Chapter Four

1. Chapter Four Models of Human Service Delivery

2. Three Models • Medical model • Public health model • Human service model

3. Medical Model • Oldest treatment model • Developed by medical profession • Assumes mental disorders are diseases/illnesses • Treatment=medication, laboratory studies, physical therapy • Psychiatric medication • Patient as recipient

4. Medical Model • This approach sees the person coming for help as “sick” or “ill” or otherwise not healthy • The physician or service provider is expected to treat and/or cure the disease • Historically, the model can be summarized by the following elements: symptom-diagnosis-treatment-cure

5. Medical Model and Human Services • Mary Richmond authored Social Diagnosis in 1917 and used the medical model to describe social casework • The social problem was rooted in the individual • The social physician was to heal the complex of conditions leading to the problem

6. Medical Model and Corrections • The corrections field adopted the medical model during the 1930s • The emphasis shifted from punishment to treatment • Rehabilitation was the treatment to allow reenter into society • Unfortunately, financial constraints limited this approach

7. Medical Model and Mental Illness • Philippe Pinel (1745-1826) applied the medical model to the field of mental illness • Mental disorders were seen as organic in nature and their diagnosis and treatment were a medical matter • Hence, those diagnosed with mental illness were to be treated as patients

8. Medical Model and Mental Illness • Sigmund Freud was initially a proponent of the medical model but would later revolutionize the treatment of mental illness with the psychoanalytic method • The patient/client would share thoughts with the therapist and the therapist would interpret the nature of their repression and suggest curative approaches

9. Medical Model and Mental Illness • Electroshock therapy was developed in the 1940s and use for a variety of conditions through the 1960s • It was effective for depression but less so for other conditions

10. Medical Model and Mental Illness • Subsequent to the 1960s psychotropic medications gained popularity • These drugs act upon the brain and are currently the most common approach to the treatment of mental illness • The study of the preparation, use, and effect of these drugs is pharmacology

11. Medical Model and Mental Illness • Psychopharmacology “focuses on the psychological effects of and the use of drugs to treat symptoms of mental and emotional disorders”

12. Psychiatric medication • Antipsychotics (major tranquilizers) • Haldol, Mellaril, Thorazine • Antidepressants (relieve depression) • Elavil, Prozac • Antianxiety drugs (minor tranquilizers) • Valium, Librium, Xanax) • Narcotic Pain Meds

13. Public Health Model • Somewhat difficult to define • It can be seen as to bridge the gap between medical model and human services model • Improving public health means improving education, nutrition, food safety, water supplies, immunization, maternal and child health

14. Public Health Model • Extension of medical model • Focuses on groups in population identified by geography, problems (abuse or poverty), or characteristics (elderly, children) • Illness /problem evaluated for impact on individual and on society • Treatment=treating individual and societal prevention

15. Human Service Model • Focuses on interaction between individual and environment • Stresses need for balance • Client/consumer/customer • Focus on interpersonal and environmental conflicts • Treatment=problem solving • Strengths-based

16. Human Service Model • Characteristics • Generic focus • Accessible, comprehensive, coordinated • Problem solving approach • Whole person • Accountable to consumer

17. Problem Solving Approach • General orientation • Problem identification • Generating alternatives • Decision making • Evaluation

18. Conclusion • All three models are in use today • Agencies may prefer one over the other depending on mission • Workers are usually skilled in and identify with one model