Mental Health
Resources

 email page    print page

All Topic Reviews
50 Signs of Mental IllnessA Beautiful MindA Beautiful MindA Bright Red ScreamA Casebook of Ethical Challenges in NeuropsychologyA Corner Of The UniverseA Lethal InheritanceA Mood ApartA Research Agenda for DSM-VA Slant of SunA War of NervesAbnormal Psychology in ContextADD-Friendly Ways to Organize Your LifeAddiction Recovery ToolsAdvance Directives in Mental HealthAggression and Antisocial Behavior in Children and AdolescentsAl-JununAlmost a PsychopathAlterations of ConsciousnessAm I Okay?American ManiaAmerican Psychiatric Publishing Textbook of Neuropsychiatry and Clinical NeurosciencesAn American ObsessionAngelheadAnger, Madness, and the DaimonicAnthology of a Crazy LadyApproaching NeverlandAs Nature Made HimAsylumAttention-Deficit Hyperactivity DisorderAttention-Deficit/Hyperactivity DisorderBeing Mentally Ill: A Sociological Theory Betrayal TraumaBetrayed as BoysBetter Than ProzacBetter Than WellBeyond AppearanceBeyond ReasonBinge No MoreBiological UnhappinessBipolar DisorderBipolar DisorderBipolar Disorder DemystifiedBlack-eyed SuzieBlaming the BrainBleeding to Ease the PainBluebirdBlueprints Clinical Cases in PsychiatryBody Image, Eating Disorders, and ObesityBorderline Personality DisorderBrain Circuitry and Signaling in PsychiatryBrave New BrainBreakdown of WillBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerCalm EnergyCassandra's DaughterCaught in the NetChild and Adolescent Treatment for Social Work PracticeChildren Changed by TraumaChronic Fatigue Syndrome (The Facts)Clinical Handbook of Psychological DisordersClinical Manual of Women's Mental HealthCognitive Theories of Mental IllnessCommonsense RebellionCommunity and In-Home Behavioral Health TreatmentComprehending SuicideConcise Guide to Child and Adolescent PsychiatryConquering Post-Traumatic Stress DisorderConscience and ConvenienceConsciousnessConsole and ClassifyContesting PsychiatryCoping With TraumaCopshockCrazy for YouCrazy in AmericaCrazy Like UsCreating HysteriaCritical PsychiatryCruel CompassionCultural Assessment in Clinical PsychiatryCulture and Mental HealthCulture and Psychiatric DiagnosisCultures of NeurastheniaDaddy's GirlsDante's CureDarwinian PsychiatryDaughter of the Queen of ShebaDaughters of MadnessDeinstitutionalization And People With Intellectual DisabilitiesDelivered from DistractionDepression In Later LifeDepression SourcebookDepression-Free for LifeDescriptions and PrescriptionsDestructive Trends in Mental HealthDevil in the DetailsDiagnosis: SchizophreniaDiagnostic and Statistical Manual of Mental Disorders DSM-IV-TRDirty Filthy Love DVDDisorders Of DesireDisrupted LivesDissociative ChildrenDivided MindsDr. Andrew Weil's Guide to Optimum HealthDr. Weisinger's Anger Work-Out BookDSM-IV SourcebookDSM-IV-TR CasebookDSM-IV-TR in ActionDSM-IV-TR Mental DisordersE-TherapyEccentricsElectroshockEmergencies in Mental Health PracticeEmergency PsychiatryEmotional and Behavioral Problems of Young ChildrenEmotions and LifeEmpowering People with Severe Mental IllnessEssential PsychopharmacologyEssentials of Cas AssessmentEssentials of Wais-III AssessmentEthics and Values in PsychotherapyEthics in Mental Health ResearchEthics in Psychiatric ResearchEthics, Culture, and PsychiatryEverything In Its PlaceFamily Experiences With Mental IllnessFatigue as a Window to the BrainFear of IntimacyFinding Iris ChangFinding Meaning in the Experience of DementiaFlorid StatesFolie a DeuxFor the Love of ItForensic Nursing and Multidisciplinary Care of the Mentally Disordered OffenderFountain HouseFrom Madness to Mental HealthFrom Trauma to TransformationGandhi's WayGender and Its Effects on PsychopathologyGender and Mental HealthGenes, Environment, and PsychopathologyGetting Your Life BackGracefully InsaneGrieving Mental IllnessHandbook of AttachmentHandbook of DepressionHandbook of Self and IdentityHealing the SplitHerbs for the MindHidden SelvesHigh RiskHope and DespairHow Clients Make Therapy WorkHow People ChangeHow to Become a SchizophrenicHow We Think About DementiaHughes' Outline of Modern PsychiatryHumanizing MadnessHysterical MenHystoriesI Hate You-Don't Leave MeI Never Promised You a Rose GardenI Thought I Could FlyI'm CrazyImagining RobertImpulse Control DisordersIn Others' EyesIn Two MindsInsanityIntegrated Behavioral Health CareIntegrative MedicineIntegrative Mental Health CareIntuitionJust CheckingKarl JaspersKissing DoorknobsKundalini Yoga Meditation for Complex Psychiatric DisordersLaw and the BrainLaw, Liberty, and PsychiatryLegal and Ethical Aspects of HealthcareLiberatory PsychiatryLife at the BottomLife at the Texas State Lunatic Asylum, 1857-1997Life Is Not a Game of PerfectLithium for MedeaLiving Outside Mental IllnessLiving with AnxietyLiving With SchizophreniaLiving with SchizophreniaLiving Without Depression and Manic DepressionLost in the MirrorLove's ExecutionerLoving Someone With Bipolar DisorderMad in AmericaMad TravelersMad, Bad and SadMadhouseMadnessMadness at HomeMadness in Buenos AiresManaged Care ContractingMandated Reporting of Suspected Child AbuseManic Depression and CreativityMary BarnesMasters of the MindMeasuring PsychopathologyMedia MadnessMedicine As MinistryMelancholy And the Care of the SoulMemory, Brain, and BeliefMental HealthMental Health At The CrossroadsMental Health Issues in Lesbian, Gay, Bisexual, and Transgender Communities Mental Health MattersMental Health Policy in BritainMental Health Policy in BritainMental Health Professionals, Minorities and the PoorMental IllnessMental Illness and Your TownMental Illness, Medicine and LawMental SlaveryMindfulness in Plain EnglishModels of MadnessMothers Who Kill Their ChildrenMozart's Brain and the Fighter PilotMultifamily Groups in the Treatment of Severe Psychiatric DisordersMuses, Madmen, and ProphetsMyths of ChildhoodNapkin NotesNeural MisfireNew Hope For People With Bipolar DisorderNight Falls FastNo Enemies WithinNolaNormalNot CrazyNovember of the SoulOf Two MindsOn Being Normal and Other DisordersOn Our Own, TogetherOn The Stigma Of Mental IllnessOrigins of Human NatureOut of Its MindOut of the ShadowsOvercoming Compulsive HoardingPathologies of BeliefPathways through PainPersonal Recovery and Mental IllnessPersonality Disorder: Temperament or Trauma?Pillar of SaltPoints of ViewPoppy ShakespearePosttraumatic Stress DisorderPsychiatric Cultures ComparedPsychiatric Diagnosis and ClassificationPsychiatric Genetics and GenomicsPsychiatric Illness in WomenPsychiatrists and Traditional HealersPsychiatryPsychiatry and ReligionPsychiatry in SocietyPsychological Dimensions of the SelfPsychology and the MediaPsychopathia SexualisPsychopathologyPsychopathyPsychotic DepressionQuitting the Nairobi TrioRaising a Moody ChildRapid Cognitive TherapyRebuilding Shattered LivesReclaiming Soul in Health CareReclaiming the SoulRecollection, Testimony, and Lying in Early ChildhoodRecovery from SchizophreniaRecovery in Mental IllnessRedressing the EmperorRelational Mental HealthRemembering TraumaRepressed SpacesResearch Advances in Genetics and GenomicsRestricted AccessRethinking the DSMReviving OpheliaRewarding Specialties for Mental Health CliniciansSaints, Scholars, and Schizophrenics: Mental Illness in Rural IrelandSchizophreniaSchizophrenia RevealedSchizophrenia: A Scientific Delusion?Self-Determination Theory in the ClinicShunnedShynessSigns of SafetySilencing the VoicesSlackjawSocial Cognition and SchizophreniaSocial Inclusion of People with Mental IllnessSoul Murder RevisitedSounds from the Bell JarSpeaking Our MindsSpontaneous HealingStop PretendingStraight Talk about Psychological Testing for KidsStranger Than FictionStreet CrazyStudy Guide to the DSM-IV-TRSurviving Manic DepressionSurviving SchizophreniaSurviving SchizophreniaTaking Charge of ADHD, Revised EditionTaking the Fear Out of ChangingTalking Back to PsychiatryTarnationTeen LoveTelling Is Risky BusinessTelling SecretsThe Age of InsanityThe American Psychiatric Press Textbook of PsychiatryThe American Psychiatric Publishing Textbook Of Child And Adolescent PsychiatryThe Anger WorkbookThe Anorexic SelfThe Behavioral Medicine Treatment PlannerThe Betty Ford Center Book of AnswersThe Bipolar ChildThe Bipolar Disorder Survival GuideThe Body in PsychotherapyThe Borderline Personality Disorder Survival GuideThe Broken MirrorThe Burden of SympathyThe Cambridge Medical Ethics WorkbookThe Case for Pragmatic PsychologyThe Center Cannot HoldThe Chemical Dependence Treatment Documentation SourcebookThe Chemical Dependence Treatment PlannerThe Child and Adolescent Psychotherapy Treatment PlannerThe Clinical Child Documentation SourcebookThe Clinical Documentation SourcebookThe Complete Adult Psychotherapy Treatment PlannerThe Condition of MadnessThe Construction of Power and Authority in PsychiatryThe Couples Psychotherapy Treatment PlannerThe Criminal BrainThe Cultural Context of Health, Illness, and MedicineThe Day the Voices StoppedThe Death of PsychotherapyThe Depression WorkbookThe Difficult-to-Treat Psychiatric PatientThe Early Stages of SchizophreniaThe Employee Assistance Treatment PlannerThe Employee Assistance Treatment PlannerThe Epidemiology of SchizophreniaThe Essential Family Guide to Borderline Personality DisorderThe Essentials of New York Mental Health LawThe Ethical WayThe Evolution of Mental Health LawThe Explosive ChildThe Fall Of An IconThe Fasting GirlThe Forensic Documentation SourcebookThe Forgotten MournersThe Gift of Adult ADDThe Good EaterThe Green ParrotThe Healing Power of PetsThe Heart of AddictionThe Heroic ClientThe Insanity OffenseThe Invisible PlagueThe Last Time I Wore a DressThe Limits of Autobiography The LobotomistThe Madness of Our LivesThe Mark of ShameThe Meaning of AddictionThe Meaning of MindThe Medical AdvisorThe Mind/Mood Pill BookThe Most Solitary of AfflictionsThe Mozart EffectThe Naked Lady Who Stood on Her HeadThe Older Adult Psychotherapy Treatment PlannerThe OutsiderThe Pastoral Counseling Treatment PlannerThe PDR Family Guide to Natural Medicines & Healing TherapiesThe Places That Scare YouThe Plural SelfThe Problem of EvilThe Psychology of Religion and CopingThe Quiet RoomThe Real World Guide to Psychotherapy PracticeThe Right to Refuse Mental Health TreatmentThe Rise of Mental Health NursingThe Roots of the Recovery Movement in PsychiatryThe Savage GirlThe Self-Help SourcebookThe Talking CureThe Trick Is to Keep BreathingThe Unwell BrainThe Virtuous PsychiatristThe Way of TransitionThe Wing of MadnessThe Wisdom in FeelingTheoretical Evolutions in Person-Centered/Experiential TherapyTherapy's DelusionsTheraScribe 3.0 for WindowsThis is Madness TooThoughts Without a ThinkerThrough the Looking GlassTo Have Or To Be?Toxic PsychiatryTransforming MadnessTraumaTraumatic PastsTraumatic Relationships and Serious Mental DisordersTreating Affect PhobiaTreating Chronic and Severe Mental DisordersTreating Self-InjuryTreatment and Rehabilitation of Severe Mental IllnessTreatment Plans and Interventions for Depression and Anxiety DisordersTwinsUnderstanding and Treating Violent Psychiatric PatientsUnderstanding Child MolestersUnderstanding DepressionUnderstanding ParanoiaUnderstanding the Stigma of Mental IllnessUnderstanding Treatment Without ConsentUnholy MadnessUnspeakable Truths and Happy EndingsUsers and Abusers of PsychiatryViolence and Mental DisorderVoices of MadnessVoices of RecoveryVulnerability to PsychopathologyWarning: Psychiatry Can Be Hazardous to Your Mental HealthWashing My Life AwayWhen History Is a NightmareWhen Someone You Love Is BipolarWhen the Body SpeaksWhen Walls Become DoorwaysWitchcrazeWomen and Borderline Personality DisorderWomen and Mental IllnessWomen Who Hurt ThemselvesWomen's Mental HealthWrestling with the AngelYou Must Be DreamingYour Drug May Be Your ProblemYour Miracle Brain

Related Topics
Empowering People with Severe Mental IllnessReview - Empowering People with Severe Mental Illness
A Practical Guide
by Donald M. Linhorst
Oxford University Press, 2005
Review by Tony O'Brien
Mar 13th 2007 (Volume 11, Issue 11)

Empowerment is a ubiquitous concept. Everyone from mental health professionals, rights activists and life coaches to advertisers and teachers seeks to empower their clients. So pervasive is the concept, and so gilded with good feelings, that there are few who would question the value of empowerment. What is most often lacking is a useful definition, and even more, a pragmatic program of how empowerment can be achieved. In Empowerment of People with Severe Mental Illness. A Practical Guide Donald M Linhorst succeeds admirably in bringing conceptual clarity to the notion of empowerment, and in providing a set of concrete interventions to guide mental health practitioners, program managers and policy makers

The first section of the book provides a context for the achievement of empowerment, with chapters on conceptualization of empowerment, a history of pwerlessness, and an exploration of coercion. Linhorst is aware that there is a paradox in the idea that one person can empower another, quoting one author to the effect that:

"The one function anyone else cannot perform for another person is that of empowerment. Empowerment is a reflexive activity, a process capable of being initiated and sustained only by the agent or subject who seeks power or self determination" (p. 9).

Such a sentiment is consistent with many first person accounts of mental illness in which people talk about recovery beginning when they took responsibility for their lives. It is also consistent with the philosophy of recovery espoused by theorists such as Patricia Deegan. On the other hand, Linhorst argues that there are ways of providing services that are more conducive to self-initiated empowerment than others.

Linhorst explores empowerment at institutional and individual levels. Drawing on research into the concept of procedural justice, he translates the broad idea of empowerment into something concrete for everyday clinical practice. He makes the case for empowerment based on historical and continuing coercion of those with mental illness, and perhaps more importantly, by arguing that empowerment is consistent with services statements about what they want to achieve for consumers. Thus seen, empowerment is both an ethical and clinical imperative.

The fourth chapter is the pivot on which the rest of the book turns. In this chapter Linhorst sets out nine conditions of empowerment. These conditions represent an extrapolation of earlier work by Joel F Handler, whose publications focus on the implications of public policy for citizen empowerment. Linhorst outlines a comprehensive set of conditions covering everything from managed psychiatric symptoms to availability of structures and processes of participation, a supportive organizational culture, resources, and incentives. To use another term that has almost lost meaning through glib usage, Linhorst's conditions are holistic. They focus on the person as an individual, as well as on the context within which they experience distress and illness. In discussing a supportive culture, Linhorst is aware that staff of mental health services need support to change and to implement new models. Empowerment involves changes in multiple systems, all of which need to align around a central philosophy of care.

Chapter four also explores models of engagement, setting the medical model alongside recovery, rehabilitation and strengths models. Linhorst points out that the medical model is not limited to the practice of physicians, but can also extends to other disciplines, like nursing, social work and psychology. I'm not sure that there is always a clear conceptual distinction between something that is properly called a "medical" model, and a broader model of paternalistic professional dominance that might be called "professional" or even "institutional". Along with much of the literature critical of mainstream psychiatry, Linhorst calls all of this "medical", but like "empowerment", terms like "medical model" need to carefully explicated if they are to be useful as more than convenient slogans.

All four models of engagement are outlined, along with their implications for empowerment. In the final part of this chapter Linhorst explores the professional norms of the major mental health disciplines. Linhorst's own profession of social work is said align most strongly with empowerment, although Linhorst notes that this ideal is not always realized in practice. More traditional disciplines such as psychiatry are less explicitly aligned with empowerment, something also highlighted by their own critics.

Each of the next seven chapters explores a critical area of empowerment. These are: treatment planning; housing; organizational decision making; planning and policy making; employment; research and service provision. These chapters share a common structure, with an initial introduction, a summary of the nine conditions of empowerment applied to the specific area under discussion, then a detailed discussion of each condition. Linhorst uses cases studies to show how his model of empowerment can be used to analyze the functioning of a service, and to plan interventions from clinical to policy levels, that will help to achieve the goal of empowerment. Each of these chapters closes with a set of guidelines based on the preceding discussion. The format of this section of the book means that these chapters are somewhat repetitive, but there is a certain inevitability about that given that Linhorst is attempting to provide a practical guide. The big advantage is that for someone concerned with say, housing, the chapter on housing will stand alone as a guide; similarly those concerned with employment, research and other areas can find useful practical guidance in the chapter focusing on their interests.

The case studies are helpful, too, in showing examples of how empowerment does or doesn't work. They would be useful for anyone planning to audit a program in terms of empowerment, or setting up a new service committed to empowerment. A theme throughout the book is that empowerment needs committed professional staff, and can be very demanding on consumers involved in proving consultancy and other services. As part of their recovery people sometimes need to leave behind their involvement in advisory roles, making succession planning and mentorship of new consumer consultants an important aspect of an empowerment program.

In the final chapter Linhorst draws the strands of the book together with a summary of opportunities for empowerment, and limitations facing people with severe mental illness. This chapter looks forward to how empowerment can be sustained, and to the challenges that face consumers and service providers in achieving empowerment on a long term basis. Like the previous chapters, this final chapter contains many practical points which could provide a basis for continued service development.

Empowerment of People with Severe Mental Illness is a book that is driven by a philosophical commitment to empowerment, and by the insight that more than rhetoric is needed to achieve empowerment in practice. Linhorst is realistic about the limitations severe mental illness may impose on consumers. But he does not accept that mental illness provides a ready made justification for coercive or paternalistic practices. There are parallels between this work and recent work on social inclusion, and this commonality would make for a fruitful collaboration. The book is clearly written and logically organized. The reference list and index are comprehensive making the book a valuable reference work for undergraduates through to experienced clinicians and those in management and policy roles. Professionals and consumers involved in developing mental health programs will find that this book delivers on its promise to provide a practical guide.

 

© 2007 Tony O'Brien

 

Tony O'Brien is a lecturer in mental health nursing at the University of Auckland, New Zealand: a.obrien@auckland.ac.nz

 


Share

Welcome to MHN's unique book review site Metapsychology. We feature over 7800 in-depth reviews of a wide range of books and DVDs written by our reviewers from many backgrounds and perspectives. We update our front page weekly and add more than thirty new reviews each month. Our editor is Christian Perring, PhD. To contact him, use one of the forms available here.

Can't remember our URL? Access our reviews directly via 'metapsychology.net'


Metapsychology Online reviewers normally receive gratis review copies of the items they review.
Metapsychology Online receives a commission from Amazon.com for purchases through this site, which helps us send review copies to reviewers. Please support us by making your Amazon.com purchases through our Amazon links. We thank you for your support!


Join our e-mail list!: Metapsychology New Review Announcements: Sent out monthly, these announcements list our recent reviews. To subscribe, click here.

Interested in becoming a book reviewer for Metapsychology? Currently, we especially need thoughtful reviewers for books in fiction, self-help and popular psychology. To apply, write to our editor.

Metapsychology Online Reviews

Promote your Page too

Metapsychology Online Reviews
ISSN 1931-5716