Guidance improves diagnostic formulation and treatment approaches for patients with problematic detachment, suggesting best practices in mental health care.
SUMMARY This article aims to help clinicians better assess and manage patients who show ‘problematic detachment’: interpersonal distancing that is resulting in functional impairment or distress. It considers both the possible relevant social contextual factors and the wide range of possible underlying psychopathologies that can result in problematic detachment, including mental illnesses, neurodevelopmental disorders and personality pathology. After giving a practical framework for diagnostic formulation, it summarises key aspects of best practice when working with such individuals. The article covers four key questions that the clinician must address. Is problematic detachment present? If so, what specific challenges underlie and maintain it in this person? Based on that, what diagnostic formulation makes sense for this individual? Finally, using this understanding, how can they best treat this individual?
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Andrew Carroll (2025) studied this question.
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