Hidden Conceptual Models in Clinical Psychiatry

Abstract Clinical psychiatry commonly makes use of four conceptual models — the medical, psychologic, behavioral, and social — in evaluating and treating patients. The test of clinical skill is the assemblage of an appropriate mix for a particular case. In practice, the choice of a model (or models) is implicitly determined by several variables, which include diagnosis, the effectiveness of available treatments, the immediacy of the social situation, the social class of the patient, and the ideology of the therapist. The complexity of the decision-making process resulting from the use of several models may unnecessarily limit the treatment options of the psychiatrist and may bewilder the nonpsychiatrist. If the conceptual models and their use in clinical psychiatry are made explicit, a broader range of treatment modalities should be made available, and communication between physicians should be enhanced.