Diagnosis, diagnostic systems and accreditation of psychotherapy models

The development of the diagnostic skills of a psychotherapist can retrace the history of the development of diagnosis in the field of psychotherapy, in a similar way to how ontogenesis retraces phylogeny. Historically, the shift from antidiagnostic positions to constructive critical positions has been observed. The hypothesis has been put forward that, since diagnosis is an unavoidable component of clinical reasoning, antidiagnostic positions reflect a confusion between different levels of clinical reasoning (informal, formal and institutional) and different levels of diagnostic systems (school-specific, psychodynamic, healthcare system). The importance of diagnosis for the development of psychotherapy, its recognition in health and institutional settings, for the definition of the population to whom a certain psychotherapeutic treatment is addressed and for the recognition of the latter as empirically supported treatment is underlined. The risks of marginalization that run the models of psychotherapy that are not empirically supported are reported in the light of the indications of the European Community, which invites Member States to make available to the population the treatment of common mental disorders in the context of primary care. Finally, a four-step process is presented to foster the development of research in models at risk of marginalization, through meta-analysis of individual cases and benchmarking.