As part of a wider review of the ISPS UK Group organisational structure and functioning, a group-based values clarification exercise was conducted in September 2014. This led to the generation of an initial cluster of themes. Following a series of reviews and critical discussions over the last 6 months (some face-to-face, others via e-mail) a revised set of statements reflecting the underlying value consensus of the group has been established. This is still a work in progress but at this stage we think it necessary to condense them for ease of immediate communication to ensure a wider scrutiny and feedback from the membership and readership.
Who we are
We are an inclusive organisation interested in the human experience of psychosis and in humane responses to people affected. We aim to promote dialogue about, and understanding of, differing perspectives on the nature of psychosis. We work to increase awareness of, and access to, a diverse range of social, psychological and creative approaches to the psychoses.
The Nature of Psychosis
Psychosis is a term which has no universally agreed definition. We use it here as an umbrella term for a range of unusual human experiences such as hearing voices, believing unusual things, finding it difficult to think clearly or feeling that oneself or the world around has changed. The impact of these experiences can range from enjoyable and productive through to bearable and manageable to distressing and disabling. We recognise that uncritical use of this term can pathologise and stigmatise; can obscure the human experience and can stop the quest for an understanding of the experience and the unique combination of factors which contribute to it.
Treatment and prevention of psychosis
Experiences labelled psychotic like all human experiences are shaped by our past and present relationships; life experiences and our biological make up. By paying attention to psycho-social causes it may be possible to prevent some people experiencing the more disabling effects of psychosis. Biological treatments, although useful at some stages for many people, are not in themselves the only route to supporting individuals with these experiences. Indeed, some individuals may choose to live with psychotic experiences rather than try to change them.
Making sense of Psychosis
Individuals with psychotic experiences and their families should be offered support in telling their stories and making sense of such experiences. Whilst some people may find it reassuring to receive a diagnosis others may find it unhelpful. Professionals should respect the person’s narrative and the understandings and insights generated and should not impose interpretations which close down such understandings.
There are many routes to minimising the impact of psychotic experiences and the pace of recovery varies. Access to information which promotes choice about what is available is crucial and professional interventions should not be limited to those recommended by diagnosis-based guidelines. The range would include psycho-social and psychological approaches; creative approaches; peer support and medication delivered by appropriately skilled staff. Effective psychological help is not just what happens in a clinic or formal therapy situation but can occur through informal everyday encounters with non-professionals.
The effectiveness of professional help is dependent on the quality and continuity of the relationship with practitioners in which trust and positive rapport are crucial.
It is important for professionals to use non-stigmatising, non-judgemental, compassionate and empathic approaches that genuinely empower and respect the uniqueness of each individual. Professionals should work collaboratively with service users; maintain a sense of curiosity; respect the power of the imagination; promote a sense of hopefulness and cultivate a capacity to tolerate continued uncertainty. To provide care which meets these standards, professionals need to be adequately supported with opportunities to reflect on their work.
Clinical practice should be based on a wide range of evidence incorporating quantitative and qualitative research, including narrative testimonies of people with lived experience as well as professional experience and judgement and, should not be dominated solely by research findings from randomised controlled trials.
The need for change
Mental health services need to change fundamentally if these standards are to be met.
We welcome your comments on this condensed version of the belief statements which reflect the underlying values of the ISPSUK Group.
Please send your comments to firstname.lastname@example.org