Abstract
BackgroundVarious models for collaborative practice in mental health care incorporating the perspectives of service-user participation and collaboration in the care have been developed. However, the emphasis in these practice models has not been on identifying specific features of “how” collaboration and service-user participation can occur and be nurtured. This suggests a need for a collaborative practice model that specifies essential strategies operationalizing the tenets of service-user participation and collaboration applicable in mental health and substance abuse (MHSA) care.MethodsA double helix approach of coalescing theoretical ideas and empirical findings to develop a practice model that is applicable in MHSA practice. A theoretical analysis is carried out to identify the critical, foundational elements for collaborative practice in MHSA practice, and has identified the philosophical-theoretical orientations of Habermas’ theory of communicative action, Bakhtin’s dialogicality, and the philosophy of personhood as the foundational features of collaboration. This base is juxtaposed with the results of a qualitative meta-analysis of 18 empirical articles on collaboration in MHSA to advance a collaborative practice model specifically in the domain of service user/professional collaboration.Results“The collaborative, dialogue-based clinical practice model” (CDCP Model) for community mental health care is proposed, within the structure of four main components. The first specifies the framework for practice that includes person-centered care, recovery-orientation, and a pluralistic orientation and the second identifies the domains of collaboration as service user/professional collaboration, inter-professional collaboration, and service sector collaboration. The third identifies self-understanding, mutual understanding, and shared decision-making as the essential principles of collaboration. The fourth specifies interactive-dialogic processes, negotiated-participatory engagement processes, and negotiated-supportive processes as the essential strategies of collaboration applicable in service user/professional collaboration which were extracted in the empirical work. An illustration of the CDCP Model in a clinical case is given.ConclusionsThe CDCP Model presented fills the gap that exists in the field of community MHSA practice regarding how to operationalize systematically the tenets of person-centeredness, recovery-oriented, and pluralism-oriented practice in terms of user/professional collaboration.
Highlights
Recovery-oriented practices have become the desired modes of mental health and substance abuse (MHSA) practice currently, and there have been various national and international efforts to implement and integrate this practice perspectives into MHSA services [1,2,3,4,5,6,7,8,9]
The CDCP Collaborative dialogue-based clinical practice model) (Model) presented fills the gap that exists in the field of community MHSA practice regarding how to operationalize systematically the tenets of person-centeredness, recovery-oriented, and pluralism-oriented practice in terms of user/professional collaboration
Various models for these modes of practice in mental health care have been developed and implemented incorporating the perspective of service-user participation and collaboration in the care, for example, Implementing Recovery through Organizational Change [16, 17], Care Programme Approach/ Care and Treatment Planning of England and Wales [9], the Recovery-oriented Behavioral Health Care [18], and many others developed in various countries [19]. The emphasis in these practice models has not been on identifying specific features of “how” collaboration and service-user participation need to occur and be nurtured, especially in terms of dialogical processes applicable in the partnerships and collaboration. This suggests a need for a collaborative practice model that is an overlay on these two modes of MHSA care so that the tenets of service-user participation and collaboration can be actualized in practice
Summary
Recovery-oriented practices have become the desired modes of mental health and substance abuse (MHSA) practice currently, and there have been various national and international efforts to implement and integrate this practice perspectives into MHSA services [1,2,3,4,5,6,7,8,9]. The emphasis in these practice models has not been on identifying specific features of “how” collaboration and service-user participation need to occur and be nurtured, especially in terms of dialogical processes applicable in the partnerships and collaboration This suggests a need for a collaborative practice model that is an overlay on these two modes of MHSA care so that the tenets of service-user participation and collaboration can be actualized in practice. The emphasis in these practice models has not been on identifying specific features of “how” collaboration and service-user participation can occur and be nurtured This suggests a need for a collaborative practice model that specifies essential strategies operationalizing the tenets of service-user participation and collaboration applicable in mental health and substance abuse (MHSA) care. We utilize three strands of philosophical-theoretical orientations to make up the foundational features of collaborative practice in MHSA practice, including Habermas’ theory of communicative action, Bakhtin’s dialogicality, and the philosophy of personhood specifying the concepts of dignity, autonomy, and singularity
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