The significance of a spiritual dimension to psychiatric practice has come to be recognised by most authorities in the mental healthcare arena. Spirituality means the investment of meaning into the presentation and management of psychiatric disorder through an understanding of the patient as a whole person with individual and societal values and beliefs and a world view. Failure on the part of the clinician to capture this almost certainly threatens the effectiveness of evidence-based interventions to relieve symptoms and can disable people from achieving recovery, well-being and citizenship.
This book explores one vehicle through which spiritual care can be brought to life – person centredness – and distinguishes this from patient centredness. The latter encourages consumers to become more active and powerful in the planning and review of care through deploying the Department of Health's current mantra of the right to actively exercise a choice. The former, originally described and practiced by Carl Rogers, encourages clinicians to adopt a non-directive approach aimed at helping the client mobilise their own strengths to drive a process of constructive personality change and self-actualisation, the therapist adopting a stance of unconditional positive regard in order to empower them to do so.
Spirituality, patient centredness and person centredness are clearly linked, but it may specifically be the last that poses the most colossal implications for a risk-averse health service focused on efficiency and concerned with actively managing people who may lack the capacity for self-determination or who may unwittingly be encouraged (through mental health legislation, for instance) to subjugate responsibility for their actions to statutory and other health and social care services.
Rachel Freeth, a consultant in general adult psychiatry in Gloucestershire and fully qualified person-centred counsellor, sets out the issues clearly and compellingly and there are powerful forewords by Brian Thorne and Mike Shooter. It is clear that all three are coming at this from a position of passion and the book is immediately engaging to any reader interested in mental healthcare, particularly relevant to reflective, empathic clinicians and absolutely necessary for medical and other clinical managers interested in creating a more emotionally intelligent clinical culture within today's National Health Service.
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