Title:
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First-episode psychosis and the moral exculpation of parents
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In recent years a significant investment has been made in order to set up Early
Intervention in Psychosis teams across England. These teams are responsible for
delivering mental health services to people said to be experiencing first-episode
psychosis, including the provision of 'psycho-education' for parents. The present
study involved conducting eight interviews with such parents using a broad range of
questions on the subject of first-episode psychosis. The study adopted a discursive
psychology perspective towards the subject matter, with the analysis focusing on the
rhetorical and interactional aspects of the discourse, through the use of specific
discourse analysis and conversation analysis techniques respectively.
The results of the analysis suggested that participants oriented to a common cultural
understanding that parents can be responsible for causing, preventing, and
intervening in the course of, such things as first-episode psychosis.
In orienting to notions of parental causality, participants were seen to invoke lay
versions of the type of causal explanations of schizophrenia that have been outlined
in the psychological literature over the last century. Yet, the participants were also
seen to work up the expert status of the interviewer, to defer to professional
knowledge, and to claim to know nothing of such matters. This aspect of the
analysis was taken as evidence of the success of the 'psy' project in establishing the
superiority of professional knowledge over lay accounts.
The analysis also demonstrated how participants attempted to work up their moral
credentials as parents. This was understood as demonstrating that the parents did
not orient to first-episode psychosis as a biological phenomenon, but rather as a
moral assessment of their children's non-conforming behaviour, for which they, as
parents, were morally culpable.
The results of the study were used to make recommendations regarding how EIP
teams should approach the task of working with parents.
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