Theoretical Paper Counselling psychology and diagnostic categories: A critical literature review

Abstract

Content and FocusCounselling psychology’s relationship with diagnostic categories on a metatheoretical level has received little attention in the literature. A few descriptive studies have explored the views and use of diagnostic categories within counselling and psychotherapy, however, the descriptive literature as pertaining to counselling psychology remains scarce. This article is a review of counselling psychology literature pertaining to diagnostic categories. The purpose of the article is to present a systematic review which highlights the contentious issue of diagnostic categories within counselling psychology theory and practice, particularly in relation to counselling psychology’s epistemological position. A literature search was conducted which included book chapters and articles that concern diagnostic categories and counselling psychology. Book chapters and articles from a pure counselling and psychotherapy perspective were excluded. The reason for not including literature from counselling and psychotherapy is because this review is positioned within counselling psychology’s epistemological value base, which is arguably different from counselling and psychotherapy. A majority of the sources positioned counselling psychology between two conflicting epistemological positions. The first one is where counselling psychology should value the phenomenological experience of the client and not assume any normative assumptions, such as through the use of diagnoses. The second epistemological position assumes a more empiricist view, whereby counselling psychology should be more willing to engage with the medical model whilst still retaining its critical perspective.ConclusionsThe literature found presented a conflicting message of the role of diagnostic categories in counselling psychology. There appeared to be, on one hand, a desire to engage in the use of diagnostic categories for pragmatic and professional reasons. On the other hand, there was also a resistance to their use based on concerns of stigma and labelling, as well as a loss of identity as counselling psychologists. As a newly formed profession that is making in-roads to the National Health Service (NHS) as practitioner psychologists, the debate remains open to whether counselling psychologists can retain their philosophical value of non-pathologising in an environment that is increasingly influenced by the medical model.