An alternative to conventional mental health diagnosis

As Counselling Psychologist, I attempt to understand a client holistically and in a place beyond medical models and the DSM. One such method for understanding holistically, is the The Power Threat Meaning Framework (PTMF). The PTMF was developed by a group of senior psychologists and service user campaigners, led by Dr. Lucy Johnstone and Professor Mary Boyle. The PTMF sees people as actively making choices and creating meaning in their lives and recognises that emotional distress and troubled or troubling behaviour are intelligible responses to a person's history and circumstances that can only be understood with reference to the cultures in which they occur.

When delivered as a guided, therapeutic discussion, the overarching questions asked in the PTMF are, “What has happened to you? How did it affect you? What sense do you make of it? What did you do to survive? What are your strengths? What is your story?” The PTMF offers several benefits by shifting the focus from diagnostic labels to understanding the context and impact of power dynamics, threats, and individual meaning-making in experiences of distress. It emphasizes a narrative-based approach, encouraging individuals to develop more hopeful and empowering stories about their lives, rather than viewing themselves as inherently flawed or "mentally ill”.