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Authoritative vs Collaborative Approaches in Healing Mental Health

Last Updated on July 20, 2023 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

question doctorsWe have long been taught to trust our doctors. After all, they take an oath to “First, do no harm,” right? Has the doctor-patient relationship become moot as a result of the prescription drug frenzy that has seized healthcare?

The phrase, “First, do no harm” or “Primum non-nocere” is actually not part of the Hippocratic Oath per se, as many of us assumed. According to another of Hippocrates’ works, Of the Epidemics, published in 400 BCE, his Second Constitution for the physician, he says the physician must

” … have two special objects in view with regard to disease, namely, to do good or to do no harm. The art consists in three things — the disease, the patient, and the physician. The physician is the servant of the art, and the patient must combat combat the disease along with the physician.” ~ Hippocrates, from “Of the Epidemics” (published 400 BCE).1

Despite any problems in translation, this wisdom continues to furnish its profound importance today.

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Authoritative Approach Is the ‘Do-What-I-Say’ of Medicine

Authoritative Approach

While many people don’t give treatment approaches a second thought, let us shed some light on the differences between the authoritative approach in care, compared to the collaborative approach, used at the Alternative to Meds Center.

An authoritarian approach draws a line between patient and practitioner. It relies upon the principle that the doctor knows best and does little to involve patients in the assessment process or decisions regarding their treatment. In the authoritative model, doctors dictate the course of treatment … period. There is little to no input from the patient on the assessment, or the treatment. This approach can put the patient in a position where they feel powerless and compelled to follow whatever advice is doled out.

Powerlessness cannot be the optimal way to approach getting well. You likely wouldn’t opt to handle any challenge in life in that way. “Patient empowerment” is more than a WHO buzzword.2 It means actually taking charge of your own health. However, a weakened and fragile person is easily overwhelmed when facing the challenges of fatigue, pain, depression or other mental health concerns, and hopelessness. It may be that a person who desires to be fully engaged, just is not in a position of strength to do so. It may help to have a family member, close friend, or support group assist you to meet these challenges. You deserve to know the ins and outs, benefits, and potential pitfalls of your medical decisions. Consider enlisting help to further your understanding of your symptoms, and to find out about all of the options that are available for relief and healing.

In today’s world, there is an increasing sense of concern about the authoritative dictates of the industry of “healthcare.” Was healthcare always authoritative? Or did something happen that caused the authoritative approach to become the “norm”?

Shift in Health Care Started at the Top

We can observe that health care has shifted in the last 100+ years. We will not go into many of the surprising and profound yet little-publicized influences on this shift, except to advise that one can research for oneself how the mainstream “industry” of healthcare was created, that diverted from natural medicines commonly in use in the prior century to what could be described as the profit-driven pharmaceutical monopolies of today.3

Priorities in some quarters may have shifted, but patient perspectives on the power they give to physicians didn’t suddenly disappear. Your voice is important.

The Patient Experience Is at a Shortfall

toxinsPsychiatrist visits changed from 45-minute talk therapy sessions to 15-minute medication consultations, largely due to the way insurance companies structure their billing policies. How much can someone really know us after a 15-minute conversation? Apparently, well enough to prescribe a mood-altering substance that we may or may not develop a lifelong dependence on. It’s no wonder why a growing number of people have a toxic affair with prescription medications. Is there any other kind?

Overprescribing medication and incentives from drug companies have led to concerns about how to properly administer and receive mental health treatment. Too often, medications are offered first, before collaborating with the patient on finding alternatives such as therapy, exercise, diet, or other lifestyle modifications. This can leave the patient feeling like they have limited options for help. In addition, because many view the psychiatrist or the GP as their personal authority on mental health, this often leads us to accept the one, single option being offered. We welcome the changes we see concerning the monopoly of the pharmaceutical industry over our personal healthcare.4

The Difference a Collaborative Approach Can Make

Trust is earned, over time and through results, which is an entirely different concept than what is found in the authoritative approach. However, trust can be fostered in the collaborative approach to healthcare, often referred to as integrative medicine, which involves patient-centered and alternative medicine, blended with conventional treatment options.5,6

collaborative approach to mental health careThis model works to empower patients in the healing process by asking for their input on the assessment, diagnosis, and treatment. It draws upon the individuals’ unique perspectives and insights into how they feel, what their condition presents, and the opportunity to choose the treatment option they feel most comfortable with.

The collaborative model places every patient as an important member of their treatment team, empowering them to care for themselves, and enlisting the help they opt to be the best for them. Isn’t that the point? The more a person chooses to exercise self-care in health matters, the more the patient-physician relationship will benefit for all the right reasons.

Our society places high esteem on licensed medical personnel and clinical practitioners, doctors especially. Today, more than ever, doctors have been viewed as the ultimate authority on anything medical concerning our bodies. We visit the hospital or the doctor’s office and then follow the recommended course of treatment, often without question. But something changes when our general practitioner pulls out a prescription pad and puts us on a drug; more specifically, a drug that puts us at risk of drug dependency, and we are sometimes told this will be necessary for a whole lifetime.

Despite the pressures of time and economics put on physicians, this alarming trend needs a second look.

Is this an abuse of power — perhaps on both patient and practitioner?

Although there is much work yet to be done, Alternative to Meds Center is pleased to see signs of a shift back to common sense in healthcare, greater educational opportunities for physicians and mental health workers, and a move away from the “quick-fix” approach that defaults to prescription drugs. We know that the improved education of health professionals will see great changes, positive ones, in the field of integrative medicine. A growing number of integrative health care professionals already know that mental health symptoms could be treated in other, safer ways.7

Evidence-based Nonpharmaceutical Options for Mental Health

Evidence-based nonpharmaceutical options for mental health can include:

We invite you to explore our services overview pages for many more holistic treatments offered at Alternative to Meds Center, used in a collaborative approach to improving mental health without relying on prescription drugs as a singular authoritative approach.

Patients Need to Own their Mental Health

For more than a century, we have been taught to take the advice of our doctor without question, which can lead to problems. Doctors today make it a practice of handing out medications liberally without much investigation, education, or collaboration with the patient. many of these valuable physicians simply have never been taught there are alternative approaches, and there are great benefits to a collaborative rather than an authoritative approach.

Statistics show the use of psychiatric medication is steadily on the rise. According to a report released by the CDC, 48% of the US population took at least one prescription drug in 2018, and 24% took 3 or more prescription drugs in 2018. The trend is not limited to the US. Published records in and outside the US on adult prescriptions indicate that the use of atypical antipsychotics in adults has soared, and of additional concern, a growing trend has emerged of off-label prescribing.8-10 This troubling shift continues all over the world today, though a growing interest in reversing this tendency has emerged.

As the number of psychiatric medications being prescribed in the US and around the world continues to grow, our awareness and self-advocacy will need to grow alongside. Patients cannot afford to blindly follow the advice offered in a quick, rushed consultation. Rather, they should question, investigate, and empower within to make the right choices for themselves and their loved ones. Every mental health treatment should be made in collaboration with the patient, not on their behalf. By implementing this collaborative approach to healing models, one can better ensure that one receives the care that is needed while feeling supported, respected, and heard. As it should be.

Learn More about the Benefits of Our Collaborative Approach to Care

1. BMJ First do no harm: the impossible oath? published online 2019 July 19 [cited 2022 Oct 20]

2. WHO authors Patients for Patient Safety published online N.D. [cited 2022 Oct 20]

3. Wouters OJ. Lobbying Expenditures and Campaign Contributions by the Pharmaceutical and Health Product Industry in the United States, 1999-2018. JAMA Intern Med. 2020 May 1;180(5):688-697. doi: 10.1001/jamainternmed.2020.0146. PMID: 32125357; PMCID: PMC7054854. [cited 2022 Oct 20]

4. NHS, reviewed by Ridge K, Good for You, Good for Us, Good for Everybody – a plan to reduce overprescribing [published online 2021 Sept 22] [cited 2022 Oct 20]

5. Zimmerman J, Dabelko HI. Collaborative models of patient care:new opportunities for hospital social workers. Soc Work Health Care. 2007;44(4):33-47. doi: 10.1300/J010v44n04_03. PMID: 17804340. [cited 2022 Oct 20]

6. Maizes V, Rakel D, Niemiec C. Integrative medicine and patient-centered care. Explore (NY). 2009 Sep-Oct;5(5):277-89. doi: 10.1016/j.explore.2009.06.008. PMID: 19733814. [cited 2022 Oct 20]

7. Kreitzer MJ, Kligler B, Meeker WC. Health professions education and integrative healthcare. Explore (NY). 2009 Jul-Aug;5(4):212-27. doi: 10.1016/j.explore.2009.05.012. PMID: 19608111. [cited 2022 Oct 20]

8. CDC statistics Therapeutic Drug Use  [published online 2019] [cited 2022 Oct 20]

9. Spence, D, Are antidepressants overprescribed? Yes BMJ 2013;346:f191 [published online 2013 Jan 22] [cited 2022 Oct 20]

10. Lao KSJ, Tam AWY, Wong ICK, Besag FMC, Man KKC, Chui CSL, Chan EW. Prescribing trends and indications of antipsychotic medication in Hong Kong from 2004 to 2014: General and vulnerable patient groups. Pharmacoepidemiol Drug Saf. 2017 Nov;26(11):1387-1394. doi: 10.1002/pds.4244. Epub 2017 Jun 30. PMID: 28665012. [cited 2022 Oct 20]

11. Firth J, Teasdale SB, Allott K, Siskind D, Marx W, Cotter J, Veronese N, Schuch F, Smith L, Solmi M, Carvalho AF, Vancampfort D, Berk M, Stubbs B, Sarris J. The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta-review of meta-analyses of randomized controlled trials. World Psychiatry. 2019 Oct;18(3):308-324. doi: 10.1002/wps.20672. PMID: 31496103; PMCID: PMC6732706. [cited 2022 Oct 20]

12. Mikkelsen K, Stojanovska L, Polenakovic M, Bosevski M, Apostolopoulos V. Exercise and mental health. Maturitas. 2017 Dec;106:48-56. doi: 10.1016/j.maturitas.2017.09.003. Epub 2017 Sep 7. PMID: 29150166. [cited 2022 Oct 20]

Originally Published Jun 18, 2019 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Authoritative vs Collaborative Approaches in Healing Mental Health
Medical Disclaimer:
Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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