I have written extensively about non-diagnostic therapy–one meaningful way of describing the sort of therapy we practice at our downtown NYC therapy center. The phrase is meant to contrast us with the model of how therapy is traditionally practiced wherein an assessment is made in the interest of producing a mental health diagnosis and then, that diagnosis determines the course of treatment based on prevailing standards of practice. This approach is standard in Western medicine and is so termed “the medical model.” Psychotherapy has historically fashioned itself in the image of medicine and therefore, the model in psychotherapy is to follow this same process of assessment, diagnosis and treatment.
And so it is with a full appreciation of the irony that several years ago, I was invited to teach a graduate course in clinical diagnostics at Hunter College School of Social Work. I am trained in diagnosis and was excited for the opportunity to teach the class. But I also hoped I could introduce students to the limitations of diagnosis. I wanted to show them the ways in which it empowers a very narrow class of people to define the scope and terms of emotional and psychological suffering for literally billions of people.
From the syllabus:
“Cognizant of the critical impact of culture, class, ethnicity, race, age, sexual orientation, spirituality, ability, and gender upon the process of diagnosis and social work practice interventions, the conceptual framework for this course is based upon a social work perspective of “normal” and “pathological” behavior including what we mean when we use these terms.”