Chantier : Social contexts and the clinic

A seminar with Yannis Gansel (January 17, 2018)

The first seminar “Disruptive behaviour in children. Social contexts in the clinic” was held on January 17th, 2018 at the University Paris Descartes,.

What happens to the social context in mental health care for children? Clinical practice and social science research are both confronted to this question. How are to be taken into account family environment, socio-cultural factors, social and migratory trajectories? How do clinical practices and theory integrate these aspects? How to build a fruitful dialogue between social sciences and clinical thinking on these issues?

These questions constituted the thread of this first collaborative interdisciplinary session. Yannis Gansel, a child psychiatrist and an anthropologist (Hospices civils de Lyon / IHRIM), reflected on how his doctoral research and his professional practice feed each other.

The presentation opened a discussion on the crossings between anthropological, sociological and clinical approaches on children’s disruptive behaviours. This discussion started with three short, complementary comments from : Eunice Nakamura (anthropologist, Federal University of Sao Paulo, Brazil), Florent Bass (day hospital psychologist in CMPP) and Isabelle Coutant (sociologist, CNRS).

Several themes were explored during the session

  • How does the social context impacts disorders? Is it a contextual element that worsens or attenuates the disorder “from the outside”? Is it rather an element associated with the disorder but that could somehow be isolated, or else is it an integral part of the disorder?
  • How do care practices adapt to the specific social contexts, particularly when managing disruptive behaviours?
  • What do professionals make of the social context? Are contextual element only used when describing a situation, or are they rather incorporated into the clinical analysis? If so, how is this done? What are the professionals’ representations of social differences?
  • Working with families from different social backgrounds or cultures: some theoretical approaches have dealt with these questions, ethnopsychiatry being a prominent one. What is their current relevance? How can the sensibility to the social context be expressed today in clinical practice? Can we envision a sociopsychiatry, which would consider the differences between specific social groups?
  • How should clinical work procede to take into account the social context? How is social work integrated in health care teams? What about multidisciplinarity and the roles of each one?
  • What role could play social sciences in advancing on these issues? What forms of collaboration and exchanges should social sciences and psychiatry build to move in this direction?