Medical Model and Traditional Treatment

One of the strange things about being a social worker in a medical setting is the difference between the professional cultures. Social workers have a different attitude and focus than psychologists, psychiatrist, physicians, and nurses. However, in observing and participating in groups with social workers who have worked in this setting for a long time, I have seen the creep of the medical model into social work practice and it's genuinely disturbing.

As an example, I attended a Discharge Planning group on the civil side of the hospital which was lead by a social worker. She spoke about CRF homes and how stepping down works. While I took issue with some of her interpersonal style, which lacked empathy and a skill-building approach, those seemed like more surface-level concerns. The clients, meanwhile, were venting their frustration over the lack of control over their discharge plan (as well as their life, in general) and the lack of autonomy they experience in the hospital. Instead of validating these concerns or showing them some skills on self-advocacy within the setting, she seemed focused solely on apologizing for the system and instilling in the patients the supreme need of medication compliance.

While I understand that medications do help those with severe mental disorders function better in the community, it is ultimately up to the client to make the decision to continue or discontinue medications. Although this is a radical viewpoint, if the client were to discontinue medications and make his reasons known to his care workers, it could be interpretted as a growing sign of independence from treatment staff and ownership of his mental health issues.