An explication of treatment ideology among mental health care providers

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Abstract
This paper presents an exploratory analysis of the treatment ideologies of mental health care providers who work with the chronically ‘mentally ill.’ Treatment ideology is understood as the complex set of beliefs providers hold about the aetiology of mental illness, the role of the client and the provider, and the efficacy of various treatments or interventions. A case study of a large, urban mental health care organisation 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 treatment preferences was developed to represent the range of treatment ideologies uncovered. The first dimension reflects differing conceptions of the role of the provider (supportive or facilitative) and the second dimension reflects differing treatment goals (adjustment or autonomy). This typology was then theoretically extended to include a custodial role for the provider and a treatment goal oriented toward social control of clients. Further study of providers in differing organisation settings is needed to determine the salience of these typologies. Research must also investigate the development and consequences of treatment ideologies, with critical attention focused on the consistency (or inconsistency) of treatment ideologies within a given system, the professional and organisational sources of differing preferences for treatment, and the effect of various belief sets on health care services and outcomes.

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