Technoscientific Knowledge Tensions of Mental Health Care Work: Negotiating Theoretical Orientations and Therapeutic Standardization

• In Event: 067 - Section on Science, Knowledge and Technology Roundtables (one-hour)
  In Refereed Roundtable: Table 03. Classification Work

Abstract

Mental health care work involves the practical application of scientific knowledge and Biopolitical governance in the form of technoscientific standardization. This paper examines how Mental Health Practitioners (MHPs) negotiate biomedical and professional standardization. Employing an interpretive, feminist version of grounded theory, 40 interviews with MHPs were analyzed. I examine MHPs theoretical orientations to mental illness as well as their negotiations of clinical practice standards in the form of Evidence Based Practices (EBPs). It isn’t biological psychiatry and EBPs in and of themselves that MHPs dislike, but the way insurance companies use the biomedical model and EBPs as procedural standards to constrain or control services that is problematic. EBP protocols have shifted not only the language of psychotherapeutic practice, but in some cases, the actual content. EBPs have been used by insurers in a way that privileges some theoretical orientations and treatments over others to the extent that many mental health professionals claim they cannot perform therapy the way they were trained. MHPs value scientific evidence and proven techniques, but not to the extent that they value the diagnosis or disorder more than individual patient subjectivity, the therapeutic relationship and the social conditions of their patients seeking treatment. MHPs’ clinical expertise has been called into question and deprofessionalized to the extent that they are significantly less able to make decisions about the proper theoretical orientation, diagnoses and treatment techniques in their work with patients.

Author

• Amber D. Nelson, Marian University