Constructing and deconstructing transitive diagnosis.

Abstract

The destabilization created by the rapid pace, ease of communication, and mixing of cultures and viewpoints that characterize the postmodern world is perhaps nowhere more apparent than in the raging controversies about health care. Psychologists and the public are alarmed by the threat of diluted access to high-quality mental health care. Concerns about cost containment, efficacy, and accountability will continue to be constraints for the practitioner, and they have forced a basic review of nearly every aspect of clinical service delivery. Follette (1996) noted that the "tentacles" of the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association, 1994) diagnostic system have extended from managed care (in the form of requirements for classifying clients to gain reimbursement for services) to funding agency requirements to organize research around DSM constructs, all "despite the fact that DSM has not been particularly successful as an organizing principle for guiding science, and its assumptions about how to interpret behavior seem inadequate from many perspectives" (p. 1117). Nonetheless, there is still an urgent need for theoretical and diagnostic frameworks to facilitate clinical work, inform "change management" strategy, and integrate technically eclectic practice.

A constructivist perspective on the science and practice of Rorschach.

“…Instead of asking, “What does such a response mean, generally?” the constructivist assessor is likely to ask, “What does such a response mean to this particular client ?” In asking the latter question, a shift is made from a nomothetic to an idiographic model (Aronow et al, 1995); each client's personal knowledge scheme (i.e., construct system) is assessed. Dispositional assessment (Faidley & Leitner, 1993; Leitner & Faidley, 1995; Leitner, Faidley, & Celentana, 2000), transitive diagnosis (Johnson, Pfenninger, & Klion, 2000), and narrative approaches to psychology and psychotherapy (Eron & Lund, 1996; Gonçalves, Korman, & Angus, 2000; White & Epston, 1990) exemplify these more idiographic approaches.…”

Constructivist theories in psychotherapy.

“…J. Neimeyer, 1993). In contrast to traditional diagnostic systems such as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (American Psychiatric Association, 2022) and the International Classification of Diseases, 11th Revision (World Health Organization, 2021), that assign clients to nomothetic medical-model categories of disorder, personal construct psychology assesses clients idiographically by identifying and evaluating across time ongoing changes in their personal constructsa process known as transitive diagnosis ( Johnson et al, 2000;Raskin, 2021). For introductions to personal construct theory, see Bannister andFransella (1986/2019), Kelly (1963), and Epting et al (2002.…”

Entrapment and escape: Exploring the relationship between suicide and emigration in a post-communist country

“…Experiencing chaos and disorder is a prerequisite for major life transformations ( Bussolari & Goodell, 2009 ; Johnson et al, 2000 ; Erdős, 2018 ). This is a liminal feature that is functional in initiation and healing rites and facilitates substantial identity deconstruction and reconstruction (see Table 1 ).…”