Implementing a strengths-based model in facilitating the recovery of persons with psychiatric disability

Abstract

There has long been a lack of recovery-oriented programs in Taiwan. The investigators launched the first program of this kind and applied the strengths perspective as the intervention model to facilitate the recovery of people with persistent psychiatric disability for two years. This study aimed to explore the attitudes towards and enactment of case managers on the application of the model. To fully understand the case managers` experiences, a qualitative approach with an in-depth interview was adopted. The interview was conducted twice with 10 case managers. The first time was three months after the program began and the second was one year after. The questions included their prior practice model, their thoughts about the strengths model, the changes in attitudes, their enactment of the principles of the model, the specific skills utilised, the impacts of the model on themselves and their organisation, the difficulties encountered and their coping methods. The transformation of practice modality took place incrementally, from pathology to a strengths and recovery-oriented mindset, from alienation to trusting and partnership, from directive to client self-determination, from being anxious to being flexible and patient, and from a single approach to a plural one. The investigators classified the case managers into four categories based on four aspects, i.e. belief, knowledge, enactment of the principles, and skills. The findings reveal that the belief system that case managers hold is critical. When they can fully embrace and internalise the perspective, they will practice efficiently. However, sometimes the belief and enactment are challenged and affected by external constraints. Therefore, the application appeared to be a bittersweet process for them and was filled with both successful stories and difficulties. The transformation of modality from pathology to strengths oriented is possible. Both system change and persistent application of this model are necessary for its future growth and development.