You Can Hear a Lot by Listening

The World Health Organization (WHO) has been focused on revising its universal system for classifying diseases, the International Classification of Disease (ICD), which is to be used by all health and mental health providers around the globe. The architecture, organization, and content of the ICD are all under development. This revision process for the chapter on mental and behavioral disorders has involved a scientific research program involving actively practicing psychologists and psychiatrists through surveys, formative and summative clinical field trials. Over 12,000 mental health professionals participate worldwide in the Global Clinical Practice Network, through which this research is conducted. What is important here is that, from the very beginning of the process to revise and improve the classification system, the WHO took a different attitude and appreciation for clinical practitioners. Rather than having a top-down “expert” imposition of classification, the WHO ICD approach has been to work with practicing clinicians around the world to gain their astute input about their perceptions and what they are seeing in their practices. We have heard dismissive criticisms for seeking input from these clinical practitioners and for not simply imposing a diagnostic system designed by “experts.” Of course, experts are involved, because the WHO orientation listens to mental health professionals via multiple scientific methodologies. One can learn a lot by listening to clinicians who are themselves trained to listen and observe in order to understand what is going on with their patients. By listening, we value the work that clinicians in practice have observed and are making the classification system responsive to their needs.