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有价值的身份和有缺陷的身份:心理健康中的康复行动计划和自我管理。

Valued identities and deficit identities: Wellness Recovery Action Planning and self-management in mental health.

机构信息

School of Social and Political Sciences, University of Canterbury, Christchurch, New Zealand.

出版信息

Nurs Inq. 2011 Mar;18(1):40-9. doi: 10.1111/j.1440-1800.2011.00529.x.

Abstract

Wellness Recovery Action Planning (WRAP) is a self-management programme for people with mental illnesses developed by a mental health consumer, and rooted in the values of the 'recovery' movement. The WRAP is noteworthy for its construction of a health identity which is individualised, responsibilized, and grounded in an 'at risk' subjectivity; success with this programme requires development of an intensely focused health lifestyle. We draw on Bourdieu and Giddens to argue that what is being developed is a 'reflexive health habitus', which is not equally accessible to all social groups, and is in tension with WRAP's recovery-orientated aims. However, it is understandable that such a programme developed in mental health, because people with mental illness are highly stigmatized as 'a risk' and viewed as in need of risk management. By developing their own form of self-monitoring 'at risk' identity, mental health consumers are, paradoxically, able to construct themselves as ideal health citizens and no longer a risk, thus re-entering the moral community. We conclude by suggesting some changes to WRAP practice.

摘要

健康康复行动计划 (WRAP) 是一种由心理健康消费者开发的、针对精神疾病患者的自我管理计划,根植于“康复”运动的价值观。WRAP 的突出特点是构建了个性化、负责任的健康身份,并以“处于风险之中”的主体性为基础;该计划的成功需要发展一种高度集中的健康生活方式。我们借鉴布迪厄和吉登斯的理论,认为正在形成的是一种“反思性健康习惯”,它并非所有社会群体都能轻易获得,并且与 WRAP 的康复导向目标相冲突。然而,考虑到该计划是在心理健康领域发展起来的,这是可以理解的,因为精神疾病患者被高度污名化为“风险”,被视为需要风险管理。通过发展自己的自我监测“处于风险之中”的身份,精神健康消费者能够自相矛盾地将自己构建为理想的健康公民,不再是风险,从而重新进入道德共同体。最后,我们建议对 WRAP 实践进行一些改变。

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