Screening and Brief Alcohol Interventions: Money, Power and Equality

1. Screening and Brief Alcohol Interventions: Money, Power and Equality Mette Irmgard Snertingdal

2. Evaluation of a briefintervention training program The Norwegian health authorities practice a zero tolerance to alcohol during pregnancy.

3. Control from the inside or the outside? • ”Society cannot exist unless a controlling power upon will and appetite be placed somewhere, and the less of it there is within, the more there must be without” (Edmund Burk 1791)

4. The questions are: • What types of governance strategies does brief alcohol interventions such as MI represent? • And what are the social consequences of this governance strategy?

5. Medicalization: “Defines behavior as a medical problem or illness and mandating or licensing the medical profession to provide some type of treatment for it.” (Conrad 1975: 12 )

6. Governmentality: is a combination of the words govern and mentality, and is frequently defined as the “art of government” or governing.

7. General versus individualsocialcontrolmeasures. Alcohol policies primary importance “should be attached to general social control measures rather than to selected subgroups of the population which often, on very flimsy grounds, are labeled alcoholics” (Bruun, 1971, p. 36).

8. MI “Honor the person’s autonomy, draw forth the inherent desire to change, and take a collaborative—rather than confrontational—approach.” Bill Miller

9. The four corner stonesof MI • Empathy • Develop discrepancy • Roll with resistance • Support self -efficacy

10. What type ofpower is at workhere?

11. What type ofsocialcotrol is at workhere? «Selfcontrol from theinside or control by another person from theoutside?»

12. Governmentality • Technologies of power are the resources used to help develop good behavior with the idea of creating positive attitudes and attributes while attempting to avoid negative ones. • Technologies of self revolve around the capacity of individuals to control and therefore govern themselves.

13. Consequences? • «Blurs the line betweenstatlypower and individualpower»

14. Consequences? «assumpsjons of moral neutrality, domination by experts, individualizationofsocial problems, depoliticizationofbehavior, dislocationofresponsibilities, usingpowerfulmedicaltechnologies»

15. Consequences? • «Individualizationrefers to a process by whichindividualsincreasinglybecamethecause and are held accountable for theirsuccesses and theirfailures»

16. Consequences? Stigmatization and thecreationofguilt?

17. Question. • Doespregnant femaleswhomdrink a glass ofwineevery Friday afternoonwiththeir husband reallyneedtherapy?

18. Thankyouverymuch for yourattetion!