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Published on: October 28, 2020
Definitional invisibility: when institutional language reframes identity as choice
1Department of Social and Behavioral Sciences, https://ror.org/0190ak572New York University School of Global Public Health, New York, New York, USA.
Summary
Definitional invisibility reframes stable identities as choices, harming patient care. This editorial offers strategies to improve person-centred care and reduce inequities by addressing choice-framing in clinical practice.
Area of Science:
- Psychiatry
- Clinical Psychology
- Healthcare Management
Background:
- Definitional invisibility systematically reframes stable identity aspects as temporary choices.
- This framing can negatively impact therapeutic relationships and perpetuate systemic inequities within healthcare settings.
Purpose of the Study:
- To explain the concept of definitional invisibility and its detrimental effects.
- To recommend practical strategies for clinicians, documentation practices, and organizations to mitigate harm.
- To promote improved person-centred care by addressing the consequences of choice-framing.
Main Methods:
- This is an editorial, presenting a conceptual analysis and expert recommendations.
- It synthesizes clinical observations and theoretical frameworks related to identity and choice.
- Strategies are proposed based on principles of ethical practice and patient advocacy.
Main Results:
- Choice-framing distorts clinical formulation and understanding of patient identity.
- It weakens the therapeutic alliance between patients and healthcare providers.
- Institutional inequities are sustained through the mischaracterization of identity as choice.
Conclusions:
- Addressing definitional invisibility is crucial for ethical and effective mental healthcare.
- Implementing recommended clinical, documentation, and organizational strategies can reduce harm.
- Adopting a person-centred approach counters choice-framing and promotes equitable care.
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