Challenges in Diagnosis in Couple and Family Systems Work

Abstract

Choosing to use a formal diagnosis in couples and family counseling can be a treatment conundrum for counselors who believe they must provide a diagnosis. To create a diagnosis for financial reimbursement is a fraudulent and an unethical practice. This article addresses diagnosis in couples and family work and offers strategies to use when not diagnosing.

Family and Systems Theory in Counselor Education: A PRISMA Systematic Review

“…Articles included in the disorders secondary theme recommend that our conceptualization of a disorder in the identified client or family recognize and incorporate a cybernetic etymology, development and maintenance of the identified disorder. Articles consistent with this secondary theme applied this cybernetic awareness to issues in couples and family systems work (Asfaw et al, 2020), addiction related disorders (Barringer & Papp, 2020; Belmontes, 2018; Day, 2017; Jankowski & Hooper, 2014), trauma and grief related disorders (Dickens, 2014; Katafiasz, 2020; Muselman & Wiggins, 2012; Overton & Cottone, 2016; Southern & Sullivan, 2021), self-harm and suicidality (Buser et al, 2014), physical disabilities, somatoform disorders, and illness (Feather et al, 2018; Sperry, 2012; Taylor & Lewis, 2018), and nonspecific pathology (Hooper & Newman, 2011; Zagefka et al, 2021).…”

Facilitators and barriers to the implementation of emotionally focused couple therapy in a large mental health agency: A preimplementation study.

“…However, couple therapy may or may not be covered by insurance for a given case, as the diagnostic codes of relational issues are rarely listed as reimbursable procedures (Clawson et al, 2018). Thus, despite the clear evidence of the effectiveness and cost-effectiveness of couple therapy, barriers exist that prevent adequate reimbursement (Asfaw et al, 2020; Russell Crane & Payne, 2011), which thereby contribute significant barriers to the provision of couple therapy services (Hubbard & Anderson, 2022) and further exacerbate public health concerns by limiting access to effective treatments (e.g., Barbato & D’Avanzo, 2020).…”