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Hi all,

I am a trainee clinical psychologist carrying out a research project into
how clinical psychologists who consider themselves critical of the medical
model continue to work in psychiatric settings.

Please could you spare a few minutes to take a look at the information
below to see if you would be interested in taking part...Thanks!


*** WHAT IS THE RESEARCH PROJECT ABOUT?

Debates about mental distress and psychopathology are often characterised
by two polarised positions. The first has been described as the medical
model (Boyle, 2001; Read et al., 2004). The medical model takes for
granted the idea that mental illness exists as a 'real' entity that can be
studied and summarised accurately by diagnosticians (Pilgrim & Bentall,
1999).

A variety of critics have argued that a lack of scientific reliability and
validity renders psychiatric diagnosis problematic. Some have highlighted
that there is a lack of evidence for the primary causal role of
biochemical abnormalities or genetic factors (Bentall, 2003; Boyle, 2001).
Others have challenged the theoretical assumptions that underpin the
medical model and view 'mental illness' as socially constructed (Parker et
al., 1995). Negative social, ethical and political consequences have been
highlighted as a reason to conceptualise certain types of experiences in
different ways (Harper, 2001).

One alternative to diagnosis-based approaches is to construe mental
distress as an understandable response to psychosocial factors (Johnstone,
2000). Despite the medical model and this psychosocial model being
described as 'fundamentally incompatible' (Johnstone, 2000) they are, to
varying degrees, the two models of understanding mental distress in
operation in the NHS adult mental health system.

Many clinical psychologists are encouraged to develop an appreciation for
the societal context of mental distress (Fleming & Burton, 2001) and to
adopt a critical approach to the utility of medicalised notions (Newness &
Maclachlan, 1996). Clinical psychology has begun to abandon diagnosis in
theory and practice (Boyle, 2007). However, within the adult mental health
system diagnostic concepts of mental illness carry massive political and
professional authority. Diagnoses are central concepts for target setting,
computerised record management and access to services (Berger, 2007;Boyle,
2007).

Clearly, some clinical psychologists find medicalised notions incompatible
with their ethos and professional identity.

A major source of disillusionment and burnout for clinical psychologists
is a lack of support to integrate their psychosocial ideologies into daily
practice mental health practice (Masters et al., 2002). It is possible
that the experience of engagement in practices conflicting with personal
beliefs leads some psychologists to experience discomfort, cognitive
dissonance (Festinger, 1975) and a sense of being personally and
professionally fraudulent (Mollon, 1989).

Clinical psychologists have been encouraged to challenge medicalised
notions ('Practice what we Preach'; The Psychologist, 2007) and take more
action to engage other professionals in 'constructive conflict' over
models of working (BPS, 2007). However, doing this seems to present a set
of professional and professional challenges. Johnstone (1993) listed a
number of ways in which her challenges to biomedical assumptions were
rejected in her day-to-day practice. Gelsthorpe (2007) asserts that many
find this experience disturbing and decide to leave and work elsewhere.


** I WOULD LIKE TO FIND OUT....


What dilemmas and challenges are encountered by clinical psychologists
working in AMH systems when the medical model is in conflict with their
personal ideologies.

How have these experiences personally affected this group of professionals
and how have they continued working in the system?


***WHAT WOULD YOU BE ASKED TO DO IF YOU TOOK PART?


I would like to interview clinical psychologists. The interviews will be
conducted over the telephone at a time to suit participants. These
interviews will be recorded so that they can be transcribed.


***WHO CAN TAKE PART?


Participants must currently work as a clinical psychologist in the NHS and
have done so for 2 years or over. They should be working in a psychiatric
setting (i.e. mental health team containing a psychiatrist).

All clinical psychologists will vary in their position on medical model
and psychiatric discourse and I want to interview those who would agree
that they:

(a) Define themselves as being critical of the medical model
(b) Find that this raises dilemmas for them in their work place
(c) Feel they have found ways of managing this


***WHAT SHOULD YOU DO IF YOU WANT TO TAKE PART?


Please e-mail me or telephone me via the contact details below. If you
choose to e-mail me, I would like to know your name and how you would
prefer to be contacted. I will get in touch with you within 2 weeks to
answer any questions you have and to arrange a suitable interview time.


***WHAT ARE THE CONSEQUENCES OF TAKING PART?


The interview will take up to an hour. The findings of the research will
be written up as an Independent Research Project and submitted to the
university Board of Examiners on order to meet my DClinPsyc training
requirements. It is anticipated that it will also be written up for
publication in a peer-reviewed journal and presented at conferences.


***WHAT ARE YOUR RIGHTS?

The study is being conducted in accordance with British Psychological
Society and local Research Ethics and Governance Committee guidelines.Your
rights as a participant, including the right to withdraw at any point are
ensured. All content will be anonymised to minimise the possibility of
participant's being identified.




Thank you for taking the time to read this information. Your participation
would be very much appreciated.

For any further information please contact me.


Bill Smythe

Trainee Clinical Psychologist
Canterbury Christ Church University
Salomons (CASP)


E-mail: [log in to unmask]
Mobile: 07723046737 (please leave a message if mobile not answered and I
will call you back)

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