It is suggested that the lack of progress made towards understanding and preventing, or even in many cases even alleviating, psychological suffering has been due, in large part, to the way in which such suffering is conceptualised – as ‘disorder’, ‘illness’ or ‘disease’ which is located, and is thus potentially locatable, within the individual. This conceptualisation of psychological suffering is referred to in this thesis as the ‘Dysfunctional Mind Account’ (DMA). The DMA, it is argued, underlies all accepted models/theories of psychological suffering and is the dominant way of conceptualising such suffering for both professionals and lay-people in Western cultures. It is further argued that the main reason the DMA is unable to assist in understanding and alleviating psychological suffering is because it is underpinned by assumptions about human beings and their suffering which are inherently flawed. The account presented in this thesis places at its centre an analysis of persons and their experience that attempts to overthrow these assumptions. The resulting reconceptualisation presents a view of psychological suffering as emergent from our continual personal and embodied enmeshment within our social world, rather than as arising primarily out of the various processes occurring ‘within’ us (whether that be our neurochemistry or our ‘mental mechanisms’ or an ‘interaction’ between them). It is essentially suggested that psychological suffering emerges from the same source as all other aspects of our personal being; from the constant coactions between the various aspects of our being in the world – personal, organismic and molecular – with the environment within which we are enmeshed. This means that the feelings/thoughts/behaviours conceptualised as ‘mental disorder’ are as much part of our personal being as any other aspect of us; they are not ‘other’, they are not ‘disease’, ‘illness’ or ‘dysfunction’. Such feelings/thoughts/ behaviours, it is argued, almost always, perhaps inevitably, represent a very adaptive response, at every level of our being, to environmental contingencies. Thus, when understood in its full context, the suffering conceptualised as ‘mental disorder’ can be seen as the very understandable responses of the embodied person to what is happening to them, rather than ‘un-understandable’ dysfunctions, aberrations and pathological processes of the ‘mind’ (or brain).

This paper deals with some of the issues that affect the understanding and functioning of descriptive psychopathology (DP). The latter remains the language of description in psychiatry and the basis for her nosological constructs. DP makes assumptions concerning the nature of its object and its underlying causes (i.e. makes use of the medical model). DP needs historical, clinical and numerical recalibration. It is suggested that in some cases, and against traditional psychometric principles, some instruments will have to be constructed that show flexibility and can be varied according to the descriptive needs presented by individual cases. / En el presente artículo se discuten algunos aspectos que afectan a la comprensión y al funcionamiento de la psicopatología descriptiva (PD), la cual proporciona un lenguaje descriptivo a la psiquiatría y las bases para sus constructos nosológicos. La PD formula postulados sobre la naturaleza de su objeto de estudio y sus causas subyacentes (haciendo uso del modelo médico). Se propone que la PD necesita una recalibración histórica, clínica y numérica. En relación a esto, se sugiere que en algunos casos, en contra de los principios psicométricos tradicionales, ciertos instrumentos deberán ser construidos de un modo flexible que permita que varíen de acuerdo a las necesidades descriptivas que presenten casos individuales.

Cognitive behaviour therapy (CBT) is a therapeutic modality which is commonly argued to be oriented to a medical model, and so to diverge significantly in theory and practice from the traditional relational and humanistic roots of counselling psychology. A large body of literature and research exists which examines counselling psychologists’ professional identity in medical settings, but there appears to be a significant gap in the extant literature relating to how counselling psychologists experience professional identity specifically in the practice of CBT, a therapeutic modality which presently provides a considerable amount of employment for counselling psychologists. To address this gap, the present study sought to explore qualitatively whether counselling psychologists’ experience of their professional identity is affected by the inclusion of CBT in their practice. A sample of eight counselling psychologists who worked with CBT and had been qualified for at least five years were interviewed. Data gathered from the semistructured interviews were transcribed and analysed using interpretative phenomenological analysis (IPA), a method selected because it is concerned with the detailed examination of personal lived experience and the meaning of experience to participants. The methodology was approached within the contextual constructionist epistemological framework. Three superordinate themes, each containing four subordinate themes, emerged from participants’ accounts: (i) components of professional identity; (ii) the contribution of CBT to the professional self; and (iii) how CBT compromises the professional self. The findings are discussed in relation to the relevant literature, and lines of enquiry that have emerged have been located in current postmodern literature, arguments and debates. One main conclusion of the present study is that feeling comfortable with CBT can CBT, Counselling Psychology and Professional Identity 3 depend upon practitioners’ initial training, personal experience, cultural background, personal characteristics and personal beliefs – that is, the professional self as emerging from the personal self. Clinical implications, methodological limitations, directions for future research and reflections upon the researcher’s reflexivity are presented.

The purpose of this thesis was to explore socially constructed discursive barriers to physical activity for people with physical disabilities. This research was informed by a critical disability studies framework. Eight interviews were conducted, split between end-users and stakeholders. The end-user article discusses their perspectives with regard to their own PA participation, their use of PA resources, and their views of how disability is constructed. The stakeholder article deals with their views with regard to Canada’s progress in creating inclusive PA guidelines, the research process as it effects people with physical disabilities, and how disability is constructed. The results showed awareness among both groups of the social model of disability, but that the medical model is still firmly rooted. Work is needed to create inclusive promotional materials and disseminate them effectively. An effective advocacy and lobbying effort was suggested as one avenue towards a possible solution to this issue.

The practice of counseling and psychotherapy is influenced by a number of ideologies, models, and paradigms. Among these, the medical model's influence is particularly salient. The ideology of the medical field pervades the theory, research, and practice of psychology and its influence deserves close examination. The few studies in this area that have been conducted are descriptive and basic in nature. The present study aimed to contribute richness and depth to conversations about medical model influence. By interviewing Counseling Psychology training directors and applying a qualitative analysis, this study provided the following themes that characterize views of the medical model's influence on professional practice: 1. Psychology can't afford to be dogmatic or deny reality, yet must critically examine the influence of the medical model. 2. Counseling Psychology has a lot to offer—so get in the game. 3. The tension between medical model influence and the values of Counseling Psychology has increased. 4. The medical influence on research is a two-edged sword—we need to think complexly about our science. 5. Medical model focus on pathology is reductionistic and restrictive. 6. Preparing students for the "real world" medical influence on practice while trying to teach values of Counseling Psychology is at times a balancing act. 7. Cautious about Prescription Privilege: Are we trying to be physicians or psychologists? It is hoped that finding and reporting the themes that emerged will lead to increased discussion, thinking, consideration, and examination of the model's influence among counseling psychology professionals.

Alcohol Use Disorder (AUD) has multiple health and social consequences which negatively affect individuals’ lives. However, the decision to utilize treatment is influenced by a variety of social factors. The stigma associated with AUD may impact individuals’ willingness to seek treatment after drinking is viewed as an issue. A highly stigmatized disorder, perceptions of AUD may be influenced by medical/moral lay theories, responsibility attributions and implicit theories. Once treatment is sought, support from others during the recovery process has been associated with treatment retention rates and success. Lay recovery beliefs, such as change perceptions, influence the amount of support offered to individuals during treatment. 249 college students completed assessments to measure their beliefs regarding medical/moral lay theories, responsibility attributions and implicit theories for AUD. Participants also completed questionnaires on social distance and perceptions of change. This study’s results indicate that medical/moral lay theories and responsibility attributions are linked to stigmatizing attitudes towards AUD. Responsibility attributions and implicit theories interact to influence stigma. It was also found that perceived likelihood of change is influenced by responsibility attributions, while perceived possibility of change is linked to medical/moral lay theories, responsibility attributions and implicit theories. Such relationships between the evaluated lay beliefs and stigmatizing attitudes may have important implications for programs aimed to reduce negative attitudes towards AUD.

No description available.

No description available.

Bipolar mood disorder has been traditionally researched, explored, and explained from a modernistic, psychiatric perspective. The purpose of this study is to explicate an alternative description for bipolar mood disorder, from a postmodern perspective. The widely accepted psychiatric knowledge focuses on the signs and symptoms of the disorder, pharmacological treatments, and manualised psychotherapies. This thesis shifts the focus from an intrapsychic, deficit perspective towards one which is inclusive of surrounding discourses and patterned relationships. The social constructionist research approach is followed, utilising vignette and thematic analyses for textual deconstruction and reconstruction. In addition to these data analyses, discourses were analysed using the actual text of the co-researchers. This allowed for a thorough explication of the ways in which discourses shape the construct bipolar mood disorder. From these analyses, emergent themes were then distilled and compared to the existing body of literature in the bipolar mood spectrum field of study. Process models were generated to depict the various pertinent aspects of the social construction of bipolar mood disorder. This research has value for the treating professional, allowing for a broader, more inclusive discourse perspective to add to the already established medical model view. Further, this research gives credence to the voice of the person who has been diagnosed with the illness. This research may also contribute to the epistemological debates within modernist and postmodernist paradigms. Key words: Bipolar mood disorder, medical model, pharmacology, mania, depression, psychiatry, psychotherapy, titrating power relations, expert, problem determined systems, belonging, problems of therapy and therapeutic problems, vignette analysis, people as meaning generating beings, context, reflexivity, self-reflection, multiple realities, positivism, social constructionist epistemology, qualitative research, process model. / Psychology / D. Litt. et Phil. (Psychology)

Staff who work in front line, direct contact support positions with community based clients with acquired brain injuries (ABI) hold unique responsibilities, and face unique challenges in their work due to the combination of three key factors: autonomous work environments, socially sanctioned power status over clients, and the decision making deficits of clients with ABI. These factors further contribute challenges to staff in the presently complex and ambiguous outreach context, where the embedded ideologies of the medical model of treatment remain in tension with the purported ideologies of the social model of disability and client self determination that drive outreach services. Using constructivist grounded theory methods and narrative and interpretive analysis strategies, this research interviewed fifteen (15) ABI outreach support workers to explore and examine their perceptions of the outreach context, how they negotiate decision spaces, and how they deal with the central ethical dilemma of outreach - achieving balance between their duty of care and the client's dignity of risk. The thesis documents decision making strategies used by the interview participants, examines the factors that influence their decision space when in the field with clients, and explores the role staff awareness of professional and personal values plays in making decisions in the best of interest of the client. Staff awareness is shown to be a critical, yet oft neglected factor in consideration of staff ethical decision making in ABI outreach. Implications for best practices in the field are discussed. / PhD Doctorate