Sustainable practice: how practice development frameworks can influence team work, team culture and philosophy of practice

J Nurs Manag. 2004 Mar;12(2):124-30. doi: 10.1111/j.1365-2834.2003.00456.x.


The current political agenda to adapt mental health services to meet contemporary needs is changing the way that psychiatric rehabilitation is organized and focused. This comparatively new branch of mental health services has over the past 20 years been subject to continual change, both through policy and clinical directive. The author argues that this consistent process of change has destabilized the clarity that is needed to offer the style of care and support that users of rehabilitation services require. Whilst broad aims of rehabilitation remain relatively clear the increasing options of principles and approaches towards rehabilitation have overwhelmed both service users and those working within the service. In this paper, author seeks to resolve these problems by providing an overview of a practice development framework that was applied to eight psychiatric rehabilitation teams over a 4 year period. The paper contains examples of equitable structures that have developed as a result of applying these frameworks. Attention is given to the creation of a representative council of service stakeholders and a paradigm of practice that has become integrated into the philosophical functioning of the teams. The tangible results of the process are ones of increased opportunity and fulfillment for those involved in the study.

Publication types

  • Review

MeSH terms

  • Community Participation
  • Decision Making, Organizational
  • England
  • Health Care Reform / organization & administration
  • Health Policy
  • Humans
  • Interprofessional Relations
  • Learning
  • Mental Disorders / rehabilitation
  • Mental Health Services / organization & administration*
  • Models, Educational
  • Models, Organizational*
  • Organizational Culture
  • Organizational Innovation
  • Organizational Objectives
  • Patient Care Team / organization & administration*
  • Patient-Centered Care / organization & administration
  • Philosophy, Medical*
  • Politics
  • Psychiatry / education
  • Psychiatry / organization & administration*
  • State Medicine / organization & administration