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Journal article

Parents' conceptualization of adolescents' mental health problems: who adopts a psychiatric perspective and does it make a difference?

Author:
MOSES Tally
Journal article citation:
Community Mental Health Journal, 47(1), February 2011, pp.67-81.
Publisher:
Springer

A cross-sectional, mixed-method study of 70 parents of adolescents receiving wraparound mental health services was used to examine: (1) how parents conceptualize their child’s mental health problems; (2) factors related to parents’ conceptualization of youths’ problems using medical model terms; and (3) associations between parents’ problem conceptualization and their emotional or coping responses to their child having psychiatric problem(s). Content analysis indicated that 54.3% of parents definitively conceptualized adolescents’ problems using psychiatric terms, 37.1% reported uncertainty about the nature of their child’s problems, and 8.6% gave alternative, non-psychiatric explanations for their child’s problems. Significant relationships were found between parents’ problem conceptualization and their attitudes and experience with mental health treatment, demographics, as well as with adolescents’ clinical characteristics. Parents who conceptualized problems using psychiatric terminology were more likely to express sadness and pessimism relative to other parents, though there were no differences in expressions of worry, guilt, pragmatism and optimism by problem conceptualization.

Journal article

The challenge of disability and access: reconceptualizing the role of the medical model

Author:
ROTHMAN Juliet C.
Journal article citation:
Journal of Social Work in Disability and Rehabilitation, 9(2-3), April 2010, pp.194-222.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA

The fields of social work and disability seek to optimise well-being and life experience for clients with disabilities. The field of disability has defined and explored several frameworks for understanding disability, which are currently polarised between the problem-centred medical models and the social disability as construction models. The differences and the interplay between them affect both individuals and society. In this article, four foundational social work theoretical models are considered in terms of their ability to integrate with disability frameworks and to address the differences between them. The author suggests the ‘bio-psycho-socio-cultural-spiritual’ model as the optimal model to both resolve the disability frameworks' duality and to optimally integrate social work and disability service provision.

Journal article

Decoupling psychological therapies from the medical model

Author:
SANDERS Pete
Journal article citation:
Therapy Today, 18(9), November 2007, pp.35-38.
Publisher:
British Association for Counselling and Psychotherapy

As counselling and psychotherapy move towards being a regulated profession, the author argues that it would be dangerous to commit to a medical model of mental health.

Journal article Full text available online for free

The medical model is dead: long live the medical model

Authors:
SHAH Premal, MOUNTAIN Deborah
Journal article citation:
British Journal of Psychiatry, 191(11), November 2007, pp.375-377.
Publisher:
Royal College of Psychiatrists

Many people criticise, and psychiatrists apologise, for the use of the ‘medical model’. The authors examine what is currently meant by this term and suggest a refinement of definition to reflect the ideals and contemporary practice of medicine. They propose that psychiatrists should use the medical model to improve and validate bio-psychosocial psychiatric medicine.

Journal article

Has the medical model a future?

Authors:
MCCULLOCH Andrew, et al
Journal article citation:
Mental Health Review, 10(1), March 2005, pp.7-15.
Publisher:
Pier Professional

Provides an overview of the current and future role of the 'medical model' within mental health care, seeking to locate it within the panoply of models available to explain mental health and illness and assess its merits. It considers its future role and proposes a way forward through synthesis and integration. The implications of this analysis for policy and services are assessed, concluding that we have only just started to think through the process of modernising mental health care using an integrative model.

Journal article

Bringing the social back in: a critique of biomedicalization of dementia

Author:
LYMAN K.A.
Journal article citation:
Gerontologist, 29(5), October 1989, pp.597-605.
Publisher:
Gerontological Society of America

Argues that adoption of the medical model of disease leads to neglect of the important social problems it presents.

Journal article

‘What meaning does somebody's death have, what meaning does somebody's life have?’ Psychotherapists’ stories of their work with suicidal clients

Authors:
NICHOLL Elizabeth, LOWENTHAL Del, GAITANIDIS Anastasios
Journal article citation:
British Journal of Guidance and Counselling, 44(5), 2016, pp.598-611.
Publisher:
Taylor and Francis

Working with suicidal clients is perceived to be demanding and anxiety provoking for psychotherapists. This investigation explores what it is like for psychotherapists who work with suicidal clients, particularly as within the prevailing culture there is an increasing focus on strategies aimed at suicide prevention. Five themes were identified through narrative analysis, with support systems such as supervision and peer support being seen as vital in surviving working with suicidal clients. However, there is also ambivalence about involving other professionals, such as mental health services, as there is a sense that to do so may be anti-therapeutic and unhelpful to the client. Overall, what emerges from this study is that it is important to challenge the prevailing culture in which a medical discourse is dominant, in order to find a different way of talking about suicide and despair. (Publisher abstract)

Journal article

A sociological exploration of the tensions related to interprofessional collaboration in acute-care discharge planning

Authors:
GOLDMAN Joanne, et al
Journal article citation:
Journal of Interprofessional Care, 30(2), 2016, pp.217-225.
Publisher:
Informa Healthcare

Patient discharge is a key concern in hospitals, particularly in acute care, given the multifaceted and challenging nature of patients’ healthcare needs. Policies on discharge have identified the importance of interprofessional collaboration, yet research has described its limitations in this clinical context. This study aimed to extend our understanding of interprofessional interactions related to discharge in a general internal medicine setting by using sociological theories to illuminate the existence of, and interplay between, structural factors and microlevel practices. An ethnographic approach was employed to obtain an in-depth insight into healthcare providers’ perspectives, behaviours, and interactions regarding discharge. Data collection involved observations, interviews, and document analysis. Approximately 65 hours of observations were undertaken, 23 interviews were conducted with healthcare providers, and government and hospital discharge documents were collected. Data were analysed using a directed content approach. The findings indicate the existence of a medically dominated division of healthcare labour in patient discharge with opportunities for some interprofessional negotiations; the role of organizational routines in facilitating and challenging interprofessional negotiations in patient discharge; and tensions in organizational priorities that impact an interprofessional approach to discharge. The findings provide insight into the various levels at which interventions can be targeted to improve interprofessional collaboration in discharge while recognizing the organizational tensions that challenge an interprofessional approach. (Publisher abstract)

Journal article

A critique of the diagnostic construct schizophrenia

Author:
WONG Stephen E.
Journal article citation:
Research on Social Work Practice, 24(1), 2014, pp.132-141.
Publisher:
Sage

This article examines problems in the clinical utility of the diagnosis of schizophrenia including reliance on questionable data, arbitrary criteria and categorization, inadequate precision for assessment and treatment evaluation, and omission of information on causal current and historical environmental factors. Some alternatives to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) are briefly considered including continuous recording of individual client’s specific problems and goals, and functional assessments and functional analyses. The article discusses how biomedical assumptions implicit in the DSM-5 diverts mental health workers’ attention from social adversity factors contributing to the development of psychotic behavior and available psychosocial interventions for this disorder, thereby perpetuating biomedical dominance of mental health services. (Publisher abstract)

Journal article

Promoting help-seeking among adolescents and young adults through consideration of the adaptive functions of low mood: a pilot study

Authors:
JOYCE Andrew, et al
Journal article citation:
International Journal of Mental Health Promotion, 13(4), November 2011, pp.30-35.
Publisher:
Taylor and Francis

Improving young people’s knowledge of depression and other mental illnesses may encourage them to seek help and therefore reduce the risk of suicide behaviour. Typically, the information presented to young people about mental health disorders has been based on a medical model, with depression framed as an illness analogous to a physical illness. This pilot study aimed to examine whether framing depression on the basis of evolutionary explanations for mental illness would influence help-seeking behaviour relative to the standard illness explanation. Specifically, the aim was to test an information sheet that contained these evolutionary concepts against an information sheet that used the medical model approach. The participants were 54 young adults, average age 19 years, 5 months, and 32 school-aged participants with an average age of 15 years, 2 months. After viewing information sheets, the participants rated which one they preferred according to how likely it would be to encourage them or others to seek help if feeling depressed. The majority of young adults preferred the evolutionary explanation, with even support for the 2 approaches from the school-aged participants. The findings provide a basis for further consideration of messages conveyed to young people about mental health problems.

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