Do I Need a Diagnosis?

Shannon M. Duffy, MFT, LCPC

In my professional experience, many individuals and couples have sought out therapy for a diagnosis to give them a label or clarification for what is or has been concerning them. For some, it is necessary to aid in providing the best form of treatment or provide appropriate referral sources for a treatment plan. However, there are also situations where the diagnosis itself can cause distress or even create disruptions within the treatment process. I’d like to focus on what a diagnosis can entail and how it can hopefully help the individual or couple versus creating any added discomfort.

The majority of therapeutic settings whether in private practice or within a hospital setting have an intake or assessment process. Hospital facilities tend to have a very thorough assessment process to gather appropriate information in a quick and efficient manner. Ideally, the presenting symptoms are the focus to collaborate with the Diagnostic and Statistical Manual of Mental Heath Disorders towards assessing if criteria is met to make a specific diagnosis. The process within the private practice sector can be more on going in creating a treatment plan based on the presenting concerns and also allowing enough time within therapy to assess the criteria towards a diagnosis.

A diagnosis is needed for health insurance companies to receive claims and provide benefits for seeking and receiving behavioral health services. If criteria is met for a diagnosis it can be extremely beneficial for aligning care with your primary care physician or psychiatrist if medication would be a component of the treatment plan. The diagnosis can also provide information necessary to note if a higher level of care is needed, such as inpatient treatment or substance abuse treatment. If full criteria is not met even though there are a few symptoms present, many providers will submit an Adjustment diagnosis to address the necessity of mental health treatment which is not labeling the individual for their presenting concerns. The initial diagnosis of Adjustment disorder can lead towards a more specific diagnosis if presented and appropriate if an individual is seeking therapy to adjust to life’s stressors.

Ideally, a diagnosis is helpful for everyone involved, the individual, insurance companies, therapists, and any additional resource providers. However, the diagnosis can create an inconsistent emotional response when it is desired from the individual. An example is an individual seeking therapy to receive a specific diagnosis to use as an excuse or label. I have observed client’s misuse the diagnosis as a crutch or a label to prove there is something “wrong” with them. However, in the therapeutic setting it is beneficial to steer away from the mindset of something is “wrong” and working on creating skills to manage the symptoms. An example is an individual presenting with anxiety, a goal in therapy is to address ways to manage their anxiety. This can aid in understanding the symptoms and behaviors to want to change when the individual is motivated to the therapeutic process for change.

However, some will get set on the diagnosis or label and not want to work on alleviating the symptoms present for the diagnosis. This can create unrealistic expectations for individuals in what therapy can provide for them. Overall, a diagnosis is ethically beneficial for treatment. Ideally, the individual would benefit from not focusing just on the diagnosis and more on how to manage the symptomatic concerns they have to be able to handle life’s stressors.