Home | Imminent vs Immediate Danger | Recovery Model Analysis | Individual Treatment Contract (c) | Violence and Psychosis | Right vs Privilege | Right To Treatment | Teaching Pages | Beating Psychosis | Consequence vs Punishment | Transinstitutionalization | NAMI: A Failed Mission | Entitlement Benefits Abuse | Individual Mandate & Serious Mental Illness

Recovery Model: Mental Health Recovery Model Applied to Severely Mentally Ill; JH Rick Massimino MD

Consequence vs Punishment

What is the difference between a Consequence and Punishment and how does this thinking influence life success?

Simply stated, a consequence is the result of an action or decision which may be perceived as pleasant or unpleasant. For example, the consequence of responsibly doing your job is receiving your paycheck.  The consequence of not responsibly doing your job is loss of employment.  Generally, in the John Henry Model, an unpleasant consequence is intended and used to teach and promote learning. A punishment is always perceived by the recipient as unpleasant and may cause cause pain, suffering, or loss. In The John Henry Model, punishment is never used. A dispenser of punishment is generally indifferent to learning or personal growth.

Unfortunately,the seriously mentally ill generally perceive a consequence and a punishment as identical, it’s all punishment! The Public Mental Health Care System fearing to be accused of utilizing punishment has abandoned consequences in its treatment settings. The result is that the seriously mentally ill are not prepared for a world which constantly utilizes consequences as a common practice.

Let’s imagine that a group home resident is required to complete a series of personal responsibilities in order to earn the privilege of a group outing to the zoo after breakfast. If the personal responsibilities are not completed and the resident is told he cannot go because he has not earned the privilege, is that a consequence or a punishment? Both teacher and student must be clear and agree on the answer. This is a consequence! Now let’s imagine that the same resident says “That’s not fair and you are punishing me, I want to file a patient’s Right complaint.” A moment later the resident becomes angry and threatening. We can now see how the teaching page Right vs. Privilege, is intricately connected to this teaching page. Actually, all of the teaching pages are intricately connected and in group meetings the relevant teaching pages are reintroduced when applicable to the group process.

Throughout the course of a day consequences are experienced naturally and/or imposed by others.  This is reality for ordinary citizens and must be reality for the seriously mentally ill. Having a clear grasp of teaching pages, therapeutic objectives, and consistency of response, is critical for parents, caregivers, therapeutic group homes and even hospitals who treat the seriously mentally ill.. The teaching pages provide the easy retention of key and critical themes for quick and accurate intervention. Like any learning process one builds on the critical learning by adding new teaching pages to one’s knowledge base after mastery begins. This applies to patients and staff equally.