Team talk and personality disorder : a discursive analysis

• Main Author: Chester, Ruth M.
• Published: University of East London 2006
• Subjects: 150
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.532604

This study's interest lay in how multidisciplinary teams talk together about clients with a diagnosis of personality disorder (PD1 ), and how such talk relates to professional and societal influences. Relationships to wider discourses, power and the creation of knowledge are also considered. Historically PD clients have held a particular role as individuals often excluded from mainstream mental health services. Experiences of exclusion and discrimination dominate service user accounts. There is evidence that mental health professionals and service providers have struggled to provide a satisfactory service response, resulting in clients receiving fragmented care. Exclusion has come to be viewed as reasonable by practitioners. The diagnosis is considered as influenced by moral; social, medical and socio-political influences, and has attracted controversy in relation to its validity, reliability and usefulness. Current proposals to amend mental health legislation and the discourse of risk contribute to the contemporary context. The analyses explored how talk related to constructions of clients, utilising both Discursive Psychological and Foucauldian analytic approaches within a social constructionist epistemological framework, and gathered naturalistic qualitative data from multi-disciplinary team meetings. Services were all adult mental health community services in London. Three Constructions were discussed: as clients in need of mental health service intervention; as clients not in need of mental health service intervention and constructions of clients as manipulative. Particular attention was paid to highlighting ways in which teams managed and negotiated a range of professional views, with a focus on language and the action orientation of discursive resources. These constructions were discussed in the context of literature related to teamwork and social psychological and psychodynamic understandings of interaction and decision making. Clinical implications are considered for a range of interest groups. ' Please note that the term PD will be used throughout to denote clients either with an explicit or implicit Personality Disorder diagnosis.