|INTERVIEWING TIP OF THE MONTH
# 29 July 2002
Letting Clients Help In the Formulation of Their Own Diagnosis
TISA Description of the Problem: We are all aware that stigmatization, despite some genuine advances in destigmatization, remains a major problem with many of our clients. Helping clients to feel comfortable with their diagnoses so that they can enthusiastically seek help and embrace ongoing therapy remains an important aspect of our daily work. In the following tip provided by Kaycia Vansickle, a creative approach to this problem is nicely described, adding yet one more way of addressing this difficult obstacle.
I have found the following strategy to be effective, particularly with adolescents and young adults, in generating enthusiasm for beginning therapy and/or medications. The strategy seems to help appropriate clients to feel more actively engaged in their own diagnosis, which often leads them to be more accepting of the diagnosis itself and the therapy we design to address it.
I have chosen a set of websites and reading materials that do a good job of describing specific diagnostic categories. If I think that the client's main diagnosis lies in one of these categories I ask the client to check out the websites and/or readings and see which, if any, of these diagnoses seems to fit the client's own personal experiences. If they return on the next visit and have the correct diagnosis (which often happens), they are usually excited that they were able to spot their own diagnosis and have a genuine enthusiasm for treatment. If they don't agree with my diagnosis or say that they don't have any of these, it still provides an excellent format for sharing my own views, and I find that they seem to be more open to my views because they have been part of the diagnostic process from the beginning.
I will sometimes follow-up with web pages and/or reading materials about various therapeutic approaches for treating the client's disorder and ask the client to read this material, a process that once again has met with great enthusiasm, as we try to co-design the most effective treatment package.
TISA Follow-up: This is a fascinating and very useful tip. I am struck by its creativity. Like all interviewing techniques and strategies, the clinician must carefully decide in which clients it may work well (literate, reasonably intelligent, and interested in "homework") and which clients it may not be as good a fit (illiterate or weak reading skills, intellectual impairments, or aversion to "homework"). For those in which it is a good fit, it may create a surprisingly robust enthusiasm and interest in treatment. It clearly immediately creates and metacommunicates a shared alliance, that can only prove to be refreshing and stimulating to the client.
Tip provided by:
Kaycia Vansickle, M.D.
Cullman Regional Medical Center