This post is part 3 of a series.
As in referencing or translating dreams in therapy—a phenomenon that many psychotherapists today sadly overlook as meaningless—part of the clinician’s role and responsibility is to consider, along with the patient, what, if anything, their symptoms might mean.
What is the concept of clinical condition?
Today, most mainstream psychotherapists are expected to build from the ground up, from a clinical, legal and ethical point of view. psychotherapy process, formulating or conceptualizing a case on which to base their tentative treatment plan. It has become what is called a “standard of care” and a “core clinical competency” in the mental health field, and it refers to a comprehensive and integrated review of the client or patient’s clinical presentation and condition.
We can say that the concept of such an official case consists of at least 10 clinical considerations, which can be called 10 P’s: presentation, predisposition, precipitating, perpetuating and protective factors, preexisting patterns, provisional psychodiagnosis, treatment plan, and forecast.
The main idea is to formulate and adapt a unique and unique treatment plan for each patient or client, in order to arrive at an appropriate decision by pre-evaluating and identifying their symptoms, biopsychosocial history, behavioral and emotional characteristics and tendencies, psychosocial stressors, strengths and weaknesses, social support system, etc. psychiatric diagnosis, treatment plan and prognosis – primarily at the first consultation.
Assuming that therapy continues beyond this initial consultation, which it sometimes does not and sometimes should not, the concept can and often does change as additional information emerges or becomes available during the course of treatment. Such conceptual flexibility on the part of the clinician is, in my view, essential to successful psychotherapy, although it may not always be practiced as preached. In general, however, there is some encouraging consensus among mental health professionals that a concept or formula should always be tailored to the specific patient, mutually agreed upon, and “resonate with the client’s experience, avoid stigmatization, and restore agency, meaning, and hope” (Eells, 2025). This is clearly in line with some of the basic tenets of existential psychotherapy. (See my previous post.)
Furthermore, according to clinical psychologist Eells (2025), “Studies comparing outcomes between formulation-based and manual-based therapies show no difference or little advantage for the former.” (See also Eells, 2015.) In other words, psychotherapy should be person- and situation-based, not one-size-fits-all, manual, or prescriptive. Nevertheless, this research at least mildly validates, supports, validates, and encourages a more existential, phenomenological, individualistic, or humanistic treatment approach.
How your therapist conceptualizes your symptoms is important
An important aspect of framing concerns how the clinician perceives, understands, or interprets the patient’s signs and symptoms. (See Part 2.) Some, if not all, of these are determined by the particular theoretical orientation adopted by the therapist.
In many cases, sharing their own perspective on the person’s symptoms and encouraging them to do the same can help the clinician to consider their possible significance, or lack thereof, together. And in any case, it is important for the client or patient to be informed and aware of how the clinician conceptualizes their problem and symptoms and the best ways to treat them, so that a decision can be made whether or not to continue with that therapist.
As some psychotherapists assume, do the signs or symptoms that a person exhibits have no hidden, symbolic, or underlying meaning or significance other than indicating the presence of mental illness or a current life crisis? Maybe. For example, the French existential philosopher Jean-Paul Sartre argued that life is inherently absurd and meaningless. Thus, a “deeper” or hidden meaning can be arbitrarily ascribed to psychiatric signs and symptoms by the clinician or the client himself.
On the other hand, another existential philosopher, Søren Kierkegaard, believed that life has meaning and that our task is to seek and discover that meaning. It is equally possible and common for patients or therapists to casually dismiss certain psychiatric symptoms or signs as psychologically insignificant. Thus, signs and symbols can be meaningless or meaningful in themselves, depending on one’s philosophical perspective. spiritualand clinical perspective. This is a question, of course, that ultimately the psychotherapy patient or client must answer for themselves.
If our signs and symptoms or dreams were just meaningless, abnormal, random neurological events, it might make sense to send them away and eliminate them. post-haste. But if the clinician recognizes that symptoms can be meaningful messages worth paying attention to attention The question arises as to what this meaning might be and how it can be understood and used clinically.
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