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Performing Autonomy: Accounting for Agency in Clinical Psychology through the Ontological Choreography of Patients, Services, and Professional Knowledge

Wednesday 11th January 2023 (13:00-14:00)

All are very welcome to join this seminar via MS Teams.

Our seminar series will feature speakers who will use ideas from science and technology studies and related fields to illuminate their area of study. If you would like more information about ISS, or would like to give a presentation in the future please contact ISS Director, Pru Hobson-West.


ISS Seminar Series 20223/23 

Speaker: Professor Martyn Pickersgill, University of Edinburgh


Wide-ranging efforts have been made across the UK to enhance access to psychological therapy. Clinical psychologists are key providers of and gatekeepers for therapy. This talk is concerned with how this professional group foster access (or not) to psychological care, and how their autonomy is performed in the process.

Following a referral, psychologists must resolve an uncertain situation: should they accept a referral and continue with an assessment? Thereafter, they must decide whether a patient is suitable for their service – in fact, for therapy more generally. Synthesising certainty entails the performance of a certain form of autonomy that is structured by - indeed, constituted through - epistemic and moral norms, wider explicit and implicit challenges to expertise, significant economic constraints, and sometimes powerful pressures to meet service targets. In sketching out these issues, I draw on interviews with 40 psychologists across England and Scotland.

Taking cues from medical sociology and science and technology studies, I speak to some of the uncertainties around access to psychological therapy, and how decisions made by clinical psychologists involve the ontological choreographies of patients, services and professional knowledges.


Martyn Pickersgill is Personal Chair of the Sociology of Science and Medicine at the University of Edinburgh, and convenes the Social Dimensions of Biomedicine Lab. His research focuses on the production, circulation, and instantiation of biomedical and psychological knowledge within academia, healthcare, policy, and everyday life. Current projects that Martyn participates in or leads are supported by the AHRC, ESRC, MRC, Leverhulme Trust, and Wellcome Trust.

Based in Edinburgh’s Usher Institute, an interdisciplinary public health department of over 300 staff across a range of fields, Martyn serves as its Director of Research and as Associate Director of the Wellcome Trust-supported Centre for Biomedicine, Self and Society. He is also Co-Director of the Wellcome Trust 4yr PhD Programme in ‘One Health Animal Models of Disease: Science, Ethics and Society’. Martyn is a recipient of the Henry Duncan Medal from the Royal Society of Edinburgh and a Fellow of the UK Academy of Social Sciences.

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Institute for Science and Society
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Law and Social Sciences
University of Nottingham
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