Doctoral Dissertation Research: How Problem Gambling is Medicalized

Duke University, Durham NC

Investigators

Abstract

SES-1131382 Linda Burton Rose Buckelew Duke University Doctoral Dissertation Research: How Problem Gambling is Medicalized Abstract This 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.