Emerging counseling practitioners face a diversity of challenges on their way to becoming professionals. From the basic understanding of psychopathology to the subsequent realization of the limits and advantages of diagnostic labels, practitioners undergo a dramatic change in individual and professional consciousness. This change either facilitates or impedes their gradual transformation into experienced counselors with a well-developed diagnostic intuition. One of the chief mistakes made by emerging practitioners is taking the value of theoretical and diagnostic knowledge for granted. However, they are still too young, inexperienced, and unprepared to make judgments that cross the boundaries of accepted diagnostic philosophies. As a result, emerging practitioners find themselves at the intersection of diverse philosophies and decision-making capabilities and learn to use their worldview, personal values, and beliefs to evaluate clients’ concerns.
In counseling, professionalism is believed to have its roots in the knowledge of psychopathology. Psychopathology is defined as the study of mental distress, mental illness, and behaviors/symptoms/manifestations that may indicate the presence of a psychological or psychiatric disorder. However, it is never enough to view psychopathology as the study of psychological impairments. Much more essential is being able to set the boundaries of normality and abnormality in the analysis of clients’ behaviors. In my view, the notion of psychopathology is inseparable from the notion of normality. I perceive these two conceptions as being closely intertwined. I fully agree with Cohen (2006), who claims that “the boundary between normal and abnormal development is central to the psychopathology perspective” (p. 11). Our analysis of seemingly abnormal and high-risk behaviors can inform our comprehension of normality, and we are obliged to consider these complex intersections before establishing the diagnosis.
The notion of diagnosis is logically correlated with the notion of psychopathology. In most cases, diagnosis is understood as the decision made by the counselor in relation to the normality or abnormality of the client’s behaviors, according to the widely accepted diagnostic systems, such as DSM-TR. Simply put, it is the label assigned by the counselor to the behaviors and actions of the client, in accordance with specific diagnostic criteria. However, it is wrong to believe that diagnosis is the final point of the counseling process or its most desired outcome. Certainly, counselors pass a long way towards establishing the most relevant diagnosis, but it is just a starting point in the therapeutic relationship between the counselor and the client. Diagnosis is made to inform future treatment strategies; in the modern system of healthcare, diagnosis also has profound financial and reimbursement implications for clients (Mannarino, Loughran & Hamilton, 2007).
Through the prism of my values and beliefs, I find it difficult to limit my view of the client to a single diagnosis. As a person who embraces holistic approaches to counseling, I believe that a single diagnosis cannot produce the full picture of the client’s problem. As a counselor, I recognize the social and historical prejudices inherent in the pathologization and diagnosis of certain clients. I try to zero the risks of pathologization and stigma, because they contradict the fundamental features of my professional identity.
At the same time, I recognize the pros and cons of making diagnoses. On the positive side, diagnosis can be treated as the source of standard information about the client’s emotional and mental state. Diagnosis facilitates communication among counseling professionals and informs the therapeutic and treatment choices made by both the counselor and the client. Unfortunately, and as Mannarino et al. (2007) put it, diagnoses are limited in their capacity to produce a holistic picture of the client’s personality. This is why, as an emerging practitioner, I treat diagnostic procedures with extreme caution. As a culturally sensitive professional, I try not to focus on pathology or abnormality. I also understand that, given that the boundary between normality and pathology is increasingly blurred, diagnostic labels may be particularly damaging for the clients from marginalized and underrepresented groups (Mannarino et al., 2007).
As I have said earlier, my beliefs about giving a diagnosis are rooted in my holistic approaches to the client and the reality, in which he/she exists. I accept diagnosis as the starting point in the development of various treatment strategies, but I also perceive diagnostic labels as limiting the client’s sophisticated personality to a set of standard explanations. I see these attitudes as equally beneficial and harmful for my professional growth. On the one hand, my “holistic” attitudes towards every client make it easier to discriminate between normal and pathological behaviors. As a counselor, I try to consider all aspects that can be potentially related to or explain the client’s behaviors, such as cultural setting, immigration, acculturation, developmental history, and others (Mannarino et al., 2007). On the other hand, this distrust towards standardized diagnostic procedures may slow down my transformation into a qualified counseling practitioner. I am still at the very beginning of the professional career, and I cannot say with confidence that the current diagnostic procedures are irrelevant or unsuitable for counseling. I think that I have to find an optimal balance of the personal values, beliefs, and professional requirements, to equip myself with the knowledge and experience needed to serve clients’ needs.
In conclusion, I view psychopathology as a complex analysis of normal and abnormal behaviors. My analysis of clients’ mental and emotional problems is rooted in the notions of normality, rather than abnormality. I believe that traditional diagnostic procedures are severely limited in the capacity to produce a full picture of the client’s mental and emotional problems. At the same time, as an emerging practitioner, I need to find an optimal balance of the standardized diagnostic procedures and holistic approaches to the analysis of the client’s personality.
- Cohen, D.J. (2006). Developmental psychopathology, theory and method. Sudbury, MA: John Wiley & Sons.
- Mannarino, M.B., Loughran, M.J. & Hamilton, D. (2007). The professional counselor and the diagnostic process: Challenges and opportunities for education and training. Columbus, OH: The Association for Counselor Education and Supervision Conference.