This article draws upon an extensive review of narrative, discourse, and conversation analyses of psychotherapy in order to outline, critically discuss, and evaluate claims made by these studies regarding the usefulness of these approaches for psychotherapy assessment. These analytic approaches are seen as compatible with the emphasis on language and meaning that characterises much of contemporary therapy theory. The claims regarding what can be evaluated through language-based analysis vary considerably, ranging from assessing the client's problems and/or psychopathology to assessing the degree of change of the client in the process of therapy, the processes through which therapy is carried out, and finally the therapist's interventions. The studies also vary with regard to the extent to which they subscribe to psychotherapeutic assumptions and practices. Along this continuum, the range extends from claims that language-based analysis can be used by therapists themselves to assess clients as part of their routine clinical work to claims that the role of language-based analysis is primarily to evaluate psychotherapeutic assumptions and practices from a critical deconstructive perspective.

Background. Discourse analytic approaches to mental distress have been developed in the last two decades as part of the broader social constructionist movement in psychology. Aims. The paper reviews existing discourse analytic studies on issues pertaining to mental distress, aiming to identify strengths and gaps in the existing literature as well as to assess their contribution to conceptualizing and managing distress. Method. Discourse analytic and social constructionist studies of different aspects of mental distress, conducted within the field of psychology, were identified and reviewed. Results. The studies reviewed have been organized in four themes: (a) exploring users' accounts and experiences, (b) examining professional accounts and practices, (c) focusing on mental health-related public texts and (d) deconstructing clinical categories. Conclusions. The main function of discourse analytic studies on mental distress has been to highlight the historically contingent and socially constructed character of professional forms of knowledge and practice. More specifically, this research trend has highlighted the discursive resources drawn upon to conceptualize mental distress, the discursive practices through which specific versions of distress are constructed and the discursive effects of these constructions for institutions, subjectivity and social practices.

Aims: A trend has emerged in the last two decades which views hearing voices as a meaningful experience and attempts to facilitate both their exploration and the development of effective strategies of coping with them. This study explores the experience of hearing voices, aiming to highlight the complexity of the phenomenon and the meaning that the experience has for the person. Methods: Semi‐structured interviews were conducted with 15 individuals who currently hear voices and are being treated by the Thessaloniki Psychiatric Hospital. The interview material was analysed by the abbreviated version of grounded theory. Results: The two out of six main categories presented in this paper concern: (a) “the function of voices”, which includes what the voices say and how the hearer deals with them; and (b) “understanding hearing voices”, which includes the explanations given by voice hearers regarding the source and origin of voices as well as the relation of voices to reality and to their thoughts. Conclusions: The study highlights that hearing voices is a complex experience which voice hearers deal with in a variety of ways, and that voice hearers develop sophisticated frameworks for making sense of that experience.

Background: Being subjected to or witnessing coercive measures in mental health services can have a negative impact on service users, carers and professionals, as they most often are experienced as dehumanising and traumatic. Coercion should be avoided, but when it does happen, it is important to understand how the experience can be processed so that its consequences are managed. Method: A systematic review and meta-ethnography was used to synthesise findings from qualitative studies that examined service users’, staff’s and relatives’ experiences of recovery from being exposed to coercive measures in mental health care settings. We identified, extracted and synthesised, across 23 studies, the processes and factors that were interpreted as significant to process the experience. Results: Recovery from coercion is dependent on a complex set of conditions that support a sense of dignity and respect, a feeling of safety and empowerment. Being in a facilitating environment, receiving appropriate information and having consistent reciprocal communication with staff are the means through which these conditions can be achieved. People employ strategies to achieve recovery, both during and after coercion, to minimise its impact and process the experience. Conclusions: The findings point to the importance of mental health care settings offering recovery-oriented environments and mental health professionals employing recovery-oriented practices, that would empower service users to develop strategies for managing their mental distress as well as their experiences in mental health care in a way that minimises traumatisation and fosters recovery.

Objectives: The study examines the clinical determinants of involuntary psychiatric hospitalization. Specifically, it investigates whether distinct clinical profiles of hospitalized patients can be discerned, what other characteristics they are linked with, and which profiles predict involuntary admission.Methods: In this cross‐sectional multicentre population study, data were collected for 1067 consecutive admissions in all public psychiatric clinics of Thessaloniki, Greece, during 12 months. Through Latent Class Analysis distinct patient clinical profiles were established based on Health of the Nation Outcome Scales ratings. The profiles were then correlated with sociodemographic, other clinical, and treatment‐related factors as covariates and admission status as a distal outcome.Results: Three profiles emerged. The “Disorganized Psychotic Symptoms” profile, combining positive psychotic symptomatology and disorganization, included mainly men, with previous involuntary hospitalizations and poor contact with mental health services and adherence to medication, indicating a deteriorating condition and chronic course. Τhe “Active Psychotic Symptoms” profile included younger persons with positive psychotic symptomatology in the context of normal functioning. The “Depressive Symptoms” profile, characterized by depressed mood coupled with nonaccidental self‐injury, included mainly older women in regular contact with mental health professionals and treatment. The first two profiles were associated with involuntary admission and the third with voluntary admission.Conclusions: Identifying patient profiles allows the examination of the combined effect of clinical, sociodemographic, and treatment‐related characteristics as risk factors for involuntary hospitalization, moving beyond the variable‐centered approach mainly adopted to date. The identification of two profiles associated with involuntary admission necessitates the development of interventions tailored to chronic patients and younger persons suffering from psychosis respectively.