Changing the Client Versus Changing the Environment

Conventional approaches to working with clients in mental health and other therapeutic settings primarily involve the use of psychotherapy and/or medication to bring about changes in the clients [Page 179]that presumably allow the clients to better adapt to their life circumstances. However, in recent years there has been a shift in this perspective among several groups of practitioners who instead favor an approach that views the source of emotional suffering as residing in the environment rather than in the client. This focus assumes that it is not necessarily most beneficial to alter the client. In this alternative approach, the guiding principle is the need for social change rather than individual change.

This shift has been influenced by a number of developing trends in the disciplines of psychiatry, psychology, social work, and allied helping professions. There is growing recognition that current dominant approaches to mental health care have not resulted in a decrease in rates of mental illness. Moreover, evidence of the dangers, adverse reactions, and side effects of psychiatric medication is becoming more readily acknowledged both within and outside the medical community. As such, clients and clinicians alike are seeking alternatives to current mainstream models of care.