The Power Threat Meaning Framework: Addressing adversity, challenging prejudice and stigma and transforming services

Advocates of a biomedical approach have argued that: it provides an evidence-based approach to classifying and understanding the causes of problems; adopting a biomedical understanding will reduce stigma; and biomedical interventions are effective and evidence-based. This article reviews the literature and finds not only that there is little or no evidence for these assumptions but that, in fact, the research evidence points to the need for the kind of alternative approach proposed by the PTMF. Alternative causal models which recognise the role of psychosocial adversities are described and alternative approaches to diagnostic classification and destigmatisation programmes are suggested and innovative attempts to redesign services in a manner consistent with the PTMF approach are described. The article concludes by discussing implications for policy-level change.