Skip to main content
Social Sci LibreTexts

1.12: The Diagnostic Process

  1. Last updated
  2. Save as PDF
  • Page ID
    221605

    • \( \newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \)

    \( \newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}} \)

    \( \newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\)

    ( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\)

    \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\)

    \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\)

    \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\)

    \( \newcommand{\Span}{\mathrm{span}}\)

    \( \newcommand{\id}{\mathrm{id}}\)

    \( \newcommand{\Span}{\mathrm{span}}\)

    \( \newcommand{\kernel}{\mathrm{null}\,}\)

    \( \newcommand{\range}{\mathrm{range}\,}\)

    \( \newcommand{\RealPart}{\mathrm{Re}}\)

    \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\)

    \( \newcommand{\Argument}{\mathrm{Arg}}\)

    \( \newcommand{\norm}[1]{\| #1 \|}\)

    \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\)

    \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\AA}{\unicode[.8,0]{x212B}}\)

    \( \newcommand{\vectorA}[1]{\vec{#1}}      % arrow\)

    \( \newcommand{\vectorAt}[1]{\vec{\text{#1}}}      % arrow\)

    \( \newcommand{\vectorB}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \)

    \( \newcommand{\vectorC}[1]{\textbf{#1}} \)

    \( \newcommand{\vectorD}[1]{\overrightarrow{#1}} \)

    \( \newcommand{\vectorDt}[1]{\overrightarrow{\text{#1}}} \)

    \( \newcommand{\vectE}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash{\mathbf {#1}}}} \)

    \( \newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \)

    \( \newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}} \)

    \(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)
    Learning Objectives
    • Explain the steps and people involved in the diagnostic process, including the case formulation

    The word diagnosis commonly refers to the identification of the nature and cause of an illness. When a mental health professional diagnoses a client or patient, the first steps can be summarized as gathering information, narrowing down the options, and formulating a diagnostic impression.

    The diagnostic process involves gathering relevant information from a person through a detailed interview that includes finding out the person’s main concerns, their symptoms, and their life history. This information includes the results from psychological tests or questionnaires and may include information obtained from the person’s family and/or from previous treatment records. Mental health professionals use this first phase of working with clients before proceeding with the treatment itself. More specifically, before a diagnosis is given, they determine whether the person’s symptoms match the DSM’s criteria for a particular mental disorder, and if there is a significant level of disturbance in the person’s cognitive, emotional, or behavioral functioning.

    Planning the Treatment

    Following an initial assessment, the client or patient and therapist come to an agreement called the treatment plan. This is a type of contract that specifies the goals of treatment; treatment procedures; and a regular schedule for the time, place, and duration of their treatment sessions. Sometimes this treatment contract is written down explicitly, but more often it is discussed between the individual seeking therapy and therapist.[3] Services are based in psychiatric hospitals or in the community. Determining the treatment site (most often private therapist’s outpatient clinic or office) is an important part of planning treatment. Community mental health centers (CMHCs) provide for community-based care as an alternative to institutionalization. At these centers, patients can be treated while working and living at home.

    The importance of the therapeutic relationship, also known as therapeutic alliance, between client and therapist is often regarded as crucial to psychotherapy. Psychotherapy focuses on the use of psychological methods, particularly when based on regular personal interaction with adults, to help a person change behavior and overcome problems in desired ways. Psychotherapists may be mental health professionals such as psychiatrists, psychologists, mental health nurses, clinical social workers, marriage and family therapists, or professional counselors. Psychotherapy aims to improve an individual’s well-being and mental health; to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions; and to improve relationships and social skills. There is also a range of psychotherapies designed for children and adolescents, which typically involve play. Certain psychotherapies are considered evidence-based for treating diagnosed mental disorders. Others have been criticized as pseudoscience. There are over a thousand different psychotherapy techniques, some being minor variations, while others are based on very different conceptions of psychology, ethics (how to behave professionally), or techniques. Most involve one-to-one sessions between the client and therapist, but some are conducted with groups, including families.

    Although clinical and counseling psychologists and psychiatrists share the same fundamental aim—the alleviation of mental distress—their training, outlook, and methodologies are often different. Perhaps the most significant difference is that psychiatrists are licensed physicians, and, as such, psychiatrists are apt to use the medical model to assess mental health problems and to also employ psychotropic medications as a method of addressing mental health problems. Psychologists generally do not prescribe medication, although in some jurisdictions they do have prescription privileges. In five U.S. states (New Mexico, Louisiana, Illinois, Iowa, and Idaho), psychologists with post-doctoral clinical psychopharmacology training have been granted prescriptive authority for mental health disorders. Clinical and counseling psychologists receive extensive training in psychological test administration, scoring, interpretation, and reporting, while psychiatrists are not trained in psychological testing.

    Link to Learning

    This APA article, “Understanding Psychotherapy and How It Works” provides a good introductory overview of what you can expect during psychotherapy.

    Evidence-Based Practice and Ethical Duties

    Professional competence—the ability to accurately assess problems, diagnose psychological disorders, recommend an appropriate course of treatment, and successfully carry out that treatment—varies depending on the degree to which the clinician keeps up to date with the latest research and effectively evaluates the evidence. The APA requires that clinicians be trained in evidence-based practice (EBP) to be equipped to appraise the range of evidence regarding the efficacy of different forms of psychotherapy, to recognize the strengths and limitations of clinical intuition, and to understand the importance of patient preferences and values as well as the relevance of the socio-cultural context in treating clients.

    Try It

    Glossary

    clinical and counseling psychologists: mental health professional with training in behavioral science who provide direct service to clients

    confidentiality: therapist cannot disclose confidential communications to any third party, unless mandated or permitted by law

    diagnosis: refers to the identification of the nature and cause of an illness or the identification of the nature and cause of something

    individual therapy: treatment modality in which the client and clinician meet one-on-one

    intake: therapist’s first meeting with the client in which the therapist gathers specific information to address the client’s immediate needs

    psychiatrists: licensed physicians (MD) with specialized training in diagnosing and treating people with psychological disorders

    psychologist: health care professional offering psychological services

    therapeutic relationship: the relationship between a health care professional and a client (or patient)

    treatment plan: collaborative goal setting or outline of how therapy takes place

    1. Halpern, L, Trachtman, H. and Duckworth, K. "From Within: A Consumer Perspective on Psychiatric Hospitals," in Textbook of Hospital Psychiatry, S. Sharfstein, F. Dickerson and J. Oldham eds. American Psychiatric Publishing, 2009, pp. 237–244. ↵
    2. Deb, K. S., & Balhara, Y. P. (2013). Dhat syndrome: a review of the world literature. Indian journal of psychological medicine, 35(4), 326–331. https://doi.org/10.4103/0253-7176.122219↵
    3. “What Is Psychotherapy?” American Psychological Association . https://www.apa.org/ptsd-guideline/patients-and-families/psychotherapy ↵
    4. wikiHow. “How to Write a Mental Health Treatment Plan.” Accessed December 9, 2020. https://www.wikihow.com/Write-a-Mental-Health-Treatment-Plan. ↵
    CC licensed content, Shared previously
    All rights reserved content

    This page titled 1.12: The Diagnostic Process is shared under a CC BY 4.0 license and was authored, remixed, and/or curated by Lumen Learning.