Doctoral Dissertation Research: How Problem Gambling is Medicalized

琳达·伯顿罗斯·巴克勒杜克大学博士论文研究：问题赌博是如何医疗化的摘要本研究将深入了解塑造问题赌博医疗化的机制。它将研究辅导员如何在问题赌博行为中构建种族和性别差异。它还将检查辅导员在日常讨论客户和客户行为时构建和理解种族和性别的方式。使用康拉德（1992）对医疗化的定义，即社会问题被重新定义为强制要求有执照的医疗专业人员进行干预和控制的医疗问题的过程，本项目将展示社会和历史因素如何塑造疾病的构建。它还将把医疗化的理论工作与街头官僚的“政策制定”研究（Lipsky 1980）和临床决策过程（Hays et al. 2010, Gushue 2004）联系起来。通过参与者观察和访谈收集的数据将解决三个主题：(1)咨询师在讨论来访者时使用的种族和性别话语类型，(2)咨询师在这些话语中提供的合法证据类型，以及(3)咨询师赋予已构建的差异的意义。数据收集策略包括与问题赌博项目的顾问和经理的访谈，以及对赌博成瘾培训研讨会、会议和呼叫中心的多地点人种学研究。很少有定性研究仔细检查心理咨询师和管理人员在形成精神疾病定义中的作用，更少认真检查他们的主观性。结合访谈与民族志方法，本研究将增进对医疗化复杂过程的了解。

SES-1131382Linda BurtonRose BuckelewDuke UniversityDoctoral Dissertation Research: How Problem Gambling is Medicalized AbstractThis study will provide insight into the mechanisms that shape the medicalization of problem gambling. It will examine how counselors construct racial and gender differences in problem gambling behavior. It will also examine the ways counselors construct and understand race and gender in their everyday discussions of clients and client behavior. Using Conrad's (1992) definition of medicalization, the process by which social problems are redefined as medical problems mandating the intervention and control of licensed medical professionals, this project will demonstrate how social and historical factors shape the construction of illness. And it will bridge the theoretical work on medicalization with research on the "policy making" of street level bureaucrats (Lipsky 1980), and on clinical decision-making processes (Hays et al. 2010, Gushue 2004). Data collection through participant observation and interviews will address three themes: (1) the types of racial and gender discourses counselors use when discussing clients, (2) the kinds of legitimating evidence counsellors provide in these discourses, and (3) the meanings counselors attach to the differences which have been constructed. Data collection strategies include interviews with counselors and managers of problem gambling programs and a multi-site ethnographic study of gambling addiction training workshops, conferences, and call centers. Very few qualitative studies closely examine the role of counselors and managers in shaping definitions of mental illness and even fewer seriously examine their subjectivity. Combining interviews and ethnographic approaches, this study will advance understanding of the complex processes of medicalization.