Standardized diagnoses matter. Beware of quacks.

"Clients can and should be given the right to identify their problems and decide their diagnosis!"

I have often emphasized the need to adhere to standardized guidelines such as the DSM-5 and ICD-11, which are backed by extensive research worldwide.

However, some clinicians believe in allowing clients to determine their own diagnoses, reducing their role to mere validation and active listening.

Essentially, these clinicians validate clients' experiences and agree with whatever diagnosis the clients wish to have. Based on this self-diagnosis, they prescribe treatments that only they can administer, citing "practice-based evidence" with little potential for replicability.

Not only do I find this approach ridiculous, but I also consider it extremely unhelpful and borderline unethical.

I will break this write-up into two parts to discuss how a lack of standardization in diagnosis impacts both clinicians and clients.

It’s a bit long, but I believe it's high time to address this issue.

Clinicians

Let's start with diagnosis.

How do clinicians who do not follow standardized guidelines conduct their assessments and diagnoses?

From my conversations with many of them, their methods seem to amount to nothing substantial. Essentially, you can go to these clinicians and get whatever diagnosis you wish.

This is essentially self-diagnosis, with these clinicians taking a strong stance on pure validation.

If I am to be bold, I could have Dissociative Identity Disorder right here and now if I go to their clinics.

Here’s an observation: clinicians who abhor standardized guidelines, seeing them as

, are often the same ones who give diagnoses based on their preferences.

You can refer to Panorama's article exposing false diagnoses of ADHD in the UK. Although I don't personally agree with their methods, the message is clear: clinicians can randomly give you a diagnosis simply because they want to, especially when no standardization is followed.

Let me provide a clearer example of why I strongly advocate for these standardizations, or even the "diagnosis categorical mindset," as some might argue.

For instance, suppose you have a fever and you go to the clinic, confidently claiming that it’s 100% due to undiagnosed brain cancer because you read online that fever is a symptom. Instead of running tests and assessments to rule out other possibilities, the physician nods and reflects, saying, "I feel you must be suffering," and agrees with your self-diagnosis. Voila, you now have a diagnosis that hasn’t been tested or assessed ethically and professionally.

My question to these clinicians is: how are you different from a random stranger on the internet who has zero knowledge in clinical diagnosis but can still validate clients and their so-called diagnoses?

Now let’s move to treatment.

Using the same example, after you’ve been given the self-diagnosis of brain cancer due to a fever symptom, your clinician prescribes you cancer treatment solely based on your subjective reporting.

Does it sound absurd? Maybe. But it’s not uncommon in mental health, where some clinicians rely solely on clients’ self-reports and base their treatment plans on that.

Their argument against using DSM-5 or ICD-11 is that these guidelines are biased and controlled by major corporations to subject consumers to certain beliefs about their problems.

Here’s my concern: aren’t you doing the same thing by not ruling out any possibilities aside from what clients share with you?

Wouldn’t that make you a hypocrite?

Another observation is that with their "practice-based" treatment with almost no scientific backup and, worse, without proper diagnostic procedures, clients have to come only to you to seek your "miracle" treatments.

It seems like you are the only one who can perform this magic, and when others like myself try to learn from you, there’s nothing to learn.

It appears that their clients' improvements are purely based on how great they are as clinicians, which others like myself can't replicate since there are no means to recreate the outcomes.

This is just straight-up unethical.

Clients

While I agree that psychoeducation is helpful to build awareness for clients to be smart consumers and do their research before seeing these quack practitioners, I don’t want to put the blame on clients.

The main reason why clients fall for these kinds of practices isn’t due to a lack of knowledge, but rather the presence of these practitioners who play on their worries and fears.

I will definitely say this:

• We can’t identify a diagnosis simply because we want to.
• We can’t miraculously have a diagnosis because we feel like we have it.
• Most importantly, we can’t be diagnosed when the problems appear only at our convenience.

A mental health diagnosis isn’t a switch that flips whenever something doesn’t go well. It should and must impact your life to the point where you struggle across settings, warranting treatments that have shown efficacy for your current conditions.

However, that doesn't mean your concerns aren't valid. On the contrary, even if there's no diagnosis like the one you think you have, clinicians should still attend to you and devise a treatment plan to match your current condition.

In short, if you have a headache and we've ruled out the possibility of brain cancer, we still have to treat your headache with care and support, as you deserve.

Can these treatments be 100% effective? Definitely not. But if we follow the research, there are options ranging from high to moderate effect sizes.

Personally, I would prefer basing my faith on this data rather than on quacks who randomly do something and claim it’s "practice-based evidence" with zero probability that other clinicians can replicate the same results.

If a treatment can only be provided or performed by one clinician, I can bet my right toe that you, as a client/consumer, are already seeing a quack, and you should leave that place instantly.

That’s the beauty of standardization in treatment and diagnosis.

It ensures that all clinicians can provide consistent, reliable support, no matter where you go as a client.

Standardized guidelines like the DSM-5 and ICD-11 are not just arbitrary rules; they are the culmination of rigorous research and collective wisdom from experts worldwide.

By adhering to these standards, we create a foundation of trust and predictability in mental health care, empowering clients to receive effective, evidence-based treatments wherever they seek help.

This uniformity fosters a sense of security and continuity, ensuring that clients are not at the mercy of individual clinician biases or unverified practices.

Instead, they can rely on a system built on scientific integrity and shared knowledge.

Embracing standardized guidelines allows us to honor the complexity of mental health with the seriousness and respect it deserves, providing hope and healing through methods proven to work.

As clinicians, our ultimate responsibility is to our clients' well-being, and by following these standards, we affirm our commitment to their health, dignity, and trust.

2 cents.

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