Desire and disappointment: adolescent psychotropic treatment and adherence.

This paper situates medication adherence among adolescents in current cultural and political-economic debates about compliance/adherence and the formation of biomedical subjectivities. Building on prior work of the authors, this paper explores the role of desire in adherence to show how subjectivities are shaped by concordant, instrumental, or conditional forms of desire. Data is used to show how parents and adolescents compare the medicated self before and after, resulting in the formation of desire. It is argued that adherence is an outcome of desire: no desire, no adherence, or varying types of desire. Moreover, adherence is not a steady state. It is produced moment to moment as adolescents confront the desires of others. The study uses interview data to construct a case study of concordant desire, which is a form most likely to produce adherence. With concordant desire the medicated come to expect a future life on medication and a life where symptoms are stripped of their social and psychological meaning and significance.

Family routines and rituals when a parent has cancer.

A growing literature has drawn attention to the psychosocial impact of cancer on families with young children. However, to help families develop adaptive responses to chronic illness, recent scholarship has begun to advocate a shift in orientation from a deficit to a strengths perspective. In this article, the authors examine the reorganization of family life after cancer diagnosis by reporting findings from a qualitative study of families with young children (ages 2-9) dealing with a parent's cancer. The authors focus specifically on parents' self-reports of how their families developed and experienced new routines and rituals while one parent underwent cancer treatment. Despite significant upheaval in family life, the families in this study found ways to stabilize routines and maintain a sense of normalcy. Although cancer compels disruptions to existing routines and rituals, families demonstrated creative resilience in their capacity to incorporate cancer care into the formation of new family traditions, habits, and practices. By considering how families manage cancer as a joint endeavor, the authors hope to illuminate the ways in which cancer can bring families together as well as pull them apart.

Adolescent experience of psychotropic treatment.

Despite growing concern over the treatment of adolescents with psychiatric medications, little research has examined youth understandings and interpretations of mental illness and psychotropic treatment. This article reports the exploratory findings of semi-structured and open-ended interviews carried out with 20 adolescents diagnosed with one or more psychiatric disorders, and who were currently prescribed psychiatric medications. Grounded theory coding procedures were used to identify themes related to adolescent subjective experience with psychiatric medications. The categories identified are interpreted as different points of view through which adolescents understand and take action upon their illness concerns; their need for medication treatment; their perceptions of how medications work; their responses to parental and other influences upon medication treatment; and, their everyday management activities.

Cultural competence reexamined: critique and directions for the future.

This Open Forum aims to stimulate productive dialogue about cultural competence in providing mental health care. The authors examine recent calls for culturally competent care in mental health practice and give a brief overview of the context in which demands for such care have arisen. Using select examples from anthropology, the authors provide evidence of the importance of culture in the production, presentation, and experience of psychic distress. Acknowledging the value of culturally appropriate care, the authors synthesize anthropological critiques of cultural competence models. The essay concludes with suggestions for future directions in cultural competence research and implementation.

The social grid of community medication management.

Practitioners involved in case management at a community mental health center organized 5 elements of a psychotropic medication experience. Using case records, interview, and observational data, the authors examined an underresearched and especially problematic area of the management process: the interpretation of a medication's effect. They describe the divisions of labor, a grid of social relations, and spaces related to management, and they describe how the limits and potential of medications are realized in the intensity of monitoring and the knowledge produced in the day-to-day practices among all participants.