Lang C L
Psychiatry. 1982 May;45(2):159-71.
During the past two decades, both the theory and practice of mental health work in the United States have been influenced significantly by the emergence of a community mental health movement. The proponents of this movement have urged conceptual and organizational reforms which would make psychiatric services more accessible and valuable to a broad range of society's population. Two of the most important of the suggested reforms represent significant challenges to the "medical model" which has long characterized American mental health practice. These mandates are: (1) to restructure traditionally stratified professional role relationships in more democratic ways, and (2) to replace traditional intrapsychic diagnostic and treatment models with more socially oriented ones. This paper examines the impact of these two proposed reforms upon the work of a group of traditionally trained mental health professionals who sought to implement the ideas of community mental health practice. It focuses, in particular, upon the status and ideological conflicts engendered by these new goals and on the factors that affect their resolution.
在过去二十年里,美国心理健康工作的理论与实践都受到社区心理健康运动兴起的显著影响。该运动的支持者敦促进行概念和组织改革,以使精神科服务能为更广泛的社会人群所获取且更具价值。所提议的两项最重要改革对长期以来主导美国心理健康实践的“医学模式”构成了重大挑战。这些要求是:(1)以更民主的方式重组传统上分层的专业角色关系;(2)用更具社会导向性的模式取代传统的精神分析诊断和治疗模式。本文探讨了这两项提议的改革对一群接受过传统培训的心理健康专业人员工作的影响,这些专业人员试图落实社区心理健康实践的理念。它尤其关注这些新目标引发的地位和意识形态冲突,以及影响冲突解决的因素。