Introduction
Clinical psychology is mainly a psychological speciality that focuses on comprehensive mental and behavioural healthcare for individuals, groups, families, couples, agencies, and communities (Pote et al., 2021). Within it are two integral processes, diagnosis and formulation, that are utilized to discern the needs of clients with mental health challenges and to determine possible interventions (Bailey, 2020). Diagnosis entails the identification and classification of specific disorders tied to established or standardized criteria. Formulation, on the other hand, focuses largely on providing a holistic approach that factors in the unique experiences of individuals, their respective personalities, and, lastly, context. In both diagnosis and formulation, there are advantages and disadvantages to both methods or processes that can impact individuals, families, and teams that form part of the treatment process. The essay will delve into both processes, outlining their advantages and disadvantages and their respective implications for individuals, families, and teams.
Advantages of Formulation and Diagnosis in Clinical Psychology
Approach
Mental health challenges have gained substantive traction in previous years, and it has become increasingly imperative to address them as early as possible (Chadwick & Billings, 2022). The formulation offers a broad or holistic approach to tackling mental health issues. It encompasses an individual in their entirety, be it their personality, environment, or the context within which they are facing their current problem or challenge (Jones, 2021). Formulation is like creating a road map to use in navigating the needs of a client. It treats each case as unique, offering different therapeutic approaches to the clients in need. For starters, it seeks to clarify the presenting problems a client seeks to address in therapy. It could be aspects such as panic attacks, anxiety, and feelings of emptiness, among others (Haynes et al., 2020). When exploring the presenting problems, formulation aids in factoring the mental health diagnosis of a client within treating their therapy as individualized and nuanced. Through such methods, formulation can aid in providing a tailor-made approach to suit the client’s needs and wants.
Diagnosis, on the other hand, focuses largely on prescribed avenues for dealing with challenges faced by clients. (Horan et al., 2022). There are standard criteria set out to tackle each mental challenge presented by a client. The advantage that comes with it is that there is already a precedent set out for the standardized intervention provided. Through a standardized approach, it becomes increasingly possible to provide mitigating or intervention that has been proven to work, and one can manage one’s expectations and those of the client (Jones & Brown, 2019). It is equally feasible to ascertain the duration with which the prescribed remedy will work.
Structure and Inclusivity
The formulation offers a more holistic understanding of individuals and incorporates their personal history, strengths, and life experiences (Berry & Hartwell, 2023). Through such an approach, the client is provided with an intervention that encompasses all facets of their day-to-day life coupled with the factors within their environment that affect their temperament. Such an approach provides for an intervention that is highly likely to be effective well into the long run (Harper & Cromby, 2022). Additionally, it gives the client perspective as to what their triggers are and how to mitigate or avoid them in the future. From the diagnostic approach, the standardized interventions provided encompass all individuals and have little or no bias. The interventions are scientifically tested and verified, which then provides a high probability for success and leaves little room for bias.
Another positive attribute of the diagnostic approach to dealing with mental challenges is that it offers substantive follow-through with its structured approach. Through this particular form of clinical psychology, the client is provided with a structured avenue of dealing with the challenges presented, which in turn results in a formulated method of tracking changes as and when they occur (Jones & Brown, 2019). The client, together with the psychologist, is provided with their respective duties or obligations throughout the entire process. Instead, everything is documented and structured. Diagnosis provides clients with clear and distinct explanations about their symptoms, which offers validation for their experiences and equally reduces uncertainty (Pote et al., 2021). It equally facilitates access to the most effective treatment coupled with support services that ultimately result in improved outcomes. For instance, a depression diagnosis will result in an individual seeking therapy or using medication, which leads to a reduction of depression and enhances their quality of life.
The formulation offers a highly comprehensive understanding of the individual, which incorporates their unique experiences, coping mechanisms, and personality traits (Quinlan et al., 2022). It assists in developing deeper insights into difficulties and finding strategies for change. For example, a formulation can explore past experiences and tie them to current behaviour or personality traits, which leads to a higher level of self-awareness and growth for the client. It equally aids them in tracing their past experiences and how, over time, they have led to the present-day individual. Within the realm of a diagnosis approach, families can benefit extensively by providing a framework that enhances understanding of their loved one’s behaviour and emotions (Seery et al., 2021). By opening up old wounds that were known or not known, families are therefore able to communicate more effectively and through it, reduce their respective feelings of either blame or guilt, or both (Smith, 2020). For example, parents tend to struggle with children who require extra assistance, such as those within the autism spectrum and beyond.
Disadvantages of Formulation and Diagnosis in Clinical Psychology Approach
Being labelled with a mental ailment or condition can negatively impact an individual, more so their self-esteem and relationships. Socially, the individual may become awkward or receive extensive bullying that could degrade their mental health even further (Smith, 2020). In both diagnosis and formulation, individuals or clients are provided a name for their ailment, which in turn can prove detrimental to the individual seeking help or assistance (Smith & Johnson, 2018). Additionally, their social relationships, be it family or friends, stigmatize the individual based on their mental health condition or the labels attached to them.
Diagnosis can have an extensive impact on families, more so when they feel ashamed or embarrassed by the diagnosis provided (Bonnaire & Billieux, 2022). Over time, it can result in strained relationships coupled with communication barriers. The diagnosis provided will have the family members viewing the said individual only through the name or label provided as opposed to how they considered them before. As a result, they will overlook the individual’s unique qualities and positive attributes and solely concentrate or focus on the label provided about their mental health difficulties (Bonnin, 2017). Through the formulation process, prodding the family dynamic might result in the family members unearthing certain challenges, which in turn could prove detrimental. It can result in making the family members feel guilty or inadequate.
Gaps in Diagnosis and Formulation
Diagnosis can result in an oversimplification of complex psychological issues by predominantly focusing purely on the symptoms as opposed to incorporating the underlying causes or issues (Dale et al., 2022). Formulation, on the other hand, is subject to substantial clinician bias, which can hamper its accuracy and effectiveness. Formulation equally needs to provide structured or clear guidance on how all parties involved, be it families or teams, can support their loved ones effectively (Krause & Behn, 2022). Over time, this can result in a lot of confusion and frustration. Diagnosis within a team setup will largely focus on the symptom, with no attention being placed on underlying issues. The result could be a more balanced approach to treatment, with team members looking at specific areas rather than working together to create a comprehensive and impactful treatment plan that works well in the long run.
Diagnosis can contribute to hierarchical challenges within a team where certain team members will have more traction pegged on their diagnostic expertise (Papadopoulos et al., 2022). Formulation is challenging to utilize within a team setup. It requires open and transparent communication, which might prove difficult for the team members (Quinlan et al., 2022). Furthermore, it also requires a willingness to engage and explore relatively complex psychological issues that might prove challenging within the team owing to a lack of cohesion, synergy, and even shared goals (Tanzilli et al., 2021). Team setups have varying dynamics, which need to work better within both the diagnosis and formulation styles (Hayes et al., 2020). Team members might feel that some members are favoured in the diagnosis process owing to their level of authority. In the formulation structure, there might be minimal communication, which makes interventions difficult to identify or implement.
Conclusion
The advantages and disadvantages of both diagnosis and formulation within clinical psychology showcase the complex nature of mental health evaluation and treatment. Diagnosis largely provides a predictable or structured framework, whereas formulation leans towards a holistic and inclusive approach. The two processes contribute to the stigmatization of clients owing to the extensive use of labels to identify mental health challenges and the necessary interventions required. It is increasingly necessary to deviate from the norm of attaching labels and seek better ways of providing interventions to clients who need them. Labels are necessary for identifying the ailment, but once done, the focus should shift immediately to the interventions or mitigation strategies that are available. Sensitization of the parties involved, especially within the very inclusive formulation process, is required. The support system of the client is meant to understand or appreciate the need to deviate from the labels, focus more on the interventions, and marry them to the unique qualities and positive attributes of the client.
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