John
I read your piece with interest. However it has left me confused and I
think it would be good if you could clarify a few points:
1. firstly a very daft question about context: where are you? managed care
is not something i recognise in a british context. Is it similar to care
management?
2. somehow i expected you to deal with surveillance in relation to the
clients of psychotherapy, so the fact that you are focusing on
psychotherapists is highly original. I think that it would be useful to
know what the management structure which you allude to and to which
psychotherapists are accountable actually is. Clearly psychotherapists are
accountable to their clients but also to the achievement of particular
outcomes, like the standardised or 'normalised' delivery of service, the
achievement of which you argue is being operationalised through a set of
techniques of surveillance. What I am interested in - and I wonder if this
is just another way of analysing and conceptualising the processes which
you identify - is the extent to which managed care is subjected to a
process of bureaucratisation and how the achievement of outcomes and the
techniques of surveillance are understood and justified by a range of
professionals, beyond the psychotherapists themselves. However i am not
sure I understand who these are, especially the macro-level customers whom
you allude to. It seems to me that government departments and insurance
companies must expect different things from the process of delivering
psychotherapy and therefore you must make explicit how each customer
applies their techniques of surveillance and the extent to which all
parties are in agreement over the aims to be achieved in the practice
process.
3. so could we argue that psychotherapists in fact represent a contested
space and to what extent is the attempt by various parties to
re-appropriate the process of delivering psychotherapy having a normalising
effect beyond psychotherapists, ie on the clients themselves - a clear case
of diffuse and dispersed power.
I could say more, Im just thinking out loud so to speak! so Ill stop. I
hope this is useful.
Emmanuelle
Emmanuelle Tulle-Winton
Department of Social Sciences
Glasgow Caledonian University
Glasgow G4 0BA
Scotland
Tel: 0141 331 3330
Fax: 0141 331 3439
I read your piece with interest. However it has left me confused and I
think it would be good if you could clarify a few points:
1. firstly a very daft question about context: where are you? managed care
is not something i recognise in a british context. Is it similar to care
management?
2. somehow i expected you to deal with surveillance in relation to the
clients of psychotherapy, so the fact that you are focusing on
psychotherapists is highly original. I think that it would be useful to
know what the management structure which you allude to and to which
psychotherapists are accountable actually is. Clearly psychotherapists are
accountable to their clients but also to the achievement of particular
outcomes, like the standardised or 'normalised' delivery of service, the
achievement of which you argue is being operationalised through a set of
techniques of surveillance. What I am interested in - and I wonder if this
is just another way of analysing and conceptualising the processes which
you identify - is the extent to which managed care is subjected to a
process of bureaucratisation and how the achievement of outcomes and the
techniques of surveillance are understood and justified by a range of
professionals, beyond the psychotherapists themselves. However i am not
sure I understand who these are, especially the macro-level customers whom
you allude to. It seems to me that government departments and insurance
companies must expect different things from the process of delivering
psychotherapy and therefore you must make explicit how each customer
applies their techniques of surveillance and the extent to which all
parties are in agreement over the aims to be achieved in the practice
process.
3. so could we argue that psychotherapists in fact represent a contested
space and to what extent is the attempt by various parties to
re-appropriate the process of delivering psychotherapy having a normalising
effect beyond psychotherapists, ie on the clients themselves - a clear case
of diffuse and dispersed power.
I could say more, Im just thinking out loud so to speak! so Ill stop. I
hope this is useful.
Emmanuelle
Emmanuelle Tulle-Winton
Department of Social Sciences
Glasgow Caledonian University
Glasgow G4 0BA
Scotland
Tel: 0141 331 3330
Fax: 0141 331 3439