Confirmation Bias - Challenging a World Being Diagnosed by Tiktok

Consumers are bombarded with choice.  They are accessing health services with their own Dr. Google Dx.  [Or worse, TikTok Influencer Dx.].  And the health industry is giving in to it.

If you are like most clinicians in the allied health space, you're clinically capable, values-driven, and deeply committed to client care. Yet, you're exhausted. You’ve become the default problem-solver for everything, and your caseload is starting to feel less like a fulfilling practice and more like an emotional endurance test.  Everyone is coming in with a self-diagnosis and a request for specific modalities.  

And to be fair, private practice has fed into that.  Practitioners who have written their website and bios to impress their peers, prove they have the credentials to be treating, and feed into the quick fix of the medical model, are just exacerbating the issues. When you lead with clinical jargon, you prioritize medical hierarchy over genuine human connection. An ideal client Googling you in a crisis at 3:00 AM does not care about your thesis topic. 

They are asking one simple, desperate question: "Can this person help me?" 

Throw Third Party-Dictated Therapy Out the Window

We are seeing this issue big time in the US and it's coming hard and fast here in Australia.  Third Party funders who are only out for big profits for their shareholders limit and dictate the number of sessions [and ultimately the quality of the sessions].   How many times have you let an insurance company's session limit of 10 or 20 sessions define the length and depth of a client's therapeutic journey? You know the clinical presenting issue requires long-term psychotherapy, yet you compromise because "that's what the rebate covers."

Therapy has become fast food.  Dirty and dangerous.  [See: Lindsey Clancy Case in the US].  Without slowing down the connection of therapy, establishing your own agency as the specialist / expert in the room, consumers are left to do their own research [essentially performing their own rule in / rule out homework-- searching the webs for their own differential diagnoses to try and find out "what's wrong with me."]. Leaving clinicians to rubber stamp treatment.  Taking ownership of your clinical authority means establishing enthusiastic informed consent from day one.  When you are transparent about your therapeutic expectations, the client is empowered to make an enthusiastic, informed decisions.  Only then can a safe space be created.  Only then does therapeutic rapport begin to be built. 

What this means for you

It's not necessarily your fault.  I mean,  it's what university taught you.  It's the agenda being pushed by governing bodies.  And while information spreads fast through social media, it's hard for clinicians to keep up.  What it does mean is that there are big gaps in health care, missed presentations, minsdiagnosises and systemic failures in the industry.  Let me ask you, when is the last time you used a differential diagnoses? When is the last time you sought supervision for a rule in diagnoses?  With the world seeming to hyperfocus on specific presenting issues, you find an increase in those diagnoses.  

Tell me which diagnosis am I talking about when I list these symptoms:

• Restlessness or feeling keyed up or on edge
• Easily fatigued
• Difficulty concentrating or mind going blank
• Irritability 
• Muscle Tension
• Sleep disturbance, such as difficulty falling or staying asleep, restless

 unsatisfying sleep

Technically, the DSM states that it could be any of these:

Generalised Anxiety Disorder

Major Depressive Disorder

Bipolar Disorder

Disruptive Mood Dysregulation

PTSD

 
OR Could be these:

ADHD

Maldative Personality Traits

Tobacco Withdrawal

Stimulant Intoxication

Panic Disorder

But have you considered the context for the human? Is she:

• perimenopausal? 
• Just had a baby?
• Managing a break up?
• Move to a new country? 
• Have a tight deadline?
  
  

If you work only with what the client has been influenced by on TikTok, you run the real risk of a conformation bias diagnosis, which might be a contributing factor the major increase in ADHD diagnoses.  If you're using your practice to help confirm that without any questioning of context or critical thinking of the rest of the DSM/ ICD then women will continue to be misdiagnosed and systemic failures will continue to harm us all. 
 

How can the industry change the narrative? 

Start with what you can change. 

1. The Website Bio is your filter, not your resume. 

The secret to a highly effective bio is counterintuitive: it is actually not about you.  When a prospective client is Googling you at 3:00 AM in the middle of a personal crisis, they are looking for the answer to one simple question: "Can this person help me?" Ideally, when you write to symptomatology [Restlessness or feeling keyed up or on edge, Easily fatigued, Difficulty concentrating or mind going blank, irritability, Muscle Tension, Sleep disturbance, such as difficulty falling or staying asleep, restless] you expand the number of folks who identify with this.  You remove the emotional and cognitive load for the individual to self-diagnose.  Now, I'm not living under a rock.  I know folks are going to do this despite your efforts to re-write the narrative in the industry.  That reality is part of the buyer cycle, it's part of the process to understanding if they even need therapy.  I get that.  But as more and more of the industry changes to symptomatology, you create human connection.  You remove the expectation that they need to know "exactly what's wrong with me" before reaching out because they realise that their inability to sleep or find joy in the things that used to make them happy - is enough of a reason to reach out.  That every day things in life is a good enough reason to seek out a therapist.  This is how we normalise therapy.  This is how we create access to the service.  See if we can shift the narrative that things have to be "bad enough" before they come it, we'll be able to stop folks from dropping out of therapy when things are going "good enough." 

2. Reclaim your Clinical Governance

If you resist the bureaucracy of "whats the problem. here's the solution. time to move on" by slowing down therapy.  Build Rapport.  Define the duration of therapy based on what the client needs and wants, along with your trained modalities, with a goal of clinical outcomes, you'll find that the right clients will continue to use your services long after the insurance or third party payers have said they "should be fixed." 

3. Protect your Client Journey with Consistent Care

Therapy is a continuous process of growth, not a disconnected collection of individual sessions. Research shows that consistent and regular attendance builds necessary therapeutic momentum, helping clients improve faster and achieve their goals sooner.  By planning and booking appointments in advance, clients protect their session times as a priority. If your bio clearly sets the stage for this level of commitment, you naturally attract ideal clients who are ready for real change. 

It’s Time to Rewrite the Narrative

Take a good look at your clinical practice. Are you inadvertently feeding into confirmation bias? Are you giving in to the demands of external powers which could be harming the clients outcomes? Take a look at your bio. Does it answer the golden question in layman's terms, or is it just a dry list of your achievements? It might be time for a rewrite.