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CHAPTER FOUR
MODELS OF SERVICE DELIVERY
CHAPTER GOALS
1. To introduce the medical model of service delivery, trace its historical
development, and identify how it can be used in service delivery today.
3. To introduce the human service model of service delivery, trace its historical
development, and identify how it can be used in service delivery today.
4. To explore coordination among models of service delivery.
CHAPTER OBJECTIVES
At the end of the chapter, students will be able
1.2 To provide two examples of how the medical model was used by Mary Richmond
and the field of corrections.
1.4 To explain the new approaches Freud advanced to treat mental illness.
1.6 To identify two challenges those using the medical model face today.
2.1 To define the public health model.
2.3 To list and describe the objectives of the public health model.
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2.5 To explain the impact of the U.S. Sanitary Commission, Dr. Louis Pasteur, and
Reverend Edward Wigglesworth on the understanding of public health.
2.7 To outline the difficulties that immigrant Sean O’Reilly faced when he arrived in
the U.S.
3.1 To define the human service model.
3.3 To explain how the community mental health center movement influenced the
development of the human service model.
3.5 To list the problems that Susan, Ted, Matthew, and Justin encounter.
4.1 To explain why it is important for human service professionals to understand and
use both the medical model and the public health model.
READINGS
Introduction to Human Services – Chapter 4
Introduction to Human Services: Cases and Applications – Chapter 4
CHAPTER SUMMARY
The chapter describes the history and philosophy of three models of service
delivery: medical, public health, and human services. Each model is used today.
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mental institution in France. He removed the chains from the mentally ill and treated
them as patients not inmates.
Sigmund Freud developed a new method of treatment for the mentally ill. His
therapy was psychoanalysis which assumed that mental disorders were psychologically
based. With the development of psychiatric drugs, the method of treatment for mental
response, Massachusetts established a Public Health Department.
Prevention became a major focus of the public health movement as Pasteur and
Koch demonstrated that germs cause disease. This included a social focus with public
education programs. Healthy People is a national effort to provide a vision and plan for
being accountable to the consumer. It is important for human service professional to use
services from both the medical model and the public health model when either or both
will help meet client needs.
CHAPTER OUTLINE
I. The medical model
A. Definition
2. Oldest of all treatment models
3. Symptom—diagnosis—treatment—cure
B. History
1. Asylums established to care for mentally ill
3. Pinel stressed clinical diagnosis and appropriate medical treatment
5. Psychopharmacology, the study of the effects of drugs on mental
disorders
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5. Managed care influences the delivery of services in the medical model
C. Case studies
2. Ralph Jones – mental illness and treatment in the 1970s
II. The public health model
A. Definition
1. Bridges the medical and human service model
3. Includes improving education, nutrition, safe food, and
water supplies
5. Emphasizes prevention
B. History
2. In 1850 pioneer Lemuel Shattuck declared the need for improved
sanitation and disease control
4. Prevention was primary concern of public health from 1890-1910 and
included reform based upon inoculations and hygienic laws
6. Healthy People is a national effort to provide a vision for the
health of all Americans
7. Health information is now easily accessible via the Internet
C. Case study – Sean O’Reilly
D. Case study – Remote Area Medical Volunteer Corps
III. The human service model
A. Definition
2. Considers the client within the context of his or her environment
4. Primary methodology is problem solving
5. Identifying strengths is part of problem solving
B. Philosophy
1. People expect society to help provide for their basic needs
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2. Society, through government, has responsibility for providing people
with human services
3. Meeting people’s needs requires an understanding of “whole” person
and his or her relationship to the environment
5. Human service model characteristics
a. Generic focus
b. An integrated service system
c. Problem solving approach
d. Consideration of the person within his/her environment
e. Treating the whole person
f. Accountable to the consumer
C. Case study – Susan and Ted
INTRODUCING THE CHAPTER
Using Human Services
1. Your aunt is 62 years old. She is recently retired and has been feeling poorly. In
spite of her ill health, she wants to work part time in a daycare facility 3 blocks
2. Think about the last time you went for help to one of the following offices:
physician, public health department, student health center, counseling center, or
any other office on campus that offers assistance. Describe your experience.
Note: Ask students to share their experiences. Make notes on the board and use
these notes in a later discussion comparing the three models.
Models of Service Delivery: Violet
1. Ask students in the class to read the following case study:
Violet was a student in human services. She enrolled in school as a single mom
with 3 children, ages 3, 12, and 15. Violet had served in the military for three
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officials and the school psychologist recommend a special school for at least six
months. Child care is required for her 3-year-old while she is in school.
2. List the services this family needs.
3. Revisit the case after introducing the three models. Ask the students which model
would best represent each of the services in the list.
LEARNING ACTIVITIES
Human Service Professionals
Interview three human service professionals. Ask the following questions:
a. How do you define human service problems?
b. Who is the recipient of services?
c. Who is the professional?
d. Where does treatment occur?
e. What is the method of treatment?
f. What is the goal of treatment?
Review the responses you received during the interview. Do these professionals “fit”
into one of the models discussed in this chapter?
the models of service delivery to teenage pregnancy by categorizing these services as
medical, public health, and/or human services. The class should then discuss their choice
of models.
READING AND STUDY GUIDE: READ, REVIEW, APPLY
These questions may help the student’s identify important concepts as they read the
chapter.
2. What is the orientation of the medical model for mental health service delivery?
3. Compare the treatment of mental illness in the medical model, the public health
model, and the human service model.
4. How was the medical model used in social casework?
5. How did the development of drug therapy influence the treatment of mental
illness?
7. Compare Robert Smith’s problems and treatment with those of Ralph Jones.
8. What are the characteristics of the public health model?
9. How do public health professionals view disease?
10. What was the first public health effort in America?
11. Why did prevention become a part of the public health model?
12. What public health issues are represented in the case of Sean O’Reilly?
13. Which of these problems are addressed by services delivered in the public health
model?
14. How does the Remote Area Medical Volunteer Corps illustrate the public health
model of service delivery?
15. What is the primary focus of the human service model?
17. Explain the steps involved in the problem-solving process.
19. What key factors contributed to the development of the human service model?
20. List the characteristics and themes of the model.
The following questions will help students in their review of the chapter.
1. Outline the differences between the medical model, the public health model, and
the human service model. What principles of the medical model and/or the public
health model are present in the human service model?
2. If you as a human service professional were working with Sean O’Reilly, how
The following exercises allow students to apply what they have learned from the
chapter.
1. Make a list of problems you know that are currently receiving the attention of the
helping professions. Choose one of those problems and discuss how each model
2. Interview 3 fellow students. Ask them to describe their experiences as a “patient”
and as a “client”. What are the differences they have experienced? What are the
advantages and disadvantages of being a “patient” or a “client”?
3. Criticisms of the antianxiety drugs include a belief that these drugs mask
TEST ITEMS
Multiple Choice
1. Information about models of service delivery is important to human service
professionals because
2. Philosophical assumptions that guide the practice of each model include beliefs
about all EXCEPT:
3. Mental disorders are organically-based diseases or illnesses that impair
functioning is an assumption of
4. Three basic models of service delivery include traditional psychiatry, the public
health approach, and the
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5. Recipients of services in the medical model are called
6. Treatment in the medical model includes all EXCEPT:
7. Which is the most widely used treatment today for mental disorders?
8. The study of the effects of drugs on mental health is
9. Freud revolutionized the study and treatment of mental illness by
10. Among the challenges facing those who practice the medical model today are cure
versus control, the development of new drugs, and
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11. The goal of the public health model is to
12. Supporting activities such as films, speakers, school programs, and pamphlets
educate the population, a goal of the
13. All of the following are characteristics of the public health model EXCEPT:
14. Linking disease to disorderly and filthy cities and believing disease was
providential were two ways public health was impacted by
15. Healthy People is a national public health effort to improve the health of all
people by
16. Today fast and easy access to health information is an advantage of
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17. The following characteristics or themes are part of the model of human services
EXCEPT:
18. The human service philosophy emphasizes the responsibilities of society and the
importance of working with
19. Which one of the following represents the problem solving approach?
20. The whole person refers to one of the following:
21. Examples of those who receive human services are all EXCEPT:
22. Integrated services reflect work with the client that is
23. Using the human service model, the professional asks all but ONE of the
following questions:
24. Both the medical model and the public health model have in common:
25. Public health and human services have in common:
Discussion
2. Describe the challenges today for professionals who use the medical model.
4. Distinguish between the medical model and the public health model.
6. Explain the purpose and role of the Healthy People initiative.
8. Apply the 5 steps of the problem solving process to a problem you have recently
resolved.
10. Create a problem situation that requires the services of all three models of service
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delivery.