Comparing and Contrasting Two Styles of Psychological Recovery: the Medical Model vs the Recovery Model

When it comes to psychological disorders, there are many schools of thought regarding treatment, each with its own merits. However, there are two basic methods of recovery that most people subscribe to. These are the medical model for recovery, which relies more on medicine and other tangible measures for recovery, and the recovery model, which focuses much more on the individual and intangible methods to recovery. Each of these can be effective, depending on the person. But in order to get a general idea of what exactly these models entail, as well as which one is, generally, more effective, it is necessary to examine just how these two models operate.

To start with the more basic one, the medical model, one must understand the psychology surrounding it. Those who successfully utilize the medical model tout its strong use of logic and evidence in diagnosing and treating psychological disorders. To this end, the medical model of recovery is constantly evolving, as new forms of treatment are discovered and implemented. One common belief is that the medical model of recovery simply relies more on medication, but this is not necessarily the case. In fact, recent definitions of the term put the medical model as any sort of attempt for treatment of psychological disorders that utilizes the best available evidence and, after treatment, asks "did that work?"  Treatment can be medicinal in nature or can include various therapies such as dialectical behavior therapy or cognitive behavioral therapy. If the answer is no, further research will be conducted, and other forms of treatment attempted (Mountain and Shah, 2008). One of the key features of the medical model, which is, to an extent, shared by the recovery model, is the concept of what "recovery" actually entails. To this end, scientists and scholars believe that "healing, empowerment, connection, human rights, a positive culture of healing and recovery-oriented services" as key goals in recovery, even for the medical model (Mountain and Shah, 2008). While the recovery model does also simply use "hope" as a sort of panacea, the medical model also creates its own criterion for recovery, as psychological disorders are generally not physical. For this reason, while an alleviation of symptoms is the primary goal of medical models of recovery, they also must consider the ultimate benefit that alleviating these symptoms brings, which is, in most cases, a general increase in the quality of life, or, if the condition is advanced and the treatment only partially works, a sign of hope. Although the medical model utilizes drugs and other concrete methods in order to alleviate symptoms, the ultimate goal of the medical method is similar to the recovery method in the desire for a greater quality of life in the patient, something many people forget about the medical model.

Hope is the core tenant of the recovery model. In fact, the factors that the medical model generally considers important (one of which is hope) is the primary motivation in the recovery model. More specifically, those within the medical community who subscribe to the recovery model believe that the medical model neglects quality of life considerations. This is untrue, of course, but for those in the recovery model mode of thinking, life satisfaction is the only thing that matters, because the recovery model, ultimately, is only about the patient, and how they feel. To this end, much of the treatment options within the recovery model are much less concrete and, some would argue, less objectively effective than the medical model. That remains to be seen, but in terms of treatment, the recovery model uses a number of tools. For starters, as stated earlier, the use of hope and optimism is one of the most important tools for practitioners of the recovery method. In order to help document this and develop the right form of treatment, doctors will often simply ask the patient, pre and post-treatment, about their overall feelings of hope and quality of life in order to help determine if a treatment was successful. Another technique frequently used in the recovery model is the use of "stories." This is where doctors take "histories," or stories, for diagnostic and treatment purposes in order to highlight their strengths and experiences in the context of their own life (Mountain and Shah, 2008). As for other treatment options, they differ vastly because each treatment option is unique to each individual patient. There are a number of processes that are used frequently, such as attempting to rebuild the individual from the inside out. Sometimes, this requires things like forcing the patient to be social, if, for example, they are suffering from severe depression (Kinderman and Tai, 2009). They are also encouraged to take responsibility for their own life, and the actions they choose to take therein. There are a number of treatments similar to those that all come down to treatment from the inside-out, rather than outside-in, which is the case with most types of medication. Looking at it a different way, doctors subscribing to the recovery model act more as personal coaches than doctors to their patients, by "offering their professional skills and knowledge, while learning from and valuing the patient, who is an expert-by experience" (Kinderman and Tai, 2009). For this reason, the recovery model is the most effective for patients who already have the tools to better themselves. For example, a patient who already has a well-paying, social job but is feeling depressed should utilize the recovery model because he or she already has the tools to recovery (that is, the social interactions that come with a normal job).

The treatment performed with the medical model revolves, obviously, around medicine. While medicine might seem like a vastly superior cure-all than simple therapy, prescribing medication and administering it also has its problems that make the medical model not quite as attractive as it might seem at first. For starters, the drugs administered by doctors are designed to fight symptoms of the psychological disorder, not necessarily the disorder itself. This means that while the medicine may overcome the initial goal of the medical model (that is, removing the symptoms), it could fail to meet the more important requirement, which is an overall recovery of quality of life (Kinderman & Tai, 2008). In addition, most practicing doctors, especially in the psychology field, are all too eager to prescribe medicine to patients showing any sort of symptoms, regardless of the effects this medicine could have on the patient. These medicines are, however, generally effective, with about 50%-65% of patients reporting an overall benefit from drug treatments (McLeod, 2008). When medicine does not work, however, it is necessary to take more desperate measures. This is where psychosurgery comes into play. These procedures are infamous for leaving the patient in a vegetative state, even with the recent advances in the medical field. The most common form of psychosurgery is the prefrontal lobotomy, which involves severing nerve fibers that are thought to be associated with the disorder (McLeod, 2008). This calls into question the ethics of the medical model, and how far the model is willing to go to ensure the removal of the symptoms. This is one of the core complaints about the medical model: that it goes too far to treat a disease that is not tangible and is only observable through second-hand means (that is, the patient's responses, questionnaires, etc). The medical model does have its advantages, however. It is objective, and, generally, much quicker in recovery than the recovery model. In addition, treatment with the medical model lessens fear about the more severe mental disorders, such as psychosis or hallucinations. Normally, those conditions have proven to be very difficult to treat with recovery model treatment alone.

The recovery model has its fair share of disadvantages as well. For example, many scientists criticize the recovery model because it attempts to fix the underlying issues with the patient, without fixing the issue itself. Think of it as destroying a nest of invasive rats in a home, but having the rats themselves remain. The recovery model destroys the proverbial nest itself, by fixing the underlying emotional problems of a patient, but, oftentimes, fails to alleviate the more immediate symptom, or the rats themselves. Another problem with the recovery model is that the ultimate goals for it differ from doctor to doctor. Because each prognosis is subjective (i.e. they do not look for physical evidence or gather much hard data about the ailment), there may be many solutions to a particular mental disorder through the recovery model. This means that treatment will oftentimes not be effective, because a doctor misinterpreted the illness the patient was suffering from. This can be especially problematic for more serious or urgent cases where a patient must be treated correctly the first time (as with Schizophrenia) lest their life or sanity be put in jeopardy. In these cases, the recovery model is simply not an effective method because of its very nature as a softer type of treatment.

Each of these two models of treatment has its respective uses, advantages, and disadvantages. The recovery model works better for long-term solutions to mental disorders, especially those that are more difficult to diagnose through conventional means. The medical model of recovery is much more concrete in its applications and is better suited for more serious mental disorders, or those where time is of the essence. Since modern science is always evolving, both of these models will continue to be revised, but the future seems to be more promising for the medical model simply because of the advances that have been made in modern medicine in the recent past. Even looking back just thirty years ago, there are already far more tools for diagnosing and treating mental disorders than ever before, and the medical model embraces that. This is why the medical model will likely continue to evolve much more quickly than the recovery model, which will still have its own applications but will not have the wide appeal that the medical model has. Both of these models remain useful in the world of psychological recovery. Neither model should be disregarded before learning about a patient's history and unique problems. The ultimate goal of psychological recovery should be to make the patient feel better as quickly as possible.

References

Kinderman, P & Tai, S. (2008) Recovery and the medical model. The British Psychological Society, 4-24.

Kinderman, P & Tai, S. (2009). Psychological health and well-being: A new ethos for mental health. The British Psychological Society 16-25.

McLeod, S. (2008). The Medical Model. Simply Psychology. Retrieved from http://www.simplypsychology.org/medical-model.html.

Mountain, D., & Shah, P. J. (2008). Recovery and the medical model. Advances in Psychiatric Treatment, 14(4), 241-244.