Psychiatric Diagnosis in Clinical Social Work

Clinical social workers have long played a foundational role in American mental health care, engaging in psychotherapy and helping shape psychiatric theory and practice. Despite this, the field has grown increasingly skeptical of psychiatric diagnosis, often influenced by concerns about biological reductionism, stigma, and sociopolitical critiques. This paper defends the importance of psychiatric diagnosis in clinical social work, arguing that mental disorders are not mere social constructs but real, empirically demonstrable conditions. Drawing on historical trends in psychiatric diagnosis, particularly through the neo-Kraepelinian movement and the work of Robins and Guze, the paper emphasizes the necessity of accurate diagnosis for effective treatment. It critiques the overuse of comorbid diagnoses and calls for a return to scientifically validated diagnostic practices. Ultimately, clinical social workers must adopt a more balanced perspective—one that integrates scientific realism with critical social awareness—to better serve patients and uphold the integrity of the profession.