The implications for the clinician of adopting a recovery model: the role of choice in assertive treatment.
Theory is something rarely referred to in psychiatric rehabilitation. But the following, though opinion at this point, is meant to be seen as part of a pursuit of theory in psychiatric rehabilitation and in social science. The ideas behind the writing here draw heavily from the work of Patricia Deegan, yet truly are as old as the Declaration of Independence. They are strongly tied to the values of freedom, liberty, and the pursuit of happiness, as choice was expressed as a value in the Bill of Rights, and the Declaration of Independence. The social sciences and the physical sciences are seen as differing, in the same way as the social sciences at root draw from personal experiences while the physical sciences are more objectively determined. Thus, the author believes it not possible to put forward social theory without going beyond the purely objective, and including implicit, non-removable aspects of subjectivity. The author is herein proposing that the implications for the clinician of adopting a recovery model impact the issue of client choice. The Western tradition is now tied to the personal freedom of individual choice and opportunity. This paper explores the benefits of offering people with mental illnesses tangible choices in those areas of life, which impact upon the individual's consequences. The goal is to place the client in maximal control of his/her consequences, to the degree that the individual is capable of comprehending the nature of the choices involved; for the alternative of professionals choosing for their clients will inevitably result in learned helplessness. Although all of case management involves assertive treatment, this paper refers to cases in any modality of treatment in which professionals strongly advocate within the lives of and with the cooperation of clients, with special focus on the clients who encounter the greatest obstacles to successful treatment. The term "client" is employed here as the author is clearly referring to the dynamics of a professional relationship. The existence of helping professionals presupposes the existence of clients.
Lunt
Alan
A
D002755:Choice Behavior; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration; D010818:Practice Patterns, Physicians'; D020127:Recovery of Function