As previously mentioned, the disease-centred model of drug action is closely linked to the biomedical approach in healthcare. The continued dominance of this approach means it is likely to shape the attitudes, beliefs and values of therapists from all psychotherapeutic backgrounds and to influence their practice in a variety of different ways. Before thinking about how to work with clients who have issues of prescribed drug dependence, it may be useful to think about your relationship to the biomedical or ‘medical model’ and its place in your therapeutic practice. This will help you to consider whether and to what extent it contributes to any beliefs you may have about prescribed psychiatric drugs.
Of course, beliefs and attitudes are not only shaped by the medical model; they will be influenced by your professional background, training and work, as well as by any personal experiences you may have had with prescription drugs. Your beliefs will also be influenced by the setting in which you work. Some therapists work within settings that privilege a biomedical framework, requiring them to use the language of psychiatric classification, standardised assessments and manualised ‘clinical’ techniques. This sits more closely with the ‘disease-centred’ model that emphasises notions of deficiency, symptomatology and medicalisation (sometimes referred to as the ‘what’s wrong with you’ approach). Other therapists work in settings that privilege theoretical frameworks emphasising the psychological, systemic and psychosocial aspects of experience thought to underpin emotional distress (which is more akin to a ‘what happened to you’ approach). You may find it useful to reflect on the professional framework and language used in your particular practice setting, and how it may affect your beliefs and attitudes about prescribed drugs.
Therapeutic modalities are also important. Within the humanistic and psychodynamic traditions, distress is regarded as having potential value and purpose. Rather than being seen as ‘pathological’ (and of little use), it can be regarded as an opportunity for change and transformation. By contrast, cognitive behavioural approaches focus mainly on removing symptoms of distress by altering patterns of cognition, emotion and behaviour that may be maintaining emotional suffering. Again, you may wish to consider how your own theoretical position shapes your understanding of psychological distress and how, in turn, it influences your perspective on the use of prescription drugs.
Questions to help you reflect on your position as a therapist, to be used on your own or in supervision:
- What do I understand by the term ‘medical model’?
- What position do I take up in relation to the medical model? Where do I locate myself?
- How does my professional training and practice setting influence the way I understand and work with issues relating to taking or withdrawing from prescribed psychiatric drugs?
- Do I have any experience of taking prescribed psychiatric drugs myself? Am I aware of any family members or friends who have taken prescribed drugs?
- If so, what do I think and/or feel about these drugs, based on my own knowledge and experience, both personal and professional?