Diagnosis and formulation: what should we tell the students?
Appropriately assessing and coherently conceptualising psychological problems are important precursors to delivering effective interventions. In this regard, trainee psychologists and, in particular, clinical psychology trainees, are faced with a dilemma. Training programme documentation is unequivocal in its emphasis on formulation in preference to diagnosis. In practice, however, diagnosis is often seen as an important skill for a clinician to develop. A lack of clarity concerning the relationship between diagnosis and formulation is reflected in the literature. In this paper we highlight training programme documentation from both Australia and the United Kingdom to illustrate the clarity that exists. We also summarise the literature with regard to the confusion surrounding the relationship between formulation and diagnosis and we explore the concept of psychiatric diagnosis from a definitional perspective. It appears that even the creators of psychiatric classificatory systems are not clear about exactly what a psychiatric diagnosis is. We conclude by offering some suggestions to improve the situation and to assist psychologists to make a greater contribution to the understanding and amelioration of psychological distress.
Centre for Remote Health, A Joint Centre of Flinders University and Charles Darwin University, Alice Springs, NT, Australia. teamcarey@thecareys.id.au
Timothy A
TA
Carey
David
D
Pilgrim
D032921:Consensus; D003299:Cooperative Behavior; D003479:Curriculum; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D033183:Interdisciplinary Communication; D007397:Internship, Nonmedical; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D011361:Professional Competence; D011586:Psychology, Clinical / Q000193:education*; D011613:Psychotherapy / Q000193:education*