ahead with their study without carefully thinking through the research question, study design, and analytical tools and types of data needed to draw credible conclusions. Such a mistake is difficult, if not impossible, to address at the end of the study. Hence, before you begin, we invite you to think about a few questions:
• What is your motivation for doing research?
• Have you thought about the process (ethics, data collection, analysis, writing etc.) and are you prepared and able to do it within the timeframe available for your studies?
• Why do you want to answer the questions that you are concerned with?
• Do you want to learn knowledge for the sake of knowing (pure research) or are you driven to understand a phenomenon better so you can apply your findings to a solution (applied research)?
• What do you expect to find? And what will this discovery say about yourself or others?
• What will this research change about yourself or others? Who are your subjects and who are your audience?
These are questions that you have probably thought about or are still thinking through. If you have not thought about them, take a moment to do so. You might get additional clarity and motivation to move ahead with your study. While you are pondering the questions above, be assured research can be daunting, even for seasoned social scientists. We recognize that you might be feeling insecure about a perceived inability to conceptualize and develop a research project, or about your training in data collection or analysis or writing. You might feel outside your comfort zone or a sense of imposterism. Those feelings are normal. We hope that after reading this chapter, you will feel more confidently about undertaking social science research. Locating yourself is an important step in the research process. Hence, we begin with a discussion on reflexivity and positionality.
1.02: A Note on Reflexivity and Positionality
Thinking through your motivations for research is an act of reflection. Reflection on one’s motivations and positionality is an essential part of every stage of research. As a consequence, we summarize both reflexivity and positionality here before outlining how to write a great research question.
Reflexivity
The ability to be reflexive is vital to the process of picking a research question, conducting research and analyzing data. To be reflexive is to be able to examine and react to your own emotions, motives, and situation (Cambridge Dictionary, 2021). In social research, this requires the ability to critically recognize your influencers and your influence on others. Holland (1999, p. 464) expounds that reflexivity is the ability to take account of one’s self and the effects of personality or presence of the researcher on the investigation. This means being sensitive to “how relations of power operate in the research process” (Reid, Greaves, & Kirby, 2017, p. 50) and affect your relationship with, and perspective of, the subject. As the subject of social research is complex, dynamic, and sometimes conducted upon populations for which you are removed or have privilege over, taking stock of your own position (with its institutional supports, privileges and limitations) is essential for both ethical (the application of moral principles and professional code of conduct to research) and epistemic (the philosophy concerning the nature of knowledge) reasons. Recognition of ethics ensures that exploitation is not taking place in your research, and epistemology ensures that your own biases are accounted for.
Positionality
A related concept to reflexivity is positionality. Positionality describes one’s worldview and the position one adopts about research and its social and political content (Holmes, 2020, p.1). This involves taking stock of
‘where the researcher is coming from’, [and] concerns ontological assumptions (an individual’s beliefs about the nature of social reality and what is knowable about the world), epistemological assumptions (an individual’s beliefs about the nature of knowledge) and assumptions about human nature and agency (individual’s assumptions about the way we interact with our environment and relate to it) (Holmes, 2020, p.1-2)
Because social research is by nature, rarely value-free, it must account for its motivations. Beliefs, values and interests are shaped by our personal experiences, gender, race, ethnicity, sexuality (dis)ability statuses, political allegiances, social class, geographic location, history. These positionalities influence our research interests and topics, the perspectives we adopt in carrying out research, our motivations, how we conduct the research, and the outcomes. Positionality also determines the subject we investigate, the participants we choose and how we conduct research (Holmes, 2020). Hence, if you are uncertain about a research topic or you know the topic but are uncertain about how to narrow it down, it might be worthwhile to think about your positionality. Think about your identity, what you believe about social processes (such as inequality), what you have learned, what your experiences are, and see if that could help you to narrow down your research topic.
Positionality Statements
Intentionally reflecting on your positionality is an important part of the research process. Hence, researchers frequently invest time in developing positionality statements and including them in their papers. A reflection on your positionality is not only important in helping you to decide on a topic, it can also help shape your methodology and interpret your findings. Positionality statements are also important because our identities and lived realities create biases in how we interpret and view the world. An awareness of our biases enhances our credibility and can be fertile for developing our theoretical positions. Below are two examples of positionality statements.
Box 1.1 – Examples of Positionality Statements
• I position myself as a bricoleur, layering feminist standpoint theory and postcolonial theory, and propose the collaborative data collection and analysis techniques, with particular attention to ethical and cultural sensitivity, using a social constructivist approach to grounded theory…In light of postcolonial critiques of Western researchers and international development, I have often wondered: Am I doing more harm than good? The privilege that accompanies my social location as a White, upper class, Canadian, academic woman means that, despite good intentions, my efforts to support education in postcolonial contexts risk being patronizing, insulting, threatening, imperialist, and recolonizing (Vanner, 2015, p. 1-2)
• Canada is not my birthplace and English is not my first language. I was born in Nigeria in the 90s and came to Canada as a very young child who spoke no English at all, but rather who conversed fluently in my native Igbo. As far as citizenship, I hold a Nigerian and Canadian passport. If identity is to be so simply ascribed, one would say that I am a Black, Igbo, Nigerian-Canadian woman…The simplicity of identities is also what hides the complexity of bellowing and the illusion of agency in determining the totality of who it is that we are (Odozor, 2020, p.43)
In both examples, the researchers are forthright about what influenced their research and their interpretations of social reality that are influenced by their positionality. As will be discussed in the methodology chapter, there are several advantages to this openness. Being candid about our positionality increases the credibility of our research and provides contexts for users of our research. Reflexivity and positionality also improve the authority and validity of our knowledge (Smith, 1999). We encourage you to develop your own positionality statement.
Writing Positionality Statements
A good positionality statement describes one’s epistemological position (i.e. how one views the world in terms of their philosophy, personal beliefs, theoretical influence and perspectives which guide the research) as well other potential influences on research such as personal characteristics and identities in terms of gender, age, social class, ethnicity and political beliefs (see Holmes, 2020, p. 4). It should also address any predetermined position that the researcher takes (e.g., participant, as an insider or outsider, theoretical influences etc.), the research context and a reflexive opinion about how these might affect the research process. Hence, taking stock of positionality requires understanding how “one’s position in the social hierarchy vis-a-vis other groups potentially ‘limits or broadens’ one’s understanding of others” (Reid, Greaves, & Kirby, 2017, p. 48). This means interrogating what biases you may have of the groups being studied and how your own social location may influence that bias. Consider the following questions: does your disdain for slow customer service perhaps come from your never having to work in the service industry? Or the opposite? Does your idealization of agricultural work perhaps come from your only having done non-physical city labour? By answering questions about why and how you have come to study your topic, you will be clearer about your presuppositions and forthright with your reader about your relationship to the subject matter.
Box 1.2 – How to Write a Positionality Statement
Writing a positionality statement helps you to intentionally reflect on your identity, life history, experiences, values and the things/issues that are important to you. This reflection can help you determine what aspect of your identity is of broader sociological interest, which can be useful in narrowing your research interests. Even if you already know what topic you want to research, a positionality statement can help you to focus your research on issues that are important to who you are or to your political/world views.Here are some things to include in your positionality statement:
• Identity characteristics (e.g., age, gender, sexuality, ethnicity, social class, disability status, citizenship, immigration status, religion, marital status etc.)
• Life experiences (previous or current job, volunteering activities, membership in advocacy groups etc.)
• Political, philosophical and theoretical beliefs (lens through which you view and interpret the world)
• Relationship to phenomena of interest (insider and/or outsider status)
Additional tips:
• There is no limit on the length of your positionality statement, but try to keep it within a paragraph.
• Get a friend or close acquaintance to read your draft positionality statement and inform you of any personal detail that you might have overlooked
1.03: Relational Accountability
In addition to social justice and applying research solutions to participants’ lives, research should benefit and include participants and their associated groups. Social research has historically been isolated from its subject matter and has acted condescendingly towards vulnerable populations (see Tuck, 2009). To counteract this trend, we encourage you to design your research to benefit participants. For example, you might be volunteering with youth, and decide to design and evaluate a program to help with their education. Participation Action Research often embodies helping participants to create solutions to their problems.
Combining Research and Respect
When thinking about your research topic, you must also think about how the processes and outcomes show respect and concern for your participants’ welfare – Chapter 2 for more on Ethics. Principles of reciprocity, monitoring power arrangements among participants, obtaining ongoing consent and permitting participants to tell their stories and empower participants as allies in the process are important guiding research principles. According to Hutchinson et al., (1994), when we take these principles in our engagement with participants, we provide opportunities for healing. Hutchinson et al., (1994) notes that qualitative interviews can be cathartic, validating to participants’ feelings and experiences (self-acknowledging), provide a sense of purpose, self-awareness (gaining new perspectives about their situation by reflecting on it); healing (providing outlets to express emotions) and providing voice for the disenfranchised. This means that when considering the issues you are already connected to or wish to connect yourself to, you should also be considering the interest, agency and proximity of the groups that would be willing to be a part of your study. This will be partly conditioned by your positionality.
Relational Accountability
Relational accountability is a term used by Shawn Wilson (2001) to describe the honest accounting of Indigenous research in relation to the people their research refers to (and therefore establishes a relationship with). “As a researcher,” Wilson (2001) asserts, “you are answering to all your relations”: implying that your research ought to (1) know its relations and (2) gain knowledge “so as to fulfill [your] end of the relationship” (p. 177). With Wilson’s concept in mind, we suggest that you do some relational accounting in generating your research question – asking about your relationship to the voices and variables which will form the datum of your argument – and then make yourself accountable to the group which is providing you access to their knowledge and experiences. Not only will the available participants of your research become more clear to you, but so too will your purpose in gathering information about those participants. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/01%3A_Generating_and_Developing_Original_Research_Ideas/1.01%3A_The_First_Research_Question_is_About_You.txt |
Having considered your positionality and your motivation for wanting to do research, it is time to focus on identifying your topic and research question. This process will be highly dependent on your own sensibility and will evolve over time. We will therefore not attempt to do the impossible and proselytize originality. There are still, however, generally helpful tips/resources that we will provide. Just remember that what matters is the eventual creation of a meaningful and effective question, not that a formal process led you there.
Investigating the Problematic
In her book, The Everyday World as Problematic, Dorothy Smith (2005/2016) elaborates on the question which underpins social inquiry: how is it that something comes to be socially normal or problematic? For Smith, this requires the recognition that seemingly necessary conditions for social life are not necessary, but constituted. In more overt contradictions, this possibility (or ambiguity) reveals itself more clearly. Incongruity can arise when you hear about a spendthrift with a love for canned food, a soccer game without kicks or a police officer disobeying laws. Our recognition of a social problem comes from: (a) an indication of a conflict in our presupposition of the situation (in how the world is supposed or expected to work, for example, such that a police officer is expected to obey laws), and (b) our experience of it: a reminder that our worldview (and our correspondent social order) is evolving and incomplete. If we take the world for granted, none of this irony appears. But as soon as we wonder at the divide between how we think things should be and what we experience, topics lacking explanation or proper justification surface. A good exercise to help you develop your research question is to intentionally identify problematics. Here are three steps to get you going:
• Thinking about a general topic of interest e.g., immigration.
• Examine your beliefs about how this issue should be (e.g., immigrants should have access to services to help them integrate and adjust to Canadian life).
• How is it in reality? [You might draw on your own experience and observations, or conduct research].
By following those steps, you are a little closer to developing a question that is worthy of sociological inquiry. This “practical reasoning” about what constitutes the ‘social order’ and, therefore, our sense of disorder, is what directs the inquiring outlook of the researcher (Smith, 2005/2016, p. 636).
In observing experience near to yourself, either informally through your own interpersonal relations, or formally through examinations and readings of a scholarly discourse, little noticeable moments of concern may arise which can be taken up and thematized alongside other concerns. Try it for yourself, think about your lived experience, examine social media, read a blog, journal, book or scholarly article. Did any social concern arise? If it did, it is likely that what you identified affects you personally. Often, that which affects you most will not be unique to you, and for this reason is sociological (Reid, Greaves, & Kirby, 2017). Take a researcher whose major concern is climate change. For evident reasons, he/she/they believe that climate change could be the end of existence as we know it, and that social action upon the issue is imperative. Clearly climate change is both a personal and collective problem for them, yet the capacity to solve the problem does not exist in them individually nor are the consequences limited to them. In this regard, how they define climate change (its causes in emissions, in consumption or production, in all of the above, etc.) will set the stage for what is thematized and directed towards resolving this problem and expanding their knowledge of it.
Identifying your interests, therefore, corresponds to what you view as problematic: something unsettled either with regard to your knowledge or social life. This problem could surface through something you intimately care about; through the experiences of your community (e.g., your workplace, peers, activist groups etc.); or through the social-political context of our entire society (Reid, Greaves, & Kirby, 2017). In social research, this indefiniteness is then engaged through observation techniques that seek to raise awareness of the issue either in tabulating occurrences (quantitative-empirical), describing occurrences (qualitative-empirical), explaining occurrences (theoretical or methodological) or some combination of these goals. Taking stock of the origin of your personal interests thus allows you to identify which unsettled aspects of our knowledge and our society are most pertinent to you.
Where research begins is when you take these problems and find a way to apply yourself to understanding them. If your initial emotions and reactions to a situation are subjective, it is in considering how your subjective interests link to others, the intersubjective, that your own emotions and interests can be aligned to the feelings/cognition of others. As undergrad researchers, this audience will likely be peers, your professor or other professors within the field. Building from what has interested you, it is time to ask whether your professor will be interested in the question as well. What determines this will be a combination of the originality and relevance of your question. Simply put: has your research idea been conducted before and why is it worth conducting? Both will correspond to what has been studied/experienced by your audience. If the topic has been studied in another domain but not applied to your discipline, then your research could appropriate this concept and relate its use to your field. Likewise, if there is an unforeseen utility of the answer, say in the discovery that rural homelessness is primarily due to a housing shortage, then you can focus upon researching solutions to housing shortages in rural areas. The relevance of the research question will involve thinking carefully about what has been done in the discipline and what are the implications of these findings, constantly begging the question: what still needs to be done? In Chapter 2, we discuss how you can make a contribution to scholarly dialogue, and in Chapter 3, you will learn how to identify and occupy your niche.
The practice of examining our personal lives and identifying broader patterns in society is central to Sociology. C. Wright Mills famously advocates for sociology as the study of the public issues that derive from the private troubles of people. Mills (2000/1959) notes that public issues are important sociologically because they impact ordinary people’s biography, and reflect the historical, political and social structural milieux in which people live. For Mills, a social researcher’s task is to seek information “in order to know what can and what must be structurally changed” (2000[1959]: 174). He advances the concept of the sociological imagination to denote both the practice of locating individuals’ private troubles and their intersection with the social structural, political and historical context that shapes their experiences. It is in making our private troubles into public issues that they can be better understood and responded to politically. Hence, social research links personal biography and society, history and the social structure and the public–private relationship. How can you make your personal troubles public issues? Consider your personal biography (your life experiences) and your positionality statement. Is there anything that you thought was unique to you that could be of relevance more generally. That is a sociological issue, and it is worth studying.
Other Sources of Research Topics
In addition to our personal interests, positionality, and biography, research inspiration can come from many places. Below are a few:
Theoretical Influence
As undergraduate students, you have undoubtedly been exposed to many theories. You might be interested in testing one or more of these theories in relation to a specific phenomena or topic e.g., how far does Feminism go in explaining students’ subject choices at university? Alternatively, you might love a theory and want to use it to explore or explore a phenomenon e.g., Can postcolonialism explain immigrants’ lived experiences in Vancouver? These are legitimate sources of research questions and if this describes you, you should do it. On the other hand, you might be interested in comparing two theories or the application of a theory(ies) to a social phenomena. This might be useful for both theoretical (essays) theses or empirical theses. For example, you might be interested in applying Marxism to understanding the Squid Games or you might compare explanations/application of Marxism versus Critical Theory.
Available Opportunities
Sometimes, there are ongoing research projects in your department or a professor that is working on a project that you are interested in. This might present the opportunity to volunteer yourself to write a thesis on a similar research project. The onus is on you to find out what your professors are working on and investigate if they have the appetite to bring you on to their project.
A Professor’s Influence/Existing Research Projects
Think back to your favourite professors or courses. Maybe they discussed a topic that inspired you to research it further. Sometimes, something as simple as reflecting on the courses you have taken or a past research paper or project that you have worked on can be that magic trick to help you identify your research topic.
Subject Area of Interest or Aptitude
Nothing inspires more than an area in which you have a track record of excellence. Think back to the courses that you did the best in or the topic of a term paper that you wrote. There might be something worthy of further exploration there.
Serendipity
You could discover an interest by pure chance. As Robinson (2015) explains below, keeping a critical mind on everyday realities could lead you to discover a topic for research that you had not previously considered.
Gary Marx’s Sources of Research Questions and Examples
Below is an outline of potential inspirations for research questions written by sociologist Gary Marx.
Table 1.1 - Gary Marx's Sources of Research Questions and Examples
Sources of Research Questions Examples
Intellectual Puzzles Phenomena that one wishes to explain or explore e.g., contradictions in the social world
Existing Literature Trying to fill a gap in the literature; general reading of the literature could stimulate interest to learn more about a topic
Replication Checking the reliability of existing findings or studying whether or not the findings are consistent in different settings
Structures and Functions Why are institutions structured the way they are? Why are there different types of the same institutions? What functions do structures serve? E.g., what functions does patriarchy serve in religious institutions?
Opposition A belief that existing work(s) is/are misguided or incomplete E.g., aiming to disconfirm previous research
A social problem Issues of concern/public problems e.g., poverty, inequality etc.,
The counter intuitive phenomena Gaps between official reality and facts at ground level or when common sense and social scientific truths conflict
Deviant cases and atypical events Events or phenomena that go against the norm e.g., How is a particular inner-city school able to produce the top results in a state?
New methods and theories Applying a newly developed theory or method to a new setting e.g., applying transnationalism to explain 1950s migration wave to Canada.
Sponsors and Teachers When inspiration come from from our mentors, reachers, funding source or other sponsors
Adapted from Marx, Gary T. "Of methods and manners for aspiring sociologists: 37 moral imperatives." The American Sociologist 28.1 (1997): 102-125.
Choosing One Question from Many
This chapter has so far offered many suggestions on where to find inspiration for your research. At this point, you may already have a list of a dozen questions that you could possibly research, so you might now be asking: “how do I choose one?” Here are some factors to consider:
• Commonalities: Are there overlaps between the questions chosen? Could the questions be related to each other? Is there a common theme? Do some of the questions point to a general problem? If yes, map your questions to general themes to narrow down the list.
• Practical: Given your constraints (time, resource, capability etc.), which topic is most manageable? What support is available? Which topic would be easiest to complete?
• Strategic: What is your long term goal? Could your research provide an entrance to a job, to work with a particular professor, is a good match for a grad school of your interest, and will provide an opportunity to volunteer at an organization of your choice?
• Impact: Which research question could have the greatest impact on the people affected?
• Passion: Do you have partiality to one topic over the others? Are you just passionate about one over the other?
If you are still unable to choose, consult with people, then just choose one (even if you have to pick it out of the hat). Your undergrad research is not life or death so do not spend an excessive amount of time deciding. Pick one and commit to it. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/01%3A_Generating_and_Developing_Original_Research_Ideas/1.04%3A_Finding_the_Right_Question.txt |
Now that you have chosen a topic that is worthy of pursuing further, how do you translate it into a good research question? Methodological researcher, Alan Bryman (2007), states that the value of a good research question lies in its capacity to “militate against undisciplined data analysis and collection” (p. 6). Adapting material from the open resource video by Steely Library NKU (2014), we have outlined four main ‘preventive’ mechanisms for you to consider when constructing a resilient research question. A good research question will be:
1. interesting to you and relevant to your field (your potential audience),
2. operational enough to adequately interpret the phenomena being studied,
3. such that you can find evidence which corresponds to your question, and
4. feasible enough to achieve steps 1, 2, and 3.
We elaborate on each of these next.
How Interested Are You in the Topic?
Interest and relevance are important evaluation criteria for any research question. You must ask yourself: is this research question interesting to me? Does it arouse my desire to find an answer to the question? Does the lack of an answer cause me anxiety? Do I believe that things will be different for me if I could just answer this pressing question? The many ways in which we become attracted to the unforeseen answer of a question is the fundamental consideration of research. This is what we attempted to unpack in the prior section. However, this is a good time to ask yourself what issue you are genuinely interested in. Even if the topic seems grandiose, allow yourself to indulge in the possibility of studying it, and discuss it with someone. It might be possible to refine it to something do-able for your undergrad work.
Operationalizing the Research Question
The second aspect of the research question involves defining its wording enough to capture the subtle intricacies of the phenomena you are investigating. This means having a methodological and theoretical framework that can adequately explain the appearance of certain types of evidence. For instance, say that I come to the research question: is aggression between baristas and customers class conflict? To come to an operational account of this question, I would need to set up a framework in which this question can account for the complexity of “aggression between baristas and customers”. This means defining your key variables in such a way that there are specific and measurable indicators for each.
For example, how would you measure aggression (maybe, physical and verbal confrontations, perceptions of offensive interactions etc.), and how do you measure class conflict? This second variable is more tricky: are you measuring class in terms of status, if yes, is it real or perceived status? Are you measuring class using proxies such as income, education or other indicators? Third, is determining how this equates to class conflict: would you only be investigating aggression between customers and baristas who have different classes? This could have serious implications because you would be deliberately excluding non-class related conflicts (e.g., what if both the barista and customers are both lower class, you would have to exclude those aggressive encounters because of similar social class). Thus, to make a question more operational, sketch your colloquial concepts a little further in order to make it able to rule out the possibility of attributing a concept to something it is not (like assuming any skirmish with a barista entails ‘class conflict’). More importantly, you need to consider the practicality of the question. In the above example, how would you collect data from irate customers and baristas? They would probably be unwilling to talk to you after an encounter. Surveys and interviews are unlikely to elicit good response rates. Observation might elicit better results but in addition to ethical questions, you have to have precise indicators of what observations would be meaningful to the research question. Operationalizing the research question would therefore mean defining your variables but also the means of collection (i.e. are you examining aggression and class conflict at coffee shops in Vancouver, or in Lifetime movies, in novels etc.?). Think about the entire context that would make the research question do-able. This leads to the third criteria: is the research question manageable?
Is This Manageable?
As discussed above, measuring class conflict and aggression between customers using surveys and interviews might not be optimal. The research question needs more defined parameters to make it manageable (i.e., defining an appropriate setting and method). This involves figuring out whether you can find evidence at all. In the above example, are you likely to find sufficient evidence by visiting coffee shops in Vancouver, reading novels or watching movies? How many visits would give you the evidence you need, how many movies would you need to watch or how many novels would you need to read? These are important questions to ask in order to determine if your research question is practical and manageable.
Consider another example: say your research question was “what doubts does Jeff Bezos have when he first wakes up in the morning?” While a fascinating question, this question is not one that can be sought after unless you can manage an intimate interview with Bezos (and would likely produce a more journalistic article than an academic paper). To consider what evidence can be sought after, think through which methods are manageable to achieve your question and whether you have the means to find data through those methods.
Manageable problems imply certain limits that need to be set on what separates a feasible project from an unfeasible one. This will depend on your aptitude and the time you can allocate to your research. In the establishment of a research question, your time and resources will be most affected by how broad and narrow the scope of your question is. All questions imply a certain framing of what is and is not associated with your question: this is the scope of your question, which can otherwise be defined as the information relevant to answering your research question.
For instance, if I was looking for gender inequality in cafe hiring practices, the colour of the patio chairs at cafes will likely not factor into my analysis. Rather, my core concerns will be in defining the “range” of my core concepts so that they can be evaluated by inquiring what “gender inequality” means when situated in cafe hiring practices. When considering the amount of data pertinent to your topic (and whether you can handle the heat), this has to do with how broad or narrow your topic is. For instance, a topic like “gender inequality” on its own will be far too broad. A quick search in the library database will produce a panoply of different accounts of gender inequality, with little that could connect to an entirely new and unique angle. On the other hand, if the gargantuan amount of data about gender equality scares you into making your topic excessively narrow by adding a bunch of qualifying factors, such as “does gender inequality, the differential treatment of people based solely on gender, exist amongst Fijiean scuba divers living in Russia?” then you may find that the data is too scarce (or non-existent) to be developed into any type of supported argument. Consequently, deciding what is a manageable question involves striking a balance between a question with a scope that provides both meaningful and organizable data, avoiding both hubris and false humility. For an extended discussion of broad and narrow scopes, check out this video from the UBC library.
Schedule
On a final note, ask yourself before you begin the brainstorm about your schedule and what you can handle before taking on research. The answer you give will of course not be perfect, and the timeline of your research will always be unpredictable, but hopefully this questioning will at least allow you to consider the amount of complexity you are willing and able to take on before you dive into a question that is of importance to you. In Chapter 2, we discuss scheduling and the construction of Gantt charts to help you visualize the research process and manage your timelines.
Box 1.3 – Student Narrative – Discovering a Ph.D. Topic at the Summer Olympics
I discovered the topic I wanted to research for my Ph.D. by pure chance. After a year into my Ph.D, I was not sure what I wanted to research. I certainly did not want to spend four years researching the topic that I originally entered the program intending to study. My interests had changed and I wanted a new topic. I spent the summer brainstorming topics but never arriving at one that I was deeply interested in. That summer, I went to the Olympic games in London 2012. The main event for the evening we went was the Women’s 4x100m relay final. The entire stadium was on its feet. It was going to be a big showdown between Jamaica and the United States (who not only won but broke the world record). I wanted to jump and shout like any Jamaican/Caribbean person would at sporting events, but I was not in the Caribbean. I was in the Queen’s country. Instinctively, I look at the anxious faces around me to determine if my jumping about and screaming would upset the people in the nearby seats. It was then that I noticed many Caribbean flags in my area: Trinidad, Barbados, Antigua, Grenada, Jamaica etc. Something struck me as strange. Why were there so many Caribbean people in my area? Was it by chance or by design? The ticketing process was done by bidding for each geographic region of origin (in my case, I bidded in the Caribbean region), but did they still put Caribbean people together? It was a curious question. I had no way to find out. But, I suddenly felt comfortable to shout and jump about. I was with my people. In that instant, I knew I wanted to study something about Caribbean unity. I didn’t know what shape the project would take, but I knew the general area. When I refined it, I ended up studying Migration, Social Identities and Regionalism in the Caribbean. I had never studied migration or identities before, but that chance discovery led to a deep interest in Caribbean identities and migration.
1.06: Summary
Writing a good research proposal is an important step in your research journey. Not only is it a gateway to winning the approval of a prospective supervisor and (potentially) admissions to honours or other research programs, it also helps you to clarify your research idea and imagine its full implementation. As we have demonstrated in this chapter, your proposal is a tentative roadmap and a checklist of the research process that you envision. As such, it can help you to stay on track with your research targets throughout the life of your work and ensure your success. Undoubtedly, it takes effort and significant time investment to produce a strong research process but by following the principles outlined in this chapter, you can have an effective proposal that will help you impress your prospective supervisor. We admonish you to invest time in your presentation (make sure it is neat, proof-read and edited) because first impression matters. Remember to include all the steps: cover page, abstract, introduction, research questions, literature review, methodology and analytical plan, limitations, significance and conclusion, timeline (optional) and reference list. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/01%3A_Generating_and_Developing_Original_Research_Ideas/1.05%3A_Evaluating_the_Question.txt |
Learning Objectives
By the end of this chapter, you will be able to:
• Think about the feasibility of implementing your research idea
• Understand the different components of a research proposal
• Write a clear and engaging abstract
• Write an effective research proposal
Suggested Timeline: Start in September and aim to complete in November
In the previous chapter, we discussed sources of research questions and ways of evaluating them. In this section, we discuss how you can convince your readers (supervisors, funders, and others) that your research is achievable and intriguing with effective research proposals. The research proposal allows you to explain the significance of your project and showcase the quality and importance of your proposed work. Research proposals also allow you to clarify your ideas, refine your focus, anticipate potential challenges and develop strategies to overcome them. They are also a roadmaps for you to consult to ensure that you are remaining on track and progressing as anticipated. If you are applying to a honours program, you will most certainly need a research proposal. Thesis-based graduate programs often require a research proposal and/or a statement of intent in the application package, and funding agencies invariably require research proposals. However, writing a good research proposal involves investing in some technical skills and adherening to conventions. In this chapter, we hope to help you to do both, and to transform your research question into a manageable project that will convince your readers of the importance of your research and of your ability to undertake it.
2.02: Components of a Research Proposal
A research proposal can be divided into many different steps but all of these configurations serve to demonstrate two qualities to your reader: that (1) there is an important question which needs answering; and (2) you have the capacity to answer that question. All the steps of a proposal must serve either or both of these goals (Wong, n.d.).
Before we delve into the substantive details of the research proposal, we want to briefly discuss two often overlooked components: title page and abstract. The first component of presenting a topic is developing a title page that accurately reflects your topic. Make sure that your title highlights the focus of your study and the expected outcomes (e.g., do you expect to discover lessons, insights, implementation strategies, improved understandings etc.). It is best to keep your title short (usually no more than two lines) and specific to your research concerns. For more tips on writing effective titles, see Hartley (2017). Apart from the actual words in your title, you should ensure that your title page aligns with the referencing style used in the rest of the proposal (e.g., check out APA convention on title pages). Regardless of the referencing style used, a good title page usually has the following information: title of the proposal, author’s name, institution and/department, program/course and the date. Including a running header and page number are optional.
2.03: Writing Abstracts
An abstract is a miniature description of your project, and includes the purpose of your research, the context of the problem, previous literature on it, your methods, and some of your preliminary/expected findings or potential contribution. A good abstract is vital, since it often determines whether readers will bother with the rest (Berkenkotter & Huckin, 1993). Abstracts are typically no more than 250 so you must be concise but also convincing to a generalized audience. To this effect, unpack or avoid jargon and acronyms. This means making the language as simple and engaging as possible while effectively outlining your research (Oxford Editing, 2013). As with other academic writing, make the text active and clear in guiding your reader through the key features of your research.
Academic writing scholar John Swales (1990) proposed a “macro-model”, CARS for writing abstract (UBC Centre For Scholarly Writing, n.d.). CARS (Creating A Research Space) utilizes three steps: First, it establishes the territory by introducing the topic, i.e., the main literature which has engaged with it. Second, it establishes a niche by outlining what is missing. Third, it occupies the niche by first stating why it is worth occupying, what methods you will or have used to occupy it, and then stating the key findings/preliminary findings that address what was missing (Swales, 1990). Practically, a social science abstract will typically address these through five steps:
1. Introduce the topic
2. State the rationale for pursuing the project (with attention to gaps in the literature if necessary)
3. Outline the research questions or statements which seek to satisfy the rationale
4. Briefly describe the methods that were use
5. Highlight the key expected or preliminary findings and/or the potential significance of the findings
Below is an example of an abstract taken from Robinson and Wilson (2022). We would like you to read through it and see if you can identify each discursive step. Check your answer with the subsequent table.
Peer mentorship programs have mostly emphasized formal structures, wherein a more experienced student guides a less experienced student. However, these practices are hierarchical and require substantive resources to organize and implement. Searching for alternatives, we research the effectiveness of an informal teaching technique that facilitates active-learning and peer-mentorship from everyday classroom settings and processes. Drawing on formative feedback from students in a lower-level Sociology course over a term, this paper analyzes how a “Liberating Structures” (LS) technique called Five Whys (an adaptation of the Nine Whys LS) can promote in-class collaboration, peer mentorship and increased engagement without training and the need to design a formal peer-mentorship program. Students identified many benefits, including that Five Whys promoted community, reflective learning, and deeper engagement with course content. However, the structuring of interactions was seen to be stifling to natural group processes. Broader implications for LS and in-class mentorship are discussed.
Table 2.1 - Abstract Divided into Five Discursive Moves
Five Discursive Moves Definitions
Introduction Peer mentorship programs have mostly emphasized formal structures, wherein a more experienced student guides a less experienced student
Rationale However, these practices are hierarchical and require substantive resources to organize and implement
Research Question Searching for alternatives, we research the effectiveness of an informal teaching technique that facilitates active-learning and peer-mentorship from everyday classroom settings and processes
Method Drawing on formative feedback from students in a lower-level Sociology course over a term, this paper analyzes how a “Liberating Structures” (LS) technique called Five Whys (an adaptation of the Nine Whys LS) can promote in-class collaboration, peer mentorship and increased engagement without training and the need to design a formal peer-mentorship program
Findings Students identified many benefits, including that Five Whys promoted community, reflective learning, and deeper engagement with course content. However, the structuring of interactions was seen to be stifling to natural group processes.
Although this is the first substantive part of your research process, you will likely write the abstract last. Whatever approach you take to write the abstract, take some time to skim through a few journal articles in your subject areas and try to identify whether the abstracts covered the above steps. Ask yourself, what else did those abstracts include? Are those necessary for my proposal? | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/02%3A_Developing_a_Research_Proposal/2.01%3A_Introduction-_the_Question.txt |
Drawing on guidelines developed in the UBC graduate guide to writing proposals (Petrina, 2009), we highlight eight steps for constructing an effective research proposal:
1. Presenting the topic
2. Literature Review
3. Identifying the Gap
4. Research Questions that addresses the Gap
5. Methods to address the research questions
6. Data Analysis
7. Summary, Limitations and Implications
8. References
In addition to those eight sections, research proposals frequently include a research timeline. We discuss each of these eight sections as well as producing a research timeline below.
Presenting The Topic (Statement of Research Problem)
The research proposal should begin with a hook to entice your readers. Like a steaming fresh pie on a windowsill, you want to allure your reader by presenting your topic (the pie on the sill) and then alluding to its importance (the delicious scent and taste of the cooling cherry pie). This can be done in many ways, so long as you are able to entice your reader to the core themes of your research. Some suggestions include:
Highlighting a paradox that your work will attempt to resolve e.g., “Why is it that social research has been shown to bring about higher net-positive outcomes than natural scientific research, but is funded less?” or “Why is it that women earn less than men in meritocratic societies even though they have more qualifications?” Paradoxes are popular because they draw on problematics (see Chapter 1) and indicate an obstacle in the thinking of fellow researchers that you may offer hope in resolving.
• Presenting a narrative introduction (often used in ethnographic papers) to the problem at hand. The following opening statement from Bowen, Elliott & Brenton (2014, p. 20) illustrates:
It’s a hot, sticky Fourth of July in North Carolina, and Leanne, a married working-class black mother of three, is in her cramped kitchen. She’s been cooking for several hours, lovingly preparing potato salad, beef ribs, chicken legs, and collards for her family. Abruptly, her mother decides to leave before eating anything. “But you haven’t eaten,” Leanne says. “You know I prefer my own potato salad,” says her mom. She takes a plateful to go anyway,
• Provide an historical overview of the problem, discussing its significance in history and indicating how that interrelates to the present: “On January 23rd, 2020, tears were shed as cabbies heard the news of Uber’s approval to operate in the city of Vancouver.”
• Introduce your positionality to the problem: How did it come of concern? How are you personally related to the social problem in question? The following introduction by Germon (1999, p.687) illustrates:
Throughout the paper I locate myself as part of the disabled peoples movement, and write from a position of a shared value base and analyses of a collective experience. In doing so, I make no apology for flouting academic pretentions of objectivity and neutrality. Rather, I believe I am giving essential information which clarifies my motivation and political position
• Begin with a quotation: Because this is an overused technique, if you use it, make sure that it addresses your research question and that you can explicitly relate to it in the body of your introduction. Do not start with a quotation for the sake of.
• Begin with a concession: Start with a statement recognizing an opinion or approach different from the one you plan to take in your thesis. You can acknowledge the merits in a previous approach but show how you will improve it or make a different argument, e.g., “Although critical theory and antiracism explain oppression and exploitation in contemporary society, they do not fully address the experiences of Indigenous peoples”.
• Start with an interesting fact or statistics: This is a sure way to draw attention to the topic and its significance e.g. “Canada is the fourth most popular destination country in the world for international students in 2018, with close to half a million international students” (CBIE, 2018)
• A definition: You may start by defining a key term in your research topic. This is useful if it distinguishes how you plan to use a term or concept in your thesis.
The above strategies are not exhaustive nor are they only applicable to the introduction of your research proposal. They can be used to introduce any section of your thesis or any paper. Regardless of the strategy that you use to introduce your topic, remember that the key objective is to convince your reader that the issue is problematic and is worth investigating. A well developed statement of research problem will do the following:
• Contextualize the problem. This means highlighting what is already known and how it is problematic to the specific context in which you wish to study it. By highlighting what is already known, you can build on key facts (such as the prevalence and whether it has received attention in the past). Please note that this is not the literature review; you are simply fleshing out a few pertinent details to introduce the topic in a few sentences or a paragraph.
• Specify the problem by describing precisely what you plan to address. In other words, elaborate on what we need to know. For example, building on your contextualization of the problem, you can specify the problem with a statement such as: “There is an abundance of literature on international migration. In fact, the IOM (2018) estimates that there are close to 258 million international migrants globally, who contribute billions to the global economy. However, not much is known about the extent of intra-regional migration in the global south such as within the African continent. There is, hence, a pressing need to study this phenomenon in greater detail.”
• Highlight the relevance of the problem. This means explaining to the readers why we need to know this information, who will be affected, who will benefit?
• Outline the goal and objectives of the research.
• The goal of your research is what you hope to achieve by answering the research question. To write the goal of your research, go back to your research question and state the results you intend to obtain. For example, if your research question is “What effect does extended social media use have on female body images?”, the goal of your research could be stated as “The goal of this study is to identity the point at which social media use negatively impact female body images so that they can be informed about how to use it responsibly.
• The objectives of your study is a further elaboration on your goals i.e., details about the steps that you will take to achieve the goal. Based on the goal above, you probably will study incidents of depression among female social media users, changes in self-esteem and incidents of eating disorders. These could translate into objectives such as to: (1) compare the incidents of depression among female social media users based on length of use (2) assess changes in female social media users’ self esteem (3) determine if there are differences in the incidents of eating disorder among female social media users based on extent of use. Notice that in achieving those objectives, you will be able to reach the goal of answering your research question.
In summary, you should strive to have one goal for each research question. If your project has only one research question, one goal is sufficient. Your objectives are the pathways (or steps) that will get you to achieve the goal i.e., what will you need to do in order to answer the research question. Summarize the steps in no more than two or three objectives per goal.
Brief Literature Review
After the problem and rationale are introduced, the next step is to frame the problem within the academic discourse. This involves conducting a preliminary literature review covering, inter alia, the history of the phenomena itself and the scholarly theories and investigations that have attempted to understand it (Petrina, 2009). In elaborating on the history of the concepts and theories, you should also attempt to draw attention to the theories which will guide your own research (or which will be contested by your research). By foregrounding the major ways of perceiving the problem, you will then set the stage for your own methodology: the major concepts and tools you will use to investigate/interpret the problem.
While in graduate research proposals the literature review often composes a section of its own (Petrina, 2009), in undergraduate research this step can be incorporated into the introduction. However, you should avoid, as Wong (n.d.) writes, framing your research question “in the context of a general, rambling literature review,” where your research question “may appear trivial and uninteresting.” Try to respond to seminal papers in the literature and to identify clearly for your reader the key concepts in the literature that you will be discussing. Part of outlining the scholarly discussion should also focus on clarifying the boundaries of your topic. While making the significance concrete, try to hone in on select themes that your research will evaluate. This way, when you go to outline the methods you will use, the topic will have clearly defined boundaries and concerns. See chapter 5 for more guidance on how to construct an extended literature review.
Box 2.1 – Tips for the Literature Review
• Summarize: The literature in your literature review is not going to be exhaustive but it should demonstrate that you have a good grasp on key debates and trends in the field
• Quality not quantity: Despite the fact that this is non-exhaustive, there is no magic number of sources that you need. Do not think in terms of how many sources are sufficient. Think about presenting a decent representation of key themes in the literature.
• Highlight theory and methodology of your sources (if they are significant). Doing so could help justify your theoretical and methodological decisions, whether you are departing from previous approaches or whether you are adopting them.
• Synthesize your results. Do not simply state “According to Robinson (2021)….According to Wilson (2021)… etc”. Instead, find common grounds between sources and summarize the point e.g., “Researchers argue that we should not list our literature (Bartolic, 2021; Robinson, 2020; Wilson 2021).
• Justify methodological choice
• Assess and Evaluate: After assessing the literature in your field, you should be able to answer the following questions: Why should we study (further) this research topic/problem?
• Contribution: At the end of the literature, you should be able to determine contributions will my study make to the existing literature?
As you briefly discuss the key literature concerning your topic of interest, it is important that you allude to gaps. Gaps are ambiguities, faults, and missing aspects of previous studies. Think about questions that you have which are not answered by existing literature. Specifically, think about how the literature might insufficiently address the following, and locate your research as filling those gaps (see UNE, 2021):
• Population or sample: size, type, location, demography etc. [Are there specific populations that are understudied e.g., Indigenous people, female youth, BIPOC, the elderly etc.]
• Research methods: qualitative, quantitative, or mixed [Has the research in the area been limited to just a few methods e.g., all surveys? How is yours different?]
• Data analysis [Are you using a different method of analysis than those used in the literature?]
• Variables or conditions [Are you examining a new or different set of variables than those previously studied? Are the conditions under which your study is being conducted unique e.g., under pandemic conditions]
• Theory [Are you employing a theory in a new way?]
Refer to Chapter 6 (Literature Review) for more detail about this process and for a discussion on common types of gaps in social research.
Box 2.2 – Identifying a Gap
To indicate the usefulness and originality of your research, you should be conscious of how your research is both unique from previous studies in the field and how its findings will be useful. When you write your thesis or research report, you will expound on these gaps some more. However, in the body of your proposal, it is important that you explicitly highlight the insufficiency of existing literature (i.e. gaps). Below are some phrases that you can use to indicate gaps:
• …has not been clarified, studied, reported, or elucidated
• further research is required or needed
• …is not well reported
• key question(s) remains unanswered
• it is important to address …
• …poorly understood or known
• Few studies have (UNE, 2021)
Research Questions & Research Questions that Address the Gap
The gaps and literature you outline should set the context for your research questions. In outlining the major issues concerning your topic, you should have raised key concepts and actors (Wong, n.d.). Your research question should attempt to engage or investigate the key concepts previously stated, showing to your reader that you have developed a line of inquiry that directly touches upon gaps in the previous literature that can be concretely investigated (ie. concepts that are operationalized). After indicating what your research intends to study, formulate this gap into a set of research questions which make investigating this gap tangible. Refer to the previous chapter for more advice about devising a solid research question. Remember, as McCombes (2021) notes, a good research question is:
• Focused on a single problem or issue
• Researchable using primary and/or secondary sources
• Feasible to answer within the timeframe and practical constraints
• Specific enough to answer thoroughly
• Complex enough to develop the answer over the space of a paper or thesis (i.e., not answerable with a simple yes/no)
• Provide scope for debate Original (not one that is answered already)
• Relevant to your field of study and/or society more broadly.
Methods to Address Research Questions
By the time you begin writing your methodology section, you would have already introduced your topic and its significance, and have provided a brief account of its scholarly history (literature review) and the gaps you will be filling. The methods section allows you to discuss how you intend to fulfill said gap. In the methods section, you also indicate what data you intend to investigate (content: including the time, place, and variables) and how you intend to find it (the methods you will use to reveal content e.g., qualitative interviewing, discourse analysis, experimental research, and comparative research). Your ability to outline these steps clearly and plausibly will indicate whether your research is repeatable, possible, and effective. Repeatable research allows other researchers to repeat your methods and find the same results (Bhattacherjee, 2012), thereby proving that your findings were not invented but are discoverable by all. Your descriptions must be specific enough so that other researchers can repeat them and arrive at the same results. It is important in this section that you also justify why you believe this specific methodology is the most effective for answering the research question. This does not need to be extensive, but you should at least briefly note why you think, for instance, qualitative, quantitative, or mixed methods (and your specific proposed approach) are appropriate for answering your research question. For more details about writing an immaculate methodology, refer to Chapter 7.
Data Analysis
This short section requires you to discuss how you intend to interpret your findings. You will need to ask yourself five critical questions before you write this section: (1) will theory guide the interpretation of the results? (2) Will I use a matrix with pre-established codes to categorize results? (3) Will I use an inductive approach such as grounded theory that does not go into an investigation with strict codes? (4) Will I use statistics to explain trends in numerical data? (5) Will I be using a combination of these or another strategy to interpret my findings?This section should also include some discussion of the theories that you intend to use to possibly explain or understand your data. Be sure to outline key notions and explain how they will be operationalized to extrapolate the data you may receive. Again, this section also does not have to be extensive. At this point, you are demonstrating that you have given thought to what you intend to do with the data once you have collected it. This may change later on, but make sure that the proposed analytical strategy is appropriate to the data collected, for example, if you are evaluating newspaper discourse on the coronavirus pandemic, unless you intend to code the data quantitatively, you would not be expected to use statistics. Content, thematic or discourse analysis might be more intuitive. See the Data Analysis (Chapters 9 and 10) for more details.
Summarize, Engage with Limitations, and Implicate
After you have outlined the literature, the gaps in the literature, how you intend to investigate that gap, and how you intend to analyze what you have found, it is important to again reiterate the significance of your study. Allude to what your study could find and what this would mean. This requires returning to the significant territory that began your proposal and linking it to how your study could help to explain/change this understanding or circumstance. Report on the possible beneficial outcomes of your study. For instance, say you study the impact of welfare checks on homelessness. Then you could respond to the following question: How could my findings improve our responses to homelessness? How could it make welfare policies more effective? Remember you must explain the usefulness or benefits of the study to both the outside world and the research community. In addition to noting your strengths, also reflect on the weaknesses. All research has limitations but you need to demonstrate that you have taken steps to mitigate those that can be mitigated and that the research is valuable despite the weaknesses. Be straightforward about the things your study will not be able to find, and the potential obstacles that will be presented to you in conducting your study (in research that is conducted with a population, be sure to note harms/benefits that might come to them). With this in mind, try to address these obstacles to the best of your ability and to prove the value of your study despite inevitable tradeoffs. However, do not finish with a long list of inadequacies. End with a magnanimous crescendo –with the impression that despite the trials and limitations of research, you are prepared for the challenge and the challenge is well worth overcoming. This means reiterating the significance, potential uses and implications of the findings.
Box 2.3 – Seven Tips for Getting Started with Your Proposed Methodology
1. Introduce the overall methodological approach (e.g., qualitative, quantitative, mixed)
2. Indicate how the approach fits the overall research design (e.g., setting, participants, data collection process)
3. Describe the specific methods of data collection (e.g., interviews, surveys, ethnography, secondary data etc.)
4. Explain how you intend to analyze and interpret your results (i.e. statistical analysis, grounded theory; outline any theoretical framework that will guide the analysis; see below).
5. If necessary, provide background and rationale for unfamiliar methodologies.
6. Highlight the ethical process including whether institutional ethics review was done
7. Address potential limitations (see below)
Table 2.2- Common Qualitative and Quantitative Analysis Methods
Qualitative Analysis Methods Quantitative Analysis Methods
Qualitative Content Analysis
Discourse Analysis
Thematic Analysis
Grounded Theory (Inductive)
Narrative Analysis
Interpretive Phenomenological Analysis
Descriptive Statistics
Mean, median, standard deviation, skewness
Inferential Statistics
T-tests, ANOVA, Correlation, regression, chi-square | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/02%3A_Developing_a_Research_Proposal/2.04%3A_The_Body_of_the_Research_Proposal.txt |
A final step that you might need to take to convince your professor that the research is do-able is presenting the timeline of activities that you intend to do over the course of the research. Think carefully about what you can do and the specific order in which you plan to do it. Your potential supervision will use your proposed timeline to help ascertain whether the proposed project is idealistic or whether you can actually get it done. It is best to present a written outline of each essential activity and the months within which you will undertake each. Please note that you can work on two activities simultaneously. Here are some typical activities that researchers carry out (depending on your research you might have more or less activities):
1. Research and write the literature review
2. Write and submit ethics application
3. Write methodology
4. Recruit participants and collect data
5. Analyze Data
6. Write up results
7. Edit paper
8. Submit final paper
In addition to explaining each step and the period within which you will do them, it is also a good idea to visually represent your timeline. This will give your reader a quicker sense of what is involved in your research and will help them evaluate what is needed to make it successful. It will also indicate whether the research is do-able within the timeframe proposed. Gantt charts have become a popular way to depict schedules, showing the start and end date for each component of your research. Below is an example of how you might present your timeline on a Gantt chart.
Table 2.3 - Illustration of an Undergraduate Project Timeline
Activities Sept Oct Nov Dec Jan Feb Mar
Write and submit ethics application X
Research and write the literature review X X
Write methodology X X
(Recruitment and) Data collection X X
Data analysis X X
Write up results X
Edit and submit final paper X X
Table 2.4 - Sample Undergraduate 6 Page Research Proposal Template
Section Brief Explanation Estimated Length
Introduction Title. Short outline of the problem and its importance. 1 Page
Literature Review Short history of other investigations into the problem. 2 Page
The Purpose Fulfill the gap in the literature and reiterate the significance of the study. 1/2 Page
RQ's A summary of the questions or thesis that you expect to guide your research. 1/4 Page
Method(s) A summary of and argument for the methods you will use to answer that research question 1 Page
Data Analysis A summary of how you intend to make sense of what you found 1/2 Page
Summarize, Engage Limitations, and Implicate Provide an overview of your study and its significance. Recognize the potential limitations before highlighting the contribution. 3/4 Page
References Attach
Adapted from Petrina, Stephen. (2009). “Thesis Dissertation and Proposal Guide For Graduate Students.” https://edcp-educ.sites.olt.ubc.ca/files/2013/08/researchproposal1.pdf
2.06: Summary
Writing a good research proposal is an important step in your research journey. Not only is it a gateway to winning the approval of a prospective supervisor and (potentially) admissions to honours or other research programs, it also helps you to clarify your research idea and imagine its full implementation. As we have demonstrated in this chapter, your proposal is a tentative roadmap and a checklist of the research process that you envision. As such, it can help you to stay on track with your research targets throughout the life of your work and ensure your success. Undoubtedly, it takes effort and significant time investment to produce a strong research process but by following the principles outlined in this chapter, you can have an effective proposal that will help you impress your prospective supervisor. We admonish you to invest time in your presentation (make sure it is neat, proof-read and edited) because first impression matters. Remember to include all the steps: cover page, abstract, introduction, research questions, literature review, methodology and analytical plan, limitations, significance and conclusion, timeline (optional) and reference list.
2.08: Additional Resources
Identifying Research Gaps
Framework for Determining Research Gaps During Systematic Review: Evaluation.
How to Write a Research Proposal
Components of a Research Proposal
Thesis Proposal Guide | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/02%3A_Developing_a_Research_Proposal/2.05%3A_Timeline.txt |
Learning Objectives
By the end of this chapter, you will be able to:
• Make an informed decision on whether or not you need to get ethics approval
• Complete institutional ethics review applications
• Anticipate common obstacles in the ethics review process
Suggested Timeline: Start in September and aim to complete in November
As a researcher, you are accountable for many different types of integrity: the fidelity to “truth,” to your discipline, and accountability to those who inform your study (participants) during and after your research is completed. These multiple obligations put the researcher in many “binds,” where one’s loyalty to their code of conduct (“truth”) can hurt his/her/their loyalty to another code (“harm to participants or your discipline”), resulting in considerations too complex to be evaluated entirely alone. That is why research institutions have established oversight through research ethics boards (REB’s), which ensure that the work done by affiliates is ethically sound.
As an advanced undergraduate student, we expect that you have taken research methods courses and have a good understanding of the importance and principles of research ethics. Accordingly, this chapter will not repeat those details. If you are unfamiliar with research ethics or need a refresher, please visit the Tri-Council Policy Statement. Our focus here is on the practicalities of deciding whether you need ethics approval and how to obtain it (if you need it) drawing on UBC’s Research Ethics Board (REB) procedures and processes (which should be fairly similar across REBs in Canada). The chapter will also outline what the components of typical ethics applications are, and then provide some additional tips for a successful application. The final two sections will refer directly to UBC policies regarding research and applying for REB approval.
3.02: Do You Need Institutional Ethics Approval
Quite simply, not all research needs approval by an institutional research ethics board. For Example, UBC’s Policy LR2 outlines the various requirements of conducting research at UBC (if you are not at UBC, your institution’s ethics review board likely has similar guidelines). In the case of social research, however, UBC’s human research policy LR9 provides the stipulations relevant to whether your work will need approval. These guidelines are consistent across post-secondary institutions in Canada. Table 3.1 summarizes this.
Table 3.1 - Does Your Research Need Ethical Review?
Does Not Need Review Needs Behavioral Ethics Review
Research that relies exclusively on publicly available information, either:
• Made accessible to the public through legislation
• Made accessible through the public domain (as on social media)
Any research that involves human participants is defined as, “individuals whose data, or responses to interventions, stimuli, or questions by a researcher are gathered or utilized for the purposes of a research project” (1.1).
This includes interviews:
• Action research
• Surveys
• Experimental research that recruits participants
Or research that uses naturalistic observation, which means that it:
• Takes place in the public domain
• Does not involve any direct interaction with participants
• Subjects have no reasonable expectation of privacy
• Dissemination does not directly identify any participants
Source: University Council (2015).https://universitycounsel-2015.sites...icy_LR9.pdfUBC’s human research policy LR9
Research that needs ethics approval is defined as any research that involves “human participants” (7.6): which are defined as “individuals whose data, or responses to interventions, stimuli or questions by a researcher are gathered or utilized for the purposes of a Research project” (University Council, 2015). This implies any research in which an individual is directly sought after, intervened with, and marked according to their response. It includes interviews, surveys, and many types of action research. According to UBC’s code of ethics, this definition does not include:
7.10.3 – Research that relies exclusively on publicly available information when such information: (i) is made accessible to the public through legislation and regulation, and is therefore appropriately protected by law, or (ii) is disseminated in the public domain (e.g. through print or electronic publications), may contain identifiable information, and for which there is no reasonable expectation of privacy (University Council, 2015, p.6);
Nor research that:
7.10.4 – Research involving the observation of individuals or groups in public places so long as: (i) the research does not involve any intervention staged by the researcher or any direct interaction between the researchers and the individuals or groups; (ii) the individuals or groups being observed have no reasonable expectation of privacy; and (iii) the dissemination of research results from such observation does not allow identification of specific individuals; and 7.10.5 Research that relies exclusively on Secondary Use of Anonymous information or Anonymous materials, so long as the process of data linkage or recording or dissemination of the Research results does not generate information about an identifiable individual (University Council, 2015, p.6).
This means that ethnographic observation that does not interfere with the subject, nor intrude on a “reasonable expectation of privacy,” does not need approval. Likewise, the secondary use of anonymous information, say through a literature review of analysis of bathroom stall scribbles, does not require approval. Use of public information, as on Facebook, Instagram, or through media articles, also does not require approval. Nonetheless, you should always consult with your supervisor and your REB before you engage in any kind of research.
Box 3.1 – Is Review Needed for Secondary Data?
Many students incorrectly assume that the use of secondary data excuse them from ethics review. Below are some guidance from the Tri-Council Policy Statement 2018:
Secondary use refers to the use in research of information originally collected for a purpose other than the current research purpose. Common examples are social science or health survey data sets that are collected for specific research or statistical purposes but then re-used to answer other research questions. Information initially collected for program evaluation may be useful for subsequent research (TPS, 2018, p. 64)
Privacy concerns and questions about the need to seek consent arise when information provided for secondary use in research can be linked to individuals, and when the possibility exists that individuals can be identified in published reports, or through data linkage (Article 5.7). Privacy legislation recognizes these concerns and permits secondary use of identifiable information under certain circumstances (TPS, 2018, p. 64-5)
Identifiable Information
Article 5.5A Researchers who have not obtained consent from participants for secondary use of identifiable information shall only use such information for these purposes if they have satisfied the REB that:
1. identifiable information is essential to the research;
2. the use of identifiable information without the participants’ consent is unlikely to adversely affect the welfare of individuals to whom the information relates;
3. the researchers will take appropriate measures to protect the privacy of individuals and to safeguard the identifiable information;
4. the researchers will comply with any known preferences previously expressed by individuals about any use of their information;
5. it is impossible or impracticable (see Glossary) to seek consent from individuals to whom the information relates;
6. the researchers have obtained any other necessary permission for secondary use of information for research purposes.
If a researcher satisfies all the conditions in Article 5.5A(a) to (f), the REB may approve the research without requiring consent from the individuals to whom the information relates (TPS, 2018, p. 64-5)
Non-Identifiable Information
Article 5.5B – Researchers shall seek REB review, but are not required to seek participant consent, for research that relies exclusively on the secondary use of non identifiable information.
The onus will be on the researcher to establish to the satisfaction of the REB that, in the context of the proposed research, the information to be used can be considered non-identifiable for all practical purposes (TPS, 2018, p. 66)
For further guidance on the use of secondary data, please see Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans –TPS 2 (2018) | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/03%3A_Ethics_Review/3.01%3A_Introduction-_Reviewing_Your_Ethics.txt |
If your research requires ethics approval, you will need to apply to your institutions’ ethics review board. At UBC, we have the “Behavioural Research Ethics Board” which reviews and officiates ethics applications. We use UBC’s process as a guideline in this chapter, but if you are a non-UBC student, the information might still be useful. Nonetheless, you must seek out the specific process and procedures that apply at your institution of enrolment.
At UBC, prior to completing an ethics application, you need to set up a RISe account. RISe will serve as the interface for submitting all your documents securely. After that, you can begin filling out the necessary documents for the application. This link (set up a RISe account), which will take you to the “Behavioural Research Ethics Board” or BREB, contains the pdf’s needed to begin. In the foregoing, I will outline what each step requires. The following link will take you to the BREB page with all the information you need to know about filling out a UBC application.
Getting Started with RISE
• Create a RiSE account following the directions linked here
Determine and state your principal investigator at the beginning of the application
• Send them an email notifying them that you have begun your application and that you will need their approval
Study Dates and Funding Information
• Figure out and state the funding of your study and the dates of beginning and ending data collection
• Figure out and state the REB board that your study most closely approximates
Summary of Study and Recruitment
• Summarize your study in 100 words for the lay audience
• State your recruitment process and inclusion criteria
Participant Information and Consent
• Discuss your participants:
• What risks may your study impose on them?
• What are the benefits of the study for them?
• What are the potential risks and benefits to the community they occupy?
• How are you ensuring that their consent is informed?
• Ensure your study meets informed consent criteria and sends in documentation of your consent forms
• Will your participants be given adequate time to understand the tasks of your research?
• What information are you sharing with them about your study? Are there any restrictions on what you will disclose? Why is that?
• Do your participants have the capacity to consent to your study?
• Does your study need consent to be renewed?
Number of Participants
• Do you need external approval from other institutions or nations? (Required for research on different institutions with their own REB). If so, see this page. If not, proceed.
• List and determine how many participants will be in your study. This section can be completed once you have finished recruiting participants.
• This section must also list your own qualifications as a researcher, including:
• The research you have done before
• The research program (Honours, for instance) that is supporting you
• Your relation to the proposed research project
• The qualifications of the principal investigator
• Whether you have completed the TCPS 2 Tutorial, linked here
Privacy, Confidentiality and Security of the Data
• Have you assured the confidentiality of your participants by protecting your data against unauthorized access, use, disclosure, modification?
• What encryption and password protection have you placed on your data files? (OneDrive, for instance, is an encrypted cloud service that will protect your data adequately).
• What is the range of privacy protection that your participants will have?
• Will directly identifiable information be shared (i.e. their name, SIN, personal health number)?
• Will indirectly identifiable information be shared (i.e. date of birth or place of residence)?
• Will coded information be used? (Direct identifiers are replaced with a code, James = Spruce)
• Will information be anonymized? (Identifiers stripped of any information that could be directed back to the participant).
• Is the information anonymous in the first place? (There was never any identifying information in the data you sourced, i.e. anonymous interview transcripts that never talk about anything that could be attributed back to the speaker).
• What will be the eventual fate of your records? (Will they be destroyed or kept? And how long into records will be removed?)
• Original data should be kept in its original form for at least five years at a UBC facility before being destroyed, and may be kept for a longer period if they are stored securely
• State the names of everyone who will have access to the raw data and how they will be made aware of their duties towards confidentiality
• Will there be any future uses for your data? Discuss potential future research projects and indicate whether participants will receive new informed consent for these projects.
• Participants should be informed if raw data is shared with other journals or future publications
• In ethnographic studies, this is not necessary for field notes so long as the ethnographic researcher explains to the participant in the initial consent process that their research may be returned to in the future.
• Ensure to offer to your participants an opportunity to give feedback on the results of your research (you can offer to send them a final copy of your research).
Documentation
• Attach the UBC logo to all documentation and ensure there is a version data on it
• All of the following documentation is submitted (if relevant):
• Research proposals
• Grant applications
• Participant Consent document
• Assent Document
• Advertisements for Participant Recruitment (often flyers)
• Questionnaires, Tests, Interview Scripts
• Cover Letter of Questionnaire (if that is used in lieu of a consent form)
• Letters of Initial Contact (e-mails or letters for the recruitment of participants)
• Agency Approval Forms (if your research needs external approval)
• Deception form (if your research requires a temporary deception) | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/03%3A_Ethics_Review/3.03%3A_Getting_Approval.txt |
To help easy assembly of information beforehand, we briefly summarize the application sections here (keeping in mind that complete information should be sought on the BREB page):
Principal Investigator and Study Team
This step will have you state the principal investigator responsible for your study. Since you are an undergraduate, this will be your supervisor.
Study Dates and Funding Information
To begin data collection immediately after the research is approved, be sure to check the first box in the section. Any conflicts of interest must also be stated in this section, so consider any potential conflicts that participants should be informed of (ie. you have a grant from a company to research “how great they are” on a specific demographic).
Study Review Type
State which research board you will be in closest proximity (if you are at UBC Vancouver, it will be Point Grey) and the affiliated institutions your research may be working with (ie. St Paul’s Hospital). This section also discloses potential risks in your study; for instance evoking trauma by questioning potentially sensitive topics. This requires that you state the potential vulnerability of your participants (socioeconomically, physically, politically, power differential etc.). As your research will be course based (through honours or a research practicum), your study likely has only minimal risk. If the risk level is higher (e.g. research on minors or Indigenous peoples), be sure to discuss it fully with your supervisor and get their assistance to complete the form. REB might also be consulted for advice or to answer questions prior to submitting your application.
Summary of Study and Recruitment
This section will ask you to describe your study in 100 non-jargony words. State the research purpose and explain briefly the procedures you will undertake (interviews, surveys, ethnography etc). The section will also ask that your inclusion criteria justify if and why it might discriminate on the basis of race, gender, sexuality and so forth. If you, for instance, are trying to investigate the “experience of South-Asian international students on campus during the pandemic” through interviews, you must provide a “valid reason” why you are only researching South-Asian students (such as their experience being typically marginalized in research or your proximity to that social group). The exclusion criteria must follow the same reasoning. The ethics of recruitment must also be discussed in this section. All of these procedures must then be summarized in a step-by-step manner. This section also includes a guide for each type of research. Finally, be consistent and clear with your terms (e.g. stick with either ‘subject’ or ‘participant’; likewise, be consistent with titles and acronyms).
Participant Information and Consent Process
This section will discuss your participants: how much time you will use with them, the potential risks (particularly psychological harms) and benefits of your study for them, the impact on their larger community, and any payments (voluntary consent means that you can offer only tokens of nominal value; not excesses that might influence to your study) or remuneration (in social science research, you may advertise a small prize draw or payment in finding participants). This section will also deal with issues of consent, which means that you must obtain informed and signed consent before collecting data. You must indicate how informed consent will be obtained (e.g., orally via tape record, signed consent form etc.). The section also requires that you indicate whether it will be you or the principal investigator who asks for consent and documentation. Consent procedures require that you outline the purposes of the study and your responsibilities as a researcher. If oral consent is proposed, you must justify why (e.g., skype/telephone interviews with participants overseas who do not have access to a fax machine/scanner, so they are unable to physically sign consent forms). In cases where oral consent is proposed, you must provide a script of how you intend to ask for this consent. Consent also requires that you give participants adequate time to consider your proposal. If there are multiple steps in the research process (as in ethnography) consent must be maintained throughout the research process.
Number of Participants
This can only be an estimate and you must get approval from other institutions where participants may be sourced from e.g., if you are conducting research with an NGO, you might need their ethics approval as well. If you are conducting research in a different jurisdiction (e.g., with Indigenous communities or outside of Canada), you might require additional ethics approval from relevant institutions in those jurisdictions. Be sure to consult with your supervisor or your REB if you are unsure about this.
Privacy, Confidentiality, and Security of Data
As you will remember from your ethics tutorials, research ethics boards want to ensure that you uphold privacy, confidentiality and anonymity (where possible) so that respondents are untraceable. Here, you need to do the following as well:
• Describe future use of data here (as in further studies or journal articles).
• Address issues concerning anonymous information – ensure that the information never has identifiers associated (e.g., anonymous surveys) and that the risk of identification of individuals is minimal.
Documentation
Includes any grant proposals, documentation of consent, documentation of assent, advertisements (used to get participants), questionnaires, contact letters, and verbal debriefings.
Fee for Service
This will almost certainly be irrelevant to your research. But if your research is being commercially sponsored, UBC’s BREB charges \$1000.
After Application Submission
Once you have submitted your application, you may not be done yet. Through the RiSE system you will be notified of the progress of your application. After around a couple of weeks in review (REB is less busy at certain times), they will notify you of the status of your application. Requests are not completely denied, but are often returned to have a section changed or revised before resubmission. Follow their notes carefully, resubmit, and you should be good to go.
Securing Approval – Testimonies and Quibbles
Below are a set of testimonies of common problems in getting your ethics approval approved and how they were solved. Hopefully one of the following accounts of ethics frustration matches your own problem.
Box 3.2 – Student Testimonial – Seeking Guidance for BREB Guidance
The BREB application process is daunting, but in all honesty, it is not as tedious as it seems. For me I would say the entire process took around one month. I would recommend getting your BREB approval as quickly as you can, because then you have time to work on amendments you might have to make, and you can leave more time to do your data collection and analysis. You really just have to set aside a couple days to think about your project and figure out how to explain your research ethics, and start writing out any ideas you have as soon as possible. There were four resources that I found extremely helpful.
First, the documents that RISe offers on their website to guide your application process are essential. I downloaded their behavioural research application template and referred to their sample form and application guides that can be found here: RISE Sample Forms
Second, I tapped into examples and advice that previous students offered me. I have found throughout my academic experience that alumni tend to be very willing to send their successful BREB applications as an example for current students, so never be afraid to reach out.
Third, I did some simple research to answer basic questions that I had. For example, if I wanted to learn about what sort of benefits and harms are common with sociology research, I would look up an article that used similar methods to my own and checked their methods section to see how they approached mitigating harms or explaining benefits.
Last, I asked my supervisor (or the professor leading the Honours cohort) specific questions or troubles I encountered. They will want you to get your BREB approval so they will always be willing to answer your questions, but since they have other priorities and students to worry about I would suggest referring to the previous three resources first!
Ella Kim, UBC Sociology Honours student, 2020-2021
3.05: Summary
Preparing ethics review applications is time consuming and is not an exciting part of the research process. To ensure that you get to the actual fun part (data collection), we encourage you to utilize the fine resources provided by your institution’s BREB. For example, UBC’s BREB provides a full walkthrough of their ethics process, full of plentiful information regarding the niche problems you may encounter in getting your research approved. Our account in this chapter was merely a simplification of this walkthrough to make it more specific to the undergraduate researcher. We began by defining whether research needed ethical approval, stating that all research that actively intervenes with “human participants” needs approval. The two main exceptions to this definition was research that relied on already public information and naturalistic observation. We then summarized all of the main steps of the ethics review process, attempting to clarify the key concerns for the undergraduate researcher. For concerns not raised by us in the ethics process, please see the comprehensive accounts provided by your BREB institution. The chapter finished with a set of testimonies by students whose ethics process was complicated. We hope that their frustrations may anticipate some of your own.
It is important, in all this checks and balances rigamarole, that this process does not let you lose sight of the spirit of this endeavor: needing to ask of your research the most vital question – is it doing the right thing? Use the ethics review process as an opportunity to consider the value of your research, whether it is able to achieve those values, and whether it is compromising other values in the process. Determining the ethics of your research means to again comprehensively consider the meaning of your research, the answer of which should remind you of the importance of all that you do, and make it easier for you to convince others of the relevance of your work. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/03%3A_Ethics_Review/3.04%3A_Walkthrough_of_Each_Step.txt |
Learning Objectives
By the end of this chapter, you will be able to:
• Differentiate between self-care and self-indulgence
• Understand how to take care of yourself emotionally, physically and mental
• Identify self-neglect and be able to implement strategies for self-care while meeting your research goals
• Develop strategies for time management, engaging in mindfulness and benefiting from peer support.
Suggested Timeline: Everyday in Some Way
Box 4.1 – Student Testimonial – Why Self-Care?
It is reading week February 2020, one month before my thesis is due in March. One of my data analysis tools, RQDA, is not working on my Mac. The application self-destructs everytime I run it; occasionally taking my files with it. I spend day until night, night until day, frantically surfing through abstruse blogs containing fierce debates between hopeless amateurs and tired experts helping the hopeless amateurs figure out RQDA. My retina burns. A coding package is required just to decipher the pages of codes telling me what I need to do. My jaw does not unclench except to eat and drink. A variety of bypasses to my problem are suggested: re-coding the platform algorithm itself in R, downloading another package which will provide the background graphics needed for RQDA, manually installing each package again and again when the full application does not work, and switching to a major in literature. None work. Or at least, I understand none of it, but I intently stare at my screen for days in the hopes my despair can solve technical obstacles. The thought of failure, of being a fraud after a year of telling others I am in honours, begins to perspire from the walls around me.After a week of suffering, I almost sold my Mac and got a Dell until my girlfriend coaxed me to send an email to my supervisor. “My supervisor? But she was so busy, and this problem was afterall minor to everyone but myself. If I could just do this.. And that… all would be fixed.” I eventually sent it, explaining in pedantic detail my dilemma and providing a plan to avoid RQDA. An hour later I received a sentence-long email in reply: “Of course, no need to use RQDA for the quantitative side anyway…Sent from my Ipad.” My supervisor was right, of course.
This is just one example of the “catastrophizing” I conducted throughout the last year of my thesis. Worker bees like me will be familiar with an armoury of stings used to rally ourselves when the motivation is not there (persuasion by fear of failure when confidence in success is not working). Everything must be a crisis, down to the alphabetical order of citations, in order to achieve perfection. It is with this kind of tyranny in mind that we wrote the following reflection on self-care. I hope it provides solace to you as well, and reminds those like me to understand their limitations, forgive them, and forgive the same in others – all while remembering the passion that led us to begin.
Alexander Wilson, Sociology Honours student, 2020-2021
We decided to address self-care early in this manual because we want you to have tools to be able to deal with the challenges that come with writing a thesis. As expressed in Alexander’s testimonial (above), this chapter is built around helping you to overcome the high-pressures that can take place in the research process. Stresses and challenges will inevitably arise at some point in your journey so it is best to develop practices that can help you to successfully navigate them. As Alexander’s testimonial in Box 4.0.1 indicates, sometimes the solution to a seemingly daunting problem is the confidence to state our concerns and ask for help. Self-care involves taking care of yourself physically, emotionally, mentally. Creative acts such as your thesis are devotional, and draw from you mentally, physically and emotionally. This can lead to self-neglect and the sacrificing of your dignity, worth, energy, confidence and self-esteem. If you notice that you are constantly comparing your work to others, and/or just being downright confused in the pursuit of some abstract ideal, you might be in need of some self-care. According to the World Health Organization (2022), Self-care is broad concept which encompasses the following
• hygiene (general and personal);
• nutrition (type and quality of food eaten);
• lifestyle (sporting activities, leisure, etc.);
• environmental factors (living conditions, social habits, etc.);
• socioeconomic factors (income level, cultural beliefs, etc.);
• and self-medication
The WHO (2022) further notes that self-care includes “aspects of the individual (e.g. self-reliance, empowerment, autonomy, personal responsibility, self-efficacy) as well as the greater community (e.g. community participation, community involvement, community empowerment)”. The aim of this chapter is to provide tips to help you address self-care holistically and to be able to respond to common stresses in the research process. The tips are rooted in the experiences and responses of different honours students over the course of their thesis, and are intended to provide both tangible tools to responding to major issues in the thesis process and to normalize rest from those stresses.
As the WHO (2022) definition above implies, self-care is intended to keep you healthy, productive and being able to reach your potential. This means that it is not the same as either self-indulgence or self-neglect. Self-indulgence involves excessive or unrestrained gratification of one’s own appetites, desires, or whims (Merriam-Webster, n.d.). Thus, while watching some Netflix might be a good self-care habit, binging for an entire month while neglecting the rest of your life is definitely too indulgent. Hence, self-care requires that you strike the balance between fulfilling your desires but not at the detriment to important things in your life.
At the opposite end of the self-care spectrum is self-neglect, which is an extreme lack of attention to one’s mental, emotional and physical needs. Just as spending a month binging on Netflix without attention to other important details of your life is not good for your health, so is obsessively working on your thesis to the exclusion of other aspects of your life. Like self-indulgence, self-neglect is counterproductive to your thesis journey. Table 2.4 below highlights some indicators of self-neglect and self-care.
Table 2.4 - Sample Undergraduate 6 Page Research Proposal Template
Section Brief Explanation Estimated Length
Introduction Title. Short outline of the problem and its importance. 1 Page
Literature Review Short history of other investigations into the problem. 2 Page
The Purpose Fulfill the gap in the literature and reiterate the significance of the study. 1/2 Page
RQ's A summary of the questions or thesis that you expect to guide your research. 1/4 Page
Method(s) A summary of and argument for the methods you will use to answer that research question 1 Page
Data Analysis A summary of how you intend to make sense of what you found 1/2 Page
Summarize, Engage Limitations, and Implicate Provide an overview of your study and its significance. Recognize the potential limitations before highlighting the contribution. 3/4 Page
References Attach
Adapted from Petrina, Stephen. (2009). “Thesis Dissertation and Proposal Guide For Graduate Students.” https://edcp-educ.sites.olt.ubc.ca/files/2013/08/researchproposal1.pdf
Box 4.2 – Institutional Support for Self-Care
Maintain social connections
1. Actively stay in touch with people near and far
2. Invite others to do activities with you
3. Engage meaningfully in course interactions (online or in-person)
4. Create study groups (online or in-person)
5. Remember, in most cases, you are doing much better than you think.
For more details, see https://keeplearning.ubc.ca/self-care/
UBC’s Thrive 5 for self-Care
For more details, visit: https://students.ubc.ca/ubclife/were-making-space-self-care-season
Teaching and Learning Support
Talk to your professors, peers, academic advisor, or anyone about any concerns that you have: https://keeplearning.ubc.ca/self-care/
Mental and Emotional Support (UBC Counselling Services)
Talk to a counselor: https://students.ubc.ca/health/counselling-services
Repeatedly emphasized in this chapter is the value of cultivating a social environment that normalizes and supports such care. Throughout your research, you will be encouraged to check in with other researchers, inquire about their interests and share your struggles. You may find that in promoting care for them as people independent of research and credentials, they will do the same for you: creating strong external bonds that could serve as a line-out when drowning in the egoism of research. Such was also our reason for creating this manual, to care for you as you care for research. We will discuss time management, mindfulness, and availing to and/benefiting from peer support as effective self-care strategies. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/04%3A_Researching_with_Self-Care/4.01%3A_Introduction-_What_is_self-care.txt |
Stress is induced by the time-crunch, the nearing of some inevitable reveal that you feel hopelessly unready for. Recounting his honours journey, Alexander notes:
If it were not for that nervous feeling that my time was coming I would not have felt nearly motivated enough to work regularly on a thesis due in a year. One of such ‘friendly’ reminders that my judgement day was nearing was the schedule I created for myself in September… and again in November … and once more in February (after the RQDA ‘catastrophe’). The schedule was an initially naive draft of when I would complete each section of my thesis: starting with refining the research question, then conducting the literature review, then assembling data, analyzing data, writing about said data, and finally the discussion and conclusion. My initial schedule was broad, and rarely noted the specific days that I would work on these sections. It was, however, later complemented by a weekly agenda, where I noted the readings I needed to do (for all my classes) and the particular sections of my thesis that I wanted to get done.
Time management involves the process of determining needs, setting goals to achieve these needs, and prioritizing and planning tasks required to achieve these goals (Claessens, van Eerde, Rutte, & Roe, 2007). In setting your goals, it might be helpful to adopt the SMART-ER principles (Macleod, 2012):
• Specific (clear, simple, significant)
• Measurable (the ability to track progress )
• Achievable (attainable)
• Relevant (reasonable, realistic, results-based)
• Timebound (time sensitive)
• Engaging (be involved)
• Rewarding (incentivize yourself)
There is of course no uniform way to do this, precisely because these tasks must be sensitive to the very non-conformist entity that is your reality. This flexibility, however, must be tempered with a good-natured rigidity. Think of the schedule as a loving but stern parent… which you gave birth to. The schedule plays a disciplinary and nurturing role. The goal is to make you aware of the steps that need to be taken in order to mitigate the scenario in which you must take on all or a lot of the stress at once. A good schedule, like any regulator, ought to protect you from that scenario by creating small, clear, realistic steps towards your goal. See Table 4.2 for a sample macro outline of how you could set targets for your thesis completion. Adapt it as necessary to suit your working habit, lifestyle and goals.
Table 2.3 - Illustration of an Undergraduate Project Timeline
Activities Sept Oct Nov Dec Jan Feb Mar
Write and submit ethics application X
Research and write the literature review X X
Write methodology X X
(Recruitment and) Data collection X X
Data analysis X X
Write up results X
Edit and submit final paper X X
An important way to balance rigidity and flexibility is to divide your scheduling into a micro and a macro model. The macro model can be the shallow but effective overarching goals you want to achieve (likely by the month). Common macro goals could include “finishing the literature review,” or “read all your media articles and create the first set of codes.” The macro model will serve as the basis of reflection when asking: “Am I fulfilling the larger purpose of my thesis”? This model can likewise be reassurance that all the little micro stuff will add up to something.
The micro-models will be the small, tangible tasks that can be achieved weekly in order to meet your macro goals. The capitalists know this process fairly well. As Henry Ford famously put it: “Nothing is particularly hard if you divide it into small jobs.” This means thinking carefully about the short-term goals involved in creating your broader goal (the thesis or research project) and setting aside times (which you trust to get work done in) to complete that task. With this in mind, it is important that your schedule does not stay broad. It must specify parts of your thesis which can be realistically completed early on.
Table 4.1 - Sample Micro-Schedule
The Month of December (Focus on specific time or section of thesis). Work Period (December-Jan)
Main Task: The Methods Section and Self-Care over Break Dec-Jan
Select and Summarize my method Dec 1st - 5th
Set boundaries for my data and write of potential difficulties Dec 5th - 10th
REST BREAK Dec 10th - 12th
Summarize the instruments and measures used Dec 13th - 15th
Outline the procedure Dec 15th - 17th
Figure out and discuss the data analysis method Dec 17th - 20th
REST BREAK Dec 21st - 30th
Rewrite and revise methods section Jan 1st
Self-Care before the second semester -
Pick a mindfulness strategy and revise your larger tasks for the second semester
Check in with other students on their progress.
Note, based on your past progress, which goals will be the most exhausting and allow yourself maximum time to achieve those tasks when outlining your next schedule.
Jan 1st - 15th
A way to facilitate conversation between our micro and macro-scheduling is through research journaling. Many undergraduate researchers use journaling to regularly keep track of their progress and the new obstacles which arose.
Box 4.3 – Student Testimonial – Journaling
UBC Sociology Honours Student (2021), Alexander explains:
[Journaling] for me, since a lot of new obstacles that I could not have predicted got in the way of my ridiculously broad schedules. Whenever I came to a crossroads in my research, be it for my own ethical considerations, a problem in my methods or data analysis, seeking to answer a different gap in the field, I would note it down in my green five-star note-book. (It was often merely a scribble with the date above; sometimes, especially when I was tired, it would be reduced to mere acronyms or half-gibberish: “Remem Avg Uber Driv Income”). I suggest you try to do the same, as it will enliven your schedule to be sensitive to every twist in the research process (and there are many).
On a final note, remember to account for plenty of rest. A schedule which exhausts and causes excessive stress/burnout is defeating the very purpose that it was created for. Instead, make sure to account for your own feelings of exhaustion and consider times of rest and recuperation when drafting your schedule. This might include, I don’t know… weekends? | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/04%3A_Researching_with_Self-Care/4.02%3A_Time_Management.txt |
One of the most common advice about writing is “just write something everyday” (see Narayan, 2012; Fallon, 2016). But this imperative is usually not enough. That is because this statement attempts to achieve the cause through the effect: write and you will care about writing. No, you should also care about writing before you write, and if you are writing about a topic you should also care about that topic enough to be driven to think about it, articulate it, and write it. As Fallon (2016) expresses, good writing is not cultivated by mindless practice, but by goal-directed, deliberate practice. Practice without direction is ritual or law without the spirit, whereas goal-directed practice is conscious of some complicated sense of ‘good writing’ that it aspires towards. A simple definition of this thing will not suffice, but you would perhaps agree that we get a gut feeling when we read good writing. When a piece of writing has a nice ‘ring’ to it, makes a complex point simple, provides some relief that you (or someone) understands the complexity of your topic, it reasonates with you. Keeping this sense in mind will allow your practice to critique itself, to play close attention to the writing that is working and the writing that is not by evaluating it according to a standard.
But just as we tried to express in the self-care section, it is important that the loftiness of the goal does not exhaust our pursuit of it. This unfortunately means to balance a paradox: be goal-directed, but take as your first goal to ensure that the goal is still directing you and not exhausting you to paralysis. Do not let your anxiety of writing imperfections stop you from practicing regularly, from being disgusted at your writing even when you are journaling alone, from having a distinct feeling of dread when the final paper is due. Care after yourself while also caring after your writing by designating times when you can lower the burden of your writing. Find enjoyment in writing activities outside research, in journaling, poetry, short stories, where you can ramble and joke and play with writing. This kind of writing will balance the moments where it is important to take your writing seriously (earnest towards some meaningful goal) with moments where your writing can play with itself (mocking the goal, conscious of its present imperfection). Like a royal court, good writing is improved by a jester.
Fallon (2016) reminds us this through her comments on fear being the biggest deterrent of good writing (p. 29). She believes that writing that begins from a place of assumed perfection, expecting a masterpiece on its first try, will inevitably end in more despair than it needed to be. As a consequence, Fallon advocates a growth mindset for writing; which means to think of all of your work, and your writing style itself, as “in progress,” as always striving for improvement. While this might cause your eyelids to droop, it proves its duration when applied to our writing. Pride and arrogance stand in your way when we try to write well. One must admire great writing like a child does a role model, feeling the inferiority and obedience which inspires emulation.
In sum, without actually sitting down to write, none of this means a thing. But without actually thinking about what writing is good for, writing is not worth a thing. Writing is a praxis, and what fine peach jams it takes from the pantry of theory it must consume on the table of practice. It must determine through test, in pleasure, disgust or boredom, whether it wants to continue with that jam or move onto a tastier style. To refine this palette, it is important to make consumption of theory (reading great writers) and testing it in writing a regular practice. How you set about to develop your writing ritual will be unique to you, but the following 15 practices are offered as a list of things that past Honours students did to keep them focussed on writing. If you do not already have a ritual that works, we suggest shopping around for one that does and changing it up when one gets stale.
Box 4.4 – Writing Rituals
1. Keep a commons journal with a list of all your ideas and research questions as they come up spontaneously (even on your phone)
2. Use the commons journal as a list of “things to still write,” consider even scheduling days and times to attempt writing about those problems. Consider adding ambitions and fears to this journal.
3. Shower multiple times of day in between writing.
4. Run and exercise vigorously when writing is becoming stale
5. Have Netflix (preferably Friends) or a nature documentary in the background while writing
6. Turn up the heat and blast music when writing
7. Open a window and feel the draft of cold silent wind while writing
8. Write a page of notes before every meal or just incentivize your writing with whatever works
9. Write with a friend you trust to keep you focussed on the writing
10. Look back at a paper you are proud of (or one you are ashamed of) to inspire you to write
11. Have a passage from a book or research article you love on hand to inspire you to begin writing
12. Take stock of what you want to write by meditating before beginning (see chapter on self care for discussion of mindfulness and research)
13. Put writing reminders and ideas in your phone or alarm
14. Coffee, tea, and biscuits break!
15. Set a time early in the morning or late at night to engage ‘mindfulness’ as discussed in the chapter on self-care. Take a moment to meditate, to think about your progress, problems, and well-being. Write down these concerns to incorporate them into your rest or writing.
Box 4.5 Student Testimonial – Research Writing During a Pandemic
Full discretion, I am writing this testimony as a way to procrastinate writing for my own thesis. I will let that speak for itself. Anyway, here are my expertly-crafted decades-long researched tips (for real) of how to get yourself and your thesis writing going.
Outlines, Outlines, Outlines
Even if you’ve spent the past four months ‘reading’ and are intimately familiar with your project and your data, I’m going to take a wild guess and say you will still struggle to get started on writing. A really good way to push yourself –to visualize your work better and to actually start writing –is by making outlines. Start off by using this as a productive procrastination method, and keep making outlines. The more you attempt to provide structure and clarity for yourself, the more confident you’re going to feel to start writing. Plus, it’s always beneficial to have your thesis compartmentalized in tidy boxes (which grow less tidy as you write). You can then use these as frameworks to guide your writing process. Additionally, it helps to make mind maps and other diagrams (I’m thinking lots of arrows), and the tactile act of scribbling with a pen on paper itself really gets the brain buzzing.
Prepare Presentations, Write Abstracts, Apply to MURC
Attempting to streamline your (initial) mess of a project and organizing it in a way that it becomes presentable to others is a hefty challenge. However, it gets easier as you practice doing it more. It helps to try to write abstracts with tight word counts so you can narrow what it is exactly that your final thesis is going to address. This also forces you to be selective about the elements of your work that are the most relevant. Similarly, preparing presentations under a tight time limit helps you see the most important and engaging aspects of your project, which goes a long way in informing your writing process (and eventually the editing process).
Make Friends in Class just so You have Someone to Read Your Work
It’s safe to say that you’re going to spend much time with your topic and will become very close to it. Everything either makes entire sense to you right now or it absolutely does not. Chances are, on both accounts you’re wrong! So get someone who has no clue what your project is about to read it and tear it to shreds (or maybe you will rouse deep interest in the person and change their political beliefs forever). This is a good practice to keep engaging in throughout your eight-month-long topsy-turvy hellish writing process.
Make Sure You’re in the Right Headspace/Physical Space
Writing is hard, it’s an active exercise and you’re going to have to put in a lot of effort every time you sit down to write. So before you get on the job, make sure you’ve psyched yourself up. You are in an environment where you can focus and on the chance that you lose that focus (which is almost certainly going to happen), the environment can put you back into the groove (by force, shame or inspiration).
Respect Your Time
Sometimes study buddies are great, other times they’re not. Similar to the previous point, make conscious decisions of how you are going to occupy your time because this is a task, and hopefully it won’t always feel like a chore. When you’re in the zone, make commitments to stay in the zone and don’t write OER testimonies to get away from your work.
Breaks
I’m kidding, productive procrastination and breaks are important! Sometimes you simply must write testimonies to break from the passion project you are now beginning to despise (or take a nap, or go snowboarding, or write an award-winning play). Over the span of eight months you’ll start to know yourself a bit better. Don’t force yourself to do work when you know you can’t – this will also motivate you to put in more conscious effort when you know you can. You will start valuing the time you do have and when you do feel like actually working more, you will! It also helps to be in a space where you have the chance to go and grab a snack or a drink if you need to.
Intertwine Some Tasks
Like I said previously, I always have a pen and paper at the ready and I like to scribble and write down or draw out any random thoughts I have about my project. I’ve really enjoyed doing some parts of the thesis project simultaneously, like data collection and writing, so there is constant momentum. If I have paper to scribble on (or a boring notes app open), I can write down a few points of analysis while I read my literature.
Move Your Body!
I like high tables or standing desks or empty cardboard boxes to place on my desk so I can stand and do my work if I wish. It helps to move around and break into interpretive dances every now and again. I also like taking walks in the middle of my writing (and getting weird looks from everybody else at the library). It’s useful to keep exercising the rest of your muscles while you get into your head to flesh out your ideas and to keep the energy up so you don’t just spend eight hours hunched over, staring at your screen until you collapse.
Hit that Save Button
Nothing else sends sweet dopamine to my brain as hitting the command and S buttons on my laptop while I’m in the middle of writing and tearing my hair out and shaking my foot until it falls off. The short interval saves are going to keep you going and are also going to ensure that you don’t lose hours of work because you have 57 tabs open and you’ve been working your computer so hard that it has finally had it, and starts to spit out sparks, 1s and 0s.
Literally just Start Writing
No, but you’ll procrastinate because you’ll think you don’t know what you’re doing and nothing is making sense but when you start writing you’ll realize that you, the engineer, the curator, the cultivator of your project, in fact, do know something (or at least we can hope). This is time-old cliché advice, but you just have to rip the band-aid. Like that fish from Finding Nemo said, just keep writing (because that’s what fish do, right? It was definitely not a quote about swimming. Don’t look at me like that).
Anupriya Dasgupta, UBC Sociology Honours student, 2021-2022 | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/04%3A_Researching_with_Self-Care/4.03%3A_Rituals_and_Self-Care_When_Writing.txt |
This section will attempt to show, in describing Alexander’s Honours experience, the potential of a mindfulness that is both useful to your work and a break from it (at the end of the chapter, we provide website linkages and other resources for mindfulness practices). Mindfulness, we will argue, is the finest diagnostic tool you have for the type of self-care that will work for you.
Table 4.2 - Mindfulness Strategies
Three Breathing Exercises Explanation
The Conscious Breath Think about your breathing while you breathe. Count 10 breaths and then relax.
The Bumble Bee Breath Sit upright with straight posture, place your tongue over the bottom mouth and make a buzzing noise as you brief through your nostrils.
Alternate Nostril Breathing Alternate breathing through nostrils by placing your thumb over one nostril and breathing through the other. Take deep breaths and rotate with each one. Repeat three times.
Source: Michelle. July 8th, 2011. “Yoga Breathing Exercises for Anxiety.” Healthfully. Yoga Breathing Exercises for Anxiety (healthfully.com)
Despite their apparent ideological differences – mindfulness being associated with yogis and time-management with Henry Ford and all – we suggest that mindfulness and time-management can be meaningfully intertwined. In fact, truly effective time-management will respond to mindfulness.
This vague term, “mindfulness,” has been used by health corporations like Mindful to refer to the practice of paying attention to “what’s happening, to what you’re doing, to the space you’re moving through” (Mindful). In other words, it aims to fend off desensitization, hyper-rationalization, and abstraction from that which is occurring most immediately. In research, this is especially important to remember, since we are often driven to research by abstract, macro-processes: the goal of getting an honours degree, of understanding and communicating how “Uber attained legitimacy amongst so and so people.” This means to coordinate our activity to some goal that is potentially years (or infinitely far) away from the present, tending to lead us to delegitimize our daily suffering in order to strive towards our abstract goals: ignoring our feelings of tedium, of loneliness, and even happiness.
Techniques of mindfulness seek to combat such belligerence to our own surroundings and feelings. They aim to rest from what we are coordinated towards (active stance) and acknowledge how we are affected (passive, listening stance) by this movement. When thinking of how we can coordinate everything towards research, every friend and feeling can become an obstacle towards your objective. Likewise, as will be discussed in the coding process (Chapter 8), any statement which does not immediately support your thesis or strengthen your project can become an enemy (and they are not!). But the mindfulness definition might still be too simplistic as Alexander explains:
The narrow-sightedness of research occasionally led me to being unreceptive. Especially as the year went on, I grew more reclusive, avoiding texts from friends, or when I did see them, struggling to relate to worries unrelated to Uber’s media campaign (who knew they could exist). My world was sometimes isolated by my seriousness; all that did not solve my problems was palaver. On the other hand, this narrow-sightedness towards my thesis inconsistently vacillated to equally narrow escapism. I occasionally tried to escape my problems by throwing myself into other distractions – reading books unrelated to Uber, going out with friends, chess videos on Youtube, ice cream, and so on – only to be snapped out of it by an honours seminar or one of the plentiful ads produced by Uber’s propaganda machine.
Box 4.6: Mayo’s Four Components of Mindfulness
Pay Attention
Live in the Moment
Accept Yourself
Focus on Your Breathing
Source: Mayo Clinic Staff. N.d. “Mindfulness Exercises.” Mayo Clinic. Mindfulness exercises – Mayo Clinic
Just as with the conditions which often lead to escapism, coming out of a long bout of escapism can mean panic. This is the kind of dangerous cycle that an insensitive schedule achieves. If we are only ‘time-managing’ towards some abstract objective, we end up (often ineffectively) torturing the free, feeling thing being managed. On the other extreme, if all time is whimsical mindfulness, we neglect the value of the future goals which our mind often seeks to interpret in our present experience – like finishing a thesis.
With this ying-yang (antinomy) in mind, we encourage you to consider mindfulness as a part of those abstract goals it purportedly seeks to quiet. Mindfulness techniques will perhaps, be most meaningful if you use it as both an opportunity to break from the goals of your thesis and be attentive to your most immediate surroundings, while still reflecting on the parts of your time management which are not harmonizing with your current state. By the latter we mean you should incorporate reflections of how you feel into your research schedule: by attempting to respond to your fears, hopes, energy and exhaustion through planning of breaks or work-periods. This likewise means to consider planning mindfulness as part of your research process. Take five minutes in the morning before work to simply breathe and reflect on your feelings that day: then, as a result of this reflection, incorporate your state into the type of activities you are working on. If you are exhausted, consider picking a simple rote task; if you have ample creative enthusiasm, skip the menial stuff and tackle your most complex questions.
Table 4.5 - Three Structured Mindfulness Exercises
Mindfulness Exercises Description
Body Scan Meditation Lie flat on your back with your arms and legs outstretched. Focus on each part of your body, beginning at your toes and then to your head. Think of your sensations, the tightness of your muscles, the movement of blood throughout your body, your temperature.
Sitting Meditation Sit with your back straight, feet on floor and hands in lap. Breath through your nose and think of how your breath moves through your body.
Walking Meditation Find any open outdoor space. Pace back and forth, paying close attention to your walking, the area around you, and allow your thoughts to flow freely. Develop a rhythm with your walking, and acclimatize to the pattern enough to let your thoughts wander.
Source: Mayo Clinic Staff. N.d. “Mindfulness Exercises.” Mayo Clinic. Mindfulness exercises - Mayo Clinic
There is no specific task that you have to run through in order to reflect on your senses and mental processes, while “Mindfulness” tasks will often involve a break from anything that could constitute a mental distraction (besides those tedious but necessary projects of breathing and pumping blood). As Alexander explains, basic, rote activities such as walking and showering can be good for the stillness required for reflection:
There were many moments in my thesis project where some type of mindfulness offered recovery. Often, when I was highly stressed about the quality of my thesis, I was immediately tempted to distract myself with tv, friends, food, my phone and fantasy. This only delayed the stress of my research. But when I took the time to do a simple breathing activity (count ten deep breaths) to calm myself before reflecting – I was better able to stave off the melodrama of my catastrophizing by placing it in respect to the real safety which currently surrounded me. In sitting back and thinking, I also was able to reflect on my hunger, the soreness of my lower back from hours of sitting, and the fact that my room smelt like an oven cooking sweat rags. I did not discard (and hence discredit) these feelings to the present. Rather, after resting and thinking, I made a sandwich, cracked open a window, and went for a walk.
We encourage you to consider a mindfulness which is not escapism. It can be, but it can also be incorporated, like your field notes, into reflections which enrich your activity. Try to set times, either to walk, run, or lay on your floor and reflect on what you are trying to accomplish and how you feel about those steps. Then write those reflections in your field notes and attempt to craft your schedule with respect to your needs. Use mindfulness as both a technique to widen your focus to important things unrelated to your research and a tool for connecting more effectively with your research by addressing your major worries, devising solutions, and then correctly evaluating their significance in the scope of your other goals. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/04%3A_Researching_with_Self-Care/4.04%3A_Mindfulness.txt |
In the honours program, the supervisor is an essential tether to our project. Without their approval to aid and evaluate our amateurish attempts at a thesis, there would be no thesis. For this reason, particularly the evaluation part, there is a tendency for students to over-rely on their supervisors: to expect that they will be available at every crossroad in your thesis, and, even worse, to feel slighted when they are not. On the other extreme, this feeling of intrusion can lead some students to never reach out to their supervisor, to make decisions alone and be left to worriedly wonder whether it was the right choice, or to fail to make decisions at all out of uncertainty. As per the rhetorical (and hopefully sagacious) tendency of manuals, the prudent path between either extreme will be advocated. A successful supervisor relationship will involve mutual respect which clearly negotiates your needs with your supervisor’s availability.
Box 4.7 – Student Testimonial – Pitching Your Project to a Supervisor
How did you pitch your project to your prospective supervisor?:
There is a simple answer to this question: After class one day halfway through the second term of my third year, I walked up to the professor I was interested in working with, briefly explained my research goals and my academic career goals, and asked her if she had the availability and interest to be my thesis supervisor. I followed up with an email with a more descriptive explanation of my research interests, some references to backup my topic, explained why I felt like she would be a good fit as my supervisor (referring to some of her work) and I told her how much I would appreciate having her guidance throughout the thesis process. Although this process was straightforward in my case, there was a lot of reflection that came before I made the pitch: I had been thinking of my potential research topic throughout my undergrad, which I know is not the case for everyone in choosing a topic, but no matter what your starting point is I would suggest to do a really basic review of the literature before pitching an idea to the professor you are interested in working with. I was interested in environmental sociology topics, so I asked my professor for SOCI 420 – Environmental Sociology. Asking a professor I already had experience with through class made the process easier because while I was unsure if my desired supervisor would have the time to supervise me, I knew she would have the interest and a breadth of knowledge in my general area of interest, as well as a fairly similar worldview.
Ella Kim, Honours student, 2020-2021
Box 4.8 – Student Testimonial – Enjoying Your Supervisor Relationship
The honours program gives you the opportunity to work and develop a relationship with a faculty member. At the start of my search for an honours thesis supervisor, I will admit the mere thought of approaching a faculty member left me feeling anxious and very intimidated. I was lucky enough to have approached a supervisor I was already familiar with as I was taking one of her classes at the time, which made me familiar with her background and previous research. This definitely made help ease my nerves when I first approached her to talk about the honours program and asked her to be my supervisor along with sharing my research topic.
Working with Dr Qian was a wonderful experience, despite most of our communication occurring over Zoom. She was such a supportive supervisor, who encouraged me and gave me advice on certain aspects of topics I was stuck on. During our meetings, it was wonderful to be able to have this relationship where I could bounce potential ideas and themes I wanted to explore, which made drafting an outline for my thesis easier. The honours program gave me this opportunity to develop this relationship with a faculty filled with mutual respect and trust, which not only fostered and fuelled my passion for my thesis but helped to push my intellectual boundaries and strive for more.
Nichole Goh, Honours student, 2020-2021
Box 4.9 – Three Steps for a Healthy Relationship with Your Supervisor
Introductions
• Reach out over email and schedule a meeting with your supervisor. Introduce yourself, your project, and get to know their work.
Boundary-Setting
• Get to know their boundaries and agree upon your working relationship. Ask about their work schedule and figure out what work they are comfortable giving feedback on. Take this time to figure out which mode of communication is best for them.
Reciprocity
• Thank your supervisor for their help and offer to help them with anything they may need. Be respectful of their time when they do go out of their way to help. Email when it seems they are more available and seek out alternatives at busy times of the year.
As supervisors have a ton of other responsibilities, they will tend to be less available for you as you would like. This fact also tends to make the process of even finding a supervisor a tough task. Often the student will have to respectfully conform to the working style of your supervisor, keeping in mind that they are doing you a favour by helping you to achieve a thesis. You should therefore go into honours with the expectation that most of your project will have to be figured out through the use of your own judgement in combination with resources such as this manual. This is not, however, the case with all supervisors. Some supervisors will expect you to complete parts of your research project on specific dates. They may even offer feedback and allocate time for asking questions.
Either style will attract different students. But what matters is that you are able to negotiate clearly with your supervisor in a style that works positively for both of you. It is your responsibility to initiate this process. As soon as your research project starts, we suggest sending an email, thanking them for their support and asking if there is a time you can meet to get to know one another and figure out a working strategy that is effective for them. If you think you will have a lot of questions, ask if you can bring them to your supervisor (depending on the answer, it may spare a lot of further question-asking). Likewise, figure out which times work for them and which communication methods are best. You should aim to establish boundaries early on, so that later, when you’re in the thick of it with deadlines, you can know when to rely on your supervisor and have the time to create other supports (like this manual) for the things you cannot expect of your supervisor.
After initial boundary-setting, make sure to offer to return the favour. If there is anything you can do to support your supervisor, they will likely be more willing to extend more support in return (however, this is not to say you should expect more support because you offered to help them). As in many healthy relationships, the attempt at reciprocity is key.
The next section is directed at tapping into peer support as a self-care strategy. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/04%3A_Researching_with_Self-Care/4.05%3A_Working_With_a_Supervisor.txt |
There are many relations in the research process, but the most comprehensive one will be with those you can open up about the entire process: not just about what’s going well and the technical quibbles, but all of the worries which make up the research process. This type of support will hopefully come from your peers. If you are in honours at UBC (where this humble manual was created), you will meet weekly with a seminar of other students who are writing a thesis. Indeed, for many honours students, it is older peers that introduce them to the program.
Elsewhere in education, there is ample research which supports the efficacy of peer support. Peer support has been shown to help students adjust to campus, increase student satisfaction (Pascarella & Terenzini, 2005; Tenenbaum, Crosby, & Gliner, 2001), and reduce stress and anxiety. But these benefits remain unclear when formulated abstractly. While the value or nature of a peer relationship cannot be reduced to a single framework, the simple fact of having another student who shares a common perspective (as has been also speculated by Collier, 2007) can be imperative for escaping the isolation of research.
Research in the humanities and social sciences can be an inherently lonely process. Most research is composed of literature reviews; and where human participants are involved, like in interviews or action research, the relationship does not require you to share your own struggles with the research process. The researcher is expected to listen, and to share only what is relevant for their audience: forcing much doubt, work, and agony to be done “behind-the-stage” of the final academic product. In order to ensure a sound and concise performance, this distinction is somewhat sensible. But it does add emphasis to what other researchers can do for each other. Peer-researchers are potential outlets for the behind-the-stage dilemmas and sideshows that affect ourselves and our research process. Likewise, in offering their own related experience, they could potentially spur on further thought and solutions to common problems in research. In this sharing, an understanding about the things which irk and assuage our research process can be given a fuller expression than is expressed by the thesis (final product) alone.
Peer-support requires a willingness to open yourself up before carefully negotiating what others are willing to give back. Once established with some, consider extending the boundaries of this confession circle with all the others in your cohort. You never know what assets another researcher can offer if allowed to participate in discussing the intricacies of their research. Opening up lines of communication amongst your fellow researchers will allow you to gain a better sense of other peoples working habits, including the ways they cope and the ways they persevere, providing you with points of comparison in which to consider your own tools for resilience.
4.07: Imposter Syndrome
The imposter syndrome is endemic in academia, and particularly affects new or marginalized researchers (Breeze, 2018; Edwards, 2019). Researching and writing about subjects niche to your field and methods, the substance of your work will often only be known to you and a select few others: but the appearance of being an academic remains. The imposter syndrome presents itself as an extreme form of self-doubt, one in which you feel a constant sense of paranoia that you will be found out, that at any moment the act will be up (Breeze, 2018). It is promulgated by a sense of loneliness, that others cannot notice your fraudulence, a loneliness that feeds itself from hiding from others who could notice. Even when others are accepting you, rewarding you for your work, the feeling of being an imposter remains. The feeling of being an imposter then simultaneously represents a genuine concern over your substance and a preoccupation with appearance.
Rest assured, if you are feeling like an imposter, it is normal and healthy. A new researcher has yet to build the substance of their work, and their bid into serious and sophisticated research will have the marks of amateurishness: naivete and clumsiness. Both are vital and redeemable qualities when they are matched by the sincerity and potential of your research. The sincerity component means acknowledging your limitations, accepting that you are brand new to this work, caring after and forgiving your exhaustions, all while retaining belief in the value of your work. The potential component is the belief that your work will improve, that even the feeling of imposterism, of not being quite good enough, is part of that yearning. But this perfectionism can often go too far, particularly when it tells you to believe that you should already be at the highest level. This is where potential must be culled by sincerity. It is important to laugh at your hubris, accept your mistakes, and choose self-care over the destruction that unreasonable ambition begets.
It is also important to fight the loneliness that imposter syndrome thrives on. In many Honours seminars that we facilitate, students discussed the importance of ‘normalizing’ the struggles of undergraduate research. Sharing your own struggles with research will break the facade of getting it right on the first try, encouraging others to also relate their inconsistency with that image of perfection. We highly encourage you to form connections and be transparent with your peers and mentors. Doing this will not only provide you a support group, but it will form a feedback loop between your perception of self and others. In other words, you will let others ‘find you out’ to dissipate the paranoia of being ‘found out.’ From here, you can work on sharing and hearing the substance that does exist in your research and others, no longer in the isolated position where you must infer substance from limited presentation and anticipate the same from others. See Box 4.6.1 for some strategies for battling imposterism.
Five Strategies for Battling Imposterism
Acknowledge the Imposterism
It sounds simple but this is the only and finest step for tackling imposterism. If imposter syndrome is an asymmetry between your appearance to others and your appearance to yourself then the first job of imposterism is to admit that asymmetry exists. The subsequent task should not then be to reveal that to everyone you run into, but rather to understand what it is that you feel is ‘pretense’ in your acting to others and what is genuine care for your work. Cultivate the genuine care for your work and avoid the pretense.
Forgive but do not Allow the Temptation to Deceive
Environments like an undergraduate honours seminar full of talented peers and educators can tempt you to present an ‘idealized’ version of yourself and your work. This is of course can be a healthy instinct, but when carried too far it can lead to deceit. It is important that you acknowledge the deceit and do not punish yourself too much for it. Do not beat yourself about saying that your methods section was done when it was not, it is a normal part of trying to keep up with your peers and odds are your peers are doing exactly the same thing. Try to acknowledge the situation you are in, the embarrassment you may feel about keeping up, and nonetheless remind yourself of the value of staying honest publicly (to maintain a consistency in expectations you have for yourself and that others have for you).
Narrow Down Exactly what Makes you Feel ‘Fraudulent’
Think of the role, responsibility, or ideal that you are not meeting. Write down what it is and put parameters on it (e.g., I feel like an imposter because my data does not perfectly represent the group I am trying to analyze). By making imposterism a definite and not vague feeling, you will be better able to address the competency that is making you feel insecure. For instance, once you have narrowed down that it is a lack of data that is making you feel unworthy to research this topic, simply be honest about the limitations of your assertions in your writing.
Share this Feeling with your Peers
Ask others if they are experiencing the same thing. The best way to cultivate an environment that allows vulnerability and avoids deceit is to first be able to acknowledge that the temptation to deceive exists in that environment. Ask your peers if they have experienced imposter syndrome, inquire into the aspects of their thesis that they are struggling with, and share the same experiences with them.
Do the Work and Forgive the Work
Do what you can to keep up with the major tasks of your thesis, but remember that you may just be one of those people who believe that ‘it will never be enough.’ Try to forgive your imperfections, but always by acknowledging that you have tried hard (who knows what ‘best’ is) to achieve your task. Fighting impostorism can become a healthy part of doing your project if you do your best to avoid those anxieties by tackling those questions early in your work and then forgiving them later on. Remember that you have already achieved ample as an undergrad researcher.
4.08: Summary
This chapter on self-care attempted to tackle many of the key stress points of undergraduate research. We began by talking about time management, perhaps the most important determinant of stress throughout the thesis. We suggested that you keep a macro and micro model of your schedule, where the specific tasks can be easily interchanged to support your flexible schedule, and the macro tasks represent the vital deadlines which the specific tasks must still align with. We then discussed the importance of mindfulness not always as an escape from your obligations in the future, but as a potential feedback loop between your present stress and your future goals. Rather than provide you with a list of Mindfulness strategies, which you can find anywhere else, this chapter attempted to position the vital activity within the goals and stresses of research. Next, we discussed the key partnership of your research process – working with a supervisor. We advocated adjustment of your expectations to that of your supervisor, which means that the first task was to simply talk to them, thank them, and align your schedules and work habits. After discussing the supervisor relationship, we went on to discuss peer support. Peer support is another vital aspect of dealing with stress throughout your thesis, as peers (particularly those also struggling with thesis work) can often provide the emotional support that mentors do not have the time and energy to provide. Struggling through the same thing as you will also provide you and your peers an outlet to be sincere about the annoying, dull, and seemingly impossible aspects of research. This can provide you and others a more accurate conception of what is expected for undergraduate research, helping to stave off the egoism of research and the feeling of fraudulence.
In sum, acts of self-care are acts of healing. They are activities you do because they make you feel healthy. They mitigate the wear and tear of stress so that you continue to be active in the things you care about beyond yourself. We hope that you are able to use this chapter to combat the stresses of research, to develop an outlook that sees the strength in self-care, and cultivate a network which does the same.
4.09: Additional Resources
UBC Sociology Time Management Tips
https://ubcsociologyta.wordpress.com/module-1b-time-management/
Technologies to help with Time Management | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/04%3A_Researching_with_Self-Care/4.06%3A_Peer_Support.txt |
Learning Objectives
By the end of this chapter, you should be able to:
• Understand your genre’s common narrative techniques and concerns
• Be familiar with major considerations for concise and engaging writing
• Develop and apply a writing ritual that works for you
Suggested Timeline: A lifelong process
To provide elements of good writing more specific to the social sciences, we drew on writing advice from major genres within the social sciences and connected them to the basics of good research writing. Our aim was to compare, combine, and summarize key aspects of qualitative, quantitative, and theoretical analysis for an account of academic writing which is not insulated within the guidelines of a specific genre nor general to the point of obtuseness. Despite attention to specificity, the advice is still bound to be more general, so please refer to the works cited if a more authoritative discussion of writing conventions in your genre is desired.
We assumed, in writing this chapter, that you were familiar with the writing basics: such as outlining, introducing a thesis, applying points to that thesis, and summarizing your argument. Because we have already, throughout this manual, provided writing tips and direction on key sections of most academic works (Title & Abstract, Introduction, Methods, Results, Discussion and Conclusion) and will do so again with specific advice in subsequent chapters, we provided only limited discussion of research writing basics. Instead, we organized the chapter into three sections: first, begin with the basic components of all academic writing. Second, we provide a comparative review of writing advice in different social sciences fields, and finally, we finish with general maxims for effective writing. If more is desired on research writing basics, we suggest looking at this video by UBC learn or this fine overview by Leeds University.
5.02: The Basics
Before we take on some of the complexities of academic writing, it is important we build from the basics. Excited for the end-product but forgetful of the rudiments of academic writing, many ambitious undergrad writers forget the foundations of academic writing. Without these foundations, their writing constructs wonderful, temporary, castles in the sky. The following is a summary of six basics to begin your process of academic writing.
Before we explain why we write, let us revisit what academic writing is. The University of Leeds’ Library (2022) offers the following definition:
Academic Writing is clear, concise, focussed, structured and backed up by evidence. Its purpose is to aid the reader’s understanding. It has a formal tone and style, but it is not complex and does not require the use of long sentences and complicated vocabulary. Each subject discipline will have certain writing conventions, vocabulary and types of discourse.
Academic writing aims to convey complex information through a concise, formal, and clear filter so that it can be readily understood by its reader (clear) and understood in the same way as its author (distinct). As a consequence, academic writing tends to use a formal and organized style, using conventions such as the introduction, literature review, methods, findings, conclusion. Academic writing is highly specialized, so to be successful, you need to be able to anticipate what information your audience wants to hear (See Chapter 1 and Chapter 2), and how to convey it (the focus of this chapter). You can become proficienty by what and how other academics express themselves and what they express by consulting your course readings, journals and other publications. We comment on both in more details next.
Outlining – What Evidence will Express What I Want to Say?
Once you have figured out the basics of what you want to write, outlining is the practice of sketching out the main points and sub-points (or arguments) and the supporting evidence that will be provided. For academic writing, using the top-down process of having a larger point to guide your discussion is essential for writing. For example, if you have a thesis, “cultural representation of Canadian mounties achieves X through Y,” and your subsequent points should be outlined to demonstrate it. The phrase “This thesis is true because…” should be imagined before every point you write in the outline. This phrase should likewise guide new paragraphs and headers as well as to signal that the following section conforms to the argument. Consider using signal words such as ‘furthermore’, ‘in comparison’ etc to demonstrate coherence in your writing. Each signal word will show the reader the placement of the evidence in your sentence with respect to your own argument (is it contrary evidence, supporting, comparative?). For more signal words, check out Manchester UK’s academic phrasebank.
Table 5.1 - Leeds University Library's Four Ways to Add Evidence
Ways to Add Evidence Description
Paraphrasing Identify a relevant theme or point of view in someone else’s work and summarize it briefly. Reference the original author and attempt to construct their point of view as charitably as possible. Put it as much as possible in your words. Connect it to your argument using the signal words stated above.
Summarizing Provide an overview of the literature or of a participants point of view. Summarizing is like paraphrasing, but it does not refer to a specific statement in the text. Rather, summarizing tries to consider the ‘larger’ statements of the text. Use other types of evidence to back up your summaries.
Synthesizing Synthesizing combines many different ideas and arguments into your own. It is a type of motivated summary which connects sometimes unrelated ideas through an argument given by your paper. It can often involve citing many different authors under a category (e.g., these authors all argue against Uber’s labour conditions (Mich, 1999, James, 1888, Spiel, 2002). Be careful to clearly distinguish whose voice is whose in this sometimes messy move.
Quoting Use with caution! Quoting is the process of reproducing the author’s words exactly in your text. It should also be used with some commentary either before or after the quotation. Make sure that it also is always related back to the text. Avoid ‘floating quotes,’ quotations which do not have any clear connection to your argument. See our section on in-text and block quotation in the qualitative analysis chapter for more information on how to do this in interview research.
Source: University of Leeds Library. (2022). “Academic Writing.” How to incorporate evidence | Academic writing | Library | University of Leeds
Concision
Now that you have planned out what you want to say, you must also figure out how to express that point as efficiently as possible. This involves consideration of how much evidence is sufficient in justifying your point, what ways of expressing that point are formal, and avoidance of redundancies (reptitions or words that do not add value to the argument).
Rules regarding sufficiency will differ by genre, but in terms of organizing your idea, try not to overload a single paragraph with a multitude of arguments or supporting evidence. As Leeds University’s (2022) writing guide suggests, each paragraph should take on only one main idea. The main idea should be expressed quickly in the first sentence on the paragraph (hopefully related to the paragraphs prior to it), and then at least two pieces of evidence should be attached to that idea in order to give it significant weight.
When expressing your ideas, be careful to uphold the formal standards of the discipline that your writing is addressing. While these formalities may seem arbitrary (and sometimes they truly are), they are common conventions which help others in the field recognize which rules your writing is following. For academic writing, these formal standards tend to uphold formal conventions in English writing. Leeds University Library (2022), highlights the following faux pas:
• Do not use contractions (instead of didn’t, couldn’t, shouldn’t, say did not, could not or should not),
• Avoid slang, avoid cliches (instead of saying “can’t make an omelet without breaking a few eggs”, just concisely state your point in relation to the research question). It is important to note that while slangs and cliches are important to creative writing, they are less tolerated in academic discourse. Hence, instead of showing off your literary skills, it is best to directly make your point in the simplest language.
• Do not use colloquialisms (such as ‘fundamentally’, ‘the thing is’, ‘basically’). Again, just state your point without preamble.
In addition, formal writing tends to use a blend of active and passive voice (Leeds University, 2022). This means that you should use active voice when expressing the agency of an object or subject (“James sought to correct his ways”) and passive voice when expressing the affliction of the object or subject (“After a series of failures, it was inevitable that change was coming to James”).
Finally, your writing should cut out as much redundancy as possible. Here is a list of the usually useless phrases that should be removed:
• in the nature of
• it has been estimated that
• it seems that
• the point I am trying to make
• what I mean to say is
• it may be argued that
• With the possible exception of
• Due to the fact that
• For the purpose of
• for the most part
• for the purpose of
• in a manner of speaking
• in a very real sense
• in my opinion
• in the case of
• in the final analysis
• Except
• Because
• For
We are not saying that these phrases are always useless, only that they tend to be. Proceed at your discretion.
Tenses
There are also conventions for referring to past, present, and future events –the tense of your speech. Box 5.2.4.1, sourced in part from Leeds University’s Library (2022), provides a basic overview of where to use tenses followed by an example from our writing, which highlights the tenses used.
Box 5.1 – Past vs. Present Tense
Past Tense For MethodExcerpt from Waldsorth et al (2021, p. 138):
We created three dummy variables: host-national (Canadian), co-national (from the same country as the respondent), other international (from another country but not the host or the respondent’s home country). From the dummy variables, we constructed measures to determine the proportion of respondents’ friends (all ten friends) that are from the host-nation, from their own country, or from a different country.
Present Tense to Conclude and Discuss Established Knowledge
Excerpt from Hou, Shellenberg & Berry (2018):
Looking at the determinants of membership in each of the four profiles, we can separate those factors that existed pre-migration from those that arose post-migration. The reason for this separation is that there are differing implications of the findings, because more can be done to improve outcomes when dealing with post-migration factors than for those that existed prior to migration.
Recommendations into the future (for the discussion section)
Excerpt from Drisko (2005, p. 592):
Authors should make each major contribution of the study clear and explicit. Beyond linking the current work to the prior literature, the discussion may point out newly apparent definitional or conceptual limitations, illustrate the impact of context and population specific understandings, point out subjugated knowledge, or identify variation in processes unmentioned in the summative literature.
Execution
All of the previous sections seek to culminate into a position on the knowledge in your field. As there is almost never consensus on the knowledge in the field (there would be no need for research if there was), it is your task to evaluate the integrity of your opinion in relation to others. This is the key point of the execution of your argument: how effectively you are able to persuade the reader to your position. While these will depend on the entirety of your argument and style, there are a couple of important discursive moves which we can pay close attention to when thinking about how we are conveying our point: hedging, boosters, and reporting verbs (Leeds University’s Library, 2022).
Hedging refers to the boundary (hedges) we place around our argument (what it can and cannot speak for). It also often refers to the confidence in which we think our point represents a given experience. If we speak over confidently, or arrogantly about our point, other academics will doubt the legitimacy of our work. Academics work hard to argue and preserve their distinctions, so you would do well to respect their reasons (particularly when you seek to persuade them). With that said, here are some good hedging phrases for qualifying assertions that you doubt:
• It is likely…”
• “It is unlikely…”
• “To the best of my understanding…”
• “This suggests…”
• “It is possible that…”
• “Perhaps…”
• “A possible explanation…”
• “Usually…”
While hedging is an important rhetorical move in communicating the fallibility of your findings (Hyland, 2001), it is also easy to go overboard with hedging and babble something so ambivalent it expresses nothing resolute or significant. For example, a statement such as “it is possible that the ego functions as a complex upon other egos, or perhaps it is the superego that achieves this end” will create doubts in the mind of your readers about the significance of your work. Hence, hedging can sometimes sometimes be a sign of cowardice, not subtlety. Take courage in asserting what you believe to be the case. While perhaps imperfect, leave some work for your reader to evaluate the strength of your assertions. (Indeed, integral to writing this manual was our belief in the value of our advice and your capacity to judge it for yourself).
To express this confidence, you can use boosters. Boosters are the opposite of hedging, they express your conviction about the truth of the statement. We strongly believe that you will be convinced by the following examples:
• “Certainly…”
• “There is definitely a connection between…”
• “There is a strong correlation…”
• “The results indicate…”
As implied before, however, boosters should be used carefully. There is nothing wrong with just stating your assertion flat out. As soon as you cover it with an assertion with hedges and boosters, you invite your reader to further test the confidence of your assertions. We suggest using both sparingly, as your assertion should speak for itself. Try to only use hedges and boosters when expanding and contracting the boundary of your claim, not to defend your statement (either by cowering or puffing out its chest) against the judgment of your reader.
Reporting verbs are another important way to represent your stance on the issue and also represent a form of hedging and bolstering. For instance, a reporting verb like “Robinson (2020) argues” represents a strong position on behalf of Robinson. These reporting verbs should thus be supported by the text (i.e., are you transparently reporting or exaggerating the position of other authors).
In summary, academic writing begins with some information or idea that it believes is important for other academics to understand. To make its point, it carefully chooses the evidence it wants to support, plans how to organize that evidence into a coherent pattern, chooses concise and formal language to express that evidence, and carefully considers the time in which that evidence or procedure took place (tenses). Having achieved this all brilliantly, it then considers to what degree its point has been made: can I express with complete conviction that “Uber is popular because of their contract labour and cheap prices”? “Should I bolster this claim and hedge the other?” This final execution of your point will determine whether you have gone too far, too short, or settled the argument perfectly. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/05%3A_Academic_Writing/5.01%3A_Introduction-_Effective_Academic_Writing.txt |
You hear it proclaimed everywhere in writing manuals, “know your audience.” But what does this mean? It is certainly as complex, and perhaps deeply related to, the Greek proverb “know thyself.” Even knowing that only your professor is going to read your paper, you still need to consider: how much access do I have to the variety of beliefs that inform their judgment? There are the general “no no’s” we have learned from our teachers over the years – an authoritative audience who communicated their preferences with dashes and checkmarks, teaching us proper grammar and spelling, to remove passive voice, vague phrases, and unsupported assertions etc. Then there are the more subtle values which gain in prominence as we climb each rung of the education ladder: the conventions of your field, fulfilling a gap in that field, your professor’s knowledgeability regarding common terms in that field. This leads us to step out further, considering the other works for which your professor is the audience and the performer: the current trends in their field, seminal works, the valid research methods and assumptions which set the groundwork for inquiries related to their own work. The consumingly social “know thy audience” begins to rear its hydra heads in every aspect of our writing process. Our audience has an audience as well, and it is in this community of watching, relating, confirming, and denying that we attempt to speak in a way that will be persuasive to those audiences. In nervous self-consciousness, in feeling a will to somehow satisfy all those audience members that sit in the theater of our judgment, we write to persuade a group of what we want (an A+, proof of concept, social change) by appealing to what they want.
It is with these considerations in mind that leading academic composition researcher John Swales has highlighted the centrality of genre for academic writing. For Swales, “genres are [the] communicative vehicles for the achievement of goals” (1990, p. 46), the agreed upon forms (the how’s) that a community believes best achieves their goals (the what’s). They are the linguistic means to a community’s given ends. In the social sciences, the genre changes by the common goals of a discipline or subdiscipline: where the social phenomenologist may seek to explain social behaviour through interpretation (connection of the particular and general context), and the positivist sociologist attempts to reduce that behaviour to a common, functional act that is corroborated by other contexts. This results in communities of scholars who develop different methods, terms, and outlooks in learning and responding to their topic. When we “address” these scholars, we should appeal to the common goals and history which underpins their discourse, even when we seek to “redress” those very ends. It is with “know thy audience” in mind that we have decided not to only provide you a set of writing tips in general, but to direct your attention to some major communicative vehicles and purposes that validate good social science writing.
Picking the Right Genre
But before learning the subtle styles of your genre, you first have to be certain of having picked the right genre (El-Masri & Wasylyshyn, 2018). Think of the genre as the larger environmental milieu which your work intends to thrive (or survive) in. If you are attempting to get your research published, then it is important that you find the right journal for your work. Seek out a journal that highlights the same methodology (qualitative, quantitative) or topic (economic sociology) and read their guidelines. The guidelines will provide you the basic rules and word limit for their publications, but not the subtle cues involved with the style of writing they expect. Looking at other publications in the journal will help you there; but lacking a step-by-step explanation of their writing intentions, junior researchers often miss some key cues. That is where further reading into the rules of the genre can come in handy. We will attempt to highlight some while also offering references for further reading. Refer to Chapter 13 (Publishing Your Research) for more details about this process.
Table 5.2 - Summarizing Genre Conventions
Genre Key Emphases Example Journals
Quantitative Methods
Only Report Findings in Findings Section
Be careful when generalizing
Social Science Research
Social Science Research - Journal - Elsevier
Qualitative Goal is thick description
Thoughtful commentary on data throughout
Thematize data into engaging narrative
Qualitative Sociology
Qualitative Sociology | Home (springer.com)
Theoretical All based around arguing the value of a theory
Helps explain major problems in the field (both academic and practical)
Avoids baseless generalization and by carefully justifying and defining its concepts
Sociological Theory
Sociological Theory: SAGE Journals (sagepub.com)
Quantitative Writing
This section begins by drawing on some guidelines offered by Maher El-Masri and Susan Fox-Waslyshyn (2018) -both seasoned academic editors and reviewers. Each has been responsible for many acceptances and rejections of quantitative articles received for publication, and have offered the following insights to help writers succeed:
• For quantitative articles, the methods section is usually the key grounds of contestation. That is because quantitative works emphasize establishing replicable, common facts that can be found by another researcher using the same procedure. Hence, the facts you discover hinges on the integrity of your procedure. This means that your writing must be clear and thorough in this section, able to quickly enunciate abstract procedures and situate them in the context of your study. El-Masri and Fox-Waslyshyn (2018) unpack this with a long set of solid recommendations, we suggest looking at the link in the bibliography for more.
• Unlike qualitative and interpretive research, the results section of quantitative research aims to present findings without any discussion or explanation (Pierson, 2004; El-Masri & Fox-Waslyshyn, 2018). This likewise implies that the presentation of findings ought to be as concise and straightforward as possible. At this point, you have already unpacked your procedures and hypotheses, so merely begin by stating a description of the sample characteristics before providing the findings. Any reporting of findings unrelated to your research question and hypotheses is discouraged (El-Masri & Fox-Wasylyshyn, 2018).
What this all hints at is elaborated in Fallon’s (2016) book on quantitative research writing in the social sciences: “quantitative research is a ‘top-down’ process” (p. 3). This top-down conceptualization is a vital difference between quantitative research, qualitative and interpretive research. This is especially important in the data analysis section, where you must efficiently communicate the findings and the methods used for them. The better you have clarified the constructs used in your methods (such as Pearson’s R), the clearer the plausibility and significance of your findings.
Top-down means that you begin writing by stating hypotheses and the constructs used to evaluate those hypotheses before gradually moving to the findings (the bottom of Fallon’s abstract knowledge pyramid) (Fallon, 2016, p. 15). It suggests the drive in quantitative research of connecting particular findings to a general theory by way of a methodological theory. Writing quantitative research therefore follows the order of deductive reasoning: it elaborates a theory and a set of hypotheses, then counts findings that validate or invalidate the general theory (top-down/theory-finding). Articulate this narrative to increase the persuasive force of your quantitative writing. Take a generalization or theory that is important to the field, clarify a population and method capable of evaluating its validity, then prove or deny the validity of that theory through your findings. By sharing a common methodology and topic area, quantitative disciplines will scrutinize the clarity of your deductive reasoning. It is your goal to surpass this scrutiny by moving from an appropriate theory to topic to method to findings back to theory.
Once the methodological apparatus is properly conveyed, then your data analysis should clearly follow. Unlike qualitative analysis, where interpretation and analysis of the findings can take place extensively (since a strict deductive logic system has not been established), it is more common in quantitative writing to be quick and concise in your findings. According to Fallon (2016), the findings section has three rhetorical goals:
1. Describe the data
2. Figure out if the variables you studied are related to the population
3. Determine if the relationship between your variable and your population is significant
Your writing should attempt to quickly offer descriptions of your data, determine if those variables are related to the population, and then determine if that relationship is significant (through a test of statistical significance that matches your study). The faster you are able to relate large swathes of data to your hypothesis the better.
As the findings section aims to be sparse, it is the discussion section where the key persuasive movement of your paper will be made: it is where you connect your findings back to the treasured theories of your discipline. But alas, the discussion is often the weakest component of the research manuscript (Perneger & Hudelson, 2004). In quantitative research, this will undermine much of the meaning of your research. El-Masri and Fox-Waslyshyn (2018) suggest that this is often because quantitative researchers are prone to overgeneralizations that are not supported by the findings. Yet, on the other hand, making generalizations is a key component of quantitative and formal methodologies in order to gauge their significance. As a consequence, quantitative researchers must find a middle-ground between humility and hubris, which is determined by close attention to the appropriate generalizability of your findings. While this will differ by the research, El-Masri and Fox-Waslyshyn (2018) suggest beginning with a clear outline of your differences from other studies and limitations. From this point, the plausibility and value of your “take home-message” (El-Masri & Fox-Waslyshyn, 2018; p. 108) will shine forth more clearly.
Qualitative Writing
Unlike quantitative writing, qualitative writing must describe social life through its qualities. This means that the qualitative writer be attentive to the variety of words formed to describe not the endless quantity of experience, but its endless distinctions. While this applies to the quantitative writers too, we highly encourage qualitative and interpretive researchers to read literature. There you will find a wealth of writers interested in “qualitative” description to make a powerful effect upon their reader. Your task is different, it deals with direct representation, not metaphor or fantasy, but many of the same tools can be applied (Jackson, 2017).
Qualitative writing moves from selected observations, analysis, themes, text discussion to the final goal of thick description (Holliday, 2012). Thick descriptions are details of the contexts of behaviours and actions as interpreted by actors so that outsiders can have a better understanding of them (Holliday, 2007). It takes fragments of a messy reality to stand in for a larger argument. Rather than just cite all the observations at random, it imposes order on the complexity of daily social life and cultivates it into a unified image (Holliday, 2007). Your hunches, values, and sincerity are not excluded from this process, but rather should inspire the fragments you take to be meaningful and ‘more’ complete (Holliday, 2013). It not only aligns a complex network of data around your argument, but seeks to achieve an articulation, a thick description, of this network (Holliday, 2013, p. 13).
A common pitfall of undergraduate qualitative writers is to merely list your data with limited commentary or thoughtful coordination. For Holliday (2013), this difficulty is worsened through the student’s cultivated passivity (one-sided lectures, reading, reiterating information), inculcating a belief that research is merely the imitation of fact. “To get over this difficulty,” Holliday suggests, “the researcher first needs to appreciate that her data is already different to the social reality it is taken from. She cannot pretend that it is a raw, true representation” (2013, p. 4). This means that when we selected Holliday’s (2013) quote, we were already performing a manipulation. We have stripped data from the context of his argument, placed it to fit a point for this manual. It is not selected at random, but according to a judgment formed by us. It is your job as a qualitative researcher to articulate the reasons behind your judgment, and if they do not exist, to make sure they do. Each quotation should be selected for the purpose of your argument, allowing the data to coordinate itself around a ‘representation’ which you have indeed partially fabricated, but for the purpose of communicating your view of a complex social situation. Thus, as Holliday (2013, p. 5) points out, the commentary around your data must always nimbly answer your readers question: “what is the point?”
It is the ‘point’ of your representation which will motivate the thematization of your data. The point goes back to our chapter on the research question: what is the gap that you want to fulfill? What is the meaningful question that you have asked, and how does this data answer that question? While this research question may be met by data that surprises your assumptions with new and interesting complications, the data you finally present in the paper must always adroitly answer your (interesting, evidential, and operational) research question. With this in mind, it is also vital that this ‘point’ complements and not betrays fidelity to the data (Jackson, 2017). The reader has come to you as a researcher out of trust for your accurate representation of reality, and thus the point of any academic genre comprises respect and integrity in representing the data accurately. Without strict methodology, your method for selecting data may appear arbitrary (without articulation of their purpose, methods-heavy papers also commit this folly), so it is even more important that you remain straightforward about: (1) the limitations of your data, and (2) the reasoning for selecting the final data that you did (why are most of your observations being left ‘back-stage’?).
After you have carefully analyzed your data and derived a coherent and interesting point (see Chapter 9), then it is time to consider the right balance between evidence and argument. A great qualitative researcher will be able to represent their data so vividly that narrative will be developed without the logical straightjacket of argument (hence, therefore, subsequently etc.). If the ‘point’ of your data exists clearly in your descriptions and sparse unpacking of that data, the reader will gain a sense of their connection without noticing you ‘forcing’ the argument crudely. On the other hand, if the point of the connection between your data is recluse, the reader may grow suspicious of their connection. Your job as a qualitative writer will then be to subtly show the themes that emerged from your data without extensive analysis. There is always a delicate balance between what is explicit and implicit to communication. This balance is especially important for qualitative writing, where data fragments are presented to make a theme explicit and other data fragments are neglected either because the point is considered not important enough or implied (Holliday, 2013).
Notice how unlike the quantitative writer, whose findings seek to confirm the presence of a predefined variable, the qualitative writer tends to present their findings as a narrative. What the qualitative writer is concerned with is the emergence of themes that draw together a set of descriptions about social life (Holliday, 2007). The quantitative writer, on the other hand, has already deduced these themes through the operationalization of quantitative variables. Thus, in your qualitative research, writing of your findings section can take on a larger narrative, showing a connection of events that you discern important to describing the phenomenon at hand.
Theoretical Writing
The final type of writing we overview is wielded by all the social science genres. Theory is perhaps the most daunting and important of the discursive purposes in the sciences. It involves the strange act of looping the causes and consequences of particular situated evidence into a summative statement: a narrative which is sophisticated and generalizable to many different contexts, and able to effectively unify various particular situations under a robust concept. Due to the ambition of this task, it inherently falls prone to conceit as researchers exaggerate the importance of their findings and absolve the distinctions between many concrete experiences under a single reductive label. Such statements as ‘Foucault is a post-modernist’ or ‘the present day economy is neoliberal’ can easily indicate to us that theory is often used stereotypically: as a commonly used, shallow narrative, that is easily generalized and more useful in conversation than in understanding. While terms like ‘neoliberal’ may have begun as a helpful insight to explain a particular trend towards economic rationalism and the shrinking power of the state, their wide application and misuse often leads to the dilution of the term, turning them into terms that are issued mindlessly, explaining everything and nothing in one lazy utterance.
But these criticisms, afterall, are only directed to the theories that are not doing their work. Many theories perform vital tasks within the social sciences, either helping us to explain or discover the reality of a phenomenon by pointing us in the right direction. This direction may not (and likely does not) perfectly describe what it is pointing at, but they are important because new theories begin with the authority of the old, and much theoretical work has to do with amending the meaning of theories (like neoliberal) in order to make them more useful. Every theoretical researcher, whether they are inventing a brand new theory or amending an old one with new evidence, therefore engages in a collaborative practice of developing the most useful theory for our current context. By useful we understand theory that is able to:
1. Be accurate: is a useful tool for helping us to think about many contexts in a way that allows us to comprehend their complexity (we say this in the heuristic, not representative sense).
2. Be relevant: help to make the theory easier to use in both academia and beyond for responding to important social issues.
3. Be pedagogical: Simplify the theory (while maintaining its robustness) to expand its usage.
It is important to note that good theoretical research does not need to conform to all three; but while your focus may be on only one aspect of this three, it is good to keep all components in mind (a good theory tends to be effective at representing what it discusses, relevant to the people it is communicating to, and clear enough to have its significance readily understood).
Box 5.2 – Student Testimonial – Organizing a Theoretical Thesis
Organizing a theoretical thesis differs from a thesis that includes hypotheses, sampling, methodology, etc. First you need a brief outline of your thesis, which typically consists of an introduction, literature review, analysis and conclusion. Second, you need a more detailed outline of your thesis which should include all the key content, points, data, and references that you want to include in your thesis. I made both, and without them, I believe that I would’ve lost my train of thought and will fail to competently convey my arguments to my readers. Thus, the writer must create the flow (the skeleton) prior to the actual writing (the meat). To have a full skeleton of an outline would mean that the data, literature (review), and the argument must all be carefully thought through. This was important in helping me to formulate my thesis statement, which I used as an analytical tool throughout the entire paper. As you can see in my outline, I had already begun citing my references. While I am unable to show my full outline (more than 6 pages), I have included the brief outline below. An important thing to ensure is that you identify the sources in your outline. I would also suggest highlighting key concepts from your literature. These should be included in your detailed outline as well.
As for the actual flow and argument of the thesis, I must have spent at least 80 hours of debate and conversation with other sociologists and professors to concretize my thesis and to be sure that it flowed and connected. I often recorded those discussions (with the consent of all present parties) so that I could refer them to my thesis later on. That process was crucial to my work as it cut out a lot of unnecessary literature, data, and arguments that were irrelevant to my main argument. I recognized that many ideas and data work well in my head and thinking, but when brought into a dialogue with other sociologists (competent ones), my weak data and arguments crumble considerably quickly.
Finding relevant literature is considerably difficult. As you are not creating/collecting your own data, much of the data must be gathered from pre-existing literature. Do not get discouraged in searching for relevant literature. I myself had gone through around 300 research articles and at least 10 books to find the relevant data points. An extremely useful method is to simply ask all the professors in the faculty if they know any relevant data or researchers that specialize in what your thesis is on.
Below is a brief outline of my thesis:
• Chapter 1: Introduction
• Chapter 2: Literature Review
• Culture & Remembering
• Identity, Perceptions and Goal Orientation in Society
• Homo-Duplex and Moral Capital
• Chapter 3: Multi-Frame Analytical Positioning Approach (MAPA)
• MAPA in Context
• Moral Racial Casting
• Moral Manicheism
• MAPA: Alternative to Identitarian Social Theory
• The Human Frame of Analyses
• The individual Frame of Analysis
• A Common underlying Meta-narrative for Multicultural Societies
• Chapter 4: Conclusion
• Limitations of MAPA
• Future Directions
• References
David Cho, UBC Sociology Honours Student, 2020/2021 | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/05%3A_Academic_Writing/5.03%3A_Many_Genres_Many_Masters.txt |
A scrupulous writer, in every sentence that he writes, will ask himself at least four questions, thus: What am I trying to say? What words will express it? What image or idiom will make it clearer? Is this image fresh enough to have an effect? And he will probably ask himself two more: Could I put it more shortly? Have I said anything that is avoidably ugly? – George Orwell, Politics and the English Language
What are you Trying to Say?
Research writing is motivated by what you seek to bring across the goal line of your reader’s mind. The whole point of academic writing is to share what you already know to others who do not. Your goal should be to translate as best as possible the image in your mind into a form which will convey the same in others. The “what” or “content” of your writing should serve to coordinate all your writing; and, as is the purpose of the research phase, this content ought to be strictly clarified before you begin writing to avoid digressions and distractions (which signify concealment of the ‘what’; perhaps because there is very little ‘so what’ to begin with). This means that you do not dabble in unnecessary ambiguity. If it can be said simply, without any level of ‘generality,’ then say it as such. You should aim to leave your reader with a clear impression of what they have gained from reading your article. And if you must deal in ambiguity (since you describe something complex), be honest about that which you do not know.
Formulaic does not Always Mean Clear
Writing consists of an endless variety of linguistic tools which have been crafted to communicate an endless variety of perceptions. It is tempting to limit and connect these endless options with the standard pretenders: thus, therefore, subsequently, consequently, with regard to, concordantly, henceforth ad infinitum. These are all fine and good when used to enunciate the placement of a point in your argument (i.e. that point a hence means point b). But if your point is itself evident in its orientation, then the repetition of the orientalia is not necessary (just say: point A period. Point B). Please spare your reader this repetition and simply go straight into your point without (henceforth) forcing a potentially artificial logical connection.
Transparency is Akin with Simplicity
Do not use words you do not fully understand. The purpose of good academic writing is to make the complex, intelligible. Weave your stories with a nauseating amount of qualifiers and your reader will lose sight of the object in the endless strings you attach to it. Heavily use of loaded jargon such as “institutional isomorphism” and your writing will similarly bemuse the uninitiated. Always begin using complex terms with a concise definition and, if possible, shove your complex information through familiar (but not overused) turns of phrase and analogies, i.e. instead of “isomorphism,” try “tendency for institutions to conform with one another.” Do not, however, use this as a replacement for words invented to describe the nuance of a complicated situation. Communicating nuance likewise requires nuance in the communication tools themselves. But do aim to relate nuance and sophisticated statements (like “isomorphism”) to more readily understood analogies or language wherever possible (e.g., “institutions are like bodies of water, when joined they seek to rise to the same level”).
Parallelism
While you should still remain wary of being too formulaic, parallels in your speech can often aid your readers ability to remember what you are saying (hence the epic poem tradition prior to writing). Particularly when crafting lists, use consistent structures and tenses to achieve a straightforward rhythm. Use parallelism selectively, however, too much consistency can create homogeneity. Below is an example of parallel and unparallel writing:
Not Parallel
This research follows four distinct phases: (1) establishing measurement instruments (2) pattern measurement (3) developing interventions and (4) the dissemination of successful interventions to other settings and institutions.
Parallel
This research follows four distinct phases: (1) establishing measurement instruments (2) measuring patterns (3) developing interventions and (4) disseminating successful interventions to other settings and institutions.
Variety is the Vitality of Language
Suppose all words were of the same length and rhythm, if speech were truly monotone repetition. If this were true, our language would be useless since separate meanings would be unable to designate something unique. The heart of communication is drama: that the variety of your speech and argument is constantly distinguishing something new, thus showing itself as animated, thoughtful, and lucid writing worth the pursuit of your readers’ eyes. This rule applies to the variety of rhythm, sentences, words, and content (Narayan, 2012). Be wary, however, of having more variety in your speech than in the thought behind it: that is melodrama.
Learn from the Mistakes of Others
Find a writer who annoys or bores you (even if it is us). Pay attention to failures in their writing and make a note not to do the same.
Do not Over-Cite or Rely on Quotations
Citing is important, both to the vocation of social science generally and your understanding specifically. But as we have discussed in the literature review section, it is imperative that you show your reader that you are also present alongside other thinkers. This means that you need sections in which your argument stands alone without the leading strings of other authorities. The same can be said for your voice when writing, ensuring that it is not mere imitation or direct quotation, but is capable of demonstrating a unique judgment.
You also do not want to over-rely on quotations to make your point. For qualitative evidence, careful use of block quotations is important, so long as those quotes are also carefully analyzed. These quotations, however, have little place in the literature review.
Rewriting and Revision
In addition to the other revision tips stated, consider completely rewriting important sections of your paper without replicating the first draft. We know… how tedious! However, rewriting after a first draft can help articulate the point more cleanly and notice what was not working in the prior draft. It also will provide you a point of comparison for which to reflect on your first draft.
Box 5.3 – Revising Your Manuscript
• Have I clearly expressed what I wanted to say?
• Am I asserting my voice?
• Am I making claims that are difficult to substantiate?
• Are there dead-weights in my sentence structures
• Are my sentences used in the negative?
• Am I using the passive voice too much?
• Are my sentences expressed in the simplest way possible?
• Do I need to split a sentence into two to make it clearer?
• Is the “to be” verb making my structures too complex?
• Am I using parallels in my sentence structures?
• Have I said something avoidably ugly?
• Is my writing too formulaic?
• Have I repeated myself unnecessarily? | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/05%3A_Academic_Writing/5.04%3A_Eight_More_Tips_For_Every_Analysis.txt |
After outlining the basics of academic writing, we highlighted the importance of genre in social science writing. There are a lot of different audiences out there, and it is your job to figure out which you can and want to write for. Afterwards, we provided a brief overview of key writing advice for different genres in the social sciences: quantitative, qualitative, and theoretical. This overview was followed by a list of helpful writing tips for each genre and a checklist to keep these tips in mind as you are revising.
None of these sections approach a comprehensive treatment of academic writing. They are written as snapshots of good academic writing practices and intend to guide you towards further academic writing books specific to your genre. We hope, for that reason, that you consider looking into the suggested readings. They are organized by genre and are excellent academic writing handbooks for each.
5.06: Additional Resources
Online Resources
1. UBC Learn. Writing. YouTube. Writing – YouTube
2. University of Leeds Library. Academic Writing. How to incorporate evidence | Academic writing | Library | University of Leeds
Ethnography
1. Narayan, K., & Ebooks Corporation. (2012). Alive in the writing: Crafting ethnography in the company of Chekhov. University of Chicago Press.
This book about ethnographic writing beautifully combines the tradition of Russian realism and ethnographic writing. Narayan emphasizes the vitality (and risks) of literary techniques in ethnographic writing, offering a range of basic principles (about passive/active voice, use of background, effective and ineffective allusion) that the beginner ethnographer can begin with.
2. Brodkey, L. (1987). Writing ethnographic narratives. Written Communication, 4(1), 25-50. https://doi.org/10.1177/0741088387004001002
Brodkey studies the divide between interpretive (experimental) and traditional (analytical) ethnographic writing, arguing that the ethnographic researcher should not gloss over epistemic crises within the social sciences but offer an answer to the question: is the researcher or research method telling the story? Brodkey argues that in ethnographic writing experience cannot be reproduced in writing, but must be narrated, forcing the researcher to abdicate the safety of being a literal translator of reality, and accept the risks and possibilities incumbent with being a story-teller.
3. Jackson, M. (2017). “Chapter 2: Writing With Care” In Pandian, A., McLean, S. (ed.), Crumpled paper boat: Experiments in ethnographic writing. Duke University Press
Jackson is brilliantly self-conscious of his work (his “anxiety to method” is a classic introduction to writing ethnographies). In this chapter, Jackson addresses the importance of ethnographic writing which is sensitive to the people it is writing about. Good ethnographic writing in Jackson’s view, must try to effect description of its subject without diminishment (excessive and unfair simplification).
Qualitative
1. Holliday, A. (2007). Doing and writing qualitative research (2nd ed.). SAGE.
A classic handbook designed by Holliday for conducting and writing about qualitative research. Holliday argues for a balance between evidence (data extracts) and argument (commentary on the extracts and articulation of the overall meaning) to create thick descriptions. In addition to insights about the basics of qualitative research, there are also plenty of examples provided.
Quantitative
1. El-Masri, M. M., & Fox-Wasylyshyn, S. (2018). Writing for quantitative research publication: A brief outline. Canadian Journal of Nursing Research, 50(3), 107-109. https://doi.org/10.1177/0844562118769202
This article offers bullet point suggestions about key things to consider when writing quantitative research publication. The suggestions are divided by section (Introduction, Methods, Literature Review, Discussion, Conclusion) and offer a clean list for you to consider in the revision stage of your research.
2. Fallon, M. (2016). Writing up quantitative research in the social and behavioral sciences. Sense Publisher.
This book is a more extensive (and engaging) account of writing quantitative research. The first chapters deal in the presentation of statistics before moving on to offer general points about writing practices and rituals. As a social psychologist, Fallon offers well-researched points about the effectiveness of certain mindsets and writing activities over others. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/05%3A_Academic_Writing/5.05%3A_Summary.txt |
Learning Objectives
By the end of this chapter, you should be able to:
• Understand the basic components and types of literature reviews
• Be able to identify gaps in the scholarship and write your review to clearly indicate how your research fulfills them
• Enhance skills in conducting searches, reading articles and taking notes
• Develop strategies for effective referencing
Suggested Timeline: Have a ‘decent’ draft by December
The literature review is that section of your thesis that provides an analytical summary of published materials relating to your research question. It categorizes, compares and evaluates the findings of key works in the field. The review points out strengths and weaknesses in this existing research to establish a context and need for new research (KSU Writing Center, 2021).
This might seem straightforward but the literature review can be either the most daunting task of undergraduate research or it can be surprisingly fun. Daunting, because it supposes the valuable but painful endeavour of seeing how your limited work-in-progress will compare to the seemingly unending run of expansive final products in peer-reviewed journals. Besides being a gobsmacking amount of information to summarize, reading papers which are often meticulously written, researched, and edited by experts in the field can produce a rousing feeling of impossibility at completing one’s research to a similar degree. Simply put, an amateur belting Mariah Carey’s “Always Be My Baby” at a karaoke bar would tend to have their confidence shaken if asked to compare their ‘cover’ against Carey’s. One might think of the literature review similarly, as it asks new researchers to consider where their work can exist alongside a pantheon of experienced minds and passionate contributions. Naturally, it can be hard to see how one can contribute. This chapter is aimed at helping you to build the confidence to confront what might seem to be a daunting challenge.
On the fun side, Greetham (2019) likens the searching process to a treasure hunt. Doing a literature review entails hunting through books, chapters, articles, conference papers, websites dissertation, new sites or any place else that contains information relating to your topic (Gretham, 2019, p. 92). The mere task of skimming through titles, abstracts and content can inspire ideas on how you will do your own research. The materials you source provide ideas on methods, arguments, and analytical strategies, which can be useful to your own project. Hence, the literature review can be the most clarifying part of the research process.
Greetham (2019) suggests that, apart from treasure hunting, the literature review entails mapping out the territory. The mapping exercise entails systematically taking stock of and recording the following:
• Current issues
• Methods
• How researchers analyze, synthesize and evaluate data
• Gathering up-to-date references,
• Consulting classic texts and
• Documenting sources (Greetham, 2019, p. 93).
As an undergraduate reading this, you might be thinking about the literature review with a feeling of dread, not adventure. However, keeping sight of the end goal is useful. You are designing research to make a contribution to the field, and the literature review helps you develop your own contribution through honest comparison to what has been said before. If conducted efficiently, you will come out of the literature review process with a host of similar studies that can provide you with concepts, methods, and gaps in which to structure your own work. Though a steep climb in the beginning, a good literature review can reinforce your confidence and objectives in conducting research. This will allow you to be more confident when your findings are unique and more clear about the research and writing conventions of your discipline. Before that, however, it is necessary to demystify the tasks involved in conducting this pivotal step of research. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/06%3A_The_Literature_Review/6.01%3A_Introduction-_Literature_Reviews_Daunting_but_Clarifying.txt |
When someone asks you to “consult the literature” on a given topic, they are asking you to find and reference what has been said by scholars on the issue (Ravei & Harper, 2020). This can be effectively used to establish background knowledge on almost any topic, but in research this consultation must go a step further. A literature review not only provides an overview of what has been said on the topic of inquiry, but also critically examines what has been said for its ambiguities, faults, and holes (all termed as the “gaps” in the literature). As mentioned in Chapter 1, gaps in the literature are instances where there is scope for further research either because data is missing, under-explored or out-dated. This could mean that a population or sub-population has not been researched or a theory, method or specific analytical strategy has not been applied. In pointing out what is missing and what is contested, you find out where you can add to the literature. Your contribution could be to clarify important confusions through adding a key dimension of the topic that has been missed, or nuancing a theory with supporting and/or contradictory evidence (Pautausso, 2013). Throughout the literature review process, your judgment on what is important will guide you to a concise and forceful account of the literature which informs your study, so be careful to cultivate your own preferences and opinion with regard to the literature you read.
Components of the Literature Review
Literature reviews have three basic components: introduction, body and conclusion:
1. Introduction or background information section. This is a summary of key themes, organization and issues that will be addressed relative to the research question. It is also advisable to include a thesis statement in your literature review. Remember that a good thesis statement offers a position on an issue, i.e., your central ideas or arguments (often one that contests or defends an existing argument or advances new ideas with supporting evidence). Note that this is different from a summary or an outline of the chapter. See https://wiki.ubc.ca/images/4/4a/Thesis_Statements.pdf for tips and examples of how to write thesis statements.
2. The body of the review, which is arranged according to one of the strategies above, and provides detailed discussion of the sources. It is important to note that you are not just listing sources, but you adopt an analytical voice (see Chapter 5) and you are synthesizing ideas. Your readers should be able to see the connection between your literature and your research question as well as how your ideas fit within the wider discussion.
3. Conclusions/Recommendations: You need to finish the literature review by highlighting what conclusion can be drawn from your discussion so far, reiterate the gaps and position the rest of the thesis to help address the gaps. You should also make recommendations on where future studies could go, if you are not attempting to close the gaps.
Types of and Strategies for Structuring Literature Reviews
As mentioned in Chapter 1, there are two broad categories of dissertations: empirical and theoretical. Empirical studies entails systematically observing social phenomena and or measuring constructs to demonstrate relationships among variables (e.g. what are immigrants’ perceptions about political correctness and its impacts on their integration in host societies?). A theoretical study, on the other hand, is based on testing, exploring or developing arguments or theories, and it generally involves observation or the compilation of information (e.g., does a transnational theory of immigration offer a better explanation of the impact of political correctness on immigrant integration than critical theory?). Most undergraduate students in the social sciences will develop empirical research questions (strategy based on the systematic observation of phenomena). The literature reviews informed by these questions tend to focus on existing findings (empirical observations) and identifying theories to explain those observations.
Theoretical theses are focused on the selection of social artifacts, ideas, theories and other secondary data to make an argument or to critique, expand, evaluate, compare or make applications of a theory(ies).
The kind of research question (empirical or theoretical) that you are investigating will influence the way that you structure your thesis. The University of Alabama’ Library (2019) catalogues the following strategies for structuring literature reviews:
• Systematic Review: Most empirical literature reviews follow this format, wherein, the writing is structured with an overview of existing evidence (findings) as they relate to your research question. In essence, they draw on previously published empirical observations, noting their methods, findings and analyses. These reviews aim to identify clear relationships between the variables of interest. This means that the literature review is often structured around themes and variables. An example of this is thematic reviews, which are organized around a topic, trends or issue or even the progression of time (if that is a theme in the study) (University of Alabama, 2019).
• Argumentative Reviews, wherein the literature is selectively examined with the goal of supporting or refuting an argument, deeply embedded assumption or a “philosophical problem already established in the literature.” These kinds of literature reviews aim to establish a body of literature that contradicts existing viewpoints. Care must be taken to show the merits of both sides of the arguments. While theoretical theses primarily structure their literature reviews in this way, aspects of empirical literature reviews can be structured around specific arguments. The important thing is to establish a voice and clearly demonstrate how the discussion fits with your thesis and the contribution you are hoping to make.
• Theoretical Reviews aim to comprehensively examine a theory and the work, concepts, phenomena that it has inspired. These literature reviews are focused on evaluating existing theories with the goal of developing new hypotheses to be tested. These reviews might reveal that existing theories are inadequate for analyzing new or emerging social problems. This is a more difficult undertaking for undergraduate students, but there is enough merit in comparing existing theories and their applications to a social problem as a project.
• Chronological or Historical Reviews are useful when trying to show how the literature has evolved over time. For example, one might start with older theories or research and discuss how they have been refined and developed overtime. Alternatively, you could write about the materials according to when they were published. This is useful if there is a clear chronological order in development of the scholarship on the issue. These reviews often start with the origin of an “issue, concept, theory, or phenomena in the literature, then tracing its evolution within the scholarship of a discipline” (University of Alabama, 2019). This is important in showing the likely direction of the field.
• Methodological Reviews focus primarily on how phenomena have been studied (methodologies) not on the findings themselves. Usually, the goal is to develop new methods or refine existing ones. It is unlikely that this will be your goal in an undergraduate thesis but you may still organize your literature review methodology. For example, if a phenomena has been studied using a variety of methods, you may wish to compare the methodological impacts of the findings. Such an approach could be useful in justifying your own methodological choice.
There is no need to commit immediately to one strategy for organizing your literature review. As you gather the literature, you should be able to discern how best to present them. Bear in mind that you can use a mixture of approaches e.g., you could start out chronologically then arrange the findings by themes or by findings. The key to note is that there are no strict rules here, you can be creative, provided it is coherent. You should also discuss your plans with your supervisor. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/06%3A_The_Literature_Review/6.02%3A_Demystifying_the_Literature_Review.txt |
The first step of conducting a literature review is to delineate your topic and audience (Pautausso, 2013). At the outset of your literature review, a strong research question should be established (as discussed in Chapter 1). It is likely that your research question will change after appraising the literature –a refinement that will hopefully allow you to better address what is missing. When adjusting your research question, remember that the gap you address need not be a big one. No one disrupts the thought of an entire tradition on the first try. There are many vital humble tasks within the search for knowledge, and your research can be as simple as adding new evidence to an important thesis. Try to take on only as much complexity as you can make transparent for your reader. It is important, however, that you do eventually find this boundary in reviewing the literature, and that you choose one that is narrow enough to be feasibly answered by you and which fulfills a gap in the field.
There are three main types of gaps you can fulfill in an established body of literature. Filling those gaps enables us to make contributions to the scholarly field. The first and most prevalent contribution is to articulate a theoretical, conceptual or methodological gap in previous research. This process involves noticing where the theory, concepts or methods of previous research seems to be lacking, and then seeks to address this lack by either adding new empirical information or pointing out internal flaws. A common instance of this is in the many social science papers being produced about COVID-19 vaccination skepticism, whereby an established concept (vaccination skepticism associated with anti-scientific attitudes) is being examined in relation to changing cultural processes, internet use, spirituality, race and other social processes (e.g. see Rutjens & van der Lee, 2020). These research are adding to our conceptual and theoretical understandings about the concept.
The second common contribution is to take an authoritative concept or tool and apply it to something apparently unrelated. In Sociology, where the concepts are as multifarious as the thing being studied (society), this often turns out to be effective in articulating a new nuance of the concept and social experience being studied. For instance, it could mean taking a model for understanding propaganda and applying it to national sports tournaments to uncover the ways in which sports inculcate patriotic fervour (something which was done by Shaw and Youngblood 2017 to understand the Cold War emphasis on sports). Finally, you can challenge an outdated concept and apply it to a current context; for instance, traditional definitions of classism (defined as an act of intentional discrimination based on class) may no longer apply within our current context. You can then indicate the defects of the concept and nuance it according to your description of the changes in the field.
You must also consider the audience for whom you are summarizing the literature (Pautausso, 2013): Is it a professor who is an expert in this field? A journal publication that focuses on migration theory? For research writing which attempts to gain approval from other experts in the field, this means that you should attempt to address the fundamental propositions and theories in your field. A good literature review should be able to address the seminal studies in the audience’s discipline while also accounting for more recent literature (Pautausso, 2013; Pacheco-Vega, 2016).
Box 6.1 – Example – Conducting a Literature Review
Generally, you will want a search net and database that captures lines of inquiry near to your own (Pautausso, 2013). Three of the most common places to start your literature search are:
1. Your university library: Most higher educational institution’s library have access to thousands of journals and databases. This should be the first place to commence your search. Once you are logged in, you will have access to all the materials that your institution subscribes to. Your institution will also have a dissertation and thesis collection –you should consult them to get ideas on how to structure your thesis. You can search UBC’s collection at https://open.library.ubc.ca/cIRcle/collections/ubctheses
2. Google Scholar: Google scholar will often help you to locate a wider range of material that you would likely find at your university’s library. The drawback is that many of those items require subscription. Despite the fact that you might not have access to some of the articles cited, knowing what is available gives you the opportunity to make a request to your librarian to access them for you.
3. Databases: Some of the best known databases in the social sciences are Proquest, Scopus and Web of Science.
4. Conducting a literature review is a systematic process. Here, we illustrate what a literature search might look like. Suppose you are researching the “positive benefits of pets for test-taking,” in which you seek to answer the question: “does studying around a pet reduce test-taking anxiety and performance?” You could begin by establishing searchable phrases that capture the scope of my question. That could mean searching both the “effect of studying by pets on test performance” and the “effect of studying by pets on test-taking anxiety.” It may also be good to understand the basic literature defining “test-taking anxiety” and studying habits which alleviate. To ensure that you are finding content more specific to your discipline, it is also a good idea to apply the “search filters” on the research. This way you can find articles that answer this question primarily through Sociological methods and theory. This can likewise be achieved by going to databases like Proquest which cater to the Social Sciences.
5. If the initial search process does not provide you with enough literature, try breaking up the topics related to your question to make the statement more broad. Back to the example above, you could break it up by searching for “pets and studying habits” or “methods for reducing test-taking anxiety” studying and pets”, “anxiety and pets”, “test-taking and pets” etc. You could also substitute “pets” with “animals”. It may also be good to understand the basic literature defining “test-taking anxiety” and “studying habits”. Be wary of this broader search, however, as it may require much more searching within papers in order to find an abstract which relates to your topic. This could mean facing an unmanageable amount of articles. Nonetheless, it is a good idea to stake out the terrain by casting a wide net. If you find you are gathering too many sources, you can narrow your search accordingly.
An essential part of an effective search process is knowing how to filter relevant/irrelevant literature (Pautasso, 2013). The filtering process requires that you return to your research question at every step and ask: “is this paper asking the same question? Does its findings provide the background to my question?” In the social sciences, where all interactions are complexly interwoven, there exists the temptation to find a relation to your question in everything. Thus, it is important that you are able to critically separate what is more and less influential on your question (critical comes from the Greek kritikos, a word derived from krino which means “I separate, judge”). Continuing with the example in Box 6.5.1, a paper that addresses the “effect of pugs on reducing anxiety” certainly has some relation to the RQ on pets and test-taking anxiety, but will not be as relevant as a paper which specifically addresses “the effect of studying around pugs on test-taking anxiety.” With limited time, it is important to be able to discern the more relevant literature. If you are finding that too much is related to your topic and are struggling to see where you fit in or how you can address it all, try narrowing the scope of your research question further. You could do this by limiting your question to a specific demographic group, location, event or debate. Alternatively, if you are finding too little information related to your research question, try broadening the scope of your research by searching generally for your key variables or concepts. This will help you more easily discern the relationship between your work and others.
Once you have found initial papers regarding your topic through the library database, the search is not over. In fact, much of the seminal papers you find will be referenced by many of the papers you first gather (Pacheco-Vega, 2016). Pay close attention to the literature reviews of other research and the authors that are commonly mentioned. Make a list of these authors, the concepts or findings proposed by them, and then search them up yourself (Pacheco-Vega, 2016). Scan through the bibliographies as well, and note the titles of the articles referenced. If there are concepts/studies which appear identical to yours, track them and note how often they are mentioned (this is a process that Pacheco-Vega called “concept tracing”). This is an indication that you need to cite those sources to join the scholarly conversation. Likewise, when you feel as if you have enough articles that talk about one concept, say “test-anxiety,” then reduce your search and look for commentary on other concepts. This is what Pacheco-Vega (2016) calls “concept saturation”. Ideally, your literature search should continue until you have reached saturation, which is indicated by your inability to find no new sources related to the topic. This can be difficult or even not feasible for an undergraduate project that needs to be completed in a year. Nonetheless, you must make sure that you have surveyed the literature thoroughly and have captured the key issues, debates and findings.
Reading and Note-taking
Now that you have learned to efficiently find literature related to your topic, it is time to efficiently read your literature. There are five key questions that are important to address when reading and taking notes on the related literature:
Why is it Written?
At every stage, it is most important to ask why this is important for answering your research question (Do the findings support or deny your hypothesis? Do their methods miss out on a key element? Do you contest the theoretical explanation of their findings? Is this key background information?).
The first step should also pertain to your filtering process. When asking why these findings are relevant or if this method is important with regard to your research, you should be able to determine early on if reading the paper is worthwhile. For instance, an abstract that discloses that this paper “only studied the negative effect of pets on social relationships” could prove relevant, but far less so than a paper that directly observes the connection between studying by pets and test-anxiety. Moreover, by asking why at every stage, your reading will gradually focus on the key problems and scholars you need to make a note of. The more intentional and reflexive you are at every step of the review, the more thorough and secure your account of the literature will be.
What is it Saying?
Ask what does this research find (what are the key findings of this investigation?).
Be clear in noting what key conclusions your literature comes to. Include in this the theoretical explanations that are given for findings. This is often a good entrypoint into asking whether you agree with the explanation given for the findings or whether there is a key component missing. At the introduction of a study, you will often be able to find a conceptual framework by each author which explains the relation between key concepts used throughout their paper (Kennesaw State Library, n.d.). It is helpful to relate each finding back to these organized concepts, and to use this concept as a connection to related literature. A concept is a generalized idea that can be used as a flynet to organize many related particular findings (Bhattacherjee, 2012, p. 10). For instance, if a paper finds a stark underrepresentation of arts students in clubs, consider categorizing this finding as an example of arts insularity: the tendency of arts students to isolate from one another. This way if you find other papers that report similar findings, you will be able to easily summarize the related findings together under low extracurricular participation and arts. Be careful, however, not to use concepts as evidence. You should always be able to unpack the evidence for your reader. Your literature review should balance breadth and coherence. Examples from a wide range of contexts will provide you breadth and the ability to organize these experiences cogently with regard to your research question will provide coherence.
Another key thing to note here is to be careful and informed about quantitative techniques for reporting findings. If while reading you find statistics/equations you do not understand, refer to proofs of that equation and the methods or notes section of a statistics paper. Here you should find a detailed explanation of the mathematical techniques used to derive a statistic from raw datum. Alternatively, look at any charts of the raw data in order to find the basic datum. From these charts you can derive your own conclusions about the statistical representation of the study. Select the evidence which you can verify, and attempt to understand statistics that you cannot immediately, but if it still does not make sense, focus on that which you know and avoid adding evidence to your paper that you do not understand.
How did it Find This?
Ask how the research comes to this finding (What is its research question? The context is investigating/responding to? What are the methods that are being used?).
When evaluating the value of the finding, it is important to also consider the methods that the researcher is using and the context they are responding to. This will allow you to consider if the findings are either reliable or comparable to your own study. For instance, a paper that interviews nine upper-class people in Italy for their experience facing gender discrimination may be more unrelated to your country-wide survey in Burma of the same experience. To best find studies closely related to your own, try to begin with ones that have a similar method and context as your own, expanding only when nothing is out there (if there proves to be no literature, then here is your gap!).
Ask when this research was conducted (Was it done 30 years ago? Are the findings still relevant?). A key aspect of the context of a study is of course when it was produced. Moreover, as academic literature is expected to be highly interactive with the studies that came before it, the lineage of prominent concepts is itself indicative. For instance, suppose Naomi Klein’s (2007) concept of the “shock doctrine” is taken up and slightly modified for the purpose of later scholars trying to explain the economic aid techniques used by imperialist regimes to establish foreign dependence, which we will call “acts of economic defibrillation.” Considering the time of the response and the time of the context they are employing this term, we can ask why “economic defibrillation” arose to explain new developments, how it differs from Klein’s originating idea, and whether it applies to the context we are attempting to understand.
Where can I Situate This?
Ask where this study is situated with respect to your other literature. (What concepts does it share with other papers? Does it contest any other research?).
Answering question five is the most crucial in the actual composition of the literature review, and it will test the extent to which you answered the preceding questions. Judging the findings, methods and context of each paper, you should begin to consider how the literature relates to other studies and your own. This step entails that your literature review not simply be a static grocery list of summaries, but must rather attempt to interact with the rest of the literature. A good way to do this is to create a list of concepts correlated to your literature and then add the authors. Then when you go to compose the literature review, you will have a list of the key concepts you think are discussed in the literature and the position of each scholar who comments on it. For an enlarged discussion of concept mapping, check out Canas & Novak (2009).
Table 6.1 - Reading and Note Taking Tips
Crucial Note-taking Questions Further Elaboration
Why is this important for answering your research question? Do the findings support or deny your hypothesis?
Do their methods miss out on a key element?
Do you contest the theoretical explanation of their findings?
Is this key background information?
What does this research find ? What is the key finding in this investigation?
How do the findings relate to the key concepts in the field?
Do I understand the findings and interpretations?
How does the research come to this finding? What is its research question?
The context is investigating/responding to?
What are the methods that are being used?
When was this research conducted? What has changed since the work was done?
How significant are those changes?
Is the research still useful? In what ways?
Where is this study situated in respect to other literature? What concepts does it share with other papers?
Does it contest any other research?
Box 6.2 – Student Testimonial – Doing Literature Reviews with NVIVO
There is no going back to a sore wrist and messy jottings after trying NVivo for the literature review. NVivo is a textual data software tool that will track and organize all your codes, annotations, and cases according to their document. In NVivo, you can upload and read your articles just as you would in a pdf reader, but this time your highlights and annotations can be organized by themes established by you. Thus, when you return to the writing stage of your literature review, all the key quotations and insights you have developed through your reading will be saved in one tidy spot. NVivo does not replace thought, of course, but what it takes from the time needed to write and organize, it frees up for critical thought about your readings. This software is available for free for UBC students.
Once you have downloaded the software and opened it up (go to link above for instructions), here is a checklist of what you will need to do to get the basics of your project going:
1. Select New Project
2. Search the literature you want on your library network and download into pdf form on your computer (if they do not have a pdf form, you can take notes on NVivo and add it to your other codes).
3. Once your literature is uploaded to your computer, go to the “import” function on the top left of NVivo, select “files” and upload your pdf’s. I would name every file according to APA in-text citation for easy use (i.e. Robinson, 2016).
4. Go to the “create” function and create a “file classification.” Use the “file classifications” to delineate the categories of your articles. (For instance, for my Uber thesis, my articles broadly addressed four topics: Uber history, Taxi history, Uber’s rhetoric, and Uber’s ahistorical depiction).
5. Once you have organized your articles, simply click on one and start reading! As your reading, use the annotate and coding functions on the top left of your screen to interpret your article. The coding function will allow you to highlight quotes from the article and organize them under one theme. The annotated function will organize your comments on the article into once section under notes.
6. When writing, return to the “codes” section to a list of the direct quotes and annotations from your readings to pull from!
7. Check out this video from QSR NVivo International for a more comprehensive overview
Alexander Wilson, UBC Sociology Honours student, 2020-2021 | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/06%3A_The_Literature_Review/6.03%3A_Conducting_the_Review.txt |
As you are writing and note-taking, begin practicing good citation-habits so you are not scrambling at the end to shoddily construct your reference list. When note-taking, it is good to have a running reference section of all the literature that you are working with so that whenever you add information, you can immediately proffer the full citation. Moreover, avoiding plagiarism will be much easier if you are clear in distinguishing between another author’s insight and your own. When quoting and paraphrasing directly, make sure to add in the page number so that you can easily refer back to the section and confirm accuracy. This way, when you come to write the review, all the relevant information needed to cite the author properly will be easily available. Other helpful tools include citation generators and trackers such as Mendeley, Papers, or Quiqqa. If this is still unclear, plagiarism checkers like Turnitin can serve as backup tools to ensure that you have not carelessly left another’s words uncited. These tools are by no means perfectly reliable, however, and so the best way to avoid plagiarism is to be intentional and careful in your work.
Now that you have found, read through, and taken notes on the studies that establish the background of your own, it is time to summarize the background of your research as concisely and effectively as possible. This task will often require that you address many different sources of information at once (especially given the space constraints of assignments and journals) (Pautausso, 2013). With this in mind, it is important to learn to synthesize and summarize findings under a key term or topic in a purposeful way; which means that you aim throughout to show the reader a meaningful gap in their field. The literature review is not just an aimless summary of what has been said on a given topic, but a purposeful summary which implicates all of the background information towards your project. The literature review is thus a type of discursive prose: prose which not only lists descriptions, but evaluates the evidence according to your research question (Taylor & Proctor, n.d.). Ask throughout: how does this relate to my research question? Is it a plausible answer to the question? When you know the concepts you are critiquing and the concepts you are supporting, then you can begin to organize the literature review in a purposeful way by establishing the background, articulating the research that your study agrees with, and then tactically challenging what is missing. With the state of knowledge and gaps established, you can propose how you intend to address what is missing. The effectiveness of the last part depends on the rest. In sum, the review answers what is there and what is important for your audience, but with a sense that something is missing, leaving your reader with the impression that something should be done to address this gap. This is where your study comes in.
Box 6.3 – General Writing Tips for your Literature Review
• Develop a thesis statement. Think about your research question and summarize how the literature answers the question.
• Do not make claims without evidence: Show that your interpretation of the literature is valid by providing evidence (e.g. quotes, statistics and other facts from sources).
• Be selective from your sources: do not write a paragraph about something because it is interesting. You must be able to relate it to your research question or the approach that you will take in your thesis. Only select sources that will elevate your argument and those that will make your paper whole.
• Do not overuse quotes: paraphrasing shows you understand and can interpret the materials. Do not rely on quotes to make your arguments. Use quotes only when you want to emphasize a point or when the author’s original point cannot be rewritten.
• Do not list sources: Synthesize. Your literature review should not read like an annotated bibliography. Instead, it should demonstrate that you understand the relationship between different viewpoints. Instead of repeating the same point made by more than one author, find the commonality between them and paraphrase it and attribute all the authors to that statement. Unless the author is saying something unique, you should synthesize. Be careful that you are not just attributing citations to banal points. Remember point #2 above: be selective.
• Assert your views: It is important to have a voice in your literature review. You can do this by starting and ending your paragraph with your own words and ideas. Remember your thesis statement –relate your points to your thesis (for more detail, see UNC Writing Center, 2021) | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/06%3A_The_Literature_Review/6.04%3A_Assuring_Proper_Citation_and_Writing_the_Review.txt |
The chapter outlined the process of conducting a literature review and the components of it. It reminded you to search widely (e.g., using your university library, Google scholar and databases) and strive for some measure of saturation. This is essential because your literature review has implications for every other section of your thesis. Previous scholarship (or the lack thereof) will impact your methodological choices, analytical techniques, interpretation of your findings and suggestions for future works in the field. It is therefore important that you invest time in producing a strong literature search. It can be quite time consuming to be searching for new literature if after you have analyzed your findings and you discover that your literature review did not anticipate or is unable to explain your results. Having said that, it is key to remember that the literature review does not end when you first complete it. It will be a work-in-progress until your thesis is finished. Hence, it is an iterative process: you will likely be doing new literature searches at every step of the thesis journey. However, a good initial review will provide a solid platform and will minimize the searches that you will need to complete.
You are also reminded to develop a thesis statement and organize the body according to one (or a combination) of the principles suggested: systematic, argumentative, theoretical, chronological/historical or methodological. It is also crucial that you take an analytical approach to note taking by asking the five W questions, by synthesizing and using an active voice in your presentation. Finally, we strongly recommend that you develop a system for managing your citations. While the literature review can be a daunting prospect, by following the suggestions offered in the chapter and the checklists, it can be a fulfilling and rewarding task.
Box 6.4 – Checklist: The Literature Review
• I have determined what kinds of sources (books, journal articles, dissertations) and what timeframe are relevant to my research.
• I have reviewed abstracts and I now have a sense of what has been written on my topic and what needs more exploration.
• I have sought sources with differing viewpoints
• I have read literature in my field and I am aware of the structure and style that is appropriate
• I have determined how I will organize my thesis (theoretically, thematically, chronologically, by debates etc.)
• I have kept an open mind throughout the process so that I do not prematurely committed to a perspective before examining multiple viewpoints/li>
• I have asserted my voice, summarized and paraphrased, and have not overused quotations.
• I have contextualized and analyzed each source for its relevance to my project.
• My paragraphs mostly begin with ideas or themes – not authors’ names (this avoids making your review read like an annotated bibliography).
• My literature review has a thesis, a body and a conclusion
• All my in-text and end-of-document citations adhere to appropriate style guidelines
• I have identified and spoken to gaps in the literature, and have laid out how my project will contribute to broader scholarship
6.07: Additional Resources
Further Readings
Writing Literature Reviews
Galvan, J. L., & Galvan, M. C. (2017). Writing literature reviews: A guide for students of the social and behavioral sciences. Routledge.
Lunenburg, F. C., & Irby, B. J. (2008). Writing a successful thesis or dissertation: Tips and strategies for students in the social and behavioral sciences. Corwin press.
Jesson, J., Matheson, L. & Lacey, F. M. (2011). Doing Your Literature Review: Traditional and Systematic Techniques. SAGE.
Ravei, Kian & Taylor Harper. “Writing A Literature Review.” Retrieved from https://uclalibrary.github.io/research-tips/workshops/writing-a-literature-review/
Kennesaw State University. “Literature and Concept Mapping.” Retrieved from https://libguides.kennesaw.edu/lr/proposal
Additional Tips on Avoiding Plagiarism:
http://www.calendar.ubc.ca/Vancouver/index.cfm?tree=3,54,111,959 | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/06%3A_The_Literature_Review/6.05%3A_Summary.txt |
Learning Objectives
By the end of this chapter, you should be able to:
• Know the components of a methods section
• Accurately describe and justify the method you select
• Write concisely about your methods and its limitations
Suggested Timeline: Draft by December
As you know from your previous courses, research methods are simply the tools that we use to gather data (e.g., surveys, interviews, case studies, diaries etc.). The methods section allows you to contribute to a reflective conversation in your field so that others can assess, replicate and validate your findings. A clearly written methods section allows others to attest to the integrity of your assertions, apply our methods in new and different works, thereby furthering scholarship in the discipline. Writing effectively about our methods tells the reader that: (1) they can trust us, (2) we have comprehensively engaged with the background of our research and, (3) have attempted to avoid the obstacles, ambiguities, and hubris that tend to corrupt assertions on any complex subject (such society). A clear methods section will allow your reader to formulate a clear understanding of the merits and limitations of your method, and correspondingly, the merits and limitations of your findings. If all is done well, a capable researcher should be able to replicate your procedure exactly and then decide for themselves whether the findings were similar enough to your research, therefore providing outside accountability.
This chapter offers a general guide to writing the methods section of your paper. We avoided detailed consideration of any one genre because that is covered in the qualitative and quantitative analysis chapters (Chapter 9 and Chapter 10). Rather, we decided to break the methods section down into five common components that are shared amongst many different social science genres. Each element has examples of the different concerns/weaknesses/strengths of the different genres, to help you understand the difference between various methods while maintaining a consistent sense of the methods section. We finish with checklists to help you review and ensure your methods section has addressed the key concerns of your audience.
7.02: Drafting the Methods Section
Drafting the Methods Section
While the substance of the methods section will differ by genre and method chosen, basic components can be derived across genres. Methods sections in the social sciences tend to have five sub-components. They must:
1. summarize the method used while arguing the value and limitations of the method for your data/context;
2. discuss the data of your study (participants, artifacts, academic literature)
3. present the instruments and measures used;
4. outline the procedure of the data (i.e. how it was collected and ensured of its integrity), and
5. Analysis: discuss how you analyzed your data.
Splitting these sections into components, however, should not give you the impression that the methods section is merely a list. The methods section is also an argument (Johnson, 2018), meaning that it aims to convince your reader of the value of your method through a narrative that briefly applies your method to the context of your research. In addition, the method must find a way to align with the research question stated in the introduction. Your methodology should build upon the introduction, justifying that the approach you utilized to investigate the problem is suitable (see Table 7.3.1 for common justifications for some established methods). We will refer back to this key point as we overview each step of the methods section.
A simple summary of your method is a good way to begin the method’s section. The length and depth of this summary depends entirely on the method chosen and the audience it is presented to. If the method is commonly known and used within your field, an overly intricate summary of the method is not necessary; a couple sentences overview will work fine. If the method is not commonly used or entirely new, however, more argument will be required for your audience to understand your choice of method. For instance, grounded theory is a commonly used paradigm in many qualitative social science journals. It is therefore unnecessary to sketch the method’s history in detail. Rather, a simple definition, such as grounded theory being an inductive approach which only designates codes after data collection (and how you enacted in your project) will suffice. On the other hand, newer methods such as linked data (methods based on web technologies such as HTTP, RDF, SPARQL, and URIs to enable semantic connections between various databases) would require a more extensive discussion. In addition, while it is good to offer your own summary of the method, the definition used by another researcher (particularly methodological researchers) is a simple way to align your research with a legitimate approach in your field.
Table 7.1 - Justifications for Some Common Methods
Theory Justifications
Grounded Theory Strong for exploratory research (where limited existing work are available), as it is able to be open to new themes and codes that the researcher may not have had in mind before combing through their data
Streamlines and integrates data collection and analysis; flexible to research contexts; produces ‘thick descriptions’ (Charmaz, 2003)
Content Analysis Able to establish the frequency and meaning of particular words, phrases and themes in a larger corpus; it also helps to establish relationships and patterns between them.
Offers objective, systematic and quantitative description
In-Depth Interviews Strong method for unpacking the depth of a participants understanding of a situation; explores issues in great detail
May allow respondents to feel more comfortable to share information based on rapport established in the research process
Ethnography Strong for community research, online research, and other research that requires careful observation of the interactions between participants
Able to capture the behavior of a participant in their environment as opposed to in the staged interview or experimental setting
Discourse Analysis Suitable for understanding a discussion between participants over a specific theme (such as Uber, beard products, or memes)
Appropriate for understanding underlying meanings in sociohistorical contexts and for revealing how language and discourse shape reality
Systematic Literature Review Takes a comprehensive approach to reviewing the literature, drawing on research from multiple theoretical, methodological and disciplinary concerns
Identifies biases and gaps in the literature, and nuances such as whether generalizations can be made across populations, subgroups, settings etc.
Surveys Inexpensive method for aggregating large quantities of data. High level of representability
Flexible across contexts and in design (e.g. online, paper etc.) and can be adapted for anonymity; can overcome interviewer effect.
Panels studies Suitable for analyzing social change, life course and understanding the interrelationships between later outcomes
Enables us to make causal inferences through controlling unobserved heterogeneity (Laurie, 2020)
Quantitative (e.g.,, regression or chi-square analyses) Strong method for establishing relationship between various variables; reliable for determining variables that impact our research topic
It also helps us to identify outliers and anomalies
The key point to keep in mind for summarizing your method is to outline its theory insofar as it explains your procedure, that is, discuss the method’s intentions with respect to how you applied it. We will touch on this again in the procedure section.
As you provide an overview of your method, you must also justify it. Justification of your method must appeal to the method’s ethical, practical and factual utility for the project. Ethical justifications are those that argue that the method is best for reducing the harm of research on your participants (and the communities they inhabit). It must also make the point that your method aligns with the principles of your institution’s ethical values.
Factual issues have to do with the value of the data your method is able to gather. It must consider whether the method is appropriate to your research question and topic. If, for instance, the research question is about “Malaysian immigrants’ conception of justice in comparison to American immigrants,” then you may argue that ‘in-depth interviews’ are the only approach deep enough to unravel a person’s “conception of justice.” Arguments for the factual benefits of a method frequently highlight its novelty for studying a particular method. For instance, there could be a lack of discourse analyses of Uber’s advertising materials (the previous research being content analyses). One could then argue that a discourse analysis approach not only has merits in its own right, but it also may be able to discover data which other approaches miss. Finally, you should outline the strengths of the methods in relation to all aspects of your research process (e.g., alignment with your theory, personal values, practicality etc.).
Practical justifications highlight why the method is suitable given logistics, administrative and everyday concerns. For example, if you are interested in studying how Malaysian migrants’ prepare for their transit to America, an ethnographic approach might be tempting. But practically (financially and time-wise), you might not be able to visit Malaysia to observe their preparations. Hence, you might decide that surveys or interviews (while less desirable) are more practical in that instance.
Again, we emphasize the importance of highlighting the limitations of your method. Every method has weaknesses, it is vital that show an awareness of them. It is important, however, not to have the weaknesses outweigh your method’s benefits. Your reader should be able to understand why you choose the methods, so you need to explain how, in spite of the limitation, your method is the most suitable choice. Hence, you need to justify why you decided to choose the methods over others. To help in the weighing of the costs and benefits of different methodological approaches, we have provided below a list of the potential limitations of some of the more common methods used in the social sciences.
Table 7.2 - Potential Limitations for Common Methods
Theory Limitations
Grounded Theory Lacks a theoretical base to drive the analysis; requires considerable skills from researchers
Reliability and validity might be questionable due to the lack of standard rules to follow; researcher-driven.
Content Analysis Can lack theoretical base; simplistic and reductive
subject to increased error, particularly when relational analysis is used to attain a higher level of interpretation (see Elo et al, 2014)
In-Depth Interviews Not generalizable to the wider population
May be prone to bias: interviewer-effect is always present
Ethnography It may take time to establish trust in order to generate honest data
Too little data may lead to false assumptions about behaviour patterns, while large quantities of data may not be processed effectively (Baral et al, n.d, p.2.)
Discourse Analysis There are multiple methods for doing discourse analysis, making replicability difficult
It focuses primarily on language which often does not tell the entire story; it might need to be supplemented with another method
Systematic Literature Review The results are only as reliable as the method the original authors uses to evaluate the effect of each study i.e., the results are dependent on the study design, interpretation and analysis of the primary authors.
There is some subjectivity in deciding how to pool studies e.g., determining how to treat discordant studies; subjected to methodological flaws
Surveys Various errors might undermine validity and reliability (e.g., measurement, coverage, non-response sampling errors)
In appropriate for getting in depth understandings
Panels Selective panel attrition can be problematic
Panel conditioning: interviews from previous waves might influence subsequent waves
Quantitative (e.g. regression or chi-square analyses) There may be variables other than the ones in the study which influence the response variable
It does not allow us to identify cause and effect; correlation does not imply causation.
Once you have provided an overview of your method and its value for your context, the next step is to discuss the data or population that the method will be used upon. Summarizing the data or population of your method often requires answering (Johnson, 2017): (a) how many participants/cases compose your data? (b) what are some of the common or key attributes of your data? And c) how did you select your data/participants?
Table 7.3 - Johnson's (2017) Three Questions About Participants
Questions About Participants What this Means?
How many participants/cases compose your data? Simple answer of the size of your corpus
What are some of the common or key attributes? Discuss the relevant demographics/variables of your population (if race/ethnicity, gender, age are relevant, list them here).
How did you select your data/participants? Discuss the sampling method you used
Source: Johnson, M. (2017). "Writing a Methods Section" In Allen, M. (2017). The SAGE Encyclopedia of Communication Research Methods (Vols. 1-4). Thousand Oaks, CA: SAGE Publications, Inc doi: 10.4135/9781483381411
The first question means answering the size (e.g., n = 88) of your corpus. Commentary on the size of your sample should also consider the total population that you are attempting to comment on. For instance, if you are writing about “student experiences with online open book examinations,” then it is important to consider how many students participated in the research compared to the students that took the examination (i.e., identify the characteristics of the sample versus the target populations). Answering the common attributions of this case study would mean considering the descriptives (usually sample size, mean, distribution etc.) or characteristics (e.g. gender, age, class, ethnicity) of participants/unit of observation. Building from our previous example, we should ask pertinent questions about the participants that took this exam: what was the average score of the exam? What grade level is this course? Which discipline was this course in, and which discipline do most students in this specific class come from? Finally, we need to also discuss how we recruited these students. Outline your recruitment process by discussing how you advertised the study, whether a stipend or incentive was offered, and how students finally agreed to join in the study (mainly regarding whether consent forms were required). For online texts or any other data that is not a participant/population, the same questions can be answered. The amount of the texts, components of the texts (their genre and author mainly), and the data collection process is all relevant to your method.
Box 7.1 – Writing About Recruitment
• Have I discussed how I advertised the study?
• Have I stated if a stipend was used?
• Have I stated if a consent form was used?
• How were participants identified?
• Where were they recruited?
While the above questions must be asked for all methods, the key concerns will differ depending on whether your research is primary, secondary, content analysis or theoretical research. Primary Research is research that collects and derives its own raw data by sampling participants/cases, such as selecting and interviewing participants. Secondary research uses data from other primary research projects, such as a systematic literature review of other research. Theoretical research uses other papers and articles, sometimes even other data (like secondary research), but with the purpose of advancing a new argument in the field. Its method does not have to be as explicit as the other two methods of research. The following table summarizes the distinct tasks of the three approaches when discussing methodology. As theoretical research often uses articles and other social artifacts to make its argument, its methodological concerns are similar to content analysis. For that reason, we have grouped them together in the following table.
Table 7.4 - Contrasting Primary/Secondary/Theoretical Research Methods
Primary Research Secondary Research Theoretical Essays
Target Sample
Discuss who the target sample was (how many, characteristics). This includes all the points that are discussed above.
Check Method of Original Research
Check the methodology of the original research and justify its association with your project.
Sampling Method
Discuss how you sample your artifacts (e.g., articles, blog posts, social media posts). This includes discussing the search term criteria that you have used to find these artifacts.
Justify Target
Argue the value of selecting and interviewing your target sample with respect to your study.
Alter Method to fit your project
State if you have removed or changed anything about the methodologies of the studies you have sourced data from.
Author and Genre
Discuss the author and audience. Briefly summarize them so you can elaborate further throughout your paper.
Sampling Method
State your recruitment method and also disclose if a stipend or any other material was used to recruit participants.
Summarize Population
If you are focusing on only a particular subpopulation, provide an overview of the sample, but discuss your subsample in detail. Justify why the focus on this subpopulation
Size of Corpus
Discuss how many articles you found initially and how many you ended up upon. Discuss this in relation to the total number of articles that might have met your search criteria (if you found them all then this means your corpus was exhaustive).
It is important to note that merely listing these components of your data/participants does not satisfy the requirements of a good methods section. Remember that you are still making an argument. While discussing the attributes relevant to your study, you are still arguing why you selected these participants/cases for your study, why you are listing that demographic/characteristic(s) as important to your study, and why you chose this sampling method over the other options. Allow yourself to be guided by the argument and the relevant things to include in your sections will follow. The following box provides a checklist of questions to help you to evaluate whether your methods section has successfully addressed all the key questions regarding your ‘data’.
Box 7.2 – Checklist for Summarizing the Data of Your Study
• Have I stated how many participants/data was in my study?
• Including in comparison to the relevant groups that they occupy?
• Have I discussed all the key attributes of my data?
• Have I discussed the relevant demographics of the populations and groups I am researching?
• If it is textual data, what is important to know about the author and genre of this text?
• Have I discussed the sampling method of my study?
• Have I argued the value and limitations of my sampling method?
Instruments and Measures
Research instruments are the tools that you use to collect, analyze and measure data in your research. These include literature reviews, survey questionnaires, interviews, focus groups, ethnography etc. In your methods section, you must describe how these serve to collect data, for example, was the survey composed of only open-ended questions, how many questions were included in the survey etc. Likewise, if you are using interviews, you need to discuss what kind of interviews were conducted (semi-structured, unstructured, structured)? How were the questions organized (e.g. by theme, no order etc.). Again, if you are doing a meta-analysis (literature review), you need to detail how it was done, what search engines, databases and search criteria were used etc. To reiterate, description of your instruments requires a an outline of how you used the particular measure to collect data.
As you will remember from your methods classes, when we talk about measurement in social research, we are referring to the process of operationalization (i.e., what concrete observations are being checked to empirically indicate a concept?). To do this, you must first identify the key variables or issues in your research question and explain how your research instrument captures it. For example, say your research question is “Do international students engage in economic transnationalism while studying on campus?” You will want to indicate how you will determine (a) who is an international student? and (b) what is economic transnationalism? It might seem silly that you need to operationalize “international student” but practically, you must have a system to determine who is an international student. It would be hard to walk around campus and determine who is an international student without having some criteria e.g. a student without Canadian citizenship. But again, how would you determine which student has Canadian citizenship and which ones do not? Operationalization requires that you specify precisely how you determine who is an international student (maybe you simply let participants self-declare their status on the survey or at the beginning of the interview). Likewise, “economic transnationalism” is a concept that needs to be measured (operationalized). You need to specify how in your research you will determine that economic transnationalism was taking place. Maybe you determined that if participants engaged in at least one economic activity (such as remitting money to origin countries, conducting business in origin countries, investing in origin countries etc), then economic transnationalism has taken place. The key to measurement is making it clear (and justifying) to your readers how your key concepts and variables are determined in the study. This requires that you consider how other researchers have measured these variables. If your measures are different from how other researchers measure the same concepts/variables, you need to justify why. On the other hand, the use of existing measures assures measurement consistency and contributes to the reliability of your study.
Measurement in quantitative studies can get complex by recoding, and the creation of composites such as indexes and scales. You must discuss how you recode variables and how the new variables allow you to better measure concepts. Likewise, you need to justify how the scales and indexes that you are using improve your measurements. If you are using established indexes and scales, it is important that you justify why they are applicable in your research. Again, if you are creating new measures, you need to identify why existing ones were inadequate for your research goals. As mentioned before, the methodology is not merely checking boxes, it requires justification of your choices, and engagement with an argument and or the literature (see the following example).
Box 7.3 – Examples – How a Team of Researchers Measured Friendship
Excerpt from Waldsorth et al (2021, p. 138) showing how friendship was operationalized in a research project:
Whenever feasible, we adopted measures already used in the literature to facilitate comparisons. Two aspects of friendship are of interest: the nationality of friends and the strength of the friendships. We asked respondents to rank list their top ten friends and identify the nationality of each friend. This is a modification of a friendship grid used by Hendrickson et al. (2011) to study international students in Hawaii. Hendrickson et al. (2011) used social network analysis to map, for each student, a list of all people with whom they interact, recording if they are from their own country or another country, and a self-determined measure of the strength of each relationship on a scale of 1–10. We felt this was a valuable measurement tool; however, we also felt that asking participants to record an exhaustive list of every person with whom they socialize was an overly onerous task, and not necessary for our purpose.
We therefore modified this grid by asking respondents to rank order the top 10 friends with whom they socialize the most and to identify their friends’ national origin (host-national, co-national or other international). In line with Jindal-Snape and Rienties’s observation that non-university “local-community” can play an important role in supporting international students (2016, p. 6), we do not limit respondents to listing friends who attend the university, which is in keeping with other studies.
Also, like other studies, we only permit participants to list a maximum of ten friends…Respondents ranked their closest friends from 1–10, based on the amount of time spent socializing; friend 1 is the friend with whom they socialize the most. As a result, in our study we operationally define an increase in time spent together as indicative of closeness. According to Hall (2019), the closeness of a friendship is appropriately measured by the time spent together; transitioning from an acquaintance to a friend and to a close friend occurs with increased time spent together. Furthermore, since there are arguably cultural differences in the meanings of close friends as opposed to acquaintances (Gudykunst et al., 1985; Hendrickson et al., 2011; Maeda & Ritchie, 2003), we employ ranked time spent together as a measure of closeness as opposed to a self-determined scale of the strength of the friendship in an effort to control cultural bias.
We created three dummy variables: host-national (Canadian), co-national (from the same country as the respondent), other international (from another country but not the host or the respondent’s home country). From the dummy variables, we constructed measures to determine the proportion of respondents’ friends (all ten friends) that are from the host-nation, from their own country, or from a different country. For each of these three ratios we created additional variables to measure whether or not the designated friendship (host, other, or co-national) was a close or distant friend: we segmented the friendship spectrum by creating measures to identify the nationality of respondents’ closest three friends (friends 1–3), middle friends (friends 4–7) and the last three friends (8–10). The segmented measures of friendship facilitate an examination of the effect of different types of friends on the international student satisfaction measures at different levels of the friendship strength spectrum.
Source: Walsworth, S., Somerville, K., & Robinson, O. (2021). The importance of weak friendships for international student satisfaction: Empirical evidence from Canada. International Journal of Intercultural Relations, 80, 134-146.
Procedure
The procedure is a step-by-step description of what you did to collect and analyze your data (see Figure 7.6.1 and Box 7.6.3). It should be the largest part of your methods section (Johnson, 2017), and it will incorporate explanation of how you collected your data, interpreted your data, and organized your data in your final-write up. As pointed out in the introduction, it is in this part of the methods section that the imitation function of methods – helping others to find our findings – is completed (Johnson, 2017). After providing a walkthrough of each step of your research process, it then discusses how you analyzed that data. The procedure clearly divides and orders the steps of your research chronologically, seeking to present a summative narrative of your research from recruitment/sampling of data to analysis. Documenting your procedure allows another researcher to attempt the exact same process as you with the expectation that they should be able to find (roughly) the same results. It is through this cross-reference system that the method can likewise become generalizable. If other researchers can replicate your procedure across contexts with effective results, then the method proves itself intuitive and effective to be useful for further research. It is an important kind of tedium!
Box 7.4 – Procedure Checklist
Recruitment
• Did I discuss how I recruited my participants and/or collect my data? Did I mention and outline the type of sampling method I used?
• Did I discuss how I ensured ethical fairness in gathering my data?
• Did I discuss how many participants I reached out to, and if any problems occurred in gathering my data?
• Did I discuss how I solved problems in recruiting my participants?
Data Collection
• Have I discussed the method for collecting data in my study (interviews, surveys, census data)?
• Have I discussed procedures for cleaning, recoding, and otherwise ensuring the integrity of my data?
Analysis
The final aim of your methods section will be to discuss how you processed and analyzed the data collected. This will differ significantly depending on the method chosen, but there are a few standard things to do depending on whether your paper is qualitative or quantitative. The following table highlights:
Table 7.5 - Steps in Describing Your Analytical Strategy
Quantitative Qualitative
Describe how you processed data for analysis (e.g., how you cleaned the data set, how you treated missing and extreme values, did you transform or recode variables for analysis?) Describe how you processed the data for analysis (e.g. transcription verbatim or for general ideas) and the coding procedures identified.
Identify what software was used to conduct analyses (e.g. Excel, SPSS, STATA, Python etc) Identify what software if any was used to facilitate analysis (e.g. NViVo, AtlasTi etc)
Describe what statistical test was used (e.g. regression, ANOVA etc.) Describe what kind of analytical strategy was used (e.g. grounded theory, thematic analysis, content analysis, discourse analysis etc.).
The next table provides a demonstration of the analysis portion of Alexander Wilson’s (2021) methodology in his undergraduate honours thesis.
Table 7.6 - Breakdown of Alexander's Analysis
Type Analysis
Analysis program “After the articles and government reports were collected, I uploaded them into NVivo where they were read with attention to the context of the discourse.”
Open Reading into Coding “After an open reading, I divided the issues present in the media into Beckert and Dewey’s (2017, p. 14) two concepts, "externalities and hopes for the future," while paying attention to the time and narrator framing Uber's legitimacy or illegitimacy.”
Example of coding “The externalities voiced in the literature, such as lower wages and safety concerns, were compared alongside the hopes expressed by Uber representatives and finally taken up by the government in legislative decisions.”
Argument for discourse analysis to analyze this data “I used an interpretive method (discourse analysis) to allow room for me to reason and justify my understanding of the context and influence of Uber's frame on the broader debate”
Source: Wilson, A. (2021). Driver’s of Dissidence: A Discourse Analysis of Vancouver’s Road to Ride-Hailing. Undergraduate Thesis. (p. 13).
The above table shows that honours student, Alexander Wilson (2021) began by discussing the instrument used to organize the analysis (NVivo) and then moves onto the steps taken to conduct a discourse analysis (which is overviewed earlier in the paper). It discusses how the media data was analyzed, through an open reading to a codification of the issues according to their being “hopes or externalities” of Uber’s service. The codification is situated within the overall method of discourse analysis, which seeks to interpret the meaning of speech/text with respect to the larger discussion that it is contributing to. For Alexander, this larger discussion leads to a change in legislation, so it is his goal to interpret the significance of Uber’s promises and externalities in the media discourse with respect to the final legislative conclusions.
Box 7.5 – Reviewing and Revising the Methods Section
• Have I summarized the method?
• Will this summary make sense to someone doing similar research?
• Have I adequately highlighted the elements of this method which are especially relevant for my research?
• Have I adequately highlighted elements of this method which are relevant for my argument regarding its value for my research?
• Have I argued the value of my approach?
• Have I argued that this methodological approach will be effective for gathering data in an ethical manner?
• What other approaches can I compare my method with? What are the tradeoffs?
• Have I summarized the data of my study?
• Have I clarified the type of my data (participants, text, articles etc.)?
• Have I stated common attributes of that data?
• Have I disclosed important ethical concerns regarding interaction with that data or population?
• Have I outlined the instruments and materials used in my study?
• Have I discussed the design and procedure of my study?
• Have I outlined how I analyzed the data?
• Did I adequately discuss the key steps of my analysis?
• Did I state how many iterations of my analysis were conducted (how many readings, how many calculations)?
7.03: Summary
The methods section briefly communicates the vital work that takes place behind the scenes of the final write-up. It outlines how the evidence was found and why that way of searching after the method was chosen. If done correctly, other capable researchers should be able to repeat your study exactly, helping to determine that your findings were not merely an invention of the imagination, but an observation that can be shared by anyone who follows your procedures. This type of communication thus aims to share and confirm a truth between researchers, not merely by an attitude of agreement, but through common observation of the evidence.
We suggested that this communicative task is best executed by breaking it down into five components: (1) summary of the method, including its merits and limits; (2) discussion of the nature of your data through outlining the pertinent demographics of your participants or the attributes of your artifacts; (3) discussion of the instruments and measures used to find and evaluate your data; (4) outline of the procedure, what actually took place to gather and organize your data; and (5) the analysis, which states how you began to make sense of what you found, a crucial lead in to your findings. By avoiding going into detail about the myriad of potential methods the social sciences use, we hoped to create a general guide of the communicative tasks for any method, a foundation to help you structure the methods section for your niche research. In the following chapters, we will attempt to do similarly. The sections on data collection, analysis, and discussion offer practical guidelines for organizing and writing each section, all while citing further resources to explore for each niche. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/07%3A_Writing_the_Methods_Section/7.01%3A_Introduction-_Why_Methods.txt |
Learning Objectives
By the end of this chapter, you should be able to:
• Understand the elements and ethics of different types of data collection in the social sciences
• Understand data quality issues and overcome collecting bad data
• Know the general rules regarding how much data is required for each paradigm
• Know where to find data for your methods and how to decide what is relevant
• Collect quality data for primary and secondary research, including for systematic reviews and theoretical theses
Suggested Timeline: Complete by Mid-January
Now that your research question is formulated and the method is selected, it is time to collect those elements of the “blooming, buzzing, confusion” of fact (James, 1890, p. 250) called data to make a bloomed, picturesque and lasting flower of an argument. Data collection refers to the processes and procedures used to gather, measure and analyze data. In this chapter we are concerned about data collection because how you collect your data will impact the rest of your thesis. Gathering data ethically and reliably is important if you are to answer your research question effectively. As the saying goes “garbage in, garbage out”, so if there are problems with your data collection, your entire project could be undermined. Bad data are “those acquired through erroneous or sufficiently low-quality collection methods, study designs, or sampling techniques, such that their use to address a particular scientific question is scientifically unjustifiable” (Brown, Kaiser & Allison, 2018, p. 2564). Quality data collection techniques overcome the likelihood and the degree to which bad data gets into your project. Gathering quality data rests on several considerations: how you collect data, how much data is collected and determining what data is the most relevant and reliable for your research purposes. Our discussion on data collection also implicates research paradigmthe set of common beliefs and agreements shared between scientist about how problems should be understood and addressed” (Kuhn, 1970, p. 43). For example, interpretive research will have methods but no simple routinized ‘procedure’; quantitative research will warrant a strict procedure (a set of rules which determines how you gather and interpret data); and qualitative research can fall in between.
Given the foregoing, this chapter begins with a discussion on bad data and some general strategies for ensuring data quality. Next, we highlight sampling concerns and data quality before discussing qualitative and quantitative methods for sampling primary and secondary data. Following that, we outline some of the most common undergraduate social science data collection techniques and procedures to ensure data quality. This is followed by recommendations on the amount of data required for each method and where data that you might be interested in can be found, taking into account different research paradigms. Finally, we present the data collection of two common interpretive methods given its unique requirement that data collection and analysis proceed simultaneously.
8.02: Enhancing Data Quality and Overcoming Bad Data
As discussed earlier, one of the primary concerns of data collection is to gather useful accurate, complete and appropriate data which will allow you to answer your research question. Robinson et al. (2019) define quality data as those that are (1) fit for their intended purpose, and (2) have a close relationship with the construct they are intended to measure. It is therefore important that from conceptualization to operationalization (measurement), collection and analysis, you work to ensure that you are intentional about the quality of the data you are collecting. Attention to the main errors that creep into research can be helpful in this endeavour. We briefly discuss each next:
• Coverage Error: whether you are sampling a large population, literature on a topic or blog posts online, if your data collection method excludes some groups, sources or social artifact that is important to your research, you will have coverage errors, and data quality issues.
• Measurement errors: if your measures do not capture the concepts that are central to your research question, your data will be of little use (see Chapter 7 for a discussion on measurement)
• Non-response errors: If a significant portion of our sample refuses to answer some (or all) of the questions on your research instrument, we might not have enough information to answer our research question.
• Sampling error: this occurs when the characteristics of our sample are different from the population from which it is drawn. This is mostly a problem in quantitative research, where it poses the problem of unrepresentativeness.
Table 8.1 - Common Errors in Social Research and Some Strategies For Overcoming Them
Errors Overcoming Errors
Coverage Error Check sampling frame to ensure that everyone, institution, artifact etc in the target population are included e.g., are all the blogs on dieting and exercise in BC included in your sampling frame?
Check to ensure that the sampling frame does not include those not in the target population e.g.Are blogs from Alberta included?
Establish parameters (e.g.,) and check to ensure that the sampling frame is up-to-date e.g. Does it include bloggers who started blogging a month ago or those 10 years ago?
Measurement Error Use established measures where possible
Use multiple measures for the same construct
Pilot test your measures
Non-response errors Set expectations about the kind of questions that will be asked and the expected duration of the survey/interview
Emphasize the benefits of the research and think of ways to reduce costs to participants
Make questions simple and interesting; surveys should be easy to navigate
Sampling Errors Define and specify the population of interest and ensure that the particular subpopulation is being recruited
Increase sample size
Consider the selection and sampling procedures that best reach the target population, and that is most appropriate to the research question (e.g. convenience versus snowball sampling)
For more information on overcoming errors in social research, see Mellenbergh, G. J. (2019). Counteracting methodological errors in behavioral research. Springer International Publishing.
The previous table outlines some of the main errors that can undermine the data that we collect. As will be discussed later in the chapter, they can result in missing and incomplete data or inappropriate data for our research question. The suggested strategies are by no means exhaustive (see Mellenbergh, 2019 for a more comprehensive discussion) but we hope they can help you to think more intentionally about your research design and collection techniques. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/08%3A_Data_Collection/8.01%3A_Introduction.txt |
Sampling is an essential component of social science research. In fact, the absence of a defined sampling method is actually a form of sampling. As mentioned in Chapter 7 (Methodology), data collection requires defining the unit of analysis and before gather information about it. In social research, that “unit” is often human beings, institutions, objects (e.g, newspapers, photographs, books) or social parameters (such as marriage, divorce, birth and death). As you will recall from Chapter 3, ethical concerns should guide any form of data collection. To guarantee quality data, you should be placing limits on the population/text you want to observe and then on the behaviour/aspect of the population you want to observe (Bhattacherjee, 2012) from the onset. This will attend to some of the issues with coverage and sampling errors discussed earlier. A guiding question can be: what is the kind of text, people, place, or behaviour that I want data about? (e.g., “2nd generation Indian immigrants in BC” or “articles referring to Uber in 2020”). The next steps are to think about: (1) how you will access that data, and (2) what claims you seek to make about the ‘unit.’ It is also important to consider the goal of your data collection. For example, if it is to generalize about a population, you will need to consider a large sample size (also, see discussion on research paradigm later in the chapter).
Effective Sampling Frame for Quality Data
Once a population or unit of analysis is determined, you will need to consider developing a sampling frame. Bhattacherjee (2012, p. 66) defines the sampling frame as “an accessible section of the target population (usually a list with contact information) from where a sample can be drawn”. In other words, it is a list of all those within a population (which could be institutions, households, individuals, social artifacts etc) that can be sample. It is crucial that you are able to access the units in your sampling frame (see Chapter 7, Methodology). Another important tip is that you should consider ways of motivating your units to participate in your research (if they are people). This means clearly explain to them why your research is significant to them. Doing so will help reduce non-response errors and contribute to you gathering quality data.
The Sampling Process as Critical to Quality Data
Besides motivation, there are two other common practical problems that should inform your sampling process. The first concerns the consistency of your data. This means that the context under which data is collected should be similar across all cases. In essence, how data is produced should be similar for all cases. Cases should have similar characteristics (same population, behaviour, event), and relate to the same setting (interviewing drug users in a police station vs. in their home will likely produce biases/inconsistencies). The second concerns the substance of your data, i.e., the data you have is capable of addressing your RQ in an unbiased manner. In sampling data, you ought to include any details about the data that may ‘corrupt’ it (such as its biases, your biases, and problems in how it is sourced) in field notes. Be reflexive about the major problems you note in finding your data, and any changes you have in your data collection processes throughout gathering. This latter process will improve the transparency in discussing methods, noting limitations of your data and the major turns in your research process. Common potential limitations may be lack of data on an important aspect of your research question, biases in your sampling (e.g. in non-probability sampling methods such as judgmental, convenience and snowball sampling), and other contextual interferences with primary data (e.g., the setting of an interview interrupts the flow or content of conversation). Paying attention to these details will reduce the likelihood of you having incomplete or irrelevant data at the end of data collection.
Choosing the Appropriate Sampling Technique
Because the potential of sampling error to undermine data quality is so grave, it is important that an appropriate sampling technique is selected for your study. Common sampling methods include systematic sampling, cluster sampling, quota sampling, and snowball sampling (see Bhattacherjee 2012, p. 67-68 for some details of the different sampling techniques).
As you will remember from your Research methods courses, simple random, systematic and cluster sampling are three forms of probability sampling. Probability sampling selects samples at random based on the theory of probability in order to limit any bias which can influence the probability that the data is not representative of the population (i.e. not skewed towards exceptions in a population). The key to probability sampling is that every member of a given population has a known and non-zero chance of being selected in the sample. These are difficult conditions to meet, hence, it is unlikely that you will be using probability techniques in your undergraduate work. Nonetheless, many government agencies and other large organizations employ probability techniques in their studies so if you are using secondary data, be sure to check the methodology, and, in your analysis, account for any limitation or strength offered by the sampling technique used. Accordingly, we briefly highlight four common probability sampling techniques: simple random sampling, systematic sampling, stratified sampling and cluster sampling. We also refer you to Box 8.3.3 for additional tips on sample selection.
In simple random sampling, a sample is chosen randomly from the population, all with the same probability of selection. Systematic sampling draws a sample according to a random starting point but with a fixed, periodic interval. For example, a researcher might be interested in “articles written about Uber by BC media outlets in 2020”, use simple random sampling to select the first case then sample at a fixed interval, say “every 10th article.” Stratified sampling divides the population according to categories (strata) of interest (e.g. certain demographic characteristics) then samples from within each strata. Finally, cluster sampling divides the population into clusters (e.g. “articles by province, cities, municipalities”) and then selects cases from among the clusters.
If you are collecting primary data for your undergraduate project, you are likely using a non-probability technique. Non-probability sampling uses ‘subjective’ criteria sample selection such that not everyone in a population has a known or equal chance of being selected. Examples of non-probability techniques include convenience, quota, snowball, and expert sampling. Convenience samples include all participants who meet the study’s criteria, and are willing and able to participate. Quota sampling divides the unit of analysis into exhaustive, mutually exclusive groups, and then picks a predetermined number of participants/cases from each group. Expert sampling involves the selection of participants who are known to be knowledgeable about the topic. Snowball sampling selects participants through “word of mouth” – through asking participants to help find other individuals who fit the goals of your study. While this will likely limit your sample to the size of your network (and the bias of your network), it will also ensure that the population your studying is one in which you have the most access too (since they are likely to be close to you and motivated to work with you because you share the same social network; this can likewise extend to reflecting biases that form and filter the milieu you occupy).
All of these sampling methods can be used alongside the types of analysis discussed later in the chapter. The following sections seek to parcel out unique data collection techniques and the assumptions which underpin them. Interpretive research, for instance, will often require a less regimented sampling procedure; but the researcher must be aware of why this is the case to still collect enough of the right data to make a meaningful interpretation. We will also unpack three common methods of data collection – sourcing secondary qualitative and quantitative data, survey data (including interviews), and interpretive research.
Box 8.1 – Thinking About Your Sample Design for In-depth Interviews: Some Practical Tips
Extensive in-depth interviews (that take upward of an hour) require more due diligence in sampling. This makes snowball sampling and other methods that rely on your ‘ties’ effective for finding people who are motivated to substantively participate in your research. As per Human Ethics Board stipulations, your research cannot pose a serious risk of harm to subjects, and so your interviews will not likely involve stressful topics (of which you would need more training to undertake) on a vulnerable population you have no connection to. With this in mind, you should think carefully of the people who will form the data of your research. Then, once you have found them, ensure that you outline in as much detail as possible the goals and requirements of your research.
If you are still struggling to find enough participants (which for in-depth interview Honours theses often ranges from 5-10) then consider posting ads on school bulletins. The ethics board at UBC permits the use of small stipends (gifts no more than \$10) for low-risk research and allows advertisements to be printed to gain participants. Make sure to make your advertisements early, however, because the ethics board will ask that you submit these ads with the rest of your information. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/08%3A_Data_Collection/8.03%3A_Sampling.txt |
Surveys and Interviews
While surveys tend to be analyzed both quantitatively and qualitatively, their method is unique and popular enough to warrant a description of their own. Bhattacherjee (2012) defines survey research as a “method involving the use of standardized questionnaires or interviews to collect data about people and their preferences, thoughts, and behaviors in a systematic manner” (p. 73). It is a remarkable method for understanding large populations while situating individual preferences, thoughts, and behaviors as the unit of analysis. (For a full list of the positives and methods on how to construct surveys, check out Bhattacherjee).
Survey research is generally split into two categories: questionnaire and interview. Questionnaire surveys consist of a list of questions constructed to create standardized responses. Surveys most commonly come in three forms: mail surveys, group-administered, and online. Mail surveys are a more uncommon breed these days (besides the census), and is send out to the addresses of the target samples. Group administered surveys involve getting people together at a common place and time to complete the questionnaire (e.g., students in a classroom). Online surveys, typically recruit samples over email or via ads on the internet, allow individuals the fill out the form on the web. Common online survey tools include Qualtrics, Google survey, SurveyMonkey, QuestionPro, and Yesinsights (full citations available in Resources section). The potential limitations needs to be weighed against the strengths when deciding to use online survey (see Sue & Ritter, 2012 for a thorough discussion).
Interview surveys are directly administered by the researcher to participants, using any configuration of open and closed-ended questions. As a result, how you construct the survey questions can dramatically affect response rate and quality. If your study wishes to provide a more descriptive and holistic account of a few participants (ie. interpretive/qualitative), then a smaller amount of subjects will be required, and more open-ended questions would be included. However, if you aim at being able to generalize your results to the larger population, the questionnaire would utilize more closed-ended questions.
Survey research generally also has many significant biases including sampling and non-response biases (explored earlier). In addition, social desirability bias –the tendency not to disclose “anti-social” information about oneself and others –is common in primary data collection. Similarly, recall bias –the bias that results when answers to certain questions are hard to recall (e.g., “describe the last lunch you ate in preschool”), is a form of measurement error, which undermines data quality. As a researcher, it is important that you think through the different biases and errors that can creep into your research and devise strategies to mitigate them. The following table outlines some common problems in primary research and offers some suggestions for overcoming them.
Table 8.2 - Common Problems with Primary Data Collection
Problem Description
Interviewing Flaws
Interviewing is a complicated and sensitive task. It requires the researcher to be patient and careful about not imposing their view, but direct enough to ensure that the interviewee stays on topic. Interviews without much skill or preparation can botch the value of primary data collection, resulting in a superficial conversation of little value to research. To correct this, carefully prepare for your interviews and ensure you have the energy to conduct them. The following article repeats the important aspects of interviewing to keep in mind:
Brinkmann, S., & Ebooks Corporation. (2013). Qualitative interviewing. Oxford University Press. https://doi.org/10.1093/acprof:osobl...61392.001.0001
Information is Incomplete
Besides inaccuracies, there are two major kinds of incomplete information you can experience in your data: with respect to your research question or within the story of the participant. Either by accident or intentionally, the story of your participant can reveal itself as full of important holes. On the other hand, the interview can be brilliant, but move away from your research question, providing data that cannot directly answer your research question. This is always somewhat the case in qualitative research. Our lives are messy, and our reflection of it is bound to have gaps, fragmentary and irrelevant information. All of our information is thus in all respects, ‘incomplete.’ Do not be discouraged by gaps in the information, use what context you can, and be sensitive to the issues that are missed.
Sometimes the gap in your data can become the subject of your exploration. In Alexander Wilson’s (2021) research on Uber, he came to realize that a key thing ignored by media articles representing Uber’s arrival was the condition of Uber and taxi workers. As a consequence, this key silence in the discourse became an important issue for him to cover, where he asked: why was it ignored? If they are occasionally referred to, what might be missing about the Uber labour story? How does Uber stand to benefit from concealing their work situation from public discourse? Or is it because the public is uninterested?
Information is Inaccurate
As opposed to merely lacking the data, inaccurate information can trick the researcher into believing it’s accuracy and then thematizing it into your argument. Do not be embarrassed should this be the case. Social research requires much trust between all parties in order to gain accurate information. Because the nature of the research often involves investigating the lives of others as an outsider, the researcher is put in the uncomfortable position of being almost completely reliant on the information of their trusted confidante. There are, however, some methods to determine the validity of your primary method.
The researcher can cross-reference the information with other literature, generally available information, and interviews. Firstly, the literature review is supposed to help hone your understanding of the subject matter, making you able to spot inconsistencies or inaccuracies with regard to your subject matter. If you encounter new information, then do not be afraid to return to the literature in search of information that is similar to what you have found in your research. As discussed in chapter 4, the literature is iterative, and should be used to pay attention to works related to yours. If no work is, do not quickly assume that it is because it has found something everyone missed, what it might have found is an outright lie.
To determine this, you will need to go beyond the literature. If you are investigating the labour conditions in Starbucks, then there are likely ample public documents available to determine some of the background information on the labour conditions. You can use this information to determine whether there is at least some alignment between the report of your participant and the reports of others.
How labourers feel about those conditions, however, will be subjective and is not to be dismissed by concerns of ‘accuracy.’ But subjective is not to say that those feelings are not shared. The key task of a primary data collector is to determine trends and patterns that emerge in the messy reality of everyday life. This means cross-referencing the information you hear from one participant with as many others as possible. Doing this will allow you to sort through the statements that attain a common sense, a common understanding, and be wary of (without ignoring) those statements that cannot be confirmed by others.
Questionnaires Neglect the key issues
It may be that your instruments are flawed at addressing the major issues of the topic. This is not necessarily because of a flaw in their design (i.e., that the questions are not reliable), but may be because the intentions (the information your striving afterwards) has changed as you’ve begun interviewing and getting data. You may have designed your questions to initially focus upon how immigrants struggle in the Canadian workplace but then find in the interview process that it is not so much immigrants who struggle as those who have speech impediments/difference (accent, syntax, diction). Your research may therefore pivot to capturing that key issue.
If your questionnaires do change throughout your research journey, it is helpful to include multiple copies of your questionnaires. Note the key changes between the drafts of your questionnaires, and state which participants had which questionnaires. If you have to revise the questionnaire entirely, then you should also include a detailed argument about this transition in your methods.
Interviews or Informants are biased/bored
Suppose your informant has no interest in your research. Their eyes glaze over as you ask the questions, they offer evasive or abrupt answers, and they seem all but ready to sprint out of the room. I think the best way to address this is to just respond to them honestly: “am I boring you?” And to remind them that this research is not coercive, they are welcome to leave. Bored informants are unlikely to provide valuable information anyways.
But of course your questionnaires should not be designed to be boring (though this is sometimes unavoidably the result). Try to make them as quick as possible, and if information can be gotten through another avenue, try not to burden your informants with unnecessary questions. For surveys, try to provide a mix of short answer questions that are engaging and quick MC answers that can be quickly fulfilled. Do not proceed with a lengthy list of long-answer questions.
Bias will also pose itself as a significant problem in your research. Bias, the desire of your informant to provide you information which positively or negatively frames the topic, exists in all social research. Since your research topic involves the participant (hence their knowledge of it), it is likely that your participant will feel some level of gratitude or resentment for the thing you discuss. It is not your task as a researcher to disregard, ignore, or take for granted this bias, but to make sense of it. You will want to think about why this participant wishes to present you this almost pastoral account of climate movements, and why the next is entirely cynical of them. The bias of each account will help you to unravel their motivations alongside their experiential description of the topic, providing you (the social researcher) a better sense of not just how they are involved in this given issue, but why
Assessment fatigue
Do not over-tire yourself! Research is hard work (we know), and it is important to take regular rests. As argued in the self-care chapter, this rest will not only improve your well-being, but also the quality of your work. Researchers who attempt to do all their interviews in one day will find themselves getting sloppy on the third go, beginning to lose motivation as the exhaustion increases. It is vital, particularly for interview research, that you show more or as much interest in the subject as they do. If they get the sense that you are not even interested in this topic, they will begin to seriously doubt their involvement. In addition, taking breaks in between assessments will help you to reflect on what was working and what was not, providing you an interim chance to refine your tools for future investigations.
But assessment fatigue does not only apply to you. It also applies to your participants, who may simply get exhausted in a 1-hour interview. Make sure they are motivated and rested before beginning your research, and try to keep all your work concise and clear. This clarity should extend as much to the value of your work as to the clarity of information. The more motivated your participant is in the outcomes of your research, the more likely they will attempt to articulate and energetically defend their viewpoint on it. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/08%3A_Data_Collection/8.04%3A_Collecting_Primary_Data.txt |
Many undergraduate researchers use secondary data because there is little time for them to design, implement and administer surveys, perform length ethnographies while completing their studies or to recruit, administer and analyze interviews with many people. In addition, secondary data is everywhere, thanks to the endless amount of research that is accessible by keywords online. It is therefore important that you know how to source the right kind of data, particularly for pre-defined coding methods. We will discuss this next.
Sourcing and Organizing Textual Data
There are many opportunities to use secondary textual data in your undergraduate projects (e.g., if you are doing an analysis of media, websites, Twitter, Instagram bios etc, you can simply tap online for data). If you are not using an interpretive method, you will have to develop a procedure that samples the bios beforehand. That will require you to set a parameter relating to your research question (e.g. the bios of BC environmental activists on Twitter). This limited parameter will allow you to select a narrow range of online documents which can be organized and read once your coding procedure is chosen.
For media analysis, this is more complex. Often media analysis corresponds to a specific event, attempting to understand how that event is depicted in the news, and whether other news stations share those representations. This will typically require you to (1) account for media bias in the news and (2) pick a narrow time frame and narrow topic parameter to ensure that the article is particularly referring to the event you are discussing.
If news sources are the unit of analysis, you will want to account for media bias. That is typically achieved by limiting the number of sources (say The Province, The Sun, CBC) and then sampling equally from among them (see Krippendorf, 2018 for additional strategies to account for media bias). If the research project is focused on themes from the event (with less emphasis on the source), you will have to decide on a sampling strategy to determine how to handle the voluminous data that you are likely to encounter (see sampling strategies discussed earlier).
Apart from accounting for media bias in your sampling, you should also determine a strict time frame. For example, instead of searching “Uber in Vancouver”, you might want to narrow it down to “Uber in Vancouver 2020-2021”. Doing so will prevent you from having to unnecessarily pour over hundreds of articles. In addition, it is imperative that you further restrict the attributes of articles (i.e., characteristics that you are interested in such as gender, media station, time produced) so that you can limit and account for potential biases. Even in qualitative research, it is crucial that you have a cleanly organized, limited, and (as much as is possible) unbiased sample set.
After accounting for bias and applying restrictions to your sampling, you will want a system for collecting and organizing your data (e.g., Google Search). We suggest that you keep the search words consistent and then scan for articles relevant to your procedure (or select all if that is your sampling method). Another strategy is to go directly to the news repositories. If you are doing a social media analysis, you can simply search, then copy and paste the quotes into a corpus file. Alternatively, there are many new softwares for “newsgathering” which will allow you to find all the articles that match your keywords. The following box offers four of them.
Box 8.2 – Four Newsgathering Softwares
Source: Marshall, S. (2013, August 2nd). “16 online tools for newsgathering.” Journalism.co.UK. 16 online tools for newsgathering | Media news (journalism.co.uk)
For organizing your recently collected data, NVivo and Twint are great tools for collecting and analyzing data (see Boxes 8.4.1.2 and 8.4.1.3 for Alexander and Bryan’s testimonials respectively). If you are a UBC student, NVivo can be downloaded for free from UBC here. There are also annual courses about NVivo basics that are run by the library, which you can sign up for here. Another alternative to NVivo is “RQDA,” a qualitative analysis tool for “R” – an open source social science coding language. This tool will more effectively perform qualitative and quantitative analyses on your text (organizing how many times a particular code has occurred and in which cases).
Box 8.3 Student Testimony – Collecting Secondary Textual Data
My Honours research investigated the discourse surrounding Uber’s integration into Vancouver, attempting to triangulate their advertising rhetoric with the conclusions of transportation regulation. Whereas accessing secondary data was easy, narrowing down the relevant data was a tougher task than it needed to be. In a bid to encompass the variety of mediums in which Uber advertised their service to Vancouver – on Youtube, Social Media, Mainstream Media, TedTalks, and within City Council hearings – I began without a stern judgement on which data to collect. This was a mistake. It took many hours of wafting through Uber commentaries about Vancouver, government backlash, and lamenting our taxi service before I adjusted my hopeless endeavour into a hopeful one. With an endlessly hashed topic like Uber, and an open method like qualitative analysis, I highly recommend you figure this out before beginning research: decide beforehand what the key data sources are, figure out how much of that source you have the time to represent and nix the data sources you cannot fairly portray.
Balance of perspectives is vital to all academic research, but perhaps especially important for thinking about collecting secondary qualitative data. As secondary data, it is data which is mediated through the perspective of another. It was therefore especially important that I gathered data from multiple stations and speakers of the Uber issue, as secondary data from merely Uber representatives would have greatly restrained the information I was using and the conclusion I came to. Having stressed myself into this conclusion, I drew up a tiered list of the variability in my data sources and tested which I could access enough data from (i.e., major Vancouver Uber influencers: Uber representatives, mainstream media stations and legislation (parliament and PTB). With that done, I nixed the sources which I did not have the space to adequately represent and tried to sample equally between the sources I could adequately represent. Once I evolved from my data slob state and established data standards, I could then move onto the next major task of secondary data collection: actually collecting the data.
Once I had figured out that it was Vancouver mainstream media and four legislative documents I was including, I made a list of the stations I would be collecting from and the time frame of the report that I was expecting. With the list made, I set about going to the archives of each of the main stations (The Province, The Vancouver Sun, The Vancouver Courier) and copy and pasting the articles into a corpus file, a collection of data (text) copy and pasted into one word document. I then uploaded the corpus file into NVivo, a qualitative analysis program which tracks the codes and cases you make, where I did my coding and data organizing. In NVivo, I could neatly organize all my articles into different cases, where I could then track comments according to the station, time, and context of the claim. NVivo allowed me to connect many cases without compromising the qualities that made them distinct (I could not recommend it enough to students using secondary qualitative data!). Throughout, I kept a running list of my citations and links to have quick reference to the source.To summarize:
• Figure out the data you can access
• Clarify the most relevant data in answering your question
• Ensure variety in that data to limit bias (if there are key silences, seek them out)
Create or use a system for organizing that data (NVivo!)
• Update your reference list as you go
Alexander Wilson, Sociology Honours student, 2020-2021
Box 8.4 Student Testimony – Scraping Twitter Text Using Twint and R
For my thesis on the relationship between Social Media and moral panics I conducted a quantitative data analysis, achieved through tokenizing a Twitter dataset scraped via Twint (a python based script) and processed through R (a coding language used mostly by statisticians to create data visualizations and analysis) to show trends of when specific language linked to CRT and Cancel Culture pop up. Twint is essentially a data scraper which operates much like how Google operates when collecting information from web pages through a process known as “scraping” or “crawling”. In order to use Twint, you must first download Python and interface to use python (like Microsoft Visual Studio Code). This interface allows you to save any changes and write code as when you download Python, python itself is just the coding language, without an interface, you cannot interact with the language. From there, you will have to download Twint onto your computer in a specific way – follow the YouTube guide for more information. It is important to note that Twint technically does violate a part of the Terms of Service outlined by Twitter, as they prefer researchers to use their API. However, as an undergraduate student you cannot get access to their “research-level” API (which is needed most likely for research projects), as they have limited it for graduate students or faculty. The only way to get access would be to have your thesis supervisor make a submission on your behalf, and even then Twitter may reject the application. However, Twint does not violate the guidance for crawlers outlined by Twitter’s “Robot.txt” file. This file essentially tells bots what parts of Twitter they may crawl – Twint does not crawl on areas of the site that are restricted by the “Robots.txt” file.
Once you have Twint installed all you have to do is point it at a Twitter handle and build a query on Visual Studio Code (VSC). By creating a file with your code on VSC you essentially create a script that allows you to run different queries, and saves these queries so you can run them again at a later time. To begin, start by figuring out what the Twitter handle of the user you want to research is. The “twitter handle” refers to the “@” of the user. For example, UBC Sociology’s twitter handle is “@UBCSociology”. From here, you are going to create a query/boolean query. A query is a string of logical statements of “OR”, “AND”, and “NOT”. These statements essentially direct Twint to pull certain tweets from the user that you have directed the program to. For example, if used the query “SOCIOLOGY OR SOCI” and pointed Twint to the UBC Sociology page, Twint will only pull posts with the keywords “SOCIOLOGY” or “SOCI” from the UBC Sociology page. The query allows you to really search for what information you want. By pulling posts with these keywords you are interested in you are also able to build a timeline of when posts increase, decrease, or even when certain terms appear! Moreover, you can use the dataset that would be created from the data draw to closely analyze the full tweet to do a textual/content analysis. This would provide even more context to the data that you have just drawn from Twitter.
Bryan Leung, Sociology Honours student, 2021-2022
Sourcing and Organizing Secondary Quantitative Data
There is an abundance of secondary data organized into reliable online data repositories which you can use to inform your study. While we will not discuss each of these repositories, you can check out UBC Library’s page of common data repositories for datasets from major primary data agencies such as StatCan and Abacus. Most of the data is downloadable in popular softwares such as SPSS, Jamovi, R, or another analysis program. A key part of any collection of vast amounts of data is knowing how to organize it. In collecting quantitative data, you will want a strict data entry method and tools to accompany it. While you can enter your data directly into the major statistical programs (like SPSS), they all have their own unique programs for saving and entering the data (like .sav), making your data harder to transfer elsewhere (Bhattacherjee, p. 120). | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/08%3A_Data_Collection/8.05%3A_Collecting_Secondary_Data.txt |
So far in this chapter, we have focused on data collection for empirical research (systematic observation of primary or secondary sources). However, many undergraduate theses take the shape of systematic literature review (meta analysis), argumentative essays or theoretical arguments. In this section, we comment on data collection for these.
Systematic Literature Review
Systematic reviews (or meta-analyses) “attempt to collate all empirical evidence that fits pre-specified eligibility criteria to answer a specific research question. It uses explicit, systematic methods that are selected with a view to minimizing bias, thus providing reliable findings from which conclusions can be drawn and decisions made” (Liberati et al, 2009, p. E3; Oxman & Guyatt, 1993). According to Liberati et al (2009, p. e3), systematic reviews are characterized by the following:
• a clearly stated set of objectives with an explicit, reproducible methodology;
• a systematic search that attempts to identify all studies that would meet the eligibility criteria
• an assessment of the validity of the findings of the included studies, for example through the assessment of risk of bias
• systematic presentation, and synthesis, of the characteristics and findings of the included studies.
While we will not review the process of conducting systematic literature review (see Liberati et al, 2009 for full details including checklists for procedures; see also Oxman & Guyatt, 1993), we highlight some key consideration for data collection in this section. We also encourage you to consult Chapter 6 (literature review) as well as UBC library’s “Planning your Review”, which will provide you information about systematic literature reviews and more. As with other procedures, for systematic literature review, the ‘right’ amount of literature collected will depend on your research question and the amount of research covered in your area. Since your research is devoted to a literature review, however, you should endeavour to cover all the relevant literature with regard to your research question or intended contribution.
There are two primary steps in the data collection process for systematic reviews. The first is establishing a research protocol or plan of how the search will be conducted. The UoM (2022) provides the following five guidelines for developing research protocols: (1) decide on the objectives of the review; (2) determine how the systematic review will be conducted (methods and processes). This will be similar to the suggestions for conducting textual data above; (3) establish eligibility criteria for the studies that will be included; (4) determine how you will extract data from the studies (see Alexander’s testimonial for how he used NViVo; simple copy and paste works as well); (5) determine what analyses will be performed (e.g., thematic, discourse, content analysis etc).
The second step is conducting the literature search. Again we encourage you to review Chapter 6 (Literature Review) for guidance in conducting a literature search. However, it is important to keep records of the databases included in the year, the years covered, dates when the searches were conducted, search terms and strategies and the number of results obtained (UoM, 2022). These details will inform your methodology (see Chapter 7).
Argumentative Essays and Theoretical Theses
As theoretical dissertations aim to propose either new conceptual models or establish the effects of the existing ones when applying the theory to societal issues (Cropanzano, 2009), you will need to start with a particular theory in mind. You will then examine how the application of such theory would help us to better understand or solve a problem or fill a gap in the scholarship (Cropanzano, 2009). Hence, the data collection process for argumentative essays and theoretical theses are similar to that for conducting systematic review –it is literature driven. However, researchers might choose to employ theoretical sampling to guide the data collection process. Theoretical sampling, according to Corbin & Strauss (2008, p. 143) is “ a method of data collection based on concepts/themes derived from data. The purpose of theoretical sampling is to collect data from places, people, and events that will maximize opportunities to develop concepts in terms of their properties and dimensions, uncover variations, and identify relationships between concepts.” Theoretical sampling is an intense process, wherein the researcher tries to reach saturation –the point at which no new data is found (Corbin & Strauss, 2008). It involves three processes: (1) selecting cases that conforms to the researchers’ central argument/ theory; (2) selecting cases that deviates from the central argument/theory; and (3) adapting the sample sizes of cases that either conform or deviates in order to explore emerging ideas or generalizations. As with all methodological choices, the researcher needs to determine and justify what cases are included and why, and establish a criteria for how cases are selected (Silverman & Marvasti, 2008). Because theoretical papers try to establish new hypotheses and theories, the method of data collection is inductive, iterative and often seen as a component of grounded theory (Corbin & Strauss, 2008). | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/08%3A_Data_Collection/8.06%3A_Systematic_Literature_Reviews_Essays_and_Theoretical_Theses.txt |
As you collect your data, it must go through some early stages of preparation before it is analyzed. The methods that you use for organization should likewise help guide your data collection, allowing for easier categorization and aggregation of the complex data that you will be receiving. We therefore recommend that you read the qualitative and quantitative analysis sections in addition to this chapter on data collection before you begin. In this final section, we briefly overview common problems and concerns that researchers have with organizing their data.
Table 8.3 - Common Problems with Data Organization
Problem Description
Coded Chaotically
Many problems with organization ultimately stem from arbitrariness. Organization implies that definite principles and rules are applied to the arrangement of information. Defining these rules allows any researcher who understands the rules to predict the placement and relationship of the information. But if no rule or pattern exists, each dive into the data will remain as confusing as the first.
As a consequence, keep your organization and coding consistent by establishing strict rules around the coded data. For each code you attribute to a set of data, define it clearly and write down its definition in your field notes. This will not only help you find related data in the future, but will also remind you of your reasoning later on.
Inconsistency in Variable Measurement Use the same measurement tool for each variable! For instance, if you use an ordinal measurement for “income,” do not apply an interval-ratio measure for subsequent variables. This will make your variable much easier to manipulate, as the same measurement will allow you to compare the data easier in your analysis. Comparing data that has used a different system of measurement will require that you translate that data into the same system of measurement before you compare (i.e. what you would have to do if you measured half with the metric system and the other with imperial).
Inconsistent in treatment of missing data How you deal with missing data is a vital part of the data collection process, and like everything else, it has to be dealt with through a consistent set of principles.
Dealing with missing data consistently first means that you actually deal with all the missing data. Make sure that if you are addressing the missing data of one variable (which you should) you do the same for all the others.
The second problem with inconsistent treatment of data is how you treat your missing data. If you acknowledge the methodological problems behind missing data for your survey of ‘immigrant incomes in Canada’ then you should try to address the same problems for your other data (which may not exist, but explain why).
Missing Data
Regardless of how you define the scope of your empirical research, there exists no complete picture of an experience. However, as a researcher, it is your task to best account for the data that relates to your topic. As a consequence, if your methods fail to capture key data that relates to your topic, then it must be discussed. There are many reasons for this, the survey may have been too long (non-response error), the interviewer may have forgotten a question (administrative error), there may have been populations out of reach of the demographer (coverage error), the variable might have been too narrowly defined (measurement error), the questions may have been leading and so on ad infinitum.
While missing data can affect your ability to answer research questions, in most cases, it is not that alarming. The questions posed by missing data are often as important as the research question itself. The data that your method does not find can often help to explain the weaknesses of the method, or the need for a different method in researching this part of social life (see Chapter 11 for a discussion about writing your limitations). The missing data may also indicate some structural barriers about your topic itself. For instance, the tendency of your respondents to not disclose their incomes may indicate a social desirability bias (the perception that they will appear more popular if they lie or omit information about low or high income). In other cases, the data is either scarce or hard to access. Missing data, oddly enough, can be an important kind of social data; they may indicate the inevitable barriers and power inequalities that mitigate the flow of information.
Because missing data is most likely to be noticed in the process of data-entry, it is important that you devise a protocol for tabulating missing data. Here is what Bhattacherjee (2012, p. 120) has to say about missing data in data entry:
During data entry, some statistical programs automatically treat blank entries as missing values, while others require a specific numeric value such as -1 or 999 to be entered to denote a missing value. During data analysis, the default mode of handling missing values in most software programs is to simply drop the entire observation containing even a single missing value, in a technique called listwise deletion. Such deletion can significantly shrink the sample size and make it extremely difficult to detect small effects. Hence, some software programs allow the option of replacing missing values with an estimated value via a process called imputation.”
Considering the importance of data-entry just discussed, it is therefore vital that you are wary of ‘imputation’ and ‘listwise deletion.’ Missing values in a dataset cannot be simply inferred if it is not attached to evidence, and listwise deletion and imputation (based on previous values) draw assumptions about the data that often cannot be easily shrugged off. As a consequence, if you are doing a statistical procedure, and need to include data that was missed, be sure to also explain in words possible reasons for the missing data, its impact on your data set, and how you treated it in your calculations.
Data Transformation
As we noted in missing data, it is sometimes necessary that you alter your data values before they can be interpreted. This, however, should be done with caution. While performing a logarithm on your data values may help to dramatize (and therefore make noticeable) the pattern within a dataset, it also can distort the viewer’s perception of your findings. That is why it is always important that you remain explicit about your methods throughout the process so your reader knows exactly why you performed the adjustments you did. That caveat stated, data transformation is an important part of dealing with statistical data. As noted before, it is to help indicate trends in the data that are not necessarily evident at first glance. As a result, data transformation is led by a search for key trends in the data. For example, a common type of transformation involves scaling up or down the weight of an item. Bhattacherjee (2012) suggests including scale measures by adding individual scale items, creating a weighted index from a set of observed measures, and collapsing multiple items into one category (see Fink, 2009 for a deeper discussion on Data Transformation).
8.08: Summary
This chapter discussed common concerns in data collection such as bad data and and militating strategies. We highlighted four of the most common types of errors (coverage, measurement, non-response and sampling) as well as some tips for minimizing them in data collection. We also indulged in an expanded discussion of sampling and considerations for developing effective sampling frames. As what might be considered an addendum to chapter 7 (Methodology), we emphasized that you ask yourself three questions as you dive into data collection: 1) What data is most pertinent to my research question? 2) How much of it can I and do I need to collect? And 3) How is my data still limited with regard to answering my question (either through bias or lack of representation)? The chapter also outlined specific considerations for primary and secondary data collection in both qualitative and quantiative studies. First, we reiterated some guidance for conducting interviews and surveys in primary research. Next, we discussed secondary data and provided a list potential sources. The chapter ended with tips to help you assess and evaluate data and procedure to ensure that you are collecting quality data, including considerations about missing data and data transformation. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/08%3A_Data_Collection/8.07%3A_Data_Organization.txt |
Learning Objectives
By the end of this chapter, you should be able to:
• Understand how to present the characteristics of your data
• Learn various styles for presenting quotes
• Discover how to create and use simple data visualizations
• Determine how to weave data into a narrative
Suggested Timeline: January – Mid February
Box 9.1 – Student Testimony – The Key Principles and Motivations of Qualitative Research
Qualitative work is never ‘objective,’ and it does not seek to be. A qualitative researcher inhabits multiple subjectivities and produces work that draws from their lived experiences, their command of the methodological and scholarly texts they corral to interrogate their topic, and through the position they advocate for in their work. As a qualitative researcher, my work in Mumbai, Delhi, and Pune, India (2011), Chicago, U.S. (2015), and Vancouver, Canada (2017) has happened in community with others. I have written work on research topics ranging from the migration and displacement of Afghan students and refugees who lived in India, intervened—through sexual prevention campaigns and government-funded studies—in the HIV epidemic brutalizing black gay men, transwomen, and women of colour in the US, and documented a small part of the emerging constellation of temporary placemaking events—or pop-ups—queers in Vancouver create to make space to salaciously play, dance, forge friendships, and find their tribe.
My advice to emerging scholars is to leverage what you know as a set of strengths, to be open to what you don’t know, to learn from others already doing the work, and to find a supportive set of mentors who value and support your intellectual growth. Good work happens through the community you keep with your research participants and the mentors who want the best for you. That requires regular communication and setting realistic and achievable expectations given the capacity of everyone, while establishing healthy boundaries for yourself to do the work asked of you.
DO: regularly and reflexively challenge your views about your topic, and how ‘uncomfortable information’ you receive dislodges former assumptions held and generates new lines of inquiry
DON’T: engage in research for the final product such as publications or presentations—research is a long journey that depends on the people you work with and who support your work. The final product will reflect this.
Ryan Stillwagon, Graduate Student, UBC Sociology
Data analysis is the process by which we make meaning from the data that we collect. In qualitative research, we do this by: (1) searching for and identifying patterns and themes; (2) providing evidence (textual data and narratives) to support the patterns and themes identified; and (3) telling a cohesive story from the data and enable us to provide answers to our research question.
As with the preceding two chapters (methods and data collection), analysis will depend on the paradigm chosen. This section will therefore relate itself to the last couple sections, aiming to distinguish the main social science paradigms for data analysis. This chapter is divided into four sections: first, we outline the basic steps of qualitative analysis; second, we discuss common frameworks for conducting qualitative data analysis with emphasis on grounded theory and content analysis; third, we discuss data analysis and presentation strategies; and finally, we discuss storylining, the process of mapping concepts into a narrative. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/09%3A_Qualitative_Data_Analysis/9.01%3A_Introduction-_Learning_to_Swim_in_the_Data.txt |
Before you get to the point where you are able to answer your research question, several things need to happen. First, you need to accurately transcribe your data into a form that will lend itself to reliable scrutiny. This includes organizing your field notes, memos, observational and other data in a way that will make it easy for you to review.
The second stage of data analysis is coding and counting (so that it does not appear that your analysis is only a series of biased anecdotes, see Silverman, 2015). Counting is the process of enumerating or assigning numbers to non-numberical data while coding is the process of organizing data into categories so that it can be analyzed. Researchers use several strategies, including grids (or matrix tables), affinity diagrams and content mapping to help discern and organize patterns. Third, you need to transform the evidence into a coherent argument while exercising reflexivity about the decisions you made to transform that evidence (Rosaline, 2011). It is only at this stage that you will be able to answer your research question. We will expand on these stages before returning to how qualitative researchers answer their questions. Let us begin by discussing transcribing and coding.
Transcribing
All audio interviews must be transcribed before being analyzed. This usually takes about 6 to 7 times as much time as the interview itself (a 1 hour interview = 6 to 7 hours of transcribing) (Halcomb et al, 2006). The amount of time taken to transcribe will depend on the software used, skill, motivation, experience or other factors. In some cases, it is significantly more, and in other cases, it can be less.
There are two approaches to assembling qualitative data for analysis: verbatim transcripts or field notes of memos of the research process. According to Halcomm, verbatim transcription refers to the “word-for-word reproduction of verbal data, where the written words are an exact replication of the audiorecorded words” (2006, p. 39). Depending on the study, researchers might be less interested in verbatim records and might focus more on field notes and memos. In some cases, they might listen to audio records as a means of supplementing the field notes and memos created during the research process. Most researchers rely on the combination of field notes, memos and verbatim transcripts. Regardless of the approach used, the qualitative data analysis process is usually guided by the same goal: to identify patterns.
Box 9.2 – Getting Started with Transcription
• Before you begin transcribing a file, listen to a few minutes of the recording to get a sense of the speech patterns and quality of the recording
• Begin transcribing with the shorter and clearer files. This will give you a sense of victory and help you build momentum. Even if you save some of the shorter files for later, do not do all the long, difficult files first. That can be demotivating.
• Take a break between transcripts
• Omitting fillers in speech patterns such as um, uh, like, you know and so forth are okay so long the context of what is stated is not greatly altered by this change
• Unless language competence is important to the research, it is acceptable to make small grammatical changes
• Try enhancing files with audio issues. Omit data only if the audio is irretrievable or if the time/resource investment is substantial. Inaudible sections should be marked with a blank (________)
• Transcribe in small amounts at a time e.g. 5 seconds of audio. This will ensure that you remember everything that was said and can be time efficient. It also enhances accuracy)
• Label emotions and actions for what they are e.g., sighs, breathes heavily, laughter
• Use ellipsis (…) to indicate unfinished sentences or pauses mid-sentence
• Numbers should be written in letters
• Start a new paragraph (block format) with each new speaker and they should be separated with an empty line.
Adapted from Frankfort-Nachmias, C. and Nachmias, D. (1996). Research Methods in the Social Sciences (5th edition). St. Martin’s Press Inc.
9.2.2.2 Transcription Softwares
There are several transcription softwares that can make the process easier for you. These include Dragon Naturally Speaking, Adobe Premiere, Otter, Happy Transcribe, Rev and Amberscript. Most of these require subscription or payment to use. However, your institution might have some available. It is also worth checking out free softwares. It is important to remember that no software is completely accurate. Regardless of the program used, you will need to make edits and corrections.
Coding in Grounded Theory
Miles and Huberman (1994) define codes as “tags or labels for assigning units of meaning to the descriptive or inferential information compiled during a study” (p. 56). Simply put, codes are abstractions, labels we assign to chunks of texts, which can be of varying size, e.g., words, phrases, sentences or whole paragraphs to summarize their meaning (Miles & Huberman, 1994). This means breaking the data into manageable chunks so that it can be analyzed to uncover relationships (similarities and dissimilarities). Coding is hence the bedrock of qualitative data analysis. We discuss three of these strategies: grounded theory, systematic analysis and content analysis.
Bhattacherjee (2012) describes grounded theory as “an inductive technique of interpreting recorded data about a social phenomenon to build theories about that phenomenon [in which] interpretations are ‘grounded in’ (or based on) observed empirical data” (p. 113). This process has three common techniques:
1. Open coding: also called emergent codes because codes are derived from the text, rather than from preconceived ideas and concepts (Blair, 2015). Open coding begins by analyzing texts to determine labels (Strauss & Corbin, 1998) then deriving concepts and categories/sub-categories, which will ultimately evolve into constructs. It is the bedrock of grounded theory because the researcher attempts to be open to new ideas while suspending pre-existing beliefs, concepts, theories and attitudes to allow meanings to emerge from the data. This is no doubt an extremely difficult undertaking.
2. Axial coding: Organizes categories and sub-categories into causal explanations that could possibly explain the phenomenon. This can be performed simultaneously with open coding. Researchers need to be alert to the categories that cut across all data sets. It is only through this process that one can determine the themes in the dataset. Remember, a theme is a collection of related codes. While conducting axial coding, the researcher is looking for general patterns and explanations by asking questions such as
3. Selective coding: “involves identifying a central category or a core variable and systematically and logically relating this central category to other categories” (Bhattacherjee, 2012, p. 114). Doing so will help to better recognize patterns and explanations. In particular, you might need to ask yourself: (1) can certain codes be grouped together under a common category? (2) are there specific relationships between codes (e.g., is there progression such as A leads to B, C mitigates B, A and B usually happens before C etc.,)? Strauss & Corbin (1998, p. 161) notes that “categories are organised around a central explanatory concept”
From the above, it is evident that open-coding is foundational to grounded theory because it generates a “participant generated ‘theory’ from the data” (Blair, 2015, p. 17). Do not make the claim that you are using grounded theory if the codes do not emerge from the data. Essentially, grounded theory coding means that the explanations and concepts used to answer the research questions are generated from within the data and not from the literature or other external sources. This requires that researchers read, re-read and label texts until they reach theoretical saturation. Theoretical saturation is “when additional data does not yield any marginal change in the core categories or the relationships” (Bhattacherjee, 2012, p. 115). In other words, it is the point at which you are not finding any new concepts, relationships or codes. Reaching theoretical saturation requires intimate connection to the data. Many insights do not stand out the first time you code the data. You must be prepared to code it multiple times, paying attention to the context in which something was said (e.g., was it said in relation to another topic, did you have to probe for it to happen etc). Taking these things into account could reveal new instances of a code or theme. However, at the point of theoretical saturation, it is important to move on. You should focus on either axial or selective coding.
On a final note, grounded theory and open coding can be used with any type of qualitative data, but content analysis is used less often to analyze interviews and other primary data. Instead, content (and template and systematic) analysis is often used to analyze secondary data e.g., institutional documents, newspaper reports, books and other social artifacts.
The Constant Comparative Method
An important element of qualitative data analysis is constantly comparing and contrasting your findings. The constant comparative method involves “looking systematically at who is saying what and in what context…it relies on identifying patterns in your data and this means that you need to do some counting” (Rosaline, 2011, p.254). Counting in this context does not equate to statistical inference but you need to provide evidence that a theme or perspective was really important. For example, you might say “seven out of the fifteen respondents articulated that…”. Hence it is important to compare and contrast the perspectives of your respondents.
Dealing with Exceptional Findings
In the coding process, you are likely to find a theme or certain insights that do not fit with the general trends of the analysis. You might be tempted to: (a) ignore the findings or (b) treat it as a major theme. You should certainly not ignore it, but neither should you treat it as the rule or as a generalizable finding. The adage, “the exception does not prove the rule,” applies here: exceptional claims require exceptional evidence. Think of your audience and background research to your field: is your finding all that unique? If it is, then it requires extra evidence: many of your interviewees should optimally have a statement that supports your point. If the exception is interesting but you lack the evidence to support it as a major finding, you should note it as an issue for further research. On the other hand, findings that are well-established in the field do not need extensive elaboration. You can simply offer only a couple of quotations before moving onto something they do not know.
Checking for Internal Consistency
Before drawing definitive conclusions from your analysis, you must check for internal consistency (whether what you are saying contradicts itself) and then (re)check your results against the raw data (whether you have omitted key evidence from what you are saying). Checking for internal consistency means applying your explanations to all the data you have gathered and ask: does it contradict any of my data? Are any of these contradictions abundant or important enough to undermine the explanatory power of the theory? For example, if some of your raw data contradicts the dominant theme that “all right-wing media outlets are funded to neglect nefarious corporate behaviour,” you will need to address the contradictions. Suppose, you find some text from a right-wing media outlet with grassroots funding that condemns big corporations, you might need to question how prevalent such a contradiction is, what are the conditions under which such contradictions happen, then evaluate the implications for your dominant finding.
Grounded theory is commonly criticized for its lack of strict standards for defining concepts before observation. Because the concepts (or bits) of data are gathered according to the judgment of the researcher, it therefore asks the reader to trust the researcher’s judgment in picking relevant and accurate data. In this respect, grounded theory can risk becoming a tool to confirm the bias of the researcher (as is also a risk of interpretive research). It still, however, is an evidence driven approach, and requires the conceptualization and amassing of evidence in order to prove its argument. Nonetheless, the grounded theory researcher should place extra emphasis on thick description in their data analysis. Thick description means providing detailed multiple descriptions (usually through verbatim quotes and narratives) and interpretations (explanations) of this. This means that many different networks of data are connected to the main argument of the research, providing the presentation of multiple viewpoints on a single topic. This concrete and direct evidence (as opposed to an abstract and jargony description), will prove to your reader that while your data presentation was still reliant on your judgment as a researcher, the judgment is based on comprehensive evidence that is coded, not fabricated.
Box 9.3 – Ensuring a Grounded Theory
Glaser (1998, p. 18-19) states that there are four primary requirements for judging a good grounded theory:
1. Fit: Emerging concepts should accurately describe the pattern of data.
2. Workability: clarifies whether the concepts and hypotheses account for how participants concerns are resolved
3. Relevance: addresses whether the issue is of social concern i.e., are people interested in the finding? What are the wider social implications?
4. Modifiability: is the theory amenable to modification if new data shed more light on the phenomena?
Source: Glaser, B.G. (1998). Doing grounded theory – Issues and discussions. Sociology Press.
Content Analysis
Content analysis begins with a different coding scheme than grounded theory. Rather than begin with open coding, content analysis uses systematic coding. Bhattacherjee (2012) therefore defines content analysis as “the systematic analysis of the content of a text (e.g., who says what, to whom, why, and to what extent and with what effect) in a quantitative or qualitative manner” (p. 115). Systematic coding determines, before reading the text, a system for sorting what could be found. Hence, it provides “inputs” for codes such as the use of specific terms such as “good” and “bad” to describe the “sentiment” a customer feels about a product or by giving broader concepts inputs such as making “care for cost” equivalent to the use of “expensive, cheap, cost-effective, cost or price” when describing Uber’s service. It is also a technique able to numerically evaluate a text, to determine quantitative relationships of how much a particular code appears throughout a given discourse. Similarly, some researchers use template coding where codes are predefined by the researcher based on prior research, reading or theory (Blair, 2015; King, 1994; Miles et al, 2014).
Content analysis can be used deductively, to test the efficacy of a theory for explaining a given phenomenon. For instance, I could derive an hypothesis (based on other readings about Uber’s arrival in urban landscapes) that the primary concern of the public about Uber is cost. I could define the code “cost” and it’s potential inputs beforehand, and then hone in on how much it is discussed relative to other potential issues such as “working conditions,” “emissions,” and “speed” to determine what is actually most mentioned in public discourse. This makes systematic coding an effective tool for clearly testing whether assumptions in the field comprehensively hold on a large discourse. Devising codes beforehand also allows more data to be easily organized, making content analysis a more effective tool for coding larger datasets.
Unlike grounded theory, content analysis involves the creation of a predesigned set of codes or constructs, which the “text” or data is then ordered into. For instance, say I am analyzing the “media about the upcoming election to determine whether one candidate is given more favourable representation than the others.” I might choose to devise codes that capture “favourable representation” with both qualitative and quantitative aspects. I could deem “favourable” as “allusion to the positive benefits of their policy or leadership (their ‘sound’ fiscal policy will…)” and then count the instances where this occurs.
Box 9.4 – Content Analysis in Five Steps
Transcription
• Are all your audio and visual data converted into an easily accessible textual file (by hand or by computer program)?
Coding Rules – What am I looking for and do I define it?
• Is your hypothesis able to anticipate what text you might find?
• How might that hypothesis be split up into clear codes? What are some potential examples for each code?
• How do you define the codes so that they are mutually exclusive and exhaustive (i.e. that they do not explain the same thing and that they capture as much text as could fit into that definition)?
• Are the codes worth finding out? Are they interesting? Has another researcher searched for the same thing and confirmed/disconfirmed the existence of that speech?
Code Data According to Rules – Have I found what I was looking for?
• Were my codes present or non-existent in my textual data?
• Have I found out the quantity of each code in comparison to the other?
• Have you addressed the frequency (amount in relation to the total responses), direction (positive or negative statement, stance towards other institution, person, idea, etc.) and depth (how many other statements was it referring to?) of each of my codes?
The Uncoded – Is there data I am misinterpreting/ignoring according to my initial rules?
• Check for data that was uncoded according to your protocols
• Have I accounted for my biases as a researcher?
• Do they reflect my biases as a researcher?
• Can any of them be redressed without compromising the intentions of my hypothesis?
Reflection and Reiteration – Has my hypothesis been proven/falsified, and which codes best prove/falsify it?
• Evaluate your findings with regard to your initial hypotheses
• Do the findings follow the trend you were expecting?
• If not, how do they deviate from that trend?
• Are there “negative cases” (cases which contradict the expectation) which you can explain?
• Nuance your expectation in an attempt to explain the cases that contradicted it
• Reread and repeat coding steps to continually test and strengthen your thesis
Table 9.1 - Sample Matrix
Hopes Beginning Discipline
Respondent 1 “I hope the movement will be able to coordinate itself better in the future. The last protest was an embarrassment, the speaker could not even find some basic agreements with each other regarding the needs of the environmental movement.” (‘30:20) “I was eight years old. My parents had informed me of the risks of climate change, and I wanted to do something about it. I joined my school’s recycling club and helped sort cans. I actually thought that was enough to fix the environment at the time. Recycling.” (‘15:45) Engineering
Respondent 2 “We need the attention of those in power. Environmental protests have been happening for thirty years, and policy is still too slow to follow the popularity of the movement. We need to focus on those in positions of power now, not just popularity.” (‘15:20) “I am embarrassed to say that I never participated until I joined university. Yeaa, I guess it was about then when my friends were protesting that I thought of joining them. Once I had attended, listened to the speakers at Vancouver’s protest, then I think the impact of the movement, which I already knew of, struck me in all its importance.” (‘10:00) Forestry
Box 9.5 – Sample Matrix
A common way to make a matrix is to simply highlight the raw data of your interview transcripts (or a collection of your textual raw data, a corpus file).
For instance, take this hypothetical interview with the first respondent of the previous matrix. The highlights are yellow for discipline, green for beginning:
• Interviewer: What is your discipline of study? Has it had anything to do with your participation in the environmental movement?
• Respondent 1: I study engineering. I suppose it has had an impact, but only indirectly. I was interested in math in high school and also felt that new technology could reduce the environmental damages of the old kind. The interests intertwined with my passion for engineering, which was not as purely theoretical as studying mathematics, nor lacking quantitative reasoning like other environmental activism roles.
Once highlighted, they can then be returned to copy into the relevant outline of your argument. If the interview transcripts take 20 pages, and there are five of them, scouring the documents for highlights can quickly become tedious. This is where having both highlights (initial data categorizations) on the raw data and narrowed key quotations (potent examples) in a separate matrix can make your final write-up much easier. One you can use to look for more data and get a sense of how comprehensive your evidence is for a particular code, the other will have a few of your most lucid examples for the write up. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/09%3A_Qualitative_Data_Analysis/9.02%3A_Transcribing_and_Coding.txt |
In this section, we will highlight three other techniques that can aid qualitative data analysis: affinity diagramming, concept mapping and memoing. Affinity diagramming is a technique used to externalize, make sense of, and organize large amounts of unstructured, far-ranging, and seemingly dissimilar qualitative data (Lucero, 2015, p. 231). By creating tangible notes based on the data and organizing them visually, researchers can map relationships between codes, identify themes and recognize patterns. Affinity diagramming can proceed through four stages (Lucero, 2015): First, the researcher examines the data and records observations (and labels) on post-it notes. Only one idea is placed on a note. Second, the notes are placed on a surface or wall where they all can be scrutinized. Third, the notes are arranged in columns or piles to reflect themes or categories, which are then labeled accordingly. Finally, the researcher refines the categories and further arrange themes into hierarchies to determine dominant patterns.
Similar to affinity diagrams, concept mapping can be quite useful for data analysis. Concept mapping is a graphical representation of concepts and relationships between those concepts (e.g., using boxes and arrows). The major concepts are typically laid out on one or more sheets of paper, blackboards, or using graphical software programs, linked to each other using arrows, and readjusted to best fit the observed data” (Bhattacherjee, 2011, p.115).
A third strategy for analyzing qualitative data is memoing. Bhattacherjee (2011, p. 115) defines memos as “theorized write-ups of ideas about substantive concepts and their theoretically coded relationships as they evolve during ground theory analysis, and are important tools to keep track of and refine ideas that develop during the analysis”. Researchers use memoing to review memos in order to discover patterns and relationships between categories using two-by-two tables, diagrams, or figures, or other illustrative displays (see Bhattacherjee, 2011 for more details). Box 9.6.1 provides additional tips for organizing codes.
Box 9.6 – Some Tips for Organizing Codes
After the initial coding, especially when open coding is used, it might be difficult to organize codes into manageable parts. The following are some tips to help you arrange your codes to determine key patterns and themes:
Analytical Question: Arrange codes according to analytical questions as feasible (What, where, how, who, when, why)
Clustering: list all the codes used, then cluster similar codes (repetitive and redundant codes can be added to more central coles). Repeat the clustering process until you have 25 to 30 codes. After that, reduce the list of codes to around 5-7 themes or descriptions (Miles et al, 2014).
Frequency, Importance and Intensity: List all the codes and the frequency of each. Based on frequency, you might be able to determine key patterns and themes. Alternatively, you can arrange codes by research questions to determine key themes relating to your topic. The relevance of the themes to your research question might also give a sense of their importance. Finally, you might examine the intensity of the themes (e.g., are they associated with strong emotions? do they emphasize certain ideas?)
Frankfort-Nachimas and Nachimas (1996) suggest that you ask yourself a number of questions to assist in your analysis:
• What type of behaviour is being demonstrated?
• What is its structure?
• How frequent is it?
• What are its causes?
• What are its processes?
• What are its consequences?
• What are people’s strategies for dealing with this behaviour?
Additional tips on identifying patterns
Identifying patterns from codes requires practice and significant commitments to develop an intimate relationship with qualitative data. Rosaline (201, p.226-7) offers the following tips to help identify patterns:
• Be open to revising your coding frame as you become aware of new distinctions and categories
• Be clear about who the speaker is (what are their characteristics?)
• Formulate reasons why similarities and differences exist (e.g. are they due to setting, respondents’ characteristics or method of data collection?)
• Determine if there are differences between respondents or groups. If there are, identify the distinctions
• Consider your expectations about the results (if you had any). Determine if you have been surprised by any of the results (why or why not?)
Reference
Bhattacherjee, A. (2012). Social Science Research: Principles, Methods, and Practices https://scholarcommons.usf.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1002&context=oa_textbooks
Frankfort-Nachimas, C., & Nachimas, D. (2015). Research methods in the social sciences (8th ed.). Worth Publishers.
Lucero, A. (2015, September). Using affinity diagrams to evaluate interactive prototypes. In IFIP (ed.), Human-Computer Interaction –INTERAC 2015, (pp. 231-248). Springer, Cham.
Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook. Sage.
Rosaline | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/09%3A_Qualitative_Data_Analysis/9.03%3A_Other_Strategies_of_Qualitative_Data_Analysis.txt |
Before unpacking relationships in the data, you should first highlight the characteristics of your sample. If the sample is people, you will likely highlight demographic information; however, for non-human units of analysis, you will likely provide an overview of types (e.g., types of newspapers, types of brewery etc.) and any other characteristics that distinguish your cases. The characteristics of the sample is discussed either at the beginning of the findings or in the methods section. For quantitative and larger qualitative studies, this part can be highly summative (see Box 9.7.1). In that case, you should consider using tables to demonstrate characteristics such as “gender,” “nationality,” and “ethnicity” of the sample. For smaller and more intimate studies, you may provide demographic details of each case or respondents, provided it adds value to the analysis and does not compromise confidentiality. Note that this should only be done if the risk of disclosure is extremely low or if the sample are well-known public figures who do not wish to withhold their identities.
Furthermore, in interview or ethnographic research, demographics and other characteristics are central to your analysis. Life history reports often present detailed descriptions of participants as well. A qualitative interview researcher will typically sparsely describe the interviewee as they introduce them to their analysis. It can go something as follows, “Louisa, a second generation Canadian immigrant and lawyer, was adamant about her loyalty to the parliamentary system,” before an excerpt from your interview with ‘Louisa’ is used. Be sure to return to key points of the demographic if they are relevant to your analysis. Say you want to compare how social class alters the views of Canadian immigrants to the U.S. on the Canadian vs. the American governing system, then the fact that Louisa is a) a lawyer (likely of middle-class), and b) a second generation immigrant, will be relevant to her interpretation of the viability of the parliamentary system.
This kind of research often also asks the researcher to present their positionality with respect to the group they are interpreting. This is because the researcher’s perspective takes on greater value in qualitative and interpretive research. As a consequence, the researcher should attempt to briefly describe the existence of any relationship or commonality with their participants by attending to questions such as: Do I have the same class background? Nationality? What brought me research their lives? While the answers to these questions should not become the focus of your study, brief coverage of these questions allows your reader to understand how your point of view influences your interpretation of the evidence at hand.
Box 9.7 – Personal Description and Summary Tables
Qualitative researchers present demographic descriptions in multiple ways: summary tables, brief descriptions or detailed descriptions. Often, qualitative researchers use a combination of summary table(s) and either brief or detailed descriptions of each participant in the text of their findings. We provide some practical examples below:
Summary Tables
Robinson (2020) interviewed 20 educational elites from 7 different Caribbean countries to understand their lived experiences in other Caribbean countries. Because disclosure risk was extremely low, he presented a descriptive table with the following four columns: nationality, gender, profession/Industry, and other Caribbean countries lived in (see Robinson, 2020, p. 76).
Brief Descriptions
Researchers often chose to provide summary descriptions of each participant when referring to them in the findings. When this is done, one must be careful to ensure that the same characteristics are mentioned. For example, if the key variable interests are gender, class and age, you need to ensure that you provide these details for each participant. Bowen, Elliot and Brenton (2014) exemplified this as follows: “Leanne, a married working-class black mother of three, is in her cramped kitchen” (p. 20) “Marquan, working-class black parents of two young girls, were constantly pressed for time” (p.22); “Greely, a married middle-class white mother of one child” (p.23). Notice that Bowen et al (2014) were consistent in highlighting pseudonyms, class, ethnicity and number of children. Please note that providing brief descriptive texts does not preclude the presentation of summary tables. Researchers often use both (see Robinson, 2020).
Detailed Descriptions
Life histories, ethnographic research and some feminist studies focus on individual participant as unit of analysis and might present detailed descriptions. For example, Myrie (2017, p.123) described a participant, Daisy, as follows: “She never once looked at me for the 2 hours and 14 minutes we spoke…Daisy is 17 years old and lives with her mother and other siblings. Before recently, moving in with her mother, she moved around frequently and lived with a number of different family members and strangers.” Myrie (2017) went on to describe her mother, siblings, other relatives and personal life history. Myrie (2017) provided detailed life histories of all her participants as well as summary tables with characteristics of each of her participants.
Presenting quotations: In-text and Block Quotations
There are two main ways in which quotations from interviews, surveys, and textual data are presented in qualitative write-ups: in-text and block quotations. In-text means to quote the participants within the sentence and must work with smaller fragments of data when weaving its arguments. For example, Robinson (2020, p. 173) in reporting the lived experiences of migrants in Caribbean countries provided this in-text citation: “Leon, a St. Lucian, stated that he heard his own countrymen yelling insults to other CARICOM nationals such as ‘go and leave our country, or you come to take drugs, or you all come here because you are hungry” [respondents’ quote italicized]. In-text quotes are, hence, suitable for shorter sentences or a mere word.
Block quotations, on the other hand, are used to express larger testimonies of data (typically greater than 40 words, APA, 2020). Block quotations then place extra emphasis on the discursive commentary of the researcher (Holliday, 2007). They provide the reader a more contextualized account from the participant. They may even allow the reader to get a sense of the difference in voice and accent of the participant, as opposed to the homogenization of voice that tends to ensue when the researcher conforms other voices to their own. However, be careful not to over-use block quotations because they may draw attention away from the main argument of the paper, and may indicate a lack of analysis. Block quotations are usually indented; see the example from Elliot and Bowen (2018, p.507):
They treat you like you’re dumb as dirt. You’re doing something wrong, the kids are fat, they’re in the upper 95 percentile or the top 100 percentile, way above some of the other kids. They tell you they’re too fat, but you let them lose a pound, your next visit they chew you out because they lost a pound. But they’re telling you the visit before they’re fat. Don’t give them the whole milk. First give them whole milk, then don’t.They treat you like you’re dumb as dirt…
Both in-text citations and block quotations require contextualization and analysis. The researcher is expected to unpack each fragment of data that makes it into their final account. Block quotations require more unpacking because they have taken the reader away from the argument for longer. The attention of the reader must be steadily brought back to the argument through awareness of the meaning of the quotation for the statements prior. This is what discursive commentary means, it is commentary which responds to the discourse of the quotation. Data analysis of participants is no different from the literature review, it also involves evaluating and analyzing the evidence that is present, synthesizing them into a coherent point for your reader.
At each point of in-text citation, a small statement can be proffered to support the meaning of the argument. In-text citations allow you to quickly allude to evidence which supports your argument. Putnam and Phelps (2017, p. 114) argue that in-text citations “ostensibly serve as evidence for a claim, which justifies using them as a basis for the judgment of the truth.” However, in-text citations, can reduce the authenticity of your account. If the participant’s voice is featured only in brackets (participant 1) the depth of their expression risks being reduced to fit a narrow and incomplete argument. The goal of providing thick description cannot be achieved without connecting a network of complicated expressions into a coherent point or topic. In-text citations should therefore find some way of communicating the context of your participants and situating the speaker before analyzing them. Box 9.8.2 below provides an example of in-text citation by anthropologist Clifford Geertz’ (2005, p. 59) ethnographic experience of a Balinese cockfight.
Box 9.8 – Example In-Text Citation
The following is an encounter of Balinese villagers teasing Geertz and his wife for running from the police after attending an illegal cockfight:
They asked us about it again and again (I must have told the story, small detail by small detail, fifty times by the end of the day), gently, affectionately, but quite insistently teasing us: “Why didn’t you just stand there and tell the police who you were?” “Why didn’t you just say you were only watching and not betting?” “Were you really afraid of those little guns?” As always, kinesthetically minded and, even when fleeing for their lives (or, as happened eight years later, surrendering them), the world’s most poised people, they gleefully mimicked, also over and over again, our graceless style of running and what they claimed were our panic-stricken facial expressions. But above all, everyone was extremely pleased and even more surprised that we had not simply “pulled out our papers” (they knew about those too) and asserted our Distinguished Visitor status, but had instead demonstrated our solidarity with what were now our co-villagers.
Notice how Geertz uses the quotes as part of the larger context of the situation, the speakers, and himself. This encounter helps explain to the audience the instinct of Geertz and his wife to run once the police arrived (despite being protected by their foreign research status). It very quickly situates the villagers, Geertz, his wife, and the police in the larger story that Clifford is trying to tell.
Source: Geertz, C. (2005). Deep play: Notes on the balinese cockfight. Daedalus (Cambridge, Mass.), 134(4), 56-86. https://doi.org/10.1162/001152605774431563
We encourage you to find a model in-text and block quotations that is effective for you. Notice what reports on the evidence work, note those that do not, and incorporate their strategies into your writing. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/09%3A_Qualitative_Data_Analysis/9.04%3A_Presenting_Your_Findings.txt |
Mapping Data: It’s all ‘Storylining’
If you refer to other social science research textbooks, you will often be given a benign and technical definition of storylining in research. Storylining, they say, is only a qualitative and interpretive technique, not something close to the heart of every rhetorical (communication) activity. For example, Bhattacherje (2012) defines it as merely where “categories and relationships are used to explicate and/or refine a story of the observed phenomenon” (p. 115). However, storylining might be better conceived as a research composition. Research writing is a genre of narratives with stricter rules for how narratives connect. These rules make research writing accountable to the truth; using methodological rules to govern how “true” narratives can be confirmed by other researchers (seen to accurately refer to reality), or relegated to the false and unproven ‘myths’ (not referring to reality or lacking data to confirm). Arguing from this perspective of research writing, we encourage you to craft the story which best reflects the truth and significance of your research.
Everyone’s narrative becomes noticeable when it seems connected to our own narrative of what we value: when it says something powerful about yourself or a topic people care about. Why is this? Because a narrative is an account of events which connect to each other, and your audience will remember a good narrative if it connects to them. A good narrative will therefore make all the events within its story meaningful to each other. This means that everything you say attempts to connect back to itself: to tie its point to the research question, and your research question to its contribution (the ‘gap’ it fills). Each piece of information would be abstruse if not for the larger purpose of your paper. For instance, the average income of Uber drivers is more meaningful when it is related to the average income of taxi drivers or wages overall, then shown to be a ignored frame in the debate over Uber, helping the acceptance of a massive change in our transportation economy (and a significant decline in transportation wages). There is a chronology of these events, allowing for cause and consequence to be tidily connected into a story which makes all its information relevant to each other.
Moreover, when we talk of “filling the gap” in the literature, we are essentially pushing you to explain how your story connects to your audience and the narratives they believe in. Why should other researchers care? They care because your narrative appeals to their own or to a larger social reality. Your research story aims to contribute to a collective intellectual project. If you make a prediction that turns out false then the connection of your narrative to that story will weaken. However, if you convince your audience your story belongs, then your narrative will garner attention, acceptance, and integration.
We thus come to our first two rules in storylining your research: (1) ensure internal connections by defining clear categories and their relationships, ensuring that your narrative connects and reacts to itself; and (2) seek external connections, make your narrative connect and react to other contexts in the literature. The first is necessary and the second less so, but truly great research will be able to achieve both exceptionally.
So to begin “storylining,” the goal will be to think hard about showcasing key internal and external connections in your paper. You will want to choose a structure of writing that makes these connections as clear as possible for your reader. For instance, in research a temporal order is deliberately established around the RQ. You begin by introducing the significance of your topic, of what is missing in its investigation, and then pose the research question which you will endeavor to answer in the next 20 or so pages. This makes the structure centered around a promise, a promise that you will mobilize all the foregoing to answer this question. Hence, your structure should aim to elucidate the connection between the development of your evidence and your research question as clearly as possible. The following three tips will help you achieve this more clearly through basic organizational tools.
Organizing Headings: Macro-Structure
The internal connections will come through with strong organization of your data analysis. That is why complex ‘bits’ of data are mobilized under larger themes; so the reader can see the general point you are connecting to the research question in all the smaller bits. Before beginning to write your data analysis, pick three or four sections of your data analysis and really consider how they answer your research question. Then, once that is finished, consider how they relate to each other. If there is any section that you think would be improved by reading the others before it, (ie. that more context would add to your readers’ understanding of its connection to your argument), then place that section at the end. Likewise, try to situate the key data that you think enunciates the most important theme you have discovered near the end of your data analysis section. This way, your reader will be pile-drived with a reminder of just how well your narrative connects with your data just before they move onto the discussion.
Under Headings: Micro-Structure
A microstructure can be quite useful in helping to construct your narrative. Some researchers (e.g. Wilson, 2021) make a list of every paragraph and summarize ‘key themes’ to ensure that a logically related paragraph followed. You should essentially be able to put “paragraph 1, hence paragraph 2” in between all your paragraphs without sounding absurd. In fact, if you have really ordered a narrative which intuitively connects, the reader should never have to go grasping for the connection (i.e. a ‘hence’ is implicit). The connections in your argument should appear so obvious that your reader never realizes that they are being guided by a careful analyst.
Once you establish the temporal order between paragraphs, it is time to relate sentences to those paragraphs, sections, and then the point of the paper. When reading through your analysis and the facts used, ensure that each fact and each analysis connects at least to the point stated at the beginning of the paragraph and then secondly to the sentence before it. It is okay to switch tacts slightly within a paragraph, but as a general rule try to avoid too many “howevers” in a paragraph. Try to start a new paragraph when showcasing a contrasting argument or datapoint so that the ‘short-story’ you advance with each concept is not made so nuanced as to lose its relevance for the larger story.
Finally, you want each individual word to resonate with your paper. Remove words that are not doing the work of accurately describing your narrative, or which inadvertently contradict it. When connecting things back to an abstract term such as “legitimacy,” be sure to use that term tactically when relating your data ( e.g., “Uber’s legitimacy”). Do not force it, but pick key instances near the end of your larger point to relate your argument to legitimacy. Just by resonating that one word with a larger section of your data analysis, you can make the connection between an entire theme and your research question clear to your reader (see Chapter 5 for further advice on academic writing).
Making Connections Beyond Your Research
While what will justify many of your internal connections will depend upon the viewpoint of your reader (e.g., a quantitative sociologist will expect adherence to numerical formulas to ensure the validity and significance of your data), you will also try to resonate your argument with the narratives of your field. This is the most important investigation in your literature review: to understand the narrative of researchers in your field. In reading their papers, play close attention to the conclusions, where they reveal the values that undergird the implications they care about. You will want to know exactly “why they care” about this phenomenon and then apply “why you care” to that sentiment. This way, when you go to justify your research, you will know the key problems and values that are on the mind of fellow researchers.
For instance, in Wilson’s (2021) honours thesis on how Uber garners legitimacy (indicated by their appeal of near century old transportation policy), the key theoretical discussion was “what were the processes that affected public consensus?” Thus, the evidence that mattered was key examples which elucidated how the public comes to consensus on an issue like Uber. When writing the discussion, conclusion, and introduction, he indicated this, and touched upon how his narrative both connected to other narratives and offered something new (see Wilson, 2021).
Likewise, when storylining your data, think about building your narrative towards that connection to the values of other researchers. Draft out the single question which appears to be on the mind of many researchers in your field and then ask how your findings relate to it. Pick an order of presenting these findings so that the reader can clearly see the key points that have developed from your study and then clearly implicate these findings in the larger narrative of researchers in your field (who have likewise spent much time trying to add graceful answers to that same question). Storylining thus encompasses the variety of tools we use to organize data in order to clearly indicate its place in a larger discussion. Chapter 11 (Writing the discussion) will dive into this further, as the discussion is where this external connection is expected to be most forcefully made. However, do not take that as meaning that is the only section of your paper where data is connected to the concerns of your audience. Many of the steps of this external connection should already be established in the data analysis – the discussion will only highlight the connections which are already latent in your data analysis.
Box 9.9 – Storylining Checklist
What story do I want to tell?
• Can I summarize my point in a sentence?
• What evidence does my story help to communicate?
• Does the evidence I am able to present match the evidence that I had to exclude?
• Is it the best evidence for expressing the point I wanted to make?
• Does the evidence sensible build upon itself?
• Is there a quicker way I could summarize and show the significance of my evidence?
• Is the order of its presentation clear (readily understandable) and sensible (easily justifiable)?
What story do others want to hear?
• Is the data (and overall narrative) relevant to my audience?
• Have I made it abundantly clear that my data is relevant to my audience?
• What gap in the larger research narrative of my field does my story address?
• Is there a practical implication to my story?
9.06: Summary
Data analysis brings together the other aspects of your research – the introduction, literature review, methods, discussion, and conclusion. In this chapter, we began by discussing basic aspects of data analysis for qualitative research. We reviewed the importance and steps of transcription, content analysis, and grounded theory. We then offered strategies for presenting demographics and quotations in qualitative writing. In conclusion, we argued that all research tells a story, that is, it tries to present a narrative of data that relates to itself and to the audience. In achieving storylining (see Box 9.10.1) in your research, you make your narrative a relevant and sturdy one for others.
Box 9.10 – Qualitative Data Analysis Checklist
• Transcribe audio data and edit field notes and memos
• Determine on the qualitative approach that you will be using (e.g., grounded theory, template coding etc.).
• Read transcripts
• Highlight quotes and make notes around data
• Code quotes and words
• Decide on a method or organizing themes
• Sort quotes into coded groups (themes)
• Interpret patterns in quotes
• Describe these patterns
• Select the best representative quotes for each theme
• Storylining
9.08: Additional Resources
Carr, D., heger Boyle, E., Cornwell, B., Correll, S., Crosnoe, R., Freese, J. and Waters, M. C. (2018). Analysis of Qualitative Data. In The Art and Science of Social Research (pp. 532-577). Norton.
The chapter offers a theoretical and practical overview of qualitative data analysis along with guidance and examples of the different techniques. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/09%3A_Qualitative_Data_Analysis/9.05%3A_Mapping_Data-_It%27s_All_%27Storylining%27.txt |
Learning Objectives
By the end of this chapter, you should be able to:
• Know what to look for in secondary data and how to process it
• Review how to present different kinds of quantitative data (descriptive and inferential statistics)
• Understand how to choose and interpret different statistics for testing of relationships, including ANOVAs, chi-square, T-tests and regressions (linear and logistic)
• Review how to write-up quantitative findings and draw conclusions
• Review big data and visualization in social research
Suggested Timeline: January – Mid-February
Quantitative data analysis can be both fun and frustrating. You can minimize frustration by having a clear plan for your analysis and doing preliminary work such as cleaning your data and re-coding variables. Your preliminary work should also include revisiting your research question(s) and hypotheses, reviewing your methodology and taking note of your procedures (how you coded the data, developed scales etc.) as well as your research question. These background tasks will help you interpret your data correctly, clarify confusions and remove ambiguities. Think of a scenario where one of your variables is arranged in descending order and the other is arranged in ascending order. The asymmetrical order will make interpretation more tricky than if both variables were in the same direction. While this is not a problem in itself, having multiple variables coded asymmetrically can increase the risk of making errors in your interpretation. Hence, the background task of re-coding to a more consistent standard can make your analysis less frustrating. Finally, your preparatory activity should include a determination of the key variables of interest, planned statistical techniques and getting practice with the analytic program that you will be using (e.g., SPSS, STATA, R, or Jamovi).
In this chapter, we make two bold assumptions: (a) that you know how to conduct quantitative procedures in the statistical program of choice and (b) that you know how to interpret the output from statistical results (if not, we will provide resources to help you with both throughout and at the end of the chapter). Accordingly, we will focus on two things: (1) how to present your findings; and (2) how to interpret the findings and draw conclusions. The chapter begins with an overview of secondary data analysis, followed by a discussion on types of quantitative analysis and presentation formats. Next, we discuss descriptive and inferential statistics, and hypothesis testing. We also recap how to identify the appropriate analysis tool for evaluating the significance of your statistics (Chi Square, Pearson’s R, t-test, regression etc.). We finish with a brief commentary about big data along with a testimony on the use of data visualizations in social research.
10.02: Secondary Data Analysis
Many of you will be using secondary data in your thesis. Statistics Canada hosts a number of data sets, which might be the source of your data (see Box 10.2.1 below). Many of these datasets can only be accessed through your institution (Research Data Centers), so be sure to check your librarian for access. In some cases, it might be necessary to obtain an Institutional Ethics Review before you can use the existing dataset, so check if there are any restrictions on access or use of the dataset early (see Chapter 3).
Box 10.1 – Examples of Datasets Available at Statistics Canada
• Workplace Employee Survey
• Survey of Financial Security
• Survey of Earned Doctorates
• National Apprenticeship Survey
• Canadian Cancer Registry
• Victimization Survey
• General Social Survey
• Census and National Household survey
• National Population Health Survey
• Survey of Household Spending
• Vital Statistics (Birth Database)
• Aboriginal Peoples survey
• Canadian Survey on Disability
• Survey of Family Expenditure
For a full list of survey by Statistics Canada, see https://www.statcan.gc.ca/en/microdata/data-centres/data
As discussed in Chapter 7, the methodological limitations of your data source will also impede your analysis. To get your secondary data ready for analysis, we suggest the following steps:
1. Understand the dataset (population, sampling process, level of representativeness, units of measurement, descriptive statistics, etc.). You can do this by consulting the codebook.
2. Statistical concerns: E.g., you should always check if the data is normally distributed, if the observations are independent, ad for homogeneity of variance etc. These will affect the kind of statistical analyses that you can do. For example, if the data is not normally distributed, you will not be able to run tests such as one way and two way ANOVA tests.
3. Sampling: Make sure that you establish how the sample was drawn. This will determine the limitations of the study. Also, look out for issues such as non-response rates (sample and item).
4. Data cleaning: decide what to do with missing data, outliers etc.
5. Determine how you will treat key variables: Examine the code book to see how the variables of interest are initially measured. Recode them in a way that would make sense for your project. Be mindful of the direction of the measures. This can impact your interpretation. It is best to recode variables that are not in the same direction e.g., if the higher number indicates higher intense attribute, ensure that this is consistent across variables.
6. Explain your (re)coding strategy: Make a note of how were variables re-coded and why? If you are using an index or a scale, explain why that particular index or scale? Justify it theoretically or point to previous research that used a similar index or scale. If your analytical strategy is different from those in the literature, explain why (see Chapter 7).
7. Know the assumptions of the tests that you are thinking of doing, and make sure that the data fits.
8. Start with descriptive analysis to get a feel of the data before performing bivariate and multivariate statistics.
9. Record your statistical results according to the referencing format that you are using.
10. Interpret and discuss the results.
11. See Samuels (2020) for additional steps in quantitative data analysis.
10.03: Types of Quantitative Data Analysis and Presentation Format
If your thesis is quantitative research, you will be conducting various types of analyses (see the following table).
Table 10.1 - Some Common Forms of Quantitative Analysis
Type of Analysis Appropriate Quantitative Analysis Presentation Format
Univariate Descriptive statistics (range, mean, median, mode, standard deviation, skewness, kurtosis) Graphs (e.g., line graphs, histograms); charts (e.g., pie chart, descriptive table.
Univariate Inferential analysis T-test, or chi square Summary tables of test results, contingency table
Bivariate analysis T-tests, Anova, Chi-square Summary tables; contingency tables
Multivariate analysis Anova, Manova, Chi-square, correlation, regression (binary, multiple, logistic) Summary tables | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/10%3A_Quantitative_Data_Analysis/10.01%3A_Getting_Started-_Cleaning_Data_and_Establishing_Procedures.txt |
Quantitative data are analyzed in two main ways: (1) Descriptive statistics, which describe the data (the characteristics of the sample); and (2) Inferential statistics. More formally, descriptive analysis “refers to statistically describing, aggregating, and presenting the constructs of interest or associations between these constructs” (Bhattacherjee, 2012, p. 119). All quantitative data analysis must provide some descriptive statistics. Inferential analysis, on the other hand, allows you to draw inferences from the data, i.e., make predictions or deductions about the population from which the sample is drawn.
Developing Descriptive Statistics
As mentioned above, descriptive statistics are used to summarize data (mean, mode, median, variance, percentages, ratios, standard deviation, range, skewness and kurtosis). When one is describing or summarizing the distribution of a single variable, he/she/they are doing univariate descriptive statistics (e.g. mean age). However, if you are interested in describing the relationship between two variables, this is called bivariate descriptive statistics (e.g. mean female age) and if you are interested in more than two variables, you are presenting multivariate descriptive statistics (e.g. mean rural female age). You should always present descriptive statistics in your quantitative papers because they provide your readers with baseline information about variables in a dataset, which can indicate potential relationships between variables. In other words, they provide information on what kind of bivariate, multivariate and inferential analyses might be possible. Box 10.4.1.1 provide some resources for generating and interpreting descriptive statistics. Next, we will discuss how to present and describe descriptive statistics in your papers.
Box 10.2 – Resources for Generating and Interpreting Descriptive Resources
See UBC Research Commons for tutorials on how to generate and interpret descriptive statistics in SPSS: https://researchcommons.library.ubc.ca/introduction-to-spss-for-statistical-analysis/
See also this video for a STATA tutorial on how to generate descriptive statistics: Descriptive statistics in Stata® – YouTube
Presenting descriptive statistics
There are several ways of presenting descriptive statistics in your paper. These include graphs, central tendency, dispersion and measures of association tables.
1. Graphs: Quantitative data can be graphically represented in histograms, pie charts, scatter plots, line graphs, sociograms and geographic information systems. You are likely familiar with the first four from your social statistics course, so let us discuss the latter two. Sociograms are tools for “charting the relationships within a group. It’s a visual representation of the social links and preferences that each person has” (Six Seconds, 2020). They are a quick way for researchers to represent and understand networks of relationships among variables. Geographic information systems (GIS) help researchers to develop maps to represent the data according to locations. GIS can be used when spatial data is part of your dataset and might be useful in research concerning environmental degradation, social demography and migration patterns (see Higgins, 2017 for more details about GIS in social research).
There are specific ways of presenting graphs in your paper depending on the referencing style used. Since many social sciences disciplines use APA, in this chapter, we demonstrate the presentation of data according to the APA referencing style. Box 10.4.2.3 below outlines some guidance for presenting graphs and other figures in your paper according to the APA format while Box 10.4.2.4 provides tips for presenting descriptives for continuous variables.
Box 10.3 – Graphs and Figures in APA
Graphs and figures presented in APA must follow the guidelines linked below.
Source: APA. (2022). Figure Setup. American Psychological Association. https://apastyle.apa.org/style-grammar-guidelines/tables-figures/figures
Box 10.4 – Tips for Presenting Descriptives for Continuous Variables
• Remember, we do not calculate the means for Nominal and Ordinal Variables. We only describe the percentages for each attribute.
• For continuous variables (Ratio/Interval), we do not describe the percentages, we describe, means, range (min, max), standard errors, standard deviation.
• Present all the continuous variables in one table
• Variables (not attributes) go in the rows
• Use separate columns for the descriptive (Mean, S.E. Std. Deviation, Min, Max, N).
To provide a practical illustration of the tips presented in Box 10.4.2.4, we provide some hypothetical data of what a descriptive table might look like in your paper (following APA guidance) in the following box.
Table 10.2 - Descriptive Statistics for Key Variables in a Hypothetical Study
Dependent Variables N Min. Max. Mean SE SD
Perception about online learning 250 1 5 2.75 0.18 0.39
Age 250 15 40 26.7 1.25 2.17
Grades 250 15 95 72.56 2.08 9.52
Number of hours studied per week 250 0 120 25 3.89 7.22
Frequency distributions are tables that summarize the distribution of variables by reporting the number of cases contained in each category of the variable. Frequency distributions are best used to represent nominal and ordinal variables but typically not continuous variables interval and ratio variables because of the potentially large number of categories. APA has specific guidelines for presenting tables (including frequency tables, correlation tables, factor analysis tables, analysis of variance tables, and regression tables), see the following box.
Box 10.5 – Presenting Tables in APA
Tables presented in APA are required to follow the APA guidelines outlined in the following link.
Source: APA. (2021). Table Setup. American Psychological Association. https://apastyle.apa.org/style-grammar-guidelines/tables-figures/tables
Measures of central tendency & Dispersion
Measures of central tendency are values describe a set of data by identifying the central positions within it. These include mean, mode, media, point estimate, skewness and confidence interval. Measures of dispersion tell how spread out a variable’s values are. There are four key measures of dispersion: range, variance, standard deviation and skewness. In your paper, you will typically report on N (number of cases), SD (standard deviation, M (mean).
Consider the output from SPSS as presented in Box 10.4.3.1. Note that even though the SPSS output includes all the statistics that you need for central tendency, you will need to convert this table so it fits APA standards (see Box 10.4.2.5 and Box 10.4.2.6). We encourage you to practice by converting Box 10.4.3.1 to APA standard for presenting descriptive statistics.
Table 10.3 - Sample Output from SPSS Showing Hypothetical Grades in a Course
Descriptive Statistic Course Grades
N Valid 1525
Missing 30
Mean 72.56
Median 70.45
Mode 68.00
Standard Deviation 9.52
Variance 43.67
Range 50
UBC Research Commons for tutorials on how to generate and interpret measures of central tendency and discpersion in SPSS https://researchcommons.library.ubc.ca/introduction-to-spss-for-statistical-analysis/
In your paper, you are most likely going to report on N, SD and M (see Box 10.3.3.2). You would simply report the findings as follows:
“The computed measures of central tendency and dispersion were as follows: N=1525, M=72.56, SD=6.52”
You should never leave your results without interpretation. Hence, you might add a sentence such as:
“The average grade in this course is typical at the university, but the large standard deviation indicates that there was considerable variation around the mean”.
Remember, that Means (M) might not be the best measure of central tendency to report. The kind of variable dictates the best measure of central tendency. For instance, when discussing nominal variables, it is best to report the mode; for ordinal variables, it is best to report the median; and for interval/ratio variables (as in our example above), it is best to report the mean. However, if interval/ratio variables are skewed, it is best to report the median. | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/10%3A_Quantitative_Data_Analysis/10.04%3A_Descriptive_Statistics.txt |
As discussed earlier, inferential statistics are not only concerned about the characteristics of the sample. We are also making deductions about population based on what is known about the sample. In this section, we recap estimation procedures and discuss common statistical tests that allow us to make inferences about the population.
Recap on estimation procedures
You will remember from your social statistics class that population values can be estimated from sample values with either a point estimate or with interval estimates (e.g., confidence intervals where the population value is estimated within a certain range). Point estimates assume that the population statistic is the same as the sample statistic (either a mean or a proportion) (Healey, 2009, p. 174). However, with interval estimates, we calculate a range of values within which the population falls. As the goal of this chapter is not to teach statistics, but to provide guidance on how to report your findings in your paper, we advise you to revise your statistics notes if you want to refresh your statistical knowledge. You can also visit this video by Dane McGuckian for more information about constructing point estimates at Point Estimate for a Mean and Confidence Interval – YouTube and confidence intervals at The steps for constructing a confidence interval to estimate the mean – YouTube.
Box below 10.5.1.2 provides hypothetical SPSS output from SPSS from a sample of UBC students.
Table 10.4 - Hypothetical SPSS Output from a Sample of UBC Students
Numbers of Hours Slept Each Week N Minimum Maximum Mean Standard Deviation
Valid N (Listwise) 152152 28.50 84.25 50.75 6.125
Suppose we want to estimate the population value based on the sample. You might remember the formula for constructing the sample interval
CI = X +/- Z (s/√n)
Where: CI is confidence interval; X=sample mean; Z= confidence level value, s=sample standard deviation and n=sample size.
To construct the confidence interval at the 95% level (z= 1.96), we substitute the values in the SPSS output into the formula.
CI = 50.75 +/- 1.96 (6.125/ √152)
CI= 50.75 +/- 1.96 (12.33)
CI=50.75+/-24.17
In your papers, you would write: “we estimate that UBC students, on average, slept between 26.58 hours and 74.92 hours each week”.
Hypothesis testing and regression
One of the reasons why you probably decided to do quantitative data analysis is to test hypotheses. Hypothesis testing involves analyzing your data to determine if the results are meaningful (e.g., Are two means similar? Does variable A impact variable B?). If you are still undecided on what statistical analysis you will use in your thesis, now is a great time to refresh yourself on different statistical techniques. Below we summarize common research objectives and the kind of statistical technique that might be appropriate.
Table 10.5 - Common Research Objectives and their Statistical Techniques
Research Objective (To ….) Statistical Procedure Sample Research Question
Test if the mean of a population is statistically different from a known or hypothesized value One Sample T-test Is the mean grade in SOCI 200 different from 70?
Test if he null hypothesis that the means of two groups are equal Two sample T-test Do males and females score the same in SOCI 200?
Compare the means of two independent groups in order to determine whether there is statistical evidence that the associated population means are significantly different Independent samples T-test What is the difference in SOCI 200 scores from two different sections (e.g. section 103 and 104)?
Compare means across three or more groups with one independent variable One way ANOVA What is the difference in average scores in SOCI 200 faculty (attributes Arts, Science, Engineering?
Compare means across groups with two or more independent variables Two-way ANOVA What is the difference in SOCI 200 grades according to gender and age?
Examine the differences between categorical variables in the same population chi-square What is the effect of gender on marital status?
Determine which independent variable (s) impacts an outcome (dependent variable) for continuous variables Linear Regression What effect do the number of hours studied have on SOCI 200 grades?
Determine which independent variable impacts an outcome (dependent variable) when the output is discrete (i.e., the presence or absence of the outcome) Logistic Regression Does gender affect whether students pass or fail SOCI 200?
To help you decide on which technique to use, we provide a bit more detail on each of these below:
1. The One and Two Sample T-test: The One Sample t Test is used to test the statistical difference between a mean and a known or hypothesized value of the mean in the population. Please note that this procedure cannot be used to compare sample means between multiple groups. Remember that if you are comparing the means of multiple groups to each other, you should consider an Independent Samples t Test (to compare the means of two groups) or a One-Way ANOVA (to compare the means of two or more groups). However, you can use a two-sample T-test to test if the means of two groups are the same.
2. Paired Samples T-Test: The Paired Samples t Test compares the means of two measurements taken from the same individual, object, or related units. In social science research, each subject is measured twice, resulting in pairs of observations. “Paired” measurements can include measurements taken at two different times, for example, a pre-test and post-test score with an intervention administered between the two time points such as measuring the impact of anti-racist education on attitudes toward minority groups. In this case, a research could distribute a survey to determine attitudes towards minority group, then offer anti-racist education, followed by a repeat of the survey. The essence of the paired samples t-test is to determine whether the mean difference between paired observations is significantly different from zero. Kansas State Universities Libraries (2022) provide additional cases where the Paired Samples t Test is commonly used, including:
• Statistical difference between two time points
• Statistical difference between two conditions
• Statistical difference between two measurements
• Statistical difference between a matched pair
Note that the Paired Samples t Test can only compare the means for two (and only two) related (paired) units on a continuous outcome that is normally distributed (Kansas state universities library, 2022).
1. Independent Samples T-Test: The Independent Samples t Test compares the means of two independent groups in order to determine whether there is statistical evidence that the associated population means are significantly different. It can only compare the means for two (and only two) groups; ANOVA should be used to make comparisons among more than two groups.
Reporting T-test results
Reporting your findings in your thesis is quite simple. You will need to report on the T value, df and sig. Your statement should take one of the following forms:
1. Identify the technique used (e.g., independent sample, paired t-test etc. and the variables of interest).
2. Note whether the means were significantly different (statistically, based on p value).
3. State the level of the difference (which group is higher or lower, or whether the mean is different from a known value).
4. Provide descriptive statistics to indicate the difference. The text in your findings can follow the template below:
A ______(type of t-test e.g., independent sample) t-test was conducted to determine if the mean for ______(name of variable) was significantly different. There was a significant or non-significant effect for _____(name of variable), t(df) = ____, p = ___, with attribute A being higher/lower (M=, SD=) than attribute B (M =, SD =).
Here is an example:
A two sample t-test was conducted to determine if the mean grades in SOCI 200 by gender were significantly different. There was a significant effect for gender, t(152) = 5.43, p =.001, with females receiving higher scores (M= 72.1, SD 2.2) than those identifying with other genders (M=66.3, SD=1.16).
Additional Resources
For further tutorials on how to run and interpret confidence intervals in SPSS, see UBC Research Commons: https://researchcommons.library.ubc.ca/introduction-to-spss-for-statistical-analysis/
Also check out this youtube tutorial for STATA: Stata® tutorial: Confidence interval calculator for normal data – YouTube
Common research objectives and their appropriate statistical technique resources
See UBC Research Commons for tutorials on how to generate and interpret the statistical procedures discussed in Box 9.8 in SPSS https://researchcommons.library.ubc.ca/introduction-to-spss-for-statistical-analysis/ | textbooks/socialsci/Social_Work_and_Human_Services/Practicing_and_Presenting_Social_Research_(Robinson_and_Wilson)/10%3A_Quantitative_Data_Analysis/10.05%3A_Inferential_Statistics.txt |
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