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Charmaine Perry May 25, 2017

Medical Model vs Wellness Model

When I was about nine or ten years old, I decided I wanted to become a therapist. In my home country, counseling and psychology was one field. So I decided I wanted to become a psychologist. Titles and letters after one’s name was not really relevant at the time. After immigrating to the US for college, I began to learn more about psychology and began to understand the various schools of psychology. I had always had a strong interest in business so I decided on organizational psychology; but by the time I graduated college, I was advised that that field was slowly dying so I once again returned to wanting to do therapy. I was encouraged to pursue counseling psychology as opposed to clinical psychology because clinical psychology was for the people who were “really crazy and had really serious problems.” After graduating, I had to take stock of the next step of my life and realized that I had not really lived outside of school, I had been going to school since the age of 3 years old until 22 years old. After looking into graduate school, I realized I would now need to commit another 8 years of my life, practically 10 more years of nothing but learning and not living, I realized that I just could no longer do that. I really needed a break. So, I decided to take a year off. In doing so, and taking my time to explore graduate programs, I came across the LPC program from Seton Hall University, and upon further searches, discovered there was another one at Fairleigh Dickinson University. The more I researched, the more my interest was piqued. I could do 2 years of school and 1 year of practicum and internship, and obtain a temporary license where I would finally be able to practice therapy. I did not have to wait another 8 – 10 years! I was ecstatic! I applied to both programs and was thankful to get into two great programs. I decided on Seton Hall and attended while working full-time. I realized that I did not have any care about the title after my name, as long as it meant that I could practice therapy.

Between undergraduate and my first year in graduate school (Bay Path University and Seton Hall University), I really began to understand the difference between counseling and psychology for the first time. The more I learnt, the more I began to appreciate counseling as a separate field. Not to say, the fields cannot be bridged, but I initially just viewed counseling as an extension of psychology. Once I transitioned to Capella University and delved deeper into my Master’s, I began to view counseling as a more holistic approach to therapy. I really liked the wellness approach as opposed to the medical explanation for everything. I felt that from my previous experience in therapy, I wanted to be able to provide the same kind of comfort and support I had received when I was younger.  I did not feel that sterile approach as I often did when I visited the doctor. I felt connected, warm even while engaging with a therapist who was responsive. Although, I have experienced this sterile approach from a therapist before, and needless to say, that counseling experience did not last long. The wellness model just seemed to fit so much better when the deep connection of the therapeutic bond is strong and engaging. From my own professional experience, a lot of the changes I see in my clients, I attribute to the dynamic of the relationship, especially when working with children. Counseling and wellness seem to go hand-in-hand. Kaplan noted in Laurie Meyers February 2014 article that wellness has always been embraced by the counseling field. I especially think this relationship between counseling and a wellness approach is even more vital now when the stresses of today’s society are considered.

Medical Model

With the use of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), we are still heavily tied to the medical model. With the setup of big business insurance, this may likely never change.  The medical model is tied to pathology and focuses on the things that are wrong with clients.  The model has been working for many decades but is rooted in psychiatry and medicine as is the history of mental illness.  The benefit of the medical model is that it is heavily based on scientific studies which allow for more objective results.  The drawback of the medical model is that it is heavily based on pathology and tends to ignore the clients’ strengths which maybe vital to helping clients overcome or manage their mental illnesses. Oftentimes, the answer may be medication first without consulting alternatives, which can especially be an issue if clients are opposed to the medication.  Ken Duckworth, M.D. emphasized that there doesn’t need to be an either/or approach when working with clients, which I completely agree with.  It is our duty to assess our clients and see where they are at and then use the best approach that will help our clients stabilize quickly and maintain their stabilization.

Wellness Model

The wellness model has been adopted by counselors, and similarly theoretical models have been created to fulfill this vision.  Blount, Lambie, and Kissinger pointed out that counselors now serve as wellness advocates via our practices of wellness- based modalities. The wellness approach focuses on the integration of the whole person and considers the individual’s strengths and weaknesses. Additionally, Blount, Lambie, and Kissinger highlighted that wellness is an individual goal to be created and pursued.  Each person’s wellness should be based on where that person is and that person’s ideal state of wellness.

The benefit of the wellness approach recognizes that a human being is a sum total of various parts.  Since we are social creatures, it would make sense that our overall wellness would be tied to a variety of areas.  As Kaplan pointed out in Meyer’s article, the holistic view considers job fulfillment, self-worth, emotional stability, coping skills, spirituality, and balanced relationships.  These areas are, of course, just the tip of the iceberg and are all inter-connected within the client.  With regards to the drawback of the wellness model, Jane Meyers and Thomas Sweeney who were also interviewed in Meyer’s February 2014 article pointed out that although counseling utilizes a wellness approach, not all counselors are comfortable exploring areas like religion and spirituality with clients. I would even go so far as to include cultural and racial experiences that deeply affect who clients are and how they experience the world around them. These are deeply rooted areas of identify that foster into the clients’ belief about themselves and their capabilities.  As counselor’s, we have to allow our clients safe space to explore these areas to develop their self-identities and self-compassion. One other drawback of the wellness model that I have considered, which goes back to what I mentioned above about the use of the DSM-5 to diagnose clients.  As counselors, we understand the need to use the manual for insurance and billing, and hopefully to streamline the clients’ treatments.  Yet, it is still a source of query that we are operating from a wellness-based approach but still utilize a pathology-based manual to also diagnose and treat clients. The irony is not lost on counselors.


As Ken Duckworth noted, it is best to utilize both approaches. For clients with more severe mental illness, medication maybe vital for them.  Yet, in also utilizing a wellness approach, I believe we take a more human approach by meeting the client on a human level and connecting with them. Going back to Roger’s Humanistic approach, we are reminded of the vital importance of the therapeutic relationship. I think this is the area that counseling excels in.  We see our clients as individuals who have the innate strengths to resolve their own issues; they may just need some guidance and support as they do so. We meet them where they are and show them compassion, attention, care, and reframe and reflect back to them, vital parts of themselves that they have lost. I think this is something that clinicians forget the longer we do this work.  As counselors, we are not immune to these same emotional and mental health struggles.  We all struggle with our emotions sometimes; we also get overwhelmed trying to balance our roles and responsibilities.  So we should remember that sometimes, we get caught up in the issues we have and sometimes we ourselves need to utilize the wellness model. We can show empathy and compassion to our clients and connect with them on a human level because we have all experienced some of the emotional conflicts that our clients have.  We can connect with our clients on the deepest human level there is. With empathy and compassion, the use of the wellness model can deeply enrich the lives of the clients we serve.
Charmaine Perry is a counselor who works mostly with adults and couples in central New Jersey. Her passion is mental health and writing and finding ways to incorporate these two fields to advocate for mental health services for African and Caribbean Americans. 

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