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In psychiatric and psychological practice, it is often assumed that when people present for an assessment the mere act of attendance suggests that the person has decided that he or she wants ‘something’, either a diagnosis or treatment. This also implies that the patient recognizes that something is wrong, that something distresses them and that they want to change or overcome their ‘problem’. A further assumption is that it is the job of the health care practitioner to give information,

advice or practical help, so as to induce positive change, improvement in health and reduce distress in their patient.