The British Psychological Society Division of Clinical Psychology have recently released a position statement on classification and diagnosis. Those of you who are prone to suspicion might consider that this forms part of a group in the DCP who are pursuing an anti-psychiatry stance. Personally, I don’t know. Anyway, here it is.

http://www.bps.org.uk/system/files/Public%20files/cat-1325.pdf

I recently responded to this in my capacity as the Director of a Clinical Psychology Training programme, and thought I might share my response, which can be found below.

“I know that we all received the attached document, with the injunction to take it up as part of our training programme:

“We feel training courses are well placed to ensure that up and coming members of the profession understand and can critically engage with the issues connected to functional diagnoses.”

I have no idea what the DCP think we already do in this respect, but find myself worried about how out of touch they seem to be. Alternatively, do they, perhaps, have particular programmes in mind where psychiatric diagnosis leads psychological training? If so, I think these should be named and shamed, because that would be a disgrace.

My understanding is that, without exception, clinical psychology training programmes take a critical view of psychiatric diagnosis and already teach formulation, providing the context of psychiatric classification systems as very badly flawed operational definitions. The fact that the NHS requires diagnoses in record systems is regrettable (and something I have taken up at times with NHS trust management) but a fact. As a clinical psychology trainer I have to prepare trainees to work in the NHS and that carries implications about what we teach (but not how). The DCP might want to take such issues up with the NHS in collaboration with other professional and service user groups, and I look forward to that as something long overdue.

Personally, I am a bit horrified that the DCP is announcing things in this way at this point; it makes it sound as if this is something new which we are itching to introduce into the profession, sweeping away what has gone before as part of a glorious revolution of thinking. This is very much not so and in my view represents a shocking position being taken by the DCP without prior consultation with the membership. An ignorant observer might suspect that the DCP has another agenda.

Although I have no problem with a Kuhnian position, I’m always suspicious of announcements of a “paradigm shift” ahead of the development and demonstrable utility of that new paradigm. And “new” is a key concept here. It is not as if psychological formulation is a new concept; its in the “DNA” of clinical psychology, put there by some very clear thinkers from a psychological perspective, starting but by no means finishing with Monte Shapiro. What I am asserting is that there is no paradigm shift and I believe it is counter-productive to make such a claim. The fact that it is done in my name, as a member of the DCP, seems to me to add insult to injury.

What on earth is the DCP thinking of?”

I note that some of the “core issues” identified apply at least as much (and in some instances more so) to “psychological formulation”. There is also no attempt in the position paper to consider the potential drawbacks and shortcomings of formulation and other alternatives. In my view the hallmarks of a campaign rather than a carefully thoughts out position paper.

Again, what on earth is the DCP thinking of? I think we should be told.

 

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