Beyond Diagnosis to Meaningful Patterns in Emotional Distress: The Power - Threat - Meaning framework and ‘Psychosis’ (half day)

Lucy Johnstone
Dr Lucy Johnstone, Consultant Clinical Psychologist and project leader

Workshop summary

The workshop describes a Division of Clinical Psychology funded project to outline the principles of a conceptual alternative to the diagnostic model of mental health difficulties and distress. It is due to for formal launch in late 2016, and builds on a number of other high-profile BPS and DCP documents, including ‘Understanding Psychosis’ (2014.) The team of psychologists and service users/survivors has developed an alternative approach to identifying patterns in distress, including those that are called ‘psychosis’. It synthesises the causal roles of power, evolved threat responses, social discourses, and personal meanings and narratives, and is called the Power/Threat/Meaning framework. It is argued that although much work remains to be done in fleshing out the suggested patterns in distress, the framework as a whole is based on sound principles and, unlike the current system, is supported by a growing body of evidence from different fields and disciplines. It is intended to provide the basis for an ongoing series of developments in clinical practice with ‘psychosis’ and other presentations, service design and commissioning, professional training, research, and service user involvement. There are also implications for the wider role of equality and social justice in mental health and distress.


  • Describe the key principles of the framework.
  • Demonstrate how the framework might work in practice, with examples and exercises.
  • Invite discussion and feedback about the framework.

Teaching methods Exposition, exercises, discussi