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Title: Counselling psychologists' experience of working with clients who have been given a psychiatric diagnosis. A grounded theory analysis
Author: Davies, Hannah
Awarding Body: University of the West of England, Bristol
Current Institution: University of the West of England, Bristol
Date of Award: 2013
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One in four people in Britain experience mental health difficulties at some point in their lives and psychiatric diagnosis is an integral part of the treatment for many of those referred for help with their difficulties. The research literature indicates the impact that diagnosis has on an individual's life and offers conflicting views as to whether or not diagnosis is useful for individuals who receive a diagnosis. However the impact that diagnosis can have on the therapeutic relationship has yet to be considered. The purpose of this research was twofold; to explore how working with clients who have a psychiatric diagnosis is experienced by psychologists and secondly to formulate an explanatory theory of this process. This grounded theory study used purposive sampling to recruit fourteen Chartered COWlSelling Psychologists and theoretical sampling to recruit one Chartered Clinical Psychologist. Participants were interviewed using a semi structured interview format. The basic social process that emerged from the data indicated that many participants experienced feelings of uncertainty when working with diagnosis and that they adopted one of three positions on diagnosis; 'uncritically adopting diagnosis' whereby they worked with diagnosis seemingly without any critical appraisal; 'challenging diagnosis' whereby they adopted a critical position towards diagnosis; and 'pragmatic positioning' which involved both compromise and avoidance of diagnosis as a way of attempting to reduce their feelings of uncertainty and cognitive dissonance. In seeking certainty many participants engaged with , I ~ diagnosis and thereby tended to disengage with their counselling psychology identity as they struggled to hold both the medical model and the counselling psychology philosophy at once. This created cognitive dissonance which motivated participants to adopt a pragmatic position to reduce the conflict. The pragmatic position adopted is untenable, leading to further dissonance and uncertainty. Some chose to opt out of working with diagnosis at a later point in the process when maintaining a pragmatic position was no longer desirable or possible for them. What has been identified is a lack of confidence in working with diagnosis and a struggle to adapt to a medical model context. This has implications for practice, supervision and training and more generally for counselling psychology as a profession. TIlls will be discussed in addition to the limitations of the study and avenues for further research. , ..
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available