The Social Cognitive Construction of Difference and Disorder

Abstract

In the previous chapter we discussed the history of the relationship between social cognitive psychology and clinical psychology and provided a set of orienting assumptions for a social clinical psychology concerned with human adjustment and maladjustment, the nature of psychological change, and the nature of the encounter between the clinician and his or her client. One of those assumptions is that the clinical encounter is more similar to than different from everyday social encounters and that, in particular, clinicians’ judgments of their clients are vulnerable to the same errors and biases that plague everyday social interactions. In this chapter, we explore this issue in detail, along with two related issues that are typically overlooked in discussions of clinical judgment and decision making, issues related to the illness ideology described in the previous chapter. The first concerns misunderstandings about the nature and definition of normality and abnormality, disorder, or pathology in psychological functioning. The second concerns problems with the traditional and accepted categorical system for classifying and diagnosing so-called psychological disorders. Understanding these two issues is crucial to achieving a richer understanding of clinical judgment because illness-oriented definitions of normality and abnormality and the current illness-oriented diagnostic-category system for construing psychological problems set the stage for error and for bias in judgment. What we present, therefore, is not simply the social cognitive research on the judgment of the clinician but a social cognitive model of how errors and biases in judgment are encouraged and maintained by the illness ideology.