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A critical realist reflection on the Power Threat Meaning Framework (PTMF) is offered. By way of introduction, critical realism is discussed in relation to varieties of constructivism. It is aligned with earlier forms linked to the symbolic interactionist tradition but not with more recent postmodern forms. This positioning is explained before moving onto a shared agenda of anti-positivism, which in part, explicitly or implicitly, underpinned the collective stance of those writing the PTMF. In particular, epistemic and ontic fallacies associated with psychiatric positivism are explained and a case is made to reinstate the value dimension to mental health work. That case has been evaded by the specious claim of positivism to separate facts from values. Not only should the moral context of patient conduct be addressed but so too the role of psychiatry in society, particularly in relation to coercive social control.

A Critical Realist Reflection on the Power Threat Meaning Framework