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Title: The unemployment agenda in mental health services : the therapist's perspective
Author: Khanom, Jusna
ISNI:       0000 0004 5372 4512
Awarding Body: University of East London
Current Institution: University of East London
Date of Award: 2015
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In recent years public policy and research has placed unemployment at the forefront of designing and evaluating mental health services, which led to support for development of the service model, Increasing Access to Psychological Therapies (IAPT). Most of the research that has informed this shift has explored the relationship between mental health and unemployment from a positivist framework, which has provided a focus on describing the psychological symptoms that people experience as a result of unemployment. However, this research has been criticised for its limitation in ignoring the causes and the context of unemployment. The aim of the study was to explore the impact of the change in emphasis on unemployment for therapists practice, the ideas they draw on to inform their work, and how therapists manage any potential conflicts. A critical realist approach was used to explore these aims with seven therapists working in IAPT services. In drawing on a critical realist approach, the study was interested in exploring the relationship between a number of phenomena: materiality (e.g. the reality of the nature of available employment), institutional practices (e.g. government policies) and social discourses (e.g. therapists understanding of the causes of unemployment). The data from the interviews were analysed using thematic analysis. The first theme indicated that the service context raised a number of challenges for therapists; theme two described therapists opposition to the employment agenda; theme three explained how therapists managed conflicts between their personal and professional perspectives by using the employment agenda minimally and complying with the demands on an administrative level; and, finally, theme four described the approaches that therapists drew on to formulate client’s difficulties with employment and its implications. The data was interpreted using psychoanalytic and critical ideas in order understanding how therapists’ experienced and responded to the unemployment agenda of IAPT service (Layton, 2009). The data was analysed by drawing on mechanisms of splitting, denial and repression to explain societies and mental health services, compliance, acceptance and support for political discourses that disadvantage the most vulnerable within society (Layton, 2009). The implications of the findings are discussed for practice, research, training and policy.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral