The medical model

1. This model assumes that the person coming for help has a ________ or sickness
2. This model assumes that the physician or service provider can prescribe a treatment or _______ for the “disease.”
3. This is probably the __________ treatment model.
4. Most modern models started with a basis in the medical model.  For example, in social work, the first __________  used the medical model to describe social casework.
5. The medical model was also adopted in the corrections field when the emphasis switched from __________  to __________.

History of the Medical Model:

6. The medical profession took primary responsibility for the care of the mentally ill with the establishment of __________; this also shifted the care from the local community to__________ settings.
7. At the end of the eighteenth century, __________  emerged as a distinct discipline and __________  __________ pushed for more humane treatment of those with mental illnesses.
8. By the middle of the nineteenth century, the medical model was the primary method of treatment but the medical model itself started to change, with a de-emphasis on medical treatment and more emphasis on __________  as a treatment for mental illness; this was based on a belief that diseases of the mind or soul were __________  from diseases of the body.
9. Sigmund Freud revolutionized treatment within the medical model, and later also developed the __________  model, which involved the patient sharing all their thoughts with the therapist and the therapist interpreting this material to help the patient recognize the sources of their problems (repression).  This method did not become widely popular however, because of the difficulty with evaluating its success and the amount of time and money needed for __________.
10. In the 1940’s, electroconvulsive or electroshock therapy became more common.  This involved administering an electric shock to the __________  which left the patient unconscious and/or in convulsions.  Problem behaviors diminished after several weeks of treatment, and this was found to be most effective with __________  patients but not as effective with other types of mental illnesses.
11. Electroconvulsive therapy lost popularity due to the negative perceptions of the treatment and the growing popularity of ____________________.
12. Psychotropic drugs are now among the most widely used treatments for mental disorders.  These drugs act on the __________.
13. __________, the study of the effects of drugs on mental health, plays an important part in human services as human services workers communicate with medical professionals and better understand the uses and limitations of these __________.
14.   There are four major classes of medication:
    1. Antipsychotic drugs – these drugs help control psychotic symptoms such as __________, hallucinations and impulsiveness
    2. Antidepressant drugs – these drugs relieve __________.  There are three kinds:

                                                               i.      __________  antidepressants

                                                             ii.      Monoamine oxidase __________

                                                            iii.      Selective __________  reuptake __________  (however, these drugs do not completely fit into this category)

3. Antianxiety drugs – these are the most __________  used medications and are used to relive anxiety, fear or tension. There are three classifications:

                                                               i.      Barbiturates

                                                             ii.      __________

                                                            iii.      Antihistamines

4. Mood stabilizers – These are used primarily in the treatment of __________  disorders and are effective in preventing a __________ state.
14. Medications have revolutionized health care and helped encourage deinstitutionalization; however, there are many __________  __________  to medications and some illnesses may not respond to typical medications.
15. The symptom-diagnosis-treatment-__________  process realistically leads to control or __________  of a mental illness; generally, it does not lead to both. 
16. There are many new __________  that do not fit neatly into one category such as the SSRIs mentioned above.
17. There is another challenge in the modern medical model – who controls medical services?  There are now multiple bodies involved with medical care from government to __________ __________ companies to physicians to other human service worker to the patient themselves.

The Public Health Model

19. This model is somewhat hard to __________  so the authors approach the definition from three perspectives:  an examination of its development and accomplishments, an examination of its goals, and defining it to reflect its __________  (energy or enthusiasm) and adaptability.
20. The mission of the public health model is to fulfill society’s interests to insure that people can be __________, and the belief that health is a basic human right.
21. This model __________  the medical model and the human services model but it is more similar to the __________  model.
22. It is often difficult to separate public health from human welfare, such as separating ill health from __________. 
23. The public health model is concerned with individuals who have problems, similar to the medical model, but it extends this to beyond the traditional medical model to include looking at the connection between people’s medical problems and other __________ problems that may cause or exacerbate the individual medical needs.
24. This model approaches social problems in two ways – looking at the causes or __________  of problems and emphasizing __________.
25. The objective of the public health model is to improve the present and future quality of life and to alleviate health problems that have consequences for __________  in general.

History of the Public Health Model:

26. Lemuel Shattuck wrote the first plan for the Massachusetts legislature for an __________  health program in the United States; this report was ignored at its time but is now seen as an important step in the development of the __________ __________ __________  .  The report emphasized the need for improved sanitation and __________ control.
27. The early 19^th century social philosophies reflected two beliefs about disease:  One belief was that poverty and __________ __________ were the result of God’s wrath toward an individual, with the obvious solution being seen as improved behavior.  The second belief was that disease was linked to __________  factors such as “disorderly” and filthy cities.
28. The 1861 organization of the U.S. Sanitary Commission became the first major __________  health group in America.  This group had a primary focus on __________, with an initial focus on teaching sanitary methods for __________  camps and hospitals.
29. Dr. Louis Pasteur and Robert Koch demonstrated that __________  cause disease and spawned the major focus on prevention in the late 1800s.  This led to the field of __________  medicine and the creation of the Public Health Service, which is today a part of the Department of Health and Human Services. 
30. The spread of __________  diseases was spawned through the development of __________.  This was followed by epidemics of __________  diseases that are now the focus of health departments.
31. By 1900, influenza, pneumonia, tuberculosis, and gastrointestinal infection were the main causes of __________  in the U.S. with a average life expectancy of 47 years. 
32. By 1950, changes in diet and sanitation and the development of __________  and vaccines increased life expectancy to 68 years.
33. By 2000, life expectancy grew to 76.9 years; with the leading cause of death now heart disease and cancer and the leading health problems are ____________________.
34. The Healthy People Initiative is reformulated each decade and contains the __________  agenda for the United States.
35. There have been many areas of success through prevention efforts; unfortunately the following problems have increased rather than decreased:  AIDS, __________, asthma and ____________________.
36. There is also a lot more information available today through the __________; it is important to check for the source of this information to insure accuracy.

The Human Services Model

37. A primary focus of this model is to provide services that help individuals to __________  their problems.  However, problems are viewed as an expected and even necessary part of everyday life, and should be considered in the context of the __________. 
38. Those who need help are called __________  or __________ and this may mean an individual, a group, a family, a community, or a population with a common __________.
39. Problem solving, which focuses on the __________ and __________, is the primary method of treatment.  There are several phases to this process with the primary two below:
    1. Problem __________  – this includes getting to now the client, fully exploring the situation and identifying strengths or resources that the client has.
    2. Intervention – this involves developing a __________  to address these issues.
40. The human services model uses the problem-solving approach because:
    1.  it provides a __________ way of thinking about complex situations,
    2. the effectiveness of the process can be __________  at each stage,
    3. clients can learn this process and use it when they are no longer receiving services,
    4. the outcomes of the process support the human services philosophy that clients can work successfully through the process through increasing self-esteem and a sense of ____________________, and
    5. this approach can help identify __________  and __________  to prevent future problems.

The philosophy of the human services model

41. The ideas behind this model include the belief that people have the right to have the resources to prevent __________ and provide for basic __________  and that the __________ has a responsibility to provide people with adequate human services.
42. The __________________________________________________, which grew out of the public health model contributed to the development of the human services model as more individuals with mental illness were moved out of hospitals and into the communities.
43. Another factor that contributed to the growth of the human services model was the medical field’s recognition of the __________  of the human services field, when it began stressing patient responsibility for lifestyle choices.
44. Former president Jimmy Carter also continued to the growth of the human services model through his work in publishing the lack of access to adequate __________ __________ __________ for many Americans.
45. Most authors agree that human services models should also include the following characteristics or themes:
    1. A __________  focus that helps apply basic helping skills to providing services for a variety of different populations; this includes the training for helpers.
    2. There needs to be an __________  service system that comprehensive, accessible and coordinated.
    3. There is a focus on the here and now through the problem-solving approach; this approach also focuses on teaching the client problem-solving __________.
    4. The focus needs to be on treating the __________  person, which includes recognizing client needs in relation to others and the environment.
    5. In the human services model, clients are __________  participants and the human services system is __________  to the consumer.