Abstract
Background: Psychological diagnosis has traditionally relied on nosological models rooted in medical paradigms, focused on symptom classification. However, this approach has been widely criticized for its reductionism, limited clinical utility, and ethical concerns. Objective: To explore case formulation from a constructivist perspective as an alternative to traditional diagnosis, highlighting its clinical, methodological, and relational contributions. Method: A theoretical and methodological review of constructivist diagnosis is presented, illustrated with clinical examples and the use of Fuzzy Cognitive Maps (FCMs) to represent personal meanings. Results: Case formulation enables the co-construction of shared hypotheses about psychological suffering, integrating personal history, dilemmas, self-positions, and therapeutic goals. FCMs provide a flexible, visual tool that helps capture the systemic complexity of clinical change. Conclusions: Constructivist diagnosis, understood as a relational and narrative act, supports a more ethical, personalized, and nuanced understanding of psychological distress, aligning with current trends in integrative and person-centered psychotherap
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