Parents’ constructions of normality and pathology in child mental health assessments

Abstract

Central to a contemporary understanding of childhood is the developmental and clinical‐medical construct of the ‘normal’ child. When judged to fall outside of culturally, socially and historically situated parameters of ‘normality’, children become labelled as ‘deviant from the norm’; for instance, in mental health contexts where this may provide the basis for psychiatric diagnosis. However, judgements of a child's ‘normality’ are further complicated by the range of individuals who may have a stake in that construction, including parents/carers, professionals and the child themselves. Using discursive psychology, we analysed 28 video‐recorded UK child mental health assessments, to examine ways that parents presented concerns about their children's development. They did this by drawing on notions of ‘ab/normal’, in ways that functioned to legitimise their need for services and built a rhetorical case to demonstrate clinical need; often by contrasting the child with other ‘typical’ children and/or contrasting the same child's behaviour in different settings or contexts. We concluded that given the growing crisis in child mental health, initial assessments play a crucial clinical role in determining diagnosis and labelling, and therefore, a critical discussion of these concepts and processes is essential.

The social construction of stigma: Utilizing discursive psychology for advancing the conceptualization of stigma in mental health.

“…The institutional business of a mental health assessment is to determine the presence or absence of a mental health condition for the child, and, in such interactions, parents typically build a case by illustrating doctorable reasons for attendance in the clinic (O’Reilly et al, 2017). In so doing, the persuasiveness of the case rests on the social construction of the “normal child” and some contrastive work to illustrate how this child does not conform in some way (O’Reilly et al, 2020). Parents utilize a range of discursive devices to accomplish this institutional business, and one such device is to appeal to the possible impact on them as a family in social situations with others.…”

Promoting the Value of Discursive Psychology for the Field of Human Resource Development: A Pedagogical Guide for Qualitative Researchers

“…Thus, building a large interactional data set (e.g., 40 hours of talk) focused on a particular phenomenon of interest can be quite useful; however, this is not always necessary given even small amounts of interactional data (e.g., 1 hour of talk) can offer important and robust insights. In published DP literature, there are a range of sample sizes, with some including six hours (e.g., Lester, Karim, & O'Reilly, 2014), and others including well over 30 hours (O'Reilly, Muskett, Karim, & Lester, 2020) or even more than 100 hours (Lester, 2014). There are no hard and fast rules about the size of the dataset, but rather a researcher must consider what they hope to make sense of and how the size of the dataset can support them in this process.…”

Tarinan vastaanotto ja affiliaatio autismikirjon häiriössä

“…Keskustelunanalyysin (KA) potentiaali autismikirjon tutkimuksessa on monipuolinen (ks. katsaukset O´Reilly, Lester & Muskett, 2016;Stevanovic & Koskinen, 2018). KA-tutkimuksessa korostuu toiminnan rakentuminen yhdessä muiden kanssa, jolloin autismikirjon henkilöiden epätyypillisenä tai ongelmallisenakin pidettävä toiminta voi näyttäytyä mielekkäänä.…”