Lucy Johnstone

Self employed trainer

Presentation and panel discussion on the importance of taking a non-pathologising approach to understanding climate related distress

Climate change poses an existential threat to today’s and future generations. Within this context, important debates are taking place about the risk of individualising and de-contextualising both climate-related distress and denial. Seeking to re-centre context and power, we tentatively share our thoughts on how the Power Threat Meaning Framework (...

The COVID-19 pandemic has led to predictions of a widespread mental health crisis. However, this makes little sense when fear and anxiety are so understandable in context. The individualisation and medicalisation of normal human reactions disconnects us from our feelings and from the appropriate solutions, in relation to the pandemic and more gener...

The Provisional General Patterns are at the heart of the Power Threat Meaning Framework’s ambitious attempt to outline a conceptual alternative to the diagnostic model of distress and troubled or troubling behavior. The article outlines the ways in which these proposed regularities differ from patterns of bodily dysfunction, all of which follow fro...

This article summarizes the results of a recently published project to develop a conceptual system incorporating social, psychological, and biological factors as an alternative to functional psychiatric diagnosis. The principles underlying the Power Threat Meaning Framework are briefly described, together with its major features and differences fro...

The project group reflects on the responses to the Power Threat Meaning Framework (PTMF) one year after publication. The group welcomes the interest shown in the document, and takes this opportunity to clarify some points, reflect on and learn from others, and suggest areas for future development.

This article summarizes the results of a recently published project to develop a conceptual system incorporating social, psychological, and biological factors as an alternative to functional psychiatric diagnosis. The principles underlying the Power Threat Meaning Framework are briefly described, together with its major features and differences fro...

A combination of international debates about psychiatric diagnosis, failure to find biomarkers to validate the 'illness' model, and emerging evidence on the role of trauma, abuse and social inequality in mental distress, is creating the possibility of fundamental change in mental health systems. However, despite the recent 'Position Statement on Cl...

The article gives an overview of psychological formulation, a rapidly expanding practice in the United Kingdom that is supported by the British Psychological Society. It is argued that formulation can provide a credible alternative to psychiatric diagnosis in the context of public admissions about lack of reliability and validity of current diagnos...

In this article, we provide an overview of developments in team formulation in Cwm Taf University Health Board, South Wales, over the last four years. We summarise some of the challenges and benefits and outline our aspirations for future developments.

This article summarises an ambitious project to embed formulation into the care pathway of a redesigned adult and later life secondary care community service. We describe the initial training package and follow-up, and reflect on further areas for development.

Objectives: To explore clients' experiences of formulation in cognitive behaviour therapy for depression and/or anxiety, as reported after the end of therapy. Design: A qualitative study using inductive thematic analysis. Method: Ten clients who had completed a course of cognitive behaviour therapy for depression and/or anxiety participated in...

The use of formulation in team working is an emerging area of practice which has been associated with a range of benefits for staff and service users. This study sought to evaluate staff experiences of formulating in teams.

A new and profoundly important paradigm for understanding overwhelming emotional pain has emerged over the last few years, with the potential to change the way we conceptualize human suffering across the whole spectrum of mental health difficulties. It is a strongly evidence-based synthesis of findings from trauma studies, attachment theory and neu...

Objectives. To investigate clinical psychologists’ accounts of their use of psychological case formulation in multidisciplinary teamwork. Design. A qualitative study using inductive thematic analysis. Methods. Ten clinical psychologists working in community and inpatient adult mental health services who identified themselves as using formulation in...

A synthesis of literature from developmental psychology, traumatology and cognitive neuroscience is presented in order to suggest that psychosis and many other forms of mental distress can be most appropriately understood as a meaningful psychological response to trauma and loss. Clinical and theoretical implications of this holistic, integrated pa...

Accessible summary Staff beliefs about why people with learning disabilities self‐harm are important because they can affect the way that staff respond to the behaviour. Staff who work with people with learning disabilities said why they think people with learning disabilities self‐harm. Staff had many different views on why people with learning di...

The concept of valid consent has become important for electroconvulsive therapy (ECT). However, many patients feel that they do not have enough information before consenting and a significant minority feel coerced into consenting. Little is known about what factors account for these views. To explore patients' perceptions about how they consented t...

Over a decade ago I wrote a critical review of the literature about family influences on ‘schizophrenia’ under the title ‘Do Families Cause “Schizophrenia”? Revisiting a Taboo Subject’ (Johnstone, 1999). The controversy has recently resurfaced in a slightly different form, in relation to the debate about the role of trauma and abuse in the developm...

The aims and principles of the Bristol reflective practice philosophy are described, along with examples of successful ideas for reflective practice groups.

The Bristol approach to teaching from a critical perspective is outlined, with examples of successful ideas and strategies. The impact on the trainees is discussed, along with suggestions about how to support them as they assimilate this challenging approach.

Background: Borderline Personality Disorder is subject to considerable debate with regards to its validity as a way of understanding people and their difficulties. This debate has taken place primarily in an academic context, though user focussed research has identified: (i) Some of the consequences of mental illness diagnosis, and (ii) Users' expe...

The principles of the Family Management interventions in schizophrenia, together with some of their advantages and limitations, are reviewed. The evidence for the widely accepted necessity of medication as an adjunct in all cases is closely examined and found to be unconvincing, and it is suggested that on the contrary perhaps a majority of those d...

Although it is known that a proportion of people find ECT distressing to receive, these adverse psychological reactions are little understood. Twenty people who reported having found ECT upsetting were interviewed about their experiences in detail. A variety of themes emerged, including feelings of fear, shame and humiliation, worthlessness and hel...

To explore the experiences of young second-generation South Asian women living in Britain; to try and understand their experiences, deconstruct the term cultural conflict and understand it within a psychological framework. In particular, the aim was to explore issues of separation and individuation, and the meanings attributed to these concepts. An...

Psychiatric theory and practice is based upon a biomedical model — that is, an assumption that mental distress is best understood as a medical illness; a disease process which involves an alteration of biological structure and functioning. This fact is so obvious that it may seem as if it does not need stating. However, it is exactly this taken-for...

The authors present a discourse analysis of an influential paper on the experience of electroconvulsive therapy (ECT). By focusing on how patients are construed in this article, they deconstruct the ways in which the case for ECT as 'helpful and not particularly frightening' is made. They argue that, as with all academic writing, a discourse of sci...