AN EXPLICATION OF TREATMENT IDEOLOGY AMONG MENTAL-HEALTH-CARE PROVIDERS

This paper presents an exploratory analysis of the treatment ideologie s of mental health care providers who work with the chronically 'menta lly ill.' Treatment ideology is understood as the complex set of belie fs providers hold about the aetiology of mental illness, the role of t he client and the provider, and the efficacy of various treatments or interventions. A case study of a large, urban mental health care organ isation providing care to the chronically 'mentally ill' was conducted in 1992. The author attended a series of staff retreats, administered a questionnaire, and completed in-depth interviews with 22 providers. A typology reflecting two dimensions that juxtapose alternative treat ment preferences was developed to represent the range of treatment ide ologies uncovered. The first dimension reflects differing conceptions of the role of the provider (supportive or facilitative) and the secon d dimension reflects differing treatment goals (adjustment or autonomy ). This typology was then theoretically extended to include a custodia l role for the provider and a treatment goal oriented toward social co ntrol of clients. Further study of providers in differing organisation settings is needed to determine the salience of these typologies. Res earch must also investigate the development and consequences of treatm ent ideologies, with critical attention focused on the consistency (or inconsistency) of treatment ideologies within a given system, the pro fessional and organisational sources of differing preferences for trea tment, and the effect of various belief sets on health care services a nd outcomes.