Editorial: Relational Diagnosis—An Idea Whose Time Has Come

• Date: 01 March 2015
• DOI: http://doi.org/10.1111/famp.12141
• Author: Jay L. Lebow
• Published date: 01 March 2015

MARCH 2015 VOLUME 54 NUMBER 1

Editorial: Relational Diagnosis—An Idea Whose

Time Has Come

JAY L. LEBOW*

Fam Proc 54:1–5, 2015

This issue offers one of the most important collections of articles ever published by

Family Process: a special section devoted to relational diagnosis. This section does not

in any sense represent the birth of a new concept. Lyman Wynne, David Reiss, and

colleagues launched a campaign to establish relational diagnosis in the DSM in the 1980s

and 1990s (American Psychiatric Association and Task Force on DSM-IV, 1998) and,

subsequent to that effort, Florence Kaslow edited an important book in which numerous

contributors described many potential relational diagnoses (Kaslow, 1996). Wynne and

colleagues even had success in spurring the inclusion of an axis as part of the DSM-IV

(axis 5) focused on assigning a rating of family relational functioning based in “The Global

Assessment of Relational Functioning” (Dausch, Miklowitz, & Richards, 1996; Group for

the Advancement of Psychiatry Committee, 1996), an instrument they had developed.

Yet all of these efforts were preliminary, a precursor to the more detailed scientific study

of relational diagnosis. The special section in this issue edited by Marianne Wamboldt

demonstrates the remarkable maturation of this body of work over the last two decades. A

small group of investigators have asked the question, “What would a rigorous version of

how to establish relational diagnosis look like?” and have provided a number of examples.

The scope of this work is quite remarkable. They have conducted field studies across 41

international sites and interfaced with both the DSM-V and ICD-11 work groups.

The importance of functioning at the level of the system (and its presentation as an

alternative to an exclusive focus of what is going on within the individual) has been a

cornerstone of family systems theory since its beginnings (Breunlin & Jacobsen, 2014;

Combrinck-Graham, 2014; Lebow, 2014), but here we finally see the accumulation of evi-

dence for the salience of various precisely operationalized relational problems. Although

some continue to argue that the idea of diagnosis itself is antithetical to family systems

concepts and best practice, that minority has shrunk over the years as the practical rele-

*Editor, Family Process, and Family Institute at Northwestern.

Correspondence concerning this article should be addressed to Jay Lebow, Ph.D., Family Institute at

Northwestern, 618 Library Place, Evanston, IL 60201. E-mail: j-lebow@northwestern.edu.

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Family Process, Vol. 54, No. 1, 2015 ©2015 Family Process Institute

doi: 10.1111/famp.12141