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A recent study released this week in a leading behavioral science journal shows that 60% of clinicians report inconsistent definitions of emotional wellbeing across services in the United States. The survey, conducted between January and June 2025 with 1,200 professionals in primary care and mental health settings, highlights divergent uses of the term in hospitals, schools, and private practices.
Researchers say the inconsistency arises from varying theoretical frameworks and measurement tools, which can undermine assessment and care coordination. The disagreement has practical consequences: patients may receive different screening results and treatment recommendations depending on which definition a clinician applies. Policymakers and administrators now face pressure to clarify terminology to improve quality and comparability of care.
Definition Variance Affects 60% Of Clinicians; Survey Included 1,200 Respondents
The study sampled 1,200 clinicians including psychiatrists, psychologists, social workers, and primary care physicians, finding that six in ten use different criteria when asked to define emotional wellbeing. Some professionals emphasize affective balance and life satisfaction, while others prioritize daily functioning and resilience to stress. The disparity was consistent across regions and care settings.
These differences translate into inconsistent screening practices and documentation. For example, clinicians who focus on symptom reduction commonly use depression and anxiety inventories, while those who emphasize flourishing employ positive psychology scales. This fragmented approach complicates aggregated data reporting and cross-setting referrals.
Experts involved in the study say the finding reveals an urgent need for consensus-driven definitions to standardize clinical practice and research. Without agreement, measurement instruments will continue to capture different constructs, limiting the ability to track outcomes and compare interventions.
Three Dominant Frameworks Identified; Positive Psychology, Clinical Symptomatology, and Functional Capacity
Analysis of responses revealed three dominant theoretical frameworks shaping definitions: positive psychology, which centers on growth and flourishing; clinical symptomatology, which focuses on the presence or absence of mental disorder symptoms; and functional capacity, which assesses daily living abilities. Each framework leads to distinct assessment tools and intervention priorities.
Positive psychology frameworks favor measures of subjective wellbeing, life purpose, and positive relationships, leading clinicians to recommend strengths-based therapies and community resources. Clinical symptomatology drives the use of diagnostic scales and pharmacological or psychotherapeutic interventions aimed at symptom reduction. Functional capacity frameworks prioritize occupational and social functioning and often involve rehabilitation and practical support services.
The coexistence of these frameworks complicates interdisciplinary care, as teams may disagree on goals and success metrics. Researchers suggest integrated models that combine elements from all three approaches to capture a fuller picture of a person’s wellbeing.
Measurement Inconsistency: Over 40 Different Instruments Cited Across Practices
Clinicians reported using more than 40 different instruments to assess emotional wellbeing, ranging from single-item subjective scales to multi-domain validated questionnaires. The most common tools were brief mood screens and life satisfaction scales, but many respondents relied on informal clinical judgment or locally developed checklists. This variety reflects the lack of a dominant standard in routine practice.
Instruments differ in scope, length, and what they quantify: some measure symptom frequency, others measure positive affect or function across domains. Because of that, two clinicians assessing the same patient can reach different conclusions about that person’s wellbeing based solely on instrument choice. The inconsistency undermines efforts to benchmark progress or evaluate interventions systematically.
Standardizing measurement would enable clearer communication between providers and more reliable aggregation of outcomes for program evaluation. The study’s authors recommend a concise core set of measures to be used across primary and mental health care to improve comparability.
Distinction from Mental Health Disorders; 72% Endorse Separate Constructs for Wellbeing and Illness
Seventy-two percent of surveyed clinicians explicitly stated that emotional wellbeing is conceptually distinct from diagnosed mental health disorders. Many emphasized that wellbeing encompasses positive functioning and satisfaction, while mental illness refers to clinically significant symptoms and impairment. This distinction affects clinical decisions about prevention, early intervention, and recovery-oriented care.
Viewing wellbeing as separate from illness supports proactive approaches focused on resilience-building, social connection, and life-goal support. Conversely, conflating the two can lead to overmedicalization of low wellbeing and underinvestment in community-based supports. Clinicians who maintain a clear separation are more likely to prescribe non-clinical interventions alongside or instead of medication when appropriate.
Policy implications include designing public health programs that target wellbeing promotion independently from mental health disorder treatment. Advocates argue that universal wellbeing initiatives could reduce population-level distress and prevent the onset of clinical conditions.
Clinical Implications: Differing Definitions Change Treatment Pathways for 48% Of Cases
Nearly half of clinicians reported that their definition of emotional wellbeing changes the treatment pathway for a significant portion of patients. When wellbeing is framed as absence of symptoms, the pathway often emphasizes diagnostic assessment and symptom-focused therapies. When framed as thriving and function, clinicians prioritize social supports and strengths-based interventions.
These divergent pathways influence referral patterns, treatment intensity, and follow-up protocols. Patients labeled as having low wellbeing but no diagnosable disorder may either receive minimal intervention or be directed to counseling, community programs, or workplace accommodations depending on provider orientation. Such variability can affect patient satisfaction and long-term outcomes.
The study encourages care teams to document their conceptual approach and align treatment goals with patient values. Clear communication about what clinicians mean by wellbeing can help patients understand suggested interventions and expected outcomes.
Training Gaps: 55% Of Clinicians Report Limited Formal Education on Wellbeing Constructs
Fifty-five percent of respondents said their formal training included little or no dedicated curriculum on emotional wellbeing as distinct from mental illness. Most training programs focus on psychopathology, diagnostic criteria, and evidence-based treatments for disorders, leaving a gap in skills related to promoting resilience, measuring positive outcomes, and delivering community-based supports.
This gap means many clinicians rely on continuing education, supervision, or self-study to incorporate wellbeing-promoting practices. The uneven training contributes to persistent definitional variation and inconsistent use of screening tools. Educators and professional bodies face calls to update curricula to include explicit frameworks and competencies related to wellbeing assessment and intervention.
Improving training could standardize care approaches and promote population-level strategies that blend clinical and nonclinical interventions. Accreditation bodies may consider competency standards that require demonstrated skills in wellbeing promotion.
Policy Recommendations: Five Steps Proposed for Clearer Definitions and Better Care
The study concludes with five policy recommendations: adopt a core definition of emotional wellbeing, select a brief harmonized measurement set, integrate wellbeing into electronic health records, expand training on wellbeing constructs, and fund research on integrated interventions. The recommendations aim to reduce variability and support consistent assessment across settings.
Implementing these steps would help health systems track patient progress, compare program outcomes, and allocate resources more effectively. Policymakers and professional associations are urged to convene multidisciplinary panels to endorse practical definitions and measurement standards. Stakeholder engagement including patients, clinicians, and researchers is considered essential for feasible and acceptable guidance.
Researchers emphasize that clearer language and shared measures are not merely academic concerns but pragmatic tools to improve care coordination and outcomes. The study’s authors hope the findings will catalyze national conversations and concrete reforms that align assessment, training, and policy with a unified vision of emotional wellbeing.
