The Controversy of Medical diagnosis in the Community Work Profession


The historical progression of the field of communal work has lent itself to a variety of different views concerning the way the practice of medical diagnosis fits into the social work profession. I will discuss and examine the argument within the social work field regarding the controversy of prognosis and labeling and exactly how it suits within the strengths structured empowerment perspective. I'll do this by critiquing the various perspectives and then outlining the professionals and cons of diagnoses and it's really relationship to the strengths perspective.

Diagnoses and Labeling

As social workers in a profession that fights against biases one must discover a way to increase awareness of bias in the mental health arena. Social personnel and practitioners do that through research and ongoing discussions about the annals and controversies that encompass many DSM diagnoses. "Thinking critically about the conceptual underpinnings that notify human being science, research often unveils hidden class, cultural/race, and gender biases in psychiatric taxonomy because many diagnoses represent stereotypes. " (Gilson, 1998) This article carries on by stating that many individuals and young families feel stigmatized by labels directed at them by associates within their cultural surroundings and society as a whole. Using the new stereotype and stigma, comes a feeling of hopelessness and home loathing. "We must start from the assumption that research hypotheses and diagnostic labels must be neutral and free from bias. " Cosgrove continues, "Avoiding bias in psychiatric identification requires critical thinking, a willingness to reflect on one's assumptions and worth, and as known above, and the capability to critically evaluate mental health research. " (Cosgrove, 2005)

Labeling a client can be dibiliating, especially since there's a bias/ stigma amongst mental health labels. Diagnostic labels are meant to locate the sources of the situation within the average person; but by no means do these labels express the individual is the problem. (Cosgrove, 2005) For instance, Cosgrove stated that researchers, "Way back when addressed the oppressive implications of psychiatric labeling and the ways in which such labeling may reinforce gender, category, and race bias. " Learning how to critique research and discover how to prevent bias when assigning diagnoses to folks are the "necessary preconditions for respecting individual and ethnical differences, as is regular with CACREP (2001) requirements, " (Cosgrove, 2005) and in turn sort out the empowrement and strengths point of view by acknowledging the person as opposed to the label and their own social ideals and stigmas associated with being labeled with a mental health affliction.

Conceptualization of the stigmatization process

Many studies have come to the final outcome that there is a correlation between your connection with stigma and the well-being of the stigmatized individuals and their families. In the arena of mental health there's been debate surrounding the amount and the amount of the consequences of labeling and stigma. Among the arguments in the articles believes that what has been used to downplay the value of the factors is the "substantial body of proof suggesting that labeling contributes to results through mental health treatment. However, labeling can all together cause both positive effects through treatment and negative results through stigma. " (Website link, 2009) Seeking treatment for mental health afflictions can help the stigmatized individuals find a new sense of self applied and self price through the therapeutic process. This inturn helps them process the stigma to be tagged with other labeled individuals and build on their strengths, i. e. seeking treatment, being proactive in their treatment, overcoming the stigma and obstructions associated with stigma and the label. As recently explained, research has shown a strong connection between the connection with stigma and the well-being of the stigmatized. Studies and experiments expose that stigma affects social connections. "Stigmatization is an obvious possibility along these lines because, as Rosenfield (forthcoming) points out, established labeling can together lead to positive treatment results and negative stigma effects. " (Link, 2009)

Link stated in his article that the conceptualization of the stigma process starts with defining stigma. He and his co personnel identified stigma in two parts, "as a "mark" that (1) places a person apart from others and (2) links back to you the marked person to undesired characteristics. " If the stigmatized people are associated with over generalized undesired characteristics, another facet of stigma comes into play and that is rejection and the unintended or planned isolation of the stigmatized peoples. This two can result in the negative parallel between stigma and diagnoses in the field of communal work. Stigma is therefore regarded as a matter of degree. Hyperlink continues by declaring that stigma is seen as the make or label that sets the individuals aside "and can vary in the amount to which it models a person aside; the noticeable person can be firmly or weakly linked to a number of unwanted characteristics; and the rejecting response can become more or less strenuous. " So the role of the social worker is usually to be aware of the stigmatization process and assist the stigmatized individuals in redefining themselves through positive relationships with other labeled peoples and interactions with in their "unlabeled" communities, as well as educate the community regarding mental disease and the labeling process.

"With respect to mental illness, a definite example of stigma would exist if a person were hospitalized for mental health issues (a symbol or label) and then assumed to be so dangerous, incompetent, and untrustworthy that avoidance and sociable isolation ensue. Thus, the idea of stigma even as we define it includes both cognitive and behavioral components. It includes cognitive processes where people -stigmatizers or the stigmatized-use labels to infer that a designated person possesses unwanted characteristics. It also includes the behavioral sequelae of such cognitive techniques in which stigmatizers reject the stigmatized or the stigmatized take part in "secondary deviance, " such as secrecy or withdrawal, as a means of "defense, assault, or version. " (Website link, 2009)

According to Hyperlink et al, culturally activated anticipations emerge in the following manner; through socialization people tend to develop the idea of what this means to be determined as a mentally sick person. They question, "Will others think less of me; reject me, because now I am a person determined as creating a mental disease (or being addicted to drugs)?" In this manner, labeling triggers targets of rejection that in turn bring down assurance levels, disrupt interpersonal discussion though isolation, and impair sociable skills. (Hyperlink, 2009)

Diagnoses as a stereotype

Stereotypes through the labeling process is one way in which people unaware, or for too little better words, uneducated relating to mental health issues, identify and pigeonhole stigmatized groups. Mental medical researchers use identification to classify people into certain treatment organizations. Yet these classifications vary trough the individuals. You might group individuals tagged bipolar together but that classification has sublevels to it. You can be bipolar depressive or bipolar manic or bipolar mixture mania and depression. Yet, as specified in systems including the DSM, examination is fundamentally a classification enterprise. (Ben-Zeev, 2010) "Classification is not the one approach to diagnosis; continuous dimensions, that happen to be discussed more completely later, provide an alternative paradigm that is less susceptible to the stigma associated with categorization. Thus, prognosis assumes that members of a group are homogeneous and that groups are recognized by definable restrictions. " (Corrigan, 2007)

Diagnostic classifications serve several purposes. It helps social personnel maintain huge amounts of information pertaining to the teams under classification. It provides clinicians and therapists with a well-organized explanation of categorised patients, not only the symptoms of said patients but also the expected treatment and examination. Yet this is where one must be careful not to over generalize the populace one is working with. And lay say to biases and stereotypes that will come up when working with grouped individuals.

Strengths Perspective and Labeling

Mental health professionals have developed a view called the strengths perspective. As Dennis Saleebey explained, doing from a strengths point of view means that everything you do as a helper will be based on facilitating the discovery and embellishment, exploration, and use of clients' strengths and resources in the service of helping them achieve their goals and realize their dreams. The strengths model has been used in helping individuals with severe and consistent mental health problems.

"Students and specialists no longer have to make an either/or choice: either validate their clients' experiences and accept the idea a diagnostic label discloses a real mental illness or struggle the label and undermine the legitimacy with their clients' distress. Such dichotomous thinking can be prevented by spotting that DSM categories are constructs that indicate implicit values, values, pursuits, and ideologies. In other words, how distress is grasped and conceptualized is a function of the terms/labels that are dominant in a specific culture at a specific time. " (Cosgrove, 2005)

As specified and pointed out throughout this paper you can use the strengths and empowerement perspective whenever using individuals stigmatized by using a mental health label. All you need to remember is that every person, family, and community has strengths. You must use and recognize those strengths to help the individuals empower themselves. Sociable staff and mental health pros' best provide their patients and clients by collaborating with them instead of for them. Whenever we approach clients as a helper; we use clients rather than on the cases because it is assumed that is what we were meant to do. Within the Strengths Point of view, clients' voices are read and valued at all levels of intervention and their treatment is contingent on the client's strengths. (Walsh, 2010)

Pros and Cons of Diagnoses

Psychiatric prognosis and the DSM give a framework within which to understand mental illness. It allows the mental physician to maintain huge amounts of information regarding the groups under classification. It provides clinicians and therapists with a well-organized explanation of labeled patients, and helps in the decision making process regarding treatment. When patients receive diagnoses; it can validate their activities by letting them know that others have had similar experiences. Yet, as record and experience dictates patients having clusters of symptoms known as diagnoses if used properly may be used to advise treatment. This however is a con just because a patient's diagnosis more often than not dictates their treatment without the patient's input. Also examination sometimes becomes a stereotype. In contrast to the positivist assumption that diagnoses accurately describe preexisting conditions. . . That is, psychiatric labels create certain realities and marginalize others and along the way, may inadvertently sustain unjust social relationships. (Ishibashi, 22005)


When working with examination and classification a mental physician should be aware of the stigma and stereotypes associated with such classification. Like a social worker one must work to help individuals empower themselves irrespective of labels thrust upon them. We can do this by concentrating on our own biasis and prejudices. Also, by working by way of a strengths and empowerment point of view and allowing your client to determine their treatment. Most importantly we must work to teach the neighborhoods about mental health issues and help them view clients as people and not labels. This paper spoke to the professionals and cons of diagnoses. Unfortunatley as Ben-Zeev(2010) mentioned "as layed out in systems including the DSM, medical diagnosis is fundamentally a classification enterprise.

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