Chen Fang-pei
Columbia University School of Social Work, New York, NY 10027, USA.
Am J Orthopsychiatry. 2008 Oct;78(4):456-65. doi: 10.1037/a0014380.
In response to research findings of insufficient family involvement in mental health services for people with severe mental illness, this grounded theory study examines case managers' interactions with families of clients in Assertive Community Treatment (ACT). Findings suggest that case managers conceptualize families as sources of social connections, rather than sources of care, for clients. This conceptualization is influenced by case managers' goals, which also guide their assessments of families for involvement in treatment in terms of the extent to which families help attain treatment goals. In developing strategies to work with families, case managers engage in ongoing assessments and consider client permission for family involvement in treatment, family availability to clients, and family wishes for involvement in treatment. Three case examples illustrate the relationships among case managers' goals, assessments of families, and selections of work strategies. The potential role of the ACT model in shaping this particular view on families is also discussed.
针对重度精神疾病患者心理健康服务中家庭参与不足的研究发现,这项扎根理论研究考察了个案管理员在积极社区治疗(ACT)中与客户家庭的互动。研究结果表明,个案管理员将家庭视为客户社会联系的来源,而非照顾的来源。这种概念化受到个案管理员目标的影响,这些目标也指导他们根据家庭在多大程度上有助于实现治疗目标来评估家庭参与治疗的情况。在制定与家庭合作的策略时,个案管理员会进行持续评估,并考虑客户对家庭参与治疗的许可、家庭对客户的可及性以及家庭参与治疗的意愿。三个案例说明了个案管理员的目标、对家庭的评估和工作策略选择之间的关系。还讨论了ACT模式在塑造这种对家庭的特定看法方面的潜在作用。