The December 2011 issue of Ethos is a special issue, entitled “Psychological Anthropology and Adolescent Well-Being: Steps toward Bridging Research, Policy, and Practice.” Building upon recent interest in policy- and practice-based collaboration among the psychological anthropology community, the issue enacts such collaboration by pairing original research articles with commentary by policy experts and practitioners. As the editors, Eileen P. Anderson-Fye and Jill E. Korbin, write in their introduction:
Demonstrating a one-to-one link from a piece of research to a practice or policy solution may be elusive. Nevertheless, psychological anthropology can enter the discussion by providing compelling and practice and policy relevant studies informed by the considerations of those directly involved in applied work. (418)
The focus of this collaboration, as the title of the issue suggests, is adolescence “as a critical period shaped by culture and human development” (415). As, again, the editors write:
Psychological anthropology has played a role in the nuanced analysis of adolescent risk and resilience, peril, and possibilities. In this issue each contributor in some way takes up the complexity of the unique challenges and potentials of this life stage in the contemporary world. …[A]dolescence may be the next high visibility frontier where a large payoff is anticipated for appropriate supports and interventions. As Worthman writes (this issue), “youth are where the rubber meets the road as the strengths and vulnerabilities formed in development hit the demands of transitioning into adulthood.” Thus, the culture and human development frames that psychological anthropology can offer—frames that consider a range of factors from biological change to demographic patterns—are relevant for a wide array of practice and policy issues regarding adolescents and adolescence. (418)
The articles and commentaries from this issue are as follows:
Traditions in Transition: Adolescents Remaking Culture
Robert A. LeVine
This article proposes a cohort-based theoretical model of understanding adolescence as a key moment in the intersection of individual and cultural change. Drawing on work from anthropology, psychology, and sociology, adolescence is shown to be a critical time for examining the proximate interactions of individuals with the cultural models and norms transmitted to them in the re-creation of new generational norms and practices. Examples are provided from Kenya, Mexico, and Nepal as well as the United States. This kind of psychocultural research contributes to policy, practice, and theory regarding both adolescence and cultural change.
Inside-Out and Outside-In? Global Development Theory, Policy, and Youth
Carol M. Worthman
Humanity is young: In 2006, over a third (2.2 billion) were under age 18 and almost half were under age 25. In addition, nearly the majority of young people ages 15–24 lives on less than $2 per day, 15 percent are undernourished, and 14.4 percent are unemployed. Although 85 percent of young people live in developing countries, only a fraction of adolescent development and mental health research is focused there. Efforts to shift the emphasis of such research also must engage with the prevailing views in development theory and policy that link human development with socioeconomic development in a “dual development model.” A critical cultural analysis of this model reveals both the bases and limitations of its power, and identifies an implicit cultural model of the life course within it. The model mandates society-to-individual (outside-in) investments in health and education that are expected to return reciprocal gains in lifetime productivity that benefit society as a whole (inside-out). The current burden and advantage of this equation are assessed as they bear on young people across the globe. A case is made for lifecourse cultural models as a potent framework for mediating among realities, perceptions, and behaviors at the level of youth, parents, and policies under conditions of rapid culture change.
Commentary: A World Fit for Youth
Jo de Berry
Young people require more than good health and educational attainment in order to make the transition to a fulfilling and productive adult life. In addition they require life skills, confidence, and the ability to explore development avenues; they will benefit from societal and cultural investments that recognize the value of and equip them with such social, emotional, and skill resources. Essentially they must be given the chance to express and act out their own agency in navigating the constraints and opportunities around them.
“If You Work in This Country You Should Not be Poor, and Your Kids Should be Doing Better”: Bringing Mixed Methods and Theory in Psychological Anthropology to Improve Research in Policy and Practice
Thomas S. Weisner
New Hope (NH) was a successful poverty reduction program that offered a positive social contract to working-poor adults. If you worked full time, you were eligible to receive income supplements, childcare vouchers, health care benefits, a community service job, and client respect. NH did reduce poverty and increase income and earnings for some participants, and improved outcomes for some children. But in spite of relatively generous benefits, NH was only selectively effective. Only those not working when NH began and those with few barriers to work were positively affected by the program through achieving more work hours, poverty reduction, and income gains. Boys in program families benefited, girls did not. Take-up of NH benefits was typically partial and episodic; for instance, some parents would not use childcare programs for young children. Ethnographic evidence was essential for understanding these sometimes-surprising program impacts and their policy and practice implications, and was effectively combined with an experimental, random-assignment research design. Psychological anthropology can bring its traditions of integrating qualitative and quantitative methods and its focus on experience, context, and meaning to understanding and improving policies and practices within a scientific frame of the committed, fair witness.
Commentary: Peering Inside the Black Box of Policy Interventions
Brian L. Wilcox and Arielle Deutsch
The New Hope evaluation generated a variety of useful findings that will help guide future iterations of antipoverty policymaking, despite the fact that the intervention was only selectively effective and impacts were generally short lived. The evaluation process itself, however, representing a blend of sound design, mixed methods, and theories drawn from psychological anthropology as well as other disciplines, is likely to significantly shape future large-scale policy evaluation efforts.
In this article, I examine clinical dilemmas in treating adolescents with eating disorders under the U.S. managed healthcare system. Managed care is built on a rational choice model of human behavior with little room for considering developmental processes. In this model, adolescents figure as little more than failed adults. This poses significant problems: if treatment providers prioritize developmental issues over quantifiable behavioral milestones, they risk jeopardizing continued coverage for their clients. If they prioritize quantifiable behavioral change without attending to underlying developmental concerns, they risk not affecting lasting change. Through a case study of a client in treatment for an eating disorder, I illustrate how this dilemma frames everyday encounters and negatively impacts client care, while at the same time missing developmentally meaningful opportunities for healing. An outline for a proposed applied psychiatric anthropology is presented, together with specific recommendations for adolescent mental health policy, research, and practice.
A practicing psychologist, active in public policy work, supports the recommendations made in Lester’s article, “How Do I Code for Black Fingernail Polish? Finding the Missing Adolescent in Managed Mental Health Care.” Psychotherapy outcome research is consistent with Lester’s premise that managed mental health care policies hinder effective, evidence-based results. The role of stigma in perpetuating neglect in managed mental health care is also highlighted. Efforts by psychologists to educate policymakers and to become involved in politics are described. Efforts to change insurance policy through collaborative efforts with other social scientists is encouraged.
“I’m Not Your Typical ‘Homework Stresses Me Out’ Kind of Girl”: Psychological Anthropology in Research on College Student Usage of Psychiatric Medications and Mental Health Services
Eileen P. Anderson-Fye and Jerry Floersch
Research has established that a large minority of college students today are taking psychiatric medications and that college mental health services are overwhelmed by this relatively recent trend. Little is known about the subjective experience of these college students in regard to their medications and utilizations of services as they transition from home to a peer-based environment during a key developmental moment in the transition to adulthood. In this article we argue that theory and methods from psychological anthropology are ripe to guide data collection in this area. We provide data from a longitudinal mixed-methods pilot study with residential college students to argue that policy and practice regarding college mental health and psychiatric medication can benefit substantially from insights gained through psychological anthropology. In particular, college administrators, counseling and health centers, and their professional organizations can benefit from research examining student experience and meaning making in particular institutional and community settings.
In response to the challenges posited by Eileen P. Anderson-Fye and Jerry Floersch in their article on college student mental health, a psychologist and counseling center director reflects on the implications for university counseling and psychological service centers. Among other things, issues related to high-risk students, the developmental barriers to help-seeking behavior, the increasing utilization of psychotropic medications, and the broadening mandate of campus mental health providers are addressed. Finally, interdisciplinary collaboration in service to university students is encouraged.
Marriage Rights and LGBTQ Youth: The Present and Future Impact of Sexuality Policy Changes
Michelle A. Marzullo and Gilbert Herdt
Studying changing attitudes toward marriage rights in the United States, we consider how sexual and gender socialization and changes in values and beliefs regarding homosexuality and marriage influence lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ) youth. We begin by presenting the cultural environment of policies, court decisions, and political maneuvers in response to the question of “same-sex” marriage. In this context, we examine fluctuations of public opinion polling from 1989 to 2009. These issues background our main focus, which is to comment on the emerging, positive research on the resiliency, strength, and future aspirations of LGBTQ youth. Such research was begun in the late-1980s with a significant community-based, ethnographic study on LGBTQ youth in Chicago. Although similar studies are being done now, more ethnographic research is necessary to build a catalog of data focused on positive traits in response to a deficiency model used in most psychological research on LGBTQ youth. We end by suggesting ways that psychological anthropologists might fruitfully engage with policy studies and advocates through such research.
Young people dream of a life together with a committed partner, and the fight for the freedom to marry has a direct and positive effect on their self-esteem and sense of empowerment as the research compiled and analyzed by Michelle A. Marzullo and Gilbert Herdt shows. Not surprisingly, young people across the board overwhelmingly support the freedom to marry and are helping fuel the momentum for ending marriage discrimination.
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