Cognitive Behavioral Therapy for Chronic Health Problems: A Critical Discourse Analysis of Professional Identity

Increasing recognition has been given to developing tailored psychological therapies for depression and anxiety disorders occurring comorbidly with physical health conditions. Much research to date has assessed clinical outcomes, however little qualitative research exists regarding professionals involved in integrating psychological with physical health treatments for mental health disorders. Five focus groups were conducted with 18 professionals working in NHS Talking Therapies services and allied health professionals in the UK. Data were transcribed and analyzed using Critical Discourse Analysis methodology. Discourses related to expertise, responsibility and innovative practice were found in relation to collaborative care. Discursive repertoires which inhibit and augment access to competency beliefs are explored. Recommendations are made to provide regular opportunities for reflexivity and responding to clinical complexity. The research highlights the niche set of behaviors, skills, adapting values and attitudes under construction by integrated therapists and the way in which their role shapes and is shaped by their interactions with counterparts.