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Reactivity and reactions to regulatory transparency in medicine, psychotherapy and counselling

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McGivern, Gerry and Fischer, Michael D. (2012) Reactivity and reactions to regulatory transparency in medicine, psychotherapy and counselling. Social Science & Medicine, Vol.74 (No.3). pp. 289-296. doi:10.1016/j.socscimed.2011.09.035

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Official URL: http://dx.doi.org/10.1016/j.socscimed.2011.09.035

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Abstract

We explore how doctors, psychotherapists and counsellors in the UK react to regulatory transparency, drawing on qualitative research involving 51 semi-structured interviews conducted during 2008–10. We use the concept of ‘reactivity mechanisms’ (Espeland & Sauder, 2007) to explain how regulatory transparency disrupts practices through simplifying and decontextualizing them, altering practitioners’ reflexivity, leading to defensive forms of practice. We make an empirical contribution by exploring the impact of transparency on doctors compared with psychotherapists and counsellors, who represent an extreme case due to their uniquely complex practice, which is particularly affected by this form of regulation. We make a contribution to knowledge by developing a model of reactivity mechanisms, which explains how clinical professionals make sense of media and professional narratives about regulation in ways that produce emotional reactions and, in turn, defensive reactivity to transparency.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Social Sciences > Warwick Business School
Library of Congress Subject Headings (LCSH): Health services administration -- Great Britain, Transparency in government, Psychotherapy -- Great Britain, Counseling -- Great Britain
Journal or Publication Title: Social Science & Medicine
Publisher: Elsevier BV
ISSN: 02779536
Official Date: 2012
Dates:
DateEvent
2012Published
Volume: Vol.74
Number: No.3
Page Range: pp. 289-296
DOI: 10.1016/j.socscimed.2011.09.035
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access
Funder: Economic and Social Research Council (Great Britain) (ESRC)
Grant number: RES-153-25-0095 (ESRC)

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