Many theories have been proposed and developed to explain
mental illnesses and guide the many treatments available
today. Most theoretical models attempt to delineate a single
course of treatment such as behavioral management (behavioral
modification), medical management (taking prescribed
medications), psychological management (receiving
psychotherapy), and social skills (learning to get along in
the community and becoming employed).
Each of these theories and their corresponding prescribed
treatments are useful and perhaps even critical in the
successful management of psychiatric disorders. However, most
people learning to manage these illnesses need a combination
of bits and pieces of each of these major treatments. The
Murphy-Moller Wellness Model demonstrates and integrates a
holistic approach to the treatment of these illnesses.
This model builds on the traditional biological,
psychological, sociological approach to psychiatry by using
common language and vocabulary.
One of the unique aspects of this model is that it
includes a major emphasis on the spiritual nature of
each of us as well as our cultural backgrounds.
The model as you see it shows the fluctuating aspect of
maintain balance in each of these areas. Very few of us ever
experience having all our needs balanced at one time. This
model is a way for people with mental illnesses and their
families to describe areas of their lives that are out of
balance.
For example, during an acute family crisis, the
environment/relationships needs circle may become much bigger
than the other three. Balance requires the base of
social support moves in the direction of symptom intensity to
provide adequate support during all three levels of wellness:
relapse, recovery and rehabilitation. Typically the base of
social support needs to widen in order to accomdodate adapting
to triggers.
Wellness involves every aspect of living. It includes the
interaction between health, environment and relationships,
attitudes/behavior, and spirituality. When a person feels well
they are able to accomplish the tasks of every day living and
achieve desired life goals.
Three levels of wellness are shown in the model: unstable,
stable, and actualized. The unstable level of wellness
occurs when symptoms overpower the person's ability to
complete normal activities of daily living.
The stable level of wellness occurs when symptoms
have stopped taking control of the person and there is some
type of positive response to medications and treatment.
Actualization is when the person can identify
symptom triggers and implement symptom management to prevent
relapse or to intervene at the earliest possible sign of an
impending relapse.
Health is the ability of all body systems to
function in a manner compatible with life and social function
and includes all the physical aspects of a person. It refers
to the general structure and function of each of our body
systems. A high level of health is achieved when all body
systems function in balance with each other.
Health includes the ability to pay attention, learn, think
clearly, solve problems and make decisions. It includes our
genetic predisposition to illnesses as well as health. A major
focus of the health circle in the Three R's Program is the
connection between the brain and the rest of the body as all
psychiatric symptoms including hallucinations and delusions
interfere with the ability to think and thus with a person's
overall level of health.
Environment/Relationships involve all the social and
interpersonal aspects of a person. It includes all
interpersonal relationships and encounters with the various
groups and communities that a person typically encounters
during life. Examples of these groups and communities include
our family relationships, work and school relationships,
social clubs, churches, and informal activities during which
we encounter other people such as going out to eat or to the
movies and taking trips or vacations. Feeling comfortable and
accepted in one's own environment is important to being well.
A hostile, critical environment increases the level of stress
and makes it difficult to achieve wellness. Being around
people who are negative decreases energy . A major focus of
the environment/relationships circle in The Three R's Program
is the ability to relate to others in spite of having a mental
illness.
Attitudes/Behavior help a person to be well or can
lead to becoming ill since this circle includes all the
psychological aspects of a person such as self-concept,
self-esteem, and the effects of life experiences on our
attitudes and beliefs toward self and others. It is important
to have hope in order to increase the current level of
wellness. Being around people with positive attitudes helps
increase energy and promote a general feeling of well-being.
Behavior is important in managing the challenges of life and
the challenges of having a neurobiological disease. Behavior
that helps people blend into society rather than appear
"different" is also important to feeling good. The more a
person dresses and behaves like other members of society the
better chance they have of being part of that society. A major
focus of the attitudes/behavior component is the ability to
negotiate, or deal with, the effects of having a chronic
illness on self image.
Spirituality refers to those aspects of human
behavior and experience that reflect an intelligence or
process that goes beyond the understanding and experience of
being human. This process inspires devotion and directs
behavior. Spirituality is both at the core of the wellness
balance and the soul of the person. Spirituality is evident
whenever there is an awareness of a broader life meaning that
goes beyond the immediate nature of everyday living and
concerns with material possessions. Spirituality is not to be
confused with religion. Religion refers to a group of
believers who accept and share a common set of beliefs,
practices, and rituals regarding spiritual concerns and
issues. Spiritual health is maintained through faith, prayer,
study, a grateful heart, integrity, and service to other
people.
In the Murphy-Moller Wellness Model, spirituality most
directly is reflected in the ability of individuals with a
neurobiological disorder and their families to find a purpose
and meaning to the presence of a mental illness in their
lives. A major goal of recovery is the ability of people to
reach out to and assist others who are struggling to manage
the symptoms associated with mental illness and the
devastating effects of stigma.
The fulcrum of the model is the Base of Social
Support consisting of community resources, kinship and
culture.
Community resources refers to all the
resources the individual can appropriately access. Everyone
uses community resources every day. It is essential these
resources be used appropriately. Kinship refers to the
sense of belonging one feels in the community in which one is
living. Different people may feel a different sense of kinship
even if they are living in the same community. Culture
is the way that people do things based on what they have
learned from family and friends. We are all taught ways of
believing about our health, our self-concept, our
relationships with those around us, and the presence of a
higher power. When we find ourselves out of our normal or
familiar culture we are often misunderstood and feel very
confused about how others are responding to us. It is
impossible to achieve a high level of wellness without taking
into account an understanding the person's culture. Sometimes
culture is linked to ethnic groups, religious groups, or race.
