issue 1 09 - APS Member Groups - Australian Psychological Society

102Using the SPECS Model to Explore New Paradigms in Health PsychologyTim MacKellarUniversity of Notre Dame, AustraliaThe SPECS framework recognises that psychological and political influences interact topromote health and wellbeing, perpetuate oppression or generate resistance andliberation. This interpretation of health and power dynamics has corrected much ofpsychology’s irrelevant scholasticism, facilitating the development of a new criticalpraxis that has the capacity to transform people and society. The comprehensive andreflexive nature of the SPECS model offers a solid foundation to which new healththeories may be incorporated, maintaining a high standard of professional dexterityDisenchantment with biomedical healthperspectives and the medical model has led toa search for alternative orientations thatattempt to improve services in light of anunderstanding of the psychosocial aspects ofhealth care. Many consider that healthpsychology to the present day should moreaptly be termed ‘illness psychology’ as itscentral focus is illness behavior and illnessmanagement. The growing awareness of theimportance of psychological and socialinfluences on health and illness has forcedhealth professionals to propose new ways ofconceptualising health (Marks, Murray, Evans,Willig, Woodall & Sykes, 2005). Engel’s(1997) biopsychosocial model challenged themedical model with the idea that health andillness are contingent upon physical,psychological and social variables. Howeverthere are significant problems with this modelas it remains essentially biomedical and itstheoretical basis has yet to be properly figuredout. Thus despite the fast growth of healthpsychology and its various interdisciplinaryinfluences, there has been no significantparadigm shift in clinical medicine and due toits shortcomings, the biopsychosocial modelhas not replaced the medical model in hospitalsand clinics (Marks et al., 2005).Engel’s model has never been adequatelydefined and therefore it cannot be practicallyoperationalised. Prilleltensky’s (2005) SPECS(strengths, prevention, empowerment, andcommunity conditions) model completesEngel’s (1997) in many ways, offering adefinitive conception of health that providescoherent accounts of how it is exactly thatpsychosocial processes influence health. Thesuperior construction of the SPECS modeladdresses the collective, relational andindividual processes that impact upon health,and also offers significant solutions that canbe implemented. Prilleltensky and Nelson(2002) place parochial conceptions of healthand illness under the broader concept ofwellbeing; a positive state of affairs in whichthe personal, relational, and collective needsand aspirations of individuals andcommunities are fulfilled.So far most health programs havefocussed on improving the wellbeing of theindividual but have overlooked thecommunity conditions that lead to sufferingin the first place. By always directingattention towards the individual level ofanalysis in explaining health relatedbehaviours, Murray and Campbell (2003)believe health psychology has contributed toconcealing the tremendous influence ofeconomic, political and symbolic socialinequalities in patterns of ill health bothglobally and within specific nations.Intrapsychic strategies that focus exclusivelyon personal wellbeing undermine wellbeingbecause they do not support the widerstructure that enhances wellbeing as a whole.It is very difficult for individuals to alter theirstate of wellbeing in the absence ofconcordant environmental changes(Prilleltensky & Nelson, 2002). Reactive,alienating and deficit based approaches thatengender patienthood instead of health,The Australian Community Psychologist Volume 21 No 1 June 2009