Advances in Psychiatric Treatment (2009) 15: 470-478. doi: 10.1192/apt.bp.107.004549
© 2009 The Royal College of Psychiatrists
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Systemic thinking and values-based practice

Gwen Adshead

Gwen Adshead is a consultant forensic psychotherapist at Broadmoor Hospital. She is a member of the Institute of Group Analysis and works as a supervisor with different members of multidisciplinary teams.

Correspondence: Correspondence Dr Gwen Adshead, Admin Building, Broadmoor Hospital, Crowthorne, Berkshire RG45 7EG, UK. Email: gwen.adshead{at}wlmht.nhs.uk

Values-based practice is a new approach to working with complex and conflicting values in mental health practice. Theoretically, it argues that many clinical and ethical dilemmas in psychiatry arise because of the different value perspectives taken by the players involved. By exploring the differences in value systems ‘held’ by each player, it may be possible to come to a richer consensus that can incorporate both similarities and differences. In particular, values-based practice suggests that, traditionally, the value perspective of the patient is often either not considered or is ignored, and that by giving it voice, clinical practice will become more patient-centred. In this article, I will compare values-based practice with other types of systemic thinking in mental healthcare and I will discuss some areas of clinical practice where values-based practice may be difficult to apply.