Academic journal article Canadian Journal of Sociology

Clinical Sociology: Social Rehabilitation of Schizophrenia in China and Implications for Aging Research

Academic journal article Canadian Journal of Sociology

Clinical Sociology: Social Rehabilitation of Schizophrenia in China and Implications for Aging Research

Article excerpt

Introduction

This article presents a clinical sociology (CS) model and a heuristic analytical grid (HAG or HG) as a methodological guide in qualitative research. These have been primarily applied to social rehabilitation but may also be useful in the study of aging, an area that is often intertwined with but not necessarily emphasized in mental health or illness research. Their relevance to aging research is based on similarities between the study of personal experience of psychiatric rehabilitation and the study of aging (Sevigny 2000, 2004; Chen 2007, 2010).

The CS and HG have been an ongoing work for roughly three decades (Sevigny 1983a, 1983b, 1984, 1985, 1996; Rheaume and Sevigny 1988; Sevigny 2007; Sevigny et al. 2009a). They were first developed at the turn of the 1980s for a study on the "implicit sociology" of mental health practitioners from Montreal (Canada). The notion of "implicit sociology" was meant to distinguish the health practitioners' formal, medical knowledge from their own, nonprofessional or laymen knowledge (and language) (Rheaume and Sevigny 1988). These were further developed and adapted to the Chinese context when, in 1990, the leadership of a large psychiatric hospital in Beijing invited Sevigny to set up a research project on their patients diagnosed as suffering from schizophrenia in need of rehabilitation during the post-Mao period. At that time, the Chinese government--and the Communist Party--had already abandoned the Soviet model (even though its influence lasted for decades). Authorities in the field of mental health decided to emphasize the well-being of patients after their crisis period instead of concentrating on pharmacology. Social rehabilitation thus became a top priority in the field of psychiatric guidelines (Sevigny 2004). The purpose of the research proposal was to understand the experience of schizophrenia and of social rehabilitation from a clinical sociology perspective. Prior to commencing field work, Sevigny had provided extensive training on the clinical sociology model and on semistructured interview techniques to six staff members from the hospital. This team interviewed twenty patients, as well as people from their immediate social environment (ISE), namely relatives, neighbours, colleagues and work unit leaders, and hospital staff. The main methodology was personal case studies on the experience of schizophrenia with a monographic design.

In this Beijing project, Sevigny expanded the notion of "implicit sociology" to "implicit knowledge" to include all social actors and all aspects in the experience of schizophrenia. Key references on such work include Sevigny (1983a, 1983b, 1984, 1988c, 1993a, 1993b, 1996), particularly those applying to the Chinese (Sevigny, 1992/1993, 1997a, 2001, 2004, 2008, 2009; Sevigny et al. 2009a, 2009b). It should be noted that Arthur Kleinman's seminal work in the form of an analytical grid for mental health practice was the original inspiration for the model to be presented here (Kleinman 1988). Works by Lee were also an important source of information (Lee 1996, 2001; Lee and Kleinman 1997; Lee et al. 2005). We must also recognize the contributions of Michel C. Phillips and Veronica Pearson to the field of mental health and social rehabilitation in China. They studied the same post-Mao period and both authors were concerned with patients and their significant others expressing their own points of view. Mainly interested in the patient's family relationship, their efforts provided important groundwork for the Beijing research design and analysis (Pearson 1993, 1995, 1996; Pearson and Philips 1994; Pearson and Yiu 1993; Phillips 1993, 1998, 2001; Philips and Pearson 1996; Phillips et al. 1994, 1997, 2000). (1) There were others who also made important contributions (especially Luk and Shek 2006; Lai and Rance 2006).

As with any other field of social sciences, the clinical sociologist must be specific about his or her own set of definitions, assumptions, concepts, epistemological posture, and methodology. …

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