Troubled young girl comforted by her boyfriend.

Treating the Person Versus Treating A Diagnosis

Every day in my practice I am asked by a client what diagnosis they have or by a parent what the diagnosis is for their family member. What I always tell clients is that while I understand that they would like to hear exactly what is wrong so we can fix it…the truth is that with mental health it’s not always that clear. In an attempt to make mental healthcare more legitimate to the medical field and the insurance companies, we adopted a more model where we have specific diagnoses that have to follow criteria to warrant a diagnosis. Now don’t get me wrong, the DSM (Diagnostic And Statistical Manual For Mental Illness) is a great tool and is on its 5th revision. It really helps clinicians conceptualize a client and help guide us in determining the treatment of some of our clients.

The main issue is that unlike medical problems, many of the mental health problems that people experience can be shades of gray and often there is co-morbidity (multiple diagnoses) that cloud the clinical picture. When doing an intake of a difficult case, I will be given report after report with contradictory diagnoses and the sad truth is that while the parents are asking what the diagnosis is, we are forgetting that we are treating a person….not a diagnosis. We can call it Captain Crunch Disease but the truth is that the way myself and the people in my practice view it…we treat people with symptoms and regardless of what we call it we are going to treat the symptoms specific to that client. Diagnoses often are more for clinicians to conceptualize in our heads but we don’t have to label it and lock ourselves into the label of X or Y and what comes with that diagnosis.

I am the type of clinician who believes that every client who walks into my office has strengths and weaknesses and it is my job to understand the person as a whole and find a treatment approach that works for them and takes into account who they are, what their life is like, and what is important to them. We try to take what they do well and use that as a tool to help overcome the areas that they are having problems in.

There are times when having a diagnosis such as ADHD, Autism Spectrum Disorders, etc. can be liberating for a client to know that they are not “dumb” or “weird” and that there is an understanding of the problem and hope for the future. I tend to pride myself on being an excellent diagnostician and understand everything that goes into developing a clear diagnosis, but let’s not lose sight of the person in the process.