The Power Threat Meaning Framework - A comment from someone with OCD

Blog written by 'Gingerbreadgirl', March 2018. The Power Threat Meaning Framework document was published earlier this year, which was described as an alternative to traditional diagnosis, developed and led by a group of senior psychologists funded by the British Psychological Society’s Division of Clinical Psychology. Click the link to read the full Power Threat Meaning Framework or a shorter overview.

The Power Threat Meaning Framework

It is said that the average OCD sufferer waits seven years before reaching out for help. That help can come in many forms - whether speaking to a GP, a close friend, or someone at a charity like OCD-UK.  For many people, reaching out for help can be terrifying – intrusive thoughts can leave you feeling exhausted, isolated, even like you’re going mad. 

For me, finding out about OCD, learning that it is an explanation for so many of my experiences, and finally receiving a formal diagnosis, have been crucial in me getting to grips with my illness and understanding it.

For me, finding out about OCD, learning that it is an explanation for so many of my experiences, and finally receiving a formal diagnosis, have been crucial in me getting to grips with my illness and understanding it.  Equally crucially, it has given me a useful shorthand for explaining to those closest to me why I experience such bizarre thoughts and behaviours - knowing I have a recognisable disorder has been so important to me.

I therefore find it slightly concerning that recently the proposed 'Power Threat Meaning Framework' proposes a move away from the use of diagnosis for mental health conditions, including OCD.  There is a significant group within the clinical psychology community who believe that such diagnoses are stigmatising and remove flexibility and individual context within treatment. They believe that such diagnoses being on a person's record can cause issues and prejudice later in life, and even that psychiatric conditions don't really exist and are simply part of a person's complex life circumstances. Most significantly, some (not all) of those who argue this case believe in it even if the client personally values having a diagnosis.

As I am not a healthcare professional, I don't know all the ins and outs of the current debate.  I also can't speak on behalf of sufferers of other types of mental health conditions, or even other OCD sufferers.

I think it is extremely important for those who value diagnosis, and have even found it life-saving, to have this view respected. 

I agree with some aspects of this - such as the importance of seeing everyone as an individual rather than just a diagnosis, the importance of not being defined by a diagnosis, and the value of individual choice not to have a diagnosis.  However, I think it is extremely important for those who value diagnosis, and have even found it life-saving, to have this view respected. 

OCD is a unique condition with a specific type of treatment.  Knowledge of the condition is variable even among healthcare professionals.  Having a diagnosis of OCD allows an individual to have more confidence that they are accessing the right type of treatment (CBT) rather than relying on the therapist or psychologist to treat correctly in the absence of a diagnosis. 

I believe it is essential that the patient's individual circumstances, personality, values, co-morbidities etc. are considered in conjunction with a diagnosis.  But this does not in my opinion mean diagnoses are harmful.

Also, I believe it is more than possible for diagnosis to be used in conjunction with a more personal formulation. Indeed I believe it is essential that the patient's individual circumstances, personality, values, co-morbidities etc. are considered in conjunction with a diagnosis.  But this does not in my opinion mean diagnoses are harmful or somehow preclude this kind of personal treatment.

I think this debate will go on and it is unlikely for diagnosis to be removed from psychological treatment altogether, at least not any time soon.  I do believe though that is a concerning direction for clinical psychology to take as a profession, and the views of service users should be very carefully considered. 

I would never have found this website and support without the label ‘OCD’, it has been life-changing.

I know I would be lost without having a name to put to my experience.  I have found information, other sufferers to connect with, and a way of dealing with my thoughts – all through stumbling on the OCD-UK website.  I would never have found this website and support without the label ‘OCD’, it has been life-changing.

- by Gingerbreadgirl.

OCD-UK Comment: We support the views shared by Gingerbreadgirl, which appear to be generally mirrored by those with OCD who have commenting on the proposed Power Threat Meaning Framework document.

We remain disappointed how some of the authors and health professional supporters of the proposed framework have routinely dismissed the views and concerns of those with lived experience of OCD since its publication.

OCD-UK would like to see far greater dialogue and consultation with a greater number of health professionals and most importantly to see the views and feelings of those with lived experience of all types of mental health problems, including those with OCD both heard and respected with future framework consultation.

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