From the margins to the NICE guidelines: British clinical psychology and the development of Cognitive Behaviour Therapy for Psychosis between 1982-2002

Article


Harper, D. and Townsend, S. 2021. From the margins to the NICE guidelines: British clinical psychology and the development of Cognitive Behaviour Therapy for Psychosis between 1982-2002. History of the Human Sciences. 35 (3-4), pp. 260-290. https://doi.org/10.1177/09526951211027738
AuthorsHarper, D. and Townsend, S.
Abstract

Although histories of Cognitive Behaviour Therapy have begun to appear, their use with people with psychosis diagnoses has received relatively little attention. In this article we elucidate the conditions of possibility for the emergence of Cognitive Behaviour Therapy for Psychosis (CBTp) in England between 1982-2002. We present an analysis of policy documents, research publications and books, participant observation and interviews with a group of leading researchers and senior policy actors. Informed by Derksen and Beaulieu’s (2011) articulation of social technologies, we show how CBTp was developed and stabilised through the work of a variety of overlapping informal, academic, clinical, professional and policy networks. The profession of clinical psychology played a key role in this development, successfully challenging the traditional ‘division of labour’ where psychologists focused on ‘neurosis’ and left ‘psychosis’ to psychiatry. Following Abbott’s (1988) systems approach to professions, we identify a number of historical factors which created a jurisdictional vulnerability for psychiatry whilst strengthening the jurisdictional legitimacy of clinical psychology in providing psychological therapies to service users with psychosis diagnoses. The National Institute for Health and Clinical Excellence (NICE) played a significant role in adjudicating jurisdictional legitimacy and its 2002 schizophrenia guidelines, recommending the use of psychological therapies, marked a radical departure from the psychiatric consensus. Our analysis may be of wider interest in its focus on social technologies in a context of jurisdictional contestation. We discuss the implications of our study for the field of mental health and for the relationship between clinical psychology and psychiatry.

KeywordsCognitive Behaviour Therapy; clinical psychology; psychiatry; schizophrenia; psychosis
JournalHistory of the Human Sciences
Journal citation35 (3-4), pp. 260-290
ISSN1461-720X
0952-6951
Year2021
PublisherSAGE Publications
Accepted author manuscript
License
File Access Level
Anyone
Digital Object Identifier (DOI)https://doi.org/10.1177/09526951211027738
Publication dates
Online28 Sep 2021
Publication process dates
Accepted25 May 2021
Deposited26 May 2021
Copyright holder© 2021 The Authors
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