Managing Uncertainty in Mental Health Care

Book excerpt: "The degree of complexity of the brain, mind and the environments in which humans live, would predict that mental health clinicians work in a perpetual state of uncertainty. That prediction would be wrong. To the contrary, in clinical practice our brains exhibit the same pedestrian bias towards irrational certainty. 1-5 Given the degree of complexity in the field of mental health, it is remarkable that we clinicians can assist anyone at all. Our professional training ratifies the scientific method in an attempt to protect us and those we treat from unwarranted certainty. Current training, however, appears to be inadequate to this task. The assessment and management of mental disorders, across specialists and non-specialists alike, is associated with ubiquitous feelings of certainty. Feeling certain despite the degree of inherent complexity and ambiguity. Feeling certain despite the rudimentary state of empirical knowledge. Feeling certain despite the absence of technologically objective methods to assist assessment or evaluate treatment results"--