Models of Human
Service Delivery
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Chapter Four
Medical model
Public health model
Human service model
Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc.
Three Models
Oldest treatment model
Developed by medical profession
Assumes mental disorders are
diseases/illnesses
Treatment=medication, laboratory studies,
physical therapy
Psychiatric medication
Patient as recipient
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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: symptomdiagnosis-treatment-cure
Copyright © 2012 Brooks/Cole, a division of Cengage Learning, Inc.
Medical Model
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
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Medical Model and Human
Services
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
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Medical Model and Corrections
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
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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
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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
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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
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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”
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Medical Model and Mental
Illness
Antipsychotics (major tranquilizers)
– Haldol, Mellaril, Thorazine
Antidepressants (relieve depression)
– Elavil, Prozac
Antianxiety drugs (minor tranquilizers)
– Valium, Librium, Xanax)
Narcotic Pain Meds
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Psychiatric medication
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
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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
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Public Health 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
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Human Service Model
Characteristics
– Generic focus
– Accessible, comprehensive, coordinated
– Problem solving approach
– Whole person
– Accountable to consumer
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Human Service Model
General orientation
Problem identification
Generating alternatives
Decision making
Evaluation
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Problem Solving Approach
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
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Conclusion