Good decision making in mental health careGood decision making in mental health care
Bear Psychology Podcast
Clinical psychologist Dr. Anna Baranowsky speaks with Dr. José Silveira and Dr. Patricia Rockman about uncertainty, error and decision making in mental health care. They discuss overconfidence in diagnosis, the value of structured assessments, and how both clinicians and clients can work more collaboratively and honestly.
1:00:41•24 Sept 2026
Good Decisions When No One Is 100% Sure in Mental Health Care
Episode Overview
- Rushing to a firm diagnosis can be harmful; focusing first on risk, functional impairment and symptoms helps reduce serious errors.
- Clinicians often feel very confident about their diagnoses even when research shows accuracy can be surprisingly low.
- Structured assessments and repeated measurement, combined with client input, tend to outperform informal conversations alone.
- Patients are encouraged to question whether treatment is helping, to notice where they are struggling, and to seek a second opinion if things feel off.
- Normalising the phrase "I don't know" in therapy and medical settings supports safer care, ongoing learning and more honest relationships.
“We don't have it all figured out. And that is a good thing because, you know, we get to continue growing and learning.”
How do people cope with the challenges of staying mentally well when even the experts admit they don’t always know for sure what’s going on? This Bear Psychology episode digs into that uncomfortable but important truth: mental health care is full of uncertainty, and pretending otherwise can hurt people. Clinical psychologist and host Dr. Anna Baranowsky talks with psychiatrist Dr. José Silveira and physician–psychotherapist Dr. Patricia Rockman about their book *Managing Uncertainty in Mental Health Care*.
Aimed at both professionals and “mental health consumers”, the conversation looks at why clinicians crave clear-cut diagnoses, why patients often want a firm label, and how this rush for certainty can lead to serious mistakes. You’ll hear the guests explain their simple but powerful framework of looking first at risk, function and symptoms instead of jumping straight to a diagnosis.
They share research showing how often initial diagnoses are wrong, why overconfidence is so common, and how structured assessments and ongoing feedback from clients can reduce harmful errors. There’s plenty here for anyone in recovery or supporting someone with mental health and addiction issues. Dr. Baranowsky talks about inviting her team and clients to point out her mistakes, and how saying “I don’t know” can actually build trust rather than weaken it.
The trio keep things practical, with ideas for patients to question their care and for clinicians to stay curious, humble and collaborative. If you’ve ever wondered whether your diagnosis fits, or you’re a practitioner worried about getting it wrong, this conversation offers reassurance that uncertainty isn’t failure – it’s a starting point for safer, more honest care. How might your own healing change if “I’m not sure yet” became an acceptable answer?
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