Date of Award

Spring 1994

Project Type


Program or Major


Degree Name

Doctor of Philosophy

First Advisor

Bud B Khleif


This ethnographic study explores the influence of two competing ideologies, the medical model and the empowerment model, on the actions of staff on an acute geropsychiatric unit. The medical model emphasizes the professional power of the physician and other health care workers. In contrast the empowerment model emphasizes the autonomy of patients and their role in directing their care. Since these beliefs are contradictory, staff may feel conflict no matter how they act. The tacit nature of these beliefs mask the source of this tension. The mission of the unit is to enhance the independence of people over 60 with mental health problems. Staff actions which enhance independence conflict with the strongly entrenched traditions of health care and the expectations that patients will be passive and compliant. Through participant observation, interviews, and document review, this study explores how these belief systems are enacted in the team meetings and less structured interactions among staff, patients, and family members. It closes with questions about the diffusion of the empowerment model in an acute geropsychiatric setting.