Some terms used by therapists to describe clients have meanings which wonâ€™t be found in textbooks. Use of these terms is rarely of benefit to the client, although the term may say as much about the therapist as the client.
- resistant to treatment
- lacking motivation
- poor historian
- personality disordered
As diagnostic systems have developed, common place words have been redefined more narrowly & precisely for clinical use (eg: anxiety, depression).
As therapeutic professions have developed, there has been a less auspicious development: diagnostic labels have developed double meanings and common place words have been elevated to the level of diagnoses without the scientific scrutiny afforded official classifications.
A diagnosis is a therapistâ€™s shorthand. The idea is that a single label will tell you not only the clientâ€™s current symptoms but also how they can be expected to change over time and what is the most effective treatment. Diagnostic systems such as the World Health Organisationâ€™s International Classification of Diseases (ICD) and the American Psychiatric Associationâ€™s Diagnostic & Statistical Manual (DSM) are employed across the world.
Unofficial diagnoses also indicate how the client is perceived by their therapist and may dictate how the clientâ€™s treatment will proceed (if at all). As these definitions are unwritten, this information is not available to clients.
Many therapists reject these cynical re-interpretations. The misuse of these labels says much about a therapistâ€™s biases and prejudices. Moreover, the perceptions and judgements that lead to their misuse probably say as much about the clientâ€™s experience of the therapist as they do about the client.
Diagnoses with double meanings create scope for confusion and poor practice:
- a diagnostic label applied objectively may be interpreted more cynically by other therapists, to the detriment of the client
- a label applied dismissively may be taken at face value by other therapists to the detriment of the client and the service
- therapists may collude in the cynical use of a label, to the detriment of all clients so labelled
How many of the above labels do you use and how certain are you that your colleagues share your interpretation of them?