Getting It Right the First Time

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When I have a problem, I want to understand what is causing it. And I want to understand the cause as fast as possible.

It took four visits by four technicians to repair my dryer. Each technician had a different diagnosis of the problem. But each diagnosis was based on the technician’s judgment. None of the technicians had a definitive test of the cause of the problem. This was wasted time and money. And my clothes were not dry.

I experienced similar delays when I had lower back pain. My general practitioner thought it was tendinitis. He sent me to physical therapy, which did not stop the pain. I then went to a pain specialist. He had me tested with magnetic resonance imaging (MRI). The MRI revealed a herniated disc. This was a definitive test of the cause of the problem. The pain specialist tried to stop the pain with injections. This did not work. I finally had two back surgeries, which stopped the pain. The whole process took two years.

Fast and accurate diagnoses are also important in psychotherapy. Research indicates that psychological tests can improve therapists’ diagnostic accuracy. These tests are thorough and consistent. They do not solely rely on a therapist’s judgment. No matter how experienced a therapist is, they may miss important diagnostic information without psychological tests. And a diagnosis may take longer without psychological tests. Similar to the MRI for my back pain, psychological tests can be definitive in diagnosing mental health problems. An accurate diagnosis leads a therapist to choose the most effective treatment for a problem.

Diagnostic speed and accuracy are particularly important for clients of color. As many as one out of two drop out of therapy after a single session. In contrast, fewer than one in three White clients drop out after one therapy session. Thus, getting a diagnosis right the first time is critical for clients of color. If a diagnosis is not made or is wrong, they may not return to therapy.

You may ask why a therapist would even try to help a client without accurately diagnosing the problem. This is a reasonable question. Here are some recommendations:

• For all psychotherapy clients, it is important to ask if the therapist uses psychological testing.
• For clients of color, it is important to ask if the psychological tests are useful with people of their background.
• The American Psychological Association offers practical information on psychological testing.

Clients’ suffering should not be unnecessarily prolonged. An accurate diagnosis the first time can speed up the healing process.