E-Book, Englisch, 198 Seiten
ISBN: 978-1-61334-568-9
Verlag: Hogrefe Publishing
Format: EPUB
Kopierschutz: Wasserzeichen (»Systemvoraussetzungen)
Each chapter follows a concrete example exploring different techniques, tools, and resources that can be used with service users who have mental health challenges. An appendix provides the handouts in online, printable form. Written by experts in person-centered care who have diverse experiences with mental health-related practices, policies, research, and education, this comprehensive handbook is a valuable resource for psychiatrists and other mental health practitioners, researchers, educators, and policy makers who work with people who have mental health challenges as well as for service users and their families.
Zielgruppe
Psychiatrists, clinical psychologists, psychotherapists, and
counselors, and students as well as researchers and mental health administrators.
Autoren/Hrsg.
Fachgebiete
- Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Medizinische Fachgebiete Psychiatrie, Sozialpsychiatrie, Suchttherapie
- Sozialwissenschaften Psychologie Psychologie / Allgemeines & Theorie Psychologische Theorie, Psychoanalyse Humanistische Psychologie
- Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie Psychopathologie
Weitere Infos & Material
|1|1 Foundations
Mental Health Challenges and the Person-Centered Approach
Mental health challenges (MHCs) may be defined in different ways. The National Survey on Drug Use and Health (NSDUH) defines an MHC as “a mental, behavioral, or emotional disorder (excluding developmental and substance use disorders)” that is diagnosed within the year, meets Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria, impedes function, and restricts day-to-day activities (Substance Abuse and Mental Health Services Administration, 2015, p. 1). There are some who view mental health challenges as the suffering that comes from pain to one's self-worth or identity (Abramson, Metalsky, & Alloy, 1989; Beck, 1967). This may include diagnoses such as schizophrenia, major depressive disorder, bipolar affective disorder, obsessive-compulsive disorder, anxiety disorders (such as panic disorder), and others. A person-centered approach (PCA) – also referred to as client-centered care (CCC) or person-centered care (PCC) – has been a relatively modern attitude in the provision of services and care. PCAs are widely used in the care of individuals with dementia (Mitchell & Agnelli, 2015). PCAs are also used to counsel individuals experiencing depression (Sanders & Hill, 2014). For almost 20 years, the UK has incorporated PCA into legislative policies along with best practice guidelines (Department of Health, 2001, 2005, 2006, 2009). In Rudnick & Roe (2011) PCA is discussed as a multidimensional construct (which includes the PCA process), person-focused (with the service user as the primary beneficiary), person-driven (the service user makes choices on the course of care actions), person-sensitive (specific to service user needs), and person-contextualized (past and present experiences are taken into consideration). The fundamental characteristics of PCA that service providers embody in a clinical relationship include those of understanding, compassion, authenticity or a genuine nature, acceptance, and unconditional positive regard, as well as empowerment or the supporting of the autonomy of the service users in their own lives (Rogers, 1949, 1956). Service providers embody these characteristics as a way of being to create a safe space where service users can work through their challenges. This may require service providers to cultivate themselves in a way that aligns with these qualities. The service provider has a sense of connectedness to the service user as a human being. Compassion involves getting into another person’s world regarding their experience, where the service provider becomes present to the associated thoughts and feelings of the service user. Of importance, compassion |2|involves taking an action, however small, which is in line with the service provider’s intention to support the service user towards recovery. Interestingly, this in turn allows for the delivery of person-centered care while being a resilient service provider (Thibeault, 2020). PCA also involves developing and maintaining supportive relationships with service users, along with (self-)respect for service users, their experiences, strengths, knowledge, and autonomous choice (Hammell, 2013). Little et al. (2001) developed a model of patient-centeredness that includes five elements: Looking at the service user’s experience with MHCs and their effects Considering the person as a whole, including their emotions and environmental context Common ground between the service user and service provider to decide upon a care plan Health promotion and taking preventative measures Improving the service user–service provider relationship through shared power. The person–environment–occupation (PEO) model is another tool that may be used to consider personal (physical, cognitive, affective), environmental (cultural, physical, social, institutional), and occupational (self-care, productivity, leisure) components that contribute to the uniqueness of an individual (Law et al., 1996). This model is person-centered in that it requires collaboration with service users and is directed by their abilities, needs, interests, contexts, and more. PCA may be applied through several different methods across health care disciplines. The key is putting the individual at the center of care. Benefits and Challenges of the Person-Centered Approach
PCAs are methods that may be applied when working with service users. Involvement of service user preferences throughout the duration of the relationship is important. PCA may foster a sense of empowerment in the service user’s life, which may lead to increasingly effective interventions (Ladd & Churchill, 2012). In them, we discuss achieving a balance between the dominant medical model approaches, with that of PCA. At times, there are acute psychological symptoms that may effectively be treated with medication. At the same time, PCA is useful to address the various factors that may have contributed to MHCs in the first place. PCA lends flexibility for both service users as well as service providers. It can be employed by new and seasoned professionals, may be used regardless of age, can be applied to different health challenges, and provides a framework from which professionals can hone their skills when working with service users (Brown, Thornton, & Stewart, 2012). PCA applies to service users who experience all kinds of challenges, whether it is mental, cognitive, intellectual, or otherwise. It is accessible to different cultures and disciplines, which means that PCAs have a broad applicability in the field of mental health (Cooper, O’Hara, Schmid, & Bohart, 2013). |3|PCA helps to validate a person’s needs, wants, preferences, beliefs, values, and more, and is shown to have mental, physical, and economic benefits (Ekman et al., 2011). These approaches support service users to develop and maintain their strengths and abilities, promoting self-efficacy, confidence, and the ability to make their own decisions (Fors, Taft, Ulin, & Ekman, 2016). PCA may help service users to maintain all or part of their independence and begin or maintain effective health behaviors (Innes, Macpherson, & McCabe, 2006). The PCA of shared decision making is rated higher among service users in the domain of quality of care when compared with those who have not experienced shared decision making during their care (Solberg et al., 2014). Ultimately, with PCA, service users may have an improved quality of life (US Department of Health and Human Services, 2010). It has been reported that service providers who employ PCA may provide more effective care emotionally, physically, and even spiritually (Puchalski, Vitillo, Hull, & Reller, 2014). PCA helps to maintain an awareness of the person being supported rather than the service provider’s attention shifting to the symptomologies of various diseases (van der Laan, van Offenbeek, Broekhuis, & Slaets, 2014). It builds trust and mutual respect, which may create greater ease in the clinical relationship (Cloninger, 2011). Brown et al. (2012) have illustrated the utility of PCA through various experiences and interactions of service users and service providers, and ways to address challenging situations. They explore the service user’s experience with MHCs by looking at the person as a whole, and searching for a common denominator between the service user and the service provider, which may enhance the clinical relationship. PCAs have been shown to improve the overall operation of health care settings (Epstein, Fiscella, Lesser, & Stange, 2010). Bertakis and Azari (2011) also found that PCA is associated with decreased annual medical charges as compared with a non-PCA in primary care. PCA supports service users in improving their understanding of the challenges they are experiencing, to the extent that they access emergency services less frequently (Epperly et al., 2015). It has been shown that service users are also thereby more likely to adhere to their treatment plan (Robinson, Callister, Berry, &...
