Reference [ii] "Practice in forensic psychiatry: A proposed interdisciplinary model"
Practice in forensic psychiatry:
A proposed interdisciplinary model
Expanding on the post about a further reference for Hodges' model:
Here, and on twitter I have sought to stress the limitations of the biopsychosocial model in healthcare, and I value Holmes et al. recognition of Hodges' model as politico-biopsychosocial.
The authors also identify the structural nature of the model.
In comparing 'models of care' there is the question of whether Hodges' model is a model of care. As a generic conceptual framework Hodges' model can of course be used in the health care (as per its original design and creation) but it can be used to compare models of care.
Below, translated by Google are the models used in the paper.
I have altered the listing bringing the Tidal and Recovery model s together. Some I've 'mapped' in pairs, using formatting to indicate the differences.
Tidal Model
"The Tidal Model is a humanistic nursing model of recovery developed by Barker (12) with the premise that the person with mental disorder has strengths, abilities, personal priorities and a future ahead (13). This model of care, popular in forensic psychiatry circles, recognizes certain deficits of the hospitalized patient but it is especially interested in the meaning that the latter attributes to them. The sick person is the expert in his life and is therefore the one who contributes the most to his own recovery. This nursing perspective is therefore centered on the phenomenological experience (lived experience) of the patient and on the role of the staff, which is to allow healing and restore hope (12,14)."
Recovery Model
"A popular model in mental health care, the recovery model is increasingly gaining ground in psychiatric care settings (28). The postulates of this humanistic model state that anyone, including those suffering from mental disorders, can aspire to a fulfilling future, participate in rewarding and inspiring activities, self-determination and finally, be able to live in an environment free of stigma and discrimination (29). The peculiarity of this model lies in the fact that recovery is part of a process where the person with mental illness can continue to show symptoms while being able to adapt to their condition (often chronic) and pursue their goals. life (30)."
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recovery strengths, abilities, personal priorities deficits healing and hope phenomenological - (lived experience) personal responsibility fulfillment - life goals patient as expert personal adaptation living with x,y,z... coping strategies |
place as context my future deficits signs - symptoms chronicity Institutional settings clinical - hospital |
humanistic - human qualities social expectations social contribution participation - social inclusion free from stigma deficits |
Institutional settings politics of recovery free from discrimination forensic deficits |
<>
Integrated Practice Model
"This model was developed by Virginia Lynch, a pioneer in forensic psychiatry, and it guides the role of practicing staff in this care setting (15). There are three main theoretical foundations: 1) the fields of expertise involved (nursing, criminal justice and forensic science), 2) the health system (victim and offender, health care and forensic nursing ) and 3) the social impact (social sanction, human behavior, crime and violence) (16). According to this model, patients should be cared for using an interdisciplinary and holistic approach (15)."
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nursing forensic psychiatry 2. health system interdisciplinary holistic OFFENDER |
nursing theoretical foundations forensic science 1. fields of expertise 2. health system interdisciplinary holistic |
VICTIM role of practitioners 2. health system 3. social impact (social sanction, human behavior, crime and violence) |
criminal justice 2. health system |
<>Model of Nursing Interaction
"This model of care includes six categories of forensic nursing interaction with the goal of establishing a relationship with the patient: establishing and maintaining a relationship (relationship based on honesty, respect and trust), encouraging and support interactions (help the patient to recognize his qualities and use his resources), the learning of social skills (encourage the patient to do social activities and talk to others), reality orientation (help the patient patient to be aware of his way of being and of acting), reflective interactions (the perception of the patient and his problems) and the learning of practical skills (encouraging the patient to develop good lifestyle habits) ( 17,18)."
Individual
|INTERPERSONAL : SCIENCEShumanistic ------------------------------------------ mechanisticSOCIOLOGY : POLITICAL|Group
patient qualities, resources
reflective interaction
self-perception of problems
reality orientation
awareness of way of being and of acting
practical skills
develop lifestyle skills
reality orientation
learn social skills
develop lifestyle skills encourage social activities
talk to othersencourage and support interactions
reality orientation
perception of patient and problems
Healthy Living Program
"This model was developed in response to metabolic syndrome and physical illnesses that may develop in people with severe mental illness (19). It includes programs related to health promotion activities such as weight reduction, smoking cessation, physical exercise, etc. It is a voluntary approach that not only improves physical health, but also independence and recovery. For the program to work in the institution and to fit into its organizational culture, the approach must be flexible and systematically maintained by the entire interdisciplinary team."[ PARITY OF ESTEEM]
mental health - metabolic syndrome physical illnesses
Individual
|INTERPERSONAL : SCIENCEShumanistic ------------------------------------------ mechanisticSOCIOLOGY : POLITICAL|Group
recovery
voluntary approach
(physical) health promotion activities such as weight reduction, smoking cessation, physical exercise,
independence
recovery
voluntary approach
for program to work in the institution and to fit into its organizational culture, the approach must be flexible and systematically maintained by the entire interdisciplinary team<>
Holistic Model
"This model is used in forensic care in the assessment, health care and psychotherapy of patients with personality disorder (22). Holistic care includes the physical (diet and exercise), cultural, spiritual, and psychosocial needs of the patient. This model is based on problem solving, anger management and decision making. Caring is a central concept in the holistic model and is actualized in an emotional, psychosocial, constant and authentic caring response (23). It is for caregivers to be present for the patient, to respect his situation, to understand his experience and to demonstrate a desire to help."
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holistic care personality disorder [mental] health care psychotherapy assessment emotion problem solving, anger management decision making actualized psycho- |
holistic care 'caring' assessment diet, exercise health care 'being present' |
-social culture holistic care 'being present' constant and authentic caring understand person's experience respect person's situation desire to help |
forensic care holistic care desire to help (also exemplified in the organisation?) |
Good Lives Model
"This model focuses on the offense committed by the mentally disordered offender, his recovery, the promotion of personal goals, the reduction of the risk of reoffending, and the treatment of mental illness (24,25, 26). The model favors an approach based on the strengths of the patient. In addition, mechanisms of change are present, that is to say that behaviors judged to be poorly adapted are replaced by adapted behaviors when the patient is equipped with the skills, resources and support provided by the nursing staff. This model contextualizes the offense, focuses on the symptoms of mental illness while conceptualizing both as inappropriate behaviors.This model helps to better understand the relationship between mental illness and crime in order to create an individualized plan of care."
Risk-Need-Responsivity Model
"This model (27) imported from the correctional environment was adapted to the psycho-legal context by the addition of the “mental illness” dimension. It was developed primarily to reduce the risk of recurrence. Care interventions are geared towards the identification and treatment of criminogenic factors. This model is based on three major principles: the risk principle (granting the highest level of resources to the group most at risk of crime), the needs principle (identifying dynamic criminogenic risk factors and targeting them in treatment) and the principle of receptivity (adjusting programs according to the characteristics of the person: learning style, motivation, strengths, etc.) (24,25)."
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mentally disordered (diagnosis) recovery characteristics of the person learning style (evidence?) motivation, strengths 3. principle of receptivity treatment: skills, resilience personal goals “mental illness” <-> crime recurrence individualized plan of care |
1. risk principle -> resource allocation recurrence treatment 2. dynamic criminogenic risk factors support of nursing staff |
treatment [social determinants?] mechanisms of change adapted behaviours inappropriate behaviours recurrence |
offense reoffending correctional environment contextualise the offence treatment principles [policy] recurrence |
<>
Hodges' Health Career Model
"This model has a
politico-biopsychosocial structure which is consistent with contemporary
interdisciplinary practice (20); that is, it relies on a
multidimensional critical approach, incorporating writings in sociology
and politics, in order to understand the person in context. It is based
on four objectives: measuring learning, providing holistic care,
supporting reflective practice and closing the gap between theory and
practice (21). This model is applicable in various clinical situations
in a psycho-legal context. When this model is used as a frame of
reference, it emphasizes the role of caregivers who must meet the
patient's needs and focus on their problems. It also serves as a guide to
assess and provide assistance to the patient vis-à-vis their physical,
psychological and social needs as well as with the justice system in
order to promote their recovery. The theoretical foundations call on
four sources of knowledge: interpersonal, scientific, sociological and
political (21)."
The PERSON in Context
(situated)
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INTRAPERSONAL INTERPERSONAL reflective practice conceptual structure psychological needs measure of learning psycho- |
SCIENTIFIC physical needs theory-practice gap |
SOCIOLOGICAL reflective practice (develop self-awareness) social needs practice-theory gap |
POLITICAL justice system (needs) -legal |
[ all embedded within the SPIRITUAL ]
Not just 'problems' Hodges' model can incorporate any desired stance, perspective or philosophical approach - strengths, disease, skills, weaknesses or deficits, psychosocial for example.
I am not sure about explicitly 'measuring learning, but the model can be used by learners and teaching staff / mentors to demonstrate their understanding and justify their output - formulation.
There is an instrumental potential in Hodges' model as a whole. Hodges' model can illustrate the degree of holistic intent - whether this is realised could also be indicated using the model.
Once again I am grateful to the authors for their inclusion of Hodges' model. The reference is listed in the blog's bibliography (please see the sidebar for others) which includes:
Doyle, M., Jones, P. (2013). Hodges’ Health Career Model and its role
and potential application in forensic mental health nursing. Journal of Psychiatric and Mental Health Nursing. 20, 7, 631-640.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2012.01961.x/abstract
Jones
P. (2014) Using a conceptual framework to explore the dimensions of
recovery and their relationship to service user choice and
self-determination. International Journal of Person Centered Medicine. Vol 3, No 4, (2013) pp.305-311.
See also on W2tQ (with overlap):
https://hodges-model.blogspot.com/search?q=forensic
https://hodges-model.blogspot.com/search?q=justice
https://hodges-model.blogspot.com/search?q=interdisciplinary
Plus the following
orcid.org/0000-0002-0192-8965