The Power Threat Meaning Framework and the understanding of psychosis
Research type
Research Study
Full title
The Power Threat Meaning Framework and the understanding of psychosis.
IRAS ID
319009
Contact name
Susannah Colbert
Contact email
Sponsor organisation
Salomons Institute, Canterbury Christchurch University
Duration of Study in the UK
1 years, 2 months, 24 days
Research summary
Research Summary
The project aims to see what impact, if any, the use of a PTMF formulation meeting has on staff and service users understanding of psychosis. Understanding how staff view psychosis has implications for clinical practice as it may impact how they care for their clients and where they may or may not signpost or refer them to for additional support. For example, if a team fails to consider what has happened to the client and only focuses on their present difficulties there may be a reduced number of referrals to psychology. Furthermore, understanding how an individual may view their own difficulties and if this is impacted following staff discussions focused on how to better support them in line with the PTMF or if they have noticed a change in their treatment is important for clinical practice. If a client has a biomedical understanding of their difficulties, they may be less reluctant to engage in trauma focused care due to thinking it is irrelevant for a biological disorder.
The power threat meaning framework (PTMF) is an alternative way of conceptualising distress and disturbed behaviour. It serves as a helpful way for people to create more hopeful narratives or stories about their lives and difficulties instead of seeing themselves as ‘mentally ill’. It highlights the links between emotional distress and wider social factors such as poverty, discrimination, and inequality.
The approach of the Framework is summarised in four questions:
1. What has happened to you? (How is power operating in your life?)
2. How did it affect you? (What kind of threats does this pose?)
3. What sense did you make of it? (What is the meaning of these situations and experiences to you?)
4. What did you have to do to survive? (What kinds of threat response are you using?)Summary of Results
This research used narrative analysis to explore staff, who have worked with psychosis, experiences of Power Threat Meaning Framework (PTMF) team formulation meetings and their subsequent understanding of psychosis.
Seven participants said they had previously held a medical model understanding of psychosis (e.g. the influence of dopamine on the brain, genetics etc.), reflecting the dominance of this narrative. Some participants showed anger towards the medical model due to its clinical/diagnosing language and restrictive interventions (e.g. hospitilisation). Six participants referred to having known friends and family members who had experienced psychosis. This showed that the development of an understanding of psychosis arose from personal experiences, as well as professional. Some participants commented on the PTMF causing the clients to be discussed in a way which brought out their humanity. PTMF led to a trauma informed understanding of psychosis which participants agreed with. However, despite the PTMF formulation meetings being spoken about positively, some participants mentioned that they rarely led to a change in the intervention the client received.
Overall participants spoke highly of the use of the PTMF team formulation meetings, and it felt important in their journeys to find their understanding of psychosis.REC name
North of Scotland Research Ethics Committee 2
REC reference
23/NS/0047
Date of REC Opinion
15 May 2023
REC opinion
Favourable Opinion