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  • Writer's pictureDeric Hollings

A Transdiagnostic Approach


My first official job in the field of mental, emotional, and behavioral health (collectively, “mental health”) was at a clinic in which people with schizophrenia, bipolar disorder, and major depressive disorder were treated.


In order to qualify for mental health services, one of these three diagnoses was required. Noteworthy, the book used to diagnose these abnormal or pathological conditions of the mind is the Diagnostic and Statistical Manual of Mental Disorders (DSM).


Although in modern parlance, people use “mental health” as a general term relating to all facets of psychiatric, psychological, and wellness (mal)functioning, this term is a misnomer. Allow me to briefly explain.


According to the American Psychiatric Association, “Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses can be associated with distress and/or problems functioning in social, work or family activities.”


This clarification makes sense, as one who isn’t in good health is often referred to as ill. However, there’s another terms that essentially alludes to the same meaning as mental illness. According to the American Psychological Association:


[A]ny condition characterized by cognitive and emotional disturbances, abnormal behaviors, impaired functioning, or any combination of these. Such disorders cannot be accounted for solely by environmental circumstances and may involve physiological, genetic, chemical, social, and other factors.


One can understand how terms are conflated in common parlance. To further muddle the issue, when undergoing the process of certification for the treatment and management of personality disorders, the instructor advised trainees that “illness is acquired and disorders are developed.”


He added that illness is treated or managed with medicine and disorders aren’t. However, this distinction doesn’t explain how bipolar disorder, posttraumatic stress disorder, and other psychiatric or psychological disorders are addressed with medication.


This matter can be confusing. Regardless of conflicting terminology and concepts pertaining to psychological dysfunction, the Western approach to these conditions relates to pathology—the structural and functional deviations from the normal that constitute disease or characterize a particular disease.


Sometimes referred to as the “disease model,” pathological consideration of abnormal cognitive, emotive, and behavioral functioning generally requires diagnosis—the art or act of identifying a disease from its signs and symptoms. As an example, schizophrenia is a diagnosis covered in the DSM.


Noteworthy, one source states, “Western and Eastern medicine refers to two different systems of medicine. Western medicine prescribes specific drugs for a disease. In contrast, Eastern medicine focuses on treating the person as a whole rather than just their symptoms.”


When initially working in a mental health clinic, I followed a Western pathological approach to care. Addressing abnormalities (illness and disorders), clients received psychotherapeutic (counseling) and psychopharmacological (medicine) interventions (treatment and management).


Well over a decade since that period in my life, I now own Hollings Therapy, LLC and practice Rational Emotive Behavior Therapy (REBT). Because I don’t accept insurance for the services I provide, I’m not confined to the Western approach to clinical intervention.


For context, one source states, “You must have a diagnosable mental health condition in order for services to be covered, as your therapist will have to use the code for your diagnosis during billing if they bill to your insurance company.”


Since I don’t rely on insurer reimbursement for the mental health services I offer, I’m not required to diagnose people will mental illnesses or disorders. In this way, I’m able to practice a transdiagnostic approach to care.


According to one source, “REBT is considered transdiagnostic, not because it ignores diagnostic manuals, but because it focuses on unhealthy negative emotions such as anxiety, depression, shame, anger, guilt, jealousy and hurt.” Still, I can diagnose people, if need be.


After all, I’m an independent Licensed Professional Counselor and Licensed Clinical Social Worker. However, I treat people through the assessment of irrational beliefs which cause unpleasant self-disturbance.


Nonetheless, the mere existence of irrational assumptions doesn’t require diagnosis. Besides, irrationality is part of the human experience. Therefore, I treat and manage the whole person, not simply diagnoses. Regarding this approach, one source states:


REBT looks at the person as a whole rather than as a symptom and teaches a model that can be successfully applied to a wide range of different emotional issues. It offers a therapeutic structure which helps the client to achieve long lasting emotional and behavioural change, a universal model they can continue to apply to all areas of their lives which they may find challenging.


In this way, a transdiagnostic approach to mental health essentially teaches the client to become one’s own therapist. Does this form of therapy sound like something in which you may be interested? If so, I look forward to hearing from you.


If you’re looking for a provider who works to help you understand how thinking impacts physical, mental, emotional, and behavioral elements of your life—helping you to sharpen your critical thinking skills, I invite you to reach out today by using the contact widget on my website.


As a psychotherapist, I’m pleased to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.


At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply helping you to feel better, I want to help you get better!



Deric Hollings, LPC, LCSW




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