Models of Mental Health

• Falling out of favour with God, feeling an abandonment by the higher power (which lies outside the individual, e.g. God),
• Suffering being a condition of penance (e.g. Carl Rogers’ parents, who were, Calvinists, believed that going to see a film or having a fizzy drink Coca Cola was sinful),
• Sinning requiring repentance, so involving fearfulness,
• Having to follow a moral code in the form of commandments or scriptures that guide people on how to live their lives.

Counselling clients may wish to talk about their relationship with faith, and it’s important to tread carefully in case the theory we’re working to (e.g. person-centred) somehow clashes with the person’s faith.

For example, person-centred philosophy advocates that all humans are essentially good, whereas Christianity suggests that babies are born with original sin.

Faith can be a really solid structure that keeps the client afloat in times of difficulty. For example, research has shown that people with faith tend to have more resilience following traumatic situations than those who don’t.

• Can link to people’s deepest values,
• Holds out hope and healing, especially with death and loss (e.g. that you can meet again in heaven),
• Allows people to feel a connection to something bigger than themselves,
• Offers spiritual support from whichever higher power people believe in,
• Promises spiritual forgiveness, once sin is repented,
• includes support from religious institutions and leaders (e.g. clergy, imams and rabbis),
• Provides communal rituals to facilitate life transitions (e.g. christenings, bar/bat mitzvahs, weddings, marriages and funerals),
• Reframes stressors into a benevolent system of meaning (e.g. the idea that the deity never puts on people’s plates more than they can handle), enhancing resilience,
• Involves the idea that people are being guided by a higher power.

Whether or not you share the client’s beliefs, it’s really important to honour them, working within this framework.

• Can be subjective in how it’s perceived (e.g. a client may genuinely believe that their deity is punishing them,
• May be insufficient, not providing all the resilience that someone needs – other interventions may be needed,
• Could be part of the problem (e.g. if a client is in a faith community that is abusive).

• Chemical imbalances or defects,
• Damage to the structure of the brain,
• Genetic factors.

Mental health difficulties are therefore divided into diagnoses (such as depression, schizophrenia, obsessive-compulsive disorder, bipolar disorder and anxiety), with treatment seen to lie in medically grounded procedures such as surgery, medication and electro-convulsive therapy.

Many clinicians these days do recognise, understand and use other models too.

• Is evidence-based (in the UK, this means it is approved by the National Institute for Clinical Excellence),
• Is readily available (often more so than talking therapies)
• Acknowledges that some mental health conditions may be genetic (at least in making it more likely certain people will develop the condition, given a particular set of environmental factors).

• Treats the symptoms, not the underlying issues,
• Pathologises natural mental and emotional distress (for example, in past times, the Diagnostic and Statistical Manual of Mental Disorders has included ‘Child Abandonment Complex – anxiety when parents split up – and even homosexuality as mental illnesses).

• • Faulty thinking,

• • Unresolved issues from childhood,

• • Introjected values.

Across all models, it is generally agreed that the therapist-client relationship is a key factor in bringing about positive change.

• • It is evidence-based, working as well as antidepressants,

• • It also provides a unique space and relationship not found in other models of mental health.

• • Some individuals may need more than one area of support,

• • Talking therapies don’t work for everyone (for example, those who are not ready for it, are too fragile, are not well enough or believe the world needs to change rather than them). However, pre-therapy (developed by Garry Prouty) could be a helpful first stage for them,

• • There is often a long wait for counselling that’s free at the point of delivery, and many people can’t afford to pay for private therapy.