| Summary: | In choosing my assignment, I was torn between a focused and well structured essay title (that is, 'Critically discuss the advantages and limitations of protocol driven CBT. .. ') and the present one, which is clearly less defined and more open for interpretation. Although I am usually drawn to structure in most aspects of my life, I felt this time I would choose controversy over structure with the hope that this would drive me to fully engage in the process of writing. A further reason for selecting this essay title is that I have been a service user of mental health services in the past and therefore I felt this would be a useful and interesting opportunity for me to take a closer look at ways of conceptualising mental health within an academic context and from different perspectives. For the purpose of this essay I am going to focus on the issues this essay title raises for me, clinical psychologists and service users. The reason I have excluded psychiatrists is firstly, because it is one area I am not familiar with and secondly, because the subject area of the essay is so vast that I felt it would be important to avoid the risk of writing too broadly. The following essay very much reflects my own journey in positioning my views within such a hotly debated topic. Introduction The essay title makes reference to a picture on the front page of a magazine called the 'The Psychologist' which is published monthly by The British Psychological Society (BPS). The BPS is a professional association for academic, clinical, and other chartered psychologists. The Psychologist features articles on a number of different topics in psychology aimed at expert and non-expert audiences. Some examples of articles that are published might be current research projects, interesting debates and practical and professional issues. Edition 20(5), 2007, of The Psychologist was published as a special issue including a selection of articles written by clinical psychologists, psychiatrists and service-users on the debate of diagnosis of mental illness. The burning book on the front cover is the Diagnostic and Statistical Manual 4th edition (DSM-IV) (American Psychiatric Association, 2000) which is a text that includes psychiatric diagnostic criteria for a range of mental disorders. There are a number of questions that this image raises for me at first glance: What is DSMIV? How is it useful and what are the implications of its use? How did it catch fire? Is anything trying to blow the fire out? What is fuelling the fire? Will it disappear into a pile of dusty ashes and if so what might replace it? In order to answer some of these questions I will begin with a brief background on the Diagnostic and Statistical Manual 4th edition (DSM-IV) outlining some key points on its use and how it operates within a medical framework. I will then discuss what I view as some positive and negative implications of conceptualising mental disorders within a medical model, for example, acting as a short-hand for multidisciplinary teams, a useful tool for containing distressing experiences, self-stigma, social exclusion and diversity. In light of these, I will then draw attention to some issues this topic raises for the way clinical psychologists operate when trying to understand mental health concerns, drawing on the idea of formulation as an alternative or adjunct to diagnosis. I will then continue by exploring alternative models proposed to address mental health concerns, for example Kinderman's psychological model of mental disorder and Zalaquett and colleagues' multicultural model. Lastly, I will end with a section on service-user perspectives and the impact of diagnosis on mental health outcomes.
|
|---|
