A second opinion is more commonly pursued by patients who are being seen by physicians. Second opinions are less commonly relied upon by those who seek the assistance of a mental health professional. Why? It’s a good question.
The truth is that you have the option to contact as many professionals as you wish, while you try to find out what might be wrong with you or someone you love. Finding a mental health professional who is skilled at determining and ruling out disorders is important, and after the diagnosis the next thing to consider is treatment options.
What happens if a professional says that you have a certain disorder, and you believe they are incorrect; what if you think that nothing is wrong? What do you do if the professional you’re seeing says they want you to begin taking prescription drugs and you feel that you should begin counseling instead? What happens if you are asked to try a treatment method that you do not believe will be effective? What if you begin treatment, but feel and think that it is not working or it is taking much longer than it should? All of these questions can be addressed, at least in part, by getting a second opinion.
Opinions in the mental health profession can vary widely because mental illness diagnosis is generally believed to be a subjective process. Such a belief has merit—because many professionals do not use psychometrically strong instruments, in combination with practice wisdom to reach a diagnostic conclusion. If they did, combined practice wisdom and instrumentation into assessments, then it is probable that more professionals would agree about what constitutes a mental illness—and what does not.
The literature that is available to assess and treat mental illness is vast, however, there is only one text that is used in the United States for diagnosis: The Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association2 used by all mental health practitioners. This manual lists symptoms, criteria, rule out considerations, familial patterns, gender issues, and social factors and prevalence for every professionally identified and labeled disorder in America. But again, a good assessment method is the key to a good and reliable diagnosis.
It is helpful to know if the professional you are seeing has used (or will use) instruments to validate a diagnosis—and if not, a second opinion is a fair consideration. It also helpful to know the clinical perspective that each professional holds prior to making an appointment—knowing what to expect before you go into the office and tell someone your life story. If you see a Psychiatrist or a Clinical Social Worker, there are two expectations you can have prior to being assessed: the Psychiatrist will likely suggest medications whereas the Clinical Social Worker is more likely to suggest counseling. This leads to the next commonly asked question: Who Should I See?
If you think a second opinion is needed a good place to start is by seeing a Clinical Social Worker—someone who has been specifically trained to look at life situations from a multivariate perspective. Multivariate assessment means that life situations are evaluated based upon multiple variables—biological issues, social issues, psychological issues, spiritual issues and environmental issues—including weaknesses and strengths.
Getting a diagnosis is a serious, serious consideration. Most people who believe that “something is wrong,” will often find a degree of satisfaction in getting diagnosed with a disorder (without full consideration for the consequences that accompany a mental illness diagnosis). Regardless, the process of assessment and diagnosis should not seem like it is/was a “rubber stamp.”
For more information consider a confidential consultation.