title: A game of slides and ladders: Māori health providers and funders

authors: Masters-Awatere, Bridgette

abstract: Devolution of government responsibility after the neo-liberal reforms of the 1980s, and the re-orientation of health services towards public health in the 1990s, created an opportunity for Māori to take control of their own health outcomes through the delivery of culturally relevant and appropriate services. By 2000 “By Maori, For Maori” service provision had burst forth as the preferred approach with Māori. While grappling with the tendency of government agencies to fund services based on pre-existing health output criteria, Māori service providers were “walking on egg shells” under the constant threat of losing their funding. Currentcontracting does not capture the extent of the work done by Māori providers to serve precariat families. Nor does it adequately acknowledge, validate or value indigenous approaches to health and wellbeing. Instead, narrow, administratively demanding and difficult to interpret contracts threaten the provision of culturally relevant services. This chapter talks about some of the creative and insightful ways Māori service providers manage contrasting cultural and contractual expectations.

text: A game of slides and ladders: Māori health providers and funders Devolution of government responsibility after the neo-liberal reforms of the 1980s, and the re-orientation of health services towards public health in the 1990s, created an opportunity for Māori to take control of their own health outcomes through the delivery of culturally relevant and appropriate services. By 2000 “By Maori, For Maori” service provision had burst forth as the preferred approach with Māori. While grappling with the tendency of government agencies to fund services based on pre-existing health output criteria, Māori service providers were “walking on egg shells” under the constant threat of losing their funding. Currentcontracting does not capture the extent of the work done by Māori providers to serve precariat families. Nor does it adequately acknowledge, validate or value indigenous approaches to health and wellbeing. Instead, narrow, administratively demanding and difficult to interpret contracts threaten the provision of culturally relevant services. This chapter talks about some of the creative and insightful ways Māori service providers manage contrasting cultural and contractual expectations.

year: 2017

title: Addiction Phenomenology In Substance Use  And Non-Substance Use Disorders

authors: McLachlan, Andre David

subjects: Addiction

abstract: There is growing research evidence and public concern over the burgeoning of disorders which share common features with substance addictions. In order to investigate the presence and role of addiction features in disorders outside of substance addictions, symptoms of addiction were explored within three addiction groups: alcohol dependence (AD), an established addiction (n = 24); pathological gambling (PG) a disorder with growing empirical support as an addiction (n = 20); and compulsive shopping (CS), a proposed 'novel' addiction(n = 20).
Participants were recruited from either the general population, or from the Auckland Salvation Army Bridge residential alcohol and drug treatment programme; Salvation Army Oasis Gambling Service; Pacific Peoples Addiction Service Incorporated; or Te Kahui Hauora O Ngati Koata Trust. Participants completed a battery of self-report measures comprising a demographics questionnaire; Addictive Disorder Questionnaire (ADQ); anxiety and depression subscales of the Symptom Checklist 90 Revised (SCL-90R); Barratt Impulsivity Scale II-r; and substance specific adaptations of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).
Three general categories of addiction symptoms: physiological, salience and dyscontrol, were identified as broad aspects of addiction, common across all three groups. Measurable aspects of addiction, including impulsivity, obsessions, anxiety and depression were found to be endorsed similarly across the three addictions, irrespective of the severity of their addiction. Compulsions were found to be higher in the AD group. Higher anxiety was found to be correlated with higher addiction in the behavioural addictions (CS and PG), whereas depression and anxiety were associated with higher addiction severity in the AD group.
The results provide support for broadening addiction diagnostic definitions, to be more encompassing of the psychological and physiological experiences of each symptom; and developing different diagnostic categories for non-substance addictions that reflect the severity of the addiction. Results also provide evidence for developmental phases of addiction, from an early 'hedonistic' impulsive phase, to a compulsive phase, in which increased dyscontrol, mood and anxiety, marks the severity of the addiction.

text: Addiction Phenomenology In Substance Use  And Non-Substance Use Disorders There is growing research evidence and public concern over the burgeoning of disorders which share common features with substance addictions. In order to investigate the presence and role of addiction features in disorders outside of substance addictions, symptoms of addiction were explored within three addiction groups: alcohol dependence (AD), an established addiction (n = 24); pathological gambling (PG) a disorder with growing empirical support as an addiction (n = 20); and compulsive shopping (CS), a proposed 'novel' addiction(n = 20).
Participants were recruited from either the general population, or from the Auckland Salvation Army Bridge residential alcohol and drug treatment programme; Salvation Army Oasis Gambling Service; Pacific Peoples Addiction Service Incorporated; or Te Kahui Hauora O Ngati Koata Trust. Participants completed a battery of self-report measures comprising a demographics questionnaire; Addictive Disorder Questionnaire (ADQ); anxiety and depression subscales of the Symptom Checklist 90 Revised (SCL-90R); Barratt Impulsivity Scale II-r; and substance specific adaptations of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).
Three general categories of addiction symptoms: physiological, salience and dyscontrol, were identified as broad aspects of addiction, common across all three groups. Measurable aspects of addiction, including impulsivity, obsessions, anxiety and depression were found to be endorsed similarly across the three addictions, irrespective of the severity of their addiction. Compulsions were found to be higher in the AD group. Higher anxiety was found to be correlated with higher addiction in the behavioural addictions (CS and PG), whereas depression and anxiety were associated with higher addiction severity in the AD group.
The results provide support for broadening addiction diagnostic definitions, to be more encompassing of the psychological and physiological experiences of each symptom; and developing different diagnostic categories for non-substance addictions that reflect the severity of the addiction. Results also provide evidence for developmental phases of addiction, from an early 'hedonistic' impulsive phase, to a compulsive phase, in which increased dyscontrol, mood and anxiety, marks the severity of the addiction.

year: 2008

title: Using vignettes in interviews: Exploring discourses around child sexuality

authors: Flanagan, Paul G.

abstract: In this case study, I describe the process of data gathering using vignettes in both interview and focus group contexts. Vignettes offer multiple possibilities when researching sensitive topics in which participants may experience vulnerability. This research examines understandings of sexuality in childhood. As a child and family counselor working closely with principals and teachers in primary schools, I supported schools and families responding to children’s “sexual" activity. Parents and teachers questioned the causes and effects of these children’s actions. Many adults responded from fear, naivety, confusion, and assumptions about children’s actions. These adult reactions led toward over-reactive and punitive consequences for children. Informed by adults’ discomfort and subsequent inscriptions of children’s actions as sexual, I developed six vignettes to elicit participant knowledge. I worked alongside ...

text: Using vignettes in interviews: Exploring discourses around child sexuality In this case study, I describe the process of data gathering using vignettes in both interview and focus group contexts. Vignettes offer multiple possibilities when researching sensitive topics in which participants may experience vulnerability. This research examines understandings of sexuality in childhood. As a child and family counselor working closely with principals and teachers in primary schools, I supported schools and families responding to children’s “sexual" activity. Parents and teachers questioned the causes and effects of these children’s actions. Many adults responded from fear, naivety, confusion, and assumptions about children’s actions. These adult reactions led toward over-reactive and punitive consequences for children. Informed by adults’ discomfort and subsequent inscriptions of children’s actions as sexual, I developed six vignettes to elicit participant knowledge. I worked alongside ...

year: 2017