Diagnosis and formulation answer different questions; neither can substitute for the other.

Diagnosis identifies what illness is present; formulation explains why it takes this form in this person.

Sound formulation depends on diagnosis to anchor understanding in the realities of psychopathology.

In contemporary psychotherapy, we often hear that "diagnosis does not replace formulation." This is true, but it is only half the story. It is equally true that formulation does not replace diagnosis. These two activities answer different clinical questions and rely on different kinds of knowledge. When they are conflated, clinical thinking quickly becomes muddled, and treatment often suffers.

The problem is not that formulation is emphasized too much. It is that diagnosis is increasingly treated as optional or even dispensable. This represents a fundamental misunderstanding of what diagnosis actually is.

What Is Psychiatric Diagnosis?

Diagnosis is a descriptive and........

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