Diagnosis and Assessment


As an example, in statistics, an abnormality may be the deviation from the average or the majority of other distributions. Intelligence is another area where there is a normal distribution of IQ scores, and then there are standard deviations that are higher or lower than the norm which can show an individual as genius (higher) or mentally retarded (lower). (Dewey, 2010).

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Society is structured with certain rules and controls that give people an understanding of normal. Normal in this situation is what the majority sees or does. People are expected to follow the rules and those who do not follow these rules are seen as abnormal. In other words, anything that goes against what is considered to be normal by the majority is considered abnormal.

The DSM-IV-TR (2000) describes mental disorders rather than saying what is abnormal. They make a distinction between mental disorders and general medical conditions. The general medical condition is defined as any condition that is not a mental condition (American Psychiatric Association (APA), 2000). They suggest that “no definition adequately specifies precise boundaries for the concept of mental disorder” (p. xxx). The APA also defines a mental disorder as a “clinically significant behavior or psychological syndrome or pattern that occurs in an individual and that is associated with present distress” (APA, p. xxxi).

The challenge in using these definitions as a way to assess clients is that clients are labeled by these definitions. For insurance purpose, the counselor must be able to make some sort of diagnosis, but in giving an abnormal diagnosis, the client receives a label that may stay with them the rest of their lives. Designating a client as normal can also create problems because the idea of normal is different for different people.

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