Resource-oriented therapeutic models in psychiatry: conceptual review.

Abstract

BACKGROUND: Like other medical specialties, psychiatry has traditionally sought to develop treatments targeted at ameliorating a deficit of the patient. However, there are different therapeutic models that focus on utilising patients' personal and social resources instead of ameliorating presumed deficits. A synopsis of such models might help to guide further research and improve therapeutic interventions. AIMS: To conduct a conceptual review of resource-oriented therapeutic models in psychiatry, in order to identify their shared characteristics. METHOD: The literature was searched to identify a range of resource-oriented therapeutic models, particularly for patients with severe mental illness. Key texts for each model were analysed using a narrative approach to synthesise the concepts and their characteristics. RESULTS: Ten models were included: befriending, client-centred therapy, creative music therapy, open dialogue, peer support workers, positive psychotherapy, self-help groups, solution-focused therapy, systemic family therapy and therapeutic communities. Six types of resources were utilised: social relationships, patients' decision-making ability, experiential knowledge, patients' individual strengths, recreational activities and self-actualising tendencies. Social relationships are a key resource in all the models, including relationships with professionals, peers, friends and family. Two relationship dimensions - reciprocity and expertise - differed across the models. CONCLUSIONS: The review suggests that a range of different therapeutic models in psychiatry address resources rather than deficits. In various ways, they all utilise social relationships to induce therapeutic change. A better understanding of how social relationships affect mental health may inform the development and application of resource-oriented approaches.