Marriage and Family Therapist

Concept: Assessment

There are two kinds of daignostics.  We are all familiar with the cursory DSM IV version, where the clinician must boil the whole of a human into a pale label.  This is convenient when you need to communicate in extreme shorthand.  Unfortunately, it leaves out a great deal and has very limited usefulness in defining a treatment plan.  You will note that treatment is for the most part a mute subject in the DSM manual.

The other form of diagnosis generates a comprehensive portrait of the individual and captures their strengths as well as their weaknesses.  This method examines an individuals history, present and aspirations for the future.  The comprehensive  diagnosis identifies current struggles in the context of the both the survival value and debilitation.  The goal is to define a real person: a person like you and me with hope and pain and a real existence.  This is very different than the diagnostic label.

The chart below provides a convenient schema to insure that your assessment captures the motivations and significant inner workings of the individual.   Think of the figure as a box in a box.  The blue vectors of the outer diamond track the primary outward motivations of the individual.  In an assessment protocol you can shade the vectors in based upon the success of the individual in that area.  The inner quadrants, labeled red, represent significant inner aspects of the individual.
 
 

These factors identify attributes of the client that may prove very useful in treatment planning.   They help us devise an approach that deals with the significant issues and that is respectful of the individual's unique sensitivities and capacities.