Collaborative relational diagnosis (II). Expanding relational diagnosis in Social Work practice

Introduction. Relational and collaborative diagnosis is based on a qualitatively different participation process of the assisted individual, directed towards creating a shared assessment between the professional and the person. The elaboration of this shared assessment, which we call co-diagnosis, rests on essential criteria linked to a post-structural Social Work practice and to a Strengths approach. The study objective was to develop the comprehensive co-diagnosis process, to include the relational criteria of joint research, and to define the logical sequence of the process. The practice moves away from a conventional position in which the professional is the expert and the client a mere recipient of assistance. A relational approach to collaboration is adopted, in which people maintain and expand their strengths and their capacity to decide about their preferred future and life goals. Methodology. We investigated how the professional and the person or family co-constructed shared visions, generating a co-diagnosis which, through conversational strategies, helped the persons to identify and decide about their possible and desired future. To this end, a state-of-the-art literature review was conducted on Social Work practice. We excluded works on conventional diagnosis, typical of structuralism and the assumptions of early cybernetics, and ensured epistemological compatibility by focusing on fundamental texts relating to Solution Focused Social Work, Narrative Social Work, and the Strengths Approach, from the 1990s until the present day. Results. The shared construction process of co-diagnosis is based on three pillars. The first is extended listening: this includes classical empathic listening, the double listening proposed by the narrative, and the constructive listening of solution-focused practice. The second pillar is the consideration of people's strengths: experiences, knowledge, skills, hopes or dreams valued by people. Third, the practice of externalisation, i.e., the relational and conversational process by which people and problems are acknowledged separately and not merged in conversation. Discussion. The results provided the key elements allowing to design the logical process of co-diagnosis construction, which can be divided into the following steps: 1. Ordering and systematising the content of the collaborative enquiry meetings; 2. Building a shared story; and 3. Co-diagnosis meeting. Conclusions. The work details the keys to the development of each step. It indicates the content of the conversations to be developed, as well as the challenges that must be faced in order to jointly formulate the co-diagnosis: what to maintain, improve or change, what goals and objectives the person wishes to achieve, and which obstacles and support measures can be identified.