Examining Attitudes Towards Mental Health Diagnoses: A Q-Methodology Study.

BACKGROUND: Debates exist regarding the validity and utility of functional psychiatric diagnoses. How mental health diagnoses are understood has real impacts for service users and service delivery. AIMS: To investigate different attitudes about the utility of psychiatric diagnoses. METHODS: Forty-one stakeholders sorted 57 statements related to the usefulness of psychiatric diagnoses. Using q-methodology, four viewpoints were identified and interpreted. RESULTS: Viewpoint 1 (Pathologising human experience) regarded diagnoses as pseudo-scientific constructs that lacked validity and obscured the relationships between lived experience and distress. Viewpoint 2 (Illnesses like any other) held that labels reflected real disorders and diagnosis offered important benefits for service users and services. Viewpoint 3 (Stigmatised conditions) similarly regarded diagnoses as reflecting real disorders, but diagnostic criteria were viewed as biased and the impacts of applying labels seen as causing problems for service users. Conversely, Viewpoint 4 (Useful short-hands) viewed diagnostic processes as imperfect but necessary for supporting communication and structuring service delivery. CONCLUSIONS: While not all viewpoints are in keeping with empirical evidence, we hope results will enable professionals and service users to take meta-positions in relation to their own and others' attitudes, and to reflect on the impacts of privileging certain viewpoints over others.

Social Psychological Theory as History: Outlining the Critical-Historical Approach to Theory.

The mainstream epistemology of social psychology is markedly ahistorical, prioritizing the quantification of processes assumed to be lawful and generalizable. Social psychologists often consider theory to be either a practical tool for summarizing what is known about a problem area and making predictions or a torch that illuminates the counterintuitive causal force underlying a variety of disparate phenomena. I propose a third vision of critical-historical theory. From this perspective, theories should be committed to deep interdisciplinarity and historical validity claims-understanding individual and group experiences as part of historically contingent forces. Theories also should be critical, containing an awareness of the researcher as implicated in the social process and committed to actively improving society. To demonstrate its viability, I review classic works from the history of the discipline that exemplify critical-historical theory and offer concrete implications for theorists interested in employing this approach in their own work.

Making Space for Community Critical Methodology: Stories from the Australian Context.

Our collective account considers the ways community critical methodologies can inform academic endeavors. Methodology is understood to be the theorizing of methods that produce and legitimate knowledge claims. For us, community critical approaches incorporate poststructural and other forms of critical theory in the questioning of taken for granted assumptions. This forms a valuable foundation for community praxis as it focuses not just on social issues outside, but on an examination within; on the institution of psychology itself. We find "examining within" a vital process for our research, teaching, and community engagement. Above all it is important to ask whose interests are served by the construction and presentation of knowledge in particular ways. We present three pieces of practice which engaged with critical methodologies. The first examines collaborative research methodologies developed with young people in rural Australia who are primary carers for a family member. The second examines tensions involved in trying to employ critical methodologies in multi-stakeholder work between community organizations, communities, and researchers. The third examines opportunities and barriers when employing critical methodologies in learning and teaching with undergraduate students. We reflect upon the intersecting threads of commonality and difference between them and consider the implications for practice.

Involvement of patients' perspectives on treatment with noninvasive ventilation in patients with chronic obstructive pulmonary disease-A qualitative study.

AIMS AND OBJECTIVES: To clarify chronic obstructive pulmonary disease patients' perspectives on treatment with noninvasive ventilation and develop management strategies for the treatment based on these perspectives. BACKGROUND: The effect of treating chronic obstructive pulmonary disease patients with noninvasive ventilation is well-documented, as is the problem of patient difficulties in tolerating the treatment. Knowledge of how patients with chronic obstructive pulmonary disease experience and evaluate treatment with noninvasive ventilation is limited; therefore, more information of patient perspectives is needed to develop treatment practices in respiratory medicine. METHOD: This study is based on critical psychological practice research. DESIGN: A co-researcher group comprising diverse health professionals was set up and headed by the principal researcher. The group convened seven times over 12 months to develop new management strategies based on patients' perspectives on noninvasive ventilation. Health professionals contributed with experience-based perspectives, and the researcher contributed with data from participant observation in the department and semi-structured interviews with 16 patients and four relatives. RESULTS: Interviews revealed that patients with chronic obstructive pulmonary disease regarded noninvasive ventilation treatment positively even though they experienced discomfort and anxiety. Patients' perspectives revealed that patients with chronic obstructive pulmonary disease conduct their everyday lives with chronic obstructive pulmonary disease looking at chronic obstructive pulmonary disease as a basic life condition rather than an illness. This approach had a major impact on chronic obstructive pulmonary disease patients' attitudes to noninvasive ventilation treatment and hospitalisation. CONCLUSION: Investigation of patient perspectives generated results that were highly productive in facilitating multidisciplinary collaboration and in developing and sustaining new management strategies. Critical psychological practice research facilitated ongoing development of clinical practice related to noninvasive ventilation treatment. RELEVANCE TO CLINICAL PRACTICE: Focus on patients' perspectives in treatment with noninvasive ventilation resulted in the development of new management strategies regarding patient care, joint ward rounds, and in addition, one room at the ward, to which a nurse was assigned, was designated for chronic obstructive pulmonary disease patients treated with noninvasive ventilation.

Why critical psychology and the neurodiversity movement need each other.

Critical psychology is a discipline that can be defined in a variety of ways, though common themes include critiquing mainstream psychology as well as critiquing society at large and engaging in social change to respond to those critiques. The neurodiversity movement is a political movement that emerged in response to the dehumanizing treatment of Autistic and other neurodivergent individuals by society in general and by mainstream psychology specifically. In this article, I describe five ways in which critical psychology and the neurodiversity movement can and have begun to benefit from each other: (a) by critical psychologists embracing neurodivergent epistemologies in the way they embrace other diverse epistemologies; (b) by resisting attempts within mainstream psychology to pathologize difference or "treat" these so-called psychopathologies by modifying behavior; (c) by practitioners developing cultural competency around neurodivergent culture within the psychotherapeutic practice; (d) by challenging the homogenization and whitewashing within the neurodiversity movement through leveraging lessons from within various critical psychologies; and (e) by researchers and practitioners recognizing and combatting instances of ableism embedded in other forms of oppression and within the field of critical psychology itself.

Critical Psychology and the Brain: Rethinking Free will in the Legal Context.

The article draws from critical psychology to discuss the rising debate on brain determinism and free will in the legal domain. As free will also corresponds to the context and culture, it can have both the public and private space of expressions. The rise of neuroscience and its influence in the legal domain offers a holistic and sociocultural meaning of responsibility. Even one becomes entitled to take free will as a 'necessary illusion' in order to be in the zone of 'moral as well as legal-social life forming activities'. In the criminal justice system free will is not taken as any kind of 'necessary illusion' but the conscious will and action of the person. This further throw light on how the wilful control of any criminal act is a social act and our brain is not separate from our collective will.

"Safety Means Everything": An ethnographic methodology to explore the formation of professional identity in nursing students.

AIM: The aim of this qualitative study is to explore how various conditions within educational contexts impact nursing students' experiences of becoming professional nurses and how these conditions affect their agency and the formation of their professional identities. BACKGROUND: Nursing education is essential to becoming professional and competent in caring for patients. A strong professional identity in nursing contributes to better patient outcomes and improves the well-being, retention, and recruitment of practitioners in the health care system. At the same time, research indicates that development of a professional identity during education is challenging and needs further investigation. DESIGN: The qualitative research design draws on the theoretical and methodological framework of critical psychology practice research. The practice research design and close collaboration with users ensure the continuous development and implementation of theory and practice. METHODS: The data used in this study originated from ethnographic fieldwork, which involved following two nursing students through their final clinical placement training at the Geriatric Department of a university hospital in Denmark. Additionally, nursing students in two classes were observed as part of their nursing education practice at a university college from April to July 2022. The participant observational design, combined with in-situ interviewing, facilitated a comprehensive understanding of the students' engagement in social practices and interactions within the context of nursing education. RESULTS: Our results show how the conditions of nursing students' everyday lives have a critical impact on their self-understanding and journey to becoming competent and professional nurses. Three main themes emerged from the analysis: (1) Perception of safety, (2) Motivation for learning in different communities of practice, and (3) The meaning of learning culture and role models. CONCLUSION: The development of nursing students into professionals is profoundly influenced by factors affecting their ontological safety that are deeply embedded in socio-cultural and educational contexts. The results underscore the need to foster ontological safety in nursing education. Creating safe, participatory, and supportive learning environments is essential to the holistic development of students into caring, competent nurses. Educators and stakeholders must remember their crucial role in this context and focus on establishing these environments to facilitate students' sense of belonging in the nursing profession. TWEETABLE ABSTRACT: The development of professional identity in nursing starts with safety. Ontological Safety in learning environments ensures competent and professional nurses. #NursingEducation#Safety#ProfessionalIdentity.

Trans(gender) journeys: rights and the (non-)recognition of "human".

A human right paradigm has been challenging the biomedical perspectives that tend to be normalized in the Western context concerning the lives of trans people. The aim of this study is to understand how trans people in Portugal and Brazil perceive the (non-)recognition of their socio-cultural, economic and political rights. Specifically, the study intends to know in what extent these perceptions influence the processes of identity (de)construction. For this purpose, 35 semi-structured interviews were conducted with people self-identified as trans, transsexuals and transvestites in Brazil and Portugal. The narratives of the participants were analyzed according to the thematic analysis method and the following six main themes emerged: (i) Who are the rights for; (ii) Types of rights; (iii) Paradigm of distribution of rights; (iv) Local or global rights; (v) Non-recognition of the "human"; and, (vi) Transphobias (and cissexism). The results allowed the knowledge of rights and the non-recognition of the "human" which is the central organizer of the analysis. Among the main conclusions of this study, we emphasize the circumscription of rights to certain international, regional and/or national contexts; the existence of local instead of global rights, since they are influenced by regional and international law, but they depend on the legislation in force in each country; and the way human rights can also be understood as a platform of invisibility and exclusion of other people. Based on a commitment to social transformation, this article also contributes to rethinking the violence that is exercised on trans people as a continuum, whether through 'normalizing devices' by medical contexts, family contexts, public space, or even through internalized transphobia. Social structures produce and sustain transphobias and, simultaneously, are responsible for fighting them by changing the paradigm about the conception of transsexualities.

The psychology of people with variable sex characteristics/intersex.

Psychological research on people with variable sex characteristics (VSC)/intersex is broadening from the traditional exploitation of this population to ask nature/nurture questions about sexuality and gender. Healthcare for this population has been highly controversial, prompting research on psychological outcomes, the life-span development of adults with VSC, and distress trajectories of parents of children with VSC. Psychological research on clinical psychologists' roles in multidisciplinary care teams, and on decision making about medical pathways informed by those teams, both inform the evaluation of contemporary healthcare. Research is broadening to consider schoolchildren with VSC, elite athletes with VSC, and public understanding of VSC. The growing interdisciplinary field of intersex studies provides critical resources for psychologists.

Patient-Assessed Quality of Virtual Consultations as Follow-Up on Long-Term Oxygen Therapy for Patients With COPD.

BACKGROUND: Long-term oxygen therapy (LTOT) can increase survival time and relieve symptom burden in patients with COPD and chronic hypoxemia. The Department of Respiratory Medicine at Odense University Hospital invites patients with LTOT and COPD to the out-patient clinic for treatment evaluation every 6 months to regulate or terminate treatment and support patients' treatment adherence. The out-patient clinic, however, experiences many absences or cancellations from patients. For that reason, patients were offered virtual consultation as an alternative to physical attendance. This study was initiated to uncover reasons for absences and the patients' experiences of virtual consultation to promote a more patient-centered clinical practice for patients with COPD and LTOT. METHODS: A qualitative study encompassing semi-structured interviews with 20 subjects was conducted in the winter of 2021. The subjects had tried or been given the opportunity of virtual consultation. Data were analyzed inspired by Kvale and Brinkmann focusing on the subject's perspectives on virtual consultation. RESULTS: The analysis resulted in 3 main themes: limitations and vulnerabilities, independence and quality of life, and personal strategies. Subjects expressed that everyday life with LTOT and COPD was characterized by limited resources in terms of energy, oxygen, and time. LTOT was perceived as a necessary means to maintain a sense of independence and quality of life. However, LTOT also meant additional limitations due to cumbersome equipment and feelings of isolation. Most subjects considered the virtual consultation to be oxygen-, energy-, and time-preserving, as it meant avoiding stressful transportation and handling of oxygen cylinders, COVID-19 exposure, waiting time, and not having to involve others for help. CONCLUSIONS: The subjects' perspective showed that follow-up on LTOT as a virtual consultation was considered a valuable offer. The chosen method was found to be relevant in uncovering subjects' attitudes toward clinical practice procedures.

Psychomedical Interventions with Transgender People in Portugal and Brazil: A Critical Approach.

This study aims to analyze biopsychomedical interventions with transgender people. For this purpose, we carried out 35 semi-structured interviews with people who self-identify as transsexuals and transvestites in Brazil and Portugal. The responses of the study participants were systematized according to a thematic analysis, which led to the emergence of the following three main themes: "institutional power", "expectations of trans-bodies", and "experiences in health services". This study demonstrates how some trans people perform bodily modifications to fight the transphobia they experience throughout their lives. In addition, they believe that, by making their bodies conform to each other, they may become more attractive and desirable. The process of cisnormativity is, furthermore, conveyed by the idea present in the answers of some respondents: that having "integrated" bodies means facing less discrimination and that they will, therefore, obtain more satisfactory ways of personally and socially experiencing their identities. This study contributes to a deepening critical reflection on the experiences/exclusions of trans people, especially in the psychomedical context of "normalization" devices. Hence, just as social structures produce and sustain transphobia, the same structures are responsible for combating it.

Competence in professional psychology practice in Ghana: Qualitative insights from practicing clinical health psychologists.

Issues concerning competence of practicing psychologists have not been critically investigated in Ghana. This study used the three-dimensional cube model of core competencies as a framework to explore competencies of professional psychologists in active clinical health practice in Ghana. Sixteen clinical psychologists with 1 to 20 years of practicing experience were interviewed on adequacy of their graduate training for practice as well as maintaining post-training competence. The results suggested that training equipped the practitioners mainly for research and teaching but less so for clinical practice. Reflective practice was underdeveloped leading to critical challenges in emotional and cultural competencies. Structural support for continuous professional development was limited. Implications for professional psychology training, research and practice are discussed. This study is the first to explore competence issues in professional psychology practice in Ghana, and it contributes to the global discourse on continuous competence in psychology.

'Health psychology' or 'psychology for health'? A history of psychologists' engagement with health in South Africa.

In contrast to the institutionalization of health psychology in North America and Europe, much psychological work on health issues in South Africa emerged as part of a critical revitalization of South African psychology as a whole, coinciding with the dismantling of Apartheid and global shifts in health discourse. The field's development reflects attempts to engage with urgent health problems in the context of rapid sociopolitical changes that followed democratic transition in the 1990s, and under new conditions of knowledge production. We provide an account of these issues, as well as reflections on the field's future, as inflected through the experiences of 12 South African psychologists whose careers span the emergence of health-related psychology to the present day.

Doing Histor{y/ies} of Health Psycholog{y/ies}.

Academic (sub)disciplines develop in time and place when particular ideas/practices are nurtured within social, gendered, cultural, community, economic and political contexts. Different histories employ different analyses, some with external views of scientific outputs describing research and practice, and others with internal, behind-the-scenes examinations of these developments, through oral histories and personal recollections. This collection, written by historians of (social) science, or practitioners or pioneering participants, uses different historiographical methods to contextualize health-related activities within the sub-discipline of health psychology and the evolving critical and/or community approaches. The papers connect the evolving health psycholog{y/ies} with changing socio-political circumstances in different countries.

Psychologists and Neoliberal School Reforms: Multi-Faceted Problems Calling for Multi-Faceted Interventions.

This paper extends on six aspects of an article on neoliberal school reforms, their possible influences on schools and school psychologists, and options for dealing with these challenges (Szulevicz, Integrative Psychological and Behavioral Sciences 2018). First, the reductions implied in the neoliberal view of the student as homo economicus and of an ideal student as self-regulated learner are described and alternative views of the student as a person (e.g., homo moralis) and of the ideal student (e.g., as intentional self-developer) are presented. Secondly, several promoting and inhibiting influences on neoliberal school reforms are discussed: competence-based school education, output-oriented school governance, and standardized school performance testing on the one hand, and critical discourses about these phenomena on the other. Third, attention is directed towards impending disadvantages of the aforementioned reforms (e.g., insufficient preparation of students for the fullness of life). Fourth, goals for interventions are discussed (e.g., reducing neoliberal influences on schools, creating an awareness of the disadvantages of neoliberal reforms, forming coalitions to promote alternatives to these reforms). Fifth, some intervention approaches for reaching these goals are considered with special emphasis on different system levels and stakeholders at which these interventions may be targeted (e.g., education policy makers, teachers and parents associations). Sixth, evaluations of the interventions are called for to monitor their effects and to refine the guiding goals, problem analyses, and strategies. In closing, some transferable principles of the preceding approach are highlighted that could be used to better understand and manage other educational problems as well.

Between Past and Present: The Sociopsychological Constructs of Colonialism, Coloniality and Postcolonialism.

If one of the major aspirations of postcolonial theory is to re-establish a balance in the relationship between the (former) colonizer and the colonized by engaging the voices of the "subaltern", and on the other hand to illuminate how power relations of the present are embedded in history (Mills 2007), we argue that important theoretical insights might inform research by anchoring post-colonial theory within a sociopsychological framework. While there is a growing corpus of sociopsychological research articles focusing on how major geopolitical events and historical processes bear on people's lives, we aim to investigate the theoretical potential of postcolonial theory within the disciplines aiming at a sociopsychological approach. By focusing on the social dynamics of power imbalances, post-colonial theory finds its operational meaning: the feelings stemming from actions committed in the past are indeed crucial in determining reparatory attitudes and policies towards members of former colonized groups. Firstly, drawing from the sociopsychological scientific production related to consequences of colonial past, seen in recent years as a growing research interest in the field, we will explore patterns and trends through a thematic analysis of literature. Social Psychology as well as adjacent disciplines can greatly benefit from this theoretical fertilization, especially in the way post-colonial ideologies relate to the symbolic promotion versus exclusion of indigenous culture (Sengupta et al., International Journal of Intercultural Relations, 36(4), 506-517, 2012). Furthermore, by comparing and contrasting the ideological cosmologies relating to this particular topic, this study aims to establish the state of knowledge in the field, to identify how research methods and thematic fields are paired, to find "gaps" and create spaces for research that become integrative of postcolonial theory. While focusing on academic production, we also hope to contribute to develop the idea of cosmopolitism within academia but also beyond academic doors.

The rapid expansion of (mainstream) health psychology in France: Historical foundations.

This article traces the historical evolution of ongoing theoretical debates in psychology in France from the 1940s until today. Its aim is to show how the conjunction of certain conditions led to a rapid expansion of American-derived mainstream health psychology during the 1980s. The authors describe the French context in the post-World War II period and outline the implementation of 'clinical psychology in health settings' in the 1950s, under the influence of Daniel Lagache. The strong critiques of the new psychology profession in the 1950s, 1960s and 1970s are examined. Our conclusion reflects upon future implications of ongoing rivalries between different approaches to psychology.

Vaginal Construction and Treatment Providers' Experiences: A Qualitative Analysis.

STUDY OBJECTIVE: To investigate specialist clinicians' experiences of treating vaginal agenesis. DESIGN: Semi-structured interviews. SETTING: Twelve hospitals in Britain and Sweden. PARTICIPANTS: Thirty-two health professionals connected to multidisciplinary teams (MDTs) including medical specialists and psychologists. INTERVENTIONS AND MAIN OUTCOME MEASURES: Theoretical thematic analysis of recorded verbatim data. RESULTS: The gynecologist and psychologist interviewees share certain observations including the importance of psychological readiness for and appropriate timing of treatment. Three overlapping themes are identified in our theoretical analysis of the MDT clinicians' talk: (1) the stigma of vaginal agenesis and the pressure to be "normal" can lead patients to minimize the time, effort, physical discomfort, and emotional cost inherent in treatment. (2) Under pressure, treatment might be presented to patients with insufficient attention to the potential psychological effect of the language used. Furthermore, the opportunity to question what is "normal" in sex is generally not taken up. It can be challenging to help the women to transcend their medicalized experiences to come to experiencing their bodies as sexual and enjoyable. (3) The reality of treatment demands, which are not always adequately processed before treatment, can lead to discontinuation and even disengagement with services. CONCLUSION: The MDT clinicians in this study emphasized the importance of psychological input in vaginal construction. However, such input should proactively question social norms about how women's genitalia should appear and function. Furthermore, rather than steering patients (back) to treatment, the entire MDT could more explicitly question social norms and help the women to do the same. By shifting the definition of success from anatomy to personal agency, the clinical focus is transformed from treatment to women.

Historical Development of Political-Critical Thinking in Colombian Psychology / Desarrollo Histórico del Pensamiento Político-Crítico en la Psicología Colombiana

Abstract The study traces the historical elements that have influenced the development of political-critical thinking in Colombian Psychology. Four historical periods have been identified and discussed: The intellectual colonialism of Colombian Psychology (1947-1960); the social Psychiatry in the years of La comisión [The commission] (1961-1980); the community Psychology and the coexistence (1980-1991); and the psychosocial studies after recent peace processes between government and armed groups (1991-2018). Colombian political Psychology did not follow a homogeneous and linear development. The reality experienced by Colombians during more than five decades of armed conflict required Psychology to abandon the direct paths of politics and opt for psychosocial studies that promise to be the most radical heirs of a generation of Latin American critical thinking as represented by Ignacio Martín-Baró, Maritza Montero and Silvia Lane.

Resumen El estudio rastrea los elementos históricos que han influido en el desarrollo del pensamiento político-crítico en la psicología colombiana. Se identifican y discuten cuatro periodos históricos: el colonialismo intelectual de la psicología colombiana (1947-1960); la psiquiatría social en los años de La Comisión (1961-1980); la psicología comunitaria y la convivencia (1980-1991); y, finalmente, los estudios psicosociales tras los recientes procesos de paz entre el Gobierno y los grupos armados (1991-2018). La psicología política colombiana no siguió un desarrollo homogéneo y lineal. La realidad vivida por los colombianos durante más de cinco décadas de conflicto armado exigió que la psicología abandonara los caminos directos de la política y optara por los estudios psicosociales que prometen ser los herederos más radicales de una generación de pensamiento crítico latinoamericano representada por Ignacio Martín-Baró, Maritza Montero y Silvia Lane.

Development of non-invasive ventilation treatment practice for patients with chronic obstructive pulmonary disease:Results from a participatory research project.

OBJECTIVES: Non-invasive ventilation treatment for patients with acute exacerbation of chronic obstructive pulmonary disease is well documented. Communication with patients during treatment is inhibited because of the mask, the noise from the machine and patient distress. Assessing life expectancy and identifying end-stage chronic obstructive pulmonary disease posed difficulties and caused doubts concerning initiation and continuation of non-invasive ventilation as life-sustaining treatment. Health professionals expressed a need for knowledge of patients' perspectives and attitude towards non-invasive ventilation. METHODS: The study adheres to principles of Critical psychological practice research. Data on patients' and health professionals' perspectives were obtained from observations from the ward and semi-structured interviews with 16 patients. A group of health professionals was set up to form a co-researcher group. The co-researcher group described and analysed treatment practice at the department, drawing on research literature, results from observations and patients' interviews. RESULTS: Interviews revealed that 15 patients evaluated treatment with non-invasive ventilation positively, although 13 had experienced fear and 14 discomfort during treatment. The co-researcher group described health professionals' perspectives and analysed treatment practice based on data from patients' perspectives developing new management strategies in clinical practice with non-invasive ventilation. CONCLUSION: The participatory approach enabled continuous and complementary development of knowledge and treatment practice. The investigation of patient perspectives was particularly productive in qualifying cooperation among health professionals. The study resulted in preparing, and implementing, new clinical strategies.