Person-centered approaches to primary prevention in mental health: Situation-focused and competence-enhancement

Summary Situation-focused and competence-enhancement approaches represent different pathways toward a richer person-centered primary prevention in mental health. Each is valid in its own right. The utility of developing both strands rests precisely on the fact that they are different means to a common end. Thus, although the approaches have somewhat different conceptual footings (one is proactive, the other reactive), differ in immediate goals and tactics, and have characteristically different target groups and times of application, they come together around the shared ultimate goal of strengthening people's psychological well-being.How much good will accrue from energetic exploration and development of these two strands remains a moot point, around which some skepticism has already been voiced (Rappaport, 1981). The two approaches singly or in combination, do not substitute for the type of social reform and provision of life opportunities (based on the concepts of justice and distribution of power) that Rappaport advocates. Nor do they compete with it. During the long period in which informed social change will remain an ideal, surrounded by uncertainty about procedural steps and outcomes, effective development of the two person-centered primary prevention strategies considered in this article can at least help to achieve a shorter-term objective, i.e., replacing aspects of traditional mental health practice known to have limited potential for advancing psychological wellness.This paper was written under support of grants from the New York State Department of Education and NIMH (MH 14547-07), for which the author expresses appreciation. Thanks also to Dr. Richard Price, who read and contributed constructively to earlier drafts of the article. I lay exclusive claim, however, to all of its remaining sins.