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Human behaviour is observable behaviour rather than invisible thoughts and innate tendencies.  Anyone can learn anything through conditioning (reinforcement and punishment)
Operant - behaviour shaped by outcome (Pavlovs salivating dogs)
Classical  - Learning to be frightened (Skinners rats)

Watson - little albert experiment

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Durkheim - Family is a unit serving society (main point of functionalism)
Murdoc - family has 4 functions, reproduction, sexual gratification, economic wellbeing, education
Parsons - those 4 plus socialising children / stabilising adults

CASE STUDY

Chloe isnt a family unit in her own right, so some family functions may be served by other people / institutions, i.e. father function may be grandad, or even grandma.

Altogether they are a family unit, and although were performing their functions, John is now not helping with economic wellbeing, although Chloe may be in his place

Children appear to have been educated and socialised, Chloe may be stable, Alfie may not be

Sheila is now the main breadwinner which is not a normal function for the mother, but helps with economic stability (but detracts from her role in keeping the family healthy and stabilising adults)

Johns low mood and alcohol coping mechanism may not be a good influence on the family for stability

John is now in the sick role and although taking meds, not going to wellbeing appointments which he should be to get better and become a worker again

Alfie is becoming stable as an adult by enrolling at college.

USE IN NHS

Everyone is an individual and should be treated as such

Prevent socio-economic sterotyping and prejudices in the NHS

Encourage patients to take responsibility for their own health

Encourage compliance issues - if non-concordant find another way that will work

Empower patients to allow them to fulfil social roles if this makes them feel better and more included in society

Modern day functionalism in the NHS is PREVENTION.  Must place emphasis on this with everyone, particularly from younger ages

Try to get around social health inequity - there may be poor mental health services in the area - are their alternatives?  Diet and exercise?  Gym programmes, social volunteer groups?  Green gyms?

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Nature v Nurture - Plato (320bc); Descartes (1644); Darwin (1871); Locke (1664)

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Nature v Nurture - Plato (320bc); Descartes (1644); Darwin (1871); Locke (1664)

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Plato / Descartes - everything is innate, born with it no matter our influence
Darwin - descent of man, survival instincts, babies to whoever feeds them
Locke - Tabula Rasa - mind is a blank slate, what happens to you is what you become

CASE STUDY

Nature and nurture?  Sheila is 'damaged', John maybe isnt, and really their children / grandchild are doing well.

Chloe is a good mum - so must have had influence from family, cannot just be genetics

Alfie couldnt have been born deviant, mum and dad are both working, so must have been environmental influence?

USE IN NHS

Encourage patients to take charge of their own well-being

Prevention rather than cure

Have to nurture people to feel safe (attachment), self-esteem (maslow) for their true nature to be unlocked?

Improve the social influences our patients are subjected to

Teach people from a young age if we are in contact with children / teenagers to help themselves, not expect a cure.

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John has developed "learned helplessness" Martin Seligman (1965).                                                                      * Teesside (Middlesbrough) is a deprive area due to the height of pollution and poor health. Social Determinants of Health are affected,  Michael Marmot (2010), the condition of which people are; born, live, grow, work and get old this affects the proletariat (the working class). *With obsessions of economic growth in Teesside and the capitalism between bourgeoisie and proletariat ( conflict theory) Karl Marx (19th century).                            * Capitalism is dominating Teesside, bureaucracy  and the protestant work ethic are greatly involved Max Weber ( early 19th century). workers in Teesside get paid little while capitalist get richer with the hard work given by the workers. Work could be a joy of John's to function as a father due to capitalism giving him hope    ( Functionalism) Emile Durkheim (1858-1917).                                                                                        * John feels alienated the modern work life has changed the way he sees him self and what he is capable  of Karl Marx (19th century).                                *John has been labelled as unemployed and developed secondary deviance which has developed into him being labelled as an alcoholic Howard Becker (1960's).   *Johns not attending his support group because he has become a pessimist, he has convinced him self he is worthless and using alcohol as a coping mecornisuim because of his depression he is suffering from and learned helplessness, Martin Seligman (1965).

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John has developed "learned helplessness" Martin Seligman (1965).                                                                      * Teesside (Middlesbrough) is a deprive area due to the height of pollution and poor health. Social Determinants of Health are affected,  Michael Marmot (2010), the condition of which people are; born, live, grow, work and get old this affects the proletariat (the working class). *With obsessions of economic growth in Teesside and the capitalism between bourgeoisie and proletariat ( conflict theory) Karl Marx (19th century).                            * Capitalism is dominating Teesside, bureaucracy  and the protestant work ethic are greatly involved Max Weber ( early 19th century). workers in Teesside get paid little while capitalist get richer with the hard work given by the workers. Work could be a joy of John's to function as a father due to capitalism giving him hope    ( Functionalism) Emile Durkheim (1858-1917).                                                                                        * John feels alienated the modern work life has changed the way he sees him self and what he is capable  of Karl Marx (19th century).                                *John has been labelled as unemployed and developed secondary deviance which has developed into him being labelled as an alcoholic Howard Becker (1960's).   *Johns not attending his support group because he has become a pessimist, he has convinced him self he is worthless and using alcohol as a coping mecornisuim because of his depression he is suffering from and learned helplessness, Martin Seligman (1965).

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Plato / Descartes - everything is innate, born with it no matter our influenceDarwin - descent of man, survival instincts, babies to whoever feeds themLocke - Tabula Rasa - mind is a blank slate, what happens to you is what you becomeCASE STUDY◾Nature and nurture?  Sheila is 'damaged', John maybe isnt, and really their children / grandchild are doing well.◾Chloe is a good mum - so must have had influence from family, cannot just be genetics◾Alfie couldnt have been born deviant, mum and dad are both working, so must have been environmental influence?USE IN NHS◾Encourage patients to take charge of their own well-being◾Prevention rather than cure◾Have to nurture people to feel safe (attachment), self-esteem (maslow) for their true nature to be unlocked?◾Improve the social influences our patients are subjected to◾Teach people from a young age if we are in contact with children / teenagers to help themselves, not expect a cure. 

# data[].attributes.subject
Plato / Descartes - everything is innate, born with it no matter our influenceDarwin - descent of man, survival instincts, babies to whoever feeds themLocke - Tabula Rasa - mind is a blank slate, what happens to you is what you becomeCASE STUDY◾Nature and nurture?  Sheila is 'damaged', John maybe isnt, and really their children / grandchild are doing well.◾Chloe is a good mum - so must have had influence from family, cannot just be genetics◾Alfie couldnt have been born deviant, mum and dad are both working, so must have been environmental influence?USE IN NHS◾Encourage patients to take charge of their own well-being◾Prevention rather than cure◾Have to nurture people to feel safe (attachment), self-esteem (maslow) for their true nature to be unlocked?◾Improve the social influences our patients are subjected to◾Teach people from a young age if we are in contact with children / teenagers to help themselves, not expect a cure. 

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Bandura - Bobo doll - children see, children do
Zimbardo - Broken Window - people see, people do (with an element of if someone else does it then I have permission to do it)
Watson / Pavlov / Skinner - negative reinforcement - skinner rats, pavlov dogs, watson monkeys?
Seligman - learned helplessness, being helpless to avoid a bad / negative situation

In case study

John - learned helplessness, depression, unemployed for 18 months, feeling helpless now to change it

John - alcohol is a coping mechanism

Alfie - Deviant behaviour - smoking, seen mum do it, joyriding and drugs, seen friends do it

Chloe - mum had baby young, so has she possibly so have family and friends

Sheila - not off sick as likely other colleagues continue to work when ill, so she will too (protestant work ethic)

Sheila - sees smoking as a coping mechanism

Jemma is not getting good role models from the male family members

GOOD:

Alfie - has seen sister working, parents working, now attempting to learn a trade

Chloe - has gotten a job, not on benefits which friends may be as single mums

Chloe - working in NHS environment may be able to encourage good health in family and friends

HOW TO USE IT:

Be a role model, not be seen smoking or eating rubbish food when we are giving the opposite advice

Consider focusing on schools / children, they may take info home to educate parents

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Capitalism

BAD:

The area is deprived, and therefore subject to health inequality

Local Authority house - likely not well maintained, damp, mould - contributes to illness

John is no longer the breadwinner and bringing home a salary as he feels is expected of him

Their place in society depends on the family's 'worth' to society - John is not working, but Sheila is, therefore they regress down the 'worth' to even lower class

Chloe is not a 'nuclear' family, no man in the picture, therefore unable to continue family functions such as reproduction, but can prepare and care for her child.

Single parents are seen as less functional / able / worthy

Protestant work ethic - sheila still working when ill, likely arrogance thinking the school will fall down if she is sick

GOOD:

They are a 'nuclear' family and have produced children which is 'expected' of them

Raising future workers to keep society going

Proving feminist marxism that women DONT rely on men to bring home the money

Preparing their children for society - knowing they are less able, so encouraging vocations instead of degrees.

Sheila is completing her role of two work days, keeping family healthy (or trying hard to) and providing unpaid care

Sheila is also a teaching assistant and helping to shape other 'workers of the future' and able to prepare children for society

How we can use this:
GOD KNOWS!? WE FOLLOW IT BY CHUCKING DRUGS AT EVERYTHING :( :(

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Conformity - Zimbardo (?); Milgram (1974); Asch (1951)

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Conformity - Zimbardo (?); Milgram (1974); Asch (1951)

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Zimbardo - stanford prison
Milgram - teacher / learner (authority pressure)
Asch - vision test
PLUS Winterbourne view
(Social conformity / Peer Pressure / Social Pressure)

BAD

Chloe has conformed to parents - has job, has ambitions

Chloe has had a child at age 18, it is possible it is the 'norm' in the area she lives in

Sheila - still working despite ill health, ?pressure to stay at work

Alfie has learned from his parents, but also succumbed to peer pressure, joyriding, drugs, but is attempting to go against peer pressure by signing up for college

John - the longer he is out of work, the more he conforms to societys image of a 'slacker' not working, depressed, claiming benefits

Neither shelia nor John are conforming to the 'sick role' in which they are expected to follow advice and get better.

HOW TO HELP / GOOD:

Alfie going to college gives him scope for new peer pressure, and will then 'conform' to his parents and society wishes of working

Encourage interaction with services, wellbeing, smoking cessation etc and following advice to get better - why arent they interacting?

It is ok to go against 'normal', society is changing every day, so their are always new 'norms'

Positive praise, honesty, small goals

Encourage patients to believe in themselves

Put patients first.  If you dont agree with a senior figure, stand up for them, patients are the centre of their care.

Gentrification - if you improve yourself, it can positively impact your surroundings (and ecological environment)

CONFORMITY IN HEALTHCARE
Fear of whistleblowing
Fear of speaking out - winterbourne, Francis
Group conformity
Healthcare trends / QOF - focus on those who you get paid for, chronic conditions, and QOF points pay for throwing medicines at people.

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Maslow's hierarchy of need - physiological, safety, love/belonging, esteem, self-actualisation

Chloes needs are filled, she is doing well, has ambitions

Alfies are not so good, he is likely at love/belonging, but is going to college so is moving up the triangle

John is going backwards down the triangle - losing self esteem, motivation, etc.

Sheila -  because everything is currently on her shoulders (double day), she is stressed and worrying, her hierarchy of needs are definitely not at the top , due to being neglected as child her emotional intelligence is poor and she is lacking self - control and self - esteem, therefore not at the top of Maslows triangle.....also lacking security and love, John is drinking, not working, no money, poor health etc

Rogers Core Conditions

Congruence (truth, honesty, candour) - being honest, positive praise, not telling off which will alienate them

Empathy - NOT sympathy, which contributes to learned helplessness, we dont know their story, all their history, but we can try to imagine

Unconditional Positive Regard - no matter what they throw at us, we remain polite, and empathetic

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Redcar and Cleveland are below the England average for ALL indicators

BAD

Health made worse by work (John, Sheila)

People reporting low life satisfaction (John, ?Sheila, ?Alfie)

Long term claimants of JSA (John)

GOOD

Development at age 5 (Chloe, Jemma is doing well at age 7)

Age 19-24 and unemployed (Alfie is going to college)

Outside spaces used for exercise / health (area is average with England, so the local authority / NHS is trying to improve things)

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Labelled as deviant due to association with youth offending team/cannabis use and hanging out with wrong croud etc.

Would also be labelled as 'deviant' by his peers if he DIDNT do the same things as them?

Link with symbolic interactionism - learnt behaviour, mum smokes, seen as a 'time out' and way to relax

And Social Interaction Theory - given 'permission' to do things by his peers doing it.  (Zimbardo broken window, and that teacher/learner one)

Operant conditioning Skinner- response - reinforcement: Alfie was with his gang, friends, smoking marihuana, accepted by friends (positive reinforcement) , got caught (punishment)

Attends his meeting and enrolled to college (positive reinforcement

Positives - attending apps with case worker and mechanics course

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John has developed "learned helplessness" Martin Seligman (1965).

* Teesside (Middlesbrough) is a deprive area due to the height of pollution and poor health. Social Determinants of Health are affected,  Michael Marmot (2010), the condition of which people are; born, live, grow, work and get old this affects the proletariat (the working class).

*With obsessions of economic growth in Teesside and the capitalism between bourgeoisie and proletariat ( conflict theory) Karl Marx (19th century).

* Capitalism is dominating Teesside, bureaucracy  and the protestant work ethic are greatly involved Max Weber ( early 19th century). workers in Teesside get paid little while capitalist get richer with the hard work given by the workers. Work could be a joy of John's to function as a father due to capitalism giving him hope ( Functionalism) Emile Durkheim (1858-1917).

* John feels alienated the moden work life has changed the way he sees him self and what he is capable  of Karl Marx (19th century).

*John has been labelled as unemployed and developed secondary deviance which has developed into him being labeled as an alcoholic Howard Becker (1960's).

*Johns not atending his support group because he has become a pessimist, he has convinced him self he is worthless because of his deperssion he is suffering from and learned helplessness, Martin Seligman (1965).

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Bowlby - 44 thieves - more likely deviant if seperated in the first 5 years

Sheila married a man 11 years older than her - not a social 'norm' and would be classed as 'looking for a father figure' - she was neglected and seperated when she was small.

Ainsworth - secure base, attachment styles

All appear to have secure attachment, despite Sheila's neglect when she was younger.

Chloe and Jemma are doing well, so likely a secure attachment there, which Chloe would have learned from her family.

It is possible that Sheila has an ambivalent attachment style, as Chloe is doing well (although being a young mum) but Alfie is showing deviance, and she cannot manage his behaviour

They all live in the house together which is likely their secure base, neither child has moved on, or run away.

Lorenz - Imprinting - born with innate sense, but have to be learned at the time the brain is 'open'

Sheila struggles to manage Alfies behaviour, and due to early neglect, may not have 'learned' how to deal with difficult situations and emotions.

Sheila's attachment style was firstly avoidant (when neglected by her parents), than ambivalent - moving from one foster care to another, had no chance to develop a secure base with her caregivers, very confused and probably became like a little adult when toddler or teenager, self - reliant and dealing with her problems on her own, scared of seeking help and support

How can we use it:

Being a secure base ourselves for them to engage with when health goes wrong

Ensuring secure attachment and not ambivalent - same demeanour every time, not up and down.

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Social Psychology (or how others affect your behaviour and vice-versa!) - Symbolic Interactionism (Blumer,  & Labelling Theory (Becker, 1963); Ecological Theory (Bronfenbrenner, ?); Emotional Intelligence (Salovey & Mayer, 1990)

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Social Psychology (or how others affect your behaviour and vice-versa!) - Symbolic Interactionism (Blumer,  & Labelling Theory (Becker, 1963); Ecological Theory (Bronfenbrenner, ?); Emotional Intelligence (Salovey & Mayer, 1990)

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Alfie is labelled as deviant for his joyriding and drug use.  Also labelled as criminal

Alfie would probably be labelled as deviant by his peers if he did not participate in these actions.  (rock and a hard place!!!)

John is deviant in non-concordance with wellbeing service, still being out of work, drinking too much - he is not fulfilling his sick role duties (functionalism)

John is labelled as 'slacker' and 'underclass' because of long term benefits

Sheila is also being deviant in not fully engaging with smoking cessation and seeking help and taking on the sick role for palpitations.

Chloe is likely labelled as 'single mum' but is going against this by working, her daughter doing well, and still living as a family unit

Sheila's emotional intelligence is likely lower than others due to her neglect as a child - emotions take over and she gets angry with Alfie, worries about John but does not deal with it

Ecological theory -

micro = immediate family, meso = those who family members interact with (ie work peers), exo = media, neighbourhood, macro = government, laws, society

Micro:  up till now the family have functioned well, but with Johns continued downhill trend, sheila becoming ill and not seeking help it could knock Chloe and Alfie (and Jemma) off their positive tracks and influence them

Meso: John does not have work colleagues, may well spend his day at home, or with other 'labelled' deviants / slackers.  Sheila has co-workers who are likely well educated (Degrees for teachers, NVQ's for TA's) as does Chloe (degrees for GP / nurses, NVQ's other colleagues) which will influence their micro system, and Jemmas meso system.  Alfie will hopefully have a micro system including teachers at college, combined with Jemma and Sheilas colleagues in his meso system.

John and Sheila will have a meso system containing Chloes NHS colleagues, which hopefully will help to impact upon their behaviour towards their illnesses.

Exo: All are influenced by their local area, the social and health inequality, economic inequality is very likely, and the area being polluted is not good for health and wellbeing.  It will have a big impact, and short of moving elsewhere is not easy to ignore.

Macro: We are in a recession, money is difficult for everyone, banks / credit problems.  Renting their home, dont own it, nothing to leave children, no way to help them get their own homes.  No way out? (learned helplessness - unable to do anything to stop the bad things)

Sheila and Alfie have likely use smoking as a coping mechanism, as John does with alcohol.

Having been in foster care, its possible Sheila is suspicious of health professionals, and does not want to go to the doctor.  May then inadvertently put John off if she says negative things.

John and Sheila in particular are quite young parents (although that is the norm nowadays) but there is 9 years difference between Chloe and Alfie, and their ecological factors would be completely different as John and Sheila grew older.

USE FOR US:

Consider how well we act and interact with others

At work we need to be as emotionless as we can, take a step back if we need to, not let emotions control us

Promote good emotions and thus good behaviour, dont focus on 'feeling sad'  focus on 'how to feel happy / what makes me feel happy'

Rogers core conditions - be honest, be truthful, empathetic and not sympathetic.

Dont enable deviant behaviour, but remember society changes, and so does the deviant label

Do not label / sterotype.  Everyone is individual, shaped by their 'journey'

Dont reinforce bad behaviour by changing how we interact, i.e. dont step into Mr Arseholes room and keep it going by being Dr Arsehole back)

Holistic assessment - a patients environment and ecological systems are key to help and treat

Family help is essential in getting patients to take responsibility and be compliant.