Values-Based Practice: Linking Science with People

Original Paper


Values-based practice is a new skills-based approach to working with complex and conflicting values in health care. In this paper we outline the point of values-based practice (to support balanced decision making), its premise (in respect for differences of values) and the ten elements of the process by which it supports balanced decision making in practice. We give examples of how values-based approaches have been applied in the development of policy and practice in mental health in the UK and outline its potential applications for contemporary psychotherapy. In a brief concluding section we show how the development of values-based practice in mental health is leading the way towards linking science more effectively with people across medicine as a whole.


Values Evidence Ethics Decision making 


  1. Balint, M. (1957). The doctor, his patient and the illness. London: Pitman Publishing.Google Scholar
  2. Beauchamp, T. L., & Childress, J. F. (2001). Principles of biomedical ethics (5th ed.). New York: Oxford University Press.Google Scholar
  3. Bettelheim, B. (1982). Freud and man’s soul. London: Penguin Books.Google Scholar
  4. Bloch, S., & Green, S. A. (2009). Psychiatric ethics (4th ed.). Oxford: Oxford University Press.Google Scholar
  5. Bortolotti, L., & Broome, M. (2009). Psychiatry as cognitive neuroscience. Oxford: Oxford University Press.Google Scholar
  6. Care Services Improvement Partnership (CSIP), & The National Institute for Mental Health in England (NIMHE). (2008). Workbook to support implementation of the Mental Health Act 1983 as amended by the Mental Health Act 2007. London: Department of Health.Google Scholar
  7. Colombo, A., Bendelow, G., Fulford, K. W. M., & Williams, S. (2003). Evaluating the influence of implicit models of mental disorder on processes of shared decision making within community-based multidisciplinary teams. Social Science and Medicine, 56, 1557–1570.PubMedCrossRefGoogle Scholar
  8. Department of Health. (2004a). (40339) The ten essential shared capabilities: A framework for the whole of the mental health workforce. London: The Sainsbury Centre for Mental Health, the NHSU (National Health Service University), and the NIMHE (National Institute for Mental Health England).Google Scholar
  9. Department of Health. (2004b). (40276) Mental Health Care Group workforce team: National Mental Health workforce strategy. London: National Institute for Mental Health England/Changing Workforce Programme/Trent Workforce Development Confederation and Social Care.Google Scholar
  10. Department of Health. (2007). New ways of working for everyone. A best practice implementation guide. London: Department of Health.Google Scholar
  11. Department of Health. (2008a). Refocusing the care programme approach: Policy and positive practice guidance. London: Department of Health.Google Scholar
  12. Department of Health. (2008b). Commissioning IAPT for the whole community: Improving access to psychological therapies. London: Department of Health/Mental Health Division/APT.Google Scholar
  13. Fulford, K. W. M. (1989). Moral theory and medical practice. Cambridge: Cambridge University Press (Reprinted 1995 and 1999).Google Scholar
  14. Fulford, K. W. M., & Colombo, A. (2004). Six models of mental disorder: A study combining linguistic-analytic and empirical methods. Philosophy, Psychiatry & Psychology, 11(2), 129–144.CrossRefGoogle Scholar
  15. Fulford, K. W. M., Morris, K. J., Sadler, J. Z., & Stanghellini, G. (2003). Past improbable, future possible: The renaissance in philosophy and psychiatry. In K. W. M. Fulford, K. J. Morris, J. Z. Sadler, & G. Stanghellini (Eds.), Nature and narrative: An introduction to the new philosophy of psychiatry (Chap. 1, pp. 1–41). Oxford: Oxford University Press.Google Scholar
  16. Fulford, K. W. M., Thornton, T., & Graham, G. (2006). The Oxford textbook of philosophy and psychiatry. Oxford: Oxford University Press.Google Scholar
  17. Glover, J. (1988). I: The philosophy and psychology of personal identity. London: The Penguin Group.Google Scholar
  18. Glover, J. (1999). Humanity: A moral history of the twentieth century. London: Jonathan Cape.Google Scholar
  19. Hinshelwood, R. D. (1995). The social relocation of personal identity as shown by psychoanalytic observations of splitting, projection and introjection. Philosophy, Psychiatry, and Psychology, 2, 185–204.Google Scholar
  20. Hinshelwood, R. D. (1997a). Primitive mental processes: Psychoanalysis and the ethics of integration. Philosophy, Psychiatry and Psychology, 4(2), 121–144.Google Scholar
  21. Hinshelwood, R. D. (1997b). Therapy or coercion? Does psychoanalysis differ from brainwashing? London: Karnac Books Ltd.Google Scholar
  22. Hoff, P. (2005). Die psychopathologische Perspektive. In M. Bormuth & U Wiesing (Eds.), Ethische Aspekte der Forschung in Psychiatrie und Psychotherapie (pp. 71–77). Cologne: Deutscher Aerzte-Verlag.Google Scholar
  23. Holmes, J. (1997). Values in psychotherapy. Australian and New Zealand Journal of Psychiatry, 31, 331–333.CrossRefGoogle Scholar
  24. Holmes, J., & Adshead, G. (2009). Ethical aspects of the psychotherapies. In S. Bloch & S. A. Green (Eds.), Psychiatric ethics (4th ed., Chap. 19, pp. 367–384). Oxford: Oxford University Press.Google Scholar
  25. Holmes, J., & Lindley, R. (1989). The values of psychotherapy. Oxford: Oxford University Press.Google Scholar
  26. Hunink, M. G. M., & Glasziou, P. P. (2001). Decision making in health and medicine: Integrating evidence and values. Cambridge: Cambridge University Press.Google Scholar
  27. Improving Access to Psychological Therapies. (2008). The IAPT pathfinders: Achievements and vhallenges. Department of Health/Mental Health Division IAPT programme.Google Scholar
  28. Jordan, A., & Meara, N. (1990). Ethics and the professional practice of psychologists: The role of virtues and principles. Professional Psychology: Research and Practice, 21(2), 107–114.CrossRefGoogle Scholar
  29. Kirtchner, K. (1996). There is more to ethics than principles. The Counseling Psychologist, 24, 92–97.CrossRefGoogle Scholar
  30. Meara, N., Schmidt, L., & Day, J. (1996). Principles and virtues: A foundation for ethical decisions, policies, and character. The Counseling Psychologist, 24, 4–77.CrossRefGoogle Scholar
  31. Mezzich, J. E. (2007). Psychiatry for the person: Articulating medicine’s science and humanism. Editorial. World Psychiatry, 6(2), 1–3.PubMedGoogle Scholar
  32. Mezzich, J. E., & Salloum, I. M. (2007). Towards innovative international classification and diagnostic systems: ICD-11 and person-centred integrative diagnosis. Guest Editorial. Acta Psychiatrica Scandinavica, 116, 1–5.PubMedCrossRefGoogle Scholar
  33. National Institute for Health and Clinical Excellence (NICE). (2009). Schizophrenia: Core interventions in the treatment and management of schizophrenia in adults in primary and secondary care. NICE Clinical Guideline 82. London: National Institute for Health and Clinical Excellence.
  34. National Institute for Mental Health in England (NIMHE), & the Care Services Improvement Partnership. (2008). 3 Keys to a shared approach in mental health assessment. London: Department of Health.Google Scholar
  35. Ricoeur, P. (1970). Hermeneutic method and reflective philosophy. In Freud and Philosophy (D. Savage, Trans., Chap. 3, pp. 37–47). London: Yale University Press.Google Scholar
  36. Rieff, P. (1959). Freud: The mind of the moralist. New York: Viking.Google Scholar
  37. Rogers, A., Pilgrim, D., & Lacey, R. (1993). Experiencing psychiatry: Users’ views of services. London: The Macmillan Press.Google Scholar
  38. Sackett, D. L., Straus, S. E., Scott Richardson, W., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM (2nd ed.). Edinburgh: Churchill Livingstone.Google Scholar
  39. Sadler, J. Z. (Ed.). (2002). Descriptions & prescriptions: Values, mental disorders and the DSMs (pp. 323–362). Baltimore: The Johns Hopkins University Press.Google Scholar
  40. Sadler, J. Z. (2005). Values and psychiatric diagnosis. Oxford: Oxford University Press.Google Scholar
  41. Stanghellini, G. (2004). Deanimated bodies and disembodied spirits. Essays on the psychopathology of common sense. Oxford: Oxford University Press.Google Scholar
  42. The National Institute for Mental Health in England (NIMHE). (2009). ESC learning materials CD-Rom. NIMHE, University of Lincoln and Centre for Clinical and Academic Workforce Innovation.Google Scholar
  43. Thornton, T. (2007). Essential philosophy of psychiatry. Oxford: Oxford University Press.Google Scholar
  44. Tjeltveit, A. C. (1999). Ethics and values in psychotherapy. London: Routledge.Google Scholar
  45. Van Staden, C. W., & Fulford, K. W. M. (2007). Lead Guest Editorial. Hypotheses, neuroscience and real persons: The theme of the 10th international conference on philosophy, psychiatry and psychology. South African Journal of Psychiatry, 13(3), 68–71.Google Scholar
  46. Woodbridge, K., & Fulford, K. W. M. (2004). Whose values? A workbook for values-based practice in mental health care. London: Sainsbury Centre for Mental Health.Google Scholar
  47. Woodbridge, K., & Fulford, K. W. M. (2005). Values-based practice. Module 4. In T. Basset & L. Lindley (Eds.), The ten essential shared capabilities learning pack for mental health practice. London: The National Health Service University (NHSU)/The National Institute for Mental Health in England (NIMHE).Google Scholar
  48. Woolf, L. (2002) Lecture to the British Academy, 15/10/02, quoted in Hansard 28/10/02 col 607.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • K. W. M. Fulford
    • 1
    • 2
    • 3
    • 4
  • Heidi Caroll
    • 5
  • Ed Peile
    • 6
    • 7
  1. 1.St Cross CollegeOxfordUK
  2. 2.Faculty of PhilosophyUniversity of OxfordOxfordUK
  3. 3.Medical SchoolUniversity of WarwickCoventryUK
  4. 4.National Mental Health Development UnitLondonUK
  5. 5.Aboyne Medical PracticeAboyneScotland, UK
  6. 6.University of WarwickCoventryUK
  7. 7.Academy of Medical EducatorsLondonUK

Personalised recommendations