Psychosis, Need Adapted treatment, and psychiatrists' agency

Background: In the Need-Adapted approach (NAA) therapy meetings are a deliberate effort to bring all meaningful parties and views to a common discussion prior to decisions; this constitutes a challenge for psychiatrists’ agency. Aims: To describe how psychiatrists see their agency in NAA. Methods: Using videos of co-research interviews, stimulated-recall interviews of 10 interviewees were conducted and transcribed verbatim. The material was analyzed via an adapted dialogical-narrative analytical method. Results: Institutional forces were experienced as having an enormous impact on psychiatrists’ agency, especially in the inpatient setting, reducing professional creativity. In the outpatient setting, psychiatrists who also attended hospital care were the most able to follow the principles of NAA. Those who only took part in outpatient treatment tended to adopt the position of medical consultants. Conclusions: The ability of psychiatrists to have agency in the language used with the clients is an underrated issue. The interview methods used in the research could be utilized in practice.