The rapeutic jurisprudence and recovery from severe and disabling mental illness

The concept of therapeutic jurisprudence (TJ) provides a useful epistemological bridge, between the legal scholarship on conflict, justice, and well-being, and the science and clinical methods pertinent to mental illness research and treatment. Primary among its implications may be the potential to more efficiently resolve conflicts that arise between individuals with severe mental illness and their family members, clinicians, the mental health services industry, or the public interest, while simultaneously promoting justice and the well-being of all involved.In this chapter, the authors suggest conflict resolution strategies from a TJ perspective in six emerging areas. The first is the expansion of relapse prevention planning through research on and the regular use of proxies and psychiatric advance directives. Next, the authors explore how mental health courts could improve outcomes by more efficiently utilizing clinical contingency management strategies, as well as further evaluating the proportionality and effectiveness of common contingencies required for successful completion of diversionary court, such as medication adherence.Another area showing promise is the possibility of integrating family law-based mediation strategies into family therapy to navigate conflicts that commonly arise for those clients. Next, the authors recommend a joint effort by both the legal and mental health communities to ensure the treatment plans commonly used as contingencies for outpatient commitment are evidence-based. Furthermore, the emphasis on utilizing evidence-based practices should be expanded to incarceration settings to lessen the intrusiveness of forced treatment, especially after Sell v. United States (2003). Finally, the authors advocate respecting a client right to treatment in mental health reform legislation by incorporating evidence-based practices into the legal standards by which mental health providers are scrutinized. The authors conclude that these six emerging areas offer important opportunities to enhance treatment outcome through application of TJ, provided that there is close collaboration between legal scholars, clinical researchers, and policy makers.