top of page
Search

Working With Clients Who Self-Diagnose: A Guide for Psychologists

Not every client who walks into your practice is seeking a formal diagnostic assessment. Some may come in saying:

  • “I’m autistic.”

  • “I think I have ADHD.”

  • “I’ve been on TikTok, and everything they said about CPTSD is me.”


Clients who self-diagnose can sometimes make psychologists feel unsure of how to respond. But the truth is, many clients turn to self-identification because they’ve been missed, dismissed, or even harmed by the formal system.


So, how can we hold space for those experiences while maintaining clinical integrity? This blog explores clinical humility, how to have collaborative conversations, and acknowledging systemic barriers—especially when a client’s sense of identity is at stake.


Two women in a bright room sign to each other. One holds a card. Both wear glasses, and one is in a pink shirt, conveying concentration.

When a Client Has Self-Diagnosed, Start With Curiosity, Not Correction


When a client tells you they’re autistic, ADHD, or something else—even without a formal diagnosis—that’s valuable psychological data.


It may not be diagnostic data, but it tells you a lot about:

  • What they’ve been through

  • How they make sense of themselves

  • What they’re hoping you’ll understand


Instead of redirecting or correcting, try asking:

  • “What led you to explore that?”

  • “What parts of that identity feel like they fit?”

  • “How has naming that been helpful—or not helpful—for you?”


This doesn’t mean you’re confirming or denying a diagnosis. It means you’re respecting their self-knowledge, and opening the door to a deeper therapeutic conversation.


Know When to Shift Into Assessment Mode


Sometimes, clients want validation. Other times, they’re seeking formal answers. It’s okay to clarify their goals. Try asking:


“Are you wanting a formal assessment to explore this further, or is it more about understanding how these traits affect you?”


If you don’t provide diagnostic assessments, be clear while remaining collaborative:

“I hear this feels like an important part of how you make sense of things. While I don’t formally diagnose, I can work with you on understanding these traits and supporting your wellbeing. If you’d like a formal assessment, I can refer you to someone who does that work.”

This allows you to remain within your scope of practice while staying supportive.


Acknowledge Systemic Barriers


Here’s the difficult part: sometimes, a client’s self-diagnosis may not align with your initial impressions. Even so, it’s essential to acknowledge systemic barriers.


  • Long waitlists for assessment

  • High costs

  • Medical gaslighting

  • Past dismissal by professionals


These barriers are real. Many people turn to self-identification because it’s the only accessible option. Instead of debating, or assuming they are incorrect, try saying:

“I can see this way of understanding yourself feels meaningful. Would you be open to exploring it more together? I’d also love to understand any barriers you’ve faced.”

This is about building safety, trust, and collaboration.


Final Thoughts


Self-diagnosis isn’t going away. For many clients, it’s the only means they have to describe their inner world when the system has failed them.


Our role as psychologists isn’t to shame or dismiss it. It’s to hold space, listen carefully, and bring clinical expertise into the room without assuming it’s the most important voice.



Further Learning

If you want to strengthen your skills in this area, I offer several trainings designed for psychologists:

bottom of page