TY - JOUR

T1 - “The Depressed” and “People with Anxiety” therapists’ discursive representations of patients with depression and anxiety in Danish Psychiatry

AU - Christensen, Anne Bryde Bryde

AU - Dyrloev, Karoline

AU - Hoej, Michaela

AU - Poulsen, Stig

AU - Reinholt, Nina

AU - Arnfred, Sidse

N1 - Publisher Copyright: © The Author(s) 2023.

PY - 2024

Y1 - 2024

N2 - Stigmatization within mental health care has previously been identified, and some diagnoses have been shown to be particularly exposed to negative attitudes and stigma. However, no previous studies have explored practitioners’ discursive construction of patients with different diagnoses within a transdiagnostic group context. We performed discourse analysis on 12 interviews with Danish mental health practitioners, who had been conducting either transdiagnostic psychotherapy (The Unified Protocol) or standard group cognitive behavioral therapy (CBT) with patients treated for anxiety disorders or major depressive disorder. The purpose of this study was to identify how patients with anxiety and depression were represented by therapists. We identified a “training discourse,” within which patients were evaluated through perceived motivation, responsibility, active participation, and progression. We argue that this training discourse can be related to a broader neoliberal order of discourse valuing efficiency and agency. The analysis indicated that patients with anxiety were sometimes “favorized” over patients with depression, and it is argued that the neoliberal order of discourse and pre-assumptions related to the diagnoses are contributing to this. The interviews indicate that multiple discourses were applied when describing patients, and ambivalence was often detectable. We discuss the findings of the analysis in relation to therapists’ general critical attitudes toward the psychiatric system and in relation to broader societal tendencies.

AB - Stigmatization within mental health care has previously been identified, and some diagnoses have been shown to be particularly exposed to negative attitudes and stigma. However, no previous studies have explored practitioners’ discursive construction of patients with different diagnoses within a transdiagnostic group context. We performed discourse analysis on 12 interviews with Danish mental health practitioners, who had been conducting either transdiagnostic psychotherapy (The Unified Protocol) or standard group cognitive behavioral therapy (CBT) with patients treated for anxiety disorders or major depressive disorder. The purpose of this study was to identify how patients with anxiety and depression were represented by therapists. We identified a “training discourse,” within which patients were evaluated through perceived motivation, responsibility, active participation, and progression. We argue that this training discourse can be related to a broader neoliberal order of discourse valuing efficiency and agency. The analysis indicated that patients with anxiety were sometimes “favorized” over patients with depression, and it is argued that the neoliberal order of discourse and pre-assumptions related to the diagnoses are contributing to this. The interviews indicate that multiple discourses were applied when describing patients, and ambivalence was often detectable. We discuss the findings of the analysis in relation to therapists’ general critical attitudes toward the psychiatric system and in relation to broader societal tendencies.

KW - discourse analysis

KW - experiencing illness and narratives

KW - mental health

KW - patient-physician relationship

U2 - 10.1177/13634593231173802

DO - 10.1177/13634593231173802

M3 - Journal article

C2 - 37191112

AN - SCOPUS:85161624833

VL - 28

SP - 390

EP - 411

JO - Health (United Kingdom)

JF - Health (United Kingdom)

SN - 1363-4593

IS - 3

ER -