Abstracts Health Sciences

A grounded theory study of the impact of strengths model training and supervision on the therapeutic practice of staff in a public mental health service

by JM Pullman

<p dir="ltr">This study explored the impact of Strengths Model training and supervision on the therapeutic practice of ten Australian public sector mental health clinicians, using a Critical Realist-informed grounded theory approach. The context was the ongoing failure of Australian mental health services to deliver on the promise of recovery-oriented service reform. The study was framed around two questions: what was the impact of Strengths Model training and supervision on therapeutic practice and, if an impact could be demonstrated, would the resulting practice represent a shift towards a recovery-oriented therapeutic paradigm in a public sector context? The first question was answered in the affirmative with the discovery of a basic social psychological process, becoming a strengths-informed practitioner. This described a discernible and sustained change towards a more person-centred, hopeful and recovery-oriented practice as participant clinicians integrated the Strengths Model into their therapeutic work. Referencing the ontological insights of Critical Realism, the study also described a confluence between becoming a strengths-informed practitioner and the Biopsychosocial Model of Health, with a corresponding antipathy to the Medical Model. The process of answering the second question took the form of a substantive literature review. This demonstrated the power of psychiatry to influence broader practice within mental health treatment systems while also tracing the historic competition for pre-eminence between psychiatric adherents to the Biopsychosocial and Medical Models. The conclusion drawn from the review was that context would always be a crucial variable. That is, the more any service relies on a Medical Model of psychiatry, the more becoming a strengths-informed practitioner will represent a paradigmatic change. The study concluded with a call for the adoption of the Biopsychosocial Model as a vehicle to support recovery-oriented mental health reform, while placing becoming a strengths-informed practitioner as a grounded theory, able to contribute to that cause.