Beyond the Disease Model of Mental Disorders

Rating:
Summary: A "must-read" book for students of mental disorders
Review: I unreservedly and enthusiastically recommend Kiesler's "Beyond the Disease Model of Mental Disorders."

A consistent bias has dominated how mental disorders are presented in contemporary society by psychiatry, by national mental health organizations, by press coverage and by depiction in the popular media. All of these have embraced a rather strict interpretation of the biomedical disease model, which presumes all psychopathological conditions are most sensibly understood and explained when reduced to a physiological level.

In addressing the disease model, Kiesler's critique first offers logical refutation of its assumptions and current applications. The central focus of the book, however, and where it really shines, is in Kiesler's encyclopedic and exhaustive review of scientific evidence from the fields of behavior genetics, personality psychology, epidemiology, developmental psychopathology, and prevention science. Kiesler shows convincingly that the available scientific evidence argues against the validity of the biomedical model. His book rightly concludes that a strict biomedical approach is myopic and he urges the mental health fields to abandon the disease model. Similarly, he persuasively advocates against the use of any etiological explanation of psychopathology that embraces a single cause (such as environmental behaviorism). In place of monocausal models, Kiesler recommends substitution of emerging multicausal biopsychosocial theories of mental disorders.

I have studied psychopathology all my professional life, and I have used Kiesler's book as a required supplementary text for a graduate level course on psychopathology and as an optional text for undergraduate Abnormal Psychology courses. In addition to these audiences, this book has clear relevance for any mental health educator or textbook writer (in either university or teaching hospital setting) who may have significant influence over predominant themes and trends with the field. Kiesler's last chapter provides a "Universal Outline of Psychopathology" designed to guide restructuring of available undergraduate and graduate abnormal psychology and psychopathology texts.

As is typical of Kiesler's work, this book provides an accurate, balanced, and totally thorough account of the state of the literature on causal models on psychopathology. His message is one that cannot be ignored as researchers and students of psychopathology work toward elucidation of all the factors that interact to produce mental disorders.