Medical and nonmedical models in clinical practice and training

The use of the medical model to deal with psychologic dysfunction is highly controversial. Some mental health professionals champion the exclusive use of medical and others the exclusive use of nonmedical models to describe, understand, and modify psychopathology. Proposals have been advanced to restrict the scope of psychiatry to conditions that best fit the medical model (schizophrenia, affective disorders, and perhaps psychoneuroses), and to leave the treatment of other conditions to other mental health professionals. All mental health professions, however, encounter a wide range of phenomena that, in order to be understood, require both anatomical/physiologic and psychologic/behavioral viewpoints. There viewpoints belong to two different universes of discourse, and their languages are not mutually; the discovery of a clinically useful metatheory or paradigm, claims made for systems analysis to the contrary, does not appear imminent. At present, both medical and nonmedical models are necessary in clinical practice and training, and neither model is sufficient by itself.