Stepping out of the box: broadening the dialogue around the organizational implementation of cognitive behavioural psychotherapy.
The dissemination and uptake of cognitive behavioural interventions is central to the evidence-based mental health agenda in Britain. However, some policy and related literature, in and of itself social constructed, tends to display discursive naïvety in assuming a rational basis for the dissemination and organizational integration of cognitive behavioural approaches. Rational constructions fail to acknowledge that the practice settings of key stakeholders in the process are likely to be socially constructed fields of multiple meanings. Within these, the importance of evidence-based interventions may be variously contested or reworked. To illustrate this, a case example from the first author will discuss the hypothetical introduction of a cognitive behavioural group for voice hearers in a forensic mental health unit. This will highlight contradictions and local organizational problems around the effective utilization of postgraduate cognitive behavioural knowledge and skills. A synthesis of social constructionist with organizational theory will be used to make better sense of these actual and anticipated difficulties. From this basis, specific ways in which nurses and supportive stakeholders could move the implementation of cognitive behavioural psychotherapy agenda forward within a postmodern leadership context will be proposed.
Poole
J
J
Institute of Nursing and Midwifery, University of Brighton, Eastbourne, East Sussex BN20 7UR, UK.
Grant
A
A
D019985:Benchmarking; D015928:Cognitive Behavioral Therapy / Q000458:organization & administration*; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D005555:Forensic Psychiatry / Q000458:organization & administration; D006212:Hallucinations / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D033181:Information Dissemination; D007857:Leadership; D015403:Nursing Evaluation Research; D009742:Nursing Theory; D010554:Personality Disorders / Q000628:therapy; D010687:Philosophy, Nursing; D033302:Postmodernism; D017410:Practice Guidelines as Topic; D016730:Program Development; D011568:Psychiatric Nursing / Q000458:organization & administration*; D011615:Psychotherapy, Group / Q000458:organization & administration; D012559:Schizophrenia / Q000628:therapy; D013222:State Medicine / Q000458:organization & administration; D006113:United Kingdom