So, if the concept of denial is a construction that serves a
"protective" function for the mental health worker, and which obscures
rather than reveals the personal worlds of schizophrenics, eliciting the
constructs of schizophrenics may take us beyond the simple dichotomy of
denial/compliance in our viewing of patients. The PCP approach should
enable one to improve the ability to collaborate effectively with these
patients.
In some cases, the goal may be medical compliance. In other cases,
perhaps not, depending on the meaning of one's illness. Or perhaps medical
compliance should be a short term goal for some patients and a long term
goal for others. Richard Bell wrote me about a paper he wrote that was
published in the '92 EPCA volume, that may have some relevance to all of
this. Has anyone read it?
Lindsay, I have looked at portions of the book I think you are
talking
about and was intrigued with the authors' proposal of the "treatment of the
person" as applied to schizophrenia. I, too, would be interested in
anything you can share about your methods or results working with your
patients. I would also like to know more about Chris Stevens' work. Also,
Barbara, I enjoyed your comments, but would like to know more about what
you actually did with your patients.
For myself, I am considering a design comparing differences in the
content or structure of construct systems of patients rated high vs. low in
denial of illness.
Regards,
Rob Adelman
Rusk State Hospital
----------
> From: Lindsay Oades <Lindsay_Oades@uow.edu.au>
> To: pcp@mailbase.ac.uk
> Subject: RE: Return response/ Recovering Psych. Patients
> Date: Friday, June 27, 1997 6:49 PM
>
> Hi Rob & Barbara,
> I have been very interested in your discussion regarding "recovering
> psychiatric clients"- as I currently work in psychiatric rehabilitation.
I no
> longer use the term schizophrenia for two reasons:
> 1) as discussed by Birchwood and his UK colleagues the term holds little
> scientific validity in the way symptoms cluster together -hence terms
such as
> voices, paranoia & delusions are perhaps more appropriate to talk about
(and
> perhaps better match what the clients also talk about (delusions
excepted).
> 2) the term schizophrenia seems to help few people- ie it doesn't really
> inform constructively how clients and heatlh professionals work together-
or
> in Kellyian terms it isn't really an effective transitive diagnosis.
>
> I have of late been asking clients of their personal meanings of voices,
> interesting beliefs (delusions & paranoia etc) and of medication.
Olanzapine
> and Clozapine are very popular where I work- the culture constructs these
as
> the "best and latest treatment" - the clients say yes there are less side
> effects and it seems to stop the voices a little- but as some of the
> cog-behaviourists in the UK are also asking- what of the personal
construals/
> beliefs about voices, how do they relate to client histories etc and (as
you
> have been discussing) how do clients construe adherence and recovery??
>
> Chris Stevens work with insight is also relevant here- is a non compliant
> client one who invalidates the predictions of the worker? Is the client
with
> no insight one who simply invalidates the world view of the worker? I see
> these as serious questions to consider, not to be thrown away as "anti
> psychiatry rhetoric".
>
> Regards
> Lindsay Oades
> Wollongong
>
____________________________________________________________________________
___
> To: pcp@mailbase.ac.uk
> From: pcp@mailbase.ac.uk on Wed, 25 Jun 1997 10:30 AM
> Subject: Re: Return response/ Recovering Psych. Patients
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> From: "Rob Adelman" <radelman@neweracoop.com>
> To: <pcp@mailbase.ac.uk>
> Subject: Re: Return response/ Recovering Psych. Patients
> Date: Tue, 24 Jun 1997 19:11:27 -0500
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> ----------
> > From: Tooth Barbara Ann <b.tooth@qut.edu.au>
> > To: pcp@mailbase.ac.uk
> > Subject: Re: Request for references on recovering psychiatric patients
> > Date: Monday, June 23, 1997 8:49 PM
> >
> > Dear Rob
> >
> > I am currently completing a research project on recovery from
> > schizophrenia and hence have some information on people's construing of
> > this process. However the part about their prospects of remaining
> > medically compliant raises far to many issues to discuss here. In short
I
> > don't think it is a useful way to look at people's experience of their
> > illness.
> >
> > Regards Barbara
> >
> >Dear Barbara,
>
> I was real glad to hear from you since I had seen your name and
> paper on the program for the conference in Seattle, but didn't know how
to
> contact you. I would
> really appreciate it if you would send me a copy of your paper. I would
be
> glad to reimburse you any costs, or perhaps you could send it
> electronically with your E-Mail. Let me know what would work best for
> you.
> > The problem I am trying to resolve through this research is to find
> some means to deal with the denial issue with psychiatric patients. I
am
> thinking that the way the patients construct their illness may provide
some
> clues as to how to work with them
> in a more collaborative way, so as to enhance their ability to manage
their
> disease.
> I'm curious about your comment about the issue of medication compliance
not
> being
> useful in understanding their experience of their illness. Maybe we are
> coming at this from different directions. Please send more. If it would
> help, I can send a couple of pages of my proposal to you..
>
> Looking forward to your response,
>
> Rob
>
>
>
>
> > On Fri, 20 Jun 1997, Rob Adelman wrote:
> >
> > > Hello out there!
> > >
> > > I am a doctoral candidate at Texas A&M - Commerce and new to the
> mail-list.
> > > I am working with a population of schizophrenic and bipolar
patients
> at
> > > the state hospital. I am interested in applying construct methods to
> > > learning about patient's constructions of their illness, and their
> > > prospects for remaining medically compliant.
> > >
> > > Anyone who has relevant research references or ideas, please write.
> > >
> > > Thanks,
> > >
> > > Rob Adelman
> > > Rusk State Hospital
> > > Rusk, Texas
> > >
> >
>
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