Health Care Analysis

, Volume 16, Issue 2, pp 77–96 | Cite as

Empowerment: A Conceptual Discussion

Original Article

Abstract

The concept of ‘empowerment’ is used frequently in a number of professional areas, from psychotherapy to social work. But even if the same term is used, it is not always clear if the concept denotes the same goals or the same practice in these various fields. The purpose of this paper is to clarify the discussion and to find a plausible and useful definition of the concept that is suitable for work in various professions. Several suggestions are discussed in the paper, for example control over life or health, autonomy, ability, self-efficacy, self-esteem, and freedom, and it is concluded that there are two plausible complementary uses, one as a goal and one as a process or approach. Empowerment as a goal is to have control over the determinants of one’s quality of life, and empowerment as a process is to create a professional relation where the client or community takes control over the change process, determining both the goals of this process and the means to use.

Keywords

Ability Autonomy Control Definition Empowerment Freedom Process Self-esteem Self-efficacy Health Knowledge Quality of life 

Notes

Acknowledgements

I would like to thank Lennart Nordenfelt and Bengt Brülde for valuable comments on earlier versions of this paper.

References

  1. 1.
    Adams, R. (2003). Social work and empowerment (3rd ed.). Hampshire: Palgrave.Google Scholar
  2. 2.
    Bandura, A. (1982). Self-Efficacy mechanism in human agency. American Psychologist, 37(2), 122–147.CrossRefGoogle Scholar
  3. 3.
    Brülde, B. (2000a). Människans handlingsfrihet [The individual’s freedom to act]. Presens, 23/24, 3–6.Google Scholar
  4. 4.
    Brülde, B. (2000b). On how to define the concept of health: A loose comparative approach. Medicine, Health Care and Philosophy, 3, 305–308.Google Scholar
  5. 5.
    Brülde, B. (2007). Happiness theories of the good life. Journal of Happiness Studies, 8(1), 15–49.CrossRefGoogle Scholar
  6. 6.
    Brülde, B., & Tengland, P.-A. (2003). Hälsa och Sjukdom: En begreppslig utredning [Health and Disease: A Conceptual Investigation]. Lund: Studentlitteratur.Google Scholar
  7. 7.
    Carnap, R. (1971). The logical foundation of probability. Chicago: University of Chicago Press.Google Scholar
  8. 8.
    Chamberlin, J. (1997). A working definition of empowerment. Psychiatric Rehabilitation Journal, 20(4), 43–46, (http://www.power2u.org/articles/empower/working_def.html) 03012006.Google Scholar
  9. 9.
    Dworkin, G. (1988). The theory and practice of autonomy. Cambridge: Cambridge University Press.Google Scholar
  10. 10.
    Eklund, L. (1999). From citizen participation towards community empowerment. Academic Dissertation: University of Tampere, Tampere.Google Scholar
  11. 11.
    Foucault, M. (1977). Discipline and punish; The birth of the prison [Surveiller et punir: Naissance de la prison, Gallimard 1975]. London: Penguin Books.Google Scholar
  12. 12.
    Foucault, M. (1986). Michel Foucault: Power/Knowledge. C. Gordon (Ed.), Brighton: Harvester Press.Google Scholar
  13. 13.
    Freire, P. (1970 Pedagogy of the oppressed. New York: Continuum.Google Scholar
  14. 14.
    Freud, S. (1976). Orientering i Psykoanalysen [Vorlesungen zur Einführung in die Psychoanalyse]. Stockholm: Natur och Kultur, 1976.Google Scholar
  15. 15.
    Gibson, C. (1991). A concept analysis of empowerment. Journal of Advanced Nursing, 16, 354–361.PubMedCrossRefGoogle Scholar
  16. 16.
    Hagquist, C., & Starrin, B. (1997). Health education in schools—from information to empowerment models. Health promotion international, 12(3), 225–232.CrossRefGoogle Scholar
  17. 17.
    Illich, I. (1972). Deschooling society. London: Marion Boyars Publishers.Google Scholar
  18. 18.
    Illich, I. (2001). Limits to medicine: Medical nemesis—The expropriation of health. London: Marion Boyars Publishers.Google Scholar
  19. 19.
    Jones, P. S., & Meleis, A. I. (1993). Health is empowerment. Advances in Nursing Science, 15(3), 1–14.PubMedGoogle Scholar
  20. 20.
    Laverack, G. (2004). Health promotion practice. Power and empowerment. London: Sage.Google Scholar
  21. 21.
    Liss, P.-E. (2003). Begreppen vårdbehov, hälsa, empowerment och underordning. [The concepts need of care, health, empowerment, and subordination]. Research report: Linköping university.Google Scholar
  22. 22.
    Lietaer, G. (1998). From non-directive to experiential. In B. Thorn & E. Lambers (Eds.), Person-centred therapy: A European perspective (pp. 62–73). London: Sage.Google Scholar
  23. 23.
    Naryan D. (Ed.) (2002). Empowerment and poverty reduction: A sourcebook. Washington: The World Bank.Google Scholar
  24. 24.
    Nordenfelt, L. (1995). On the nature of health: An action-theoretic approach (2nd revised ed.). Dordrecht: Kluwer.Google Scholar
  25. 25.
    Nordenfelt, L. (1997). On ability, opportunity and competence: An inquiry into people’s possibility for action. In G. Holmström-Hintikka & R. Toumela (Eds.), Contemporary action theory (Vol I, pp. 145–158). Dordrecht: Kluwer.Google Scholar
  26. 26.
    Nussbaum, M. (2000). Woman and human development. The capabilities approach. Cambridge: Cambridge University Press.Google Scholar
  27. 27.
    O’Hara, M. (2006). The radical humanism of Carl Rogers and Paulo Freire: Considering the person-centered approach as a form of conscientiazao. In G. Proctor, et al. (Eds.), Politicizing the person-centered approach: An agenda for social change (pp. 115–126). Ross-on-Wye: PCCE Books.Google Scholar
  28. 28.
    Proctor, G., Cooper, M., Sanders, P., & Malcolm, B. (2006). Politicizing the person-centered approach: An agenda for social change. Ross-on-Wye: PCCS Books.Google Scholar
  29. 29.
    Raeburn, J., & Rootman, I., (1998). People-centered health promotion. Chichester: Wiley & Sons.Google Scholar
  30. 30.
    Rawls, J. (1971). A theory of justice. Oxford: Oxford University Press.Google Scholar
  31. 31.
    Rappaport, J. (1981). In praise of a paradox: A social policy of empowerment over prevention. American Journal of Community Psychology, 9(1), 1–25.PubMedCrossRefGoogle Scholar
  32. 32.
    Rappaport, J. (1984). Studies in empowerment: Introduction to the Issue. Prevention in Human Services, 3, 1–7.Google Scholar
  33. 33.
    Rappaport, J. (1985). The power of empowerment language. Social Policy, 16, 215–221.Google Scholar
  34. 34.
    Rissel, C. (1994). Empowerment: The holy grail of health promotion? Health Promotion International, 9(1), 39–47.CrossRefGoogle Scholar
  35. 35.
    Rodwell, C. (1996). An analysis of the concept of empowerment. Journal of Advanced Nursing, 23, 305–313.PubMedCrossRefGoogle Scholar
  36. 36.
    Rogers, C. (1961). On becoming a person. Boston: Houghton Mifflin.Google Scholar
  37. 37.
    Rogers, C. (1977). Carl Rogers on personal power. New York: Delacorte.Google Scholar
  38. 38.
    Ryle, G. (1971). Knowing that and knowing how, in collected papers, Vol II Collected essays 1929–1968. New York: Barnes & Noble.Google Scholar
  39. 39.
    Sen, A. (1999). Development as freedom. Oxford: Oxford U P.Google Scholar
  40. 40.
    Skelton, R. (1994). Nursing and empowerment concepts and strategies. Journal of Advanced Nursing, 19, 415–423.PubMedCrossRefGoogle Scholar
  41. 41.
    Starrin, B. (1997). Empowerment som tankemodell [Empowerment as a model for thought]. In E. Forsberg & B. Starrin (Eds.), Frigörande kraft—Empowerment som modell i skola, omsorg och arbetsliv. Stockholm: Gothia.Google Scholar
  42. 42.
    Swift, C., & Levin, G. (1987). Empowerment: An emerging mental health technology. Journal of Primary Prevention, 8(1&2), 71–94.CrossRefGoogle Scholar
  43. 43.
    Swift, A. (2006). Political philosophy: A beginners’ guide for students and politicians. Cambridge: Polity press.Google Scholar
  44. 44.
    Tengland, P.-A. (2001). Mental health: A philosophical analysis. Dordrecht: Kluwer Academic Publishers.Google Scholar
  45. 45.
    Tengland, P.-A. (2004). Empowerment: Mål eller medel för hälsovetenskaper [Empowerment: a goal or a means for the health sciences] In I. Nordin (Ed.), Rapporter från hälsans provinser. En jubileumsantologi. Linköping: Linköpings universitet, Tema H:s serie SHS, nr 32.Google Scholar
  46. 46.
    Tengland, P.-A. (2006). The goals of health work: Quality of life. Health and Welfare, in Philosophy, Medicine and Health Care, 9, 155–167.CrossRefGoogle Scholar
  47. 47.
    Tengland, P.-A. (2007a). Empowerment: A goal or a means for health promotion? Medicine, Health Care and Philosophy, 10, 197–207.CrossRefGoogle Scholar
  48. 48.
    Tengland, P.-A. (2007b). A two-dimensional theory of health. Theoretical Medicine and Bioethics, 28(4), in press.Google Scholar
  49. 49.
    Tones, K. (1997). Health promotion: Empowering choice. In L. Myers & K. Midence (Eds.), Adherence to treatment in medical conditions (pp. 133–160). London: Harewood academic publishers.Google Scholar
  50. 50.
    Vickridge, R., & Ayub, R. (2003). Participation and empowerment. In T. H. MacDonald (Ed.), The social significance of health promotion (pp. 43–65). London: Routledge.Google Scholar
  51. 51.
    Wallerstein, N., & Bernstein, E. (1988). Empowerment education: Freire’s ideas adapted to health education. Health Education Quarterly, 15(4), 379–394.PubMedGoogle Scholar
  52. 52.
    Wallerstein, N. (1992). Powerlessness, empowerment and health: Implications for health promotion programs. Behavior change, 6(3), 197–205.Google Scholar
  53. 53.
    WHO (1986). Ottawa charter for health promotion. WHO: Geneva.Google Scholar
  54. 54.
    WHO (1998). Health promotion glossary. WHO: Geneva.Google Scholar
  55. 55.
    Zimmerman, M. A., & Rappaport, J. (1988). Citizens participation, perceived control and psychological empowerment. American Journal of Community Psychology, 16, 725–750.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Health and SocietyMalmö UniversityMalmoSweden

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