When it Comes to Diagnosis, Simpler is Often Better

Many, many, MANY times when I am seeing a new client who has seen other clinicians I find they have a stack of diagnoses.  This seems especially true with children.  My favorite are the mutually exclusive diagnoses, such as the child who has a diagnosis of Oppositional Defiant Disorder and Conduct Disorder.  These two diagnoses explicitly say you can be one or the other, not both.  But there are other fun ones, such as Bipolar Disorder and ADHD.  Tell me, if you are truly manic and have racing thoughts, high energy, increase in goal driven behavior but potentially terrible follow through, how would you distinguish ADHD out of that?  It would seem to be way to confounding to me.

But maybe I’m just a simple counselor trying to make the world make sense to my clients.

Anyway, over diagnosis, or what I like call the disorder stack, is a real problem in the mental health world.  A diagnosis is a real, powerful thing.  My father, a medical doctor, once told me his self-named “Barrett’s Theorem” which states, “Correct diagnosis usually leads to correct treatment.”  Idiotically simple, but to many people do not take the time to diagnose correctly, which leads to poor treatment.  Add to that the piling on of 3, 4, 5 or more diagnoses and you truly have to wonder what “effective treatment” would look like.

All of this rambling is to tell you, the parent, to take a hard look at what your child is diagnosed with.  Do not accept just everything thrown around, understand.  Dave Ramsey, the financial coach, talks about how you want an investment advisor that has “the heart of a teacher.”  I want to encourage you to see if you can’t get the same thing out of your counselor.  They should teach you about why these diagnoses fit, and what the treatment plan will be then.

Remember, we are human, and sometimes we make mistakes.  Be willing to ask polite questions, and demand real answers.  Your child needs good treatment.


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