Two models of psychiatric rehabilitation: a need for clarity and integration

Two distinct models are identifiable in the processes of psychiatric rehabilitation: treatment and training. The treatment model, which also can be presented as the "medical model," approaches the issues on the basis of defect which needs to be diagnosed and rectified. On the other hand, the training model, which can also be referred to as the "educational model," approaches the situation from the perspective of recognizing what strengths or abilities the individual may have which can be brought to bear constructively, and how to orchestrate that process. These two models involve different perspectives and different processes, and the model which is chosen affects the relationship of the clinician to the consumer. In the practical clinical situation, a thoughtful amalgam of these two orientations is called for in order best to serve the recipient. But clinicians nevertheless benefit from remaining aware of the two models involved and their attendant assumptions and modes of action, so that inconsistencies are minimized while the most effective and integrated services are provided. Administrators, payers, and researchers will similarly benefit from an understanding of the potential benefits of each of these two approaches to intervention.