The Pros and Cons of Viewing Formal Diagnosis From a Social Constructionist Perspective

Abstract

Over the last few years, counselor training has focused more on formal diagnosis, but this increased focus has been questioned. In the end, the question seems less about whether formal diagnosis will be taught and more about how it will be taught. The author argues that diagnosis should be taught from a social constructionist rather than an objectivist perspective because of the former perspective's humanistic focus.

Counselor Identity: Conformity or Distinction?

“…Many argue that the realities of practice mean counselors must conform to the dominant model (Hinkle, 1994;Hohenshil, 1993Hohenshil, , 1996Seligman, 2004). However, Hansen (2003Hansen ( , 2007 and others (McLaughlin, 2006) have suggested ways that the medical model can be used without the need for such conformity. For instance, Hansen (2003) suggested that counselors can use diagnosis, a central aspect of the medical model, as a "survival skill" (p. 101) rather than as a clinical skill, thus preserving their own distinctiveness.…”

“…Second, counselors have debated whether to adopt one of the many approaches mentioned as a basis for their common identity; however, no consensus has emerged regarding the various approaches put forth. Finally, they have debated whether to conform to the currently dominant medical model or to retain their own distinctive, humanistic approach (Fong, 1995;Hansen, 2003;Hinkle, 1994Hinkle, , 1999Hohenshil, 1993Hohenshil, , 1996McLaughlin, 2006;Seligman, 2004).…”

“…Counselors on one side of this third debate insist that the realities of practice, getting paid, and landing jobs demand that they conform to the dominant medical model; counselors on the other side say that they should retain their distinctive, humanistic approach-that failure to do so will undermine the emergence of a counselor identity (Foos, Ottens, & Hill, 1991;Gale & Austin, 2003;Geroski, Rodgers, & Breen, 1997;Hansen, 2003;Hershenson, 1993;Hinkle, 1994;McLaughlin, 2006;Myers et al, 2002). Although it is true that the current practice realities (e.g., licensure, reimbursement issues, professional status, and credibility) are currently tied to the dominant medical model, it is also clear that alternate (e.g., preventative, ecological) models are gaining momentum and will likely play a major role in the future (Gerig, 2007;Lewis, Lewis, Daniels, & D'Andrea, 2003).…”