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将改变阶段模型应用于严重精神疾病康复:贡献与局限

Applying stages of change models to recovery from serious mental illness: contributions and limitations.

作者信息

Davidson Larry, Roe David, Andres-Hyman Raquel, Ridgway Priscilla

机构信息

Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06513, USA.

出版信息

Isr J Psychiatry Relat Sci. 2010;47(3):213-21.

Abstract

Research on recovery has proliferated in recent years. Some investigators have advanced stages of change models that segment the overall process of recovery into discrete and sequential phases, through which a person progresses from being overwhelmed by mental illness to taking on an increasingly active role in understanding, managing and overcoming the impact of psychiatric disability. The authors review this body of literature, and reflect on the contributions and limitations of stages of change approaches to understanding mental health recovery. They conclude that stages of change models need to more accurately reflect the non-linear nature of recovery, the fact that processes are influenced by person-disorder-environment interactions, and the fact that the persons own motivations for change and decisions in this regard while of central importance are by no means exclusive factors in recovery, as they do not take into account sufficiently such issues as discrimination and the presence or absence of crucial resources and supports. A richer set of concepts is needed as we continue to deepen our understanding of the complex, dynamic and ongoing process of mental health recovery.

摘要

近年来,关于康复的研究大量涌现。一些研究者提出了改变阶段模型,该模型将康复的整体过程划分为离散且有序的阶段,一个人会经历这些阶段,从被精神疾病压垮,到在理解、管理和克服精神残疾的影响方面发挥越来越积极的作用。作者回顾了这一文献体系,并思考了改变阶段方法在理解心理健康康复方面的贡献和局限性。他们得出结论,改变阶段模型需要更准确地反映康复的非线性本质,即过程受到个体 - 疾病 - 环境相互作用的影响这一事实,以及个体自身改变的动机和在这方面的决定虽然至关重要,但绝不是康复的唯一因素这一事实,因为这些模型没有充分考虑诸如歧视以及关键资源和支持的有无等问题。随着我们继续深入理解心理健康康复这一复杂、动态且持续的过程,需要一套更丰富的概念。

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