Contemporary Psychotherapy and the Medical Model: Response to “Thinking About Our Work: What Do We Mean by ‘Mental Health’?”

Group ◽  
2017 ◽  
Vol 41 (2) ◽  
pp. 163
Author(s):  
Chris Scott
Keyword(s):  
Mental Health ◽  
Medical Model ◽  
Model Response ◽  
Contemporary Psychotherapy

scholarly journals Centering Social Justice in Mental Health Practice: Epistemic Justice and Social Work Practice

2021 ◽  
pp. 104973152110109
Author(s):  
Marjorie Johnstone
Keyword(s):  
Mental Health ◽  
Social Justice ◽  
Social Work ◽  
Lived Experience ◽  
Medical Model ◽  
Work Practice ◽  
Social Work Practice ◽  
Policy Advocacy ◽  
Health Practice ◽  
Epistemic Justice

This article examines how mental health social work practice can move outside the hegemony of the medical model using approaches that honor the centering of social justice. By using the philosophical analysis of epistemic injustice and the ethics of knowing, I move out of the traditional psychiatric and psychological conceptual frameworks and discuss new guiding principles for practice. In the context of the radical tradition in social work and the impetus to blend theory with practice, I consider the use of narrative and anti-oppressive approaches to center social justice principles in individual dyadic work as well as in wider systems family and community work and policy advocacy. I evaluate these approaches through the principles of epistemic justice and discuss the importance of a relational collaborative approach where honoring the client and exploring lived experience are central to both the concepts of testimonial justice, hermeneutic justice and anti-oppressive practice.

The Current Situation in Psychiatry and its Effects on the Delivery of Mental Health Services in the Next Decade

1971 ◽  
Vol 2 (2) ◽  
pp. 138-145 ◽  
Author(s):  
William J. Horvath
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Behavioral Treatment ◽  
Additional Data ◽  
Current Knowledge ◽  
Medical Model ◽  
Behavioral Disorder ◽  
Treatment Alternative

As long as mental illness is regarded as primarily a behavioral disorder, current and foreseeable manpower shortages in psychiatry make it necessary to increase the participation of nonmedical personnel in the treatment process. The controversy between those advocating behavioral treatment and those favoring the medical model cannot be resolved due to the fact that our current knowledge of the biologic roots of mental illness is inadequate. A breakthrough in research in this area could resolve the argument and solve the manpower problem by transferring psychiatric disorders into physiologic disease susceptible to medical treatment. Alternative models for the delivery of mental health services can be developed to allow for different possibilities in the outcome of research. Additional data is needed, especially on the costs and effectiveness of future therapies, before an evaluation of programs can be carried out.

scholarly journals Mental Health Act reform

1999 ◽  
Vol 23 (10) ◽  
pp. 578-581 ◽  
Author(s):  
Trevor Turner ◽  
Mark Salter ◽  
Martin Deahl
Keyword(s):  
Mental Health ◽  
Medical Profession ◽  
Medical Model ◽  
Chief Executive ◽  
Radical Change ◽  
Medical Decision ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
Mental Treatment ◽  
Health Legislation

Psychiatrists have been complaining about mental health legislation for over a century (Smith, 1891), usually in terms of the delays engendered, paperwork and bureaucracy, and the impositions on clinical practice. As a result they have gained more powers, and perhaps much-needed status within the medical profession, to the concern of some commentators (e.g. Fennell, 1996). Thus, the ‘triumph of legalism’ (Jones, 1993) of the Lunacy Act 1890 was modified by the Mental Treatment Act 1930, whereby outpatients and voluntary patients were encouraged and ‘asylums' became ‘mental hospitals'. Then came the radical change of the Mental Health Act (MHA) 1959, making compulsory detention an essentially medical decision and removing the routine of the courts, but retaining a theme of requiring ‘treatment in hospital’. The Mental Health Act 1983, however, was a touch anti-medical, since it strengthened the role of the approved social worker (ASW) and enhanced the importance of a patient's consent to treatment. “The primacy of the medical model and the paramountcy of the psychiatrist are certainly subject to greater limitations and external review”, was the opinion of William Bingley, then Mind's Legal Director, now Chief Executive of the Mental Health Act Commission – reviewing the Act in its early days (Bingley, 1985).

Multidisciplinary working, evidence, treatment, and decision-making in medicine

2019 ◽  
pp. 70-88
Author(s):  
Ahmed Samei Huda
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Treatment Effectiveness ◽  
Medical Model ◽  
Mechanisms Of Action ◽  
Initial Assessment ◽  
Controlled Trials ◽  
Emergency Situations ◽  
Quantitative And Qualitative Research ◽  
Multidisciplinary Working

Patients have many needs and not all can be met using the medical model, hence the necessity of multiple therapeutic models and multidisciplinary working. Doctors’ sapiental role relies on evidence from research which can vary in quality. Quantitative and qualitative research are both useful. Randomized controlled trials with blinded assessments are the best method of assessing treatment effectiveness. Objectives of treatment should be jointly decided between doctor and patient and are often not simply about cure. Mechanisms of action of intervention do not always reverse disease progress but may involve other processes such as indirect compensation. Medication has many complex effects, both therapeutic and adverse. The medical model allows doctors to see many patients and work in emergency situations including providing overnight cover. This is because after the initial assessment, further assessments can be brief and if medication is used it is usually taken outside consultations. This ability to see many patients at all hours means mental health services will often include doctors using the medical model.

Right Answers, Wrong Reasons: Revisiting the Deletion of Homosexuality from the DSM

1997 ◽  
Vol 1 (3) ◽  
pp. 256-270 ◽  
Author(s):  
Gary Greenberg
Keyword(s):  
Mental Health ◽  
Health Professions ◽  
Social Constructionist ◽  
Scientific Authority ◽  
Psychotherapeutic Practice ◽  
Contemporary Psychotherapy ◽  
The Way

The deletion of homosexuality from DSM–II and subsequent diagnostic manuals is generally seen as a triumph of science over prejudice and oppression. An examination of actual circumstances of the deletion and of the changes that it engendered shows that this view overlooks crucial points. Specifically, the received version conceals the way that deletion served a nonscientific vision of justice, as well as that postdeletion practice regarding homosexuality is inescapably political and moral. These concealments help to maintain the mental health professions' claim to scientific authority, a claim that has little basis in fact. Furthermore, the deletion represented an inadvertent application of social constructionist principles to psychotherapeutic practice, one that makes clear the pragmatic value of postmodern psychologies to contemporary psychotherapy.

Two narratives: recovery journeys in mental health

2020 ◽  
Vol 24 (2) ◽  
pp. 105-110
Author(s):  
Andrew Voyce
Keyword(s):  
Mental Health ◽  
Design Methodology ◽  
Medical Model ◽  
Therapeutic Interventions ◽  
Mental Health Recovery ◽  
Health Issues ◽  
Content Type ◽  
Recovery Models ◽  
Practical Implications ◽  
Model Approach

Purpose The purpose of this study is to compare lived recovery journeys in mental health with recovery models. Design/methodology/approach Unstructured interviews with prompts were conducted with two individuals. Findings Some recovery models correspond in part with the live experience of subjects. These narratives have personal emphasis that is incongruent with the highlighted models. In particular, the subjects have a place for therapeutic interventions, i.e. talking therapies and medication. Research limitations/implications The live experience of the two people with mental health issues crosses boundaries of recovery models. Relevant models include those used in peer support; however, they too do not fit exactly with the detailed journeys. Practical implications A varied approach without preconceptions is appropriate to understand the components of these two recovery journeys. Social implications The medical model approach to mental health is not discounted rather it is integral to these two recovery journeys. Originality/value This is qualitative research using stated models of mental health recovery. In addition to the principles of hope, meaning, connectedness, identity and empowerment, the two subjects include the essential part for medication and talking therapies in their recovery.

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