A first of its kind scoping review, carried out by Irish researchers, has demonstrated the merits of utilising an alternative framework to the predominant psychiatric diagnostic model of understanding human distress.
The Power Threat Meaning Framework (PTMF) was published by the British Psychological Society’s (BPS) Division of Clinical Psychology in 2018 as an alternative to the Diagnostic and Statistical Manual of Mental Illnesses (DSM), a diagnostic model with a focus on pathologising human experiences.
The PTMF is not a single model or approach, but a broad perspective that includes many aspects of current theory and practice as an alternative to more traditional models based on psychiatric diagnosis.
The scoping review considers in depth the empirical evidence-base across a range of disciplines, settings, and populations which has emerged since the publication of the PTMF.
The paper states:
“The stated aim of the PTMF is to provide a holistic framework for identifying patterns in the origins, experiences and expressions of emotional distress and troubled/troubling behaviour. The framework of thinking presented by the PTMF is intended to differ from the predominant psychiatric diagnostic model of such phenomena. Where the latter tends to focus on pathologising human experiences and behaviours, the former aims to position human experiences and behaviours within the various biological, psychological and social contexts which surround them. The PTMF contains four core concepts, which can be translated into four core questions: (1) power – what has happened to you?, (2) threat – how did it affect you?, (3) meaning – what sense did you make of it?, and (4) threat response – what did you have to do to survive?”
The 17 studies included in the scoping review were conducted across a variety of disciplines (e.g. clinical psychology, forensic psychology, mental health, education) and populations (e.g. prison officers, prisoners, psychology professionals, service users, general public).
The researchers note that “this diversity perhaps reflects the holistic focus of the PTMF, and that despite the fact that the majority of the main PTMF author group had professional backgrounds in psychology, the PTMF has clearly resonated in a variety of settings.”
The paper demonstrates that psychologists are dissatisfied with the dominant psychiatric diagnostic model used in clinical practice.
However, the research notes that while it is promising that interest in and uptake of the PTMF has continued to grow, uptake of such alternatives will be hindered without investment in training, professional collaboration and service-level change.