From adherence to self-determination: Evolution of a treatment paradigm for people with serious mental illnesses

Patrick W. Corrigan, Beth Angell, Larry Davidson, Steven C. Marcus, Mark S. Salzer, Petra Kottsieper, Jonathon E. Larson, Colleen A. Mahoney, Maria J. O'Connell, Victoria Stanhope

    Research output: Contribution to journalReview article

    Abstract

    Treatment adherence and nonadherence is the current paradigm for understanding why people with serious mental illnesses have low rates of participation in many evidence-based practices. The authors propose the concept of self-determination as an evolution in this explanatory paradigm. A review of the research literature led them to the conclusion that notions of adherence are significantly limited, promoting a value-based perspective suggesting people who do not opt for prescribed treatments are somehow flawed or otherwise symptomatic. Consistent with a trend in public health and health psychology, ideas of decisions and behavior related to health and wellness are promoted. Self-determination frames these decisions as choices and is described herein via the evolution of ideas from resistance and compliance to collaboration and engagement. Developments in recovery and hope-based mental health systems have shepherded interest in self-determination. Two ways to promote self-determination are proffered: aiding the rational actor through approaches such as shared decision making and addressing environmental forces that are barriers to choice. Although significant progress has been made toward self-determination, important hurdles remain.

    Original languageEnglish (US)
    Pages (from-to)169-173
    Number of pages5
    JournalPsychiatric Services
    Volume63
    Issue number2
    DOIs
    StatePublished - Feb 1 2012

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    Personal Autonomy
    Hope
    Behavioral Medicine
    Evidence-Based Practice
    Decision Making
    Mental Health
    Public Health
    Health
    Research

    ASJC Scopus subject areas

    • Psychiatry and Mental health

    Cite this

    Corrigan, P. W., Angell, B., Davidson, L., Marcus, S. C., Salzer, M. S., Kottsieper, P., ... Stanhope, V. (2012). From adherence to self-determination: Evolution of a treatment paradigm for people with serious mental illnesses. Psychiatric Services, 63(2), 169-173. https://doi.org/10.1176/appi.ps.201100065

    From adherence to self-determination : Evolution of a treatment paradigm for people with serious mental illnesses. / Corrigan, Patrick W.; Angell, Beth; Davidson, Larry; Marcus, Steven C.; Salzer, Mark S.; Kottsieper, Petra; Larson, Jonathon E.; Mahoney, Colleen A.; O'Connell, Maria J.; Stanhope, Victoria.

    In: Psychiatric Services, Vol. 63, No. 2, 01.02.2012, p. 169-173.

    Research output: Contribution to journalReview article

    Corrigan, PW, Angell, B, Davidson, L, Marcus, SC, Salzer, MS, Kottsieper, P, Larson, JE, Mahoney, CA, O'Connell, MJ & Stanhope, V 2012, 'From adherence to self-determination: Evolution of a treatment paradigm for people with serious mental illnesses', Psychiatric Services, vol. 63, no. 2, pp. 169-173. https://doi.org/10.1176/appi.ps.201100065
    Corrigan, Patrick W. ; Angell, Beth ; Davidson, Larry ; Marcus, Steven C. ; Salzer, Mark S. ; Kottsieper, Petra ; Larson, Jonathon E. ; Mahoney, Colleen A. ; O'Connell, Maria J. ; Stanhope, Victoria. / From adherence to self-determination : Evolution of a treatment paradigm for people with serious mental illnesses. In: Psychiatric Services. 2012 ; Vol. 63, No. 2. pp. 169-173.
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