Exploring beliefs, narratives, and understandings of psychosis: insights from literature and staff stories utilising the power threat meaning framework

Purpose: The understanding of the causes of ‘psychosis’ continues to shift over time. The understanding of psychosis can impact people’s perception of individuals with psychosis and the self-perception of those people who experience psychosis and their help-seeking behaviours. This review aimed to synthesise studies that have captured people’s beliefs, understandings and narratives of psychosis and consider how these may have developed.

Methods: A literature review was conducted, followed by a thematic synthesis of the included qualitative studies, focusing on either clinicians, clients, or family members and carers, narratives of psychosis. 11 studies with a total of 228 participants were included. The quality of these papers was assessed using the CASP qualitative quality appraisal tool (CASP, 2018).

Findings: Four themes with a total of five subthemes were identified in the studies used (interpreted by the researcher). These themes explored how relationships, support, and fear of blame can influence individual's’ understanding of psychosis. A lack of understanding may lead to confusion and uncertainty, while the type of support and concern about being blamed can shape beliefs about its causes. The quality of the studies varied.

Conclusions: These themes contributed to, and provided evidence for, the variety and development of individual’s beliefs and understandings of psychosis, and highlighted the importance of relationships, clinical interventions and blame in such understandings. They also highlighted the factors that contribute to individuals not developing a clear understanding of psychosis.