Trauma-informed Approaches: Moving Beyond Psychiatric Diagnosis with Dr Lucy Johnstone

Have you ever stopped to ask whether people need a psychiatric diagnosis? Or, rather than asking ‘What is wrong with you?” in order to try and understand how to heal someone suffering mental distress, should the question actually be: “What has happened to you?”’ 

Mental distress is very real. But what we are very rarely told is that the dominant explanations for these experiences – that they are ‘symptoms’ of an ‘illness’ caused by a ‘chemical imbalance’ which psychiatric drugs will rectify - has never had any evidence to support it. This will feel to many of us a very controversial viewpoint in a world where the ‘biomedical model’ of distress has taken such a hold of public consciousness and become the accepted system in Western society. Yet, as levels of distress seem to be increasing in our society, along with a rise in prescriptions, it is difficult to ignore.

In response to a failing ‘biomedical model’ where we give labels to mental health “disorders” and “conditions”, we now have a range of alternatives to the diagnostic approach. These alternatives focus around listening to people’s stories – stories that often, though not always, involve trauma, abuse, loss, neglect, poverty and discrimination. Lucy will describe the trauma-informed approach to mental distress, and a recent project, the Power Threat Meaning Framework, which aims to take us beyond the failed diagnostic paradigm.

SPEAKER: Dr Lucy Johnstone

Dr Lucy Johnstone is a consultant clinical psychologist, author of 'Users and abusers of psychiatry' (2nd edition Routledge 2000) and co-editor of 'Formulation in psychology and psychotherapy: making sense of people's problems' (Routledge, 2nd edition 2013) and ‘A straight-talking guide to psychiatric diagnosis’ (PCCS Books 2014), along with a number of other chapters and articles taking a critical perspective on mental health theory and practice. She is the former Programme Director of the Bristol Clinical Psychology Doctorate and was the lead author of 'Good practice guidelines on the use of psychological formulation' (Division of Clinical Psychology, 2011.) She has worked in Adult Mental Health settings for many years, most recently in a service in South Wales. She was lead author, along with Professor Mary Boyle, for the ‘Power Threat Meaning Framework’ (2018), a Division of Clinical Psychology-funded project to outline a conceptual alternative to psychiatric diagnosis.

Lucy is an experienced conference speaker and lecturer, and currently works as an independent trainer. Her particular interest and expertise is in the use of psychological formulation, in both its individual and team versions, and in promoting trauma-informed practice. 

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