Sundet Rolf, Kim Hesook Suzie, Karlsson Bengt Eirik, Borg Marit, Sælør Knut Tore, Ness Ottar
Faculty of Health and Social Sciences, Department of Health, Social & Welfare Studies, University of South-Eastern Norway, PO Box 235, 3603 Kongsberg, Norway.
Int J Ment Health Syst. 2020 Jun 9;14:43. doi: 10.1186/s13033-020-00377-4. eCollection 2020.
Various models for collaborative practice in mental health care incorporating the perspectives of service-user participation and collaboration in the care have been developed. However, the emphasis in these practice models has not been on identifying specific features of "how" collaboration and service-user participation can occur and be nurtured. This suggests a need for a collaborative practice model that specifies essential strategies operationalizing the tenets of service-user participation and collaboration applicable in mental health and substance abuse (MHSA) care.
A double helix approach of coalescing theoretical ideas and empirical findings to develop a practice model that is applicable in MHSA practice. A theoretical analysis is carried out to identify the critical, foundational elements for collaborative practice in MHSA practice, and has identified the philosophical-theoretical orientations of Habermas' theory of communicative action, Bakhtin's dialogicality, and the philosophy of personhood as the foundational features of collaboration. This base is juxtaposed with the results of a qualitative meta-analysis of 18 empirical articles on collaboration in MHSA to advance a collaborative practice model specifically in the domain of service user/professional collaboration.
"The collaborative, dialogue-based clinical practice model" (CDCP Model) for community mental health care is proposed, within the structure of four main components. The first specifies the framework for practice that includes person-centered care, recovery-orientation, and a pluralistic orientation and the second identifies the domains of collaboration as service user/professional collaboration, inter-professional collaboration, and service sector collaboration. The third identifies self-understanding, mutual understanding, and shared decision-making as the essential principles of collaboration. The fourth specifies interactive-dialogic processes, negotiated-participatory engagement processes, and negotiated-supportive processes as the essential strategies of collaboration applicable in service user/professional collaboration which were extracted in the empirical work. An illustration of the CDCP Model in a clinical case is given.
The CDCP Model presented fills the gap that exists in the field of community MHSA practice regarding how to operationalize systematically the tenets of person-centeredness, recovery-oriented, and pluralism-oriented practice in terms of user/professional collaboration.
已经开发出各种精神卫生保健协作实践模式，这些模式纳入了服务使用者参与和协作护理的观点。然而，这些实践模式的重点并非识别“如何”发生并培育协作及服务使用者参与的具体特征。这表明需要一种协作实践模式，该模式明确规定适用于精神卫生和药物滥用（MHSA）护理的服务使用者参与和协作原则的基本策略。
采用双螺旋方法，融合理论观点和实证研究结果，以开发一种适用于MHSA实践的实践模式。进行理论分析，以确定MHSA实践中协作实践的关键、基础要素，并确定哈贝马斯的交往行为理论、巴赫金的对话性以及人格哲学的哲学 - 理论取向为协作的基础特征。将此基础与对18篇关于MHSA协作的实证文章的定性元分析结果并列，以推进专门针对服务使用者/专业人员协作领域的协作实践模式。
提出了社区精神卫生保健的“基于对话的协作临床实践模式”（CDCP模式），其结构包含四个主要组成部分。第一部分规定了实践框架，包括以人为主的护理、康复导向和多元取向；第二部分确定协作领域为服务使用者/专业人员协作、跨专业协作和服务部门协作。第三部分将自我理解、相互理解和共同决策确定为协作的基本原则。第四部分规定了互动 - 对话过程、协商 - 参与性参与过程和协商 - 支持性过程，作为在实证研究中提取的适用于服务使用者/专业人员协作的协作基本策略。给出了一个临床案例中CDCP模式的示例。
所提出的CDCP模式填补了社区MHSA实践领域在如何就使用者/专业人员协作系统地实施以人为主、康复导向和多元取向实践原则方面存在的空白。
