I don't undertand the comment:
how you assess the morality of assigning a 'sick role' versus implicitly endorsing victim blaming
I think this is a false dichotomy. I think you can be with a person in a way they find helpful, and is helpful, whilst also acting as an activist on the underlying determinants of health and wellbeing without labelling people or trying to fix them.
Tim.
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-----Original Message-----
From: John Cromby <[log in to unmask]>
Sender: The UK Community Psychology Discussion List <[log in to unmask]>
Date: Wed, 13 Oct 2010 08:04:05
To: <[log in to unmask]>
Reply-To: The UK Community Psychology Discussion List <[log in to unmask]>
Subject: Re: [COMMUNITYPSYCHUK] Wellness Recovery Action Plan (WRAP)
An interesting (or, perhaps, interested) question.
On the one hand, why should we simply wait for *others* to tackle
capitalism?
On the other, one of the reasons biomedical interventions remain
acceptable - apart from the propaganda of big pharma - is precisely
because they remove blame and responsibility.
So whether WRAP and related interventions are considered better than
biomedicine depends in part on how you assess the morality of assigning
a 'sick role' versus implicitly endorsing victim blaming.
When making such assessments the very weak efficacy of WRAP and related
interventions, the recognition that any lasting change they apparently
produce is already contingent upon an array of other factors (available
resources and power, the happy accident of a new job or relationship
etc.) must surely be a factor.
And that's before we even contemplate a Foucauldian perspective on this...
J.
On 13/10/2010 07:25, Tim Anstiss wrote:
> But while we wait for the selfish capitalist system to be overthrown, does WRAP represent progress over the biomedical model? Tim.
> Sent using BlackBerry® from Orange
>
> -----Original Message-----
> From: Annie Mitchell<[log in to unmask]>
> Sender: The UK Community Psychology Discussion List<[log in to unmask]>
> Date: Wed, 13 Oct 2010 07:21:33
> To:<[log in to unmask]>
> Reply-To: The UK Community Psychology Discussion List<[log in to unmask]>
> Subject: Re: [COMMUNITYPSYCHUK] Wellness Recovery Action Plan (WRAP)
>
> Hi Mel,
>
> I agree with your critique. If you re able to search the archives of this list you will find that this topic has been debated along similar lines in the past .
>
> Much of the current moves in health provision ( WRAP included) , while no doubt in part and to some extent well -intentioned serve merely to add weight to the systemic victim blaming of those on the margins, and to distract and dis-arm the unwary from focusing on and fighting the structural, socio-economically determined ( selfish capitalist) causes of distress.
>
> Good wishes,
>
> Annie
>________________________________________
> From: The UK Community Psychology Discussion List [[log in to unmask]] On Behalf Of Deborah Chinn [[log in to unmask]]
> Sent: 12 October 2010 21:56
> To: [log in to unmask]
> Subject: Re: [COMMUNITYPSYCHUK] Wellness Recovery Action Plan (WRAP)
>
> Dear Mel
>
> I thought your critique was very cogent and well-argued. I'd agree that
> this model uses discursive strategies to create a "normal"/expected service
> user who responds appropriately to expectations of self-management and is
> likely to further marginalise people who dont fit in. Your request for any
> information about the impact of this is a relevant one.
>
> I dont have experience with this particular model, but would tend to be
> suspicious of claims that putting in words like "hope" and
> "self-assertiveness" achieve much. Any amount of "person-centred" language
> in learning disabilities services for instance, has not actually handed
> power over to disadvantaged and marginalised service users and has blunted
> real reflection by care providers on the uses and abuses of paternalism. I
> think that you can maintain and foster respect, sensitivity, curiousity and
> tolerance without needing this sort of framework. Another example is from
> children's services where practitioners are meant to complete "holistic"
> assessments including looking at social, economic and cultural context.
> They usually just leave that section out and focus on pathologising children
> and parents.
>
> Deborah
>
> ----- Original Message -----
> From: "Mel Wiseman"<[log in to unmask]>
> To:<[log in to unmask]>
> Sent: Tuesday, October 12, 2010 11:31 AM
> Subject: Wellness Recovery Action Plan (WRAP)
>
>
> Hi
>
> I’m a newly qualified clinical psychologist currently in AMH, a new poster
> on the forum, and relatively new to Community Psychology as an entity,
> although I have held the values and ideas that now draw me to it for some
> years.
>
> I would like to ask the forum for their comments and experiences in relation
> Wellness Recovery Action Plan (WRAP) which is both a tool and an approach
> that is being promoted across mental health in the community, acute settings
> and in prisons across the Midlands and some other areas. For those who are
> uninitiated http://www.mentalhealthrecovery.com/, but essentially it works
> officially on 5 principles for ‘Wellness’ in 'recovering from a breakdown':
> Hope, Self-Responsibility, Self-Assertiveness, Education and Support from 5
> people. There has been some nod toward 2 additional considerations of
> ‘power’ and ‘context’, but this is not part of the original model and is not
> well understood or integrated. It seems to perform a similar role to Care
> Plans and Relapse Prevention plans, but encompasses more than just mental
> health and is owned by the person.
>
> I have recently been to a training session on WRAP and am being asked to
> comment on it as an approach within or alongside psychology and AMH
> generally – how it fits. It is being sold as a vast improvement on current
> practise due to the ‘handing responsibility and ownership to the service
> user’ and ‘collaborative approach’. Psychologists and Psychiatrists here
> are being asked to lead on its implementation as we become a ‘Recovery led
> NHS trust’. Comments that I (et al) made to the training facilitator were
> the following:
>
> · Use of the term ‘Wellness’ – implies illness and does nothing to move away
> from the medical model.
> · Perpetuation of individualised notions of mental distress through
> ‘self-responsibility’ and ‘self-assertiveness’ – no understanding of whether
> someone has the power to improve or maintain their ‘wellness’ through these
> methods or whether they find it meaningful to think in this way.
> · Potentially abusive use of clinician devolved ‘self-responsibility’ and
> competency of individuals to deliver this approach competently and
> sensitively.
> · Primarily has been targeted at BME groups, ‘hard to engage’ groups and in
> some cases involuntarily to secondary care mental health service users in
> prison. I’m concerned that this may further burden people who have less
> power to be ‘responsible’ for their mental health because they don’t fit the
> existing systems – maybe it frees them from services they don’t want to be
> part of?
>
> I don’t think that I have the knowledge or experience to comprehend the
> impact (positive or negative) of such a shift in emphasis (if it indeed
> happens in practice). I would be interested in the views of others who may
> have experienced the uses and abuses of this, have alternative suggestions,
> comments or reactions in relation to mental health practise or Psychology in
> general.
>
> Thanks
>
> Mel
>
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