Stephen Black writes: "But so far I haven't found anyone but myself referring to the two as the "true medical" and "quasi-medical" models, a distinction I find very helpful. Is it mine, or does anyone know of a source?"
You won't see people in medicine using the term "medical model" to refer to what they do. It would be like hydrologists talking about using the hydraulic model. The medical model is a model for psychologists in that it is a metaphor or a model for what they do. Which is also why it isn't necessary to refer to a "quasi-medical model". The word "model" carries the meaning of being a metaphor. The extent to which the metaphor is effective or useful can be argued but it is only a model. Rick Dr. Rick Froman Professor of Psychology John Brown University Siloam Springs, AR 72761 (479) 524-7295 e-mail: [EMAIL PROTECTED] web: http://www.jbu.edu/academics/sbs/faculty/rfroman.asp -----Original Message----- From: Stephen Black [mailto:[EMAIL PROTECTED] Sent: Friday, December 03, 2004 5:20 PM To: Teaching in the Psychological Sciences Subject: Re: APA President-elect (now "medical model") On 3 Dec 2004, Scott Lilienfeld wrote: > As a number of authors, including Paul Meehl and Paul > Blaney, have noted, the term "medical model" actually refers to a large > number of quite different models, many of which bear little or no > conceptual relation to each other. When I was young and na�ve (as opposed to being old and na�ve, as I am now), I was mightily confused about this term. I understood that the medical profession (naturally) used the medical model (good) but that traditional psychotherapy also used it (bad). Why was it good in one case but bad in the other? I eventually stumbled upon the difference. What I call the "true medical model" is what doctors use in treating patients. They observe symptoms (signs) of the sick patient (e.g, "headache") and from them draw a conclusion about the underlying cause of the disorder ("brain tumour"). Generally (although there are exceptions) the symptom isn't treated (the doctor doesn't prescribe aspirin) but uses the symptoms to determine the true cause so that effective treatment can be given (surgical excision of the tumour). Traditional psychotherapy does the same, sort-off. The therapist observes the patient for symptoms (depression, anxiety) and diagnoses the underlying cause (repressed memories of child sexual abuse). He/she then treats the underlying cause (e.g. with recovered memory therapy) rather than the symptom. But there's a critical difference in the way that a doctor uses the model and the way that the psychotherapist does. The difference is that in the true medical model, the postulated cause is a real, structural one (a tumour, bacterium, or virus). In its use in psychotherapy, the postulated cause is a fictitious, metaphoric one, a "psychic" one, which no one expects to observe under a microscope (try detecting a repression in the way you detect a tumour). So I call its use in psychotherapy a "quasi-medical model". I have no doubt that the enthusiastic endorsement of the quasi-medical model by traditional psychotherapy is based on its association with the prestige and effectiveness of the true medical model with which it is confused. Unfortunately, while the use of the true medical model to treat disease has been strikingly successful, the use of the quasi-medical model to treat psychological disorders has been less so. Once I realized the need for a distinction between the two kinds of medical model, things made sense for me again. I'm not sure where this distinction originated, so I just spent some time trying to dig up sources. What I found was that Ullmann and Krasner (1965), in a classic early collection of behavior modification readings, discuss much of what I've said above in their introduction under the heading "medical model". But they don't distinguish between the two kinds. I also have a discussion from Lovaas (1979) where he calls it the "disease model" and points out that there are two kinds, one which postulates psychic damage and the other, structural damage. But so far I haven't found anyone but myself referring to the two as the "true medical" and "quasi-medical" models, a distinction I find very helpful. Is it mine, or does anyone know of a source? Stephen References Lovaas, O. (1979). Contrasting illness and behavioral models for the treatment of autistic children: a historical perspective. Journal of Autism and Developmental Disorders, 9, 315--323. Ullmann, L, & Krasner, L. (1965). Introduction: What is behavior modification? In: Case studies in behavior modification. New York: Holt, Rinehart. _______________________________________________ Stephen L. Black, Ph.D. tel: (819) 822-9600 ext 2470 Department of Psychology fax: (819) 822-9661 Bishop's University e-mail: [EMAIL PROTECTED] Lennoxville, QC J1M 1Z7 Canada Dept web page at http://www.ubishops.ca/ccc/div/soc/psy TIPS discussion list for psychology teachers at http://faculty.frostburg.edu/psyc/southerly/tips/index.htm _______________________________________________ --- You are currently subscribed to tips as: [EMAIL PROTECTED] To unsubscribe send a blank email to [EMAIL PROTECTED] --- You are currently subscribed to tips as: [email protected] To unsubscribe send a blank email to [EMAIL PROTECTED]
