International Clinical Sociology [2 ed.] 3030545830, 9783030545833

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Clinical Sociology: Research and Practice

Jan Marie Fritz  Editor

International Clinical Sociology Second Edition

Clinical Sociology: Research and Practice Series Editor Jan Marie Fritz University of Cincinnati, Cincinnati, OH, USA University of Johannesburg, Johannesburg, South Africa

The series explores key research and practice in this rapidly expanding field. Topics include ethical and legal aspects of intervention; the nature of client relationships; methods of intervention and evaluation; and the role of clinical sociology in specific settings. This open-ended series appeals to practitioners, policymakers, students and professors in sociology, social work, community psychology, public health, health education, social policy, and counseling.

More information about this series at http://www.springer.com/series/5805

Jan Marie Fritz Editor

International Clinical Sociology Second Edition

Editor Jan Marie Fritz University of Cincinnati Cincinnati, OH, USA University of Johannesburg Johannesburg, South Africa

ISSN 1566-7847 Clinical Sociology: Research and Practice ISBN 978-3-030-54583-3 ISBN 978-3-030-54584-0 https://doi.org/10.1007/978-3-030-54584-0

(eBook)

1st edition: © Springer Science+Business Media, LLC 2008 © Springer Nature Switzerland AG 2021 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG. The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Sankofa

The word Sankofa comes from a tribe of the Akan people in Ghana. The Sankofa is a mythical African bird whose feet are firmly planted on the ground while its head is turned backward toward a golden egg. This golden egg represents the treasure of historical wisdom. While there are a number of interpretations of the Sankofa symbol, we cherish the idea that one looks back for the wisdom of the past and brings that wisdom forward as a guide for building a strong future—a future we see as inclusive, rights-based, and sustainable. In the following pages, we focus on the history of clinical sociology in five regions of the world and then discover some of the clinical sociology efforts to bring about that strong future.

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Contents

Part I

The Essentials

1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Jan Marie Fritz

3

2

The Basics: From Concepts to Models . . . . . . . . . . . . . . . . . . . . . . . Jan Marie Fritz

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Part II

Regional Histories

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The History of Clinical Sociology in the United States . . . . . . . . . . . Jan Marie Fritz

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Clinical Sociology in Québec: When Europe Meets America . . . . . . Jacques Rhéaume

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5

On the Origins of Clinical Sociology in France: Some Milestones . . . Vincent de Gaulejac

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6

Clinical Sociology in Japan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yuji Noguchi and Hideyo Nakamura

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The Emergence of Clinical Sociology in South Africa . . . . . . . . . . . 109 Tina Uys

Part III

Selected Applications

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The Patient’s Personal Experience of Schizophrenia in China: A Clinical Sociology Approach to Mental Health . . . . . . . . . . . . . . 131 Robert Sévigny

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Bridging Social Capital: A Clinical Sociology Approach to Substance Use Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Miriam Boeri vii

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Children’s Human Rights as a Buffer to Extremism: A Clinical Sociology Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 Yvonne Vissing

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Clinical Sociological Contributions to the Field of Mediation . . . . . 201 Jan Marie Fritz

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The Art of Facilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 Jan Marie Fritz

13

Organizational Consulting for Strategic Change in a Public School in Colombia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237 Fernando de Yzaguirre

14

Climate Resilience Initiative in Metro Manila: Participatory Community Risk Assessment and Power in Community Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257 Emma Porio

15

The South African Military and Gender Integration: Bridging Theory and Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277 Lindy Heinecken

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Focus Groups in the Context of International Development: In Pursuit of the Millennium and Sustainable Development Goals . . . . 295 Janet Mancini Billson

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317

About the Contributors

Janet Mancini Billson, Ph.D., C.C.S. is Director of Group Dimensions International and former Professor of Sociology at George Washington University and Rhode Island College. Her keynote speech for the 2019 AACS Annual Meeting focused on Sustainable Development Goals as a roadmap for clinical sociological practice. Billson conducts qualitative research and training for policy, evaluation, and organizational development. Since 1981, she has served a wide variety of clients in international development, social policy, and organizational collaboration/strategic planning for foundations, hospitals, universities, and government agencies; hospitals; the World Bank and other international development banks; research organizations; and United Nations agencies. She will serve as Killam Visiting Professor in Canadian Studies at Bridgewater State University (2020–21), focusing on her participatory research with refugees. A Woodrow Wilson Fellow and NIMH Fellow (Brandeis), Billson was Alumna of the Year (Baldwin-Wallace College 1999) and received the Award for Sociological Practice (SAS 2000), the Stuart A. Rice Achievement Award (DC Sociological Society 2001), and the Lester F. Ward Distinguished Contributions to Applied and Clinical Sociology Award (AACS 2008). Miriam Boeri, Ph.D. is an Associate Professor of Sociology at Bentley University in Waltham, Massachusetts, USA. She is also an ethnographer and has received funding from the National Institute on Drug Abuse (NIDA, an agency in the U.S. National Institutes of Health (NIH), to study people who use drugs. Her research has produced numerous peer-reviewed journal articles, many of which are publicly available on PubMed. Her book, Women on Ice: Methamphetamine Use among Suburban Women, based on a three-year study in suburban towns, introduced her initial work on the social recovery intervention. Another book by Boeri, Hurt: Chronicles of the Drug War Generation, won the Distinguished Scholarly Book Award in Clinical Sociology from the International Sociological Association’s RC 46 Clinical Sociology.

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About the Contributors

Jan Marie Fritz, Ph.D., C.C.S. is a Professor at the University of Cincinnati and Distinguished Visiting Professor at the University of Johannesburg. She also was a Distinguished Visiting Professor with the Honors College at the University of South Florida, Fulbright Senior Scholar with the Hungarian Academy of Sciences, Fulbright Distinguished Chair in Human Rights and International Studies at the Danish Institute of Human Rights, and Woodrow Wilson Fellow at the Woodrow Wilson International Center for Scholars in Washington, D.C. She has received a number of awards including the American Sociological Association’s Distinguished Career Award for the Practice of Sociology, the Ohio Mediation Association’s Better World Award, and the Lester Ward Award from the Association for Applied and Clinical Sociology. She was a Vice-President of the International Sociological Association (ISA) and is an ISA representative to the UN. She also is a member of the ISA Executive Committee, the Mayor of Cincinnati’s Gender Equality Task Force, and the U.S. Environmental Protection Agency’s National Environmental Justice Advisory Council. Vincent de Gaulejac, Ph.D. is a Professor Emeritus at the University of Paris and Doctor Honoris Causa at the Universities of Mons (Belgium) and Rosario (Argentina). He was director of the Social Change Laboratory in the Universities Paris Dauphine and Paris Diderot (1981–2014). He has been the president of the International Network of Clinical Sociology (RISC) since 2015. He has received a number of awards including the Russian Sociological Association’s Sorokin Prize and, in 2018, the Distinguished Scholarly Book Award in Clinical Sociology from Research Committee 46 of the International Sociological Association. He was President of the Research Committee 46 in the International Sociological Association (ISA) and President of the Research Committee 16 in the Association International des Sociologues de Langue Française (AISLF). Lindy Heinecken, Ph.D., C.S.P. is Chair of the Department of Sociology and Social Anthropology at Stellenbosch University in South Africa. The main focus of her research is in the domain of armed forces and society where she has published widely on a range of issues, including civil military relations, military unionism, and defense transformation. Her current research focuses on gender integration in the military, military recruitment, and the effect of militarization on society. Her most recent book is South Africa’s Post-Apartheid Military: Lost in Transition and Transformation. She serves on numerous academic boards, including the Council of the Inter-University Seminar on Armed Forces and Society (IUS), and is currently the President of the International Sociological Association’s Armed Forces and Conflict Resolution Research Committee (RC01). She is a National Research Foundation B rated researcher. She is also a Certified Sociological Practitioner (C.S.P.) a designation awarded by the Association for Applied and Clinical Sociology.

About the Contributors

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Hideyo Nakamura, Ph.D. is a Professor of Sociology in the College of Humanities and Sciences at Nihon University, a private research university in Tokyo. She is the author of Recovery from Eating Disorders (Shinyosha 2011) and “Illness Experiences and Medical Discourses: A Case Study about Recovery from Eating Disorders in Japan” (Seijo Communication Studies, 2013). In 2012, she received the JSS Award from the Japan Sociological Society. She has studied addiction and 12-step programs from a sociological perspective. Yuji Noguchi, M.A. is a Professor of Sociology and Social Work at Tokyo Gakugei University. He was a Vice-President of Tokyo Gakugei University and a President of the Japanese Society of Health and Medical Sociology. He is the author of several books, including Caring as Narrative, Narrative Based Clinical Sociology, and Narrative and Community. He has worked in the mental health field as a social worker and studied in collaboration with experts in a variety of clinical fields. Emma Porio, Ph.D. is a Full Professor and past Chair of the Department of Sociology and Anthropology, School of Social Sciences at Ateneo de Manila University, and Science Research Fellow of the Manila Observatory, Philippines. During the past two decades, Professor Porio has led and/or represented the Philippine Sociological Society, Philippine Social Science Council (PSSC) in the Asia Pacific Sociological Association (APSA), Asian Social Science Research Council (ASSREC), International Social Science Council (ISA), International Sociological Association (ISA), and the Global Development Network (GDN). Currently, she is President of ISA’s Clinical Sociology Division (RC 46), as well the Project Leader of the inter/transdisciplinary action research project, “Coastal Cities at Risk: Investing in Climate and Disaster Resilience,” the flagship program on climate and disaster resiliency of the Ateneo de Manila University and the Manila Observatory. Professor Porio is interested in bridging the science–policy– practice nexus by mobilizing climate and disaster science toward actionable programs for community resilience. Her research and publications focus on climate and disaster risks in relation to social-cultural vulnerability, risk governance, and community social well-being and resilience. Jacques Rhéaume, Ph.D. is Professor Emeritus, Department of Social and Public Communication, University of Quebec in Montreal (UQAM); he was a Full Professor from 1978 until 2008. He has a doctorate in sociology (Montreal University), a master’s in psychology (University of Sherbrooke), and a master’s in philosophy (University of Quebec in Trois-Rivieres). He is a member of the SHERPA Research Institute, located in the University Integrated Center of Health and Social Services, in Montreal Center-West Area, and was the Scientific Director there for 12 years (1999–2011). He is currently an associate member of the Health and Communication Research Center at UQAM. His teaching focuses mainly on groups and organizational issues, from a psycho-sociological and clinical sociology perspective. He has conducted research in different areas including mental health, work and

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About the Contributors

management, community development, cultural diversity, and life narratives. He is Vice-President of the International Sociological Association’s clinical sociology division as well as a member of the International French-Speaking Sociological Association and of the Reseau International de Sociologie Clinique (International Network of Clinical Sociology) in Paris. Robert Sévigny, Ph.D. is an emeritus professor of sociology at the Université de Montreal. He is a founding member and first president of the clinical sociology division of the International Sociological Association. He also was a founding member of the clinical sociology division of the Association des Sociologues de Langue Française. He was the scientific director of a research center that specialized in the cultural and ethnic aspects of social and health services. A monograph of French Canadian families—Le Québec en Héritage (Quebec Heritage)—was among his first clinical sociology studies. Mental health is his main area of research and he introduced the idea of implicit sociology to study both mental health practitioners and clients/patients. His work has been published in Canada, France, England, China, Brazil, and the United States. Tina Uys, Ph.D. is a Certified Clinical Sociologist (CCS) and a Professor at the University of Johannesburg, South Africa. In 2013, she was a Fulbright Visiting Scholar at George Washington University in Washington, D.C., and at the University of Cincinnati in Cincinnati, Ohio. She is rated as an Internationally Acclaimed Researcher (B3) by the South African National Research Foundation. She is a past Vice-President of the International Sociological Association (ISA), past President of two ISA research divisions—Clinical Sociology and Social Psychology—and a past President of the South African Sociological Association. She is the author or editor of more than 50 publications including Exclusion, Social Capital and Citizenship: Contested Transitions in South Africa and India (Orient Blackswan 2012) and Contemporary India and South Africa: Legacies, Identities, Dilemmas (Routledge 2012) both coedited with Sujata Patel. She also is the coeditor, with Jan Marie Fritz, of Clinical Sociology for Southern Africa (Juta 2020). Yvonne Vissing, Ph.D. is a Professor at Salem State University in Salem, Massachusetts, where she is the founding director of its Center for Childhood and Youth Studies, co-founding member of its Department of Healthcare Studies, and former chair of its Sociology Department. She is the US child rights policy chair for Hope for Children’s UN Convention on the Rights of the Child Policy Center in Cyprus, is on the Human Rights Council for the American Association for the Advancement of Science in Washington, D.C., and is on the Steering Committee for Human Rights Educators (HRE) USA. She completed Equitas’s International Human Rights Training Program and the Association of College and University Educators training program in higher education instruction. Author of eight books and many chapters and articles, she is CEO of Training4Excellence.com and Child Abuse Prevention Training for Organizations (CAPTA4.org). Dr. Vissing is a consultant with the

About the Contributors

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American Sociological Association and was a Whiting Foundation Fellow studying child rights programs in the UK, the EU, and Ireland. Fernando de Yzaguirre, Ph.D. is a professor in the sociology program at Universidad del Atlántico (Atlantic University) in Colombia. He is also an invited Professor with the psychology master’s degree in organizations at Magdalena University in Colombia and an invited professor in the master’s in gender studies at the National Distance Education University (UNED) in Spain. He has a master’s degree in organizational intervention, with an emphasis on clinical sociology, from the University Paris VII in France, and a Ph.D. in sociology, with a specialization in social psychology, from the Universidad Complutense de Madrid (UCM) in Spain. He is a member of the clinical sociology division (RC46) of the International Sociological Association (ISA) and the International Network of Clinical Sociology (RISC). His fields of specialization are clinical sociology and health sociology. Among his awards are the 2013 Distinguished Service Award from the ISA’s RC46 Clinical Sociology and the 2003 Social Sciences Essay Award from the Asociación Castellano-Manchega de Sociología. In 2018, he and his team members from Atlántico University received an honorable mention award for two years of “excellent work” as consultants at a public school (INEDIC) in Columbia.

Part I

The Essentials

Chapter 1

Introduction Jan Marie Fritz

1.1

Defining Clinical Sociology

The discipline of sociology has at least three traditions: science (empirical approach, using a combination of rigorous observation and inference), humanities (a study of aspects of the human condition such as literature, languages, culture or history using methods that might be primarily critical, analytical or speculative), and practice (intervention and analysis as well as practical research). In different regions of the world, sociological practice is sometimes referred to by different terms and sometimes the same terms are used but have different definitions.1 In this volume we use the definitions that have developed over time in the United States and some other regions (e.g., France, French-speaking Canada. South Africa). Sociological practice is the general term for applied sociology (practical research) and clinical sociology (analysis and intervention for improvement). Some sociological practitioners do both applied and clinical work, but choose the term that they think best characterizes their work. These practitioners (or scholar-practitioners) may call themselves clinical sociologists, applied sociologists. sociological practitioners or may find it helpful to use a term that does not include the discipline (sociology) but just focuses on their

1 Sociology, particularly in an economically developing country, might always have been seen as a discipline that contributes to the development of the country and so there is no need for a special term to refer to practice. A country might use a term like professional sociology to refer to those who are working outside of academic settings. In some regions, a newer term like public sociology might be used and this term may (or may not) involve education and training in practice. When it does have an emphasis in practice (engaged public sociology), the work can be referred to as applied, clinical or sociological practice.

J. M. Fritz (*) University of Cincinnati, Cincinnati, OH, USA University of Johannesburg, Johannesburg, South Africa e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_1

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type of contribution (e.g., organizational consultant, counselor, facilitator, policy analyst). Clinical sociology, one of the forms of sociological practice, is a creative, humanistic, rights-based and interdisciplinary specialization that seeks to improve life situations for individuals and groups in a wide variety of settings. Clinical sociologists, working individually or as part of a team, initiate their own projects (e.g., provide ideas for policy development) or assist clients/client systems (e.g., assist a school in making changes). Clinical sociologists assess situations and avoid, reduce, or eliminate problems through a combination of analysis and intervention. Clinical analysis is the critical assessment of beliefs, policies, or practices, with an interest in improving a situation. Intervention is based on continuing analysis; it is the creation of new systems as well as the change of existing systems and can include a focus on prevention or promotion (e.g., preventing environmental racism or promoting community sustainability). Clinical sociologists have many different areas of expertise, such as health promotion, organizational development, needs assessments, social conflict reduction, or cultural competence, and they work in many capacities. They are, for instance, university professors (full-time or part-time) who also may be consultants or advisers; community organizers; sociotherapists; mediators; social entrepreneurs; focus group facilitators; activists; social policy implementers; elected officials; social impact evaluators; action researchers; managers; and organizational analysts. The clinical sociologists who have an organizational focus may be interested in helping organizations in the public sector (government and nonprofit organizations) and/or for-profit enterprises that are publicly or privately owned. Clinical sociologists have undergraduate or graduate university degrees. They usually have training in more than one discipline and experience in working with intervention teams whose members have a variety of backgrounds. Because of this, clinical sociologists use a range of theoretical approaches (e.g., grounded, standpoint, multicultural-liberationist, psychoanalytic, systems, land ethic, conflict, social constructionism, symbolic interaction, critical, and/or social exchange) and often integrate them in their work. Depending, in part, on the amount and kind of research training they have received, clinical sociologists may conduct research, collaborate with researchers or primarily focus on intervention. Clinical sociologists with advanced degrees usually have training in a variety of quantitative and qualitative research methods. Their work frequently involves case studies, life histories, surveys, group work, participatory action research, sociodrama/role playing, ethnographic research and interviews but also can incorporate techniques such as demographic analysis and Geographic Information Systems. Clinical sociologists are practitioners who bring together the three sociological traditions—science, humanities and practice—in their work. Their assignments take into account relevant scientific information and also often result in scientific contributions in their areas of practice. The humanities tradition includes, for instance, historical perspectives, language/cultural awareness and storytelling; these are three very important parts of effective practice. Clinical sociologists also have education, training and experience in applied as well as clinical work. Much has been written

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about how university students increasingly want to major in areas that are directly connected to the job market (e.g., Connolly 2020, p. 33). The field of clinical sociology has this connection to the job market, but also emphasizes the importance of education in science and the humanities in order to be an effective practitioner.

1.2

Clinical Sociology in Its Global Context

Clinical sociology is as old as the field of sociology, and its roots are found in many parts of the world. The clinical sociology specialization often is traced back to the fourteenth-century work of the Arab scholar and statesperson Abu Zayd 'Abd al-Rahman ibn Khaldun (1332–1406). Ibn Khaldun, in addition to his research and teaching, provided numerous clinical observations based on his varied work experiences such as the chief judge of Egypt and secretary of state for the ruler of Morocco. Auguste Comte (1798–1857), Émile Durkheim (1858–1917), Karl Marx (1818–1883) and Marcel Mauss (1872–1950) are among those who frequently are mentioned as precursors to the field. Comte, the French scholar who one of the first to use term sociology, believed that the scientific study of societies would provide the basis for social action. Émile Durkheim’s work on the relation between levels of influence (e.g., social in relation to individual factors) led Alvin Gouldner (1965) to write that “more than any other classical sociologist (Durkheim) used a clinical model”. Karl Marx, as Alfred McClung Lee noted in 1979, brought to his written work “the grasp of human affairs only possible through extensive involvement in praxis. . ., social action, . . .agitation, and. . . social organization”. And Mauss gave us “some of the strongest ideas at the base of clinical sociology” including the importance of “lived experience” and “the need for sociology to take into account the meaning people give to their lives” (de Gaulejac 2008, p. 59). Clinical sociology has developed in a number of countries including the United States, France, Canada, Italy, Uruguay and Spain. The first known use of the term clinical sociology was in Spain by a surgeon named Rubio y Gali (1899). If one focuses on the use of the words clinical sociology, the specialization has its longest history in the United States and has resulted in many publications in English directly linked to the specialization. The American clinical sociologists emphasize intervention, designed a certification process, and have a commission that accredits clinical as well as applied sociology programs. French is the language of many of the current international clinical sociology conferences, and many publications clearly linked to clinical sociology have appeared in Quebec, Canada and France. The French clinical sociologists emphasize clinical analysis and frequently focus on the relationship between psychology and sociology. They have a solid international network and have done an excellent job of attracting psychologists and professionals in other fields to their network. Italians have hosted clinical sociology conferences and workshops, published clinical sociology books and articles, offered a graduate program in clinical sociology, and established an association of clinical sociologists.

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Clinical sociology also is found in other parts of the world. Of particular interest would be developments in Greece, Brazil, Mexico, Japan, Malaysia, Spain, Colombia and South Africa. In South Africa, for example, one university’s sociology department put a sociological clinic in place, another sociology department developed a graduate specialization in counseling and one university, the University of Johannesburg, has a program that has been accredited by the U.S.-based Commission for the Accreditation of Programs in Applied and Clinical Sociology (CAPACS). Mexico, Brazil, France, Canada, Italy, Uruguay and Greece are among those countries that have hosted international clinical sociology conferences. The international development of clinical sociology is supported by two major organizations. The clinical sociology division of the International Sociological Association (ISA) was organized in 1982 at the ISA world congress in Mexico City. The other major influence is the clinical sociology section of the Association Internationale des Sociologues de la Langue Française (International Association of French Language Sociologists). Other important organizations include the Commission for the Accreditation of Programs in Applied and Clinical Sociology (providing accreditation for university programs), Association for Applied and Clinical Sociology (offering individual certification as a Certified Clinical Sociologist or Certified Applied Sociologist), and clinical sociology is one of 22 thematic working groups in the South African Sociological Association. In France, two groups have been established: the clinical sociology committee of the Association Française de Sociologie (French Sociological Association) and, in 2015, the Réseau International de Sociologie clinique (RISC) (the International Network of Clinical Sociology). Global clinical sociology is now established and there are many publications focusing on the field and its specialization. (A brief list of basic publications and websites is provided at the end of this chapter.) While there is a common core in the regions and countries, there are differences. For instance, in some countries there is more of an interest in analysis and providing advice to policymakers rather than in undertaking intervention. There are practitioners working at all levels of intervention (e.g., individual through global), but some areas of intervention (e.g., health or organizations) may be more of a focus in one country than in another. In some countries, individuals and their approaches are clearly labeled as clinical sociology, while in other countries the label is not used very frequently. Finally, it should be highlighted that while scholar-practitioners in the United States; Quebec, Canada; and France have had important roles in the development of clinical sociology, there are now a number of other national and regional influences that also will shape the future of this global specialization.

1.3

The Organization of This Volume

This second edition of International Clinical Sociology is organized the same way as the first volume, but this new edition includes seven new chapters and nine updated ones. Chapters 1 and 2 are both introductory chapters with Chapter 2 outlining some

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of the basic concepts, diagrams and models in the field. Chapter 2 also includes details about rights-based intervention and the influences on individual and group actions. The introductory chapters are followed by the two main parts of the volume. Part I, Selected Regional Histories, discusses the history of clinical sociology in five areas of the world. The chapters in this part of the book are presented in order of the continuing use of the term clinical sociology. In Chapter 3, I discuss the history of clinical sociology in the United States, where the term clinical sociology was first used in the late 1920s and early 1930s by the dean of a medical school, and sociologists Louis Wirth and Ernest Burgess. In Chapter 4, Jacques Rhéaume discusses the history of clinical sociology in Quebec, Canada. The term clinical sociology first appeared in Quebec in the 1950s in the work of sociologist Fernand Dumont and those affiliated with Laval University. In Chapter 5, Vincent de Gaulejac discusses the history of clinical sociology in France, where the term clinical sociology was first used in 1963 by Jacques Van Bockstaele, Maria Van Bockstaele, and two of their colleagues. He traces the continuous development of clinical sociology and connects this development to the work of Émile Durkeim, Marcel Mauss, Georges Gurvitch and many others. In Chapter 6, Yuji Noguchi and Hideyo Nakamura discuss the history of clinical sociology in Japan. The term clinical sociology was introduced in a continuing way in 1993, although earlier books were published with the words “clinical sociology” in the titles in 1954 and 1985. In Chapter 7, Tina Uys discusses the emergence of clinical sociology in South Africa. Uys notes that South African sociologists only became familiar with the field of clinical sociology during the early part of this century, but a large portion of sociological work in South Africa always has focused on finding solution to social issues such as poverty and unemployment. The second part of the book, Clinical Sociology Applications, provides nine examples of interventions and analyses by clinical sociologists. Chapter 8, “The Patient’s Personal Experience of Schizophrenia in China” by Robert Sevigny, explores the experiences of four patients “in the context of a modern, urban China” and discusses Sevigny’s idea of an “implicit sociology.” In Chapter 9, “Bridging Social Capital: A Clinical Sociology Approach to Substance Use Intervention,” Miriam Boeri discusses her Social Recovery Initiative. Boeri noted that people who were leaving drug treatment programs often relapsed because they lacked “bridging social capital” (connection to new networks). Her program focused on social situations, social environments and network building. The author also discusses the evolving nature of a clinical intervention as adjustments are made because of trends regarding treatment. Chapter 10, “ Children’s Human Rights as a Buffer to Extremism: A Clinical Sociology Framework” was written by Yvonne Vissing. The author discusses the importance of a rights-respecting framework at the macro, meso and micro levels to deal with young people’s violent extremist attitudes and actions. She discusses rolemodeling at the individual level, community intervention at the macro level and school intervention at the meso level. Vissing embraces a partnership, multidisciplinary approach with an emphasis on macro-level interventions.

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Chapter 11, “Clinical Sociology Contributions to the Field of Mediation” and Chapter 12, “The Art of Facilitation” were both written by Jan Marie Fritz. Fritz has been a mediator and facilitator for more than 25 years and includes examples from her work in both chapters. The mediation chapter covers important concepts— multilevel system intervention, cultural competency, empowerment, theoretical analysis, and redefinition of the situation—that are basic not only for a clinical sociologist working as a mediator but for those working in many other areas of specialization. The facilitation chapter is about assisting a group to reach a goal or goals. Topics covered include the differences between novice, experienced and artisan facilitation; types of groups that can benefit from professional facilitation; and advice for facilitating a meeting. A case study is provided which points to some of the problems that can develop when not enough attention is given to effective facilitation. Chapter 13, “Organizational Consulting for Strategic Change in a Public School in Colombia,” was written by Fernando de Yzaguirre. The objectives of this consultation were to (1) work with the school’s teachers and management team to allow a more interactive update of the school’s Institutional Educational Project (IEP), the school’s strategic management tool, and (2) increase the teachers’ motivation to create processes of integration and collaboration among the teachers. The chapter describes the participatory process that was used to work with teachers and the administration staff. The consulting group was composed of former sociology students who had been trained in facilitation and their professor. In Chapter 14, “Climate Resilience Initiative in Metro Manila,” Emma Porio discusses a climate change adaptation initiative in poor urban communities that used a participatory community risk assessment (PCRA). Women’s groups, in partnership, with a clinical sociology team from a local university, used the PCRA process (i.e., constructing risk profiles through social vulnerability analysis) to negotiate with local officials to access more resources and services. In Chapter 15, “The South African Military and Gender Integration: Bridging Theory and Practice,” Lindy Heinecken discusses the challenges of gender integration internationally as well as in South Africa. She explains how her research resulted in invitations to present at international, national and Department of Defense forums. She argues that a sociological practitioner needs to be a critical as well as an empathetic researcher in order to have an influence on policy. In the final chapter, Chapter 16 “Focus Groups in the Context of International Development: In Pursuit of the Millennium and Sustainable Development Goals,” Janet Mancini Billson covers many aspects of focus groups and details her work with international clients. International as well as national and civil society organizations increasingly are turning to stakeholders to help them assess needs and determine development impacts. Billson notes that focus groups, as well as key informant interviews, have become a regular part of international development monitoring and evaluation (M&E).

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References Connolly, J. (2020, Spring). Dialogue across divides. Academe, 30–37. de Gaulejac, V. (2008). On the origins of clinical sociology in France: Some milestones. In J. M. Fritz (Ed.), International clinical sociology. New York: Springer. Gouldner, A. (1965). Explorations in applied social science. Social problems 3, 169–181. Reprinted in A. Gouldner & S. M. Miller (Eds.), Applied sociology (pp. 5–22). New York: Free Press. Lee, A. M. (1979). The services of clinical sociology. American Behavioral Scientist, 22(4), 487–511.

Selected Readings and Websites in International Clinical Sociology The following list includes many of the basic readings in the field of clinical sociology. The list was developed with two objectives in mind: include publications that (1) are basic in the different countries, and (2) focus generally on the field of clinical sociology. Readings that are less well known, do not mention clinical sociology in the title, or cover specialized areas of application are less likely to be included in this short list. Alinsky, S. (1934). A sociological technique in clinical criminology. In Proceedings of the sixty-fourth annual congress of the American Prison Association (pp. 167–178). New York: American Prison Association. Araujo, A. M. (2011). Sociologia Clinica, una epistemologia para la accion. Montevideo: Psicolibros universitario. (In Spanish). Araújo, A. M. (Ed.). (2019). Sociologia Clinica desde el Sur: Teoria—Praxis. Montevideo: Psicolibros universitaro. (In Spanish). Association for Applied and Clinical Sociology. www.aacsnet.net. Offers certification for clinical sociologists. Battisti, F. M., & Tosi, M. (Eds.). (1995). Sociologia Clinica e sistemi sociosanitari: dalle premesse epistemologiche allo studio di casi e interventi [Clinical sociology and social-health systems: From epistemological premises to the study of cases and interventions]. Milano: FrancoAngeli. (In Italian). Benvenuti, L. (2017). Lezioni di Socioterapia [Lessons of socio-therapy]. Ancona: StreetLib. (In Italian). Bouilloud, J. (1997). Epistemological aspects of clinical sociology. International Sociology, 12(2), 205–216. Bruhn, J. G., & Rebach, H. M. (1996). Clinical sociology: An agenda for action. New York: Springer. Clark, E. J., Fritz, J. M., & Rieker, P. P. (Eds.). (1990). Clinical sociological perspectives on illness and loss: The linkage of theory and practice. Philadelphia, PA: Charles Press.

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Clinical Sociology Review. (1982–1998). Journal of the Clinical Sociology Association. All issues. Retrieved from http://digitalcommons.wayne.edu/csr Commission on the Accreditation of Programs in Applied and Clinical Sociology (CAPACS). Provides standards by which quality academic undergraduate and graduate programs in clinical sociology can be developed and accredited. www. sociologycommission.org Corsale, M. (2008). La sociologie clinique comme science regoureuse et comme pratique sociale. International Review of Sociology, 18(3), 487–495. (In French). Corsale, M. (Ed.). (2010). Sociologia clinica e terapia sociale [Clinical sociology and social therapy]. Milano: FrancoAngeli. (In Italian). Corsale, M. (2014). Il sociologo clinico nell’ambito del sistema dei servizi [The clinical sociologist within the system of public and social services]. In QSCQuaderni di Sociologia Clinica, n. 6. Roma-Faenza: Homeless Book. (In Italian). de Gaulejac, V., & Coquelle, C. (Eds.). (2017). La part du social en nous: Sociologie Clinique et psychotherapie. ERES. (In French). de Gaulejac, V., & Coquelle, C. (2018). La part de social en nous: Sociologie clinique et psychothérapies. France: Eres. (In French). de Gaulejac, V., & Roy S. (Eds.). (1993). Sociologie clinique [Clinical sociology]. Paris: Desclée de Brouwer. (In French). de Gaulejac, V., & Yzaguirre, F. (2018). Sociología clínica y emancipación del sujeto. In J. L. Alvaro Estramiana (coord.), La interacción social (pp. 251–270). Madrid: Centro de Investigaciones Sociológicas. (In Spanish). de Gaulejac, V., Hanique, F., & Roche, P. (Eds.). (2007). La sociologie clinique: enjeux théoriques et méthodologiques. Ramonville Saint-Agne: ERES. (In French). de Gaulejac, V., Giust-Desprairies, F., & Massa, A. (Eds.). (2013). La recherché Clinique en sciences Sociales. Toulouse: ÉRÈS. (In French). Eistner, A., & Hildenbrand, B. (2009). Psychiatrische soziologie als klinische soziologie-Ein beitrag zur Professionalisierung in psychiatrischen handlungsfeldern [Psychiatric sociology as clinical sociology: A contribution to professionalization in psychiatric aresa of activity]. Psychotherapie und Sozialwissenschaft: Zeitschrift far Qualitative Forschung und klinische Praxis, 11(2), 99–126. (In German). Enriquez, E. (1992). Remarques terminales vers une sociologie clinique d’inspiration psychanalytique [Final remarks toward a clinical sociology with psychoanalytic inspiration]. In L’organisation en analyse. Fevrier. Paris: P.U.F. (In French). Enriquez, E. (1997). L’approche clinique: genèse et développement en France et en Europe de l’Ouest [The clinical approach: genesis and development in France and in Western Europe]. International Sociology, 12, 151–164. (In French). Enriquez, E., Houle, G., Rhéaume, J., & Sévigny, R. (1993). L’analyse clinique dans les sciences humaines [Clinical analysis in the human sciences]. Montreal: Éditions Saint-Martin. (In French). Fatayer, J. (2008). Addiction types: A clinical sociology perspective. Journal of Applied Social Sciences, 2(1), 88–93.

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Fleischer, M., & Winston, N. (2018). Entry on “Accreditation” for Dictionnaire de sociologie clinique. Journal of Applied Social Science, 12(1), 12–16. Fortier, I., Hamisultane, S., Ruelland, I., Rhéaume, J., & Beghdadi, S. (2018). Clinique en sciences sociales: Sens et pratiques alternatives. Quebec: Les presses de l’Université du Quebec. Fritz, J. M. (1985). The clinical sociology handbook. New York: Garland. Fritz, J. M. (1991). The emergence of American clinical sociology. In H. Rebach & J. Bruhn (Eds.), Handbook of clinical sociology (pp. 17–32). New York: Plenum. Fritz, J. M. (2005). The scholar-practitioners: The development of clinical sociology in the U.S. In A. J. Blasi (Ed.), Diverse histories of American sociology (pp. 40–56). Leiden: Brill. Fritz, J. M. (Ed.). (2006). The clinical sociology resource book (6th ed.). Washington, DC: American Sociological Association Teaching Resources Center and the Clinical Sociology Division (RC46) of the International Sociological Association. Fritz, J. M. (Ed.). (2008). International clinical sociology. New York: Springer. Fritz, J. M. (2010). La Sociologia Clinica è una sociologia pratica: Un’introduzione (An introduction to clinical sociology, On the Sociologia Clinica webpage (Italy) (trans: Piscitelli, G.). Retrieved May 17, 2020, from https://www.homelessbook. it/autore/fritz-jan-marie/5117 Fritz, J. M. (2011). Addressing environmental racism: A clinical sociological perspective. SOCIOIIPOCTIP: The Interdisciplinary Collection of Scientific Works on Sociology and Social Work, 1(2), 65–75. (Journal based in Ukraine). Fritz, J. M. (2012a). The importance of creativity in clinical sociology. In A. V. Rigas (Ed.), Creativity: Psychology of art and literature in social clinical perspectives (pp. 19–30). Athens: Publications Gutenberg. Fritz, J. M. (2012b). Including sociological practice: A global perspective and the U.S. case. In D. Kalekin-Fishman & A. Denis (Eds.), The shape of sociology for the twenty-first century: Tradition and renewal. London: Sage. Fritz, J. M. (2012c). Practicing sociology: Clinical sociology and human rights. In D. Brunsma, K. Smith, & B. Gran (Eds.), Handbook of sociology and human rights. Boulder, CO: Paradigm. Fritz, J. M. (Ed.). (2014). Moving toward a just peace: The mediation continuum. Dordrecht: Springer. Fritz, J. M. (2017). Clinical sociology. In K. Korgen (Ed.), The Cambridge handbook of sociology (pp. 339–347). New York: Cambridge. Fritz, J. M. (2019). Principi fondamentali dell’Intervento comunitario (con una presentazione di Marco Omizzolo) [Original version: “Essentials of Community Intervention”. In J. M. Fritz, & J. Rheaume (Eds.) (2014), Community intervention. Clinical sociology perspectives, Springer. Translated by Gianluca Piscitelli, QSC-Quaderni di Sociologia Clinica, n. 19, Roma-Faenza: Homeless Book. (In Italian). Fritz, J. M. (Ed.). (2020). International clinical sociology (2nd ed.). Dordrecht: Springer.

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Fritz, J. M., & Rhéaume, J. (2014). Community intervention: Clinical sociology perspectives. Dordrecht: Springer. Giorgino, E. (1998). Per un ridefinizione del lavoro professionale in sociologia [For a redefinition of professional work in sociology]. Sociologia e Professione, 29, 8–23. (In Italian). Giorgino, V. M. B. (2018a). La Sociologia clinica. Il campo e le sementi [Clinical sociology. The field and seeds]. In QSC-Quaderni di Sociologia Clinica, n. 14. Roma-Faenza: Homeless Book. (In Italian). Giorgino, V. M. B. (2018b), La fecondazione incrociata tra sapere contemplativo e pratica sociologica [The cross fertilization between contemplative knowledge and sociological practice]. In QSC-Quaderni di Sociologia Clinica, n. 15. RomaFaenza: Homeless Book. (In Italian). Glassner, B., & Freedman, J. A. (1979). Clinical sociology. New York: Longman. Gordon, J. (1989). Notes on the history of clinical sociology at Yale. Clinical Sociology Review, 8, 42–51. Guerrero, P., & de Gaulejac, V. (2017). Sociologia clinica del trabajo. In X. Zabala, P. Guerrero, & C. Besoain (Eds.), Clinicas del trabajo: Terorias e itervenciones. Santiago de Chile: Universidad Alberto Hertado. (In Spanish). Hall, C. M. (2006). Narrative as vital methodology in clinical sociology. Journal of Applied Sociology, 23(1), 54–67. Hildenbrand, B. (2018a). Klinische soziologie. In H. Olbrecht & A. Seltrecht (Eds.), Medizinische Soziologie trifft Medizinische Padagogik:Gesundheit und Gesellschaft. Wiesbaden: Springer VS. Hildenbrand, B. (2018b). Klinische Soziologie: Ein Ansatz fur absurd Helden und Helden des Absurden.(Clinical Sociology—A Concept for Absurd Heroes and for Heroes of the Absurd). Wiesbaden: Springer VS-Verlag fur Sozialwissenschaften. (In German). Kashikuma, K. (1985). Hikou no rinsho-skakaigaku [Clinical sociology of juvenile delinquency].Tokyo: Kakiuchi-Shupan. (In Japanese). Kato, M. (1954). Rinsho-shakaigaku josetu [An introduction to clinical sociology]. Tokyo: Chudai-Shupansha. (In Japanese). Lee, A. M. (1944). Sociology, clinical. In H. P. Fairchild (Ed.), Dictionary of sociology (p. 303). New York: Philosophical Library. Lehnerer, M. (2003). Careers in clinical sociology. Washington, DC: American Sociological Association. Translated into Italian in 2018 as Professione Sociologo Clinico. La passione singe all’azione. http://www.homelessbook.it/ collana/sociologia-clinica/25 Lehnerer, M., & Perlstadt, H. (2018). Building a community of sociological practice: Certifying practitioners and accrediting programs. Journal of Applied Social Science, 12(1), 17–24. Luison, L. (Ed.). (1998). Introduzione alla Sociologia Clinica: Teorie, Metodi e Tecniche di Intervento [Introduction to clinical sociology—Theory, methods and intervention techniques]. Milano: FrancoAngeli. (In Italian).

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Luison, L. (2006). La mediazione come strumento di intervento sociale [Mediation as a tool for social intervention], Milano: FrancoAngeli. (In Italian). Luison, L., Minardi, E., & Piscitelli, G. (2008). SC come Sociologia clinica. Percorsi di sviluppo della Professione sociologica [Clinical sociology. Paths of development in the sociology profession]. Teramo: Il Piccolo Libro. (In Italian). Minardi, E. (2018). Sociologia Clinica: come si ripresentano i dilemmi della sociologia [Clinical sociology: How sociology’s dilemmas recur]. In QSCQuaderni di Sociologia Clinica, n.12. Roma-Faenza: Homeless Book. (In Italian). Minardi, E. (2019a). La costruzione dell’intervento sociale [The construction of social intervention]. In QSC-Quaderni di Sociologia Clinica, n.16. Roma-Faenza: Homeless Book. (In Italian). Minardi, E. (2019b). Sociologia accademica e sociologia professionale [Academic sociology and professional sociology]. In QSC-Quaderni di Sociologia Clinica, n.17. Roma-Faenza: Homeless Book. (In Italian). Noguchi, Y., & Ohmura, E. (Eds.). (2001). Rinshou-Shakaigaku no Jissen [The practice and experience of clinical sociology]. Tokyo: Yuhikaku Publishing. (In Japanese). Ohmura, E. (Ed.). (2000). Rinshou-Shakaigaku wo Manabu Hito no Tameni [For the people studying clinical sociology]. Kyoto: Sekaishisousha. (In Japanese). Ohmura, E., & Noguchi, Y. (Eds.). (2000). Rinshou-Shakaigaku no Susume [Introduction to clinical sociology]. Tokyo: Yuhikaku Publishing. (In Japanese). Opalić, P. (2007). Klinićki sociology u psihijatriji—profesionalni most izmedu psihijatrije i sociologije. Sociologija/Sociology: Journal of Sociology, Social Psychology & Social Anthropology, 49(2), 117–126. (In Serbian). Patuelli, P. (2019). Il rovescio del sociale. Appunti per una clinica sociologica [The backhand of the social. notes for a sociological clinic]. In OnTheRoad, n.3. Roma-Faenza: Homeless Book. (In Italian). Piscitelli, G. (2010). La cooperazione consapevole. Un modello di intervento sociologico a sostegno delle organizzazioni e dei protagonisi della societa civile [Aware cooperation. A sociological model of intervention in support of civil society actors]. Rome: ARACANE EDITRICE. (In Italian). Piscitelli, G. (2013). Il valore dell’esperienza per lo sviluppo della professione sociologica [The value of the ‘experience’ for the development of the sociological profession]. In QSC-Quaderni di Sociologia Clinica, n.4. Roma-Faenza: Homeless Book. (In Italian). Piscitelli, G. (2018a). Awareness, creative adaptation and growth. Clinical sociology for innovation, change and well-being. In QSC-Quaderni di Sociologia Clinica, n.13. Roma-Faenza: Homeless Book. (In English). Piscitelli, G. (2018b). Translation (English to Italian) and introductory essay for “Professione Sociologo Clinico. La passione singe all’azione” by Melodye Lehnerer. http://homelessbook.it/collana/sociologia-clinica/25. (In Italian). Piscitelli, G. (2020), Bullismo e altre espressioni di violenza giovanile: riflessioni a sostegno della teoria e della pratica professionale sociologiche (con uno scritto di

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Randall Collins) [Bullying and other expressions of youth violence: Reflections in support of the theory and professional practice of sociology (with a text by Randall Collins)]. In QSC-Quaderni di Sociologia Clinica, n.22. RomaFaenza: Homeless Book. (In Italian). Piscitelli, G., & Minardi, E. (2019). Breve storia della sociologia clinica in Italia. Elementi per la ricostruzione di un percorso umano, sociale e intellettuale [A brief history of clinical sociology in Italy. Elements for the reconstruction of a human, social and intellectual path]. https://www.academia.edu/41555810/ Breve_storia_della_sociologia_clinica_in_Italia. (In Italian). RC46 Clinical Sociology of the International Sociological Association. https://www. isa-sociology.org/en/research-networks/research-committees/rc46-clinical-sociol ogy/ and https://clinical-sociology.org Rebach, H. M., & Bruhn, J. G. (1991). Handbook of clinical sociology. New York: Plenum. Rhéaume, J. (1997). The project of clinical sociology in Quebec. International Sociology, 12, 165–174. Rhéaume, J. (2009a). Relato de vida Coletivo e Empoderamento. In N. M. Takeuti & C. Niewiadomski (Eds.), Reinvençoes do sujeito social: Teorias e praticas biographicas (pp. 166–190). Porto Alegre: Salina. (In Portuguese). Rhéaume, J. (2009b). La sociologie clinique comme pratique de recherché en institution. Le cas d’un Centre de santé et services sociaux [Clinical sociology as a research practice in institutions. The case of a center of health and social service]. Sociologie & Sociétés, 41(1), 195–215. (In French). Rhéaume, J. (2010a). L’expérience de la recherche au CSSS De la Montagne. La perspective de la sociologie clinique. Cahiers de l’équipe METISS du Centre de recherche et de formation, CSSS De la Montagne, 5(1), 19–36. (In French). Rhéaume, J. (2010b). L’action communautaire d’inspiration nord-américaine. In I. Sainsaulieu, M. Salzbrunn, & L. Amiotte-Suchet (Eds.), Faire communauté en société (pp. 171–182). Presses Universitaires de Rennes: Rennes. (In French). Rhéaume, J. (2011). Dimensiones epistemologicas de las relaciones entre teoria y practica. In A. M. Araujo (Ed.), Sociologia clinica: Una epistemologia para la accion (pp. 57–66). Montevideo: Psicolibros. (In Spanish). Rhéaume, J. (2012). Sociologia Clinica del Trabajo: De la Psiquis a lo Social. In Revista electronica Dialogos de la Comunicaciòn, no.83. Tema: Discurso, Interraciòn y Gobernanza : Pensar la Organizaciòn desde la comunicaciòn, 24 p. https://dialnet.unirioja.es/servlet/articulo?codigo¼6800079. (In Spanish). Rhéaume, J., & Mercier, L. (2007). Récits de vie et sociologie clinique [Life histories and clinical sociology]. Quebec City: Presses de l’Université Laval. (In French). Rigas, A. V., & Zygouris, N. H. (Eds.). (2017). Psychosocial, clinical and neuropsychological interventions in individuals and groups with special abilities. Athens: Gutenberg. Rubio y Gali, F. (1899). Clinica social. Revista Ibero-americana de Ciencias Medicas, 2(3–4), 50–78.

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Sand, H. P. (2013). Clinical sociology and moral hegemony. Advances in Applied Sociology, 3(7), 253–257. Published online November 2013 in SciRes. Retrieved May 3, 2020, from http://www.scirp.org/journal/PaperInformation.aspx? PaperID¼39143 Sévigny, R. (1996). The clinical approach in the social sciences. International Sociology, 12, 135–150. Sévigny, R., Rheaume, J., Houle, G., & Enriquez, E. (1993). L’Analyse Clinique dans les Sciences Humaines [Clinical analysis in the human sciences]. Montreal: Editions Saint-Martin. (In French). Sévigny, R., Weng Y., Yang, Z., Loignon, C., & Wang, J. (2010a). Jingshenbingxue kangfu: youguan lingchuang shehuixue de tansuo [Psychiatric rehabilitation: A clinical sociology approach]. In W. Yongzen, R. P. Liberman, & X. Yingqing (Eds.), Jingshenfenliezhen Kangfu Caozuo Shouce [A handbook of rehabilitation for patients with schizophrenia]. Beijing: People’s Medical Publishing House. (In Chinese). Sévigny, R., Sheying, C., & Chen, E. Y. (2010b). Explanatory models of illness and psychiatric rehabilitation: A clinical sociology approach. Qualitative Sociology Review, 6(3), 63–80. Siza, R. (2013, January). La professione del sociologo tra sviluppo e diffusone della sociologia [The profession of the sociologist between development and diffusion of sociology]. Journal Sociologia Italiana. (In Italian). Siza, R. (2019). The Sociologist: a profession without a community. International Review of Sociology/Revue Internationale de Sociologie, 29(3). Sociological Practice. Retrieved from http://digitalcommons.wayne.edu/socprac Spencer, L. (2009). The expanding role of clinical sociology in Australia. Journal of Applied Social Sciences, 3(2), 56–62. Straus, R. A. (2001). Using sociology: An introduction from the applied and clinical perspectives (3rd ed.). New York: Rowman and Littlefield. Tosi, M., & Battisti, F. (Eds.). (1995). Sociologia Clinica e Sistemi Socio-Sanitari: Dalle Premesse Epistemologiche allo Studio di Casi e Interventi [Clinical sociology and public health systems]. Milano: FrancoAngeli. (In Italian). Uys, T., & Fritz, J. M. (Eds.). (2020). Clinical sociology for Southern Africa. Claremont: Juta. Van Bockstaele, J., & Van Bockstaele, M. (2004). La Socianalyse: ImaginerCoopter [Socioanalysis: imagining and co-opting]. Paris: Edition Economica/ Anthropos. (In French) Van Bockstaele, J., Van Bockstaele, J., Van Bockstaele, M., Barrot, C., & Magny, C. (1963). Travaux de Sociologie Clinique [Clinical sociology work]. In L’Année Sociologique. Paris: Presses Universitaires de France. (In French). Vandevelde-Rougale, A., & Fugier, P. (2019). Dictionnaire de sociologie Clinique. Toulouse: Eres. (In French). Vandevelde-Rougale, A., & Guerrero Morales, P. (2019). Emocion, discurso magagerial y resistencia: El mobing como revelador. Psicoperspectivas. 18/3. November. (In Spanish).

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Wan, A. H. (2004). The crowning of sociology: The genesis of clinical sociology. Unpublished manuscript. Wan, M., & Wan, H. (2020). Clinical sociology: Moving from theory to practice. Dordrecht: Springer. Wirth, L. (1931). Clinical sociology. American Journal of Sociology, 37, 49–66. Wozniak, Z. (2014). Socjologia kliniczna—Interwencyjny wariant raktycznych zastosowan socjologii. Ruch Prawniczy, ekonomiczny i Socjologiczny, 76(4), 333–347. (In Polish). Yzaguirre, F., & Fernández-Cid, M. (2017). Rubio y Galí y su Clínica social de 1899: Precedente de una Sociología Clínica. Psychofenia, 20(35–36), 97–114. (In Spanish).

Chapter 2

The Basics: From Concepts to Models Jan Marie Fritz

2.1

Introduction

Clinical sociology is a humanistic and creative specialization that seeks to improve the quality of people’s lives. Clinical sociologists bring contributions from two or more disciplines (frequently sociology and psychology) to their work and incorporate knowledge and experiences from the areas of practice (e.g., health, criminal processing system, community development, organizational analysis, human rights) in assisting with or undertaking a management or intervention process. This chapter presents some of the basics of the analysis and intervention that is clinical sociology—the concepts, ideas about intervention, theory, diagrams, and models. Concepts (important terms), diagrams (simple visual representations), and models (explanations or visualizations of how practitioners should function) help us define the field and can serve as a baseline for discussions regarding intervention. These basics provide a useful starting point for readers interested in intervention by/for/ with the dreamers, plodders, survivors, planners and activists who live among us.

2.2

Rights-Based Intervention and Other Basic Concepts

The authors contributing to this volume have mentioned or discussed many concepts that are basic to sociology and clinical sociology. The concepts used frequently by clinical sociologists include humanism; sociological imagination; cultural competence; social identity; multilevel intervention; sustainability; well-being; social J. M. Fritz (*) University of Cincinnati, Cincinnati, OH, USA University of Johannesburg, Johannesburg, South Africa e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_2

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justice; structural facilitators and constraints; redefinition of the situation; and empowerment. Especially important to clinical sociology, and defined here, are the concepts of rights-based intervention; structurally-conducive settings; creativity; inclusion; client and client systems; and socioeconomic development.

2.2.1

Rights-Based Intervention

Rights-based intervention refers to the creation of new systems as well as the change of existing systems (including a focus on prevention or promotion) while taking into account everyone’s human rights. The rights often are those defined by national as well as international documents such as the United Nation’s Universal Declaration of Human Rights. Alice Donald (2012) identified five principles that are basic to rights-based interventions: Participation (of all those involved); Accountability (ensuring goals are met); Non-discrimination; Empowerment (addressing power imbalances) and Legality (applying national and international standards). A rights-based approach means that an intervention will “promote and maintain a minimum standard of well-being to which all people. . . would ideally possess a right” (Johnson and Forsyth 2002). Interventions, then, should “protect and promote,” or at least not undermine, “the interests of [those who are] poor and vulnerable” (Johnson and Forsyth 2002). And as Alfred McClung Lee noted in 1979, a clinical sociologist could not work for just any client, as the specialization has to serve humane goals.

2.2.2

Structurally-Conducive Settings

Neil Smelser (1962) reminded us (when he discussed conditions necessary for episodes of collective behavior) that the first condition is structural conduciveness. Smelser indicated that the organization of a community—including a good communication network and open administration—sets the stage for forms of collective activity. Clinical sociologists create settings and analyze existing ones and, in doing so, identify their facilitators and barriers for intervention. Structurally-conducive situations (e.g. in organizations, communities, nations) are very important for interventions to be both creative and inclusive.

2.2.3

Creativity

Creativity, a process that is essential to innovation, attempts to generate new concepts, ideas, objects, or associations. Vraneski (2006) stated that the “ability to take existing objects, concepts or ideas and combine them in different ways for new

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purposes is shared by all human beings.” Even if all people have the capacity to be creative, fostering creativity is particularly important in an intervention process. You have to examine situations to see which foster or hinder creativity or imaginative thinking. Creativity requires openness, listening, risk-taking, trust, and collaboration and this is more likely to happen in a structurally-conducive situation.

2.2.4

Inclusion

Inclusion is about the involvement of all people, or their representatives, and empowerment; the dignity, worth and views of all people are recognized through meaningful involvement. The field of sociology is known for its focus on factors such as class, race and gender. This focus has developed into an integrated approach that is known as intersectionality. This term indicates that to understand people’s lives it often is not enough to look at one factor—such as class or age; one needs to identify the multiple factors that might be involved and how they intersect.1 Taking into account multiple factors and their intersection is very important for effective intervention as is hearing from all those who are or may be involved or affected if an intervention is put in place. Inclusivity if often a goal as well as an essential consideration in intervention work.

2.2.5

Client and Client Systems

A client is defined here as a person, category of people or group that has received or is receiving professional advice or services. The client may be paying (directly or through some kind of assistance) for services (e.g., sociotherapy, facilitating international efforts) or there may be no payment involved. A client system refers to the client and those individuals and groups in the client’s informal and formal networks whose beliefs and/or actions might affect the client’s situation and/or can help resolve the client’s concerns or problems (Fritz 2020). The word “client” is usually used in certain instances (e.g., receiving therapy or advice on organizational development) but, in other instances, the word is not used. For instance, a counselor in an academic organization usually would not refer to the students as clients and a mediator would talk about working with parties or participants—not clients—in a mediation. There also are instances where a clinical sociologist might initiate or be involved in a change effort (e.g., environmental impact assessment) where no “client” has asked for the work to be done.

1 Additional factors might include ethnicity, citizenship, sexuality, ability, geographic setting or the context in which people function (e.g., the amount of authority or power in a work setting.

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The characteristics of the client system are particularly important during a period of change. The largest share of work in any change initiative generally must be undertaken by the client. . Therefore, the extent and quality of the change will depend, in large part, on the energy, capability (including available resources), and motivation of the client and the client system. When there is a client, it is particularly important for all those involved, including the consultant, to have identified the actual client. For instance, if a clinical sociologist is brought in to improve the work of a department within a university, is the client the department, the college in which the department is located or the university? The consultant and the involved university units need to know this, for instance, when arranging for initial and exit interviews; exploring change strategies as well as writing and delivering the report.

2.2.6

Socioeconomic Development

Socioeconomic development is a planned and comprehensive economic, social, cultural and political process in a defined geographic area. It is a rights-based and ecologically-oriented process that aims to continually improve the well-being of the entire population and all of its individuals (Fritz 2004). Economic development is the process of raising the level of prosperity through increased production, distribution, and consumption of goods and services. Social development, on the other hand, refers to the complexity of human dynamics (the interplay of social structures, processes, and relationships) and focuses on (1) the concerns of the people as objects of development and (2) people-centered, participatory approaches to development. Individuals would be actively involved in open, meaningful participation in development and in the fair distribution of benefits. This comprehensive definition of socioeconomic development2 has three components: social development, economic development, and environmental protection. There has been a growing recognition that economic development is a source of dynamic changes and generates wealth, but it does not, by itself, create prosperity for all. There is now increasing interest in national economic planning that includes

2

According to James Midgley (1994), it is not a new idea to link social interventions and economic activities. In the late 1800s, for example, the volunteer workers of the Charity Organization Society in England helped impoverished individuals find employment and start small businesses. In 1954, the British authorities adopted the term social development to link social welfare and community development to the economic development efforts in their colonies. The development processes, however, were not smooth or effective for a number of reasons. For instance, postcolonial development efforts often were centralized, top-down approaches, and development strategies in the Global South frequently focused only on economic growth for the benefit of national elites and transnational corporations.

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social concerns and this has come about, according to Chimhowu, Hulme and Munro (2019: 81), because of the “initiative led by countries of the global South” and the UN’s Sustainable Development Goals. Socioeconomic change is needed and intervention is required to make changes. Three points about intervention are specific to socioeconomic development intervention: 1. Harmony between social and economic interventions: Social interventions should contribute in a positive way to the economy, and economic interventions should improve the quality of people’s lives. A review of this situation is particularly important when one or more parts of a client system assume that economic changes will inevitably lead to social progress. 2. Protection of vulnerable populations: These populations could include refugees, immigrants, victims of war, racial/religious/ethnic minorities, children, the elderly, and women. Women, for instance, have been gaining formal rights, but this progress has not been matched by improvement in their quality of life. Hidden barriers and ceilings to women’s participation are still in place, and the shift to more responsibilities for families and communities has been an increasing burden for women. Socioeconomic development interventions need to improve the quality of all people’s lives including vulnerable populations. 3. Participatory planning at all levels.: The U.N. Sustainable Development Goals (SDGs) have been one of the key factors in moving countries to develop their social, economic and environmental agendas. As noted by Qu and his colleagues (2020): (sustainable development) SD goals and targets are continuously evolving, country specific, complex to implement, and are often given relatively short time horizons, such as the 15-year horizon for the SDGs. Many SD issues need a much longer time horizon as the policy interventionsto deal with these issues can take decades before their effects become apparent.

While there has been a large increase in national planning3 (Chimkowu 2018; Chimhowu et al. 2019), there are big differences in the quality of the plans in terms, for instance, of having identified financing for the plans4 and the extent to which there is effective participation of all sectors of the community. Effective development requires a participatory approach to planning at all levels (e.g., local community, national) and would not be characterized as top-down style of planning.

3

According to Chimhowu (2018) and his colleagues (Chimhowu et al. 2019), the number of countries with a national development plan has more than doubled. There were 62 national plans in 2006 and there were 134 in 2018. This is a “stunning recovery of a practice that had been discredited in the 1980s and 1990s.” 4 Some countries now have been the recipients of funds from another country (this process has been called debt-trap diplomacy) in which the terms were not seen and discussed by the public and can result in those countries losing control of their important resources. See, for instance, Parkinson et al. (2020).

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Intervention and Interventionists

This section briefly covers four important topics regarding intervention. The topics are the levels of intervention, the intervention process, consultation models, and conducting interventions.

2.3.1

Levels of Intervention

The role of the clinical sociologist involves one or more levels of focus from the individual to the global. Even though the clinical sociologist specializes in one or two levels of intervention (e.g., marriage counseling, community consulting), the practitioner will move among a number of levels (e.g., individual, organization, community, national) in order to analyze, manage or intervene. The intervention levels (from individual through global) are represented in Fig. 2.1 by circles to indicate that no level is assumed to be more important than another. The lines among the levels help show that clinical sociologists focus on one

Fig. 2.1 The levels of intervention

2 The Basics: From Concepts to Models

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Fig. 2.2 Progress toward the goal or objective Goal/ Objective

level (which could be shaded for emphasis) but also have an additional focus or at least a background in one or more other levels and integrate that knowledge in their work. The global level refers to work done on a worldwide basis as well as to a time when other worlds may converse with us (and we with them).

2.3.2

The Intervention Process

The basic intervention process with a client system (the individual or group that uses the assistance of a clinical sociologist or intervention team), as outlined by Ronald Lippett and his colleagues (1958), is divided into seven stages: (1) The client system discovers the need for help, sometimes with assistance from the change agent. (2) The helping relationship is established and defined. (3) The change problem is identified and clarified. (4) Alternative possibilities for change are examined and the goals of the change are established. (5) Change efforts are attempted. (6) Change is generalized and stabilized. (7) The helping relationship ends or a different type of continuing relationship is defined. Two general points can be made about these stages. First, it is possible not only to progress through the stages but also to cycle back through them as necessary. Figure 2.2 shows that progress toward a goal should not be depicted by a straight line.5 One might expect that if the project generally stays on track, more of the cycling back will be at the beginning of the process. If there are unusual problems (e.g., change of leadership, change of direction of the organization, plateau in terms of effort), the trajectory and cycling back might be represented in a different way. The second point is that the length of time required for each stage will depend on a number of factors, including the kind of change under consideration. Lippett’s stage three, in which the helping relationship is established and defined, is interesting for two reasons. First, it is at this point that the issue or change problem

5

This same idea is captured in a slightly different way by David Sternberg (1981) in his discussion of doctoral students’ progress on their dissertations and W. Warner Burke’s (2002) discussion of the “nonlinear nature of organization change.”

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Fig. 2.3 Identification of the issue or problem

(and eventually the participants) are fully identified. Figure 2.3 shows that the issue or problem is identified and focused on while taking into account its context.6 The issue (the focus) may be changed somewhat after more information is collected, but it is essential for the intervention process to initially establish the issue or issues by this point. Second, initial assessments of the situation may be conducted during the third stage.7 There are other types of intervention models in addition to the basic one presented by Lippett and his colleagues. If there were a disaster of some type e.g., tornado, earthquake, bridge collapse, bombing), for instance, a different approach to consultation would be needed. The simplest model might be disaster, response and reconstruction. A more developed model would start long before the disaster with assessment, planning, prevention/mitigation (reducing the potential for the disaster) and preparedness. Crisis intervention may be needed quickly for an individual or group; it also might begin some time after a disaster occurs. Roberts and Ottens (2005, pp. 5–9) identified a seven-stage model of crisis intervention that is used for clients “on the road to stabilization, resolution and mastery.” The intervenor would: – Plan and conduct a thorough biopsychological and lethality/imminent danger assessment; – Make psychological contact and rapidly establish rapport; – Identify the major problems, including crisis precipitants; – Encourage and deal with feelings and emotions;

6 7

This figure is based, in part, on Eva Soeka’s (2004) presentation on the development of a dispute. Research efforts (which could include initial assessments) are discussed later in this chapter.

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– Generate and explore alternatives and new coping strategies; – Restore functioning through implementation of an action plan; – Plan follow-up and booster sessions. Roberts and Ottens (2005) consider these to be typical stages and note that they are sequential, but can be overlapping. Clinical sociologists frequently use stage models in their consulting work. In the discussion of stages here, Robert and Ottens noted that the stages in their model are typical ones. . . which means there is flexibility. The discussion of Lippitt’s model talked about the possibility of cycling back through certain stages and the chapter on mediation in this volume also talks about a frequently-used stage model but notes that mediation can be flexibly structured. In the consulting process, then, a model is only a starting point and may be changed.

2.3.3

Consultation Models

Clinical sociologists differ in their consultation models (e.g., control or influence, extent of citizen participation). The ends of the line in Fig. 2.4 indicate that a consultant’s approach might be directive (telling clients what to do) or collaborative (part of a client group and, like other members of the group, offering one’s skills to help the group make a decision). The shading on the main line indicates that most clinical sociologists usually operate in a facilitative or collaborative way.

2.3.4

Conducting Interventions

It is useful to outline the principles, attitudes, and tools needed by clinical sociologists in conducting interventions. While these may differ somewhat depending on the level of intervention (e.g., individual, community, nation), they include: having an ethical framework, practicing inclusiveness, working with the people’s interests and opportunities, encouraging recognition of other viewpoints, demonstrating interdependence as a factor in the change process, encouraging capacity building, having relevant knowledge and knowing how to access more of it, and having a long-term perspective. Change agents need to be open-minded, courageous, and able to work well with others.

Fig. 2.4 Approach used by the intervenor

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Fig. 2.5 The intervenor’s decision-making process. (Adapted from Laue and Cormick 1978)

James Laue and Gerald Cormick discussed the approach of intervenors in their 1978 article, “The Ethics of Intervention in Community Disputes.” Based on their discussion and diagram, Fig. 2.5 visualizes the relationship between an intervenor’s basic assumptions, values, ethical principles, decision-making and actions. For Laue and Cormick, the basic values were freedom, justice, and empowerment. It certainly is worth discussing if the assumptions, values, and principles will be the same for different intervenors and in different circumstances, particularly when the outside influences (e.g., funders, participants, intervenor’s employer) may have different assumptions, values, and principles. The context in which change takes place is very important. The change agent and the client system need to identify and review the internal and external forces that foster or resist change at the onset as well as throughout the process. This is a particularly creative part of the change agent’s work, whether the interventionist is collaborative, facilitative, or directive, and is basic in the selection of intervention tools and techniques for effective, sustainable change.

2.4

Research and Intervention

Clinical sociologists who conduct research (qualitative and/or quantitative) may do so before beginning an intervention project, to assess the existing state of affairs; during an intervention, to follow the process or possibly change directions; and/or

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Fig. 2.6 The role of research in the intervention process

after the completion of the intervention, to evaluate the outcome. Figure 2.6 illustrates the role of research if undertaken by an intervenor or intervention team. For some clinical sociologists, the research activity is a central part of their own clinical work and they look for opportunities to conduct research.8 Other clinical sociologists may be interested only in research in a very limited way and only as it is useful (e.g., for assessment) for a specific project. They may prefer to concentrate on management and/or interventions and leave any research to other team members or research specialists.

2.5

Theories and Models

Theory is generally defined as a hypothetical explanation for one or more observations or a possible answer to a question (Derksen and Gartrell 2000). The concept of scientific theory has been referred to as a “hypothetical explanation that states the possible relationships among scientific concepts” (Derksen and Gartrell 2000) or as “a set of interrelated constructs (concepts with high levels of abstraction), definitions, and propositions that present a systematic view of phenomena by specifying relations among variables, with the purpose of explaining and predicting the

8

Epistemology, theory, and research methods are linked. The kind of research methods used and the ways in which they are used generally reflect the epistemology and theories held by the clinical sociologist or those responsible for the intervention.

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phenomena” (Kerlinger 1973). Theory, then, is defined in different ways. It can be used to examine issues of all sizes, but also can be seen as a worldview—one’s lens on the world. Clinical sociologists, in good part because of their multidisciplinary education and varied work experiences, use a wide range of theories. Some theories frequently used by clinical sociologists are as follows: grounded, standpoint, social construction, symbolic interaction, multicultural-liberationist, systems, conflict, critical, social capital, psychoanalytic, and social exchange. Theory gives a scientist or a practitioner a focus, defining what is interesting and relevant. In doing so, it excludes elements that are not seen as central. Theory allows us to understand and advance our understanding, but the cost of moving forward may be that certain considerations are diminished or left out completely. Theories, implicitly or explicitly, are a basis for the models that explain how practitioners should function. As Lang and Taylor (2000) have noted, “models represent appropriate, aspirational, or best practices; they include guidelines for implementing them.” Clinical sociologists use theories to formulate models that will be helpful in identifying and understanding problems and strategies to reduce or solve the problems. Clinical sociologists also have shown that practice can influence existing theories and help develop new ones. It might be useful here to mention a few points about theory in relation to clinical sociology. First, in any discipline or area of practice, there might be only one or primarily one theoretical approach (or paradigm) and it may be implicitly or explicitly held. Clinical sociology can be characterized as a specialization that has many theories and paradigms that compete for our attention. As will be seen in this book, many clinical sociologists are very interested in identifying and discussing the theoretical underpinnings of their work. Second, models or frameworks (which concretely explain how something works) are often used in a discipline or area of practice. These models or frameworks may be explicitly connected to certain theoretical approaches, but also may be presented as if they almost were without theoretical connections. Third, theories have different levels (e.g., micro, meso, and macro) of explanation. In disciplines that cover one or more levels, there is a need to integrate the theoretical approaches that might be used at the different levels. Clinical sociologists, because of their varied applications and interdisciplinary backgrounds, frequently are concerned with theoretical integration. Fourth, clinical sociologists have found it is important to critically examine the use of social theories by practitioners to assess effects on the practice as well as participants. Fifth, clinical sociologists often work as members of consulting teams. Those members often come from different disciplinary or organizational backgrounds and hold certain theoretical approaches as central to their work. Team members need to discuss the utility of different theories in approaching their work.

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Influences on the Actions of Clients and Client Systems

The contributors to this book provide a great deal of information that allows us to begin to understand and raise questions about the similarities and differences in clinical sociology in various areas of the world. One interesting point to consider is to how these authors (as well as intervenors with different disciplinary backgrounds) view the actions of clients or client systems (such as those of individuals, organizations, communities, and nations) in relation to the influences affecting those actions or behavior. Figure 2.7 provides one possible way of viewing these influences. This diagram (defined as a visual representation of all or part of a model) shows the client’s behavior/actions (in the center) influenced by social, psychological, biological, and environmental factors such as air, land, water, and the built environment. Some social scientists do not include environment or biology as major influences and others might want to highlight one or more of these areas as more important. Even though the behavior/action part of the diagram is not very big, the central part could be highlighted, shaded or increased in size to indicate that the client system is influenced but not controlled by these factors. Figure 2.8 shows the same set of influences depicted in Fig. 2.7 with one new element added. In this figure, the context surrounds the more immediate influences on the client agency. The context is meant to include historical, economic, and political considerations. In many situations, the context is a central factor and may provide an important explanation of the more immediate influences. Figure 2.9 shows the same set of influences on actions as in Figs. 2.7 and 2.8, but in this case the context is very important (as indicated by its size and dark color) and Fig. 2.7 Influences affecting the actions of the client system

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Fig. 2.8 Influences (including the historical/ political/economic context) affecting the actions of the client system

Fig. 2.9 The historical/ political/economic context strongly affecting the actions of the client system

perhaps even overwhelming. In an era of globalization, some social scientists think (sometimes before but also after completing a project) that a client or client system (even a nation state) may not be able to act effectively within the national and global context in which it operates.

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Conclusion

This chapter only begins our discussion of the basics in international clinical sociology. There is agreement on most of the basics in the different countries, but one does find some differences in the concepts and theories that are generally adopted as well as the main areas of practice and approaches to intervention. The use of diagrams and models helps the reader as well as a client to visualize what is being discussed. The problem with models and diagrams is that if they are too complicated, they are difficult to understand and remember; if they are too simple, important points may be diminished or omitted. We need to remind ourselves that diagrams and models only serve as starting points for our discussions.

References Burke, W. W. (2002). Organization change: Theory and practice. Thousand Oaks, CA: Sage. Chimhowu, A. (2018). Five things we’ve learnt about national development plans. Retrieved April 30, 2020, from http://www.nationalplanning.org/index.php/en/2018/02/08/5-things-aboutnational-development-plans/ Chimhowu, A., Hulme, D., & Munro, L.T. (2019). The “new” national development planning and global development goals: Process and partnerships. World Development, 120, 76–89. Retrieved April 30, 2020, from https://www.sciencedirect.com/science/article/pii/ S0305750X19300713 Derksen, L., & Gartrell, J. (2000). Scientific explanation. In E. F. Borgatta & R. H. Montgomery (Eds.), Encyclopedia of Sociology (2nd ed., pp. 2463–2473). New York: Macmillan. Donald, A. (2012). A guide to evaluating human rights-based interventions in health and social care. London: Human Rights and Social Justice Research Institute, London Metropolitan University. Retrieved April 30, 2020, from https://www.humanrightsinhealthcare.nhs.uk Fritz, J. M. (2004). Socioeconomic developmental social work. In UNESCO encyclopedia of life support systems. UNESCO-EOLSS project on sustainable world development. Oxford. http:// www.eolss.net Fritz, J. M. (2020). Social intervention. In T. Uys & J. M. Fritz (Eds.), Clinical sociology in southern Africa. Juta: Claremont. Johnson, C., & Forsyth, T. (2002). In the eyes of the state: Negotiating a “rights-based approach” to forest conservation in Thailand. World Development, 20(9), 1591–1605. Kerlinger, F. N. (1973). Foundations of behavioral research. NewYork: Holt, Rinehart and Winston. Lang, M. D., & Taylor, A. (2000). The making of a mediator: Developing artistry in practice. San Francisco: Jossey-Bass. Laue, J., & Cormick, G. (1978). The ethics of intervention in community disputes. In G. Bermant, H. Kelman, & D. Warwick (Eds.), The ethics of social intervention (pp. 205–232). Washington, DC: Halsted Press. Lee, A. M. (1979). The services of clinical sociology. American Behavioral Scientist, 22(4), 487–511. Lippett, R., Watson, J., & Westley, B. (1958). The dynamics of planned change. New York: Harcourt, Brace and World. Midgley, J. (1994). Defining social development: Historical trends and conceptual formulations. Social Development Issues, 16(3), 3–19.

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Parkinson, J., Areddy, J. T., & Bariyo, N. (2020, April 17). As Africa groans under debt, it casts wary eye at China. Wall Street Journal. Retrieved April 30, 2020, from https://www.wsj.com/ articles/as-africa-groans-under-debt-it-casts-wary-eye-at-china-11587115804 Qu, W., Shi, W., Zhang, J., & Liu, T. (2020). T21 China 2050: A tool for national sustainable development planning. Geography and sustainability. Retieved April 29, 2020, from https:// reader.elsevier.com/reader/sd/pii/S2666683920300080?token¼F93ED9CD880BE4AAE 4BA47773DBD92A93A3 Roberts, A. R., & Ottens, A. J. (2005). The seven-stage crisis intervention model: A road map to goal attainment, problem solving and crisis resolution. Retrieved April 27, 2020, from https:// triggered.edina.clockss.org/ServeContent?rft_id¼info:doi/10.1093/brief-treatment/mhi030 Smelser, N. (1962). Theory of collective behavior. New York: Free Press. Soeka, E. M. (2004, June). Presentation as part of a mediator training for the Ohio Office for Exceptional Children. Columbus, OH. Sternberg, D. (1981). How to complete and survive a doctoral dissertation. New York: St. Martin’s Press. Vraneski, A. (2006). Al di là dell’arte e della scienza: Cultura e creativita nella mediazione. [Beyond art or science: creativity and culture in interactive mediation]. In L. Luison (Ed.), La mediazione come strumento di intervento sociale (pp. 58–80). Milano: Franco Angeli.

Part II

Regional Histories

Chapter 3

The History of Clinical Sociology in the United States Jan Marie Fritz

3.1

Introduction

Sociology in the United States began to develop during the Progressive Era, a period that dates from about the early to mid-1890s through the early to mid-1920s. It was an age marked by protest, reform and, at the same time, the emergence of corporate capitalism (Sklar 1988). There was rural and urban poverty, a growing need for economic security,1 women were still without the vote,2 and there were lynchings.3 1 People’s economic security was affected by movement to the cities and by an economic depression. Between 1880 and 1920, a huge number of rural residents moved to the cities. The U.S. population went from 72% rural to 51% urban and this “dramatically increased workers’ dependence on monetary earnings” and also “deprived individuals and families of (the) effective support networks” in their rural communities, particularly when a worker became incapacitated or died (Moss 1996). The depression of 1893 lasted five years and is seen as one of the worst depression in U.S. history. It had an enormous effect on the United States, influencing the development of an interventionist state as well as increasing labor strikes and agrarian movements. There was “heightened class tension” and a rise in anti-immigrant, anti-Black, anti-Semitic, and anti-Catholic feelings (Steeples and Whitten 1998; Taylor 2017). 2 According to the U.S. National Archives (2007), “Passed by Congress June 4, 1919, and ratified on August 18, 1920, the 19th amendment guarantees all American women the right to vote. Achieving this milestone required a lengthy and difficult struggle; victory took decades of agitation and protest. Beginning in the mid-nineteenth century, several generations of woman suffrage supporters lectured, wrote, marched, lobbied, and practiced civil disobedience to achieve what many Americans considered a radical change of the Constitution. Few early supporters lived to see final victory in 1920.” 3 According to Martin (1987), there were at least 4736 lynchings between 1882 and 1962, and about 70% of the victims were black. The 1890s “saw the heaviest toll—154.1 lynchings annually.”

J. M. Fritz (*) University of Cincinnati, Cincinnati, OH, USA University of Johannesburg, Johannesburg, South Africa e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_3

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At the turn of the twentieth century, frustration led to public protests and the development of public interest groups and reform organizations (Clemens 1997; Sanders 1999). In this climate, it is not surprising that many of the early sociologists were scholar-practitioners interested in reducing or solving the pressing social problems that confronted their communities. In 1896, Albion Small, chair of the Department of Sociology at the University of Chicago and founding editor of The American Journal of Sociology, published an article, “Scholarship and Social Agitation.” Small thought that the primary reason for the existence of sociology was its “practical application to the improvement of social life” (Timasheff and Theodorson 1976, p. 2). In Small’s (1896, p. 564) words: Let us go about our business with the understanding that within the scope of scholarship there is first science, and second something better than science. That something better is first prevision by means of science, and second intelligent direction of endeavor to realize visions. I would have American scholars, especially in the social sciences, declare their independence of do-nothing traditions. I would have them repeal the law of custom which bars marriage of thought with action. I would have them become more profoundly and sympathetically scholarly by enriching the wisdom which comes from knowing with the larger wisdom which comes from doing.

Clinical sociology in the United States developed with the goal and practice of merging thought with action. The field is defined (Fritz 2020) as a creative, humanistic, rights-based and interdisciplinary specialisation that seeks to improve life situations. Clinical sociologists work with individuals or groups to assess situations and avoid, reduce, or solve problems through a combination of analysis and intervention. This chapter traces the development of the field beginning with profiles of four prominent sociologists. The following sections discuss the earliest use of the term clinical sociology (beginning with the late 1920s), the first courses, and clinical placements. Finally, there is a brief discussion of contemporary contributions and some concluding remarks.

3.2

Scholar-Practitioner Profiles

This discussion of the development of clinical sociology begins by noting the contributions of four prominent scholar-practitioners: Jane Addams (1860–1935), William Edward Burghardt Du Bois (1868–1963), Charles G. Gomillion (1900–1995) and James Laue (1937–1993).

3.2.1

Jane Addams

Jane Addams (1860–1935), the first woman from the United States (U.S.) to win a Nobel Peace Prize (1931), is remembered as a clinical sociologist, social worker,

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community organizer, peace activist, and urban reformer (Fritz 1991b, 2004, 2005, 2014a, b; Misheva and Blasko 2018). She was one of the most influential women in U.S. history (Lewis 2012, p. 1).4 In 1889, three years before the Department of Sociology was founded at the University of Chicago, Addams and her good friend Ellen Gates Starr, established a settlement house in the decaying Hull Mansion in Chicago, Illinois. HullHouse, as it was called, was described by Addams (2008, p. 83) in 1910 in the following way: The Settlement. . . is an experimental effort to aid in the solution of the social and industrial problems which are engendered by the modern conditions of life in a great city. It insists that these problems are not confined to any one portion of a city. It is an attempt to relieve, at the same time, the over accumulation at one end of society and the destitution at the other; but it assumes that this over accumulation and destitution is most sorely felt in the things that pertain to social and educational advantages. . . . The one thing to be dreaded in the Settlement is that it lose its flexibility, its power of quick adaptation, its readiness to change its methods as its environment may demand. . . It must be hospitable and ready for experiment.

One of Hull-House’s aims was to give privileged, educated young people contact with the real life of the majority of the population. Addams (2008, p. 83) expected the residents to have “scientific patience in the accumulation of facts” and “be ready to arouse and interpret the public opinion of their neighborhood.” The core HullHouse residents were well-educated women bound together by their commitment to progressive causes such as labor unions, urban environmentalism,5 the National Consumers League and the suffrage movement. Hull-House, a national symbol of the settlement house movement, was a center for activities for the ethnically diverse, impoverished immigrants in the Nineteenth Ward of Chicago, Illinois. Hull-House fostered democracy as “a rule of living” through, for instance, interaction between residents and others from the community; learning between those from different ethnic backgrounds about each other as well as how to succeed in the U.S.; and life-long learning opportunities. Jane Addams’ philosophy was not to plan what should be done for the community, but, instead, to listen and then respond to community needs. By the end of the first five years, some 40 clubs were based in the settlement house, and over 2000 people came into the facility each week. Hull-House operated a day nursery, hosted meetings of four women’s unions, established a labor museum, ran a coffee house and held economic conferences bringing together business owners and workers. The Working People’s Social Science Club held

4 Opdycke (2012, p. 1) thought that “A hundred years ago, Jane Addams was the most famous woman in America” and Spain (2011, p. 51) saw Addams as the “most famous American woman of the Progressive Era.” Addams’ obituary in The New York Times (1935) said “she was, perhaps, the world’s best-known and best-loved woman.” 5 Tara Lynne Clapp (2005, p. 157) noted that the environmental justice movement “draws on a tradition of worker protection and urban environmentalism. . . exemplified by the work of Alice Hamilton and Jane Addams of the settlement house movement.”

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weekly meetings, and a college extension program offered evening courses for neighborhood residents. A few University of Chicago courses were available there, and the Chicago Public Library had a branch reading room on the premises. Jane Addams “was not just the driving force in the. . . (U.S.) settlement movement; she also was a major leader in the movements to promote peace, child welfare, women’s suffrage, improved housing, education, juvenile justice, labor relations, and civil liberties, and the reform of urban and state politics” (Carnes 2012, p. ixx). Addams challenged the competency of male city administrators. She criticized their civic housekeeping skills, questioned their willingness to meet social needs and thought they deprived American citizens of genuine democracy. Nearly every major reform proposal in Chicago (1895–1930) had Jane Addams’ name attached in some way. Her involvement in major issues—such as factory inspection, child labor laws, and improvements in welfare procedures, recognition of labor unions, compulsory school attendance and labor disputes—catapulted her to national prominence. Intellectuals, including Beatrice Webb and Sidney Webb, came from around the world to Chicago to meet Addams and her colleagues. During the founding years of sociology in the United States (1892–1920), Jane Addams was the “foremost female sociologist” in the country and she has been referred to as “a virtual adjunct professor in sociology at Chicago” (Deegan 1981, p. 1819). In documenting the relationship between the university and the settlement house, Rosenberg (1982, p. 3234) wrote: Most of the Chicago social scientists participated in some way in the work of Hull House, leading seminars, giving lectures or just having dinner with the exciting group of people who always gathered there . . . Hull House became a laboratory for sociologists, psychologists, and economists. . .

Addams, a prolific writer, authored many books6 including, Democracy and Social Ethics (1902), Newer Ideals of Peace (1907), The Spirit of Youth and the City Streets (1909), Twenty Years at Hull-House (1910), A New Conscience and an Ancient Evil (1912), Peace and Bread in Time of War (1922) and The Second Twenty Years at Hull-House (1930). In 1895, Hull-House Maps and Papers, by the Residents of Hull-House (2007), was published.7 This ground-breaking publication, dealing with topics such as tenement conditions, sweatshops and child labor, was the first systematic attempt to describe immigrant communities in a U.S. city. The maps have been described as “brilliant”8 and the book has been referred to as “the

6 She also wrote “several hundred shorter pieces—nearly all of them thought-provoking and some of them truly memorable” (Opdycke 2012, p. xi). 7 Jane Addams wrote the preface and a chapter about the role of the settlement in the labor movement. 8 According to Haar (2011, p. 36), “The brilliance of the maps lies in the visualization of the data. . . They translated and revealed the intricate life of the neighborhood residents and the intermingling of ethnic and economic groups. They belied the image of American immigrant neighborhoods— often considered ghettos—as homogeneous, sectarian spheres.

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single most important work by American women social scientists before 1900” (Sklar 1998, p. 127). Addams’ later years were devoted to global peace activities and she has been called “one of the most radical feminist pacifists of all times” (Alonso 2009, p. 203). Her pacifism9 emerged through her work at Hull-House,10 where she saw that people of all kinds of backgrounds could live and work together, and became “radical” during World War I (Alonso 2009, p. 205). In 1914, at the outbreak of World War I, Addams opposed the war and, in 1915, helped organize and became head of the Women’s Peace Party (U.S.) and then the Women’s International League for Peace and Freedom. In 1915, she also was chosen to head the National Peace Federation and she presided over the 12-country International Congress of Women at the Hague.11 Addams was one of five women elected at the Congress to meet with the heads of all European governments to see if they would be interested in ending the war through mediation (Opdycke 2012, p. 180).12 Addams’ “fundamental plan for peace. . . was not to focus on treaties and armies but to fight poverty and inequality and discrimination” (Opdycke 2012, p. 210) so that war would not be viewed as necessary or acceptable. While Addams was seen in other countries as an important leader working for peace, after the U.S. joined the war in 1917, many in the U.S. harshly and repeatedly criticized her and some thought she was a traitor. It was only in the 1930s that she was once again generally seen in the U.S. as an important public citizen and it was at this point that she received many awards including the Nobel Peace Prize.13

9

There are other, sometimes conflicting, influences. Addams deeply respected her father and while he was not a Quaker, he was a Quaker-sympathizer. He was against slavery and, as a state legislator during the U.S. Civil War, supported all proposed war measures and helped develop a regiment to fight as part of the Union Army (Opdycke 2012, p. 175; Alonso 2009, p. 204). 10 Hull-House went out of existence on January 27, 2012. 11 In advance of taking part in the congress, the participants (more than 1000) had to commit to women’s suffrage and the peaceful resolution of international disputes (Opdycke 2012, p. 179). 12 Addams also met with President Woodrow Wilson. Wilson (1980, p. 243) who wrote the following in a “My adorable Sweetheart” letter in 1915 to Edith Bolling Galt: “I had a visit to-day, by the way, from Miss Emily Balch, who, like Miss Jane Addams, has been visiting European prime ministers and foreign secretaries in the interest of peace, and who, like Miss Addams, wants me to assemble a conference of neutral nations (which I am expected and invited to ‘dominate’) which shall sit (and I with it, I wonder? I did not inquire about that) continuously till the war ends and all the while, patiently and without sensitiveness to rebuffs, and by persistent suggestion, heckle the belligerent nations about terms and conditions of peace, until they are fairly worried (I suppose) into saying what they are willing to do. I can’t see it. And yet I am quite aware that they consider me either very dull, very deep, or very callous. Alack and alas!” 13 Judy Whipps (2010, p. 278) noted that in the last 10 years of Addams’ life, “she occasionally talked about democracy as an aspiration, but not with the same sense of hope as in her earlier years. On the rare occasions when she used the term, it was often with some nostalgia, as in 1934, when recalling the nineteenth-century vigor for ‘self-government and democracy,’ which has been replaced, she says, by a ‘demand for economic security.’”

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Jane Addams died of cancer on May 21, 1935 at the age of 74. On May 22 and 23, she lay in state in Bowen Hall at Hull-House. According to Louise Bowen (1935), the leader of the Hull-House Women’s Club: During the twenty-four hours she was there thousands of people passed through the Hall. The Hull House Women’s Club formed a guard of honor. . . The hall was opened at five o’clock in the morning, and working men on their way to their jobs came in with lunch boxes in their hands, many of them kneeling on a little stool in front of the casket and saying a prayer. . . The morning of the funeral—and it was a beautiful day—she was taken from Bowen Hall and placed upon the terrace in Hull House Court. . . The funeral was at 2:30 in the afternoon. As early as ten o’clock in the morning the Court Yard was crowded with people, one or two thousand standing there all day in order to be present at the services. . . Strong men and women with children in their arms all stood weeping for the friend they had lost.

The public grief for Jane Addams in Chicago14 and elsewhere in the US was so strong that some compared it to the reaction to the death of US President Abraham Lincoln in 1865. Jane Addams wanted to be buried in the small family plot in Cedarville, Illinois, her hometown. There one finds her tombstone with the epitaph that she requested: “Jane Addams of Hull-House and the Women’s International League for Peace and Freedom.”

3.2.2

W.E.B. Du Bois

William Edward Burghardt Du Bois (1868–1963) was one of the American pioneers of sociological practice (Fritz 1987, 1990a, 2005). Du Bois made major contributions as a clinical and applied sociologist to the development of this country through his many scientific and popular publications and through his organizational efforts. He was a founder and general secretary of the Niagara Movement, an early advocate of women’s rights (H. Aptheker, personal communication 1988), a founder of the National Association for the Advancement of Colored People (NAACP), and, from 1910 to 1934, the internationally known founding editor of the NAACP’s The Crisis. Du Bois’s autobiographical essay, “The Negro Wants First-Class Citizenship,” was written when he was in his mid-seventies. It provided some information about Du Bois’s direct connections to sociology, such as his academic work at Harvard15; his studies with Schmoller and Weber; his offer to teach sociology at Wilberforce16;

Opdyke (2012, p. 229) discussed the mourning in the Hull-House neighborhood: “Up and down Halsted Street and all through the 19th Ward, shops and even saloons were draped in purple and black. ‘Purple for the nobility of her life,’ explained an Italian grocer; ‘black for our great loss.’” 15 Sociology was not a separate discipline when Du Bois was at Harvard (Du Bois 1944) from 1888 until 1891, but Du Bois took many social science courses and, in reviewing his background, has written that his “course of study would have been called sociology” (Du Bois 1940). 16 Du Bois taught at Wilberforce University in Ohio from 1894 to 1896. 14

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his development of the Atlanta Conferences (including the 1943 meeting for the 17 Negro land grant colleges in the South); and his research in Atlanta (Wright 2016) and Philadelphia. Du Bois’s pioneering work, The Philadelphia Negro: A Social Study, was published in 1899.17 Particularly interesting are the ties that Du Bois made between science and social change. Du Bois (1944) recalled that, when he was in his forties, he “followed the path of sociology as an inseparable part of social reform, and social uplift as a method of scientific investigation.” He said he was changing his attitude about the social sciences. He thought there “could be no . . . rift between theory and practice, between pure and applied science.” Du Bois (1944) discussed the times when urgent action was imperative: I faced situations that called—shrieked—for action, even before any detailed, scientific study could possibly be prepared.. . . I saw before me a problem that could not and would not await the last word of science, but demanded immediate action to prevent social death. I was continually the surgeon probing blindly, yet with what knowledge and skill I could muster, for unknown ill, bound to be fatal if I hesitated, but possibly effective, if I persisted.

A review of Du Bois’s early work shows his long-standing interest in sociology, science, and social change. In a speech to the sociology club at Atlanta University in 1897, for instance, Du Bois stressed the mission for such an organization: The aim. . . ought to be to furnish accurate information to such agencies as are engaged in the work of social reform, to endeavor to increase the cooperation between these agencies and to seek to establish new agencies for reform in neglected and unknown fields of effort.

Du Bois’s concerns also are evident in his “A Program for Social Betterment.” Du Bois gave a presentation, with this title, around 1908 to the first sociological society of Atlanta, Georgia. Du Bois again indicated the important link between science and social reform and gave examples of 32 specific initiatives that might be undertaken by the group. The listing included many practical suggestions such as a “mission” that would “provide ice for [the] poor and encourage flower- raising”; “maternity refuges” for “women in confinement;” an “anti-credit crusade,” which would “encourage cash buying,” and a “dress reform,” which would advocate “warm, simple clothing and [the] prevention of extravagance.” Du Bois engaged in numerous important activities that are not very well known. In 1900, for example, he unsuccessfully challenged the Southern Railway systems for denying him, on racial grounds, a sleeping berth and petitioned the Georgia state legislature regarding cuts in funds for black public schools. In 1917, he was in the front ranks of an NAACP-organized march in New York City to protest lynching. That same year, he collected testimony from survivors of an East St. Louis massacre of African Americans. In 1918, Du Bois helped organize the Negro Cooperative Guild to study and coordinate African American-run cooperatives, and in 1919 he E. Digby Baltzell, in his introduction to the 1967 edition of The Philadelphia Negro, noted that “a classic is sometimes defined as a book that is often referred to but seldom read. The Philadelphia Negro, written by a young scholar who subsequently become one of the three most famous Negro leaders in American history, surely meets this requirement.”

17

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organized and was elected executive secretary of the first Pan-African Congress. In the 1920s, “along with Alain Locke [Du Bois] was a founder of the so-called Harlem Renaissance” (H. Aptheker, personal communication 1990) and in 1950, Du Bois was the Progressive Party candidate for the U.S. Senate from the state of New York. Over the years, Du Bois also was a newspaper columnist, a novelist, a poet, the founding editor of Phylon, and a cofounder and the editor of The Brownies’ Book, a magazine for African American children. Du Bois repeatedly tried to bring about a more just society.18 In the course of doing this, he put new initiatives in place and did not hesitate to criticize individuals or programs when he felt the criticism was warranted. At times, he was at odds with Booker T. Washington, the NAACP, Marcus Garvey, the American Communist party, and the trustees of Atlanta University. In 1918, the Department of Justice warned him that he risked prosecution for his criticism of racism in the U.S. armed services. In 1951, when Du Bois was 83, he was indicted by the U.S. Government, accused of being “an unregistered, foreign agent,” and in 1952 the federal government arbitrarily refused to issue him a passport. The last two matters were resolved, eventually, but not without restriction, pain, and, finally, a change of citizenship. At the age of 93, in 1961, Du Bois left the United States to work in Ghana, a country where he received “worshipful, esteemed status” (Horne 1986), and was given citizenship and a passport. He went there to undertake a major project, the Encyclopedia Africana, but he also left the United States because he was completely frustrated. Several weeks before his departure, he wrote a letter to a woman who was having difficulty securing decent housing (Horne 1986): I just can’t take anymore of this country’s treatment. . . We leave for Ghana October 5th and I set no date for return. . . Chin up, and fight on, but realize that American Negroes can’t win.

In 1963, William Edward Burghardt Du Bois died in Ghana, a country where he was honored both in life and in death.

3.2.3

Charles G. Gomillion

Charles Goode Gomillion (1900–1995) was born in Johnston, a small town in rural South Carolina (Fritz 1988a, 2005, 2008). His father, a custodian, was illiterate, and his mother could barely read and write. At the age of 16, with only 26 months of formal education, Gomillion left home to live and attend high school some 40-miles away at Paine College, in Augusta, Georgia. Paine, an historically black college, provided secondary education, at that time, in addition to college classes.

According to Aptheker (personal communication 1988), Du Bois “thought people were like himself” in that he “never thought of making money [and] was singularly dedicated to service and truth.” 18

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After graduating from Paine, Gomillion passed up a position selling life insurance, to take a teaching post with the high school program at Tuskegee Institute (now Tuskegee University) in Tuskegee, Alabama. Tuskegee also was a high school and college for African American students and had an all African American faculty and administration. During his affiliation with Tuskegee, Gomillion also took graduate courses at Fisk University and then received a Ph.D. in sociology from Ohio State University when he was 59 years old. Gomillion was a sociology professor at Tuskegee University and served, at various times, as Dean of the Division of Social Sciences, Dean of Students, Chair of the Division of Social Sciences and Dean of the College of Arts and Sciences. While Gomillion is remembered for his years of work at the university, he is remembered nationally for his involvement in the civil rights struggle. He was the forceful, patient president of the Tuskegee Civic Association (TCA) from 1941 to 1945, 1951 to 1968 and again in 1970. As TCA president, Gomillion and the community organization began to challenge the treatment of African Americans by the city of Tuskegee and the larger county (Macon). The struggle was long and difficult; numerous legal actions had to be initiated. A boycott of Tuskegee’s while-owned businesses began in the early 1950s. The Tuskegee boycott (known locally as the trade-with-your-friends campaign) was officially endorsed by TCA in 1957 and lasted two more years. It was so effective that half of the white-owned businesses were gone by the spring of 1958 and sales were down 45–60% for those businesses that survived. As a result, white resistance finally started to diminish, voter registration of African Americans began to take place and the courts started to be responsive. Gomillion won his most impressive legal victory (Gomillion v. Lightfoot) in the U.S. Supreme Court in 1960 (Taper 2003). Gomillion’s successful suit stopped the local gerrymandering which had kept all but about 10 African Americans from voting in the city of Tuskegee’s elections. According to the attorney for the Tuskegee Civic Association (Guzman 1984, p. xi): the Gomillion case is one of the landmark cases of the century. It opened the door for the redistricting and reapportioning of various legislative bodies from city hall to the U.S. capitol and also laid the foundation for the concept of ‘one-(person)-one-vote.’

Gomillion described his life’s work as that of an educator and community activist. He wanted his students and colleagues to understand the importance of using their gift—their education—to improve the conditions of society. Dr. Gomillion’s work received many awards, but his first award from a sociology association came from other clinical sociologists in 1988 (Fritz 1988b). The award was presented by someone who was very familiar with Gomillion’s important civil rights work; the presenter was James Laue.

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3.2.4

J. M. Fritz

James Laue

James (Jim) Laue (1937–1993) was born in River Falls, Wisconsin. He completed his undergraduate degree in sociology at the University of Wisconsin and then went on to get his master’s and doctoral degrees in sociology at Harvard University. While at Harvard, Laue studied race relations as well as the sociology of religion, and he became increasingly involved in civil rights work. His Ph.D. dissertation was entitled “Direct Action and Desegregation: Toward a Theory of the Rationalization of Protest.” Laue, beginning in 1965, was the Assistant Director for Community Analysis for the U.S. government’s Community Relations Service (CRS). The CRS was the “first congressional effort to establish a Federal agency to assist communities to restore or maintain racial peace” (Community Relations Service 1994, pp. 1–2). The CRS was established in 1964 under the US Department of Commerce (because of the number of disputes involving public accommodations); the CRS was transferred to the U.S. Department of Justice in 1966. According to Laue’s colleagues, Laue had a major role in the design of CRS’s conciliation and mediation19 frameworks (Potapchuk 2020; Levine 2005, p. 44). In 1968, Laue was in Memphis, Tennessee “on assignment with the Community Relations Service of the US Department of Justice” because of “racial tension swirling around the sanitation workers’ strike, mass marches and scattered violence” (Laue 1993). Laue heard what sounded like “a cherry bomb” (Laue 1993) and left his room, room 308, at the Lorraine Motel and found civil rights leader Dr. Martin Luther King, Jr.20 lying on the motel’s balcony just outside of King’s room, room 306 (Nandi, n.d.). Ralph Abernathy, in his autobiography was describing Jim Laue when he wrote that there was a white man on the balcony after King was shot who was “frightened enough to be crawling on his hands and knees but brave enough to bring a blanket to spread over Martin” (Hampson 2018, p. 3). After leaving CRS in 1969, Laue was affiliated with the Laboratory of Community Psychiatry at Harvard’s Medical School for two years. From 1971 to 1987, Laue was a Vice Chancellor at Washington University in St. Louis and then Director of the Center for Metropolitan Studies at the University of Missouri—St Louis.

Mediation is a creative, humanistic, non-adversarial, flexibly-structured process in which an impartial third party helps individuals and/or groups that want to discuss one or more issues to identify their mutual interests and perhaps reduce or resolve their differences. 20 Laue (1993) thought King died immediately but King was “officially announced dead at the hospital an hour later.” In 1993, just before the 25th anniversary of King’s death, Laue wrote what he called a report in honor of Martin Luther King, Jr. He wrote the piece as if it had been written in 1968, and he unexpectedly presented what he wrote to those who attended a service at a Methodist church in Burke, Virginia in 1993 (Baker 2020b). Laue talked about what happened in Memphis, Tennessee in 1968 and King’s effect on him: “Fate or God. . . had given me 8 years of knowing Martin Luther King, Jr. His life—and his death—changed my life. He taught me that ‘conflict resolution,’ a laudable goal on the surface, does not truly occur without struggle refined in love and that justice is not fulfilled without reconciliation.” 19

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Beginning in 1986, Laue was affiliated with George Mason University where he was the first Lynch Professor of Conflict Analysis and Resolution and also had a senior affiliation with the Conflict Clinic, Inc, a non-profit dispute-resolution organization. Among Laue’s accomplishments: Vice Chair of a bipartisan commission that led to the establishment of the U.S. Institute for Peace; mediated civil rights disputes from Selma, Alabama in the 1960s to Northern Ireland in the 1990s; helped with the development of former U.S. President Jimmy Carter’s conflict resolution program; and was the first Chair of the National Peace Institute Foundation. Laue, with the support of the Kettering Foundation in Ohio, also was the lead mediator/facilitator working on developing “a shared commitment to deal with the chief problems and/or opportunities” (Kunde 1997) in Gary, Indiana. Gary’s 8-month process (a Negotiated Investment Strategy) involved stakeholders from all levels of government and the community. Laue “helped to establish the field of conflict resolution as a distinct academic discipline” in which he “combin(ed) social theory and practical problem-solving into a new practice of clinical sociology” (George Mason University Special Collections, n.d.) Ron Kraybill (2002, p. 33), also noted Laue’s pivotal role in the development of mediation in the United States and said he was one of the two godfathers of mediation in the country. Bill Potapchuk (2020), executive director of the Community Building Institute, thinks what was particularly special about Jim’s work was that “he married dispute resolution with a social justice framework.” Jim Laue died in 1993 after months of struggle that included two transplants and diabetes complications (Baker 2020a, b; Washington Post 1993). He was only 56 years old.

3.3

Clinical Sociology in Print

While many of the trail-blazing sociologists were very involved in sociological practice, the earliest known written document using the words “clinical sociology” in the United States was put forward not by a sociologist but by Milton C. Winternitz, a physician who was dean of the Yale School of Medicine from 1920 through 1935 (Fritz 1989). At least as early as 1929, Winternitz began developing a plan to establish a department of clinical sociology within Yale’s medical school. Winternitz wanted each medical student to have a chance to analyze cases based on a medical specialty as well as a specialty in clinical sociology. Winternitz vigorously sought support from the Rosenwald Fund, but was unable to obtain funds for a department of clinical sociology. Winternitz did note, however, the success of a course in the medical school’s section on public health that was based on the clinical sociology plan. In 1929, Winternitz wrote about his effort to build a department in a report to the university president, and the report was published in the Yale University Bulletin. Also published in 1930 was the speech Winternitz gave at the dedication of the University of Chicago’s new social science building in which he mentioned clinical sociology.

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Abraham Flexner, a prominent critic of medical education and director of the Institute for Advanced Study (1930–1939) at Princeton University, mentioned clinical sociology in 1930 in his Universities: American, English, German. Flexner did not approve of the Institute of Human Relations that Winternitz was establishing at Yale but did note that “only one apparent novelty is proposed: a professor of clinical sociology.” Winternitz continued to write about the value of clinical sociology until 1936. One of his most forceful statements in support of the field appeared in his 1930–1931 annual report, which stated, in part, “Not only in medicine and in law, but probably in many other fields of activity, the broad preparation of the clinical sociologist is essential.” The first published discussion of clinical sociology by a sociologist was Louis Wirth’s (1931a) article, “Clinical Sociology,” in The American Journal of Sociology. Wirth wrote at length about the possibility of sociologists working in child development clinics, though he did not specifically mention his own clinical work in New Orleans (Tulanian 1928). Wirth wrote, “It may not be an exaggeration of the facts to speak of the genesis of a new division of sociology in the form of clinical sociology.” In 1931, Wirth (1931b) also wrote a career development pamphlet in which he stated: The various activities that have grown up around child-guidance clinics, penal and correctional institutions, the courts, police systems, and similar facilities designed to deal with problems of misconduct have increasingly turned to sociologists to become members of their professional staffs.

Wirth “urged (sociology students) to become specialists in one of the major divisions of sociology, such as social psychology, urban sociology. . . or clinical sociology.” In 1931, Saul Alinsky was a University of Chicago student who was enrolled in a clinical sociology course. Three years later, Alinsky’s (1934) article, “A Sociological Technique in Clinical Criminology,” appeared in the Proceedings of the SixtyFourth Annual Congress of the American Prison Association. Alinsky, best known now for his work in community organizing, was, in 1934, a staff sociologist and member of the classification board of the Illinois State Penitentiary. Edward McDonagh’s “An Approach to Clinical Sociology” was published in 1944. McDonagh proposed establishing social research clinics that would use groups to study and solve problems. The first formal definition of clinical sociology also appeared in 1944 in H.P. Fairchild’s Dictionary of Sociology. Alfred McClung Lee,21 the author of that definition, later used the word clinical in the title of two articles, his 1945 “Analysis of Propaganda: A Clinical Summary,” and the 1955 article “The Clinical Study of Society.”

21

Alfred McClung Lee (1906–1992) was one of the founders of the Society for the Study of Social Problems, the Association for Humanist Sociology, and the Clinical Sociology Association. He also was, from 1976 to 1977, president of the American Sociological Association.

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In 1946, George Edmund Haynes’s “Clinical Methods in Interracial and Intercultural Relations” was published in the Journal of Educational Sociology. Haynes was a co-founder of the National Urban League (in 1910) and the first African American to hold a U.S. government subcabinet post. His 1946 article, written while he was executive secretary of the Department of Race Relations at the Federal Council of the Churches of Christ in America, discussed the department’s urban clinics. The clinics were designed to deal with interracial tensions and conflicts by developing limited, concrete programs of action.

3.4

The First University Courses

The first clinical sociology course was taught by Ernest W. Burgess at the University of Chicago (Fritz 1990b, 1991a). In 1928 and 1929, the course was a “special” course and did not appear in the catalog. It was offered as a regular course from 1931 through 1933 and, though it was listed in the catalog for the next several years, was not taught after 1933. The University of Chicago’s catalogs did not include a description of the clinical sociology course, but it always was listed under the social pathology section. All those courses dealt with topics such as criminality, punishment, criminal law, organized crime, and personal disorganization. According to the notes of one of the students enrolled in the 1933 course (Fritz 1991a), Burgess said clinical sociology “denotes an interest in pathological cases,” and that students used forms to analyze personalities and conduct a case study. Required reading for the course included The Soul of a Child (Bjorkman 1922), The Natural History of a Delinquent Career (Shaw 1931), Reluctantly Told, by Jane Hillyer (the 1926 story of the author’s mental breakdown), and You Can’t Win, by Jack Black (a 1926 account of the author’s life as a professional thief). Many students in these first clinical sociology courses were placed in Chicago’s child guidance clinics. Clarence E. Glick, for instance, was the staff sociologist at the Lower North Side Child Guidance Clinic, and Leonard Cottrell was the clinical sociologist at the South Side Child Guidance Clinic. Clinical courses also were offered in the 1930s at Tulane University and New York University. The Tulane University (1929) course was designed to give students the opportunity to learn about behavior problems and social therapy. The New York University (NYU) course, taught by Harvey Warren Zorbaugh (1939), provided undergraduate and graduate preparation for visiting teachers, educational counselors, clinicians, social workers, and school guidance administrators. Zorbaugh was a faculty member in the NYU School of Education and, along with Agnes Conklin, offered a seminar in clinical practice in 1930. The course was intended to qualify students as counselors or advisers dealing with behavioral difficulties in schools. From 1931 through 1933 the clinical practice course, titled “Seminar in Clinical Sociology,” was open to graduate students who were engaged

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in writing theses or conducting research projects in educational guidance and social work. Zorbaugh, author of The Gold Coast and the Slum: A Sociological Study of Chicago’s Near North Side (1929), had been involved with clinics at least since 1924, when he and Clifford Shaw organized two sociological clinics in Chicago. Zorbaugh was associate director of the Lower North Child Guidance Clinic in 1925 and also a founder, in 1928, of NYU’s Clinic for the Social Adjustment of the Gifted. Zorbaugh was director of this clinic for intellectually gifted and talented preadolescent children at its inception, and was actively involved in its work for more than 15 years. The clinic gave graduate students the opportunity to have supervised experiences in teaching, clinical diagnosis, and treatment of children with behavioral problems. During the 1953–1954 academic year, Alvin Gouldner22 taught a foundations of clinical sociology course at Antioch College in Ohio. The college bulletin provided the following description of the course: A sociological counterpart to clinical psychology with the group as the unit of diagnosis and therapy. Emphasis on developing skills useful in the diagnosis and therapy of group tensions. Principles of functional analysis, group dynamics, and organizational and small group analysis examined and applied to case histories. Representative research in the area assessed.

3.5

Contemporary Contributions

While publications mentioning clinical sociology appeared at least every few years after the 1930s, the number of publications increased substantially after the founding of the Clinical Sociology Association in 1978.23 The association, which later became the Sociological Practice Association, made publications a high priority, particularly in its early years, and helped make available the world’s most extensive collection of teaching, research, and intervention literature under the label of clinical sociology. The Clinical Sociology Review and the theme journal, Sociological Practice, were published by the association beginning in the early 1980s. These annual journals were eventually replaced by a quarterly publication, Sociological Practice: A Journal of Clinical and Applied Sociology. The Sociological Practice Association merged with the Society for Applied Sociology in 2005. The new association, the Association for Applied and Clinical Sociology (AACS), now publishes the Journal of Applied Social Science. 22 Alvin Gouldner (1920–1980) was the Max Weber Professor of Sociology at Washington University (1959–1967) and a president of the Society for the Study of Social Problems. 23 For instance, John Glass, the first president of the Clinical Sociology Association, had published a book on humanist sociology in 1972 (Glass and Staude) and a theme in Glass’s later articles about clinical sociology was the connection between humanism and clinical sociology. In 1979, Roger Straus edited a special issue on clinical sociology for the American Behavioral Scientist and, that same year, Barry Glassner and Jonathan Freedman published Clinical Sociology.

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In the 30 years since the founding of the Clinical Sociology Association, numerous books and articles about clinical sociology have been published. For instance, The Clinical Sociology Handbook, by Jan Marie Fritz, was published in 1985 and included information about many of the publications of the members of the Clinical Sociology Association. Beginning in 1984 and again in 1986, Elizabeth Clark, a former president of the Sociological Practice Association who later became executive director of the National Association of Social Workers, and Jan Marie Fritz, the second president of the Clinical Sociology Association, edited the first four volumes about clinical sociology courses for the American Sociological Association Teaching Resources Center. The fifth and sixth edition of this volume, edited by Fritz, was published in 2001 and 2006. In 1990, Clark and her colleagues (1990) published Clinical Sociological Perspectives on Illness and Loss’. Three editions of Using Sociology, a textbook for introductory sociology courses or for courses in clinical sociology, were edited by Roger Straus (e.g., 2002) and contained chapters by association members such as Phil Robinette, David Kallen¸ Harry Cohen, and Arthur Shostak. Among the earliest publications that mentioned clinical sociology was the 1931 careers pamphlet written by Louis Wirth (1931b) that indicated that clinical sociology was one of the major divisions of sociology. Over 70 years later, Melodye Lehnerer published the first edition of Careers in Clinical Sociology (2003) for the American Sociological Association. It included a definition of the field of clinical sociology, discussed career preparation, and gave examples of career possibilities such as advocate, sociotherapist, trainer, organizational consultant, and program evaluator. When reading the wide range of publications about clinical sociology, it is interesting to think about what brought these people together under the label of clinical sociology. The core group that developed the specialization in the 1970s and 1980s was tied together by an interest in wanting to address society’s social problems and their connections to humanism. For instance, Alfred (Al) McClung Lee, a past president of the American Sociological Association, and Elizabeth (Betty) Briant Lee, a past president of the Association for Humanist Sociology, were among the founders of the Clinical Sociology Association.24 The book written by Galliher and Galliher (1995) about Al and Betty’s life contributions contains six chapters and two of them include clinical sociology in the chapter titles. For both Al and Betty, a clinical sociologist could not work for just any client; they thought the specialization had to serve humane goals (Lee 1979). There also is the series of clinical sociology books published by Springer. Early volumes included many volumes by US scholar-practitioners—John Bruhn and Howard Rebach’s (1996) Clinical Sociology: An Agenda for Action; Melvyn 24 Al and Betty Lee were remarkable people in many ways. I remember Al coming to an 8 a.m. roundtable session on clinical sociology at a professional conference (with a large room full of tables) and he asked how he could help. Al noticed that there were two young sociologists at one table who were ready to give presentations, but there was no one sitting at their table to hear them. They were overwhelmed that a founder/president of important sociology organizations would want to hear their presentations, and he was genuinely happy to join them.

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Fein’s (1999) The Limits of Idealism; Rosalyn Benjamin Darling’s (2000) The Partnership Model in Human Services; Rebach and Bruhn’s (2001) Handbook of Clinical Sociology; Linda Weber and Allison Carter’s (2002) The Social Construction of Trust and Bruhn and Rebach’s (2007) Sociological Practice. More recent publications include Jan Marie Fritz’s (2014a) Moving Toward a Just Peace: The Mediation Continuum and Jan Marie Fritz and Jacques Rheaume’s (2014) Community Intervention: Clinical Sociology Perspectives. There were other contributions25—such as individual certification and program accreditation—in addition to publications. The certification process for individual practitioners is offered by the Association for Applied and Clinical Sociology (AACS). The PhD certification was first offered in 1983 and certification at the master’s level was made available in 1986. The process, which is available to clinical sociologists from different countries, involves the submission of a portfolio including letters of assessment, university transcripts and documents that verify clinical or applied practice. If an application is approved, the candidate will be invited to a give a peer-reviewed demonstration which can lead to certification as a clinical sociologist (CSS).26 Program accreditation is available through the Commission on the Accreditation of Programs in Applied and Clinical Sociology (CAPACS 2020). CAPACS accredits undergraduate, master’s and doctoral programs in the United States and in other countries. Applicant programmes can be full programs as well as tracks or concentrations in sociological practice, clinical sociology, applied sociology and engaged public sociology. Accreditation standards help programs develop, promote and support quality sociological education and practice.27 Clinical sociologists from the United States are active in practice organizations such as the Association for Applied and Clinical Sociology, the practice section of the American Sociological Association and professional organizations connected to their areas of specialization (e.g., Association for Conflict Resolution, Organization Development Network, Human Rights Educators). They also are active in at least two international sociology groups. The clinical sociology division (RC46) of the International Sociological Association (ISA), which was organized in 1982 at the

25 There are, of course, many examples of practice. One is the work of Louisa Pinkham Howe (1915–1998), an assistant editor of the Clinical Sociology Review in the late 1980s and a founding member, in 1978, of the sociological practice section of the American Sociological Association. She was a founding member of the Psychomotor Institute in 1971 and in 1978 she started a private practice in Pesso Boyden psychotherapy. More than 20 years earlier she had provided (under the name Louisa Holt) “expert testimony in the landmark racial desegregation case of Brown v. Topeka Board of Education” (Nichols 2019, p. 378). This case was consolidated with other cases and was appealed the U.S. Supreme Court. The judges in that 1954 Supreme Court case ruled unanimously that racial segregation of public school children was unconstitutional. 26 For more information, visit the website of the Association of Applied and Clinical Sociology (http://www.aacsnet.net/certified-sociological-practitioners). 27 For more information, see http://www.sociologycommission.org/

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ISA World Congress in Mexico City, and RC26, the ISA division focusing on sociotechnics-sociological practice.

3.6

Conclusion

The term clinical sociology has had its longest continuous use in the United States. The strongest pushes for the specialization were from a core group in sociology at the University of Chicago (in the 1930s) and from a core group of individuals (in the mid-1970s to mid-1980s) who were scattered around the nation. These clinical and applied sociologists were linked first through the Clinical Sociology Association, later the Sociological Practice Association and then the Association for Applied and Clinical Sociology as well as the Clinical Sociology division (RC46) of the ISA. Clinical sociologists in the United States, in comparison to other countries, still have the only significant contributions in terms of teaching materials, certification processes, and accreditation. Clinical sociologists in other countries have developed interdisciplinary networks of practitioners and have strong publication records. Clinical sociologists in the United States now use a wide range of theories, intervention techniques, and research methods (in addition to the standard case analysis). These clinical sociologists are interested in many different topics, as evident in the work (mediation, focus groups, substance use intervention, rightsrespecting behavior and facilitation) described by the U.S. authors featured in this volume. Because of the different areas of application, the clinical sociologists belong to many kinds of professional associations. As their interests have broadened, their work might not be explicitly labeled as clinical sociology and, even though several organizations or divisions of organizations have a focus on clinical sociology, it has become harder to know and profit from each other’s work. The clinical sociologists who met in the 1970s and 1980s formed a national practice organization in order to help the American Sociological Association (ASA) and the discipline of sociology really embrace practice. After all, sociology has at least three traditions—science, humanities and sociological practice—and practice was not being emphasized. The thinking, at the time, was that the ASA would change within a few years—undergraduate and graduate sociological practice tracks or programs would develop (and increase sociology enrollment) and sociology students and their faculty members would be easily able to see the clear links between their education and the world of practice. In the last 35 years very little progress has been made by the ASA in really including practice, and most of the introductory textbooks still only emphasize the science tradition.

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References Addams, J. (1902). Democracy and social ethics. New York: Macmillan. Addams, J. (1907). The newer ideals of peace. New York: Macmillan. Addams, J. (1909). The spirit of youth and the city streets. New York: Macmillan. Addams, J. (1912). A new conscience and an ancient evil. New York: Macmillan. Addams, J. (1922). Peace and bread in time of war. New York: Macmillan. Addams, J. (1930). Forty years at Hull-House: Being “Twenty years at Hull-House” and “The second twenty years at Hull-House”. New York: Macmillan. Addams, J. (2008). Twenty years at Hull-House: With autobiographical notes. Mineola, NY: Dover Publications. (Original work published 1910). Alinsky, S. (1934, September). A sociological technique in clinical criminology. In Proceedings of the sixty-fourth annual congress of the American Prison Association (pp. 167–178). Alonso, H. H. (2009). Can Jane Addams serve as a role model for us today? In M. Fischer, C. Nackenoff, & W. Chmielewski (Eds.), Jane Addams and the practice of democracy (pp. 203–217). Urbana and Chicago, IL: University of Illinois Press. Baker, M. L. (2020a, April 19). Telephone interview with Mariann Laue Baker, James Laue’s widow. Baker, M. L. (2020b, April 24). Telephone interview with Mariann Laue Baker. Bjorkman, E. A. (1922). The soul of a child. New York: Knopf. Black, J. (1926). You can’t win. New York: Burt. Bowen, L. (1990). Letter of Louise de Koven Bowen of 27 May 1935. In M. L. M. Bryan & A. F. Davis (Eds.), One hundred years at Hull-House (pp. 203–205). Bloomington, IN: Indiana University Press. Bruhn, J. G., & Rebach, H. M. (1996). Clinical sociology: An agenda for action. New York: Plenum. Bruhn, J. G., & Rebach, H. M. (2007). Sociological practice: Intervention and social change (2nd ed.). New York: Springer. Carnes, M. C. (2012). Editor’s preface. In S. Opdycke (Ed.), Jane Addams and her vision for America (pp. ix–x). Upper Saddle River, NJ: Pearson Education. Clapp, T. L. (2005). Environmental justice. In R. W. Caves (Ed.), Encyclopedia of the city (pp. 156–158). New York: Routledge. Clark, E. J., Fritz, J. M., & Rieker, P. P. (Eds.). (1990). Clinical sociological perspectives on illness and loss: The linkage of theory and practice. Philadelphia: Charles Press. Clemens, E. S. (1997). The people’s lobby: Organizational innovation and the rise of interest group politics in the United States, 1890–1925. Chicago, IL: University of Chicago Press. Commission on the Accreditation of Programs in Applied and Clinical Sociology [ CAPACS]. (2020). Retrieved January 15 2020, from http://www.sociologycommission.org/ Community Relations Service, U.S. Department of Justice. (1994). The annual report of the Community Relations Service. 30th anniversary issue, 1964–1994. Washington, DC: Community Relations Service. Darling, R. (2000). The partnership model in human services. New York: Springer. Deegan, M. J. (1981). Early women sociologists and the American sociological society. American Sociologist, 16(1), 14–24. Du Bois, W. E. B. (1897). A program for a sociological society. Speech to the first sociological club. Atlanta University; Atlanta, Georgia. Microfilm edition of the W.E. B. Du Bois Papers at the University of Massachusetts Library, Amherst. Reel 80, Frame 1. Du Bois, W. E. B. (1940). Dusk of dawn: An essay toward an autobiography of a race concept. New York: Harcourt, Brace. Du Bois, W. E. B. (1944). My evolving program for Negro freedom. In R. W. Logan (Ed.), What the Negro wants (pp. 31–70). Chapel Hill, NC: University of North Carolina Press. Du Bois, S. G. (1971). His day is marching on. Philadelphia, PA: Lippincott. Fein, M. L. (1999). The limits of idealism: When good intentions go bad. New York: Kluwer Academic/Plenum.

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Flexner, A. (1930). Universities: American, English, German. New York: Oxford University Press. Fritz, J. M. (1985). The clinical sociology handbook. New York: Garland. Fritz, J. M. (1987). W.E.B. Du Bois, Scholar-Practitioner, The Practicing Sociologist. Fall/Winter. Fritz, J. M. (1988a). The history of clinical sociology: Charles Gomillion, Educator-Community Activist. Clinical Sociology Review, VI, 13–21. Fritz, J. M. (1988b, July 19). Civil rights activist receives award. Baltimore Afro-American. Fritz, J. M. (1989). Dean Winternitz, clinical sociology and the Julius Rosenwald Fund. Clinical Sociology Review, 7, 17–27. Fritz, J. M. (1990a). In pursuit of justice: W.E. B. Du Bois. Clinical Sociology Review, 8, 15–26. Fritz, J. M. (1990b). The uses of sociology in clinical settings. In E. J. Clark, J. M. Fritz, & P. P. Rieker (Eds.), Clinical sociological perspective on illness and loss: The linkage of theory and practice (pp. 10–22). Philadelphia, PA: Charles Press. Fritz, J. M. (1991a). The history of American clinical sociology: The first courses. Clinical Sociology Review, 9, 5–26. Fritz, J. M. (1991b). The emergence of American clinical sociology. In H. Rebach & J. Bruhn (Eds.), Handbook of clinical sociology (pp. 17–32). New York: Plenum. Fritz, J. M. (2004). Jane Addams. In R. W. Caves (Ed.), Encyclopedia of the city (p. 5). London: Routledge. Fritz, J. M. (2005). The scholar-practitioners: The development of clinical sociology in the United States. In A. J. Blasi (Ed.), Diverse histories of American sociology (pp. 40–56). Leiden, NL: Brill. Fritz, J. M. (2008). Charles goode gomillion. In The African American National Biography. Cambridge, MA: W.E.B. Du Bois Institute, Harvard University and Oxford University Press. Fritz, J. M. (2014a). Jane Addams and Hull-House. In J. M. Fritz & J. Rhéaume (Eds.), Community intervention: clinical sociology perspectives (pp. 327–241). New York: Springer. Fritz, J. M. (2014b). Moving toward a just peace: The mediation continuum. New York: Springer. Fritz, J. M. (2020). Clinical sociology: A global perspective (Chapter 1). In T. Uys & J. M. Fritz (Eds.), Clinical sociology for Southern Africa. Juta: Claremont, Republic of South Africa. Fritz, J. M., & Rhéaume, J. (Eds.). (2014). Community intervention: Clinical sociology erspectives. New York: Springer. Galliher, J. F., & Galliher, J. M. (1995). Marginality and dissent in twentieth-century American sociology: The case of Elizabeth Briant Lee and Alfred McClung Lee. Albany, NY: State University of New York Press. George Mason University Libraries’ Special Collections. (n.d.). James Laue Papers (1936–1999). James H. Laue C0055. Retrieved April 18, 2020, from scrc.gmu.edu/finding_aids/laue.html Glass, J. F., & Staude, J. R. (Eds.). (1972). Humanistic society; Today’s challenge to sociology. Pacific Palisades, CA: Goodyear. Glassner, B., & Freedman, J. A. (1979). Clinical sociology. New York: Longman. Guzman, J. P. (1984). Crusade for civic democracy: The story of the Tuskegee Civic Association, 1941–1970. New York: Vantage. Haar, S. (2011). The city as campus: Urbanism and higher education in Chicago. Minneapolis: MN. University of Minnesota Press. Hampson, R. (2018). For those at the Lorraine Motel when MLK was killed, what does it mean to witness martyrdom? Retrieved August 15, 2020, from https://www.usatoday.com/story/news/ nation/2018/03/28/lorraine-motel-mlk-assassination-witnesses/1071959001/ Haynes, G. E. (1946). Clinical methods in interracial and intercultural relations. Journal of Educational Sociology, 19(5), 316–325. Hillyer, J. (1926). Reluctantly told. New York: Macmillan. Horne, G. (1986). Black and red: W. E. B. Du Bois, writings. Boston, MA: Twayne. Kraybill, R. (2002). Reflections on twenty years in peacebuilding. In C. Sampson & J. P. Lederach (Eds.), From the ground up: Mennonite contributions to international peacebuilding (pp. 30–44). Oxford: Oxford University Press.

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Kunde, J. E. (1997, October). Metropolitan investmentstrategis of sustainable communities. Joint Center for Sustainable Communities press release. Laue, J. H.(1993). 25 years ago: A personal report from Memphis. This report, dated April 4, 1968 was delivered in April 1993 at a Methodist church in Burke, Virginia. Copy obtained from Mariann Laue Baker, Jim Laue’s widow, and made available under the heading “Memphis Mission”. Retrieved May 10, 2020, from theplaceforstories.com Lee, A. M. (1944). Sociology, clinical. In H. P. Fairchild (Ed.), Dictionary of sociology (p. 303). New York: Philosophical Library. Lee, A. M. (1945). The analysis of propaganda: A clinical summary. American Journal of Sociology, 51(2), 126–135. Lee, A. M. (1955). The clinical study of society. American Sociological Review, 20(6), 548–653. Lee, A. M. (1979). The services of clinical sociology. American Behavioral Scientist, 22(4), 487–511. Lehnerer, M. (2003). Careers in clinical sociology. Washington, DC: American Sociological Association. Levine, B. (2005). Resolving racial conflict: The community relations service and civil rights, 1964–1989. Columbia: University of Missouri Press. Lewis, H. (2012). Introduction. In H. Lewis (Ed.), The essence of Jane Addams’ twenty years at Hull House (p. 117). Mount Jackson, VA: Axios Press. Martin, R. E. (1987). Lynching. The Encyclopedia Americana, 17, 884–885. McDonagh, E. C. (1944). An approach to clinical sociology. Sociology and Social Research, 27(5), 376–383. Misheva, V., & Blasko, A. (2018). Jane Addams’ sociology and the spirit of social entrepreneurship. Uppsala, Sweden: AUU and the authors. http://www.diva-portal.org/smash/get/ diva2:1197862/FULLTEXT01.pdf#page¼63 Moss, D. A. (1996). Socializing security: Progressive-era economists and the origins of American social policy. Cambridge, MA: Harvard University Press. Nandi, R. (n.d.). James H. Laue. National Civil Rights Museum at the Lorraine Motel. Memphis, Tennessee. Retrieved April 18, 2020, from www.civilrightsmuseum.org/from-the-vault/posts/ james-j-laue New York Times. (1935, May 22). Obituary: Jane Addams a foe of war and need. The New York Times. Retrieved April 19, 2020, from http://www.nytimes.com/learning/general/onthisday/ bday/0906 Nichols, L. T. (2019). Louisa Pinkham Holt, Public Sociology and Racial Desegregation. Society, 56:378–382. Retrieved 10 April 2020, from https://doi.org/10.1007/s12115-019-00385-2 Opdycke, S. (2012). Jane Addams and her vision for America. Upper Saddle River, NJ: Pearson Education. Potapchuk, W. (2020, April 20). Interview with James Laue’s colleague and former student. Rebach, H. M., & Bruhn, J. G. (Eds.). (2001). Handbook of clinical sociology (2nd ed.). New York: Kluwer Academic/Plenum. Residents of Hull-House. (2007). Hull-House maps and papers: A presentation of nationalities and wages in a congested district of Chicago, together with comments and essays on problems growing out of the social conditions. Urbana, IL: University of Illinois Press. (Original work published 1895). Rosenberg, R. (1982). Beyond separate spheres: The intellectual roots of modern feminism. New Haven, CT: Yale University Press. Sanders, E. (1999). Roots of reform: Farmers, workers, and the American state, 1877–1917. Chicago: University of Chicago Press. Shaw, C. (1931). The natural history of a delinquent career. Chicago: University of Chicago Press. Sklar, M. (1988). The corporate reconstruction of American capitalism, 1890–1916: The market, the law and politics. New York: Cambridge University Press. Sklar, K. K. (1998). Hull-house maps and papers: Social science as women’s work in the 1890’s. In H. Silverberg (Ed.), Gender and American social science: The formative years (pp. 127–155). Princeton, NJ: Princeton University Press.

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Small, A. W. (1896). Scholarship and social agitation. American Journal of Sociology, 1(5), 564–582. Spain, D. (2011). The Chicago of Jane Addams and Ernest Burgess: Same city, different visions. In D. R. Judd & D. Simpson (Eds.), The city, revisited: Urban theory from Chicago, Los Angeles, and New York (pp. 51–62). Minneapolis, MN: University of Minnesota Press. Steeples, D., & Whitten, D. O. (1998). Democracy in desperation: The depression of 1893. Westport, CT: Greenwood Press. Straus, R. A. (Ed.). (1979). Special issue on clinical sociology. American Behavioral Scientist, 22, 475–608. Straus, R. A. (Ed.). (2002). Using sociology: An introduction from the applied and clinical perspective (3rd ed.). New York: General Hall. Taper, B. (2003). Gomillion versus lightfoot: The right to vote in Apartheid Alabama. Tuscaloosa: The University of Alabama Press. Taylor, S. L. (2017). “I have the eagle:” Citizenship and labor in the Progressive Era (1890–1925). Georgetown University Dissertation. Retrieved April 23, 2020, from https://repository.library. georgetown.edu/bitstream/handle/10822/1044627/Taylor_georgetown_0076D_13790.pdf? sequence¼1 Timasheff, N. S., & Theodorson, G. A. (1976). Sociological theory, its nature and growth. New York: Random House. Tulane University. (1929, June 1). Bulletin of the Tulane University of Louisiana 30/6. New Orleans, LA: Tulane University. Tulanian. (1928). Child guidance clinic planned by sociologists. The Tulanian, 1(7), 8. U.S. National Archives. (2007). 19th Amendment to the U.S. Constitution: Women’s Right to Vote. Retrieved April 4, 2020, from http://www.archives.gov/historical-docs/document.html? doc¼13andtitle_raw¼19th%20Amendment%20to%20the%20U.S.%20Constitution:%20 Washington Post. (1993). Obituary: James Laue, GMU Specialist in conflict resolution, dies. The Washington Post. Retrieved April 19, 2020, from https://www.washingtonpost.com/archive/ local/1993/09/30/james-laue-gmu-specialist-in-conflict-resolution-dies/9cca375b-69e7-4fc69a6e-c8a4fe10de2c/ Weber, L. R., & Carter, A. (2002). The social construction of trust. New York: Kluwer Academic/ Plenum. Whipps, J. D. (2010). Examining Addams’s democratic theory through a postcolonial feminist lens. In M. Hamington (Ed.), Feminist interpretations of Jane Addams (pp. 275–292). University Park, PA: The Pennsylvania State University. Wilson, W. (1980). Letter from Woodrow Wilson to Edith Bolling Galt. August 18, 1915. In A. S. Link (Ed.), The papers of Woodrow Wilson (Vol. 34, pp. 240–244). Princeton, New Jersey: Princeton University Press. Winternitz, M. C. (1930). Practical study of social relations: Plan for Graduate Department of Clinical Sociology at Yale (Records of Dean, YRG-27–A-5–9, Box 174, Folder 3608). New Haven, CN: Yale University Archives, School of Medicine. Wirth, L. (1931a). Clinical sociology. American Journal of Sociology, 37, 49–66. Wirth, L. (1931b). Sociology: Vocations for those interested in it. Vocational guidance series (no. 1) [Pamphlet]. Chicago: University of Chicago. Louis Wirth Collection, University of Chicago, Department of Special Collections. Box LVI, Folder 6. Wright, E., II. (2016). The First American School of Sociology: W.E.B. Du Bois and the Atlanta Sociological Laboratory. London: Routledge. Zorbaugh, H. W. (1929). The gold coast and the slum: A sociological study of Chicago’s near north side. Chicago: University of Chicago Press. Zorbaugh, H. W. (1939). Sociology in the clinic. Journal of Educational Sociology, 12(6), 344–351.

Chapter 4

Clinical Sociology in Québec: When Europe Meets America Jacques Rhéaume

4.1

Introduction

Clinical sociology is a way of doing sociology, so formally it is a methodological approach within sociology. However, methodology cannot be separated from theory, and clinical sociology involves, in some respects, a construction of a particular field of sociology. Methodology is not only a set of techniques used to gather data for analysis by sociologists in their role as an expert; methodology, in a broader sense, is about what kind of social issues are of interest, who is producing the proper knowledge to address those issues, and how can we develop not only theory but practical knowledge about those issues. This chapter illustrates this approach by examining the development of clinical sociology in Québec. It is interesting to note that we speak of such a development in Québec and not in Canada. Sociology in Québec, as is the case for most social and human sciences, has been much more influenced by ideas and contributions from the United States or Europe than from the other Canadian provinces. The particular political status of Québec stems from a long history of resistance in an attempt to remain Francophone and culturally different from the rest of Canada. This is also reflected in the way sociology developed. Perhaps a more careful and extensive search would point to similar U.S. influences among Toronto or Vancouver sociologists. Nevertheless, cross-references between Québec and Canadian sociologists in publications, manuals, and, even more importantly, in actual research and practice projects are rare or nonexistent. Such is also the case for clinical sociology. This discussion of the historical development of clinical sociology is divided into four parts. The first two parts are more chronological and bear on the precursor and founding disciplinary influences. Clinical sociology appears in the 1950s as a

J. Rhéaume (*) Université du Québec a Montréal, Montreal, QC, Canada e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_4

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sociographic approach. Its development in the 1970s and 1980s was influenced by the field of psycho-sociology. The third part accounts for the actual development of clinical sociology as an emerging institutional field in diverse professional or academic associations and conferences, starting in the late 1980s. The final part relates to specific clinical sociological practices and refers to the more important publications and theoretical developments of the period. The basic issue concerning the existing gap between the formal and institutional development of clinical sociology on one hand, and the actual clinical sociology in practice on the other hand also will be addressed. I conclude by identifying some basic characteristics of a clinical approach to sociology.

4.2

Clinical Sociology: Foundations

The term clinical sociology appeared explicitly in Québec sociology in the 1950s and associated in particular with the works of the sociologist Fernand Dumont and with the majority of the work in sociology at Laval University in the city of Québec. The social and political context in Québec during the 1950s was marked by the policies of the conservative government in power and supported by a strong institution, the Catholic Church. The emerging social sciences faced criticism. At the helm of this opposition were people affiliated with the Church. At the same time, in the period following World War II, a progressive movement appeared supported by dynamic economic growth and a significant increase of international and intercultural relations. Social research was able to build on these progressive trends as well as the numerous conflicts that ensued between clashes among traditional conservatives and those espousing a more progressive and modern outlook. The arrival of the Révolution Tranquille (Quiet Revolution), with the election of the more progressive Liberal Party in 1960, heralded a new progressive era for Québec. Until the 1960s, clinical sociology, given its marginal place in the wider developments occurring within the social sciences, was mostly oriented to a better understanding of the shift between traditional practices and values to modern, open, and pluralistic values within the context of active industrial society. In this context, clinical sociology took on an ethnographic aspect. Its principal objective was to examine regional or subregional cultures in their totality in order to better understand the processes of social transformation. One such significant social change concerned the passage from a preindustrial society in Québec to an industrial one, and the potential for development strategies. This general question was at that time a real concern for Québec society, which was principally characterized by a rural economy. One good example of clinical sociology during this time is the study directed by Fernand Dumont (Dumont and Martin 1963) on the region of SaintJérôme, a semirural center north of Montreal, Québec. Among the methods used by Dumont to explore the specificity of this local culture were personal accounts, meticulously detailed descriptions of cultural and political institutions (school, church, and local government), statistical analysis, documentary analysis, survey

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by questionnaire, and participant observation. Dumont labeled this type of approach clinical sociology. To quote Marcel Mauss (1950), it aimed to understand the total social phenomena under study. It is certainly not a coincidence that Laval University’s journal of sociology, founded in the early 1960s, was given the title Recherches Sociographiques (Sociographical Researches). In that sociographical context, one of the methods adopted by researchers trained at Laval (Nicole Gagnon, Gilles Houle) was the analysis of life stories, a method designed to examine the transformations of social structures on the basis of the histories of individuals selected according to specific research criteria (such as age or experience). The Institut Québécois de la Recherche sur la Culture (IQRC) (Québec Research Institute on Culture), created in the 1970s and directed by Fernand Dumont, identified the global study of Québecois culture as its mandate. This research orientation also was represented at the University of Montreal, in the work of sociologist Robert Sévigny, who had studied at Laval University and had shown an early interest in the ethnographic perspective. While contributing to the development of a psycho-sociological practice in the early 1970s (which is discussed later in this chapter), he also collaborated with Marcel Rioux and other sociologists in an innovative ethnographic study on alienation in the everyday lives of Montrealers. In a later publication, Le Québec en Héritage, Sévigny (1979) analyzed the content of five in-depth interviews undertaken with couples from different social origins. It was a project that served as a point of departure for what would later become a research program of implicit sociology, that is, the sociological knowledge present in the everyday life of social practitioners (Rhéaume and Sévigny 1988). The general idea was that practitioners in any professional field possessed a real social knowledge to be discovered in order to better understand social practices. In this sense it was the people’s sociology at work. This type of research can be linked to the very influential tradition of cultural anthropology and to contributions of the well-known Chicago School at the beginning of the century. This was a period characterized by a very inventive and original sociology adopting an interdisciplinary perspective; a sociology in which the commitment of researchers to the social problems of the day, such as immigration, family breakdown, alcoholism, poverty, and street gangs, is emphasized. The well-known work of Thomas and Znaniecki (1918–1920), reflecting on their fieldwork in urban contexts, was published in this period. The objective of these authors was the study of social life in transformation. Their sociology also was distinctive in its choice of an interpretative approach. W.I. Thomas was convinced that we can understand nothing of human action if we ignore the goals that actors pursue and the particular perception that they have of their situations and possibilities. Here again, epistemological questions were translated methodologically by using a strategy of multiple data collection techniques: the study of city maps and open-ended interviews, and the analysis of documents of all types (such as periodicals, personal journals, and life stories). As for theoretical and empirical relations, the sociologists of the Chicago School viewed theory construction as a long and patient process characterized by a constant movement between observation and theorizing and the consideration of

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each observed case rather than just the principal tendencies. They placed more emphasis on the concepts themselves than on the validation of hypotheses, and on the relations between the concepts (Bertaux 1976, pp. 14–15). The Chicago School has also been an important source of influence for contemporary clinical sociology. It has been at the crossroads of different influences, including phenomenology (Schutz, Berger, and Luckman) and symbolic interactionism (Mead, Goffman). The almost simultaneous publication of three key texts illustrates these orientations: Symbolic Interactionism by Herbert Blumer (1969), Studies in Ethnomethodology by Harold Garfinkel (1967), and The Discovery of Grounded Theory by B.G. Glaser and A. Strauss (1967). The social construction of reality in symbolic interaction between social actors, the active and sustained reference to implicit rules and meanings of human interaction (ethnomethodology), and the progressive construction of theory from representations in everyday language (grounded theory) are some of the basic approaches that have been incorporated into clinical sociology. We can recognize also influences from European authors and theories. Marcel Mauss (1950) is one such author who espouses a vision of an anthropological sociology in studying total social phenomena. That is to say, he includes the individual and the collective, the cultural and the economic, the local and the general through varying sources of data. Max Weber’s (1964) comprehensive sociology is also a decisive influence; likewise is the American Talcott Parsons (1957) and his theory of social action. Another theoretical field that has had a great influence on many sociologists in Québec during that period is that of culture and personality (Dufrenne 1953; Kardiner 1969). The latter, with its focus on the relationship between the individual and society, will become a central focus of psycho-sociology, as well as another source of influence for clinical sociology. Three important points central to the study of clinical sociology can be drawn from these primary sources of inspiration: a direct and intimate field knowledge of a given social group considered in the complexity of its everyday life, the involvement and critical distance of the observer in the situation being studied, and the corresponding theoretical preference of a sociology where the subjectivity of social actors should always be included in a global and integrated understanding of social practice. Thus, in clinical sociology we need to understand the different social actors’ viewpoints in order to build an appropriate knowledge of a given situation. These three points are interrelated; it is difficult to have access to the internal, the more subjective knowledge of social actors, without a minimum involvement in the interaction with them and without a shared conceptual frame of reference. At the same time, the preoccupation of the researcher as a sociologist is to maintain a critical distance and to develop a solid theoretical perspective. In those first early studies, the theoretical reference is mostly structural functionalist. It was not so difficult from a clinical sociographic point of view to maintain a muchdetached attitude toward actual social intervention. Understanding was the key word, empirical data gathering and systematic analysis were the methods, including, as a main source of data, the subjective input from social actors. This tendency

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toward an objective stance will change with the second major influence of psychosociology and community development in clinical sociology.

4.3

A Major Development: Human Relations and Psycho-sociology

Psycho-sociology is another major school of thought that must be examined in order to situate the current network of researchers in clinical sociology. This school of thought emerged in Québec in the early 1960s. In the 1960s, Québec was marked by significant social changes. This period of drastic transformation is referred to as the Quiet Revolution. After many years of a Conservative Party regime, the Liberal Party came into power with the aim of constructing a modern state. The main priorities of the new government included the establishment of a new educational system, the development of a complete health and social services public program, and the secularization of society. In this new context, the human and social sciences, which were once at the margins of society, suddenly became essential resources for planning change. Management sciences and related academic fields became highly valued in order to prepare leaders for industry and public services. Democratic participation, planned change, and social innovations were the buzz words used in the public arena. Certain sociologists, social workers, and other social scientists became involved in this social transformation, and their contributions prepared new perspectives for a clinical approach to sociology. Robert Sévigny, of the sociology department at the University of Montreal, is one of the pioneers of this approach. Toward the end of the 1950s, he attended specialized training sessions in group dynamics and organizational consultation at the National Training Laboratory in Bethel, Maine. These sessions were part of the work of Kurt Lewin and his collaborators in the 1940s and 1950s in the United States. In Québec, the vast Alcan manufacturing intervention project in the 1960s, in which many psycho-sociologist-consultants were involved, marked the beginnings of a psycho-sociological practice.1 The training group method (small groups), more authentic interpersonal communication, conflict resolution, and participative problem solving were some of the strategies and tactics developed for this type of practice, which aimed at improving social organizations. It is to be noted that those practices were referred to as human relations approaches or applied behavioral and social sciences. The terms psycho-sociology and psycho-sociologist came later from France.

1 Robert Sévigny was trained in Québec by the social psychologist Bernard Mailhot, a disciple of Lewin. Other psychologists—Fernand Roussel, Roger Tessier, Michelle Roussin, Yvan Tellier, Yves Saint-Arnaud, André Carrière—also played important roles in the development of psychosociology.

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This practice was influenced by the action research approach initiated by Kurt Lewin in social psychology in which the constitution of scientific knowledge was considered inseparable from social practice. More precisely, the scientific project becomes one of problem solving through action, based on an epistemological model of radical pragmatism. The solutions put into practice—from the resolution of problems specific to enterprises to the functioning of small groups or community development—are the functional equivalent of the validation of hypotheses set out in the early stages of a project. Moreover, these social experimentations become privileged spaces for advancing the understanding, and science, of social change. Action, in this sense, precedes knowledge. While maintaining its focus on the specificity and singularity of the social and historical situations under study and on the participation of social actors and researchers, psycho-sociological practice constitutes a laboratory for social experimentation. This participation is particularly evident in small groups. Group dynamics was, for instance, the principal method of intervention used in the Alcan study mentioned above. Based on democratic participation, such an approach was attractive in Québec in the 1960s because of the societal transformations taking place.2 It was also a period in which researchers and practitioners grouped together in private training, research, and consultation centers, such as the Centre d’Études des Communications (Center for the Study of Communications), Institut de Formation par le Groupe (Training Group Institute), and Centre Interdisciplinaire de Montréal (Interdisciplinary Montreal Center). The principal domains of intervention were industrial organizations and the educational system, the latter being the object of major reforms by the state in the 1960s. The principal psychosocio-logical practices were organizational consultation and the training group method. Psycho-sociology was not only a product of American influences. Collaboration with Europeans also was initiated in this period and continues with, for instance, French psycho-sociologists such as M. Pagès, E. Enriquez, and V. de Gaulejac. It also was influenced by institutional analysis (the study of basic institutions, of power and values in formal organizations) as developed, for example, by R. Loureau and G. Lapassade; social analysis or group psychoanalysis (social interaction examined from the point of view of psychoanalysis); and the sociotechnical approach (optimal integration of technique and human relations in formal organizations).3 The theoretical and practical integration of European and American ideas could be considered a characteristic trait of psycho-sociology in Québec. Psycho-sociological practices involve the use of the same basic methods, such as group dynamics, action research, consultation, and participatory research. However, the theoretical references are quite different. For instance, the terms used to describe the field vary accordingly. The term psycho-sociology is specifically derived from

2

This period of Québec history, known as the Quiet Revolution, also was characterized by a major reform of state institutions, under the direction of new political leadership, following the election of the Liberal Party and its program of participative and democratic changes. 3 Social analysis and sociotechnical approaches were first developed in England.

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France. In the United States and in Québec, the most common terms used in resolving social problems include the study of human relations and applied behavioral sciences. Psycho-sociology refers, more importantly, to a disciplinary issue, and of a relationship to be established between psychology and sociology. It is also distinguished in this respect from social psychology, which is either a specific subfield of psychology or of sociology. What is common throughout this whole discussion is the idea that psycho-sociology or the study of human relations or applied behavioral sciences is multidisciplinary and related to the resolution of social problems. However, the debate goes further than differences in the terms that are used. In England and France, when people speak of psycho-sociology, importance is given to psychoanalysis, rather than to behavioral or cognitive psychology, while they are more receptive to humanistic psychology. In the field of sociology, Marxist and postMarxian views are dominant, a departure from the functionalist and positivist schools of thought. Social power issues, social inequalities, and social class movements constitute the more or less main referents of such a view. Pierre Bourdieu, Alain Touraine, and Michel Foucault are good examples of European referents. This is why, in France, psycho-sociological intervention is frequently seen as the development of a reflexive and critical consciousness of participants in groups or organizations rather than simply a pragmatic problem-solving technique. Critical understanding of situations is the key term. Québec sociology often mixed influences from the U.S. and from France or England. A sort of critical pragmatic view progressively emerged, one that tried to take into account both perspectives. Still, the functionalist, pragmatic, and humanistic views would come first in Québec, while psychoanalysis and the Marxist views and their various proponents become secondary in psycho-sociological practices. The term clinical sociology was not used during this period to describe these developments and practices. Nevertheless, these practices later defined the project of clinical sociology while adding new dimensions. The principal new aspect relates to the close relationship between theory and action; the notion of action-research strongly indicates a shift from a more objective stance. Understanding and theorizing are not enough; instead, research must relate at least to some intentional social change. This leads to a revision of the relationship between the researcher and the participants in a project: involvement and interpersonal interaction. This does not mean that the researcher must become an activist or a simple participant. He or she continues as a social scientist to uphold a critical understanding of the situation. Finally, there is another consequence for clinical sociology: the necessity to combine different disciplinary contributions in order to gain a better understanding of social problems. Can we still speak of clinical sociology? Or do we speak of a clinical psycho-sociology? As long as we define ourselves as sociologists, the focus will remain on clinical sociology. Still, to be clinical necessitates complementary contributions from related disciplines such as psychology, anthropology, and communication studies. Certain other specific influences need to be briefly mentioned in the development of clinical sociology in Québec—namely, those of social intervention and the counterculture movement.

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Community Development and Social Action

Social intervention is another practice that emerged in Québec during the same period (1960s and 1970s). More specifically, it was used in urban–rural community and regional development projects in which facilitators and researchers experimented with different modes of collective social participation. Social intervention shares many characteristics with psycho-sociological practice. It emphasizes, for instance, the relationship between research and action, between participation and teamwork, and the important relationship between researcher and population. Michel Blondin (1968) and Louis Favreau (1989) are the pioneers and principal representatives of this type of practice. Generally speaking, it is also a more politicized practice whose inspiration comes largely from critical sociology, Marxism, or other influences. Important references for social intervention during this period include literacy projects undertaken by Paulo Freire (1970) in Brazil and Chile, and Saul Alinsky’s (1976) work on urban social movements in Chicago. Practitioners from this social intervention trend tend to criticize Lewin’s (1948) psycho-sociology, which is considered to be, in the political spectrum, a right-wing ideological practice. An important interrelationship developed between numerous psycho-sociologists and social practitioners of social intervention, of which many were social workers. The development of health and social services based on state regulations and institutions (in neighborhoods, subregions, agencies, hospitals, and the like) appealed to professionals coming from both fields of practice. The critical sociological perspective was more present in social work training and practice, but the pragmatic and humanistic views of psycho-sociology were gradually adopted in many social intervention approaches. Social intervention’s main contribution in clinical sociology was the development of a critical perspective that stressed power relationships and social inequalities within society. Working with poor, marginal, or vulnerable groups raises the question of empowerment. But is such a normative perspective acceptable for sociologists as scientists? It seems that in any case a clinical approach with people has to deal in some respect with the issue of ethical involvement.

4.5

A Radical Change of Culture

Other practices relating to the counterculture of the 1970s also should be mentioned in order to complete this portrait of various influences. The counterculture movement of the 1970s was strongly influenced by so-called humanistic psychology (Bugental 1967). In North America, the nondirective or person-centered approach of training and personal growth groups was well known to the psycho-sociologists of the day. Within this approach two opposed yet complementary camps can be identified: the Rogerians (followers of Carl Rogers) and the Lewinians (followers of Kurt Lewin).

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The first were identified by the priority given to working with and helping individuals, the second by its more collective and pragmatic approach to problem resolution particularly in industrial contexts. With increasing interest in new therapies and personal growth experimentation associated with the counterculture, ideas became even more radical. Primacy clearly was given to the individual and to an alternative vision of social organization, which called into question the domination of a centralized, rationalized bureaucracy in every sphere of society (such as work, education, and family). Advocates of the countercultural approaches distanced themselves, however, from the critical perspective of Marxist analysis, which they considered to be too rationalistic and collectivistic. Thus, a certain number of new culture techniques based on body awareness or the exploration of the “imaginaire” (imagination) were added to the arsenal of psychosociological techniques of intervention, although not without very lively debates that only accentuated the polarization between Rogerians and Lewinians. Many proponents of these approaches became psychotherapists or management counselors. A small number continued practicing while maintaining a necessary tension between these two poles of reference. The majority of the partisans of clinical sociology came from this latter group, the ones who combine collective and rational action and individual and affective change. Counterculture is also important because it reflects a social transition in Québec and North America. The 1970s marked a turning point for culture and social movements about minority rights, women’s equality struggle, and union development due to continuing postwar economic growth, increasing global richness, and a stronger appeal for citizens’ participation. Counterculture goes even further, looking for a radical change to bring about individual well-being and a greater leisure life. But by the end of the decade, a much more complicated situation emerged with the energy crisis and an increased focus on a market economy, which reintroduces new types of restrictions on expected social developments. It is in this new context that Québec clinical sociology develops during the 1980s.

4.6

Clinical Sociology as an Academic and Professional Reference

The notion of clinical sociology was explicit in the early texts of sociographic sociology. At that time, however, clinical sociology represented a point of view, which we would now consider to be limited. Therefore, it became marginalized even within the sociographic approach. The second important influence on clinical sociology, that of the psycho-sociological approaches, remained mostly implicit. This is particularly evident in varied practices as planned change, organizational development, human relations, social intervention, group dynamics, and personal growth groups. Furthermore, for these practitioners, the term clinical referred particularly to the clinical practice in psychology (psychotherapy) or medical practice. Sociological

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analysis was more or less important in these practices, depending on the approach— less important in personal growth groups and more important in social intervention. The relative marginality of clinical sociology, in the sense of not having a clear and formal labeling had to be addressed. Some sociologists use an indirect strategy, that is to say, getting international recognition in order to be recognized at home. An important turning point for clinical sociology came about in 1982 when Robert Sévigny and Gilles Houle (Houle 1987), both from the University of Montreal, participated in the creation of the ad hoc Committee in Clinical Sociology within the International Sociological Association (ISA) Conference in Mexico in collaboration with American colleagues. Their initiative drew from the double tradition that we have just outlined, but went further in redefining the field of clinical analysis according to the evolution of its practices and ideas. This redefinition was worked through formal steps of development in further ISA conferences: as a Working Group in 1986 at New Delhi and in Madrid in 1990. In 1992, the status of a regular research committee was obtained and maintained until now, meeting regularly in the successive International Global Conferences: Bielefeld (in 1994), Montreal (in 1998), Brisbane (in 2002), and Durban (in 2006). Another similar development is produced in the “cousin,” l’Association Internationale des Sociologues de Langue Française (AISLF, the International Association of French Language Sociologists). In 1988, a research ad hoc group in clinical sociology was created (Geneva, Switzerland), meeting again in 1992 (Lyons, France) and then transformed as a regular research committee in 1996 (Evora, Portugal), meeting after that on a regular basis (Québec, Canada, in 2000, and Tours in 2004). Many clinical sociologists from Québec also were present at the creation (2003) of a research committee in clinical sociology in the new and revised national Sociological French Association (AFS, l’Association Française de Sociologie), at a conference held in Paris. It’s a long way since the creation of the American Clinical Sociology Association and Sociological Practice Association in the late 1970s. It should be noted that clinical sociology associations have been created in many regions, particularly in the late 1990s or more recently in Uruguay, Mexico, Italy, and Moscow. These developments helped established a network of researchers who serve as a source of reference and common vision of a clinical approach to sociology. What happened in Québec during that period? What were the kinds of practices and results? What was the historical and political context?

4.7

Clinical Sociology Redefined in the 1980s and 1990s

The Quiet Revolution of the 1960s transformed Québec into a stronger province. Bureaucratic tendencies also increased with the creation of a much larger public service sector, both in structure and volume. During the same period, the independence or nationalist political movement formed a party, the Parti Québécois, which

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won the election in 1976 and remained in power for many years. The reinforcement of the public service sector was an important dimension of Parti Québécois policy; this contributed to even more bureaucracy. At the same time, in the early 1980s and further on in the 1990s, the world energy crisis (petroleum prices) and the emerging globalization phenomena resulted in fierce competition among companies for survival. Management sciences were replacing social sciences as basic references for social practices in the workplace and also in public services. The focus was on efficiency and rational and technical problem solving with the help of the new computerization technology that had penetrated every sphere of social life. Psycho-sociology, clinical sociology, and the like were challenged by this dominant technocratic and information-based culture. Nevertheless, these social approaches were still very much needed to address the social issues raised by these new social, political, and economic forces. Human factors became even more crucial in the development and management of industrial or public organizations. On the opposite side of the labor force, an increasing number of people joined the excluded and marginal, the unemployed—a fragmented population. Clinical sociology could now develop. Two particular events put forward the idea of clinical sociology in Québec. The first one occurred in the January 1990 colloquium in Montreal City, Clinical Analysis in the Human Sciences (Sévigny et al. 1993). The objective of this colloquium was to describe the principal characteristics of a clinical approach in the social sciences, its defining issues, and its challenges for the future. The intention was to determine the specificity of this approach from the point of view of theory and empirical research. A second colloquium was held in September 1993, Clinical Approach in the Human Sciences: Possibilities and Limits. In both cases, the participants and the content of the presentations demonstrated the originality and force of the clinical sociology project. The colloquia were organized by representatives of the two principal institutions involved in the current network of clinical sociology: the University of Montreal and the University of Québec in Montreal (UQAM). In addition to a core group of sociologists, there were 200 or so participants from widely varied disciplines and sectors of intervention (management, psychiatry, psychology, education, criminology, social work, communication, and anthropology). This multidisciplinary and the inclusion of different sectors of intervention are characteristic of the clinical approach in Québec. The same can be said of the principal themes addressed—work and organizations, mental health and therapy, social problems, and methodological questions—which well represented the targeted fields of activity. Finally, the presence of several European and American researchers was an indication of the international collaboration that existed in the network of researchers in clinical sociology. The colloquia were good illustrations of what constitutes clinical sociology in Québec: an open network rather than a formal organization; a project rather than an established practice; a new vision of the social sciences rather than just another

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method or new sector of research; and, of course, a dedicated group of individuals and institutions.4 Additionally, there are numerous links with researchers who identify little, or not at all, with clinical sociology per se, but whose ideas and practices converge with this approach. Some examples include those working in the field of mental health intervention (the Revue de Santé Mentale in Québec [Québec Journal of Mental Health] and researchers at the Douglas Hospital); the field of organizational intervention (researchers from the Hautes Études Commerciales, or the Higher Studies School of Business) studying the individual-organization relation and organizational cultures; researchers at UQAM in management and human resources; and, in the field of social work, the Revue Internationale d’Action Communautaire (International Journal of Community Intervention), University of Montreal, and the journal Nouvelles Pratiques Sociales (New Social Practices) at UQAM. Links also exist among researchers with interests in qualitative research,5 action research, life stories, or science action. This latter approach is represented in the work of psychologist Yves Saint-Arnaud, professor at the University of Sherbrooke (Québec, Canada). The University of Sherbrooke offers an academic program (master’s level) in the psychology of human relations, which adopts a psycho-sociological perspective. The University of Québec in Montreal also offers a program at the bachelor’s level in communication and human relations, in which psycho-sociology is very much present. But what would be the common characteristics shared by all these people that allow us to speak of a clinical sociology approach to social practice? We will give two actual examples of sociological practice that illustrate the clinical perspective: research and intervention in life narratives or life stories, on the one hand, and research and intervention in mental health issues in the workplace on the other.

4.8

Clinical Sociology 1990–2005: From Life Story to the Workplace

Life narratives as a social practice in research, training, and intervention have developed a great deal since the first experiences of the sociographic school in the 1960s and the seminal work edited by Danielle Desmarais and Paul Grell (1986). The life narrative research and training approach is based on the basic postulate that 4

A number of names can be mentioned: Robert Sévigny and Gilles Houle (sociologists at the University of Montreal); Jacques Rhéaume, a sociologist, and Simone Landry, a psychologist (Department of Communication, University of Québec in Montreal); Danielle Desmarais, an anthropologist (Department of Social Work), and Shirley Roy, a sociologist (Department of Sociology), from the same university; Monique Morval, a psychologist and the director of the doctoral program in Applied Social Sciences, University of Montreal; Adrienne Chambon, a sociologist, University of Toronto; and others. 5 Some of the orientations of qualitative research in Québec are shared with a clinical perspective.

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social actors are built through time and history, and that gaining better access to their own lived history helps to improve future choices and leads to empowerment, either on an individual or collective basis. The forms of intervention are varied: personal written life stories commented on in small research and training groups; personal narratives using more verbal and nonverbal expressions; life stories produced in more classic research interviews; and collective life narratives produced by a group of people in formal organizations. A book, Récits de Vie et Sociologie Clinique (Life Narratives and Clinical Sociology), edited by Lucie Mercier and Jacques Rhéaume (2007), presents the theoretical and methodological dimensions of this approach as well as providing numerous examples.

4.8.1

Consciousness Raising Through Life Stories

One such dimension is the family novel and social trajectories, a method of life narratives developed first in France by Vincent de Gaulejac (1999), a clinical sociologist, and then in Québec by Jacques Rhéaume (2000) and others. Typically, this research and training experience is offered or requested by professionals in social intervention: social workers, psychologists, nurses, consultants, and teachers. The method is based on intensive small groups meetings of 3–4 days, on a particular theme. It uses verbal and nonverbal techniques (such as drawings, socio-dramas, genealogical trees, and photos). For example, a research topic can focus on life stories exploring the participants’ views of money and wealth. This not only permits an exploration of the psychosocial life experience of the many dimensions of wealth and poverty, but also touches upon the social and economic transformations that condition these experiences. The most developed aspect centers on the importance of family intergeneration transmission of different capitals—economic, cultural, professional, and social—that constitute one’s social status. The people participating in such an experience appreciate the increased understanding they gain about their own lives, but more significantly prepare them to better understand the people they meet daily as professionals. This is part of their training so they can improve their work and practice in institutions such as schools, hospitals, community groups, and enterprises. In a way, this approach can be seen as a preventive social intervention, helping people to prepare themselves to better meet complex people problems. There is also, unavoidably, a personal interest in exploring and resolving one’s own life issues. Professional and personal motives are involved in this kind of experience.

4.8.2

Healthy Work

Another sector of research and intervention is the psychodynamic of work, a method developed in France by the physician and psychoanalyst Christophe Dejours (1993) and colleagues, and adapted and developed in Québec by Marie-Claire Carpentier

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Roy and Jean-Pierre Brun, both sociologists. A group of ten researchers from five universities and different social or health sciences (sociology, psychology, social medicine, ergonomy, and ergotherapy) have established in 1998 the Québec Institute of Psychodynamic of Work. Since 1992, more than 15 research projects have been completed using this social clinical approach in industrial plants, hospitals, social and health local services, unions, penitentiaries, and governmental agencies. Some of these experiences are reported in two publications edited by Carpentier-Roy and Vezina (2000) and the institute (Institut de Psychodynamique de Travail 2006). This approach closely follows a typical sociological clinical format that we can describe in four phases. First, a social demand or request leads to a study in a given organization. The request can originate from human resources people, or, more often than not, from union representatives or the medical services. Usually there is a problem situation in the workplace marked by health issues, even suicide casualties. A real need exists to examine the troubled work situation. At the beginning, there is a complex process of establishing a contract between researchers and management and employees’ representatives. One guiding principle that should be kept in mind is that the concerned employees should remain the principle actors and that they should get involved in the research after having been informed on every aspect of the procedure. Information meetings, discussions, and free voluntary participation precede the more formal contract to be signed between parties. Second, a pre-investigation step consists of document analysis, visits, and direct observation of the workplace sites, as well as preliminary interviews with representatives. The aim of this phase is for the researchers to get familiarized enough about the situation, the culture, and the specific terms to be able to conduct properly future collective interviews and to establish a relationship of trust with the participants. It is also during this phase that the group of researchers (usually three or more working together) becomes familiar with the case and exchange ideas with respect to their proper expertise. For example, the occupational therapist will particularly appreciate being able to directly observe work activities, while the sociologist becomes most interested in the conflict history between union and management. Third, collective interviews are conducted with groups of 8–12 employees who share a similar type of work. At least four meetings are conducted. Two meetings address participants’ self-expression of their relationship with work, the suffering or pleasure they experience, and the defensive strategies—individual or collective— they employ to resist an increase in suffering. This gives a very specific picture of the work situation as it is subjectively experienced by the workers, accompanied by concrete and detailed description of incidents. A third meeting addresses the analysis produced by the researchers, which is then confronted with the participants’ own analysis. This debate forms the basis of the written research report, which is presented and discussed in a fourth meeting with each group of workers. The final phase of this research process is the validation and diffusion of the written report. Comments are included from every group of employees that took part in the research. This process can minimally include two groups or it can extend to 15 groups or more depending on the size of the organization. The groups of

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participants are the ones who decide, with the researchers, what will be put in the report, to whom it will go, and for what purpose. The researchers present the reports to different publics, inside or outside the organization, and comment on them and answer ensuing questions. Their intervention stops here; the researchers leave the responsibility to the different leaders and collectives in the situation to take action based on the study’s findings. The researchers, however, do not completely disappear; they remain available to provide support and to further explain the study. This is a typical process representative of a clinical model of sociology. It is clinical, because we can see the multilevel interaction among researchers and social actors, theory and action, and social problem resolution as an ultimate aim. The particular psychodynamic approach just described is partially sociological in that the sociology of work and organization are at the center of the analysis: how work can cause good mental health or mental illness. However, this research object cannot be completely understood without the contribution of other scientific knowledge, namely the works of psychology, occupational health, and medicine.

4.8.3

The Development of Clinical Sociology in Recent Years

Research and interventions related to clinical sociology, or, as we often call it in Quebec, a clinical approach to the social sciences (Fortier et al. 2017), are addressing similar issues built around healthy work projects and life stories research and training activities. Research related to healthy work issues, has been enriched by different clinical perspective, interdisciplinary (Rhéaume 2017). While the main influence has been the one around the psychodynamic of work, other perspectives have appeared to complete this approach: the clinics of the activity, developed in France by Clôt and Gollac (2014), and ergology, based on the work of Schwartz and Durive (2009). The clinical analysis of work activity, following Clôt, is a close examination of individual worker activity, based on observation of daily life working situations (direct observation with video, completed by interviews) and then, discussed in small groups, through a process called auto-confrontation of data or crossed-confrontation. It gives more importance to empirical data than the group dynamic, experience-based psychodynamic approach. For Schwartz, the focus is on the social construction of normative contexts in work activities, the relationship between workers and professional norms, the organizational ones, or the different obligations resulting from legal or socio-economic rules. Ergology is based on the creative role of workers who continuously adapt or transform those norms through their collective working activities. The methodology is close to Clôt’s clinical approach: interviews of the individual detailing his or her work experience and a focused exchange in small groups settings. If the three perspectives just mentioned have different methods of doing research and intervention, they all share the same clinical, I would say, a clinical sociology process of doing participatory actionresearch.

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The research and practical uses of life stories or life narratives is still an important dimension of clinical sociology in Quebec. There is a group of practitioners (social workers, educators, community leaders) that are trained with the methodology of family stories and social trajectories, based on Vincent de Gaulejac’s work. There is also a new development with what we call the collective life stories approach, applied particularly in community development (Rhéaume 2014). That methodology is based on the story the members of an organization build around their historical foundation and development, stressing the successes and failures they have experienced. It is a strong consciousness-raising experience, helping the whole collective to better envision the future of its organization and main activities. The use of life stories also have been developed in the field of immigration and refugee situations, focusing on the complex social integration issues related to the host society. Exploring the life course of those people, from their country of origin to their actual situation gives a deep understanding of the cultural, social, economical and political dimensions of this very often difficult journey. The collective publication of our group in clinical sociology in Québec represent a good synthesis of those developments (Desmarais et al. 2012). In all those initiatives, past and present, one central theme is the methodological and epistemological dimensions involved in a clinical sociology intervention, what can be called the necessary exchange of knowledge among the scientific, professional and common sense or experienced approaches. The basic issue is the power relationship related to the socially and historically constructed hierarchy of knowledge, reflecting the socially constructed social inequalities between people. The clinical and critical social scientist has to value the other kinds of knowledge establishing what we can call a pluralistic epistemology; one that is non-hierarchical and values scientific knowledge, professional knowledge, common sense, and also aesthetic or spiritual views in understanding different social issues and problems. Each view has its own value and should not be superseded by another. Each one contributes to an enriched view of a meaningful and democratic world. In that sense, to be clinical is to adopt a facilitating and transverse attitude: to listen to people, their experience and special expertise, urging them to express their views and knowledge. This means we share, as clinical “sociologists,” our understanding of many points of view, without imposing a sociological point of view. It is the very process of a social dialogue, in the sense developed for example, by Paulo Freire (1970), indicating that when there is dialogue, each party has to change one’s own view, learning from the others and integrating new elements into his or her own language. In the academic field, interdisciplinary (sociology, management, education, social work and others) is still the characteristic of our network, with regular collaboration with colleagues in France, Brazil, Uruguay, Chile, the US and others. We are still very active with clinical sociology research groups on the international level, like the International Sociological Association RC46 (the research division on clinical sociology); the Association Internationale des Sociologues de Langue Française (The International Association of French-Speaking Sociologists, AISLF), CR 19; and the Réseau International de Sociologie Clinique (International Network of Clinical

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Sociology, RISC), based in Paris and initiated by Vincent de Gaulejac and colleagues in 2015.

4.9

The Clinical Sociology Approach

The confrontation of ideas and practices developed in Québec through the sociographic approach in sociology, psycho-sociology, social intervention (social animation), counterculture, and action research introduces several themes that define a clinical approach in sociology.

4.9.1

A Social Contract

First, these practices enable us to clarify even further the relations of involvement between researchers and other social actors. This involvement is revealed through the development of increasingly sophisticated analyses of how the researcher/practitioner treats social demands of groups asking for intervention, and through a better understanding of the contractual relations between the researcher/practitioner and client, and the power inherent in this relation. Second, these practices involve a closer link between the researcher and the field since this relation is defined as an action situation. It is no longer sufficient to arrive at an understanding of the situation from the point of view of social actors, with all the distance implied by a sociographic perspective. Instead, the objective is to help them understand the situation in order to be able to act on it. This reference to action is necessary and calls into question purely speculative and detached perspectives of social research.

4.9.2

Interdisciplinary Complexity

Third, the debates surrounding the different forms of social clinical practices introduce the necessity for researchers and practitioners to redefine research and intervention in light of the theory of complexity and dialectical interaction between action and analysis; between different so-called levels of reality, from the individual to the group, to the organization, to global social categories (ensembles); between different modes of expression, whether rational, emotive, concrete, symbolic, or imaginary; and between a critical sociological perspective, which gives all its weight to structural constraints and determinations, and an interpretive sociology of the construction of meaning by social actors in interaction. The special issue of the journal Sociologie et Sociétés (1977) (Sociology and Societies), published under the title

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Psychologie, Sociologie, Intervention (Psychology, Sociology, Intervention) provides an excellent discussion of these themes.

4.9.3

An Ethical Issue: Democracy

Fourth, clinical sociology cannot separate scientific knowledge production from values or ethical issues. Given that clinical intervention and research are closely linked to action and based on a shared project between the researchers and the participant, goals and values need to be made explicit. Most generally, clinical sociology projects aim at developing a greater reflexive consciousness, social justice, and democracy. For example, responding to workers’ demands for a better understanding of a difficult work situation can facilitate improvement of people’s work quality of life, which in turn means personal and collective empowerment. This is also true of community development projects and even professional training, as illustrated earlier with the life-stories approach.

4.10

Conclusion

We cited some examples of clinical sociology today in Québec—life stories and mental health in the workplace. But there are many other domains where similar practices develop without explicitly referring to clinical sociology. The development of clinical sociology in Québec follows a network pattern without an explicit formal organization of clinical sociology as was done in other countries. But clinical sociology principles and approaches are very much present. A final example can be given to illustrate this reality and also serve as a conclusion. It refers to one of the founders of clinical sociology in Québec. In 1992, Robert Sévigny founded the Center of Research and Training in a local community services center (health and social services) in a large neighborhood in Montreal, characterized by a dominant immigrant population. He developed an intensive, multidisciplinary research program on social and health services for the immigrants and refugees. Nowadays, this center involves, on a regular basis, forty or so researchers from fields such as sociology, medicine, social work, nursing, and anthropology. The basic principles or orientations of the research center are essentially clinical: • Research is a response to needs expressed by professionals and the population. The process of creating research must follow a basic rule: people, researchers, managers, professionals, and the general population must be involved in the process. • The production of knowledge refers to a pluralistic epistemological basis, mixing different disciplines and confronting the scientific knowledge with professional

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knowledge and common sense, each representing a necessary contribution in the understanding of social action and social problem. Clinical sociology, however, is rarely explicit at the center and very few researchers, even among sociologists, identify themselves with this label. Yet, why is it so, when practices are so close to a clinical model? Two reasons could be invoked. First, the word clinical is generally associated with medicine and the biomedical model; therefore, many sociologists resist such a label. Second, mainstream sociology, and this is not only true for Québec, does not easily accept the involvement of researchers in social intervention, especially when it is done in response to specific social demands. Actually, the important thing is that clinical sociology exists in practice and is at least recognized by an active minority of sociologists, which allows research and training to be pursued in this way. Clinical sociology has only survived in Québec on the basis of social practice, specifically contributing to the development of sociology.

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Fortier, I., Hamisultane, S., Ruelland, I., Rhéaume, J., & Beghdadi, S. (Eds.). (2017). Clinique en sciences sociales. Sens et pratiques alternatives [Clinical approach in social sciences. Meaning and alternative practices]. Québec: Les Presses Universitaires du Québec. Freire, P. (1970). Pedagogy of the oppressed. New York: Continuum. Garfinkel, H. (1967). Studies in ethnomethodology. Englewood Cliffs, NJ: Prentice Hall. Glaser, B., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine de Gruyter. Houle, G. (1987). Le sens commun comme forme de connaissance: de l’analyse clinique en sociologie [Common sense as a knowledge form about clinical analysis in sociology]. Sociologie et Sociétés, 19(2), 77–87. Institut de Psychodynamique du Travail. (2006). Espace de réflexion, espace d’action en santé mentale au travail [Space for reflexive thinking, space for action in work mental health]. Québec: Presses de l’Université Laval. Kardiner, A. (1969). L’Individu dans sa société. Essai d’anthropologie psychanalytique [Individual in his society. A psychoanalytic anthropological essay]. Paris: NRF, Editions Gallimard. Lewin, K. (1948). Resolving social conflicts. New York: Harpers. Mauss, M. (1950). Sociologie et anthropologie [Sociology and anthropology]. Paris: Presses Universitaires de France. Mercier, L., & Rhéaume, J. (Eds.). (2007). Récits de vie et sociologie clinique [Life stories and clinical sociology]. Québec: Presses de l’Université Laval. Parsons, T. (1957). Toward a general theory of action. Cambridge, MA: Harvard University Press. Rhéaume, J. (2000). Le récit de vie en groupe: réflexions épistémologique et méthodologique [Life story in groups: epistemological and methological thinking]. Revue Internationale de Psychosociologie, 6(14), 107–121. Rhéaume, J. (2014). Community development and empowerment: A clinical sociology perspective. In J. Fritz & J. Rheaume (Eds.), Community intervention (pp. 59–72). New York: Springer. Rhéaume, J. (2017). Les nouvelles formes d’organisation du travail et de management confrontées à une approche clinique du travail [New work organisation and management patterns confronted to a clinical approach of work]. In D. Mercure, M. P. Bourdages-Sylvain (Eds.), Travail et subjectivité. Perspectives critiques [Work and subjective experience. Critical views] (pp. 245–262). Québec: Les Presses de l’Université Laval. Rhéaume, J., & Sévigny, R. (1988). La sociologie implicite des intervenants en santé mentale. Vol. 1. Les pratiques alternatives: Des groupes d’entraide aux groupes spirituels; vol. II. Les intervenants professionnels: De la croissance personnelle à la guérison [Implicit sociology of mental health practitioners. Vol. I. Alternative practices: From self help groups to spiritual groups; vol. II. Professional practitioners: From personal growth to healing]. Montreal: Éditions Saint-Martin. Schwartz, Y., & Durive, L. (Eds.). (2009). Travail et ergologie. Entretiens sur l’activité humaine [Work and ergology. Discussions about work activity, Tome 1]. L’activité en dialogue. Entretiens sur l’activité humaine [Activity in dialogue. Discussion about human activity, Tome II], Manifeste pour un ergo-engagement [Commitment in ergology, a manifesto]. Toulouse: Octares. Sévigny, R. (1979). Le Québec en héritage: La vie de trois familles montréalaises [Québec’s heritage: Three montrealese families’ life]. Laval, QC: Editions Saint-Martin. Sévigny, R., Rhéaume, J., Houle, G., & Enriquez, E. (Eds.). (1993). L’analyse clinique dans les sciences humaines [Clinical analysis in the human sciences]. Montréal: Éditions Saint-Martin. Thomas, W. I., & Zaniecki, F. (1918–1920). The polish peasant in Europe and America (5 Vols.). Boston: Gadger. Weber, M. (1964). The theory of social and economic organization. New York: Free Press of Glencoe.

Chapter 5

On the Origins of Clinical Sociology in France: Some Milestones Vincent de Gaulejac

5.1

Introduction

Clinical sociology emerged in France in a continuous way in the 1980s and was affiliated with psycho-sociology and the work of the Laboratoire de Changement Social (Social Change Research Center) (LCS) at the Université Paris Diderot. In Geneva, in 1988, a workshop was launched within the Association Internationale des Sociologues de Langue Française (International Association of French Language Sociologists, AISLF) on the initiative of Robert Sévigny, Gilles Houle, Eugène Enriquez, and me. A working group that included these members also became a permanent research committee within the International Sociological Association (ISA) in 1992. The first clinical sociology conference organized in France was held at the Université Paris Diderot in the same year. Co-sponsored by the AISLF and ISA research committees, the conference brought together more than 150 researchers from over 15 countries. An account of these events and the papers they produced were published the following year (Gaulejac and Roy 1993). In the 1980s, clinical sociology, which is essentially based on the research led by the LCS, gradually imposed itself as a new perspective in the field of the social sciences. Three events marked the recognition of this new research trend: first, the foundation of the Institut International de Sociologie Clinique (International Institute of Clinical Sociology) in 1999 in Paris; second, the creation of a French committee of clinical sociology within the Association Française de Sociologie (French Association of Sociology) in 2004 and three the creation of the Réseau International de Sociologie Clinique (International Network of Clinical Sociology) in 2015. This recognition of clinical sociology is the result of debates and discussions that have run through sociology since its birth. It was as though clinical sociology was a

V. de Gaulejac (*) Université de Paris and Réseau International de Sociology Clinique, Paris, France © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_5

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reemergence of questions lying at the very foundations of sociology. This chapter explores these origins, starting with the sociology of the French School, particularly that of Emile Durkheim, Marcel Mauss, and Georges Gurvitch, to trace the debates surrounding psychology and psychoanalysis, and to identify the influence of the Frankfurt School, Freudian Marxism, and American social psychology in the 1950s. Finally, I will discuss psycho-sociological sources to the extent that they influenced the founders of French clinical sociology.In an article introducing the genesis of the clinical approach in sociology, Eugène Enriquez (1993) wrote, “Clinical sociology, a recent branch of sociology still in progress, has a long history, [which has] long been forgotten, obscured or repressed.” He evokes the famous quarrel between Emile Durkheim and Gabriel Tarde, the former considered a real sociologist while the latter was cast off to collective psychology because he was preoccupied with psychological forces. Here, I will not mention the causes of this quarrel, which must be placed in context to be fully understood. I will focus instead on the difficulties that many sociologists have in taking psychic dimensions (such as thoughts, desires, affects, emotions, ideals, and beliefs) of social relations into account. It appears as though such dimensions are the concern solely of psychologists or psychoanalysts, because they simply could not be considered as social facts. The celebrated rule of sociological method—“treat social facts as objects” (Durkheim 1937/1981)—drives a good number of sociologists to produce a rigid representation of society, without soul and without passion. It is as if the preoccupation with objectivity should be rewarded with the elimination of all that expresses the emotional and affective parts of the human being. However, many, if not the majority, of writers, who were no less talented often opposed this tendency. To begin with, there is Durkheim, the founder of French sociology. We have here a paradox. Most sociologists make reference to Durkheim to justify their rejection of psychic dimensions, even though he himself wrote that “the study of psychic-sociologic phenomena is not a simple annex of sociology; it is the substance itself” (Durkheim 1885). We can suppose, therefore, that the deep suspicion held by many sociologists toward psychology is at odds with the work envisioned by the founder of French sociology. Understanding how the founders of sociology addressed these issues is not a trivial matter, considering how the privileged objective of clinical sociology is, to restate a proposition of the Collège de Sociologie (Caillois 1979), to study the mutual relationship of the being of an individual and the being of society.

5.2

Durkheim and Socio-psychic Processes

The Rules of Sociological Method (Durkheim 1937/1981) clearly affirms the primacy of social account and the exclusion of all psychological interpretation: The determining cause of a social fact should be sought among the social facts preceding it, not among the states of the individual consciousness.

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Durkheim affirms sociological explanation over all other forms of explanation including metaphysical, organic and psychological. As Durkheim (1937/1981) states: The function of a social fact can not be but social. . . It is because sociologists have been often been unaware of these rules and considered these social phenomena from an overly psychological point of view that their theories appear to numerous minds as too vague, too baseless, too distant from the special nature of things which it assumes to explain.

The defense of one fundamentally sociological position drove Durkheim to formulate a basic rule of method: “In all instances where the social phenomena are directly explained by a psychic phenomena, we can be certain that the explanation is false.” On the grounds of this formulation, several generations of sociologists have adopted a hostile and combative attitude toward psychology, and also psychoanalysis, distancing themselves from the study of socio-psychic facts. In the same work, however, Durkheim is much more specific and dialectic on the relationship between the social and the psychic than most of his disciples. Although his arguments on this issue are certainly not as clear as his affirmation of the primacy of sociological causal explications, a less elaborate quote reveals his predicament: This is certainly not to say that the study of psychic facts are not indispensable to sociology. If collective life is not derived from individual life, the one and the other are [nonetheless] bound; if the latter can not explain the former, it can, at least, facilitate an explanation.

In this remark, we sense his concern over protecting sociology and assuring its independence from psychology as he defends the basic principle explains the social with the social. It is only appropriate to go to the furthest rims of sociological thought before crossing the boundaries in search of explanatory factors in other disciplines. The point of departure that Durkheim (1937/1981) proposes for interaction between sociology and psychology is detailed in the hierarchy he established between the two disciplines. The object of psychological study is reduced to no more than that which sociological explanations do not consider: We can see it clearly in the development of Durkheimian collective psychology, which would focus on the tensions and not on the cooperation between the two sciences. The part that Durkheim has left to pure individual psychology would, little by little, be eroded by his disciples.

Here, René Bastide (1962) underlines a decisive point: the transformation of the theoretical debate from the aspect of knowledge to that of disciplinary corporatism. How many times, during conferences, university classes, or thesis defense examinations, have we heard colleagues assert that “it’s not sociology” in a peremptory manner? As soon as researchers venture to the frontiers of the discipline, and particularly on the relationship between social and psychic processes, they are brought to order and forced to choose their camp. We could understand this position if it was stated at a time when sociology was not recognized as a discipline, in an epoch when it needed to build and assert itself. Yet today, sociology still clashes with an inevitable element; social facts are also psychic facts. Durkheim (1937/1981) explicitly recognized this:

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Sociologists, therefore, must acquire psychological training and then abandon psychology in order to ground themselves “at the very heart of social facts.” Durkheim also adds in a footnote that “psychic phenomena can not have social consequences except when they are so intimately united with social phenomena that the action of one and the other is necessarily bound. This is the case for certain sociopsychic facts.” To illustrate this point, Durkheim draws on the “social energy” which lies at the junction of the drive and power bound to professional status: Thus a public official is a social force, but he is at the same time an individual. It ensues that he can be useful as a social force which he bears, in a sense determined by his individual nature and, through this, he can have an influence on the constitution of society.

While the behavior of actors is mostly conditioned by their social status, function, and position, they are also individuals who can use their “social energies to fulfill personal ideas.” Here, Durkheim (1937/1981) evokes not only the interest of the actors, their strategies for keeping their positions of power, but also their desires, aspirations, feelings, and the manner in which their drives underlie their conscious intentions. This is another opening from sociology toward psychoanalysis.

5.3

From Durkheim to Freud

There is another point in the preface to Durkheim’s (1937/1981) The Rules of Sociological Method, which calls for our attention: “Simultaneously, as institutions impose themselves on us, we comply with them; they oblige us and we like them.” The relationship between individual and institutions or organizations is social relations. They are imposed on us and they are also affective relations; for instance, we love and we hate them. We must read Freud and his 1921 (1975) essay, “Group Psychology and the Analysis of the Ego,” to better understand the love relationship that is established in a group, especially in an organization such as the church or the army. Each person projects one’s own ideal on the object of love and interjects the qualities of that object. This double movement, at the core of passion, of fusion with the beloved person, is found in the relationship of soldiers with their army or the clergy with their church. The social relation, today the object of multiple interrogations, is fundamentally a libidinal link, and yet it cannot be reduced to the dimension of drive or impulse. It is both totally social and totally psychological. There is then continuity between Durkheim and Freud. In Durkheim, from 1895, we find the attention he paid to the notion of sociopsychic facts. He develops the links that exist between individual psyche and collective psyche in his last work, The

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Elementary Forms of Religious Life (1912/2001), in which he insists on the essential role of faith and passion in collective life. In particular, Durkheim evokes “the state of effervescence of collective life which changes the conditions of psychic activity: mental energies are over-excited, passions more alive, sensation stronger.” The topics and themes that concern clinical sociologists, therefore, were present from the founding of sociology. It is befitting to underline this point to those who think that clinical sociology is nothing more than a new costume for psychosociology, a Trojan horse of social psychology that will attempt to secretly penetrate the field of sociology or, even worse, that it will take the side of Gabriel Tarde against Emile Durkheim. This debate can seem rather farfetched at this point, but we have here the same processes at work in family histories. The sociological “family” is still inhabited by a primary antipsychologism often attributed to Durkheim, although this “great-grandfather” advocated a deeper relationship between sociology and psychology, a theme that has been developed by his nephew.

5.4

Mauss and Psychological Sociology

Since Durkheim, many sociologists have defended the need to have an interest in the psyche. To begin with, there is Marcel Mauss (1924/1968), according to whom “social phenomena are principally social, but are, in the same instance, psychological and sociological simultaneously.” In a conference of the French Society of Psychology, Marcel Mauss, Durkheim’s nephew, gradually developed his conception of the relationships between the two disciplines. He considered sociology as a living science: There is no society but among the living. Sociological phenomena are of life. Therefore, sociology is but a part of biology, just like psychology for you, and we deal only with men of skin and bones, living or having lived.

Consequently, sociology and human psychology “belong to this part of biology that is anthropology, that is to say, all of the sciences which consider man as a living being, conscious and social.” Mauss thought that as sociology and psychology have complementary perspectives on human facts, it is only fitting, therefore, to construct a psychological sociology that has “the relationship between psychic and material facts within society” as an object of analysis. Sociology has as an object “material facts,” which require analysis from three perspectives—morphological, statistical, and historical—but it also has as an object of analysis the relationship between material and psychic facts, which constitute “an essential part of sociology or even collective psychology.” The object of this psychological sociology concerns the collective representations that gather the “thoughts, concepts, categories, and motives of action and of traditional practices, collective sentiments and rooted expressions of emotions and of sentiments” (Mauss 1924/1968). In conclusion, the study of people cannot be

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divided: “Today, we are dealing with man’s body, his entire mentality, given at the same time and suddenly. Fundamentally, body, soul, society are blended together.” The analysis of this complex combination, which Mauss refers to as the “totality of phenomena,” demands from sociology, as well as psychology, a multidisciplinary opening in order to take into account all the aspects of the individual, “his body, his instincts, his emotions, his will, his perceptions and his intellect.” The notion of the total social fact becomes, therefore, the point of connection between a concrete psychology and sociology, equally concrete, which come together to describe individuals as “complete and complex beings, in their organisms and their psyches” (Mauss 1924/1968). Mauss brings us some of the strongest ideas at the base of clinical sociology: the importance of the vécu (the lived experience) as an inevitable specificity of the human; the need for an anthropological approach, which evokes the definition of the clinical as “the study of the man in situation” (Lagache 1949); the attention representations, sentiments, and emotions; the apprehension of the human beings in three components—biological, psychological, and social; the project to construct a sociopsychology, which considers social phenomena in their material and psychic dimensions; and the need for sociology to take into account the meaning people give to their lives and to the history of which they are the protagonists.

5.5

The College of Sociology and the Analysis of “The Vital Elements of Society”

In the 1930s, similar concerns were shared by the founders of the Collège de Sociologie (the College of Sociology). In particular, Georges Bataille and Roger Caillois, joined by Michel Leiris, led a project to define “the vital elements of society” or what is more “the points of coincidence between the fundamental obsessing tendencies of individual psychology and the guiding structures which govern the social organization and command their revolution” (Hollier 1979). Sociology should identify the turbulences of social life in connection with the intimate experience of the individual’s tragedies, cursed relationships, excess in eroticism, wars, celebrations, games, and all the human activities that have “communal value in the active sense of the word, which is to say that they are crea- tors of unity” (Bataille 1979). Three concerns are highlighted as priorities: power, consecration, and myth. It is fitting, therefore, to develop “critical work having as its object the mutual relationships of the being of man and the being of society: that which man expects of society and that which society demands of man” (Caillois 1979). In the end, it is a matter of bringing into question the academic separation between knowledge and action. Between Marx, who wanted to transform the world, and Rimbaud, who wished to change life, there is space for a third voice, that of an engaged science, which tackles “the burning subjects” of its time. Researchers form

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part of their object of study. Researchers are engaged whether they want to be or not. There is no possible neutrality when we study the deepest aspects of social life. At the first meeting of the Collège de Sociologie, Bataille (1979) stressed with force how the sociologist engages one’s own life in the analysis: Depending on how men consider the whole that they form either as heaps of dust or bun- dles of grains, [that is either] as waves composed of molecules which are united by nothing but [their common] movement or, on the contrary, as the organizations, possessing all rights over the members who compose them, they take arms in one camp or in the opposing camp and the game to the death begins among them.

These words took on particular resonance within the context in which they were written. Europe was in economic and social crisis. The popular front governed in France, the civil war caused rage in Spain and opened fire on the pro-Franco dictatorship, while Hitler took over all powers in Germany. Faced with the rise of Nazism and the threat of war, the sociologist was obliged to choose a camp. The scientist was forced to take up issues that were overwhelming but could not be ignored. In this context, the sociologist had no choice but to take risks. The existential engagement of the researcher was inevitable because analysis became an integral part of one’s life. Hollier (1979) quotes Bachelard, who was not part of the Collège of Sociology, but we can be certain that his remark, published by Caillois in 1936, was known and appreciated by the members of the college: “We must give back to human reason its function of turbulence and of aggressiveness. . . .We must go where reason loves to take risks.” It is a matter of questioning the taboos of knowledge, of blending reason into the most obscure sphere of the being of the individual and in the shadows of the being of society. The endeavors of the Collège de Sociologie would not last (Hollier 1979). The meetings stopped in July 1939. The war put an end to its creativity, and its influence on French sociology became almost nonexistent. In fact, its members are more often cited in the field of literature than in the human or social sciences. Their influence has been marginal even though the topics they raised have remained essential: the importance attached to the existential dimension of social relations; the opposition to all the forms of thinking that, in the name of science, evacuates “the irrational”— the cursed, sexuality, eroticism, drives, the affective—all that constitutes the viral element of society; attention to the obscure forces of social life, to “the cursed parts” of economic and social phenomena; and the involvement of sociology in knowledge and in action as two indissoluble facets of the same motion. World War II put a stop to this intellectual effervescence. The German occupation, liberation, and then the reconstruction consumed all energies, and France was left livid from this ordeal. We must wait until the 1950s to witness a renaissance of the intellectual debate, marked by the influence of Jean-Paul Sartre and of Marxism on the intellectual milieu. Following the liberation by the allied forces and the Marshall Plan, the “made in America” culture became a model in the domain of music, the arts, and culture. In the human sciences, this influence arose primarily in a diffuse manner and ran between two poles, the one quantitative and positivist, of which the figure-head

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was Paul Lazarsfeld, and the other qualitative and humanist, dominated by the figures Kurt Lewin and Carl Rogers who later accompanied the emergence of the French School of Psycho-sociology. In academia, French universities also were dominated by the Sorbonne where students read Daniel Lagache in clinical psychology and psychoanalysis, Jean Stoetzel in social psychology, and Raymond Aron and Georges Gurvitch in sociology.

5.6

Gurvitch and Total Psychic Phenomena

The post-war rebuilding of sociology after the war also was marked by the decline of Durkheimian influence followed by the rise of Marxist sociology, American sociology, and structuralism. Raymond Aron and Georges Gurvitch were profoundly affected by World War II. Aron witnessed the rise of Nazism and of anti-Semitism in Germany while he prepared his thesis. In 1940, he rejoined General Charles de Gaulle in London where his interest in political and geopolitical issues grew stronger (Aron 1983). Aron and Gurvitch fought the ideologies, all the forms of totalism, professing a practical liberalism inspired by Alexis de Tocqueville and Max Weber. Gurvitch was a companion of Lenin, and he participated in the Russian Revolution of 1917 before taking refuge in France in the mid-1920s. The anti-Semitic rule of the Vichy regime obliged him to take exile in the United States, from where he returned after liberation. If Marx remained for him an incontrovertible thinker, particularly in terms of dialectical analysis, he rejected the idea of a principle of causal determinism of the economic type for a pluralist approach compatible with freedom (Gurvitch 1955a). Gurvitch denounced simple oppositions between the individual and society, structure and conflict, the individual and collective, or psychology and sociology. He defended the “reciprocity of perspectives” between the different paliers, levels, of social reality. To study social fact, Gurvitch thought the sociologist must analyze its different platforms without any of them being, a priori, determinant. These elements interact in a dialectical complementary sense, which he defines as “opposites completing each other within a whole by a double motion which composes to grow and intensify itself, at times in the same direction, at others in opposite directions”. At these different levels, we can obtain the demography, social models, organizations, collective attitudes, collective values and ideas, mental states, and psychic acts. Individuals make up society; society in return constrains them. It is only fitting to rethink the relationship between sociology and psychology (Gurvitch 1955b): It is in the most intimate depths of our “I” that we find again the collective consciousness; we observe that it is under the most intense conditions that the collective consciousness ceases to exert pressure on the individual consciousness. The collective consciousness is therefore in each of us and each of us is in the collective conscience.

The relationship between individuals is placed within a “We” who renders the dis- tinction between individual and collective consciousness rather uncertain.

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From this perspective, Gurvitch (1955b) proposes the completion of Mauss’s proposition on total social phenomena through the study of “total psychic phenomena.” He defines the psyche as follows: A play of growing and decreasing tension towards spontaneous reaction, which can also be individual, interpersonal or collective, preferably the three simultaneously. We have in the psyche. . . [diverse] tendencies towards the collective (us, groups, classes, global societies), the interpersonal (inter-individual or inter-group) and individual entangled. Under these conditions, the concept of total psychic phenomena. . . comprehends, at once, all the degrees of the psyche, all its colorations, all its unconscious, conscious, subconscious manifestations, all its directions towards the collective, the interpersonal and towards the individual, and finally the entirety of conflictual situations upon which the psyche transplants itself.

Thus, the psychic manifestations are at work in all the aspects of social life. They are integral parts of social being. The disciplinary frontier between sociology and psychology is blurred. The psychic aspect and the social aspect obey rules of their own, but their interwoven complexity renders them inseparable. They support each other, come together, mutually influence one another, and connect themselves in permanent and indissoluble relations. It remains for sociology, as well as for psychology, to analyze these reciprocal influences insofar as we can never isolate individuals from their social context, just as we cannot separate the analysis of social phenomena from the psychic manifestations that constitute them.

5.7

Wilhelm Reich: Between Marxism and Psychoanalysis

In the reestablishment of French sociology after World War II, references to Marx, Weber, and Freud became central. The defeat of Germany revived different lines of thought formerly repressed by the Nazi regime. More than anything, the horror of the war and the Holocaust compelled intellectuals to attempt to understand what was considered the defeat of reason. How and why was civilization driven to barbarism? Was it conceivable that modernity, in all its radiant ideas of progress and rationality, could fall into savage, destructive, and irrational regression? One author, Wilhelm Reich, totally marginalized except for during the events of 1968, attempted to answer these questions by returning to historical material, the dialectics of Marx and the psychoanalytic analysis of Freud. From 1929, Reich set the basis for an articulation between Marxism and psychoanalysis, attentive to the risk of confusion between socioeconomic and intrapsychic aspects. If sociological questions are not overrun by the psychological method, the psychoanalytical approach permits us to understand certain social phenomena such as the setting up of ideologies, the problem of class-consciousness or even the internalization of ideals. The veritable object of psychoanalysis is “the psychic life of man which became social being” (Reich 1970a). According to Reich, we must not see economic causes and unconscious motivations as opposites, but consider psychic processes as the “mediating forces between

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the social being and the mode of human reaction.” Reich (1970b) applied this theoretical model to understand the adherence of the masses to Nazism, to a dictatorial, repressive, and foolish power. Reich (1970b) wrote that “what must be explained. . . is not why starving people rob or why the workers strike, but why all starving do not thieve and why the majority of the exploited do not go on strike.” Two hypotheses were brought forth to explain this double motion of adhesion and submission. On the one hand, there existed a strong correlation between the economic structure of one society and the psychological structure of its members and, on the other hand, the sexual repression that produced citizens adapted to an order based on private property. The sexual suppression reinforced the political reaction by means of substitute satisfaction such as sublimation. Herbert Marcuse developed this idea of repressive sublimation. Sexual morals inhibited the class-consciousness, and, therefore, the revolt against the forces of oppression. The result was the acceptance of a socially unjust, inegalitarian order, and submission to authority that was simultaneously feared, idealized, and infallible. Reich struggled against what he believed to be sexual repression, economic exploitation, and political repression—the major causes of alienation of the masses and their incapacity to revolt—by undertaking research on “character armor,” the unleashing of sexual energy through the use of bioenergetic techniques. Reich became the inspiration for movements such as vegetotherapy, action analysis (AA), communitarianism (advocating sexual freedom), those who wanted the abolition of private property, and others who espoused the collective upbringing of children. Despite its deeply innovative nature, Reich’s work was discredited. Reich’s theory, though, had a considerable impact on Freudian–Marxist thought and certain members of the Frankfurt School. This influence was particularly noticeable among the young participants of the movement of 1968 and in that decade. It petered out, however, with the collapse of Marxism as a theory of reference among intellectuals following the collapse of the communist regimes in Eastern Europe, on the one hand, and the eruption of psychoanalysis. Today, if the influence of Reich is forgotten or even repressed, it remains eventful for the “sixtyeighters.” We retain, in particular, the connection between social contradictions and sexual conflicts; the analysis of relationships among emotional, corporal, and social inhibitions; the critique of the “small family” as an enterprise of a neurotic generation; the articulation between socioeconomic structures, forms of intra-familial power, and intra-psychic processes; and, finally, the need to support theoretical reflection as a mode of practice at once clinical and political.

5.8

Freudian Marxism and the Frankfurt School

In many instances, we find these same questions in the debates of the Frankfurt School. The Institut för Sozialforschung (Institute of Social Research) in Frankfurt was founded in 1923 by Felix Weil, and the first director was Carl Grünberg.

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Beginning in 1930, the director was Max Horkheimer. Among the well-known collaborators were Theodor W. Adorno, Herbert Marcuse, and Erich Fromm. The school developed “critical theory,” which was based on Marxism and, in an interdisciplinary way, took into account Hegelian philosophy, psychoanalysis, and sociology. Critical theory rejects the Hegelian idea of identity as a conceptual unity that overcomes its contradictions. For critical theory, there can be no final resolution of inherent contradictions. The illusion of a universal truth, therefore, must be renounced. Against rationalism, positivism, and the abstraction of scientific activity disconnected from social life, the development of a critical sociology was required. The first renowned topic of research proposed by Horkheimer at the Institute of Social Research was the project of clarifying “the question of the rapport between economic life and society,” including the psychic development of individuals. It involved researching the social mentality of qualified workers and employees under the Weimar Republic to find the answers to one theoretical question (Horkheimer et al. 1978): What kind of relationship can be established in a definite social group. . . between the role of the group in the economic process, the transformation of psychic structure of its individual members, and the ideas and institutions which affects the psychic structure?

The methodology proposed for this study had to combine statistics, the examination of socio-psychological texts, and in-depth questionnaires completed by workers and employees. This first investigation would not be published. The Nazi dictator forced the members of the institute to take refuge in Paris, and later in the United States. The second investigation on authority involved articulating a theoretical question with an empirical study. The mandate sets out the aptitude, conscious or unconscious, to integrate or submit the faculty of living to dependence on imposed orders and foreign volition. The investigation had three sections—a theoretical part combining philosophical (Horkheimer), psycho-sociological (Fromm), and political (Marcuse) approaches—to which the addition of an economic approach was sought but not realized; an empirical part with questionnaires supervised by Fromm; and a third part consisting of monographs developed from a qualitative analysis of interviews with 59 families. The multi-focused articulation between theoretical questions and field investigations, the introduction of case analysis, and the combination of sociological and psychological insights also can be found in a third study of anti-Semitism that was undertaken by the Institute of Social Research after it moved to the United States. In a period dominated by positivist quantitative approaches, the study combined quantitative data with in-depth interviews. The final document combined a psychological and sociological study of veteran combatants and included a contribution from Bruno Bettelheim, a psychoanalytical interpretation of anti-Semitism, with Adorno’s section on the authoritarian personality. The introduction, by Max Horkheimer (Adorno and Horkheimer 1947) stated:

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These points illustrate the struggle against the negative aspects of human behavior and the destructive forces of society. On the status of psychoanalysis, as in the link between research and intervention, the debate is opened. Psychoanalysis supplies the elements of comprehension to decipher the social consciousness in its unconscious dimensions. A link between fantasy and historical consciousness develops, opening a path to Freudian Marxism and to socio-psychoanalysis. However, the psychoanalytical theory remains a theory of reference among others and not the basis of a universal theory of the individual and of society. It becomes an element inserted in a theory of the social, “one of the components in a box of critical tools” (Assoun 1987). Critical sociology resorts to psychoanalysis in order to explore the unconscious dimensions of social processes, for example, the aspects of the processes that constitute an authoritarian personality. The idea here is to constitute a social analytical psychology. As Paul-Laurent Assoun (1987) notes: “Marxist analysis found in psychoanalysis an instrument to decipher the famous link between superstructure and infrastructure, which supposes a significant articulation from the libidinal structure to the social structure.” For the Frankfurt School, research should not only resolve theoretical problems but also respond equally to social and political concerns. Scientific knowledge should produce diagnosis revealing concrete interventions and projects of emancipation. Here, we find the beginnings of a clinical approach on the social in a context where it concerns understanding “why humanity sunk into a new form of barbarism,” or even “the auto-destruction of Reason” (Adorno and Horkheimer 1947). This historical crisis of logos, linked to the rational ideal of the domination of nature and to the will to master the self and the world, was driven to a critique of instrumental reason and an analysis of the genealogy of evil. Thus, Marcuse introduced himself as the “progressive doctor of culture” and reintroduced the idea of “therapy” as conceivable at the level of society (Barus-Michel 2004). This review of some of the “ancestry” on which French clinical sociology is constructed shows continuity in how the psychic in social phenomena was addressed. We find another similar debate within psychology about the presence of the social in psychic phenomena. Clinical sociology does nothing more than return to these sources of sociology to study the narrow and indissoluble relationships between the individual and society. The links between social phenomena and psychic processes are central; they are at the heart of the psycho-sociological history.

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Social Psychology, Psychosociology, Socioanalysis, and Sociopsychoanalysis

The need to reconnect psychology and sociology, to integrate psychoanalytical reading in the analysis of social phenomena has continued, since the 1950s, from theoretically heterogeneous reference points. The history of this nebulous situation is not clear as it spilt out of the university, which is often perceived to be the exclusive site in the production of knowledge. In the years after World War II, French psychosociology develops under the influence of French psychologists who surrendered to the United States under the execution of the Marshall Plan. Anne Ancelin-Schützenberger began to study group dynamics at the Research Center for Group Dynamics at the University of Michigan, which was founded by the students of Kurt Lewin. She participated in the first training group in Bethel, Maine, in 1951. She met Léon Festinger, Ronald Lippitt, and particularly J. L. Moreno, whose works she came to know in France. Throughout these discoveries, there was a new conception of social psychology emerging. As Ancelin-Schützenberger (2005) noted, “Kurt Lewin thought that psychology should be linked to life and to that which occurs in normal and active life, and the only thing that matters is social change.” Action research, group dynamics, and psychodrama would legitimize the investigative methods constructed on paradigms closer to clinical measures than the psychotechnical methods used by the partisans of so-called scientific psychology. A cleavage had already emerged between experimental methods and clinical measures, between, on the one hand, a psychology founded on observation and experimentation and, on the other hand, a clinical psychology built in the wake of and in rivalry with psychoanalysis (Ohayon 1999). Other French psychologists went to the United States to discover these new methods. According to (Ohayon 1999), “They bring back, hastily stuffed in their suitcases, human engineering, group dynamics, Morenian psychodrama and the non-directive orientation of Carl Rogers.” In 1950, Max Pagès met Carl Rogers at the University of Chicago. Rogers obtained a grant that enabled Pagès to take part in his postdoctoral seminar. “I have fallen in love with the ideas of Rogers,” Pagès (1996) wrote, explaining the three reasons for his attraction: (1) a way to integrate two contrary positions (a very rigorous scientific demand to conceptualize, verify, and measure made compatible with an engagement in the subjectivity, which is more than a dimension but the very motor of therapy); (2) decompartmentalization of diverse professional practices— psychotherapy, counseling, psycho-pedagogy, social work, education, and mental health—which are all variants of the aid relationship but in France, correspond to differentiated and compartmentalized crafts and functions; and (3) the empathy, congruence, openness, availability to the self, taking into account of emotions, capacity to recognize one’s own sentiments, and a permanent search for authenticity (There were so many elements that defined a clinical posture).

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Hired upon his return by CEGOS, a large consulting organization, Pagès developed forms of intervention in firms that utilized nondirective methods and group talks. In this context, he recruited collaborators such as Eugène Enriquez, André Lévy, and Jean-Claude Rouchy, who became significant actors in the history of psycho-sociology. In 1955, he returned to Bethel in the United States for an Organization for Economic Cooperation and Development (OECD) mission (organized by the National Training Laboratory) that introduced Europeans to training groups and methods of bringing change, inspired by the works of Lewin. In 1958, with Guy Palmade, Pagès founded the Association de Recherche et d’Intervention Psychosociologiques (ARIP, Association of Psychosociological Research and Intervention) within which reflection and practice of action research and of intervention developed from training and encounter groups. The group is the nodal element between the individual and collective, between personal change and social change. In an intellectual context dominated by Marxism and psychoanalysis, psychosociology was the object of virulent attack. Some accused it of being a pawn. Its arrival in France as luggage accompanying the Marshall Plan was obvious proof to some of its collusion with American imperialism and of its adaptive capitalistic aims. Others placed it at the service of the psychology of the “I” (ego psychology), negating unconscious intrapsychic conflicts. For example, Jacques Lacan stigmatized “the ideal of impulsive harmony” and “the ideal of group conformity” and said the believers of “human engineering” (“engineers of the soul”) were devoted to these ideals (Lacan 1956). These debates influenced, in a lasting manner, the history of French psychosociology. This particularly was true for the years around 1968. The question is, Which parts of human behavior, and to what extent, can be attributed to social determinants, intrapsychic conflicts, and corporal factors? These debates are no doubt intellectual, but also are existential insofar as the theoretical options have affective, political, and professional consequences. “I can bear witness,” wrote André Lévy (1997), who had fully experienced the events: to the shock provoked by psychoanalysis among psycho-sociologists who, until then, were nicely tied up to the cozy herd led by Lewin and Rogers.. . . The discovery of the unconscious did not occur without provoking a veritable crisis of personal, professional and institutional identity, leading at times even to a breach of old friendships. The contributions of psychoanalysis have been acquired none other than at the price of painful, and at times brutal, questioning of representations and securely anchored modes of thinking.

The conflicts were also as virulent concerning the question of social change. Must we wait for a structural change, a rupture from capitalism, a revolutionary action of overturning the bourgeois order? Or should we await a transformation of human relations, a renovation of personal or therapeutic development? Are the debates of French society—between Marxism and psychoanalysis, sociology and psychology, structuralism and phenomenology, revolutionary and adaptive positions, social and personal change—cut across psycho-sociology? In this context, some authors, nonetheless, open a channel to overcome this opposition. Let me note, in particular, the movement surrounding Socialisme et

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Barbarie, founded by Cornélius Castoriadis and Claude Lefort (Castoriadis 1975), who denounced Stalinism and militants for founding the social and political sciences on new paradigms. Castoriadis and Edgar Morin, who was engaged in a critical questioning of Marxism, became “woven together” to understand the processes that connect the individual and society, the imaginary and reality, objectivity and subjectivity, the rational and irrational, reason and sentiment, the psychic and the social, and of course psychology and sociology. If they did not claim a link between psycho-sociology and clinical sociology, even though Morin (2001) used the term clinical sociology and Castoriadis practiced psychoanalysis, they provide a legitimacy in the eyes of many psycho-sociologists who are more involved in practice than in theoretical and epistemological issues. Adopting a position at once critical and clinical, they have become irrefutable references in pyscho-sociology and clinical sociology. Psycho-sociology enjoyed a “golden age” in the 1960s and 1970s. However, it was not known as a scientific discipline among academics despite university placement of numerous psycho-sociologists by universities. Sociology rejects it on the pretext that psycho-sociology commits itself to adaptive interventions to serve management and that it promotes psychologism. Psychology, rallied around its internal conflicts among the cognitivists, experimentalists, and psychoanalysts, marginalized social clinical psychology (which found refuge elsewhere), while social psychology, with the notable exception of Serge Moscovici (Faucheux and Moscovici 1971), locked itself inside experimental and scientist constructs. Here, the paradox is that the majority of students are able to find work in the clinical domain, although the training received gives them little more than marginal positions. This is the reason, above all, that psycho-sociology grew outside the universities in numerous practices and under heterogeneous denominations. Institutional pedagogy (F. and J. Oury, F. Tosquelles, F. Guattari), for instance, brought together psychiatry, pedagogy, education, nursing, and psychoanalysis to develop educative and therapeutic practices that question the relationship among the problems of pupils, the sick, and the functioning of institutions charged with taking care of them (Barus-Michel et al. 2002). Institutional analysis, under the initiative of R. Lourau and G. Lapassade, proposed to uncover the “blind spots” of research on institutional power, so as to struggle against repressive and alienating aspects. Jacques and Maria van Bockstaele et al. (1963) developed “socioanalysis,” a device designed to organize and analyze the social transfer of groups, or of individuals, invested in a project. Also, G. Mendel (Mendel and Prades 2002) founded a “sociopsychoanalytical” method of analyzing the mutual influence between social and individual psychic facts, including the unconscious, and a method of intervention to help groups reflect on the forces that influence their personalities. Didier Anzieu and René Kaës, at the Centre d’Études Françaises pour la Formation et la Recherche Active en Psychologie (CEFFRAP, French Center of Studies for Education and Action Research in Psychology), developed interventions in group psychoanalysis grounded on a group psychodramatic technique (Kaes and Didier 1976). They proposed the notion of group psychic tools, which give accounts of transversal psychic phenomena in groups and also in institutions.

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In 1969, Pagès founded and directed the Laboratoire de Changement Social (LCS, Social Change Research Center) at Paris 7 University. I succeeded Pagès as director (1980–2014), and we developed a significant research program that focused on the question of power in organizations—the relationship between transformations in managerial practice and its effects on employees in terms of stress, professional exhaustion, social harassment, and symptoms of depression. We conducted research in both state and private companies, and developed forms of socio-clinical intervention on the links between ongoing conflicts and organizational and economic contradictions that included the silent partners and workers. Furthermore, we set up groups for personal development and research using the biographical approach that allowed participants to analyze their family history and their social trajectory. Reflection on the links between the psychic and social aspects drove us, along with Pagès, to conceive of complex therapeutic devices. We practiced dialectical and pluridisciplinary analysis, which adopts multiple theoretical referents and varied methodological tools. The various orientations in universities are reflected by practitioners who intervene in different professional fields such as mental health, government, private firms, social work, education, maternal and child protection, delinquency prevention, and community-based organizations and associations. Even if the practitioners do not draw on both psychosociology and clinical sociology, they are all invigorated by the convergences of clinical measures analyzing interferences between psychic and social processes, the need for a pluridisciplinary approach combining psychoanalysis, social psychology, sociology and anthropology, and, finally, continuous reciprocity between research and intervention.

5.10

Conclusion

Clinical sociology in France stems from the different schools discussed here. In its more recent history, there is still much to be done. As an actor in this adventure, I leave the historical recording of my own contribution to others. I cannot but be a witness from my own path (Gaulejac 1997). When I completed La Névrose de Classe (Class Neurosis) in 1986 with the theme “for a clinical sociology”(Gaulejac 1987), I was not aware that others, such as Robert Sévigny in Canada and Jan Marie Fritz in the United States, were advocating the creation of a working group on this very topic in the International Sociological Association. When I transferred to Paris 7 in 1989, I rejoined Eugène Enriquez and I greeted Jacqueline Barus Michel after the closing of the Laboratoire de Psychologie Sociale Clinique (Laboratory of Social Clinical Psychology). The Laboratoire de Changement Social (LCS, Social Change Research Center) became a major pole of clinical sociology in France (Gaulejac 2007, 2020). We built an international network that grew rapidly in liaison with our colleagues in Quebec and the United States. The network had representation from Southern Europe (in Greece with Klimis Navridis; in Spain with Fernando de Yzaguirre; and in Italy with Michelina

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Tosi and Massimo Corsale), as well as from Turkey (with Verda Irtis, Iclal Incioglu and Metin Cevizci); Russia (with Igor Massalkov); and in Latin America. The Latin America participants included Elvia Taracena in Mexico; Norma Takeuti, Teresa Carreteiro, Christine Girard, Ana Massa, Fernando Gastal de Castro and Jose Newton in Brazil; Ana Maria Araujo in Uruguay; Marcela de Grande y Ana Correa in Argentina; and Patricia Guerrero, Francisca Marquez and Dariela Sharim in Chili. Since the first Clinical Sociology Conference in France in 1992, meetings have been organized on three continents providing occasions for numerous publications in French, Portuguese, and Spanish. Nowadays, we have expanded that network and it became, in 2015, le Réseau International de Sociologie Clinique (RISC) (the International Network of Clinical sociology) (RISC 2015) with the publication of a very important book, the Dictionnaire de Sociologie Clinique (Glossary of Clinical Sociology). This book is the result of an international intensive collaboration of more than a hundred contributors (Vandevelde-Rougale and Fugier 2019). The final part of our history remains to be written. Before being written, however, it first will be built and enlivened.

References Adorno, T., & Horkheimer, M. (1947). La dialectique de la raison [The dialectic of enlightenment]. Paris: Gallimard. Ancelin-Schützenberger, A. (2005). Eléments d’histoire de vie et choix théoriques [Elements of life history and theoretical choice]. In Parcours de Femmes, Collection Changement Social (pp. 159–235). Paris: L’Harmattan. Aron, R. (1983). Mémoires. Paris: Julliard. Assoun, P. L. (1987). l’École de Francfort [The Frankfurt School]. Paris: PUF. Barus-Michel, J. (2004). Souffrance, sens et croyance [Suffering, meaning, and faith]. RamonvilleSainte-Agne: Erès Barus-Michel, J., Enriquez, E., & Lévy, A. (Eds.) (2002). Vocabulaire de Psychosociologie [Glossary of psychosociology]. Ramonville-Sainte-Agne: Erès. Bastide, R. (1962). Sociologie et Psychologie [Sociology and psychology]. In G. Gurvitch (Ed.), Traité de Sociologie Génerale. Paris: PUF. Bataille, G. (1979). L’apprenti sorcier [The sorcerer’s apprentice]. In D. Hollier (Ed.), Le Collège de Sociologie (pp. 36–59). Paris: Gallimard. Caillois, R. (1979). Pour un collège de sociologie [For a college of sociology]. In D. Hollier (Ed.), Le Collège de Sociologie (pp. 29–35). Paris: Gallimard. Castoriadis, C. (1975). L’Institution Imaginaire de la Société [The imaginary institution of sociology]. Paris: Seuil. de Gaulejac, V. (1987/2014). La Névrose de Classe [Class neurosis]. Paris: Payot. de Gaulejac, V. (1997). S’autoriser à penser, Cahiers du Laboratoire de Changement Social (No. 2) [Dare to think, papers of the Social Change Research Center]. Paris: L’Harmattan. de Gaulejac, V. (2020). Dénouer les noeuds sociopsychiques (Untie the socio-psychic knots). Paris: Odile Jacob. de Gaulejac, V., & Roy, S. (Eds.). (1993). Sociologie Clinique [Clinical sociology]. Paris: Desclée de Brouwer.

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de Gaulejac, V., Hanique, F., & Roche, P. (Eds.). (2007). La Sociologie Clinique [Clinical sociology]. Toulouse: Éres. Durkheim, E. (1885). Éléments d’une Théorie Sociale [Elements of a social theory]. Paris: Editions de Minuit. Durkheim, E. (1912/2001). The elementary forms of religious Life (trans: Cosman, C.). Oxford: Oxford University Press. Durkheim, E. (1937/1981). Les Règles de la Méthode Sociologique [The rules of sociological method]. Paris: PUF Quadrige. Enriquez, E. (1993). L’approche clinique: genèse et développement en France et en Europe de l’Ouest [The clinical approach: genesis and development in France and Western Europe]. In V. de Gaulejac & S. Roy (Eds.), Sociologie Clinique (pp. 19–35). Paris: Desclée de Brouwer. Faucheux, C., & Moscovici, S. (1971). Psychologie Sociale Theorique et Experimentale. Recueil de Texts Choisis et Presentes [Theoretical and experimental social psychology]. La Haye: Mouton. Freud, S. (1921/1975). Psychologie Collective et Analyse du Moi [Group psychology and analysis of the ego] (trans: Jankélévitch, S.). Paris: Payot. Gurvitch, G. (1955a). Déterminismes sociaux et liberté Humaine [Social determinism and human liberty]. Paris: PUF. Gurvitch, G. (1955b). Dialectique et sociologie [Dialectic and sociology]. Paris: PUF. Hollier, D. (Ed.). (1979). Le Collège de Sociologie [The college of sociology]. Paris: Gallimard. Horkheimer, M., Ferry, L., & Renaut, A. (Eds.). (1978). Théorie Critique: Essais. Paris: Payot. Kaes, R., & Didier, A. (1976). Chronique d’un Groupe: le Groupe du Paradis Perdu Observation et Commentaires [History of a group: The group of lost paradise: Observation and commentaries]. Paris: Dunod. Lacan, J. (1956). Écrits [Written works]. Paris: Seuil. Lagache, D. (1949). L’Unité de la psychologie [The unity of psychology]. Paris: PUF. Levy, A. (1997). Sciences Cliniques, Organizations Sociales [Clinical sciences, social organizations]. Paris: PUF. Mauss, M. (1924/1968). Sociologie et Anthropologie [Sociology and anthropology]. Paris: PUF. Mendel, G., & Prades, J. (2002). Les Méthodes d’Intervention Psychosociologiques [Methods of psychosociology intervention]. Paris: La Découverte. Morin, E. (2001). Une Sociologie du Présent [A sociology of the present]. In Histoires de Vie et Choix Théoriques, Cahiers du Laboratoire de Changement Social (Vol. 6, pp. 39–81). Paris: L’Harmattan. Ohayon, A. (1999). L’Impossible Rencontre, Psychologie et Psychanalyse en France 1919–1969 [The impossible encounter; psychology and psychoanalysis in France 1919–1969]. Paris: La Découverte. Pagès, M. (1996). Le Travail d’Exister [Work to exist]. Paris: Desclée de Brouwer. Reich, W. (1970a). Matérialisme Dialectique, Matérialisme Historique et Psychanalyse [Dialectical materialism, historical materialism and psychoanalysis]. Paris: La Pensée Molle. Reich, W. (1970b). Psychologie de Masse du Fascisme [The mass psychology of facism]. Paris: La Pensée Molle. RISC. (2015). Website: https://www.sociologie-clinique.org/ (Languages: French, English, Spanish). Van Bockstaele, J., Van Bockstaele, M., Barrot, C, & Magny, C. (1963). Quelques Conditions d’une Intervention de Type Analytique et Sociologie [Some conditions of an analytical and sociological kind of intervention]. In L’Année Sociologique (pp. 238–262). Paris: PUF. Vandevelde-Rougale, A., & Fugier, P. (Eds.). (2019). Dictionnaire de sociologie clinique [Glossary of clinical sociology]. Toulouse: Éres.

Chapter 6

Clinical Sociology in Japan Yuji Noguchi and Hideyo Nakamura

6.1 6.1.1

History of Clinical Sociology in Japan Background

According to Jun Ayukawa (2000), while Japanese sociology was “established by introducing the works of H. Spencer and A. Comte. . ., [it was] mainly imported” from Germany before World War II. After the war, “there was wholesale importation of sociological theory from the United States without any regard to. . . the Japanese situation.” In the 1950s and 1960s, sociologists began to use social surveys and statistical analysis, and a lot of research was conducted using these methods, particularly in the fields of rural sociology, urban sociology, and sociology of the family. By the 1970s, structural-functional theory was mainstream and, in the 1980s, microsociological approaches such as symbolic interactionism and ethnomethodology were popular among younger sociologists. In the 1990s, postmodern philosophical theory and social constructionism had great influence. At the same time, some clinical problems in the mental health field (e.g., child abuse, domestic violence, and codependence) gradually attracted attention because Japan experienced an extraordinary number of crimes, accidents, and disasters. Some sociologists became interested then in doing research on these phenomena. The clinical perspective in Japanese sociology was born in this sociocultural context and, as Ayukawa (2000)

Y. Noguchi (*) Tokyo Gakugei University, Tokyo, Japan e-mail: [email protected] H. Nakamura Nihon University, Tokyo, Japan e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_6

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noted, by the late 1990s, young sociologists were interested in a number of areas including medical sociology and clinical sociology.

6.1.2

Before 1998

The history of clinical sociology in Japan is quite short. Clinical sociology was introduced in a continuing way in 1993, although it was mentioned before that time. For instance, Masayasu Kato (1954) wrote An Introduction to Clinical Sociology, which was inspired by psychoanalytic studies by Freud and neo-Freudians and social psychological developments in the United States (e.g., group dynamics, sociograms). Some 30 years later, Koji Kashikuma (1985) wrote Clinical Sociology of Juvenile Delinquency, a collection of articles, some of which were published previously in journals written for officers of reformatories or the court. The term clinical here may refer in general to approaches to dealing with delinquency, but no definition of clinical sociology is provided. Neither volume refers to the development of clinical sociology in the United States or any other country. At the annual meeting of the Japanese Society of Health and Medical Sociology in 1993, Yuji Noguchi introduced clinical sociology to Japan. This was done by discussing the contents of the Handbook of Clinical Sociology, a book written by the American authors Howard Rebach and John Bruhn (1991), referring particularly to the history of the field in the United States, the theories mentioned in the volume, and the potential applicability of this work to Japanese society. Until then, few Japanese sociologists had used the term clinical sociology, and, if they did, they only used it as a kind of rhetoric that meant sitting “beside patients” or “beside clients.” They had not illustrated the original framework of the concept and did not refer to the development of clinical sociology in the United States or other countries. The paper that resulted from the 1993 presentation was titled “Clinical Sociology: Its Methods and Implications” (Noguchi 1994) and it appeared in the Annual Review of Japanese Health and Medical Sociology the following year. This journal was not very well known at that time because its primary audience was medical or health sociologists. It was not until a few years later that many Japanese sociologists became aware of the concept of clinical sociology.

6.1.3

1998–2010

A special session, with the title “Clinical Sociology,” was held for the first time at the annual meeting of the Japan Sociological Society in 1998. The session was planned jointly by Eisho Ohmura, one of the foremost sociologists of religion in Japan, and Noguchi. Ohmura and Noguchi agreed on the necessity of clinical sociology in Japan for two reasons. First, many kinds of social problems are generated in the context of the Japanese social system, and require practical solutions from the

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sociological perspective. Second, a large number of sociologists analyze many different kinds of social problems in the Japanese academic context, but few had taken part in actual problem-solving processes. Ohmura and Noguchi thought both of these contexts required acknowledgement of the importance of sociological practice and particularly of clinical sociology. Ohmura and Noguchi held another session on clinical sociology at the annual meeting of the Japan Sociological Society in 1999. As the former session had focused on the theoretical dimension of clinical sociology, this one presented the actual experiences of sociologists working in Japan. Research was presented based on work in a wide range of settings: a general hospital, school classroom, halfway house for mentally disabled, nursing home for the elderly, and psychiatric hospital. Given the kinds of presentations mentioned here, readers may have the impression that clinical sociology in Japan looks like clinical social work in the United States. There is a good reason for this thinking. As clinical sociology has not been known in Japan, a sociology graduate who was oriented toward sociological practice had to take a formal role in clinical settings as a social worker, nurse, or some kind of therapist. The difference between clinical sociology and clinical social work is important. For instance, all the contributors to the 1999 session had specialized in sociology (not social work) in graduate school and, therefore, their different kinds of practice were all inspired by the sociological perspective. Until this session, their practice work had never been called clinical sociology. The introduction of the new terminology has since then allowed them to refer to their own practices as clinical sociology. The first textbook about clinical sociology to appear after 1993 was RinshoShakaigaku no Susume (Invitation to Clinical Sociology) written by Ohmura and Noguchi and published in 2000. This volume, based on the 1998 session on clinical sociology, focused on the theoretical framework of the field, and discussed a variety of subjects—psychotherapy, identity work, the problem family, school classrooms, child-rearing policies, regional policies, death, and religion. The material tended to argue the necessity of a clinical sociology rather than focus on the details of different kinds of practice. A second textbook, Rinsho-Shakaigaku wo Manabu Hito no Tameni (For the People Studying Clinical Sociology) by Ohmura was published that same year. This volume also focused on theoretical analyses rather than actual practices. The third textbook, Rinsho-Shakaigaku no Jissen (The Practice and Experience of Clinical Sociology) was edited by Noguchi and Ohmura and published in 2001. This volume was based on the second session in 1999, and all of the contributors were asked to introduce their own practices through a self-narrative style. It was expected that this style would inevitably require the contributors to focus on their own practice rather than on analysis. But it was a difficult challenge for the editors. Because sociologists are trained as scientists who analyze a matter from an objective point of view, they are not trained to write papers in such a subjective way. Some contributors said it seemed more like writing an essay rather than an article. Nonetheless, it was supposed that if an objective format had been adopted, no one would understand

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the uniqueness of clinical sociology. Thus, this style was indispensable for informing many other sociologists of the necessity for clinical sociology. Stimulated perhaps by the publications in the field, presentations including the term clinical sociology at academic conferences increased, and the number of people who introduce themselves as “clinical sociologists” also grew in Japan. Some interesting sociological practices were reported with the term clinical sociology. Tadashi Nakamura (2001), for instance, reported that he had managed a therapeutic group activity that was called a “men’s support room.” This group was for adult male batterers and it developed a unique educational program aimed at reorienting them and rethinking masculinity. Nakamura (2003) discussed the characteristics of his program as follows: Because men, in general, are located at the center of society, when they come to realize the constraints and antisocial behaviors as well as the power and privileges in their own gendered lives, their increased critical awareness and practices related to the construction of masculinity will, together with the efforts of women, engender the possibility for greater social change.

This program is based on the sociological perspective and understanding of the problems. Another example of sociological practice is an application of the reflecting process to a help line (telephone counseling service) for victims of child abuse (Yahara 2004). The reflecting process is a unique clinical method developed in the family therapy field (Andersen 1991). The uniqueness is derived from the role conversion between observers and observed persons. In a regular family therapy session, a client family may be observed by therapists through a one-way mirror. However, Tom Andersen and his colleagues added a reversal to this structure. In the first session, therapists take a normal role as observer, but in the second session, the role is reversed. The conversation then is observed and commented on by the client family. Following this, the roles continue to be reversed again and again. This structure has been called the “reflecting team” or “reflecting process.” Takayuki Yahara (2004) identified a sociological meaning of this process in relation to the concept of observation in Luhmann’s (1990) social system theory. Yahara introduced this idea into the helpline staff meeting and found that it was effective for the staff’s understanding (from a different point of view) of the clients’ problems, to promote mutual understanding among staff members, and to help reduce the staff members’ stress or pain. Some sociologists reconsidered the relationship between social pathology and clinical sociology (Hatanaka 2000; Hatanaka et al. 2004), and another discussed the problems of a psychologized society from the viewpoint of Lacanian psychoanalytic theory (Kashimura 2003). Moreover, the Japanese Journal of Addiction and Family published a special issue on the present and future of clinical sociology in Japan (e.g., Nakamura et al. 2004; Noguchi 2004).

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After 2010

Since 2010, the volume of clinical sociological research results based on interviews and fieldwork has been accumulating. This qualitative research is characterized by its focus on the narratives of those suffering illness and disability. It addresses topics such as peer support, eating disorders, families of pediatric cancer patients, congenital disease, and developmental disabilities. A special edition of the Japanese Journal of N: Narrative and Care, devoted mainly to the clinical sociology of narrative, was published in 2015 (Noguchi 2015). Hideyo Nakamura (2011) considered recovery narratives by examining interviews of people who have recovered from eating disorders. And Yasusuke Minami et al. (2018) presented a collection of peer-staff narratives by people working at facilities supporting recovery from drug addiction. Shining a light on the narratives of people directly affected by illness and disabilities is a major achievement of clinical sociology during this period. The clinical sociologists performing this research, it could be said, were interested in examining transformations in peoples’ narratives and examining recovery from illness and disability. Also, clinical sociologists have been working as practitioners in various areas, for example, juvenile justice. Mariko Inoue has published the book titled Family Violence and Community Intervention (2018). More recently, there has been a new development in clinical sociology in Japan. This is Noguchi’s (2018) focus on community. In the past, the narrative approach emphasized liberation from the dominant story causing suffering and obtaining an alternative story by which life is easier to negotiate. For this practice approach, there is a tendency to view social networks and communities as means for changing an individual’s narrative. However, it is not only changes in the narratives that emerge in clinical settings; new narrative communities develop through the sharing of narratives, as can be seen in self-help groups and some practices in the mental health field such as the open dialogue approach (Seikkula and Olson 2003), and these communities support people having mental health problems. Noguchi noticed this phenomenon and presented the new perspective of “achieving community through narrative (Noguchi 2018).” This has added a new perspective—one of obtaining a community through narrative—to the conventional argument for changing the narrative. Clinical sociological work certainly is increasing in Japan. However, in spite of these publications, the authors of this chapter think the number of clinical sociologists is still too small to establish an academic association devoted to this field. More actual results need to be accumulated to prove the effectiveness of clinical sociology and increase the number of sociologists involved in sociological practice.

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Theoretical Framework: Narrative Social Constructionist Approach

As already established, clinical sociology applies sociological theories to practical problem solving. Which theory should be adopted? It depends on the case or the practitioner’s orientation. Noguchi’s approach is characterized by social constructionism and the narrative approach. In Japan, the paradigm shift in social problem studies occurred in the early 1990s. During this time, Constructing Social Problems, written by Malcolm Spector and John Kitsuse and originally published in 1977, was translated into Japanese. It invited exciting debate in the academic arena in Japan in the same way it had in the United States (Holstein and Miller 1993). By the late 1990s, the study of social problems had mainly adopted the social constructionist method. Noguchi also was involved in the debate and expressed his views in some anthologies on social constructionism (Nakagawa et al. 2001; Ueno 2001). But his position was ambivalent. In actuality, he agreed with the argument that social problems were socially constructed through people’s everyday language activities. But he could not agree that such a study or analysis often nominally treated social problems and consequently neglected the victims’ reality or pain. At the same time, Noguchi was interested in the new movement occurring in the family therapy field. This movement is now called “narrative therapy” or a “narrative social constructionist approach.” At first it was difficult for Noguchi to understand because it was based on postmodern social and linguistic theories. After finding a particular book, however, he grasped the outline of the movement and its vision for sociological practice. The book was Therapy as Social Construction (McNamee and Gergen 1992). It was very exciting for him, and so with his colleague, Naoki Nomura, he eventually translated the book into Japanese and published it in 1997. One of the editors of Therapy as Social Construction is Kenneth Gergen, a famous social psychologist who has published many books including Realities and Relationships (1994) and An Invitation to Social Construction (1999). From Noguchi’s view, Gergen should be called a sociologist, rather than a social psychologist, as his theories are very sociological. For example, the title Therapy as Social Construction is extremely suggestive for clinical sociologists. If the therapy at the micro level can be considered as social construction, sociological practice at the macro level must be social construction too. This perspective largely helped Noguchi to dissolve his ambivalence caused by the debate within the study of social problems. Sociological practice is also social construction. Sociologists can analyze social problems, but they also can contribute to solving problems through social constructionism, because both the problem and solution are socially constructed. Noguchi had found his theoretical position. The theoretical premises of the narrative social constructionist approach can be formulated as follows (Noguchi 2002, 2005):

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1. Realities are socially constructed. 2. Realities are discursively constructed. 3. Discourses are organized by narratives. The first premise has been quite familiar to us since Peter Berger and Thomas Luckmann’s (1966) The Social Construction of Reality. The second and the third have not been fully elaborated in the sociological field. They are mainly originating from the linguistic turn in postmodern thought in recent years. These premises lead us to some epistemological changes and to the following questions: What discursive resources have constructed the realities of problems? How can we eliminate the present realities and reconstruct new realities through our discursive practices? These questions suggest a new direction for clinical sociology.

6.3

Case Presentations

The narrative social constructionist approach alters the stance and perspective of clinical sociologists, proposes new relationships among sociologists, clinicians, and clients, and contributes to constructing new clinical realities. The three cases below are examples of such new realities.

6.3.1

Case 1: Beteru no Ie (Group Home of Psychiatric Ex-patients)

In a small town beside the Pacific Ocean in Northern Japan, there is a group home for ex-patients of a psychiatric hospital. It is called Beteru no Ie (Bethel), which means the “House of God” in the Old Testament of the Bible. The facility houses about 150 people who are mentally disabled with psychiatric disorders such as schizophrenia, bipolar disorder, mental retardation, and alcohol dependence. The residents have gained a great deal of attention because of some of the home’s unique activities. They are now widely known to many academics and mental health professionals in Japan and they have been awarded prizes by professional organizations such as the Japanese Society of Psychiatry and Neurology and the Mainichi Newspapers (Urakawa Beteru no Ie 2002). One such unique activity is the Genkaku Mousou Taikai, which means the contest of delusions and hallucinations. The contest is held once a year and the champion is honored with the Best Delusion or Hallucination of the Year Award, with supportive laughter and humor. This is quite a fantastic and extraordinary idea for the tradition of the mental health professions. It has been supposed that a delusion or hallucination should not be public because it is not real and that it would not be formally accepted by the profession. But the contest radically challenged this commonsense attitude, and the patients obtained new realities that encouraged them in their lives.

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When Noguchi first heard about the contest, he was very surprised, not only because it was a fantastic idea, but also because he was familiar with a very similar idea in the field of family therapy that had been proposed by Michael White and David Epston (1990), famous narrative therapists in Australia. They formalized the method of externalization of problems. In the mental health field, problems are generally internalized in the clients as deficits. But this internalization often makes the problem difficult or severe and leaves the client debilitated. When the problems are externalized, the client becomes encouraged in the new reality that it is the problem that is bad, not the client. In this way, clients have changed their self-image from persons having inner deficits to persons who are bravely fighting an external opponent. Put differently, the problems are constructed by our everyday discursive practice. Therefore, if the discourse is changed, the problems can be changed too. Needless to say, this idea is derived from social constructionism. As Noguchi was surprised by the similarities between the Genkaku Mousou Taikai and narrative therapy, he told the staff of Beteru no Ie that he thought they had an excellent idea and he connected it to the externalization of problems, an idea that was drawing attention from around the world as an admired new method in the field of family therapy. They also were surprised with this coincidence and, since then, they began using the term externalization to explain their own activities. In this case, Noguchi may not be called a direct practitioner, but he has been called an indirect practitioner or co-practitioner. As a consultant or co-practitioner, Noguchi provided the staff members with a concept to understand the sociological meaning of their unique practice and encouraged their activities. On the other hand, he also has taken every chance to lecture many other clinical professionals about this topic; he has tried to publicize the significance of externalization of problems as a therapeutic tool proposed by clinical sociology. He sees this as one of his sociological practices.

6.3.2

Case 2: Reminiscence Board (for Elderly Patients with Dementia in a Geriatric Hospital)

Remembering past events or episodes has positive therapeutic effects for the elderly who have dementia. This method is called a reminiscence approach and has been adopted in many geriatric hospitals and nursing homes by psychologists and therapists. This case is one of those approaches, but it is unique in that it uses a display board, not just conversation with patients. A reminiscence board is the presentation of the important events or episodes in a patient’s life. A therapist asks a patient about memories of his/her younger days, negotiates whether it can be put on the display board or not, and then illustrates the patient’s life history on the board. The board is then placed at the patient’s bedside, open to everyone in the ward. This approach is closely connected with the narrative approach in that both of them consider life as narrative. One day, a student who planned to use the

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reminiscence approach with elderly patients who have dementia consulted Noguchi on the relationship between reminiscence and narrative. She also had been interested in the narrative approach and supposed that a reminiscence board might be a powerful tool for this approach. Noguchi agreed with her in two senses. First, the negotiation process between the therapist and patient is simply a social construction process. The self-narrative of the patient becomes more real through the social discursive process. In other words, words create worlds. Second, if the life history of the patient can be shared by many of the staff or patients in a ward, the patient may experience some changes. If so, this can be an example of the social construction of a new reality. Interestingly, the outcome that emerged was on an entirely unexpected level. Clear change was found in the staff rather than the patients. One of them said that the patient was, in fact, not a patient before coming here, that she had lived a long life and had ended up here. Another said that the patient had suffered from many troubles in her younger days, and that he hoped she was happy here. What does it mean that the staff changed? The reminiscence board made them aware that the patient possessed not only the symptoms of dementia that annoyed them, but also a unique and respectable past. The board constructed a new reality and changed the relationship between staff and clients (Ohshima 2003).

6.3.3

Case 3: Studies of a Clinical-Sociology-Based Narrative Approach (Recovery from Eating Disorders)

Clinical sociological research began to spread around 2010, and results from interview-based studies and fieldwork examining psychiatric and various other disorders making life difficult for individuals began to emerge. One example of this research is work carried out by Hideyo Nakamura (2011, 2012). In her research, Nakamura examined eating disorders and recovery from them. In Japan, anorexia and bulimia became problems mainly for young women in the latter half of the twentieth century. Researchers in the field of psychiatry and clinical psychology have searched for causes and therapies for eating disorders. However, recovery can be achieved in various ways, sometimes without medical treatment. And there is a need for clinical sociological approaches that can discern and address social factors in recovery. Through interview-based studies of 18 people who have recovered from eating disorders, H. Nakamura (2011, 2012) shed light on how people recover from eating disorders. Interview subjects spoke about various recovery realities that exist in society but are never talked about within the framework of medicine. Amid the spread of clinical sociological research, H. Nakamura (2011, 2013, 2014), in particular, relies on the narrative social constructionist approach (Noguchi 2002, 2005). She does this in focusing on the major effects various narratives in

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society have in exacerbating eating disorder symptoms and on the process of recovery. She found, for example, that the narrative that thin bodies are beautiful was driving women to engage in behaviors that developed into eating disorders. She also discovered mothers experiencing suffering caused by the narrative that eating disorders originate with mothers. These are narratives that cause people to suffer. But H. Nakamura also describes various narratives that led people to recovery. Examples include recoveries following the formation of a relationship with a boyfriend and relationships with fellow self-help group members. Recovery stories told by people who have recovered have the potential to lead people suffering from eating disorders to recovery. By shining a light on unnoticed recovery narratives, clinical sociological research can develop a new reality for recovery in society. Research that relies on the narrative social constructionist approach has the potential to contribute to the formation of new realities oriented toward individual liberation.

6.4

Clinical Sociologists as Co-constructors of Clinical Reality

As the first two cases presented here are indirect practice, you might wonder if this should be called clinical sociology. The authors think there are many ways to practice clinical sociology. In the first case, Noguchi located the sociological meaning of the practices and encouraged their activities by giving them the concept behind the practices. In the second case, Noguchi suggested a sociological outcome of the practice and encouraged the practitioner to try the new method. In both cases, Noguchi was not just an observer or adviser because he engaged in constructing new clinical realities jointly with the practitioners. This role should be called a co-constructor of the clinical reality. Sociologists can take on these kinds of roles in clinical settings through their discursive practices. In the third case, H. Nakamura worked with interviewees and documented previously unknown recovery stories. She also has determined that there are people who have achieved their own recoveries by reading these stories in book form. In performing this work, H. Nakamura functioned as not only a researcher but also as a co-constructor of recovery realities. She did this in two ways: first as a co-constructor with interviewees and second as a co-constructor with readers. These examples of sociological practice were inspired by social constructionism. As mentioned before, social constructionism tells us that social problems exist in the universe of discourse. If so, sociological discourse can help us to see social problems and give them reality. Of course, some discussions might have a major influence, while others would be minor. Every sociological discourse, including definition, analysis, interpretation, and discussion, contributes to some extent to the construction of social problems. Social constructionism is now one of the influential

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frameworks in Japanese sociology and clinical sociology has led this discussion by introducing a narrative social constructionist approach. This theoretical position changes the role of clinical sociologists in confronting social problems. They cannot stand and solve the problems at the objective point of view like a physician, but they can participate in the linguistic system constructed around the word problems and enlarge the universe of discourse on the problems (Anderson and Goolishian 1988). They can “open conversational spaces and thus increase the potential for the narrative development of new agency and personal freedom” (Anderson and Goolishian 1992). They can participate in the linguistic system not as advisers for problem solving, but as co-constructors of the reality. Social constructionism proposes a new approach to social problems, and clinical sociology can be considered one of the discursive practices for addressing social problems. From this point of view, whether a practice is good or not should be evaluated not by the correctness of assessment and intervention but by the power to enlarge the discourse of problems and change the socially constructed reality. It would be interesting to use this point of view to reexamine many sociological practices already completed and identify their discursive power in changing realities. Social constructionism is constructing a new reality of clinical sociology in Japan.

References Andersen, T. (1991). The reflecting team: Dialogues and dialogues about the dialogues. New York: W.W. Norton. Anderson, H., & Goolishian, H. (1988). Human systems as linguistic systems: Evolving ideas about the implications for theory and practice. Family Process, 27, 371–393. Anderson, H., & Goolishian, H. (1992). The client is the expert. In S. McNamee & K. J. Gergen (Eds.), Therapy as social construction. London: Sage. Ayukawa, J. (2000). The sociology of social problems in Japan. American Sociologist, 31(3), 15–26. Berger, P. L., & Luckmann, T. (1966). The social construction of reality: A treatise in the sociology of knowledge. New York: Doubleday. Gergen, K. J. (1994). Realities and relationships. Boston: Harvard University Press. Gergen, K. J. (1999). An invitation to social construction. London: Sage. Hatanaka, M. (Ed.). (2000). Rinsho-shakaigaku no tenkai [The development of clinical sociology]. Tokyo: Shibundo. Hatanaka, M., Hirose, T., & Shimizu, S. (2004). Shakai-byorigaku to rinsho- shakaigaku [Social pathology and clinical sociology]. Tokyo: Gakubunsha. Holstein, J. A., & Miller, G. (Eds.). (1993). Reconsidering social constructionism: Debates in social problems theory. New York: Aldine de Gruyter. Inoue, M. (2018). Famiri baiorensu to chiikishakai: Rinsho shakaigaku no siten kara [Family violence and community intervention]. Tokyo: Taga shobo. Kashikuma, K. (1985). Hikou no rinsho-skakaigaku [Clinical sociology of juvenile delinquency]. Tokyo: Kakiuchi-Shupan. Kashimura, A. (2003). Shinrigakuka suru shakai no rinsho-shakaigaku [Clinical sociology of the psychologized society]. Yokohama: Seori-Shobo. Kato, M. (1954). Rinsho-shakaigaku josetu [An introduction to clinical sociology]. Tokyo: ChudaiShupansha.

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Luhmann, N. (1990). Die wissenschaft der gesellschaft [Science of society]. Frankfurt: Suhrkamp Verlag. McNamee, S., & Gergen, K. J. (Eds.). (1992). Therapy as social construction. London: Sage. Minami, Y., Nakamura, H., & Sagara, S. (Eds.). (2018). Tojisha ga shien suru [Life histories of recovering staff of drug addiction rehabilitation centers]. Tokyo: Shumpu-Sha. Nakagawa, N., Kitazawa, T., & Doi, T. (Eds.). (2001). Shakaikochikushugi no supekutoramu [The spectrum of social constructionism]. Kyoto: Nakanishiya-Shupan. Nakamura, T. (2001). Domestikku baiorensu: Kazoku no byori [Domestic violence: Pathology of the family]. Tokyo: Sakuhinsha. Nakamura, T. (2003). Regendering Batterers. In J. E. Robertson & N. Suzuki (Eds.), Men and masculinities in contemporary Japan: Dislocating the salaryman doxa (pp. 162–179). London: Routledge Curzon. Nakamura, H. (2011). Sesshokushogai no katari: Kaifuku no rinsho-shakaigaku [Recovery from eating disorders]. Tokyo: Shinyosha. Nakamura, H. (2012). Overcoming bulimia nervosa: A qualitative study of recovery in Japan. Proceedings, 17, 101–109. Nakamura, H. (2013). Illness experiences and medical discourses: A case study about recovery from eating disorders in Japan. Komyunikeshon-Kiyo/Seijo communication studies, 24, 39–55. Nakamura, H. (2014). 2012 JSS award winner: Book division “recovery” from eating disorders: Narrative-based clinical sociology: A summary by the author. International Journal of Japanese Sociology, 23, 140–156. Nakamura, T., Ishikawa, Y., & Noguchi, Y. (2004). Zadankai: Rinshou-shakaigaku no kanousei [Discussion: Present and future of clinical sociology in Japan]. Adikushon to Kazoku/Journal of Addiction and Family, 20, 397–411. Noguchi, Y. (1994). Rinsho-shakaigaku no houhou to kanousei [Clinical sociology: Its methods and implications]. Hoken Iryou Shakaigaku Ronshu/Annual Review of Japanese Health and Medical Sociology, 5, 46–51. Noguchi, Y. (2002). Monogatari toshiteno kea [Caring as narrative]. Tokyo: Igaku-Shoin. Noguchi, Y. (2004). Rinsho-shakaigaku no kanousei: Tokushu ni atate [Foreword: Present and future of clinical sociology in Japan]. Adikushon to Kazoku/Journal of Addiction and Family, 20, 355. Noguchi, Y. (2005). Naratibu no rinsho-shakaigaku [Narrative based clinical sociology]. Tokyo: Keiso-Shobo. Noguchi, Y. (2015). Tokushu ni atatte: Naratibu no rinsho-shakaigaku [Introduction to special issue: Narrative based clinical sociology]. N: Naratibu to Kea/Japanese Journal of N: Narrative and Care, 6, 2–4. Noguchi, Y. (2018). Naratibu to kyodosei [Narrative and community]. Tokyo: Seidosha. Noguchi, Y., & Ohmura, E. (Eds.). (2001). Rinsho-shakaigaku no jissen [The practice and experience of clinical sociology]. Tokyo: Yuhikaku. Ohmura, E. (Ed.). (2000). Rinsho-shakaigaku wo manabu hito no tameni [For the people studying clinical sociology]. Kyoto: Sekaishisousha. Ohmura, E., & Noguchi, Y. (Eds.). (2000). Rinsho-shakaigaku no susume [Introduction to clinical sociology]. Tokyo: Yuhikaku. Ohshima, M. (2003). Chihosei-koreisha heno naratibu apurochi [A narrative approach to elderly people with dementia: Working with elderly people with reminiscence board]. Kango Kenkyu/ Japanese Journal of Nursing Research, 36(5), 73–82. Rebach, H. M., & Bruhn, J. G. (Eds.). (1991). Handbook of clinical sociology. New York: Plenum. Seikkula, J., & Olson, M. E. (2003). The open dialogue approach to acute psychosis: Its poetics and micropolitics. Family Process, 42(3), 403–418. Spector, M., & Kitsuse, J. I. (1977). Constructing social problems. London: Routledge. Japanese edition: Spector, M., & Kitsuse, J. I. (1990). Shakai-mondai no kochiku (trans: Murakami, N, Nakagawa, N., Ayukawa, J., & Mori S.). Tokyo: Maruju-Sha.

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Ueno, C. (Ed.). (2001). Kochikushugi towa nanika [What is constructionism?]. Tokyo: KesoShobo. Urakawa Beteru no Ie. (2002). Beteru no ie no hi-enjoron [Not-helping in beteru no ie]. Tokyo: Igaku-Shoin. White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton. Yahara, T. (2004). Chairudorain ni okeru rihurekutingu-purosesu no ouyou [Application of the reflecting process to child line]. Adikushon to Kazoku/Journal of Addiction and Family, 20, 388–396.

Chapter 7

The Emergence of Clinical Sociology in South Africa Tina Uys

7.1

Introduction

This chapter starts with an overview of the development of sociology as a discipline in South Africa. From its outset in the early twentieth century, the newly established discipline of sociology in South Africa engaged with societal issues and problems, while being fractured into various traditions from the start. The decisions on who benefitted from these interventions were intertwined with the relations of power within the society at the time. Various socio-political factors created the climate and structures before or at the time of its inception that led to this fracturing of the discipline. The Anglo-Boer War (1899–1902) had brought about massive devastation, social dislocation and impoverishment of both the Afrikaner (Boer) and black African population. Over 9000 Boer soldiers were killed and an estimated 26,000 Boer women and children and more than 12,000 black Africans lost their lives in British concentration camps. The War had a catastrophic impact on the lives of black people, as In addition to the thousands who died in the concentration camps, innumerable black Africans were caught up in the sieges, lost their jobs (for example, when the gold mines were closed down during the conflict) or were evicted from their land in areas overrun by war. (Encyclopaedia Brittanica 2019)

Black people were almost completely dependent on whites for employment. Those working on the mines were exploited and had to endure appalling living conditions in the compounds. The feelings of betrayal among black elites when Britain reneged on its promise of some form of political rights for black people laid the groundwork for the establishment of the African National Congress in 1912. T. Uys (*) University of Johannesburg, Johannesburg, South Africa e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_7

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Kitchener’s scorched earth policy resulted in the destruction of 30,000 Boer homesteads, including the livestock and crops. The resentment and bitterness felt by the defeated Boers in the aftermath of the War, as well as with regard to policies followed by the British after the annexation of the two Boer republics after the war, took place in a context characterized by enormous social dislocation negatively impacting relations between the English and Afrikaans1 communities for many decades to come (Encyclopaedia Brittanica 2019; Gillings 2008). With this as the context, this chapter considers the contributions of various scholar-practitioners who played a role in establishing the field of clinical sociology within South Africa. It concludes by discussing curricular trends in sociology departments in South African universities, particularly the emergence of clinical sociology as a specialized field in the discipline.

7.2

The Development of Sociology as a Discipline in South Africa

The genesis of South African sociology can be traced to the founding of the Association for the Advancement of Science in South Africa in 1903. At its first annual congress a paper on the sociology of August Comte introduced several ideas which were addressed by a number of speakers at subsequent conferences, leading to a call to establish sociology as a discipline at university level (Groenewald 1984, p. 156; Jubber 2007, p. 528). The first university courses in sociology were introduced by the University of South Africa in 1919, followed by the University of Cape Town in 1926; both courses were taught by departments of social anthropology (Groenewald 1984, pp. 157–159; Jubber 1983, p. 52). The impetus for the introduction of sociology as a discipline in South African university curricula largely lay in the desire to find solutions to several pressing social problems. The already high levels of poverty by the end of the nineteenth century were exacerbated by the destruction of property2 during the Anglo-Boer War of 1899–1902, and the extended agricultural depression and widespread unemployment among skilled artisans in South Africa that followed the First World War (Peterson 1966, pp. 34–35; Terreblanche 2002, pp. 267–8). The value of sociology was given a particular boost by the appointment of two American sociologists by the

1 Afrikaans evolved in southern Africa during the nineteenth century as a simplified, creolized version of Dutch ‘mixed with seafarer variants of Malay, Portuguese, Indonesian and the indigenous Khoekhoe and San languages’ (Willemse 2017, p. 1). Initially denigrated as a ‘kombuistaal’ (kitchen language), from the turn of the twentieth century it was increasingly purged of its proletarian roots and claimed by white Afrikaans speakers to form the basis for the promotion of Afrikaner nationalism. It replaced Dutch as one of South Africa’s two official languages in 1925. (The other was English) (Steyn 2016, p. 482). 2 According to Terreblanche (2002: p. 45) an estimated ‘60% of the assets of Afrikaners in the Transvaal and OFS—i.e., houses, furniture and livestock—were destroyed’.

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Carnegie Corporation of New York to investigate the so-called ‘poor white problem’ (Jubber 2007, p. 529). The report of the Carnegie Commission on the Poor White Question, published in 1932, is considered to be ‘the first important stimulus to the development of sociology in South Africa’ (Pauw 1958, p. 1095). The Carnegie investigation’s recognition of the importance of sociology in providing solutions to social problems contributed to a growing awareness of the value of sociological insights and research (Groenewald 1984, pp. 411–412). The general view that teaching sociology was an essential component of the training of social workers resulted in the establishment of a number of departments of Sociology and Social Work in the 1930s: the University of Stellenbosch (1933), the University of Pretoria (1934), the University of Cape Town (1936) and the University of the Witwatersrand in Johannesburg (1937) (Groenewald 1984, pp. 401–402; Pollak 1968, pp. 14–15). The sociological research conducted during this period was applied with the main focus on poverty, rapid urbanization, unemployment, race relations, and social pathologies such as alcoholism, crime and prostitution (Jubber 1983, p. 52; Pauw 1958, p. 1095; Peterson 1966, p. 35).

7.2.1

Main Figures in the Early Development of Sociology

Four main figures3 dominated the early years of establishing sociology as a discipline in South Africa. While all four viewed the main aim of sociology as finding solutions to persistent societal problems, in particular poverty, they employed different approaches. In 1932, Hendrik Verwoerd was appointed as the first professor of sociology and social work at the University of Stellenbosch. In his view, solving the social problems of the day required a welfare society with a focus on reform through social work. With no formal training in sociology, his background as a psychologist led him to seek solutions to problems of poverty in an analysis of The fact that the main figures were all white men is a reflection of the segregated and patriarchal nature of South African society at the time and the differential opportunity structures available to women and black people. Initially higher education was mainly available to black students through the University of Fort Hare, established as the South African Native College in 1916, which only started teaching sociology in 1962 (Pollak 1968, p. 14). Prominent black scholars at Fort Hare were Davidson Don Tengo Jabavu (1885–1959), who became the first black professor in African languages and ZK Matthews (1901–1968) who was appointed a lecturer in social anthropology in 1936. In 1936 Benedict Wallet Vilakazi (1906–1947) became the first black South African to teach white South Africans at the university level when he was appointed as a lecturer in the Bantu studies department at the University of the Witwatersrand. He was also the first black South African to receive a PhD in 1946. Charlotte Makgomo Maxeke (1871–1939), a South African religious leader, and social and political activist, was the first black South African woman to graduate with a university degree, which she received from Wilberforce University Ohio in 1901, where she studied under W.E.B. Dubois. Some prominent organic intellectuals were Tiyo Soga (1829–1871) who was the first black South African to be ordained, Sol Plaatjie, (1876–1932), author of Native Life in South Africa, published in 1916, and Olive Schreiner (1855–1920), a feminist and socialist writer and social theorist, who published Women and Labour in 1911. 3

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individual behavior (Miller 1993, pp. 640–641). After leaving academia to become the chief editor of Die Transvaler in 1937, and especially when becoming involved in politics from 1948, he played a pivotal role in the expansion and legitimization of the ideology of apartheid. The writings of Geoffrey Cronjé, the first professor of sociology at the University of Pretoria, and the only one of the four founders of South African sociology who had a doctorate in sociology (from the University of Amsterdam, Holland), focused mainly on family life, family pathologies and social welfare, with a particular interest in the white Afrikaner. Cronjé played an important role in the introduction of applied sociology and the eventual establishment of a department of criminology (Jubber 2007, p. 530). Edward Batson was appointed as the Social Science Chair at the University of Cape Town in 1935. His training was in economics at the London School of Economics. He employed a social economy lens to address issues related to poverty, and emphasized the need for societal reform through a focus on the structural causes of poverty, and its social consequences (Groenewald 1984, pp. 325–331, 337–338). By conducting the first all-encompassing social survey of Cape Town using sampling theory and developing the first South African poverty datum line formulations, Batson ‘highlighted sociology’s role as the discipline that would provide the tools to identify areas needing social relief, and to provide such welfare’ (Ally et al. 2003, p. 79). J. L. Gray, the first head of department and professor of sociology at the University of the Witwatersrand in Johannesburg, argued in his inaugural lecture in 1937 that race relations and the living conditions of black people were the most urgent South African societal problems. He proposed the use of comparative sociology in studying inequality between black and white with regard to wealth and levels of development and coming up with ‘alternative solutions to the problem’ (Hare and Savage 1979, p. 344; Groenewald 1984, pp. 283–284, 336–338). During the 1950s and 1960s the ties between sociology and social work were gradually relaxed, and by the end of the sixties the discipline of sociology was hosted in separate departments of sociology. S.P. Cilliers from the University of Stellenbosch played a major role in this process. As a student of Talcott Parsons he was also instrumental in facilitating the adoption of structural functionalism as the dominant paradigm in South African sociology (Jubber 2007, p. 531).

7.2.2

Apartheid and Sociology

The National Party victory in the 1948 parliamentary elections on an apartheid4 platform ushered in a period of intensified institutionalization, expansion and

4 Apartheid was a formal policy of institutionalized racial segregation adopted by the South African government after the National Party victory during the 1948 general elections.

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consolidation of apartheid policies and practices, including an increasingly comprehensive system of racist legislation (Terreblanche 2002, pp. 297–306). Between 1945 and 1948 Cronjé produced four publications in which he provided a justification for the South African government’s apartheid policies, which various commentators viewed as ‘the most articulate and comprehensive theoretical statement in support of Apartheid’, and also that these publications ‘played a major role in arming the agents of Apartheid with the concepts and arguments they needed to make Apartheid a reality’ (Jubber 2007, p. 530). The ultimate aim was to achieve complete separation of the various ‘population’ groups into separate socio-economic units. The promulgation of the Extension of University Education Act of 1959 exacerbated the cleavages5 already existing between the Afrikaans-medium6 and Englishmedium universities. This Act provided for separate universities for the various ethnic groups in South Africa and prevented black students from registering at ‘white’ universities without permission from the relevant Cabinet Minister (Hare and Savage 1979, p. 331). While Coloreds, (people of mixed race) and Asians found it relatively easy to obtain the ministerial permit, black African applicants found it significantly more difficult. As late as 1983 (the year in which the permit system was scrapped) only 36.6% of black applicants were granted permission to study at a white university, compared to 78.8% of Asian applicants and 91.5% of Colored applicants (The Ratcatcher 2012, p. 4). The Afrikaans-medium universities justified this legislation as a means of providing to the black people of South Africa the same opportunity to have their own universities ‘for the full maturation of a group culture and for helping the group to attain a better life’ (Viljoen 1977, p. 184). The two ‘open’ English-medium universities (Witwatersrand and Cape Town) saw the legislation as an infringement of their academic freedom and continued to allow access to black students without applying for the permit required by the legislation.7 By the mid-1980s the discipline of sociology was firmly established at the university level, with 20 South African universities offering sociology. Unfortunately, the divisions engendered by the apartheid historical forces also were reflected

5

See Welsh and Savage (1977) for the origins and unfolding of these cleavages, with the Afrikaansmedium universities viewed as strongholds for the mobilization of Afrikaner nationalism and the English-medium universities as rooted in British imperialism. These divisions were largely a perpetuation of the resentments and the breakdown in relationships as a result of the Anglo Boer war. 6 The nine South African universities at this stage were divided into four Afrikaans universities (Pretoria, Stellenbosch, Orange Free State and Potchefstroom), four English (Cape Town, Witwatersrand, Rhodes and Natal) and one bilingual (University of South Africa) which is a distance education institution. Although the University of Fort Hare was established as the South African Native College in 1916, it was only declared an institution for higher education in 1923 and students were awarded University of South Africa degrees until 1970. It only started teaching sociology in 1962 (Pollak 1968, p. 14). 7 Even before 1959 this access was for academic purposes only and did not allow any social or non-academic racial integration. See Welsh and Savage (1977, pp. 138–140) for a discussion of the restricted nature of the inclusion of black students at the open universities.

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in higher education. From the 1960s, an ‘intellectual and political fissure’ opened up between the largely liberal English-medium universities and ‘their more conservative Afrikaner counterparts’ (Jansen 1991, p. 19). These divisions also were reflected in the sociological associations that were formed in the late 1960s and early 1970s. The first to be established was SASOV (the South African Sociological Association). The inclusion of a clause restricting membership of the organization to whites only, led to the three drafters of its constitution (Edward Batson from the University of Cape Town, S. P. Cilliers from Stellenbosch and O. J. M. Wagner from the Witwatersrand) withdrawing from the organization before its first congress was held in 1968 in Bloemfontein. While this clause was scrapped in 1977 in the context of then President Vorster’s détente with neighboring countries,8 the reluctance of many Afrikaner academics to challenge the prescriptions for association and operation set by the apartheid government, led to an increasing polarization between the Afrikaans- and Englishmedium campuses (Grundlingh 1994, pp. 56–57). The formation of the Association for Sociology in Southern Africa (ASSA) in 1970 in Mozambique as a regional association that welcomed social scientists in general and was open to all regardless of color, provided a home to those sociologists who did not want to associate with SASOV. However, in the early years of its existence ASSA did not have ‘a clearly defined oppositional identity’ (Grundlingh 1994, p. 59). In his 1976 ASSA presidential address, Marshall Murphree argued that Southern African social scientists were ‘cognitively conforming’ rather than ‘cognitively radical’ and made a call for a search for ‘new theoretical perspectives that were indigenous to Africa’ (Grundlingh 1994, p. 61). It was in response to the dramatic changes that followed after the Soweto uprising of June 19769 that ASSA started to develop a more critical sociology that unequivocally opposed state repression (Grundlingh 1994, pp. 62–65). The field of industrial sociology moved away from a focus on management studies to a concentration on labor process and trade unionism. Other areas of sociology also were affected by the activities of social movements. As sociologist Eddie Webster (1991, p. 72) explained: “The sociology of education has been influenced by the students uprisings of 1976 and the militant student movement, urban sociology by the emergence of urban social movements and medical sociology by the emergence of organisations struggling for a better health system.” A number of South African sociologists, especially those based at the Afrikaans– medium universities, became actively involved in research focused on the successful

8

Vorster’s policy of détente entailed an attempt to ease hostilities through negotiations with various African leaders aimed at establishing diplomatic relations with countries on the African continent. 9 The Soweto uprising commenced on the morning of June 16, 1976 as black high school students in Soweto arose in protest to the government decree that compelled all black schools to use Afrikaans as a medium of instruction in 50% of the subjects offered (Hare and Savage 1979, p. 332).

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implementation of apartheid policies (Jubber 2007, p. 531). A blatant example of collusion between Afrikaans-speaking sociologists and the apartheid state to subvert sociological research was exposed by the revelations surrounding the Information scandal in 1977. Nic Rhoodie, head of a University of Pretoria sociological institute, had received covert research funding through one of the secret projects of the South African Department of Information to produce research publications promoting the public image of the apartheid government (Savage 1981, p. 52). While the Afrikaans-medium universities were increasingly seen as providing the ‘intellectual scaffolding for the justification, pursuit and extension of apartheid policies’,10 the English-medium universities were ambivalently positioned in producing a liberal or critical scholarship on apartheid, without alienating big capital, which provided them with substantial research funding, such as the Anglo American Corporation (Jansen 1991, pp. 24–25; Taylor 1991, pp. 34–35). Rifts were also apparent in the relations between the white universities and the so-called ‘tribal’ or ‘ethnic’ universities. The white English universities especially tended to refer disparagingly to these universities as ‘bush colleges’, staffed by the ‘most reactionary products of the established Afrikaans-medium universities’ (Balintulo 1981, p. 149). Hare and Savage state bluntly that ‘[a] substantial number of these [white] staff have low qualifications and would find it difficult to obtain an equivalent post in a ‘white’ university’ (1979, p. 332). As creations of the apartheid government they were viewed as instruments in the ‘maintenance of the overall apartheid socio-political agenda’ (Bunting 2002, p. 74), aimed at providing an education to black students that would ‘systematically but subtly . . . indoctrinate them in their own inferiority’ and also fragment and ‘weaken their collective resistance’ (Balintulo 1981, p. 147). In contrast to these views, and in spite of state repression, the crisis of legitimacy at the black universities was expressed in high levels of student activism and resistance, such that protest activities, and the presence of the police and the military became permanent features of many of these campuses (Taylor 1991, pp. 32–33). Doug Hindson, ASSA President (1989–1990) argued that . . .some of ASSA’s most vocal opponents of apartheid come from the black campuses, where some have faced expulsions and deportations for their attempts to transform these universities into more democratic, community oriented institutions. (Hindson 1989, p. 71)

The black campuses played an important role in popularizing sociology—especially during the 1970 and 1980s as sociology made sense because of its focus on social change and intervention. From the late 1960s and early 1970s the black universities actively started challenging the apartheid state through their alignment with the Black Consciousness Movement (BCM). Simultaneously the BCM rejected a role for either liberal or radical white intellectuals in the liberation struggle. This experience of a double marginalization, from both white radical black politics, and an increasing sense of

10

See Taylor (1989, p. 66) and Uys (2010, p. 241) for some exceptions to this trend.

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intellectual irrelevance, created the ideal conditions for the development of Marxist sociology in the white English-language universities (Ally 2005, p. 79; Jubber 1983, pp. 61–62; Webster 1985, p. 45). In the 1970s and 1980s the state imposed various restraints on researchers in the social sciences. This included the banning of publications considered subversive, the banning of sociologists such as Fatima Meer and Jack Simons, the deportation of Marxist sociologist Herbert Vilakazi from the Transkei11 on the insistence of the South African government, restrictions on access to places and people, and the unstated but nonetheless clear indications that certain research topics were taboo (Hare and Savage 1979, pp. 347–349; Webster 1985, p. 47). The members of SASOV generally responded to these events by withdrawing ‘themselves in their departmental ivory towers and . . .leaving it to others to determine the socio-political developments in South Africa’ (Oosthuizen 1981, p. 35; own translation). Within the ranks of ASSA, sociologists debated whether committed scholarship and critical engagement necessarily required taking an overtly political stance (Grundlingh 1994, pp. 66–67). Ken Jubber (2006, p. 338) referred to the negative impact of “a narrow, almost straight jacket vision of ‘relevance’ and ‘progressive’ which, while it served the liberation project, also caused curriculum, professional and personal damage”. The release of Nelson Mandela and the unbanning of the African National Congress and the South African Communist Party at the beginning of 1990 as a precursor to a negotiated settlement, paved the way for the reintegration of South Africa into the international community. Especially since the 1980s South African academics had been subject to an academic boycott, and exclusion from international associations. The International Sociological Association (ISA) was not prepared to approve collective membership for two associations for South Africa. This facilitated discussions between the two organizations with regard to a possible merger, which came to fruition with the establishment of the South African Sociological Association (SASA) in 1993, one year before the first democratic national elections took place in 1994 (James 1993, p. 115).

7.2.3

Post-apartheid Sociology

Since 1994 higher education in South Africa has been undergoing some dramatic changes in the attempt to balance the competing goals of promoting social equity and redress, on the one hand, and higher education of high quality on the other (Badat 2009, pp. 461–462). A restructuring of the higher education landscape through a

11 In line with apartheid policy four of the South African homelands reserved for occupation by a particular black ethnic group—Transkei, Bophuthatswana, Venda, and Ciskei (the so-called “TBVC States”), were declared independent by the Government of South Africa but their independence was not recognized internationally or by the anti-apartheid forces in South Africa.

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series of mergers and closures of higher education institutions (HEIs) reduced the total number of HEIs from 36 to 26 (including three universities established since 2013) (Mzwangwa and Dede 2019, p. 11). This reduced the number of universities offering sociology programs to 16. However, despite this decline, in general the number of sociology students have increased exponentially across the university sector since 1994. As an example the Department of Sociology at the University of Johannesburg has grown from about 400 undergraduate and 20 postgraduate students in 1994 to a student complement of about 2000 undergraduate and 143 postgraduate students (which includes 53 doctoral students) in 2020. A similar expansion is evident at other sociology departments. SASA is operating on a solid footing with a substantial membership being maintained, its annual congresses well-attended and its journal South African Review of Sociology having international standing. In 2006 it hosted the International Sociological Association World Congress in Durban, KwaZulu-Natal. Initially after the first democratic elections in 1994, emphasis was placed on the shortage of critical skills in the science, engineering and technology fields (SET). Through the intervention of sociologists such as Dr. Ari Sitas the important role of the humanities and social sciences in promoting equity, justice and social responsibility was placed on the agenda. This culminated in the establishment of the National Institute for the Humanities and Social Sciences (NIHSS) in 2013 with the mandate ‘to broadly enhance and support the HSS in South Africa and beyond, as well as to advise government and civil society on HSS related matters’ (NIHSS Brochure, n. d.). South African sociologists are actively involved in making the new democratic state work. A number of them have worked in the administrative division of the Independent Electoral Commission to ensure the smooth running of the first democratic elections in 1994. Janis Grobbelaar was the Information Manager of the South African Truth and Reconciliation Commission, the first of its kind globally with the mandate of achieving restorative justice through public hearings where victims seeking restitution, and perpetrators seeking amnesty could provide testimony about crimes relating to human rights violations.

7.3

Clinical Sociology in South Africa

While South African sociologists only became familiar with the field of clinical sociology during the early years of the new millennium, it could be argued that, since sociology’s inception, a large portion of sociological work in South Africa belonged to this field. It is evident from the initial focus of sociology as a service discipline, concentrating on finding solutions to social problems such as poverty, social pathologies, and unemployment, and providing training to social work students (Jubber 2007, p. 530; Webster 1985, p. 45). Oloyede (2006, p. 346) considers the early success of sociology as due to “its use as heuristic device and ‘tool’ for social engineering”. Sociology’s impact on government policies was reflected in the

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number of sociologists appointed between the 1930s and 1950s to manage statefunded research institutes. Webster classified the early years of South African sociology, with its focus on serving “the limited concerns of a client—welfare agencies, or the broader concerns of a patron—the government” as having “a strong policy orientation” (Webster 2004, p. 28). The 1950s and 1960s were characterized by the development of a professional sociology with the introduction of Parsonian structural functionalism and the establishment of a national and a regional sociological association. During the late 1970s, a critical sociology emerged through the adoption of a Marxist sociology in some sociology departments and among some members of ASSA. In his 1984 presidential address Webster (1985, p. 47) argued for a sociology that takes “a critical view of social arrangements, by its disclosure of inequality, forms of domination, ideological misrepresentations and their sources. . .”. Webster (2004, pp. 30–31) viewed the 1980s as a high point for the establishment of an engaged public sociology with the development of “a rich and vibrant sociological community in close dialogue with the new social movements struggling against apartheid” (2004, p. 30). It was within this context that sociologists moved closer to the ethos of a clinical sociology in service of the broader society. For instance, in 1984 a report on the second Carnegie Commission of Enquiry was released, this time with the focus predominantly on poverty in the black community (Francis and Webster 2019, p. 789). The transition to a democratic South Africa after 1994 led to many of the former counter-publics becoming absorbed into government structures, accompanied by structural changes to higher education institutions with the aim of promoting “global technological and economic competitiveness” and an increasing demand for “more technical policy-oriented research”. Webster viewed these changes as eroding critical and public sociology in favor of a more instrumental approach to knowledge and sociologists yielding to the attraction of consultancy work. What are the implications of these trends for clinical sociology in South Africa? Clinical sociology’s focus on serving the needs of clients may create the perception that it only is about accountability to a client, whether the private sector or the state. In a study of South African sociology conducted in 1966 American sociologist Richard Petersen (1966, p. 37) argued that the clients of sociological research “tend to support research which will have more or less direct payoff for social planning”. He also stated that “sponsored research is focused on technical questions of administration, “the engineering of solutions” rather than the “clinical” examination of problems in their context” and furthermore that “clients give little encouragement to pursue questions at a more sophisticated conceptual level or to pursue comparative analyses which might raise larger policy questions”. As early as 2004, Eddie Webster (2004, p. 35) warned against the inclination of South African sociologists to become more instrumental in their approach to knowledge in response to the democratic government’s demands “for more technical policy-oriented research”. The critical lesson for clinical sociologists is that the tendency towards policy recommendations in service of the bureaucrats should be

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balanced against the normative presumption that policies should be devised to the advantage of those who are affected by the interventions. Two years later, Jacklyn Cock (2006, p. 305) warned against the tendency to want to bypass the state in finding solutions to urgent social problems through “an implicit suspicion of the state as a threat, as a source of authoritarian, impersonal, bureaucratic power”, and emphasized the state as an essential source of the provision of resources and rights in the fight to meet the needs of the poor. Cock also argued convincingly that “the ‘client’ could be the vulnerable, the dispossessed, and the marginalised, who need the expert knowledge of policy sociology to help devise solutions and formulate demands that meet their needs”. She stressed the importance of South African sociology in producing collective, participatory research that is “empowering; . . .can build analytical capacity, consolidate alliances, generate new forms of solidarity, and contribute to meaningful change”. This implicit clinical sociology emphasis is apparent in Michael Burawoy’s depiction of South African sociology as “quite distinctive in the way it has combined public engagement, principled intervention, and theoretical exploration” (2009, p. 224). Fred Hendricks (2006, p. 96), a former president of SASA, demonstrated the important role that sociology should “play in making the world a better place” by arguing: Our relevance as a discipline depends not only on our ability to rationally interpret the world but also on the extent to which we may have an impact on the processes of eliminating poverty, disease and ignorance as well as on how much we can contribute to the difficult transition from subjection to citizenship in South Africa and further afield.

Hendricks continues by saying “This is the social landscape which confronts us and it is both professionally and morally incumbent on us to assist in reshaping it”.

7.4

Scholar-Practitioner Contributions Towards Establishing Clinical Sociology as a Field Within South African Sociology

While a relatively small number of South African sociologists currently identify themselves explicitly as clinical sociologists, a scrutiny of the work of many reveals a strong alignment with the core values of clinical sociology. This entails a body of knowledge and intellectual endeavor devoted to understanding and explaining social relations and social behavior that enables us to suggest solutions to social problems. The clinical sociology contributions of a number of these scholars began with their engagement in the liberation struggles during apartheid and in the reconstruction of South Africa post-apartheid. As a Marxist labor scholar Harold Wolpe’s (1926–1996) most influential theoretical contribution was through the formulation of his cheap labor thesis, which “emphasized the role of migrant labour, pass laws and influx control as the means used by the state to continue to ensure cheap labour under apartheid” (Lichtenstein

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2015, p. 598). He believed strongly in the importance of doing more than just theorizing through finding ways to apply theory to the practice of reconstruction.12 This is especially evident in his efforts to expand a framework for the reconstruction of South African higher education that he started to develop prior to his return to South Africa in 1991 and his defense of . . .the ongoing struggle for ‘people’s education’—a schooling that would eliminate ignorance and illiteracy, cultivate an understanding of apartheid and all its oppressions and inequalities, that would counter competitive individualism with collective organization, that would equip people with the capacity to realize their potential. (Burawoy, 2004 p. 668)

Fatima Meer (1928–2010), a South African Indian activist, was the first black woman appointed as a lecturer at a white university in South Africa, when she was appointed as a sociology lecturer in 1956. She was also the only banned person who was ever permitted to teach at any South African educational institution (South African History Online 2019). Throughout her academic career, and even after she retired as a Full Professor from the University of Natal in 1988, “her scholarly work championed the pressing social issues of the day and added ammunition to ongoing struggles on the ground” (Desai 2010, p. 121). A large part of her sociological enquiry was devoted to exploring how the agency of black women workers were impacted by apartheid, capitalism and patriarchy. She was one of the founders of the Institute of Black Research in 1972, which she used as a vehicle for disseminating her academic work, her writings and her activities as a community activist both during and post-apartheid (Desai 2010, p. 123; South African History Online 2019). Hendrik van der Merwe (1929–2001) was another scholar-practitioner born at the end of the 1920s, who pioneered conflict resolution and mediation13 in South Africa. He was instrumental in arranging a meeting between nationalist/ pro-apartheid newspaper editors and ANC leaders in Lusaka, thereby paving the way for talks between the ANC and the South African government. He felt strongly that restitution formed an essential part of the peace and reconciliation process (Quakers in the World, n.d.). A number of South African scholar-practitioners had been forced into periods of exile due to their participation in the struggle against apartheid. During Bernard Magubane’s (1930–2013) doctoral studies in sociology in the USA he was one of the organizers of one of the first anti-apartheid demonstrations outside the South African consulate in the West Coast. Throughout the three years he spent as a lecturer at the University of Zambia and the 27 years in a tenure-track appointment at the University of Connecticut, he maintained strong links with the leaders of the South African liberation movement, which is reflected in the mutual impact of his academic and political writings. As Adesina (2013, p. 87) puts it: “. . .[his] scholarly 12

See Chap. 12 of Uys and Fritz (2020) for a more detailed description of Wolpe’s contribution to clinical sociology. 13 See Chap. 14 of Uys and Fritz (2020) for a more detailed description of Van der Merwe’s contribution to clinical sociology.

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writings were driven by political commitment, as much as the political was driven by intellectual demands”. Archie Mafeje’s (1936–2007) education and teaching experience was predominantly in the field of social anthropology. His appointment as a senior lecturer at the University of Cape Town (UCT) in 1968 was withdrawn following pressure by the apartheid government. Student protests demanding his reinstatement resulted in UCT establishing an Academic Freedom Research Award in his honor, with the disclaimer stating that government had removed the university’s right to appoint lecturers. Following the completion of his PhD at Cambridge University in the UK, he had various appointments in the UK, Tanzania, the Netherlands, Egypt and Namibia. Upon his return to South Africa in 2000, the National Research Foundation (NRF) appointed him as a Research Fellow at the African Renaissance Centre at the University of South Africa. Mafeje’s contribution to clinical sociology is evident in his work on land reform and the agrarian question in Africa, in particular his emphasis on the importance of formulating land reform policies that focused on improving the living conditions and livelihoods of the “historically and politically oppressed and exploited mass of the population” (Mpofu 2014, p. 81). Nabudere (2011, p. 93) described Mafeje as “the South African radical, who may not have been popular with those who took power in a ‘negotiated settlement’ for South Africa, but who stood for the rights of the exploited masses as a scholar and thinker and for which he worked out a strategy for future struggles”. Another example of a scholar-practitioner who spent time in exile is Herbert Vilakazi (1943–2016). He left South Africa as a child when his family moved to the US after the implementation of Bantu education. He returned to South Africa in 1980 to become a professor of sociology at the University of Transkei. After a student uprising in 1984 for which his lectures and reading groups were blamed, he was arrested and deported from the Transkei. He escaped to the US where a South African human rights lawyer assisted him in receiving permission to return to South Africa. In 1998 he became the deputy chairman of the Independent Electoral Commission. The focus of his work was largely on ways in which effective and realistic development policies for Africa could be achieved through employing African indigenous knowledge (Barron 2016; Vilakazi 2004). Without ever referring to themselves as clinical sociologists, a significant number of members of the next generation of South African sociologists continued the tradition of viewing sociologists’ role as stretching beyond understanding the world to finding solutions for tenacious social problems. Eddie Webster,14 a former president of ASSA, and head of the sociology department and founder of the Sociology of Work Unit (SWOP) at the University of the Witwatersrand demonstrated this when he argued: If Sociology is to have a future in Southern Africa, it will have to develop a balance between responding to the legitimate demands for skills and knowledge to reconstruct and develop

14 See Chap. 9 of Uys and Fritz (2020) for an example of Webster’s most recent contribution to clinical sociology.

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the region, with a concern with the traditional preoccupations of academic sociology. (Webster 1998, p. 126)

Eddie Webster’s sustained and innovative scholarship in the areas of labor studies and precarious work, and especially the activities of SWOP (now known as the Society, Work and Development Institute) that he founded and directed for many years, has produced generations of scholars whose work shows a clinical sociology slant. In his doctorate in industrial sociology completed under Webster’s supervision, Ari Sitas developed the idea of cultural formations and the defensive combinations of supportive social networks employed by workers in their struggle against oppressive work and living conditions. He translated these theoretical ideas into real life experiences through organizing worker plays and performances as part of the Culture and Working Life project (Webster 2018). Webster also collaborated with Rob Lambert and Andries Bezuidenhout (2008) in producing a book which explored how workers respond to the rising levels of insecurity as a result of globalization, and in particular, the possibility of the emergence of counter-movements in an attempt to address these insecurities. Another example is the work of Karl von Holdt and a team who conducted research into the functioning of the Chris Hani Baragwanath Hospital in Soweto, reputedly the biggest hospital in the southern hemisphere. They advised the management with regard to possible interventions aimed at improving “management efficiency, staff morale and patient care” (von Holdt et al. 2012, pp. 30–31). Sakhela Buhlungu (2010) is a further product of SWOP who conducted extensive research on the role of trade unions in the South African democratic transition. Jacklyn Cock is one of the clearest exemplars in South Africa of a clinical sociologist who consistently applied her research outcomes to interventions with regard to curriculum innovation, building organizational links, and developing policy initiatives. Her research agenda with its explicit focus on exploring issues of inequality and the social struggles of the oppressed and downtrodden members of society ranges from a ground-breaking study of the relationship between domestic workers and their employers, and research into militarization and the internal liberation movement of the 1980s in South Africa, to a focus on environmental justice which is connected to her activism in the environmental justice movement (Webster 2008).15 A number of South African sociologists left their academic careers to apply their sociological knowledge in the political arena. Frederik van Zyl Slabbert (1940–2010) became a Member of Parliament in 1974 for the Progressive Party, the official opposition, after lecturing for a number of years at Stellenbosch, Rhodes, UCT and Wits. In 1979 he became the leader of the party, which was now known as the Progressive Federal party. His abrupt resignation from both the party and parliament in 1986 was met with shock in liberal circles. In 1987 he arranged a high-level delegation of 60 white people, mostly Afrikaners, to meet the ANC

15

See Chap. 11 of Uys and Fritz (2020) for an example of Cock’s contribution to clinical sociology.

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leadership in Dakar, Senegal (Beresford 2010). He was awarded the National Order of the Baobab in Silver (posthumously) in 2014. In 2009 Wilmot James left his position as Professor of Sociology at UCT to become a Member of Parliament with the Democratic Alliance, South Africa’s official opposition. He served in various portfolios, as Shadow Minister of Higher Education, Basic Education, Trade and Industry and Health. In June 2017, James left parliament to join the global fight against infectious epidemics as a visiting Professor at the University of Columbia Medical Centre in New York and Special Advisor: Global Health Security and Diplomacy at the Columbia University Vagelos College of Physicians and Surgeons (Capazorio 2017; Heard 2017). And Blade Nzimande, a former president of ASSA, is currently ANC Minister of Higher Education and Training, and General Secretary of the South African Communist Party (SACP) since 1998 (DoHET, n.d.).

7.5

Institutional Recognition for Clinical Sociology at South African Universities

Official recognition for clinical sociology as a field of study at South African universities is still in its infancy. Frans Bezuidenhout pioneered a sociology curriculum with a clinical sociology focus when he introduced three group dynamics degrees at the sociology department at Nelson Mandela University in Port Elizabeth in 2000. Students could register for a course-based BA Honors (Group Dynamics) or a course-based MA Sociology (with focus on Group Dynamics) or for DPhil Sociology (with focus on group dynamics). Both the Honors and MA degrees included an internship component. The Honors students were placed in a work team and under leadership of a team leader for a period of a month. They had to produce a report that reflected on their experiences during the month. The MA students had to identify a problem area to address in a work area. Their minor dissertations needed to focus on some intervention. Unfortunately, soon after Bezuidenhout’s departure from the university in the middle of 2013 all the group dynamics programs were terminated (Bezuidenhout, personal communication). The sociology department at North West University (NWU) introduced clinical sociology modules at two of its three campuses. The first was the Vaal Triangle campus where they offer a third-year course in clinical sociology that was developed by Pierre van Niekerk in 2011. Their structured MA program that included a clinical sociology component has been placed on hold due to a shortage of labor power. Plans to incorporate a larger component of clinical sociology in their BA Honors Medical Sociology program is still in the early stages (Nell, personal communication). Tina de Winter (personal communication) launched a third-year course in clinical sociology at the Potchefstroom campus of NWU from 2014. The University of Johannesburg (UJ) has been teaching clinical sociology at a second year level from 2012 and at the honors (fourth year level) from 2017. Their

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BA Honors program is accredited by the Commission for the Accreditation of Programs in Applied and Clinical Sociology ( CAPACS). UJ’s Department of Sociology also offers an MA program in Social Impact Assessment with a strong clinical focus. At the University of KwaZulu-Natal Mariam Seedat-Khan (personal communication) has developed an honors program in clinical sociology. It is being considered for approval by the South African Department of Higher Education. South African sociologists are actively engaging in clinical sociology activities through various associations. Clinical sociology is one of the 22 thematic working groups that are part of the South African Sociological Association (SASA). Papers have been presented during clinical sociology sessions at SASA annual congresses since 2015. And South Africans make up more than 25% of the membership of Research Committee 46 (Clinical Sociology) of the International Sociological Association. South African sociologists also have become Certified Clinical Sociologists (C.C.S.) or Certified Sociological Practitioners (C.S.P.) through the Association for Applied and Clinical Sociology. In 2020, a volume with the title Clinical Sociology for Southern Africa was published in South Africa. This is the first volume to present the work of and views about clinical sociology in Southern Africa and one of the first volumes about the field to be published in the Global South. A range of interventions are discussed. Among the topics that are covered are interventions, counseling, ethics, interventions to strengthen families, social entrepreneurship, mediation/facilitation, organizational interventions related to corruption and whistleblowing, work/unemployment/decent work, civil society interventions and social policy.

7.6

Conclusion

While the promotion of clinical sociology at South African universities, on the one hand, answers the call from the post-apartheid government to equip students with marketable skills, on the other hand it also enhances students' ability to apply sociological knowledge, based on empirical investigation, in the service of making the world a better place for all. By applying their sociological imagination, clinical sociologists can unmask deceptions and illusions and realize their commitment to improving the world we live in. Rather than restricting our efforts to understanding and interpreting societal institutions and practices, South African sociologists should actively contribute to the transformation of South African society through searching for solutions to the challenges it faces. With its focus on analysis and intervention within an overarching social justice framework, clincial sociology is well-placed to assist in this endeavor.

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Part III

Selected Applications

Chapter 8

The Patient’s Personal Experience of Schizophrenia in China: A Clinical Sociology Approach to Mental Health Robert Sévigny

8.1

Introduction: The Chinese Context and Clinical Sociology

In most parts of the world, psychiatry has experienced dramatic and drastic changes in the last 30 years. One of those changes is a general movement toward the social integration, in the largest sense, of persons suffering from severe mental illness. Since the Reform period or the post-Maoist era, which commenced with Deng Xiaoping’s ascent to power in 1978, China has been included in this trend. In the Chinese context, the development of the idea and practice of social rehabilitation has been a significant aspect of overall social transformation (Sévigny 1993; Chen 2002a, b; Yip 2005). In China, as elsewhere, many factors influenced this development toward the increasing social integration of psychiatric patients: new drugs made it possible to help or control patients, clinical professionals and researchers began stressing the social dimensions of mental illness, and social movements heightened awareness of the social and personal situations of people experiencing severe mental illness. Indeed, the introduction of the notion of mental health, as opposed to mental illness, emerged during this period and included a focus on the quality of life of those suffering from severe mental distress. Since the Reform era, psychiatry, like all of Chinese society, has experienced a period of important changes. After focusing exclusively on medical treatment and sociopolitical reeducation, nowadays psychiatry is more oriented toward a bio-psycho-sociopolitical approach that sees psychiatric social rehabilitation as an important factor in treatment. In so doing, it moves slowly toward a practice that emphasizes the consequences of severe mental illness

R. Sévigny (*) University of Montreal, Montreal, QC, Canada e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_8

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on the patient’s personal experience. Psychiatry and Chinese society at large have become a vast laboratory of social change. This chapter explores the patient’s personal experience (or experiencing, to use a more technical term) of schizophrenia in the context of a changing Chinese society, and presents a few important aspects of clinical sociology. The clinical sociology approach is based on a two-part psychological and epistemological hypothesis: the private personal experiences of the individual and the individual’s experience of the wider society are one and the same, and this applies to people who have been diagnosed as mentally ill and viewed as alienated as well as to people who are considered normal in their social integration and interactions. According to this working hypothesis, experiencing schizophrenia implies experiencing the society as understood by patients. Patients are affected by the reality of such forces as a market economy and globalization, internal migration, and the gap between the wealthy and the poor, and not only purely through their individual personality. So, to understand how mentally ill persons give meaning to their experiences, we must understand how, explicitly or implicitly, they take into consideration their social environment (Kleinman 1988; Kleinman and Kleinman 1999; Sévigny 1996, 2004; Sévigny et al. 2009; Phillips 1993).

8.1.1

The Immediate Context of This Research Project

This research was carried out between 1992 and 1997 in a large Beijing psychiatric hospital. The sample included 20 patients. For each patient selected, about ten were interviewed, as were people from the patient’s immediate social environment (relatives, neighbors, doctors, and nurses who had been in contact with the patient, and work colleagues and leaders of the patient’s work unit, where applicable). All of the patients included in the study had been diagnosed with severe schizophrenia by the hospital medical staff. The sample was stratified according to relevant factors, such as the patient’s age, education, marital status, gender, previous job, whether or not the individual had been attached to a work unit (and, if so, the type of work unit), whether or not other organizations had been involved (especially the residential committee [jiaweihui], the street committee [jiedao], and the subdivision of the Public Security Bureau [paichuuo]. Age and length of hospitalization also were controlled in order to limit the sample to those between 25 and 45 years of age. The interviews were conducted by six members of the research group from the hospital, made up of two psychiatrists, two nurses, and two psychologists. The fieldwork was preceded by an intensive training session led by the author. Semi-structured interviews were used, including both open-ended questions and probing questions. These questions allowed the interviewees to “move” among the themes and subthemes related to the heuristic grid presented below. Most interviews took place at the patient’s residence or work place. They were recorded and later transcribed and translated so that both the Chinese transcription and English translation of the interviews were available to the researchers. The hospital leaders and

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the members of the research team agreed to the following ethical norms: everyone should be assured of confidentiality, everyone should have the freedom to refuse to be interviewed, and no harm should result from participation in the research.

8.2

Methodology and Concepts

Clinical sociology includes general characteristics shared by most sociological researchers and practitioners. Within the general framework of clinical sociology, a few conceptual or methodological issues strike me as particularly noteworthy and applicable for the study of the personal experience of schizophrenia in China. The issues most relevant to my methodological approach are the related notions of implicit sociology and experiential knowledge (for example, giving priority to objective data or to the meaning or representation of experiences). Additional relevant issues include the action research aspect of clinical sociology as well as three important preliminary definitions: person/experience, society, and social rehabilitation. I conclude this section with a brief presentation of the use of a heuristic guide and the notion of “critical incident” or “central experience” à for generating useful data.

8.2.1

Implicit Sociology and Experiential Knowledge

In some of my previous studies, I used the notion of implicit sociology. When I wanted to apply this notion to my Chinese data, I began to refer to a larger and more comprehensive idea: experiential knowledge. The notion of “implicit language” was first applied to Canadian mental health workers and their representations of their practices. Previous analysis showed that mental health workers, whose principal task is explicitly to understand and to help or care for individuals, made numerous references to the social dimensions of their intervention. In other words, when these practitioners wanted to give meaning to theiror intervention practices, they would refer explicitly, for example, to psychological or psychiatric theories. They also would refer, at least implicitly, to their patients’ social environments, to the social context of their practice, and sometimes to their own personal and social experiences. For example, I interviewed a psychiatrist who worked with psychotic patients in an underprivileged neighborhood of Montreal for 10 years. To explain to himself, and to others, what he does and why, he refers not only to psychological theories but also to the knowledge that he has acquired in his contacts within the milieu in which he works. He has acquired practical expertise on what it means to live in an underprivileged neighborhood, and on the specificity of the helper-helped social relations, which can be maintained in this type of neighborhood. His practical knowledge, gained through experience, is at the heart of his implicit knowledge

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and language. But the notion of implicit has a deeper meaning or at least a more personal and intimate one: he has his own feelings about his relationships with his clients or patients. There are also some experiences in his own private life that he implicitly employs in his understanding of his clients or patients. A female psychoanalyst, during a long interview about her practice, came to express a similar view (Sévigny 1983a, b). While describing her practice in a very concrete and detailed way, she realized the importance of her own experience as a child in the small village in which she was raised. As she expressed this in her words, “I realize something I have never told any one of my colleagues or during academic seminars. Of course, when I listen to a patient, I use my conceptual knowledge, but my understanding, my interpretation, is often based on my own experience as a child in a small village.” This type of experiential knowledge is also an important aspect of what I have come to call implicit sociology. This implicit language is often referred to in terms of common sense or in terms of the layman by opposition to learned language. It is important to realize that this everyday language is used by everybody (including, for instance, doctors, leaders, and intellectuals) as it is most often the language of emotions, feelings, opinions, and impressions that, for whatever reason, cannot be so easily expressed in a direct or overt manner. In the previous Canadian study (Rhéaume and Sévigny 1988a, b), implicit language was applied to medical practitioners, but all social actors use explicit and implicit languages. This implicit/explicit dichotomy is related also to the formal/ informal dichotomy. When someone uses a formal type of knowledge, the person may be communicating very explicit information, but part of the information may be difficult to express that way. Work unit leaders, for example, may use a very formal and explicit language to discuss why a mental patient has some difficulties with the job requirements. On the other hand, when work leaders want to express how they personally feel about the situation, or how they understand the patient’s medical problem, they may resort to images, metaphors, nonverbal signs, and even silences. Or they may limit themselves to describing their own behavior without trying to elaborate on their feelings (which does not mean that they have none concerning the whole situation). Everybody, at one point or another, is confronted with such a complex experience. In all those cases, the language used is relatively implicit. I extend this notion of implicit sociology to all social actors including the schizophrenic patients and to all types of knowledge that referred to those actors’ personal and social experience.1

1 All in all, one is confronted with an important epistemological and social problem as it is not possible to separate “learned” people who would know, understand and explain the social world, from those, who would only be able to express naïve or even mistaken representations about their own experiences.

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The Action/Research Issue

In my own version of clinical sociology, two different types of objectives, though intimately interrelated, may be pursued: intervention and research (Sévigny 2001). The main thrust of this chapter is research, not intervention; it is based rather on classical qualitative concepts and analysis. On the other hand, it is also intimately related to the intervention dimension of clinical sociology for three reasons. First, all the fieldwork has been produced in conjunction with the management and staff of hospital X in the context of a research-action methodology. Second, all the patients and the other interviewees from their immediate social environment (ISE) were considered as social and personal actors. In other words, as a clinical sociologist, I study persons who, in diverse ways and degrees, intervene in their own experience. The ultimate objective of such research is to propose to psychiatric practitioners a clinical sociological model for the treatment and social rehabilitation of the severely mentally ill.

8.3

Three Preliminary Definitions

We had to refer to some basic concepts that were guiding us in applying our approach to clinical sociology. Three of them were central, supported by an interview guide based on what is called a heuristic grid.

8.3.1

Person and Experience: A Rogerian Approach

The clinical sociology approach calls for a conceptual and theoretical understanding of the person. Many studies, especially those in the French tradition, borrow from psychoanalysis to conduct this type of analysis. The present monograph fits into the classic Rogerian approach to personality and experience. In drawing from this perspective, I developed a concept of self-image and the representation of one’s environment as early as my first works on religious experience. Using this conceptual approach, the person is mainly formalized in terms of the intimate connection between experience and self or self-image. In this conceptual framework, experiencing, to use the technical word, implies a holistic reaction; it is the whole organism that acts and reacts to its environment. In this perspective, all the most central representations of one’s experience should be taken into consideration during the analysis, making it possible to consider the uniqueness of each personal experience. I will apply this perspective to the experience of severe mental illness and more particularly to schizophrenia.

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Definition of Society

A clinical sociological approach also calls for an operational term for society. The intent is not to start with an ad hoc definition of a certain society, but to use a heuristic scheme that encompasses the main dimensions of any society: interpersonal relationships, relationships to close circles of family and friends, and relationships to organizations and greater sociocultural clusters. Again, as such, this multilevel notion of society is nothing new; what is new is (1) the application of these categories to narrations of people directly or indirectly related to a severe mental health problem, and (2) the consideration of people’s personal private experiences and people’s experience of society as one analytical unit.

8.3.3

Definition of Social Rehabilitation

Although clinical sociology may apply to any particular field or sector of society, each case implies a set of operational definitions. This is no less the case with the mental health field. Mental health implies many different types of practices, many varieties of unit of analysis (from overarching public health policies toward mental health/illness; to the different organizations involved; to the personal experience of illness, treatment, and social rehabilitation). The ultimate goal of this research project, the social rehabilitation of patients, necessitated a preliminary definition of social rehabilitation. In very general and simple terms, rehabilitation was defined as the experience, for patients, of returning to their previous places in life, of regaining a previous status. In that sense, any rehabilitation is a social rehabilitation and, theoretically, may involve the family, the neighborhood, local organizations, and (especially in this case) the work unit (danwei), the first level of political structure in urban China. According to one’s theoretical ideal of rehabilitation, the capability to return to the world, for example, may or may not be considered an important part of rehabilitation. To understand the social rehabilitation of psychiatric patients, we have to take into account the relationship between mental illness and rehabilitation.

8.3.4

A Heuristic Grid

To make sense of the information generated in the interview process, the team employed a heuristic grid. To demonstrate how this was used, let us suppose a clinical sociologist interviews work unit leaders about how they think and feel about mental illness and rehabilitation in general and, more specifically, about a member of their own work unit who suffers from a severe mental disorder. A first goal of the grid is to allow the sociologist to follow the leaders’ stream of conduct without imposing a personal point of view. A second goal is to allow the sociologist to check

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if he or she is getting relevant information about the main significant aspects of the work unit leaders’ experience with mental illness. The latter does not necessarily have something to say about each item of the grid, but it is important to be certain that the sociologist had the opportunity to comment on each included element. A third goal is to check that the researcher is not imposing his or her own representations on the leaders but rather aiding the leaders in genuinely expressing their point of view. In other words, the main purpose of such a general model is twofold: first, to structure the interaction process between researchers and actors (the work unit leaders, in our example); and second, to ensure the validity of the data. In the Chinese project, the grid included, as fully as possible, most of what could be implicit or explicit answers to the following questions: What are the representations regarding the experience of mental illness? What interventions took place? What happened in the patient’s implicit social experience (ISE)? Was the larger social system (LSS) involved in the experience of the individual? What was expressed about each actor’s personal identity? This grid also allowed me to focus on the interactions between those five questions and answers.

8.3.5

Critical Incident or Central Experience

In this study, the notion of central experience was borrowed and adapted from Cohen-Émérique (2000). It includes everything (events, facts, experiences, situations, behaviors) to which the main actors refer when they want to give meaning to the patient’s experience. For example, these might include an event or a situation that a patient feels is the cause of the illness, a violent behavior that is perceived by most of the patient’s entourage as a sign of illness, a relationship with a significant other, the difficulties encountered in returning to work. Each of these central experiences takes us back to the self–society relationship, and most of the time the focus on these central experiences is shared by most of the people in the patient’s ISE. The analytical process was a very flexible one. While keeping in mind both the heuristic grid and the critical or central experiences, each element of each interview that was relevant to a theme or subtheme of the heuristic grid was considered a unit of analysis.

8.4

Understanding Schizophrenia in China: An Illustration

This section presents four vignettes to give a general idea of how patients and those in their ISEs represent their experience of being a mentally ill person. Each of these vignettes focuses on the patient’s experience. Among other findings, these examples suggest that an individual’s most intimate feeling or self-image does sometimes relate to the LSS. Furthermore, what an interviewee (a patient or someone from the ISE) considers a central experience may sometimes seem very minute, superficial, or

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accidental from an outsider’s point of view. The objective of the following vignettes is to convey how patients organize some key events of their experience and how they talk about this experience to themselves and to others.

8.4.1

Pang Shi

Pang Shi, a worker born in 1951, is married. He does not hold a diploma, but passed exams at the first-year level of secondary education. Shi has had many relapses. The last, in 1992, happened not long after he was refused admission to the Communist Party. He attacked the secretary of the Party with an ax. The director of the factory where he worked said he would rather pay him his salary to stay home than allow him to come back to work, even at a lower salary. In 1978, while he was on sick leave for hepatitis, his work unit refused to give him a wage increase. Everyone around him remembers those negative events associated with his work unit. According to Shi’s family, there were no other major events in his life that could be seen as contributing to his condition. Although family members mention his wife’s desire to divorce him, they say that since Shi and his wife have a child and because of his condition, his wife did not go through with it, and, instead, was very nice to him and took good care of him. On the other hand, everybody around Shi, even those from his work unit,2 think he was deeply affected by not having been admitted as a Party member. During his interview, Shi does not mention either his rejection by the Party or the episode where he attacked the secretary of the Party with an ax. In his mind, though, many of his problems arise from his relationship with his work unit.5 “After all,” he told the interviewer, “I was sent to the hospital by the factory.” At the same time, he does not seem to have heard, or to remember, that his work unit leader told others that he would never have him come back to work at the factory. On the contrary, when asked by the interviewer about his plans for the future, he answers, “I just want to go to work. I want to work after I am recovered.” His work situation, therefore, is really at the center of his experiencing and its representation. At one point, Shi mentions another event related to the work unit where he became very aggressive: I couldn’t bear it when they mocked me. . . They just meant to make jokes with me some times, but I couldn’t accept it. Thus, my mind and my psychology couldn’t stand such a heavy burden. I broke the windows. I was working as the gate guard, so I broke all the windows of the gate-guard room.

A few minutes before, when asked by the interviewer, he had already mentioned this feeling of “being mocked” and his confusion about this experience: The reader must bear in mind that the Chinese work unit (danwei) is the first level of the Communist Party organization: the work unit is not same employer it would be in the Western world.

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Why were you hospitalized? Because they always mock me (lao ji duiwo). Why do they always mock you? I don’t know myself. They always treat me as if they were investigating me.

He has the deep feeling that he is accused of something he cannot understand (“I don’t know myself”). Furthermore, he has the feeling that nobody is really communicating with him directly. In his own words, this is how he describes his relationship with others: None of them said anything to me in person. They didn’t say to me that I have problems. . . I could hear them talking, as far as I know. They talked to me (gen wo dui hua) through other people. Sometimes I could hear when they talked to me directly.

Beyond his problems with the work unit, he still hopes that the traditional situation (i.e., since 1949) in urban China will apply to him: each person must be part of a work unit and the work unit must take care of its members. This is the iron rice bowl that Mao had promised to all Chinese. When questioned about the meaning of what is happening to him, he says to himself and to the interviewer that he does not know. Interviewer: Shi: Interviewer: Shi:

What do you think of your disease? I think of my disease. . . I don’t have any ideas. You don’t think you are sick? No, I don’t think I am sick.

But not knowing is only one part of his feelings about his experience. He has another explanation; he considers that his illness is related to his own “nature” (his word). He portrays himself as being “eccentric,” “solitary,” “suspicious,” and “overly sensitive.” Shi says, “Because of this, people look down on me.” Things may not be completely clear in his mind, but there are elements that he makes sense of either by referring to some aspects of his personality or to some elements of his environment. His feelings or fantasies of being “investigated” could also, at least symbolically, refer to the state police and even to the political context in general.

8.4.2

Weng Yan

Weng Yan is a worker. She was born in 1952 and is married. She did not finish secondary school. A series of events marked Weng Yan’s experience: First, according to the politics of the day, she was one of those sent back to work in her native village, in the countryside. While working in a factory, Yan’s roommate accused her of stealing 10 yuan. According to Yan and people close to her, that was the first moment of

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tension. Yan had to leave and had to find a job at Tianjin, the region’s big city. She was hospitalized for the first time shortly thereafter, in 1975. In 1976, an earthquake struck Tianjin and had a big impact on Yan. Most people from her close environment (ISE) consider the accusation of stealing and the earthquake as important events in her life, even though no one makes a direct connection between them and her illness. Another important event happened shortly before our interview with Yan: she and her husband were forced to leave their home to go in a dazayuan.3 Because her neighbors said that she was fighting and breaking things, she was forced to leave. She considers this eviction to be a determining factor in her life because it made her realize that she did not like either her family or her in-laws and that she wanted to break all connections with them. These difficult relationships with others, at the end, include everybody around her. This is how she describes her contacts with her neighbors and how she comes to feel she does not fit their expectations of a normal person: I cannot have contact with others. I stay at home all day long. I don’t think my mental state can be balanced. In the compound, the relationships with the neighbors are complicated, not friendly. . . I don’t go to their homes. I just shut my door and live my own life.

Yan regrets this situation. All she has left is solitude and confinement. Why, according to her, does she find herself in this position? She believes that her mental state is “not balanced.” She looks for an answer within herself rather than in the attitude displayed by her neighbors. She never forgets that she is not normal: “For a normal person, if she doesn’t think anything when something happens to her, then this is a normal person. As for me, I just cannot get rid of it. For instance, I also think about it even on the public bus.” She dreads other people’s opinions of her and feels that she does not belong. She associates this feeling of rejection with the effects of medication on her behavior or attitudes. The core of her problem seems to be the reaction of others toward her. She does not feel weak or unqualified, but in front of others she is ashamed of herself. She has probably internalized the lack of understanding other people have of her condition, or applies to herself the reaction she would apply to somebody else in her condition. In her mind, she makes a distinction between the way she must behave and her inner feelings: “People in this courtyard have no such requirement about how you feel. The key point is how you do things.” This allusion to the philosophical distinction between being and seeming, between reality and appearance, sums up the patient’s experience: the loneliness, the lack of social bounds, the rejection and lack of understanding from others, and the shame or fear of being looked down on. In a way, this is her daily reality. These

3

Dazayuans are those old traditional homes in China built around a small garden. One characteristic of this type of residence is that people lived very close to one another and usually had to share common spaces. At the time of the field work, many of those dazayuans still existed, but there was a new policy: work units, instead of renting housing to their members, would try to sell apartments to the members. This was a step towards a market economy system.

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difficulties do not prevent her from keeping in touch with another reality, the reality of her social conditions. Here again the work-unit association comes into play. Upon learning from a newspaper that her danwei was about to build an apartment building and sell condos to the members, Yan went to her work unit’s office to get information about this opportunity.7 She found that it was out of the question that her family could not afford to buy one. Hey, we still are not [financially] a “comfortable” family. . . I went to the work unit. Isn’t there a house-project? I read a pamphlet in the newspaper. So, then, I went to the work unit. In fact, they wanted you to buy a house. How can we afford to do it? At the moment, we just make do with this one. Three of us in a single room.

Yan is well aware that the danwei is trying to relegate its responsibilities to its members; instead of offering an apartment at a low rental cost, work-unit members might purchase one. Yet this new social system is not conceived for people like her. Despite the economic development around her, the money she receives does not allow her anything beyond “fitting three people in the same room.” Here, her confinement and marginality are not linked exclusively to family members, neighbors, and people she met in public places. This marginality is no longer exclusively linked to her being mentally ill, but also to the experience of being poor. The poverty of her family does not allow them to benefit from the homeownership program launched by her danwei. The feeling of isolation from her neighbors is made even more difficult to bear. She is not pointing to any direct relationship between her family’s poverty and her mental illness, but in her exchanges with the interviewer she makes it clear that in her experience the two go together, that is, her mental condition reinforces her poverty, and her poverty makes her mental condition more obvious to those around her.

8.4.3

Li Wan

Li Wan, a nurse, was born in 1962. She studied nursing and music at the college level. Wan’s parents were moved to a rural zone and were still living there when they divorced. Wan and her brother were young then. Wan’s father initially had custody of her, but later Wan’s mother took her along when she moved to Beijing. Her father still lives in the country. After her mother remarried, Wan went to live with her brother, but when his wife had a child, she went back to live with her mother and stepfather. She has worked 12 years in a hospital, first as a midwife and then as a senior nurse. Additionally, she has musical talent, and her work unit, taking great pride in her success, gave her the privilege of singing lessons in a famous institute. They also gave her a less tiring job in the supply department, so that she could spend more time on music. After receiving her music diploma, she continued working in the supply department. Her mother, who owns a clothing store, provided additional financial support for her music lessons.

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According to her relatives, the occurrence of certain abnormal behavior at home and at work led to her hospitalization. Yet here, too, it happened in a very unusual way. First, a few years before her hospitalization, her family had consulted a doctor without telling her work unit, which went against the usual procedure. Then a psychiatrist who did consultations at her hospital decided that she should be sent to a psychiatric hospital rather than be treated at the hospital where she was employed. It seems that the nursing department was anxious about allowing a mentally ill person to work as a nurse. She was then transferred to hospital H. without anyone telling her why. Thanks to her mother’s financial resources, Wan was given preferential treatment: she had a private room and nurse. After Wan’s hospitalization, her work unit refused to let her continue working, but continued giving her a salary. The fear of being rejected or discriminated against was very present in Wan’s mind. As for the hospital where she was treated, Wan said, “The attitude of the hospital is quite standard. One is to comfort you; the other is not to discriminate against you.” In this statement, Wan expressed both the fear of rejection and the need for care. She has the same anxiety concerning her job. Since her hospitalization, Wan has not gone back to work, yet when she thinks about it, she expresses her concern of “being looked at as scum.” Her previous quotation continues: If I go to work, I just hope people won’t treat me unequally. Of course, I haven’t worked yet. I just hope after I go to work, they won’t look down upon me. Just give me more encouragement. So long as I make some achievement, praise me more. Encourage us.

From this excerpt, we realize how Wan perceives her environment being divided between “us” and “them,” with “us” being the patients and “them” being the others. The others represent an identity that she wishes to recover or not to have lost. The “us” she sometimes perceives as a threat, as it means being different from the others; it is also the part of her that needs help and comfort. In this “us,” she expresses a collective identity based on her mental illness. A few minutes earlier in the interview, she had explained what “comfort” meant to her. Here again she makes a very significant distinction between her overt behavior in daily life and her inner feelings. Wan said that her family is “concerned about my daily life and my mood. . . In general, they are careful with the words they use with me.” Wan’s craving for comfort, for encouragement, for being looked at as a normal person, is similar in both the context of her daily life and of the job she still hopes to regain one day.

8.4.4

Lu Hua

Lu Hua, a male, was born in 1968. He did not finish secondary school and is without a regular job. Some dramatic events shaped Hua’s path. When he was a child, his mother committed suicide. As a consequence, he lived with different families on his mother’s side, and later lived with his father, a hemiplegic who was sick for a long

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time and died when Hua was about 20. His only sister already was married. He found himself living alone. Even before his father’s death, he traveled a turbulent path. In secondary school, shortly after failing all his exams, his father kicked him out of the house. He lived as a homeless person and was considered delinquent. He had to spend 3 years in a “reeducation through work” center and then was employed for a while by a work unit where one of his relatives worked. After he quit, Hua displayed aggressive and violent behavior. He broke things belonging to a neighbor, who complained to the Public Security Office. Hua’s behavior was found to be abnormal, so the Office contacted his sister and asked her to give permission for Hua to receive psychiatric care. She agreed, and Hua was made aware of her decision. He spent 1 month in Hospital H. When he left, his sister helped him find a temporary job selling videos. Hua has experienced violence, aggressiveness, shame, and confinement for a long time. During the interview, Hua clearly states his shame at having been temporarily committed to a psychiatric hospital, a feeling aggravated by the fact that he does not see himself as mentally ill. When conversing with the interviewer, Hua probably revisited his past. When he expressed his anger, he did not speak to the interviewer per se, but to everybody at the same time: Face is as important to a man as bark is to a tree. A dog will leap over a wall in desperation. Damn it, if I lose my temper, I can gamble. . . Just don’t drive me crazy. Are you going to let me live? Damn it, I am also a human being anyhow. I am not an animal.

Hua has a strong reaction to the marginalization he experiences. To him, social rehabilitation should mean being treated like a human being, especially by the social institutions around him. His worst feelings of resentment are directed toward the institutional environment that shaped his youth. Hua had been rejected by two local institutions, the Street Committee (Jiedao) and the Residents Committee (Juweihui) that could have helped him before the reform period. Hua was hoping for their help, but he hadn’t received any assistance. As Hua said, “The Neighborhood Committee doesn’t care about me. Neither does the Office. I just find my way outside.” The only other institutional resource available to provide help in the face of mental illness is the work unit. As Hua never experienced stability at work and never became affiliated with a specific work group, he does not have access to this kind of help either. Hua talked about his current employment and the role his sister had played in his job search. When Hua was helpless, he received some support from his sister; but he is still ambivalent toward her because she was the one who agreed that he should be sent to the hospital. At first, Hua discusses his job as a sales representative in an essentially business-like manner, but he then speaks aggressively of his sister: Interviewer: Hua: Interviewer: Hua: Interviewer: Hua:

What are you doing now? I am just helping them, not a permanent staff. How are you doing with your work now? Very well. You get a salary every month?

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Interviewer: Hua: Interviewer: Hua:

I am a sales representative. I get whatever commission based on my performance. Just depends on your skill. What are you selling now? Videos. Is the place you work a private shop? State-owned. My older sister introduced me there. Who could I depend on after I came out? It was she who sent me to the psychiatric hospital. Who else should I go to for help? I went to see her at her friend’s. She said, “How could they send you back?” She said such a thing. I was really angry. She said, “Let me find you a job.” I said, “OK. Where?” She said, “When you go to see our relatives, if they ask who found you the job, you say ‘my elder sister.’” I’ll remember you, bitch, all my life.

Even when there is aggressiveness and resentment in his narration, Hua also shows pride when he talks about his job. This job requires “skills” and he performs well. At the same time, he is aware of his fragility and dependence (“Who could I depend on?”). Hua also is aware that his marginality is exacerbated by the fact that he does not belong to any work unit. In his mind a work unit would normally help him. He nevertheless, in an indirect way, expresses this need or dream to belong to a work unit. As we have just seen, he is sure no work unit feels responsible for him. Yet, he still feels that the work unit is an important factor in the image he has about the world around him. To the interviewer (who is a member of the medical staff), he says, “I am really happy you can come to see me. It makes me feel I am in a work unit. Once a worker has some accident in the work unit, the leaders go to see him at home, right? I am really very happy.” For a short moment, he feels he belongs to society. He knows that no work unit leader will ever come to his place because he fell ill. He knows that this interviewer works as a nurse in the hospital where he spent some time. He thus realizes that this interviewer does belong to a work unit and this gives him the feeling of not being left out (Sévigny and Loignon 2005).

8.5

Some Results and Conclusion

The objectives of this chapter have been to present clinical sociology as a particular approach to study schizophrenia in urban China, and to understand schizophrenia in the Chinese context. I will make five very brief concluding comments, each of them relating to both objectives.

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Patients Say It in Their Own Words: Experiential and Implicit Knowledge

Many people—professionals and laypeople alike—often see people with severe mental illness as “nonpersons” unable to express their experiences, so it is worth noting that patients and members of their close environment are indeed able to “say it in their own words,” to borrow an expression sometimes used to describe the impact of psychotherapy. Their knowledge includes their understanding of their personal experiences as well as their interpretations of the changing context of urban Chinese society. People involved in the mental health/illness experience are all real persons. Additionally, in our sample, they were not just patients, mothers, or work unit leaders; they were specifically Chinese patients, mothers, or leaders. Shi expresses very well the ability to give sense to his experience: he refuses the idea that he is sick, but at the same time he hopes to go back to work when he “recovers.” He does not know why he is sick, but he has deep feelings about his personality (in his words, his “nature” and his “psychology”). And he refers to going back to work, implying that working (in his danwei) would be part of a rehabilitation process. Yan, for her part, even has elegant words to express the differences she feels between herself and “normal” people: when something happens to her, she cannot stop thinking of it, “even on the public bus.” Wan, in her own words, makes the distinction between the overt behavior her relatives expect from her and her own inner feelings. When Hua exclaims, “I am not an animal,” he uses very strong, clear words to express his experience.

8.5.2

The Experience of Illness and Rehabilitation as a Collective Construct

The experience of mental illness and its complex meaning are truly a collective construct. Each patient is part of a network that contributes to his/her experience and this collective production becomes, in a way, an integral part of the patient’s experience and its representation. This network ceases to be solely a social context and becomes an actor in and of itself. On the other hand, this network, or the immediate social environment, is not the only collective actor. There is also the larger social system that is mentioned by many interviewees. Of course, those references evoke a specific period (1993–1997). Many macro social changes already have transformed this collective construct. For instance, there has been rapid change in the implementation of a market economy, the changing role of the work unit toward the social welfare of its members, and the massive migration of people from rural areas to large cities. All those factors, and others, are bringing significant changes for individual patients, but even for the most isolated ones, the experience of mental illness will remain a collective construct, although perhaps a more complex one that we have yet to

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understand. In a way, Wan’s experience is, in good part, the result of her immediate environment. Her family consulted a doctor without giving her the reason for their concerns. The same doctor transferred her to a psychiatric hospital, again without telling her the reasons. The preferential treatment she enjoys at the hospital is because her mother is financially well off, and the danwei continues paying her salary without offering her any job. In Hua’s case, the local political world (for example, the neighborhood committee, the danwei) is part of the world in which he feels rejected. These are only a few illustrations of the concept of collective construct as part of the patients’ personal experience.

8.5.3

Actors Feel and Act According to Their Representation of Normality

Medical professionals and social scientists often make a distinction between social and clinical normality. The patient finds himself or herself at the center of this distinction. Medical personnel, for instance, tend to stress (exclusively) their intervention at the clinical dimension of abnormality. The directors of a work unit, who control the sociopolitical and work environment of their members, often judge situations in terms of social normality. But this distinction between clinical and social normality is never completely clear in the actors’ minds. When the mission of a work unit involves contact with medical authorities, its attitudes, decisions, and actions sometimes are based simultaneously on these two types of normality: clinical and social. Besides, patients and relatives, for example, often have the feeling that the medical diagnostic gives a new meaning to what they tended to perceive as a social abnormality. From a patient’s point of view, both types of normality are an intimate part of their experiencing.

8.5.4

An Implicit Definition of Social Rehabilitation

All in all, the implicit knowledge carried by all the actors involved in social rehabilitation leads us to an implicit definition of social rehabilitation. Not only do actors have words to tell their story and give it meaning, they also foresee some elements that, in their view, should serve as the basis of any social rehabilitation process. According to the patients, social rehabilitation interventions should avoid a radical break between the hospitalization of a patient and her or his social milieu. Among our four interviewees, there is a clear unanimity: the road to rehabilitation should be through work and mainly through danwei support. In that sense, their views reflect very well the beginning of the 1990s. At that time, reform had already taken place in urban China; particularly, the market economy had started to change the role of the danwei as the main social welfare support system in regard to health

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services. While all the patients in our research project did not express the same view, those four and those in their immediate social environment quite clearly were expressing an identification reflecting the recent past rather than the changing urban China. According to them, working within the danwei organization was still the only—and the ideal—type of social rehabilitation they could contemplate.

8.5.5

Clinical Sociology: A Tool for Rehabilitation Intervention?

In reference to the practice of psychiatry, the primary aim of this chapter was to present clinical sociology as an approach that can be applied to the experience of severe mental illness with all its complexity: the personal, interpersonal, organizational, social, political, and cultural dimensions. The second objective was to offer a perspective that would take into account the context of modern urban China. Through my very brief introduction and the illustrations provided by a few cases, I hope to have partially illuminated the understanding of so complex an experience.

8.6

An Additional Commentary: 30 Years Later

An action-research model (Lewin 1946) was readily accepted by the authorities of the hospital right at the beginning of the project in the early 1990s. Some members of their staff would participate actively at the planning and realization of the fieldwork. The intent being to eventually help mental workers to understand the patient’s experience of schizophrenia in the context of his or her social and cultural environment. In this early post-Mao period, as a clinical sociologist, this venture was geared toward social change. I knew the challenges and uncertainties of this model but always remained convinced of its usefulness. The financial contribution of the hospital was to absorb the cost of the ChineseEnglish translation of the interviews already transcribed by the researchers of the team. When the first translations came out, some members of the research group came to me saying: “We cannot use those translations, they are too biased,” Translators decided to take out some important parts of interviews they considered inappropriate politically. Of course, I went to the hospital director who recognized the fact, but told me he could do nothing and, furthermore, that he had discovered that the price was so high that the hospital could not finance the full translation costs. I figured I could not forget the 600 h and more spent with the group in training and preparation work. I decided I would use the amount I had received from the Canadian Council for Social Science and Humanities and ask my assistant (from Chinese origin) in Montreal to work on this translation instead of helping me later on to analyze the material.

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Another difficult moment happened when most of the group members were interested to analyze for themselves the interviews they had with “their” interviewees. I was happy to have their interest and was sure they really were able to use what they had learned while training and interviewing patients. The person in charge of keeping track of the transcriptions refused any access to them: something that reminded me of a strong tendency to secrecy. Secrecy within the organization was in relation to the danwei, and so I decided not to formally intervene even though I felt sorry for the younger assistants. Alone, in this context, I knew then I would never succeed to analyze all the data of the sample. The primary objective was still to introduce a clinical sociology approach which could eventually be applied by the hospital staff. Furthermore the reading of all the interviews would help me to understand the multiplicity and complexity of patient’s experiences to propose a more complete conceptual grid and to write a few monographs in the future. So the project did, in fact, continue as planned and I continued to accept invitations to present this research model in different Beijing mental health institutions and at Beida University. Furthermore, at the end of the 3 years, the director of the hospital and I could organize a public workshop offering the opportunity to present our model along with other presentations by Chinese researchers on mental health. A few months later I did organize a similar event in Montreal at one of the main psychiatric hospitals. Four senior Chinese professionals who had followed our research activities also attended this Montreal workshop. The story of this research does not stop here. In 2010, Dr. Weng, who had initiated this project and had published many books on schizophrenia, planned another volume about rehabilitation and schizophrenia. He asked me to contribute an extensive chapter on the clinical sociology approach. For the second edition, he asked me to present a revised version of that chapter (Sévigny et al. 2020). All this was good news. Around 1990, I had the opportunity and the pleasure to contact Professor Sheying Chen, a sociologist I had met previously at a meeting of the International Sociological Association and then at his university in New York. (He is now teaching at Pace University). His own field is “aging” rather than mental health. He shared my interest in a clinical sociology approach. He offered me his collaboration in a series of papers based on my conceptual model. He became a real “motivator” for me. The result of this collaboration produced many joint publications in international journals. Two of them are mentioned above and in another one I presented most of the conceptual perspective I had already explored in the first edition of this paper (Sévigny et al. 2014). Finally I had achieved my purpose: the objective of these papers was to propose a clinical sociology approach that could eventually help mental workers to understand the patient’s experience of schizophrenia. The last step was, of course, the presentation, in the Chinese language. On a more personal note, this all has been a real intercultural experience for me. This was not the objective of the project, but as a French Canadian working in China I had to deal with this issue. Many events involved cultural differences. But no

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problems remained unsolved and they were always discussed in a pleasant and constructive atmosphere. I still have in mind dozens of those moments. So 30 years later I still believe strongly in the importance of collaborative working relationships. Acknowledgments I am most grateful to Professor Weng Yongzhen, who invited me to initiate this research at Beijing Huilongguan Psychiatric Hospital while he was vice-director. Without his help and the close collaboration of Dr. Zou Yizhuang, this research project would have not taken place. The same must be said of Dr. Chuanyi Zhao, who was director when decisions were made, and of Dr. Zhang Peiyan who was director at the time of all the fieldwork. Dr. Chu an Ju-hsien always supported me in all aspects of this research. The fieldwork would not have been possible without the dedication of the research team headed by Dr. Yang Wenying and that included Xu Dong, Li Guo Wang, Su lin, Wang Haijun, and Wang Yanling. This research was sponsored by the Human Sciences Research Council of Canada.

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Sévigny, R. (2004). Social welfare policy: Social rehabilitation of psychiatric patients in urban China. International Journal of Social Psychiatry, 50(3), 241–261. Sévigny, R., & Loignon, C. (2005). A esquizophrenia na China : a experiência de Lu Lu. [Schizephrenia iin China: Lu Lu’s experience], Belo Horizonto, Brésil. Psicologia em Revista, 11(18), 159–175. Sévigny, R., Chen, S., & Chen, E. Y. (2009). Schizophrenia, mental health and urban change in China: Social rehabilitation and the role of danwei in 1990’s Beijing. Cultural Medecine, Psychiatry, 33, 86–111. Sévigny, R., Chen, S., & Chen, E. Y. (2014). Clinical sociology: Social rehabilitation of schizophrenia in China and implications for aging research. Canadian Journal of Sociology, 39(92), 181–210. Sévigny, R., Weng, Y., Yang, Z., Loignon, C., & Wang, J. (2020) Jingshenbingxue Kangfu: Youguan Lingchuang Shehuixue De Tansuo [Psychiatric rehabilitation: A clinical sociology approach]. In W. Yongzen, R. P. Liberman, & X. Yingqing, (Eds.), Jingshenfenliezhen Kangfu Caozuo Shouce [A handbook of rehabilitation for patients with schizophrenia]. Beijing: People’s Medical Publishing House. Yip, K. S. (2005). An historical review of the mental health services in the people’s republic of China. International Journal of Social Psychiatry, 51(2), 106–118.

Chapter 9

Bridging Social Capital: A Clinical Sociology Approach to Substance Use Intervention Miriam Boeri

9.1

Introduction

It had been a long and tiring day, and when I finally sat down in one of the chairs arranged in a circle, my stomach started to growl from lack of food. I looked around at the 20 or so faces staring at me. They had been waiting for me to join this meeting, one I had requested to discuss my proposal on social activities. I was late. They were patient––and so quiet I thought they heard the growling of my stomach. I started the day teaching an early class at my university in the northeastern suburbs of Atlanta and had coffee for breakfast. After class, most of the daylight hours were spent driving from small suburban towns to cul-de-sacs and trailer parks, talking to people and hanging up fliers about my research project. I had an appointment to interview a woman I had met previously. I grabbed a few snacks to bring to her trailer and ate one of the candy bars she told me she really liked. That and coffee kept me going. Although I had calculated more time for the evening rush hour traffic around Atlanta to make my 5 o’clock meeting in Decatur, southwest of Atlanta, a traffic accident on the interstate forced me to take city roads, and now I was late. The men and women sitting in the circle were participants in the Decatur drug court. Having observed a variety of drug courts in the area, I knew this was the bestin-its-class. The judge was compassionate, and the drug court director was open to new ideas that might help reduce recidivism rates for graduates of the program. I brought him one of my own ideas based on my studies and drawing from social capital theory. In a nutshell, my idea involved introducing participants to social activities in the community that would provide new opportunities and connections to increase their social capital. The director asked me to talk about this with the participants first. He

M. Boeri (*) Bentley University, Waltham, MA, USA e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_9

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was in the circle that day, but mostly kept quiet. Discussing social capital theory without boring them would not be easy. First, I explained that I wanted to arrange for new social activities for them––activities that maybe they had never engaged in before, or had hoped to return to, but did not have access or time. I added that this would also bring them into contact with people who might have resources for them. Mindful of not appearing to not talk down to anyone, I told them this was called social capital. “Sounds like social currency,” someone said, which encouraged me that he got it. We discussed what kind of activities they would enjoy. Most of them asked for volunteer activities, such as feeding the homeless, saying they wanted to “give back.” I attempted to encourage activities that they might enjoy for other reasons, such as learning a new skill, a hobby, or a recreational activity. Art classes were proposed. Sports events. We were on a roll. Then I asked if they had any suggestions for what to call the intervention. “The Socialization Program,” piped an exuberant young woman. “Looks like we are being re-socialized here anyways.” My heart sank. She was not insinuating anything negative by pointing out that this seemed like a socialization program, but the term “re-socialization” pricked my tender liberal sensibilities in ways she most likely did not intend. Familiar with Goffman’s (1961) “total institutions,” I was attuned to the fine line between re-socialization and lifelong socialization, which is what I envisioned for myself as well as participants using the model. I also was sensitive to the fact that my participants were in a criminal justice environment, which made any social activity suspect from the start. I did not have drug courts in mind when I began conceptualizing this project. I had approached treatment programs outside the criminal justice system asking if they would try the social activity intervention, but they all claimed to be doing activities already, without a clear understanding of how the social capital building mechanism I proposed was different. But this drug court, with its open-minded director, caring staff, and all participants housed in the community, was an environment that would allow social activities outside the standard “treatment” model, which is essential for building social capital. We did not choose a name that day. I first referred to the initiative as “the Bridge,” but the term “socialization“was attached to the intervention by some of the participants. The name I eventually gave the concept, “Social Recovery,” led to calling the intervention the “Social Recovery Initiative.” Although I avoided using the term socialization, the term recovery became problematic as new research on stigmatizing terms impacted drug treatment terminology (Ashford et al. 2018). This chapter chronicles the history, trajectory, and evolvement of a sociological intervention that was tested and found to be successful. It is also a reflexive account of discovering “sociology as an eminently political science, that is crucially concerned with, and enmeshed in, strategies and mechanisms of symbolic domination” (Bourdieu and Wacquant 1992, p. 50). As with any social endeavor, an intervention will run into criticisms that must be addressed and barriers that must

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be surmounted, and in sociology this includes surmounting the epistemological obstacles as well. First, I will explain the conceptual foundations of the Social Recovery Initiative, why this is a clinical sociological intervention, the social capital theory that inspired the intervention, and a description of the intervention implemented and evaluated. Next, a brief explanation of how the intervention can be applied at different levels is illustrated with first-hand accounts. This is followed with a discussion of current semantical critiques of recovery and treatment, which impacted my further development of this intervention. For the sake of parsimony, “Social Recovery Initiative” (the intervention) will hereafter be referred to as the SRI, whereas Social Recovery will refer to the conceptual model behind the intervention. I refer to People Who Use Drugs with the acronym PWUD in deference to the movement toward using less stigmatizing terms (Kelly et al. 2016), which I explain more in a section on contemporary semantics of recovery. I end with a discussion of directions for the future of this intervention.

9.2 9.2.1

Conceptual Foundations and Permutations Clinical Sociology

A clinical sociology approach to solving social problems compels us to actions that “contribute to improving the capacity of persons or groups to develop a critical understanding of their own situations and problems, and then to change their situations and possibly reduce or solve their problems” (Wieviorka 2008, p. vi). Consistent with a clinical sociology approach, the development of the Social Recovery model is grounded in a humanistic philosophy with multidisciplinary perspectives employed to help address society’s enduring problems with substance use. The concept was born out of many years of conducting basic research on substance use as an ethnographer, which entailed walking streets, visiting people in their homes, hanging out in bars, clubs and late-night diners as I talked with people and observed the everyday reality of their lives. My research was often supported with funding from the National Institute on Drug Abuse (NIDA). Research methods for these funded studies included ethnographic fieldwork as well as the collection of surveys and recorded in-depth interviews. Analysis of this data provided new findings on drug use risks and problems, building on the insights from other academic literature, many of which focused on the need for, and the lack of access to, treatment (see for example Boeri et al. 2016; Boshears et al. 2011; Lamonica and Boeri 2015; Woodall and Boeri 2014). Evidence began to mount showing that treatment was lacking a social component, which led to my focus on developing an intervention to meet this need. What sets this clinical project apart from basic research projects was the goal to apply research findings to develop working solutions with an awareness that continual analysis was needed for

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improvement and adaptation purposes. Social capital theory provided the momentum for developing a theoretically-informed clinical sociology intervention.

9.2.2

Social Capital: The Theoretical Foundation

The idea for a social intervention for treatment purposes emerged from my desire to find better solutions to problematic drug use with individualized recovery strategies that focused on social situations, social environments, and network building. Informed by social capital theory, it was apparent that people leaving treatment often relapsed due to a lack of bridging social capital. Social capital is generally defined as social resources available to individuals within their communities and across social networks (Bourdieu 1984; Coleman 1990; Portes 2000). Putnam (2000) writes that social capital refers to “the social norms and networks that enhance people’s ability to collaborate on common endeavors” (p. 35). The conceptual lens of social capital can provide insight into the nature of cessation of problematic drug use by emphasizing the social bonding within a recovering network and the change in social capital that might occur during the recovery process (Boeri et al. 2014). Social capital intersects with a web of links to social networks (Moody and Paxton 2009). Some argue that social capital is the relationship between the individual, social networks, and community resources––defining social capital a process and not a thing (Schuller 2007; Wacquant 1998). Drawing on Bourdieu’s conceptualization of social capital within “habitus” and “field,” Wacquant (1998) portrays social capital as relational (as opposed to substantial), and “defined only in relation to specific social space or arena of action” (p. 27). Likewise, arguing that analysis should not be individuals, groups or communities, but more specifically relations between and among them, Schuller (2007) proposes to move beyond social networks by focusing on the process involved in acquiring or losing social capital. Schuller posits that a social capital analysis should include not merely membership in a social network but what the network means, how embedded it is, how it functions, and the individual relations in this network and other networks. To this end, Schuller proposed a typology to consider the various relationships that exist between and among social networks along the dimensions of high or low bonding and bridging social capital. Bonding social capital is defined as “the links with others who are broadly similar in kind,” and bridging social capital as “the links a community has with others that are different” (Schuller 2007, p.15). Although high bridging with low bonding alienates individuals, a very tight bonding mechanism in a social network may be detrimental if there is a lack of bridging, resulting in the dark side of social capital— an exclusionary community. Applied to PWUD, both bonding and bridging mechanisms are critical when seeking recovery. However, while treatment programs, particularly 12-step programs, emphasize bonding social capital among peers, bridging social capital (relationships with people outside the community of recovering

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PWUDs) is discouraged. Treatment staff and peers often warn people in recovery to stay away from old friends and places, but they provide few strategies for making new friends other than the friends found in new recovery groups. The concept of social capital is often used to explain the unequal distribution of social resources available to individuals that act as a barrier to obtaining desired goals (Lin 2001; Wuthnow 2002). Although family is a starting part for inheriting social capital (Blau and Duncan 1967; Lin et al. 1981), the community is the source of social capital most likely to profit an individual after young adulthood (Bryson and Mowbray 2005). As people become imbedded in community relationships, they rely on these relationships when needed, for example when searching for employment (McDonald and Elder 2006). While “community” refers to neighborhoods and social relationships, social networks also can serve as a community (Singer 2009, 2005). Studies consistently find that drug use, and what is often diagnosed as addiction or drug dependence, is social in nature (Adams 2008; Davies 1998; Graham et al. 2008; Hammersley and Reid 2002; Hughes 2007; Lindesmith 1938). Therefore, it can be argued that social capital is crucial to recovery from problem drug use and drug dependence (Boshears et al. 2011; Cheung and Cheung 2003; Weinberg 2005; Zschau et al. 2016).

9.2.3

Recovery Capital

Granfield and Cloud (2001), noting a direct correlation between social capital and recovery, coined the term “recovery capital,” defined as the combined physical resources, skills, knowledge, and social capital available to a recovering person. Strategies used to increase recovery capital include engaging in alternatives to drug use, creating new relationships to take the place of old drug relationships, and avoiding triggers (Cloud and Granfield 2008). The four domains of their recovery capital model are social capital, physical capital, human capital and cultural capital (Cloud and Granfield 2008). The concept of recovery capital has been widely employed in drug studies, providing substantial evidence for its utility for measuring and predicting successful recovery (Hennessy 2017; Kahn et al. 2019; Laudet and White 2008). In a review of studies on recovery capital, Hennessy (2017) organized the focus of recovery capital into domains of “individual” “micro”, and “meso” levels. The individual domains were physical, human, personal health, and growth. The micro domains were identified as social and family. Meso domains were identified as cultural and community recovery. Zschau et al. (2016) call attention to the fact that there has been very little research on the accumulation of recovery capital during treatment at the individual level. Moreover, when recovery capital engages at the individual level, its analytical lens remains primarily on individual actions and behaviors and individual accountability rather than on the individual’s social environment, as is evidenced by the measures used to study recovery capital (Laudet and White 2008). Some relational aspects of recovering networks are examined, but the

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many social relations that comprise everyday life in real situations (work relations, recreational relations) are underexamined. While the bonding aspects of social capital are intensely measured by recovery capital, the bridging characteristics of social capital have been largely overlooked (Schuller 2007; Zschau et al. 2016). This gap in the conceptualization of recovery capital when applied to the everyday situations of people’s lives after treatment led to the development of social recovery as a needed enhancement to the concept of recovery capital.

9.2.4

Social Recovery

In contrast to recovery capital, which examines the combined physical resources, skills, knowledge, and social capital available to a recovering person (Granfield and Cloud 2001), social recovery refers to the process of acquiring the skills, resources, and networks needed that enhance people’s ability to live in society without resorting to problematic substance use (Boeri 2013; Boshears et al. 2011). Social recovery, as a conceptual aid, is different from the current development of recovery capital in that social recovery points its lens less on individual actions and more on social interactions, acknowledging that both social bonding and bridging relationships outside treatment is needed for measurable and sustained success. For PWUD who are in treatment or seek help to control their substance use, social recovery emphasizes the process of recovering socially rather than defining recovery as the abstinence from all substances. This conceptualization of social recovery was drawn from years of research among PWUD, as well as personal involvement with my brother, who had been using opioids and other drugs since a young age. My brother’s frequent relapses over his life also led me to examine drug trajectories, revealing that discontinuity in drug use over the life course was the norm rather than sustained recovery (Whalen and Boeri 2014) A growing body of research on relapse call for more research that extends its lens beyond contemporary treatment options (Clark et al. 2015; Kelly et al. 2019; Klingemann and Klingemann 2007; Scott et al. 2005; Velander 2018). Treatment success is an ambiguous concept and the definition of success unevenly defined (Calabria et al. 2010; Kiluk et al. 2019; Reisinger et al. 2003). I propose that social recovery is a missing link in treatment strategies that were shown to be successful for some, but not for all, and not forever (Boeri et al. 2014).

9.3

Developing the Social Recovery Initiative (SRI)

The journey from an idea to the implementation of the SRI is discussed here in chronological order, organized by how the intervention was formed, developed, implemented and adapted over time, and how it evolved within contemporary changes in policy, environment, treatment models, social norms, and scholarly

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perspectives of this problem. In a SRI intervention, the clinical sociologist takes the role as a consultant, which implies more of a collaboration than an interventionist in the conventional sense of a counselor, psychiatrist or doctor intervening with a patient. According to Fritz (2008, p.12), a consultant role also has more flexibility: The consultant’s approach might be directive (telling clients what to do) or collaborative (part of a client group and, like other members of the group, offering one’s skills to help the group make a decision).

Over time, SRI emerged through a recursive process between theory and action. The development of SRI involved many collaborations over the years, including communicating with research assistants, community members, treatment staff, and with PWUD. The main components of this recursive process included (1) listening to the people who are insiders––those with experiential knowledge and insights of problem drug use; (2) involving people in the community who may not have direct experience but are impacted by problem drug use directly or indirectly; (3) implementing an intervention based on a conceptual model of social recovery; (4) continually transforming the intervention to address everyday life, theoretical advances, and changing political environments. Listening to the Insiders The concept of an insider refers to someone who belongs to a group or sub-group that has personal, intimate knowledge of this group, its members, norms, people, customs and important details that those outside the group would not possess (Becker 1963). In research aimed to acquire a better understanding of populations that are stigmatized or considered deviant, hidden, or marginalized, it is essentail that people in this population are provided ample opportunity to share their knowledge (Boeri and Shukla 2019). In my studies, not only were they participants in the study, but also insiders were part of the research team (Boeri 2017). A variety of terms are used to describe the people who help ethnographers with insider information as recruiters or as gatekeepers to the population under study. Called community consultants, outreach workers, or key informants, these terms refer to people from the community who are involved in the research through a paid or unpaid relationship with the ethnographer (Page and Singer 2010; Singer and Page 2019; Valdez et al. 2019). This kind “knowledge from below” is vital for situated discovery (Fessel et al. 2019, p. 132). Listening to insiders is helpful for research, as well as empowering for the person who is being heard, often for the first time. Throughout the development of SRI, I engaged with the people involved in the intervention, including PWUD, treatment staff, and research assistants, listening to what they said and respecting their valuable insights from diverse perspectives. Involving the Community Engaging community members in research, also known as Community-Based Participatory Research (CBPR), is a popular strategy in ethnographic studies and increasingly used in health-related studies (Aguirre-Molina and Gorman 1996; Guarino and Teper 2019). Members of the treatment and recovery community consisted of treatment directors and staff (counselors, psychologists, psychiatrists), family, relatives and significant others of PWUD, and representatives of the regulatory agencies involved in governmental control of illegal drug use in the community (police, courts). The views of these community members were

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often in contrast to the perspectives of the insiders themselves, and reconciling the two was sometimes impossible. At the time, few listened to the views of PWUD, although with the increase in peer-mentors and concomitant respect for their views, this is changing (MacLellan et al. 2015; Surey et al. 2019; White 2004). Implementing a Conceptual Model as an Intervention The ideas that shape the conceptual model informing an intervention must be tested. This usually requires a pilot study be implemented and evaluated for how well goals are achieved, cultural adaptation necessities, feasibility, and practical challenges that need to be addressed (Haight et al. 2010; Kahn et al. 2019). For the SRI, I needed a partner organization that would allow the intervention to be implemented and tested. This proved to be more difficult than expected. Existing treatment programs would be the most natural setting for an intervention focused on increasing recovery success; however treatment directors and staff I approached were unwilling to collaborate. Most said they already had activities in their programs. Established 12-step meeting groups (e.g., Alcoholics Anonymous, Narcotics Anonymous), embraced the social bonding aspect of social capital but did not seem to understand the social bridging aspects that required meeting new people in new places. Most had strongly internalized beliefs against socializing with anyone but people in recovery. The only treatment program that welcomed my offer to test the SRI was a local drug court.1 Transforming the Model The SRI was implemented in a drug court treatment program in DeKalb County in Georgia in 2007. Modifications were made during and after the pilot intervention, and the SRI was incorporated into the treatment program at the drug court where it was piloted. I continued to work with the director of the drug court providing student interns to help with activities and evaluation. In 2012, I moved to Massachusetts. By this time, drug courts were considered part of the neoliberal’s “culture of control,” and despite its popularity among criminal justice and treatment professionals, social criticism of drug courts continued (Garland 2009; Kaye 2020; Schept 2015; Tiger 2013). While acknowledging the problems with a top-down approach to treatment that worked with or though the criminal justice system (Boeri 2017), I nevertheless saw an opportunity to promote social inclusion for those suffering from isolation and alienation due to drug use. Borrowing from successful programs for social re-integration, I continued to transform SRI to meet changing situations (Basaglia and Basaglia Ongaro 2005; Dell’Acqua and Mezzina 1998; Portacolone et al. 2015). After the new millenium, drug policy and treatment practices underwent rapid change in response to an ongoing opioid crisis that reinforced the need for less punitive responses to drug use (Okie 2010; Scholl et al. 2019). But changing policy and practices provided few insights on what to do about the complex interaction of influences impacting stakeholders in the arena of substance abuse treatment. Continuing my inquiry with PWUDs and community members forced me to question my

1 Drug courts were one of the criminal justice system’s answer to calls for providing treatment instead of jail through therapeutic jurisprudence (Nolan 2003; Thompson 2006). See Sect. 9.3.2.2.

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assumptions at every turn, and to critically examine my own views. I also reflected on how I had been using labels that were not helping and could be stigmatizing. For example, when writing this chapter, I no longer use the terms “drug user” or “addict,” but instead the more prevalent use of PWUD, although I wonder when this acronym will also be considered a stigmatized term. As I questioned the influence of past and prevailing norms and attitudes on my work, my conceptualization of SRI also changed with the times.

9.3.1

Overview of the SRI Conceptual Model

A brief overview of the SRI conceptual model is helpful to highlight the theoretical foundation of social capital and to distinguish social recovery from other social capital-informed models used in treatment. • The SRI approach facilitates the process of acquiring the skills, resources, and networks that enhance people’s ability to live in society without resorting to problematic substance use. • SRI can be implemented at the individual level by helping a friend, loved one or new acquaintance enjoy activities other than drug use. • SRI can be implemented in schools, churches, clubs, or social-minded organizations through organizing and facilitating SRI activities. • SRI can be implemented in established treatment programs by incorporating SRI as a component of the program with a greater focus on activities and social networks outside recovery groups. • SRI should not be implemented as a drug substitute or alternative but as a paradigm shift that views problematic drug use as a societal problem, not an individual one. • SRI requires reintegration or new integration into social life, and encourages a client-centered approach with community engagement to help develop short-term recovery plans and long-term reintegration processes that fit each individual’s social situation and life goals.

9.3.2

The SRI: Intervention at the Organizational Level

9.3.2.1

Research Methods

Throughout this journey, ethnography provided the epistemology to conduct research at the ground level and to understand my research findings. Like Michael Agar (2006, p. 19), I found in ethnography a logic for research:

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I think of ethnography as a kind of logic rather than any specific method or any particular unit of study. Ethnography names an epistemology—a way of knowing and a kind of knowledge that results—rather than a recipe or a particular focus.

Conversations with insiders and community members, observations on the street, in homes and in treatment facilities, iterative reflections with concepts and theories, and discussions with colleagues led to the development and evolvement of what started as the SRI intervention. For the kind of large-scale ethnography I conducted, I needed funding, which I received from the National Institute on Drug Abuse (NIDA) for four separate ethnographic studies on the lives of PWUD. Each study had similar aims toward providing a more in-depth understanding of drug-use trajectories and accessibility to health services, but each was focused on different populations (people who used methamphetamine in the suburbs; older adults who used illegal drugs, women who used illegal drugs, and opioid use in the suburbs). Ethnographic research requires spending many days in the “natural settings” (field) of the people who are the focus of the study, observing their actions and engaging with them to build rapport, trust, and relationships (Desmond 2014; Page and Singer 2010). Ethnography has been widely used in a range of disciplines, such as anthropology, sociology, and criminology, and has expanded into other disciplines, such as business, nursing, education, and psychology. Yet ethnography is often vaguely defined or described differently depending on the resources, investigator, or training. A book by Boeri and Shukla (2019, pp. 3–4), with 21 ethnographers contributing chapters that describe their ethnographic methods, illustrates the range of what is called ethnographic research: Ethnographic research is indispensable for an in-depth understanding of behaviors that are stigmatized, criminal, or considered deviant and often enacted in secret. However, what ethnography is and how to do it is debated even among the most successful ethnographers... Ethnography can be practiced in a variety of ways within different disciplines, but it essentially involves in-depth interactions with people in settings where they live, work, or play.

My in-depth interaction with people while living their everyday lives, whether they are working, or using drugs, was one of the motivating forces behind social recovery. Ethnographic methods, including observational notes, focus groups, and interviews, helped to develop and transform the SRI model.

9.3.2.2

Implementation in a Drug Treatment Court

Drug courts are one kind of justice diversion with the goal of processing offenders by other than institutional incarceration (Inciardi 2004). Starting in Florida, USA, in 1989, drug courts proliferated over the past three decades, expanding to jurisdictions across the United States and in other countries (Vîlcica et al. 2010). Their success

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rates have been hotly debated and governing methods highly criticized.2 This chapter describes only one drug court in Decatur, Georgia that was similar to many drug courts in design, but controlled by a benevolent and compassionate judge, one of the defining influences on the success of drug courts in terms of therapeutic outcomes (Nolan 2017). Drug courts typically involve a closely-monitored drug treatment plan and case management by a counselor or drug court staff, frequent interaction with drug court staff, regular attendance in court before a drug court judge and drug testing. The structure of programs and intensity of monitoring varies widely between drug courts, often based on available funding and staff expertise; however graduated phases (stages) are a standard in all programs. Participants are processed through the phases depending on their adherence to the rules. They are rewarded with additional liberties, such as an extended curfew or a visit to a family member’s home, as they graduate from each phase and move to a phase that includes more personal responsibilities and less intense court monitoring. At any phase, participants receive sanctions for breaking the rules, such as two-weeks in jail for missing a drug test or a return to a previous phase for not regularly attending 12-step meetings. The severity of sanctions varies widely from court to court and typically is dependent on the presiding judge. Participants seeking to “graduate” from the drug court program (usually a minimum of 2 years) must provide evidence, usually through drug tests, that they are no longer using any substances, including alcohol, and have established participation in 12-step programs in the community. Some stay in the program for more than two years, while others may opt to return to jail or prison or be mandated back to fulfill their criminal justice sentence instead of completing the program. Some research on drug courts found that participants might spend more time incarcerated than they would have if they had not agreed to court supervised treatment, and those who fail to graduate from drug court are disproportionately minorities (Kaye 2020; Marlowe et al. 2016) Programs differ in respect to when participants are allowed to enter drug court. Many programs allow participants to enter before a trial and before a plea, however others allow a post-plea but pre-trial entry into drug court, and some allow participation after a conviction is made, or use a combination of pre-trial diversion, postplea sentencing, and pre- or post-adjudication (Nolan 2003). Additional exclusion criteria include the type of charge and criminal history. Most participants have non-violent offenses. Participants who enter a pre-trial diversionary program typically have their charges dismissed when they graduate, while those who enter post-

2

Some research suggested that drug courts are generally beneficial in terms of lowering recidivism rates among offenders, reducing crime, and saving criminal justice costs typically paid for by the public (Banks and Gottfredson 2003; Gottfredson et al. 2003; Hora et al. 2002; Marlowe et al. 2016; Shaffer 2011). Other research suggests drug courts are “black boxes” of secrecy with the potential for brutalizing coercion, abuses of power, and continuation of the racial discrimination inherent in the criminal justice system (Bouffard and Taxman 2004; Kaye 2020; Tiger 2013).

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adjudication have their sentences suspended until successful completion of the program, at which time the charges are dismissed (Gottfredson et al. 2003). My interest in drug courts was motivated by the persistent movement toward providing treatment rather than jail for people whose primary crime was drug use (Kaye 2020; Nolan 2003, 2017). I began to include observational assignments for students as part of the instruction in my courses on drug use and society. Students were required to visit a range of drug courts covering rural and suburban areas in northeast Georgia, and in the urban areas of Decatur and Atlanta. I accompanied students to quite a few of these courts for training. After two years of observations from 2006 to 2007, I had accumulated over 150 separate ethnographic field notes and a few research papers that students wrote as they continued research on this topic. There was clear evidence from the observations, confirmed by community members, that the DeKalb County Drug Court (DCDC) was the best in Georgia if not in the southeastern United States, further evidenced by continued funding and honorable awards received by the DCDC‘s progressive director. I made an appointment to see the director to ask about the possibility of implementing the SRI. Not only was he open to the initiative, but also he included his entire staff in the training and asked that we talk to the participants regarding the initiative before agreeing to implement it.3 Participants in the DCDC court were mostly African American, and many had been in and out of jail numerous times, as well as through various treatment programs. Most lived in low-income and distressed communities. While they appeared to have strong bonding social capital, for example many attended the same church or denomination, their bridging capital was limited. Some had not had regular employment or stable housing for years before they came to drug court. My meetings with them showed that most were very involved with the program and friendly with the court staff, who except for the judge and director, were mostly of the same race as the participants. The SRI was new to them, and at first they were hesitant, but since their counselors would be coming to many of the social activities, they were inspired to attend as well. The original purpose of the SRI was to introduce new social activities to DCDC participants that would expose them to new norms and networks (i.e., social capital). The intervention was called “the Bridge” when introduced to DCDC participants, but they referred to it by different names.4 DCDC participants offered their own ideas for events and activities, which were included along with other events aimed at building “bridges” to new networks. Student assistants helped with planning and coordination of events.5 3

See Sect. 9.1 for an illustrative anecdote of staff and client participation. See Sect 9.1. 5 One of my student research assistants, Liam Harbry, volunteered to coordinate the SRI and used the experience for developing a senior research thesis. He coordinated the program throughout its first year, and was hired by the DCDC director upon his graduation from college. When Liam received his Master of Public Health (MPH) degree, he was hired as the Executive Program Director of the DCDC and incorporated the SRI as part of the program. Liam established the DCDC 4

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Another challenge was obtaining funding for the activities in the intervention. Our first social event was a car wash by participants to pay for attending a play at the Shakespearean theater. Subsequent planned events during that first summer included a free concert at a city university, college lectures open to the public, and a whitewater rafting trip. Attendance was voluntary but also could substitute for the one monthly social activity already required by the DCDC. Prior to the introduction of the SRI, this social activity requirement was fulfilled primarily at church-based activities with their counselor. Either the SRI coordinator or I (sometimes both) attended all activities. We took careful observational notes on participant reactions to each event, both visual (e.g., happy engagement, apprehension) and communicated reactions. A “debriefing” with participants was held after each event in which participants shared their opinions of the event informally. Some events were well attended and others had no DCDC attendees. Comments by DCDC participants on activites attended and reasons for not attending specific events provided valuable data for future planning. Below are a few excerpts from the lessons learned through debriefing and observations, organized by themes. “Who are you and what are you doing here?” One unanticipated question came during our first event at the car wash. Over 15 DCDC participants came to wash cars to raise money for social activities. I arranged the event at a local oil change establishment on a high-traffic corner. As four or five DCDC men and women worked diligently washing the cars, the car owners stood by the side and talked with those who were waiting to wash the next car. They eventually asked what social cause we were collecting money for, and they were given different ambiguous answers. We discussed this question informally at the car wash and later at DCDC meetings. One common consensus was not to reveal that they were participants in the DCDC due to the stigma attached to drug use. At another event, while a few DCDC participants were in a whitewater raft with the SRI coordinator along with a few unknown tourists, one of the tourists noticed the camaraderie between the SRI coordinator and the DCDC participants. “How do you guys know each other?” he asked. The SRI coordinator pondered the question and replied in all honesty: “We work together.” The man asked the usual response question “Where do you work?” At this point, the SRI coordinator was a little more hesitant and perhaps visibly flustered. If he said the drug court, it might expose the participants who did not wish others to know of their status in this setting. The SRI coordinator replied with a vague reference to working for the DeKalb County government and quickly changed the subject. This uncomfortable conversation led to further dialogue among the SRI coordinator, the DCDC participants, and me concerning how we would introduce ourselves in the future. The decision was made

Foundation to apply for grants and received funding to continue the SRI. After leading the DCDC for seven years, he moved on to work in the healthcare industry. The DCDC SRI has taken on a life of its own beyond the intervention described in this chapter, and its legacy is shown by a current research evaluation of SRI as a family-oriented program for drug court-involved parents, conducted by a professor who studied the DCDC SRI when at Georgia State University (see http://cdsi.fau. edu/sccj/administration/guastaferro/)

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that when participants felt uncomfortable being identified with recovery we would respect their anonymity and refer to ourselves as a social events club. However, in circumstances where it would benefit the development of social capital to identify with recovery, such as when volunteering at an inner-city organization that employs kitchen staff (an opportunity for bridging social capital), we would be transparent. In this case, the consent of all DCDC participants in attendance was obtained before attending the event. To encourage DCDC participants to build bridges between networks, we decided that our responses to questions from those we meet at events may vary depending on the situation, but we should be ready with answers that are (1) honest; (2) do not break the personal boundaries established by DCDC participants; and (3) allowed for social capital connections. “How do we diversify events?” The original plan for the SRI was to have different events hosted by different people, with the SRI coordinator merely organizing the events. It soon became apparent that finding hosts was an ongoing and time-consuming process. The events they offered tended to stay within the responsibilities of the SRI coordinator and myself. Events ranged from those I selected, such as lectures, theater, and poetry readings, to those suggested by the SRI coordinator, which were more physical activities, such as mountain hikes, and community service. Another issue was how to motivate attendance in a constructive way to produce the best outcomes. Participants often did not know which event they might like to attend. Some participants attended events based on time availability without preference or socialization goals. The SRI coordinator eventually organized a theme chart depicting events by three activity types: (1) Mind—events and activities that are engaging intellectually, stimulating thinking and creativity, such as book studies, lectures and plays; (2) Body—events and activities that promote physical activities and self-care, such as walking tours and hiking; (3) Soul—events and activities centered on the development of emotional life and interpersonal skills in community life, such as community service projects and inter-personal development skills (Fig. 9.1) (Boeri et al. 2011). “How do we know what’s going on?” It soon became evident that communication would be an issue. When we first started in 2007, smart phones were not widely available. We asked DCDC participants if they had access to a computer and all confirmed they did. We created an internet social network website so DCDC participants could check the website for instructions, the monthly calendar of events, and participate in a discussion board online. Within a few weeks we realized that we assumed too much in terms of technological aptitude and access for DCDC participants. Thereafter, we distributed hard copy fliers to inform participants of new events as they were organized. Once the SRI coordinator developed the three types of activities explained above, he created monthly calendars with all activities clearly defined by type, a brief description, the event address and host name (Boeri et al. 2011). The SRI coordinator distributed the monthly calendars at court and DCDC meetings. Although smart phones are more prevalent now than when we began, the distribution of paper copies at the monthly events is helpful to remind participants about upcoming events so they can go online and schedule those they want to attend.

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Fig. 9.1 Socialization program & events

At the end of the first year of the intervention, we conducted evaluations (see findings below). The DCDC staff called the events the “socialization program,” a term that was picked up by many participants. We discontinued the name “Bridge” and used the name “Social Recovery Initiative” (SRI) when it was incorporated into the DCDC program.

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Evaluation of the SRI

In the second year of the pilot study, students were recruited from my research methods class to interview DCDC participants regarding their experiences and suggestions for SRI activities. The students were trained in human subjects research and the university’s Institutional Review Board approved the study protocol. Three student interviewers who were not associated with the SRI previously conducted a total of nine in-depth audio-recorded interviews, including five male and four female respondents. A colleague who is a qualitative researcher and not involved with the SRI conducted an objective analysis of the transcribed data.6 Findings showed the DCDC participants felt they benefitted from their involvement in the SRI, and the majority were thankful to have the opportunity to reach out to the community in a socially productive manner. Their comments indicated that they regarded their participation as valuable and constructive.7 The analysis highlighted three areas of impact from SRI activities, which are summarized below. Social Confidence DCDC participants said that involvement in the SRI taught them to be more confident in their ability to attend social events and have a good time without using legal or illegal substances. One female respondent explained that after having attended several events at coffee houses and parks, she knew that “even after I graduate from drug court I could still go to, like, social events and enjoy myself without the use of alcohol or drugs.” Participants also indicated they were also more confident in their social abilities. Having the confidence to engage socially is critical in building relationships outside the usual peer group and in acquiring social capital. By introducing participants to new venues and activities, the SRI provided former PWUD with new options and potential networks. One female participant said that the program made “me not so afraid of new experiences. [. . .] I remember I used to shy away from new experiences. Now it’s like okay take a big breath and just jump on it and do it.” Another participant indicated she felt better about her future social possibilities, “I have a choice and that’s a pretty good feeling.” New Horizons Apart from boosting the DCDC participants’ confidence in their social capabilities, the intervention provided participants with a new outlook on life when many were ready to give up on themselves. The SRI gave some participants, as one female stated, “a better idea of how I would like to spend my time.” Another said he appreciated the fact that his world was now larger. He explained that the SRI had

6 Since I had developed and implemented the intervention, the validity of an evaluation of the intervention is increased by using external evaluators and not being involved in the evaluation data collection or analysis. The data provided by interviews were qualitative in nature, therefore, a qualitative researcher who was experienced in analysing qualitative data was the evaluator for this study (see Boeri et al. 2011). 7 As is common in qualitative research, direct quotes from participants are not edited. Quotes are presented verbatim; a word is inserted in brackets if needed for clarity.

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“changed my mind state because my world is so small. My thinking was so closed. Nothing really existed outside of my neighbor[hood].” The SRI with its varied offerings allowed participants to slowly expand their horizons and incorporate new experiences into their repertoire. The realization that there was a whole non-drug using world out there that they could be part of was important to reintegrating former PWUD and helping them build lasting networks after they left the drug court environment. Bridging Social Capital DCDC participants who were involved in the SRI all welcomed the bridging opportunities that were offered by the social activities outside the DCDC and recovery groups. Evidence of this was shown in participants’ comments such as appreciating the chance to “meet people, build friendships.” One person explained that it encouraged him to “not just sit home and mope around [. . .] I can go out and socialize. I can socialize with other people.” One of the bridging achievements of the SRI was community service, which had been suggested by the DCDC participants themselves to “give back” to the community. Although the motivation to give back appeared to be part of their recovery treatment counseling, the events did show some benefit. For example, one participant expressed his views: . . .being a felon means that I’m in a separate entity in society and for me to ask to do anything as far as volunteer, go feed at the jail. As a felon it’s looked down on like you gotta be kidding me, you have some ulterior motive for wanting to. So with the outreach or the socialization program, I got somebody to mediate for me, to advocate for me. I have an opportunity to build a relationship without talking, and it’s helped me.

This participant put into words what others also expressed in various ways, that is, that having someone mediate—or helping them connect with other networks— opened doors to new social opportunities they never would have had considered possible given their stigmatized status. Case Event Through these diverse social activities, the DCDC participants developed networks and expanded their social activities outside their immediate DCDC peer network. One of the most popular events was the “Poetry Slam“ held at a local coffee house. Since it was free and on a bus line to the group homes, many DCDC participants came to the event before knowing what Poetry Slam meant. After a few weeks, DCDC participants signed up to read their own poems, songs, and raps before a primarily middle-class audience. The enthusiastic reaction from audience members for their first attempts increased subsequent performances by SRI participants. One DCDC participant, who I thought was very shy, attended the Poetry Slam every week. Although I had talked with him a few times, he never looked me in the eyes and always seemed socially apprehensive, so I often sat with him at the Poetry Slam. I saw he began to bring a notebook and was writing in the notebook in between acts. One week he signed up to read his own poem. I never heard this man speak publicly in any of the group meetings we had, and I was slightly worried. Yet, he read his love poem with pride and confidence in front of an audience of peers

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and strangers showing no hesitation or fear. I wondered if he was the same person who told one of the students conducting anonymous evaluation interviews: “I used to wake up and not know what to do. Now I wake up and write a poem.” His story gave me motivation to try social recovery at the individual level with Harry, my brother.

9.4

Harry, Social Recovery Intervention at the Individual Level

During the time that I was developing and implementing the SRI, and while I was conducting ethnographic research among PWUD, my brother was in prison. Harry, a year older than me, was first incarcerated at age 12 for robbing a pharmacy for drugs. Only years later did I learn these were opioids and he was addicted to them. He continued to be in and out of jail, mainly on drug charges, as a young adult until his criminal record made gainful employment impossible. Addicted to heroin, without a job, and not wanting to rob individuals or deal drugs, Harry started a career as a bank robber. Harry’s sentences got longer after the “three strikes and you’re out” laws (see Wacquant 2009). His last conviction added 20 years to a 10-year sentence for two robberies, to be served consecutively. Harry spent most of his last five years of prison in solitary confinement due to continued drug use while incarcerated.8 When Harry was paroled after about 25 years in prison, he stayed with my mother and sister in Florida. My sister found him work as a dishwasher at a nice restaurant, and Harry did well in this environment. However, when his parole officer found out the restaurant served alcohol, he could not work there because it violated his parole. Harry found another dishwasher job working at Denny’s 24-hour restaurant during the overnight hours, what is called the “graveyard shift”. He lived in a one-room efficiency apartment above Denny’s. Working the night shift, Harry had little dishwashing to do and often helped at the counter just to talk to people. The crack epidemic was thriving in Daytona Beach, Florida, and Denny’s was a frequent stop for many of the people using crack through the night. One couple left their little girl asleep in the booth at Denny’s and asked Harry to keep an eye on her while they went out. He eventually gave them the keys to his efficiency and said they could use his apartment to let the little girl sleep instead of Denny’s. The couple soon invited others to smoke crack in Harry’s place while he was working, a routine that came to include days when he was not working as well. Although Harry did not join them in using crack, he did accept the opioid pills they offered him, mainly to help him sleep during the day. The pills were discovered when he had a car accident falling asleep at the wheel, and he was sent back to prison. The next time Harry was paroled, a few years later, I took more interest in his situation since my mother was not well. I strongly encouraged him to stay in 8

See more of Harry’s story in Boeri (2018).

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Philadelphia so he could take part in the new re-entry programs that the mayor had implemented. Harry participated in a work preparatory program that required weeks of classes. At the end of the program he was given a list of places to apply to for work. He applied to all of them and never received a call back. Finally the director told me “your brother is unemployable,” a fact I suspected. He suggested Harry go to the corners where day workers are picked up for small daily jobs, but even there, Harry was never selected. He was older than most of the men and much thinner, and he was told he did not appear to be somebody who could do hard manual labor. He became more depressed about his situation when we talked in the evenings. I came to Philadelphia to help Harry enroll in the Community College of Philadelphia. It was difficult for Harry to find a place to live with no permanent job and no rental history, but we finally found a room in a boarding house, with a landlord who had compassion for the formerly incarcerated. He got a college grant with a student work-study assistantship and started work in the library. Once Harry told me he was an “addict” and always would be addicted to a drug. He said I had to understand that he did not fit in normal society. While in school, he substituted alcohol and marijuana to avoid using heroin. Harry said taking opioids would interfere with his schoolwork, but he drank during the day to help him fight depression, and smoked marijuana to help him sleep. I noticed that as he became more involved in school and work, he began to drink less frequently. Within a year, Harry changed from being depressed about his future to envisioning a life for himself outside the prison walls. After taking one ceramics class, he became absorbed in pottery, and often worked on the porch forming clay bowls while he watched the kids play on the streets. He proudly showed me one of his pieces on display in the college library. He had made friends, was enjoying classes, and was appreciated by the staff at the library. He would soon be graduating, and I asked him what his plans were. He had become friendly with one instructor who taught a class on addiction. He told me he wanted to be an addiction counselor. “How can you be an addiction counselor if you drink alcohol and smoke marijuana every day?” I asked him, knowing that almost all treatment programs in the United States insist on abstinence, particularly for counselors or peer-counselors. “Yeah, I thought about that,” he replied. “I figured it won’t hurt my work with them. I learned how to control my use, and today there are approved medications for people with serious drug dependence.” I laughed at this because he was probably right. Recently he told me that his supervisor at the library, who liked Harry very much, told him that one of the other workers said he always smelled like whisky. “Yes, I guess I do. You see I carry around a flask of whiskey and take a sip now and then throughout the day,” he replied sincerely. “It sort of eases my mind, you know. Does it affect my work?” “No,” she answered after a thoughtful pause. “I guess it doesn’t.” She never mentioned it again. I joined in Harry‘s enthusiasm to start a treatment program that focused on control and not abstinence. With his graduation drawing near, I began to look for a house to rent or buy for Harry to come and live in Atlanta, Georgia, where I was living at the

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time. We discussed starting a program where Harry could live with other men and women who were trying to stop problematic use of hard drugs but might not have a problem with alcohol or marijuana. It would be based on a Housing First model (Tsemberis et al. 2004), in which no one would be kicked out of this home for smoking marijuana or having a drink, as long as it did not cause a problem. I introduced Harry to Social Recovery strategies, which he realized were what he was doing by going to college, meeting new people, spending time learning pottery, and gaining social capital to achieve his new goals in life. Harry had reached a turning point. One evening he told me something I never thought I would hear. I think I might be able to do this, you know, living in the real world thing. At first I was doing it because it made you happy, and I had nothing else to do anyway. I was pretty sure I would be sent back, or be killed trying to run. I could not see me living long in society. But now, I can—and I like it. And I think I might make it out here after all.

The Community College of Philadelphia had changed Harry’s life. Having a responsibility in mainstream society motivated him to stop hard drug use and to use alcohol and marijuana less frequently. This was the social control mechanism that he was never allowed to experience while being in prison and on parole. Now, for the first time in 40 years, he saw a place for himself in society without having to use heroin. Before he could fulfill this dream, Harry was shot and killed in a drug deal that occurred in the boarding home where Harry lived in Philadelphia. The person convicted of the murder, who went by the street name of Snap, confirmed in court that Harry was not involved in the deal. He knew Harry from prison; they were both in in “the Hole” (isolation) and talked to each other through the bars to pass the long hours. When Snap saw Harry on the street near the college in Philadelphia, he asked for Harry‘s address. He arranged the drug deal at Harry‘s house in a part of Philadelphia where his face was not known.9 I asked for Snap‘s case file and looked up his records online. When I read his rap sheet, I realized that Snap’s life was much like my brother’s. Snap was younger by 23 years, but, like Harry, he started abusing substances at a young age. He had a number of traumatic incidents as a child, and he suffered from depression. He had 20 arrests as a juvenile and was committed to juvenile reform institutions. Like my brother, being in a reformatory led to a life of crime. In and out of jail as an adult, he

9

Two people were killed during this incident–Harry and the person who came with money to buy a large quantity of cocaine. Although Snap was convicted of both first-degree murders, he testified that he set up the deal but did not come to the house at the time of the meeting. I am not convinced the murderer is Snap. A week before the murders, my brother had mentioned meeting Snap, and he told me some men with guns barged into his house looking for Snap. I provided this information to the detective and the Assistant District Attorney prosecuting the case. They did not use it since it cast doubt on their case that Snap committed the murders. I attended Snap’s court case and was not allowed to provide any testimony that would have impacted the case. Snap was convicted because the prosecutor built his case on character assasination that convinced the jury Snap was guilty of murder. I am in contact with Snap, who is serving a life sentence, and trying to help him in his appeal for a new trial.

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had no record of legal employment. His life story, like many I have heard and read, showed a lack of social capital that would provide him the networks he needed to succeed in life outside of crime. My brother was part of Snap‘s network only because they met in prison. This was Harry’s social network following him even after incarceration. Harry had started making new social network connections using social recovery strategies.10 Snap, it appears, never had this opportunity. After Harry’s death, I stopped work on the SRI. I moved to a new city and took a new position in a new university. I received another grant to study people who used opioids. Opioids had made a fierce return, instigated by a pharmaceutical company flooding the market with strong prescription opioids called Oxycontin (Cicero et al. 2005; Okie 2010; Scholl et al. 2019). After a few years of research, I came back to the concept of social recovery. With a renewed focus on medication-assisted treatment, treatment models addressing the social environment was still lacking, with no effort toward increasing social capital while in treatment. Rather than attempt to implement the SRI in a treatment program, which I predicted would be harder than the first time I tried to do this, I worked on creating a web presence to disseminate the conceptual model of Social Recovery. I put Social Recovery material on the website, with instructions on how to use Social Recovery strategies at the individual, group, and organizational levels. I provided stories of people who used Social Recovery to help them address problem drug use. Listening to advice from a lawyer, I started the application for a federal nonprofit status for “Social Recovery Inc.” The website was put on hiatus until the legal work was completed. Meanwhile, I learned that the term recovery was becoming problematic. The nonprofit application for Social Recovery Inc. needed a new name.

9.5

The Semantics of Recovery: A Rose by Any Other Name

For decades, the term recovery has been used in the United States with a general acceptance that when used in the context of drug recovery, the term indicated abstinence. Recovery in substance use treatment is also referred to as rehabilitation or reintegration in some places. As Rigas and Papadaki (2008, p. 119) noted: One of the most important responses to social correlates of drug addiction in Greece is the establishment of forty specialized social reintegration and vocational integration units for

10

After Harry died, I received many calls from people who knew him. One was a woman Harry stayed with while looking for a place to live. She confirmed Harry had stopped using drugs after he started college. She told me she had offered him heroin and he said he would not want to disappoint me by failing out of school. Social Recovery activities alone are not enough, a trusting and caring relationship is helpful for those who are alone. Many of the SRI clients who participated in activities said they came to the events because Liam or I would be there. Criminal justice reform is also needed. Harry’s story also calls attention to the fact that without structural responses to problematic situations Harry faced when re-entering society (e.g., employment, housing, criminal record), social stability is always elusive.

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former drug users. The aims of the units include providing job-hunting skills, improving educational levels, increasing vocational training, and increasing opportunities for entering the labor market by special subsidy schemes.

Rigas and Papadaki (2008) refer to a number of popular strategies employed in rehabilitation in Greece, which originated in the United States but are used in treatment programs around the world. Some, such as cognitive behavioral therapies, are based on research showing individuals can learn to correct problematic behaviors (Carroll and Onken 2005; Carroll et al. 2008). Other evidence-based therapies using behavioral change techniques work in conjunction with pharmacotherapies (Dole et al. 1966; Fiellin et al. 2006). In recent years, and particularly in response to the opioid crisis, drug research and treatment have become more focused on integrating findings from the neuroscience and brain mechanisms (Schaefer et al. 2017). Yet, these therapies still address the individual and not the social environment. Concomitantly, the terms used have changed from the traditional scientific terms to more treatment focused terms. For example, opioid replacement therapies (ORT) such as methadone or buprenorphine became known as medication-assisted treatment (MAT), with the goal to reduce the suggestion that one drug was being substituted for another and to “normalize addiction treatment” (Collins and McAllister 2007; McCance-Katz 2004; National Institute on Drug Abuse 2018). Similar to the evolving semantics in opioid treatment, terms used by academics, medical providers, and treatment professionals to identify the person who was called a “drug user” became “person who uses drugs, or people who use drugs, often acronymized as PWUD (Ashford et al. 2018, 2019; Pivovarova and Stein 2019). While terms such as “addict,” “dopefiend,” and “junkie” were employed by the most cited and respected researchers in the recent past (Acker 2002; Bourgois and Shonberg 2009; Fafard 2012; Fry et al. 2008; Granfield and Cloud 1996; Singer 2005), these words are rapidly disappearing from peer-reviewed articles. By 2016, guidelines had been developed on the use of non-stigmatizing language for journal articles, and only PWUD was permitted in most journals (Saitz 2016). The term “recovery” was also identified as a potentially stigmatizing term. Many times, I am interrogated on why I use “recovery” in Social Recovery. The typical question I am asked is “why assume the person needs to recover?” As more of my colleagues pointed out the problem with the term recovery, I began to stop using this word in writing and withdrew from promoting the Social Recovery model. Although addressing stigma involves more than simply using a new term (Corrigan 2014), I resigned myself to finding a more acceptable term. Drawing from my philosophy of community-based research, my goal was to collect perspectives on recovery and other terms directly from PWUD before further developing Social Recovery with a new term. My frequent conversations with PWUD while in the field led to the discovery that they either did not have an issue with the term recovery and in fact some preferred this term, or they offered a variety of terms and combination of terms to use with little agreement. Examples include relatively newer terms that are sometimes used in treatment, such as reintegration, transformation, as well as older

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terms that have been rejected by the avant-garde of semantics entrepreneurs, such as rehabilitation (e.g., “why assume the person needs to be rehabilitated?”). Even when the term recovery is used, there is no consensus on its definition. Recovery is often used to indicate total abstinence of alcohol and drug use, particularly in 12-step literature where the process of maintaining abstinence is referred to as being in recovery (Granfield and Cloud 1996; Hoffman 2003; Laudet 2007; Laudet and White 2008). In some cases, the term recovery is employed to indicate the cessation of an addictive and problematic drug but not necessarily all alcohol and drug use (Barker and Hunt 2007; Weinberg 2000). I used the term recovery to indicate cessation of problematic use of any drug (or alcohol) but not necessarily the abstinence of drug or alcohol use if it is not problematic. Around the time I was looking for a new term to use, I was asked to write this chapter for the second edition of International Clinical Sociology. I have developed and implemented only one clinical intervention––the Social Recovery Initiative. While I believe the initiative provided good results when implemented and tested, I was still hesitant to publish anything regarding the model without having a new term to use. I knew Social Recovery fulfilled the requirements of a clinical sociology intervention. It was a multidisciplinary and humanistic approach applying social theory, concepts, and methods to address a problem in society, it aimed to reduce suffering, and it involved a change in current treatment models (Fritz 2006; Gargano 2008; Rigas and Papadaki 2008). Looking reflexively at my own cautious attitude, I realized that the current situation regarding semantics did not change the good that this intervention had shown and can continue to show in the future. Promoting the strength of clinical sociology is more important than worrying about any academic criticism I will receive for using an outdated terms. Michel Wieviorka (2008, p. v), a former President of the International Sociological Association, reminds us: One of [clinical sociology’s] strengths is its interest in individuals as human beings, their everyday lives, their histories and trajectories, their knowledge, and their hopes and fears as well as their capacity to build an understanding of their situation and to change it. Another strength is that clinical sociology entails intervention by researchers, who do not remain in their ivory tower.

I am not concerned about my position in the academic “ivory tower.” I am concerned that treatment continues to be focused on the health and psychological aspects of what is called addiction, and most treatment programs attempt to change the individual without changing their social situation or environment. By proposing Social Recovery, I am not assuming that all PWUD need social recovery, but for those who are having a re-occurring problem with substance use after being in treatment, the social context of their lives is often the aspect that causes or influences drug problems directly or indirectly. Having developed this intervention while engaging in the everyday reality of people who are suffering, I recognized the gap in treatment programs is that they are not addressing the social context of people’s lives. I proposed a Social Recovery intervention––a dynamic model that can be adapted to address individual situations as it is transforming the lives of those who engage in the social activities designed to provide social capital. This intervention can be adopted by anyone, any group, or any organization to address the individual’s situation and need for bridging social capital.

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Conclusion

Writing this chapter, I reflected deeply on how the social intervention I implemented in a drug court impacted the participants, as well as how the participants influenced the further development of the intervention. I contemplated how I was able to inspire social recovery in my brother’s life, successful beyond my hopes; however, his death reminded me of the limitations of what an intervention can achieve without macro social changes. I reflexively questioned by own motives, training, beliefs, values, and actions. I am convinced that this clinical sociological intervention is needed more than ever in contemporary treatment. I might call it the Social Transformation Intervention when I write about it again or implement it. I suggest that each person, group, or organization that uses the conceptual model call it whatever fits their needs (or like I did with my brother, call it love). Whatever term is used, the intervention fits the definition of clinical sociology discussed by Wieviorka (2008, p.v). [Clinical sociology] is in the very process of transformation that the analysis contributes to creation or activation. This means that research can be scientific and directly connected with social needs and demands and also that it can be developed by academics, with a real involvement of the people who are studied and their active and conscious participation in the analysis... involved in concrete social activities dealing with real individuals.

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Chapter 10

Children’s Human Rights as a Buffer to Extremism: A Clinical Sociology Framework Yvonne Vissing

10.1

Human Rights, Extremism, and a Clinical Sociology Approach

Clinical sociology offers a special framework for our understanding of psycho-social problems. It empowers us to examine the interface among macro, meso and micro factors and how they influence particular outcomes. In doing so, it provides intervention strategies that may produce, or prevent, certain consequences. This chapter explores the rise of extremism and offers an approach that makes rights-respecting behavior more likely. It focuses on socialization of youth and the intersection of interpersonal, psycho-social, organizational and community factors as they influence either human rights respecting attitudes and behaviors or the acceptance of violent extremist beliefs and actions. Consider possible trajectories for youth. Greta Thunbergh (2019), Malala Yousafazi (2013), and Parkland, Florida high school students in the US (Witt 2019), all under 18 years of age, were socialized to know they were entitled to human rights. They are using their rights in respectful ways to promote social change. Fighting for climate change, safety, access to education, and gun control, they have personal and organizational support systems that help them. These systems have relied upon the value of human rights treaties and principles to empower actions. The result is that all of these young people have become positive change-agents for the world (Lam 2012). Their use of human rights to advocate for themselves and others isn’t unique. There is a global social movement of pro-active youth fighting for human rights and positivity (Vissing 2019a, b). There are countless efforts being made around the world by and for youth to engage in pro-social constructive actions, including peace,

Y. Vissing (*) Salem State University, Salem, MA, USA e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_10

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justice and anti-violence. Youth regularly engage in volunteerism and behaviors designed to promote tolerance, acceptance of diversity, and loving-kindness. Youth altruism, anti-bullying and opposition to violent behavior have increased (Brittian and Humphries 2015; Eisenberg et al. 2006; Telzer et al. 2018), as have efforts to help children to be more empathetic (Bhugra 2016; Davidio and Banfield 2015). But other children are socialized towards the acceptance of extremism. For instance, in the US, Nazi-salutes have become vogue in certain schools (Gorman 2019; Hassan 2018; McIlhinny 2019; Vera 2019). Youth alt-right white supremacy groups like Generation Identitaire are popping up around the world (ValenicaGarcia 2018). Youth are targeted for recruitment through online platforms and school-based propaganda campaigns (Anti-Defamation League 2020). For example, since 2009, 8000 children have been recruited and used by Boko Haram in Nigeria to engage in terrorizing behavior; in 2015 the United Nations verified 274 cases of children recruited by Islamic State in Iraq and Levant (ISIL) in the Syrian Arab Republic, growing to over 1000 since then (Counter Extremism Project 2020). During the heyday of the Ku Klux Klan in the United States in the 1920s, many of its eight million members were children, recruited as Ku Klux Kiddies. While membership in the KKK may have declined, the number of hate and white supremacy groups in the U.S. has reached an all-time high to over 1020 hate groups in 2017 (Blakemore 2019). The number of hate groups has increased worldwide (Laub 2019). The New York Magazine (2019) dedicated an issue to the growing terrorist movement, a movement fueled by white supremacy, hatred of people from different races and ethnic groups, a threat that is global in nature. Many involved in this new form of terrorism and extremism are young in age, with the majority appearing to be male. Children and youth are recognized as a primary target for extremist recruitment (Harper 2018). Adults may strategically or without realizing it socialize their children to be biased against certain groups of people. Prejudice can be transmitted intergenerationally through routine conversations (Alvy 2019; Inzlicht et al. 2011; Pappas 2012; Skinner et al. 2016). Because schools tend to have contact with all the children in a community, what they impart is of extraordinary importance. The United Nations Convention on the Rights of the Child regards every child having the right to learn about human rights (Mehta 2015; UN 2011). Education for respectful, democratic citizenship is vital for the achievement of peaceful, sustainable and inclusive societies based on the human rights of everyone. Rightsrespecting education lies at the heart of work by the Council of Europe, the United Nations Educational, Scientific and Cultural Organization (UNESCO), the Office for Democratic Institutions and Human Rights of the Organization for Security and Co-operation in Europe, and the Organization of American States (Tibbitts 2015). Education functions as a multiplier, enhancing all rights and freedoms when it is guaranteed while jeopardizing them all when it is violated (Jerome et al. 2015). Thus, human rights education has a significant role in securing the enjoyment and protection of children’s rights as it enables the process by which children can learn about and through their rights. When education is used to promote extremist views, it too may have a multiplier effect.

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Encouraging children to think and behave in particular ways is nothing new. In the most simplistic terms possible, children are the future of the world. Having them replicate attitudes and actions adults deem desirable is understandable and referred to as the replication of society (James and Prout 1990). As they are taught through formal or informal means, their education results in the transformation of society as they become both creators and utilizers of knowledge. When children are taught that certain views—political, religious, or about certain groups of people are important, they are more likely to carry them forward in their own lives (Corsaro 2017). This can be in positive or negative directions. How can clinical sociology help us to mitigate the effects of violent extremism by promoting human rights respect in youth? This is what this chapter will explore.

10.1.1 Defining Extremist Behavior The term extremist is often associated with groups such as the Islamic State in Iraq and Syria, or ISIS. But the term is being redefined to address contemporary events. The US Federal Bureau of Investigation finds that racial and nationalistic extremism has become a global threat that “puts it on the same footing as ISIS and homegrown violent extremists inspired by foreign terrorist groups” (Boboltz 2020). And increased demographic diversity has contributed to an increase of violent extremist attitudes and actions among your people (Jones 2018). Extremism is defined in this chapter as a spectrum of attitudes and actions that starts with embracing negative stereotypes and biases that can lead to prejudicial attitudes and ultimately violent behavior (Fig. 10.1). Extremism starts with prejudice, which is a pre-judgment that reflects a notion of “that’s how those people are” as reality. Prejudice categorizes some groups as positive and better than others, while negative stereotypes portray others in ways that are disparaging. While it is almost impossible to escape being exposed to stereotypes and having some degree of prejudice, those prone to extremism accept harsh views of “the other”. As Robert Kennedy (1964) is credited for saying, “What is objectionable, what is dangerous about extremists is not that they are extreme, but that they are intolerant. The evil is not what they say about their cause, but what they say about their opponents”. In order to counter violent extremism, it is therefore necessary to critically assess how young people come to embrace biased, distorted thinking of others in the first place. Replication of experienced behaviors is considered vital in the social construction of reality (Hoffer 1951; James and Prout 1990). Research on child abuse finds that Biased & Prejudicial Atudes

Minor Discriminaory Acons

Fig. 10.1 Stages of extremist socialization

Major Discriminatory Acons

Violence & Aggression

Terrorism & Intent to Kill

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use of violence against children is often learned and transmitted from one generation to another as both normative and appropriate (Straus 2017). Research on bullying indicates that children who became bullies were often themselves the targets of bullying and aggression (Coloroso 2009). The words that children hear and actions they observe about how to refer to and treat others may have major long-term consequences. In the spectrum used here, youth may engage in minor discriminatory actions, such as verbal abuse or setting people up to be embarrassed or inconvenienced. If there are sufficient social and organizational supports to curtail these actions, extremism might be circumvented. However, if youth receive positive reinforcement for engaging in these discriminatory actions, they obtain incentives for engaging in more severe types of discrimination. Feeling emboldened through positive responses from others for discriminating, there may be heightened encouragement for more intense aggression and violence. The willingness to terrorize others and to engage in violent extremism is nurtured and can escalate unless interventions are implemented (Coloroso 2009). And as Fig. 10.1 illustrates, there are many different points of intervention that could turn the tide away from extremism. At the end of the spectrum when violence is greatest, criminal justice interventions may be effective. But long before they are necessary, other diversion strategies, especially at the individual and organizational level, may be effective to prevent more harmful actions that constitute terrorism. Extremism is traditionally viewed as a radical, fanatical fundamental political or religious ideology that can be far-left or far-right in orientation. Those acting in extremist ways may appear to be obsessed and sure their position is correct, unwilling to compromise, and tend to demonize “the other” that they oppose (Wintrobe 2006). Extremism, like mass shootings or bombings, are often looked at as an outcome rather than a process. But shootings or bombings are just the end-point of a lengthy trajectory of socialization and reinforcements. Focusing more on the process by which extremist attitudes are learned and supported have front-end benefit in preventing back-end violence. Laird Wilcox’s typology of extremism (1987) fits into the Fig. 10.1 spectrum. He alleges that extremists engage in character assassination, question someone’s qualifications, make fun of someone’s looks, personality or mental health. They employ negative labels and resort to epithets that disparage others, making sweeping false generalizations. They discount the importance or use of facts, exaggerate information, rely on double-standards, and rely on inadequate proof for making assertions that place others in a negative light. Black-and-white thinkers, people who disagree with their views or challenge them, are viewed as evil, bad, immoral, or dishonest people who are wrong. Seeing themselves as having moral superiority, their attempts to quash critics may be intense, as they are perceived to be enemies that must be stopped. Extremists feel a need to “win” or be “right”, thus may deliberately lie, distort, slander, defame, promote misinformation or undertake violence in “special cases“even over minor interpersonal slights because it is deemed necessary to

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protect their “good cause” and reputation. Extremists are prone to conform to groupthink, which makes social media and associations with like-minded people dangerous—but group-think also could be used to promote pro-social attitudes and behaviors as well (Janis 1972). Thus interpersonal and relational interventions may be best suited to disrupt these kinds of hostile thinking patterns and replace them with pro-social groups that support respectful values, attitudes, and actions.

10.1.2 Defining Rights-Respecting Behavior At contrast to extremist behavior, rights-respecting behavior is more than just being “nice”. As used in this chapter, respect is behavior that regards the feelings, wishes, rights, and traditions of others. It is tolerant, accepts diversity in all its forms, and seeks to honor the dignity and integrity of others. When there is conflict or differences of opinions, attempts are made to promote a just and equitable solution. It includes respecting one’s own rights as well as respecting others. It stems from an attitude appreciating the humanity that is inherent in every living being. It includes admiration for what human rights treaties stand for. Even if someone has challenges accepting someone who they have learned is different, there is the attempt to try to do the right thing by finding common ground to work through those differences. Respect is antithetical to aggression and oppression. While there are many different human rights documents, starting with the Magna Carta I in 1215 and the 1948 Universal Declaration of Human Right, today the 1989 United Nations Convention on the Rights of the Child (CRC) is the most ratified human rights treaty in the world. All 193 UN member nations have ratified it except for the United States (University of Minnesota Human Rights Library 2020). The treaty lists over forty articles pertaining to children’s rights, particularly in the areas of provision, protection, and participation (Office of the High Commissioner for Human Rights 2020). As the CRC pertains to promoting rights-respecting behavior and preventing being exposed to extremist ideology, the treaty (Articles 28, 29) mandates that children should be educated about human rights and the details of the treaty. This is based on the assumption that if children learn that they have the right to be respected in all aspects of their rights, they will learn that others do as well. Supporting rights-respecting behavior is positive for both individuals and society as a result. Giving one group human rights does not take away the rights of others; in fact, rights-respecting actions are assumed to beget more rights-respecting actions. Article 2 in the CRC is essential in the prevention of extremism: States Parties shall respect and ensure the rights set forth in the present Convention to each child within their jurisdiction without discrimination of any kind, irrespective of the child’s or his or her parent’s or legal guardian’s race, colour, sex, language, religion, political or other opinion, national, ethnic or social origin, property, disability, birth or other status and States Parties shall take all appropriate measures to ensure that the child is protected against all forms of discrimination or punishment on the basis of the status, activities, expressed opinions, or beliefs of the child’s parents, legal guardians, or family members.

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Articles 30 and 36 further elaborate on protections against prejudice because of who or what they are. Article 6 of the CRC recognizes that every child has the inherent right to live and survive; Articles 19 and 24 protect them from physical, sexual, verbal and emotional maltreatment and their right to good physical and mental health. Article 32 protects them from economic exploitation. Article 27 recognizes the right of every child to a standard of living adequate for the child‘s physical, mental, spiritual, moral and social development, and Article 37 protects them from being degraded or tortured. Articles 12, 13, 14 and 17 protect the right of children to form their own views— which implies that they should not be brainwashed or forced to adhere to views that are not in their own best interests. They should be allowed to have access to information that will expand their horizons of possible ways to think and not have certain bodies of information unavailable because adults don’t want them to know about them or think in particular ways. The assumption is that education and information that is good and unbiased will help them to be critical thinkers, and when children are critical thinkers they will ask questions to help them choose thoughts and actions that are positive and in their best interest—and in the best interest of society as a whole.

10.2

Interventionist Framework

The framework proposed here (Fig. 10.2) conveys an interrelationship between macro, meso and micro levels of influence on children’s socialization. What happens at home; with peers; and within school, organizations, and the larger community all impact the way children perceive and interact with others. In the socialization of children towards respect or extremism, all of these units have a contributing effect. But which level influences the other for our target of intervention? This is representative of the classic chicken-and-egg conundrum. As sociologists, we know that family interaction patterns are influenced by community factors. In some communities there is a climate in which it is normative for people to care about each other, where diversity is seen as normal, expected, and welcomed. Government, schools, businesses, faith communities and organizations go out of their way to demonstrate tolerance, respect, and find ways to create opportunities that will lift up all peoples. They help one another when people are in distress or oppressed. Where there is a sense of abundance or “having enough”, communities may make efforts to make sure everyone has enough to eat, decent housing, adequate incomes, and supports that work when people are in need. People are able to give to others and be generous of resource and spirit when they have sufficient supports. Children benefit from this abundance and may be exposed to both family and community role-models who are altruistic and open-minded to ways

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Fig. 10.2 Child extremistrespectful socializationintervention framework

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to help others. When they hear positivity, respect for others, and concerns about how to be socially responsible, children will assume these are normative attitudes and behaviors that they are supposed to replicate. Conversely, there are other communities where conflict reigns, crime is high, and competition for resources is normative. This all leads to distrust, intolerance, anger, and resentment. Such emotions in turn may fester into oppression, discrimination, hate, and violence. These types of communities do not experience abundance but deprivation. Not having access to good jobs that pay well, where hard-scrabble realities make it challenging to even walk down the street safely, where hunger and economic distress exist may morph into personal distress and trauma. When someone has access to resources that others don’t, competition results in suspicion and intolerance. Protecting one’s own fragile and vulnerable existence may result in taking defensive actions that harm the reputation, ability, or even lives of those identified as threats. When parents complain about other people taking advantage of them, and blame personal or social troubles upon certain individuals or groups of individuals, those messages are not lost on children. Communicating that the only way to get ahead is by getting rid of those who seem to threaten you is not supportive of a civil, respectful society. Children who grow up witnessing oppression, aggression, or even violence against certain people as acceptable behavior are likely to replicate similar actions and attitudes because they think they are the correct thing to do.

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In short, community-level factors directly impact children’s day-to-day experiences, which become perceived as actual realities that confront individual’s lifechoices (Community Tool Box 2020). People logically respond to their social milieu. In this way, one can argue that intervention at the community level is essential to shaping a young person’s perception of the world and values about goodness of others and norms about what is appropriate behavior. In short, the more a community embraces respect for others, the more likely children are to adjust their perceptions and behavior accordingly. The more violence and intolerance for others are deemed acceptable, the more likely it is the child will come to embed those views and actions as their own. We also know that community factors are influenced by individual level dynamics. In the study of social movements, it is clear that when a core of individuals feels strongly about something and they bond and work together with a common goal in mind, a small group of people may be able to change the way leaders and the public view a problem (Moyer 1987). In civil rights struggles from the US to India, we can see that when the tolerance level of the public rises against oppression that social change can occur. Segregation was outlawed in the US and the caste system was broken in India (Gandhi 2020; King 1964). Conversely, when a group of people who feel oppressed decide to take action to gain power and control, they may direct their negative emotions onto vulnerable or identifiable groups. Since 2016 there has been a sharp increase of hate crimes in both the US and EU which seems to be a result of a change in tone and climate within national political leadership, according to the Center for the Study of Hate and Extremism (Levin 2018). Hate crimes by race, gender, and religion have increased, with increases attributed to changes in the national leadership and social climate (Hassan 2019; Pitter 2017; Williams 2018). In sum, a child’s extremist or respectful behavior is impacted by the influence of micro, meso and macro forces.

10.2.1 Micro-Level Factors Children imitate the behavior of parents and significant others (Hassenfrantz and Knafo 2015). While parents and family, as primary group members, are most influential in a child’s early attitude formation, other people emerge as influential role models over time (Baumrind 1971; Power 2013). These may include teachers, coaches, clergy, governmental leaders or others. Adults instill in children values and norms about what is acceptable or non-acceptable behavior. For instance, nonviolence may be regarded as passive and weak, whereas violent extremism may be viewed as positive because it conveys control and action for a cause. Cliques and peers can directly influence the way a youth thinks or acts. Social media comes to play an important role as a youth interacts with others online, reading their posts and comments (Piotrowski, Vossen and Valkenburg 2015). Youth become influenced and inspired to read or view materials, understand news or contemporary social issues, and join with like-minded others around causes that they deem good, bad,

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right or wrong, respectful or extremist (Akram 2018). While social media has become a recruitment mechanism for extremists on both the left and right (Morris 2016), well-designed social media can also become a conduit for the dissemination of altruistic, pro-social behaviors. Whatever is learned in intimate relationships may bubble out into the larger community. These micro-level interactions may merge to create a tipping point when the community morphs into either a rights-respecting community or one whose climate reputation is one of intolerance and violence (Gladwell 2000).

10.2.2 Meso-Level Factors Schools bridge micro and macro factors. Melzer (1995) observes that children are regularly exposed to both respect and violence at schools. Schools are a dominant institution where many aggressions occur. Schools have contact with most of the youth in the community, generation after generation, and are therefore in a superb position to set standards for how to show students how to be rights-respecting. The model recommended here places an emphasis on schools as a critically important socialization agent for the following reasons. One, children can be exposed to material and information about the importance of honoring human rights and the dangers of extremism. Two, they can witness teachers and other adults who exemplify rights-respecting behavior through words and actions. Three, schools socialize children who may become parents, thereby giving them skills on how to interact with children to learn respect for others. Four, schools can become the epicenter for human rights dissemination that inspires human rights embeddedness into policies and practices at the organization and community level. This transformation in schools occurs in several ways. One is at the curricular level; there are many different human rights educational curricular materials available from preschool through higher education. The pedagogical approach becomes vitally important. Another way schools influence students respectful or extremist action is at the operational level; some schools are warm, nurturing places where students and faculty seem to like and respect each other, others seem more like prisons or total institutions where there is heavy control, authoritarian leadership, and vicious competition. The type of rules, policies, procedures, and criteria for disciplinary action can vary a lot. For instance, spanking a child in the US is forbidden in some states but actively used in others (Caron 2018); states may operate with different rules about what constitutes a violation or how disciplinary actions should be handled (Education Commission of the States 2020; Kane 2017). Another influence occurs on the interpersonal level between students and this is often invisible to outsiders of the interaction. This is where bullying, harassment, and micro-aggressions occur. Bystanders, especially those in positions of leadership, can switch a youth’s inappropriate behavior from aggressive to respectful (Stopbullying. gov 2020). It may be challenging for adults and peers to impart rights-respecting behaviors when in conflict-ridden situations or environments (Sainz 2018). Even

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though conflict may pose serious limitations or challenges for those promoting a rights-respecting approach, such situations may actually provide unique opportunities to figure out how to be respectful rather than extremist. The wisdom of knowing how to act in conflictual situations may determine the trajectory of outcome, making the use of phronesis (practical wisdom) an important interpersonal skill to develop in youth (Darnell et al. 2019). Access to human rights education ideally occurs in a scaffolded manner from preschool through higher education, so over time students gain a comprehensive understanding of human rights. Civic engagement, volunteerism, service learning, or global education may be portrayed as human rights but unless students have a larger rights-reflecting framework they cannot be expected to automatically generalize experiences to higher-level thinking (Vissing 2019a, b).

10.2.3 Macro-Level Factors Every community (local, regional, national) has its own climate, reputation, or personality. Rankings announce “best places” or “most livable communities” to reside based often on their safety and how much people enjoy living there. Community standards, resources, government functioning, laws, organizations, police, social services, arts and humanities, crime rates, structures and infrastructures all impact community climate. It is not just the buildings and organizations that matter—it is the way people interact, live and work together. What is the community response when intolerance occurs? Some communities develop pro-social partnership problem-solving strategies while others choose vitriol, retaliation, oppression or violent response. Lack of resources and elevated social instability create fertile ground for growth of extremism. When confronted with violence, some communities create anti-hate groups like Not in our Town (2020). In short, community climate filters down to the meso and micro levels. Macro or institutional- level responses makes it possible for certain actions to be pursued (or forbidden) at an individual level. When a community has in place structures, infrastructures, policies and procedures on what to do when something occurs to support youth, and give them resources for enhancing wellbeing, this has a greater impact than communities that take a laissez-faire orientation, a “let others do it approach” or one that reinforce intolerance and aggression. It is my view that macro forces have greater ability to influence micro behaviors and attitudes than the other way around. Communities are well-advised to employ partnership, collaborative models toward addressing the respect-extremism dynamics. Schools and parents cannot do this alone. A dominant view explaining how children come to embrace extremist views comes from the psychological literature. Some children are regarded as being more psychologically vulnerable to extremist views that can lead to their radicalization (Coppock 2014). They need to be given coping skills, resources, and supports to avoid the pressures that may lead them towards extremism. The criminal justice

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community plays an important role in protecting the community from terrorism and extremists. Early identification, diversion and intervention programs for youth at-risk of recruitment into extremism are essential. Community providers who are equipped with the skills and training, practice, and lived experience are needed to address the pressing social issues and concerns in communities. Clinical sociologists can help them negotiate paths toward respect and how to counter extremism.

10.3

Example of Rights Respecting Schools

While on the surface how to act respectfully may seem obvious, it is always useful to have tangible examples of how to do it. UNICEF (2011; 2020) understood this and put together a set of materials that teachers can use in order to become A Rights Respecting School (RRS). This initiative uses the United Nations Convention on the Rights of the Child as the basis for enhancing an inclusive, participatory and respectful school culture for children and adults. As a framework for educational improvement, the initiative helps schools address the whole learning environment through a consistent, rights-based approach. It is premised on the understanding that in order for children to want to achieve, they have to feel included, that they belong and that they matter. It brings children into early contact with the universal ideals of respect for oneself and for others, in the school community and in an interdependent world. The United Kingdom (UK) has actively undertaken the charge and implemented many RSS, but Canada, Ireland, Iceland, Yemen, Democratic Republic of the Congo and Dubai are other nations that show how RSS can be incorporated anywhere. An evaluation of RSS for UNICEF found that the UK has the most developed RSS system, with over 1.5 million children in the UK attending a Rights Respecting School, and that more than 4000 schools there working towards that designation (University of Brighton 2018). Focusing just on the UK as an important example, the UK has taken a stand to both support UNICEF’s rights respecting school initiative but also to adhere to the UK’s Counter-Terrorism and Security Act 2015, which puts a statutory duty on schools to “prevent people from being drawn into terrorism“. It specifies: “Being drawn into terrorism includes not just violent extremism but also non-violent extremism, which can create an atmosphere conducive to terrorism and can popularize views which terrorists exploit.” It requires that school leaders train staff on how to identify children who are at risk of being drawn into extremism and to challenge extremist ideas. This is done by providing the positive messages in the RSS framework and by ensuring that pupils do not access extremist material online. Schools are to consistently challenge “the twisted narrative that has seduced some of our vulnerable young people” since schools have a vital role in protecting students from being radicalized. Responding to extremism, including the messages from the far right or left, requires an education system where schools have community support

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and shared strategies for teaching about democracy and about human rights from nursery school through university (Coughlan 2015). In order to ensure that schools comply with the standards for receiving the RSS designation, an Office for Standards in Education, Children’s Services and Skills inspects and regulates educational services for children and young people. The RSS is based on Article 29 of the CRC which says that education must develop every child’s personality, talents and abilities to the full. It must encourage the child’s respect for human rights, as well as respect for their parents, their own and other cultures and the environment. The RSS framework requires implementation of rights, equity, inclusion and participation of youth. The framework expects impact; success and achievement for rights education is part of the principle of Non-Discrimination (Article 2) and requires schools accelerate the progress of all and minimize gaps in attainment. It expects fairness, mutual respect, and high rates of attendance. RRS are founded less on a ‘rules based’ system and more on a shared understanding of everyone’s rights and a commitment to respect one’s own and other people’s rights. Leaders, teachers and learners are to work together to create an environment that gives pupils voice and agency in the life of their school and a meaningful part to play in decision making. RRS expects student development of talents; building of resilience and confidence; empowerment around physical and mental health; and that students value diversity and the promotion of active citizenship (MacDonald, Pluim and Pashby 2012). A rights-based approach provides school leaders with a globally recognized values base and a clear philosophy on which to build highly-effective school systems and structures. It empowers and challenges leaders to see children and young people as collaborators in the educational enterprise and to always take action “in the best interests” (Article 3) of their pupils ( UNICEF 2020). Schools that adhere to the framework can be given a Rights Respecting School Award. The University of Brighton reported that about 3000 of the 4000 UK schools attempting to get the award have done so. One reason the RRS initiative has been successful is that it has national support and resources (macro-level support). Rights-respecting curriculum and materials exist (meso-level supports), but schools need the necessary resources to ensure they have the capacity and tools to support their students, teachers, and administrators to prevent and respond to incidents of hate and exclusion (micro level) (Kruvant 2017). There are many different school-based programs designed to teach students respect and tolerance. UNESCO coordinated international partners to review education for democratic citizenship and human rights curriculum and strategies that prepare young people and adults to play an active part in democratic life and respectfully exercise their rights and responsibilities in society (Tibbitts 2015). UN ICEF Canada has developed a resource guide and human rights tool-kit schools can implement. Organizations like Teaching Tolerance have designed materials to promote respect for others that coincide with children’s developmental and cognitive stages (Williams 2019). Other respect-building programs include PBIS–Positive Behavioral Interventions & Supports (pbis.org 2020), Positive Action (positiveaction.net 2020), Caring School Community (youth.gov 2020) and Positive

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Behavior IS (2019). Many such programs have good intentions but most have a long way to go before achieving that goal as they may not incorporate the full strength of the CRC articles and framework. Studies convey that teachers must receive better training on how to manage conflict and promote civility in their classroom (Kruvant 2017). Teachers often don’t receive this type of training when they are in college, and many fail to obtain it in teacher workshops when they are hired. Without macro support, teachers committed to teaching their students about human rights may have to learn and prepare the material on their own time and at their own expense (Vissing 2018). Research shows rights instruction is often fragmented at best. For instance, students may learn about the Civil Rights movement, the Women’s Movement or the LGBTQ+ movement, but they may never have received instruction about the UDHR or the larger human rights framework (Fernekes 2012; Vissing 2019a, b; Teaching Tolerance 2020). As a result, teachers cannot teach what they never learned. Similarly, as students become adults, they cannot do what they never learned. In order for teachers, administrators, parents and other adults to be role-models for respect, they must assess their own beliefs and behaviors to make sure that what they do is consistent with the message they want to deliver to youth (Leo 2005). In the replication of childhood, adults may re-create models, attitudes, words and actions they learned as children. Those exposed to intolerance and aggression may find them to be normal and natural to emulate. Conversely, those exposed to tolerance and rights-respect have a better chance of replicating that model (Stephans 2007).

10.4

Conclusion

Clinical Sociology is predicated upon the assumption that it is possible to make individuals and society better if research-based best-practices are put into place. If we go back to the chicken-and-egg conundrum—while macro, meso and micro forces can nurture the rise of either respect or extremism, where should we put our emphasis to try to prevent violent extremism? Often interventions are targeted at the micro, individual or family levels rather than the macro, organizational, structural levels. Reasons for this are understandable—it is often easier to manipulate an individual’s attitude than to change institutions. Individual attitudes, especially during childhood, are so malleable that it is easy to sway attitudes in certain directions, especially when people do not have access to all the information necessary to make well-informed decisions on what to think or how to act. When influenced by significant others whose extremist opinions matter, people may say or do things that they otherwise may not have done if there were positive rolemodels. Realizing that individual attitudes are influenced by social media, family, peers, clergy, and government leaders heightens our awareness of the intersectionality of macro, meso and micro forces. As systems theory has long demonstrated, a change

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in one factor poses changes in others. When national leaders embody rights-respect for others and there are national resources put into place that support human rights, logically respect should filter down into the regional and community levels. Conversely, when national leaders pronounce extremist views and behave in ways that are not respectful of human dignity, this too filters down to the local and individual levels. Schools, as a meso level, may have the greatest potential in buffering extremist views and actions by advancing a rights-respecting alternative. Crises and conflict are inevitable, whether at the individual or national level. There are always choices available about how to address those conflicts. By using the power of critical thinking and the rich history of human rights theory and literature, teachers have tools that could change how students think about others and assess what the most humane reaction should be when confronted with the threat of extremism. Extremism begins in the ways we think about ourselves in relation to others. Clinicians point out that prejudiced intergroup attitudes result from two motivational goals in individuals—competition-driven, dominance-power-superiority motivation and threat-driven social control and group defense motivation. These are triggered by perceived social and intergroup threat and inequalities in or competition over power and dominance (Duckitt 2001). Much of the research on prejudice has been at the individual rather than the social or intergroup levels (Stangor 2016). Clinical sociology provides an antidote to that concern. Macro level measures that address structural inequality should logically minimize prejudicial attitudes that nurture extremism. Focusing on macro and meso levels of intervention, as well as the individual level, is a strong base for clinical sociology approaches. Human rights actions have the power to nurture interpersonal respect and be a vaccine protecting people from violent extremism. There is no time to waste to implement human rights-oriented social policies. Children today become adults of tomorrow, thus socializing them towards respect rather than extremism could have long-term benefit for society. An “inconvenient truth” is that society can only truly uphold the rights of young people if it is prepared to supercede some traditional ways of doing things. Challenging how adults define their responsibilities is essential to nurturing responsible, tolerant young people who are well-equipped to work with changing community, national and global forces (Wearmouth 2012). Organizations wedded to old exclusionary practices and policies are encouraged to re-evaluate their processes and procedures to ensure that micro-aggressions and institutionalized discriminatory actions are curtailed. These social changes provide an opportunity for a fresh examination of what we are doing and to develop better ways of operating (Lee 2017). This effort is a strategy that also empowers and liberates (Palmer et al. 2019). Socializing children to have extreme views will ultimately not serve them or society well. Human rights treaties were designed to honor the humanity and dignity in all peoples. Articles were constructed to lift all boats so justice and equality could become normative. The world is at a fragile moment in time where we have the opportunity to choose how we will socialize our children. The destinations of the two paths, of respect or extremism, are clear. Using our clinical sociological expertise to chart the routes for social action has never been more important.

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Leo, P. (2005). Connection parenting: Parenting through connection instead of coercion, through love instead of fear. Deadwood, OR: Wyatt-Mackenzie Publishing. Levin, B. (2018). Hate crimes rise in US cities and counties in time of diversion and foreign interference. Online report. Center for the Study of Hate and Extremism. https://www.csusb. edu/sites/default/files/2018%20Hate%20Final%20Report%205-14.pdf MacDonald, Angela, Gary Pluim, & Karen Pashby. (2012). Children’s rights in education: applying a right-based approach to education. Resource Guide. Unicef. https://www.acade mia.edu/2466313/Childrens_Rights_in_Education_Applying_a_Rights_Based_Approach_to_ Education_A_Resource_Guide_and_Activity_Toolkit McIlhinny, B. (2019). Findings on Nazi salute photo. Online article. WV Metro News. http:// wvmetronews.com/2019/12/30/findings-on-nazi-salute-photo-ignorance-was-the-cause-butmessage-reflects-hate/ Mehta, S. (2015). There’s only one country that hasn’t ratified the Convention on Children’s Rights. Online article. American Civil Liberties Union. https://www.aclu.org/blog/humanrights/treaty-ratification/theres-only-one-country-hasnt-ratified-convention-childrens Melzer, W. (1995). The syndrome of right-wing extremism in school children. In G. Neubauer & K. Hurrelmann (Eds.), Individualization in childhood and adolescence. New York, NY: Walter de Gruyter. Morris, E. (2016). Children: Extremism and online radicalization. Journal of Children and Media, 10(4), 508–514. https://doi.org/10.1080/17482798.2016.1234736. Moyer, B. (1987). The movement action plan: A strategic framework describing the eight stages of successful social movements. http://www.historyisaweapon.com/defcon1/moyermap.html New York Magazine. (2019). Inside a growing terrorist movement. Online article. New York Intelligencer. https://nymag.com/intelligencer/2019/12/white-supremacy-terrorism-in-america2019.html Not In Our Town. (2020). About Us. https://www.niot.org/about-us Office of the High Commissioner for Human Rights. (2020). Convention on the Rights of the Child. Resource document. United Nations. https://www.ohchr.org/en/professionalinterest/pages/crc. aspx Palmer, G, Ferńandez, J, Lee, G., Masud, H., Hilson, S., Tang, C, Thomas, D, Clark, L, Guzman, B, & Bernai, I. (2019). Oppression and power. Online book. Pressbooks. https://press.rebus. community/introductiontocommunitypsychology/chapter/oppression-and-power/ Pappas, S. (2012). Young kids take parents word on prejudice. Online article. Live Science. https:// www.livescience.com/19187-children-learning-prejudice.html Piotrowski, J, Vossen, H, & Valkenburg, P. (2015). Media and Child Development. International Encyclopedia of the Social & Behavioral Sciences, 1–10. https://doi.org/10.1016/B978-0-08097086-8.92145-7. Pitter, L. (2017). Hate crimes against Muslims continue to rise. Online article. Human Rights Watch. https://www.hrw.org/news/2017/05/11/hate-crimes-against-muslims-us-continue-rise2016# Positive Action. (2020). Welcome to Positive Action. positiveaction.net Positive Behavioral Interventions & Supports (PBIS). (2020). Positive Behavioral Interventions & Supports. pbis.org Power, T. G. (2013). Parenting dimensions and styles: A brief history and recommendations for future research. Childhood Obesity, 9(1). https://doi.org/10.1089/chi.2013.0034. Sainz, G. M. (2018). The challenges of teaching children their rights in a violent context. In G. M. Sainz (Ed.), International perspectives on practice and research into children’s rights. Centre for Human Rights Studies: Mexico City. Skinner, A., Metzoff, A., & Olson, K. (2016). Catching social bias: Exposure to biased nonverbal signals creates social biases in preschool children. Psychological Science. https://doi.org/10. 1177/0956797616678930.

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Stangor, C. (2016). The study of stereotyping, prejudice, and discrimination within social psychology: A quick history of theory and research. In T. D. Nelson (Ed.), Handbook of prejudice, stereotyping, and discrimination (pp. 3–27). London: Psychology Press. Stephans, K. (2007). Parents are powerful role models for children. Online article. Parenting Exchange. https://www.easternflorida.edu/community-resources/child-development-centers/ parent-resource-library/documents/parents-powerful-role-models.pdf StopBullying.gov. (2020). Bystanders are essential to bullying prevention and intervention. https:// www.stopbullying.gov/resources/research-resources/bystanders-are-essential Straus, M. (2017). Behind closed doors: Violence in the American family. New York: Routledge. Teaching Tolerance. (2020). Lesson outline. Teaching Tolerance. https://www.tolerance.org/class room-resources/tolerance-lessons/the-rights-of-the-child Telzer, E., van Hoorn, J., Rogers, C., & Do, K. (2018). Social influence on positive youth development: A developmental neuroscience perspective. Advances in Child Development and Behavior, 54, 215–258. https://doi.org/10.1016/bs.acdb.2017.10.003. Thunberg, G. (2019). No one is too small to make a difference. London: Penguin. Tibbitts, F. (2015). Curriculum development and review for democratic citizenship and human rights education. Paris: UNESCO Publishing. UNICEF. (2011). Rights respecting schools. http://www.e-activist.com/ea-campaign/action. retrievefile.do?ea_fileid¼13844 UNICEF. (2020). Rights respecting schools. https://www.unicef.org.uk/rights-respecting-schools/ United Nations. (2011). United Nations declaration on human rights education and training. Online declaration. United Nations. https://www.ohchr.org/EN/Issues/Education/Training/Com pilation/Pages/UnitedNationsDeclarationonHumanRightsEducationandTraining(2011).aspx University of Brighton. (2018). UNICEF rights respecting schools evaluation. https://www.brigh ton.ac.uk/research-and-enterprise/groups/education/research-projects/unicef-rights.aspx University of Minnesota Human Rights Library. (2020). Ratification of human rights treaties USA. http://hrlibrary.umn.edu/research/ratification-USA.html Valenica-Garcia, L. (2018). Generation identity: A millennial fascism for the future? Online article. Europe Now. https://www.europenowjournal.org/2018/02/22/generation-identity-a-millennialfascism-for-the-future/ Vera, A. (2019). California high school students seen in video giving Nazi salute and singing Nazi marching song. Online article. CNN. https://www.cnn.com/2019/08/19/us/california-highschool-nazi-salute/index.html Vissing, Y. (2018). Human rights literacy in a global world. In J. Zajda (Ed.), Globalisation, comparative education and policy research. New York: Springer. Vissing, Y. (2019a). The children’s rights movement is here: Are you paying attention? Online article. Public Seminar. https://publicseminar.org/essays/the-childrens-rights-movement-ishere/ Vissing, Y. (2019b). Celebrating Human Rights. Online article. Public Seminar. http://www. publicseminar.org/2018/11/celebrating-human-rights/ Wearmouth, E. M. (2012). Children’s rights and parent responsibilities: An inconvenient truth. Archives of Disease in Childhood, 97(1). https://doi.org/10.1136/archdischild-2012-301885. 403. Wilcox, L. (1987). What is political extremism. Archived journal article. Volunaryist.com. https:// web.archive.org/web/20060621095801/http://www.voluntaryist.com/articles/https://web. archive.org/web/20060621095801/http://www.voluntaryist.com/articles/027a.php Williams, A. (2018). Hate crimes rose the day after Trump was elected. Online article. Washington Post. https://www.washingtonpost.com/news/post-nation/wp/2018/03/23/hate-crimes-rose-theday-after-trump-was-elected-fbi-data-show/ Williams, D. (2019). Beyond the golden rule. PDF of Parent’s Guide. Teaching Tolerance. https:// www.tolerance.org/sites/default/files/general/beyond_golden_rule.pdf Wintrobe, R. (2006). Rational extremism: The political economy of radicalism. Cambridge: Cambridge University Press.

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Witt, E. (2019). From Parkland to sunrise: A year of extraordinary youth activism. Online article. The New Yorker. https://www.newyorker.com/news/news-desk/from-parkland-to-sunrise-ayear-of-extraordinary-youth-activism Yousafazi, M. (2013). I am Malala. New York: Little, Brown and Company. Youth.gov. (2020). Caring School Community. https://youth.gov/content/caring-schoolcommunity

Chapter 11

Clinical Sociological Contributions to the Field of Mediation Jan Marie Fritz

11.1

Introduction

Many disciplines and organizations have contributed to the field of mediation. One of these influences, the discipline of sociology, has assisted with the theoretical analysis of conflicts and dispute intervention mechanisms such as mediation. Clinical sociology, a subfield of sociology, not only has contributed to the theoretical analysis of conflicts and conflict intervention techniques, but clinical sociologists also are involved in conducting mediations and establishing and improving mediation systems (e.g., Miller 1985, 1991; Robinette and Harris 1989; Wan and Wan 2014; Fritz 2020a, b). This chapter defines mediation and then identifies and discusses some of the clinical sociological contributions to the field of mediation.

11.2

Mediation

Mediation is a creative, humanistic, and flexibly-structured process in which an impartial individual or individuals (third party) help disputants identify their individual and mutual interests and perhaps reduce or resolve their differences. This non-adversarial process is sometimes referred to as facilitated negotiation. The mediator establishes an open, trusting environment in which parties are encouraged to discuss the facts of the matter as well as their personal feelings about the issue or issues that brought them to the table. This chapter is based on “Contributi della Sociologia Clinica alla Mediazione” (Fritz 2006b) as well as Fritz, ed. (2014). J. M. Fritz (*) University of Cincinnati, Cincinnati, OH, USA University of Johannesburg, Johannesburg, South Africa e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_11

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It is useful to distinguish between the terms conflict and dispute. Conflicts are larger (perhaps very large) and their boundaries cannot easily be established. In a conflict, it sometimes is not easy to identify all the stakeholders (parties) or all the relevant issues. A dispute can be part of a larger conflict (e.g., a disagreement between a manager and an employee in a company located in a war zone), but it also may be a disagreement that is much less likely to be part of anything larger (e.g., a disagreement between male acquaintances at a bus stop about who should get on the bus first). A dispute is a disagreement among a few identified stakeholders who usually can identify their issues. Mediation is used to discuss, and possibly settle, a wide variety of disputes and conflicts among individuals, organizations, communities, and governments as well as combinations of these stakeholders (e.g., community residents might have a dispute with a company that they believe is polluting their neighborhood as well as with the government agencies they believe should protect their interests). Mediation can be an excellent method for reducing or resolving some kinds of problems, in part because it can be faster and less expensive than the alternatives. Most importantly, the parties can create their own resolution to a problem rather than have a decision imposed on them.1 Mediation is carried out by different kinds of individuals and groups, and this is particularly true at the community, national, and international levels. Byrne (2006), for instance, has outlined the following mediator roles in international disputes: insider-partial mediator (comes “from within the conflict and is accepted by the parties”), quasi-mediator (party to the conflict who seeks to facilitate de-escalation of the conflict, undertakes quasi-official work in preparation for diplomatic methods), principal or primary mediator (perceives their interests will be affected by the outcome, has “benefits to deny; . . . can threaten harm”), and external ethnoguarantor mediators (external and “regionally powerful third-party mediators. . . with regional interests who perceive they have a direct . . . connection as well as a shared national identity with the internal disputants”). There are times when mediation is not seen as an appropriate method for resolving a dispute or conflict (e.g., parties prefer another dispute intervention mechanism. a settlement needs to be decided by a court, parties are too upset to talk, or one or more parties refuse to participate). Lois Presser and Emily Gaarder (Presser and Gaarder 2000) have made the argument that mediation is not appropriate in regard to victims of domestic violence or battering. Presser and Gaarder think that the mediation model resembles the “hands-off tactics of police responding to domestic assaults” and “serves the interests of the batterer, not the victim.” A New York Times story on divorce (Fritsch 2001) quoted Jane Rutherford, a law school professor, as saying that some divorce lawyers and women’s groups dislike

1 Larry Connatser (2019), an extension specialist with Virginia State University, says “owners and managers of small, medium and large businesses, farms and home-based enterprises across the United States have begun to recognize the wisdom of avoiding litigation in favor of (mediation) a friendlier settlement of disputes.”

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mediation for divorce cases because women who can come up with money to litigate will come out better in financial terms. Rutherford thinks there is “a tremendous problem with emotional and physical power in mediation” and “women back down because they are afraid, and mediators won’t necessarily take control.” A nongovernmental organization (NGO) in England that counsels parents about their children’s rights in terms of special education does not think mediation is a good option because parents do not know enough about their rights. And Toronto lawyer Markus Koehnen has noted that mediation and mediators are only there for compromise (Daw 2001). Koehnen was quoted as saying that “mediation is not necessarily about justice. . . it is about negotiation.” Some mediators, particularly those who specialize in areas such as economic development, transportation, education, community governance, or environmental disputes, also have facilitation skills. Facilitation is “any meeting of a group of people in which a facilitator structures and manages group process to help the group meet its goal” or “a meeting between two people: a facilitator and an individual who accepts process help and guidance” (Rees 1998). So sometimes the facilitator may be the moderator and at other times an adviser on group process. For instance, I was contacted by the head of a chapter of an NGO that was located 1000 miles away to help with the design of a facilitated intervention process. The caller discussed the suicide of an important community figure and how it had laid bare strong divisions within the community. We talked about options that could be put in place for a community discussion process, a timeline for this work, and how to locate local facilitators who could help with this process. Sometimes the word facilitation may be a more acceptable term for a discussion with community groups instead of using the word mediation. For example, I was asked to help design a process for discussing a contentious community issue. The dispute was about whether some concrete stairs—located in a public space (a woods) behind expensive houses—should be left open (providing access to all community members) or be closed (possibly providing safety for nearby homeowners). This dispute had been going on for 2 years. In this particular case, those who wanted to keep the stairs open said they wanted to take part in a mediation, but the homeowners who wanted the stairs closed said they would not agree to a mediation. They thought a mediation would lead to a binding decision. While they MIGHT have accepted a facilitated discussion, it is important to note, in this case, that they expected the city leaders would decide in their favor without having to have any community discussion.

11.3

An Example of a Mediated Case

It might be useful at this point to provide an example of an actual case that I mediated for one of the largest employers in the United States. The case was difficult because there were strong feelings on each side—an employee had frequently experienced differences of opinion with several supervisors, the main issue had been unresolved

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for a long period of time, and everyone was sure that no agreement of any kind was possible. The complainant, a black woman, was expected to work overtime but, without permission, had walked away from the assignment. She had told her new and inexperienced supervisor, a white man, on the morning of the day in question that she needed to waive any possible overtime assignment that evening. Some problems were that she had not asked in writing, explained why she needed to waive the overtime that particular evening, or submitted her written request in advance of the day she needed to waive overtime. While none of these actions was required by her employer, all of them could have increased her possibility of not having a problem. In the afternoon, when the supervisor told the complainant that she would have to work overtime that evening, she questioned him about this. He declined to answer (because he felt there was nothing to discuss) and walked away. A separate case about this overtime issue was going to the third level of grievance (a separate procedure involving her union and management) when she filed an equal opportunity case alleging that the supervisor excused a white man from overtime duty that same evening. This mediation for the equal opportunity office was expected to be about the alleged discrimination, the issue of not staying at work to complete the overtime assignment, and any other issues that the parties wished to raise. The complainant brought a union representative to help her with the case and the new supervisor brought the man who had been the regular supervisor as his representative. The manager to whom the supervisors report was also there as a management representative. In all, there were five participants. All the participants were sure that this three-month-old case would not settle. The complainant wanted the letter of warning that had been placed in her file to be removed instead of remaining there for the usual 2-year period. The supervisors and manager were adamant that the letter should remain in her file for two years. When an employee is given an order, it is to be followed. The supervisors and manager felt the employee was lucky that she had not been given a stronger reprimand. The management team also thought that it would look bad back on the floor if they did not treat this failure to obey an order in the way it would usually be handled. After three-and-a-half hours of discussion, the parties agreed to settle this case. They agreed that (1) the letter of warning would remain in the employee’s file for nine months instead of 2 years (if there were no other violations), (2) the employee would ask the union to withdraw the grievance because the matter was now resolved, and (3) the employee and the new supervisor would continue to improve their communication about workplace matters. This seemed like a textbook case of how a mediation could reach an agreement. The parties and their representatives came to the mediation convinced that this issue would not be resolved and they had firmly held positions. Then they really listened to each other during the course of the conversation. The employee learned that the supervisor had not treated her differently (the other employee had been released from overtime because of equipment failure and so there was no discrimination), and the new supervisor learned that the employee had not lied to him. The employee, supervisor, and representatives did “role reversals” and talked about the various

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ways the situation might have been handled by the two people. The parties discussed what the outcomes might have been if things had been done differently. Near the end of the mediation, the employee stated she had never before walked away from an assignment or done anything like this in her eleven years with the organization, had not helped her case when she decided not to submit a written request or explain her problem, and said she would never again walk away from an assignment. The new supervisor apologized for misunderstanding some things and for not communicating. He said he could have done things differently, and he now realized he could have been the employee’s advocate in talking with those who made the overtime assignments.

11.4

Five Contributions to the Field of Mediation

The contributions made by different organizations and disciplines to the mediation process usually fit with their values and general approaches. For instance, the Friends Conflict Resolution Programs, an organization connected with the Philadelphia Yearly Meeting of the Society of Friends (Quakers), developed a system of community mediation, beginning in 1976, that airs emotions; values reconciliation; emphasizes improving future relations and problem-solving ability (as more important than reaching a detailed agreement); and uses co-mediators (Beer and Stief 1997). All of this was to be expected as the Religious Society of Friends (Quakers) believes in equality (because there is “that of God in every one”), simplicity, harmony (peace and pacifism), and community (fellowship) (Louis 1994). The United States Postal Service, which delivers the mail, uses a transformational approach2 to mediation because the postal service wants its employees, whatever the outcome of a mediation, to have better working relationships. A mediator working on a commercial dispute or one working in a court system may be expected to use a form of mediation that puts a premium on a shorter mediation process (for efficiency) and puts a high value on reaching agreements. Clinical sociology also has made contributions to the field of mediation that reflect the subfield’s orientation—to improve programs and people’s lives. Five of these contributions—multilevel system intervention, cultural competency, empowerment, integrated theoretical analysis, and redefinition of the situation—are discussed here.

2 Transformative mediation stresses the empowerment and recognition of parties so that parties can discuss current and future issues in a more productive way (Bush and Folger 1994).

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11.4.1 Multi-level System Intervention Clinical sociologists, as part of their general education, are expected to be knowledgeable about social systems as well as intervention at two or more system levels (e.g., individual and organization). (See Chap. 2 for a discussion of intervention levels.) This theoretical and practical knowledge, when paired with training in mediation and knowledge of a mediation setting (e.g., court, environment, public policy), makes the clinical sociologist a particularly valuable mediator. For example, a clinical sociologist/mediator who is knowledgeable both about employee/management relationship issues and about various organizational structures and styles might be helpful if an employee and the employee’s supervisor sort through how things might be handled on the individual level as well as analyze relevant organizational policies and procedures. The mediator might facilitate a settlement of immediate issues (between the individuals) and also deal with options for avoiding, handling and/or solving potential problems in the future on both the individual level as well as the organizational level. In two cases I mediated for the U.S. Equal Employment Opportunity Commission, female employees had filed sexual harassment charges against their employers for situations that had developed during work hours. In both cases, employers tried to understand what happened and, when convinced that the complainants had credible cases, the employers also wanted to discuss how they might adjust the work situation (including the layout of the workplace, policies and procedures) so that this kind of problem might be less likely in the future. In some mediations, this discussion might never take place because it might not be raised by either side, but this “prevention door” can be opened by the mediator. Many fields value intervention at more than one level to address a problem. [See, for instance, Yap et al. (2017) regarding their work with the family as well as adolescents to deal with adolescent depression and anxiety or Knight and Gitterman (2018) about integrating micro and macro intervention.] Clinical sociologists are trained to work at two or more system levels (e.g., individual and organizational; local community and national) and can move between or among the levels when working as mediators to help participants in a mediation “make sense of the complex social contexts that shape conflicts” (Winslade and Monk 2000). This means a clinical sociologist can bring a number of important resources to the table because of a knowledge of current structures, relevant history, trends and intervention strategies at different intervention levels. The multi-level approach also can be achieved when a mediator who is not a clinical sociologist has been trained in two distinct disciplinary settings or when a dispute is co-mediated by mediators with different backgrounds (e.g., counseling and law; environmental justice and religious studies).

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11.4.2 Cultural Competency Sociology, according to Piotr Sztompka (1999), made a paradigmatic shift in the last half of the twentieth century. The move was from an emphasis on “social collectivities (societies). . . (to an emphasis on) socially embedded individuals.” This emphasis on social action is “rich” in that it not only includes rationality and calculating exchanges but also emotions, value orientations, social bonds, and cultural components. American clinical sociology, with its more than 90-year history, has grown up with the theoretical and research interests in culture (that Sztompka traces) and also a practical interest in culture. Like a number of other practice areas (e.g., nursing, counseling, management), there has been increasing attention to culture and particularly to cultural competency. Cultural competency3 is an ongoing process as well as a goal toward which systems, agencies, or individuals “must continually aspire” (Rorie et al. 1996). Cultural competency refers to a set of attitudes, behaviors, policies, and procedures that enable a system, agency, or individual to function effectively with culturally diverse individuals and communities with diverse heritages/approaches (e.g., nationality, religion, socioeconomic class) (Chung 1992; Rorie et al. 1996; KerseyMatusiak 2019). The components of cultural competency are cultural assessment (a periodic appraisal of one’s own individual or agency cultural background and how it may affect practice); cultural sensitivity (appreciation of other cultures and subcultures); cultural knowledge (education about the variety of cultures and subcultures); cultural skills (methods that are appropriate to use with particular cultures and subcultures); cultural encounters (having direct interaction with people from other cultures and subcultures); and initiative (taking action in some way to deal with a discovered problem/oppression). Some discussions of cultural competency do not include the assessment or initiative components, but I think it is important for both to be included. Clinical sociologists are expected to be striving for cultural competency,4 and those who are mediators would introduce cultural competency in any mediation training that they may contribute to or put in place. I consider this to be such an important concept for mediators that I introduce it at the beginning of mediation training and courses (Fritz 2001) along with other basic values such as empowerment. While there certainly are cases that should not go to mediation, those that are mediated deserve a mediation where the “playing field” is rather even in terms of power and where the mediator is dealing with issues of power and justice. This, then, brings us to the topic of empowerment.

Some refer to this idea as “cultural humility” (Kersey-Matusiak 2019:6). Sociologist Margaret Herrman and her colleagues (2001) identified “cultural and diversity competency” as one of thirteen skill areas and “cultural issues” as one of eighteen knowledge areas that are important for mediators who intervene in “interpersonal disputes (e.g., community, employment, family or smaller commercial disputes).” 3 4

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11.4.3 Empowerment Empowerment is a concern of practitioners in many fields including mediation. Mediation involves collaboration. When participants express their “concerns, perspectives, feelings, and ideas clearly and in a way that others can hear and understand. . . this is the essence of empowerment” (Isaacson et al. 2020:2). One of the best statements on empowerment is still the one put forward in 1978 by James Laue and Gerald Cormick.5 They connect the mediator’s values with her/his principles and actions, and they believe that justice, freedom, and proportional empowerment are the basic values for the ethical principles they proposed. (See Fig. 2.5) Laue and Cormick (1978) believe that proportional empowerment refers to the intervenor’s (mediator’s) contributions to structural changes: It refers to a condition in which all groups have developed their latent power to the point where they can advocate their own needs and rights, where they are capable of protecting their boundaries from wanton violation by others, where they are capable of negotiating their way with other empowered groups on the sure footing of respect rather than charity.

Laue and Cormick (1978) noted that it was the intervenor’s responsibility “to promote the ability of the weaker parties to make their own best decisions” by “helping them obtain the necessary information and skills to implement power.” As the authors saw it: The intervenor should assess the relative level of information, negotiating skills, and analytical ability of the parties and, if there is a considerable differential, help even the odds through training or other forms of advocacy.

The mediator role envisioned here is an active one. The intervenor is expected to be very familiar with the dynamics of power and the possibly oppressive situation at hand (e.g., sexism or racism), and the intervenor’s actions should contribute to the empowerment of the less powerful. Laue and Cormick (1978) cautioned that the intervenor should “not claim to be (or worse, actually feel) neutral.” If the intervenor makes neutrality claims, Laue and Cormick thought “the intervenor’s actions (even if well motivated) will result in damaging the position of the weaker party and strengthening the hold of the party in power.” Although Laue and Cormick were discussing the role of the intervenor (mediator) in community disputes, their points are just as appropriate for those mediating other kinds of conflicts. Mediators must go over in their mind the opportunities taken or lost with regard to fostering empowerment. A clear example of the empowerment process can be an environmental dispute in which all the parties agree that some experts need to 5

Laue, a clinical sociologist, was asked by President Carter in 1979 to chair a commission to create a national academy to teach peacemaking techniques. The commission’s work led to the establishment of the U.S. Institute of Peace, an independent, nonpartisan federal institution that promotes research, education and training on international peace and on conflict resolution. Gerald Cormick has a Ph.D. in business administration and more than 50 years experience mediating and facilitating complex disputes in the United States, Canada and other countries. He is a principal in the CSE Group, a conflict resolution consulting firm.

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educate all the parties, or it might be agreed by all that community members might need certain kinds of training (e.g., negotiation skills training, workshops that provide assistance on understanding technical reports or language). Sometimes empowerment issues are not so apparent. Once I was mediating a case in a small-claims court between a landlord and his tenant. The landlord had brought the case to the court and mediation in part to hassle the tenant. He knew the tenant was an hourly worker and she was losing money every hour the case was in court. I thought I was making a lot of progress with this case by helping her so that she could articulate her problems with the landlord and working with the landlord so that he could really hear and understand what she was saying. Every time she and I had a private meeting, however, the landlord would return to our meeting room in a terrible mood and we always seemed to be starting over. Finally, I told both parties to stay in the meeting room, and I went out to the waiting room to see if I could figure out what was going on. I found two teenage boys in the corner who seemed to be in a rather good mood. It turned out that one was the son of the tenant and the other was his friend. Each time the landlord had come into the waiting room, the boys had talked loudly about him in negative ways. I “banished” the teenagers to the court’s lunchroom and told them the mother would come down there to look for them as soon as we finished. After that, the discussion between the parties was very productive. They settled their main issues and were even were able to discuss the boys’ behavior. (The roads to empowerment are frequently foggy and unfamiliar, but the benefits justify the journey.)

11.4.4 Integrated Theoretical Analysis Theory, whether implicit or explicit, is important. It affects how mediators, their employers, and agencies (establishing or funding) view disputes and the kind of mediation process they put in place. Theories also are important to parties. Parties involved in a dispute have their own explicit or implicit theoretical approaches and probably would find it useful to understand that there are a variety of mediation styles, formats and theories that underlie the different approaches to mediation. Here is a listing of some of the approaches to mediation have been identified (Fritz 2004, 2006a): facilitative/participant-centered, solution-oriented, transformative, narrative, and humanistic/integrated process (HIP). The latter approach is participant-centered but very flexible. Depending on the circumstances of the mediation, the HIP mediator may include aspects of any of the other approaches. Each of these approaches has ties to one or more theories. For instance, the facilitative/ participant centered approach has been linked to humanism; the solution-oriented approach is often connected to utilitarianism; Della Noce et al. (2002) stated that their transformative approach is related to a social/communicative view of human conflict in the discipline of communicative science; and the narrative approach has been connected to humanism and particularly to postmodern thought. The HIP approach is connected to a kind of humanism that is neither anthropocentric

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(human centered) or biocentric (moral consideration given to all living things). This form of humanism includes respectful consideration of the natural environment and fits very well with Aldo Leopold’s (1949) land ethic theory. Mediators following the HIP tradition may have a strong connection to standpoint or multicultural/liberationist theory. Traditional sociological education emphasizes classic and contemporary theory. Clinical sociologists, because of their traditional education in sociology as well as their additional interests in interdisciplinary studies and theoretically-based practice, are knowledgeable about a range of theories, approaches, and models in different fields. Clinical sociologists interested in conflict analysis are knowledgeable about a number of biological, individual, social, and land-based theories that are used to explain conflict. They are interested in the theories that are basic to mediation (as well as other conflict intervention approaches) in different settings, and they usually find it is useful to integrate these theories in their work. This is particularly true if one is working in a mediation team and the other practitioners have different disciplinary backgrounds.

11.4.5 Redefinition of the Situation The “definition of the situation” (Thomas 1928, 1931) is a basic idea in sociology, and it means that whatever a person or group believes to be true becomes real in its consequences. To analyze any social situation, then, “requires an understanding of how it looks to those persons who are the constituent parts of the situation or structure, because the persons will act according to how it looks to them” (Glassner and Freedman 1979). Mediators often are interested in starting with the stories of the participants in part to get to underlying interests. After a story has been presented, the mediator may restate what a participant has said (while asking if this is correct) and another technique (used “cautiously as parties can easily feel patronized or coerced”) is to ask a party to restate what the other party or parties have said (Beer and Stief 1997). Each party probably needs to broaden its definition of the situation in order to work on solutions. The problem needs to be “reframed” or “redefined.” This can be done as the parties “shift from presenting their (dispute) as stories and positions” to viewing the situation in a new, more comprehensive way that focuses on “mediatable issues” (Beer and Stief 1997). Clinical sociologists, whatever their specialization, realize the importance of reframing or redefining the situation when trying to reduce or resolve problems. Given their humanistic values and interest in empowerment, clinical sociologists who are mediators are not working just to have individuals adapt to their situation (Straus 1984). That is only one option and may not be best or even acceptable for one or more of the parties in a mediation. A clinical sociologist as a mediator, then, can be particularly helpful to individuals and groups in improving their communication, identifying a variety of ways to define or redefine the situation, and selecting and assessing options.

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Conclusion

The magic in the mediation process can happen when all the parties involved in the mediation want to find a way to resolve a matter and really listen to each other. The mediator can foster the mediation process, in general, by being patient, empathetic, impartial, gentle, imaginative/creative, flexible, and comfortable with arguments as well as by being willing to “respectful[ly] confront” (Weinstein 2001). The mediator also should have a low need for personal recognition in the resolution process (Beer and Stief 1997). While the characteristics mentioned here are particularly valuable in mediation, different kinds of disputes also can benefit from mediators with different disciplinary backgrounds, experience, and personal characteristics. Would the workplace case outlined in this chapter have settled if the mediator had training other than in clinical sociology? To begin to answer that question, let’s return to four of the five clinical sociological contributions that were detailed in this chapter. While this case did involve working at more than one level (individual and organizational) and did involve cultural competency (e.g., different ages and racial backgrounds of the parties), issues of empowerment were not central here. The last contribution, the redefinition of the situation, was particularly important in this case. The role reversal technique allowed the participants to begin to see the situation from the standpoint of the other and, I believe, really moved the parties toward settling the issues. This case required a mediator who had a good deal of experience, knowledge of organizations and, because of the high energy level and conviction of all the participants, the ability to help participants with the process. Even though the contributions of the clinical sociologist were useful in this case, the case certainly could have been resolved by an experienced workplace mediator with training in an area other than clinical sociology. It should be highlighted here that the point of this chapter is not that clinical sociologists are the only ones to bring to the table multi-level intervention, cultural competency, empowerment, integrated theoretical analysis, and redefinition of the situation. This discussion is intended to show that (1) clinical sociologists generally can be expected to establish or strengthen these five areas in new and existing mediation processes, and (2) it can be useful to identify the strengths that different disciplines and experiences bring to the interdisciplinary field of mediation.

References Beer, J., & Stief, E. (1997). The mediator’s handbook. Gabriola Island, British Columbia: New Society Publishers. Bush, R., & Folger, J. (1994). The promise of mediation: Responding to conflict through empowerment and recognition. San Francisco, CA: Jossey-Bass. Byrne, S. J. (2006). The roles of external ethnoguarantors and primary mediators in Cyprus and Northern Ireland. Conflict Resolution Quarterly, 24(2), 149–172.

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Chung, D. (1992). Asian cultural communities. In S. Furuto, R. Biswas, D. Chung, K. Murase, & F. Ross-Sheriff (Eds.), Social work practice with Asian Americans (pp. 274–275). Newbury, CA: Sage. Connatser, L. A. (2019). Mediation: Simply a better idea for resolving disputes and managing risk. Virginia Cooperative Extension. Accessed April 4, 2020, from https://vtechworks.lib.vt.edu/ bitstream/handle/10919/93380/FCS-138.pdf?sequence¼1 Daw, J. (2001, July 12). Mediation’s half loaf better than none. Toronto Star, E02. Della Noce, D. J., Baruch Bush, R. A., & Folger, J. P. (2002). Clarifying the theoretical underpinnings of mediation: Implications for practice and policy. Pepperdine Dispute Resolution Law Journal, 3, 39–66. Fritsch, J. (2001, July 29). New York law may fan the fire in divorces like Giuliani’s. New York Times. Accessed April 4, 2020, fromhttps://www.nytimes.com/2001/07/29/nyregion/wherebreaking-up-harder-new-york-law-may-fan-fire-divorces-like-giuliani-s.html Fritz, J. M. (2001). Mediation skills. In J. M. Fritz (Ed.), The clinical sociology resource book (pp. 49–53). Washington, DC: American Sociological Association Teaching Resources Center. Fritz, J. M. (2004). Dierriere la magie: Models, approaches et theories de mediation [Behind the magic: Mediation models, approaches and theories]. Esprit Critique, 6(3). Fritz, J. M. (2006a). L’approccio al conflitto: Il ruolo della teoria nella mediazione [Approaches to conflict: Social theory and mediation]. In L. Luison (Ed.), La Mediazione come stumento di intervento sociale (pp. 24–36). Milano: Franco Angeli. Fritz, J. M. (2006b). Contributi della sociologia clinica alla mediazione [Contributions of clinical sociology to mediation]. In L. Luison (Ed.), La Mediazione come stumento di intervento social (pp. 81–93). Milano: Franco Angeli. Fritz, J. M. (2020a). Increasing the number of women mediators in peacemaking initiatives. International Journal for Crime, Justice and Social Democracy, 9(1), 68–79. Fritz, J. M. (2020b). H.W. Van der Merwe: Peacebuilder. In T. Uys & J. M. Fritz (Eds.), Clinical Sociology for Southern Africa. Claremont: Juta. Glassner, B., & Freedman, J. (1979). Clinical sociology. New York: Longman. Herrman, M., Hollett, N., Gale, J., & Foster, M. (2001). Defining mediator knowledge and skills. Negotiation Journal, 17(2), 138–152. Isaacson, K., Ricci, H., & Littlejohn, S. W. (2020). Mediation: Empowerment in conflict management. (3rd ed.). Long Grove, IL: Waveland Press. Kersey-Matusiak, G. (2019). Delivering cultural competent nursing care (2nd ed.). New York: Springer. Knight, C., & Gitterman, A. (2018). Merging micro and macro intervention: Social work practice with groups in the community. Journal of Social Work Education, 54(1) 3-17. https://www. tandfonline.com/doi/abs/10.1080/10437797.2017.1404521 Laue, J., & Cormick, G. (1978). The ethics of intervention in community disputes. In G. Bermant, H. C. Kelman, & D. P. Warwick (Eds.), The ethics of social intervention (pp. 205–232). Washington, DC: Halsted Press. Leopold, A. (1949). A Sand County almanac, and sketches here and there. New York: Oxford University Press. Louis, M. R. (1994). In the manner of friends: Learnings from Quaker practice for organizational renewal. Journal of Organizational Change, 7(1), 42–60. Miller, J. S. (1985). Sociologists as mediators: Clinical sociology in action. Clinical Sociology Review, 3, 158–164. Miller, J. S. (1991). Clinical sociology and mediation. In H. M. Rebach & J. G. Bruhn (Eds.), Handbook of clinical sociology (pp. 247–257). New York: Plenum. Presser, L., & Gaarder, E. (2000). Can restorative justice reduce battering? Some preliminary considerations. Social Justice, 27(1), 175–195. Rees, F. (1998). The facilitator excellence handbook. San Francisco, CA: Jossey-Bass. Robinette, P. D., & Harris, R. A. (1989). A conflict resolution model amenable to sociological practice. Clinical Sociology Review, 7, 127–140.

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Rorie, J. L., Paine, L. L., & Barger, M. K. (1996). Primary care for women: Cultural competence in primary care services. Journal of Nurse-Midwifery, 41(2), 92–100. Straus, R. A. (1984). Changing the definition of the situation: Toward a theory of sociological intervention. Clinical Sociology Review, 2, 51–63. Sztompka, P. (1999). Trust: A sociological theory. Cambridge, EN: Cambridge University Press. Thomas, W. I. (1928). The child in America. New York: Knopf. Thomas, W. I. (1931). The unadjusted girl. Boston, MA: Little, Brown. Wan, H., & Wan, P. M. (2014). Clinical sociology and community mediation: Training grassroots leaders in multiethnic Malaysian communities. In J. M. Fritz (Ed.), International clinical sociology. New York: Springer. Weinstein, R. J. (2001). Mediation in the workplace: A guide for training, practice, and administration. Westport, CT: Quorum. Winslade, J., & Monk, G. (2000). Narrative mediation: A New approach to conflict resolution. San Francisco, CA: Jossey-Bass. Yap, M., Lawrence, K. A., Rapee, R. M., Cardamone-Breen, M. C., Green, J., & Jorm, A. F. (2017). Partners in parenting: A multi-level web-based approach to support parents in prevention and early intervention for adolescent depression and anxiety. JMIR Mental Health, 4(4), 1–13.

Chapter 12

The Art of Facilitation Jan Marie Fritz

12.1

Introduction

There are a number of ways to successfully facilitate (assist a group with) activities. Clinical sociologists who are facilitators learn different techniques/styles/methods such as probing, reframing, positive reinforcement, design, use of resources,1 problem analysis, peer evaluation, reflection practice, managing dynamic tensions (see, for example, Chen et al. 2019, p. 37, 40; Fierro 2016, p. 34; Hartwig 2010, pp. 18–19), and methods of decision-making. The use of such techniques is only a part of a facilitated activity; facilitation is an art,2 a creative undertaking in which the facilitator needs to continually act,3 focusing on what is currently happening while taking into account a group’s setting, participants, aims, relevant history, current situation and future opportunities. This chapter discusses the creative facilitation of meetings and provides a case study which points to some of the problems that can develop when not enough attention is given to effective facilitation. This chapter is an updated version of “The Art of Facilitation” that appeared in Moving Toward a Just Peace (2014) edited by Jan Marie Fritz (2014). 1 Nielsen (2012, p. 87) wrote about how “a range of semiotic resources (whiteboard, colored cards, speed markers, re-usable adhesive putty, body posture, gestures, gazes, pauses and talk) is used in a facilitated meeting. 2 Shaw et al. (2010, p. 4) indicated “the true art of an effective facilitator is often not always about the methods, tools or techniques that they employ but on the internal condition of the facilitator” which allows the facilitator to “create transformation in groups.” 3 According to Shaw et al. (2010, p. 4), “as scholars and practicing facilitators have emphasized, facilitators work intuitively, and often need to act in the moment. . .deciding if, when and how to intervene. . .”

J. M. Fritz (*) University of Cincinnati, Cincinnati, OH, USA University of Johannesburg, Johannesburg, South Africa e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_12

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Defining Facilitation

The term facilitation refers here to the act of making something easy or, at least, easier. The concept is known in many countries, but not all. Japan, even in 2010, had no word for facilitation in Japanese, but the idea of facilitation, particularly in the areas of education and training, was “increasingly gaining attention and acceptance” (Kato 2010, p. 694). Because facilitation is such a general term, one finds it used in different ways in many areas including neuroscience (increase in postsynaptic potential evoked by a second impulse); health care settings (facilitation activities implement evidencebased interventions) (Baloh and Ward 2018; Harvey et al. 2018); pharmacy (“implementation facilitation” improves the “delivery of anticoagulation care”) (McCullough et al. 2017, p. 1014); and business (running meetings). The term also is used in reference to nature hikes, museums and schools (where parents or teachers might facilitate children’s mobile technology-based educational experience) (McClain 2018; Harerimana and Mtshali 2017); ecology (for instance, when a plant provides shade for a seedling); veterinary medicine (e.g., “one-to-one facilitation” to treat sheep with footrot) (Grant et al. 2018) as well as human trafficking (facilitators are the people who are engaged in illegal trafficking across international borders). There also are “practice facilitators” (PFs) who are health care professionals—for instance in England, the Netherlands, Australia, Canada and the US—who assist primary care clinicians with “a variety of activities, including enhancement of documentation and delivery of clinical interventions, particularly preventive services; improvement of office systems; and implementation of Health Information Technology” (Nagykaldi et al. 2005, p. 583). And there also is “facilitative dialogue” (Smock and Serwer 2012, pp. 1–2), a conversation, moderated by a third-party, to help those involved in a discussion overcome any barriers to effective communication. While facilitative dialogue can be used in many situations, Smock and Serwer (2012) discuss its use in conflict and post-conflict areas.4 “Facilitative leadership,” an approach “based on the core beliefs and practices of group facilitation” (Bens 2006, p. 8), is also frequently discussed (e.g., Kato 2010, p. 694; Fryer 2012; Subramaniam 2011). Finally, there is “guerilla facilitation,” techniques that are used by a meeting participant when a participant thinks a meeting is not going well and wants to be more involved in moving the meeting forward (Wilkinson n.d.; Kaufman 2018). As the term facilitation has so many uses, one can expect some differences in the definition. Haskell and Cyr (2011, p. 5), for instance, defined facilitation, in a group facilitation journal, “as the design and management of structures and processes that help a group do its work and minimize the common problems people have working

4 Smock and Serwer (2012, p. 2) indicate that the three components of facilitated dialogue in conflict and post-conflict situations are (1) being sensitive to situations and intervening as needed to make conversations productive, (2) focusing on underlying interests and (3) organizing topics to achieve early consensus on less-difficult topics.

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together.” Amnesty International (2011, p. 20), in its training manual about facilitation, has provided a useful definition of the term that has much less of a management focus: Generally speaking, facilitation is defined as making things occur easily, or making something possible. Facilitation is an enabling and guiding process which creates and supports a space for purposeful engagement and participation.

There is a lot of discussion about the characteristics of excellent facilitators. Mie Femø Nielsen (2012, p. 89) indicated that a facilitator is a “content neutral” person “working to enable: [a group or organization] to collaborate, work more effectively and achieve synergy,” or to think in a deeper way about its assumptions, beliefs, values, processes, or other areas by using a rather informal, flexible alternative “to constricting formats like parliamentary procedure or Robert’s Rules of Order.”5 Amnesty International (2011, p. 22) emphasized that a facilitator’s qualities include “resourcefulness and creativity” because: Each group is as different as the people who make it up. A good facilitator needs an overall programme and objectives but may also adapt these to fit changing conditions and opportunities. . .

According to Smock and Serwer (2012, p. 163), a skilled facilitator in conflict zones should be “actively engaged in directing the discussion and helping the participants reach consensus;” this kind of facilitator would not be a “neutral traffic cop.” Some might see this approach to facilitation is an option in many kinds of facilitation (not just in conflict zones) while some others might think that this characterization opens the door to a facilitator being directive or opinionated. Facilitators, whether they are internal personnel or outsiders, LISTEN, encourage participation, draw out the opinions of participants, ask questions, clarify communication, keep a meeting on task, guide groups through difficult discussions, test assumptions, are optimistic, give as well as receive feedback, are creative, have no substantive decision-making authority and, periodically, summarize progress. Stephen Thorpe, in an editorial for Group Facilitation (2011, p. 3) lovingly described the role of the facilitator: A facilitator ‘in the moment’ might be likened to the metaphor of a swan that skillfully and gracefully glides on the surface of a pond: guiding the group towards their purpose, making subtle interventions, and cutting through blockages and conflict with precision. The group [members] may find that they are achieving [the group’s] goals, are becoming empowered, and participants are amazed at how easy it all seemed to flow—even through those tough bits they had been avoiding. Yet, just beneath the surface of the water, that facilitator’s feet are paddling away, drawing on a number of inner resources, picking up on subtle currents and bringing deeper awareness to all that is happening. This I call the inner practice of a group facilitator. . . There is a need now. . . to further explore and write about these subtle aspects of the group facilitator role. . . [so that others] can truly see the magic in the things we are. . . . doing while we are facilitating.

5 Robert’s Rules of Order, Newly Revised, (11th ed.), is a widely used parliamentary authority in the U.S. The first edition of the procedures was published in 1876.

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Mediation and Facilitation

Facilitation is a concept that is frequently used by mediators and many others to characterize some or all of the work they do. Mediation is a humanistic and creative process in which one or more impartial individuals help disputants discuss an issue or issues that concern one or more of the parties. This process is sometimes referred to as facilitated negotiation. The mediator will establish an open, trusting environment in which parties are encouraged to discuss the facts of the matter as well as their personal feelings about the issue or issues that brought them to the table. Mediation is usually problem-centered with a flexibly-structured process that can be free flowing or rather controlled or directed. If the outcome of this process is an agreement, it would be shaped by the parties and mutually satisfactory. The U.S. Institute for Environmental Conflict Resolution (n.d.) indicates that mediation and facilitation “are the cornerstone of the U.S. Institute’s services.” The Institute indicates that mediation is a negotiation process in which “‘resolution’ is the goal” while facilitation is a collaborative process that aims to “seek a shared understanding of the issues at hand, and to explore how they might work together to meet their common goals.” The Institute’s definition tries to draw a strong line between the two processes. . . but that is actually hard to do. Both mediation and facilitation can be broadly defined and are overlapping. For instance, New Zealand’s guidance note (Sefton 2009) for environmental disputes sees the role of mediator and facilitator as the same except that “outcomes of facilitated meetings are summarized at the conclusion” and “at closure, the agreement of a mediation is nailed.” Mediators, for a number of reasons, may refer to some or all of their work as facilitation. It may be that the term mediation is not understood by most or some segment of the public or it may be that some think if the term “mediation” is used that it means there is a severe problem. Facilitation may be a more acceptable term for those reasons. Also, a mediator may feel that the work she or he is doing— perhaps because it involves many people or a number of groups6—really is facilitation, although she or he uses many mediation skills. Mediators in the U.S. who regularly work with large groups usually have been trained in and have experience with facilitation. However, not all mediators (particularly those working with individuals or small groups) have been trained in facilitation. Increasingly, there has been an interest in and opportunities for these mediators to have this training. For instance, some large civic discussions (e.g., about national health options or problems facing women who wish to fully participate in society) have offered facilitation training to mediators and asked them to serve as table or group facilitators. Also, special education mediators in the U.S. are being trained or have been trained by a number of state education departments to

6 According to The State of Queensland, Department of Justice and Attorney-General (Australia) (n. d.), “mediation doesn’t usually involve large numbers of people. . . [and] facilitation is used for large-scale disputes, often involving several parties, an organization, a department or entire community.”

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serve as facilitators. These individuals have increasingly been made available to school systems to run meetings or develop models for running meetings when parents and school system representatives are trying to develop an individualized education plan for a student with special needs. The thinking is that if the initial meetings between parents and school system representatives are successful, there will be less problems in the future and less need to have mediators deal with special education disputes. Mediators and facilitators often belong to the same professional organizations. They may be active, for instance, in the International Association of Facilitators or the Environment and Public Policy Section (or other sections) of the Association for Conflict Resolution. The US Institute for Environmental Conflict Resolution (n.d.) frequently uses “contracted private-sector” mediators and facilitators in addition to its own small staff in dealing with environmental disputes. The Institute maintains a national roster of dispute resolution and consensus building professionals who all are third-party professional facilitators and/or mediators. The selection of mediators and facilitators generally should be acceptable to all the members of the groups. However, sometimes mediators and facilitators are assigned and it is only after assignment that a person or organization might question if the person is appropriate for the assignment. Both mediation and facilitation involve creativity. The situations of groups involved in mediation and facilitation may often be unclearly defined (what have been called “ill-defined domains”). Particularly when that is the case, creativity may not just be a contribution of the mediator or facilitator; the creativity may be in the collaboration/sharing of the participants as well as the contributions of the facilitator or mediator (see Reilly 2008). Mediation and facilitation often are broadly defined and the definitions can be quite similar. This certainly is seen when mediation is described as “facilitated negotiation.” And when Hampson and Zartman (2012, p. 35, 51) refer to “triple talk” (when a mediator becomes involved with parties who have been negotiating) as “mediated negotiation” or say a mediator is “by any other name [a] facilitator, good offices, third party, etc.” While there are some differences between mediation and facilitation, sometimes the definitions don’t reflect these differences because the definitions are not detailed enough or the differences are differences in emphasis (rather than absolute differences). One general difference between mediation and facilitation is that facilitators need to be able to work with large meetings (as well as small ones) and mediators, based on their special area of work, may not have to work with large groups. Also, mediators have to be able to write formal agreements while facilitations often do not have such an outcome. Some think that a facilitator’s main task is to improve the process or structure of a group while a mediator most frequently is working on resolving an issue. (While this may generally be true, there are many exceptions.) Finally, facilitators, because they are expected to have the capacity to work with large groups of people, may have exposure to many different techniques (particularly ones that encourage participation) as part of their training while some mediators, depending on the area of practice, may not have this training or experience.

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Professional mediators who work with large groups usually also are facilitators; some mediators who work with individuals and small groups are facilitators, and, increasingly, the others are being trained in the art of facilitation.

12.4

Novice, Experienced and Artisan Facilitation

Facilitators may not be needed in particular situations. The authors of a book about collaboration (Dukes and Firehock 2001, p. 29) noted that when a group has low conflict and “the meeting process is not terribly demanding,” a meeting can be managed by a chair or a member of the group. And Andy Williams (2012, p. 137) studied student learning when an open facilitation approach was used regarding “solo camping” (camping on your own). He concluded (p. 153) “that soloists can and do attach important meanings to their experiences without the need for a facilitator to guide or structure the learning process on their behalf.” Williams (p. 154) underlined, however, that he was not saying that “facilitator-led solo activities should become a thing of the past” but, rather, that all should be aware of the “potential of a more open mode of facilitation (a learner-centered approach in) which participants (solo campers) have more ownership of the process and outcomes of their own learning because facilitators were encouraged to take a step back.” When facilitation can be useful, what level of facilitation skill is needed? Facilitators do have different levels of expertise (see, for example, Hardiman and Dewing 2019, p. 2769; Bens 2000, p. 35; Rees 2005, pp. 261–283).7 Modifying Berkvens’ typology of facilitators (2012, p. 360), this chapter discusses the following levels: novice facilitator (little or no training in facilitation; uses more authoritarian style that she or he probably has experienced without checking the backgrounds and needs of participants; no continuing support offered to participants); experienced facilitator (has received training, some experience after training and some feedback from more experienced facilitators; has thought about background and needs of participants and sometimes has done a needs assessment; provides support for participants by asking how they are doing) and artisan facilitator (has extensive training and experience; periodically is given feedback by experienced and artisan facilitators; can use many different techniques in facilitating meetings; continually adjusts what is being done by taking into account the context and needs of participants; optimizes full participation of all participants, known for creative handling of situations). Holborn (2002), Hogan (2002), and Jenkins (2004) have noted the complex skills (such as clear communication, neutrality, process and participation skills) required in

7 Shaw and his colleagues (2010, p. 5) have defined intentional facilitator in the following way: “we use the label ‘intentional’ to distinguish a purposeful (or formal or professional) facilitator from one who facilitates a group meeting with only a tacit awareness of the reasons or motives behind actions or with limited knowledge of facilitation tools and techniques.”

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facilitation. And Amnesty International (2011, pp. 20–22) discussed experienced and particularly artisan facilitation when it described what facilitators should do: – – – – – –

Promote inclusion and active participation of all members of the group. Promote dialogue in a constructive way. Emphasize process, as well as outcomes. Manage tensions. Recognize and address power imbalances. Inspire!

Is there any evidence that experienced and artisan facilitation are better than novice facilitation? The general expectation is that experienced or artisan facilitation is better. Dukes and Firehock (2001, p. 30), based on their experience with environmental conflicts, noted that “the more diverse the group, the greater the scope of the group’s purpose and potential impact, and the more complex or conflictual the issues, then the more likely you will need a skilled and experienced facilitator or mediator who will take an active role in all elements of the group’s process.” Espiner and Hartnett (2011) also noted the value of a skilled facilitator. In discussing personcentered facilitation of planning with adults who have intellectual disabilities, they8 (Espiner and Hartnett 2011, p. 63) wrote that “the facilitation of a person’s aspirations requires a skilled facilitator who is a clear communicator giving priority to the aspirations and choices expressed by the person.” The researchers (Espiner and Hartnett 2011, p. 69) concluded that “skilled facilitation in the planning process will be essential to honour the adult’s voice and to promote a greater sense of ownership and control.” This study, however, did not discuss the different levels of skilled facilitation. Two studies are mentioned here because of their interest in both effectiveness and different levels of facilitation. One study of electronic meetings—by Wong and Aiken (2003, p. 125)—concluded that “automated facilitation was as good as experthuman and better than novice-human facilitation for simple idea generation and ranking tasks.” One of the big limitations of this study was that “no attempt was made to automate more cognitively complex facilitation tasks such as ensuring that parties are heard, that one ‘faction’ does not take over the meeting, that all ideas are discussed fairly, intimidating or derisive comments are discouraged, and that new ideas are considered.” The other study—by Kolfschoten et al. (2007)—compared facilitators who had different levels of experience. For their research (Kolfschoten et al. 2007, p. 353) novice facilitators were those who had facilitated less than 25 workshops, experienced facilitators had facilitated between 25 and 100 workshops and expert facilitators had conducted over 100 workshops. The researchers (Kolfschoten et al. 2007, p. 347, 354, 359) concluded that “generally, the time to prepare diminishes when experience increases,” novices and experienced facilitators regularly use less (facilitation) techniques than experts,” “novices have less access to a consulting team” and 8

Hardiman and Dewing (2018, 2769) identify two types of facilitators—novice and proficient.

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novices “are more likely to encounter surprises (e.g., unexpected outcomes or conflict) yet they are less equipped to handle (by adapting their facilitation designs) these surprises.9” These findings lend support to the value of experienced and artisan facilitation and also provide some suggestions about how facilitation can be improved.

12.5

Types of Groups That Can Benefit from Professional Facilitation

There are many kinds of activities that use or could use excellent facilitation.10 Here are some examples: Focus Groups. These are meetings of small groups (e.g., 8–12) of people who have been chosen because they are similar in some way (e.g., female independent voters who are between the ages of 25–40, new residents, mothers of elementary school children) to discuss, in a very specific way, a particular issue or issues (e.g., whether the most important issue facing your community is environmental protection or raising the minimum wage). Retreats. Retreats are lengthy meetings (e.g., one or two days) of a group. The long meeting may be needed, for instance, for developing a strategic plan, changing organizational culture, building relationships or encouraging creativity/innovation. Business Meetings. These are regularly or specially scheduled sessions in which a moderator helps a group deal with topics such as everyday concerns of the organization, making decisions, discussing something that is problematic, obtaining feedback or generating options. Advisory Committees. These groups (e.g., Mayor’s Task Force on Gender Equality) are frequently appointed individuals who meet infrequently but have been asked to provide the group’s comments/advice on an important topic or topics by a particular date. Open Discussions. These might be large gatherings where people share information or present posters and engage in informal discussions in order to obtain feedback. Public Meetings or Hearings. Government groups, civil society organizations (CSOs) and political parties often hold public meetings to discuss issues or options for resolving problems. Special Education/Special Needs Meetings. Many states in the United States now offer facilitation services to school districts to help assist with and design planning or

9 Dukes and Firehock (2001, p. 32) noted that “a volunteer facilitator, or even a paid agency staff person with minimum training, may not have the skills required to help parties negotiate the twists and turns of a highly political and/or highly technical issue: Innocent mistakes by an untrained person may result in parties leaving the group or other adverse outcomes.” 10 See, for instance, Herd (2019, 21–27).

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evaluation meetings involving school personnel and parents of students with special education needs. Design Charettes. Community planners often stage these events to “focus attention on specific physical design problems (in the local community) and (for the) generation of agreed upon solutions” (Herd 2019, p. 22) In discussing facilitation, there are some differences of opinion about where one usually finds facilitation being used and how it should be done. According to Nielsen (2012, p. 89), for instance, facilitators “are frequently used in innovation projects and change management projects; but usually not used in ‘ordinary,’ intraorganizational idea development meetings.” The Association for Talent Development (2018) also thinks that standard/regular meetings do not require a facilitator (although a “highly functional” group might use a rotating facilitator) but that outcomes can be improved by using a facilitator for meetings that are decisionmaking, informational, creative, and/or require a moderator who is neutral. Two examples of facilitated meetings might be useful at this point. The first, an initiative in a Minnesota county (CR Planning, Inc. n.d.), required a permanent stakeholder advisory commission be established for decisions involving parks, trails and open space. A consulting group, CR Planning, used a facilitated public participation process (during a one-year period) to “engage citizens, landowners and public officials in a respectful dialogue” at the start of the planning process and then facilitated discussion of the Park Advisory Committee. A policy plan was adopted by the County Board and this was followed by an implementation plan.11 As a second example, I facilitated a series of meetings (every two weeks for several months) for a “blue ribbon” citizen advisory group that had been put in place by a large city’s school board. The school board had been “encouraged” by community groups to get input from civic and business organizations representing minorities (as well as unions) regarding inclusive, local hiring in connection with new construction that the school system was going to undertake over a 10-year period. The facilitator, in this case, was involved in the process after the participants already had been selected, helped design the process that would be used for each meeting, facilitated each session, provided research and perspective for the head of the advisory group and assisted in developing the Committee’s report to the board. Facilitators also serve as advisers or mentors about facilitation processes. For example, SwissPeace (n.d.), which describes itself as a “practice-oriented peace research institute,” has a coaching program (2012–2013) for women in Myanmar who are engaged in peace processes. As another example, I advised the head of a chapter of a national NGO in developing a process for bringing together parts of a community that was deeply divided. And, finally, I also helped a community 11 Full implementation did not happen. According to Brian Ross (2012) of CR Planning, the implementation work was to be managed by an employee of the small parks department and not the consultants. Most of the plan was not implemented because the parks department employee who was to manage the implementation was hired away by another organization and county officials disbanded the parks department and shifted the responsibility for parks to another county department that had a different focus.

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organization revise its process for a public forum that would bring together members of the community to discuss a multi-service center that was proposed by a religious organization based outside of the community. The religious group thought that the center was an excellent idea but had not collaborated with the community organization sponsoring the public forum or other community groups in developing its project. Many community organizations (and many members of the community organization sponsoring the public forum) were skeptical or opposed to the project. The community room in which the meeting was held was packed and included local residents as well as sign-carrying members of the outside church. Some facilitators run meetings dealing with environmental, community or public policy issues. Frequently such meetings are part of a series of meetings that may take place over a long period of time (e.g., months or years). Depending, in part, on the importance and urgency of the issue to those attending the meetings, the need to agree on a process, the level of controversy and the number of sectors and groups involved, the facilitator (or facilitation team) may organize a set of planning meetings to arrange the actual decision-making meetings. Those planning meetings could cover topics such as the number of organizations that will be represented in the meetings; how many representatives each group will have; how decisions will be communicated to the public (if needed); who will facilitate the actual meetings; how representatives will communicate and get the involvement of the organizations they represent; how absences will be handled; what topics will be covered and how decisions will be made. Some facilitators work in conflict zones or with post-conflict situations (see Asuni 2012, pp. 113–126; Smock and Serwer 2012, pp. 163–169). Smock and Serwer (2012) provide advice about a number of difficult issues including getting minority representation in meetings and getting minority representatives to have full and accepted participation from those with more power. They caution that if discussions involve national policies, there need to be links to Track One (official) diplomacy. And they discuss that frequently participants want to represent themselves rather than their organizations which can have consequences in moving things forward in a country or region. While Smock and Serwer’s advice is based on working in conflict zones, their points are true (or can be adapted) for many other kinds of facilitation settings.

12.6

Steps to a Better Meeting

Facilitators, whether external (outside of the group making decisions) or internal (a member of the group making decisions who is taking on the role of a facilitator), are expected to improve the processes and outcomes of group meetings.12 The

12 Nielsen (2012, p. 89) indicated that “a workshop facilitator is often an external consultant, working to organize and lead events like meetings, seminars, workshops and group sessions in

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meetings may differ in substantial ways such as the emotional connection of some or all participants to issues being discussed, different power of participants, or group traditions including usual approaches to making decisions. The purpose for the meeting also can be quite different. Because of these differences, no one set way of facilitating a meeting is the only way to do things. Even though meetings can be quite different, there are some general considerations (e.g., Herd 2019; Frediani 2009; Bens 2000, pp. 39–44; Doyle and Straus 1976) that can be put forward as basic for most business-type meetings in the United States (with varying applications in other countries). This section of the chapter is divided into five parts—before, beginning, during, ending and after the meeting.

12.6.1 Before the Meeting 12.6.1.1

Plan the Meeting Carefully

Meetings often require a great deal of advance work. Among the questions to be answered: Who should attend? What will be discussed? When will the meeting be held? (In some situations, the timing of when a meeting will be held is extremely important.) Where will the meeting be held? What will be the best seating arrangement for the meeting room? Will there be refreshments? Why is the meeting being held? What is the desired outcome or outcomes of the meeting? If a series of meetings might be needed, how many will there be? Will the meeting be a safe environment? Will guests or the public be invited/allowed/encouraged to attend the meeting? How much notice needs to be provided before the meeting? Will a quorum be needed? Will Robert’s Rules of Order (Robert 2011) or some other format need to be followed? Management representatives (at the highest level) should be involved in the planning meeting or meetings to make sure that there is agreement about the process, content and goals.

12.6.1.2

Collect Needed Background Information

This often involves more than one interview. (Sometimes you learn surprising information in individual interviews. In advance of a small meeting, I learned that two participants had not spoken to each other in 10 years and that junior members of the work group were afraid to say anything in front of senior people.) A review of documents (including records and accounts of previous meetings) also may need to be undertaken. Some documents may need to be distributed at and/or in advance of the meeting. order to help their participants reach a certain goal or conclusion defined in advance (by the participants or the management).”

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Prepare and Send Out a Tentative Agenda in Advance of the Meeting

The tentative agenda should identify the kind of meeting that will be held, the proposed topics for discussion and the tentative amount of time that will be devoted to each item. (The facilitator’s copy of the draft agenda also should include process notes indicating how each agenda item will be handled—e.g., each person will give one story, brief report from three people, or establish13 evaluation criteria.) Comments/suggestions should be invited about the topics, the order of the topics and amount of time required for discussion. Depending on responses, a revised agenda may need to be sent out in advance of the meeting.

12.6.1.4

Arrive Early at the Meeting Site and Set up the Meeting Room

Make sure that there is sufficient time to set up your room before your meeting begins. I have found that arrangements made in advance sometimes do not result in what is expected. Be prepared, for example, to move tables and locate extra seating.

12.6.1.5

Plan and Check All Technical Aspects of the Meeting

This should be done well in advance of the meeting and again just before the meeting. Have plans in place about what will be done in the event that some equipment is not there or does not function.

12.6.1.6

Have a Troubleshooter Poised and in Position

If you are greeting those attending the meeting or are the facilitator, you probably will not have the possibility of dealing with a security issue (e.g., threatening person) or other problem. It always is best to have one or two people identified as troubleshooters who know it is their job (if you indicate) to solve any problem that develops.

12.6.2 At the Beginning of the Meeting 12.6.2.1

Greet Those Attending the Meeting

Make people feel welcome when entering the meeting room and ask if they have any questions. This might be done just before or at the beginning of the formal meeting

13

See, for instance, Retreats that Work (2006) by Liteman, Campbell and Liteman.

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or, if people are attending who are not known to the facilitator, as each person enters the room. This might be a point to ask what people are expecting from the meeting or why they are attending. This gives the facilitator some sense of who is in the room and why people are attending the meeting.

12.6.2.2

Identify the Type of Meeting

Indicate if the meeting will be, for instance, all or in part informational, planning, advisory, relationship-building or decision making. This is good to do at the beginning of a meeting and also may need to be done during the meeting.

12.6.2.3

Establish Ground Rules?

Some meetings can progress very nicely without establishing any ground rules. If ground rules or stated principles (e.g., confidentiality) are needed, they can be developed (with the help of the participants) at the beginning of the meeting or at any point during the meeting.

12.6.2.4

Start on Time

The announcement of the meeting and the agenda indicate the starting and ending times for the meeting. Those attending generally expect that these times are accurate.

12.6.2.5

Have Participants Introduce Themselves and Perhaps State Their Expectations for the Meeting

Don’t assume everyone knows everyone else. Set a process in place that lets everyone hear what is being said but doesn’t let anyone monopolize the introduction process. Two meetings I attended were problematic from the very beginning. In one a rather large number of people were asked by the novice facilitator to introduce themselves (without a microphone) and nobody heard or understood the information because most of the names and affiliations were spoken quickly and in low tones. One of the meetings had people introducing themselves with a microphone but the novice facilitator also asked each person to say a little something about her or his project. Many of the people talked for a rather long time about their projects while the novice facilitator did nothing (but wring his hands and look pained) while this was going on. Introductions can be a very good idea at the beginning of the meeting but the approach that is used, the directions that are given and the handling of this process by the facilitator are very important. (In a large meeting, it may be that only a small number of people can be given the opportunity to introduce themselves to each other and/or people can introduce themselves as they contribute to the meeting.)

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Clearly Define Roles14

The facilitator should use an approach that makes clear the expectations for all those participating in a meeting. It may be that each person is expected to speak and also that each person should encourage others to contribute. Participants should understand the role of the facilitator and whether a recorder (writing a public display of notes) will be used rather than a secretary (with private notes). Who will be acting as the timekeeper? Will roles possibly change (e.g., people sharing the recorder role) during the meeting? If a top manager or official is there, what will be her or his role during the meeting?

12.6.2.7

Review, Revise, and Order the Agenda (Including Times)

The agenda already has been through at least one review and may have been resubmitted to those attending the meeting. This would be a final review, even though topics and times still may be changed during the meeting.

12.6.2.8

Review Action Items, If Any, from Previous Meetings

This can bring participants up-to-date, note accomplishments or progress, identify problems and help bring closure on some issues.

12.6.2.9

Explain the Process That Will Be Used

In addition to explaining the roles of those participating in the meeting, explain (or discuss) the process that will be used for any discussion and decision-making (e.g., ranking and evaluating, multi-voting, ranking/prioritizing, nominal group, force-field analysis).

12.6.3 During the Meeting 12.6.3.1

Focus on an Issue (All in the Same Way and the Same Time)

The facilitator, with the help of all participants, has to keep the meeting on track. The process that has been explained at the beginning of the meeting will help the

Those who want more information about defining roles in meetings may find it useful to look at How to Make Meetings Work (1976) by Michael Doyle and David Straus.

14

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facilitator do this and also to handle new topics or difficult points that may emerge during the discussion.

12.6.3.2

Consider Using Small Groups

This approach can bring involvement/energy or renewed energy to a discussion. Groups need concrete directions and a time limit.

12.6.3.3

Consider Having One or More Breaks

Breaks can be an excellent way to get people to talk or caucus with each other, change the seating arrangements and/or have the meeting easily go in a different direction. Participants do need to know the specific time when the meeting will reconvene. While having breaks can be a very effective tool, I have seen meetings where participants did not return on time and some used the break as an opportunity/ invitation to leave.

12.6.4 At the End of the Meeting 12.6.4.1

Review the Group Memory

This is easily done if there is a public version (e.g., poster sheets on walls) rather than a private record (personal notes). It is most important that action items are established or confirmed including who will take an action, what will be done and when it will be done.

12.6.4.2

Set the Date, Time and Place of the Next Meeting (If One Is Needed) and Develop a Preliminary Agenda

It may be that only suggestions for dates, times and places can be mentioned if one also has to consider the preferences of those who were not able to attend this meeting.

12.6.4.3

Evaluate the Meeting

This can be done casually or in a formal way. Information obtained at the end of a meeting can be helpful to those who may put another meeting in place.

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Close the Meeting on Time: Crisply and Positively

Unless the whole group has agreed to extend the meeting, it is best to close the meeting at the announced time. After this formal ending, a group or groups may be given encouragement to meet.

12.6.4.5

Clean Up and Rearrange the Room

People in charge of a space appreciate some help in getting a room ready for the next meeting. The amount of help that is appreciated will vary depending on the administrators (e.g., hotel manager, school principal) and/or the regular set-up for the space.

12.6.5 After the Meeting 12.6.5.1

Evaluate the Meeting/Write and File a Report

Review any comments given orally or in writing by participants and add your own comments. Even if there will be no additional meetings, at least a brief report (including the agenda, any action items and evaluations) should be developed based on the meeting as well as the preparatory and evaluation sessions. This will serve as guidance to others who may eventually hold a meeting of these participants or run a meeting dealing with the same or similar topics.

12.6.5.2

Follow-up on Any Action Items and, If There Will Be a Next Meeting, Begin to Plan It

A plan needs to be put in place dealing with the completion of action items.

12.6.5.3

Give Praise (as Deserved) for Those Who Helped Develop and Run the Meeting

It is important to thank people by name for their assistance. It also may be a good idea, in some cases, to write letters of thanks that will be included in personnel files.

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Dealing with Facilitation Difficulties: The Well City Experience

The hearings described below were held in Well City,15 a medium-sized community in the U.S. The first hearing was in a court room and run by the city’s elected mayor. The second hearing was in a university building and run by an experienced facilitator. Aurora Punch, Well City’s Health Commissioner, knew that tobacco use was a preventable cause of disease and death. She also knew the American Cancer Society and the American Lung Association were encouraging communities to put tobacco use prevention regulations in place and she wanted to do that in Well City. In September, Commissioner Punch sent letters to selected organizations, including the city council, indicating that she was forming a “task force of community leaders” to study the tobacco problem. She wanted representatives from each group to “actively participate” in the work of the task force. The task force first met eight months later (in May) with 18 representatives, including the mayor, two city council members, the clerk of court, three city board of health members, a county health department employee, a representative from the hospital, an employee of the county commissioner’ office, and a member of the business community. One of the task force members, a representative of the American Cancer Society, was a retired regulatory technologist and familiar with the indoor air standard accepted by the American Society of Heating, Refrigerating, and Airconditioning Engineers (ASHRAE). The American Cancer Society representative along with the city health commissioner and two other task force members formed a smaller working group—the Clean-Air Regulation Subcommittee. In July, the subcommittee recommended a clean air regulation to the city board of health that incorporated the ASHRAE standard of ventilation. The proposed regulation stated that “lighted smoking materials in public places is declared a public nuisance and hazardous to the public health.” It prohibited the possession of lighted smoking material in any form in any commercial establishment (including bars, restaurants, and bowling alleys), public vehicles, restrooms, elevators, and selected public facilities (libraries, educational facilities, museums, auditoriums, and art galleries). The proposed regulation did allow an owner of a facility to permit smoking if the owner installed a ventilation system based on the ASHRAE standard or have a hearing if the owner wanted a variance. It was anticipated that owners would not attempt to meet the ASHRAE standard, as this would be an expensive undertaking, and also that few variances would be given. Any owner or operation that failed to comply with the regulation could be charged with a minor misdemeanor and fined up to $100. Essentially what was being proposed was a total smoking ban for public places. The example described here is based on an actual case that is discussed at length in “The Bumpy Road to a Tobacco-Free Community: Lessons from Well City” (Fritz et al. 2000). Pseudonyms are used here and in the original article for the names of the city and individuals. 15

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The city health commissioner proposed the regulation at a city board of health meeting in October and the city’s first public hearing (meeting) was held in November. That hearing, by all accounts, was bedlam. About 250 people jammed a small courtroom and the group heard more than 50 speakers. The meeting lasted more than four hours. While no smoking was allowed in the courtroom, smoking was allowed in the hall just outside the courtroom. Tobacco smoke from the packed corridor poured into the hall every time the court’s doors opened. The mayor, who served as head of the city’s health board, facilitated the public hearing. The mayor indicated that anyone who wanted to speak could do so. He allowed speakers to go beyond the prescribed time limits and speakers frequently repeated what others had said. Hecklers were not controlled. Most of those opposing the proposed regulation were bar, restaurant, or small business owners. One of the speakers was Marge Can, a well-known, realtor in the community, who had owned her own business for more than 10 years. She was smart and energetic. While not frequently active in the public life of the community, she had headed the committee (whose members all were smokers) that organized the American Cancer Society’s annual (fundraising) golf tournaments for the two years prior to Well City’s tobacco-control initiative. Each morning Marge went for coffee at P.T.’s, a local restaurant, and joined the regulars for a discussion of local events. One morning the talk turned to the story on the front page of the local paper, the city and county’s proposed tobacco control regulation. After considerable discussion, Marge, who smoked two to four packs of cigarettes a day, and a farmer decided to form an organization, BADLAW, to fight the proposed regulations. The core group of organizers also included the owner of a restaurant and the non-smoking owner of a travel agency. They spoke at the public hearing and Marge gave interviews to the city newspaper. Marge said the main issue was one of freedom. She pointed out that the health boards were not elected and had no right to be making tobacco-control rules. Marge felt that if she and a client wanted to smoke in the conference room of her office, they should be able to do so without government interference.16 After the shock of the chaotic public hearing, the city health department began licking its wounds, and two months later, in January, the city and county health boards started working together on revising the proposed regulation. The new proposal dropped the term “clean air” and the list of exemptions and variances began to grow to include (1) bars, bowling alleys, and pool halls (if they have signs

16

Five years after Marge’s group (BADLAW) lost its last court battle against the city, Marge Can, 52, died of lung cancer. During the 20 years she had lived in Well City, Marge unsuccessfully tried many methods to quit smoking, including acupuncture, hypnosis, and the patch. She did not try to quit smoking while she was the spokesperson for BADLAW. One year before she died, Marge learned she had lung cancer and would have to have surgery. She stopped smoking. During her last year, she established a website to let others follow her progress in dealing with cancer. When she became too weak to type her own website entries, family members made the entries for her. The obituary that appeared in the local paper noted Marge’s community service, particularly her volunteer work on behalf of the American Cancer Society.

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stating that a no-smoking area is not available; (2) an employee vehicle where the driver and all the passengers consent to smoking; and (3) retail tobacco stores. More than one year after the first hearing, in October, the city and county boards of health held a joint public hearing at the Well City campus of a state university to collect feedback on the revised proposal. The university building was chosen because it was removed from city departments and offices and no smoking was allowed in the whole building. This time there would be no smoke coming in from the corridors. This public hearing was held in a large auditorium, much larger than the expected number of participants, and it was run by a trained facilitator. The facilitator gave a rather complete informational presentation that began the meeting. After the presentation, audience members were able to speak, but they had to follow guidelines. Speakers had to sign up in advance and no more than one speaker was allowed from an organization. Length of speaking time and heckling were now under control. Security personnel were available if needed, and the organizers of the hearing had agreed in advance that if the event got out of control in some way, it would be ended early. The meeting ended at the announced time. The facilitator has to be in control of a meeting, in this case, a community hearing. Well City’s first public hearing was a disaster. It was led by an elected official who did not want to upset any of his constituents; he allowed people to speak too long and repetitively, did not control heckling, and held the hearing in a place where tobacco smoke could pour into the hearing room. By the time of the second hearing, Well City public health officials had learned a lesson. The hearing was held in a building that was smoke-free on a college campus (neutral territory). The meeting room was much larger than the number people that would be in attendance. This setting—a large room with many empty seats rather than a crowded court room—means that the setting will not easily add fuel to the controversy. There was visible security and the hand-picked, experienced facilitator had a long, thorough, informative introduction about the main topic and established a speaking process that was inclusive, orderly and calm. The second hearing gave the public the opportunity to take part in the discussion, but, unlike the first hearing, there was no chaos.

12.8

Conclusion

There is evidence that facilitated processes can be very effective. Shaw and his colleagues (2010, p. 9), based on their research of facilitator impact during a quality improvement process, concluded that external facilitators, who are experienced or artisan, “are able to ask critical questions, hold people accountable, and even ‘see’ processes or dynamics that the insider may not.” The art of facilitation can help meeting participants work through difficult issues; really involve people in their organizations and communities; help people who have had difficulty participating in groups as well as those who think that others should not be full participants; and develop creative, inclusive long-range plans. All groups do not need professional

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facilitators, but experienced and artisan facilitation often can make a central contribution to a group’s progress. Meetings often need to be carefully prepared and, if a facilitator or facilitator team is involved, the facilitators need to be part of the planning as well as the implementation effort. As noted in the Well City case, meetings that are not well-prepared may not accomplish goals, can reinforce initial positions and anger as well as lose participants.

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Smock, D. R., & Serwer, D. (Eds.). (2012). Facilitating dialogue: USIP’s work in conflict zones. Washington, DC: United States Institute of Peace Press. Subramaniam, M. (2011). Grassroots groups and poor women’s empowerment in rural India. International Sociology, 27(1), 72–95. SwissPeace. (n.d.). Retrieved Oct 16, 2012, from http://www.swisspeace.ch The State of Queensland, Department of Justice and Attorney-General (2010–2012). (n.d.). Dispute resolution: Facilitation. Brisbane: The State of Queensland. Accessed Oct 16, 2012, from http:// www.justice. qld.gov.au/justice-services/dispute-resolution/facilitation Thorpe, S. (2011). Editorial introduction. Group Facilitation: A Research and Applications Journal, 11, 3–4. U.S. Institute for Environmental Conflict Resolution. (n.d.). Accessed Oct 16, 2012, from http:// www.ecr.gov/ HowWeWork/Services.aspx Wilkinson, M. (n.d.). Guerilla facilitation: What to do if the meeting leader is not leading. Accessed Oct 18, 2012, from www.inifac.org/articles/arGuerillaFacilitation.pdf Williams, A. (2012). Taking a step back: Learning without the facilitator on solo activities. Journal of Adventure Education & Outdoor Learning, 12(2), 137–155. Wong, Z., & Aiken, M. (2003). Automated facilitation of electronic meetings. Information & Management, 41, 125–134.

Chapter 13

Organizational Consulting for Strategic Change in a Public School in Colombia Fernando de Yzaguirre

13.1

Introduction

This chapter1 showcases the consulting process for organizational change carried out in 2019 in a public school in Barranquilla, Colombia. The intervention involved all the 53 teachers and 4 management team members (three of whom were teachers as well as administrators) of the District Educational Institution Citadel July 20th, cited from now on as INEDIC school. There were two main aims in this consulting assignment. The first was to increase the teachers’ motivation to create processes of integration and collaboration among teachers. The second was to update, in a participative way, the strategic tool used by the school management: The Institutional Educational Project, cited from now on as IEP. This introduction to the chapter is divided into two parts. In the first part I discuss INEDIC, the public school, and then the management tool IEP which is the main focus of this consulting work. Part two describes how the sociology students were trained as clinical sociology facilitators and how they came to be involved in this consulting assignment. The second part takes into account that this consultancy is based on the socio-clinical innovative approach and interventional techniques developed by many authors among them Gaulejac (2019), Fritz and Rhéaume (2014) and Yzaguirre and Castillo (2013).

1 I would like to thank the following for their help in developing this chapter: Lina Fernanda Ruiz, Edgardo Enrique Olier Marrugo, Karol Dayana Ibañez, and María Claudia Salcedo. I also want to thank the following for their assistance with the translation of this text from Spanish to English: Álvaro García, Isabel Fernández-Hearn, Pablo de Yzaguirre, and Natalia Rodríguez.

F. de Yzaguirre (*) University of the Atlantic, Barranquilla, Colombia e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_13

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Following this introduction, the chapter discusses the work at the school during the two phases of consultation. The first phase was from December 2018 through April 2019, and the second was from April through December 2019. I will discuss the objectives, methodology, development and results of each phase.

13.1.1 The Strategic Management Tool IEP at the INEDIC School Colombia is the second richest country in the world in terms of biodiversity, at the same time it is the seventh poorest in Latin America, with 19.6% of Colombians living under conditions of multidimensional poverty (DANE 2019, p. 3). Based on 2018 data, CEPAL (2019, p. 100) indicates that Colombia has the third highest rate of poverty of the countries in Latin America (15 countries) as well as the highest rate of extreme poverty (10.8) and is fifth highest in total poverty (29.9). And, since the 1950s, there has been widespread displacement, corruption, inequality and violence (e.g., United Nations 2020; OECD 2019; Guzmán et al. 1962). The problem of violence is reproduced within the schools as DANE (2012) has shown in a large study carried out in Bogotá, the capital of Colombia. INEDIC school is one of the 154 public schools in Barranquilla city. The town is located in north Colombia, in the Caribbean region. It is the fourth biggest city in Colombia, with more than 1.2 million inhabitants. This school offers free education from primary to high school, for a community of nearly 1700 students, the majority from low and very low socio-economic strata. There are many immigrants, especially from Venezuela. Since 2004 the school has provided two official shifts (complete sessions) so that it can serve the highest possible number of students. The school’s staff is composed of 57 teachers, including 4 manager teachers, and is led by a rector (principal). The national education policy requires that schools have strategic management tools. As Radinger et al. (2018, p. 50) have noted “Every school must develop and put into practice and educational project (Proyecto Educativo Institucional, IEP) together with the school community.”. INEDIC school has the IEP, and an Institutional Improvement Plan, cited from now on as IIP, and these are connected to the school’s yearly self-evaluation. Our consulting work relates to these two management tools, and particularly the IEP. What is an Institutional Education Project (IEP)? Jaramillo Roldán et al. (2004) stated that since 1994 the Education General Law and the 1860 Decree have established the necessary requirements to achieve the democratic participation of educational communities in their daily collective work. An Institutional Educational Project is formalised as an institutional strategic document that schools with primary, middle-school and secondary education have to elaborate and approve through an internal participatory procedure. These documents expect programs’ lines to guarantee quality while pursuing their objectives. It is said that the IEP is the “navigation

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chart” of each institution, which means that a school’s development path must correlate to it. It has to be shared, questioned and updated periodically. Investigations show that the reading and discussion of the IEP among teachers is a variable which clearly makes a difference in the quality of educational institutions. In higher-quality institutions, the teachers have participated more actively in the development of the IEPs. In lower-quality institutions, either the IEP does not exist, or it exists only as a formality to be shown to the supervisors from the Ministry of Education when they require it. As De Zubiría (2015, p. 45) has noted “In institutions of higher quality, the IEP was alive, it was collectively built...” The experience from this consulting work has allowed us to understand the IEP’s strategic importance, which, in our view, resides in at least six elements. It shows agreement for the process, and gives an identity to an institution. It promotes the participation of the whole school community. It engages the administration. It defines the institution’s direction and builds a common project for all the educational community. The stages of INEDIC school’s IEP development are similar to that of any other public school in the country. There are three key moments in this document’s revision at INEDIC. The first one took place at the end of 1999. The document was strengthened because INEDIC added secondary education (until 16 years old) and so the curriculum was expanded. A strong emphasis on values formation also was incorporated, which continues today. The second moment happened in 2009 when the document was made more complete and more coherent, in harmony with the school’s mission and institutional vision. This IEP was valid for 6 years, from 2009 to 2015. From 2015 on, the IEP remained “on standby.” The school waited for the first results of the consulting work, in April 2019, to reach its third stage. The consulting work was an intervention conducted by Sociocaribe, an external consulting group from the Universidad del Atlántico (University of the Atlantic), under the direction of professor Fernando de Yzaguirre, the principal investigator, cited from now on as PI.

13.1.2 Academic Background of the Consulting It is important to understand the academic antecedents because of their role in this consulting assignment. In the following two sub-sections I discuss some of the elements of clinical sociology as it was introduced as an academic speciality and professional practice in Colombia. First I discuss the academic “Road Map” and then the interventions that were conducted at the INEDIC school.

13.1.2.1

The Road Map in Clinical Sociology

The Road Map in Clinical Sociology, cited from now on as “Road Map”, for the Program in Sociology’s undergraduate students, began in 2015 at the Faculty of

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Human Sciences at the Universidad del Atlántico. The Road Map connects undergraduate studies and training in clinical sociology with professional practice. The main elements are summarized below. This is the first time that clinical sociology training has been introduced in a degree program in Colombia. In 2015 the Clinical Sociology and Psycho-sociologic Intervention Seedbed (a research group incubator) was created, cited from now on as SOCLIP.2 Undergraduate sociology students must choose seven specialization elective courses during the last two years of the 4.5 year sociology program, and they are offered a number of options. In 2015 an elective course—Clinical Sociology of Business and Work—was introduced in the undergraduate program. Later on, in 2016, two additional specialization elective courses were added; (1) Qualitative Perspective, Symbolic Interactionism and Grounded Theory and (2) Socio-clinical Perspective and Psychosocial Intervention. That same year an extra 100-hour university training started to be offered; it was called Graduate in Socio-Clinic Facilitation, cited from now on as GSCF. This training was organized by SOCLIP during a 3-year period (2016–2018), and it included 60 practice hours as facilitators and researchers in social intervention. The trainees gave socio-clinical workshops around the topic “Life Project and Professional Orientation” at INEDIC school for a 3-year period. The workshops successfully trained 250 students. The workshops were free of charge for INEDIC and were featured in a chapter in an international book (Yzaguirre et al. 2019). As part of the Road Map, we began, in 2017, a university-funded project of research and social intervention (Acompredes3) at the Universidad del Atlántico. The project’s aim was to use a socio-clinical approach to prevent a high student dropout rate during the first and second semester at the university. Some 30 sociology students, previously trained in clinical sociology specializations and in GSCF, were able to have their required practice experience as socio-clinical facilitators in the Acompredes project. In addition, some did their graduation assignments around the previously mentioned project. Four of the students presented written reports that were published in the conference proceedings of an international congress held by the Asociación Latinoamericana de Sociología (ALAS) in Montevideo, Uruguay in 2017 (Ibáñez et al. 2018; Gómez et al. 2018; Yzaguirre et al. 2018). This Road Map resulted in two important achievements in 2018. The first was sponsoring an International Seminar in Clinical Sociology,4 which was introduced

2 See the following websites for information about SOCLIP‘s second and third anniversary celebrations: https://www.uniatlantico.edu.co/uatlantico/semillero-soclip-celebr-segundoaniversario-0 and https://www.uniatlantico.edu.co/uatlantico/tercer-aniversario-del-semillero-desociolog-cl-nica-soclip 3 Information about the Acompredes project can be found at https://www.uniatlantico.edu.co/ uatlantico/noticias/acomprendes-proyecto-piloto-para-prevenir-la-deserci-n 4 The call and images of the first International Seminar of Clinical Sociology at the Universidad del Atlántico can be found at the following websites: https://www.uniatlantico.edu.co/uatlantico/1seminario-de-sociolog-cl-nica-y-psicosociolog and https://www.uniatlantico.edu.co/uatlantico/ numerosa-asistencia-al-primer-seminario-de-sociolog-cl-nica

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by Ana María Araújo, a professor from the Universidad de la República del Uruguay, who is one of the most important representatives of Latin American clinical sociology. The second was the formal registration of Sociocaribe5 Social Consulting, a professional group that serves as a consulting organization, managed by hard-working members of SOCLIP who were involved in the Road Map for three years. In this chapter I am describing Sociocaribe’s first long-term professional consultancy. In 2018 a publication by the Centro de Investigaciones Sociológicas (CIS), Spain‘s National Center for Sociological Research, celebrated the work of Spanish sociologist José Ramón Torregrosa. Professor Torregrosa introduced clinical sociology in Spain, and, thus, centrally contributed to its introduction in Colombia. The prestigious CIS gathered essays by Vincent de Gaulejac and Fernando de Yzaguirre (2018, p. 259) defining clinical sociology and its foundations as well as a 25-year short history about the clinical sociology tradition in Latin America and Spain. The following pioneering academics contributed to this tradition: Elvia Taracena, México; Ana María Araújo, Uruguay; Dariela Sharim and Patricia Guerrero, Chile; Christiane Ferreira, Ana Massa and Fernando Gastal de Castro, Brazil; Ana María Correa, Argentina; José Ramón Torregrosa, Spain; and Fernando de Yzaguirre, Spain and Colombia. Regarding publications, apart from the four connected to the ALAS conference, two more have been issued by Delgado and Mercado (2018) and Yzaguirre et al. (2019). Sapere Aude editions plans on publishing one book (about the work of the Acompredes project and other SOCLIP initiatives) that will be part of its clinical sociology collection. It’s important to note, that starting from the clinical sociology specialization courses that were created, the Road Map worked as a preparatory cycle for the professionalization of sociology so students without resources to pay for a Master’s degree could specialise as professional Facilitators after their graduation. Unexpectedly, the Road Map from Universidad del Atlántico was interrupted in 2018, as the sociology degree’s board decided to discontinue the two specialization subjects in clinical sociology, which were its indispensable base. Also, the Acompredes project, a 2-year initiative, was discontinued because the university did not have the money to support the second year of the project. Thus, the GSFC in socio-clinical facilitation, the Acompredes project with its degree practices and SO CLIP were suspended. Sociocaribe was not directly connected to the school specializations and it continued.

13.1.2.2

Socio-clinical Interventions in INEDIC School

The GSCF training is a direct antecedent of this consultancy. Students who followed the Road Map and did the GSCF training, followed through with their practice at the

5

Information about Sociocaribe can be found at http://www.sociocaribe.org/

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Fig. 13.1 Teachers, administrative staff and lead consultant for the INEDIC school

INEDIC school, where a total of 47 developmental workshops were carried out. When the GSCF training was suspended, practice at the school was halted. So IN EDIC lost a tool for student development which was very positively valued. However, this led to a new situation. The facilitators who had practiced at the INEDIC school also were involved with Sociocaribe. INEDIC school applied for a new consulting project with Sociocaribe, but instead of the INEDIC students being the clients, the clients would now be INEDIC school’s teachers and administrators. The facilitators that carried out this consulting were not practice students anymore, but young graduated sociologists who specialized in socio-clinical facilitation because they had followed the Road Map. The INEDIC school has been instrumental in supporting the sociologists from Universidad del Atlántico. First it gave them the opportunity to train themselves by doing their practice with the school’s students, and now it gave them the opportunity to perform their first professional consultancy with the teachers and management team (Fig. 13.1). The main elements of the consulting work with the teachers and administrators— the objectives, methodology and main achievements—are described in the sections that follow. I also will show the project’s development which I have divided in two phases. The phases follow the basic intervention process described by Ronald Lippett and his colleagues in seven stages (Fritz 2008, pp. 9–10): (1) The client system discovers the need for help (2) The helping relationship is established and defined. (3) The change problem is identified and clarified. (4) Alternative possibilities for change are examined and the goals of the change are established. (5) Change efforts are attempted. (6) Change is generalized and stabilized. (7) The helping relationship ends or a different type of continuing relationship is defined.

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Phase One: The Basis for Change and the Renewal of the IEP

The first phase of this socio-clinical intervention consisted in accompanying6 the professionals of an educational institution to help them resolve some of the difficulties they were facing. The difficulties had made it harder for them to update, in a participative way, the strategic document (IEP) which set the institution’s goals and was now out-of-date by 3 years. The subsection below describes the work done in the first phase, which included the first four months of consultation, when the basis for the organizational change was established and the IEP was renewed.

13.2.1 Starting Point The school’s management team, headed by the rector, Celia Durán de Ortíz, a former teacher with 40 years of experience in the institution, was clear about the main problems, and she wanted an innovative approach to change because she thought a successful outcome would be difficult to reach. The school decided to contract with our consulting firm, but the school had a very modest budget. The first meeting in the consulting process was held in December 2018. During this and the following meetings, with the management team and the Academic Council,7 two types of difficulties became quite clear. The first difficulties were general and considered more important because they affected the global functioning of the school; the second type was more particular and affected the renewal of its strategic document, the IEP. Among the general difficulties were the existence of a discouraging atmosphere and apathy among the teachers, who each day had to face big challenges to adequately carry out their jobs. The other general difficulties were the lack of communication among the teachers and internal cohesion; parents not involving themselves with school processes; a lack of involvement in the academic community to identify and resolve problems; and the need for the teachers to decide on a school project as well as reinforce a 6 For the sake of this work, we will use the term “accompaniment” as a psychosocial or socioclinical technique, which involves not only the support and close collaboration with a person or a group, but goes even further. It refers to the establishment of a relationship of mutual cooperation, from a subject-subject epistemology, where the intention is to avoid the figure of a “consultant” who is helping the “consulted”, or a researcher who helps the researched. Rather, we refer to a work which is done collaboratively, in a process of mutual analysis and change in a horizontal way, performing active listening and creating the conditions for the person or group to discover and express ideas and feelings at the service of the analysis and of a development of meaning that helps the processes of understanding and change in the facing of problems. 7 The Academic Council is composed of the School’s four administrators and eleven teachers who are responsible for different areas of teaching.

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common identity among all the professionals. All this affects a teacher’s attitude when facing the manifold challenges of her or his work and institution. The particular difficulty had to do with meeting the requirement for updating the IEP. INEDIC school had not been able to previously use a collective process that involved the teachers. That was required to update the IEP, the document which is the school’s strategic guideline: This difficulty, of course, was connected to the general difficulties. The double challenge of this consultation could be summarized in this way: teachers had to be motivated and the IEP updated. A successful result would be getting the teachers motivated to collectively update the IEP, turning it into a living tool for the school’s improvement. Achieving this would help recover the teaching staff’s hope and trust, and set a new direction to strengthen the construction of a common school project. I now will discuss the fundamental elements of the organizational intervention.

13.2.2 Objectives and Methodology The general objective of the consultation was to motivate the teachers and renew the IEP in a participative way. The specific objectives were the following: • To promote the integration of the teachers and to lay the foundations of change ensuring a collective engagement to work to improve the school. • To introduce new processes of collaborative work. • To identify difficulties and strengths perceived by the teachers. • To get teachers to engage with the IEP for its renewal in a participative way. The methodology was based on the clinical sociology perspective (Gaulejac 2019; Gaulejac and Yzaguirre 2018; Fritz and Rhéaume, 2014; Fritz 2008). This approach was combined with traditional techniques: questionnaires to collect information, work meetings and the systematic presentation of results. To reach the objectives, especially the first specific one, we wanted to avoid processes focused on prescribed instrumental tasks, because they are perceived as administrative and a source of work overload. It was agreed we would begin by establishing a context to reach a change in the outlook of all levels in the staff. In order to do it, a methodology was needed that was capable of engaging participants so they would facilitate a change from themselves; this can be envisaged from the clinical sociology perspective through a consultation that addresses the dimension of subjectivation (described below) and engagement. Such processes allow integration, as Gaulejac and Yzaguirre (2018) noted, as well as active listening and group search for a better understanding of the difficulties that are being faced, in order to identify possible strategies of change able to overcome them. To implement these processes, the intervention design included two levels referenced by Fritz (2008, p. 10): the collective, where the more subjective initial work would be done, and the

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organizational, towards which would be directed the result of the former level, to achieve a strategic change in organization. The notion of subjectivation is of utmost importance for clinical sociology and is addressed by numerous sociologists. Alain Touraine, for instance, works on the concepts of subject, historicity and conscience; subjectivity is a permanent construction. François Dubet’s sociology of experience advocates a subjectivity with a drive to construct autonomous action and its own identity. To Giust-Ollivier (2019, p. 625): La notion de subjectivation est une notion récente qui est de plus en plus utilisée. . . par les sociologues de langue française (...) L’individu—en particulier dans la tradition fonctionnaliste et marxiste—n’était que l’envers de structures sociales dont il intériorisait les normes et les modèles culturels. Aujourd’hui l’acteur n’est plus seulement ce personnage social, il devient dans le regard des sociologues un sujet en quête d’émancipation qui entretient un rapport conflictuel avec sa socialisation.8

The methodology applied in the consulting involved workshops designed as a simplified adaptation of Groups of Research and Involvement. The adaptation was needed because of the limited resources available, especially in terms of the available time to work with teachers and the modest economic budget. The Groups of Research and Involvement (GRI) works with biographical elements and promotes the engagement of participants, who share personal experiences and elaborate their “historicity” during workshops, easing within the group the integration of different individual experiences, which are discussed in connection with social determinations. These workshops allow “the participants to understand themselves better, as the product of a history of which they try to become subjects” (Gaulejac 2019, p. 326), generating elements of personal empowerment and improved awareness of challenges and difficulties, which are shared by the group. One of the challenges of this work with groups was to reduce their size so that each group was supported by two trained facilitators. This was achieved thanks to Sociocaribe, as it supplied ten junior facilitators who worked under the direction of one senior facilitator, the IP.9 This allowed us to work flexibly with several groups simultaneously. The facilitation team carried out design and training sessions before the interventions. Its role was to align the workshops with the working groups and, once the workshops were finished, to write reports and participate in the systematic analysis of the results.

Here is the English translation of Giust-Ollivier’s ideas: “The notion of subjectivation is a recent notion which is used more and more. . . by French-speaking sociologists (. . .) The individual— especially in the functionalist and Marxist tradition—was not more than the other side of social structures whose norms and cultural models he internalised. Today the actor is not anymore this social character, he becomes—to the sociologists’ eye—a subject in search of emancipation who maintains a conflictive relationship with his socialisation.” 9 I would like to thank the following individuals for their work with this consultation: Lina Fernanda Ruiz Ortíz, Roberto Avendaño, Karol Dayana Ibañez, Edgardo Enrique Olier Marrugo, Antonio Castellón, Sonia Cuadrado, María Claudia Salcedo, Karina Jinete, Felipe Cardona, Dilan Bujato, Angie Blanco, Jeffrey Cortés, Néstor Hamburguer, Alexandra Pérez, Marilyn López. 8

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At the beginning of each workshop it was important to make sure that the composition of each GRI group was well designed. The main criterion was to achieve the highest integration among a group’s members, which helped with the objectives of the consultation. Due to the existence of two work shifts, a breach between “two schools” emerged; this had to be solved as it hindered the idea of having a common school project. Therefore, groups were designed to include teachers both from the morning and afternoon shifts; keep a balance between sexes; ensure a balance between teachers of all levels, and, finally, include no more than one administrator in each group. From the total of 57 participants, including three teachers who are also administrators and the rector, five groups were created with approximately 11 members in each group. One of the approaches employed was drawing, a projective technique. Teachers were asked to do several drawings, some about the school experiences in their childhood as students; others related to the present, as teachers. By including these drawings as a basis for discussion, the workshops became invigorated. The dynamics allowed for the tackling of a wide range of elements, problems, experiences and motivations, both from personal and collective points of view. This exchange and mutual understanding helped facilitate a path for common discourse around the school and IEP they would like to have. These group workshops, applying GRI methodology, assured the flexible but ordered circulation of narratives, creating an ambiance of respect and active listening. Conditions for the production of new knowledge were established, which is one of the aims of the clinical sociology perspective. Roche (2019, p. 161) has called this “the coproduction of knowledge:” “La coproduction des savoirs est le principe selon lequel des chercheurs et des acteurs produisent ensemble des savoirs dans le cadre de pratiques...”10

13.2.3 Development and Results of the First Phase of Consulting Between December 2018 and January 2019, there were seven meetings between the school and the consultants, all of a preparatory character. During these meetings the school members informed the consultants of the main challenges. This resulted in an initial project design which was presented to and discussed with the directive team (the rector and the three administrators who also are teachers) and the Academic Council. In these meetings the intervention was defined and a decision was taken to establish two days without classes, in order to have all of the teachers complete their work. This decision showed the commitment of the school to the consulting process.

10 Here are Roche’s words in English: “The coproduction of knowledge is the principle that researchers and actors produce together a new knowledge within the field of their practices.”

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Once the consultation’s design was revised and approved by the directive team and the Academic Council, it was presented to the teachers and administrators in a participative and open way. Doubts were discussed, suggestions were made and the Principal Investigator (PI) directly asked all teachers for their active participation. Everyone agreed to do so. The two complete working days took place in February and March; interventions were made with all the school’s professionals. After each day there was a feedback session with management, and in April there was a discussion regarding the final feedback presented to all the teachers and administrators, showing results and conclusions of the first consulting phase. In the following sub-sections I describe the dynamics of the two complete working days which involved all the school’s teachers and administrators.

13.2.3.1

First Day of the Intervention

The dynamics were similar among the five groups. They started with the group’s “tuning” and mutual listening. Then two drawings were requested of each participant. Draw the “cool” teacher and the “bad”. Draw the “cool” school and the “bad”. Both referred to each participant’s childhood. It was explained that the drawings could refer to any element alive in each participant’s memory such as values, behavior, pedagogical strategies, feelings, and school identity. Each person presented her or his drawings before the group, in a respectful and equitable way, with the assistance of the facilitators. After a break, the participants were asked to draw and discuss two new drawings. Draw the ideal INEDIC. And draw what you can contribute to build that ideal. Just as we did before, each participant presented their drawings for group discussion. Presentations to the group, guided by the methodological frame, generated very enriching dynamics that were sometimes even “liberating”. The teachers and administrators were satisfied with their participation and being heard. They remembered their own teachers’ strengths and weaknesses in relation to the practice of their present profession. This allowed the participants to build their historicity and construct ideas applicable to the present. And by sharing their ideas with the group members, they easily identified common values.

13.2.3.2

Results of the First Day

The day’s activities produced many results. They are organized here under three themes: General Results, Questionnaire and SWOT Matrix.11

11 A SWOT matrix is a technique used for strategic planning which helps to identify an organization’s strengths, weaknesses, opportunities, and threats.

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General Results of the First Day

The workshops were successful. The participants’ attitudes were positive and there was coherence in the content of the workshops. The meetings increased the understanding of the participants. It became evident how important these meetings were for the organization’s horizontal and vertical integration. The exercise to imagine together the ideal school allowed the participants to share key elements that were included afterwards in the design of the working groups for the second day. We identified what each teacher could contribute to the school’s improvement. These contributions included areas such as teamwork, better communication when facing difficulties, overcoming oneself, engaging oneself more with the institution, enriching one’s relation with the students, increased motivation, and working with families. Brainstorming took place in every area of interest. Various problems were identified, such as: no team work; no engagement; communication between managers and teachers is lacking; and no clear objectives. We could see that all of this was basic to reinforcing group identity and increasing each teacher’s sense of belonging.

13.2.3.2.2

Questionnaire

During the first day the teachers and administrators responded to a questionnaire. The results indicated: – 72% believe that “this process of IEP renewal is going to unite more teachers around a common school project”, 21% “have important doubts” and 7% answered that this process will not help. – 36% perceive that the teaching staff’s degree of engagement with this process is: “very high”; 36% “high” and 28% “normal”. – 45% estimate that what gives more identity to the school are its institutional components including the IEP. – 57% think the biggest strength of the school is its human resources. – 93% agree with the statement that “This day has had very satisfactory results” – 96% think we have “very good ideas to define about what school we want” – 80% agree with “We know how to build the school we want” – 49% think “There are too many difficulties”. The most repeated barrier was “the lack of organization and communication”. The most important objective was “to renew the IEP”.

13.2.3.2.3

SWOT Matrix

Finally, with all the entries collected, we used the SWOT matrix (Strengths, Weaknesses, Opportunities, Threats) and arrived at the following results:

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Strengths The main one is the human factor—vocation, values, mutual respect, experience and the quality of the teachers’ training. There is a constant acknowledging of the importance of “values”. Other strengths were the good disposition of managers and that the great majority of teachers were participating actively in the consultation. There also is the fact that 72% of the teachers do believe in the IEP renewal process. Weaknesses The Institutional Educational Project (IEP) expired three years ago. Other organizational weaknesses include: lack of communication, teamwork and engagement; problems of continuity in processes; and no unity regarding educational criteria and in deciding on the school’s objectives. There are infrastructure problems including the lack of halls and green zones. Distance from families is an issue. Also, the teachers are in two separate schools (because of the morning and afternoon shifts), find instances of favouritism and do not have a strong identity and sense of belonging. Problems involving students include retention, not enough discipline, low academic standing and difficulties in coexistence with other students. Opportunities There is a strong wish to improve the current situation. There are ideas and some agreement about what areas should be improved. Profitable collaboration agreements with institutions and enterprises in the neighbourhood can be made. There is optimism as 93% expressed that the meeting day was very satisfactory and 80% indicated “We know how to build the school we want”. Threats These include the school administration as well as the teachers do not have information about the students’ families and their social circumstances. There is a lack of security in the school’s neighborhood and the perception that the school does not have a defined direction or shared project. In addition, 21% of the teachers and administrators have important doubts about the success of the IEP renewal process and 7% believe it will not be successful. Finally, 49% think “There exist too many difficulties” to overcome in this process.

13.2.3.3

Second Day of the Intervention

Before the second day-long session, all the information gathered during the first day was analysed and shared in meetings with the directive team and the Academic Council. The initial results were positively evaluated and the second day was designed. We thought the format of participatory work from the five groups could be established as a more permanent strategy, and that the working groups should establish “Improvement Areas” according to the biggest challenges that were manifested on the first day. These areas were provisionally named while giving freedom to each group to modify both the topical area and the name. During the day, the groups’ work was centred on defining their objectives and tasks. The directive team and the Academic Council revised the IEP‘s mission, vision and institutional values. The contributions given by all the teachers on the first day were taken into account in doing this. Of particular note is the addition of

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Improvement Areas as a participatory tool. At the end of the day, there was a plenary meeting to share the renewed IEP and the results of the five groups working on area improvements.

13.2.3.4

Results of the Second Day

Below are some of the results: A revised/renewed IEP. The revised document strengthened INEDIC’s vision as a school that wants to educate students to be able to transform their surroundings for their own and the community’s benefit. Inclusion of the improvement areas in the IEP as a dynamic and ongoing betterment process. This is an innovative strategy which places the participatory work of the school members (teachers, administrators, parents and students) as a motor for the institution’s strategic change. Specific assignments regarding the improvement areas. Each of the five improvement areas was detailed including its name, the teacher chosen as coordinator, a general objective, three specific objectives and task planning. The names of the five improvement areas and their general objectives are included below: • Innovator Teachers. General objective: To develop the abilities and dexterities of teachers to train competent students capable of transforming their environment. • Parents. General objective: To reach a dynamic, collaborative and conscious participation of the family in the educational process for the students’ academic and coexistence advancement. • Development and beautification of institutional spaces. General objective: To build, tailor and improve institutional spaces and infrastructures. • Students. General objective: To create working teams that organize the development of projects and spaces which generate impacts in the students’ education and the transformation of the environment. • Organization and Planning. General objective: To improve the educational community through the timely and efficient organization and planning of all activities in order to achieve a harmonious ambience.

13.3

Phase Two: Affirming Change

The consulting work was extended for four months and then until the end of the year (December 2019). The second phase consolidated what had been built in the first phase and the implementation was made through the improvement areas. The approach was based on working meetings assisted by a facilitator, who provided feedback about the process and helped specify the results. Four “rounds” of meetings were carried out. Each round was a complete cycle of meetings regarding the five improvement areas and there was one joint meeting with a quality committee (which

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later became the Committee of Quality and Improvement Areas). The facilitation team reviewed the minutes for each meeting and summarized and systematically organized all the content. During this process new needs, difficulties and challenges arose, which were incorporated in order to perfect the process. Some of the results are highlighted below: • A mixed working group of administrators and teachers was temporarily created to deal with any difficulties that could slow down progress. • A “Committee of Quality and Improvement Areas” was constituted. The members of this committee were the four administrators, a teacher acting as a secretary, five teachers who each represented an improvement area and the PI. At this stage of the consultation, the tools of management and improvement, the IEP and IIP, were reviewed to be sure they were in agreement. • The main result of the work in the five areas was the involvement of the members who had periodic meetings; joint debate and reflection; involvement in the search for consensus and engagement in executing tasks. Out of this activity, several outcomes particularly should be mentioned: A family day and bingo along with a food exhibit and multiple activities were organized in order to secure funds for the improvement of the school’s spaces. Cleaning brigades were put in place. A merit system for outstanding students was developed. A system was organized to have students volunteer to work on areas such as improving coexistence. • At the end of 2019, each area made a poster summarizing its objectives and results. The posters were presented in the year’s closing session (Fig. 13.2).

13.4

Discussion of the Results

The main results of this consulting work were (1) the teachers’ were directly involved in the development of the IEP and their motivation improved; (2) the IEP was revised and renewed by teachers as well as administrators; and (3) the GRI methodology applied to the initial working groups was key to promoting change and overcoming stagnation. The conversion of the working groups into permanent groups dealing with area improvements is another result of the intervention, and those Improvement Area Groups will be instrumental for the creation of strategic initiatives for the school. The same can be said about the creation of a “Committee for Quality Assurance and Improvement”. Those groups are a source of motivation and will reinforce the feeling of belonging to the school. The young facilitators of the Sociocaribe consulting group carried out their first long-term professional consultation with success, which is an achievement for both the Universidad del Atlántico and INEDIC. This work will contribute new tools for the region and its numerous challenges in different areas. It is worth noting the contributions of clinical sociology to group and organizational consulting that have been described here, in particular, the power to promote

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Fig. 13.2 Example of an improvement area poster

change as well as improve motivation in situations of stagnation and kick-start a path for the strategic development of local organizations. To conclude this section, it should be mentioned that in February 2020 the INEDIC school renewed the consultation for another year.

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253

Conclusion

This intervention shows that knowledge and mutual trust between the organization and the consulting group were defining factors. In this case this was possible thanks to the previous collaboration between the sociology students and the PI with INE DIC, a public school. This consultancy and previous experiences described by Yzaguirre et al. (2018, 2019); Yzaguirre and Salcedo (2018) show the good results of developing a Road Map in professionalising clinical sociology as the Road Map connected undergraduate studies and training with professional practice. The training imparted in the Faculty of Human Sciences at the Universidad del Atlántico proved to be a successful strategy in the process of the students’ education, specialisation and consulting practice, with direct benefits to a most vulnerable community. This intervention supports the wider development of facilitators, researchers, and agents of change who are oriented to assist with change. These students can be educated and trained in sociology and multidisciplinary social science undergraduate and graduate programs to meet the needs of groups, organizations and communities (Yzaguirre et al. 2018, 2019; Yzaguirre and Salcedo 2018). In the face of the great challenges that public and private educational institutions have to take on in a context of hyper-modernity (Aubert and Gaulejac 2017; Aubert 2019, p. 327), in the middle of the constant acceleration of the pace of work and a constant demand for better and better results, new theoretical proposals with practical application are needed, including those put forward by clinical sociology: According to Fritz and Rhéaume (2014, p. 1), “Clinical sociologists assist communities in economically-developed as well as economically-developing countries to visualize and move toward a desired future.” Such proposals, in addition to contributing “creativity” and “innovation,” as we have seen in this work, rest on a “rightsbased approach” (Fritz and Rhéaume 2014, pp. 1–4), as well as on people’s “emancipation” (Gaulejac and Yzaguirre 2018, p. 251). The intervention described here shows, in particular, how subjectivation strategies can be applied to achieve changes in organizations, outlining the validity of a participatory, person-centred, humanist, creative, subject-related and innovative perspective. And I want to underline the importance of human talent in any given process of strategic change. A humanistic and socio-clinical approach that results in full participation in an organization allows me to characterize those organizations as “organizations with sense” (Yzaguirre 2015, 2019). Currently the world faces the crisis unleashed by the coronavirus Covid-19. Today, more than ever, in spite of the promises of technological development and the free market system, as well as the philosophy of development, people might have to accept that our future depends on taking more heed of “social interaction” and “social interdependence.” The complexity of this task requires the collaboration of sciences and practice fields, which are engaged, interdisciplinary, humanist and person-centred, in order to facilitate change and help us all achieve a better future.

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References Aubert, N. (2019). Hypermodernité. In A. Vandevelde-Rougale & P. Fugier (Eds.), Dictionnaire de sociologie clinique (pp. 327–328). Toulouse: Érès. Aubert, N., & Gaulejac, V. (2017). El coste de la excelencia. Asturias: Sapere Aude. CEPAL. (2019). Panorama social de América Latina. Santiago: Naciones Unidas. Accessed March 1, 2020, from https://repositorio.cepal.org/bitstream/handle/11362/44969/5/S1901133_es.pdf DANE. (2012). Encuesta de convivencia escolar y circunstancias que la afectan – ECECA, para estudiantes de 5
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de Bogotá, año 2011. Bogotá, Departamento Administrativo Nacional de Estadisticas. Accessed February 2020, from https://www.dane.gov.co/files/investigaciones/ boletines/educacion/presentacion_ConvivenciaEscolar_2011.pdf DANE. (2019). Boletín técnico, Pobreza multidimensional en Colombia, 2018. Ref. COM-030-PD001-r-004 V8. Accessed March 1, 2020, from https://www.dane.gov.co/files/investigaciones/ condiciones_vida/pobreza/2018/bt_pobreza_multidimensional_18.pdf Delgado, T., & Mercado, B. (2018). La sociología clínica: Una experiencia en relatos de vida. In A. Salcedo (Ed.), Sociedad y contextos: Investigación para la transformación social T2 (pp. 114–139). Barranquilla: Corporación Univ. Americana. De Zubiria Samper, J. (2015). Hacia un acuerdo nacional para mejorar la calidad de la educacion basica y media en Colombia. Revista Educacion y Ciudad, 19, 39–56. Accessed August 2020, from https://revistas.idep.edu.co/index.php/educacion-y-ciudad/article/view/118 Fritz, J. M. (Ed.). (2008). International clinical sociology. New York: Springer. Fritz, J. M., & Rhéaume, J. (2014). Community intervention. Clinical sociology perspectives. New York: Springer. Gaulejac, V. (2019). La neurosis de clase. Trayectoria social y conflictos de identidad. Asturias: Sapere Aude. Gaulejac, V., & Yzaguirre, F. (2018). Sociología clínica y emancipación del sujeto. In J. L. Álvaro (Ed.), La interacción social (pp. 251–270). Madrid: Centro de Investigaciones Sociológicas. Giust-Ollivier, A. C. (2019). Subjectivation. In A. Vandevelde-Rougale & P. Fugier (Eds.), Dictionnaire de sociologie clinique (pp. 624–627). Toulouse: Érès. Gómez, Y. M., Aragón, V. L., & Yzaguirre, F. (2018). Una reflexión sobre los procesos de diseño de proyectos de investigación – intervención. In A. Rivoir (Ed.), Las encrucijadas abiertas de América Latina. La sociología en tiempos de cambio. Montevideo: ALAS. Guzmán, G., Fals-Borda, O., & Umaña, E. (1962). La Violencia en Colombia. Estudio de un proceso social. Bogotá: Ediciones Tercer Mundo. Ibáñez, K. D., Atencia, M., & Yzaguirre, F. (2018). La técnica de relatos de vida en una investigación – intervención con estudiantes universitarios. In A. Rivoir (Ed.), Las encrucijadas abiertas de América Latina. La sociología en tiempos de cambio. Montevideo: ALAS. Jaramillo Roldan, R., Morales Duque, L. F., Zapata Gordon, A. (2004). Participacion y construccion de los PEI en instituciones de educacion basica en Antioquia. Revista Educacion y Pedagogia, Universidad de Antioquia, 16(38), 123–127. OECD. (2019). OECD Economic Surveys: Colombia OECD Publishing, Paris. Accessed May 2020, from https://read.oecd-ilibrary.org/economics/oecd-economic-surveys-colombia-2019_ e4c64889-en#page3 Radinger, T., Echazarra, A., Guerrero, G., & Valenzuela, J. P. (2018). OECD Reviews of School Resources: Colombia 2018. Paris: OECD Publishing. Accessed May 13, 2020, from https:// www.oecd-ilibrary.org/docserver/9789264303751-en.pdf?expires¼1589506637&id¼id& accname¼guest&checksum¼C012442F00097972FCFDAC1265308CE7 Roche, P. (2019). Coproduction des savoirs. In A. Vandevelde-Rougale & P. Fugier (Eds.), Dictionnaire de sociologie Clinique (pp. 161–164). Toulouse: Érès. United Nations. (2020). Situation of human rights in Colombia. A/HRC/43/3/Add.3. In Report of the United Nations High Commissioner for Human Rights. Accessed May 2020 (p.3), from https://www.hchr.org.co/documentoseinformes/informes/altocomisionado/A_HRC_43_3_ Add.3_AdvanceUneditedVersion-2019-2.pdf

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Yzaguirre, F. (2015). Más allá del conocimiento y del talento: Las organizaciones con sentido. Para una clínica de las organizaciones. Asturias: Sapere Aude. Yzaguirre, F. (2019). Organisations et sens. In A. Vandevelde-Rougale & P. Fugier (Eds.), Dictionnaire de sociologie clinique (pp. 451–454). Toulouse: Érès. Yzaguirre, F., & Castillo, C. A. (2013). La perspectiva de la sociología clínica: Una sociología de proximidad orientada al sujeto. In Actas del XI Congreso Español de Sociología. Crisis y cambio: Propuestas desde la sociología, vol. Adenda, (pp. 832–840). Yzaguirre, F., Cuadrado, S. E., & Salcedo, M. C. (2019). Orientación vocacional en bachilleres de Barranquilla desde la sociología clínica y los relatos de vida. In A. M. Araújo (Ed.), Sociología clínica desde el Sur. Teoría – Praxis (pp. 21–40). Montevideo: Psicolibros Universitario. Yzaguirre, F., Gómez, Y. M., & Ibáñez, K. D. (2018). El semillero de sociología clínica e intervención psicosociológica, SOCLIP. In A. Rivoir (Ed.), Las encrucijadas abiertas de América Latina. La sociología en tiempos de cambio. Montevideo: ALAS. Yzaguirre, F., & Salcedo, M. C. (2018). Origen, objetivos y diseño, de un proyecto de investigación, intervención y prácticas de grado: Acompredes. In A. Rivoir (Ed.), Las encrucijadas abiertas de América Latina. La sociología en tiempos de cambio. Montevideo: ALAS.

Chapter 14

Climate Resilience Initiative in Metro Manila: Participatory Community Risk Assessment and Power in Community Interventions Emma Porio

14.1

Introduction

Climate change-related effects such as floods resulting from the increasing intensity and frequency of tropical storms, typhoons, monsoon rains, sea level rise (SLR) and storm surges have devastating impacts on coastal cities, especially marginal populations like the urban poor in informal settlements. About 40% of Metro Manila’s population of 12 million live in informal settlements in risky and underserviced areas; thus, they do not have access to adequate services and facilities for potable water, electricity, health and sewage and sanitation (Magno-Ballesteros 2000; Porio 2011). Metro Manila has a land area of 636 km2 with a semi-alluvial plain formed by the sediment flows from the Meycauayan and Malabon-Tullahan river basins in the North, the Pasig-Marikina river basin in the East (Bankoff 2003), and the West Manggahan river basin. The city is open to Manila Bay on the West and to a large lake, Laguna de Bay, on the Southeast.

The data used in this chapter is from a transdisciplinary action research initiative carried out under the Coastal Cities at Risk in the Philippines: Investing in Climate and Resilience Project. The project was aided by a grant from the International Development Resource Centre (IDRC), Canada, and implemented by the Ateneo de Manila University (ADMU), in collaboration with the Manila Observatory (MO), Ateneo Innovation Center (AIC), and the National Resilience Council (NRC). This chapter is an updated version of “Climate Change Adaptation in Metro Manila: Community Risk Assessment and Power in Community Interventions” (Porio 2014b) that appeared in Community Intervention: Clinical Sociology Perspectives (2014) edited by Jan Marie Fritz and Jacques Rhéaume. E. Porio (*) Ateneo de Manila University and Coastal Cities at Risk in the Philippines, Manila, Philippines e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_14

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According to Liongson et al. (2000): Therefore, the metropolitan area is a vast drainage basin that experiences frequent inundations from overflowing rivers and storm waters that render the existing system of esteros (modified natural channels) and canals constructed during the Spanish and American colonial periods inadequate.

The impacts of climate change on this ecological-environmental system are highlighted by the marked sea level rise (SLR) and increase in monsoon rains, typhoons, and floods. Moreover, this environmental context interacts in complex ways with the patterns of human activities in the metropolis (Adger 2000; Porio 2010, 2011, 2014a, b). This study is part of a larger participatory community risk assessment (PCRA)1 of flood impacts on urban poor families living in the KAMANAVA (acronym for the cities of Kaloocan, Malabon, Navotas, and Valenzuela) flood basin, which largely include residents along river banks, marine ponds, coastal areas, creeks and other water channels and nearby areas classified as danger zones by the government. The poor, informal settlers, in these areas also have suffered terribly from the monsoon floods of 2012. The areas have been declared unsuitable for human habitation because of the risks of flooding. Owing to this government policy, several assessments of flooding impacts on the informal settlers in these danger zones have been done by government and non-government institutions. While this chapter describes the particular PCRA process conducted in Tanza, Navotas City between September 2012 and January 2013, it utilizes some of the data obtained in the earlier community assessment of flood impacts brought about by tropical storm/typhoon Ondoy in 2009. The first part of the study outlines the approach and methodologies utilized in the conduct of the PCRA while the second part describes the profile of the population at risk to floods and other climate change-related effects. The third section describes the application and formulation of the community-based risk reduction plan, including the tasks and responsibilities of each sector. The last part reflects on the intersections of social relations of power as shown in the assertions of key community groups (e.g., women’s groups, local leaders, disaster management officials) during the whole process of the PCRA and the formulation of the community-based risk reduction and management plan (CB-RRMP). Finally, the chapter ends with a short postscript or update of the community just a month after the Enhanced Community Quarantine (ECQ) or lockdown of Metro Manila and the whole island of Luzon on March 15, 2020 to contain the Covid-19 pandemic. Most of the members of the community have been relocated in a safer and more secure part of the city with permanent housing and access to basic services like potable water, electricity and health services. But the lockdown had given them a greater risk—hunger and malnutrition. To a certain extent their organization

1

Participatory community risk assessment utilizes participatory methods/approaches in identifying or assessing risks posed by climate change effects like typhoons, floods, sea level rise and the like. For elaboration, please see van Aalst et al. (2008) and Agra et al. (2019).

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provided them access to social networks that mobilized support for them in the first few weeks of the lockdown.

14.2

Background and Context of the Study

The Philippines ranked ninth riskiest country in the world in terms of climate change-related risks and disasters (World Risk Index 2019; UNDRR 2019). The country’s index, 20.69 (9th), improved from 25.14 in the period 2015–2018. Located within the so- called Pacific Ring of Fire and the typhoon belt of the North Pacific Basin, the country suffers high risk levels from the dangers and impacts of earthquakes, volcanic eruptions, storm surges, landslides, floods and droughts. These many disasters greatly erode and challenge the efforts of both the national and local governments of the Philippines to reduce poverty and the number of people that are highly at risk of these natural hazards. Over the past 10-15 years, the number of deaths and losses from typhoons and floods have increased. The devastating effects of these natural hazards have been intensified by the lack of preparedness among affected communities and most of all, on the part of government, civil society and the private sector. This lack of preparedness prevents them from being able to respond proactively to these calamitous events and assist the affected communities more effectively. The Philippines gets an average of 20 typhoons annually. In 2009, Metro Manila weathered 10 strong typhoons bringing heavy rainfall and floods to the metropolis requiring the evacuation of thousands to schools, churches and basketball courts serving as relief centers and sleeping quarters. In 2011, damages of typhoons Pedring and Quiel were estimated to amount to Php 15 billion (about US$ 377 mil- lion); in 2012, the heavy moonsoon floods submerged the metropolis, resulting to damages worth Php 604.63 million (US$14.31 million). Aside from Metro Manila, 42 Philippine cities and municipalities, were also declared under a state of calamity by their local governments. In the national capital alone, about 366,669 people were severely affected by the floods, with 109,023 housed in evacuation centers for several days (Malig 2011). Most of the evacuees were residents of urban poor communities or informal settlements, with no tenurial security2 and no access to adequate housing and basic services. Finally, in 2019, the damages and losses from typhoons and floods amounted to US$ 23 billion.3

2

Urban poor families without security of tenure to their home lots can be evicted from their places of residence any time the owner wants to use, sell or take possession of the property. 3 For more information, see https://www.unisdr.org/files/68265_682308philippinesdrmstatusreport. pdf

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The link between poverty and the level of vulnerability among urban poor communities to the impacts of floods, sea level rise (SLR), storm surges and coastal inundation, and other climate-related hazards4 is very high. High-risk sites such as informal settlements along the coasts and riverine5 systems also suffer from very poor quality housing and absence of social services and badly needed infrastructure support. The risk levels of these communities also have been greatly heightened by badly planned, low quality roads and infrastructure (e.g., highway officials raising the roads with no adequate drainage systems which end up flooding the nearby communities). Inventory or assessment of damage and losses from typhoon and flood impacts are done by disaster management officials at the local government unit or city level. Hardly any assessment is done at the community level or, more importantly, from the perspective of marginal, urban poor communities. Thus, the conduct of this community-based PCRA by the women’s group in Tanza, Navotas city with support from the clinical sociology team from the university is very significant in promoting collaborative research and analysis with community groups as a basis for formulating effective community interventions. This is affirmed by a report about the proceedings of the December 2012 Doha Climate Conference (Alert Net News 2013): Yvette Abrahams, a researcher with Gender CC and a member of Women for Climate Justice in South Africa, during the Alert Net-hosted debate in the conference announced: ‘We cannot develop climate adaptation plans in nice air-conditioned offices far away from the women who make a living off the land and think that we are going to come with ready-packaged solutions’. In response, the ministers adopted an agreement calling for greater gender balance at future conferences, with governments promising to add more female delegates. But more needs to be done to bring in women’s views and understand their needs.

Thus, top-down approaches to assessing the impacts of climate change-related effects on cities and their marginal populations have so far dominated disaster risk reduction planning and programming. But, these approaches are quite inadequate because of the general lack of participation of the poor. The absence of their perspectives or voices in local decision-making, especially those pertaining to planning and implementing climate disaster-related projects and programs in vulnerable settlements and communities is a widespread phenomenon in third world countries like the Philippines. This study, conducted in Tanza, Navotas City (see Fig. 10.1) is an attempt to contribute to this gap in the literature (Fig. 14.1).

4 For elaboration on the link between poverty and other climate-related hazards like typhoons, floods, sea level rise (SLR), storm surges, coastal inundation, please see Eliott (2000). 5 In Asia, where large number of communities are settled along river systems like those in the Marikina-River System or the Navotas-Malabon River System are considered riverine communities.

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Fig. 14.1 Map of Metro Manila and Tanza, Navotas City. (Source: Porio 2013)

14.3

Approach and Methodology

The university-based clinical sociology group in partnership with the women’s groups (henceforth, the Team), examined the vulnerability and adaptation of urban poor families (with special focus on vulnerable groups like women-headed households) living in the riverine communities of the cities of Navotas and Malabon. This chapter is particularly focused on the making of the “Tanza Participatory Community Risk Assessment (PCRA)” by the Tanza Women’s Association in Tanza,

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Navotas City. Located in the KAMANAVA6 Flood Basin, one of the three flood basins of the metropolis, the clinical sociology team and women’s CBOs concentrated on producing a community risk profile that the Tanza Womens Association (TWA) could use in formulating a community-based risk reduction and management plan (CBRRMP). In turn, this became the basis of TWA’s advocacy for better social and environmental services before its local government unit (LGU) and national government agencies like the Social Welfare Department and the Disaster Risk Reduction and Management Council. In conducting the PCRA, the team used the following participatory action research methodologies: (1) focus group discussions (FGD), (2) key informant interviews, (3) life histories, which highlighted residential changes associated with climate-related events like typhoons and floods, and (4) community risk mapping. Through these methodologies, groups of neighborhood women were dynamically engaged in the risk assessment and planning for risk reduction that will be described in the next sections.

14.4

Organizing and Conducting the Participatory Community Risk Assessment (PCRA)

In employing participatory research methods, the mobilization and organization of the community by the Team (the women’s group in partnership with the universitybased clinical sociology group) became efficient and effective. Engaging the community neighborhood groups through these methods to formulate their own community-based risk reduction and management plan became a doable project for the women’s group. The mobilization of the community to conduct the PCRA consisted of the following activities: (1) preliminary talks and negotiations by the university-based clinical sociology group with its community-based partners, namely, the TWA officers/members and the local officials, (2) signing of the tripartite memorandum of agreement (MOA) among the partners, (3) training of the members of women’s groups in employing participatory action research methods in risk assessment, including conducting focus groups, having key informant interviews, conducting community walk-throughs, making community/life histories and doing community risk mapping, (4) data collection and processing, (6) collating and presenting the PCRA results by the women leaders to the whole community and their local officials, and (7) formulation of the CB-RRMP by the women’s groups. All of these activities which involved many tutoring sessions, group meetings and community assemblies, took a total of six weeks between September 2012 and December 2012.

6 KAMANAVA is an acronym for the cities of Kaloocan, Malabon, Navotas and Valenzuela, four of the 17 municipalities and cities comprising Metro Manila.

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The PCRA process is summarized below by Malou, the president of the Tanza. Women’s Association7: During our mapping process, we interviewed 50 men and women, who were very interested in participating in the community risk assessment of flood impacts and how these affected their livelihood options. The women, and to lesser extent men, were very eager to participate in our group activities as they could see its potentials to create changes in the quality of life of their neighborhoods and communities. We organized a total of 7 focus group discussions (FGDs) which attracted a total of 105 people, women, children, youth, men, from the seven (7) neighborhoods of the Tanza community. Our women leaders led and coordinated the conduct of FGDs, in collating and summarizing the information about the flood impacts and climate-related risks that our community suffered from and continue to bear. It was a long and arduous process but very enlightening to our spirit that we can see these experiences recorded now in our community data bases; more importantly that we are using it in planning activities and programs that will make our community safer from flood-related disasters.

Profiling the Community of Tanza Located along the eastern shores of Manila Bay and the mouths of the Tullahan River System, Tanza is one of the 14 barangays (villages) of Navotas City, the fishing capital of the Philippines. Tanza is largely inhabited by fisherfolks and workers in the nearby fish port. Thus, about 70% of its population derive their livelihood from fishing, fish trading, fishnet mending, and fish processing. The construction of the community profile and risk map involved several group activities and challenges. The profile and risk map were constructed from the data obtained by the women’s research teams through the following activities: (1) community walk-through, (2) seven focused group discussions or FGDs, and (3) in-depth interviews of 50 families. These data collection activities focused on the community’s experiences of flood impacts and losses, including the families’ residence moves and livelihood changes associated with climate-related events. The conduct of these activities jointly by the Team (the women’s group and the university-based clinical sociology group) and the community greatly facilitated the building of trust and confidence with each other and feeling of solidarity among the residents. The research and mobilization activities demanded a lot of time and commitment from the Team. Ana, a community leader, elaborated on their difficulties and gains from the community risk assessment process8: At first, it was quite hard to motivate the people to come to the meetings or to get them involved in the group activities. After several one-on-one conversations and group sessions with the women leaders and the university-based researchers, the people finally understood that the activities were for the good of their children and families. After this, we were able to capture their attention and dedication to participate—to be open about their problems and

7 This quote is excerpted from the community leader’s speech (Malou Pescador) during the culmination activity of the project (held before the community general assembly on December 15, 2012). 8 This is an excerpt from an in-depth interview with the community leader, Ana Maria Lampitoc, conducted by the author on November 28, 2012.

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their possible contribution or roles in reaching solutions to these problems. But we also have to strategize how to sustain their interest in conducting the activities. It took quite a lot of discussion and negotiation but we collectively formulated an appropriate or commensurate incentive structure/processes that facilitated the continuing community interest to flow during the weeks and months of community data collection and mobilization. The material incentives were further sustained by their strong motivation to make a better life for their families. During the final presentation of the output and subsequently our planning for action, the whole assembly told us, it was extremely fulfilling because they claimed that they gained a greater knowledge of their community and most important of all, they felt. . . closer to their neighbors and other members of the community because they faced the same set of challenges and realized they must work together in finding solutions to their problems.

Constructing the Community Risk Map During the construction of the community risk map,9 especially in its finalization during the community sessions, it is interesting to note that different groups highlighted different risk points. The women pointed out sources of risks that were connected to their roles/activities such as bringing their young children to school, washing clothes in the river, and fetching water during floods. Moreover, they pointed out that after the floods they spent an enormous amount of time and resources cleaning their houses (from mud and sludge) and taking care of other home and childcare-related activities (see Tables 14.1, 14.2, 14.3, 14.4). The men, on the other hand, identified sources of risk that were connected to their livelihood and security (e.g., fishing and deterioration of the mangroves). The community leaders and officials, however, were more concerned about the strength of the dikes and navigational gates during high tide and flooding season. They also were concerned about the fitness of schools and daycare centers for evacuation while the women were more interested that their children can go to school right after the floods. The overriding concerns of each group, therefore, seem to reflect their social locations and their corresponding socio-political interests in the community.

9

Community mapping is a grassroots-led, community-focused tool whereby grassroots women’s groups work to jointly analyze a specific situation or issue in their community and its direct effect on women. Community mapping is also a leadership tool because it positions individuals or marginalized groups, who are normally excluded from decision-making or research work, to lead the effort. A mapping involves community members methodically moving through an area, talking to other community members through one-on-one interviews or focus group discussions, listening to residents’ challenges and desires, and documenting the findings for future advocacy and lobbying campaigns. Community mappings have been used by grassroots women’s organizations and community-based organizations to enhance their activities. They can help organizations provide better services, create and improve linkages with government agencies and NGOs, and advocate on behalf of the community. Community mappings often lead to mobilizing community members and other stakeholders to address community needs (Huairou Commission 2007).

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Table 14.1 Summary of costs/losses of urban poor households (HH) by gender due to floods from tropical storm Ondoy

No. of school absences No. of work days lost from sickness No. of work days lost Avg. income loss Avg. expenses on medicines Avg. losses (appliances, etc.) Avg. monthly income

Pre-Ondoy Menheaded HH 6

Womenheaded HH 8

Ondoy period MenWomenheaded headed HH HH 14 17

Post-Ondoy MenWomenheaded headed HH HH 6 7

5

7

9

10

5

8

6

8

20

22

6

9

P1715 P300

P3250 P400

P7250 P3200

P6450 P3000

P2750 P500

P3400 P450

P25,000

P20,000

–

–

P6500

P4200

P6250

P5000

Source: Porio (2012, 2014a, b)

Table 14.2 Percent increase/decrease of costs/losses for women-headed households due to floods from tropical storm Ondoy

No. of school absences Work days lost from sickness No. of work days lost Avg. income loss Avg. expenses on medicines Avg. losses (appliances, etc.) Avg. monthly income Source: Porio (2012, 2014a, b)

Pre-Ondoy Women-headed HH " 33% " 40% " 33% " 90% " 33% – #  20%

Ondoy Period Women-headed HH " 21% " 11% " 10% #  11% #  6% #  20% –

Post-Ondoy Women-headed HH " 17% " 60% " 50% " 24% #  10% – #  35%

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Table 14.3 Summary of costs of basic needs/services (monthly in pesos, US$ 1 ¼ P40)

Food Drinking water Cooking & washing (well/piped) Energy/electricityc Sanitation/laundry House Repair

Pre-Ondoy Menheaded HH P6000 P50 P80/ P500 P2000 P300

Womenheaded HH P5800 P45 P80/P500 P1800 P310

Ondoy Period Menheaded WomenHH headed HH P2000a P2500a P240 P240 P80b/ P80b/ P1,500 P1,500 P5000 P4500 P2000 P2000 P1500– P1000– P15,000 P8000

Post-Ondoy MenWomenheaded headed HH HH P6500 P6000 P60 P50 P80/ P80/P700 P740 P2500 P2150 P360 P320

a

Including relief goods Long lines c Mud, waist deep; cleaning took two weeks to one month Source: Porio (2012, 2014a, b) b

Table 14.4 Percent increase/decrease of costs of basic needs/services in men- and women-headed households (monthly)

Food Drinking water Cooking/ washing (piped) Energy/ electricity Sanitation/ laundry House repair

Pre-Ondoy Menheaded WomenHH headed HH # 3% # 10% " 10%

Ondoy Period Menheaded WomenHH headed HH " 20% Same Same – –

# 10% " 3%

same

Post-Ondoy Menheaded WomenHH headed HH # 8% # 17% # 5%

# 10%

# 17%

Same

# 11%

# 33% to 47%

Source: Porio (2012)

The case box (14.1) below shows the timeline of events associated with the PCRA formulation in the flood-prone Tanza community.

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Case Box 14.1 Timeline of Key Events Leading to Community-Driven Interventions in Tanza, Navotas City, Philippines 1992—Reclamation project proposed before the city council which led to many informal land reclamation in the community 2006—Start of the construction of the flood control program (supported by foreign loans) 2009—Tropical Storm (or typhoon) Ondoy10 wrought heavy damages to Metro Manila. University clinical sociology team started working in the flooded informal settlements of KAMANAVA 2011—Typhoon Pedring11 wrought immense damage to Metro Manila and Central Luzon 2011—Fires raged in Navotas City rendering 8000–10,000 homeless 2012 August—Heavy monsoon rains for three weeks causing continuous flooding in Metro Manila but the storm/tidal surges in KAMANAVA led to the displacement of hundreds of families in Tanza, Navotas City. 2012 September—Signing of memorandum of agreement between the university clinical sociology team, Tanza Women’s Association, and the Tanza Community Council 2012 October—Community mobilization meetings and training sessions on participatory methods and a community walk-through in preparation for the risk mapping 2012 November—Hold focus groups, conduct key informant interviews and make the community risk map 2012 December—Presentation of the community risk assessment results and formulation of the community-based risk reduction and management plan (CB-RRMP) 2013 February—The Community Council recognized the CB-RRMP submitted by the women’s groups. The officials promised the community assembly and especially the women leaders that most of the components of the plan will be incorporated into the local disaster planning and management process of the city, perhaps with the exception of those which demand a huge resource outlay like provision of alternative livelihood and housing sites (see Case Box 9.2). As illustrated in the risk map below (Fig. 14.2), the whole community is surrounded by the coastal waters of Manila Bay, rivers and water channels. A large part of what used to be a marine pond mainly composed of mangrove trees (until recently), has been informally reclaimed, inhabited and densely populated by informal settler families (ISF). While the last census (2007) pegged Tanza’s

10 11

Ketsana is the innternational name for typhoon Ondoy. Nesat is the international name for typhoon Pedring.

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Fig. 14.2 Community risk map of Tanza community. (Source: Porio 2013)

residents, local officials estimate its 2013 population to be about 26,608, distributed in an area of 4.76 km2 (Local Government of Navotas City 2013).

14.5

Processing and Analyzing the PCRA Information/ Data Bases

Themes/patterns emerged from the focus groups discussions, community and life histories; key informant interviews; and the community risk mapping. The community risk mapping revealed that the following ecological-environmental and social factors pose dangers and risks to the life, homes and livelihoods of the people in Tanza. Ecological-Environmental Factors: 1. Storm/tidal surges and coastal inundation from Manila Bay; 2. Flooding from the Navotas-Malabon River and Tanza River that bring heavy siltation of the soil as well as garbage from upland and surrounding communities;

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3. Flood dikes surrounding the community, especially in the government relocation areas, are supposed to protect the community from coastal waters. (When storm/ tidal surges are high during floods, the navigational gates have to be closed. The dikes then hold both upland and coastal waters and nearby communities are flooded.) Social-Environmental Factors: 1. Increasing population and congestion of settlements along river banks; 2. Clogging of canals and creeks with trash/garbage which slows the flow of flood waters into the main rivers, the Navotas-Malabon and Tanza rivers; 3. Floods and tidal surges that bury dug wells and water pumps, the main sources of water for cleaning, cooking and drinking. 4. The key problems facing the community were identified as pollution of the environment; clogging of water channels; overfishing and habitation of wetlands; overpopulation; and lack of adequate income sources. Economic and Political Factors: 1. The poverty levels of the informal settler households were classified and ranked according to their income levels: (1) better-off (Php 12,000/month or about US$ 300), (2) poor (Php 8000 or about US$ 200) and 3) poorest of the poor who were mostly women-headed households (Php 4200 or about US$ 100); 2. The poverty levels of households were highly correlated with their tenurial status (own housing structure, renter, sharer) and length of residence; 3. The poverty rankings of households were postively correlated with their varying levels of access to potable water, electricity, health, sewage and sanitation facilities; 4. About two-thirds of the households (poor; poorest of the poor—mostly womenheaded households) suffered more losses (e.g., income, work, health/sickness, household appliances, housing damage) from typhoons, floods, and tidal/storm surges but only a small portion of them obtained help from formal institutions (e.g., local government units or LGUs, charitable agencies); 5. Majority of the households only received help from their own support networks of relatives, friends and neighbors. 6. Most of the women-headed households appeared most vulnerable - consistently incurred higher losses (e.g., income and workdays) and intense inconveniences (e.g., water source buried by floods, toilets blocked and wastes sometimes over- flow to their floors) compared to male-headed households (See Tables 10.1 and 10.3). 7. More importantly, the ecological-environmental vulnerability of the low-lying flood prone areas (especially those in the swampy areas or wetlands) along the rivers and water channels interact strongly with the social vulnerability of poor households, in the process, intensifying the impacts of climate-related effects (intensity of monsoon rains, floods and tidal/storm surges) on the impoverished households (Table 14.5).

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Table 14.5 Cost of health services in health center/hospital to climate-sensitive diseases Service Estimated cost Ordinary checkup Php 300–1500 Sputum analysis/Check-up Php 7501500 Denguea Php 35,000–60,000 Leptospirosisa Php 10,000–50,000 Blood analysis P2320—P750–3200 Urine analysis P90—P700 Blood typing P90—P700 ElectroCardioGram P90—P1000–2500 X-ray P90—P500 Physical exam A (including Blood Chem, Blood typing, and P490—P2500 ECG) a

Climate-sensitive diseases where patients are referred to public hospitals and pay minimal amounts Source: Porio 2012

The above themes can be partly gleaned from the summary tables below. As pointed out earlier, women-headed households incurred higher losses compared to male-headed households. Children from women-headed households consistently had more school absences before, during and after the floods (Table 10.1). In the same manner, they also lost more workdays and incomes due to sickness and floods. Interestingly, women-headed households seem to better manage their expenditures on basic services (Table 10.3) compared to male-headed households. But the costs of climate-related diseases such as dengue and leptospirosis was much higher com pared to those of other health complaints/services (Table 10.5).

14.6

Formulating the Community-Based Risk Reduction and Management Plan (CB-RRMP)

The last section of this chapter focuses on how the PCRA processes and methodologies enabled the Tanza Women’s Association in Navotas City to enhance its advocacy for a safer, adaptive and resilient community through the formulation of its CB-RRMP. The Tanza Women’s Association crafted their CB-RRMP following these steps: (1) identified the key themes and sources of risks from the assembled information bases needed to formulate a risk reduction and management plan, especially for those living along the marine pond, rivers and other water channels; (2) mobilized its members to organize and manage the strategy formulation sessions in seven neighborhood groups12; (3) collectively processed the insights from the PCRA information base and pinpointed the sources/areas and categorized the themes that emerged; 12 These neighborhood groups are called purok. Several of these constitute a barangay (village), which is the lowest political-administrative unit of the government.

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(5) fleshed out or gleaned the implications of the themes/patterns that emerged from the community risk profile; and, finally, (6) formulated the action plans to reduce risk of flooding and the negative impacts on the community infrastructure, social services and livelihood activities. Case Box 14.2 Summary of Risk Reduction and Management Interventions in the CB-RRMP The Tanza Women’s Association report the following summary of resolutions and actions: Principles of Action 1. Every community/family member must be pro-active in managing their surroundings such as protecting river walls, water channels and drainage systems from siltation, trash and clogged wastes. 2. At the family level, decisions about livelihood, income and expenditure and other resource-related issues must be agreed by the spouses/family members and aligned with the neighborhood and community risk reduction and management projects. Community-Based Risk Reduction Strategies13 1. Clean-up and clear coastal areas and river/water channels of wastes on a monthly basis. Protect the mangroves in the coastal lines from fuel and fish egg poachers in order to support the fishing households in the community. 2. Maintain the river and coastal concrete walls through donation of materials from the government and NGOs and collective labor support from the community. 3. Continue advocacy before the local councils and disaster risk reduction and management council of the city to improve drainage systems, roads and basic services (water, electricity and sanitation). 4. Support the community-based organizations’ efforts, especially those of the women’s groups, in mobilizing the resources of the community, including partnering with external NGOs, private sector and local-national government agencies.

The women’s group concluded that their collecting and analyzing community data allowed them to better understand the risks their community faces with the increase in typhoons and floods over the years. The results of their participatory community risk assessment allowed them to push for creating a risk reduction and management plan for their community. It also provided them an effective advocacy

13

These strategies are going to be implemented by the CB-RRMP Council, composed of the local officials, women’s leaders, neighborhood representatives, church leaders and private sector representatives.

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tool before their local community councils to support the following community collective efforts: (1) rehabilitating the river walls/barriers along the water channels, (2) improving drainage systems; (3) installing more flood pumps (locally known as bombastic); (4) strengthening the community-based disaster warning systems during typhoons, heavy monsoon rains and floods, and, finally, (5) providing resources and supporting community’s efforts to improve their “water-based lifestyle” that include raising the floors or increasing the number of floors in their homes, building makeshift bridges among households in swampy areas, and building Styrofoam boats for transport. Given all these initiatives on their part and from the local disaster risk reduction and management councils, the women leaders and their members concluded that local governments, NGOs/CBOs and the private sector must “partner” with each other to maximize the resource- and capability-building initiatives designed to increase adaptive capacities of communities to the effects of climate change.

14.7

Lessons Learned from the Participatory Community Risk Assessment and Planning

During a community assembly, the women leaders and local officials enumerated the following lessons that they learned while conducting the community risk assessment and planning activities: • Openness and transparency lead to receptivity and cooperation of both local officials and community leaders; • Belief in genuine participation and contribution of ordinary people in the community and how they can be constrained by the structures of power in their communities; • Sharp analysis of the community structures of leadership/authority (different kinds of leaders and authority); • Local development can be made most effective and relevant to local needs when there are active partnerships between local government and mobilized communities; • The magnitude of problems caused by poverty can only be solved by principled, collaborative and empowering partnerships of civil society, market and state actors with vertical and horizontal support from all sectors to act effectively, through a pooling of human, technical and financial resources; • Admittedly, engaging the government and the community through participatory assessment methods demands a great investment in time and resources for a collaborative examination and reflection of the community’s problems and potentials. • Because of the collaboration of the vulnerable groups in producing the data used in the formulation of CB-RRMP, their flood losses and experiences became central considerations in crafting the local government budgetary appropriations for its disaster risk reduction and management plan.

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14.8

273

Clinical Analysis, Intervention and Intersections of Power

Clinical analysis and intervention bring the Team (the clinical sociology research group and the women’s group) face-to-face with the structures of power in the community. During the community assembly, the women noted that these intersections of power relations were reflected in the access and distribution of resources during floods and disasters. They understood that relief services and other assistance were often distributed unevenly across different income groups, with the poorer and women-headed households getting less because their voices and experiences of loss and devastation did not get reported accurately in the official documents. The women leaders explained that these patterns of distribution were often correlated with the groups’ positive relationships or high “connectedness” with local government officials, CBOs and NGOs operating in the community. Before the women’s group conducted the community mobilization activities, their political connections or social capital with local authorities seemed lower compared to those of men leaders. But afterwards, the women leaders reported that they have acquired more political visibility and influence before the local community council. The women leaders asserted that their demonstration of community leadership through the community risk assessment project will shape the subsequent pattern of distribution of resources in the next flood season. They reasoned that they now have more knowledge and control of the community situation because they produced the community risk profile and maps which also outlines the potential resources that they can tap and/or mobilize. Through these activities, the women further argued they have proven their leadership capacity and performance to the local officials and the whole community. Participatory research methods and analysis, to a certain extent, can provide data that support the vulnerable groups in their claims to resources before the larger community and their local governments. It can also build their confidence in asserting for their rights before their local leaders/officials. But the traditional sources of power and authority, such as male-based local authority systems and hierarchies, still mediate the local decision-making processes regarding planning and resource distribution.

14.9

Concluding Comments

The analysis and intervention described in this chapter illustrate the clinical sociology principles articulated by Jan Marie Fritz (2008, pp. 1, 7–18): Clinical sociologists work with systems to assess situations and avoid, reduce or eliminate problems through a combination of analysis and intervention. Clinical analysis is the critical assessment of beliefs, policies, or practices, with an interest in improving the situation. Intervention is based on continuing analysis; it is the creation of new systems as well as the

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change of existing systems and can include a focus on prevention or promotion (e.g., preventing illness or promoting healthy communities; preventing environmental racism or promoting community sustainability.

Participatory Community Assessments (PCA) facilitate the formulation of actionable risk reduction strategies and community adaptation to floods and other climaterelated risks. Through community mobilization of Community-Based Organizations (CBOs), the production of community risk maps and risk reduction management plans and programs reflect more accurately the capacities/commitments of the community groups and their partners in government, private sector and civil society organizations. Moreover, community-driven interventions facilitate and support adaptation strategies already being practiced by the poor in vulnerable communities. Through this process, participatory risk assessment approaches increase their resilience to climate change-related effects such as floods, typhoons, sea level rise and storm surges that regularly ravage these informal settlements. Clinical analysis and intervention promote community adaptation and resilience among vulnerable groups because it maximizes the potentials of insider and outsider knowledge/expertise, in particular the combined institutional and human resources of the marginal communities, academia, civil society and the state. Through this process, the production of science-based (i.e., systematic) but community-driven databases result in interventions that create sustainable resource networks. Therefore, collaborative engagements from different sectors produce more effective and sustainable solutions. Collaborating with the community in producing risk reduction and management plans through employment of participatory research action methodologies is making sociological practice relevant and meaningful to the larger society, especially those who need it most, such as the marginalized women’s groups in urban poor communities. Postscript A few weeks before the March 16–April 30 Enhanced Community Quarantine (ECQ) or the lockdown to contain the Covid-19 pandemic, I visited Felicidad, the current head of the women’s group whom we partnered in conducting the PCRA and related community organizing activities from 2011–2014. She and the other members of her organization were relocated in 2016 to a formal resettlement housing with all the basic services (water, electricity, health and community infrastructure). In part, because of their community profiling and organizing activities, the women claimed that they were able to receive more resources and better services in their new place of residence. They argued that unlike in their informal settlement before where they were always in danger of eviction, here, in their new settlement, they can work towards (i.e., pay mortgage payments) owning their own homes and have access to potable water, electricity, and health services. She attributed the improvement of their socio-economic situation to their membership in the women’s group and their partnership with civil society organizations (CSOs), local government and the private sector in this past decade. A few days after the start of the Covid-19 lockdown, Felicidad texted the author that her group had not received any assistance at all, contrary to announcements in the media that the local government had released a special assistance fund (SAF) to

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assist urban poor families, especially those who had informal sector jobs. So, the author linked Felicidad’s group to an NGO and a private sector group that organized a system of support—food packs and medicine—for the first two weeks, while the social services from the city provided for the subsequent weeks. As of this writing (April 20, 2020), the women are hoping that the lockdown will be lifted on April 30, so they can return to a normal life, although they know that nothing will ever be the same again.

References Adger, W. N. (2000). Social and ecological resilience: Are they related? Progress in Human Geography, 24(3), 347–364. Agra, F. et al. (2019). Participatory community risk assessment of informal settler communities in Barangay Loyola heights (Unpublished). Alert Net News. (2013). January 7–10. Elliot, L. (2000). Environmental security. In W. Tow, R. Thakur, & I. Hyun (Eds.), Asia’s emerging regional order: Reconciling traditional and human security (pp. 157–177). Tokyo: The United Nations University Press. Fritz, J. M. (2008). International clinical sociology. New York: Springer. Fritz, J. M., & Rhéaume, J. (2014). Community intervention: Clinical sociology perspectives. New York: Springer. Huairou Commission. (2007). Community mapping handbook. Huairou commission: Women, homes community. Accessed March 10, 2013, from http://huairou.org/sites/default/files/Com munity%20Mapping%20Hand- book.pdf Lampitoc, A. (2012, December). Community-based risk reduction planning and management proceedings of the Tanza women’s association (Unpublished). Liongson, L. Q., Tabios, G. Q., & Castro, P. P. M. (2000). Pressures of urbanization: Flood control and drainage in Metro Manila. Quezon City: University of the Philippines, Center for Integrative and Development Studies (UP-CIDS). Local Government of Navotas City. (2013). Disaster risk reduction and management plan of Navotas City, (Unpublished). Magno-Ballesteros, M. (2000). Land use planning in Metro Manila and the urban fringe: Implications on the land and real estate market. Discussion Paper Series (No. 2000–20). Malig, J. (2011, October 06). ‘Pedring,’ ‘Quiel’ damage soars to more than P9 billion. ABS-CBN News. Accessed July 10, 2012, from http://www.abs-cbnnews.com/nation/10/05/11/pedringquiel-damage-soars-p94-billion Porio, E. (2010, November 24–26). Vulnerability on flooded riverlines in urban Philippines. Background paper for “The Environments of the Poor” Conference. New Delhi, India. Porio, E. (2011). Vulnerability, adaptation, and resilience to floods and climate change-related risks among marginal, riverine communities in Metro Manila. Asian Journal of Social Science, 39(4), 425–445. Porio, E. (2012). Enhancing adaptation to climate change by integrating climate risk into long-term development plans and disaster management: The case of Manila, Philippines. Asia-Pacific Network for Global Change Research (APN). Accessed April 23, 2013, from http://www.apngcr.org/resources/archive/ files/06516ed9ac5850386cdd0d5d73f7033 f.pdf Porio, E. (2013, February 7–12). Characterizing vulnerability to climate change in Metro Manila. Paper presented at the International Conference on Coastal Cities at Risk. Makati City, Philip pines.

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Porio, E. (2014a). Climate change vulnerability and adaptation in Metro Manila: Challenging governance and human security needs of urban poor communities. Asian Journal of Social Science, 42, 75–102. Porio, E. (2014b). Climate change adaptation in Metro Manila: Community risk assessment and power in community interventions. In J. Fritz & J. Rheaume (Eds.), Community intervention: Clinical sociology perspectives. New York: Springer. UN Office for Disaster Risk Reduction (UNDRR). (2019). Disaster risk reduction in the Philippines: Status Report. 2019. https://www.unisdr.org/files/68265_ 682308philippinesdrmstatusreport.pdf van Aalst, M. K., Cannon, T., & Burton, I. (2008). Community level adaptation to climate change: The potential role of participatory community risk assessment. Science Direct Global Environmental Change, 18, 165–179. World Risk Report. (2019). Accessed April 26, 2020, from https://weltrisikobericht.de/english-2/

Chapter 15

The South African Military and Gender Integration: Bridging Theory and Practice Lindy Heinecken

15.1

Background

Women’s integration in the military continues to be a debate in many countries, especially as armed forces open up ground combat units to women (Brownson 2014). Central to this is women’s right to equal opportunities, as well as their suitability to serve in all occupational branches in the military (Goldstein 2001). From a liberal equal rights perspective, the argument is that women have the right to participate in all social and political roles (including war roles), and that the exclusion of women from combat based on cultural and biological presuppositions is socially unjust (Maleṧevic 2010). This, rather than personnel shortages or needs, has obliged armed forces to open up combat positions to women in most Western countries and remove all policies and practices that perpetuate sexism and discrimination that prevent women’s emancipation (Keating 2012). However, in recent years the focus has shifted from exclusion, to the need to include more women based on the unique contribution they make to peacekeeping operations (Carey 2001; Puechguirbal 2010). In South Africa the need to recruit and deploy more women in the military and on peacekeeping operations mirror these debates (Heinecken 2015, 2017). Here the inclusion and opening up of combat roles to women is a marked shift from the past where their roles were limited. During the apartheid era, women were only permitted to serve on a permanent basis in the South African Defence Force

L. Heinecken (*) Stellenbosch University, Stellenbosch, South Africa e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_15

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(SADF) since 1971. Their admittance at the time was driven by an acute shortage of ‘manpower’ during the height of the Border War,1 essentially to relieve men for combat duties. However, their participation in the military was voluntary and limited to non-combat support roles. The patriarchal nature of society, as well as the fact that the SADF was involved in offensive missions, barred them from combat and serving in the frontline. In the SADF they were ladies first, and soldiers second. Given their ‘place’ in society and emphasis on the need to maintain their femininity, they never posed a threat to the hegemonic masculinity of male soldiers, or the warrior ethos of the military. The gendered division of labour remained largely accepted, and reinforced by society (Heinecken 2019). With the end of the Cold War, the Border War and the beginning of a new democratic era in South Africa in 1994 after the demise of the apartheid regime, this changed dramatically. The adoption of a new Constitution for the Republic of South Africa in 1996,2 which included a Bill of Rights called for the eradication of all forms of racial and gender discrimination, which paved the way for gender reforms in the military. Following a liberal equal rights agenda, the newly formed South African National Defence Force (SANDF) was obliged to open up all positions to women, including combat. Hence, the motivation to allow women to serve in combat positons was not driven by operational necessity, but by a political equal rights agenda. Particularly women serving in the revolutionary forces of the African National Congress (now the ruling party) and the Pan African Congress, who trained alongside male soldiers, emphasized the need for equal rights for women (Cock 2005) With the emphasis on equality, they were now expected to be ‘soldiers first’ and ‘ladies second’. Interestingly, women soldiers are still typically referred to as ‘ladies’, denoting an underlying sexism which continues to prevail within the military. Nonetheless, with the emphasis placed on gender equality, an assertive affirmative action campaign has increased the number of women serving in the SANDF to over 25% and 15% in peacekeeping operations (Heinecken 2019). Added to this, there has been a conscious effort to deploy more women on peacekeeping missions, which is in line with the recommendations of the United Nations Security Council, Resolution 1325 (UNSC 2000). Associated with this is the recognition that war affects men and women differently, and that the gendered impact of war needs to be factored into peace missions. A call was made to all member states of the UN Security Council to mainstream gender in all facets of decision-making relating to security and to increase the number of women in the military, including peacekeeping operations (Willet 2010). In line with international treaties and protocols the SANDF committed to increase the number of women in decision-making positions to 30% and in terms of recruitment to 40% (Heinecken 1

The South African Border War, and Angola from 26 August 1966 to 21 March 1990 against a perceived communist threat from the north of South Africa and Namibia’s borders, most notably in Namibia and Angola. 2 The adoption of the South African Constitution on 8 May 1996 was one of the turning points in the history of the struggle for democracy in South Africa and was considered one of the most advanced in the world, given the inclusion of a Bill of Rights.

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2015). With this one sees a marked shift away from a purely, equal rights approach to gender integration to a more radical feminist agenda advocating the need to both recognize and value gender difference. However, for the military, which is traditionally male dominated and has a masculine, warlike military culture, this has brought forth different tensions in terms of how to manage gender integration (Heinecken 2017). In this regard, the theoretical debates and changes in policy shaped my research and fed back into public discourse in various ways. Thus, the aim of this chapter is to illustrate how feminist viewpoints informs our understanding of the tensions that gender integration evokes, the implications thereof and the effects in practice. Accordingly, the chapter is divided into three sections. The first focuses on the different theoretical debates that shape the prevailing discourse on gender integration in the military. The second moves beyond theory to practice, to show how my research evolved in line with the theoretical debates, changes in policy and implementation of reforms. The third section, illustrates how this research has fed back into the SANDF and other international forums beyond academia, as the gender debate within security sector reform gained momentum.

15.2

Feminist Views on Gender Integration

The integration of women in the military has solicited different feminist debates in terms of their exclusion and inclusion, especially regarding their right to serve in combat positions. The most frequently cited reason for limiting women’s role in the military is biological, given their comparative lack of speed and physical strength compared to men (Simons 2001; De Groot 2001; Maninger 2008). Added to this, is that men have more testosterone than women, which correlates with aggressive behaviour, making men more suited to combat and military service (Maleṧevic 2010, p. 277). However, feminists have challenged the masculinist biological and cultural arguments, stating that while men are slightly more aggressive, this is socially learned and that just as men can be trained to become more aggressive, so can women (De Groot 2001; Goldstein 2001). This cultural conditioning, together with their roles as mothers and wives, that need the protection (by men), are some of the main reasons why women are excluded from warfare across most cultures. Within the military, a division of labour has emerged where women are channeled into occupational specializations more suited to their abilities, nature and social responsibilities (Cohn 2013, p. 5; Keating 2012; Titunik 2000, p. 231). According to liberal feminists, this is considered unfair and unjust for a number of reasons. Firstly, it perpetuates gender stereotypes that women are more suited to certain fields. Secondly, it precludes them from serving in the elite jobs (most often associated with combat) that confer “more prestige, rewards and possibilities for faster rank advancement”, and are based on sexism aimed at preserving male domination (Archer 2013, p. 367). However, this is only one dimension in the pursuit of gender equality in the military. For women to be accepted as equals, they must not only meet

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the physical standards, but assimilate masculine values, norms and behavior to be respected as soldiers (Lopes 2011). This creates tension around issues of meritocracy that are not only influenced by women’s inferior physical abilities, but their suitability to serve in certain posts based on cultural norms, practices and values (Heinecken 2017). Typically, to be recognized as a soldier women have to stylize their behavior in accordance with the identity practices of the warrior image, which is associated with being assertive, aggressive, competitive and insensitive (Butler 2007, p. 140; Connell and Messerschmidt 2005, p. 829; Sasson-Levy 2011, p. 448). In the military, these masculine norms and behaviors are afforded more “status and value than those seen as feminine” (Cohn 2013, p. 7). However, the consequence is ‘diluted femininity’, given that feminine qualities are typically not valued, celebrated or promoted in the military (Carreiras 2008, p. 175). This runs counter to the ideals which underpin the broader radical feminist, gender mainstreaming agenda, which advocates for more women to be included in the security forces based on the presumed (essential) difference between nurturing femininity and violent masculinity. Here the argument is that women’s unique qualities can enhance the success of peacekeeping missions, where a more conciliatory approach is required in engaging and dealing with local populations affected by armed conflict (Carreiras 2010; Hudson 2000; Olsson 2000; Puechguirbal 2010). Instead of feminine qualities being an impediment, women are considered to add value and make a special contribution to the military because they are thought to be “more effective than men in conflict resolution and decision making, even though they may be less effective than men in combat” (Goldstein 2001, p. 41). From an instrumentalist view, the claim is made that women contribute something different to organizations than men, based on ‘typical female traits’ that can enhance operational success (Benschop and Verloo 2011, p. 281). The problem with such arguments is that they perpetuate “dangerous stereotypes that rightly can be typified as essentialist, reductionist, counterproductive and self-defeating for the feminist project” (Hudson 2000, p. 135). Hence, this ‘special contribution’, can reinforce existing gender stereotypes and affect women’s ability to function as equals, where these continue to the undervalued and linked to female bodies. Even where women’s contribution is valued, what is not taken into account is the effect of patriarchy and sexism,which is embedded in the structures, cultures and practices of the military (King 2015). Where women come to enter the military in larger numbers, these power structures are disrupted posing a threat to the status, power and hegemony of men (Yoder 1991, p. 184). Typically, this may result in women leadership’s authority being undermined, or subjected to increased scrutiny and even sabotage (Morris 1996). Such forms of gender harassment are frequently experienced, but are less likely to be reported than incidences of sexual harassment for fear of ridicule, as well as the consequences this may hold for their careers (Pershing 2003; Rosen and Martin 1997). In this way, women’s sexuality is used as a means to reinforce male power over women, and even to exclude them from certain roles (Sasson-Levy 2011, p. 455). For example, in peacekeeping operations, the

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threat of rape and the potential political consequences this may pose serve to justify the exclusion of women from certain operations (Lopes 2011). Consequently, women come up against a barrage of challenges that prevent them from infusing alternative values into the organization and bringing about a more androgynous military culture (Alvesson and Billing 2009, p. 175). As such, they tend to adapt to, rather than question, the existing status quo out of fear that they are seen as incompetent if they do not adopt the “work practices, priorities and assumptions that have been developed by men and who have established the norms” (Cohn 2013, p. 18). The implication of this is compromised femininity, as women often have to sacrifice their femininity in order to be seen (by men) as competent soldiers. In terms of definition, this is somewhat different from diluted femininity, which implies the assimilation of masculine values. Compromised femininity pertains to the relationship between constructed masculinity and femininity, and the power relations these embody, which in masculine institutions make it difficult for women to bring about a fundamental change in gender relations (Heinecken 2017; Woodhill and Samuels 2004).

15.3

Research, Policy and Practice

Given the above theoretical positions, my own research over the years has centred on how these issues play out in practice as gender reforms became implemented in the SANDF in all the different arms of service.3 In post-Apartheid South Africa, the achievement of gender equality became part of the country’s political agenda. These ideals were included in the White Paper on National Defence of 1996, which stated that the SANDF shall develop a non-racial, non-sexist and non-discriminatory institutional culture, that the composition of the SANDF shall broadly reflect the racial composition of South Africa; and that women have the right to serve in all ranks, and positions, including combat roles (DOD 1996). Since the establishment of the SANDF, there has been a strong commitment to gender integration and equity. Consequently, instructions were issued that all arms of service, train employ, train and promote women on the same bases as their male counterparts. In 1997, an Equal Opportunities Chief Directorate was established to oversee this process and specific funds and human resources were dedicated to achieve the goal of gender equality. An affirmative action plan was put in place to promote women to senior positions, as well as increase their representation in roles and ranks. Based on the policy recommendations, my research sought to establish both the process and challenges that gender integration evoked. 3

According to the latest Department of Defence annual report, the Department had 75,555 personnel in its employment in February 2018. As of 31 March 2018, the SA Army had 38,572 personnel in its ranks, the SA Air Force 9652, the SA Navy 6992 and the SA Military Health Service 7624. Other divisions such as Legal Services and Human Resources accounted for several thousand others (DefenceWeb 2019).

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15.3.1 The Challenges of Gender Integration My early research focused on the biological and cultural debates that influence the utilization of women in combat roles. While there was slow acceptance that women can serve in any position within the military, existing stereotypes linked to cultural determinism were prevalent (Heinecken 1998). Many believed that women do not have the aggressiveness to fight, and if necessary kill, or ability to withstand the fear and stress of the battlefield (Heinecken 2000). Men were guarded in their views of whether women should serve in the infantry, and especially the Special Forces that require exceptional endurance, courage, mental strength and the ability to operate alone and far behind enemy lines for lengthy periods of time (Heinecken and van der Waag-Cowling 2009; Heinecken and van der Waag-Cowling 2009, p. 38). Even though these gender stereotypes have abated, a Department of Defence (DOD) Gender Survey in 2010 showed that only half of respondents (48%) believed that it was possible to have women in combat posts without compromising the effectiveness of the military (Van Breda 2010, p. 12). Besides the issue of women in combat roles, gender integration raised concerns about the impact of women on unit cohesion, discipline and morale. Most of the arguments stemmed from the perceived double standards for men and women, sexual harassment and romantic relationships within the unit (Heinecken 2002). Furthermore, there were the typical female considerations, which revolved around uniquely female issues of pregnancy and deployment. Here the main concern was the effect of pregnancy on units that were disproportionately female, or understaffed. Pregnancy and childcare are two of the most controversial and emotional issues associated with female integration (Heinecken 2002; Heinecken and van der WaagCowling 2009). The impact is felt most by women serving in positions with unconventional hours and who are expected to spend lengthy periods away from home. Research on the deployment of women on peacekeeping missions revealed that family responsibilities and relations weigh more heavily on women, given the patriarchal relations that exist within society (Van Breda 2010). A further reality is that many of the women who deploy are single mothers, who depend on family members (rather than a wife) to take care of children, which places an additional stress on them (Heinecken and Wilen 2019). Another issue associated with gender integration is sexual harassment. While sexual harassment typically receives more attention, gender harassment is more frequent and contributes to the subordination of women. Unlike sexual harassment, which refers to unwanted sexual comments or advances, gender harassment refers to certain patterns of behaviour which are used to reinforce traditional gender stereotypes. For example, women feel under constant scrutiny to prove themselves as capable soldiers. They also report having to ‘pull rank’ more often than their male counterparts to get things done. In general, women experience gossip more negatively than men and are far more prone to name-calling and rumor mongering. In this regard, my research found that that true equality falters where patriarchal attitudes that render women inferior remain (Heinecken 2017).

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Within the SANDF, patriarchy is practiced through exclusionary tactics that contribute to gender equality. According to Walby (1990) this occurs within six patriarchal structures that restrict women and help to maintain male domination, all of which surface within the military. As explained, in terms of paid work, the gendered division of labour has meant that women typically serve in support roles, reserving the higher status combat positions, which generally lead to promotion for men. In the household, they carry a higher burden or responsibility for childcare, making them less likely to deploy away from home or on peacekeeping missions. In terms of culture, the different types of behaviour expected of men and women, physical attractiveness and appearance are biased towards hegemonic militarized masculinity. This has a bearing on issues of sexuality, where a double standard of morality exists in terms of how women are labelled as ‘sluts’ or ‘whores’, but promiscuous men are not. In this regard, among men virility and sexual conquests are admired, but are scorned in relation to women (Mankayi 2008). Such attitudes, in turn, may contribute to sexual harassment and the threat of violence as a form of power over women (Heinecken 2015; Wilén and Heinecken 2018a, b). Last but by no means least, is the role of the state, and the extent to which it, including the military, attempts to address these issues through the enforcement of regulations (Waweth Agency 2006). In this regard, an independent audit conducted in 2006, found that the DOD’s policies were not adequately aligned with international compliance frameworks such as the Convention on the Elimination of all Discrimination Against Women (CEDAW) and the UN Security Council Resolution 1325 (UNSCR 1325) (Waweth Agency 2006). Despite government commitment to increase the number of women in decision-making, the audit revealed that women were under represented in senior decision-making forums; that insufficient attention was being given to gender issues such as facilitating work-family balance; that support to women in leadership was lacking; and that sexism and sexual harassment was rife. Furthermore, that gender issues related to peacekeeping were not adequately addressed (Waweth Agency 2006).

15.3.2 Gender Mainstreaming and Peacekeeping Consequently, in June 2008 the Department of Defence’s Gender Mainstreaming Policy was promulgated to ensure that a gender perspective is infused in all policies, planning and reforms related to defence management (DOD 2008). This included a commitment to align the SANDF’s policies and practices with international, continental and regional obligations. Besides CEDAW and UNSCR 1325, the DOD’s Gender Mainstreaming Policy reiterated the need to commit to continental level agreements such as the Namibian Plan of Action on Mainstreaming a Gender Perspective in Multidimensional Peace Support Operations (2000), the AU Solemn Declaration on Gender Equality in Africa (2004), in addition to the SADC Declaration on Gender and Development (1997), and the Addendum on the Prevention and

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Eradication of Violence against Women and Children. A commitment was made to meet a 30% target for women’s involvement at all levels of decision-making including representation in the armed forces and in peacekeeping operations (Van Breda 2010, pp. 8–9). A premium was also placed on the role of women in post-conflict reconstruction and development, and their participation in security sector reforms “not as a matter of political correctness” but as key to “operational effectiveness” (DOD 2008 p. 4). In recent years, a number of United Nations Security Council (UNSC) Resolutions have addressed the plight of women in combat zones. The most significant of these is the United Nations Security Council Resolution 1325, which in 2000 recognized for the first time the different effects of war on men and women. This resolution stressed the important contribution women can make in the prevention and resolution of conflicts, as well as peacekeeping, and called for the incorporation of gender mainstreaming in all peace operations (Heinecken 2013a). With this, the focus of my research shifted from the gender integration, towards examining the debates on the deployment of women in peacekeeping operations. Since 1999, South Africa became involved in peacekeeping and post-conflict reconstruction and development on the continent (Heinecken and Ferreira 2012; Heinecken 2013a). Serving mainly in Burundi, the Democratic Republic of Congo and Darfur/Sudan, it was now one the largest troop-contributing countries on the continent (Heinecken and Ferreira 2012). By May 2015, 14% of persons deployed on peacekeeping missions were women (DOD 2015). Their increase resonated with the belief that female peacekeepers are able to enhance the access of local women to services, improve community relations, reduce the incidence of sexual and genderbased violence, and break down traditional views that discriminate against and marginalize women (Carey 2001; Duncanson 2009; Puechguirbal 2010). While this is certainly possible, my research found that these ideals are often not realised due to women being socialised, trained and deployed ‘just like men’. This has led to many, especially men, not valuing their unique contribution as highly as women, or questioning this on the basis that it is just rhetoric and not based on substantive evidence (Heinecken 2015, 2017). Based on interviews conducted with peacekeepers, my research found that women are not trained to perform gender specific roles. Thus, female peacekeepers reported that they did not really know what the specific security concerns of women were, nor did they understand the underlying gender power relations in the communities. Added to this, they did not know how to address or assist victims of sexual violence, as this was not their role. Although peacekeepers agreed that women are better at interacting with the local community, especially women and children, this was context-specific. Far more important was the ability to communicate with the local community in their own language and being aware of the culture of the local population. For example, in some cases the local women in Sudan were hostile towards the female peacekeepers because they felt the peacekeepers did not respect their culture in the way they dressed and behaved in terms of gender norms (Heinecken 2015.) What this indicates is that female peacekeepers may be seen as norm-breakers, challenging existing stereotypes in some contexts (like in the DRC),

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but that this can solicit a counter-reaction where the necessary respect for local culture is not considered (Heinecken 2015, 2017; Alchin et al. 2018). Besides this, the female peacekeepers suffer under a hyper-masculine military culture, because they are ‘othered’ on many levels that affect their performance. Physically, the environment is demanding, especially when on foot patrols, due to their comparative lack of physical strength. This creates resentment among males, who feel that their presence poses a security risk, by slowing down patrols and in some cases inviting hostility. Psychologically, the operational environment is more taxing for women, given the extreme forms of sexual violence against women in countries like the DRC and Dafur/Sudan, where rape is used as a weapon of war. In this regard, both the threat of rape and the potential political consequences this may pose are used to justify the restrictions on the utilization of women in peacekeeping. In this way, not only are old stereotypes replicated but they are used to undermine the prospect of an equal partnership between men and women in peacekeeping (Heinecken 2015; Wilén and Heinecken 2018a, b). This necessitated a closer introspection of why women, despite their increased numbers were not able to shift gender binaries that perpetuate their subordination.

15.3.3 Regendering the Military Subsequent research revealed that both the threat of rape and the potential political consequences this poses are used by those in positions of authority (mostly men) to justify the restrictions on the utilization of women in peacekeeping. In reality what this means is that it becomes virtually impossible to imbue alternative ways of dealing with and resolving conflict where ‘feminine’ qualities are undervalued, suppressed, and where they are seen as a threat or a liability. The only way to ‘regender’ the military is to stop privileging masculinity over femininity and this is not likely where peacekeeping remains steeped in the warrior ethos, and the hypermasculine operational context remains hostile to women. In peacekeeping, masculine values are still privileged despite the argument for a new soldier identity, given the fact that most militaries now serve in roles that involve the protection of vulnerable populations, including women and children. These missions are less oriented towards violence, which has meant that the warrior ethos be balanced with the new task requirements that require a more conciliatory approach to dealing with conflict (Soeters et al. 2003, p. 252; Woodward and Winter 2006). Yet, feminine values remain seen as incompatible with military culture. Even where women are represented in significant numbers, they have little choice but to “contribute to the war system, which reinforces gender roles” (Goldstein 2001, p. 412; Pillay 2006) This is no different in the SANDF, as reflected in the comment of one female peacekeeper: “If those rebels see you. . . . you must walk like a man, you talk like a man . . . behave like a soldier, not a women and must always be aggressive.” (Heinecken 2015, p. 232). The fact that masculine traits continue to be privileged and valued more than feminine traits has meant that despite

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the significant increase in women in the military, their ability to bring about a more gender-balanced, or androgynous military culture remains elusive (Duncanson 2009; Heinecken 2017). A regendered military is one where ‘masculine’ and ‘feminine’ traits are equally valued and the hierarchical structure disappears. This implies that traditional ‘feminine’ qualities such as compassion, empathy and communication, become as acclaimed as ‘masculine’ attributes, like courage, strength and rationality. To achieve such a transformation, it is essential to not only emphasize the diversity that women can bring, but also to increase the number of women in the army so that women’s bodies disrupt the dominant, masculine norms (Duncanson and Woodward 2016). In this regard, three strategies are considered necessary to shift gender norms, namely inclusion, reversal and displacement (Wilén and Heinecken 2018a, b). In terms of inclusion, this has been achieved in the SANDF by the significant increase of women in the military in all occupations, and increasingly in combat specialisations. Here one sees that women are disrupting gender norms, but not necessarily changing them. In terms of reversal, there is the recognition that women add value but in an instrumentalist way based on what their feminine characteristics bring to the organisation (Wilén and Heinecken 2018a, b). This tends to reinforce, rather than shift gender binaries. Both inclusion and reversal are not sufficient to regender the military. Affecting this, is the deep-seated patriarchal values that ‘other’ women, and which affects their status as soldiers. Here we found that women’s civilian identity as mothers served to reinforce gender stereotypes. These qualities continue to be associated with women’s bodies and remained firmly entrenched in the “feminine” sphere as if men do not possess these traits. At the same time, the ability to displace gender stereotypes was linked to women soldiers’ sexuality, which was seen as an advantage in some cases, when interacting with rebels, a threat when fraternization affected authority relations and a liability, when it increased both women and men’s vulnerability to attack (Heinecken 2015, 2017; Wilén and Heinecken 2018a). The latter was linked to the extra burden women posed when deployed, given their vulnerability to sexual abuse or rape by enemy forces. So what can be made of this analysis in terms of the regendering of the military? The South African case shows that there in an increase in the number of women who are challenging traditional masculinity within the military, which is provoking anxiety and discomfort (Heinecken 2017). Such a discomfort may be constructive in soliciting change in terms of gender equality and inclusion. However, the female soldiers’ presence does not seem to be transformative, as most women find it easier to conform to the values associated with hegemonic militarized masculinities, than to challenge it. Thus, while women may be unsettling gender binaries, it appears as if their increased numbers and instrumentalist value are not sufficient to transform the institutional gender relations within the military (Welland 2010). This is not only due to the masculine nature of the institution, but the patriarchal attitudes that privilege masculinities and perpetuate gender inequalities in South Africa at large. The mixture of a conservative military culture together with a patriarchal, traditional society seems, therefore, to increase the risk for backlash when it comes to a

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regendered army. One sees evidence of this within the SANDF among men, who question the effect that women are having not only on military culture, but on overall military effectiveness as their numbers increase (Heinecken 2017). Based on the preceding discussion, one can see how my research shifted over the years in line with changes in policy and the implementation of gender equality and mainstreaming in practice. Initially, the research focused on the challenges of gender integration from a liberal equal rights perspective, as well as the institutional challenges gender integration posed around issues of cohesion, sexual and gender harassment and the eradication of gender stereotypes. With the implementation of gender mainstreaming a more assertive radical feminist agenda informed the ‘gender’ agenda, which placed the emphasis not only on the need to include and deploy more women on peacekeeping missions, but how to bring about security sector reform. This was associated with the need acknowledge women’s voice as equally important when it came to security issues, as well as to transform the institutional culture of the military that continued to privilege masculinity (Woodhill and Samuels 2004). Unfortunately, this has not been achieved as most military women assimilate, rather than challenge the status quo. By merely fitting into the masculine organization and exchanging major aspects of their gender identity, without men having to ascribe to a similar “degendering project,” undermines gender equality and serves to this maintain the gender gap (Goldstein 2001, p. 41).

15.4

Public Engagement and Policy Influence

The question is what has been the impact of this research? This is difficult to answer, but what one can see is how the research is received and debated by audiences beyond academia. In this regard, the publications in academic journals have led to numerous invitations to contribute to policy formulation, conduct commissioned research for the Department of Defence and invitations to attend various workshops or events. I limit the focus to those forums beyond academia that were involved in trying to understand and manage the challenges that gender integration poses; how to ensure the better utilization of women on peacekeeping missions; or bring about security sector reform around issues of gender. As one of the few researchers who have gained access to do both quantitative and qualitative research within the SANDF, this empirical data is often highly valued, and scarce. The fact that I served as a researcher and Deputy Director at the Centre for Military Studies at the South African Military Academy and currently as one of the pool of specialists for the Chief of the South African Army, has facilitated access and led to invitations by the DOD to conduct research on gender and other issues. This invitation stemmed from the need by the SANDF to obtain different perspectives from academia on military issues. A kind of insider-outsider trust relationship exists, albeit strained at times where providing policy advice on contentious issues (Heinecken 2016a). As indicated, my research was often prompted by a direct request from the DOD, or in response to policy change or public debates. For example, one of the first

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articles published included an assessment of public opinion regarding women in the military (Heinecken et al. 1997). Stemming from this, I researched the contentious debates on women’s rights to serve in all roles and the claimed effect on combat effectiveness (Heinecken 1998). This initial research sketched the international debates and showed how within the South African context, certain military, societal and cultural factors, including race, class and gender impact on the attitudes of women, and towards women serving in the SANDF. The DOD used these findings in subsequent surveys by the Equal Opportunities Chief Directorate on the attitudes and opinions of DOD members toward women in combat. Similarly, subsequent research served as a resource for the Chief Directorate Transformation Management (CDTM) on the Status of Women in the DOD: A Review of Women in the South Africa Department of Defence’(Van Breda 2010). Consequently, I was invited to comment on the report and conduct a follow up study at the annual DOD Gender Conference in 2012, where I presented my research findings on the Challenges that gender Integration poses for military leadership from a theoretical perspective. At the conference, the CDTM granted permission to conduct a survey to establish the specific issues affecting gender integration. The data was collected by means of a structured questionnaire which posed questions on career options and choices; the value and challenges of women deployed on peacekeeping operations; on military culture, leadership and authority relations; and lastly on questions relating to sexual and gender harassment. The questionnaire also included one open-ended question where respondents could describe what they thought were the main issues affecting gender equality in the SANDF. The findings of the study were revealing in terms of whether gender training should be integrated or separate, if serving in combat arms should be voluntary or compulsory for women, and the ratio of men and women in the workplace. Of particular interest, were the opinions on the effect women had on authority relations, on unit cohesion and the fighting spirit of the military and the extent to which women’s contribution to peacekeeping operations were valued. On almost all issues, there were significant differences in the attitudes of men and women that the SANDF needed to take note of (Heinecken 2013b). The outcome of this study was not only submitted as a report, but presented to senior military personnel of the Army Command Council, Directorate Army Strategic Direction, South African Infantry Formation and at the South African Military Academy. The invitation to present the research at these forums was due to my appointment as one of the pool of specialists for the Chief of the Army. Based on the findings certain recommendations were made in terms of the need for career guidance to ensure a better ‘person-post’ fit, how to reduce attrition of women in the combat branches and to ensure that the necessary support structures are in place to enable women to meet the standards and criteria for the posts. Further recommendations included the need to communicate what conduct is perceived as offensive and detrimental to gender integration. This pertained particularly to gender and sexual harassment and the need for more visible attempts to stop these practices, along with more support for those who wish to lay complaints. Based on the research it became apparent that gender mainstreaming initiatives were not treated with the

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seriousness and commitment they deserve. To understand the underlying tensions, a theoretical model was developed to explain the complexities of gender integration and the importance of dealing with the gender binaries that perpetuate inequalities. This research was published in a subsequent article in the journal Armed Forces and Society, titled ‘Conceptualizing the tensions that gender integration evokes (Heinecken 2017). The presentation of this research opened up opportunities to conduct research on the deployment of women on peacekeeping missions, which followed previous research on the experience of peacekeepers on deployment (Heinecken and Ferreira 2012). However, this research focused specifically on the experiences of women on peacekeeping operations, the impact on their careers as well as the challenges peacekeepers face, reintegrating back into the home environment. The publications on gender integration and women in peacekeeping appeared in prominent academic journals, such as International Peacekeeping, Armed Forces and Society and in Gender, Work and Organisation. I was also invited to contribute to book volumes on gender and the military such as The Palgrave International Handbook of Gender and the Military and Gender and Women in Military Affairs: A comparative Study. Publications create public awareness of one’s work, and led to many invitations over the years to share my research findings with a broader audience. Within South Africa, this included invitations to speak, amongst others at the Institute for Security Studies and Royal Danish Embassy in Pretoria, as well as the Volkswagen Stiftung Foundation Fellowship Symposium. Besides this, the research on peacekeeping resulted in an invitation to Nairobi, Kenya by the African Peacebuilding Network, who also funded the gender and peacekeeping research. The most notable invitations subsequent to this was to the Kofi Annan International Peacekeeping Training Centre, Accra, Ghana, to the Women, Peace and Security Lessons Learned Conference, where I presented a paper on ‘Enhancing the capacity of female peacekeepers and local women in peacebuilding in Africa’. The three-day conference attended by more than 40 invited participants, served to increase awareness and develop practical lessons learned on Women, Peace and Security considerations. The participants were from 13 African countries, as well as Germany, the Netherlands. United States military officials and non-government personnel presented information during the conference, which focused on preparing U.S. AF RICOM to respond to the Women, Peace and Security (WPS) National Action Plan. The topics included the challenges facing women at the tactical level and how to enhance the capacity of female peacekeepers and local women in building peace in Africa. Participants identified obstacles that currently hinder the efforts to place women in peacekeeping roles (US Africa Command 2012a). Beyond Africa, the most prominent exposure, was the presentation of my research on Gender Integration and the South African Armed Forces at the Gender Mainstreaming in African Armed Forces Conference, hosted by the Africa Centre for Strategic Studies, Washington, DC in 2012. The workshop included a meeting with Secretary of State Hilary Clinton, and brought together more than two dozen experts and practitioners from 14 African countries, the African Union, Intergovernmental Authority on Development (IGAD), and the United States

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government to examine and highlight the progress made, challenges experienced, as well as the opportunities available to enhance gender mainstreaming in African security forces. The experts at this workshop stressed the need for African militaries to integrate gender perspectives into recruitment, training, and personnel management strategies and to re-evaluate policies that affect the recruitment, promotion and retention of women, especially those related to maternity leave, sexual discrimination and harassment (US Africa Command 2012b). Another significant event was an invitation to Georgetown University, Institute for Women, Peace and Security, Washington, in 2015 to present a paper on Bridging Theory and Practice Symposium. At this event, scholars and practitioners came together to compare the progress on the integration of women in the military, what worked and what has not and the extent to which gender perspectives that enhance operational effectiveness are evident. Ambassador Melanne Verveer, Executive Director of the Georgetown Institute for Women, Peace and Security attended this workshop. She also serves as the Special Representative on Gender Issues for the OSCE Chairmanship. The outcome of this event let to the publication of the book Women and Gender Perspectives on the Military, which examined the experiences of gender integration in a number of country cases, including Sweden, the Netherlands, Canada, the United States, the United Kingdom, Israel, Australia, and South Africa (Egnell and Alam 2019). The comparative findings revealed many policy-relevant insights into women and gendered perspectives in the military. Further invitations were received by Elsie Initiative for Women in Peace Operations, The Netherlands Ministry of Foreign Affairs, held in the Hague from 13–14 November 2018. This event hosted in collaboration with Norway and Canada brought together many experts (governmental officials, researchers and practitioners) from various backgrounds and served as an opportunity to concretize research priorities and encourage political momentum on gender dimensions within security sector organizations and UN peacekeeping operations. This all with the overarching end goal of getting more women involved in peace operations (NMFA 2018). Last, but by no means least was a more recent invitation by the European Union External Action Service Academic Conference on Women, Peace and Security (WPS), in June 2019. The event, held at the European Union in Brussels sought to find new ways of working with the implementation of the EU policy on WPS by engaging with scholars and academia. The purpose of the Academic Roundtable on WPS was to engage with renowned scholars from across the world doing WPS research in order to ensure the effectiveness of the EU Strategic Approach to WPS, its implementation and achieve a better outreach to EU Member States and the international community. The Academic Roundtable discussions focused on three key strategic areas: WPS in general, Sexual and Gender Based Violence and Women’s Participation in security sector reform. Some of the leading scholars who attended the event included, the renowned scholar Professor Cynthia Enloe and others such as Prof Annick Wibben, Prof Maria Stern, Dr Paul Kirby and Dr. Dara Kay Cohen (European Commission 2019) Besides this, another platform through which to promote the research is through the media. This engagement with the media occurred mostly around Women’s Day

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and facilitated by Stellenbosch University’s public relations division. In this regard, I have published a number of articles in local newspapers in South Africa such as the Mail & Guardian, Daily News and New Age on women in the military and the challenges they face and internationally in newspapers such as the Washington Post. (Heinecken 2016b, c, d; Wilén and Heinecken 2018a, b.). Added to this, the research on gender and the military was included in the publication Research at Stellenbosch University: Showcasing Research Excellence both in 2017 and in 2018. Such exposure results in numerous requests, especially during Women’s month for radio and television interviews, which promotes ones research to a wider public audience. Once one becomes known through the media, and by the media, one is often asked to comment on issues which opens up opportunities to write op eds on various platforms. Here, the academic publication outlet, The Conversation (theconversation.com), has been one of the most important forums to get my work recognised within and beyond academia.

15.5

Concluding Remarks

Reflecting on my research, a number of key factors influence the ability of one’s research to reach a wider audience. The first is access to do the research and second is accessibility in terms of how content is conveyed. The fact that my academic career started off as a researcher doing applied research for the military on issues of strategic concern, cultivated a specific style of research, writing and putting across information to a wider audience. Ultimately the challenge of applied and clinical sociology is how to use sociological concepts in such a way that theory and practice are brought together to provide a different lens on issues, but at the same time ensures that the content is not lost in translation. In this regard, my research has tried to straddle an academic, practitioner and policy audience. Whether I have achieved this is difficult to determine, but the fact that my research solicits invitations that engender wider public engagement, both within the military and beyond to a diverse global audience, is a greater indication of success in my view than academic citations. More importantly, it demonstrates the relevance of sociology as a discipline that brings distinctive insights to analysing specific issues or events. In this regard, I would say that my research falls squarely within the confines of clinical or applied sociology which has sought to interrogate social injustices within the military with the purpose of soliciting debate and reform. In doing so one of the greatest challenges has been not to be overtly critical as to alienate one’s subject (the military), but to use theoretical positions to substantiate research findings and to make solid recommendations on how to bring about policy reform. To conclude, I concur with Feagin et al. (2009, p. 85) that one of the challenges one faces as a critical sociological practitioner is to “face real-life threats from people and institutions with power. One’s career, reputation, and opportunities to do research are often at risk in the battle for social justice and human betterment.” In

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my recent book, South Africa’s Post Apartheid Military: Lost in Transition and Transformation (Heinecken 2020), I address some uncomfortable social realities facing the SANDF, but attempted to do so as an ‘empathetic social scientist’. The balance is important if one wants to engage, inform policy and ensure that one’s work penetrates public discussion on issues of critical concern to society.

References Alchin, A., Gouws, A., & Heinecken, L. (2018). Making a difference in peacekeeping operations: Voices of South African women peacekeepers. African Security Review, 27(10), 1–19. Alvesson, A., & Billing, Y. D. (2009). Understanding gender and organisations. London: Sage. Archer, E. (2013). The power of gendered stereotypes in the US Marine Corps. Armed Forces and Society, 39(2), 359–391. Benschop, Y., & Verloo, M. (2011). Gender change, organizational change and gender equality strategies. In E. L. Jeanes, D. Knights, & P. Y. Martin (Eds.), Handbook of gender, work and organization (pp. 277–290). West Sussex: Wiley. Brownson, C. (2014). The battle for equivalency: Female US Marines discuss sexuality, physical Fitness and military leadership. Armed Forces and Society, 40(4), 765–788. Butler, J. (2007). Gender trouble: Feminism and the subversion of identity. London: Routledge. Carey, H. (2001). Women and peace and security: The politics of implementing gender sensitivity norms in peacekeeping. International Peacekeeping, 8(2), 49–68. Carreiras, H. (2008). From loyalty to dissent: How military women respond to integration dilemmas. In H. Carreiras & G. Kümmel (Eds.), Women in the military and in armed conflict (pp. 161–181). Weisbaden: VS Verlag fur Sozialwissenshaften. Carreiras, H. (2010). Gendered culture in peacekeeping operations. International Peacekeeping, 17 (4), 471–485. Cock, C. (2005). Forging and new army out of old enemies: Women in the South African military. Women’s Study Quarterly, 23(3-4), 97–111. Cohn, C. (2013). Women and Wars. Cambridge: Polity Press. Connell, R., & Messerschmidt, J. (2005). Hegemonic masculinity: Rethinking the concept. Gender and Society, 19(6), 829–859. De Groot, G. (2001). A few good women: Gender stereotypes, the military and peacekeeping. International Peacekeeping, 8(2), 23–38. DefenceWeb. (2019, January 7). SANDF personnel strength by the numbers. DefenceWeb. Department of Defence (DOD). (1996). South African White Paper on Defence. Pretoria: Department of Defence. Department of Defence (DOD). (2008). Gender mainstreaming strategy, No 1 of 2008 CHR/TMCD/R/106/dated July 2008. Pretoria: South Africa. Duncanson, C. (2009). Forces for good? Narratives of military masculinity in peacekeeping operations. International Feminist Journal of Politics, 11(1), 63–80. Duncanson, C., & Woodward, R. (2016). Regendering the military: Theorizing women’s military participation. Security Dialogue, 47(1), 3–21. Egnell, R., & Alam, M. (Eds.). (2019). Women and gender perspectives in the military. Georgetown: Georgetown University Press. European Commission. (2019). EEAS high-level academic conference on WPS. Accessed February 16, 2020, from https://webcast.ec.europa.eu/eeas-high-level-academic-conference-on-wps Feagin, J., Elias, S., & Mueller, J. (2009). Social justice and critical public sociology. In V. Jeffres (Ed.), Handbook of public sociology (pp. 71–88). Lanham: Rowman & Littlefield Publishers. Goldstein, J. (2001). War and gender. Cambridge: Cambridge University Press.

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Heinecken, L. (1998). Social equality versus combat effectiveness: An institutional challenge for the military. African Security Review, 7(6), 3–16. Heinecken, L. (2000). Securing South Africa’s future: Putting women in the frontline. Strategic Review for Southern Africa, 22(2), 76–102. Heinecken, L. (2002). Affirming gender equality: The challenges facing the South African Armed Forces. Current Sociology, 50(5), 715–728. Heinecken, L. (2013a). Building capacity from above and below: Why gender matters in the peacekeeping and peacebuilding contexts. In H. Hudson & T. Neethling (Eds.), Post-conflict reconstruction and development in Africa: Concepts, role-players, policy and practice (pp. 130–144). Cape Town: UCT Press. Heinecken, L. (2013b). Report on the findings of the defence gender integration and leadership. Pretoria: Chief Directorate Transformation Management. Heinecken, L. (2015). Are women ‘really’ making a unique contribution to peacekeeping? The rhetoric and the reality. International Peacekeeping, 19(4), 227–248. Heinecken, L. (2016a). Reflections on insider-outsider experiences of military research in South Africa. In H. Carreiras, C. Castro, & S. Frederic (Eds.), Researching the military (pp. 36–41). London: Routledge, Taylor and Francis Group. Heinecken, L. (2016b, August 8). Military women need to trouble gender relations and roles for peace’s sake. Mail and Guardian. Heinecken, L. (2016c, August 11). Dropping a gender bombshell. Daily News. Heinecken, L. (2016d, August 11). Military needs more women. The New Age. Heinecken, L. (2017). Conceptualising the tensions that gender integration evokes. Armed Forces and Society, 43(2), 202–220. Heinecken, L. (2019). Three waves of gender integration: The causes, consequences and implications for the South African armed forces. In R. Egnell & M. Alam (Eds.), Women and gender perspectives in the military (pp. 207–221). Georgetown: Georgetown University Press. Heinecken, L. (2020). South Africa’s Post Apartheid military: Lost in transition and transformation. Cham: Springer. Heinecken, L., Cilliers, J., Schutte, C., Liebenberg, I., & Sass, B. (1997). Public attitudes regarding women and language usage in the SANDF. African Security Review, 6(3), 3–14. Heinecken, L., & Ferreira, R. (2012). Fighting for peace: South Africa’s role in peace operations in Africa (Part I). African Security Review, 21(2), 20–35. Heinecken, L., & van der Waag-Cowling, N. (2009). The politics of race and gender in the South African armed forces: Issues, challenges and lessons. Commonwealth & Comparative Politics, 47(4), 517–538. Heinecken, L., & Wilen, N. (2019). No place like home? Post-deployment reintegration challenges facing South African peacekeepers. Armed Forces and Society. Published online, December, p1–20. Hudson, H. (2000). Mainstreaming gender in peacekeeping operations: Can Africa learn from international experience? African Security Review, 9(4), 18–33. Keating, J.E. (2012). Where a women’s place is on the front lines. Foreign Policy. Accessed February 16, 2020, from http://www.foreignpolicy.com/articles/2012/02/10/where_a_womans_ place_is_on_the_front_lines King, A. (2015). Women warriors: Female accession to ground combat. Armed Forces and Society, 41(2), 379–387. Lopes, H.. (2011). Militarized masculinity in peacekeeping operations: An obstacle to gender mainstreaming. PeachBuild, 2011. http://peacebuild.ca/Lopes% 20website%20ready.pdf Maleṧevic, S. (2010). The sociology of war and violence. Cambridge: Cambridge University Press. Maninger, S. (2008). Women in combat: Reconsidering the case against the deployment of women in combat-support and combat units. In H. Carreiras & G. Kümmel (Eds.), Women in the military and in armed conflict (pp. 9–28). Weisbaden: VS Verlag fur Sozialwissenshaften.

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Mankayi, N. (2008). Morality and sexual rights: Constructions of masculinity, femininity and sexuality among a group of South African soldiers. Culture, Health and Sexuality, 10(6), 625–634. Morris, M. (1996). By force of arms: Rape, war and military culture. Duke Law Journal, 45(4), 651–781. Netherlands Ministry of Foreign Affairs (NMFA). (2018). Elsie research to action workshop, 13–14 November, Accessed March 15, 2010, from vensi.nl/elsie-research-action-workshopnovember-13-14-2018-bazaar-ideas/268891466 Olsson, L. (2000). Mainstreaming gender in multidimensional peacekeeping: A field experience. International Peacekeeping, 7(3), 1–16. Pershing, J. (2003). Why women don’t report sexual harassment: A case study of an elite military institution. Gender Issues, 21(4), 3–30. Pillay, A. (2006). Gender pace and peacekeeping: Lessons from Southern Africa. Pretoria: Institute for Security Studies. Puechguirbal, N. (2010). Discourses on gender, patriarchy and resolution 1325: A textual analysis of UN document. International Peacekeeping, 17(2), 172–187. Rosen, L., & Martin, L. (1997). Sexual harassment, cohesion, and combat readiness in U.S. army support units. Armed Forces & Society, 24(2), 222–223. Sasson-Levy, O. (2011). The military in a globalized environment: Perpetuating an extremely gendered organization. In E. L. Jeanes, D. Knights, & P. Y. Martin (Eds.), Handbook of gender, work and organization (pp. 391–490). West Sussex: Wiley. Simons, A. (2001). Women in combat units: It’s still a bad idea. Parameters, 31(2), 89–100. Soeters, J., Winslow, D., & Weibull, A. (2003). Military culture. In G. Caforio (Ed.), Handbook of the sociology of the military (pp. 237–254). New York: Kluwer Academic. Titunik, R. (2000). The first wave: Gender integration and military culture. Armed Forces & Society, 26(2), 229–257. United Nations Security Council. (2000). Resolution 1325 on women, peace and security. http:// www.un.org/events/res_1325e.pdf US Africa Command. (2012a). AFRICOM’s women, peace and security conference ends. Accessed February 16, 2020, from ,https://www.modernghana.com/news/414583/africoms-womenpeace-and-security-conference.html US Africa Command. (2012b). AFRICOM: Empowering women to be agents of peace. Accessed February 16, 2020, from https://www.africom.mil/media-room/article/9168/africa-centerafricom-empowering-women-to-be-agent Van Breda, B. (2010). Status of women in the DOD: A review of women in the South African Department of Defence. Pretoria, RSA: Department of Defence. Walby, S. (1990). Theorizing patriarchy. Oxford: Basil Blackwell. Waweth Agency. (2006). Gender mainstreaming audit report. Pretoria, RSA: Waweth Law and Policy Research Agency. Welland, J. (2010). ‘Feminine trouble’ and the (re)constitution of the militarised masculine subject. Political Perspectives, 4(1), 1–30. Wilén, N., & Heinecken, L. (2018a). Regendering the South African army: Inclusion, reversal and displacement. Gender, Work and Organisation, 25(6), 670–686. Wilén, N., & Heinecken, L. (2018b, August 1) Women now make up almost 24 percent of South Africa’s military. Why aren’t they treated equally? Washington Post. Willet, S. (2010). Introduction: Security Council Resolution 1325: Assessing the impact on women, peace and security. International Peacekeeping, 17(2), 142–148. Woodhill, B., & Samuels, C. (2004). Desirable and undesirable androgyny: A prescription for the twenty-first century. Journal of Gender Studies, 13(1), 15–28. Woodward, R., & Winter, P. (2006). Gender and the limits to diversity in the contemporary British army. Gender, Work and Organization, 31(10), 45–67. Yoder, J. D. (1991). Rethinking tokenism: Looking beyond numbers. Gender and Society, 5(2), 178–192.

Chapter 16

Focus Groups in the Context of International Development: In Pursuit of the Millennium and Sustainable Development Goals Janet Mancini Billson

16.1

Introduction

The central thought is that of a true science of society, capable, in the measure that it approaches completeness, of being turned to the profit of mankind. . . in its practical character of never losing sight of the end or purpose, nor of the possibilities of conscious effort. It is a reaction against the philosophy of despair that has come to dominate even the most enlightened scientific thought. It aims to point out a remedy for the general paralysis that is creeping over the world, and. . . it proclaims the efficacy of effort, provided it is guided by intelligence. (Ward 1906)

The legacy of the twentieth century and the promise of the twenty-first century were on the minds of leaders, change agents, and ordinary people around the world as the new millennium approached. The most far-reaching aspirations—the Millennium Development Goals (MDGs)—were adopted in 2000 by all 189 member-states of the United Nations General Assembly, the International Monetary Fund (IMF), the Organization for Economic Cooperation and Development (OECD), and the World Bank Group (WBG), which includes the International Bank for Reconstruction and Development or IBRD and the International Monetary Fund or IFC). The Millennium Declaration was designed to throw into relief the values of various organizations concerned with international development and to stimulate concerted action (United Nations 2000). The Millennium Declaration “was a defining moment for global cooperation in the twenty-first century” (United Nations 2002). The eight central goals were to: (1) Eradicate extreme poverty and hunger; (2) Achieve universal primary education; (3) Promote gender equality and empower women; (4) Reduce child mortality; (5) Improve maternal health; (6) Combat HIV/Aids,

J. M. Billson (*) Group Dimensions International, Saco, ME, USA e-mail: [email protected] © Springer Nature Switzerland AG 2021 J. M. Fritz (ed.), International Clinical Sociology, Clinical Sociology: Research and Practice, https://doi.org/10.1007/978-3-030-54584-0_16

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malaria and other diseases; (7) Ensure environmental sustainability; and (8) Create a global partnership for development.1 The MDG Gap Task Force reported in New York City in 2015 that “. . .there have been significant positive developments pointing to an effective international partnership in [the goals], but several deficits in development cooperation have continuously highlighted the need for a rejuvenation of the global partnership for development.”2 Based on the remarkable success of the MDGs, and with much work left to be done, the same stakeholders met again in 2015 to forge a new commitment to the Sustainable Development Goals (SDGs) that are meant to be accomplished by 2030.3 Although the SDGs are both more numerous and more detailed, the basic mission remains the same: Reduce global poverty and further gender equity; enable a greater portion of the world’s population to further their education, live healthy lives in resilient cities and productive farmlands, and thrive in well-governed societies marked by viable infrastructures, healthcare, and educational institutions. Sustainability and protection of the earth’s fragile ecosystems are new goals.4 These two global agreements serve as critical guideposts for our work as clinical sociologists who are focused on international development.

16.2

Talking to People Systematically

When most of the world signed on to the MDGs, it became more apparent than ever that international development agencies would need to talk to intended beneficiaries about the intended consequences of aid and technical assistance. In fact, since the MDGs were adopted, the international (multilateral and bilateral) development agencies have shifted even more toward qualitative research methods—talking to people systematically. Impact assessments or needs assessments, stakeholder

1 Progress on Goal 8 is available in United Nations, 2015. Taking Stock of the Global Partnership for Development: MDG Gap Task Force Report, 2015. https://www.un.org/millenniumgoals/pdf/ MDG_Gap_2015_E_web.pdf. 2 United Nations, 2015. MDG Gap Task Force Report 2015: Taking Stock of the Global Partnership for Development. https://www.un.org/development/desa/dpad/publication/taking-stock-of-theglobal-partnership-for-development 3 United Nations (2015). Taking Stock of the Global Partnership for Development: MDG Gap Task Force Report, 2015. https://www.un.org/millenniumgoals/pdf/ MDG_Gap _2015_E_web.pdf; and United Nations (2019), Report of the Secretary-General, Special Edition: Progress towards the Sustainable Development Goals. https://sustainabledevelopment.un.org/content/documents/ 24978_Report_of_the_SG_on_SDG_Progress_2019.pdf. 4 J. M. Billson, “Sociology and the Sustainable Development Goals: Or, Do We Really Have a Role in Changing the World?” Journal of Applied Social Science (September 2020).

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perceptions, and results on the ground cannot be determined without the voices of the intended beneficiaries of aid and loan programs. Qualitative approaches have been the backbone of our work at Group Dimensions International (GDI) since 1993, as it became clear that much international aid was not “reaching the ground,” but rather was lining the pockets of emerging elites, and that the social dimension of development had not been fully recognized or integrated into projects (Cernea 2004). Corruption, lack of transparency, and insufficient aid coordination surfaced as major stumbling blocks in achieving national development goals. Insufficient understanding of how culture and context affect development, inattention to the powerful forces of gender and ethnicity, and disregard for social impacts (as opposed to economic gains) plagued many development interventions in the past (Billson and Mancini 2007). Now, the main challenges in closing the global gender gaps, for example, rest on “social and cultural norms” tethered in thousands of years of tradition (Billson 2020c). The persistence of patriarchal structures and male privilege hinder equality of opportunity in many realms— girl’s education, as well as women’s labor force participation and access to economic assets such as loans for medium and small enterprises. The SDGs recognize that gender gaps also include situations in which boys and men may have fallen behind females on certain indicators of well-being. The MDGs and SDGs are intended to help both countries and donors/lenders focus not simply on the amount of aid (“disbursements”) but also on outcomes. For example, has poverty been reduced? Yes, under the MDGs. Are school completion rates for girls catching up to those for boys? In fact, in some countries the girls have surpassed boys through secondary and even tertiary education, but often lag in labor force participation regardless of advanced degrees. Have infant mortality and maternal health been mitigated? Yes, but too many babies, small children, and women still die from preventable illness and as victims of refugee crises. While these and other indicators are certainly susceptible to (and best measured by) statistical means, the how and why of progress toward goal achievement lends itself admirably to focus group and key informant interviews (Billson 2019). Talking to people, rather than simply measuring dollars or kilowatts, has steadily gained currency in development evaluation. Focus group research was developed in the post-World War II period by sociologists Paul Lazarsfeld (who used the term focus interview) and Robert K. Merton (who coined the term focused group interview). Merton and Patricia J. Kendall wrote about the method in a 1946 article that was later expanded upon by Merton et al. (1956). The methodology was almost immediately submerged by the discipline’s intense efforts to prove itself a “hard science” through increasingly sophisticated survey and statistical work, but the market research community rediscovered it during the 1960s. Since the 1980s, focus groups, as part of the resurgence of qualitative methods, have gradually become a respected tool that reflects the practice orientation and more qualitative nature of early twentieth-century sociology. Focus groups can be defined as structured, guided discussions that have as their sole purpose the gathering of data for scientific purposes (Merton et al. 1956). Their

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success depends on a well-trained moderator who facilitates the discussion through guided interaction so that ideas generated by the group can be pursued. The moderator draws out motivations, feelings, and values behind verbalizations through skillful probing and restating responses but, just as importantly, participants stimulate each other through “discussion, debate, dialogue, and disagreement” (Billson 2007b) that cannot occur in individual interviews or on questionnaires. Why focus groups? Of all social science methods, focus group discussions excel in engaging the participation of those who are the intended beneficiaries of various programs and projects. In an era of increasing attention to participatory research and involvement of local stakeholders in program design, implementation, and evaluation, focus groups stand out as a logical vehicle for structured, systematic discussion. Focus groups enable researchers to develop a picture of how things work and then to take that analysis to ensuing focus groups in order to verify, expand, and possibly revise assumptions (Billson 1991). For example, Mosavel et al. (2005) used a series of focus groups with black South Africans in Cape Town to explore the (perceived) need for cervical cancer screening. By using focus groups and individual interviews to engage community stakeholders in interpretive analysis, the team “developed a research framework that incorporated the community’s concerns and priorities, and stressed the intersecting roles of poverty, violence, and other cultural forces in shaping community members’ health and wellbeing.” The interviews led the researchers to refocus away from “cervical cancer” screening toward “cervical health” screening, which was a concept that the community related to more immediately as having a direct impact on women’s lives. Using focus groups for early-point and midpoint monitoring can uncover problems before they sabotage the intervention. Asking about lessons learned and best practices at the end-point evaluation can help to shape more effective programs for future implementation. The key point methodologically is that group interaction generates insights through the cross-fertilization of ideas, affording depth and insight into the research question and helping contextualize quantitative data (Krueger and Casey 2000; Puchta and Potter 2004; Billson 2007b, 2012). Like any other method, focus groups have limitations, especially when researchers or moderators lack training and experience in the approach or the recruitment lacks rigor, but their power as generators of complex analyses is difficult to match.

16.3

Focus Groups in the International Context

Qualitative approaches to understanding differences in behavior, attitudes, and values among various cultural groups within a country’s borders and between countries are now used (and respected) virtually worldwide (Billson 2013/2020). Focus groups are especially popular in education and health but are also used as a vehicle for participatory research, rapid appraisals, monitoring, evaluation, and case or comparative studies in sectors such as water and sanitation, urban development, human development, private sector development, agriculture, and environment.

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Focus groups also have become popular in accessing critical data for crosscutting issues such as food security and gender. One impetus for the recent interest (and confidence) in focus group research stems from the insistence by local beneficiaries that quantitative methods cannot adequately capture their lives or the true situation “on the ground” when it comes to needs or to the performance of development projects. International development organizations are discovering the limitations of quantitative methods for studying vulnerable populations (such as the poor and the elderly) or for evaluating programs intended to reach such populations. Increasingly, focus groups have become institutionalized, especially by international development organizations. For example: • The World Health Organization and many other U.N. and international entities have established international standards for conducting focus groups (Hawthorne et al. 2006). • The World Bank has commissioned its own “guidelines” for conducting focus groups (Billson 2012), which were disseminated to one thousand resident missions worldwide. • Organizations, such as the Wilder Foundation, have developed their own focus group and community meeting guidelines (Hoskins and Lucas 2003). • One of the most influential studies of the late twentieth century, Voices of the Poor: Crying Out for Change, utilized focus group methodology (Narayan et al. 2000; World Bank Group 2000/01). This study asked poor women and men in twenty countries, “How do you define well-being or a good quality of life, and ill-being or a bad quality of life?” (Billson and Fluehr-Lobban 2005). Furthermore, focus groups have matured to the point that some researchers are integrating unique strategies into the traditional focus group context (eight to ten participants sitting around a table and responding to a set guide for about two hours). For example, Barata et al. (2006), asked Portuguese and Caribbean Canadians about their attitudes toward participating in research. Then, they role-played a fictional recruitment and informed-consent agreement process with respondents in the focus group, which revealed very different reactions when the two cultural groups were compared. Atkinson et al. (2006) used Internet focus groups (IFGs) to explore patientreported outcome measures (PROs) in both Germany and the United States, and then used thematic coding methodology to develop culturally sensitive questionnaire content using the natural language of participants. Then they asked participants to return for an evaluation of the PRO (survey-type) questions. According to the researchers, “Overall, the IFG responses and thematic analyses provided a thorough evaluation of similarities and differences in cross-cultural themes, which in turn acted as a sound base for the development of new PRO questionnaires.” Hermalin (2003) conducted focus groups in four Asian countries to explore the well-being of aging citizens. Everywhere, focus groups are held under trees, in community halls, in government conference rooms, or in homes—wherever beneficiaries and other stakeholders can reasonably be expected to gather for a structured

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group interview. Guidelines for rapid assessment focus groups in the field can be found in Billson (2020a).

16.4

Using Focus Groups to Advance Well-Being

Group Dimensions International is dedicated to building capacity for group effectiveness through research, training, organizational development, and facilitation with the goal of achieving positive social change. Our work in international development has involved clients such as the World Bank Group, the United Nations, the Foundation for Advanced Studies on International Development (FASID—Japan), and the European Commission. Our purpose is to assist communities and organizations in becoming more effective internally and externally; to foster organizational insight; and to help organizations shape their programs, policies, and products through knowledge and expert application of social science concepts, theories, and methodologies. This entails guiding organizations and communities in better understanding the needs of their constituencies, evaluating their work, and envisioning their futures. Always, the overarching goal is to advance well-being among individuals, organizations, communities, and societies. We take “development” to imply movement toward well-being for those who are affected by projects; this means that evaluation must go beyond financial auditing and expenditure reporting to focusing on actual impacts on the intended beneficiaries. Our mission is in keeping with the underlying values of the MDGs—to achieve poverty reduction and improve well-being. In that sense, we take our research to be practice. Our work contributes to uncovering the complexities of development effectiveness, to the extent that it is possible, in order that future projects will be more likely to succeed (Billson and Fluehr-Lobban 2005). In keeping with this mission and in concert with sophisticated quantitative methods (Bamberger 2000), our corporate strategy is to advance the use of qualitative methodologies, especially individual and focus group interviews, as legitimate, powerful, and systematic research tools. Group process theory undergirds our facilitation, organizational analysis, and strategic planning functions. Thus, we employ focus groups in evaluation research (Billson 2020b), needs assessments, and strategic planning. We often harness the rich data from focus groups to data generated by key informant interviews, surveys, secondary analysis of census or other statistical data, and direct observation. Our work typically lays the foundation for client decisions regarding program development, policy analysis, organizational improvement, enhanced insight into challenges and contexts, and, ultimately, positive social change. Examples of our work are provided in the sections that follow. To protect client confidentiality, specific challenges in conducting focus groups could only be discussed in a general way.

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16.4.1 Needs Assessment, Strategic Planning, and Program Development Needs assessments help shape a project or program directly and responsively to the expressed concerns of a target population. They precede project implementation and monitoring and evaluation (M&E) but may uncover indicators that should be incorporated into the M&E processes. For example, in 2006, GDI conducted focus groups on tourism development with private and public sector respondents in Savannakhet Province, Laos (Billson 2006). Abbott et al. (2002) used focus groups to design communication campaigns for a forestry project in Russia. Strategic planning also involves the process of assessing the needs of stakeholders (usually in an organization, community, or government agency) in relation to their stated goals and detailed outcomes for the future. Strategic planning may involve a situation analysis before the session (generated by key informant interviews, desk review of annual reports and other materials, and a survey of stakeholder satisfaction with the current situation and preferences for future directions). Strategic planning sessions can result in concrete ideas for program development and the decision to do a formal needs assessment with those who are slated to implement the plans. For example, GDI’s work with the Canada–United States Fulbright Program involved a needs assessment for training and professional development that included a survey of all fifty Fulbright directors worldwide, development of the training agenda for their annual retreat, evaluation of the retreat, and generation of ideas for future program structure and directions (Billson and London 1999a, b).

16.4.2 Monitoring and Evaluation The OECD defines monitoring and evaluation as follows: Monitoring is a continuous function that uses the systematic collection of data on specified indicators to provide management and the main stakeholders of an ongoing development intervention with indications of the extent of progress and achievement of objectives and progress in the use of allocated funds. Evaluation is the systematic and objective assessment of an ongoing or completed project, program, or policy, its design, implementation, and results. The aim is to determine the relevance and fulfillment of objectives, development efficiency, effectiveness, impact, and sustainability. An evaluation should provide useful and credible information that enables the incorporation of lessons learned into the decision-making process of both recipients and donors (Kusek and Rist 2001). Group Dimensions International has carried out three major studies of the M&E processes, which are critical in determining to what extent development programs are in fact achieving their intended outcomes. These discussions took place within the context of the growing stress on results-based management (RBM), an emphasis that has become even stronger in the quest for achievement of the MDGs. Results-

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based management has to do with how governments and other development entities achieve or fail to achieve results. Focus groups provide an excellent way to explore this question with both stakeholders and beneficiaries, although triangulation of methods or differential use of methods is indicated according to stakeholder needs for information, the complexity of collecting data, political sensitivity regarding the collection of data, and intended uses of the information (Kusek and Rist 2001 [p. 17], 2004; Kusek et al. 2004; Lefevre et al. 2004). Results-based management depends on an efficient feedback loop that sends M&E information into stakeholder communication streams so that reform, transparency, and programmatic changes can be engineered. This process usually involves capacity-building on the part of those who are managing change and may involve participation of intended beneficiaries in helping to determine how effective interventions are and what could make them more effective in the future. Focus groups can be useful during the monitoring process to ensure that mechanisms for accountability are in place (and in use) and to gauge beneficiary satisfaction and impacts. They are not used just during formal evaluation, which usually occurs toward the end of a project or program, or even years after its completion. For example, GDI conducted one of the earliest stakeholder evaluations of the World Bank’s evaluation methods and practices (Billson 1996a). The purpose was to elicit perceptions of the image, mandate, performance, processes, and products of the World Bank’s Operations Evaluation Department (OED), and to generate ideas for OED’s future work in enhancing development effectiveness. Six groups were conducted at Bank headquarters with operations division chiefs, managers from central vice-presidencies, operations directors, and task managers. Six groups were held in three borrower countries—Colombia, Zimbabwe, and Indonesia—with government ministries, national planning departments, nongovernmental organizations (NGOs), and Bank resident mission staff. Respondents suggested the use of more participatory methodologies, heavier reliance on community-based qualitative datagathering techniques, broader dissemination of findings, and mechanisms for introducing results in a timely fashion so as to impact future projects. A similar evaluation was conducted for the Inter-American Development Bank (Billson and Murray 2011) with focus groups and key informant interviews in the Bank’s Field Offices and with government counterparts in Peru and Guatemala, following a survey of Bank staff in Field Offices and Headquarters. The “Review of the Women’s Rights and Citizenship Program Research Agenda—Latin America and the Caribbean, South/Southeast Asia, Middle East and North Africa” stemmed directly from the International Development Research Centre’s commitment to achieving the genderrelated MDGs (Billson et al. 2009). Research by Billson and Steinmeyer (2006) focused on the perceptions of staff and management regarding the bank’s M&E system; how staff and management view the use and usefulness of the Bank’s internal Independent Evaluation Group (IEG; formerly OED) evaluation results, products, and information; and the challenges staff and management encounter as they attempt to incorporate monitoring information and evaluation results into design of future development projects. Focus groups and executive interviews were conducted with the World Bank task team

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leaders, sector managers, country directors and coordinators, board members who serve on the Committee on Development Effectiveness, and IEG staff. This study contributed to IEG’s 2006 Annual Review on Operations Evaluation (2006). The study focused on the use and usefulness of monitoring information and evaluation reports; the application of M&E information to manage for results; challenges, incentives, and disincentives in using monitoring information and evaluation results; and the possible disconnects between perceptions of those who use M&E information and those who produce it.

16.4.3 Program Evaluation and Impact Assessment The capstones of M&E are program evaluations and impact assessments (Baker 2000). Both require careful research design (best prepared in advance of program implementation) and often involve comparison groups. In development, however, the availability of comparison groups may be ethically or logistically impossible to arrange. For example, if the Asian Development Bank determines the need for a power dam in two provinces of the Philippines, it cannot decide to build a dam only in one province, but not in the other, simply to measure comparative impacts. A second challenge in conducting program evaluations or impact assessments lies in identifying indicators—before a project begins—that are measurable and trackable by local or national authorities through the end of the project. Statistical records (e.g., of funds dispersed, number of kilowatt hours generated, or number of people served by a new dam) also may not provide a meaningful picture of the project’s true impacts or relative success. Issues of displacement, resettlement because of flooding lands along the river, or insufficient infrastructure to transmit power to those who need it most could confound a project’s positive impacts. Group Dimensions International has used qualitative methods to carry out many program evaluations, both domestic and international. In 2007, GDI led a thematic evaluation of Emergency School Feeding Programs (ESF) sponsored by the U.N.’s World Food Program (WFP) (Billson and Steinmeyer 2007). The evaluation used group interviews and key informant interviews in Pakistan, Sudan, and Congo. The purpose and objective of the evaluation was to draw lessons for future implementation of ESF in the various emergency contexts in which the WFP operates; to identify aspects of ESF on which further guidance is needed; to inform the preparation of the WFP’s policy paper on food for education; and to refine the 2004 Guidelines for School Feeding in an Emergency Situation. The perceptions from the field of current WFP practices with regard to emergency situations and protracted relief and recovery operations led to exploration of four general aspects of ESF operations: (1) the relevance of objectives generally associated with ESF operations in the various emergency and operational contexts of WFP projects; (2) the efficiency and effectiveness of ESF operations for contributing to these objectives; (3) the constraints and opportunities of managing ESF operations in the different emergency and operational contexts, and how these influence project

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performance; and (4) the factors influencing the sustainability of ESF benefits in the various contexts encountered by WFP. These evaluation elements—relevance, efficiency, effectiveness, constraints and opportunities, performance, and sustainability—can be used in any program evaluation. Impact assessments present even greater challenges when the period under examination covers many years and a multiplicity of interventions has occurred. In this case, statistical analyses are limited; gathering the perceptions of those who have closely watched the passing of history may be more fruitful in exploring impacts. For instance, in 1996, when the World Bank performed a public expenditure tracking study of funds earmarked for schools in Uganda, it was determined that less than 30 percent of the money was making it down to the local level. The majority was being siphoned off by administrative costs at the central government level or into the pockets of the elite (ESSDN, 2003). This raised general questions about the impacts of donor lending and the extent of (and need for) aid coordination among donors. It was in this context that GDI was asked to conduct seven focus groups in Kampala, Uganda’s capital, to help determine the impacts of donor lending since the fall of Idi Amin in 1979. The report (Billson 1999) became part of the World Bank’s participatory evaluation for the Uganda Country Assistance Review. Over seventy stakeholders from the Government of Uganda, donors, parliament, NGOs, civil society, media, and the private sector participated. Participants were asked to discuss both successes and shortfalls in country and donor performance, as well as “lessons learned” that might improve future performance. Respondents deplored the fact that only a small portion of aid funds was making it to the intended populations; they stressed the importance of “plugging the holes” in the system and empowering civil society to ensure better implementation of projects. They were positive that decentralization would lead to greater accountability and better project implementation at the local level but agreed that capacity building at the district level is also crucial. Agricultural modernization and land reform, capacity building in the government and media, and better research facilities and more current statistical/ census data were identified as key building blocks for future development.

16.4.4 Policy Analysis Group Dimensions International has employed focus groups to explore policy issues and policy implementation. For instance, as part of the move from development as a “bricks and mortar” exercise toward the broader goal of improving lives through poverty reduction, GDI was asked to conduct focus groups with task managers (now called task team leaders) and economists at the World Bank (Billson 1996b). Respondents were invited to define social development—in the sense of social integration, poverty reduction, social justice, human resource development, political stability, and beneficiary participation—and relate it to the concept of development in general.

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The World Bank respondents reported that “social development” tends to merge with images of social sector work to create an amorphous picture that is hard to separate from “economic development.” Many respondents believed that, for the most part, good economic development (and analysis) produces (and therefore subsumes) good social development (and analysis). Social sector work and the broader category of social development “go beyond individual human resource development and sustainability” to include stakeholder participation and a notion of growth. Furthermore, respondents said they were unsure of how to find sociologists or anthropologists to contract regarding work on social development issues. Along these lines, GDI’s focus group study of task managers revealed that when the World Bank’s policy regarding involuntary resettlement (designed by sociologist Michael Cernea) was not consistently implemented, it was because of lack of knowledge of how to manage the social dimension in development work rather than out-of-hand rejection of the resettlement policy itself (Billson 1993). Another focus group study showed that task managers were unclear about how to engage sociologists and anthropologists effectively in studying girls’ education in Asian and African countries (Billson 1995b). These and other studies led to intensified efforts to integrate the social dimension into Bank projects, policies, and processes through a variety of internal mechanisms incorporated into the project cycle (including identification, preparation, appraisal, and supervision). As Cernea (2004) argued, At each and every “stage” in the Bank’s project cycle, there is a different set of socio-cultural variables and issues that must be addressed, there are values, attitudes, and expectations to be known and taken into account. . . . A good social specialist would have specific, and distinct, functional tasks to perform.

Enhancing the social dimension of development is an ongoing policy initiative in the World Bank and remains at the core of GDI’s work. Most recently, Billson (2020d) has used intensive participatory methods to conduct interviews on resettlement and integration challenges for Bhutanese, Congolese, Kurdish, Liberian, Rohingya, Syrian, and Vietnamese refugees in Canada. Although this is a scholarly study, the purpose is to inform Canadian policy and practice.

16.4.5 Conference, Workshop, and Product Evaluation Merton’s original conceptualization of focus group discussions was to garner impressions from respondents who were exposed to a common stimulus, such as a radio show. This is still an excellent use of focus groups—evaluating conferences, workshops, or products to which a group (or category) of respondents has been exposed. Billson and Steinmeyer (2005) evaluated the flagship publication of the United Nations Economic and Social Commission for Asia and the Pacific (UNES CAP), based in Bangkok, Thailand (the largest of the five U.N. Commissions). U NESCAP’s annual Economic and Social Survey of Asia and the Pacific had been

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produced for fifty years without a formal evaluation. Focus groups were held with UNESCAP staff and managers, and individual interviews were held via telephone throughout the ESCAP region with readers in think tanks, universities, governments, and corporations. In the middle of the Asian Economic Crisis of 1997, the Asian Development Bank and the World Bank sponsored a week-long Asian Development Forum in Manila. Group Dimensions International used on-site focus groups with a random sample of participants from the region, along with post-session surveys, to evaluate the conference (Billson and London 1997a). Similarly, we used focus groups in evaluating the World Bank’s Global Knowledge Conference in Toronto (Billson and London 1997b), and the WB/Foundation for Advanced Studies on International Development program, “Development Effectiveness: The Environment and Urban Development,” which was held in Malaysia and Japan (Billson 1997). Evaluating conferences and workshops involves perceptions of content and organization, but also of how people learn best in this type of setting.

16.5

Challenges to the Integrity of Focus Group Research

Most cultures engage naturally in small group discussions within families, neighborhoods, and political entities. This renders focus groups especially appropriate as a methodology for exploring development issues. For instance, in Laos, focus group participants said they enjoyed the interview and found it a comfortable format because they participate in “morning chitchats” (a tradition among men but increasing among Laotian women as well). Strong recruitment and moderation for balanced participation are essential. Careful planning and preparation help minimize misinterpretation and maximize participation, but caution must be employed at every step of the way. Challenges to conducting professional, systematic focus groups include the following:

16.5.1 Communication Because of the liabilities of communicating across great distances during the preparation stage, errors in communication are likely when organizing focus groups in the international context. • Communication surrounding recruitment and logistics can be clumsy and inaccurate. • Email is the preferred way to communicate and leaves a “trail,” but it is also an informal mechanism that is subject to technological glitches and misunderstandings.

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16.5.2 Recruitment: Obtaining Balanced Stakeholder Viewpoints Validity of the data depends on acquiring a reasonable distribution of all stakeholders in the focus groups to avoid biasing results. – Recruitment in small or rural communities raises questions of duplication of results (by inadvertently recruiting inside kinship or friendship groups) or of politicizing the process. Although it is desirable to involve local residents and train them in neutral recruitment techniques (a step toward participatory research), close supervision is necessary to help recruiters resist pressure from local networks. – Focus groups in the international development context often involve government agencies and other large bureaucracies as key stakeholders. It is possible for mega-organizations to overshadow the viewpoints of other stakeholders. Governments may for convenience overrecruit government personnel versus NGO respondents. Separation of these stakeholders into separate groups helps to avoid this problem. – Inadvertent politicization of the research can occur when prestigious governmental officials are invited to a focus group, rather than those who are specifically knowledgeable about the topic. Holding separate focus groups with beneficiaries, NGOs, and other public groups will help balance government viewpoints. – Stakeholders and intended beneficiaries, like citizens of developing countries whose taxes probably support international development funds, may be unaware of projects, hostile toward them, or supportive of them (Department for International Development 2002). It is essential to select those who are aware of the development intervention and are in a position to evaluate it.

16.5.3 Moderation Strong moderation involves balancing participation and staying on the client’s key research question. • Especially in politically charged situations, it may be difficult to keep the group focused on the topic at hand rather than allowing the interviews to devolve into gripe sessions. Dominators may overtake a focus group if the moderator does not exert appropriate control and employ special moderation techniques. • Retaining respondents for the full time allotted (generally two hours) may be hard when the temptations of email and telephone messages—or of other meetings— are only a few steps away. This is especially true for members of bureaucratic organizations. • Inconsistencies in moderation occur because of the need for multiple moderators (in large studies) or the lack of moderator training, which can confound the data

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and data analysis. It is important that all moderators on a research project be retrained to the current guide, population, and research question (Billson 2007a). • Weak moderator guides with poor questions that fail to generate interaction may result in thin, off-target data. Clients often want focus group researchers to employ survey-type questions, which is inappropriate and must be addressed up front.

16.5.4 Cultural Issues Cultural sensitivities must be anticipated and addressed in doing international focus group research (Billson 1991, 2007a, b, d, e, 2012, 2015; Knodel 1995). Participants bring varying expectations and habits regarding small group interaction. Ground rules and procedures must be established at the outset, while taking into account what will work better in one culture versus another. • In some cultures, the concern for harmony and aversion to criticism strongly affect group discussions. Moderators must be certain in the “preamble” to reassure participants that it is not only acceptable but also essential for them to give their most honest opinions and ideas—even if others might disagree with them. We find that taking extra care to create a safe environment in which genuine disagreement can be expressed helps reduce the press toward harmony and agreement. • The research design must compensate for difficulties that surround conducting focus groups in cultures in which critical or negative remarks are considered impolite. Stratifying the groups by gender, socioeconomic status, role in the community, and place of residence may help participants speak more honestly. It is preferable to compose the groups of nonacquaintances who use fictitious names, and to reassure participants that their names will not be used in reports, publications, or discussions with local authorities. • In some cultures, making direct eye contact with participants might be considered rude. We acknowledge this cultural difference and stress the need for eye contact as a part of skilled moderation. • Language barriers and interpretation difficulties always occur in cross-cultural interviews; they raise special problems in focus groups. We find that whenever researchers work outside their linguistic/cultural communities, meaning is lost and confusion occurs over the exact intention of the research and the questions. Technical support with professional translation of the guide (in advance) and interpretation (during the interview) is essential. Interpreters should not simply be someone local who is interested in the project and speaks the relevant languages; training is essential (Maynard-Tucker 2000). As with moderators, interpreters can bias responses; they should be apprised of the project’s purpose, the critical role of neutral interpretation, the nature of the participants, and the logistics. The moderator should anticipate spending at least two hours reviewing the

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moderator’s guide with the interpreter well before the first group. An appropriate interpreter must have full command of both languages, be able to interpret simultaneously or quickly—the “one-second rule”—and be able to concentrate and stay in role (Billson 2007a). The moderator should not also be the interpreter, because the moderator needs to pay close attention to group process, as well as to content. Each of these challenges must be met head on before the sessions (in the case of recruitment and politicization issues) or during the session (in case of facilitation and retention issues) if the research is to be conducted systematically.

16.6

Strategies for Conducting Focus Groups in a Comparative Mode

Questions of comparability of data arise when focus groups are conducted in several cultures (or communities) for the same project. For instance, a study of female urban micro-enterprise owners in four countries should yield a clear picture of these women in each country, but should also afford a comparative view across countries. This requires a structural approach to conducting the research that involves (1) developing solid case studies based on the data for each country, and (2) systematically comparing data across all project countries (Table 16.1).

Table 16.1 Nine critical strategies for comparative cross-cultural research 1. Craft a common, required research design and “group blueprint” (segmentation of the population according to key variables). 2. Set aside ample time for careful preparation for the focus groups (including recruitment strategies and mechanisms, incentives for participation, and determination of who will make the best recruiters). 3. Thoroughly train recruiters and recruit without biasing samples. 4. Develop a uniform moderator’s guide with a preamble that reiterates the research purpose and ethical concerns (such as anonymity, use of the data, who will receive the report). 5. Thoroughly train moderators and interpreters (professionals trained in policy research interviews rather than in market research are preferable in development venues). 6. Organize close, on-site supervision of the entire research process. (This is especially crucial for ensuring comparability when working across communities, cultures, or countries.) 7. Create and follow a common structure for data analysis (e.g., global coding, interrater reliability mechanisms, and developing agreement on emergent themes). 8. Create and agree upon a common structure for report presentation (including headings, subheadings, and use of direct quotes). 9. Follow basic strategies for conducting ethical qualitative research. Adapted from Billson (2007a).

310 Table 16.2 Group blueprint for Peru: two key variables

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Gender Male Female

Income Low income Group 1 Group 2

Low-to-medium income Group 3 Group 4

16.6.1 The Group Blueprint If you place the key variables on a grid, you create a group blueprint that helps you visualize the ways in which major variables interact with each other (Billson 2007b). Group blueprints not only help determine the number of groups, but also help shape the direction of the research. Especially when it is necessary to curtail the number of focus groups, a blueprint helps you decide rationally rather than randomly which groups to eliminate (Table 16.2). Sagasti (2004) had a professional market firm conduct focus groups in Peru. The focus groups were stratified by socioeconomic status and gender. Other variables (which would have yielded more focus groups) could have been urban vs. rural residence, education level, age band, occupational type, or participation in or beneficiary of a particular program. Limited funding, time, and the burden of managing enormous amounts of qualitative data discourage conducting a large number of focus groups. Most projects can generate sufficient data by holding from four to twenty focus groups, although many larger projects exist. A solid research design makes sure that respondents reflect the profile of the population from which they are drawn. Weak design inevitably results in poor research and possibly unusable results; strong design supports the generation of valid, reliable, and useful data.

16.6.2 The Moderator’s Guide (Protocol) Designing focus group questions is as much an art as a science. The moderator’s guide should always be developed in collaboration with the clients (and beneficiaries, stakeholders, and key informants) and then piloted in each community/culture/ country with respondents who are essentially similar to intended respondents. Several iterations of the moderator’s guide will occur, especially when concepts must be translated from one language into another. Working closely (even electronically) helps eliminate misunderstandings. Developing a uniform moderator’s guide provides project integrity; ensuring that the guide is identical across countries (or regions/districts within the same country) provides data consistency (Billson 2007a). In spite of these efforts, implementation of the guide identically in multiple settings and often with multiple moderators remains a challenge (Hawthorne et al. 2006). The highest standards of supervision, guidance, and auditing are essential if data are to be compared with rigor.

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16.6.3 Framing the Questions Across Cultures The moderator’s guide for a cross-cultural study should contain the same core questions for all groups and all countries, but tailor-made questions for each culture can be placed in add-on modules. • Core questions can include “identical” (no wording differences) and “parallel” questions (that tap the same material but with slightly different terminology). Example: In Bangladesh, women might refer to contraception as “birth control,” and in Thailand women might use the term contraceptives. As long as the wording is identical except for these interchangeable terms that have to do with local usage, it is a parallel question. • Tailor-made questions address specific issues and should not constitute more than about 10 to 15 percent of the entire guide, if the project goal is to make meaningful comparisons across cultures. Example: A tailor-made question might address unique programs or events: “The Ministry of Health conducted an education campaign in your district regarding contraception. How did women react to that?” Certain concepts might not easily be translatable into some languages. For example, we found that Canadian Inuit women did not relate to a question about “problems”—a word that does not appear in Inuktitut, their language (Billson and Mancini 2007). Comparable terms must be negotiated during the process of developing the moderator’s guide—not during the focus groups.

16.6.4 Coordinating Logistics The opportunity for true comparative research also presents multiple opportunities for failure of the data-collection process. If focus groups are held with women in very informal, freewheeling settings in one country, with husbands and children wandering in and out of the room, but in a very formal setting in another country, without interference, the results may be quite different. Similarly, if community leaders are allowed to observe the focus groups because the local logistics person cannot prevent them from entering the focus group setting, the data may look very different from data gathered in a more neutral setting. Close, on-site supervision of the process by one central coordinator will strengthen consistency of processes and procedures across sites and serve as a sounding board for solving problems unique to each country. If logistics and data collection processes are kept as uniform (and controlled) as possible, then comparative analysis is protected. Consequently, there is a particular need in cross-cultural focus group research for the following:

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• Training of all logistics and support staff • The assignment of one person in each country who is responsible for and present for all focus groups in that country; preferably, the person coordinates logistics and observes at least one focus group per moderator to ensure consistency of style and approach • The presence of at least one representative from the project’s central headquarters (or a consultant who oversees all country research activities); if this is not possible, then a videotape of at least one focus group from each set should be reviewed for consistency, along with a review of logistics • Email reports on logistics and the progress of the research to be sent before, during, and after the focus group session Even when researchers do not moderate the focus groups themselves, they can be intimately involved in the research process. As Sagasti (2004) writes about the Agenda Perú project, “We frequently stood behind a two-way mirror to observe the progress of the focus groups and spent a considerable time reading the detailed transcripts of each session.” This increases the likelihood that the entire datagathering process will be carried out in a consistent, systematic manner.

16.6.5 Recording the Data Regardless of the method used to record a session, it must be accurate and thorough. Audio-taping recording sessions protects data that are needed for most social and policy-related research; note-taking is acceptable as the primary means of documenting the interview, to avoid the necessity of formal transcription, but the session also should be tape-recorded. Later, the note-taker should check notes against the tapes recordings for accuracy. Group Dimensions International has experimented with a variety of systems; the results definitively suggest the value of having tapes recordings. In our view, even though transcribing adds to project costs, tape-recording with formal transcripts provides the most accurate and reliable data. It also is essential in doing cross-cultural work because of translation issues.

16.7

The Importance of Training

The group interview offers a lens through which we can see a wide variety of experiences and opinions. This presents both advantages and disadvantages because moderators serve as the “instrument of research,” which makes it is easy for their biases to influence the data. All moderators must be trained particularly on the core questions that will be used across cultures—how and when to probe, how to restate the questions without changing them if respondents do not immediately contribute,

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and how to avoid biasing respondents by their own reactions to participant responses. Group Dimensions International has trained community-based recruiters/moderators in many countries—for example in Canada, for studies of gender relations in seven cultural communities (Billson 1996a); in Laos, for a tourism project (2006); in Trinidad, for Ministry of Public Information and Administration studies; and in Bolivia, for the improvement of public education. Trainees can be extremely helpful in the design and recruitment stages, and, with supervision, can serve as effective moderators.

16.8

Conclusion

Focus groups constitute a universal methodology, but they must be reshaped for each cultural context without losing the depth of data associated with local, regional, and national sensitivities, their scientific nature, or the capacity for crosscultural comparison. By asking critical questions of all parties involved in attempting to create positive social change and improve well-being, sociologists help development practitioners avoid the fatal disconnect between theory and policy. Focus groups, as a type of in-depth interviewing, can provide invaluable insights into the complexities of development implementation and impacts. Through triangulation, focus groups can amplify other methods to reinforce the advantages and strengths of each method while minimizing their disadvantages and weaknesses. For example, participant observation and key informant interviews could explore how people frame the key research questions; focus groups could generate debate and collaborative interpretation; a face-to-face survey of a larger sample of community members could broaden the base of understanding; and preliminary conclusions and hypotheses could be discussed in focus groups to contextualize data as part of a “progressive verification method” (Billson 1991). Focus groups harness our collective understanding of the complexities of human interaction and help uncover layers and types of information that are not easily accessed through other methods. Used properly, this maturing social science technique can produce rock-solid data regarding many different questions or settings. Through many methods, but especially through focus group research because it is so well suited to exploring the worlds of interest and experience that exist in every society, sociologists make unique contributions. We work actively in shaping policy and programs that address the most pressing problems of this century by helping to evaluate the progress so far toward achievement of the MDGs and similar aspirations. Group interviews, which were developed by sociologists in the last century, have grown in both popularity and misuse. The challenge of this century is to bring more discipline to the method, use it responsibly, and present findings creatively.

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References Abbott, E. A., Gouverniuk, K., Liamets, L., & Ukhanova, T. (2002, August). Using cross-cultural focus groups as a tool for communication campaign design: An example from Russia’s Forest Project. Paper presented to the Research Special Interest Group, Agricultural Communicators in Education (ACE), Savannah, GA. Atkinson, M. J., Lohs, J., Kuhagen, I., Kaufman, J., & Bhaidani, S. (2006). A promising method for identifying cross-cultural differences in patient perspective: The use of Internet-based focus groups for content validation of new patient reported outcome assessments. Health Quality Life Outcomes, 4, 64. Baker, J. (2000). Evaluating the impact of development projects on poverty: A handbook for practitioners—Directions in development. Washington, DC: World Bank Group. Bamberger, M. (2000). Integrating quantitative and qualitative research in development projects— Directions in development. Washington, DC: The World Bank. Barata, P. C., Gucciardi, E., Ahmad, F., & Stewart, D. E. (2006). Cross-cultural perspectives on research participation and informed consent. Social Science Medicine, 62(2), 479–490. Billson, J. M. (1991). The progressive verification method (PVM): Toward a feminist methodology for studying women cross-culturally. Women’s Studies International Forum, 14(3), 201–215. Billson, J. M. (1993). Complexities of involuntary resettlement policies in World Bank projects. The World Bank, Environment and Social Policy Division. Billson, J. M. (1995b). The research process in World Bank projects: The perspectives of task managers. The World Bank, Asia Technical Division. Unpublished report. Billson, J. M. (1996a). Perceptions of evaluation methods, processes, and products—Washington, Colombia, Indonesia, and Zimbabwe. The World Bank, Operations Evaluation Department. Unpublished report. Billson, J. M. (1996b). Social development in World Bank work: Perspectives of task managers and economists. The World Bank, Task Group on Social Development. Unpublished report. Billson, J. M. (1997). Evaluation of the EDI/FASID Joint Seminar-Study Tour Program (Development Effectiveness Program on the Urban Development and Environmental Management— Malaysia, Japan). The World Bank, Economic Development Institute, and the Foundation for Advanced Studies in International Development. Unpublished report. Billson, J. M. (1999). Participatory evaluation: Country assistance review—Uganda: focus groups for public and private sector stakeholders. The World Bank, Operations Evaluation Department. Unpublished report. Billson, J. M. (2006). Public sector and private sector perspectives on tourism in Savannakhet Province, Laos. Foundation for Advanced Study on International Development and the Japan International Cooperation Agency. Unpublished report. Billson, J. M. (2007a). Conducting focus group research across cultures: Consistency and comparability. Bath, England (Online): University of Bath, Economic and Social Research Council, Research Group on Well-Being in Developing Countries, WeD Working Paper No. 27. http:// www.bath.ac.uk/econ-dev/wellbeing/research/workingpaperpdf/wed27.pdf. Billson, J. M. (2007b). The power of focus groups: A training manual for social and policy research (5th ed.). Barrington, RI: Skywood Press. Billson, J. M. (2007d). The power of focus groups: Focus on health. Barrington, RI: Skywood Press. Billson, J. M. (2007e). The power of focus groups: Focus on education. Barrington, RI: Skywood Press. Billson, J. M. (2012). The world bank institute guidelines for effective focus group research. Washington, DC: World Bank Institute Evaluation Group. Billson, J. M. (2013/2020). The power of focus groups: A training manual for social and policy research—Focus on international development (5th ed.). Barrington, RI: Skywood Press. Billson, J. M. (2015). El Poder de los Grupos Focales, un Manual de Entrenamiento para Investigación Social y de Políticas Públicas, e Investigación de Mercados [The Power of

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Index

A Abstinence, 156, 169, 171, 173 Accreditation, 6, 50, 51 Addams, J., 36–40 Addiction counselor, 169 Adorno, T.W., 87 Affirmative action, 278, 281 Agar, M., 159 Alinsky, S., 46 American Society of Heating, Refrigerating, and Airconditioning Engineers (ASHRAE), 231 Ancelin-Schűtzenberger, A., 89 Anglo-Boer War, 109, 110, 113 Anonymity, 164, 309 Antioch College, 48 Apartheid, 112–116, 118–121, 277, 278, 292 Applied sociology, 3, 5, 48, 50, 112, 291 Aptheker, H., 40, 42 Araujo, A.M., 93, 241 Aron, R., 84 Asian Development Bank (ADB), 303, 306 Asian Development Forum, 306 Association de Recherche et d"Intervention Psychosociologiques (Association Psychosociological Research and Intervention) (ARIP), 90 Association for Applied and Clinical Sociology (AACS), 6, 48, 50, 51, 124 Association for Conflict Resolution environment and Public Policy Section, 219 Association for Sociology in Southern Africa (ASSA), 114–116, 118, 121, 123 Association for the Advancement of Science, 110

Association Française de Sociologie (French Sociological Association) clinical sociology committee, 6 Association Internationale des Sociologues de la Langue Française (International Association of French Language Sociologists) clinical sociology section, 6 Atlanta Atlanta conferences, 41 Atlanta University, 41, 42 Georgia, 41, 169

B Balch, E., 39 Barranquilla, 237, 238 Bastide, R., 79 Bataille, G., 82 Batson, E., 112, 114 Battering, 202 Beijing, 132, 141, 148, 149 Berger, P.L., 60 Bezuidenhout, F., 122, 123 Billson, J.M., 8, 295–313 Black Consciousness Movement (BCM), 115 Blumer, H., 60 Boeri, M., 7, 151–174 Bourdieu, P., 63, 152, 154 Brazil, 6, 241 Bruhn, J., 49 Bullying, 184, 189 Burawoy, M., 119 Burgess, E.W., 7, 47

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318 C Caillois, R., 82, 83 Canada, 191, 192, 216, 290, 301, 305, 313 Canada-United States Fulbright Program, 301 Capitalism corporate, 35 Carnegie Commission on the Poor White Question, 111 Cases, 4, 8, 29, 43, 45, 47, 48, 51, 100–104, 134, 136, 146, 147, 161, 164, 167, 170, 173, 182, 184, 203–207, 209, 211, 215, 219, 223, 230, 231, 233, 234, 253, 266, 267, 271, 284–286, 290, 298, 304, 309 Castoriadis, C., 91 Centro de Investigaciones Sociológicas (CIS), 241 Cernea, M.M., 297, 305 Certification, 5, 6, 50, 51 Change planned, 61, 65 radicals, 146 social, 8, 20, 37, 115, 146, 153, 154, 163, 173, 188, 193, 253, 313 Change agents, 23, 25, 26, 181, 295 Charity Organization Society, 20 Child guidance clinics, 46–48 Children, 7, 21, 38, 40, 42, 46–48, 95, 98, 109, 121, 134, 138, 141, 142, 170, 181–194, 203, 216, 222, 263, 264, 270, 282, 284, 285, 295, 297, 311 China, 7, 131–148 Cilliers, S.P., 112, 114 Civil society organizations (CSOs), 8, 222, 274 Clark, E., 49 Class neurosis (La Névrose de Classe), 92 Client centered, 159 Client systems, 4, 18–21, 23, 26, 29–30, 242 Climate change disasters, 259 related effects, 257, 258, 260, 274 resilience, 8 Clinical analyses, 3–8, 17, 36, 46, 48, 51, 97, 104, 118, 135, 136, 153, 201, 210, 211, 215, 260, 273 approach to the social sciences, 67 interventions, 3–8, 17, 18, 23, 25–27, 31, 36, 48, 51, 105, 119, 122–124, 135, 151–174, 194, 201, 206, 210, 211, 216, 239, 240, 244, 253, 260, 273 Clinical sociology definitions, 3, 46, 49, 96, 104, 133, 136, 174 foundations, 48, 121, 241

Index histories, 3, 5, 7, 35–51, 95–99, 173, 241, 262 research group, 240, 273 Clinical Sociology Association, 46, 48, 49, 51 Clinical Sociology Review, 48, 50 Clinics, 6, 45–48 Cloud, W., 155, 156, 172 Coastal Cities at Risk in the Philippines, 257 Cock, J., 122 Cognitive behavioral therapies, 172 Cohen-Emèrique, M., 137 Collaborative work (collaborative working relationship), 244 Collective psychology, 78, 79, 81 Collective sentiments, 81 Collège de Sociologie, 82 Colombia, 6, 8, 237–254, 302 Commission for the Accreditation of Programs in Applied and Clinical Sociology (CAPACS), 6, 50, 124 Common identity, 243 Communist Party, 42, 116, 123, 138 Community consultants, 4, 157 developments, 4, 17, 45, 99, 118, 156, 157, 160, 164, 203, 284 interventions, 4, 7, 17, 18, 22, 26, 50, 99, 157, 160, 181, 186, 188, 191, 192, 203, 206, 257–275 mappings, 262, 263, 267, 268 profiles, 8, 258, 262, 263, 271, 273 risk assessment process, 263 social action, 64 sustainability, 274 Community-based organizations (CBOs), 262, 264, 271–274 Community based participatory research (CBPR), 157 Community-based risk reduction and management plan (CB-RRMP), 258, 262, 267, 270–272 Community College of Philadelphia, 169, 170 Community Relations Service (CRS), 44 Compromise, 184, 203 Comte, A., 5, 95, 110 Concepts, 7, 8, 17–31, 43, 96, 98, 102, 104, 113, 133–135, 146, 152, 153, 155–157, 160, 171, 173, 207, 216, 218, 245, 291, 298, 300, 304, 310, 311 Conflicts, 4, 28, 44, 45, 47, 50, 109, 120, 185, 187, 190, 193, 194, 201–203, 206, 208– 210, 216, 217, 219–222, 224, 280, 284, 285 Connell, R., 280

Index Consultants, 4, 20, 25, 49, 102, 157, 223, 224, 242, 243, 246, 312 Consultation models, 22, 25 Context economics, 29, 30, 297 historical, 29, 30 political, 29, 30, 139, 147, 285, 302 social, 30, 96, 110, 118, 132, 133, 135, 145, 147, 297 Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW), 283 Convention on the Rights of the Child (CRC), 182, 185, 186, 191–193 Coproduction of knowledge, 246 Cormick, G., 26, 208 Correa, A.M., 241 Corsale, M., 93 Council of Europe, 182 Counterculture movement, 63, 64 Counter-Terrorism and Security Act, 191 Covid-19 lockdown, 258, 274 Crack, 168 Creativity, 18–19, 164, 217, 219, 222, 253 Critical incident (central experience), 133, 137 Critical theory, 87 Cronjé, G., 112, 113 Cultural capital, 155 Cultural competency, 8, 205, 207, 211 Cultural control, 158

D Definition of the situation, 210 Dejours, C., 69 DeKalb County Drug Court (DCDC), 162–167 Dementia, 102–103 Department for International Development (DFID), 307 Depression, 110, 169, 170, 206 Depression of 1893, 35 Desmarais, D., 68 de Winter, T., 123 Diagrams, 7, 17, 26, 29, 31 Dialectical analysis, 84 Diplomacy debt-trap, 21, 224 Disaster community-based, 258, 260, 272 resilience warning system, 272 risk reduction, 258, 260, 271, 272

319 Discrimination, 39, 161, 184, 185, 187, 204, 277, 278, 283, 290 Disputes, 24, 26, 38, 39, 44, 45, 201–203, 205– 209, 211, 218, 219 Divorces, 138, 202, 203 Dropout, 240 Drug courts, 151, 152, 157, 158, 160–167, 170, 174 trajectories, 156 Du Bois The Philadelphia Negro:A Social Study, 41 William Edward Burghardt (W.E.B.), 36, 40, 42 Dumont, F., 7, 58, 59 Durkheim, E., 5, 78, 80, 81

E Eating disorders, 99, 103–104 Emancipation, 253, 277 Empowerment, 8, 18, 19, 26, 192, 205, 207–211, 245 Engagement, 116, 119, 159, 163, 190, 217, 244, 245, 248, 249, 251, 274, 287–291 Enhanced Community Quarantine (ECQ), 258, 274 Enriquez, E., 62, 77, 90 Environment ecological-environmental systems, 258 Environmentally and Socially Sustainable Development Network (ESSDN), 304 Environmental racism, 4, 274 Epistemology pluralistic, 72 Ergology, 71 Ethical norms confidentiality, 133 freedom to refuse participation, 133 no harm, 133 Ethics decision-making, 26 democracy, 38, 74 ethical qualitative methods, 309 principles, 208 Ethnography ethnographers, 160 ethnographic research, 160 Ethnomethodology, 60, 95 European Commission (EC), 300 Exchange of knowledge, 72 Experience lived, 191

320 Experiential knowledge, 133–134, 157 Extremism, 7, 181–195

F Facilitation difficulties, 231–233 external, 233 internal, 215 Facilitator artisan, 8, 220, 221, 233 experienced, 8, 220, 221, 233 novices, 8, 220, 221, 227 Family social trajectories, 69, 72 stories, 72 therapy, 98, 100, 102 Femininity, 278, 280, 281, 285 Ferreira, C., 241 Focus group discussions (FGDs), 262, 263, 298, 305 Focus groups coding, 299 comparative cross-cultural research, 309 cultural sensitivity, 308 data, 298–300, 302, 307, 309, 311, 313 data analysis, 309 data consistency, 310 Fortier, I., 71 Foundation for Advanced Studies on international Development (FASID), 300, 306 France, 3, 5–7, 77–93 Frankfurt School, 78, 86 Freire, P., 64, 72 Freud, S., 80, 96 Freudian–Marxist, 86 Friends Conflict Resolution Programs, 205 Fritz, J.M., 3–8, 17–30, 35–50, 120–122, 173, 201–210, 215–233, 237, 242, 244 Fromm, E., 87 Fugier, P., 93

G Garfinkel, H., 60 Garvey, M., 42 Gastal de Castro, F., 93, 241 Gatekeepers, 157 Gaulejac, V. de, 7, 72, 73, 77–92, 237, 241, 245, 253 Gender equality, 222, 278, 279, 281–283, 286–288, 295, 297 harassment, 280, 287, 288

Index mainstreaming, 280, 283–285, 287–289 Generation identitaire, 182 Gergen, K., 100 Gerrymandering, 43 Ghana, 42, 289 Giorgino, V., 12 Glass, J.F., 48 Globalization, 30, 122, 132 Goffman, E., 60, 152 Goldstein, J., 277, 279, 280, 285, 287 Gollin, A.E., 297 Gomillion, C.G., 36, 42 Gomillion v. Lightfoot, 43 Gouldner, A., 5, 48 Granfield, R., 155, 156, 172 Gray, J.L., 112 Greece, 6, 171, 172 Grobbelaar, J., 117 Grounded theory, 240 Ground rules, 227, 308 Group blueprints, 309, 310 Group Dimensions International (GDI), 297, 300–306, 313 Group dynamics, 48, 96, 123 Groups of research and involvement (GRI), 245, 246, 251 Guerrero, P., 93, 241 Gurvitch, G., 7, 78, 84

H Harbry, L., 153, 162, 166 Harry, 49, 168–171 Harvard University, 44 Haynes, G.E., 47 Heinecken, L., 8, 277–291 Hendricks, F., 119 Hindson, D., 115 Historicity, 245, 247 Horkheimer, M., 87 Houle, G., 59, 66, 77 Housing First, 170 Huilongguan Psychiatric Hospital, 149 Hull-House, 37–40 Hull-House Maps and Papers, 38 Human capital, 155 Humanism, 17, 49, 209, 210 Humanistic psychology, 63, 64 Humanities, 3–5, 51, 117, 147, 185, 190, 194 Human relations, 46 Human resource development, 304, 305 Human rights, 7, 17, 18, 50, 117, 121, 181–194 Human rights education (HRE), 182, 190 Human Sciences Research Council of Canada, 149

Index Hyper-modernity, 253

I Ibn Khaldun, Abd-alRahman, 5 Identity social, 18 Impact assessments, 19, 124, 296, 303–304 Implicit sociology, 7, 133–134 Inclusion, 18, 19, 114, 158, 192, 221, 250, 277, 279, 286 Insiders, 157, 158, 160, 233, 274 Institución educative distrital ciudadela 20 de Julio (INEDIC), 237–242, 244, 247, 250–253 Institute of Social Research, 86 Institutional analysis, 62, 91, 166, 274, 286 pedagogy, 91 Institutional Educational Project (IEP), 8, 237–239, 243–251 Institutional Review Board (IRB), 166 Institut québécois de recherche sur la culture (IQRC), 59 Integration, 8, 28, 113, 131, 132, 159, 171, 237, 244–246, 248, 277–292, 304 Inter-American Development Bank (IDB), 302 Interdisciplinary complexity, 73 Internal cohesion, 243 International Association of French Language Sociologists (AISLF), 6, 66, 72, 77 International Congress of Women, 39 International development, 6, 8, 295–313 International Monetary Fund (IMF), 295 International Sociological Association (ISA) RC46 clinical sociology division, 6, 50, 66, 72, 92, 116, 117, 148, 173 Internet focus groups (IFGs), 299 Intervenor/interventionist collaborative, 26 directive, 26 facilitative, 26 Intervention approaches to multilevel, 8, 17, 71, 205 conducting, 22, 25, 201 crisis, 24 levels of (micro, meso, macro), 28, 188 processes, 17–19, 22–27, 157, 203, 237, 242, 244, 246, 253, 301 techniques, 4, 26, 51, 201 Interviews semi-structured, 132

321 Involuntary resettlement, 305 ISIS, 183 Italy, 5, 6 Ivory towers, 116, 173

J Jabavu, D.D.T., 111 James, W., 123 Japan, 6, 7, 95–105, 216, 300, 306 Job market/employment/careers, 5, 7, 20, 49, 122, 143, 155, 162, 168, 206, 274, 280, 281, 289

K Kato, M., 96, 216 Kennedy, R., 183 Key informant interviews (KII), 8, 262, 267, 268, 297, 300–303, 313 King, A., 280 King, Jr., M.L., 44 Kitsuse, J., 100 Ku Klux Klan (KKK), 182

L Laboratoire de Changement Social (Social Change Research Center) (LCS), 77, 92 Lacan, J., 90 Lagache, D., 84 Larger social systems (LSS), 137 Latin America, 238, 241, 302 Laue, J. (Jim), 26, 36, 43–45, 208 Lazarsfeld, P., 84, 297 Lee, A.M., 5, 18, 46 Lee, E.B., 49 Lefevre, P., 302 Lehnerer, M., 49 Lewin, K., 61, 84, 89 Life histories, 4, 47, 102, 103, 262, 268 narratives, 99, 102 stories, 47, 99, 171 Lippett, R., 23, 24 Lorraine Motel, 44 Luckmann, T., 101 Luison, L., 12, 13

M Mafeje, A., 121 Magna Carta, 185

322 Magubane, B., 120 Malaysia, 6, 306 Mancini, K.M., 297, 311 Marcuse, H., 86–88 Marijuana, 169, 170 Market economy, 132, 140, 146 Marx, K., 5, 84, 85 Masculinities, 98, 278, 280, 281, 283, 285–287 Massa, A., 93, 241 Matthews, Z.K., 111 Mauss, M., 5, 7, 59, 78, 85 Maxeke, C.M., 111 McDonagh, E., 46 Mediation workplace, 211 Mediation approaches facilitative/participant-centered, 209 humanist/integrated process (HIP), 209 narrative, 209 solution-oriented, 209 transformative, 209 Mediator roles, 202, 208, 211, 218, 221 Medication-assisted treatment (MAT), 171, 172 Meer, F., 116, 120 Meetings facilitated, 215, 218, 220, 223, 264 Mental health, 95, 99, 101, 102, 131–149, 184, 186, 192 Mental illness, 131, 135–137, 141–143, 145, 147 Mercier, L., 69 Merton, R.K., 297, 305 Messerschmidt, J., 280 Mexico, 6, 51 Migration internal, 132 Militaries, 8, 115, 277–292 Millennium Declaration, The, 295 Millennium Development Goals (MDGs), 295–297, 300–302, 313 Minardi, E., 13, 14 Models, 5, 7, 17–31, 50, 135, 137, 147, 148, 152, 153, 155–160, 170–174, 188–190, 193, 202, 210, 219, 289 Moderator's guide for focus groups ( moderation, guide, protocol) interpreters language barriers, 308 logistics, 306, 308, 311 moderation, 306, 307 politicization, 307, 309 project integrity, 310 report presentation, 309 research design, 303, 308–310

Index stakeholders, 310 structural approach, 309 training, 307 triangulation, 302, 313 Monitoring and evaluation (M&E), 8, 303 Moreno, J.L., 89 Morin, E., 91 Moscovici, S., 91 Motivations, 8, 20, 167, 168, 194, 237, 246, 248, 251, 252, 264, 278, 298 Murphree, M., 114

N Nakamura, H., 7, 95–105 Narcotics Anonymous (NA), 158 Narrative approaches, 99, 100, 102–104, 209 Narrative social constructionist approach, 99–101, 103–105 National Association for the Advancement of Colored People (NAACP) The Crisis, 40 National Consumers League, 37 National Institute for the Humanities and Social Sciences (NIHSS), 117 National Institute on Drug Abuse (NIDA), 153, 160, 172 National Peace Federation, 39 National planning, 21, 302 Natural settings, 158, 160 Needs assessments, 4, 220, 296, 300, 301 Negotiation facilitated, 201, 218, 219 New York University (NYU), 47, 48 Niagara Movement, 40 Noguchi, Y., 7, 95–105 Non-governmental organizations (NGOs), 271–273, 302, 304, 307 Normality representation of, 145 Nurses, 97, 132, 141, 142, 144 Nzimande, B., 123

O Ohmura, E., 96, 97 Opioid replacement therapies (ORT), 172 Opioids, 156, 158, 160, 168, 169, 171, 172 Organizational change, 237, 243 Organizational consulting, 8, 237–253 Organization for Economic Cooperation and Development (OECD), 238, 295, 301 Organization with sense, 253

Index P Pagès, M., 62, 89 Paine College, 42 Papadaki, A., 171 Participatory action research, 4, 262 evaluations, 298, 302, 304 methods, 262, 267, 272, 298, 302, 305 planning, 21, 262, 272 processes, 8, 20, 250, 258, 274, 302, 307 research, 4, 119, 157, 262, 274, 298, 302, 307 tools, 250, 272 Participatory community risk assessment (PCRA), 8, 257–274 Patient-reported outcome measures (PROs), 299 Patients affected by, 132 age, 132 length of hospitalization, 132 Patriarchy, 120, 280, 283 Peacekeeping, 277, 278, 280, 282–285, 287–290 Peer counselors, 169 People Who Use Drugs (PWUD), 153, 154, 156–160, 166–168, 172, 173 Perlstadt, H., 12 Person/experience, 133 Pharmacotherapies, 172 Phronesis, 190 Physical capital, 155 Piscitelli, G., 11, 13, 14 Plaatjie, S., 111 Poetry Slam, 167 Policy analysis, 300, 304–305 Porio, E., 8, 257–275 Pottery, 169, 170 Prejudice, 182, 183, 186, 194 Professional practice, 239, 240, 253 Program evaluation framework constraints, 304 effectiveness, 303 efficiency, 303 opportunities, 303 performance, 304 relevance, 304 sustainability, 304 Progressive Era (US), 35, 37, 40, 44, 49, 121, 181–183, 188, 189, 216, 219, 259, 266, 269, 289, 290 Psychiatrists, 132, 133, 142, 157 Psychiatry

323 research, 67, 91, 103, 131 treatment, 103, 131 Psychoanalysis, 135 Psychological sociology, 81–82 Psychologists, 5, 38, 61, 68, 100, 102, 111, 132, 157 Psychosociology, 61, 81, 89–92 Public schools, 8, 41, 237–239, 253 Putnam, R., 154

Q Quakers, 39 Qualitative research methods, 4, 296 Quality of life, 21, 131, 263, 299 Quebec (Canada), 3, 5–7

R Rapid assessment, 300 Rebach, H.M., 49 Recoveries, 21, 99, 103–104, 152, 153, 155–158, 164, 167, 171–173, 303 Recovery capital, 155–156 Redefinition of the situation, 8, 18, 205, 210, 211 Re-entry programs, 169 Rehabilitation, 136, 145–146, 148, 171–173 Rehabilitation interventions, 146, 147 Reich, W., 85 Reintegration, 116, 159, 171, 172 Relapses, 138, 156 Reminiscence board, 102–103 Research methods case studies, 4 demographic analysis, 4 ethnographic research, 4 geographic information systems, 4 group work, 4 interviews, 4 life histories, 4 participatory action, 4 research, 4 sociodrama/role playing, 4 surveys, 4 Réseau International de Sociologie clinique (RISC) (International Network of Clinical Sociology), 6 Resettlement and integration, 305 Residents Committee, 143 Respect, 158, 161, 164, 183, 185–189, 191–194, 208, 246, 249, 284, 285

324 Results-based management (RBM), 301, 302 Revolution quiet, 58, 61, 62, 66 Rhéaume, J., 7, 50, 57–75, 237, 244 Rhoodie, N., 115 Rigas, A.V., 171 Rights, 18, 21, 35, 40, 43–45, 109, 119, 121, 144, 147, 169, 181, 182, 184–186, 188, 189, 191–194, 203, 208, 232, 264, 273, 277–279, 281, 287, 288, 302 Rights-based intervention, 7, 17–21 Rights respecting schools (RRS), 191–193 Rioux, M., 59 Risk maps, 263, 264, 267, 268, 274 Risk reduction strategies actionable, 274 community-based, 271 Road map in clinical sociology, 239–241 Rogerian approach to personality and experience, 135 Rogers, C., 64, 84, 89 Rosenwald Fund, 45 Roy, S., 68 Rubio y Gali, F., 5

S Sankofa, v Schizophrenia, 7, 101, 131–148 Scholar-practitioners, 3, 6, 36, 49, 110, 120 Schreiner, O., 111 Schuller, T., 154, 156 Sciences, 3–5, 36, 40, 41, 43, 45, 48, 51, 112, 116, 117, 147, 152, 209, 240, 253, 295, 297, 298, 300, 310, 313 Secrecy, 148 Seedat-Khan, M., 124 Self-help group, 104 Semantics, 153, 171–173 Settlement house, 37, 38 Sévigny, R., 7, 59, 61, 66, 68, 74, 77, 92, 131–149 Sexism, 208, 277–280, 283 Sexual conflicts, 86 harassment, 206, 280, 282, 283, 287, 288, 290 Sharim, D., 93, 241 Simons, J., 116 Sitas, A., 117, 122 Siza, R., 15 Slabbert, F. van Zyl, 122 Small, A., 36 Snap, 170, 171 Social

Index changes, 8, 20, 21, 37, 41, 98, 99, 101, 103, 105, 114–116, 119, 131, 132, 145–147, 153, 154, 156, 163, 173, 174, 181, 188, 193, 194, 253, 300, 313 confidence, 166, 167 contract, 305 contradictions, 86 control, 131, 146, 156, 158, 169, 170, 181, 188, 194 developments, 7, 20, 36, 41, 96, 105, 111, 116, 131, 141, 153, 156, 164, 174, 186, 253, 297, 300, 304, 305, 313 environments, 7, 29, 37, 132, 133, 135, 143, 145–147, 152, 154–157, 171–173, 206 inclusion, 158 interactions, 132, 137, 156, 160, 313 interdependence, 253 justice, 18, 38, 45, 117, 122, 152, 158, 181, 184, 190, 194, 206, 291, 304 macro social, 145, 174 media, 185, 188, 193, 274, 297 networks, 7, 99, 122, 145, 154–156, 159, 162, 164, 166, 167, 171, 259 norms, 154, 156, 162, 188, 280, 297 problems, 36, 37, 41, 46–49, 95, 96, 98–105, 110, 111, 117–119, 121, 134, 153, 155, 157, 158, 170–173, 188, 206 recoveries, 103, 104, 153–160, 164, 167–174 reintegration, 171 vulnerability analysis, 8 Social capital bonding, 154, 156, 158 bridging, 154, 156, 158, 164 Theories, 151–154 Social construction, 28, 50, 100, 101, 103, 183 Social constructionism, 4, 95, 100, 102, 104, 105 Socialisme et Barbarie, 90–91 Socialization, 152, 164, 165, 167, 181, 183, 184, 186, 189 Social phenomena total, 59, 85 Social psychology, 46 Social Recovery Initiative (SRI), 7, 152, 153, 156–168, 171, 173 Social rehabilitation, 131, 133, 135, 136, 143, 146–147 Societies, 5, 37, 41–43, 46, 48, 49, 96–98, 101, 103, 104, 109, 111, 117, 118, 122, 124, 131–133, 136, 137, 144, 145, 153, 156, 159, 162, 167, 169, 170, 173, 182, 183, 185–187, 192–194, 207, 218, 231, 232, 259, 272, 274, 278, 282, 286, 289, 292, 295, 296, 300, 304, 313

Index Society of Friends (Quakers), 120, 205 Society, Work and Development Institute (SWOP), 121, 122 Socioanalysis, 89, 91 Sociocaribe social consulting, 240 Socio-clinical approaches, 237, 240, 253 facilitators, 237, 240, 242 Socioeconomic development, 18, 20–21 Socio-environmental factors, 269 Sociographic approach, 57, 65 Sociological imagination, 17, 124 Sociological practice, 3, 4, 40, 45, 48–51, 97–100, 102, 104, 105, 274 Sociology Chicago School, 59 medical, 45, 46, 96, 114, 123, 134 traditions, 3, 4, 51, 109, 121, 135, 241 Socio-psychic facts, 79, 80 SOCLIP (clinical sociology and psychosociology intervention seedbed), 240, 241 Soga, T., 111 Solitary confinement, 168 South Africa, 3, 6–8, 109–125, 260, 277, 278, 281, 284, 286, 288–292 South African Sociological Association (ASSA, 1970–1993), 6, 114, 116, 124 South African Sociological Association (SASOV, 1968-1993), 114, 116 South African Truth and Reconciliation Commission, 117 Spain, 5, 6, 241 Spector, M., 100 Stigma (stigmatizing), 152, 153, 159, 163, 172 Strategic management tools, 8, 238–239 Strategic planning, 247, 300, 301 Strauss, A.L., 60 Street Committee, 132, 143 Structural facilitators and constraints, 18 Structurally-conducive settings, 18 Students, 5, 8, 19, 23, 43, 45–48, 51, 102, 112–115, 117, 121, 123, 124, 158, 162, 166, 168, 169, 181, 189–194, 219, 220, 223, 237–242, 246, 248–251, 253 Subjectivation, 244, 245, 253 Substance use problematic, 156 treatment, 7, 156, 171, 173 Sustainability, 4, 17, 274, 296, 301, 304, 305 Sustainable Development Goals (SDGs), 8, 21, 295–314 Symbolic interaction, 4, 28

325 T Taracena, E., 93, 241 Tarde, G., 78 Teachers, 8, 47, 188, 189, 191–194, 216, 237–239, 242–251 Terrorism, 182, 184, 191 “The Hole”, 170, 304 Theoretical analysis integrated, 205, 209–211 Theory conflict, 87 critical, 8, 194, 313 grounded, 240 land ethic, 4, 210 multicultural-liberationist, 4, 28, 210 psychoanalytic, 98 social constructionism, 4, 28 social exchange, 4, 28 standpoint, 4, 28, 210 symbolic interaction, 4, 28 systems, 193 Therapies, 19, 47, 48, 98, 100, 102, 103, 172 Thunbergh, G., 181 Tobacco control, 232 Torregrosa, J.R., 241 Total institutions, 152, 189 Trajectories, 23, 152, 156, 160, 173, 181, 184, 190 Transformation, 99, 131, 172, 174, 183, 189, 215, 250, 286, 288, 292 Tsemberis, S., 170 Tulane University, 47 Turning points, 170, 278 Tuskegee Civic Association (TCA), 43 Tuskegee University (Tuskegee Institute), 43

U United Nations UN Economic and Social Commission for Asia and the Pacific (UNESCAP), 305 UN Emergency School Feeding Program (ESF), 303 UN General Assembly, 295 UN World Food Program (WFP), 303 United Nations Educational, Scientific and Cultural Organization (UNESCO), 182, 192 United Nations Security Council Resolution 1325 (UNSCR 1325), 283, 284 United States, 3, 5–7, 35–52, 95–97, 100, 160, 162, 169, 172, 182, 185, 202, 203, 208, 222, 225, 289, 290, 299, 301

326 United States Postal Service, 205 Universal Declaration of Human Rights (UDHR), 18, 193 Universidad del Atlántico (University of the Atlantic), 239–242, 251, 253 University of Chicago, 36–38, 45–47, 51 University of Johannesburg, 6, 117, 123 Uruguay, 5, 6, 240, 241 U.S. Department of Justice, 44 U.S. Institute for Environmental Conflict Resolution, 218 Uys, T., 7, 109–124

V Van Bockstaele, J., 7 Van Bockstaele, M., 7 Van der Merwe, M., 120 Vandevelde-Rougale, A., 93 van Niekerk, P., 123 Verwoerd, H., 111 Vilakazi, B.W., 111 Vilakazi, H., 116, 121 Violence domestic, 202 Vissing, Y., 7, 181–194 Voices of the Poor, 299 Vulnerable populations, 21, 285, 299

W Wacquant, L.J.D., 152, 154, 168 Walby, S., 283 Wan, H., 201 Wan, M., 201 Ward, L.F., 295 Washington, B.T., 42 Water-based lifestyle, 272 Wealthy and poor gap between, 132 Webb, B., 38

Index Webb, S., 38 Weber, M., 48, 84, 85 Well-being, 17, 18, 20, 297, 299–306, 313 White, E.M., 281 Wieviorka, M., 153, 173, 174 Wilberforce University, 40, 111 Wilcox, L., 184 Wilén, N., 282, 283, 285, 286, 291 Wilson, President W., 39 Winternitz, M.C., 45, 46 Wirth, L., 7, 46, 49 Women’s International League for Peace and Freedom, 39, 40 Women’s Peace Party, 39 Work healthy, 69–71, 274, 296 psychodynamic of, 69, 71 Working People’s Social Science Club, 37 Workshops, 5, 148, 193, 209, 221, 240, 242, 245, 246, 248, 287, 289, 290, 305, 306 World Bank Group (WBG) Committee on Development Effectiveness (CODE), 303 Global Knowledge Conference, 306 Independent Evaluation Group (IEG), 302 Operations Evaluation Department (OED now IEG), 302 Uganda Country Assistance Review, 304 World Health Organization (WHO), 299

Y Yongzhen, W., 149 Yousafazi, M., 181 Youth, 38, 143, 181–184, 188–193, 263 Yzaguirre, F. de, xii, 8, 92, 237–252

Z Zorbaugh, H.W., 47