The Solving Problems in Everyday Living Model: Toward a Demedicalized,Education-Based Approach to “Mental Health”

Abstract

We argue that human existential pain and threat may usefully be helped by a noncoercive educational approach that also resonates with many interpersonally focused psychological approaches, rather than by the widely touted current medical model of “mental health” treatment (using psychoactive drugs and supportive psychotherapy). First, the “progress” leading to the latest Diagnostic and Statistical Manual of Mental Disorders is briefly reviewed, highlighting the scientific limitations of the medical model. Next, an educational model of self-understanding and change, based on Popper’s fallibilism, Freire’s critical pedagogy, and Miller’s feedback-informed treatment is explicated. Finally, some options for funding and testing the model are discussed. We hope this offers mental health clinicians another important alternative to conceptualize the helping encounter to ameliorate personal problems in living.

Keywords

education feedback-informed treatment medical model mental health personal change psychiatry psychotherapy social work

Get full access to this article

View all access options for this article.

References

Alakeson

(2010). International developments in self-directed care. Commonwealth Fund, 78, 1-11.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Andreasen

N. C.

(2007). DSM and the death of phenomenology in America: An example of unintended consequences. Schizophrenia Bulletin, 33, 108-112.

Asay

T. P.

Lambert

M. J.

(1999). The empirical case for the common factors in therapy. In Hubble

M. A.

Duncan

B. L.

Miller

S. D.

(Eds.), The heart and soul of change: What works in therapy (pp. 23-55). Washington, DC: American Psychological Association.

Bailey

(1995). Karl Popper as educator. Interchange, 26, 185-191.

Bandura

(1961). Psychotherapy as a learning process. Psychological Bulletin, 58, 143-159.

Bargmann

Robinson

(2012). Manual 2: Feedback-informed clinical work: The basics. Chicago, IL: International Center for Clinical excellence.

Bentall

R. P.

(2003). Madness explained: Psychosis and human nature. London, England: Penguin Books.

Bringhurst

Watson

Miller

Duncan

(2006). The reliability and validity of the Outcome Rating Scale: A replication study of a brief clinical measure. Journal of Brief Therapy, 5(1), 23-30.

10.

Campbell

Hemsley

(2009). Outcome Rating Scale and Session Rating Scale in psychological practice: Clinical utility of ultra-brief measures. Clinical Psychologist, 12, 1-9.

11.

Caplan

P. J.

(1995). They say you’re crazy: How the world’s most powerful psychiatrists decide who’s normal. New York, NY: Perseus Books.

12.

Chatoor

Krupnick

(2001). The role of non-specific factors in treatment outcome of psychotherapy studies. European Child & Adolescent Psychiatry, 10(Suppl. 1), 119-125.

13.

Chomsky

(2000). Chomsky on miseducation. Lanham, MD: Rowman & Littlefield.

14.

Cooke

(Ed.). (2014). Understanding psychosis and schizophrenia. Retrieved from http://www.bps.org.uk/networks-and-communities/member-microsite/division-clinical-psychology/understanding-psychosis-and-schizophrenia

15.

Deacon

B. J.

(2013). The biomedical model of mental disorder: A critical appraisal of its validity, utility, and effects on psychotherapy research. Clinical Psychology Review, 33, 846-861.

16.

DSM-5 Open Letter Committee. (2012, June). Response to the final DSM-5 draft proposals by the Open Letter Committee. Retrieved from http://dsm5-reform.com/2012/06/response-to-the-final-dsm-5-draft-proposals-by-the-open-letter-committee/

17.

Duncan

B. L.

Miller

S. D.

Wampold

B. E.

Hubble

M. A.

(2010). The heart & soul of change: Delivering what works in therapy (2nd ed.). Washington, DC: American Psychological Association.

18.

Elkins

D. N.

(2009). The medical model in psychotherapy: Its limitations and failures. Journal of Humanistic Psychology, 49, 66-84.

19.

Frances

(2012a, February 2). Can the press save DSM-5 from itself? Huffington Post. Retrieved from http://www.huffingtonpost.com/allen-frances/dsm-5-press_b_1272068.html

20.

Frances

(2012b, May 8). Newsflash from APA meeting: DSM-5 has flunked its reliability tests. Huffington Post. Retrieved from http://www.huffingtonpost.com/allen-frances/dsm-5-reliability-tests_b_1490857.html

21.

Frances

(2013). Saving normal. New York, NY: HarperCollins.

22.

Frank

J. D.

Frank

J. B.

(1993). Persuasion and healing: A comparative study of psychotherapy. Baltimore, MD: John Hopkins University Press.

23.

Freire

(1970). Pedagogy of the oppressed. New York, NY: Continuum Publishing.

24.

Freire

(2014). Education for critical consciousness. New York, NY: Bloomsbury Academic. (Original work published 1974)

25.

Freire

(1985). The politics of education. Granby, MA: Bergin & Garvey.

26.

Giroux

H. A.

(1985). Introduction. In Freire

(Ed.), The politics of education (pp. xi-xxv). Granby, MA: Bergin & Garvey.

27.

Gomory

(1997). Mental health services. In Reisch

Gambrill

(Eds.), Social work in the 21st century (pp. 163-174). Thousand Oaks, CA: Pine Forge Press.

28.

Gomory

(2013). The limits of evidence-based medicine and its application to mental health evidence-based practice (Part 1). Ethical Human Psychology and Psychiatry, 15(1), 18-34.

29.

Gomory

Cohen

Kirk

S. A.

(2013). Coercion: The only constant in psychiatric practice? In Dellwing

Harbusch

(Eds.), Krankheitskonstrukti.und Krankheitstreiberei: Die Renaissance der soziologischen Psychiatriekritik [Disease constructions and disease mongering] (pp. 289-312). Berlin, Germany: Springer.

30.

Greenberg

(2013). The book of woe: The DSM and the unmaking of psychiatry. New York, NY: Blue Rider Press.

31.

Guerney

B. G.

Stollak

Guerney

(1971). The practicing psychologist as educator: An alternative to the medical practitioner model. Professional Psychology, 2, 276-282.

32.

Hacohen

M. H.

(2002). Karl Popper: The formative years, 1902-1945, politics and philosophy in interwar Vienna. New York, NY: Cambridge University Press.

33.

Holzman

(2014). “Vygotskian-izing” psychotherapy. Mind, Culture and Activity, 21, 184-199.

34.

Insel

Cuthbert

Garvey

Heinssen

Pine

D. S.

Quine

. . .Wang

(2010). Research domain criteria (RDoC): Toward a new classification framework for research on mental disorders. American Journal of Psychiatry, 167, 748-751.

35.

Jacobs

D. H.

Cohen

(2010). Does “psychological dysfunction” mean anything? A critical essay on pathology versus agency. Journal of Humanistic Psychology, 50, 312-334.

36.

Kinderman

Read

Moncrieff

Bentall

R. P.

(2013). Drop the language of disorder. Evidence-Based Mental Health, 16, 2-3.

37.

Kirk

S. A.

Gomory

Cohen

(2013). Mad science: Psychiatric coercion, diagnosis, and drugs. New Brunswick, NJ: Transaction.

38.

Kirsch

Deacon

B. J.

Huedo-Medina

T. B.

Scoboria

Moore

T. J.

Johnson

B. T.

(2008). Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine, 5, 260-268.

39.

Kirylo

J. D.

(2011). Paulo Freire: The man from Recife. New York, NY: Peter Lang.

40.

Kutchins

Kirk

S. A.

(1988). The business of diagnosis: DSM-III and clinical social work. Social Work, 33, 215-220.

41.

Lacasse

J. R.

(2014). After DSM-5: A critical mental health research agenda for the 21st century. Research on Social Work Practice, 24, 5-10.

42.

McLeod

S. A.

(2015). Humanism. Retrieved from www.simplypsychology.org/humanistic.html

43.

McWilliams

(2003). The educational aspects of psychoanalysis. Psychoanalytic Psychology, 20, 245-260.

44.

Miller

S. D.

Duncan

B. L.

Brown

Sorrell

Chalk

M. B.

(2006). Using formal client feedback to improve retention and outcome: Making ongoing, real-time assessment feasible. Journal of Brief Therapy, 5(1), 5-22.

45.

Miller

S. D.

Duncan

B. L.

Brown

Sparks

J. A.

Claud

D. A.

(2003). The Outcome Rating Scale: A preliminary study of the reliability, validity, and feasibility of a brief visual analog measure. Journal of Brief Therapy, 2(2), 91-100.

46.

DeVilder

(2013). The pedagogy of recovery. Psychiatric Services, 64, 1068-1069.

47.

Peckham

(1979). Explanation and power: The control of human behavior. New York, NY: Seabury Press.

48.

Perkinson

(1984). Learning from our mistakes: A reinterpretation of twentieth-century educational theory. New York, NY: Praeger.

49.

Popper

K. R.

(1963). Conjectures and refutations: The growth of scientific knowledge (2nd ed.). London, England: Routledge.

50.

Popper

K. R.

(1979). Objective knowledge. New York, NY: Oxford University Press.

51.

Radin

(2009). Brain compatible teaching and learning: Implications for teacher education. Educational Horizons, 88(1), 40-50.

52.

Read

Haslam

Sayce

Davies

(2006). Prejudice and schizophrenia: A review of the “mental illness is an illness like any other” approach. Acta Psychiatrica Scandinavica, 114, 303-318.

53.

Robbins

B. D.

Kamens

S. R.

Elkins

D. N.

(2017). DSM-5 reform efforts by the Society for Humanistic Psychology. Journal of Humanistic Psychology, 57, 602-624. doi:10.1177/0022167817698617

54.

Rogers

C. R.

(1959). Significant learning: In therapy and in education. Educational Leadership, 16, 232-242.

55.

Rogers

C. R.

(1983). Freedom to learn for the 80’s. New York, NY: Macmillan.

56.

Rousmaniere

(2017). Deliberate practice for psychotherapists: A guide to improving clinical effectiveness. New York, NY: Routledge.

57.

Substance Abuse and Mental Health Services Administration. (2013). National expenditures for mental health services and substance abuse treatment 1986-2009. Washington, DC: U.S. Department of Health & Human Services.

58.

Swann

(2012). Learning, teaching and education research in the 21st century: An evolutionary analysis of the role of teachers. New York, NY: Bloomsbury Academic.

59.

Szasz

(1963). Psychoanalysis as education. Archives of General Psychiatry, 6, 46-52.

60.

Szasz

(1974). The myth of mental illness: Foundation of a theory of personal conduct (Rev. ed.). New York, NY: Harper & Row.

61.

Szasz

(1987). Insanity: The idea and its consequences. New York, NY: John Wiley.

62.

Tallis

(2011). Aping mankind: Neuromania, Darwinitis, and the misrepresention of humanity. Bristol, CT: Acumen.

63.

Tharp

R. G.

(1999). Therapist as teacher: A developmental model of psychotherapy. Human Development, 42, 18-25.

64.

Vail

D. J.

(1959). Education as therapy. Psychiatric Services, 10(3), 17-19.

65.

Wampold

B. E.

(2012). Humanism as a common factor in psychotherapy. Psychotherapy, 49, 445-449.

66.

Wampold

B. E.

Imel

Z. E.

(2015). The great psychotherapy debate: The evidence for what makes psychotherapy work (2nd ed.). New York, NY: Routledge.

67.

Welch

Klassen

Borisova

Clothier

(2013). The DSM-5 controversies: How should psychologists respond? Canadian Psychology, 54, 166-175.