RE: Return response/ Recovering Psych. Patients

Lindsay Oades (
28 Jun 1997 10:49:45 +1100

Hi Rob & Barbara,
I have been very interested in your discussion regarding "recovering
psychiatric clients"- as I currently work in psychiatric rehabilitation. I no
longer use the term schizophrenia for two reasons:
1) as discussed by Birchwood and his UK colleagues the term holds little
scientific validity in the way symptoms cluster together -hence terms such as
voices, paranoia & delusions are perhaps more appropriate to talk about (and
perhaps better match what the clients also talk about (delusions excepted).
2) the term schizophrenia seems to help few people- ie it doesn't really
inform constructively how clients and heatlh professionals work together- or
in Kellyian terms it isn't really an effective transitive diagnosis.

I have of late been asking clients of their personal meanings of voices,
interesting beliefs (delusions & paranoia etc) and of medication. Olanzapine
and Clozapine are very popular where I work- the culture constructs these as
the "best and latest treatment" - the clients say yes there are less side
effects and it seems to stop the voices a little- but as some of the
cog-behaviourists in the UK are also asking- what of the personal construals/
beliefs about voices, how do they relate to client histories etc and (as you
have been discussing) how do clients construe adherence and recovery??

Chris Stevens work with insight is also relevant here- is a non compliant
client one who invalidates the predictions of the worker? Is the client with
no insight one who simply invalidates the world view of the worker? I see
these as serious questions to consider, not to be thrown away as "anti
psychiatry rhetoric".

Lindsay Oades
From: on Wed, 25 Jun 1997 10:30 AM
Subject: Re: Return response/ Recovering Psych. Patients
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From: "Rob Adelman" <>
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Subject: Re: Return response/ Recovering Psych. Patients
Date: Tue, 24 Jun 1997 19:11:27 -0500
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> From: Tooth Barbara Ann <>
> To:
> Subject: Re: Request for references on recovering psychiatric patients
> Date: Monday, June 23, 1997 8:49 PM
> Dear Rob
> I am currently completing a research project on recovery from
> schizophrenia and hence have some information on people's construing of
> this process. However the part about their prospects of remaining
> medically compliant raises far to many issues to discuss here. In short I
> don't think it is a useful way to look at people's experience of their
> illness.
> Regards Barbara
>Dear Barbara,

I was real glad to hear from you since I had seen your name and
paper on the program for the conference in Seattle, but didn't know how to
contact you. I would
really appreciate it if you would send me a copy of your paper. I would be
glad to reimburse you any costs, or perhaps you could send it
electronically with your E-Mail. Let me know what would work best for
> The problem I am trying to resolve through this research is to find
some means to deal with the denial issue with psychiatric patients. I am
thinking that the way the patients construct their illness may provide some
clues as to how to work with them
in a more collaborative way, so as to enhance their ability to manage their
I'm curious about your comment about the issue of medication compliance not
useful in understanding their experience of their illness. Maybe we are
coming at this from different directions. Please send more. If it would
help, I can send a couple of pages of my proposal to you..

Looking forward to your response,


> On Fri, 20 Jun 1997, Rob Adelman wrote:
> > Hello out there!
> >
> > I am a doctoral candidate at Texas A&M - Commerce and new to the
> > I am working with a population of schizophrenic and bipolar patients
> > the state hospital. I am interested in applying construct methods to
> > learning about patient's constructions of their illness, and their
> > prospects for remaining medically compliant.
> >
> > Anyone who has relevant research references or ideas, please write.
> >
> > Thanks,
> >
> > Rob Adelman
> > Rusk State Hospital
> > Rusk, Texas
> >