Towards a Framework for Practice
The ideas and approaches which have been explored in this book reflect a diverse range of starting points, from the situated knowledge of service users and of practitioners of various disciplines, to the application of social and psychological theories and research evidence. Brought together, they provide a set of intersecting perspectives, rather than a unitary social model. Nevertheless there may be seen to be substantial common ground, particularly in terms of underlying values and principles, and in terms of certain core ideas (see Chapter 1). The contributions contained in this book mark only the start of a process: there are significant gaps to be filled, and many ideas require to be developed further in order for their full potential to be realised.
The current practice context is one in which social model thinking still tends to be somewhat marginalised. It is not easy or effective to 'tack on' a few isolated social ideas around a practice discourse whose terms are defined by the biomedical model. Experience suggests that initial attempts at a synthesis of medical and social approaches may not have been entirely successful in underpinning a holistic approach to mental health: for example, the idea of the biopsychosocial model did not fully take account of issues of power, differences in value base and potentially fundamental differences in approaches to knowledge. If such issues are not addressed, the likely outcome in practice can be a tendency to revert to more conventional ways of working in which biomedical perspectives remain dominant – and a concern with the overall