How Psychiatrists Make Decisions : The Science of Clinical Reasoning

In an age of 'scientific psychiatry' and evidenced-based medicine, the judgement of the psychiatric clinician in treating an individual patient has been devalued as the 'art' of medicine as opposed to science, with reduced evidentiary value.The clinician is asked to apply the results of formal research studies of groups of patients, the patient reduced to a token of a type, the latter usually defined by diagnosis.Yet the limits of formal research to guide the treatment of the unique individual requires clinical judgments where there is little formal guidance while the clinician's deliberations are devalued as necessary but of questionable validity.This dilemma has been encouraged by the tacit nature of the way clinicians reach decisions.In this book, Heinrichs makes explicit the underlying methodology of the clinical reasoning of experienced psychiatrists.Starting with a detailed phenomenological examination of specific cases, he argues that this methodology involves constructing model