1. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. Chapter Four Models of Human Service Delivery

2. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. Three Models Medical model Public health model Human service model

3. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. Psychiatric medication Antipsychotics (major tranquilizers) –Haldol, Mellaril, Thorazine Antidepressants (relieve depression) –Elavil, Prozac Antianxiety drugs (minor tranquilizers) –Valium, Librium, Xanax) Narcotic Pain Meds

13. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. Human Service Model Characteristics –Generic focus –Accessible, comprehensive, coordinated –Problem solving approach –Whole person –Accountable to consumer

17. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. Problem Solving Approach General orientation Problem identification Generating alternatives Decision making Evaluation

18. Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc. 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